Many, Many More Doctors – 03/03/2023 – Rodrigo Zeidan

Brazil needs more doctors (and dentists and nurses) for yesterday. We tried to overcome this deficiency with the Mais Médicos program, a step forward, but insufficient to overcome the problems of supply of medical professionals in the Brazilian countryside. Doctors for Brazil, from the previous government, was a failure and left hundreds of cities uncovered.

We have huge inequality in the distribution of health professionals across the country. Trainees seek well-paid specialties in urban centers. There is no shortage of doctors in Rio de Janeiro, Porto Alegre or Manaus. But, to attract professionals, city halls and interior governments have to pay very well, which creates a critical situation: the poorest cities pay much more for health professionals.

In 2009, the brother of an ex-girlfriend earned more than R$ 20,000 a month as an outsourced dentist in a city in the interior of Amapá. Today, in the city of Amapá (MA), of the 550 employees of the city hall, the 5 highest salaries are the 5 doctors with a formal contract in the city (between R$ 10 thousand and R$ 13 thousand per month). Sixth, comes the mayor. There must be many other health professionals outsourced, earning even more than that (the city’s annual per capita GDP is R$ 7,900).

Each one of the city’s 7,000 citizens deserves to be treated well by the State, but we are far from doing it efficiently. And no, the solution is not to forcibly reduce the remuneration of professionals — if with these values ​​we don’t have enough professionals in the countryside, forcibly lowering them would only make the problem worse.

This is not just a Brazilian problem. Of the 18,000 doctors in Denmark, 2,000 are foreigners. And, while the country has no formal agreements with a country like Cuba, the idea is similar. Doctor trained in India? Please come to Denmark for a certain number of years and then come home.

Incidentally, patient organizations are pressuring the government to let even more foreign doctors and nurses work in the country, as the health system is overwhelmed. As in Brazil, physicians’ associations try to bar potential competitors from entering.

The Mais Médicos program was far from being well designed. The most important thing would be to encourage foreign doctors to want to live in Brazil permanently. Taking the trouble to train and help thousands of professionals to create ties with the country and then not hand over citizenship? We are not Denmark, where there is even xenophobia in public policy. We have professionals in all corners of the world, many times better trained than in Brazil, who would be willing to live for a long time saving money in the Brazilian countryside.

Bringing in health professionals with contracts of 5 to 7 years, with citizenship at the end, would be an excellent way to increase the supply of health professionals in Brazil. If there’s one thing we do well, it’s integrating foreigners into our social fabric. We don’t need to do this with the Cuban government, although there are excellent professionals in the country. The idea is really to steal “brains” from abroad. No expelling anyone who likes the country.

Syrian doctors? Venezuelans? Ukrainians? Come everybody. Dentists? Nurses? Come too. We don’t need More Doctors, we need Many More Health Professionals. And a better SUS. For yesterday.

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