Bottom Line: The percentage of physicians making campaign contributions in federal elections increased to 9.4 percent in 2012 from 2.6 percent in 1991, and during that time physician contributors shifted away from Republicans toward Democrats, especially in specialties dominated by women or those that are traditionally lower paying such as pediatrics.
Author: Adam Bonica, Ph.D., of Stanford University, California, and colleagues.
Background: Few analyses have been done regarding the political behavior of American physicians, especially as the numbers of women physicians has increased and the number of solo practionioners has decreased. Information on campaign contributions in federal elections is publicly available.
How the Study Was Conducted: The authors analyzed campaign contributions made by physicians from 1991 through the 2012 election cycle to Republican and Democratic candidates in presidential and congressional races and to partisan organizations, including party committees and super political action committees (Super PACs).
Results: Physician contributions increased to $189 million from $20 million during the study period. Male physicians were more likely to donate to Republicans than female physicians. Since 1996, the percentage of physicians contributing to Republicans decreased, to less than 50 percent in the 2007-2008 election cycle and again in the 2011-2012 election cycle. Most of this shift away from the Republicans resulted from an influx of new donors more likely to support Democratic candidates than prior donors, including an increased percentage of female physicians and decreased percentage of physicians in solo and small practices. In the 2011-2012 election cycle, contributions to Republicans were more prevalent among men than women (52.3 percent vs. 23.6 percent); physicians practicing in for-profit vs. nonprofit organizations (53.2 percent vs. 25.6 percent); and surgeons vs. pediatricians (70.2 percent vs. 22.1 percent).
Discussion: "Between 1991 and 2012, the political alignment of physicians in the United States changed dramatically. A profession once firmly allied with Republicans is now shifting toward the Democrats. Indeed, the variables driving this change – sex, employment type and specialty – are likely to continue to be active forces and to drive further changes."
(JAMA Intern Med. Published online June 2, 2014. doi:10.1001/jamainternmed.2014.2105. Available pre-embargo to the media at http://media.jamanetwork.com.)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Commentary: Physicians and Politics
In a related commentary, Arnold S. Relman, M.D., retired from Brigham and Women's Hospital, Boston, writes: "This is an interesting study, although the results are largely predictable."
"The authors are careful not to extrapolate much beyond their findings. Their data show a recent shift toward the Democrats in the traditional physician support of Republicans, and they believe that this shift is likely to continue," Relman writes.
"However, these data may not be representative of the rank and file physicians. The authors consider only contributions to individual candidates or party-connected organizations that total $200 or more over an election cycle, the threshold for reporting to the Federal Election Commission," the author notes.
(JAMA Intern Med. Published online June 2, 2014. doi:10.1001/jamainternmed.2014.509. Available pre-embargo to the media at http://media.jamanetwork.com.)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Media Advisory: To contact corresponding author David J. Rothman, Ph.D., call Karin Eskenazi at 212-342-0508 or email ket2116@cumc.columbia.edu. To contact commentary author Arnold S. Relman, M.D. email arnoldrelman@gmail.com. A podcast with the authors will be available on the JAMA Internal Medicine website http://bit.ly/IZGqPC when the embargo lifts.
Journal
JAMA Internal Medicine