Doctor and Patient - How Good Are Foreign-Trained Doctors? - NYTimes.com (titled "When the Doctor Doesn't Look Like You" online)
This article provides an interesting look at the medical profession in the US. It reports a study which concludes that foreign-born, foreign-trained doctors are at least as effective as American-born, American-trained doctors. Foreign-trained doctors represent 25% of all practicing physicians. The article suggests that American-born, foreign-trained doctors may not be quite as effective.
The article says that international graduates "now account for nearly 30% of primary care doctors, a specialty that has had increasing difficulties attracting American medical students."
The study, of 240,000 patients hospitalized with either congestive heart failure or heart attack, found that board certification and, interestingly, fewer years since med-school graduation led to better results:
Dr. Norcini and his co-investigators also found that patient mortality rates were related to the doctor’s board certification and time since medical school graduation, regardless of his or her background. Those physicians in the study who were board-certified had substantially lower death rates among their patients. And the greater the number of years since medical school graduation, the more likely that doctor was to have a patient with heart attack or congestive heart failure die in the hospital.
“If you put these two pieces of data together,” Dr. Norcini said, “they make a strong argument for board certification and the maintenance of certification programs currently being put in place to improve the periodic reassessment of board-certified doctors.”
Here's what I posted to the related NYT blog:
What a shame it is that America’s best and brightest no longer flock into medicine and basic research, and instead head for the highly-rewarded and risk-socialized FIRE sector — Finance, Insurance and Real Estate.
We no longer reward doctors as heavily, and we expect them to bear more of the risk when treatments don’t unfold ideally.
And then we draw from foreign countries the people who could make a tremendous difference in their homelands, both in their role as doctors and as human beings and educated citizens.
Joe Stiglitz made a comment in Queensland a couple of weeks ago about the FIRE sector: “The financial sector (the banks and regulators) are the culprits behind the global financial crisis which has crippled the global economy. Apparently, moneylenders have been skimming 40 percent of the profits from companies that actually make and produce things. His big point was that this is not really the role of the financial sector. The financial sector’s job is to support economic growth, not cripple it.
“Finance is a means to an end,” he said. “The lack of balance between the financial sector and the economic sector was actually the real problem in this economic crisis (NOT the real estate bubble).”
When the FIRE sector gets to skim 40% of whatever producers make, why should our best and brightest go into medicine?
For all sorts of reasons, we need to reign in this reaping-what-others-sow structure.
When we stop socializing the risks taken by the financial sector while permitting them to privatize the rewards (think about hedge fund managers who pay only 20% federal income tax on their multi-multi-million wages, about all the entities we bailed out which paid high bonuses to their employees) and change the structures which require doctors to practice defensive medicine and carry expensive malpractice insurance, we'll have a healthier population and a healthier economy. In the meantime, we're all sharecroppers.
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