Here is a study on quality of care by physicians from US versus other medical schools:
http://www.bmj.com/content/356/bmj.j273
https://hbr.org/2017/02/immigrant-doctors-provide-better-care-according-to-a-study-of-1-2-million-hospitalizations
Hospitalists, but how about primary care docs?
Hmm, now I’m curious. I know over half of my doctors are immigrants but I haven’t the slightest clue where they were educated. I’ve said before on here that I’ve generally had better results and interactions with my migrant doctors than native-born. (Then again the worst PCP I ever had was an Eastern European immigrant- I think Russia.)
I read an interview with the head of the Cleveland Clinic the other day in which he said that immigrant doctors are far more likely to serve under-served and impoverished communities in the US–could that perhaps be a factor in the above study?
Some larger practices do have information pages on their physicians which do list where the physicians got their medical degrees.
However, individual variation between physicians is large enough that where they got their medical degrees is a minor factor in comparison when it comes to selecting a specific physician.
This is so interesting. I live in a foreign country with socialized medical care. Last week I went to an orthopedic clinic because I had been self treating a wrist problem, DeQuairvain syndrome, for two months with no improvement. I knew I needed a cortisone shot. I went to the clinic, walk in appointments only, shortly after they opened for their afternoon hours. I had my problem translated on a word document that I printed. The doctor read it, agreed with my assessment, gave me a shot, I paid the equivalent of forty dollars, and was out of there in a total of 20 minutes. Five days later I am nearly symptom free. So simple and done, the foreign doctor believed me. I am a believer in this approach to medicine, almost unheard of in America. I kind of dread it when we move back to the US in a few years. I like the foreign doctors and foreign system.
IMGs have to pass the USMLE exams and do a residency in the United States. And (I think) they have to have graduated from an accredited foreign medical school. They also have to pass an English language exam. Still many have such heavy accents that they are difficult to understand, which could make doctor-patient communication difficult in some situations.
Above^^ - It’s good that your self-diagnosis was correct. I’d feel more comfortable if my doctor diagnosed my condition first before rendering treatment.
northernMom61
"foreign doctors " in a foreign land are not foreign.
a greek doctor in greece would not be foreign.
a greek doctor working in brazil would be a foreign doctor.
so if you are in a foreign land and you see a local doctor you are the foreigner not the local doctor.
p.s. you do not want a doctor who agrees with your self diagnosis/assessment(in any country) " the foreign doctor believed me." you want a doctor who uses their knowledge and training along with whatever necessary diagnostic tests maybe required to make a proper diagnosis and if needed send you to a specialist or sub specialist. while you maybe correct in what you found on google or web md or wherever , you want a doctor who listens to what you tell them about symptoms , past history etc…and cares about your well being. not who just goes ahead and does what you want. that is not the proper practice of medicine. I hope I do not sound preachy…however it is an important point no matter where on the planet you go to a doctor.
Then there’s the study that female doctors have better outcomes: https://www.theatlantic.com/health/archive/2016/12/female-doctors-superiority/511034/
The excerpt from the article you posted uses the terms “slightly more” “slightly higher” “did not differ” - so IMO, the study is a bit of a wash - “slightly” is not probably going to overall effect the care I’d get to a noticeable degree.
I fully agree with @zobroward post above.
From spending a long time living/working overseas and in the US, I think the quality of care that I received was the same. The differences are that it is very expensive here in the US and where I lived it was possible to get many medicines without a doctor.
The hatch on my Prius’ trunk hit me on the head a few weeks ago and I had to go to Urgent Care to get 5 staples by a PA. They cleaned it and gave me a shot to numb and slow the bleeding and then put in the staples. It took 20 mins and my bill is $460. I would think in most countries it would be less than $100.
Necessary to have a doctor’s order here for cholesterol meds. Then in order to get a refill you need to get a blood test. In order to get a blood test you need a doctor’s order. Where I lived I just went to the local pharmacy to get the same medicine (and paid a lot less for the med) and periodically went to a clinic to have cholesterol and liver checked, The costs were minimal vs here in the US where it is very expensive after one jumps through all of the hoops.
yearstogo what state do you live in?
“I had my problem translated on a word document that I printed. The doctor read it, agreed with my assessment, gave me a shot, I paid the equivalent of forty dollars, and was out of there in a total of 20 minutes. Five days later I am nearly symptom free. So simple and done, the foreign doctor believed me. I am a believer in this approach to medicine, almost unheard of in America. I kind of dread it when we move back to the US…”
My PCP is not an immigrant. I went in for my tennis elbows and asked for cortisone shots in both elbows and got them. I also told him last year that I had taken one of my mom’s Soma’s along with a Meloxicam and my lower back, which had been in spasm for days, relieved in hours. He prescribed both for me. It’s my rescue drug.
I pay $20 co-pay for doctor visits.
My Urogynocologist is a Chinese Canadian who went to medical school in the US. She is fantastic, also. I had gone to another urologist (old white guy) for a cystoscopy, who dismissed my issues and told me it was all in my head. Fortunatately, my gynecologist (youngish white American who went to med school in the US) suspected from the get-go what I had and was able to get me into the Uro-gyno (who had a 3 month waiting list to see her.) Diagnosed at first appointment based on what I told her were my symptoms (she also had my history from time of onset of symptoms.) I was put on a med that costs $10 for a 90 day supply, plus six weeks of PT, and I’ve been fine ever since. It’s a chronic condition so I am on this medicine indefinitely.
$20 co-pay.
On all my doctor’s practice website they list all their educational training, including undergrad, med school, fellowshiips, etc., and they have their diplomas on their office walls.
Your co-pay is your insurance offering.
Anyone can look up backgrounds online, sometimes the UG isn’t listed, but usually the med school and subsequent training and/or certification.
The link is worth reading. But note, it’s about Medicare. That already means a distinct pool.
“Necessary to have a doctor’s order here for cholesterol meds. Then in order to get a refill you need to get a blood test. In order to get a blood test you need a doctor’s order. Where I lived I just went to the local pharmacy to get the same medicine (and paid a lot less for the med) and periodically went to a clinic to have cholesterol and liver checked, The costs were minimal vs here in the US where it is very expensive after one jumps through all of the hoops.”
My script comes with a year of refills. When it runs out and if it’s before my annual appt, I call my PCP’s office and the call it in to the pharmacy.
I pay $15 for 90 day supply for Crestor.
Yes, I know I’m lucky I have great insurance that is also ridiculously inexpensive.
How much do you think malpractice lawsuits drive up the medical cost in the US? That may be one of the reasons american medical system is costly and rigid. I can’t imagine what would happen doctors here administer cure based on the patient’s diagnose and something goes wrong.
igloo
“I can’t imagine what would happen doctors here administer cure based on the patient’s diagnose and something goes wrong.”
any doctor who would do that deserves to be sued. and lose their license.
http://theincidentaleconomist.com/wordpress/what-makes-the-us-health-care-system-so-expensive-introduction/ describes the many sources of added cost in US medical care. The sources of extra cost are widely distributed, so it is hard to find any one big target of extra cost to cut (the big chunk of “outpatient care” added cost is not one single thing). Of course, each source of extra cost has a lobbying interest defending it. Malpractice lawsuits and related defensive medicine are one of those small slivers of extra cost.
This is not to say that there are no other problems with malpractice lawsuits; a NEJM study found that about a quarter of malpractice lawsuits studied had results that did not match whether there was a medical error in the case (in both directions).
Interesting. In other words, it costs because we can afford it?
In Canada, it would be $0.