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dseattle

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filipinos and indians in america constitute over 2 million each. they are within the top three highest asian american groups (1st is chinese), with a majority within the health care professions. the purpose of this forum is to discuss this social fact and its implication and applications to local and international issues, generational issues, culture, and everything else.

some topics to discuss:

-affect of brain drain (mass migration of professionals to the us) on the home countries

-similarity in histories/cultures, both during and post colonial

-immigration/generational issues

-parental/cultural push towards health care

-possible competition between american and foreign students for schools/programs/residencies, etc.

-possible difficulty in applying because filipinos/indians are "well represented" in the health fields

-the options to go to the home countries for schooling

-available programs for mission work, pre health and professional

-anything else: personal stories, hardships, revelations, trips to the homeland and affect on career decisions, etc.
 

NonTradMed

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Are you talking about foreign doctors in this country? I'm assuming you are since you mentioned brian drain.

I guess importing foreign students is needed since we don't produce enough medical studnets in this country to fill all the residency spots. This is a problem, especially in countries like the Phillipines where there is such a need for healthcare workers. I don't think there's a easy answer for how to resolve this problem since the US do benefit from this brain drain.

The cultural implication is also far reaching. We have a significant minority of foreign nationals who are doctors. Many are fluent in english (duh) but the cultural naunces involved in speaking with a patient, the inflections that may indicate a different meaning...those things may be lost on a doctor who had no previous experience with Americans. Furthermore, the cultural clash may be immense. What may be normal in one culture may be seen as strange in another and a doctor may miss something or misunderstand something b/c of this barrier.

The solutions will probalby have to be long term. Perhaps increasing the number of US med students would mitigate the need to import foreign ones. Otherwise, I can't imagine what else can be done to resolve this problem.
 

Miami_med

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Brain drain is solely a function of people looking for a better life. Most people don't want to permanently move to a foreign country, which implies that life must seem MUCH better over here. To prevent brain drain, proper treatment of doctors in their home countries would be the best course of action. The idea that the doctor should deal with severe maltreatment, poor pay, poor conditions and bypass the chance to pursue a better life in the name of some kind of altruistic self-sacrifice to his country of origin is bogus. This kind of thinking is why doctors are treated so poorly in their home countries in the first place.

As long as our asian colleagues keep producing highly intelligent and capable clinicians in countries that do not appreciate their value, there will be more of them here and less of them at home.
 
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Faebinder

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Brain drain is solely a function of people looking for a better life. Most people don't want to permanently move to a foreign country, which implies that life must seem MUCH better over here. To prevent brain drain, proper treatment of doctors in their home countries would be the best course of action. The idea that the doctor should deal with severe maltreatment, poor pay, poor conditions and bypass the chance to pursue a better life in the name of some kind of altruistic self-sacrifice to his country of origin is bogus. This kind of thinking is why doctors are treated so poorly in their home countries in the first place.

As long as our asian colleagues keep producing highly intelligent and capable clinicians in countries that do not appreciate their value, there will be more of them here and less of them at home.

:thumbup:

I'll add one comment. The reason why doctors are treated so poorly in asia to begin with is that the value of human life is low. Thus your job is unimportant (to save lives) and undervalued.
 

NonTradMed

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Brain drain is solely a function of people looking for a better life. Most people don't want to permanently move to a foreign country, which implies that life must seem MUCH better over here. To prevent brain drain, proper treatment of doctors in their home countries would be the best course of action. The idea that the doctor should deal with severe maltreatment, poor pay, poor conditions and bypass the chance to pursue a better life in the name of some kind of altruistic self-sacrifice to his country of origin is bogus. This kind of thinking is why doctors are treated so poorly in their home countries in the first place.

That may be the case in some countries but not all doctors who want to come here do it becuase their own countries are not paying their actual net worth. They come because their own countries are so poor, even being 'well off' in their respective countries is still 'poor' as compared to the US.

Wealth is relative. Doctors in third world countries may enjoy a higher standard of living than the average citizen, but if a country is very poor, that standard of living may still be lower than that in the US.

As for respect, I've heard the opposite complaint from highly educated immigrants---that many were the best of the best in their native countries whereas *here*, they are underappreciated b/c of their 'foreign' education. My parents worked in the university for almost 20 years, and I've heard this from alot of Chinese and Indians, including doctors. They talk about how they were the best of the best, and they got the respect that came from being the top. However, in the US, they're foreign education is a drawback and people perceived it as an inferior education. It irks some of them.

However, the reason they may have come here is because of the higher standard of living due to the different state of economic development of the two countries, not b/c people in their native countries were not paying them what their worth.

Simple economics just made it nicer to be a doctor in this country than in their own. So a doctor graduating from an elite med school in China may live in a very nice apartment, have all the nice applicances and even save enough for a car. That is very nice standard of living in China. But in this country, they may have a huge house, drive three nice cars, send kids to private schools etc. It's all relative. Same skillset, different standards of living. Of course, if given the option, many would want to come here.



