By now most Americans have had their lives upended, at least to some degree, by COVID-19. But states that have not yet been hit by the brunt of the virus must take this extra time to prepare for the respective peaks that are coming. The best way to do that is to seriously consider the problems the worst-hit regions have faced—with physician and healthcare worker shortages among the most pressing—and take early mitigation efforts.
The northeast corridor, amid sharply increasing infected patience, has simultaneously been devastated by increasing physician shortages as the already limited number of healthcare workers continue to fall ill. As a result, the states that are in the midst of their “peaks”—namely New York and New Jersey— are rapidly mobilizing to bring in new healthcare personnel, including foreign doctors, to deal with the sick and dying.
For a short period of time, other states have a luxury that the current epicenters do not—time. With this time, every other state should implement similar regulatory and emergency changes that New York and New Jersey have made to increase the number of healthcare workers ready to take on the disease that is coming to both small towns and big cities in America. To do so effectively requires states to quickly capitalize on the foreign doctors, nurses, and other essential healthcare workers that want to help, but can’t due to regulatory barriers.
Both New York and New Jersey announced sweeping changes to professional licensing and liability requirements that allow for additional healthcare workers to contribute to the care of patients, and to expand the abilities of other healthcare workers to help deal with the crisis. Using emergency authorities, the governors of both states temporarily modified their laws and regulations to allow graduates of foreign medical schools to provide patient care in hospitals, provided they have at least one year of graduate medical education in the U.S. Another critical change made by New Jersey is to temporarily allow foreign doctors in good standing in other jurisdictions to practice in the state if they choose.
Similarly, Governor Gary Herbert in Utah signed a bill that adopts Canada’s international licensure standards. Now, foreign medical graduates don’t have to repeat their residencies if they practiced in Australia, the U.K., Switzerland, South Africa, Hong Kong, or Singapore. This change alone will reduce restrictions to practice for well over 7,500 physicians this year.
It’s important to note that the process for foreign doctors to practice in America is pretty much the same as it is for doctors here. Every foreign physician applicant must have graduated from medical school, and all interested foreign medical school graduates apply for a three-seven year residency program.
It’s also worth noting that not all applicants for residencies in the U.S. are “new” doctors—some are highly experienced and are looking for specialized training in niche fields that only the U.S. offers, thereby increasing the caliber of applicants. Thus, it should come as no surprise that the competition for spots is stiff: according to the National Residency Matching Program (NRMP) there were 35,000 applications for 27,000 positions in 2016.
Granting foreign medical graduates with at least one year of practice the flexibility to move to epicenters of need is an urgent, vital change—but states should go further. New York, for example, also allows other “specialist assistants” to provide patient care in hospitals, many of whom are immigrants.
In fact, according to the New American Economy, foreign immigrants make up large portions of critical healthcare fields:
- Physicians: 27.9% are foreign-born
- Home Health Aides: 27.7%
- Surgeons: 25.4%
- Nursing Assistants: 25.2%
- Health Diagnosing and Treatment Practitioners: 24.6%
Effective immediately, states should follow suit by allowing nurses, emergency room technicians, pharmacists, and respiratory therapists to provide patient care, regardless of the place of the location of their training. And in addition to waiving specific jurisdictional requirements of practicing physicians and healthcare workers, states should follow New York and New Jersey’s example by providing liability immunity to healthcare workers on the frontlines of the COVID-19 response.
State Governors should also push administration officials to ensure that the nearly 4,200 foreign physicians set to come to the United States this year on J-1 visas are actually able to come. Because the State Department has effectively paused the issuance of visas, these doctors may not be able to accept the residency matches they just received last month, and contribute to a crisis that looks like it will unfold over the course of many months—not weeks—in the U.S.
States must capitalize on the precious time they have at their disposal to prepare for the onslaught of COVID-19 cases. Allowing foreign physicians and related personnel to provide care for the hundreds of thousands of Americans in need is a desperately necessary step.
Photo Credit: By Javed Anees – District Hospital, Tirur, CC0, https://commons.wikimedia.org/w/index.php?curid=87879036