I’ve heard but not read much about how the US government limits the number of foreign medical students who are allowed to practice in the United States after graduation. The official line seems to be that foreign doctors would undercut domestic doctors’ salaries. There are exemptions for acquiring the H1 visa for medically underserved and rural areas, but to me this has the feel of protectionism, a bit like a steel tariff. Can you elaborate on this issue and correct any of my incorrect assumptions?
I truly don’t believe that the number of foreign medical-school graduates allowed to practice is a fixed criterion based on the need to protect jobs for American graduates. The standards may be strict, or even somewhat arbitrary, but I see no evidence of protectionism. I frankly don’t think there is that much concern whether US graduates have jobs or not, though I also don’t think job availability is the major problem right now either. The issue remains more one of quality of care and whether there are enough physicians to go around under the current system.
Many local newspapers have recently published anguished op-eds written by doctors bewailing the heartless cruelty of the huge increases in malpractice insurance costs. The “before” and “after” premium rates are always cited, and then the writers proceed to say they will have to “leave” that particular line of practice. The rest is left to the reader’s imagination.
Curiously, these same doctors never provide the reader with an income statement or a business balance sheet to properly evaluate these claims. And if so many doctors are “leaving the field,” where in the hell have they all gone?
What’s your take on these claims in the overall picture of the ongoing efforts at “tort reform”?
Des Moines, WA
These are not necessarily the same issues. (1) We live in a very litigious society, and doctors are often the target of frivolous lawsuits. At the same time, many doctors do commit malpractice and harm patients. But malpractice is not an effective way to police doctors in any case, hence the need for tort reform. (2) Many doctors are leaving the profession, mostly because of increased stress, responsibility and paperwork, with less and less monetary reward. Having said that, I too think that the majority of doctors still make very decent incomes and shouldn’t spend their time bellyaching. (3) Like any other profession, you shouldn’t be doing it unless you have a passion and an affinity for it. Bottom-line thinking, especially regarding income, may certainly undermine a doctor’s dedication, which further undermines the healthcare system.
I am a retired hospital administrator and am busy promoting universal health insurance.
I am half-way through an excellent book, Dead on Arrival: The Politics of Healthcare in the 20th Century, by Colin Gordon (a history professor at Iowa U), recently published by Princeton University Press. I highly recommend it for anyone interested in the subject.
FREDERICK C. SAGE
Thanks for the reference. The inequities in the current system don’t serve many well, and few are happy with the direction our healthcare system has taken. Universal health insurance would be a step in the right direction if it were administered properly. Privatization will lead to waste and further inequities, including exploitation of the have-nots, as I don’t need to tell you.