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 needed.

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.