We Have Changed

The shortage of doctors is not just an African phenomenon, it is a worldwide phenomenon. In the United States, for example, new physicians avoid primary care medicine like the plague. Older physicians burn out quickly, and retire at a relatively young age. Medical students clamor for dermatology residencies like the world truly needed a disproportinate number of skin doctors. And yet waiting rooms are teaming with the uninsured and forgotten. And these needs pale in comparison to the developing world. Why?
While doctors and other health care professionals cannot complain about salary in the developed world (but do, nonetheless), there is much more to job satisfaction than money. Long hours can preclude family time, personal growth, sanity. While caring for the sick is a privledge, it's not easy, and it has its toll.
So what about a new model for health care provision? Maybe the majority of health care doesn't need to be provided by doctors and nurses. Maybe those who begin at one level- say an entry level medical assistant- could earn time towards nursing or medical school, and that doctors could move from clinical years to teaching years or innovation/research time or foreign development or medical business or public health or whatever. Maybe a lifetime in just one medical clinic for a doctor is not a realistic expectation anymore. Neither is a clinic staffed by mostly doctors. Medical technicians, physicians assistants (all with the incentives of moving up the ladder of medical professionals) may make more staffing sense. In Zambia, much of the care is provided by nonphysicans. But they're under tremendous stress, without the possibility of promotion. That needs to change. Something needs to change.