09-24-2009
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Subject: Oh Where, Oh Where, Did All The Doctors Go?
Here is a very interesting article: South Africa: Doctor brain drain
continues.
The article states:
"The country is losing 17% of its qualifying doctors every year
and, in the four years since 2005, nearly 1,000 new doctors did
not register to work, according to government figures."
The author then quotes Mike Waters, the shadow minister of health for
the official opposition Democratic Alliance as stating:
"It mirrors the depth of dissatisfaction among doctors over
South Africa's public health system."
What is interesting about this is that South Africa seems to have
the type of medical system being proposed for the United States.
Medical schools are state-run and student tuition is subsidized by
the government. In addition to a year of internship, graduates are
also required to contribute twelve months of their life to community
service at a state-run health institution before being allowed to
obtain a license to practice medicine. The majority of the health
care system is run by the government, and is available without charge
to roughly 80% of the population. And yet, despite this idyllic
set-up, there appears to be problems in paradise.
As the article explains:
"Community service doctors and interns are crucial to the
public health system, which suffers a 40% vacancy problem.
Newly graduated doctors are expected to 'give back' to the
community, and they are often deployed to very remote and
under-equipped hospitals where their skills are most needed.
Working conditions are often extremely difficult."
"South Africa employs 18,000 doctors in state-run hospitals
— or one doctor for every 3,800 people without medical
aid"
Ravick van der Merwe, an industrial relations adviser for the South
African Medical Association states:
"Considering the money they will earn after five years, new
doctors might run away even before they enroll for community
service. The remuneration that they get is not enough for some
to pay back loans that they would have borrowed."
What ideas are being considered to solve this problem? The article
states:
"One way of trying to ease the medical brain drain is to
select students who display social responsibility and a
commitment to the country and to communities, especially in
rural areas."
Well, if I was really ill or injured and required extensive or
complicated medical assistance, I know that I would much rather
have a doctor who pursued that career out of self-interest, following
their thirst for knowledge and love of that type of work. Those are
qualities that I can rely upon in a critical situation. I would not
be comforted to know that the criteria used to select my doctor was
"commitment to the country and to communities." He might
be a warm body filling a space in a hospital, but a person's
"social conscience" tells me nothing about their commitment to
themselves and their work! When my life hangs in the balance, I
want the self-motivated, competent doctor making the judgment or
holding the knife, not the "nice guy".
The article concludes with the following observation:
"South Africa has been experiencing a brain drain for decades,
undermining the regional economy. Previous studies have shown
that 25% of medical graduates have been lost to the US alone.
And it is not only doctors who move to greener pastures.
Official statistics estimate that between one and 1.6 million
people skilled in professions and managerial occupations have
left the country since 1994, the year South Africa became a
democracy."
As those of you who have read Atlas Shrugged know, this
"Brain Drain" phenomenon — or the John Galt effect — was
described by Ayn Rand as a completely predictable consequence of the
ever tightening government regulation of any profession or industry.
If we continue to move in the direction that the Obama administration
is leading us, this is one aspect of the future awaiting us.
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