The Immigration Ban And The Physician Workforce
By Matthew Basilico and Michael Stepner
Mar 6 2017
The Executive Order restricting visas for citizens of Iran, Libya, Somalia, Sudan, Syria, and Yemen has many legal, political, and moral implications. But here we will focus on the medical implications of the executive order, by considering its impact on the physician workforce in the United States and the patients that rely on these immigrant doctors. There are 14 million doctor’s appointments provided each year by physicians trained in those six countries. These doctors are working all across America, but they are especially concentrated in the Rust Belt and Appalachia, seeing many patients in communities in Ohio, Michigan, West Virginia, Indiana, and Kentucky.
We are part of a team of economists from Harvard and the Massachusetts Institute of Technology (MIT) who have analyzed available data to understand the contribution of physicians from targeted countries to the health care workforce in the United States. Using data from Doximity, an online professional network for doctors, we have estimated the number of doctors trained in affected countries working in every area of the United States, and the number of appointments they provide to patients each year (see note 1). Below we have included a map of the doctors from the six targeted countries working in each “Commuting Zone”—a group of adjacent counties that have close economic ties—within the United States.
What We Found
The results of our analysis are clear: physicians from banned countries provide an important contribution to the health care workforce of the United States. There are more than 7,000 physicians trained in countries targeted by the executive order working in the United States. Together, they see an estimated 14 million visits from patients each year. Furthermore, our analysis finds that these physicians make up a larger share of the workforce in several Rust Belt and Appalachian states. They provide 1.2 million doctor’s appointments per year in Michigan; 880,000 in Ohio; 700,000 in Pennsylvania; and 210,000 in West Virginia. The five cities in America with the highest share of doctors from these countries are Detroit, Michigan; Toledo, Ohio; Los Angeles, California; Cleveland, Ohio; and Dayton, Ohio.
Physicians in targeted countries also provide 2.3 million patient visits in areas with physician shortages. They work in these areas at the same rate as American-trained doctors. Rural and underserved communities in the United States have long struggled to attract high-quality physicians in sufficient quantities. Incentive programs have attempted to bridge this gap, but shortages remain. Our analysis suggests that physicians entering from these countries do not cluster preferentially into the major metropolitan areas, but rather are situated on the front lines of medical need.