Pundits are tracking every tick in public opinion on health care reform. Insurance companies are claiming the government will have an unfair advantage in the open market. Hospitals are promising to cut their own spending to avoid a class with the Obama administration. Everyone’s taking a side–but where do doctors stand on the idea of national health care plans?

That’s a difficult question, given that the answer has evolved over the months-long health care debate. Back in May, the American Medical Association made some snippy comments about health care reform:

The AMA does not believe that creating a public health insurance option for non-disabled individuals under age 65 is the best way to expand health insurance coverage and lower costs across the health care system. The introduction of a new public plan threatens to restrict patient choice by driving out private insurers, which currently provide coverage for nearly 70 percent of Americans.

Lately, however, the association has officially come around to Obama’s health care bill:

Dr. Rohack said the AMA decided to back the bill after its authors made several key changes to the original discussion draft. Although the legislation still includes a public plan option, it no longer would require Medicare-participating physicians to accept the new plan’s patients.

The association says it’s staying at the table to help shape the unfinished product, but also acknowledges that other physicians’ groups – the Medical Association of Georgia and Texas Medical Association, among others–have yet to sign on to Obamacare. But these dissenting voices don’t really provide an accurate snapshot of which doctors believe what, and why.

That’s just what Aaron Carroll and Ronald Ackerman of Indiana University examined back in 2002, when they surveyed a random sample of physicians who were members of the American Medical Association. The researchers found that just 49% of doctors supported the idea of a national health insurance plan. Their followup last year, however, found that overall support for legislation had since shot up to 59%.

Put the larger political shift aside, however, and the partisan divide between subspecialties jumps out. Those in pediatrics and psychiatrics showed some of the strongest support for national health care; some of the biggest jumps occurred in emergency care and family medicine, about 15 percentage points each. (Psychiatry topped the list with a 20-point jump, with more than 80% surveyed in support.)

Graham Roberts / grahamyvesroberts.com

Interestingly, the more specialized their field, the less doctors tended to support national health insurance. Surgery and anesthesiology hovered near the bottom of the list. Radiology could only rack up 30% enthusiasm for a government plan. And while all categories that had data for both years rose in support for a public option, the five-year time span barely made a dent in the opinions of more conservative specialists.

It may in fact be because of the way the current health care system works: less emphasis on prevention, far more on expensive tests and procedures. Just take a look at Atul Gawande’s New Yorker article on the American system, where he chronicles the health care dilemma of McAllen, TX, a small town with, inexplicably, one of the most expensive health care systems in America. Gawande points out that these patients (and their doctors) order batteries of unnecessary tests: “Between 2001 and 2005, critically ill Medicare patients received almost fifty per cent more specialist visits in McAllen than in El Paso, and were two-thirds more likely to see ten or more specialists in a six-month period.”

Specialists benefit from this sort of overuse. And that’s just the kind of overuse that a national plan, with adequate emphasis on preventative care, would seek to reduce.

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Chart created for TakePart by Graham Roberts.