The U.S. Senate will soon have a practicing physician who's a Democrat for the first time since 1938, with the election of Dr. Annie Andrews, a pediatrician, in South Carolina.
Her win — among many other physician candidates Tuesday night — marks a dramatic shift when it comes to doctors with political power across the country. Historically, doctors have been elected to Congress more often as Republicans, not Democrats. But that changed this cycle.
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In the recent past, the Republican party attracted doctor-candidates who were essentially small business people who had concerns about high taxes and government overreach. The new crop of candidates from health professions often work for large hospital systems and are interested in issues that align with Democratic priorities like public health, equity and affordability.
Andrews told NPR before she won that she was motivated to enter politics after watching parents worry about the cost of things like inhalers for asthma patients and insulin for kids with diabetes.
"I watch as worried parents leave the hospital in the evening so that they can go work their third shift job just so they can make ends meet," she said. "And then, like the majority of pediatricians in America, I've cared for kids who've been shot." Guns are the leading cause of death for children in the U.S.
"It really clicked to me that the path to catalyzing this change that I want to see in America for the children in America is through politics," she explained.
Blue wins, red losses
In the current Senate, all four of the physicians are Republicans. Two of them, Sen. Bill Cassidy, R.-La., and Sen. Roger Marshall, R-Kan, lost their reelection bids this year. With the election of South Carolina's Andrews and Dr. Abdul El-Sayed, an epidemiologist, in Michigan, there will now be an equal number of Republican and Democratic physicians in the upper chamber. (El-Sayed trained as a physician but did not do a residency or practice medicine, instead pursuing public health.)
In the House, the six members of the Democratic doctor's caucus will be joined by at least two more: New Jersey's Dr. Adam Hamawy, a former U.S. Army surgeon, and pediatrician Dr. Richard Pan in California. In the GOP doctor's caucus, neurosurgeon Dr. John Cowan was elected in Georgia, but at least two incumbents lost their seats, with a few races still too close to call.
A big recruiting effort
Many of these new Democratic physician-lawmakers were recruited and backed by 314 Action, a name that refers to the mathematical constant pi. The organization supports progressive candidates with science backgrounds to run for office, and it invested more than $30 million in dozens of Democratic candidates competing in state and federal races, including 48 physicians.
The group's president, Shaughnessy Naughton, says that the organization does leadership development and recruits scientists to run across the country, then helps candidates in a variety of ways.
"We work to help them put together their campaign strategy, communication strategy, media training, we help to get them local and national media exposure, work with them on their fundraising, and fundraise for them," she explains.
Those candidates won big time on Tuesday. In addition to big national names like Senators-elect Andrews and El-Sayed, and Governor-elect Dr. Amy Acton of Ohio, many of the downballot candidates 314 Action supported won as well. Among them are several incoming state legislators who will be the only elected physicians in their chambers: Dr. Nikhil Wagle in Iowa, Dr. Amelia Gallitano-Mendel in Arizona, and Dr. Jarod Fox in Florida.
Naughton attributes that success to health care and affordability being front of mind. Also, polls show the public trusts doctors, and the candidates effectively countered messaging from Health Secretary Robert F. Kennedy Jr., a longtime anti-vaccine activist who has downplayed ongoing measles outbreaks.
"People were sick of it," Naughton says. "We should not have American children dying — or anyone dying — of measles in 2026. And yet, not only did we have that happening, we had a health secretary that only made the situation worse."
A key vote, a damaging investigation
Outgoing chair of the powerful Health, Education, Labor and Pensions committee, Sen. Bill Cassidy, R.-La., spoke often from the dais about how his experience as a physician shaped his perspective as a lawmaker and committee chair.
During Kennedy's confirmation hearing in Jan. 2025, Cassidy memorably spoke about the root of his passion for vaccination. "In the early 2000's, I was loading a patient onto an air ambulance, an 18-year-old young woman, to go to get a liver transplant from acute liver failure due to hepatitis B," he said, noting the expensive surgery and ongoing hospital bills she would face, if she lived. "It was the worst day of my medical career, because I thought: $50 of vaccines could have prevented this all."
