Puerto Rico Faces Doctor Exodus, Testing Nurse Practitioner Reform
Puerto Rico is experiencing a significant exodus of physicians, with a 2023 study projecting a loss of up to 4,800 doctors by 2030 due to retirement and relocation. This trend is fueling a fierce debate over whether nurse practitioners (NPs) should be granted expanded clinical authority to fill the growing healthcare gap. The island's physician corps is shrinking faster than almost any other in the United States, leaving approximately 5,600 practicing doctors to serve a population of about 3.2 million residents. The drivers behind this exodus are structural, including Puerto Rico's fiscal crisis, a decade of economic contraction, and more favorable salaries and Medicare/Medicaid reimbursement rates in mainland U.S. states like Florida and Texas. The remaining medical workforce is also aging rapidly, indicating an acceleration of retirements. Nurse practitioners, who are registered nurses with graduate-level clinical training, can diagnose conditions, order tests, and prescribe medication, but their legal a... 
