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#1Stunner

Question for the Medical Professionals -- H1B Visas

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I was listening to a Podcast this morning (which was admittedly, a Liberal leaning podcast).

Anyway, the narrative of this episode was that a foreign national / foreign trained, H1-B visa physician (he was from India, living Oregon) desperately wanted to travel to New York to help with COVID-19, but could not, because of our draconian immigration laws.  That it was an outrage / heartbreaker.  That this was the fault of cold-hearted, money grabbing, probably racist Republicans.

 

The narrative of the story was essentially this:

(1) We have a massive shortage of medical doctors in this country, and these H1-B Visa physicians are crucial.    IS THIS REALLY TRUE?

(2) Republicans are unfairly barring these H1-B Visa doctors, or making it difficult for them, while the Democrats want expansion or to temporarily suspend the program.

(3) We could be saving thousand of lives, if we simply recruited more foreign trained physicians.   We don't have enough people that want to be doctors.

 

What are your thoughts and experiences with this?

Seems like we could easily be educating thousands of more HIGHLY CAPABLE American citizens to be doctors (lots of people want to be doctors), but that the large corporations hospitals are chasing after the H1-B visas, not to fill needs, but to get people on the cheap.   If there is such a shortage, why aren't we expanding educational opportunities for Americans to be medial professionals?  You telling me that there aren't enough smart enough to go to medical school?

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There is different data available and different countries operate with different standards. But most of the studies I have seen indicate the US has a lower number of doctors per capita than many other countries. A few comparison countries from this study from Kaiser Family Foundation of practicing physicians:

During the 1980s and 1990s admissions to medical schools in the US were basically flat even as the US population grew. In 2006, the Association of American Medical Colleges called on its members to begin increasing admissions to avoid a future crisis. The existing schools increased admissions and new medical schools and new osteopathic schools opened. This chart shows the lack of growth for several decades followed by an increase in medical school admissions after 2006.

https://www.aamc.org/system/files/reports/1/factsdatachart3.pdf

But it takes time to move a doctor through school, residency, etc.

Then of course there is a cohort retiring, About 45% of active physicians are over the age of 55.

https://www.aamc.org/data-reports/workforce/interactive-data/active-physicians-age-and-specialty-2017

The other issue is where doctors are located. There are many areas in the US with fewer physicians per capita available than in other areas.

 

 

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4 hours ago, FresnoFacts said:

There is different data available and different countries operate with different standards. But most of the studies I have seen indicate the US has a lower number of doctors per capita than many other countries. A few comparison countries from this study from Kaiser Family Foundation of practicing physicians:

During the 1980s and 1990s admissions to medical schools in the US were basically flat even as the US population grew. In 2006, the Association of American Medical Colleges called on its members to begin increasing admissions to avoid a future crisis. The existing schools increased admissions and new medical schools and new osteopathic schools opened. This chart shows the lack of growth for several decades followed by an increase in medical school admissions after 2006.

https://www.aamc.org/system/files/reports/1/factsdatachart3.pdf

But it takes time to move a doctor through school, residency, etc.

Then of course there is a cohort retiring, About 45% of active physicians are over the age of 55.

https://www.aamc.org/data-reports/workforce/interactive-data/active-physicians-age-and-specialty-2017

The other issue is where doctors are located. There are many areas in the US with fewer physicians per capita available than in other areas.

 

 

 

Why aren't medical schools in the United States expanding enrollment to solve the problem?

Also, are they rejecting a bunch of white males (the largest demographic group in the United States) in the name of having nicer looking diversity?

Seems like thousands of SMART people would love to attend medical school.

@StanfordAggie, any thoughts?

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Idk about doctors, but California is projected to have a shortage of 44,000 nurses by 2030.

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5 minutes ago, TheSanDiegan said:

Idk about doctors, but California is projected to have a shortage of 44,000 nurses by 2030.

Interesting.

I don't work in the medical field. 

Is it difficult to get accepted into nursing school?

 

Getting accepted to medical school is almost impossible for some very smart kids, at the local State Universities, where they live (where in-state tuition is available). 

The question is... If we have a doctor shortage, Why?

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17 minutes ago, #1Stunner said:

 Interesting.

I don't work in the medical field. 

Is it difficult to get accepted into nursing school?

 

Getting accepted to medical school is almost impossible for some very smart kids, at the local State Universities, where they live (where in-state tuition is available). 

The question is... If we have a doctor shortage, Why?

It’s not just Medical school slots you need but you also need residency slots and training a resident isn’t for free.   We already have graduating medical students from US Med schools who are unable to find a residency match.   I tried to help a friend of my daughter in law who didn’t have great test scores but would have been a great family practitioner.  No luck.  She is currently back in Canada.  
 

Remember is a market based system supply is not determined by total demand.  Supply is determined by profitable demand for the doctor and the hospital.  In every market based system, demand exists that isn’t profitable to serve.   

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1 minute ago, sactowndog said:

It’s not just Medical school slots you need but you also need residency slots and training a resident isn’t for free.   We already have graduating medical students from US Med schools who are unable to find a residency match.   I tried to help a friend of my daughter in law who didn’t have great test scores but would have been a great family practitioner.  No luck.  She is currently back in Canada.  
 

