Stop stealing developing world doctors

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Economic concerns are so acute in the Philippines, for example, that since American standards for foreign nurses are easier to meet, thousands of doctors retrained as nurses and emigrated between 2000 and 2005. Dr. Jaime Galvez Tan, former Philippine secretary of health, has said: "The flight of nurses has had a corrosive effect on healthcare." Tan estimated two years ago that 80% of the country's government doctors had become nurses or were enrolled in nursing programs, hoping for an American green card. "I plead for justice," he said in a telephone interview with the New York Times. "There has to be give and take, not just take, take, take by the United States."

Dr. Agyman Akosa, the director of Ghana's health service, also told the New York Times that "Ghana, with only six doctors for each 100,000 people, has lost three of every 10 doctors it has educated to the United States, Britain, Canada and Australia, each of which has more than 220 doctors per 100,000 people." We seem to be in the morally difficult position, on the one hand, of shipping AIDS medicines to Africa while, with the other, to be depriving it of medical personnel.

This is a consequence of the failure of wealthier countries to train enough doctors. For example, in 2005, one study found that the United States had only about 17,000 medical school graduates each year for 22,000 first-year residency slots. Tragically, maintaining doctor shortages is apparently a major objective of the American Medical Assn. as it works to ensure higher doctor incomes. Greedily declining to train enough healthcare professionals, medical interests in the United States have guaranteed scarcity that supports the high medical fees so characteristic of American medicine. As a consequence, we experience chronically understaffed healthcare facilities and overworked medical professionals. Patients who in the past would have been occupying hospital beds are now routinely treated on an outpatient basis, with the result that sicker hospital patients are being cared for by diminishing nursing staffs and fatigued doctors. Rather than dealing with this shortage domestically, healthcare companies are trying to import their way out of the problem.

Finally, there is an ironic consequence to the commonplace practice of raiding underdeveloped nations for their healthcare personnel. It is that many healthcare personnel seem to more attracted by the lure of financial gain than by the prospect of service to the sick. As a consequence, we get exactly what we pay for. We get a coals-to-Newcastle-like infusion of healthcare workers who are primarily motivated by money.

Lee Karr is a retired psychologist living in Florida. He is currently completing his book, "Let the Patient Beware: The Psychology of Our Broken Healthcare System."