Foreign-educated and foreign-born health professionals play a vital role in the U.S. health care workforce, but strategic shifts such as changes in immigration laws may be needed to stabilize the nation's health workforce, according to a new RAND Corporation study.
The two groups fill important gaps in the U.S. health care workforce, particularly among primary care physicians, nurses in hospital settings and other areas with worker shortages, according to findings published in the November edition of the journal Health Affairs.
However, continuing to rely on foreign-educated and foreign-born health workers may reduce incentives for the nation to address problems such as the inadequate supply of primary care physicians and lead to a less-stable U.S. health care workforce, researchers say.
"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 G. Chen, the study's lead author and an associate natural scientist at RAND, a nonprofit research organization. "Policy changes could increase the stability of the nation's health care workforce, while also improving the experiences of foreign-born health workers."
The study outlines the contributions that foreign-educated and foreign-born health professionals make to the U.S. workforce, including:
Four major categories of visas allow legal admission to the United States for health professionals, but none is exclusive to health care workers, researchers say. The most formalized channels of entry are for foreign-educated physicians, who often come to the U.S. for medical residencies and stay once their training is finished.
Despite their significant representation in the workforce, foreign-born and foreign-educated health workers say they often face problems such as unethical recruitment practices, discrimination in the workplace and difficulties navigating cultural differences. In addition, migration of health workers to the United States may leave lower-income nations with workforce shortages and weaker health systems.
The study's authors say U.S. policymakers may want to consider immigration changes to make it easier to recruit needed health professionals such as direct care workers. In addition, domestic health care organizations need to commit to improving recruiting practices and workplace conditions for migrants.
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