J-1 Doctors abused in Nevada
J-1 Doctors abused in Nevada
Date: Friday, April 03, 2009 1:36 AM
<<<<< JOB DESTRUCTION NEWSLETTER No. 1999 -- 4/02/2009 >>>>>
The Las Vegas Sun has been doing an ongoing investigation about the
exploitation of J-1 doctors.
Before I go further lets talk briefly about what a J-1 visa is, and they are
used by foreign doctors. If you don't want to slog through the technical stuff
just jump to the article. What is going on in Nevada will make a lot more
sense if you read everything because the article doesn't have enough detail to
make sense. Another alternative is to read the article and then come back to
read the technical details.
The J-1 visa is a nonimmigrant visa which allows foreign students to study at
a university in the U.S. and it authorizes them to work in their field of
study. It also allows their big families and numerous relatives into the U.S.
so that they too can hold jobs. Their length of stay in the U.S. is somewhat
undefined because the visa can last for whatever time period their program
lasts, and J-1 visa holders can ask for extensions of the visa to stay longer.
In the case of graduate medical students, they usually stay in the U.S. for
their residency, which can be for several years.
There is a catch to J-1. If the visa holders want to get an H-1B visa or a
green card so they can stay in the U.S. they must go back to their home
country for two years before they can apply. BUT, THERE IS A LOOPHOLE!
For foreign doctors, there are ways to get waivers so that they don't have to
go back home. These waivers allow them to stay in the U.S. with their
J-1 visa while they apply for an H-1B or green card. The only catch is that
they will have to work in designated rural areas. The rationale behind all of
this is that there is a shortage of doctors who will work in these areas so a
carrot and stick approach is necessary to entice foreign doctors to work in
places that are considered undesirable (like Briarwood, NY and Phoenix, AZ).
Foreign doctors get waivers by using the following programs:
* Conrad -- up to 30 foreign doctors per state per year can get a waiver.
* Veterans Administration -- there is no limit on foreign doctors. Another
enticement to work at the VA is that they are exempted from the H-1B visa cap
of 85,000 per year. Foreign doctors who want to stay in the U.S. and work at
the VA can do so as long as they pay their dues, like working long hours for
low pay -- and kissing the rear end of their mean American bosses.
* The Delta Region Authority -- this area covers 252 counties and parishes in
parts of eight southern states. They can give an unlimited number of waivers
and like the VA they are exempt from the H-1B cap.
* Appalachian Region -- this area follows the spine of the Appalachian
Mountains from southern New York to northern Mississippi. It includes all of
West Virginia and parts of 12 other states: Alabama, Georgia, Kentucky,
Maryland, Mississippi, New York, North Carolina, Ohio, Pennsylvania, South
Carolina, Tennessee, and Virginia. They can give an unlimited number of
waivers and they are exempt from the H-1B cap.
As you can see, there is no shortage of exemptions for J-1 foreign doctors.
The list above is far from complete, and there are also many other exemption
programs for J-1s; like for instance the Dept. of Defense exemption for J-1
scientists. It might be argued that many of these areas are rural, but with
enough searching exceptions are easy to find. One thing for sure, J-1 visa
waivers are used for big city hospitals and clinics as well as rural areas.
Their common denominator is that they don't want to pay enough to interest
American doctors.
J-1 doctors are used as slaves. Of course it's a well known fact that all
medical graduates are used as slaves until they fulfill their residency
requirements, so it would probably be more accurate to say that J-1 doctors
are lower cost slaves than American doctors. There is even a blog devoted to
trying to convince themselves that they aren't slaves:
http://blog.j1physicians.com/?p=12
J1 Physicians are not Slaves
The first thing you must understand is that designated rural areas are often
not rural. More often than not they are a hospital or clinic that lobbied to
get themselves designated as rural because they want to hire low cost doctors.
Even when they are rural the reason they can't find medical graduates is
because they don't want to pay enough, and the working and living conditions
are usually so bad an American doctor wouldn't tolerate working there.
To find out what areas of the country are qualified for J-1 doctors, you can
use one of these two web sites. There is almost nowhere in the country that J-
1 doctors can't work!
http://www.hpsafind.hrsa.gov/HPSASearch.aspx
Shortage Designation: HPSAs, MUAs & MUPs
http://www.shusterman.com/md-jwvr.html
J-1 WAIVERS FOR PHYSICIANS
A quick search of their databases rendered two results that can be used as
case examples:
Phoenix Children's Hospital
1919 E Thomas Rd
Phoenix, AZ 85016
Project Samaritan Health Services
13802 Queens Blvd
Briarwood, New York, NY
I produced these results after just a couple of searches in counties with
large cities. Many more examples could be found for those that know their
local areas.
