The issue: Some of America’s most politically sensitive issues concern our health: abortion, stem cell research, firearm safety and contraception, for example. In many cases, Democrats and Republicans split on these questions down party lines. So do doctors, according to a new study, depending on their political affiliation. These biases may be influencing how doctors treat patients.
An academic study worth reading: “Democratic and Republican Physicians Provide Different Care on Politicized Health Issues,” published in the Proceedings of the National Academy of Sciences, 2016.
Study summary: Eitan Hersh and Matthew Goldenberg at Yale University sought to build on evidence suggesting that people who identify strongly with a political position allow their beliefs to affect work decisions or their happiness. They focus on primary care physicians (PCPs) “who often take a patient’s social history in the context of a new patient interview,” hypothesizing that doctors’ counseling on sensitive and politicized issues will demonstrate political bias.
Hersh and Goldenberg sifted over 20,000 PCPs’ voter registration records in 29 states to obtain party affiliation and then surveyed a sample of 1,529 Democratic and Republican doctors without alerting them that their party affiliation was known. In the end, the researchers drew on responses from 233 Democratic and Republican PCPs. Of nine clinical vignettes the doctors were asked to assess, three “addressed especially politicized health issues (marijuana, abortion and firearm storage.)” Others were not expressly political, focusing on issues such as smoking, obesity and depression. The doctors rated the seriousness of each issue and their likelihood of offering specific counseling, each on a 10-point scale. The authors then controlled for the doctors’ age, gender and religiosity.
(If a study is behind a paywall, as is this one, journalists can typically get a free copy by contacting the publisher’s press office, in this case here.)
Findings:
- Republican doctors were most concerned about abortion and marijuana use.
- Democratic doctors were most concerned about the storage of firearms.
- Male Republican doctors were more concerned about abortion than their female Republican counterparts.
- Republicans are more likely to discuss the risks of marijuana and abortion and urge their patients to stop using marijuana or not have an abortion.
- Democrats and Republicans did not differ on their judgement of engaging with sex workers, though Republicans were more likely to discuss the legal and personal risks.
- Democrats are more likely to encourage patients with children not to store firearms at home, but Republicans are more likely to ask about the safe storage of weapons.
- On issues of alcohol and cigarettes, Republicans are “only slightly more” likely to discuss health risks. But they are three-times more likely to recommend patients stop or cut down on marijuana use. The authors conclude that Republican doctors are more assertive in treatment in general, but especially for an issue like marijuana that is politically salient yet “with a lower associated health risk.”
Helpful resources:
A November 2016 survey by the Pew Research Center found a widening partisan gap over support for abortion, with 62 percent of Republicans saying it should be illegal in all or most cases compared with just 18 percent of Democrats.
The Gay and Lesbian Medical Association publishes a list of physicians it considers LGBT-friendly.
State licensing boards can help patients file complaints about doctors they feel have acted unethically or inappropriately.
In Florida, physicians are legally prohibited from asking patients if they keep a gun at home. Other states have introduced similar laws, but according to an editorial published in the Annals of Internal Medicine, Florida’s law, which was supported by the National Rifle Association, a lobby, is the most restrictive.
Other research:
Previous research has found variations in how doctors of different genders treat patients, and how doctors treat patients of different races or ethnicity.
A 2014 paper shows a large increase in doctors’ contribution to political campaigns since the early 1990s.
A 2009 paper discusses how people with different political affiliations behave differently when making economic decisions.
Journalist’s Resource profiled a 2016 study on how doctors show racial bias in assessing their patents’ pain.
Keywords: Medical care, physicians, party affiliation