Episode 24 | #COVIDConvo Ep. 10
#COVIDConvo Ep. 10: Temporary Healthcare Workers and VISA Ban by the Trump Administration
Alex and Dr. Wendy Tong, MD MHA, talk about the recent events with the COVID-19 pandemic happening all over the world and discuss topics like healthcare, eldercare and keeping your loved ones safe.
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ALEX: Today we explore the impact of a recent proclamation in US immigration policy, on the COVID pandemic. A few days ago, on June 22nd, the US released a proclamation suspending the entry of quote “Aliens Who Present a Risk to the US Labor Market Following the Coronavirus Outbreak” end quote. This effectively suspends H-1B, H-2B, J and L visas under which foreign doctors and nurses fall. The US has long experienced a shortage of healthcare workers especially among doctors and nurses which has been further heightened by the COVID pandemic. Wendy, how dependent are we as a nation on foreign healthcare workers? and can you comment on how this proclamation may further compound the shortage of health care providers as we anticipate a surge of COVID cases during the winter cold and flu season?
WENDY: The US is critically dependent upon foreign health care workers. Immigrants make up 17% of all US health care workers. And over one in four doctors are immigrants. Even before the pandemic, the American Medical Association (AMA) estimated that the US will have a physician shortage of up to 121,000 by 2032. Every year, 4000 foreign physicians enter the US workforce on J1 visas. The suspension of these visas means our US citizens will have even less access to medical care. Lives will be lost and we will start noticing it in a few months especially during the winter cold and flu season when the need for health care resources will increase.
ALEX: Isn’t there an exemption for healthcare workers since they are helping us respond to the Coronavirus outbreak?
WENDY: Not really, if you read the fine print in the proclamation, the exact wording of the exception is limited to health care workers who are providing “medical care to individuals who have contracted COVID-19 AND are currently hospitalized”. This only applies to a small population in proportion to ALL the medical needs for our entire population.
ALEX: But don’t individual states control their licensing requirements so that they can allow foreign health care professionals to practice?
WENDY: You are correct, Alex. And Andrew Cuomo in New York waived certain licensing requirements for foreign physicians to practice. However, NY has been the only state that has taken this action. Don’t forget Alex, that state level licensing can only apply to physicians and nurses who are already residing in the US and won’t address the problem of bringing in physicians and nurses into the country.
ALEX: Has US immigration policy always been restrictive to foreign health care professionals? It seems hard to believe since health care is an industry with highly specialized professionals for whom there is always a demand?
WENDY: Sadly, US immigration policy has a long history of being restrictive to all immigrants and even those with specialized and needed skills…skills that aren’t taking away from an American because it’s in an area of shortage where there aren’t enough Americans in that occupation to begin with. An Indian doctor typically can wait 20 years for a green card and can only practice in certain geographic (often rural) areas for certain populations.
ALEX: Wendy, it’s irrefutable that the US has a dire need for healthcare workers, a need that’s been increased dramatically with COVID. The proclamation suspending the entry of much needed healthcare workers into the US has been made and will add to an existing shortage of healthcare workers and therefore impact the quality and access to healthcare for all of us. What do you predict will be the fall out?
WENDY: Alex, I’m going to speak like an economist…whenever the supply of resources cannot meet the demand for that supply, then market forces will create replacements or substitutions for those resources. If those substitutes aren’t sufficient, then the next response will be to shift the demand. Applying these principles to healthcare, we’ve already seen the rise of telemedicine that extends the productivity of physicians. Telemedicine alone won’t be sufficient to meet the demand and doesn’t fully substitute for in-person patient care. Nor will substituting nurse practitioners or physician assistants for physicians, completely suffice. Therefore, the demand will be forced to shift and how I see this happening is patients across the board will be shunted to lower levels of care…patients who would otherwise be cared for in the intensive care unit, will be transferred to the medical ward and the patients who would normally be on the medical ward may be discharged to a rehab facility and those in the rehab facility would be discharged home with home care.
ALEX: Wendy, your company Wendy’s Team is in elder home care. What you are describing will impact home care, how are you preparing for all of this?
WENDY: I’m preparing my Team Members by offering them additional training on taking care of clients whose needs are higher than what we are usually accustomed to. For example, we don’t take care of more than a couple of Clients who are completely bed bound or at the end-of-life at any given time. I’ve started providing additional training for my Team Members into how to take care of these more complex patients to my Team.