The Political Alignment of US Physicians: An Update Including Campaign Contributions to the Congressional Midterm Elections in 2014

We recently reported that between 1991 and 2012, the political alignment of American physicians shifted from predominantly Republican toward the Democrats.¹ In 2014, the Republican surge changed party control of Congress: the Republicans gained 9 Senate seats and became the majority party there, and the Republican majority in the House of Representatives increased to the largest since 1928. To determine if the political alignment of physicians also shifted toward Republicans, we studied their campaign contributions to federal elections in 2013 and 2014. We found that physicians’ campaign contributions did not shift to the Republicans, in contrast to the change in the public’s voting behavior. In general, the shift in campaign contributions toward the Democrats that prevailed in 2011 to 2012 and earlier election cycles continued, even in the 9 states where the Republicans gained Senate seats.

Our methods, including how we identified physicians, measured their campaign contributions, and analyzed the data, have been previously described.¹ We grouped 2013 and 2014 contributions by the 2-year congressional election cycle and calculated the percentage of physicians who contributed to Republicans for all donors, previous donors, and new donors, both unweighted and weighted by amount of contribution, and the total amount of physician contributions.

The Table lists physicians’ contributions in each 2-year election cycle from the 1993-1994 cycle through the 2013-2014 cycle. In the 2013-2014 election cycle, 45% of all physician donors contributed to Republicans, including 45% of previous donors and 44% of new donors; when the percentages were weighted by the amount of the contributions, the comparable percentages were 50%, 50%, and 46%, respectively. Nearly all physicians contribute exclusively to 1 of the 2 major parties. Few physicians ever switch parties, so shifts in contributions reflect the exit of previous donors and the entry of new donors.

The Figure shows the percentage of physician campaign contributions to Republicans by sex, for-profit vs non-profit employment status, and surgeons vs pediatricians. In all groups, there was a small uptick in the Republican direction in the 2013-2014 election cycle; however, the shift toward the Republicans was less than in the 2009-2010 cycle, when Congress debated and voted on the Affordable Care Act during President Obama’s first term. In all groups, the percentage of physician campaign contributions to Republicans was less than in the 2005-2006 election cycle, when the Democrats gained control of the Senate.

In the 2013-2014 cycle, there were far fewer new physician donors than in the 2009-2010 cycle, when the Affordable Care Act was under consideration (5737 vs 14 724); the total amount of physician donations also decreased ($57.5 million in 2013-2014 vs $81.6 million in 2009-2010).

In the 9 states where the Republicans gained Senate seats in the 2013-2014 cycle, physician contributions were equally split between Democrats and Republicans, with 49% of previous donors and 51% of new donors contributing to Republicans (Table). When the percentages were weighted by the amount of contributions, Republicans secured the majority of funds: 57% from previous donors and 60% from new donors.

Although the results of the 2014 congressional midterm elections in the United States may have constituted an important political shift toward the Republicans, the majority of physicians continued to be aligned with the Democrats. Of physicians who contributed to federal campaigns in the 2013-2014 election cycle, 55% contributed to Democratic candidates, 45% to Republican candidates.

Political divisions among physicians will almost certainly persist. Given the increasing numbers of women physicians and salaried physicians, who typically ally with the Democrats, in contrast to surgeons, who typically ally with the Republicans, our findings suggest that the medical profession will be challenged to achieve consensus on health policy issues. The profession is unlikely to speak with one voice on questions such as the provision of health insurance or controlling the costs of medical care. The polarization among physicians, however, may spur both political parties to work harder to maintain and increase physicians’ support. Thus, the political divisions among physicians may have the unintended effect of enhancing the political standing of the medical profession.

Corresponding Author: David J. Rothman PhD, Center on Medicine as a Profession, Columbia College of Physicians and Surgeons, 622 W 168th St, PH15-25, New York, NY 10032 (djr5@columbia.edu)

Published Online: April 27, 2015. doi:10.1001/jamainternmed.2015.1332.

Conflict of Interest Disclosures: None reported.

Additional Contributions: Kristy Blackwood, BA, Center on Medicine as a Profession, provided exceptional editorial and administrative assistance for this article. She was not compensated for her contribution beyond her normal salary.