The Doctor is In, Let’s Not Send Her Out
Tom Brokaw recently published an Op-Ed remarking upon the incredible diversity of medical talent that populates our nation’s healthcare system. Without question, we derive tremendous benefits from international medical graduates, nurses, physical therapists, medical researchers and other allied healthcare professionals who help to fill gaps in care for rural and medically underserved populations all over the country. For example, according to the American Association of Medical Colleges, 24% of all practicing clinical physicians are graduates of foreign medical schools. These physicians make up key percentages of the total numbers of Internal Medicine (38.6%), Psychiatry (30.2%), Pediatric (25.4%) and Family Medicine (22%) physicians practicing in the United States, compensating, in part, for the projected shortage of more than 100,000 physicians by 2030. Foreign-born nurses constitute about 15% of all nurses employed in the U.S., helping alleviate a chronic nursing shortage that is on track to worsen as the U.S. elderly population increases. No wonder Mr. Brokaw took note of the “ethnic puree” of medical care he’d received and witnessed across the country.
As a business immigration attorney whose practice focuses on the healthcare sector, Brokaw’s writing struck a familiar chord. I thought about the many examples I’ve seen over the years of communities previously without healthcare suddenly having access because an immigrant agreed to provide it; of small community hospitals that hadn’t previously been able to offer Cardiology or Neurology services, becoming empowered to offer potentially life-saving aid to people in their community solely because our U.S. immigration system provides incentives to attract foreign-educated, U.S.-trained, physicians to work in underserved areas. And I couldn’t help but think, in particular, about my many clients who hail from some of those “s@!thole” countries, whose citizens our president thinks aren’t worth welcoming to our country. For example, the Haitian-born registered nurse working in rural south central Virginia who, thankfully, was able to maintain Temporary Protected Status long enough to initiate the green card process. Or, the psychiatrist, born in Nigeria and trained in Boston and New York, now providing urgently needed psychiatric services to underserved patients in western Maryland. I bet the patients served by these healthcare professionals would strongly disagree that Haitians and Nigerians have nothing to contribute to the U.S.
For all of its flaws, our current immigration system does a decent job of attracting healthcare providers to medically underserved parts of our country. In exchange for a waiver of what would ordinarily be a two-year requirement for many international physicians to return home following their U.S. training, we ask them to commit to working for at least 3 years in a federally designated physician shortage area, or at a Veterans Affairs (VA) facility. This is the “Conrad 30” program, which is once again up for renewal before Congress, and as such, its continued fate remains uncertain. In exchange for a 5 year commitment at such a location, international physicians can also get a green card. In addition, recognizing that there is a national shortage of Registered Nurses and Physical Therapists, we streamline the green card process for these types of workers, though it still takes many months and involves stringent background checks and U.S. workforce protections in the form of prevailing wage requirements. These statutory incentives are a win-win: foreign nationals obtain valuable benefits that enable them to remain in the U.S. and build productive lives; and U.S. citizens get access to healthcare that would otherwise be denied.
In these turbulent times, when the rhetoric surrounding the immigration debate is so often infused with fact-free bombast and bluster; with baseless blaming and racist ranting, I hope that the Administration, Congress, and the American people will look to the U.S. healthcare sector as an example of the vital and sustained contributions that immigrants are making to our society on a daily basis and will come to the same realization as Mr. Brokaw: “We’re lucky to have them.”