Politics!! Politics!! How party affiliation may affect how you treat patients, your specialty choice, and possibly income!

It’s that time of year: politics time! The debates are raging all over social media – Trump or Clinton, Republican or Democrat, move to Canada or Europe!! Interestingly, where your beliefs’ stack up on party lines may effect much more than just your vote at the ballot box. There is a couple surprising articles out recently that show your political affiliation can determine how you treat patients, the specialty you may choose, and as a result possibly the income you make.


Let’s start with a recent study published in the Proceedings of the National Academies of Sciences. They surveyed a few hundred primary care physicians on a sample of patient vignettes and compared their responses to political affiliation. Maybe not surprisingly, there were several hot topic political areas that significant differences were found in responses. Republicans were found to be much more likely to inquire about multiple abortions and more likely to discourage against future abortions, including mental health aspects/risks. Democrats on the other hand, were found to be very concerned about gun access, and were more likely to urge firearms not to be stored at home. Less likely were Democrats to highlight risks of marijuana use or to encourage cutting down on its use. Interestingly as social topics became less political decisive, such as alcohol or tobacco use, differences in patient care were minimal between political distinctions.  ->> Democratic and Republican Doctors Treat Patients Differently

Political data was also mined to see the relationship between specialty choice and political affiliation. Significantly, certain specialties did tend to correlate with higher numbers of a certain political parties. For example, surgical specialties, urology, and anesthesia each note about two-thirds of their ranks as Republican. Likewise, about two-thirds of internal medicine, pediatrics, psychiatry, and infectious disease doctors identified as Democrat. Look at how specialty, %Republican, and income trended out on the graph below:


The original article gives even more detail on how political affiliation and specialty type tend to cluster. –> Your Surgeon is Probably a Republican, Your Psychiatrist Probably a Democrat

When I look at that graph above what stands out to me is the almighty $$$ dollar. The higher paying specialties tended to have a higher percentage of Republican members as income rose. So the big money question is the “old chicken or the egg” argument. Do Republican leaning individuals tend to gravitate to high paying specialties? Or do high paying specialty physicians tend to agree more with Republican ideals? The article above mentions how as a medical student, we may gravitate towards specialties where we feel most at “home” – something that could include our political leanings.

Personally, as an anesthesia resident, its rare to find an attending that’s a Democrat – or at least those that are keep it much closer to the vest. I also have always leaned Republican, though like many younger doctors, have much, much, MUCH, greater social liberalism than Republicans before me. Financial topics in particular though, I do certainly identify more clearly  with the conservative party. That said I can’t imagine ever thinking I felt more comfortable in the field of anesthesia because of politics. I can’t remember political issues ever coming up in any of my interviews – even though 4 years ago as I interviewed in anesthesia it would have been during another election cycle. BUT, I’ll admit the undeniable financial benefit of anesthesia compared to say, family medicine, was a real part of why I went into anesthesia.

So in that basic regard, maybe placing a higher priority towards financial gain has made me more likely to identify Republican and more likely to go into a higher paying specialty such as anesthesia! While less financially motivated individuals tend to go into lower paying specialties, and identify more commonly as Democrat? Who knows? There are so many different ways people come to specialty choice, and exam scores definitely have an impact. But it sure is a fun argument to have! What do you think? Have political considerations ever made a difference in your medical career, specialty choice, or how you interact with patients? Let me know if you have any examples or thoughts in the comments below!


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