Immigration reform and health care reform both receive a
great deal of press. Living in Texas, I follow the immigration debate closely. As a border state, Texas has almost 1.4 million unauthorized immigrant adults, with two-thirds of those living with American born, citizen children. More than half, 59%, of those adults and 36% of their children have no health insurance. The coverage and care of this population is one side of the immigration debate.
Another side of equal concern is the use of foreign born, American trained physicians (FBAT), in America. Unless you have been hiding in a closet, you know that we face a physician shortage. A viable source to help in this area are physicians born in other countries who attend medical school abroad, but come to the US for residency and fellowship training. Currently we have in place a program called the Conrad 30, which helps states place these FBAT physicians in rural areas where American born, American trained (ABAT) physicians are harder to place.
Conrad 30, J-1, and H-1B candidates and the process for sponsoring and hiring one of these candidates can be complicated and expensive.
Many facilities abandon the idea before they even start when they hear some of the complexities involved.
Given our involvement in Primary Care, I believed I was aware of the legislation impacting our world, but I was surprised to read an article today stating that the immigration reform bill currently under debate will affect both these areas of concern. Although it is unlikely that the bill will ever pass in its current form, tucked away in the middle of the bill is a section that addresses the hiring of FBAT physicians and the Conrad 30 program. Carl Shusterman, an immigration attorney from LA, is very excited about the physician part of the bill. He stated that the Conrad 30 is a good program but, “like any program there are a bunch of flaws that we have been trying to correct for 20 years and this bill corrects most of them.”
This part of the bill is not very controversial and will likely remain untouched as the haggling continues, and will hopefully make the hiring of FBAT physicians easier. In the article Immigration Bill Lowers Hurdle for Foreign Born Docs , John Commins, does a great job summarizing the effects of Immigration S.744.
Easing the restrictions on the placement of FBAT candidates
won’t solve the physician shortage, but every little bit helps. Now, here is
where I need to choose my words carefully. We talk to many facilities, even in very rural communities, who are unwilling to consider these candidates. Their open positions remain open for well over nine months, yet they remain committed
to hiring an ABAT physician. They offer a variety of potentially valid
objections including, they will only stay for as long as their J-1 status
allows, the sponsorship process is too complicated, they won’t be accepted by the patients, and they are not trained as well as ABAT candidates.
Our goal is to help our clients provide medical care to patients who are not being seen and to bring revenue to a facility that needs a provider. FBAT candidates have completed the same residency and fellowship training as any ABAT candidate and are well qualified. Most are Board Eligible
or Certified. If they are welcomed into the community, in most cases, they
become involved and often stay. On the other hand, even if they do not, the facility has seen revenue and patients for three years that they would have missed without the provider. And as far as the patients not accepting them, it does not take long, when there is a need, for patients to find that an FBAT physician trained in Primary Care is a compassionate provider, and that
overcomes most objections.
When our clients open their parameters to allow us to speak
with FBAT candidates, they see a pipeline that they were previously missing. Improving the legislation, making it easier for hospitals and states to navigate Conrad 30, will eliminate one log jam. Educating administrators and consumers about the benefits of FBAT candidates can eliminate another.
Maybe we will get lucky and they will pass some form of Immigration S.744 and they won’t tinker with that section in the middle about physicians. Well, we can hope.
Let’s make a plan. Let’s go from chaos to calm. Let’s get things inline. The Inline Group.