Temporary USDA Resumption of Visa Waiver Program Not a Solution to Rural Physician Deficit, Providers Say

Although the U.S. Department of Agriculture last week temporarily reversed its decision to end participation in a federal program that allows foreign-born doctors to practice in underserved areas, some advocates and lawmakers say the decision does not solve the problem of attracting providers to rural areas, the Fresno Bee reports (Doyle, Fresno Bee, 4/19). Under Immigration and Naturalization Service rules, immigrants admitted to the United States to participate in educational exchange programs receive a J-1 visa. They must return to their home nations for two years after participation in the program before applying for an immigrant visa, permanent residence in the United States or an additional nonimmigrant visa. However, certain government agencies can request a waiver of the two-year home residence requirement. Since 1994, the USDA has participated in the Waiver of Recommendations for Foreign Physicians program, administered by the Department of State, requesting waivers on behalf of foreign-born doctors who agree to practice in underserved areas for three to five years. In March, USDA ended its participation in the program due to security considerations in the aftermath of the Sept. 11 attacks. The USDA on April 16 temporarily reversed its decision, saying it would process 86 pending requests (Kaiser Daily Health Policy Report, 4/16).

Recruiting More Difficult
In a recent letter to Agriculture Secretary Ann Veneman, a California native, California Reps. Cal Dooley (D) and Mike Thompson (D) wrote that permanently ending participation in the program "may have devastating consequences for rural California," adding, "Without the J-1 visa waiver program, proper health care will be even more scarce in rural California." The Bee reports that six of the 10 primary care providers California's Stanislaus County recruited in recent years have come through the visa waiver program. Dr. Paul Griffin of Fresno County said, "Recruiting doctors has always been a difficult thing in our area, because it's remote and it's not a glamorous location. What we can get with a J-1 (waiver) is a good doctor who's happy to be here" (Fresno Bee, 4/19). Wayne Meyers, a retired physician who recently spoke at an advisory committee on regulatory reform convened by HHS Secretary Tommy Thompson, said that if visas are revoked for foreign-born doctors currently practicing in the United States, 212 rural counties would be without a primary care physician, up from 161 currently (Snowbeck, Pittsburgh Post-Gazette, 4/18).