The United States has had a shortage of physicians for several decades. It is only because immigrant physicians have come to the US that we have been able to address the shortage, particularly in rural and inner city communities. Almost 25 percent of physicians in the US, some 200,000, graduated from medical schools abroad, reports Liz Mineo for the Harvard Gazette.
Physician shortages in the US has been a problem for more than a century. Medical professionals made it hard to become a physician. They made it especially hard for women and minorities. The profession opened up in the 1960’s. But, medical school is expensive, and it’s hard to become a physician without amassing significant debt. Loan forgiveness programs have always been needed.
In 1965, the Hart-Celler Immigration and Nationality Act was designed to help fill the physician void after Medicare and Medicaid became law. The US had 20 million more insured Americans but not enough physicians to treat them all. Many rural and urban communities lacked an adequate number of US-born health care workers. Few US doctors wanted to practice in these communities.
As a country, we depend heavily on immigrant physicians. Immigrant physicians have especially helped provide care in poor urban and rural communities. Eram Alam, an associate professor at Harvard University, documents the role of immigrant physicians in her new book, “The Care of Foreigners: How Immigrant Physicians Changed U.S. Healthcare.”
Today, foreign-born doctors tend to practice primary care medicine and work in underserved hospitals and clinics. They most often come from India and Pakistan. They also come from the Philippines and Nigeria. Because of cultural and social differences, they must learn to fit in.
We are now facing the prospect of a shortage of immigrant physicians. Rural hospitals will suffer significantly. The Trump administration has raised the cost of the H-1B visa to $100,000 from $5,000. Many rural hospitals rely exclusively or nearly exclusively on immigrant physicians but cannot afford to pay the new cost. The US also needs more physician assistants, nurse practitioners and community health workers treating patients when physician skills are not needed.
Here’s more from Just Care:
- Rural hospitals need government help to survive
- Democrats successfully contest some provisions in the Republicans’ reconciliation bill
- Republican bill would increase medical debt significantly
- Congressional Budget Office finds $1 trillion in Medicare Advantage overpayments
- New physician survey finds prior authorization harms cancer patients
