An analysis of survey responses from primary care physicians in the United States revealed correlations between their political affiliations and their approaches to managing obese patients. Republican physicians were more inclined to ask about the duration of obesity and discuss related health risks compared to their Democratic counterparts. The paper was published in Clinical Obesity.
Political affiliation refers to an individual’s association with a specific political party or ideological group, typically categorized as Democrat, Republican, or Independent. It represents a person’s agreement with the policy positions, values, and beliefs endorsed by a particular party. Political affiliation is linked not only to voting behavior and policy preferences but also to social perspectives and, frequently, to various behaviors in everyday life.
Previous studies have indicated that political affiliation may be associated with the way medical staff deliver their services, particularly when working with politically salient health conditions. For example, a previous study found that Republican primary care physicians were more likely than Democratic ones to discuss the health risks of cannabis use and to discourage patients from having abortions.
In their new study, Laura Y. Zatz and her colleagues aimed to investigate if similar politically-driven differences existed in the treatment of obesity. Obesity has become increasingly prevalent in recent decades, leading many scientists to refer to it as a global pandemic. A national public opinion survey indicated that Republicans are more apt than Democrats to attribute obesity primarily to individual diet and exercise habits, rather than environmental, social, or genetic factors. Differing views on policies for reducing or preventing obesity further highlight its political significance.
The study’s authors reexamined the results of a survey, conducted in 2014 and 2015, which was designed to explore if political party affiliation correlated with physicians’ perceptions of the seriousness of certain health issues and their management strategies for the more politically charged ones. The survey involved 301 primary care physicians registered to vote across 28 U.S. states and the District of Columbia.
The survey asked physicians about their NPI numbers and used them to obtain data on their voter registration status as Democrat or Republican. The remainder of the survey comprised nine vignettes depicting scenarios where a patient visits the clinic and describes their situation. Physicians then selected options that reflected their likely responses and actions in such scenarios.
Some of the vignettes described health issues hypothesized to be partisan (e.g. cannabis use, elective abortion), while other described issues the researchers did not consider particularly partisan (e.g. obesity, helmet use). For this paper, the study authors analyzed responses to a vignette describing a 38-old male obese patient coming to the physician for his first appointment.
Results showed that both Democratic and Republic physicians most frequently answered that they would point to the health advantages of exercise, urge the patient to exercise, and to change his dietary habits. More than 80% of physicians would also inquire about the patient’s desire to lose weight.
However, 73% of Republican physicians would ask about the duration of the patient’s obesity, while only 56% of Democratic physicians would do the same. Similarly, 91% of Republican physicians, compared to 78% of Democratic ones, would discuss obesity’s health risks with the patient.
Although only a small percentage of physicians indicated they would prescribe medication, this figure was 6% among Republicans and 2% among Democrats. Additionally, 25% of Democratic physicians would refer the patient for counseling, compared to 22% of Republicans. These last two differences (prescription of medication, referral to counseling) were too minor to be generalized beyond the study sample, as they were not statistically significant.
“Our findings suggest that medication and counselling referrals are absent from many PCP’s [primary care physicians’] plans for managing a patient with obesity. Across eight clinical management options for obesity, we observed two differences among PCPs by party affiliation. Republicans were more likely than Democrats to report that they would inquire about the time course of obesity and discuss the health risks of obesity. This suggests that political affiliation may play a role in clinical obesity care,” the study authors concluded.
The study makes an important contribution of the scientific understanding of the links between political views and professional conduct. However, it also has limitations that need to be taken into account. Notably, physicians in the study gave answers to a vignette specifying a limited number of characteristics of a patient, while physicians’ responses were selected from a checklist. Physicians’ behavior in real-life situations, which offer a broader range of options and greater complexity, might differ.
The paper, “Physicians’ political party affiliation and clinical management of obesity”, was authored by Laura Y. Zatz, Eitan Hersh, Kimberly A. Gudzune, Anne N. Thorndike, Matthew N. Goldenberg, and Sara N. Bleich.
