Puerto Rico doctors are quickly moving to areas like New York and Florida where bi-lingual doctors are needed and the reason, more money.  Patients are also moving to the US to get better care.  It’s a long line wait to see a doctor imagein Puerto Rico and they too depend on Medicare but they get paid less than they would in the states or in the US Virgin Islands who’s rate is 14% less.  Medicare is the best paying plan in town.  Retiring doctors, just like we have in the US is yet another reason for shortages.  Not that many doctors study endocrinology, geriatrics and urology any more as well so specialty MDs are even harder to find.

Well if so many doctors in Florida for example are getting paid less than Medicare by some commercial insurers, that really puts an emphasis on what the doctors make in Puerto Rico too.  A good job offer is probably not too hard to come by.  In the meantime 2 new hospitals are being built for medical tourism where a lot of US clients come for cosmetic surgery, crazy.  BD

SAN JUAN, Puerto Rico (AP) — Going to the doctor in Puerto Rico has for years often meant getting in line. Now, it might mean getting on a plane.

A medical exodus is taking place in the Caribbean territory as doctors and nurses flee for the U.S. mainland, seeking higher salaries and better reimbursement from insurers. Many of their patients, frustrated by long waits and a scarcity of specialists, are finding they have no choice but to follow them off the island.

The exodus of doctors is part of a larger wave of professionals who have left the U.S. island territory in recent years, settling in states such as Florida and New York, where there is a big demand for bilingual workers, especially police and nurses. Many Puerto Ricans also seek to escape a wave of violent crime and higher cost of living. Almost a million more Puerto Ricans now live on the mainland than on the island.

At the same time, the island's medical tourism industry is growing, with two new hospitals being built in Manati and Bayamon, catering mostly to foreigners from elsewhere in the Caribbean, and even some from the U.S. mainland, said Pedro Pierluisi, the island's representative in Congress who has limited voting powers. "In a way, it's inconsistent," he said.

The government pays for the residencies of at least 95 percent of all Puerto Rican medical students, investing $35,000-$45,000 a year for each, Aponte said. Puerto Rico has four medical schools, and roughly 400 medical students graduate a year.  If the bill is approved, students would have to reimburse the government the cost of their residency if they leave before practicing medicine for the required time



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