Health care issues are hot political topics, but a new report shows few doctors actually influence national health care policy by serving in the U.S. Congress.

Only eight of the current 535 members and four delegates of the 108th Congress are physicians. Also, only 25, or about 1percent, of the members of the U.S. House of Representatives and the Senate who have served since 1960 have been doctors.

Researchers say that’s in stark contrast to the early years of the country. More than 10 percent of the signers of the Declaration of Independence were involved in medicine, and nearly 5 percent of the Congressional seats from 1789 to 1889 were held by doctors.

"There is real irony in our findings," says researcher Thomas Suarez, MD, director of medical education at Sinai Hospital of Baltimore, Md., in a news release. "Health care issues are increasingly at the forefront of the presidential election debate, national health care spending is at an all-time high of 14 percent of GDP (gross domestic product), and a record 45 million Americans lack health insurance.”

“One could argue that the need for medical leadership has never been greater, yet few physicians walk the corridors of power in Washington, where major decisions are made," says Suarez.

More Republican Doctors in Congress

In the study, which appears in the Nov. 3 issue of The Journal of the American Medical Association, researchers studied members of the U.S. Congress from all 50 states and all represented territories who served from January 1960 to April 2004 using public biographical data.

1960 was chosen as the starting date due to its proximity to the establishment of the nation’s two largest health benefit programs, Medicare and Medicaid.

The study showed that 25 or 1.1 percent of the 2,196 members of Congress during this 44-year period were doctors.

Researchers found doctors elected to Congress were more likely to be Republican (60 percent). But they were similar to other members of Congress in terms of their sex (4 percent female doctors vs. 7 percent of all members) and average length of service (nine years for physicians vs. 12 years for all members).

The majority of Congressional members during the study period were lawyers (45 percent), followed by those working in business (14 percent), public service (10 percent), and education (7 percent). Physicians were tied for ninth place, behind those from military, banking/insurance, and media/entertainment backgrounds.

Researchers say that although there are fewer doctors than attorneys in the U.S., the 5 to 4 ratio of attorneys to doctors doesn’t explain the 40 to 1 ratio in Congress.

Other possible explanations for the decline in physician representation in Congress may be lack of financial incentives for public service, as average physician and Congressional salaries are similar. In addition, researchers say doctors may feel that the demands of daily medical practice may hamper them from exploring other career options while caring for patients.

Finally, researchers say those in medicine don’t share the tradition of seeking public office as those in other professions do, such as law and business.

By  Jennifer Warner, reviewed by  Michael W. Smith, MD

SOURCES: Kraus, C. The Journal of the American Medical Association, Nov. 3, 2004; vol 292: pp 2125-2129. News release, Johns Hopkins Medical Institutions.