Exporting doctors

THERE’S both a shortage and a glut of doctors. Shortage, in the sense that anyone who has ever stepped foot in a hospital will see first-hand the enormous demand for physicians. Glut, in the sense that every year at least 300 new doctors graduate from university and currently there are 7,345 doctors registered with the Medical Board. The causes of this paradoxical situation are complex. But the Prime Minister’s December 7 announcement of a plan to partner with Guyana so that 50 local doctors can work there betrays the thinking required to tackle the problems of the health sector head-on.

Counter-intuitive might seem the suggestion that, when clinics are overrun with patients, we should export doctors. After all, doesn’t charity begin at home? What about preventing brain drain?

But one reason why there are not enough medics available to treat patients relates to the fact that while there is a surplus of fresh-faced graduates each year, these graduates, despite internships, are perceived as not yet having the experience needed to take up positions. It’s a classic catch-22: to get a job you need experience; to get experience you need a job. The Kamla Persad-Bissessar administration’s plan would thus not only provide employment to up-and-coming practitioners, but it would allow this cycle to be partly broken by opening a new avenue for graduates.

The deeper problem, however, relates to the state itself.

Simply put, authorities have not been hiring enough. According to the World Health Organization, the rate of physicians per 1,000 people doubled between 2010 and 2020. Yet, there is no flood of doctors when you step into a health centre or an accident and emergency department.

Governments have not been willing or able to pay for more trained personnel – including, as the nursing association president Idi Stuart notes, nurses – and are not expanding health facilities enough to align demand with supply. Ms Persad-Bissessar’s claim that $100 million in equipment in a brand-new hospital opened by her in 2015 was left to rot by the PNM, if substantiated, is shameful. But also bad is the failure to staff fully that Couva facility.

The old culture of seeing a local GP seems to have waned, adding to the sense of fewer opportunities for graduates. Allowing doctors to open private practices more easily, alongside strengthened professional regulations, might kill two birds with one stone: increasing employment while reducing public health burdens.

Parents repeatedly encourage their children to become doctors. That cultural obsession, too, needs to be reflected on. Until it changes, exporting personnel might not be a bad thing. In fact, it would be good for regional integration. A batch of 50 might not make a significant dent. But it’s a start.