WEBVTT 1 00:00:00.560 --> 00:00:05.559 It's nice w BZ Radio. 2 00:00:07.839 --> 00:00:10.320 Well, we had a guest with us a couple of 3 00:00:10.320 --> 00:00:12.919 weeks ago who's joining us now for an hour to 4 00:00:13.000 --> 00:00:17.079 take some phone calls as well as to continue our conversation. 5 00:00:17.280 --> 00:00:21.760 Delighted to be joined again by doctor DEEB. Salem. I 6 00:00:21.879 --> 00:00:24.600 pronounced the last name correctly, doctor. 7 00:00:25.280 --> 00:00:27.760 Just like they all right, thank you very. 8 00:00:27.719 --> 00:00:31.600 Much, Senior vice president for Academic Integration and Tough's Medicine, 9 00:00:31.600 --> 00:00:34.039 former cardiologists and share of the Department of Medicine at 10 00:00:34.079 --> 00:00:41.079 Tough Medical Center. And we're talking about the Physician Pathway Act, 11 00:00:41.520 --> 00:00:44.920 which is now law in Massachusetts, assigned into law by 12 00:00:44.960 --> 00:00:50.159 the Governor in November. And what that piece of legislation 13 00:00:50.520 --> 00:00:57.840 is intended to do is to make more available more doctors. 14 00:00:57.960 --> 00:01:03.920 And I'm assuming prime merely you know PCP primary care 15 00:01:03.960 --> 00:01:07.920 physicians available in Massachusetts. I think doctor Salem, you and 16 00:01:08.000 --> 00:01:12.280 I can agree that it's that that Massachusetts is the 17 00:01:12.319 --> 00:01:15.120 medical capital of the universe. I mean, people from all 18 00:01:15.159 --> 00:01:17.000 over the world come here to be treated at some 19 00:01:17.040 --> 00:01:19.280 of the great institutions that we have. We can agree 20 00:01:19.280 --> 00:01:20.439 on that, correct. 21 00:01:20.799 --> 00:01:27.280 That absolutely, and the medical care in Massachusetts is probably 22 00:01:27.280 --> 00:01:28.560 the best in the country. 23 00:01:29.480 --> 00:01:31.359 I'll say it's the best in the world because I 24 00:01:31.400 --> 00:01:34.439 see all of these folks from various and sundry points 25 00:01:34.439 --> 00:01:39.760 across the globe coming here for either special surgeries, special operations, 26 00:01:39.840 --> 00:01:42.680 or to be treated generally. And I think that the 27 00:01:43.120 --> 00:01:48.640 proof exists right there that people are not oftentimes you know, 28 00:01:48.760 --> 00:01:52.840 the the most influential and the most wealthy, and whether 29 00:01:52.879 --> 00:01:56.560 they're you know, singers, you know Adele or some of 30 00:01:56.599 --> 00:01:59.959 the singers who have had throat problems, or whether they 31 00:02:00.280 --> 00:02:06.040 professional athletes or actors. We are the mecca for top 32 00:02:06.159 --> 00:02:09.680 medical care in my opinion. But the downside of that 33 00:02:09.919 --> 00:02:12.159 is that there are a lot of people in Massachusetts 34 00:02:13.199 --> 00:02:17.439 who are having a very difficult time finding a family 35 00:02:17.520 --> 00:02:23.439 practitioner where we call you know, family doctor PCP. Why, 36 00:02:23.599 --> 00:02:26.439 first of all, what's the problem with what cause has 37 00:02:26.479 --> 00:02:29.319 caused that problem? And then we can talk about what, 38 00:02:29.479 --> 00:02:34.039 hopefully the Physician Physician Pathway Act will do to solve 39 00:02:34.120 --> 00:02:36.919 or maybe at least alleviate that problem. 40 00:02:37.439 --> 00:02:42.520 Yeah, hopefully you can alleviate it. The problem is multifold 41 00:02:42.879 --> 00:02:46.639 and it's happening all over the country. Uh. One, the 42 00:02:46.680 --> 00:02:51.520 population has gotten older, and the older you get, the 43 00:02:51.960 --> 00:02:57.560 more often you need medical care. Two, not enough physicians 44 00:02:58.199 --> 00:03:03.240 are going into primary care. When I was chair of medicine, 45 00:03:03.800 --> 00:03:07.960 early on, we had a large percentage of our doctors 46 00:03:07.960 --> 00:03:12.199 and internal medicine go into primary care. As the years 47 00:03:13.039 --> 00:03:17.319 go by gone by, we saw less and less doing that. 48 00:03:18.319 --> 00:03:23.400 Why is it? It turns out that these days, the 49 00:03:23.520 --> 00:03:28.000 graduates of medical school often have a huge debt, and 50 00:03:28.199 --> 00:03:34.840 primary care in general is paid less than specialty care, 51 00:03:35.280 --> 00:03:38.080 and so more and more of the physicians to get 52 00:03:38.120 --> 00:03:40.800 it coming out of medical schools all over the country 53 00:03:41.280 --> 00:03:45.840 are not going into primary care. And that's really the thing. 