Concerned About Jobs in Your Community? What You Can Do To Help

Did you know that with nearly 9% unemployment we are importing tens of thousands of foreign born and foreign trained doctors, nurses, pharmacists and other health workers every year rather than training Americans to do these jobs.  Roughly 1.5 million foreign born and trained health workers are currently working in the US.  With average salaries above $60,000 per year, this represents an annual loss of over $90 billion in wages that could have gone to Americans.  Every year American medical, nursing, and pharmacy schools turn away tens of thousands of qualified students who are desperate to enter a career in healthcare but are permanently locked out of careers in the largest and fastest growing sector of the economy.  Perhaps this has happened to you or someone you know.  In exchange we get foreign health workers who score lower on licensing exams than American trained workers; are unfamiliar with the American health systems, American lifestyles and attitudes toward illness and health; and often are not fluent in English.

The good news is that you can help solve the problem. You don’t have to be a doctor or a nursing professor to help ensure that more Americans are trained to fill existing healthcare jobs and that developing countries also have enough health workers to meet their basic health needs.

Here are concrete actions at each level of government that you can take:

Community Level:  Either individually or with your local church, Rotary club, or local businesses approach your local community college to see how you could help them expand existing health worker training programs and start new ones.  Shortages exist at all levels from community nurses, to pharmacy techs, to occupational and physical therapy assistants.  Many hospitals will also be willing to pay for nurses’ tuition in exchange for a few years of service. You don’t have to focus on physicians, although an estimated 50 additional new community-based medical schools will need to be founded to eliminate our reliance on foreign trained doctors.

Approach local government leaders to see if they will invest community development funds in the establishment or expansion of schools.  Health professional schools are economic engines that greatly improve the economy of the communities in which they are located and many businesses prefer to locate in communities with ready access to high quality, affordable healthcare.

State Level:  Contact your governor and state legislators and encourage them to invest in training additional health workers for your state.  Inform them of the large number of Health Professional Shortage Areas in your state and the need to train locally.   We particularly need more programs to train nurse practitioners and physician assistants.

In addition, most states could benefit from several health services high schools that help students from medically underserved communities enter healthcare careers.  Contact your state level expert in integrating health careers into high school curricula.

National Level:  Contact your senators and representatives and let them know that this is an issue that is important to you, your family, and community.  We need to invest more in training Americans to be health workers.  If you are concerned about additional government spending, we can use $1.5 billion of existing Job Corps funding that currently goes to programs with very low employment rates or train workers for declining or struggling industries.   As we expand programs to train additional American health workers, there needs to be a rationalization of the accreditation of health professional schools so that new requirements for schools do not continue to drive up the cost of health workers education without strong evidence of improved public health outcomes.

In addition, the State Department should immediately stop issuing health worker visas to health workers from the twenty worst effected countries on the World Health Organization’s list of Health Workforce Crisis Countries.  We should gradually stop issuing health worker visas to the remaining 37 countries on the WHO’s list that cannot meet even basic public health needs such as vaccinating children and attending childbirth due to the recruitment of their health workers.

Global Level:  The US is the world’s largest importer of foreign trained health workers.  This practice inadvertently destabilizes poor countries’ health systems and because recruitment often includes professors, makes it impossible for the countries to train replacement workers.  In fact, the largest cause of loss of African medical school professors is immigration to the US.  You can help by supporting the training of new health workers in the hardest hit countries. Check with your faith group or favorite charity to see if it supports health worker education or you can directly support the training of a new health worker in a developing country though the IntraHealth non-profit which specializes in health worker training.  Donations as small as $5 can make a big difference. IntraHealth has set up a website to collect funding directly for the training of new nurses in Ethiopia, the second most populous country in Sub-Saharan Africa with less than 0.4 health workers for every thousand people and where 1 in five children dies before her fifth birthday. Training a single additional nurse in these communities means that entire communities will now have access to lifesaving care.

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Atlantic Wire Lists “America’s Health Worker Mismatch” as “Five Best Friday Column”

Atlantic Wire, the online edition of The Atlantic has listed my NYT Op-Ed piece as one of its “Five Best Friday Columns”:  http://www.theatlanticwire.com/national/2012/09/five-best-friday-columns/56866/

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My New York Times Op-Ed Piece on Health Labor Markets

I have an Op-Ed piece on health labor markets and the state of US health professional schools on page A23 of today’s New York Times.  It’s also available online here.

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Webinar on Innovative Financing of Health Professional Schools

In collaboration with the Maternal and Child Health Improvement Project (MCHIP) and the Global Alliance for Nursing and Midwifery, I’ll be presenting a webinar on Innovative Financing of Health Professional Schools. re a global deficit of over 4 million health workers and in order to train these additional workers we’ll need to tap into additional sources of financing.   Participate in the webinar and the following in person and online discussion to learn what you can do at the school, national, or global level to increase the amount of funding to train additional health workers.

The webinar will be conducted from 10 to 11:30am Eastern Standard Time on Tuesday, September 4 (GMT-05:00).  Connect with the webinar here: https://connect.johnshopkins.edu/pse/

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Labor Day Special: “Insourced” Featured on IntraHealth’s Website

In order to draw attention to the labor implications of the insourcing of foreign trained health workers, IntraHealth International has featured an article on “Insourced” on its website.  Foreign trained health workers are more likely to accept lower wages and unsafe working conditions (including unsafe patient loads) and illegal labor practices than American trained health workers.  They also are less likely to unionize or file complaints about working conditions.

If you have Monday off, please give a thought of thanks to all the health workers around the world who are working on the holiday in hospitals, ERs, and nursing homes to keep us safe and sound!

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Migrant Labor is Exploited in the US

NPR’s “On Point” program has done a great piece on exploited foreign labor in the US.  The   discussion mainly focused on agricultural and blue collar jobs, but the same situation applies to foreign trained health workers, especially  nurses and medical residents.  They are often paid less than the prevailing wage and given patient loads higher and shifts longer than is generally considered safe.  In addition, any employers have used the threat of hiring foreing nurses to break American nursing unions. Not only are the foreign nurses abused, but the profession is degraded and patients are endangered.  Patricia Pittman did a great study which revealed that 50% of foreign-trained nurses experienced significant labor violations.

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UK Releases Report on Global Healthcare Teams

The UK All-Party Parliamentary Group on Global Health and the Africa All-Party Parliamentary Group have released their All The Talents Report on how global health goals can be reached through creating and managing more effective healthcare teams.  With this report and the “Value for Money” meeting of African Finance ministers in Tunis last week, I think it’s finally safe to talk about cost-effectiveness in healthcare again.

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