RICHMOND, Va. – A forthcoming book titled “The Care of Foreigners: How Immigrant Physicians Changed U.S. Healthcare,” authored by Eram Alam, an assistant professor of the history of science at Harvard University, delves into the significant yet frequently overlooked contributions of foreign-born doctors in the American healthcare system.
This work specifically examines the surge of such physicians after the 1965 immigration law and discusses their often conflicting relationship with the U.S.
These doctors, many of whom hail from South Asian nations like India, have come to fill critical labor shortages, frequently settling in underserved communities that can be hostile towards immigrants.
Alam’s exploration highlights the dichotomy faced by immigrant physicians. They enter a field that both needs their expertise and, at times, expresses hostility towards their presence.
In a recent interview, Alam explained that this tension is symptomatic of a broader issue within the immigration debate in the U.S.
“The U.S. has these shortages of labor… and immigrant labor is absolutely vital for the functioning of many sectors including healthcare,” Alam said.
He draws parallels to other industries affected by mass deportations, where there is a clear reluctance to remove immigrant workers due to their essential roles.
This balancing act was first established with the Hart-Celler Immigration Act of 1965, which created a framework allowing foreign-born professionals to immigrate while simultaneously harboring a contradiction of ‘We want you to come; we don’t really want you to come, but we actually need your labor.’
One of the pressing issues addressed in Alam’s book is the moral implications of ‘brain drain’ – the migration of highly skilled professionals from the Global South to the Global North.
Alam proposes that the U.S., as a leading power in healthcare spending, has a moral obligation to consider ways to alleviate the immigration burden by producing more homegrown physicians rather than relying on foreign expertise.
Furthermore, he discusses how recent immigration policy changes could destabilize this fragile balance between supply and demand for foreign-born physicians.
“There are some glimpses of it,” Alam noted, particularly referencing changes enacted by the current administration, which have made it more challenging for immigrant physicians to enter the country.
He cited a specific instance where, due to restrictions placed on visa interviews abroad, fewer foreign-born doctors were able to come to the U.S., resulting in hospitals losing essential medical staff.
“Some hospitals had 10 immigrant physicians scheduled to start work, but only eight managed to arrive,” he explained.
The impact of these changes could be profound, as Alam pointed out that immigrant physicians often serve vulnerable populations that have limited access to healthcare.
“The most vulnerable people are the ones being taken care of by immigrant physicians,” he said, emphasizing the necessity of these professionals in maintaining healthcare quality.
Moreover, Alam referenced studies showing that immigrant physicians have fewer malpractice cases than their U.S.-trained counterparts, highlighting the quality of care they provide.
Alam’s book aims to illuminate the critical role of immigrant healthcare labor while pushing the conversation towards a global perspective on healthcare distribution.
He hopes to foster greater public awareness on how the essential labor of immigrant physicians forms the backbone of the U.S. healthcare system.
As the book’s release date approaches, Alam encourages readers to rethink the narrative surrounding immigrant labor and recognize its importance in healthcare.
In a world increasingly fraught with immigration challenges, Alam’s work serves as a reminder that the contributions of foreign-born professionals are not just valuable but indispensable to the functioning of U.S. healthcare.
“This question of the distribution of healthcare labor must be viewed as a global issue,” he concluded.
The book is set to be published by Johns Hopkins University Press on Oct. 14.
This interview has been edited for clarity and brevity.
(Reporting by David Sherfinski; Editing by Ayla Jean Yackley.)
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