Democratic and Republican physicians provide different care on politicized health issues

Edited by Theda Skocpol, Harvard University, Cambridge, MA, and approved August 9, 2016 (received for review April 25, 2016)
October 3, 2016
113 (42) 11811-11816

Significance

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.

Abstract

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.

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Acknowledgments

For outstanding research assistance, we thank Jane Strauch. For helpful advice, we thank Peter Aronow, Adam Bonica, Zach Cooper, Deborah Erlich, Mark Friedberg, Shira Fischer, Jacob Hacker, Ben Hagopian, John Henderson, Dan Hopkins, Greg Huber, and Kelly Rader. E.D.H. thanks Yale University’s Institution for Social and Policy Studies for financial support. M.N.G. thanks Yale University's Department of Psychiatry for financial support.

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Information & Authors

Information

Published in

Go to Proceedings of the National Academy of Sciences
Go to Proceedings of the National Academy of Sciences
Proceedings of the National Academy of Sciences
Vol. 113 | No. 42
October 18, 2016
PubMed: 27698126

Classifications

Submission history

Published online: October 3, 2016
Published in issue: October 18, 2016

Keywords

  1. primary care
  2. physicians
  3. partisanship
  4. politics
  5. health care

Acknowledgments

For outstanding research assistance, we thank Jane Strauch. For helpful advice, we thank Peter Aronow, Adam Bonica, Zach Cooper, Deborah Erlich, Mark Friedberg, Shira Fischer, Jacob Hacker, Ben Hagopian, John Henderson, Dan Hopkins, Greg Huber, and Kelly Rader. E.D.H. thanks Yale University’s Institution for Social and Policy Studies for financial support. M.N.G. thanks Yale University's Department of Psychiatry for financial support.

Notes

This article is a PNAS Direct Submission.

Authors

Affiliations

Eitan D. Hersh1 [email protected]
Department of Political Science, Yale University, New Haven, CT 06520;
Institution for Social and Policy Studies, Yale University, New Haven, CT 06520;
Matthew N. Goldenberg
Department of Psychiatry, Yale School of Medicine, New Haven, CT 06510

Notes

1
To whom correspondence should be addressed. Email: [email protected].
Author contributions: E.D.H. and M.N.G. designed research, performed research, analyzed data, and wrote the paper.

Competing Interests

The authors declare no conflict of interest.

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    Democratic and Republican physicians provide different care on politicized health issues
    Proceedings of the National Academy of Sciences
    • Vol. 113
    • No. 42
    • pp. 11639-E6547

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