June 3, 2014

"Between 1991 and 2012, the political alignment of US physicians shifted from predominantly Republican toward the Democrats."

"The variables driving this change, including the increasing percentage of female physicians and the decreasing percentage of physicians in solo and small practices, are likely to drive further changes."

Says a new study that's getting a fair amount of attention.

20 comments:

Michael K said...

I suspect that Obamacare will cause a shift back if my students are any indication.

Strelnikov said...

I would expect all future employees of the National Health Service to have that predilection.

campy said...

MDs don't like IRS audits? Who'd have guessed.

Biff said...

One of the lesser remarked impacts of the reforms is the incentivization of larger units of practice (such as hospital systems) at the expense of solo/small practices. In general, smaller physician businesses face much greater difficulties with meeting the regulatory burdens, resulting in a real shift in the clinical population towards hospitalists, as opposed to the neighborhood practitioner. I can't help but wonder how much of that is politically driven, i.e. hospitalists and docs at academic medical centers tend to be much more Democratic than solo practitioners, who are, essentially, small business owners. If you eliminate the small businesses, then will you end up with docs as a reliable Democrat voting bloc? I think so. My work frequently has me engaging with small practices and larger hospital systems, and it is interesting to see the contempt each has for the other.

traditionalguy said...

The Dems are benefiting from men and women who see human suffering left un compensated by insurance after horrible accidents. Seeing that, many have developed a strong resentment of the GOP's sell out to business and insurance companies that has eliminated Personal Injury recoveries in significant Liability cases.

The opinion has become, "If all of the GOP guys are willing to tell lies to change the American legal system for a little money, well to hell with them."

The Drill SGT said...

increasing percentage of female physicians and the decreasing percentage of physicians in solo and small practices, are likely to drive further changes."

Michael K,

Can you comment on my hypothesis that it both of these trends will exacerbate the Doc shortage?

1. salaried Docs in hospitals I suspect work 40 hour weeks and small practice docs 60-70?

2. I have heard that female docs lifetime work hours amount to a bit more than 50% of a male doc. (e.g. shorter weeks, flex time, time out for children, marriage and earlier retirement...)

Curious George said...

MD stands for "money dumb".

Mike and Sue said...

Certainly a true trend. The doctors' lounge at my hospital feels like the faculty lounge. The split is not only gender but also age related. The young doctors are overwhelmingly lefty.
When applying to the UW medical school, I hid my libertarian market based outlook. It was obvious in the late 80's who they were trying to admit. The long march through the institutions chalks up another victim.

n.n said...

Follow the leverage (e.g. money).

Illuninati said...

Mike and Sue said...
"When applying to the UW medical school, I hid my libertarian market based outlook. It was obvious in the late 80's who they were trying to admit. The long march through the institutions chalks up another victim."

Well stated. It used to be that a good MCAT score, good grades, and good recommendations were enough. Now applicants are expected to go through additional hoops to be considered. This along with the interviews is where the lefties can sort out their people. Another issue is undoubtedly the increasing number of foreign medical graduates.

David said...

"The young doctors are overwhelmingly lefty."

They are well aware who is going to be paying them throughout their careers.

tim maguire said...

People whose interests are met through rent seeking will always skew Democrat. People whose interests are met through hard work and risk taking will always skew Republican.

~ Gordon Pasha said...

Not surprising. The best and brightest no longer go into medicine. The age of the average clinical endocrinologist is about 58 years old.

mccullough said...

This would explain the VA health system debacle.

Michael K said...

:resulting in a real shift in the clinical population towards hospitalists, as opposed to the neighborhood practitioner."

One weakness of this trend is that hospitals, like the one I used to use, bet heavily on Obamacare but the results are not good. The narrow networks mean that the money to pay the salaries of all the doctor employees is not there. They are being strained and I don't think it will get better. Hospitals are labor intensive.

On the doctor shortage, the admissions committees when I was a student and there were few female medical students, assumed women would work less hours than men and chose accordingly. Now, 50 years later, it is apparent they were correct. Female docs work about 60% as many hours as men and men work fewer hours than we did.

I think we will see a two tier system evolve with low quality care for Obamacare which will survive as a sort of Medicaid for all. Private care may become more and more for cash with insurance only for hospitalization. There are hospitals being excluded from Obamaacre and there are new models of insurance that may allow the cash market to thrive.

This is happening in Canada and is the rule in France.

jr565 said...

maybe that's an example of the difference between libs and conservatives. Repubs are congizant of problems of liberal programs because they are the ones who are in small business (at least the doctors). And so can see first hand the one size fits all approach of the libs never works.

Jason said...

DEATH TO THE SMALL-BUSINESS OWNER PHYSICIAN!!! /democratmode

Beloved Commenter AReasonableMan said...

~ Steven said...
Not surprising. The best and brightest no longer go into medicine.


I would like to see the evidence for this statement given that entering MCAT scores keep steadily increasing.

Sam L. said...

traditionalguy said...

The Dems are benefiting from men and women who see human suffering left un compensated by insurance after horrible accidents. Seeing that, many have developed a strong resentment of the GOP's sell out to business and insurance companies that has eliminated Personal Injury recoveries in significant Liability cases.

The opinion has become, "If all of the GOP guys are willing to tell lies to change the American legal system for a little money, well to hell with them."
---
And Obamacare will improve this how? Does the VA example play a part?

Sam L. said...

traditionalguy said...

The Dems are benefiting from men and women who see human suffering left un compensated by insurance after horrible accidents. Seeing that, many have developed a strong resentment of the GOP's sell out to business and insurance companies that has eliminated Personal Injury recoveries in significant Liability cases.

The opinion has become, "If all of the GOP guys are willing to tell lies to change the American legal system for a little money, well to hell with them."
---
And Obamacare will improve this how? Does the VA example play a part?