54 00:03:45.879 --> 00:03:48.599 And I think I mentioned most time, it's gotten so 55 00:03:48.800 --> 00:03:52.759 bad that I have physicians calling me up asking me 56 00:03:52.879 --> 00:03:56.439 to help them find the primary care doctor in Massachusetts. 57 00:03:57.319 --> 00:04:01.879 Well, there's nothing that I heard in our interview before 58 00:04:01.919 --> 00:04:06.120 which emphasized so clearly the problem. When you mentioned that 59 00:04:06.199 --> 00:04:10.960 there are doctors who obviously need to have a doctor 60 00:04:11.000 --> 00:04:13.120 for themselves, and they don't want to be the doctor 61 00:04:13.120 --> 00:04:15.840 for their family. They're looking for a family practice or 62 00:04:15.879 --> 00:04:21.279 a primary care physician. And this is a horrific situation. 63 00:04:21.959 --> 00:04:25.680 Is it worse in Massachusetts than other states around the country, 64 00:04:25.680 --> 00:04:29.040 Because I'd always thought, Hey, the places that don't have 65 00:04:29.120 --> 00:04:35.199 doctors or places like Montana or Mississippi. Massachusetts, we have 66 00:04:35.399 --> 00:04:39.360 plenty of doctors. Is it just gotten worse everywhere or 67 00:04:39.439 --> 00:04:41.160 is it now just hitting Massachusetts. 68 00:04:42.240 --> 00:04:45.519 I don't have the statistics, but I think it's as 69 00:04:45.560 --> 00:04:53.720 bad here, particularly outside of Boston in the rural Massachusetts. 70 00:04:55.399 --> 00:04:58.199 I don't think it's much worse anywhere else that I 71 00:04:58.279 --> 00:05:00.279 know of. Now. 72 00:05:00.399 --> 00:05:03.399 There have been, you know, movies, and I think of, 73 00:05:03.920 --> 00:05:07.360 you know, like the movie Field of Dreams where the 74 00:05:09.319 --> 00:05:13.839 baseball player has one opportunity to play in the major leagues, 75 00:05:13.839 --> 00:05:16.759 but he goes home and is a lifetime doctor in 76 00:05:16.759 --> 00:05:19.319 his small town in Minnesota. Was in Field of Dreams, 77 00:05:20.720 --> 00:05:25.240 doctor Graham, And you think when you were growing up, 78 00:05:25.319 --> 00:05:27.800 I think anyone who thought for a moment they could 79 00:05:27.839 --> 00:05:31.360 be a doctor, there was sort of a romanticism involved 80 00:05:31.360 --> 00:05:33.399 that you would be a doctor in a small town. 81 00:05:33.519 --> 00:05:35.519 You would know everyone in the town, you would be 82 00:05:35.560 --> 00:05:38.519 the most respected person in the town, you would tend 83 00:05:38.560 --> 00:05:42.759 to people in the twilight of their lives, and you 84 00:05:42.759 --> 00:05:46.439 would bring children into the world. And it was sort 85 00:05:46.439 --> 00:05:51.199 of what small town America was. But that apparently has 86 00:05:51.240 --> 00:05:55.240 gone away. So what I want to do is the 87 00:05:55.240 --> 00:06:01.680 physician act that we're talking about tonight, which the title 88 00:06:01.800 --> 00:06:06.399 of is the Physician Pathway Act is intended to remedy 89 00:06:06.920 --> 00:06:11.319 this situation. Uh, it's just gone on the books, so 90 00:06:11.360 --> 00:06:13.800 it's not we're not going to have an overnight fix, 91 00:06:14.519 --> 00:06:20.120 but hopefully it will have over time a benefit, a 92 00:06:20.199 --> 00:06:23.759 benefit to the commonwealth. Instead of you starting to answer 93 00:06:23.800 --> 00:06:25.800 that for me right now, doctor, because I want to 94 00:06:25.839 --> 00:06:29.120 get a real thorough answer from you, let's let's just 95 00:06:29.160 --> 00:06:30.839 take a break. I have to take a news break 96 00:06:30.879 --> 00:06:33.199 in about a minute. Anyway, we'll take the break a 97 00:06:33.240 --> 00:06:35.199 little early and we'll come back and we'll talk. Now 98 00:06:35.360 --> 00:06:39.199 we've outlined the problem, and now let's talk about the solution. 99 00:06:39.680 --> 00:06:40.480 Is that okay with you? 100 00:06:41.639 --> 00:06:44.040 That's that's fine. I have plenty of times. 