That’s a very personal decision, but U.S. Homeland Security requirements make it exceedingly difficult for foreigners to live and work legally in America. And, in the Latin culture family ties are very important, so the doctors may prefer to remain closer to their extended family environment. Guatemalan doctors work very hard to earn their credentials out of a deep devotion to keeping people healthy by utilizing the latest technological advances. Perhaps many of them would rather continue their practice in a country where it is most appreciated, without the burden of government and legal interference, than to join America’s bureaucratic medical system.