What we can do about growing doctor shortage in Midwest

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A doctor gives a patient a prescription.

The Midwest is plagued by a physician shortage. Aging baby boomers are beginning to further strain the healthcare system, just as doctors themselves are retiring. Medical schools can’t fill gaps fast enough. And with hospitals supplying more than 4 percent of the labor force across Midwest states, the health of the healthcare sector is critical to our local economy.

So where should we turn for healthcare labor? With already 25 percent of all physicians and surgeons and 16 percent of other healthcare workers in the United States foreign-born, immigration will be an increasingly important lifeline. Yet immigrants, including high-skilled doctors and nurses, face challenges in joining the U.S. workforce, from visa caps to convoluted and inconsistent licensing standards.

Though immigration reform is a challenging issue to raise in an election year, it is clear that we cannot afford the status quo.


According to administrators at Presence Health, the largest Catholic healthcare system in Illinois with more than 150 locations, foreign-born doctors are vital for meeting patient demand, need and providing culturally competent care to a growingly diverse population. More than half the resident doctors at St. Francis Hospital in Evanston are foreign born, as are 71 of the 79 internal-medicine and preliminary-year residents at Chicago’s St. Joseph Hospital. And across the country, demand for high-skilled medical labor is far outpacing supply, especially in rural areas.

Yet U.S. immigration laws limit the number of individuals who are allowed to join the labor force each year and how many new foreign-born doctors each state can take. Further, by adding years of educational requirements and limits on the number of years they can practice before returning home, current policy harms our health care system by expediting doctor shortages.

Cultural competency is another issue we need to address. More than 41 million people in the United States are native Spanish speakers, yet fewer than 4 percent of healthcare providers are proficient in Spanish, let alone other less common languages. These linguistic barriers limit trust and engagement with healthcare systems, which in the long run mean more ER visits and higher costs for everyone. Certainly, healthcare systems that prioritize the hiring of foreign-born healthcare professionals and individuals who speak multiple languages will have a competitive advantage in today’s global economy.

How do we address the barriers to entry of foreign-born medical professionals? Immigration reform will be critical. Specifically, this or the next president’s administration will need to issue visas according to labor force demands; remove quotas and caps on doctors and surgeons; address credentialing challenges for foreign-born professionals; allow undocumented immigrants better access to care; and train healthcare professionals to provide linguistically and culturally competent care to diverse populations.

The vitality of our Chicago and Midwest healthcare sector is at stake.

Nicole Fisher is the founder and CEO of HHR Strategies, a healthcare- and human-rights-focused advising firm started in the Midwest. She is the author of the report “Midwest Diagnosis: Immigration Reform and the Healthcare Sector.”

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