Is There a Doctor in the House? . . . Or the Senate?

Given the fervor of our most recent election, we reviewed a JAMA article published in 2004 highlighting the decreasing role and influence of physicians and surgeons in politics despite the increasing proportion of the GDP (16%) devoted to health care. 

 

The authors summarize 44 years (1960- 2004) of physician participation (or lack thereof) in holding political office. They set the stage for this observational study by pointing toward the increasing and expanding role of government in health care. Gone are the days of the government as simply a financier, argue the authors. Today, the government seeks to shape the way research is conducted, medications are produced and health care is delivered. They, therefore, contend that physician leadership is needed now more than ever before in government and other forms of public service. 

 

As of 2004, merely 25 (1.1%) of 2196 members of Congress had been physicians, mostly Republican (60% vs. 45% for all members). Four times as many physicians (252, 4.6%) attained political office in the first 100 years of Congress; five of the fifty-six signers of the Declaration of Independence were physicians. There has been wide variability in the number of physicians in Congress since 1960 with 5 (1960), 3 (1970), 4 (1980), 2 (1990), and 10 (2000), at the start of each decade respectively. In this most recent election, at least 14 physicians ran and lost while 3 newly elected physicians will join the House, bringing the current total to 14. The authors proffer several reasons for why doctors avoid politics: (1) financial concerns, (2) patient-centered training that emphasizes individual care rather than population-based health, and (3) a lack of political tradition in medicine. 

 

Comment: 

The outrage that many physicians feel toward health reform and the political process should be rechanneled into a movement to increase participation in public service. Moreover, the lack of strong leadership and a unified voice emanating from the few physicians in Congress is problematic. Certainly, there are health reform options, which despite ideological differences and political affiliations, around which physicians in Congress could find common ground. A more recent JAMA article found that physicians in rural areas, members of underrepresented minority groups, and those practicing in teaching settings were most likely to be actively civic minded. Nonetheless, simply adding physicians to the Congressional rolls is not the answer. Rather, promoting real leadership by all physicians in the development of long-lasting and meaningful health care reform is necessary. 

 

JAMA. 2004. 292: 2125-2129. 

JAMA. 2006. 296:2467-2475.

by

Stanley Frencher, Jr., MD, MPH

Robert Wood Johnson Clinical Scholar