Puerto Rico’s doctors are abandoning the island in significant numbers as an economic crisis forces them to seek work elsewhere, according to the US territory’s College of Surgeons.

In a statement on April 12, the medical body reported that 361 doctors left the country in 2014 alone. Most relocated to the United States, attracted by vastly greater salaries: a pediatrician, according to the island’s Pediatrics Society, earns 1.9 times as much on the US mainland than in Puerto Rico.

While some made the move northwards to get new experiences and study specialities that are not available on the island, most migrating doctors cite the low fees they earn from health plans as the driving factor.

“I’ve now spent six weeks in the United States, and I’m asking myself why I didn’t go before,” Héctor Nieves, now based in Wauchula, Florida, told El Nuevo Día.

The pediatrician explained that dramatically rising costs over a quarter-century in Puerto Rican medicine were nowhere near matched by feeble salary growth.

“Twenty-five years ago when I started, rates of private health plans started at $22 [per visit] and at the end of my practice were $27,” Nieves reported, adding: “what was initially prosperous, in recent years became untenable.”

The Florida resident mentioned that he receives phone calls every week from Puerto Rican colleagues looking to up sticks to the US mainland.

José Ponce Ríos, a doctor since 2009, has moved to Boston, Massachusetts, to secure a residency in pediatrics, and familiarize himself with other health systems and a different way of life.

“My goal was to return to Puerto Rico, but as you make all the changes, you begin to understand the market, and here is where the jobs are,” he said. For Ríos, the dramatic pay hike was also a welcome bonus.

Surgery “Crisis”

Back in Puerto Rico, senior medical personnel fear a growing shortage of trained staff could damage patient care.

The capital city of San Juan is home to 40 percent of the island’s specialized doctors, while less populous parts of the country have to get by with clinics and general practitioners.

According to Edgar Colon, dean of the University of Puerto Rico’s Faculty of Medicine, the island is “facing a significant crisis” in general surgery, with no training of trauma surgeons having taken place for over 10 years.

For Victor Ramos, president of the island’s College of Surgeons, the specialities facing the greatest shortfall those trained to carry out vascular and pediatric cardiovascular surgery.

Ticket to Ride

Ramos explained the drain of local medical personnel by noting that a local pediatrician is paid US$27 per visit, while the same doctor on the US mainland can earn $200.

Luis Dávila, a lawyer and leading political commentator in Puerto Rico, told the PanAm Post that the example of the doctors is no different to other groups of Puerto Ricans that have chosen exile during the island’s current “great depression.”

“They leave because in the USA you earn more, the cost of living is 25 percent less, you pay 50 percent fewer taxes, there’s greater security, public schools are better quality, the government is not stifling its citizens, and there’s first-world quality of life,” he said.

“Plus, the only visa that we need is a flight ticket”, Dávila concluded.