Blog | Thursday, June 5, 2014

QD: News Every Day--Doctors leaning Democratic in recent years

Physicians shifted toward the democratic party between 1991 and 2012, driven by in influx of more female doctors and the decreasing percentage of physicians in solo and small practices, a study found.

To analyze campaign contributions in presidential and congressional races and to partisan organizations, including party committees and super political action committees (Super PACs), researchers used regression analysis to explore the influence of sex, for-profit vs nonprofit practice setting, and specialty.

Data on contributions to individual candidates or party-connected organizations in primary and general elections came from records of the Federal Election Commission and the Internal Revenue Service. Geocoding software that linked contributors to congressional districts.

Results appeared online June 2 at JAMA Internal Medicine.

Of the more than 140,000 physicians who contributed in at least 1 of the 11 election cycles spanning 1991 through 2012, nearly 72,000 contributed in 1 election cycle, nearly 29,000 in 2, and nearly 40,000 in 3 or more.

Physicians have become more politically active overall. From the 1991 to 1992 election cycle through the 2011 to the 2012 cycle, physician campaign contributions increased from $20 million to $189 million, a percentage increase from 2.6% to 9.4%.

Since 1996, the percentage of physicians contributing to Republicans has decreased, to less than 50% in the 2007 to 2008 election cycle and again in the 2011 to 2012 election cycle, authors wrote.

Contributions to Republicans in 2011 to 2012 were more prevalent among men vs. women (52.3% vs. 23.6%), physicians practicing in for-profit vs nonprofit organizations (53.2% vs. 25.6%), and surgeons vs. pediatricians (70.2% vs. 22.1%). In 1991 to 1992, these contribution gaps were smaller. For sex, it was 54.5% vs 30.9%. For doctors practicing in organizations, it was 54.2% vs 40.0%. By medical specialty, it was 65.5% vs 32.7%. Specialties with higher mean earnings had more Republican contributors (correlation, 0.84 for mean log earnings).

Authors noted that most physicians have high earnings compared with the population at large, a mean income in the lowest-paying specialties of about $200,000, compared to the median U.S. household income of $50,000.

“The large and increasing differences in physicians’ partisanship by sex far exceed the differences among voters in general,” the authors wrote. “Already more than 20% in 1992, the gap between the sexes in physician donations between Democrats and Republicans without adjustment for other independent variables neared 28% by 2012. These gaps are substantially more than the 10% gap among all voters in the 2012 presidential election.”

In an invited commentary, Arnold S. Relman, MD, MACP, noted that women, who trend Democratic, will soon be half or more of all physicians, and will have an effect not only on themselves but on colleagues.

“Physicians have unique power to reshape the medical care system,” Dr. Relman wrote. “They are what makes it work and are best qualified to use and evaluate its resources. But if they never unite to press for major reform, the future of health care in the United States will indeed be bleak. We will end up either with a system controlled by blind market forces or with a system entangled in complicated and intrusive government regulations. In either case it would be impossible to practice good patient-centered medicine, and the quality and effectiveness of our health care system would sink even lower among the ranks of developed countries. It is up to the medical profession to see that this does not happen.”