Will we have more or fewer doctors?
The government was correct in its diagnosis, but prescribed a remedy that must be taken by force, which may have side effects.
There is no doubt that the government's diagnosis is correct. Brazil urgently needs "More Doctors," as the program launched by the Ministry of Health calls it. With 1,8 professionals for every thousand inhabitants, the country is well below the world average. Just to cite a controversial example, Cuba, which could export professionals here if it weren't for ideological prejudice, has an average of 6,4 and a ranking in the UN's Human Development Index related to health that is much higher than Brazil's. Furthermore, Brazil needs "More Doctors" especially in remote regions. While the average number of professionals in the Southeast and the Federal District is greater than 2, it is below 1 in the North, Northeast, and Central-West regions.
A recent study by the Institute for Applied Economic Research (Ipea) also pointed to medicine as the most promising career in Brazil. It is the one capable of generating the highest earnings, with an average income of R$ 8,4 per month, and the greatest ease in finding employment – which, today, happens with 97% of medical graduates.
This is a typical situation in a booming job market, where young graduates can choose where to work. Often, faced with the choice between the Amazon rainforest or the outskirts of large metropolises and private hospitals located in the upscale neighborhoods of urban centers, they choose the latter, even though their education was subsidized by the state at public universities.
This situation creates obvious distortions. In Rondônia and Mato Grosso, doctors in local communities can earn up to R$ 30 per month. And even in the prosperous state of Rio Grande do Sul, mayors of smaller cities have difficulty attracting and retaining professionals. For this very reason, municipal managers across the country have shown themselves to be in favor of importing doctors.
The government's response was to open the Brazilian market to foreign professionals – which is correct – and to make young students' work in the Unified Health System compulsory during the last two years of their medical course, with monthly stipends of R$ 10, which raises doubts about the legality of the so-called "mandatory civil service," as pointed out by medical entities.
In launching the program, the government targeted underserved populations, as is its role, but failed to consider the perspective of those who are currently considering a career in medicine. For many, this forced solution could act as an incentive, resulting in fewer doctors – not more. Hopefully, it's merely a smokescreen to quell resistance from professional associations regarding the necessary importation of professionals.