Originally published February 1 2013
State medical boards are creating doctor shortages, harming your health
by David Gutierrez, staff writer
(NaturalNews) The removal of antiquated regulations designed to increase doctor profits could end doctor shortages in half of U.S. states, according to a study conducted by researchers from the University of Virginia.
Many state medical boards have a policy that in order to get a state license, foreign-educated physicians - - who account for more than a quarter of practicing doctors - must serve a longer residency than physicians educated domestically. A state license allows a doctor to practice unsupervised and therefore earn a much higher income.
Studies have shown that expected earning potential is one of the major factors influencing where doctors decide to migrate. Therefore, the researchers speculated, an extra year or two of residency before achieving higher earning potential might pose a major obstacle discouraging foreign-educated doctors from moving to the United States.
Not for patient protectionAlthough the regulations are officially meant to ensure that all practicing doctors are held to the same standards, the researchers challenge this rationale. They note that no foreign-educated doctor may even apply for a U.S. residency without passing three sections of the same U.S. Medical Licensing Exam taken by U.S.-educated doctors. Then they must secure a residency position, which itself is another level of screening. In 2008, only 42.6 percent of foreign-educated medical graduates passed the U.S. exam on the first attempt, and only 73 percent who passed were able to secure a U.S. residency. The researchers further note that studies show essentially no difference in patient outcomes or state disciplinary actions between U.S. and foreign medical graduates.
The real reason for the longer residency requirements, the researchers allege, is discriminatory. Until the 1970s, when the Supreme Court declared the practice illegal, U.S. state medical boards regularly barred non-citizens from receiving licensure. The first longer residency requirements were implemented following this court decision. Indeed, the researchers found that states with medical boards financed by member doctors (widely considered less publicly accountable than state-financed boards) are significantly more likely to impose longer residency requirements on foreign-educated doctors.
Significantly, states with longer residency requirements for foreign graduates have lower quality medical service, as well as higher doctor salaries (and therefore higher patient costs).
A simple solutionUsing computer modeling, the researchers estimated that equalizing residency requirements for U.S. and foreign graduates would end shortages of general practitioners in 25 states. Not only would this dramatically improve patient care, it would also save the average state $139 million per year in fewer hospital visits alone.
Other medical and cost savings would be expected to come from lower rates and severity of chronic diseases, increased numbers of specialist physicians, and decreasing the income disparity between doctors and the general population.
"Each of these omissions suggest that we vastly underestimate the economic impact of eliminating international medical graduates' residency requirements in this counterfactual policy simulation," the researchers wrote.
"While equalizing residency requirements would not completely satisfy physician needs in half the states, it is a straightforward, practical policy change that can result in measurable improvements in social welfare," researcher Sonal Pandya said.
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