| Immigration: Matters Arising Part 4 |
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| Sunday, 13 March 2005 | |||||||||||||
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In this article I will discuss more factors influencing medical immigration to the United States. Various numbers usually incredulous have been bandied about regarding the number of U.S based Nigerian physicians. However the most authoritative figure is from the Association of Nigerian Physicians in the America's which is a Pan-Nigerian physician association. The figure given is 3, 500.This can be corroborated by using state Medical boards information about practicing physicians, Nigerian Medical school Alumni organizations, residency programs and Masters in Health related programs. This figure however is small when compared to that of Indians, Pakistanis and Filipinos. A lot of money goes into Medical and Health related expenditure in the United States. A recent New York Times article stated that in 2004 Health care spending amounted to 1.8 Trillion Dollars by 2014 it is projected to rise to 3.6 Trillion dollars. The expenditure is perspective was 15.4% of Gross domestic Product in 2004 and projected to be 18.7 % of GDP in 2014. Medicare would spend 69.9 Billion dollars on Prescription medications next year.Talk less of the expenditure on Hospital admissions etc. Medicaid nation wide costs 300 Billion dollars a year. Medicare is medical insurance for people above 65 years who have fulfilled certain requirements during their working career. It also covers people with various disabilities and others people as determined by an act of Congress. Medicaid on the other hand is run by the states unlike Medicare which is a Federal program and covers the poor and Nursing Home resident. This gives us a perspective of the dollars involved in the Health care industry The United States has 120 Medical Schools but the number of graduates are not enough for the population of 350 Million. A look at the residency matching program results over the last several years will show that some specialties such as Internal Medicine, Family practice and Pediatrics fill about 50% of their positions with Foreign Medical graduates.Also various organizations like the Institute of Medicine have predicted that there would be a shortfall of Medical personnel such as Physicians, Nurses, Physical Therapists, Nurse Practitioners and Physician Assistants. Recent statistics in the US News and World Report further illustrate the shortage with regards to Nurses and is quoted here ''The US Department of Health and Human Services estimated that by 2020 hospitals will be shy almost 810, 000 nurses that represents a 29% vacancy rate versus 7% today" The article goes on to say that in the 1980's and 90's enrollment in Nursing Schools reduced as young women took advantages of opportunities in other fields. By the year 2000 the average age of Registered Nurses was 43 and this group will start retiring in the next 10 to 20 years. It is quite obvious that since the Medical Schools and Nursing schools are not significantly increasing their enrollment it is obvious where the people to fill the shortfall would come from. The United states is of course addressing this by various immigration reforms for Medical and high skilled workers. Another trend is the rising quantity of medical knowledge, procedures and technology giving rise to increase in number of specialties and subspecialties. New ones which have arisen or expanded in the past several years include Hospitalists, Interventional Cardiologists, Electrophysiologic Cardiology, Minimally invasive Surgery and Interventional Radiology to mention but a few. Also there are a lot of opportunities in Pharmaceutical companies and insurance companies that did not exist before. Also recently the fortune 500 companies through the leapfrog organization has started taking a lot of interest in spiraling medical costs and health quality issues because they are third party payers for their employees and families medical expenses. Hence there is a lot of talk about electronic medical records and various quality programs related to various diagnostic groups. Tommy Thompson the most recent Health and Human Services Secretary likened hospital electronic medical records to be not as good as as what obtains in grocery stores. This Electronic Medical records revolution that is ongoing would of course involve a lot of personnel- Physicians, Nurses, Hospital administrators and Information technologists and other Computer specialist. As a conclusion to these series of articles on immigration I would like to thank everybody who has read the article and sent feedbacks or criticisms. These are appreciated and I would of course continue to write these issues which are of paramount interest to me. Dr Olumide Ogunremi is an attending physician in internal medicine in St Louis, MO and the host of The Village Doctor Forum
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Posted by Robot| 13.11.2005 09:55