Still, Cassidy ultimately cast a key vote to confirm Kennedy into the job, despite Kennedy's long history of anti-vaccine activism. Kennedy flaunted vaccine-related promises Cassidy said he made to earn that vote, and even supported the Republican primary challenger who managed to unseat Cassidy earlier this year.
In a surprise Tuesday night, Dr. Roger Marshall, R.-Kan., also lost his reelection bid — another senior member of the HELP committee. Marshall is an OBGYN and staunch supporter of Kennedy. In September, the New York Times reported that Marshall had sued more than 700 patients for unpaid medical bills. One of the patients filed a class action lawsuit against him last week. Marshall described his actions as a way to "keep the lights on" in a last-minute social media video. He lost to challenger Adam Hamilton, a Methodist minister, by four points.
All the way back to 1776
Dr. Chadd Kraus has studied physicians in Congress. Kraus is now an emergency room doctor and the vice chair for research for the Department of Emergency and Hospital Medicine at Jefferson Health Lehigh Valley in Pennsylvania. Two decades ago, after studying political science as an undergrad and pursuing a masters in public health, he worked on an analysis of the physicians in Congress.
"In 1776, 10.7% of the signers of the Declaration of Independence were physicians," the paper notes. Kraus explains that was an era where practicing medicine involved leeches; germs hadn't been discovered and antibiotics hadn't been invented. Kraus suggests those physicians happened to be "part of a class that owned land that was educated."
In the next two hundred years, medicine transformed, and for a time, very few physicians served as federal lawmakers. "In the period of time that we studied [from 1960-2004], there were 25 physicians total who had served in the U.S. Congress, whether the House or the Senate," he explains. "In the current Congress, there are as many physicians — nearly — as there were in that whole period of time that we studied, which was several decades."
The new count
To be specific, there are 20 physicians in the current Congress, and Republicans outnumber Democrats two to one. There are six Democrats and 10 Republicans who serve in the House. All four doctors in the Senate are Republicans.
In the new Congress, there will be at least 18 physicians in Congress, 10 of them Democrats. Depending on the outcome of several House races, Democratic physician-lawmakers may outnumber Republican physician-lawmakers. Another notable win was in Ohio, where oncology nurse practitioner Kristina Knickerbocker flipped a Republican House seat. Nurse Lauren Underwood, a Democrat, held onto her House seat in Illinois.
In addition to Republicans Cassidy and Marshall losing their Senate seats, in the house, Rep. Neal Dunn of Florida, a urologist, retired, and Reps. Mariannette Miller-Meeks, an ophthalmologist in Iowa, and Jen Kiggans, a nurse in Virginia lost their seats.
Kraus says, when it comes to making laws, "physicians have a valuable perspective, not a monopoly on good policy," he says. "And the need for physician voices in government has grown, I think, over the course of time, as healthcare has become more complex and politically consequential."
He says the emergency department, especially, is a place where you can see the effect of health policy in real time. He recalls at the beginning of the opioid crisis, how emergency physicians were among the first to sound the alarm to policymakers. When the uninsured rates increase, they see patients coming in sicker than they would otherwise be, he says. "We see the challenges of health policy and the consequences of it," he says
A health policy shake up?
Many of the new members of Congress campaigned on health policy issues, like the cost of health insurance and prescription drugs. There's widespread dissatisfaction with the cost of health care across the political spectrum. Democratic leaders have said that reversing Republican cuts to premium subsidies for health insurance and work requirements for Medicaid will be at the top of their agenda.
Beyond those immediate issues, more than 15 years after the passage of the Affordable Care Act, there may be political appetite and public demand for major new health legislation in the coming years. Some candidates ran on Medicare-for-all, a national health insurance plan, which has become increasingly popular in public opinion surveys.
"I think we all certainly agree, no matter one's political views or perspective, that there is the potential for a better system," Kraus says. "I do think that having physicians and other health care professionals meaningfully incorporated into the policymaking process is really critical to finding what those innovations might be."
Naughton of 314 Action says the health-professional candidates her group supported care about and have ideas about how to change the health care system, but that hasn't been their only pitch to voters.
"I do think that they really lead with what they essentially are, which is problem solvers," she says. "We can fix this problem — we can make health care accessible and affordable — and not make it a choice between life or debt."
Lexie Schapitl contributed reporting to this story.
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