Doctors Few and Far Between in Congress

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TUESDAY, Nov. 2 (HealthDayNews) -- Try not to get sick if you visit the Capitol building, because you're not likely to find a doctor in the House -- or, for that matter, in the Senate.

Even though close to 11 percent of our founding fathers were physicians, just over 1 percent of the members of Congress have been doctors during the past 44 years, reports a new study in the Nov. 3 issue of the Journal of the American Medical Association.

"Physician representation in Congress is low and is in stark contrast with physician roles during the first century of the United States," wrote the authors of the study.

But Bruce Vladeck, a professor of health policy and geriatrics at Mount Sinai Medical Center, finds that point to be debatable when the number of physicians in Congress are extrapolated into the general population. Doctors make up less than 0.5 percent of the population, he said, so they may actually be proportionately overrepresented in Congress.

In any case, he said, "it's hard to imagine, even if that number tripled or quadrupled that, it would make a significant difference."

Dr. Mary Frank, president of the American Academy of Family Physicians, thinks that doctors can make a difference and that they often do, just not necessarily at the national level. She said many physicians are involved in local and state politics, probably because these positions allow them to continue practicing medicine.

"I think [physicians] need more representation at the national level, but I'm not sure it equates to running for office. Physicians can get involved by testifying, writing letters and speaking out," Frank said.

Steffen Schmidt, a university professor of political science and radio host under the name "Dr. Politics" at Iowa State University in Ames, said many groups are underrepresented in Congress, but that doesn't always translate to their interests not being served.

"Farmers aren't well represented in Congress, yet Congress has been extremely generous to farmers," said Schmidt, adding that about the only group that's well represented in Congress is lawyers.

In fact, the study found a ratio of 40 lawyers to every one physician in Congress. In the general population the lawyer-to-physician ration is currently five to four, said the study.

So, why do the authors of this study feel that physicians need to make up a greater proportion of the Congress? Largely because so many health-care issues are coming to the forefront of policy making right now, the article says. The authors cite the growing elderly population and their medical needs, medical liability, stem cell research and funding for health care.

"A greater presence of physicians in Congress -- with their specialized training and unique perspectives on health care -- could potentially have a significant impact on health policy, especially if physicians reach positions of Congressional leadership," the authors wrote.

For this study, the authors reviewed congressional biographical data and information available in public access databases.

They found that 25 of 2,196 members of Congress during the past 44 years were physicians. These members represented 17 states, the Virgin Islands and Puerto Rico. Eight physicians are currently serving in Congress, notably Bill Frist (R-Tenn.), the Senate Majority Leader. One of the major Democratic candidates for President in the early going, Howard Dean, is a doctor.

Sixty percent of those doctors were Republican, which is significantly higher than the average number (45.1 percent) of Republicans in Congress during that time. Almost 7 percent of all members of Congress in the past 44 years have been females, yet only 4 percent of physician members of Congress have been female.

The average time a member of Congress served was 12.3 years, but only 9.2 years for physicians, according to the study.

Schmidt said that "getting elected to Congress is one part of [representing physician's interests], but is a large step for someone to take and they would have to get out of their profession, perhaps during the middle of an active career."

He said there are plenty of other ways for physicians to get involved and try to shape the health-care debate and eventual reform. They could be active in their political parties and work to promote the party's platform, or they could become a delegate to the national conventions.

"Is there a role for physicians as legislators?" asked Frank. "Absolutely, but you need to look at what it takes to attain that. If you are considering legislative involvement, go ahead, we can certainly use you." But, she reiterated that political activism can take many forms and doesn't have to be on a national level to make a difference.

More information

For a primer on how the legislative branch of the U.S. government works, visit the U.S. Government Printing Office's Ben's Guide to U.S. Government for Kids.

SOURCES: Photo of Sen. Bill Frist, M.D., R-Tenn.; interviews with Mary Frank, M.D., president, American Academy of Family Physicians, and private practice, Rohnert Park, Calif.; Bruce Vladeck, Ph.D., professor, health policy and geriatrics, and director, Institute for Medicare Practice, Mount Sinai Medical Center, New York City; Steffen Schmidt, Ph.D., University Professor of Political Science and "Dr. Politics," WOI radio, Iowa State University, Ames; Nov. 3, 2004, Journal of the American Medical Association
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