Porto Alegre, Brazil – Social problems, including health care concerns, led millions of people to protest on the streets of Brazil in 2014. Brazil has approximately 18 doctors per 10,000 inhabitants, a number that is above the world’s average of 14 doctors. There are more than 400,000 doctors for a population of 200 million inhabitants. Even so, there is a shortage of doctors in many regions of the country. A health program called “More Doctors” was offered to Brazilian physicians to improve the distribution of health care providers. Adherence was negligible, however, due to the reimbursement conditions and lack of basic infrastructure in many of the recruiting sites.

This “import” of professionals has led to new discussions about the quality of care that is being delivered, since providers’ credentials are not comprehensively validated. In the commentary, “More Doctors: Thoughts about a Controversial Health Care Policy,” published in Value in Health Regional Issues, authors Antonio C. Westphalen, MD, PhD from the University of California, and Stephen D. Stefani, MD from the Unimed Foundation, discuss the need for an international standard of professional qualification as a vital point that demands immediate debate. The authors state that the discussions should be based on scientific points, but typically they become a matter of political views. They urge the scientific community to define the models and goals of health care quality assessment.

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