PHM-Exch> WHO Exec Board: flow of health professionals from poor torich countries (3)

[Claudio Schuftan]

1. From Matt Anderson <maanders at montefiore.org>

I hate to say the emperor has no clothes, but really!  If they US (and the
other "developed" countries) trained enough doctors for their populations -
correction, enough primary care doctors - then this problem would cease to
exist.  The rest is commentary.

2. From: Scott A. Wolfe swolfe at oneworldpartners.ca

 It would be great to see WHO take a firmer stand on HHR flow issues such as
this, and active poaching is a terrible thing. However, if the WHO and
others wish to arrest such phenomena then I believe that there needs to be a
broader, multi-pronged approach. The issue of HHR drain brain is not simply
about physician and nurse supply, but rather, how we organize and utilize
health professionals.within our health systems.

Perhaps the best place to witness this is at the level of primary (health)
care. Unless we become more effective at collaborative practice and task
shifting among cadres of providers within our health systems, especially
within richer countries that tend to actively recruit foreign trained
professionals, then we will forever be perpetuating a need for more and more
physicians and nurses from poorer countries. I believe this challenge is
particularly acute with respect to general practice / family physicians
which are a major cost-driver at the level of primary care due to salary/fee
levels and a tendency to (over)prescribe absent a formal connection between
physician and other levels of clinical management, illness prevention and
health promotion.

So, I sincerely hope that WHO will link its HHR flow efforts to other key
initiatives, especially primary health care reform, with particular
emphasis on expansion of collaborative, inter-professional care.

In my estimation, a firm stand on the brain drain is ultimately much sound
and fury unless we dedicate greater attention to actual health system reform
and a move away from strictly medical or selective care models.

I would be interested to hear others' thoughts.
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