Doctors don’t vote — at least not enough.
We’re less likely to vote than lawyers, other professionals, farmers, and the general population. In some recent elections, less than one-third of doctors voted.
It’s not clear why. Some doctors may simply be too busy and, without protected time from work, can’t get to the voting booth. Some may feel that caring for patients fulfills their sense of social purpose, making other forms of civic participation, like voting, seem less important. Indeed, physicians seem to volunteer and donate to candidates at lower rates than other professionals, too.
One positive sign is that more physicians are now running for office. Between 1960 and 2004, only 25 members of Congress were physicians, accounting for just 1 percent of elected representatives. Since 2005, however, 27 physicians have been elected to Congress, with 18 serving in the 114th Congress alone. In some ways, this represents a return to our roots: More than 10 percent of the signers of the Declaration of Independence were physicians, and during the first 100 years of Congress, almost 5 percent of its members were.
But an important disconnect should be highlighted: Physicians as a group are growing more liberal while those representing the profession in Congress are almost exclusively conservative.
Political donations made by doctors to Republicans have declined substantially over the past 20 years. In 1996, nearly 75 percent of physician campaign contributions went to Republicans; in 2012, less than half did. A key driver in this shift is the increase in women and minority physicians, who tend to support Democrats. Medical students, too, are now far more likely to identify as liberal than are other young adults.
Contrast this with the physicians currently serving in Congress: All are men, most are white, and all but three are Republican. This is not problematic in itself, but it does suggest that physician representatives have very different views than the physician electorate — and that those purporting to speak for the profession actually may not be.
Adding an important voice
Regardless of party affiliation, more politically active physicians could add an important voice to our political and social discussions. Health care accounts for the largest share of the economy, at more than 17 percent of the gross domestic product. In the 2012 presidential election, health care was the second most important issue to voters. This year, prescription drug pricing emerged as a major public concern, and both Republican and Democratic voters favor government intervention to help reduce prices.
Americans, increasingly skeptical of and disenchanted with politics, still seem to trust doctors. A recent poll found that 90 percent of Americans had a “great deal” or “fair amount” of respect for doctors, as compared to 48 percent for business executives, 45 percent for lawyers, and 20 percent for politicians. They also identify doctors as the professionals most likely to make the right decisions for the health system.
Political participation could also help doctors preserve autonomy in a profession increasingly encroached upon by external factors like guidelines, regulations, metrics, and payment changes. As medicine continues to evolve, we must do a better job helping to navigate and drive these changes. If we abdicate our role in the political process, we do so at our own peril.
Finally, physicians provide an increasingly rare link in an increasingly unequal society. We not only bear witness to the struggles of the most disadvantaged members of the communities we serve, but we’re also in a position to do something about them. For doctors — unlike for many policymakers — it’s more than just theoretical when a homeless shelter is closed or an insurance benefit cancelled. It’s not an abstract concept when a young mother can’t take a day off work to see me for her diabetes, or an elderly man can’t afford the medications I prescribe. Our work forces us to confront these issues in a visceral, not a cerebral, way.
Doctors are leaders of an evolving health system now equal parts medicine, economics, and politics. But we’re not as involved as we need to be. Our responsibilities to patients, policy, and the public extend beyond clinics and hospitals. We can’t all volunteer, donate, advocate, or run for office. But at the very least, let’s vote.
Dhruv Khullar, MD, is a resident physician at Massachusetts General Hospital and Harvard Medical School.
