Call a Doctor! Florida has Fidel-o-phobia

Even in retirement, Fidel Castro exerts outsized influence over our  
country’s political life. Even now, he may affect the access  
Floridians have to health care.

How can this be? To teach Castro a lesson, a state legislator is  
fighting to ban American doctors, educated in Cuba, from practicing  
medicine in Florida.

This story, about a small and largely symbolic issue, speaks volumes  
about how Fidel-o-phobia can cause even our most well-meaning public  
officials to do the strangest and most self-defeating things.

Nearly a decade ago, President Castro founded the Latin American  
School of Medicine, also called “ELAM,” where foreign students are  
given a medical education for free. They come largely from developing  
countries’ poor and indigenous communities where medical care is  
desperately needed, and they are encouraged to return to those  
communities to practice. ELAM is a classic example of Cuba’s  
application of soft-power in its international diplomacy.

Over a hundred American students—mainly from minority communities--  
are now enrolled there. Who are these students? They are whip smart,  
highly motivated kids, desperate to become physicians, yet unable to  
afford a medical education in the United States, or unwilling to  
shoulder the $200,000 debt that now hits the average US medical  
student the day after graduation.

So, they go to Cuba, learn Spanish (coming home bilingual), take  
bridging courses in sciences if necessary and spend six years being  
trained as physicians in Cuba alongside students from 28 other  
countries. After which, the hope is, they will return to the United  
States and practice medicine in some of the thousands of our country’s  
under-served communities.

Is a Cuban medical education any good? According to experts we’ve  
consulted, the answer is yes. Dr. Fitzhugh Mullan, a former U.S.  
Assistant Surgeon General, says Cuban medical education is well- 
respected and that Cuba’s achievement in scaling up physician training  
is an important example for other countries. The first US graduate has  
already passed his medical boards and is in his first year of  
residency in New York City. With the latest class, a total of 17 will  
have graduated by this summer.

Enter Rep. Eddy Gonzalez.

His bill, HB 685, which has been “workshopped" by the Committee on  
Health Quality, would strictly prohibit any of these American medical  
students currently enrolled at ELAM from practicing medicine in Florida.

According to the Federation of State Medical Boards, this would make  
Florida the first state in the nation to ban all physicians who  
graduated from any school in a particular country.

Even though Rep. Gonzalez has called facets of Cuba’s health care  
system "state of the art," he says that students educated in Cuba,  
whose government he despises, “do not possess the basic judgment and  
character required for the ethical practice of medicine in Florida."

Rep. Gonzalez vastly underestimates the idealism and the devotion to  
medicine possessed by these doctors, and nothing in his legislation  
will change the Cuban system. What it will do is stop Florida from  
getting young, talented physicians to practice where they are surely  

Dr. Karl Altenburger, president of the Florida Medical Association,  
calls the state’s doctor shortage severe. He’s said that young doctors  
don’t want to come to Florida to practice; the state lacks  
internships, residency programs, and fellowships. The average age of  
doctors in Florida is 51 and a quarter of the state’s physicians are  
over 60.

Florida, the fourth most populous state, is ranked 20th in its number  
of active physicians by the Association of American Medical Colleges.  
Tad Fisher, executive Vice President of the Florida Academy of Family  
Physicians, said that Florida needs an additional 12,000 primary care  
physicians by 2020 to meet its health care needs.

nd there are plenty of underserved people in Gonzalez’s home district:  
the Health Council of South Florida’s Miami-Dade County’s 2007  
Community Health Report Card gave “access to health care” a pretty  
scary “F”.

Florida acknowledges these problems and advertises on the internet to  
recruit physicians to treat patients in the state who don’t have  
adequate access to doctors. It even offers waivers to attract foreign- 
born, foreign educated physicians to serve. But American students  
educated in Cuba? They need not apply.

When Floridians come down with Fidel-o-phobia, they torment each other  
(and the rest of us) just to show Castro up. More often than not, we  
end up with silly ideas like this which hurt us, not him. Now that  
Fidel’s retired, we should stop dancing at the end of his string, look  
squarely at our own interests, and decide for ourselves the right way  
to pursue our nation’s ideals.

-- Sarah Stephens and Gail Reed

Gail Reed M.S., is a journalist who serves as International Director  
of Medical Education Cooperation with Cuba (MEDICC). Sarah Stephens is  
Director of the Center for Democracy in the Americas.