Tuesday, November 4, 2008

Will physicians reverse the pattern of voting at a lower rate than lawyers or the general public?

In a landmark 2007 study, ACP members David Grande, David Asch and Katrina Armstrong found that "Physicians have lower adjusted voting rates than lawyers and the general population, suggesting reduced civic participation," and that this dates back to the late 1970's (Do doctors vote? JGIM. 2007; 22: 585-9).

The authors speculate that "physicians may view their clinical work as having a greater social purpose [than voting]. As a result, civic participation might appear less important. Voting in particular may be viewed as trivial relative to the significance of physicians' daily clinical encounters."

The Physicians' Charter on Professionalism endorsed by the ACP, states that civic engagement is integral to professionalism. "Physicians must individually and collectively strive to reduce barriers to equitable health care. Within each system, the physician should work to eliminate barriers to access based on education, laws, finances, geography, and social discrimination. A commitment to equity entails the promotion of public health and preventive medicine, as well as public advocacy on the part of each physician, without concern for the self-interest of the physician or the profession." [Emphasis added].

Public advocacy can involve many things, but in my mind it starts with voting.

It is understandable that some busy internists, faced with a choice between spending hours in line to vote, or devoting the same time to encounters with patients, might choose the clinical encounter over voting.

But as Drs. Grande, Asch, and Armstrong put it, "the U.S. health care system is widely recognized as plagued with major problems, including the intractable number of uninsured and thousands of associated deaths . . . As members of a profession, physicians should be participating in public affairs and contributing solutions."

I encourage our physician readers to show up at the polls today. You can help make 2008 the year that the medical profession participates in the voting process, at least to the same degree as your patients.

Today's questions: Did you vote today? Why or why not?

Tomorrow: my initial thoughts on what the election results mean for health care.

1 comment :

christine.harter said...

I voted Libertarian (see my comments under the primary care blog about the reasons that I believe that private, including charitable, funding of medicine is the only long-term sustainable way to go.)

I am, by the way, 49 yrs old, worked 18 years in an indigent neighborhood in Baltimore at a community health center, and am a former member of Physicians for a National Health Plan. But federal programs lead to enslavement. All you have to do is look at this one issue of ACP Advocacy. ICD-9 was already enough to just about drive me out of medicine (I'm not kidding--it's because I consider being a doctor a ministry rather than a job that I stayed). So I am glad to see ACP's strong advocacy to fight the ICD-10. But this is the kind of onerous nonsense we get when we have a federal program (and because Medicare is the benchmark for almost all reimbursement, we do indeed already have a federal program of health care.)

Isn't it a shame all the money that has been spent at CMS and in various coding and other societies on ICD-10, for the main purpose of allowing Medicare to deny more reimbursement, rather than paying doctors for good primary care, or giving people their money back so that THEY can pay their doctors for the care that they see fit.