Docs Exodus

A cure for looming crisis caused by doctors' migration

Inquirer News Service

OUR country's problem with regard to the dwindling number of doctors, with many of them going abroad to work as nurses, just follows the global trend that has been going on for the past 100 years and has seen over 200 million people of different nationalities leaving their homelands to find a decent life elsewhere (UN statistics).

It is depleting the ranks of the medical professionals because the government has neglected the welfare of health workers, not to mention the country's problems with a doddering economy, massive graft and corruption in government, endless politicking and unstable peace and order.

Time will come when only a very few, overworked practicing doctors will be left in the country to care for the health needs of the Filipino people. By then, it will be too late to find a solution to the problem.

Filipinos in the lower economic brackets, especially those in the rural areas, are already suffering from the lack of doctors, nurses and other health care workers. I understand, even the bigger medical centers in Metro Manila are now feeling the pinch.

In the United States, the suggested ideal population-doctor ratio for satisfactory and sustained medical care is 5,000 to 1. There are about 750,000 licensed US doctors but only about 600,000 of them are practicing doctors taking care of the 300 million people in the United States. (The rest are in research, the academe, the military, etc.)

In the Philippines, there are reportedly more than 100,000 licensed doctors, but about one-fourth of them are not in active practice. With a population of 85 million people, this means the people-doctor ratio in the country is 20,000 to 1.

With the migration of so many MD-RNs (1,000 yearly?), coupled with the retirement, disability, or death of the "senior" doctors, expect the gap to widen. Expect a worse scenario with the rapidly declining enrollments in Philippine medical schools and the increasing number of doctors enrolling in nursing schools (6,000 lately, as per DOH report).

The only viable solution to ensure that the Philippines will be able to maintain a decent health care service is to train graduate nurses, who are now in abundance, so that they deliver non-complicated, basic health care services that at present are being provided by family physicians, pediatricians, anesthesiologists (as anesthetist), internists and obstetricians, the same way it is being tried now in several American states.

For this, the nurses should take up an extra two years of postgraduate training. School expenses, including board and lodging, should be shouldered by the government. And yes, the Philippines should pay these nurses good salaries and give them privileges.

CONRAD G. JAVIER, M.D., president, The Broadway Medical Center, Cleveland, Ohio; former chief of staff, St. Michael Hospital (a University Hospital of Cleveland Health System, USA)