Patients once traveled on foot from Afghanistan to see my father, a Cleveland Clinic-trained doctor who practiced in Peshawar, Pakistan. It is easy to attribute such health care to a developing country. But California’s economy outperforms whole nations, and patients in the Central Valley still drive for hours to get life-saving treatment. I have lived and studied in both of these “doctor deserts,” one arid and one fertile. Both are plagued by the same crisis: the exodus of the very people trained to heal them. Doctors are trained to save lives. But in Pakistan and California’s Central Valley, their absence speaks louder than their presence. The very systems that are meant to anchor physicians are designed in ways that push them elsewhere. And when medicine becomes unlivable for providers, it becomes unreachable for patients.
Every year, Pakistan trains thousands of new doctors. And every year, it loses them. In 2022, more than 2,500 physicians left the country to work abroad. Surveys show this is not a short-term blip. Nearly one in three medical students openly plan to build their careers overseas.
This “brain drain” has spiraled into a pipeline. Wealthy countries depend on Pakistan’s steady export of medical talent, while Pakistan itself is left with barely 1.1 doctors per 1,000 people, which is half the level the World Health Organization recommends…