Chris, again quite coincidentally, I saw this story after your posting earlier Friday about immigrant medics. The audio is not showing up on their website as user-accessible, but may have the elusive web underline under the title header by Monday. It discussed the plight many immigrant physicians face about returning to their native country and the different realities they face when they do. It was a good piece of journalism, fair in airing both sides. The piece largely focused on Indian medicals in the US, but pointed out that some of them who return to India with hopes of making a big difference find that inadequate facilities in the countryside forces them to practice back in the cities, primarily to the rich, so they don't see much difference in practicing that way or back in the US. Where I see the United States as a prime player in this dilemma is the awful transition (some might say strangulation) in health care we are at turns avoiding and addressing. If North America is recruiting so many foreign students to learn and then serve here (a medical GI bill) then my question is why can't American medical schools recruit enough native students? Is it our methods, the grueling hours, the prohibitive costs of private practice or the frustrating realities of managed care? (see link and excerpt below). My eldest daughter is preparing to go to nursing school, and I was delighted to hand her information about a truly bipartisan US Congress legislation that passed swiftly, everyone happy all around, which essentially created a Nurses GI bill, meant to address the growing shortage of nurses. As the PBS piece points out, India has such arrangements with their native graduates, but 2/3 of them don't not honor their commitment. This should be addressed. Overseas, it may be the shortage of good teaching hospitals in many countries so that the supply of graduates is small while the needs continue to expand, but many Third World countries have focused on other critical infrastructure areas at the neglect of native health care - and that's one reason so many missionary hospitals continue to be vital to developing countries. They are often resented, naturally, as a holdover in some cases from colonial times, but nevertheless an influential component to health care distribution in much of the world and the prime component for the constant exchange of foreign students into the US. China's hospital system (and its folklore remedies) are of particular interest. In effect, they did what the Japanese did for 200 years, isolated themselves from outsiders, but the population and natural resources of China make their history of development much different - in a much shorter time. I guess we could say that this is a universal and generation problem, something along the lines of that song that bemoaned "once you left them see gay Paris" or something like that, "you can't keep them back down on the farm." It shouldn't be this way. But it may get much worse before it gets any better. I hope I'm wrong about that. Regards, Karen
Going Home? Fred de Sam Lazaro of Twin Cities Public Television reports on U.S.-trained foreign doctors and the countries they've left behind. http://www.pbs.org/newshour/newshour_index.html US Nursing Legislation (http://www.washingtonpost.com/ac2/wp-dyn?pagename=article&node=opinion/colu mns/broderdavid&contentId=A52730-2002Aug6¬Found=true). Rise in Insurance Forces Hospitals to Shutter Wards By JOSEPH B. TREASTER (NYT) Aug 24, 2002 Around the country this summer, at least half a dozen hospitals have closed obstetric wards, others have curtailed trauma services, and a string of rural clinics have been temporarily shuttered as a result of soaring costs for medical malpractice insurance. Mercy Hospital in West Philadelphia closed its maternity ward on Friday, and the Largo Medical Center, near Tampa, Fla., plans to do so in December. In the last few weeks, the only trauma center in Las Vegas closed for 10 days; the Central Florida Regional Hospital in Sanford, Fla., reduced surgical procedures for five days; and a handful of rural clinics across Mississippi sat empty in the summer heat for part of a week. All the closings were because of problems with malpractice insurance. Increasing malpractice costs over the last two years have led doctors to order batteries of costly exams and limit risky procedures; many doctors decided to retire early. Now the costs are directly affecting medical institutions and the care they deliver to patients, according to interviews with hospital administrators in many states. For the rest of the story, see http://www.nytimes.com/2002/08/25/business/25HOSP.html BTW, the interview discussion that Ray Suarez led on Friday's NewsHour about the secret FISA court and the Justice Department was also an articulate piece, for those interested. http://www.pbs.org/newshour/bb/law/july-dec02/court_8-23.html I'm sorry that PBS stations don't have enough money to post all their interviews as audio feed, and some of them are available only as transcripts. They are still much better than commercial news.
