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The travel ban and the rural doctor shortage

Just another unintended consequence.

In Texas and across the country, foreign-trained doctors like the Iranian-born [Dr. Hossein] Yazdani fill a critical need in rural communities, which often struggle to attract physicians born and trained in the U.S. That reality has been highlighted in the weeks since President Donald Trump signed an executive order temporarily banning travel from several predominantly Muslim countries.

A revised version of the order issued Monday was intended to keep terrorists from entering the country, but it also threatens to block international medical graduates, who help fill a growing physician shortage.

Yazdani is a classic example. He came to Houston for a prestigious fellowship at Texas Heart Institute. When he completed the training in 1997, he was given two choices: Return to Iran, or apply for a J-1 visa waiver, which allows international doctors to stay in the U.S. in exchange for working as primary care physicians in medically underserved areas.

Yazdani went to work in Anahuac.

“I had to stay three years to meet my requirement,” he said during a recent interview at his clinic. “But after that, I was interested to stay here in the community. A lot of doctors are in the big city. But there are poor people here who I like to help.”

In Chambers County, where he practices, nearly 80 percent of residents voted for Trump. A few blocks from his tiny clinic, a huge “Trump-Pence” campaign sign is painted on the side of a barn.

But inside his office, he said, politics rarely comes up.

“Patients come to see me, and I help them. That is all,” he said. “Patients don’t ask where I come from.”

Physicians who attended medical school in the six countries affected by Trump’s new order – Iran, Syria, Libya, Yemen, Sudan and Somalia – provide 14 million appointments to American patients each year, according to an analysis by Harvard and Massachusetts Institute of Technology economists. That includes more than 2.3 million office visits in areas with doctor shortages.

[…]

The problem is bigger in Texas, [Travis Singleton, senior vice president of Merritt Hawkins, a Dallas-based medical recruiting firm] said, where an additional 13,000 doctors are needed just to bring the state in line with the national average of physicians-per-resident. Thirty-five of Texas’ 254 counties have no doctors at all. About 150 counties have no general surgeons, psychiatrists or gynecologists.

International doctors are helping fill the gap: A third of Texas’ doctors were born abroad, including more than 1,000 from one of the six countries named in Trump’s order, according to a Houston Chronicle analysis of Texas Medical Board licensing data.

The rural doctor shortage, in Texas and elsewhere, is nothing new. It was cited as a reason for passing the 2003 tort “reform” proposition, which doesn’t make any more sense now than it did then and which obviously hasn’t had much effect. My guess is that if it was pointed out to the Trump-voting people of Anahuac who have been patients of Dr. Yazani that they might never have had his services had a travel ban like Trump’s been in existence before, that they’d react the same was as those people in Illinois who didn’t understand why one of their longtime and well-liked local residents had been targeted for deportation. But he’s one of the good ones! That’s not what I voted for! Well, it is what you voted for, and the Trump administration doesn’t distinguish between “good” immigrants and “bad hombres”. Maybe check the fine print next time. In the meantime, will any Republican elected official who represents a rural county that may never have a doctor again speak up about this?

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15 Comments

  1. Bill Daniels says:

    It’s a three month travel ban, a ban on people coming here, not a ban on people already here, and not a permanent ban. Obama has done similar, short duration travel bans, and I don’t recall that wholesale gutting our medical industry. Why is THIS 3 month travel ban different? Why is THIS 3 month travel ban the one that’s going to decimate medical service in the US?

    And you mention Carlos, the undocumented restaurant manager who gives out free meals to the fire department and police when he isn’t out driving drunk. Lots of criminals do “favors” for police and elected officials, in the hope of getting favorable treatment from them for their crimes. Remember the Tony Buzbee DWI case and how it just seemed to disappear? I wonder what kind of favors Buzbee had done for the Harris County DA, or for the dept. that arrested him? I bet he donated a lot to charity, too.

    What we learned from Carlos’ story is, Carlos didn’t bribe the right law enforcement people. I’m glad he’s gone. How many lives in the US were saved because Carlos won’t be able to run over US citizens, drunk, now that he’s gone? Maybe he should have sent his delicious meals to ICE, instead?

  2. Flypusher says:

    “It’s a three month travel ban, a ban on people coming here, not a ban on people already here, and not a permanent ban. Obama has done similar, short duration travel bans, and I don’t recall that wholesale gutting our medical industry. Why is THIS 3 month travel ban different? Why is THIS 3 month travel ban the one that’s going to decimate medical service in the US?”

    Because the first draft of the ban was not adequately researched and vetted, was poorly executed, and burned a lot of innocent people. As the saying goes, you never get a second chance to make a first impression. Add to that the whole racist/xenophobic flavor of Trumplandia, with Trump on the record saying that he wanted to ban Muslims, Rudy Guilliani running his fool mouth about crafting a Muslim ban that wouldn’t look like a Muslim ban to the courts, Steve Miller running his fool mouth about how this really wasn’t about national security. Then we have David Duke and all his ilk feeling empowered and that they are now socially acceptable and Trump won’t even make the effort to send a tweet distancing himself from them. An innocent man from India is murdered in an obvious hate crime in Kansas City, and this administration had NOTHING to say about it for 6 days. The travel industry is reporting a decline in tourism form abroad. Perception can often become reality, and the perception taking hold here is that America is letting the xenophobes run amuck. All that very well could give foreign MDs, especially those who hail from the ME, and/or whose skin tones tend dark, to reconsider practicing medicine here.

