Your doctor’s political views may influence how he or she talks to you about abortion and marijuana, a new study finds.
Surveying more than 200 primary care doctors in several states, Yale University researchers found that Republican and Democratic physicians respond differently to politically sensitive health issues such as abortion, marijuana use and firearm safety.
The findings suggest that even a presumably objective, science-based field such as medicine is not safe from the spillover of personal political beliefs, which, research has shown, can affect anything from consumer spending to dating to hiring.
“For a lot of people, politics affect how they make all sorts of judgments,” said political scientist Eitan Hersh, an assistant professor at Yale who co-authored the study published Oct. 3 in the Proceedings of the National Academy of Sciences.
Hersh and his colleague, Matthew Goldenberg, found that Republican physicians were more likely to discuss the mental health aspects of abortion than their Democratic colleagues.
Republicans also tended to view marijuana smoking as a serious issue and opted to discuss the health and legal risks of marijuana with patients, urging them to cut down on smoking.
Democrats, on the other hand, were more likely than Republicans to urge patients not to store firearms at home.
“The issues we studied here are just the surface. There’s end-of-life care, LGBT health and, of course, reproductive health and drugs,” Hersh said. “Physicians, as part of [their] routine work, have to deal with a lot of issues that are politically sensitive topics.”
“On nonpolitical issues, there’s really no difference between doctors’ responses. But on marijuana, for example, all the Democrats are saying that it’s not a big deal, and all the Republicans are saying, ‘Yes, this is a big deal.’”
- Eitan Hersh, Yale University
To determine how doctors’ political beliefs affected the care they provided, Hersh and Goldenberg looked up primary care physicians’ political party registrations and asked them to participate in the research. About 200 doctors did so, filling out surveys presenting hypothetical scenarios about patients who had potentially concerning issues in their health histories.
Besides abortion, marijuana use and firearms possessions, the other issues weren’t politically sensitive. For example, a hypothetical patient may have acknowledged that she doesn’t wear a helmet on her motorcycle. Another patient may have reported occasional bouts of depression.
The doctors were then asked to rank, on a scale of 1 to 10, how serious these issues were and how likely the doctors would be to choose a treatment option.
“On nonpolitical issues, there’s really no difference between doctors’ responses,” Hersh said. “But on marijuana, for example, all the Democrats are saying that it’s not a big deal, and all the Republicans are saying, ‘Yes, this is a big deal.’”
The researchers took into account the gender, age and religiosity of the doctors, and still, it was politics that explained the differences in how they responded.
More research is needed to confirm the study’s results and understand the scope of the problem, Hersh said. But the findings suggest that political orientation can be added to a number of other biases that may affect health care. Previous studies, for example, have found evidence that physicians may provide different care based on patients’ race and ethnicity.
“We are hoping that physicians, in the training and during their professionalization, are thinking about how their background and ideological view might impact how they respond to scenarios like this.”
On top of these personal political biases, physicians sometimes face overtly political regulations. In Florida, for example, medical professionals are banned from discussing firearms with their patients, despite research showing that counseling by doctors can encourage patients to improve their gun storage habits. The ban is a state law, nicknamed “Docs vs. Glocks,” which passed five years ago and was upheld for the third time by a federal court of appeals in 2015. At least 10 other states have taken similar steps, though none of the bills have passed.
As for reproductive health, Catholic hospitals follow their own rules and have been involved in multiple lawsuits for denying women access to certain procedures.
These biases go both ways.
“We are not really out to embarrass one side or another,” Hersh said. “One interesting anecdote we heard from a couple of different people was that pro-life patients who were in environments where all the obstetricians were on the liberal side felt that the doctors were pressuring them to do prenatal testing, and they weren’t comfortable with that, because they were not going to change their mind about the pregnancy.”
Some organizations have already taken steps to help patients find the doctors best suited to their situation, Hersh noted. The Human Rights Campaign, for example, recommends patients consult an online directory of LGBT-friendly doctors. The American Association of Pro-Life Obstetricians and Gynecologists has an online list of pro-life providers.
“Everyone can look up their doctor’s politics — it’s all public record,” Hersh said. “If the treatment decisions the doctors are making are informed not only by medical evidence but their ideologies as well, then patients might want to think about this when they are choosing their doctor.”