PJ Media

I have worked with several American docs who spent a good portion of their careers in impoverished areas in Africa. One guy spent most of the time there and would come back to work double shifts in ER to make enough money to support what he was doing.

Finest people on earth. As physicians they knew how to diagnose with simple tools. Old school medicine stuff like actual taking a history and physical exam. I worked with one radiologist in convincing a company to donate a portable ultrasound to his missionary hospital which he carried himself on the plane because such things tend to get ‘lost’ in standard shipping.

Hopefully some docs from there who have trained or emigrated elsewhere will go back to bring new technology home.

People writing articles like this in NEJM maybe they have experience or not, but they are not addressing ground level medical concerns. This is fluff targeted to posh Bostonian or west coast liberal leaning types who would like to think that they have done something by reading and supporting an article couched in pseudo intellectual terms.

Impact of these sorts of editorial articles is near zero. Achievable preventive or treatment for malaria, dehydration, or AIDS is where focus needs to be.

I understand that it is frustrating when your best leave to seek better opportunity elsewhere. So maybe there are economic and political issues to keep more of them. That is outside the scope of medicine.