1154 



The Stevens-Vermeulen study made no mention of asserted AMA 

 restrictive policies but did stress maldistribution of medical manpower 

 as a causal factor in the doctor shortage. It gave this explanation : 



The nature of the "pull" factors deserves special scrutiny, however. Has the 

 United States been training too few physicians to meet current needs? Current 

 efforts toward a rapid increase in the number of medical students would suggest 

 that it has. Yet in comparative terms the United States is already one of the 

 world's richest countries in terms of its production and supply of physicians. It 

 is perhaps more accurate to say that the American health system encourages a 

 relatively prodigal use of physicians, compared with the more tightly organized 

 health systems elsewhere, and that this, in turn, reflects the absence of goals and 

 policies for physician manpower distribution in America. If so, domestic and 

 foreign policies cannot be considered separately.*^ 



PULL OF HIGH SALARIES AND CAREER OPPORTUNITIES 



The shortage of scientific, engineering, and medical manpower com- 

 bined with the Nation's powerful economic base make the United 

 States the strongest competitor in the world's labor market. Heavily 

 influenced by rates of economic growth in the world economy, respon- 

 sive to the pull of undersupply, and highly mobile internationally, 

 professional human capital is attracted to such areas where produc- 

 tivity is highest and manpower demands strongest. And as Professor 

 Thomas observed, the "magnetic pull" of high salaries and career 

 opportunities is "felt right down to the poorest of countries." ^°^ 



Students of brain drain cite salary as a principal economic "pull" 

 factor. This conclusion would seem to be supported by the salary 

 differential between professionals in the United States and those 

 in the LDCs, and even in other advanced countries. In March 1966, 

 the National Science Foundation reported that in the United States 

 the median annual salary for chemists and mathematicians was 

 $11,000; for physicists, economists, and statisticians, $12,000; for 

 professional medical personnel, $15,000. The difference between this 

 salary scale and those offered in some LDCs is substantial. In many 

 Asian and African countries the annual median for such professions 

 hardly exceeds $3,000. Even allowing for substantial differences in 

 purchasing power, the U.S. salary scale would still provide a much 

 higher standard of living.^o^ In India, in the mid-1960's medical and 

 engineering graduates received Rs. 677 ($90.00) and Rs. 540 ($72.00), 

 respectively a month; those trained in geology, mathematics, statis- 

 tics, and zoology were paid Rs. 420 or $56.00 a month, while falling 

 between the last two categories were chemists and other scientists.'"^ 

 Symbolic of the widespread discontent in India among professionals 

 is the doctors' strike in February 1974 for higher salaries.^"* 



A report on migration from Chile shows somewhat comparable sal- 

 ary differentials. Three-fourths of the highly skilled emigrants earned 

 between $150 and $300 a month before leaving, and in the United 



*>* Stevens-Vermeulen, op. clt., p. xil. 

 =«5 Thomas, op. clt., p. 40. 

 *^Eren, op. clt., p. 11. 



-.r.^I^^P"'"* °^ ^■^- Secretary General, Outflow of Trained Personnel from LDCs, Nov. 5, 

 1968, op. 35.60—61. 



*» The New York Times, Feb. 17, 1974, p. 8. 



