Rochester Post Bulletin
Tucked into the comprehensive immigration reform bill that's working its way through Congress is a provision that has deep implications for Rochester and Mayo Clinic.
Sen. Amy Klobuchar's Immigration Innovation Act would change rules that force foreign-born doctors to return to their home countries and allow them to remain in the United States — if they agree to practice in rural and other underserved communities.
Such doctors would address a pressing need. The Association of American Medical Colleges projects a shortage of 63,000 doctors by 2015 and more than 130,000 by 2025. The AAMC, as well as the American Medical Association and the American Hospital Association, support changes to federal immigration law that allows more visa waivers to ease physician immigration.
Klobuchar was at University Center Rochester on Friday to explain how physicians who are training in America on J-1 visas are required to return to their home country for two years after completing their residency. Klobuchar's legislation would waive the two-year, home-country requirement if physicians agree to work in an underserved area for three years. Her bill also would expand the number of available J-1 visas.
Currently, each state is granted 30 J-1 visas per year. Some states fill them quickly, while other states don't. For example, the Virginia Department of Health has no slots available, according to its website. Meanwhile, the Pennsylvania Department of Health reports that it received 39 applications and has just eight vacant slots remaining.
"We've lost candidates because we couldn't promise them one of the 30 slots," said Dr. Patricia Simmons, Mayo Clinic's Executive Medical Director for Health Policy, who appeared with Klobuchar at Friday's news conference.
The immigration bill would create three new J-1 visas per state for academic medical centers and employ a formula to increase state waivers by five whenever 90 percent of them are filled nationwide.
Huge changes are immediately in store for America's medical system with the aging of both patients and their doctors. About 10,000 people reach retirement age every day, and nearly half of the 830,000 physicians in the United States are older than 50 and approaching retirement.
Adding to the demographic changes are the addition in 2014 of 30 million previously uninsured people with access to heath services through the Affordable Care Act, also known as Obamacare.
We strongly favor Klobuchar's sensible provision for immigration reform, and we hope this bill doesn't get caught up in emotional rhetoric employing the Boston Marathon bombings as a reason to delay changes in immigration laws.
Klobuchar's bill is one component to addressing health-care shortages in remote areas. Other solutions might include having more second-tier providers, such as nurse practitioners and physician assistants, handle duties typically done by primary care doctors. We expect a combination of health-care reforms ultimately will address these physician shortages.
This legislation is not about displacing American medical professionals. It's about providing health care to people who live in regions where access to doctors is increasingly harder to come by.