- The AMA is calling on US Citizenship and Immigration Services (USCIS) to work through its backlog of H-1B Visas to allow non-resident physicians to practice in the country. Non-resident physicians play a significant role in closing physician shortage gaps in medically underserved regions and improving patient care access, AMA said.
In a letter to USCIS, AMA expressed concern about the backlog of H-1B visas for highly-skilled professionals awaiting green cards.
H-1B visas allow non-residents to reside in the United States in exchange for performing a specialty job or service. In the case AMA presents, H-1B visas allow non-residents to live in the United States in exchange for providing medical care, especially in traditionally medically underserved areas.
Currently, the per-country caps are prohibiting USCIS from approving all of the visa applications, which is keeping the medical community from leveraging its full workforce to address physician shortages across the country.
In 2016, the US experienced a physician shortage of just under 20,000 physicians, according to data from the Associating of American Medical Colleges (AAMC). That shortage is predicted to swell to between 42,600 and 121,300 by 2030, AAMC reported.
There is little disagreement in the medical industry about the importance of closing care gaps that stem from the physician shortage, and industry leaders have proposed numerous solutions to the problem. Prominent among those solutions is supporting a foreign-trained medical workforce and hiring non-residents.
“These physicians play a critical role in providing health care to many Americans because they tend to choose primary-care specialties and work in areas of the country with higher rates of poverty; they are providing important medical services to communities in need,” AMA wrote in its letter to USCIS. “According to a recent report, about 20.8 million Americans live in areas where at least half of the physicians are foreign-trained.”
Growing the medical workforce is of great importance in all areas, but especially in areas that are already medically underserved. And as the AMA pointed out, foreign-born physicians typically practice in these underserved areas.
But these areas will need more support as the physician-patient ratio continues to widen. Currently, 85 million patients live in an area that is deemed medically underserved, and those regions need about 15,000 more physicians to get rid of that distinction, AMA reported.
AMA is calling on USCIS to refigure its policies for processing H-1B visas to enable more foreign-born clinicians to work in the US, support patient access to care, and close care gaps in medically underserved areas.
“The six-year limit on H-1B visas, coupled with a USCIS policy ‘instructing its officers to apply the same level of scrutiny to both initial petitions and extension requests for certain nonimmigrant visa categories’ is creating additional roadblocks for these physicians who are providing quality health care to some of the neediest Americans with some of the most complex health issues,” AMA concluded. “As a result, it is critical that we work to immediately clear the large H-1B visa backlog for IMGs who are actively practicing in the U.S. and provide them with permanent resident status.”
AMA is not alone in advocating for visa expansion as a method for addressing physician shortages.
Legislation proposed in 2017 in both chambers of Congress called for extension of the Conrad State 30 Waiver program through 2021. The Conrad State 30 Waiver program allows states to grant visas to foreign-born physicians under the condition that physicians will practice in rural areas or areas that are otherwise medically underserved.
Expanding the visa program makes good sense, supports of the bills said. Most of the visas’ recipients received their medical educations in the United States. It only makes sense that the nation work to keep these clinicians in the US, especially when the clinicians are working to address care access gaps cropping up across the country.
In June 2017, USCIS reported that it would resume “premium processing” for physicians receiving an H-1B visa under the Conrad 30 Waiver program.
However, this most recent letter from AMA suggests USCIS must do more to expedite processing in order to grant more providers the ability to practice in medically underserved areas and improve patient access to care.