Vital Signs

The Healthcare Business Blog

Providers should look to foreign-educated workforce to address shortages, study says

By Ashok Selvam

As the White House and members of Congress scurry to revive immigration reform in the waning legislative session, a new study argues that U.S. healthcare providers could address critical workforce shortages in underserved areas and primary care by nurturing the ranks and pipeline of foreign-born workers.

Though the foreign-educated workforce is growing—international medical graduates represent close to 26% of the U.S. physician workforce—the authors of the new RAND Corp.-backed study conclude that hospitals and the government need to do more to support these workers.

“There is no cohesive national policy that outlines a strategy for how to incorporate foreign-born and foreign-trained health professionals into the U.S. workforce,” said Dr. Peggy Chen, the study's lead author and an associate natural scientist at RAND. “Policy changes could increase the stability of the nation's healthcare

workforce, while also improving the experiences of foreign-born health workers.”

The research, published in Health Affairs, brings together a variety of data on foreign-born healthcare workers, with the goal of providing the audience with a better perspective on immigration and other issues, Elizabeth Bradley, one of the study's co-authors and professor of health policy and management at the Yale School of Public Health, told Modern Healthcare.

Many of the numbers reported in the study, Bradley pointed out, have been reported before—for example the estimate that 20% of direct-care workers in the U.S. entered the country illegally. But the research team vetted what was published and sifted through much of the anecdotal and bad data that could skew perceptions, she said.

Foreign-born nurses, according to the study, represent 12% to 15% of the registered nurses in the U.S., and 5.4% of U.S. nurses are both foreign-born and foreign-educated. From 2001 to 2009, the number of direct-care workers from other countries grew from 375,820 to 676,200—as many as a quarter are now foreign-born.

The authors make a few suggestions to improve the healthcare system and the lives of foreign-born workers. They include allowing more of them to become legal permanent residents, reimbursing workers' home countries and adopting policies that encourage the immigration of direct-care workers to the U.S. The authors also encourage healthcare employers to better support foreign-born workers.

Bradley pointed out that hospitals play a particularly important role because they are most apt to sponsor a worker's visa. “Also, it's inside a hospital, a large organization, that they'll have the structure to be committed to the better treatment of people from diverse backgrounds,” she said.

Follow Ashok Selvam on Twitter: @MH_aselvam


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