101 00:06:44.240 --> 00:06:46.839 Yeah, I just don't want to interrupt your thoughts. And 102 00:06:46.879 --> 00:06:51.160 if if you have had problems, I'm finding a doctor 103 00:06:51.600 --> 00:06:54.879 here in Massagers our name of where our program is 104 00:06:54.920 --> 00:06:58.519 being heard right now, please give us a call. I 105 00:06:58.519 --> 00:07:00.759 I know I went through this if few years ago 106 00:07:01.360 --> 00:07:04.079 and it was not an easy task. I had a 107 00:07:04.120 --> 00:07:09.199 doctor for thirty five years who I revered fellow by 108 00:07:09.199 --> 00:07:11.519 the name of doctor Alan Cole. He had a practice 109 00:07:11.560 --> 00:07:15.600 in Natick. He was just an incredible, incredible human being 110 00:07:15.759 --> 00:07:21.959 and uh, you know, an incredible doctor. He you know, 111 00:07:22.040 --> 00:07:25.800 I miss him to this day. But he got a 112 00:07:25.800 --> 00:07:28.240 little overwhelmed with a lot of the paperwork and also 113 00:07:28.279 --> 00:07:30.560 the onset of COVID and had reached a certain point 114 00:07:30.560 --> 00:07:32.519 in his life where he wanted to spend time with 115 00:07:32.560 --> 00:07:35.079 their grandchildren, which is understandable. We'll take a quick break 116 00:07:35.079 --> 00:07:38.240 if Alan, if you're listening tonight, I can't tell you 117 00:07:38.279 --> 00:07:40.040 how much they thank you for the care that you've 118 00:07:40.079 --> 00:07:44.439 provided me for thirty five years. Just an extraordinary physician. 119 00:07:45.199 --> 00:07:47.560 Going to be back on Nightside, Uh, if you like 120 00:07:47.680 --> 00:07:50.600 to join this conversation six one, seven, two, five, four 121 00:07:50.639 --> 00:07:53.079 ten thirty six one seven, nine three one ten thirty, 122 00:07:53.079 --> 00:07:56.199 we'll be back on Nightside with my guest, doctor DEEB. 123 00:07:56.399 --> 00:08:01.959 Salem has an extraordinary career associated with Touft's Medical School, 124 00:08:02.879 --> 00:08:07.439 and we're going to talk about this Physician Pathway Act. 125 00:08:07.879 --> 00:08:11.399 And obviously there's some other solutions that I think doctor 126 00:08:11.639 --> 00:08:15.720 Salem knows I'm very interested in. We'll talk about those 127 00:08:15.759 --> 00:08:19.120 as well, and from your solutions in addition, back on 128 00:08:19.199 --> 00:08:20.240 Nightside right after this. 129 00:08:20.800 --> 00:08:23.959 Now back to Dan Ray Live from the Window World, 130 00:08:24.079 --> 00:08:27.240 night Side studios on WBZ News Radio. 131 00:08:28.879 --> 00:08:31.600 All right, we are back and with me is my guest, 132 00:08:31.600 --> 00:08:34.639 doctor Deep Salem, Senior vice president of Academic Integration and 133 00:08:34.720 --> 00:08:37.600 Tough's Medicine, former cardiologist, chair of the Department of Medicine 134 00:08:37.600 --> 00:08:42.480 and Tough's Medical Center. Quite a resume, Doctor Salem, explain, 135 00:08:42.559 --> 00:08:45.279 if you will, the idea of the Physician Pathway Act, 136 00:08:45.440 --> 00:08:50.440 and is this legislation a piece of a legislation that 137 00:08:50.559 --> 00:08:52.600 is in effect in other states or is this a 138 00:08:54.120 --> 00:08:59.320 piece of legislation that is specific to Massachusetts. 139 00:09:01.039 --> 00:09:05.600 I believe that there is one or two states that 140 00:09:05.960 --> 00:09:12.600 are trying this right now. One is Tennessee and the 141 00:09:12.639 --> 00:09:18.679 other is somewhere out west. So this is fairly new. 142 00:09:19.480 --> 00:09:24.399 And the problem is that the issue is that a 143 00:09:24.519 --> 00:09:29.960 number of physicians sometimes are forced to leave a country 144 00:09:30.320 --> 00:09:35.480 or come here because of political issues. And they may 145 00:09:35.519 --> 00:09:40.200 be excellent physicians, but are not able to get a 146 00:09:40.240 --> 00:09:44.720 medical license now unless they spent three years in a 147 00:09:44.799 --> 00:09:48.679 residency program. And if you're you know, forty five years 148 00:09:48.720 --> 00:09:53.120 old and you have a family, you're not going to 149 00:09:53.559 --> 00:09:58.279 try to find the residency. So this I got involved 150 00:09:58.320 --> 00:10:04.000 with this through the as Medical Society and Governor Baker 151 00:10:04.080 --> 00:10:09.279 put together, a bunch of us together, including someone from 152 00:10:09.320 --> 00:10:12.919 the Board of Registration of Medicine, to say, what could 153 00:10:12.960 --> 00:10:17.480 we do to take physicians that know what they're doing, 154 00:10:17.639 --> 00:10:21.639 that are very experienced, and give them a pathway to 155 00:10:21.679 --> 00:10:25.200 get a license in Massachusetts. That's what it's all about. 