Immigrating docs and nurses
The BMJ and Lancet have had a flurry of articles about the migration of health care workers migrating from the developing to the developed world. Apparently, this is rampant (no surprise to anyone in health care in the US) and leads to a substantial hardship in areas like sub-Saharan Africa where there are inadquate numbers of medical professionals.
The situation is compounded by the fact that countries like the U.K. and U.S. depend on immigration as they don't train enough docs and nurses.
As the spouse of an immigrant (from the Philippines) who has a number of physicians in-laws I can certainly understand the appeal of living and working in the US, described in this letter:
I think his point about the difficulty and frustration working in a corrupt society is particularly well taken.
While working in your own country you were used to fashioning a chest drain from a discarded drip set; you had to buy the catheter for that patient because otherwise he or she could not go to theatre; and you had to buy drugs on occasions when your salary hardly lasted a week.
Then, given the opportunity to either study or work in the West, you start to enjoy your work, although you work longer hours. You can get a chest x ray film within an hour, and you don't have to worry about your salary running out before the end of the month. You start to re-evaluate your life. You look at the priorities of the society you left behind—often it is not so poor that it cannot afford these things, but greed, corruption, and a total lack of political will has stopped any form of growth in health care. Even senior doctors are oblivious to what the world is about, and you despair.
I don't have any brillant insights. My libertarian instincts say we shouldn't prevent people immigrating as they wish and that the market will work out the best solution, but in this case that solution is pretty clearly with a lot of foreign born and educated RNs and MDs practicing for high salaries in the US while the poor in the developing world lack care.