A ‘cure’ for medical brain drain

Several months ago, I wrote a post suggesting that outsourcing (from developed countries to developing ones) should be viewed  as a potential cure for brain drain (which flows in the opposite direction).

One problem with that argument, which I acknowledged then, is that even if skilled workers stay in their home countries, they are still contributing their skills to the economies of developed countries.

But I now unveil to you, an idea which works around this problem, at least in medical outsourcing. When I say, “medical outsourcing” by the way, I’m excluding medical tourism (I don’t think that really qualifies as “outsourcing”). For a discussion of medical services that can be outsourced, see here.

The Idea

Let us establish a medical outsourcing facility in an African country that has a diaspora that includes many doctors practicing in other countries (Uganda, Ethiopia and Liberia, among many others). The doctors employed here will provide medical services outsourced by hospitals in rich countries.

BUT! We will restrict their hours to one of the following schedules:

Doctors may only work 20 hours per week -OR-

Doctors may work 40 hours per week, every other week

The agreement will be that those doctors who only work 20 hours per week will practice medicine in or around the city where the outsourcing facility is located.

Those who only work every other week, will practice medicine in rural (or otherwise more distant) areas during the alternating weeks.

This model overcomes two obstacles:

1. Doctors’ standard of living: Developed countries are sometimes accused of “looting” developing countries of their skilled professionals. In truth, it’s the individual workers who make the choice to use their skills in another country. Understandably, someone who has invested so heavily in their own education and skills wants to be compensated with a good salary and comfortable standard of living. Hospitals in the developing world are often unable to provide this, and consequently, doctors emigrate.

Although our facility would have to be able to provide a particular medical service at a lower cost to entice hospitals in the West to outsource that function, the difference in cost of living indices should allow our doctors to make a salary that is equal at purchasing power parity (but not at exchange rates) to what they would make if working in the US, Europe, Japan, etc.

2. Contribution to home country: A traditional outsourcing facility has obvious economic benefits for the workers employed there, but beyond that, it’s harder to gauge its benefit. In our setup, the doctors are practicing medicine in their home country, not just providing a second opinion on cases from somewhere else.

True, they would still only be seeing patients in their country half the time, but that is much better than practicing medicine there none of the time, which is the situation in the status quo, when a doctor chooses to practice medicine in a distant land.

Overall, this model has the potential to cure brain drain in a sector where it is particularly severe, and its consequences most harmful.



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