Exodus of Professionals: A Realistic Dialogue

Much ink has flowed during these months about the crisis that is looming over Puerto Rico with the exodus of doctors and other health personnel who, encouraged by the good salaries paid in the United States, and fed up with putting up with the excesses of the insurance companies, decide to put the sea in between.

It is said that at present there are only three neurosurgeons to attend to a huge sector of the population at risk of suffering or already convalescing, from cerebrovascular accidents. On the other hand, I do not know how many specialists the island has to attend to the number of broken or shot heads that accumulate on a weekly basis.

The first question is this: why do all these people leave? And, for starters, there is no simpler answer than this: they leave because they can, writes Mayra Montero (Shutterstock).

I suppose the same will be true for orthopedic services. It seems to me that it was the geologist José Molinelli who warned years ago that, should a strong earthquake occur, causing countless injuries due to broken bones, there would not be enough orthopedics to attend to the victims, operate on them in time and avoid terrible outcomes, such as gangrene.

Simultaneously to the medical crisis, last week the shortage of social workers was announced. Incidentally, the salaries paid in the United States were compared with those paid here, and the truth is that teachers, engineers, pharmacy graduates and technicians of all types, colors and specialties must be added to the exodus. A real drain that harms development and destabilizes society. Some say that before the pandemic, the exodus was not so dramatic. The reason may be that the United States, as a receiving country, is in need of a greater number of skilled employees, and therefore there is more demand.

In my opinion, this monumental brain drain would have to be part of a political dialogue.

The first question is: why are all these people leaving?

And to begin with, there is no simpler answer than this: they leave because they can.

Not everyone who wants to earn more, or have a better quality of life, can leave their country for another that offers a much more promising future. The current status of the Island, the accreditation enjoyed by its universities, allows a Puerto Rican, recently graduated, who specializes here or there, to choose between continuing there, if he/she is used to it and has job offers, or emigrate if he/she has graduated here and decides to make a life elsewhere.

In what other country in Latin America or the Caribbean can a specialist, a neurosurgeon, no matter how eminent and experienced he may be, pack his bags, take a flight to New York and start working the next day?

The exodus of professionals from the island is linked, in large part, to the peculiarity of the status. The government can tighten the screws on insurers, in the case of doctors, and sooner or later it will have to do so. But, at the end of the day, it will be difficult to stop emigration because it is also a cyclical phenomenon, one relative drags the other, and the ease of traveling and settling "out there" is a fact. The free transit so much talked about in the sovereign and free association formulas of the proposed plebiscite, has to do directly with this. The leaders of all political formations understand very well that they would not even get to the corner if certain "customs", embedded in the psyche of the population, are broken.

On the other hand, can any professional be blamed for emigrating to a place where the doors are open to him/her, as soon as he/she gets off the air bus, without having to worry about revalidations?

I heard the Secretary of Health say that a neurosurgeon in an American hospital earns more than a million dollars a year. Economists should answer how those salaries could be equalized so that the Island could be more competitive. Social workers cannot be paid what is paid in Houston or Chicago either. And computer engineers, I suppose, are not paid anywhere near what they would be paid in San Francisco.

In Spain, doctors often emigrate to France and Germany, and that creates problems. Now, they need to process documents to do so, both in Spain and in the country of destination. Thousands of doctors have left Venezuela, some of them will be good and others regular, but before being able to practice their profession, and while they burn their eyelashes to revalidate their degrees, they have to work in any job that appears.

The opposition parties denounce, but they should talk about solutions, beyond paying higher salaries. Firefighters earn more in the United States. Optometrists. Electricians. Veterinarians. What can be done here, a party of millions (that do not exist) to retain them all? I do not know if it would be feasible to prepare physicians, neurosurgeons, since we are talking about them, in medical schools that do not necessarily have the accreditation of U.S. institutions, but that, well trained, would help to solve this emergency. One person to whom I mentioned this idea told me that nobody would want to study for that. In other words, no one will want to receive a degree if it is not valid in the United States.

Well, if that is the case, we have made a good job of it. How can this attitude be remedied?

A realistic dialogue is needed, without patriotic slogans or empty promises. Let's see what comes out.

This article was originally published in Spanish in El Nuevo Día.

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