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Chris Musillo on Nurse and Allied Health Immigration

THE US IS RUNNING OUT OF NURSES

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by Chris Musillo

The Atlantic has a longform article detailing the current US nursing shortage in which it highlights that 1.2 million nursing positions will be unfilled in the next five years. While nursing shortages have existed in the US for most of the last forty years, this one is going to be different. The US nurse supply has been artificially inflated since the start of the recession. Now that the recession has abated, nurse retirement numbers are spiking. Musillo Unkenholt saw more demand for foreign-trained nurses in 2015 than we had in the whole of 2009-14.

The reasons for the current US nursing shortage are many:

Baby Boom Generation Demand. The US Baby Boom generation, those born 1946-1964, has reached an age where they will increasingly demand nursing services. As The Atlantic points out:

Today, there are more Americans over the age of 65 than at any other time in U.S. history. Between 2010 and 2030, the population of senior citizens will increase by 75 percent to 69 million, meaning one in five Americans will be a senior citizen; in 2050, an estimated 88.5 million people in the U.S. will be aged 65 and older.

Aging Nursing Workforce. Out of the 3 million US nurses, one million are over age 50 and will be expected to retire in the next 10-15 years.

Few Nurse Educators. Nursing Ph.D. programs have been unable to attract nursing faculty. These nurses Ph.D’s have traditionally made up large numbers of nursing school faculty. Part of the reason for this is that a Bachelor nursing graduate is usually offered a job at graduation, thus reducing that graduate’s incentive to seek out graduate nursing education. Without a dramatic increase in nurse faculty, it will be impossible for the US to supply enough nurses to meet the demand.

Distribution Challenges. Some of the American nursing problem stems from the lack of mobility ion the nursing force. Nurses are often unwilling to leave their hometowns for jobs in rural areas or high-nurse demand areas, even if those positions pay better.


Lack of Foreign-Nurses.
Because of a terribly though-out US immigration policy, it takes a nurse from the Philippines many years to legally obtain a visa, in spite of the nursing shortage. The Philippines has traditionally been the greatest supplier of US nurses. The story is even worse for India, which would certainly be able to supply the US with many nurses if it did not take 10 years for a fully-qualified nurse to obtain a US visa. As a result of the lack of US nursing visa options, foreign-trained nurses have declined sitting for the US licensing exams.

Ten years ago the US congress passed a special EX visa just for occupations that were found to be nationally short by the Department of Labor. These occupations were placed on the DOL’s Schedule A. By placing an occupation on Schedule A, the Department of Labor finds that the importation of workers in the occupational classification will not negatively impact existing US labor.

Only two occupations are on Schedule A – Registered Nursing and Physical Therapy. Does it not stand to reason that there ought to be a better immigration program to allow these badly needed workers entry into the US?


Please read the Musillo Unkenholt Healthcare and Immigration Law Blog at www.musillo.com and www.ilw.com. You can also visit us on Facebook and follow us on Twitter.

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Updated 02-22-2016 at 03:41 PM by CMusillo

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Comments

  1. nephdoc's Avatar
    USA is also facing Physician shortage which will worsen.

    S. 1189 Conrad 30 bill is pending with Senate Judiciary Committee.

    see these articles

    https://www.aamc.org/download/426260/data/physiciansupplyanddemandthrough2025keyfindings.pdf


    Example: Nephrology Fellowship Match 2016 results:
    Nephrology Match for AY 2016
    Recent trends?increasing numbers of unfilled nephrology training programs (58.9%) and fellowship positions (59.2%)?continued in the first year of ?All-In.? Government is spending billions of dollars for patients with kidney diseases and dialysis but less doctors are choosing Nephrology and shortage is growing.

    Senate Judiciary Committee should act. Nurses can not carry out orders if there are not enough physicians to see patients and order treatment. So address physician shortage first.

    While there is lot of emphasis on providing people with health insurance, there isn't any emphasis on fixing physician shortage , health insurance will not really make enough difference with physician shortage which will become critical as time goes by.

    International Medical Graduates are filling this gap.

    Both Republicans and Democrats from Senate Judiciary Committee should add provision to the Conrad 30 bill (S.1189) to move BOTH Conrad 30 and NIW physicians from EB-2 to EB-1 employment based green card category (NOT just NIW physicians) (including alien physicians who completed such service before the date of enactment of this Act and any spouses or children of such alien physicians) - a simple fix which does not increase green cards or immigration. Then they should bring this bill to vote.
  2. ConradPhysician's Avatar
    1. Help make Conrad 30 physicians in under-served areas more independent, and that will enable them to create new jobs in the local community
    2. Help create better physician retention in the community, improving medical services to the local residents
    3. Local investments will also bring-in patients from other communities, further providing stimulus to local economic activity
    4. Significantly close the gap in "standard of care" between major cities and under-served areas

    Today, in contrast, there is well documented shortage of physicians in under-served areas.....and the gap in "standard of care" is significant. While there is lot of emphasis on providing people with health insurance, there isn't enough emphasis on making physicians independent - without independent physicians, health insurance will not really make enough difference....

    TO MAKE IT HAPPEN WITH EASE:

    1. Add provision to the Conrad 30 bill to move BOTH Conrad 30 and NIW physicians from EB-2 to EB-1 employment based green card category (NOT just NIW physicians) (including alien physicians who completed such service before the date of enactment of this Act and any spouses or children of such alien physicians) - a simple fix which does not increase green cards or immigration.

    OR

    2. Amending proposed provision to the Conrad 30 bill to exclude BOTH Conrad 30 and NIW physicians from the annual cap/numerical immigration limitations on employment based Green Cards (NOT just NIW physicians as proposed) (including alien physicians who completed such service before the date of enactment of this Act and any spouses or children of such alien physicians).
  3. CardioConrad30Doc's Avatar
    U.S. faces 90,000 doctor shortage by 2025, medical school association warns

    https://www.washingtonpost.com/news/to-your-health/wp/2015/03/03/u-s-faces-90000-doctor-shortage-by-2025-medical-school-association-warns/
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