156 00:10:26.240 --> 00:10:31.399 We worked almost a year putting this together. And actually 157 00:10:31.799 --> 00:10:34.320 when we had the white paper sort of come out, 158 00:10:34.879 --> 00:10:39.399 it was the time that Mara Heally was becoming governor 159 00:10:39.639 --> 00:10:43.519 and I actually called her before she even started because 160 00:10:43.559 --> 00:10:46.480 I've known her and I told her about this and 161 00:10:46.639 --> 00:10:50.039 she got excited about it. So it's the nice thing 162 00:10:50.519 --> 00:10:55.600 about this. It's a bipartisan effort to help in this 163 00:10:56.519 --> 00:10:59.039 physician shortage issue. 164 00:10:59.320 --> 00:11:05.159 Okay, now, what do you think realistically, if this is 165 00:11:05.200 --> 00:11:08.559 not going to happen overnight, how quickly do you think 166 00:11:09.840 --> 00:11:13.519 qualified physicians from other countries around the world either they 167 00:11:13.559 --> 00:11:16.919 have decided to come here. We don't want to obviously 168 00:11:17.120 --> 00:11:21.360 rob second and third world countries of their pool of 169 00:11:21.480 --> 00:11:28.120 their physicians pool. How much of a I guess, how 170 00:11:28.200 --> 00:11:30.279 large a group do you think we could eventually get 171 00:11:30.320 --> 00:11:34.039 on an annual basis? Are we talking about double digits physicians? 172 00:11:34.200 --> 00:11:38.240 Twenty thirty four of you we're talking about a large album. 173 00:11:38.480 --> 00:11:42.000 I'm thinking maybe close to one hundred, but I may 174 00:11:42.039 --> 00:11:47.840 be over excited. I guarantee you you can find, at 175 00:11:47.919 --> 00:11:53.080 least in our hospital. I've run into two physicians from 176 00:11:53.159 --> 00:11:59.720 foreign countries that are working as lab technicians to earn 177 00:11:59.759 --> 00:12:06.200 a living. And so I think you scan the Massachusetts 178 00:12:06.320 --> 00:12:10.679 or even outside of Massachusetts, you'll find that there are 179 00:12:10.759 --> 00:12:14.639 physicians that can't those have a license and will give 180 00:12:15.440 --> 00:12:20.159 anything to get one, and so they're around so known. 181 00:12:21.440 --> 00:12:28.320 Yes, would there be more academic requirements or some sort 182 00:12:28.360 --> 00:12:32.600 of a test that these physicians who would present themselves 183 00:12:32.679 --> 00:12:38.080 as potential, you know, participants in this physician pathway program, 184 00:12:38.120 --> 00:12:42.519 that they would have to do something above and beyond 185 00:12:42.600 --> 00:12:45.919 just saying I am already licensed to practice in Lincolnstein 186 00:12:46.200 --> 00:12:49.960 or or Libya or wherever, and I want to just 187 00:12:50.039 --> 00:12:52.440 picking two countries that came to the top of my head. 188 00:12:53.080 --> 00:12:55.279 I don't know why Lickenstein and Libya other than the 189 00:12:55.279 --> 00:13:00.879 fact that they both begin with the letter L. What 190 00:13:00.879 --> 00:13:01.480 have they got to do? 191 00:13:01.519 --> 00:13:06.240 Once I think the I'm sorry, the qualifications would first 192 00:13:06.720 --> 00:13:12.200 be coming from a recognized medical school. Uh and you 193 00:13:12.240 --> 00:13:16.799 know so it the Board of Registration has a good 194 00:13:16.840 --> 00:13:21.399 idea of medical schools all over the world that are very, 195 00:13:21.519 --> 00:13:25.679 very good, and that's number one. Number two, that the 196 00:13:25.759 --> 00:13:29.559 exams that they would have to pass the same way 197 00:13:29.639 --> 00:13:34.799 that our physicians are going into practice have to pass 198 00:13:35.080 --> 00:13:41.200 UH to get a license in Massachusetts, So that those 199 00:13:41.279 --> 00:13:45.200 two things are qualifiers, and they have to show that 200 00:13:45.240 --> 00:13:51.120 they've had