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The decades long wait times for green cards for immigrant doctors is also hurting health care in rural America. https://money.cnn.com/2018/06/08/news/economy/i

The decades long wait times for green cards for immigrant doctors is also hurting health care in rural America. https://money.cnn.com/2018/06/08/news/economy/immigrant-doctors-green-card-backlog/index.html https://money.cnn.com/2018/06/08/news/economy/immigrant-doct... https://www.wusa9.com/article/news/local/maryland/communities-losing-doctors-due-to-battle-over-green-cards/65-3755e73c-5148-48dd-b6ec-944ab47b7ed7 https://www.wusa9.com/article/news/local/maryland/communitie... https://time.com/5299488/international-medical-graduates/ https://time.com/5299488/international-medical-graduates/

hestipod 7y ago
Friend married a Russian cardiac surgeon, one with 20 years of experience, brilliant woman. She was not allowed to practice in the US without years of redoing residency and entry level exams and loads of money. She ended up changing careers as it was so much bother. Patients ended up losing out on a caring and bright provider.
- honkycat 7y ago
  That is a feature, not a bug. Why would a well-paid, highly regulated profession allow people to come into their turf and undercut them? Not saying this is a GOOD thing. Merely pointing out that the system is working as intended.
  - C4stor 7y ago
    If the final user is losing, it's a bug.
    - magashna 7y ago
      At least in the IT world, there are lots of contractors sold on their certifications who end up being complete frauds. I'd like there to be some sort of way to prove your merit especially when you have people's lives in your hands.
      - Nuzzerino 7y ago
        In my experience being at the receiving end of many arrogant and unprofessional "doctors", having that medical license is far from proof of anything. If anything, the licensing requirement functions as little else than yet another barrier to competition, which ultimately harms the patients.
  - marrone12 7y ago
    There is no "undercutting" in health care. Vast majority of services are already priced out by insurance companies, there just aren't enough people to do all of them.
    - ses1984 7y ago
      >...there just aren't enough people to do all of them. which factors into the economics of prices negotiated between providers and insurance companies.
- PopeDotNinja 7y ago
  That sucks. There's probably a situation in the future where doctors, or at least surgeons, can work remotely. Russian doctor marries US citizen, logs into VPN in Russia from USA living room, performs Surgery with Nintendo remote.
- jermaustin1 7y ago
  A DBA I worked with a couple jobs ago was a surgeon in China. He immigrated in the mid 1980s. After he was told he would have to redo his med school, he also decided it wasn't worth it and instead "learned computers".
- jeegsy 7y ago
  If there is already an over-supply of docs already in the country, I don't see how an influx of foreign doctors helps anyone.
charlieflowers 7y ago
Some smart business in a foreign country should start providing tele-medicine to the US for reasonable prices. We could send blood work overseas cheaper than the piracy prices of labcorp, for that matter. They could explain it legally as "not medical advice" to skirt any FDA laws, but provide world class health care in reality. It's a business model that could really work. The "skirt America's dumb self-inflicted crap" business model.
- lazyasciiart 7y ago
  That would be illegal because they would need to be licensed as doctors in the state of the patient, nothing to do with the FDA. https://www.ruralhealthinfo.org/toolkits/telehealth/1/barriers https://www.ruralhealthinfo.org/toolkits/telehealth/1/barrie...
  - miracle2k 7y ago
    More likely, it would need to be legal in the country of the provider, and they would need to be out of reach of the US justice system, would seems doable in principle.
    - lazyasciiart 7y ago
      Sure - but it's hard to stay out of reach of the US justice system while staying easily accessible to patients by live video and internet payment in a low-cost-of-living area.
chimi 7y ago
I believe the American Medical Association (AMA) lobbying congress to shut down medical schools and artificially limit residencies and thus the supply of doctors is a much bigger factor. A lot of people who are capable and motivated to be doctors for good reasons are shut out because doctors don't want there to be more doctors who will serve to limit their wage growth.
- journalctl 7y ago
  Do you have sources for this? I see this claim a lot on HN.
  - chimi 7y ago
    https://www.washingtonexaminer.com/thanks-to-doctors-there-arent-enough-doctors https://www.washingtonexaminer.com/thanks-to-doctors-there-a... I also like this 45 minute lecture Milton Friedman gave to physicians telling them how they were making healthcare worse due to this type of lobbying by their representatives. https://www.youtube.com/watch?v=rWlk9HreE7U https://www.youtube.com/watch?v=rWlk9HreE7U
    - yourbandsucks 7y ago
      Shouldn't Milton Friedman be complimenting them for pursuing their narrow interests and having faith that it will contribute to the optimal free market outcome? When someone doesn't even buy their own brand..
      - chimi 7y ago
        He stays quite true to his brand in the video when he chastises them with a list of the many things they have done to destroy the free market in healthcare.
        yourbandsucks 7y ago
        What a fragile free market. You're telling me that the free market requires willing selflessness of players to function? That sounds more like the ghost of Christmas than the invisible hand to me..
opportune 7y ago
There are plenty of highly qualified Americans who do not get accepted into medical school each year. We need to make the AMA stop preventing medical school class sizes from increasing
segmondy 7y ago
Have you ever thought about the fact that the issuing of green card to immigrant doctors is really hurting other countries? Other countries need doctors as much as America, there's a huge brain drain when green card is issued for immigrant doctors. BTW, I'm not saying that I'm for it or against it. I also want to point that that giving a migrant doctor green card is not guarantee that they can practice in the US. Passing the board and getting certified is really difficult and there are tons of doctors that come to the US with hope of practicing and end up driving a cab, becoming a nurse or doing some sort of odd jobs.
- trianglem 7y ago
  That's not America's concern. We're looking for the best and the brightest.
Bombthecat 7y ago
Is the green card attached with the rule, that you need to work umin rural area? Otherwise those people would just do what everyone would do. Work in a big city / hospital etc..

