Trump immigration policies disrupt health care: Column

The United States has faced a persistent physician shortage for decades, particularly in rural and poor urban areas. Now, with two new Trump administration policies, the problem is only going to get worse.

Foreign national doctors have helped to fill this massive geographic gap in health care, receiving training in the United States and then working in underserved areas in return for continued visa status and the prospect of settling permanently in the U.S. More than a quarter of all physicians in the U.S. are foreign nationals, a figure that has remained relatively unchanged for decades, and American patients have benefited greatly from their presence.

President Trump’s new travel ban, combined with another major change announced by immigration authorities, threatens to turn the current regime for foreign national doctors on its head and intensify the country’s shortage of doctors. That’s bad news for all of us, especially for residents of rural and small-town America. Those areas are already disadvantaged in recruiting doctors — and they are also where Trump racked up his winning margins on Election Day.

Trump’s new executive order, with some exceptions, bars nationals of Iran, Libya, Somalia, Sudan, Syria and Yemen from obtaining new visas. This executive order came a few days after the government announced a six-month suspension of “Premium Processing” for H-1B skilled worker visas. These are the visas many doctors must use, and the program allowed fast processing of them.

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The travel ban is shrinking U.S. access to quality physicians and will make life harder for many who are here, by preventing their relatives from visiting or living in America. Syria and Iran have long supplied us with top-notch physicians (about 14,000 doctors in the U.S. hail from these two nations). Barring new visas from these countries will cut off an important supply of great doctors.

And even doctors in the U.S. supposedly unaffected by the new order are going to be hurt. For example, once these doctors become U.S. citizens, they can petition for their elderly parents to join them in the U.S. Under the new order, until some uncertain date in the future when the ban is lifted, parents must go through a stringent case-by-case waiver process. This could be a deal breaker in retaining these doctors.

Premium processing is critical in many physician immigration cases. The normal processing time for the visa doctors use is around eight months. Premium processing cuts that to two weeks. Employers pay an additional $1,225 to get the faster turnaround, which more than covers the government’s extra costs in getting the work done fast.

What’s the big deal if these cases take months instead of weeks? Well, for one, the country’s teaching hospitals all select their medical residents this month and those doctors all begin their training July 1. The doctors must use Premium Processing to have any shot at starting on time; without it, training programs across the country will be disrupted.

And the program that allows doctors to take jobs in underserved areas after their training is finished also will be disrupted. For a variety of reasons, the doctors often only have a few weeks to get a work visa approved and transition from their training programs to the small-town and inner-city hospitals and clinics they’ve agreed to serve in exchange for being able to stay in America. A lot of patients will find themselves without access to these trained, vetted doctors for months because of the suspension of the program.

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The suspension will also prevent doctors from traveling internationally and from renewing their driver’s licenses for the months their cases are pending, a serious problem for doctors living in rural communities.

Perhaps that’s the Trump administration’s plan: to make the lives of the foreign doctors difficult enough that they’ll want to leave, while preventing new ones from coming. If that’s the case, then the first to be harmed will be the urban and rural poor, who will be forced to wait longer and travel further for the care they so desperately need.

James Hollis and Greg Siskind are immigration lawyers based in Tennessee. Greg Siskind is the author of the Physician Immigration Handbook. Follow them on Twitter @jwhollis and @gsiskind

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