experience, and the priority is for doctors that 201 00:13:51.639 --> 00:13:56.799 are going to be in primary care now UH, so 202 00:13:56.879 --> 00:14:00.320 that that will be in your You're right, it's not 203 00:14:00.440 --> 00:14:03.440 going to happen overnight. I'm guessing it will take us 204 00:14:03.480 --> 00:14:10.679 about a year to get this going, and we're starting 205 00:14:10.759 --> 00:14:13.200 now to talk to see how we're going to The 206 00:14:13.279 --> 00:14:20.360 implementation is going to be interesting. But I'll just give 207 00:14:20.440 --> 00:14:26.679 you an idea of primary care doctors these days take 208 00:14:26.720 --> 00:14:31.919 care of maybe about fifteen hundred to two thousand patients. 209 00:14:32.120 --> 00:14:37.159 So if you think of it that way, the more 210 00:14:37.240 --> 00:14:40.480 we have that will really help. It's not going to 211 00:14:40.559 --> 00:14:43.879 cure the problem, but if you're doing a thousand to 212 00:14:43.960 --> 00:14:47.159 two thousand patients at a time, you're helping a lot 213 00:14:47.200 --> 00:14:51.919 of people. And again, we're the focus on putting these 214 00:14:52.320 --> 00:14:58.679 physicians in areas that are underserved now, not in Boston, 215 00:14:59.159 --> 00:15:02.200 but you know, go in the more rural areas. And 216 00:15:02.279 --> 00:15:07.960 the magic about this too. Let's say the physician is Hispanic, Well, 217 00:15:08.600 --> 00:15:13.279 put that person in an area that there are a 218 00:15:13.279 --> 00:15:18.039 lot of Hispanic people, then they're not only going to 219 00:15:18.120 --> 00:15:20.240 be doing a good job, they'll be doing a better 220 00:15:20.320 --> 00:15:25.000 job than people like myself who don't know the culture 221 00:15:25.039 --> 00:15:28.399 well and their language issues. So that's some of the 222 00:15:28.519 --> 00:15:29.759 nice things about this. 223 00:15:30.480 --> 00:15:33.600 Okay, so let me ask you this as part and 224 00:15:33.720 --> 00:15:37.440 parcel of this. This is a state action by Massachusetts. 225 00:15:38.639 --> 00:15:42.440 How does this interact with the federal government? Are they 226 00:15:42.480 --> 00:15:45.720 given a visa and a pathway to citizenship if you're 227 00:15:45.759 --> 00:15:51.759 asking a physician from again, whatever country will stick with Lithuania, allows, 228 00:15:52.039 --> 00:15:57.320 we'll stick with the l theme here. Are they given 229 00:15:57.480 --> 00:16:01.159 a promise of if they want a athlete a citizenship 230 00:16:01.360 --> 00:16:03.080 and that can only be done I assume by the 231 00:16:03.080 --> 00:16:03.840 federal government. 232 00:16:05.000 --> 00:16:08.159 Yeah, so that's not we have not looked at that. 233 00:16:08.200 --> 00:16:11.159 We've looked that this is set up now and they 234 00:16:11.240 --> 00:16:13.960 go in the future, But it's set up now for 235 00:16:14.519 --> 00:16:20.519 physicians that are already here and are already have citizenship 236 00:16:20.679 --> 00:16:25.120 or there. We're not into that now. It becomes if 237 00:16:25.120 --> 00:16:29.960 we become more desperate. That may be something, but none 238 00:16:30.039 --> 00:16:33.559 of the discussions I've been involved with have talked about that. 239 00:16:33.600 --> 00:16:36.240 They'd have to be people just like the people I've 240 00:16:36.279 --> 00:16:39.879 run into in our own hospitals that already have they're 241 00:16:39.879 --> 00:16:48.159 working somewhere. Often they're working in some medical related issue. 242 00:16:48.600 --> 00:16:52.759 Some of them have actually didn't come nurses or or 243 00:16:52.840 --> 00:16:56.759 something else. But there are some that are working totally 244 00:16:56.799 --> 00:17:01.080 outside the field of medicine. But they have to already 245 00:17:01.159 --> 00:17:06.680 be eligible to stay in the country before this happens. 