Thursday, June 2, 2011

Beware of Stereotypes About Physicians and Their Politics

Attempting to get at truth means rejecting stereotypes and clichés.

Harold Evans (1928 - ), British Journalist and Historian

Dave Racer, a conservative Minnesota- based publisher and commentator on Obamacare (www. has asked me to comment on two New York Times May 30 pieces - “Doctors Soften Their Stance on Obama’s Health Overhaul” by Gardiner Harris, and “As Physicians Change, So Do Their Politics” by Tara Parker-Pope in her NYT blog. Her blog drew 97 mixed responses from physicians.

The authors admit there are no national polls on the issue of doctors and their political leanings. They base their opinion that doctors are turning left on what’s happening in Maine, where doctors are withdrawing their opposition or softening their opinion on Obamacare.

I find these this article and the accompanying blog to be an exercise in wishful and stereotypic thinking. According to Wikipedia, “ a stereotype is a popular belief about specific social groups or types of individuals. The concepts of ‘stereotype’ and ‘prejudice’ are often confused with many other different meanings. Stereotypes are standardized and simplified conceptions of groups based on some prior assumptions.(most often untrue).”

Stereotypes about the medical profession include:

• Idealistic medical students and women physicians lean left.

• Pragmatic doctors in private practice lean right.

• Salaried doctors in academic medical centers lean left.

• Young doctors and doctors abandoning private practice to work for hospitals lean left.

There may be an element of truth in these stereotypes, but there are yet to be verified by physician polls. These opinions depend on selective reporting.

For example, the Maine story comes out of a state which leans liberal on social issues and has two RHINO (Republican in Name Only) senators. You will find similar stories in Vermont, which has just voted for a single-payer system); Massachusetts, which has had a “universal” health program for five years; and states on the “left coast,” such as California, Oregon, and Washington State.

These isolated stories do not mean the majority of other states or physicians who practice there embrace liberal policies and politics. With 26 states challenging the individual mandate in court, the converse may be true.

Physician politics depend on the issues involved. I was speaking to a successful ophthalmologist in his office yesterday. He voiced a common opinion among doctors, to wit, “ I think all patients ought to have coverage. Nobody should go bankrupt from using my services. I agree health plans restrictions ought to be curtailed."

Then, I waited for the inevitable But. Sure enough, it came. "But, on the whole, I do not approve of Obamacare’s provisions to cut my pay, to force me to install an EHR, or to join an accountable care organization. Under his plan, quality and access will deteriorate.”

This response reminds me of two comments: One, President Harry Truman’s remark that he had yet to meet a one-handed economist. There is always a caveat,a "but," an “on the other hand” followup; Two, on the observation “When you lose your job, it’s a recession. When you lost your job, it’s a depression.”

In politics, the 18 months before the next presidential election is a lifetime. Who is elected will depend on how much health costs go up over that time frame, how many folks lose their current coverage as health plans pull out of markets, how many Americans remain unemployed, how the current Medicare flap over the Ryan Plan plays out, and how much the economy craters or recovers.

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