Even in today’s politically correct climate, some patients and healthcare professionals hold on to the belief that a foreign doctor’s education is far inferior to that of American physicians. Though possibly true in certain instances, a study published in the August 2010 issue of Health Affairs, calls this belief into question. In the study, the performance of primary-care clinicians, internal medicine physicians and cardiologists related to the care of congestive heart failure (CHF) and/or heart attack patients were tracked and the clinical outcomes of the patients noted. Despite popular opinion, the results of the study showed that patients of foreign physicians trained outside the United States had a lower patient death rate compared to American doctors. Like any study, the results are subject to criticism, but here are some points to consider when analyzing the results: Crème de la crème According to John Norcini, chief executive officer of the Foundation for Advancement of International Medical Education and Research and co-author of the study, the lower death rate of patients attributed to foreign physicians may be a result of the lack and quality of American-born doctors choosing to practice primary care medicine. Norcini explains, “Internal medicine and primary care have failed to attract the best U.S. students because of lower pay, relative to other specialties”. Norcini continues, “Primary care may not be getting the best and the brightest from U.S. medical schools”. Because the requirements of a foreign physician being able to practice medicine in the United States requires extensive testing of competencies as well as a devotion to practice medicine abroad, the population of foreign physicians practicing in the United States are comprised of individuals who graduated at the top of their class. Study includes American physicians that were trained offshore The higher death rate of patients under the care of American physicians may be due to the fact that the sample includes those who obtained their medical degree overseas. It is possible that these physicians who sought a medical degree outside the United States were unable to get into American medical schools due to their mediocre grades and poor test scores. Foreign medical schools are known to have lenient admission requirements and some accept students without college degrees or MCAT scores. Patients are treated by a team -- not just one doctor Because caring for patients is team-based, especially for more complex cases like patients with CHF and/or heart attack, it is difficult to conclusively determine which physician – foreign or American – is solely responsible for a patient’s prognosis. Therefore, the results of the study call into question whether the right doctor was credited with the lower death rate. Taking the above variables into consideration, it’s important to not judge your colleagues competence level according to their nationality. While the study concludes that foreign physicians have better patient outcomes – regardless of origin – it really comes down to the quality of a physician’s training. Source