246 00:17:06.920 --> 00:17:09.559 Yeah. I've been told by a friend of mine who 247 00:17:09.559 --> 00:17:14.319 has spent some time recently in being hospitalized, and she 248 00:17:14.400 --> 00:17:17.920 happens to be a former nurse, that she has met 249 00:17:18.440 --> 00:17:21.680 nurses in some of the facilities in which she's been treated, 250 00:17:22.039 --> 00:17:26.480 in which the nurses disclosed to her that they had 251 00:17:26.519 --> 00:17:31.559 been physicians in their homeland and they had come hard. 252 00:17:33.240 --> 00:17:37.680 Yeah, well, they should be very happy. I love hearing 253 00:17:37.720 --> 00:17:41.599 that because it just tells us that there is And 254 00:17:41.599 --> 00:17:45.680 by the way, it's a shortage of nurses too. As 255 00:17:45.720 --> 00:17:49.599 this moves on, I think they'll be a move to 256 00:17:49.680 --> 00:17:55.079 do similar things for other health workers that have come 257 00:17:55.119 --> 00:17:57.920 to this country and can't get licensed now. 258 00:17:59.200 --> 00:18:01.440 I don't want to just for a minute or two, 259 00:18:01.480 --> 00:18:02.960 and I want to talk about this more, but I 260 00:18:03.000 --> 00:18:08.279 also want to take phone calls. There are hundreds, literally 261 00:18:08.640 --> 00:18:14.480 hundreds or maybe thousands of Americans young people who are 262 00:18:14.480 --> 00:18:19.799 studying to secure medical degrees at countries literally all over 263 00:18:19.839 --> 00:18:25.359 the world. Many of them in places like Antigua, Aruba, Belize, 264 00:18:25.480 --> 00:18:33.599 Cayman Islands, Curroso, Dominiqua, Guyana, Montsaret proably not Monsret because 265 00:18:33.640 --> 00:18:38.640 they had a tremendous volcanic eruption, Saint Kitts and Nevis, 266 00:18:38.960 --> 00:18:41.799 Saint Lucia, Saint Vincent, These are all in the Caribbean. 267 00:18:43.079 --> 00:18:46.720 These are some of our best and brightest who are 268 00:18:46.759 --> 00:18:53.240 bringing their medical degrees back from some very distinguished offshore 269 00:18:53.839 --> 00:18:57.039 medical schools. Now, I know when we spoke last you 270 00:18:57.119 --> 00:19:03.720 told me that there's no room for these medical UH 271 00:19:04.000 --> 00:19:08.839 school graduates UH to be placed in a residency program. 272 00:19:09.759 --> 00:19:13.119 But that is a pool of people who I think 273 00:19:13.519 --> 00:19:16.680 we need to somehow incorporate into this They are not 274 00:19:16.880 --> 00:19:23.000 obviously focused on the this Physician Pathway Act. What can 275 00:19:23.119 --> 00:19:26.480 what can the medical societies here in America do about 276 00:19:27.000 --> 00:19:30.839 those students who maybe weren't able to get into Georgetown 277 00:19:30.920 --> 00:19:35.240 or UMass or Boston University or TOPS. But they've gone 278 00:19:35.279 --> 00:19:38.400 to to Saint George's or Saint john some of these 279 00:19:38.680 --> 00:19:41.920 these schools in the Caribbean and elsewhere and are coming 280 00:19:41.960 --> 00:19:43.079 home with medical degrees. 281 00:19:44.599 --> 00:19:48.200 Uh So that's a great question. But I will add 282 00:19:48.240 --> 00:19:54.599 to this UH that there are thousands of qualified uh 283 00:19:55.039 --> 00:20:01.039 people in the United States that uh and get into 284 00:20:01.319 --> 00:20:06.799 medical school. They're not foreigners. And by the way, many 285 00:20:06.880 --> 00:20:11.559 years ago, my sister describe what my sister did by 286 00:20:12.960 --> 00:20:17.079 my family. My sister and I were born in this country. 287 00:20:17.160 --> 00:20:22.759 Our parents were immigrants from Lebanon, and my sister couldn't 288 00:20:22.799 --> 00:20:27.880 get into medical school in the States in that era. 289 00:20:28.039 --> 00:20:32.599 She went to the American University of Beirut and then 290 00:20:32.880 --> 00:20:35.559 came here and got a residency. 291 00:20:36.400 --> 00:20:36.519 Uh. 292 00:20:36.880 --> 00:20:41.400 So the point is it is a great limiting factor. 293 00:20:42.039 --> 00:20:50.680 There is not enough residency capacity to train more physicians 294 00:20:50.720 --> 00:20:55.440 in this country. And that the capacity. The medical schools 295 00:20:56.240 --> 00:20:59.839 loved to get more students because you know, the tuitions 296 00:20:59.839 --> 00:21:04.960 are pretty high, seventy thousand dollars a year. The problem 297 00:21:05.359 --> 00:21:12.759 is to matriculate a physician, it's not just bookwork. They 298 00:21:12.799 --> 00:21:16.839 have to have a medical school, they have to go 299 00:21:17.079 --> 00:21:19.920 into a hospital, and be taught how to take care 300 00:21:19.960 --> 00:21:25.559 of patients, and that's