Physician shortage and foreign-trained doctors are subject of talk

Physician shortage and foreign-trained doctors are subject of talk
La Mesa Courier
Apr 21, 2014

Challenges facing foreign-trained doctors eager to practice in California at a time when physician shortages are expected to get worse will be the topic of a forum sponsored by the Grossmont-Cuyamaca Community College District, the Grossmont College-based Welcome Back Center, and UC San Diego's School of Medicine on April 22 at UCSD.

The Association of American Medical Colleges has forecast a shortage of more than 91,500 doctors by 2020 and 130,600 by 2025, a shortage that could be exacerbated by the millions of Americans securing health insurance through the Affordable Care Act.

"Meanwhile, there are thousands of foreign-trained doctors that have scored well on U.S. medical exams but they cannot find residencies in the U.S., and there is little to no support for them to become doctors in this country," said Gail Patterson, program manager at the Welcome Back Center at Grossmont College, which was developed to aid internationally trained healthcare workers that have moved to California.

Speakers at the April 22 event include:

Dr. Wael Al-Delaimy, professor and division chief of Global Health at the UCSD Department of Preventative Medicine. Al-Delaimy practiced medicine in his native Iraq and then Jordan between 1991 and 1995 before finishing his Ph.D. from Otago University in New Zealand in 2000. He was a Research Fellow and Research associate at Harvard School of Public Health between 2000-2004, a scientist with the International Agency for Research on Cancer in 2003, and a faculty member at UCSD since 2004.

Dr. David E.J. Bazzo, a clinical professor in family and preventative medicine who has been named a Top Doctor in family medicine by the San Diego County Medical Society and San Diego Magazine every year since 2005.

Dr. Esmatullah Hatamy, assistant clinical professor of family and preventative medicine at the Global Health Initiative who graduated from Kabul Afghanistan Medical School in 1988 and has been a member of the Afghan Medical Association Board of Directors.

Dr. Dustin Lillie, a primary care physician who is an associate clinical professor of medicine at UCSD.

The April 22 forum is scheduled from 6 to 8 p.m. at the Medical Education and Telemedicine Building, Room 141, at 9500 Gilman Drive on the UC San Diego campus. Those attending can learn about what foreign-trained doctors need to do to secure residencies in the United States and discuss the general U.S. health care system's pending challenges.

UCSD Medical Center is interested in developing a program with the Welcome Back Center that would help foreign- trained doctors traverse the complex path of U.S. medical exams and residency applications that would increase their chances of getting a residency and becoming licensed to work in California.

The Welcome Back Center offers a wide range of services to immigrant healthcare workers who wish to obtain professional credentials. The Welcome Back Center is a division of the Health Workforce Initiative (HWI) program of the California Community Colleges. Ann Durham, based at Grossmont College, directs the HWI program in behalf of nine community colleges serving San Diego and Imperial counties.

Further information can be obtained by contacting Gail Patterson at (619) 644-7206 or administrative assistant Samantha Cardenas at (619) 644-7059.

Why are American doctors paid so damn much?

Chart: Why are there so few doctors in the US?

Because the medical establishment has intentionally limited the number of doctors in this country--so doctors could make more money by serving more patients. Of course, this has resulted in poorer medical care.

"This is yet another reason not to shed too many tears for doctors. They've basically brought this on themselves. If the market were allowed to produce as many doctors as there's demand for, they'd already be getting paid less. Right now they're enjoying the substantial rents that come from squeezing their own supply, and they've fought like lemmings for decades to keep it that way." -- Kevin Drum

Why Are American Doctors Paid So Damn Much?
By Kevin Drum
Mother Jones
Nov. 20, 2013

Conservatives have picked up today on a Kaiser Health News piece reporting on doctor complaints that insurers plan to pay them less for Obamacare patients than for other patients:

Insurance officials acknowledge they have reduced rates in some plans, saying they are under enormous pressure to keep premiums affordable. They say physicians will make up for the lower pay by seeing more patients, since the plans tend to have smaller networks of doctors. But many primary care doctors say they barely have time to take care of the patients they have now.

Matt Yglesias is unsympathetic. He says American doctors are very well paid and should quit griping: "If we ever reach the point where American doctors have been squeezed so badly that they start fleeing north of the border to get higher pay in Canada, then we've squeezed too hard. Until that happens, forget about it."

That's pretty cold. But if you really want to know what's going on, take a gander at the chart... [above]. It's from the OECD, so it includes all of the world's relatively rich countries:

That's damn peculiar, isn't it? If Econ 101 is to be believed, higher pay should produce more doctors. And yet, even though the United States pays doctors far more than any other country on the globe, we're in the bottom third. We have more doctors per capita than poorish countries like Mexico and Poland, but far fewer than Belgium and Britain and Germany—all of which pay doctors considerably less than we do here. So what's going on?

As Matt says, the basic answer is that U.S. doctors operate as a cartel. They artificially limit their own ranks, which drives up their compensation.

What we really ought to be doing is working to further pressure the incomes of doctors through supply-side reforms. That means letting nurse-practitioners treat patients without kicking a slice upstairs to an M.D., letting more doctors immigrate to the United States, and it means opening more medical schools. Common sense says that since the population both grows and ages over time, there should be more people admitted to medical school today than were thirty years ago. But that's not the case. Instead we produce roughly the same number of new doctors, admissions standards have gotten tougher, and doctors have become scarcer.

This is yet another reason not to shed too many tears for doctors. They've basically brought this on themselves. If the market were allowed to produce as many doctors as there's demand for, they'd already be getting paid less. Right now they're enjoying the substantial rents that come from squeezing their own supply, and they've fought like lemmings for decades to keep it that way. You can hardly blame them for that, but there's no reason the rest of us should put up with it. It's time to fight back.