Tag Archives: Foreign-born physicians

Foreign-born, US-trained Physicians in Medical Travel vs US-born, Foreign-trained Physicians Practicing in the US and Foreign-born, Foreign-trained Physicians Practicing in the US

Those of you in the Workers’ Comp space have probably read my earlier posts extolling the benefits of medical travel, and promoting its implementation into workers’ comp.

Yet, in all those posts, hard evidence of the quality of care provided by physicians in these destinations was not presented.

However,  there is evidence that foreign trained, US  born doctors practicing in the US, provide as good as or better care than that provided by graduates of US medical schools, according to a recent study mentioned over the weekend in a post by Peter Rousmaniere, in his blog, Working Immigrants.

From this data, it may be possible to suggest that foreign-born doctors, trained in US schools provide the same good or better care than their American-born classmates, when they return to their home countries and work in medical travel facilities.

Before beginning to write this post, I tried to research some data on this, but was unable to find any recent information. However, it is well known that there are considerable numbers of foreign-born, US trained and Western trained physicians in medical travel facilities, which is one key factor in choosing to go abroad for medical care.

As Peter reported, among the 12.4 million workers in the health care field in 2015, 2.1 million, or 17% were foreign born. Of these, the foreign born accounted for 28% of the 910,000 physicians and surgeons practicing in the US. 24% of that number are in nursing, psychiatric and home health care.

How many of the foreign-born physicians trained in the US return home is not certain, but given the fact that many foreign born, foreign trained physicians have a hard time gaining access to practice in the US, it is not difficult to ascertain that those who do not enter the US end up working in their home country. In order to practice in the US, they must pass tests by a special commission and enter a residency program, even if they have done them before.

How many foreign trained, US born physicians practice in the US? According to Peter, about 25% of practicing physicians graduated from foreign medical schools. About a third of them are Americans. They are more likely, Peter says, to practice in rural and poorer communities, and are overrepresented in primary care. Given the physician shortage that I and others have commented on, there will be a need for more foreign-born doctors, and perhaps, more US trained, foreign-born doctors to work in medical travel facilities.

The Education Commission for Foreign Medical Graduates (ECFMG) gave roughly 10,000 certifications in 2015. 30.9% were issued to US citizens, 18.9% were issued to citizens of India and Pakistan, and 7.9% from Canada.

The states with the highest percentage of practicing physicians who graduated from foreign medical schools are New Jersey (40%), New York (38%), and Florida (35%).

Most of the New Jersey physicians no doubt practice in the Metropolitan New York Area, given the state’s proximity to NYC. And Florida has a large percentage given the demographics of that state.

So, if foreign-born, US trained physicians are ok for treating injured workers here, why can’t their fellow countrymen do the same back home if an injured worker, or his employer choose that as an option to expensive surgery at an American hospital?

Don’t tell me there is a difference, because there isn’t. It is only ignorance and prejudice that prevents foreign-born, US trained physicians from treating injured workers in medical travel facilities. That is another problem our health care and workers’ comp systems need to deal with.

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H-1B Visa Order To Limit Number of Foreign-Born Doctors

Before most of the Risk Management and Workers’ Comp industry goes to Philadelphia for next week’s Risk and Insurance Management Society (RIMS) annual conference, I want to share an article on Kaiser Health News about what the recent executive order on H1-B visas will have on healthcare, and by extension, workers’ comp.

I wrote about this two weeks ago when I said that the travel ban will affect the physician shortage in the United States.

According to Kaiser, limiting the number of foreign doctors who can practice in the US could have a significant impact on certain hospitals and states that rely on them.

A study in JAMA found that more that 2,100 US employers were certified to fill nearly 10,500 physician jobs nationwide in 2016, representing 1.4% of physician workforce overall.

States such as New York, Michigan, and Illinois account for most of the H1-B visa applications for foreign physicians. a third of the total.

North Dakota, on the other hand, had the most applicants as a percentage of its workforce, or 4.7%.

While the focus of the executive order was to clamp down on the loopholes in the program that allowed tech companies to hire foreign workers for high skilled jobs that Americans could take, it will also have a negative effect on how patients will receive care in some US hospitals.

And coupled with the fact that the process of getting to practice here without an executive order is difficult and time-consuming, means that both general health care and workers’ comp patients may not be able to get necessary treatment due to the predicted physician shortage.

So while general healthcare can offer an alternative in the form of medical travel, it is high time that work comp does the same.

Or do you really want your claimant patients to wait months before getting needed surgery or other medical procedures?

 

Travel Ban to Affect Physician Shortage: What Medical Travel Can Do

The following post, from fellow blogger, Joe Paduda, who has a guest post from former WCRI CEO, Dr. Rick Victor, states that the current political regime in Washington’s ban on travel from certain countries and ban on allowing a certain religious minority into the country will further exacerbate the already projected physician shortage that this writer had previously discussed in earlier posts on the subject.

Here is the link to Joe’s and Dr. Victor’s posts.

If there ever was a good enough reason for the implementation of medical travel into general health care, and into workers’ comp medical care, this is it.

Do you really want to see injured workers go without treatment or without needed surgeries because there aren’t enough US-born physicians and surgeons, because some narcissistic, egomaniacal, billionaire con artist has banned needed foreign-born physicians from entering the country?

Who knows? Maybe one of these doctors has a revolutionary new treatment or therapy that can bring relief to millions of Americans, or can cure a terrible disease?

Banning them only makes America weaker, not Great Again.

P.S. Here is a follow-up post from Peter Rousmaniere’s Working Immigrants blog.