These locations are hardly rural. The Phoenix location is right in the middle
of downtown. The Briarwood location is next to a huge freeway system with
buildings all around it -- except for the large park just to the west on the
other side of the expressway, which might seem rural if you can block out the
vehicle noise (LOL!). See for yourself and have some fun by searching in your
own area by using the databases above and google maps satellite view. Plug the
two addresses above into google view to get an idea what "rural" looks like
from above:
http://maps.google.com/maps?hl=en&tab=wl
Demand for J-1 doctors is likely to increase because of President Obama's
economic stimulus package. That's because billions of dollars will be made
available for Community Health Centers throughout the United States. Those
types of institutions have voracious appetites for cheap doctors so they love
to hire J-1 doctors. Fortunately for these institutions there is nothing in
the stimulus package requiring that American doctors should be favored.
OK, now to that Nevada news article.
A lengthy Sun investigation in 2007 showed that many employers in
Nevada were abusing the J-1 program by hiring doctors under the
pretense of employing them in clinics in underserved areas, and
instead assigning them to hospitals, where they could bring in
more money for the boss.
As previously demonstrated, there is no pretense of hiring J-1 doctors
exclusively in rural areas -- they are hired all over the place and especially
by big urban hospitals. They Sun is correct on the money thing though. Greedy
bosses just love cheap labor!
In the article, foreign born doctors like El Salibi complain of working 100
hours a week and of having to see too many patients. Hmmmmmmm! I have talked
to many a doctor that said they did the same thing when they graduated from
medical school. All of that is just part of the initiation for medical
careers.
El Salibi, who now works on his own, said he can speak freely about
his J-1 experience now because his immigration status is secure.
Looks like Dr. Salibi got his green card, so he no longer will be called Dr.
Slaveboy.
REFERENCES:
http://www.dra.gov/programs/doctors/
Bringing Doctors to the Delta
http://www.arc.gov/index.do?nodeId=24
Appalachian Region J-1 Visa Waivers
http://www.acq.osd.mil/ecs/
DoD J1 Visa Waiver Program
http://www.dra.gov/programs/doctors/
Bringing Doctors to the Delta
http://www.shusterman.com/cgi-bin/ex-link.pl?www.gao.gov/new.items/d0752.pdf
November 2006
FOREIGN PHYSICIANS
Data on Use of J-1 Visa Waivers Needed to Better Address Physician Shortages
http://www.shusterman.com/md-jwvr.html
J-1 WAIVERS
FOR PHYSICIANS
http://faq.visapro.com/J1-Visa-FAQ.asp
J-1 Visa FAQs
http://www.raconline.org/info_guides/hc_providers/j1visafaq.php
J-1 Visa Waiver Frequently Asked Questions
+++++++++++++++++++++++++++++++++++++++++++++++++++
http://www.lasvegassun.com/news/2009/mar/29/abuse-under-foreign-doctor-program-alleged/
Abuse under foreign doctor program alleged By Marshall Allen
Sun, Mar 29, 2009 (2 a.m.)
When he started working for Dr. Dhiresh Joshi in February 2006, Dr. Fadi El
Salibi was a "J-1 doctor," a participant in a government program to bring
foreign physicians to medically needy communities.
A lengthy Sun investigation in 2007 showed that many employers in Nevada were
abusing the J-1 program by hiring doctors under the pretense of employing them
in clinics in underserved areas, and instead assigning them to hospitals,
where they could bring in more money for the boss.
El Salibi claims that Joshi forced him to work 100 hours a week and tried to
pressure him to see up to 70 patients a day at multiple hospitals until his J-
1 term ended in October 2007. He said he worked himself to exhaustion just
seeing 40 to 50 patients a day, working every day of the week and being on
call on the phone every night.
Other infectious disease specialists say it s virtually impossible to see more
than about 30 patients a day.
J-1 doctors are required by federal law to work at least 40 hours a week in a
clinic in a medically underserved area. Elizabeth Neubauer, Joshi s former
billing manager, said Joshi rented space in the clinic of another doctor and
the staff there kept a bogus schedule for El Salibi, complete with false
patient names, in case state inspectors came calling.
El Salibi said he put in an appearance two mornings a week at the clinic where
he was supposed to work. Meanwhile, Joshi assigned him to hospitals throughout
Las Vegas. He said he was afraid state health officials would find out he was
violating the terms of his agreement with the government, but they never came
to the clinic.
Joshi said he never broke any of the rules that guided the J-1 program and
said that El Salibi was always free to find other employment.
El Salibi, who now works on his own, said he can speak freely about his J-1
experience now because his immigration status is secure.
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