In the United States there is 1 physician for every 350 people. In India there is 1 for every 1700 people, in Ghana 1 for every 8000, and in Mozambique 1 for every 50,000.[1]
The diseases and the well-being of the poorest populations on the globe should matter to us as Americans – both for humanitarian reasons and for pragmatic concerns.
Today's world is famously flat. Commerce moves quickly, but disease and people travel even more rapidly. Infectious agents move at the speed of the jet plane, as do migrating doctors.
Twenty-five percent of America's physicians are international medical graduates – the majority from poor nations.[2] These doctors have good reasons to migrate to the United States, but our failure to train enough medical students for our own needs has created a huge vacuum that pulls doctors out of the rest of the world to the considerable detriment of health services in those countries.
What to do?
We as a nation need to make 2 basic commitments. The first is to ramp up US medical education swiftly toward the goal of self-sufficiency in medical practice. We simply need to train enough doctors to meet our basic needs.
The second is to create a United States Global Health Service that would mobilize many more US physicians to serve abroad as clinical teachers, clinicians, and public health counselors.[3] This “Peace Corps for health” would provide crucial support to countries suffering epidemic disease and poverty.[4] It would give a measure of recompense to nations whose physicians have provided enormous benefit to patients in the United States. And doctors serving abroad with the US Global Health Service would be citizen ambassadors, demonstrating the generosity of America – a message we would do well to send to the corners of this planet.
That's my opinion. I'm Dr. Fitzhugh Mullan, Professor of Pediatrics and Public Health at the George Washington University.
Footnotes
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Readers are encouraged to respond to the author at fmullan@gwu.edu or to Paul Blumenthal, MD, Deputy Editor of MedGenMed, for the editor's eyes only or for possible publication as an actual Letter in MedGenMed via email: pblumen@stanford.edu
References
- 1.World Health Organization (WHO) The World Health Report: Working Together for Health. Geneva, Switzerland: World Health Organization Press; 2006. [Google Scholar]
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- 3.Institute of Medicine. Healers Abroad: Americans Responding to the Human Resource Crisis in HIV/AIDS. Washington, DC: The National Academies Press; 2005. [Google Scholar]
- 4.Mullan F. Responding to the global HIV/AIDS crisis: a Peace Corps for health. JAMA. 2006;297:744–746. doi: 10.1001/jama.297.7.744. [DOI] [PubMed] [Google Scholar]
