Currently both North America and more affluent areas of Europe are facing an increasing shortage of physicians in primary healthcare and in various hospital specialities, a shortage which in many of these countries is being alleviated by the excessively aggressive recruitment of foreign doctors. For example in the UK national health service, poor planning and under-investment in medical education has lead to a third of physicians now being recruited from overseas. Frequently these doctors are citizens of poorer EU nations or commonwealth countries in Africa and the Indian sub-continent that can ill afford to lose such expensively educated personnel. Yet sadly these poorer nations are now effectively subsidising the healthcare of the wealthy West. The UK is of course not alone in its reliance on foreign physicians- the same strategy has been employed in the US and Canada, as well as affluent EU countries such as Germany and Sweden. While the rights of individual workers to migrate should be protected, clearly health services in developed countries should be moving towards more ethical ways of solving their physician shortage.
The long-term solution is to increase the supply of domestically educated medical doctors, but policy makers could also consider ways of reducing the current demand on physicians by developing systems and work flows that allow other healthcare professionals and hospital workers to perform those tasks where the input of a doctor is not essential. Currently there are artificial barriers developed decades ago preventing highly educated healthcare workers from providing services that they are competent to offer. For instance specialist nurses and medical assistants could triage patients, order lab tests and either treat patients directly or refer them to doctors as necessary, and the bulk of a physician