hestipod 7y ago

Friend married a Russian cardiac surgeon, one with 20 years of experience, brilliant woman. She was not allowed to practice in the US without years of redoing residency and entry level exams and loads of money. She ended up changing careers as it was so much bother. Patients ended up losing out on a caring and bright provider.

honkycat 7y ago
That is a feature, not a bug. Why would a well-paid, highly regulated profession allow people to come into their turf and undercut them? Not saying this is a GOOD thing. Merely pointing out that the system is working as intended.
- C4stor 7y ago
  If the final user is losing, it's a bug.
  - magashna 7y ago
    At least in the IT world, there are lots of contractors sold on their certifications who end up being complete frauds. I'd like there to be some sort of way to prove your merit especially when you have people's lives in your hands.
    - Nuzzerino 7y ago
      In my experience being at the receiving end of many arrogant and unprofessional "doctors", having that medical license is far from proof of anything. If anything, the licensing requirement functions as little else than yet another barrier to competition, which ultimately harms the patients.
- marrone12 7y ago
  There is no "undercutting" in health care. Vast majority of services are already priced out by insurance companies, there just aren't enough people to do all of them.
  - ses1984 7y ago
    >...there just aren't enough people to do all of them. which factors into the economics of prices negotiated between providers and insurance companies.
PopeDotNinja 7y ago
That sucks. There's probably a situation in the future where doctors, or at least surgeons, can work remotely. Russian doctor marries US citizen, logs into VPN in Russia from USA living room, performs Surgery with Nintendo remote.
jermaustin1 7y ago
A DBA I worked with a couple jobs ago was a surgeon in China. He immigrated in the mid 1980s. After he was told he would have to redo his med school, he also decided it wasn't worth it and instead "learned computers".
jeegsy 7y ago
If there is already an over-supply of docs already in the country, I don't see how an influx of foreign doctors helps anyone.

charlieflowers 7y ago

Some smart business in a foreign country should start providing tele-medicine to the US for reasonable prices. We could send blood work overseas cheaper than the piracy prices of labcorp, for that matter. They could explain it legally as "not medical advice" to skirt any FDA laws, but provide world class health care in reality. It's a business model that could really work. The "skirt America's dumb self-inflicted crap" business model.

lazyasciiart 7y ago
That would be illegal because they would need to be licensed as doctors in the state of the patient, nothing to do with the FDA. https://www.ruralhealthinfo.org/toolkits/telehealth/1/barriers https://www.ruralhealthinfo.org/toolkits/telehealth/1/barrie...
- miracle2k 7y ago
  More likely, it would need to be legal in the country of the provider, and they would need to be out of reach of the US justice system, would seems doable in principle.
  - lazyasciiart 7y ago
    Sure - but it's hard to stay out of reach of the US justice system while staying easily accessible to patients by live video and internet payment in a low-cost-of-living area.

chimi 7y ago

I believe the American Medical Association (AMA) lobbying congress to shut down medical schools and artificially limit residencies and thus the supply of doctors is a much bigger factor. A lot of people who are capable and motivated to be doctors for good reasons are shut out because doctors don't want there to be more doctors who will serve to limit their wage growth.

journalctl 7y ago
Do you have sources for this? I see this claim a lot on HN.
- chimi 7y ago
  https://www.washingtonexaminer.com/thanks-to-doctors-there-arent-enough-doctors https://www.washingtonexaminer.com/thanks-to-doctors-there-a... I also like this 45 minute lecture Milton Friedman gave to physicians telling them how they were making healthcare worse due to this type of lobbying by their representatives. https://www.youtube.com/watch?v=rWlk9HreE7U https://www.youtube.com/watch?v=rWlk9HreE7U
  - yourbandsucks 7y ago
    Shouldn't Milton Friedman be complimenting them for pursuing their narrow interests and having faith that it will contribute to the optimal free market outcome? When someone doesn't even buy their own brand..
    - chimi 7y ago
      He stays quite true to his brand in the video when he chastises them with a list of the many things they have done to destroy the free market in healthcare.
      - yourbandsucks 7y ago
        What a fragile free market. You're telling me that the free market requires willing selflessness of players to function? That sounds more like the ghost of Christmas than the invisible hand to me..

opportune 7y ago

There are plenty of highly qualified Americans who do not get accepted into medical school each year. We need to make the AMA stop preventing medical school class sizes from increasing

segmondy 7y ago

Have you ever thought about the fact that the issuing of green card to immigrant doctors is really hurting other countries? Other countries need doctors as much as America, there's a huge brain drain when green card is issued for immigrant doctors. BTW, I'm not saying that I'm for it or against it. I also want to point that that giving a migrant doctor green card is not guarantee that they can practice in the US. Passing the board and getting certified is really difficult and there are tons of doctors that come to the US with hope of practicing and end up driving a cab, becoming a nurse or doing some sort of odd jobs.

trianglem 7y ago
That's not America's concern. We're looking for the best and the brightest.

Bombthecat 7y ago

Is the green card attached with the rule, that you need to work umin rural area? Otherwise those people would just do what everyone would do. Work in a big city / hospital etc..