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January 2012

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Physician migration: the economic, ethical and political issues

Physician migration: the economic, ethical and political issues

Although sometimes seen through a state, regional or national lens, health care workforce (and physician migration patterns) are of global concern. In addition, the distribution and movement of health professionals have socioeconomic and ethical consequences.

This topic was the subject of the keynote address at the November meeting of the AMA International Medical Graduates (IMG) Section, featuring speakers Richard Culbertson, MD, and David Hotchkiss, MD, of Tulane University School of Medicine. Key points included:

  • About 25 percent of physicians in the United States and Europe are IMGs.
  • A number of nations (such as China, Cuba, India, the Philippines) promote and encourage physician emigration.
  • In 2010, the World Health Organization adopted voluntary principles and practices for "the ethical international recruitment of health personnel."
  • Different standards of education/training from one country to the next inhibit the exchange of health professionals.
  • "Brain drain" is "neither the main cause nor would its reduction be the main solution to the world wide health human resources crisis."
  • Lack of access to primary care is a global problem.
  • Looking forward, the US will likely continue to rely on IMGs for its physician workforce needs, especially in rural/urban underserved areas.