Editorial: Sick and ailing

PAUL is more than familiar with the equation, Philippine medical brain drain = personal gain. (Pseudonyms used to respect the sources’ request for confidentiality.)

Within the next 400 days, Paul has been advised by the US embassy to expect his immigrant visa.

Paul is in his 60s, a professor teaching science to undergraduate and graduate students for more than 20 years. He has occupied for two terms a senior position in the academic institution he will soon be exchanging for the life of a retiree in the US. He has done consultancies and researches for many national and international databanks.

Marie’s portfolio is no less impressive. Still in her 50s, she has a thriving private practice in many hospitals. The obstetrician of 20 years divides the rest of her time among the medical colleges where she is teaching.

Paul and Marie will soon be flying to the US where she has a contract to work as a nurse.

Paul and Marie are anomalies, based on Labor Secretary Patricia Sto. Tomas’ projection that the medical brain drain will not encroach on the upper tier of professionals whose seniority, career and status will inure them from the temptations of working abroad.

Paul and Marie fit this profile except in one detail: immigrating to the US is the quickest route assuring their children’s future.

Deskilling

During a recent videoconference sponsored by the Asian Institute of Management Policy Center, Irena Vojackova-Sollorano, regional representative of the International Organization for Migration (IOM), said that there are three reasons for working abroad: low income, lack of jobs, and advancement potentials outside the home country.

Paul and Marie do not foresee that their careers will go into a resurgence once they immigrate. However, both discussed that the rewards outweigh the risks of starting anew in a foreign country. Three of Paul’s nieces work as nurses in the US. He describes their lifestyles as more than comfortable.

In Marie’s batch of medical professionals recruited to work abroad, there are obstetricians, pediatricians, internists, cardiologists and surgeons with an average of 10-15 years of actual practice.

Paul says doctors opt to retool themselves as nurses to gain entry abroad because it is difficult and expensive, sometimes requiring retraining, to pass US licensure exams for medical practice.

The Ibon Foundation calls this phenomenon as double-edged deskilling: the internal brain drain affecting the number and quality of human resources in the country even as Filipino white- and blue-collar workers face deskilling by being underemployed abroad.

Missing links

Paul says the medical exodus, if unabated or unaddressed by health officials, will affect the two important links crucial for health service delivery: nurses and residents.

The loss of experienced nurses is critical because they are trained by doctors to interact with patients, carry out the doctor’s orders for managing patients, troubleshoot, and respond first to emergencies. Trained nurses anticipate what to do, saving more lives.

Residents, on the other hand, train under specialists. They attend to the patient, calling on the specialist only when his or her expertise is already required. For instance, Marie’s private practice thrives because she can attend to the patient most in need of her expertise while residents attend to less urgent cases in other hospitals.

Seeing the overseas demand for nurses, the student population has reacted quickly to the market, as indicated by the increasing enrolment in nursing and the declining enrolment for medicine.

With medical tuition fees requiring P52,000 a semester, nursing at P17,000 for a semester’s tuition is even more attractive. It requires 14-16 years to become a specialist in the country, and even then the earnings are easily outstripped if one works abroad as a nurse.

Paul and Marie’s three sons-two doctors and a nurse-are processing their immigration papers so they can eventually apply for coveted residency slots in US hospitals, which prioritize citizens and immigrants over foreigners.

IOM’s Sollorano has said the Philippines has to substitute the loss of specialists like Paul and Marie. But with professionals of their caliber feeling they are unfairly taxed by the government, deprived of specialization and research opportunities, and overwhelmed by economic and political realities in the country, what will soon be the state of the country’s hospitals?

Source: http://www.sunstar.com.ph/static/ceb/2006/01/30/oped/editorial.html

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