Author Insights: Women a Growing Political Force in Medicine

David J. Rothman, PhD, of Columbia University, and colleagues found that physicians’ political allegiances are shifting as more women enter the profession. Image: Columbia University

David J. Rothman, PhD, of Columbia University, and colleagues found that physicians’ political allegiances are shifting as more women enter the profession. Image: Columbia University

Despite the common assumption that politically speaking, US physicians lean Republican, growing ranks of women in the profession are shifting the profession’s political leanings toward the left, according to research published in JAMA Internal Medicine this week.

Women as a voting block have long favored the Democratic Party, but political parties and political observers are increasingly recognizing the power women have to swing elections, noted one of the study’s coauthors David J. Rothman, PhD. Rothman, professor of social medicine at Columbia University in New York City, cited a recent New York Times article on the growing political power of single women. Women account for roughly one-third of the US physician workforce, and that proportion will grow, given the nearly equal numbers of men and women entering medical school. Although many have speculated how this trend would change the way medicine is practiced, Rothman and his colleagues were surprised to find the growing ranks of women in medicine are also shifting the profession’s political allegiances.

The new study involved an analysis of donations from physicians to national political campaigns between the 1991-1992 election cycle through the 2011-2012 election cycle. They found that physician campaign contributions increased during this period from $20 million to $189 million and that the percentage of physicians contributing to national campaigns increased from 2.6% to 9.4%. Physician contributions to Republicans declined between the mid-1990s and the 2007-2008 election cycle, with fewer than half of physicians who made contributions backing Republicans in the 2007-2008 cycle. Republican contributions by physicians recovered in the 2009-2010 cycle, but dipped back down to about 50% in 2011-2012. Although the majority of male physician contributors still back Republicans, only 31% of female physician contributors supported that party.

Rothman discussed the findings with news@JAMA:

news@JAMA: Why did you decide to do this study?

Dr Rothman: I founded the Institute on Medicine as a Profession and we offer a 2-year fellowship to encourage physicians to become active as advocates. I invited Howard Rosenthal, PhD, who has studied political polarization in the United States at New York University to talk with the fellows. He and his colleagues have quantified every vote in Congress from 1789 to the present to see how much overlap there was in the voting of Republicans and Democrats. They found that Congressional voting has never in history been as polarized as it is now. After his talk, we went to dinner with the fellows and the question came up: “Wouldn’t it be interesting to see how physicians’ political leanings have changed as a cohort?”

Ours is among the first studies on physicians’ political behavior. There have been a few studies on physicians’ political preferences and some studies on the lobbying behavior of the American Medical Association and other physician groups.

news@JAMA: Do you think the public’s perceptions differ from what you found?

Dr Rothman: It’s not clear to me. Patients don’t ask their physicians about politics, and physicians don’t ask their patients about politics. Most patients know that physicians are high earners, so they would likely put physicians on the right end of spectrum. Some may remember fierce opposition to Medicare by the AMA. The fact that most physicians backed the Affordable Care Act may not register.

We show that perception was Right 25 years ago; physicians used to mostly contribute to Republicans. But now, contributions to Democrats are on the upswing.

news@JAMA: What do you think is driving the shift?

Dr Rothman: The first thing driving it is women, as they become more prominent in the profession. Women are more likely to vote Democratic and contribute to Democrats. The second thing is the growing number of salaried physicians at not-for-profit institutions. The third element is specialty. Very high earners, those with surgeon in their title, are very much on the Republican wing, but when it comes to pediatricians, psychiatrists, and internists, income drops and political allegiances shift to the left.

There are some interesting twists. Women surgeons trend Republican, but are more likely to support Democrats than male surgeons. Pathologists are right in the middle.

news@JAMA: What is the most important take-home message of the study?

Dr Rothman: Our results suggest physicians as a group are in play; don’t take it for granted that they are Republican. Those seeking political victory should count them as open to persuasion. The second big take-home message is that there are now 20 physicians in Congress, and 16 are Republicans. They are older and mostly guys, but that is going to change.

Not only are physicians in play as a group. I think we will see more physicians go into politics. Parties should be engaged with physicians and physicians are going to be engaged with parties.

Categories: Health Policy, Medical Practice, Uncategorized