We must relax restrictions on foreign doctors

The Trump administration just made it a bit easier for foreign doctors to join the fight against the coronavirus.

This month, U.S. Citizenship and Immigration Services authorized foreign doctors in the Conrad 30 program to conduct telehealth visits across state lines. Previously, these doctors — up to 30 per state — could only practice in the rural, underserved communities to which their visas assigned them. The move could reduce pressure on hospitals in COVID-19 hotspots by allowing patients who need care for other reasons to seek it without leaving their homes.

It’s a small step in the right direction. Foreign-trained physicians have long been key members of America’s healthcare workforce. Our leaders must attract more of them to this country — and permit them to practice to the fullest of their abilities, both now and after the pandemic passes.

The United States is in dire need of doctors. The Association of American Medical Colleges estimates the country could be up to 122,000 physicians short over the next decade. Some regions are already facing shortages. The South needs some 31,000 doctors to meet present demand; the Midwest, about 13,000.

COVID-19 has exacerbated this state of affairs. Hospitals in coronavirus hotspots have had to deal with a surge in patients, often without a corresponding increase in providers. Those doctors who are on the frontlines can be knocked out of commission for weeks if they contract the virus.

Policymakers have tried all sorts of things to increase the supply of doctors, from graduating medical students early to coaxing doctors out of retirement. But they’ve been surprisingly reticent to open our doors to more foreign doctors.

USCIS recently suspended “premium” visas, which the government has to process within 15 days. Eliminating the premium option forces foreign physicians into the regular applicant pool, which was already plagued by a years-long backlog. Currently, 10,000 doctors are waiting for a visa.

Foreign-trained doctors also face absurd bureaucratic barriers. The government requires foreign physicians to submit a paper copy of their application for an H-1B visa, which allows someone to work in a highly-skilled profession and can run hundreds of pages. Even when granted, H-1Bs prevent doctors from switching employers, working in other states, or practicing outside their approved specialty. These restrictions have prevented experienced doctors with low caseloads from relocating to states that have been hit hard by COVID-19.

As Dr. Shantanu Singh, a critical care physician in West Virginia, puts it, the existing visa policy “takes thousands of physicians out of the pool that can buttress the loss of doctors from exposure, infection and illness while fighting the pandemic.”

Among those thousands of physicians are an internal medicine hospitalist based in rural Delaware, who recently told The New York Times he’d been bombarded with calls from recruiters hoping to shuttle him to hospitals struggling with COVID-19. Visa restrictions prevented him from moving. An Illinois-based internist who has been working in the United States for 13 years told NPR his visa bound him to his employer and prevented him from helping out in New York.

The United States is even less accommodating to foreign medical students doing their residencies here. If they’re on a J-1 visa, as most are, then they must return to their home countries for at least two years before they’re allowed to apply to return to the United States, with limited exceptions. About one-third of these foreign doctors training in the United States are from India.

In other words, the United States routinely turns away foreign doctors as soon as they’ve finished their training here. That makes little sense.

COVID-19 has revealed the depths of America’s doctor shortage. Foreign-born and foreign-educated physicians want to help fill that shortage. We must allow those who are qualified and can meet our nation’s examination requirements to do so.

Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.

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