DOCTORS ’ LOUNGE
DOCTORS ’ LOUNGE
( continued from page 27 ) also allowed “ if a need is demonstrated in the state or region .” The American Academy of Family Practice estimated in 2016 that even though its members account for only 15 percent of the outpatient workforce , they perform over 40 percent of the patient care visits in rural areas .
Foreign medical graduates make up a quarter of our medical workforce . Without them , large sections of rural America would go without doctoring of any kind . In 2012 , nearly 21 percent of KY physicians were born and went to medical school in other countries , up from 16 percent in 2002 . According to Forbes ’ contributing editor Nicole Fisher , writing this past July , 20 percent of nurses and aides , and 15 percent of dentists , pharmacists and clinical techs currently working in the U . S . are foreign-born . As my generation of doctors ages and retires , we will lose up to a third of our current MD workforce . Who is going to take care of my generation when we ’ re sick , and who is going to take care of our descendants ? Ms .
Fisher cites a projected shortage of more than 46,000 doctors by the year 2025 . The AAMC has predicted even higher numbers , up to 95,000 , by 2025 , based on the increasing xenophobia and the roadblocks to immigration that the current regime has established .
Seema Yasmin reported in the Feb 1 st Scientific American that foreign medical students and residents are “ nervous and afraid to leave the country ,” per their deans and program directors . According to Dr . Jessica Bienstock , associate dean at Johns Hopkins , the Match this year might produce giant gaps , because of all the uncertainties of the political landscape . Dr . Atul Grover of the AAMC is worried that the best applicants will look for British , Canadian and European opportunities instead of American ones . Current holders of H1-B visas , which expire and must be renewed after so long post-residency , used to hold out hope for getting at least green-card status . Dr . Omar Alsamman , a Syrian and internist in New Hampshire , wishes he had trained in Britain , he said . “ I ’ ve been in paralyzing fear since the executive order was signed . I only came here to accomplish the American dream . I found love here . I found a home here . Now everything is in jeopardy .”
Bigotry kills outright , as in the murder of innocents , and it kills slowly , as it will the rural old who run out of both medicine and the person who prescribed it . Bigotry kills hope . It can turn would-be Americans into would-be enemies . It shrivels the souls of the bigoted , who rejoice in their blindness and fear .
Bigotry is something every American should fight against . Americans stand for freedom of religion , meaning every single religion . We stand for equal opportunity , for innocent until proven guilty , and for free speech under the law . We will not stand for having five year olds handcuffed in airports .
Dr . Barry practices Internal Medicine with Norton Community Medical Associates-Barret . She is a clinical associate professor at the University of Louisville School of Medicine , Department of Medicine .
LETTER TO THE EDITOR
Ronald L . Levine , MD
GLMS Editorial Board :
I want to thank Dr . Mary Barry so very much for her excellent article “ Pressure Cooking .”
The article addresses a continuing sore point for me that seems to be present in many medical institutions today . The inappropriate methods of taking of blood pressure are almost ubiquitous . First and foremost to me is the use of the automatic blood pressure machines . During my years in the Ob-gyn Clinic at U of L , I found that these instruments often gave inaccurate readings .
I continue to see their use in many hospital and clinic settings and doctors ’ offices . Another poor method involves the placement of cuffs over clothing and auscultating over the clothing . I then frequently witness the possibly inaccurate methods of taking blood pressure readings by neglecting to check and be aware of the auscultatory gap .
The avoidance of the auscultatory gap has been shown to avoid monitoring errors , but this technique has disappeared from the medical environment . ( See recommendations by The American Heart Association ,
2005 ).
I think Dr . Barry ’ s article was right on point . I am retired now , but it was very upsetting to me to also not have the availability of a manual BP cuff and a working aneroid or mercury column sphygmomanometer . We need more such columns to remind us of the good practice of medicine !
Ronald L . Levine , MD is a retired Professor and Chief of Gynecologic Surgery , Department of Obstetrics & Gynecology & Women ’ s Health for the University of Louisville
28 LOUISVILLE MEDICINE