Journalist David Begnaud interviewed a group of medical students in Puerto Rico, asking about the reasons many of them might leave the Island. NimB reported earlier this year that there are 9,492 doctors remaining in Puerto Rico out of 18,754 who were on the island in 2009. Specialists are becoming so rare that patients must wait for months to see the doctors they need. Caring for patients in early stages of a disease can often be much more successful than care that begins later.
The students were clear: underfunding of the healthcare system is the problem.
“The chronic underfunding has two causes,” one student said, citing federal and local sources. “This is just blatant discrimination…If we were a state, we would be receiving around 80% of our Medicaid expenses [from] the federal government.”
In fact, Puerto Rico receives no more than 55% under federal law. The percentage has been raised temporarily – most recently in response to the COVID-19 pandemic, but that increase is scheduled to expire in December 2022.
No choice?
“We want to stay here and practice,” the student continued, but it is not just a personal choice. “Around 400 medical students graduate but only 200 residency positions are available, so 200 medical students need to leave to the United States to finish their training.”
For those who are able to finish their training in Puerto Rico, the difference between the income available in the Island and what doctors are paid in the states is significant.
Zippia estimates that the average physician salary in Puerto Rico is about $32,000 less per year than the average for the nation as a whole. However, the physician positions advertised at Zippia are actually up to $100,000 lower than the stated average income for doctors in the United States overall.
The students pointed out that payments to doctors are not made on time and that the problems with the infrastructure cause patients to be denied care or for the available care to be inadequate. The situation can be heart-breaking for doctors, regardless of the amount they are paid.
“They operate under the assumption that the main problem here is that physicians are leaving, while we know that this is just a symptom of the underlying disease,” the student said. “We don’t need more temporary reprieves. We need permanent solutions.”
