As I watch the debate over immigration reform in Washington, D.C., it is apparent our leaders need to be reminded of the implications the issue has for the future of medicine.
As the chairman and physician-in-chief of the Cleveland Clinic Children’s Hospital, I can tell you that one-third of my colleagues here are immigrants. They help provide a diversity of ideas and top-tier global talent to the American medical system.
I, myself, am an immigrant. I came to the United States 23 years ago as a pediatric resident. I am thankful for the opportunities this country has afforded me, particularly the opportunity to practice medicine in a world-class environment. The Cleveland Clinic provides unmatched care to patients and conducts important research to advance innovations in the field.
However, the entire American medical system is increasingly stretched thin. By 2020, the United States is projected to have a shortage of 45,000 doctors. In particular, the aging “baby boom” generation and their increasing need for medical care is testing the limits of quality and availability. The country is going to need more primary care physicians along with specialists in geriatric medicine and pediatrics. General physicians and specialists are already very hard to come by in rural areas. There are many parts of the country, including some communities in eastern Ohio, that are currently underserved.
There are numerous highly-qualified candidates who can help provide the care America needs. Nearly 50 percent of STEM (science, technology, engineering and math) students in Ohio’s research-intensive universities are foreign-born. Simply put, the physician shortage cannot be attributed to a lack of trained graduates in these fields. We are indeed educating many of the brightest minds in medicine, but through red tape and a convoluted visa system, we are making it difficult for hospitals and medical practices to retain those who wish to stay in the country. Most need to return home at least two years after completing their education.
This makes little economic sense. In fact, the Partnership for a New American Economy found that 262 American jobs are created for every 100 foreign-born graduates with a master’s or Ph.D. in a STEM field who remain working in the United States.
The specialty-worker, or H-1B, visa system is quite limited in its current state. Only 65,000 specialty-worker visas are awarded annually. A fraction of those go to doctors.
If the demand is there, and foreign-born doctors meet the language, skill, and accreditation requirements, we should undoubtedly be welcoming them.
President Barack Obama and Congress should consider the health care field as just another reason for immigration reform. A visa process that would encourage foreign-born doctors to practice in underserved areas of rural America would be an excellent start. Expanding the specialty-worker program would be another wise choice for policymakers. More physicians should be allowed to stay in the country upon graduation. Country-specific caps should also be re-examined, as some nations are providing more adequately trained future doctors than others.
These are just some of the potential changes that can be made to address this growing problem. At the end of the day, it will take political will. I am confident, however, that the country I now call home and where I raise my children will rise to the challenge. Innovation and the highest-quality care depend on it.
Giovanni Piedimonte, M.D., is chairman and physician-in-chief of the Cleveland Clinic Children’s Hospital.