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Foreign-Trained Physicians Save More Lives

Having trouble pronouncing your doctor’s name? Your prognosis just improved by 0.4 percentage points.

A new study published in the British Medical Journal finds Medicare patients treated by internists who graduated from foreign medical schools were slightly less likely to die than those treated by U.S. med school grads:

The mortality analysis included 1,215,490 patients admitted to the hospital under the care of 44,227 general internists between 2011 and 2014. Patients treated by international graduates had lower mortality (adjusted mortality, 11.2% v 11.6%; adjusted odds ratio, 0.95; 95% confidence interval [CI], 0.93 – 0.96; P < .001).

“Based on the risk difference of 0.4 percentage points, for every 250 patients treated by US medical graduates, one patient’s life would be saved if the quality of care were equivalent between the international graduates and US graduates,” the authors write.

The cost analysis included 1,276,559 patients treated by 44,680 physicians during the same study period.

Overall, patients of internationally trained internists had slightly higher adjusted costs of care per admission ($1145 v $1098; adjusted difference, $47; 95% CI, $39 – $55; P < .001) [Rick Lewis, “US Patient Mortality Lower with Non-US-Trained Physicians,” Medscape, 2017.02.02].

So run 1,000 Medicare patients through the hospital, and for $47,000 more, those foreign-trained internists will save four more lives than U.S.-trained colleagues. About $12,000 per life—fair trade?

The study noted that the training countries represented most in the study sample were China, Egypt, India, Mexico, Nigeria, Pakistan, the Philippines, and Syria. Syria.

5 Comments

  1. Roger Elgersma 2017-02-13 11:28

    About thirty five years ago my mother changed doctors because she found out that her first doctor had removed eight feet(one third) of her intestines twenty years before and never told her. He then removed her records from the hospital and his office and brought them home to look at them and they never came back. So her new doctor did not know her situation. She told him what she knew and he had trouble believing her. An American doctor and an Egyptian doctor. She needed her gall bladder taken out so they did the surgery. They found out that my mother was correct on what she had told them. Every day for a week the Egyptian doctor came to her room and appologized for not believing her. Is an American doctor ever going to appologize? They are to afraid of being sued. But honesty was a great medicine for my mother. honest people also make better decisions.

  2. happy camper 2017-02-13 19:44

    Once again your slant didn’t include this tidbit:

    “They suggest that the testing process may select for the top international medical school graduates. The fact that some internationally trained internists may have completed two residencies (one in the home country and one here) might also contribute to the slightly better mortality outcomes of their patients.”

    So the best of the best still want to come here and they’re better: what a shocker.

  3. Cory Allen Heidelberger Post author | 2017-02-14 07:14

    Good grief: one moment folks tell me my posts are too long; the next, Hap tells me I need to include every little detail, including details that don’t change my thesis one iota.

    I said if your doctor is from elsewhere, you may have a better chance of surviving the encounter. The point Hap includes doesn’t show any slant on my part or debunk my original statement; it actually supports my statement. If the testing process selects top talent, then that’s all the more reason to expect better results from the people selected by that process.

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