Now that I am covering health workforce as my "beat" for my 8350 class, it seems like I see "workforce" everywhere. Last week I was walking down the hall in the Grady School and saw a CNN segment on Filipino doctors leaving the Phillipines coming to America become nurses. Upon further investigation, I find out that this has been going on for quite some time. I have been to Manila, and I knew that people often left the country for greater wages, but I had no idea that medical doctors would ever consider leaving their country.
Why are they coming? It turns out that training to be a nurse is the easiest way to get a visa and work in the US. A CBS story references a research paper by former Philippine Secretary of Health Dr. Jaime-Galvez Tan who says that three years ago, around 5,000 doctors became nurses. A associated press story in USA Today in January of this year tells the story of one such doctor and how things did not turn out the way recruiters in the US told him it would.
You can see the lure though. Nurses in the US make 10 times what they do in the Phillipines, and about five times more than even a doctor make in his native homeland. Having been in the Phillipines, the cost of living is far less there.
According to Dr. Tan, the departure of health care professionals from the Phillipines is having a devastating effect on their own health care systems.
So what should the US do? Our own need is causing our elected officials to change public policy that make it easier for such people to migrate to our country. Maybe a better long term solution would be to think of ways to incentivize our own young citizens to pursue nursing and other health related fields.
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It seems like a lot of young women I talk to are going/have gone to school to become nurses. I have always thought it was a very popular option. So it is interesting that they are saying we don't have enough U.S. citizens who want to be nurses.
I think the problem is that so many baby boomers are retiring, it's creating a void in our workforce. If we can't fill the void, then why not let those interested migrate to do so. That's what our country has done since it was founded, right? We're not called the melting pot for nothing.
For decades, physicians and nurses trained in other countries have been immigrating to the US to work. Like less educated immigrants, they often fill jobs that native-born Americans disdain. These are often not very lucrative practices in small towns or low-paid staff positions in state institutions such as mental hospitals or correctional facilities.
There are a lot of folks in our country who wouldn't get any medical care at all if the US wasn't a magnet for internationally trained health providers. And, as Amber notes, the demand for primary care will soar as boomers retire.
At two different top-tier med schools, I've heard droves of middle class, US-born kids say they have come to med school for humanitarian reasons. Four years later, when they compete for residency programs, they've often set their sights on the highest paid specialties and careers in academic medicine.
The best competitors will raise their families in desirable urban areas, work in medical schools and teaching hospitals, and if all goes well discover something that advances medical treatment.
What they won't do is treat thousands of low income patients in small towns in the Southern Black Belt or the Midwestern Rust Belt or the increasingly empty Great Plains. For that we need a different breed of doctor -- trained at an expanded MCG, for example, or imported from countries where providing primary care to all comers is still regarded as a desirable and honorable career.
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