Tuesday, May 31, 2011

Employed Physicians and Their Political Leanings

Reporting for work!
Read this "Doctor's Inc" article in the New York Times, and it's easy to get the impression that the absence of employed physician support for the Republican Party translates into their active support for the Democratic Party.  Times reporter Gardiner Harris implies this shift is somehow responsible for waning doc interest in liability reform, greater support for public health issues such as consumer safety and the American Medical Association's decision to back President Obama's health reform agenda.

Don't be so sure, says the Disease Management Care Blog.  While it has opined on the  generational "Millennial" shift and what it means for population health management and the practice of medicine, it's not convinced that that means that the physicians will experience a meaningful political shift.  There's little reason to believe that they'll trade their country club memberships, tasseled shoes and Fox News habits and for professional soccer season tickets, pinot grigo at a Sheryl Crow concerts and Pelosi twitter feeds. In fact, midway through the article, Mr. Harris points out that there are no surveys that objectively track physicians' political leanings or can correlate it with employment status.

There are several reasons why the DMCB doubts that things are so simple:

1.  During its multi-decade career as an employed doc, the spectrum of opinion among its employed colleagues spanned the political spectrum  This was not a granola crowd. 

2. There are many instances of mutual support between organized private practice physician groups and large employed physician groups.  This is a good example.  There are others.  

3. It's not unusual for large employed physician groups to cover the dues of membership in County and State medical societies, as well as the AMA.  This is one example.  That's because 1) some docs want to join organized medicine 2) these professional organizations do much of the "political heavy lifting" in areas such as provider reimbursement, 3) at a local level, they've generated a lot of community good will, and 4) can they aid in physicians' professional development.

The DMCB also thinks its unfair to assert that the AMA changed its stance or that the liability reform is no longer a hot button issue.  The AMA had long established principles for national health reform, and it arguably attempted to make a reasonable compromise over what they regarded as an "imperfect" Democratic proposal.  Many of the States have instituted liability reform (here's a good example) precisely because organized physician groups, employed physicians and their employers were unanimous in their agreement that the current tort system is broken.

While there may be something to the notion that being an employed physician makes it easier to be politically unengaged, the DMCB agrees with Health Affairs' John Iglehart that it's too early to tell. It's possible that after a few years, a significant number of employed physicians will have second thoughts.

1 comment:

Bradley Dean Stephan said...

I view this 'salaried trend' as great news for both the profession and the industry. It removes the perverse incentive of sickness-based income, while allowing physicians the opportunity to focus on the art and science of medicine, rather than the art and science of business. However, as you point out, the art and science of politics will remain viable and varied. But, as the author points out, it cannot help but skew both viewpoint and priority.