Wednesday, February 1, 2017

Hospitals feeling the early effects of Trump immigration ban

Hospitals and healthcare systems are feeling the effects of President Donald Trump's executive order banning immigrants from seven Muslim-majority countries.

The ban has caused uncertainty within the healthcare industry as providers attempt to figure out what a stricter immigration policy means for the thousands of non-US citizens who come and live in the country every year to train and work.

Some employees, including physicians, have been directly affected, while others fear that they will be. At least one hospital's human resources department is gearing up to address potential problems resulting from the policy.

“We are aware of three of our associates at this time who have been directly affected by this order,” said Ann Nickels, a spokesperson for MedStar Health, a 10-hospital system serving the Baltimore-Washington, D.C. area. She said MedStar has “a number” of staff with international backgrounds, including some that come from the countries named in Trump's order.

In keeping with its policies for visa sponsorship, “MedStar is providing support for these associates and their families,” Nickels added. She said she was not able to provide more details about who the associates were, where they were from, how they had been affected, or what support MedStar was providing.

Currently, there are roughly 15,000 doctors working in the US who are from the countries targeted in the immigration ban, according to Jim Stone, president of The Medicus Firm, a leading physician staffing agency. But the impact could reach farther when counting foreign-born doctors who are not originally from one of the countries on the travel ban list but may hold passports from those states.

“As a percentage of 800,000 doctors in the United States that's not an insignificant percentage,” Stone said. “Considering the shortage of physicians already, anything that's being done that decreases the supply of physicians is going to be a bad thing for healthcare.”

At Henry Ford Health System, a five-hospital system in the Detroit metro area, its more than 23,000 employees have not been directly affected or stranded by the travel ban -- yet.

“That could certainly change in the coming days,” said Brenda Craig, a spokesperson for Henry Ford. The system has a large number of foreign-born physicians, hailing from at least 60 countries. Some of them are from the countries named in Trump's executive order and either have temporary work visas or green cards.

Those employees still worry about the implications of the ban on future plans, They might have to cancel work-related travel, such as medical missions, or trips for family-related events, such as weddings. Their family members may also be unable to visit the U.S., Craig said. Should those employees be affected by the ban in the future, “our human resources team has put measures in place to respond immediately,” Craig added.

Other health systems have openly rejected the anti-immigration sentiment espoused in the ban and other Trump administration policies.

In a letter circulated Monday to members of the community of the Montefiore Health System, CEO and president Dr. Steven Safyer vowed not to disclose information about the immigration status of its patients, students or employees “without appropriate legal proceedings.”

The Cleveland Clinic reported over the weekend that as many of three of its physicians had been affected by the order Trump signed Friday that bans all travelers from Iran, Iraq, Syria, Sudan Libya, Yemen and Somalia from entering the US for 90 days while suspending admission for all refugees for 120 days.

While two physicians were detained but were ultimately allowed entry, a third clinician, first-year resident Dr. Suha Abushamma, was ordered to fly back to Saudi Arabia because she holds a passport from Sudan.

“Although this has been a difficult experience, I am grateful to be safe with my family in Saudi Arabia,” Abushamma wrote in a statement released by Cleveland Clinic on Sunday. “Please know that I am deeply committed to my medical career and to helping patients at Cleveland Clinic.”

The consequences of the travel ban have begun to be seen among a number of the country's most prestigious academic medical centers, who reported having staff members or patients who have been affected by traveling restrictions.

Representatives from the Mayo Clinic said they were aware of 20 patients whose travel to or from the clinic for treatment may be affected by the ban. They said roughly 80 staff members, including physicians and scholars associated with the clinics have ties to the seven countries listed on the executive order, but at this point was not aware of anyone who was directly affected in terms of barred entry into the U.S.

A spokesman for Massachusetts General Hospital stated as many as five of its employees had been affected by the travel ban, with some unable to get on a plane back to the U.S. even though they have visas, while others had visa applications that were in the approval process. Other still were awaiting interviews to obtain a visa.

The executive order has prompted widespread condemnation by some of the country's leading medical groups, who expressed concerns that the country's reputation as a medical leader could be tarnished if the best foreign-born health professionals and researchers become discouraged from coming to the U.S.

“I fear this is having a chilling effect on the view that physicians and medical scientists have of the U.S. as a welcoming place where excellence in healthcare is recognized and rewarded,” said Dr. Darrell Kirch, president and CEO of the Association of American Medical Colleges.

Kirch estimated around 1,000 non-US citizens with ties to the seven countries targeted by the travel restrictions have applied to residency and fellowship positions in U.S. medical facilities this year. He was concerned they might not come to the U.S. if the travel restrictions are extended.

“These people have been put into limbo,” Kirch said.

Trump's order inspired protests throughout the weekend. It also faces legal challenges from government and social justice agencies. On Monday, the acting attorney general was fired by Trump after she refused to defend the order.

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