usually in the third and fourth year. 301 00:21:26.119 --> 00:21:31.640 There are not enough teaching hospitals to support it. One 302 00:21:31.720 --> 00:21:34.880 of the needs we need to consider in a test. 303 00:21:34.960 --> 00:21:38.440 For example, we have two community hospitals and one of 304 00:21:38.480 --> 00:21:42.400 them we're hoping to build it up to have the 305 00:21:42.519 --> 00:21:48.000 capacity to take medical students and if they if we 306 00:21:48.160 --> 00:21:55.799 do that, our medical school could have bring in more kids. 307 00:21:55.400 --> 00:21:57.920 What happens to if I could ask doctor and then 308 00:21:57.920 --> 00:22:00.720 I get a break for news herein let me ask 309 00:22:00.720 --> 00:22:02.880 you the question and you can formulate the answer during 310 00:22:02.880 --> 00:22:05.759 the news break. My question is what happens to these 311 00:22:05.799 --> 00:22:09.160 American students who have graduated, sometimes from some of the 312 00:22:09.160 --> 00:22:13.200 greatest colleges in America, they're not able to get into 313 00:22:14.240 --> 00:22:17.559 an American based, US based medical school. They go off 314 00:22:17.559 --> 00:22:21.960 and they get a degree from some really fine medical schools. 315 00:22:23.079 --> 00:22:25.279 I assume and I know that some of them end 316 00:22:25.400 --> 00:22:28.799 up practicing here. Maybe you can tell me. I mean, 317 00:22:28.799 --> 00:22:32.559 there's you know, Saint George's University School of Medicine or 318 00:22:32.599 --> 00:22:35.039 Ross University School of Medicine. These are all schools that 319 00:22:35.079 --> 00:22:39.000 you're familiar with, and they may not be toughs. They 320 00:22:39.039 --> 00:22:41.519 may not be Harvard, they may not be Boston University, 321 00:22:41.559 --> 00:22:44.400 they may not be Georgetown, but there's still great medical 322 00:22:44.400 --> 00:22:46.880 schools and some you know as well as I do 323 00:22:47.319 --> 00:22:52.160 someone they hone their craft, and I just want to 324 00:22:52.160 --> 00:22:56.480 make sure we don't miss this pool of potential physicians. 325 00:22:56.759 --> 00:22:58.599 So I'm going to ask you that question when we 326 00:22:58.640 --> 00:23:00.400 come back right after the break here the bottom of 327 00:23:00.400 --> 00:23:01.680 the hour, and then we're going to get to phone 328 00:23:01.680 --> 00:23:04.039 calls and if you like to join the conversation and 329 00:23:04.200 --> 00:23:06.440 sill have a couple of open lines at six one, seven, two, five, 330 00:23:06.480 --> 00:23:08.680 four to ten thirty or six one, seven, nine three 331 00:23:08.880 --> 00:23:13.119 ten thirty. We're coming right back with my guest, doctor DEEB. Salem, 332 00:23:13.240 --> 00:23:16.599 who has been at TOUGH for many many years, retired cardiologist, 333 00:23:17.279 --> 00:23:19.880 and he is trying to do something about getting more 334 00:23:20.799 --> 00:23:26.079 doctors available for all of us, as all of us 335 00:23:26.160 --> 00:23:28.519 every day get a little old, get a little older, 336 00:23:28.559 --> 00:23:31.000 a day at a time. Back on Nightside, right after this. 337 00:23:32.279 --> 00:23:37.279 Night Side with Dan Ray on WBZY, Boston's news. 338 00:23:37.119 --> 00:23:41.400 Radio, doctor Deeve Salem is with me and we are 339 00:23:41.480 --> 00:23:45.759 talking about what's called the physic the Massachusetts Physician Pathway Act. 340 00:23:46.880 --> 00:23:51.200 I just don't want to see the American students doctor Salem, 341 00:23:51.519 --> 00:23:54.880 who at the age of twenty three or twenty four 342 00:23:55.519 --> 00:23:59.119 go away to get a medical degree, forgotten about in 343 00:23:59.119 --> 00:24:01.680 this process. I and I hope that the leadership of 344 00:24:01.720 --> 00:24:06.799 the Mass Medical Society of other important groups remember these 345 00:24:06.799 --> 00:24:09.400 young people as well. That's that's my place. 346 00:24:10.079 --> 00:24:13.799 So Dan, we do, I guess have to correct something. 