Monday, January 30, 2017

Trump’s travel ban hits hospitals hard

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(CNN)The White House's travel ban encompassing seven majority-Muslim countries is a blunt instrument that's already wreaking havoc and the impact is already being disproportionately felt in American health care. The administration emphasizes it's preventing only a "small percentage" of global travelers from entering or leaving the country, but our hospitals rely on a steady influx of international physicians to keep running.

Throughout my medical career I've benefited from working alongside medical graduates from around the world. I've enjoyed professional relationships with Russians, Saudis, Canadians, Israelis, Iranians and Italians in the halls of medical centers in Alabama, Ohio, Missouri, Massachusetts and Georgia. Thanks to our conversations between cases I've learned about different medical systems and different approaches to managing the same conditions, and I've enjoyed their camaraderie.
    Today I work at one of the top rehabilitation hospitals in the country, and on our wards I've recently had the pleasure of overseeing a resident physician from Iran who's doing her rehabilitation specialty training through Emory University School of Medicine. She holds an H-1B visa, the kind our government grants to the highly skilled workers our economy needs.
      Under President Trump's new order, even after the interventions of two federal courts, if she left the country for any reason, such as going to visit family, she might be locked out from returning. Her colleagues, including myself, trust her to care for patients at the country's eighth ranked rehabilitation hospital, but our government doesn't trust her enough to let her travel.

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      The President's decision is as ill-timed as it was sudden. The initial 90-day order encompasses Match Day, the already anxiety-inducing third Friday in March when medical school graduates officially commit to their clinical training programs. Unless the administration or the courts quickly fix the mess President Trump just created, many American hospitals could face staffing crises come July when new residents are slated to start working.
      The international doctors who come to our shores represent some of the best ambassadors for their native countries, but they all have their own reasons for choosing to build medical careers in America. In doing so many are looking to leave behind more authoritarian regimes.

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      When it comes to the impact on our health care system, some countries may appreciate President Trump's new medical blockade. As the Iranian-born resident working with me pointed out, her home government will be happy to see its educated citizens and scientists stay right where they are. "If [Trump] wants to fight with the Iranian government in this way, it doesn't work at all."
      It doesn't seem to matter what element of American medicine this President touches; on issues ranging from vaccines to health insurance to simply keeping our hospitals staffed, Trump has a way of downgrading his patient to life support.
      We have a phrase for this kind of unfortunate person in medicine, and it doesn't matter whether you graduated from med school in Iran or Alabama, you know it: a black cloud. If your black cloud persists, you might need to think about an alternate career. With his cloud's darkness spreading fast, it's past time Trump step away from the health care policy arena.

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