Melissa Freeman
Most of the news coverage of President Donald Trump’s recent executive order on immigration has appropriately focused on the harm to refugees. But many Americans are not aware that the executive order will also have a serious negative effect on health care for U.S. citizens.
The United States depends on foreign medical graduates to provide essential care in designated underserved areas. The Conrad-30 visa waiver program allows 1,500 foreign physicians each year – 30 per state – to pursue the American dream in exchange for working in areas that struggle to recruit U.S.-trained physicians. These areas that suffer physician shortages include many rural areas and small towns where Trump enjoyed strong electoral support.
The American Council on Graduate Medical Education estimates that there are over 10,000 physicians in the United States who graduated from medical schools in Syria, Sudan, Somalia, Iran, Iraq, Libya and Yemen: the seven countries named in the immigration ban. In addition, some subspecialties suffer from a workforce shortage and depend on the visa waiver program to partly fill in the gaps.
As a neurologist, I care for adults with serious autoimmune diseases such multiple sclerosis and neurodegenerative diseases such as Alzheimer’s disease, as well as movement disorders such as Parkinson’s disease and Huntington’s disease, among other neurologic conditions. Multiple sclerosis and movement disorders are treatable, but delays in diagnosis increase the risk of poor outcomes like permanent disability.
Unfortunately, due to a shortage of providers in my specialty, these diagnostic delays are common. What’s more, many of my patients must travel for hours to attend their specialty visits. I count among my close friends and colleagues several excellent physicians who are covered by the visa waiver program. Without them, the situation would be even more dire for all of our patients.
In the long term, I am very concerned that the travel ban will have a chilling effect on recruitment of international physicians, even those from countries not specifically named in the ban. If a United States visa can be cancelled with the stroke of a pen, the best and brightest doctors will seek positions in Canada, Europe or elsewhere. Americans – particularly those who live in small towns and rural areas, or have the misfortune to require the services of a scarce subspecialty – will suffer via the loss of affordable, accessible healthcare.
Donald Trump campaigned on a promise to improve the lives of working-class Americans, particularly those living outside of major urban areas. Keeping much-needed doctors out of the country is not a good start.
Melissa Freeman, MD, practices in Vancouver, Washington. She is joined by several co-authors on this piece, and they go by the twitter handle @physicianwomen
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