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Investing in US-Trained Health Workers: Kate Tulenko Responds to 'America Is Stealing the World's Doctors'

On March 7, Matt McAllester highlighted how the US imports tens of thousands of doctors, pharmacists, and other health care workers in a New York Times Magazine story, “America Is Stealing the World’s Doctors.” I appreciated Mr. McAllester shining a spotlight on this important issue and Dr. Kunj Desai’s honesty in discussing the reasons he left Zambia.   

As I discussed in a recent interview on The Daily Circuit, the most important solution is for the US to train more of its own health workers, especially frontline primary health care workers such as physician assistants, registered nurses, nurse practitioners, and community health workers. Ten out of the twenty fastest-growing occupations in the US are in the health sector. With an aging population with increasing health needs, we have to invest in our own people to train more health workers. Only by investing in training here in the US can we eliminate our dependence on foreign-trained health workers.

During World War II the US doubled the output of medical and nursing schools. What we need now is a similar effort, this time focused on frontline health workers.  We can do this via community-based training programs that take advantage of existing hospitals, clinical facilities, and their staff.

Investing in training more Americans to be health workers will cost money. After all, one of the reasons we import foreign health workers is because it’s cheaper in the short run. But in the long run we end up with an economy like the one we have now, with nearly 9% unemployment and 25% of our health workers foreign-born and foreign-trained. With expenditure at 17% of GDP, health care is the largest sector of our economy. Imagine nearly one million six-figure and high five-figure physician and nurse jobs that Americans have not been able to access here in our own country. That’s the reality of this challenge.  

To fund the expansion of existing schools and the founding of new ones, we can tap into existing state and federal financing that currently goes into job training programs with very low success rates. In addition, we can open the federal funding programs that pay for the training of health workers for underserved communities to communities and private donors, so they can put their money into them without the need to create parallel administrative systems.

Health professional schools are also incredible economic engines for communities. Not only do they create hundreds of jobs, but they bring in the spending power of students, patients, and their families.  Many businesses prefer to locate in a region that has access to excellent affordable health care. An economic study conducted by the Northern Ontario School of Medicine in Canada revealed that every dollar spent by the medical school had two dollars of economic impact in the community. 

What can you do? If your local college or community college has a nursing program or other health workers program, encourage them to expand it. If the college doesn’t have health worker programs, encourage them to develop some.