Just half of practicing physicians are registered to vote and not all of them actually show up at the polls, a new U.S. study finds. An analysis of data on physicians in three states - California, New York and Texas - between 2006 and 2018 found less than 40% had voted in 2018, a year in which many Americans were prompted to vote because of concerns about health care. That year, and across the entire study period, researchers found, physician participation overall was lower than that of the general population, according to the results published in JAMA Internal Medicine. "The main issue seems to be low voter registration," said the study's lead author Dr. Hussain Lalani, a resident in internal medicine at UT Southwestern Medical Center. "I think there is a combination of factors driving that. First, registering to vote is hard in some states and physicians are busy. There is also the issue of voter suppression which affects many populations, including doctors." Dr. Lalani thinks the culture of medicine may also play a role in younger physicians not registering to vote. "We work long hours during residency training and it's easy to be exhausted at the end of the day," he said. "The culture of medicine prioritizes work over everything else." To look at physician voting, the researchers merged the National Provider Identifier (NPI) registry with state voter files from L2, a nonpartisan political data corporation and then identified physicians registered to vote in general elections by using a matching process based on names, NPI enumeration dates, dates of birth and occupational data from commercial reports. The number of active physicians was derived from state workforce files from the Association of American Medical Colleges. Lalani and his colleagues identified 112,032 physicians registered to vote in 2018: 50,854 in California, 39,046 in New York and 27,578 in Texas. Most, 73,893 (66%), were male; 51,570 (46%) were white, 9,837 (9%) were Hispanic, and 3,001 (3%) were African American. A total of 45,133 (40%) were baby boomers and 39,668 (36%) belonged to generation X. Primary care was the largest specialty with 49,550 (44%) of the physicians in the study. Physician voter participation and registration were lower than the general population for all elections from 2006 through 2018. Pooled physician voter participation was 14 percentage points lower than in the general population: 486,671 (37%) versus 182,982 000 (51%); and was driven primarily by differences in pooled voter registration: 670,489 (50%) versus 236,244,000 [66%]. When the researchers looked only at registered voter participation, however, they found physicians outperformed the general public by 1-7 percentage points in every year analyzed. Another study by the same authors published in the Journal of General Internal Medicine on Wednesday (https://bit.ly/35wQGeI) shed some light on why younger doctors might not be voting. The researchers asked 175 resident physicians to rate four barriers to voting: voter registration, logistical hurdles, time, and psychological factors. The top barrier was time, followed by psychological barriers and the belief that their vote would not make a difference. It's not as if physicians don't care, said study coauthor Dr. Arthur Hong, an assistant professor at UT Southwestern. "There are lots of folks interested in getting involved," he said. "I field a lot of requests from different levels of trainees and colleagues asking, 'What can I do?' And it strikes us that (voting) is a relatively simple thing to do. And in a lot of ways it's a bedrock way to get involved." Dr. Albert Wu wasn't surprised by the new findings. "I've heard this before, but the data I've seen is all old," said Dr. Wu, an internist and a professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health in Baltimore. "This is welcome data. But it would have been even more welcome if it came before registration deadlines had closed." Dr. Wu agreed that many physicians probably don't get around to registering to vote because of crammed full schedules. "I don't think most physicians are apolitical, but virtually all practicing physicians are very busy," he said. "All the same, the results are striking in a country where there is diminishing respect for knowledge and expertise," Dr. Wu said. " I would really like to see more physicians weigh in at election time." —Linda Carroll Source
