Doctors’ political beliefs can skew the advice they give patients on sensitive issues such as abortions and cannabis use, according to new research.

A survey of more than 200 doctors found that those with conservative views were more likely than others to discourage patients from having an abortion in the future. They also handed out more stern warnings over the legal and health risks of using cannabis.



The results suggest that doctors’ political leanings can spill over into the guidance, and even the treatments, they offer to patients under their care. The findings build on previous work that has highlighted gender and race biases in the medical treatment different people receive.



“Doctors need to think through these kinds of issues, because if they are dealing with politically sensitive issues, this is unavoidable,” said Eitan Hersh, a political scientist at Yale University. “If we can get this out to physicians, they can be more aware of it.”



“If you’re a patient and you are choosing a new doctor, you might want to know their views beforehand,” Hersh said.



Writing in the journal, Proceedings of the National Academy of Sciences, Hersh and his colleague Matthew Goldenberg, describe how they linked more than 20,000 primary care doctors in 29 US states to their political party affiliations using public voter databases. From these they selected more than 200 doctors, half Democrat, half Republican, to receive a survey from Yale medical school, rather than their own Institution for Social and Policy Studies, to disguise the political nature of the study.



In the survey, the doctors were asked to rate the seriousness of nine scenarios presented by patients. The vignettes included references to drinking too much alcohol, smoking cigarettes, using marijuana, being depressed, visiting sex workers, riding a motorbike without wearing a helmet, storing guns in a house where there were children, and having had two elective abortions in the past.



The doctors more or less agreed on the seriousness of the less politically-charged issues, such as alcohol abuse and not wearing a helmet. But they differed substantially in their reaction to more sensitive issues, such as cannabis use, elective abortions and having guns in the home. The Republicans were more concerned than Democrats about patients having future abortions and using cannabis. Meanwhile, Democrats were more vexed than Republicans at patients having guns in the home.



A similar split emerged when doctors proposed how they would treat each patient. The survey found Republican doctors were more likely to warn patients about the health risks of using too much cannabis. They raised the legal risks of the drug too, and urged patients to cut down. They took a stronger line on abortions, too, the researchers found.



“As a patient, it’s useful to ask ‘is my doctor telling me this because it’s what the medical evidence says, or is it because of their world view?’” Hersh said. “Doctors sometimes say they think of themselves as mechanics, that whatever patient comes in they will treat them the same way. But it’s obvious that’s not true. It’s never the textbook scenario.”



Hersh says the findings point to a need for greater transparency. With that in mind, he is considering setting up a website that links doctors to their political affiliations, an idea he said did not appear to be popular among doctors he had spoken with. “There’s a strong economic incentive for them not to close off half of their business because they are with what patients might regard as the wrong party,” he said.