    “And you mention Carlos, the undocumented restaurant manager who gives out free meals to the fire department and police when he isn’t out driving drunk.”

    According to the link, the man stopped drinking.

  3. Bill Daniels says:

    @Fly:

    Look at England today, proving again just how non racist/xenophobic they are. Of course, some people in London had to die today to demonstrate just how non racist/xenophobic they are, but that’s really a small price to pay to virtue signal, right?

  4. Flypusher says:

    Tell me Bill, who do you think kills more Americans, the recent immigrants “inspired” by foreign terrorist groups, or disgruntled home-grown White guys with easy access to guns?

  5. Jen says:

    Who is killing the most Americans? Republicans, that’s who. Every day, 5 to 8 Texans die simply because Greg Abbott and Dan Patrick and the rest of the Republican leadership in Austin won’t expand Medicaid. That’s about 46 dead people each week, just for the sake of political posturing. Unnecessary posturing, since many Republican governors have expanded Medicaid.
    Yessiree there is a real Death Panel for you.

  6. Bill Daniels says:

    @Fly:
    Moral equivalency is your justification argument?

    When you figure out a way to boot disgruntled, home grown, white guys, with easy access to guns out of the country legally, let me know…..I’ll support getting rid of them. Until then, we have to focus on keeping undesirable people out, and getting rid of the undesirables that we have legal grounds to deport.

    Political correctness kills people. There are people in England that aren’t going home to their families, because England feels the need to prove how tolerant they are, and how great multiculturalism is. Those dead were sacrificed on the alter of political correctness.

  7. Flypusher says:

    Bill demonstrates clearly how bad so many people are at assessing risk. This link has an interesting chart:

    http://www.businessinsider.com/death-risk-statistics-terrorism-disease-accidents-2017-1

    Note that your lifetime risk of being killed by a foreign terrorist is more than 45,000 to 1. Also note that there are many things on that list with much higher odds AND that having access to medical care can lower them.

  8. Flypusher says:

    Bill Daniels
    March 23, 2017 at 12:59 pm
    @Fly:
    Moral equivalency is your justification argument?

    No Bill, it’s risk assessment.

  9. Flypusher says:

    “Until then, we have to focus on keeping undesirable people out, and getting rid of the undesirables that we have legal grounds to deport.”

    But you would err on the side of keeping the greater number of desirables out, people who would come here to practice medicine and save far more lives than would be lost to the rare lone wolf.

  10. C. L. says:

    @Bill…. Um, you do know the London attacker was a born-n-bred 52-year old Englander, right ?

  11. Bill Daniels says:

    @C.L.

    The Fort Hood shooter was born in the US. The Orlando shooter was born in the US. Do you know what the common thread between the Ft. Hood shooter, the Orlando shooter, and the London attacker is? (Hint: it isn’t workplace violence.) It’s the same common thread we need to do our best to keep OUT of America by not importing more of it.

  12. Jen says:

    And meanwhile, Republican extremism kills more people every two weeks than all those shooters combined. 92 or so, just in Texas. Any way we can get rid of this nasty, deadly ideology?

  13. Flypusher says:

    “The Fort Hood shooter was born in the US. The Orlando shooter was born in the US. Do you know what the common thread between the Ft. Hood shooter, the Orlando shooter, and the London attacker is? (Hint: it isn’t workplace violence.) It’s the same common thread we need to do our best to keep OUT of America by not importing more of it.”

    Eric Rudolph was a born in the USA religiously motivated terrorist too.

  14. C. L. says:

    @Bill.. Your argument makes no sense. You’ve referenced three individuals who were all born in their respective Countries [Hasan was born in VA, Mateen in NY, and Masood in Kent, ENG] , then claim to stop the violence, the solution is to stop more folks migrating into the US [or England] ? Am fairly certain the facts are in – more violence is perpetrated by the legal residents of this Country than by the individuals who’ve recently migrated here or are here through illegal means.

  15. Bill Daniels says:

    @C.L.:

    Way to avoid the 800 lb. elephant in the room. Radical Islam is the common thread, citizen OR immigrant, and any and every Muslim is potentially a time bomb. Would you support the importation of time bombs, and justify that by saying, “well, most of them won’t go off, so why not?” How about, “well, we already have potential time bombs in the US, so why try to keep out more potential time bombs?” That’s like telling smokers, “go ahead and toss your cigarettes out the window while driving, because most of those lit butts won’t cause forest fires, and we have forest fires that are caused by lightning anyway, so why bother to prevent new forest fires?”

    You know Al Qaeda has an online magazine, right? You know how many English Muslims download that magazine each year? Around 50,000. That’s 50,000 ticking time bombs, waiting to go off. I wonder how many American Muslims read that magazine? How many Muslims seeking entry to the US read that magazine?

    http://www.freerepublic.com/focus/bloggers/3537516/posts?page=24

    Muslim terrorism isn’t new, it isn’t rare, and it isn’t going away. You may want to pretend otherwise, but there are the facts. The original topic was Muslim doctors in the US. I’d say that in general, they would be less likely to become terrorists than the average Muslim, but even they are not immune from the mental disease that is radical Islam. The Ft. Hood shooter proves that.

    We can’t do anything about the problem if we are too politically correct to even talk about it.

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