347 00:24:14.200 --> 00:24:17.440 If and of my patients are listening. I still am 348 00:24:17.480 --> 00:24:20.440 seeing patients. I have a big one of tomorrow. I 349 00:24:20.440 --> 00:24:22.519 don't want them to free streak out. 350 00:24:23.359 --> 00:24:27.119 I'm sorry, I I what was written for me was 351 00:24:27.160 --> 00:24:29.759 that you were a retired cardiologist. And if that is 352 00:24:29.839 --> 00:24:30.160 not so. 353 00:24:32.000 --> 00:24:35.480 Uh yeah, I used to be chief of Cardiology. I 354 00:24:35.559 --> 00:24:37.960 retired that what I retired of is a lot of 355 00:24:38.000 --> 00:24:39.319 the administrative things. 356 00:24:39.839 --> 00:24:44.400 Okay, so you're you're a current practicing cardiologist. My apologies 357 00:24:44.480 --> 00:24:48.640 and uh apologies, thank you for the correction. 358 00:24:50.400 --> 00:24:55.079 Uh so the one you know, as I people that 359 00:24:55.119 --> 00:25:01.200 go outside the country, UH will compete to get residencies. 360 00:25:01.319 --> 00:25:05.200 The whole trick to getting the license is to get 361 00:25:05.240 --> 00:25:09.000 the residency in the United States. So the places you 362 00:25:09.160 --> 00:25:13.000 mentioned when I was chairing of Medicine, we would have 363 00:25:13.400 --> 00:25:19.200 we'd see Americans that had gone to couldn't get into 364 00:25:19.240 --> 00:25:26.680 medical schools in the US, go to a school outside 365 00:25:26.759 --> 00:25:31.960 the US show us that they're often brilliant people. It's 366 00:25:32.039 --> 00:25:34.440 just hard to figure out how they didn't get into 367 00:25:34.519 --> 00:25:40.119 medical school. So they apply for residencies with everybody else. 368 00:25:40.440 --> 00:25:45.480 And so most teaching hospitals will have a percentage of 369 00:25:45.559 --> 00:25:50.720 their students whether they're Americans or not Americans apply for 370 00:25:50.839 --> 00:25:57.160 their residency. So that's how it's done. Main step is 371 00:25:57.200 --> 00:25:58.319 the residency. 372 00:25:58.559 --> 00:26:01.559 I think that you and I know that all the 373 00:26:01.599 --> 00:26:04.000 greatest doctors in the world didn't go to the same 374 00:26:04.119 --> 00:26:07.279 single medical school, and that all the greatest baseball players 375 00:26:07.519 --> 00:26:10.599 didn't go to the same school. People mature and develop 376 00:26:10.680 --> 00:26:13.640 at certain ages. And I know that the best lawyers 377 00:26:13.680 --> 00:26:16.559 in the world that I know of, all of them 378 00:26:16.640 --> 00:26:20.359 went to different, you know, different law schools, and some 379 00:26:20.440 --> 00:26:22.640 of them went to law schools that you might say, well, 380 00:26:22.720 --> 00:26:25.559 you know that maybe wasn't quite Harvard, or there were 381 00:26:25.599 --> 00:26:28.960 others that you know have done very well. So people 382 00:26:29.000 --> 00:26:31.160 mature at different agents. Okay, let's go to phone calls 383 00:26:31.160 --> 00:26:34.759 from my guest, doctor Dee Salim Salem, doctor Deep Salem. 384 00:26:35.119 --> 00:26:37.680 Let me go to Larry and Dennisport first, Larry first 385 00:26:37.680 --> 00:26:38.960 this hour and nice side welcome. 386 00:26:40.480 --> 00:26:45.079 Thanks for taking on call, Dan and doctor. I'm not 387 00:26:45.119 --> 00:26:47.400 sure if this would be a solution to help the problem, 388 00:26:47.400 --> 00:26:49.920 but I've been going to the same I had the 389 00:26:49.960 --> 00:26:53.720 same doctor for over twenty years over in Cambridge. It 390 00:26:53.799 --> 00:26:59.160 was integrated medicine, had acupuncture, chiropractor, had everything. And when 391 00:26:59.200 --> 00:27:03.240 my primary he was getting ready to retire, he had 392 00:27:03.279 --> 00:27:07.200 a nice young woman sitting in who was actually a PA. 393 00:27:08.079 --> 00:27:12.920 And from what I understand, if in Massachusetts, as long 394 00:27:12.960 --> 00:27:17.880 as there is a MD in the practice, a PA 395 00:27:18.160 --> 00:27:23.920 can become your PCP. And she was excellent. Unfortunately only 396 00:27:24.000 --> 00:27:25.720 last of the year, moved on to bigger and better 397 00:27:25.799 --> 00:27:29.759 things and I finally got a new doctor after two years. 398 00:27:29.880 --> 00:27:33.039 But let's see if you're corrected that assumption, Larry. I'm 399 00:27:33.039 --> 00:27:34.359 not going to cut you off. Let me just see 400 00:27:34.400 --> 00:27:37.799 if that's if that is accurate, Doctor Salem. 401 00:27:39.319 --> 00:27:45.559