I think the problem with brain drain is that one country is educating their top students and then seeing none of that come to fruition. However, I think it's also human capital wasted if the smartest are not allowed into the best places to flourish. The problem is that in medicine, unlike in research, when doctors leave a country, it's not just national pride that suffers but people may go without decent health care, even if they can pay, in relative amounts, the same as an American pays for their health care. That's a problem. But I don't think it's something that we, as individual doctors, can do anything about. Physicians are only human and want to go where the grass is greener. It's up to governments to entice doctors to stay in their own countries. This is not a problem that individuals can solve.
 

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I think the problem with brain drain is that one country is educating their top students and then seeing none of that come to fruition. However, I think it's also human capital wasted if the smartest are not allowed into the best places to flourish. The problem is that in medicine, unlike in research, when doctors leave a country, it's not just national pride that suffers but people may go without decent health care, even if they can pay, in relative amounts, the same as an American pays for their health care. That's a problem. But I don't think it's something that we, as individual doctors, can do anything about. Physicians are only human and want to go where the grass is greener. It's up to governments to entice doctors to stay in their own countries. This is not a problem that individuals can solve.

I think that this is the problem right here. This is a problem that ONLY individuals can solve.
 

Miami_med

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The failure of governments to do this for the last 50 years, for one.

Secondly, the major problem in most of these countries is underdevelopment. If you have no economy, you have no money. If you have no money, you have a lower quality of life. If you have a lower quality of life, your physicians will want to go to where they can get a higher quality of life. Modern examples, including countries from China to Vietnam, show that by rolling back government involvement in the economy as a whole, individual profits will increase. These increases in profits at the top will initially create an incentive to stay in order to provide concierge services. This will create a base infrastructure in the country. As the economy grows, money will trickle down, allowing more and more people to access the doctors. More doctors will stay, because salaries will increase, and the society around them will provide a higher quality of life. Short term losses in some forms of access will be overturned in time with higher quality and more physicians for the majority of the population.

You see, the lack of doctors is a symptom. The disease is a political structure that prevents economic development. Secondary to development, the healthcare problem will solve itself. The government trying to give more money to doctors to treat this problem is like giving someone with Aspirin who has a chronic leukemia. The whole system is still sick.
 

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filipinos and indians in america constitute over 2 million each. they are within the top three highest asian american groups (1st is chinese), with a majority within the health care professions....
I think it's a very positive thing that America is still able to provide a venue for immigrants seeking a better life. In the past decade large numbers of asian nurses have moved here. The nursing shortage is such that they have their choice of cities and hospitals.

It does beg the question: "Why is American nursing education not providing enough nurses?"
 

dseattle

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wow, thats dope that people are posting on this, i wasn't sure which of the topics would flourish the most so i kept it rather general. but all in all they are related. the brain drain is incredibly complex because it always results in sacrifice. i cant imagine how hard it is for foreign doctors to make a decision where they are leaving everything they know, questing out to a foreign land with the american dream, but at the same time anticipating the racism and prejudice that will constantly remind them of their difference. deciding whether or not to teach your children their native tounge so they would seem more "american" and so you can protect them, hoping they wont go through the same hardship as you. seeing all the problems going on in your country and your family going on without you, wishing you could be there to do something. also in america foreign doctors sometimes can't get into the specialization they trained for (and have to retrain), they have to take all the boards at once, i think redo residency, practice in really random rural places that have never seen a person of color, and sometimes not even become a physician.

sometimes as children of immigrants we forget how hard it was, and still is for our parents. we take for granted our lives in america where our biggest daily decision is to go to mcdonalds or burger king. but at the same time, when we are pressured to go into a field that has allowed them to provide so much for their family, it is the hardest thing in the world because it is hard to understand where they are coming from as we simplify this pressure as a something logical as everything else they've told us. thats where it is hard to go beyond being a "legacy", and to really dig deep and find our own personal reasons. thats why i put that topic about mission trips to our homelands because we can do what our parents couldnt do, but wanted to. i guess this whole thing came up when i watched "surgery saved my life" and i was really inspired by this guy that we can use our american education to help what is very personal to us.

when will we see a reverse drain? which at the same time would counter the need for health care in the us. so once again, sacrifice.
 

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I think it's a very positive thing that America is still able to provide a venue for immigrants seeking a better life. In the past decade large numbers of asian nurses have moved here. The nursing shortage is such that they have their choice of cities and hospitals.

It does beg the question: "Why is American nursing education not providing enough nurses?"

In many areas, there are long waitlists due to lack of nursing educators. A nursing professor often makes far below what a staff nurse makes. There's little incentive financially to go into education if you're a nurse.

Even if we had enough teachers, there are many other serious problems that are contributing to the shortage of nurses. Until healthcare administrators are willing to address these issues, they will continue to use the band-aid cure of importing nurses.
 
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