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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About Dr. Kate Tulenko

Dr. Kate Tulenko is a physician, health policy specialist, and Senior Director for Health Systems Innovation at IntraHealth Internatonal. She is the former coordinator of the World Bank’s Africa Health Workforce Program and recently served as team lead on Health Workforce Shortage for the “Reinventing Primary Care Project” for the Hope Street Group, a bipartisan coalition of business, civic and policy leaders. Dr. Tulenko serves on the board of the National Physicians Alliance and on the board of advisors for the Global Business School Network and in 2002 she received a Rainer Arnhold Fellowship for innovation in global development. She is a practicing pediatrician and a Fellow of the American Academy of Pediatrics. Dr. Tulenko has degrees from Harvard; Johns Hopkins; and Emmanuel College, Cambridge and holds adjunct faculty positions at the Johns Hopkins School of Public Health and the George Mason School of Health and Human Services. Her book, "Insourced: How Importing Jobs Impacts the Healthcare Crisis Here and Abroad", addresses how the U.S. is underinvesting in training young Americans to be health workers and instead imports doctors and nurses from poor countries with extreme health worker shortages. Opinions expressed in "Insourced" represent those of Dr. Tulenko alone and do not represent opinions or policies of any of her current or past employers. Dr. Tulenko grew up in Lynchburg, Virginia and Gainesville, Florida. She lives in Alexandria, Virginia with her husband and two daughters with whom she enjoys exploring the beauty of art and nature. Follow Dr. Tulenko on twitter at ktulenko.
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