Democratic and Republican physicians provide different care on politicized health issues

Political beliefs have been shown to spill over into nonpolitical domains, such as consumer spending, choice of romantic partner, and job hiring. Our evidence suggests that political beliefs predict the professional decisions of primary care physicians. On politicized health issues, like marijuana and abortion, physicians' partisan identity is highly correlated with their treatment decisions. Because physicians regularly interact with patients on politically sensitive health issues and because the medical profession is increasingly politicized (e.g., state governments are regulating politicized aspects of medicine), it is necessary to understand how doctors’ own political worldviews may impact their actions in the medical examination room.

Physicians frequently interact with patients about politically salient health issues, such as drug use, firearm safety, and sexual behavior. We investigate whether physicians’ own political views affect their treatment decisions on these issues. We linked the records of over 20,000 primary care physicians in 29 US states to a voter registration database, obtaining the physicians’ political party affiliations. We then surveyed a sample of Democratic and Republican primary care physicians. Respondents evaluated nine patient vignettes, three of which addressed especially politicized health issues (marijuana, abortion, and firearm storage). Physicians rated the seriousness of the issue presented in each vignette and their likelihood of engaging in specific management options. On the politicized health issues—and only on such issues—Democratic and Republican physicians differed substantially in their expressed concern and their recommended treatment plan. We control for physician demographics (like age, gender, and religiosity), patient population, and geography. Physician partisan bias can lead to unwarranted variation in patient care. Awareness of how a physician’s political attitudes might affect patient care is important to physicians and patients alike.

I always suspected as much. In a detailed breakdown of the physicians, 35.9% were Dems, 31.5% were Republicans, and 32.6% were registered as independents or to a third party.

The authors surveyed 1529 of the physicians (ca 8%), nearly evenly split between Democrats and Republicans. Overall, approximately 20% responded. The survey contained nine vignettes with scenarios involving politicized issues such as firearm storage and marijuana use and abortion, as well as less socially charged issues such as helmet use, obesity, and depression.

Physicians were asked to rate on a 1 to 10 scale the importance of the issues and their likelihood of engaging in specific management options. (For individual vignettes, the number of responses varied between 231 and 233.)

Among the findings were that Republicans were more likely than Democrats to discuss the health implications and legal risks of marijuana and to urge patients to reduce marijuana use. Republicans are also more likely to discuss the mental health aspects of abortion and to encourage the patient not to have more abortions.

Democrats were more likely than Republicans to urge patients not to keep guns at home, whereas Republicans were more likely to ask patients whether they were storing them safely.

Physicians of either party rated importance similarly for issues such as wearing a helmet, treating a patient with high BMI, or social smoking.

The effects appear not to be skewed by demographic confounding; "For the three vignettes that exhibited the strongest partisan differences—marijuana, abortion, and firearms—the partisan differences remain even when respondents are stratified by sex, church attendance, and patient socioeconomic status," the authors wrote.

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The authors have another paper, referenced in a New York Times article [ http://www.nytimes.com/2016/10/07/upshot/your-surgeon-is-probably-a-republican-your-psychiatrist-probably-a-democrat.html?_r=0 ], that breaks out affiliations by specialty.

I haven't yet figured out how to post it efficiently as my detailed data are behind a registration-required paywall. Sorry for the long post and unlikely response - still digging out from Hurricane Matthew.

Sorry for the long post and unlikely response - still digging out from Hurricane Matthew.

This looks like an interesting piece.It appears as if political/social philosophy even permeates medical practice.A leftist physician would tell a patient to stop smoking tobacco (which is the responsible thing to do) but wouldn't say a word about marijuana.And a leftist physician wouldn't entertain for a minute the possibility that an abortion can cause a woman long term...even life-long...psychological/spiritual harm.

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