Remember is a market based system supply is not determined by total demand.  Supply is determined by profitable demand for the doctor and the hospital.  In every market based system, demand exists that isn’t profitable to serve.   

Then why aren't Hospitals increasing residency slots (which benefits American citizens), and instead crying "we don't have enough doctors!!!"

Why are hospitals chasing after foreign national H1-B Visa doctors, when, per your story, recent medical graduates desperately want to be hired for a residency, and hospitals won't hire them?

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4 minutes ago, #1Stunner said:

Then why aren't Hospitals increasing residency slots (which benefits American citizens), and instead crying "we don't have enough doctors!!!"

Why are hospitals chasing after foreign national H1-B Visa doctors, when, per your story, recent medical graduates desperately want to be hired for a residency, and hospitals won't hire them?

Because it costs money to train a resident.  Same as any job training a new employee.   Again, many hospitals are for profit entities.  

You could ask the same question about why does Silicon Valley hire so many H1B engineers from India.  

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8 minutes ago, sactowndog said:

Because it costs money to train a resident.  Same as any job training a new employee.   Again, many hospitals are for profit entities.  

You could ask the same question about why does Silicon Valley hire so many H1B engineers from India.  

So, you think the government should subsidize private, for profit corporations (Hospitals), by helping them to give jobs to cheaper labor H1B visas doctors, over more expensive American Citizens?

Basically, hire the cheap labor, at the expense of Americans?

 

Are you really a Democrat?  You sound like a Republican. 

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19 minutes ago, #1Stunner said:

So, you think the government should subsidize private, for profit corporations (Hospitals), by helping them to give jobs to cheaper labor H1B visas doctors, over more expensive American Citizens?

Basically, hire the cheap labor, at the expense of Americans?

 

Are you really a Democrat?  You sound like a Republican. 

I’m not a Dem or a Republican.  You asked a question and I gave you an answer and pointed out it’s not much different than other for profit industries.   You didn’t ask nor did I offer, as it wasn’t asked, my opinion on the approach.  BTW, if they only could hire doctors they had to incur the costs to train, I would guess we would have an even greater doctor shortage.  

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If you think there is a shortage of doctors now, what do you think would happen if we went to a universal health care system? 

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Physicians want it very hard for foreigners to get licensed here.  The more they restrict the supply of physicians the higher pay they get.   That is why USA doctors are paid ridiculously more than foreign counterparts and it is one reason why American medical is so expensive.   The USA has a crony capitalist system that serves certain narrow private interests.  It is the same reason they won't allow importation of drugs from abroad.   $$$$$  Classic cartel behavior to restrict supply by creating unnecessary hurdles.

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6 hours ago, Akkula said:

Physicians want it very hard for foreigners to get licensed here.  The more they restrict the supply of physicians the higher pay they get.   That is why USA doctors are paid ridiculously more than foreign counterparts and it is one reason why American medical is so expensive.   The USA has a crony capitalist system that serves certain narrow private interests.  It is the same reason they won't allow importation of drugs from abroad.   $$$$$  Classic cartel behavior to restrict supply by creating unnecessary hurdles.

You really have no clue about what you’re spewing.

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13 hours ago, #1Stunner said:

Is it difficult to get accepted into nursing school?

San Francisco State admits 60 to 80 students per year, Turkey Tech (Cal State Stanislaus) admits 60 students per year. What a cluster..... 

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12 hours ago, soupslam1 said:

If you think there is a shortage of doctors now, what do you think would happen if we went to a universal health care system? 

How do you explain this?

19 hours ago, FresnoFacts said:

A few comparison countries from this study from Kaiser Family Foundation of practicing physicians:

  • US - 2.6 per 1,000 residents
  • UK -  2.8 per 1,000
  • France - 3.2 per 1,000
  • Australia - 3.7 per 1,000
  • Sweden - 4.1 per 1,000
  • Germany - 4.3 per 1,000

 

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9 hours ago, modestobulldog said:

San Francisco State admits 60 to 80 students per year, Turkey Tech (Cal State Stanislaus) admits 60 students per year. What a cluster..... 

Great example.

That's part of the problem. 

How can there be cries that we have a shortage of medical professionals in this Country, when the schools won't increase enrollment for qualified people that WANT the degrees.

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6 hours ago, bsu_alum9 said:

How do you explain this?

 

All those countries have a far far lower population than we do. Beside that some of those countries have longer waiting times than we do for many procedures even with more doctors. Tell me how many young students would want to be a doctor with the government dictating their treatment of patients and what they could charge. The government interferes too much now. 

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9 minutes ago, soupslam1 said:

Tell me how many young students would want to be a doctor with the government dictating their treatment of patients and what they could charge. The government interferes too much now. 

Bigger problem is that it costs about half a million dollars in educational costs to become a doctor here. 

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21 hours ago, #1Stunner said:

 

I don't work in the medical field. 

Is it difficult to get accepted into nursing school?

You have to have a great ass and look good in a pair of thigh highs and 5" heels according to some of the movies I've been watching lately.  This could just be Hollywood propaganda though.

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