The Moral Healthcare Blog

Social Science & Medicine : Political self-characterization of US women physicians:

“The political self-characterization of US physicians, especially including women physicians, has been poorly described. We used data from the 4,501 respondents to the Women Physicians’ Health Study (WPHS), a stratified random sample of US women M.D.s surveyed in 1993–1994, to assess US women physicians’ political characteristics. US women physicians were most likely to consider themselves politically moderate (36.6% of respondents). More considered themselves liberal (28.4%) or very liberal (8.8%) than considered themselves conservative (20.5%) or very conservative (5.8%). US women physicians predominantly bring moderate and liberal voices to political discourse. Organizations that wish to attract US women physician members should consider promoting less conservative policies.”

from Erika Frank at Emory (1999) (she’s now at UBC, Vancouver, where she did the study of med students, below).

And another one…

Political Self-characterization of U.S. Medical Students:

“RESULTS
Among these medical students, 5% self-characterized as politically very conservative, 21% conservative, 33% moderate, 31% liberal, and 9% as very liberal.” Being male, white, Protestant, intending to specialize in Surgery or anesthesiology/pathology/radiology, or currently or previously being married significantly (P≤.001) increased the likelihood that a student self-identified as very conservative or conservative. Disagreement or strong disagreement with the statements, “I’m glad I chose to become a physician” and “Access to care is a fundamental human right,” were also both associated with being very conservative or conservative. Being more liberal was reported by blacks and Hispanics; those intending to become ob-gyns, psychiatrists, and pediatric subspecialists; and atheists, Jews, and adherents of eastern religions.

CONCLUSIONS
U.S. medical students are considerably more likely to be liberal than conservative and are more likely to be liberal than are other young U.S. adults. Future U.S. physicians may be more receptive to liberal messages than conservative ones, and their political orientation may profoundly affect their health system attitudes.”

from Erica Frank, Jennifer Carrera, and Shafik Dharamsi

A little more on this topic. There is hope!

This is not new data, but I am just trying to get as much information into this blog as I can. So here we go, first from Archives of Internal Medicine in 2004, by Himmelstein and Woolhandler of PNHP:

Single-Payer National Health Insurance: Physicians’ Views

Danny McCormick, MD, MPH; David U. Himmelstein, MD; Steffie Woolhandler, MD, MPH; David H. Bor, MD

Arch Intern Med. 2004;164:300-304.

Results Of 1787 physicians, 904 (50.6%) responded to our survey. When asked which structure would provide the best care for the most people for a fixed amount of money, 63.5% of physicians chose a single–payer system; 10.7%, managed care; and 25.8%, a fee-for-service system. Only 51.9% believed that most physician colleagues would support a single–payer system. Most respondents would give up income to reduce paperwork, agree that it is government’s responsibility to ensure the provision of medical care, believe that insurance firms should not play a major role in health care delivery, and would prefer to work under a salary system.

Conclusions Most physicians in Massachusetts, a state with a high managed care penetration, believe that single–payer financing of health care with universal coverage would provide the best care for the most people, compared with a managed care or fee-for-service system. Physicians’ advocacy of single–payer national health insurance could catalyze a renewed push for its adoption.

A response from Dr. Palmisano of the AMA

The Danger of Single-Payer Health Insurance
Donald J. Palmisano
Arch Intern Med. 2004;164(20):2281-2282.
EXTRACT FULL TEXT

Dr. Palmisano cites Dr. Ian Bogle in his “Outgoing speech as Chairman of the British Medical Association Council.” Available at: http://www.bma.org.uk/ap.nsf/Content/ARM03chcouncil.

and a survey published a year earlier to make his case: “Support for national health insurance among US physicians: a national survey.” Ann Intern Med. 2003;139:795-801.

Regarding the former, England has a National Health Service, not a single payer system, though I always urge us to learn from the faults of other systems. We are not doomed to repeat the mistakes of others (unless we’re stupid).

Regarding the second study, which Dr. P argues “found that only 26% supported a single-payer system,” here is the results section of the abstract:

Results: Sixty percent of eligible participants returned a survey. Forty-nine percent of physicians supported governmental legislation to establish national health insurance, and 40% opposed it. Only 26% of all physicians supported a national health insurance plan in which all health care is paid for by the federal government. In analyses adjusting for differences in personal and practice characteristics, physicians in a primary care specialty, physicians reporting that at least 20% of their patients had Medicaid, and physicians practicing in a nonprivate setting or in an inner-city location were statistically significantly more likely to support governmental legislation to establish national health insurance.

The editors’ notes from the journal:

With the exception of family practitioners, anesthesiologists, and surgical subspecialists, more than half of physicians in major specialties supported national health insurance. Support was highest among pediatricians, psychiatrists, and general internists.

With all due respect to the authors, these questions were as clear as mud. I am very engaged and strongly favor single payer, but I don’t know how I would have answered these questions. I’d suggest: “Would you favor expanding Medicare to all citizens?” for instance.