We’re not just stealing the water. We’re smashing the pump.

Welcome back, dear colleague!

“We’re not just stealing the water. We’re smashing the pump.” Dr. Kate Tulenko made this comment in our recent conversation and when you think about the context and the problem it points to, it hits hard. 

She was talking about the global health workforce crisis — and how the U.S. plays a much bigger role in it than most people realize.

This week’s edition of People Power Health Insights features Dr. Tulenko, pediatrician, health systems expert, and global advocate for the people behind our care: clinicians. Her career has taken her from pediatrics to policy to authorship, but her focus has stayed steady — building a health system that invests in its people instead of extracting from others.

Here’s what every courageous clinician needs to know:

The U.S. has a clinician shortage. But how we fix it matters.

The U.S. healthcare system has a serious problem: we haven’t trained enough clinicians to meet our population’s needs. And instead of investing in local talent — especially from rural areas and historically marginalized communities — we’ve outsourced the solution.

That means relying on low and middle income countries to fill the gap. The best-trained nurses and doctors are being pulled from countries that need them just as much, if not more. As Dr. Tulenko explains, this means we’re draining talent from health systems that are already under strain.

Our problem is global. And interconnected.

In her book Insourced: How Importing Jobs Impacts the Healthcare Crisis Here and Abroad, Dr. Tulenko lays out the full picture: underinvestment in health worker education here directly impacts access to care abroad. The result is a domino effect of shortages, especially in maternal health, primary care, and emergency medicine.

What can be done — right now?

Plenty. And some of it doesn’t even require new funding. Here are a few levers Dr. Tulenko lifts up:

• Redirect state higher education funding to align with real workforce needs — especially in medicine, nursing, and allied health.
  

• Invest in students from the communities most affected by the provider shortage — including rural, African-American, Latino, and Native American students.
  

• Address dropout rates by supporting mentorship, housing, transportation, and child care — often the barriers that push students out.
  

• Support educators. In many countries, nursing programs can’t expand because there aren’t enough teachers. Even teaching one course can help.

What clinicians can do?

This isn’t just a policy problem. It’s a community problem — and clinicians are in a position to lead:

• Mentor someone. Especially someone who might be the first in their family to go into healthcare. A single conversation or ongoing support can change a life.
  

• Fund scholarships. In some places, $500 can mean the difference between someone finishing their training or dropping out.
  

• Teach. If you have a master’s degree, even part-time or virtual teaching can help break the logjam in health worker education.
  

• Tell the story. Too few people understand the deep connection between workforce justice here and abroad. Use your voice.

That’s what Dr. Tulenko told us — and we believe her. Because change doesn’t come from the top. It comes from communities of clinicians organizing, sharing knowledge, mentoring, and demanding something better.

That’s why the Courageous Clinicians Community exists. And why we’re featuring voices like Dr. Tulenko’s — to remind each other what’s possible when we connect the dots between care, policy, and people.

Listen to the entire conversation HERE!

LATIDOS - Are you ready to address health inequities and create real change in your community? 

After three powerful editions of HEART: Advocacy Training for Courageous Clinicians, we’re excited to announce our new cohort—and the first-ever edition in Spanish! 🌎✨

As a clinician, you witness the impact of health inequities every day. But creating change doesn’t have to be a solo journey.

That’s why we created LATIDOS: Liderazgo y Acción para Transformar, Innovar y Defender la Organización en Salud - a free, interactive, 6-week online program designed to equip clinicians with the skills, support, and strategy to lead impactful advocacy and community organizing work.

This program is for healthcare professionals ready to move from awareness to action and lead the charge toward health justice.

The application form is available HERE!