Physicians have actively participated in the political processes of American democracy throughout the nation's history. The purpose of this study was to compare physicians' participation in public office during the first and second centuries of American democracy. Following the commencement of the US Congress, physicians were active members of the legislative branch. However, physicians' membership in Congress has diminished significantly in modern times. The executive and judicial branches of the federal government have recorded only marginal representation by physicians and none during the 20th century.