The medical crisis we can fix

In my travels across Illinois in August, I consistently heard one thing: shortages of key medical professionals threaten the good health and, in some cases, survival of the people of our state. 

In the South Suburbs of Chicago, a mayor told Rep. Robin Kelly (D-Ill.) and me that he doesn’t have the EMTs to man the ambulances. In the city of Chicago, a hospital CEO and his suburban counterpart told me of the desperate shortages of nurses. A Springfield hospital CEO is setting out to create 500 regional nursing education slots. In Southern Illinois, filling health professional vacancies with contract or traveling staffers is pushing clinics and hospitals into bankruptcy. 

Everywhere I turned, the story was the same: pandemic burnouts, retirements, and heightened demand are forcing hard, sometimes life-threatening decisions by critical health care providers. 

In the long term, we have to address the need to recruit and train a new generation of health care workers. We need to introduce high school students to the life-saving opportunities in health care by providing internships and shadow visits. We need to ensure that our nursing schools have the funds to pay their faculties, so that we have enough spots for American students. And our medical schools and residencies also must provide enough slots for American students.  

But this still would not address the health care professionals who are leaving in droves today. According to the American Hospital Association (AHA), we are expected to lose 500,000 nurses by the end of the year. One in five health care workers have left medicine since the COVID-19 pandemic began. The AHA recently called the current hospital workforce shortage a “national emergency”. Similarly, the Association of American Medical Colleges estimates that the U.S. could see a shortage of up to 139,000 physicians by 2033. These shortages tend to hit rural and medically underserved areas the hardest. 

The health care worker shortages we face are dire. But there are solutions within our reach.  

A few years ago, I heard the story of Dr. Ram Sanjeev Alur, an internist and hospitalist in the Marion Veterans Affairs Medical Center in Marion, Ill. An immigrant, Dr. Alur has served the Marion community for 11 years. Unfortunately, Dr. Alur is one of thousands of doctors who are stuck in the decades-long waiting list for immigrant visas, also known as the green-card backlog. He has been forced to renew his temporary visa four times since he started working at the VA. 

Dr. Alur told me, “The pandemic shook our family. Being a temporary worker on a visa never stared us in the face more. This lack of protection is every frontline immigrant doctors’ nightmare.” Dr. Alur realized that if he died or was incapacitated by COVID-19, his family would lose their right to live in the United States and face deportation. Enabling immigrant doctors like Dr. Alur to stay in America, and incentivizing them to provide care in medically underserved communities, would be a lifeline that could help us through this crisis in the short term.  

The immigration reform debate is no stranger to me. As the lead author of the Dream Act, I have been pushing for years for bipartisan comprehensive reform to fix our broken immigration system. But while broader immigration talks continue in the Senate, we have a unique opportunity to address our health workforce crisis with targeted reforms that senators from across the political spectrum support.  

First, we can pass my Healthcare Workforce Resilience Act, bipartisan legislation that is narrowly targeted to strengthen the health care workforce and respond to workforce shortages worsened by the COVID-19 crisis. 

This bill would allow thousands of qualified and approved immigrant nurses and doctors to get their green cards immediately. Many doctors have been serving our communities in a temporary status due to the lack of available visas, severely limiting their capacity to address our workforce shortages. The bill allows the Department of Homeland Security to recapture green cards that were unused in the past, allotting up to 25,000 immigrant visas for nurses and up to 15,000 immigrant visas for physicians.   

Another bipartisan bill is the Conrad State 30 and Physician Access Reauthorization Act, a billintroduced by my colleagues Sens. Amy Klobuchar (D-Minn.), Susan Collins (R-Maine), Jacky Rosen (D-Nev.), and Joni Ernst (R-Iowa). This bill expands and reauthorizes the Conrad 30 Waiver program. This program waives the requirement that international doctors who enter the U.S. on J-1 visas to receive medical training must leave the country upon completion of their training. And importantly, waivers are granted for doctors who practice in underserved areas.  

Allowing immigrants to fill these necessary positions should be a solution we all back. With rural hospitals shutting their doors, our constituents are traveling miles for care. If we have the qualified folks to fill these positions and deliver care, why would we hesitate? Peoples’ lives are on the line.  

On Wednesday, the Senate Judiciary Subcommittee on Immigration, Citizenship, and Border Safety held a hearing on this crisis. We examined the national shortages of doctors, nurses, and other health care professionals and how reducing barriers for qualified immigrants can help address these workforce gaps. We heard directly from Dr. Alur about his struggles as he navigates our broken immigration system, all while trying to save the lives of veterans in Southern Illinois.  

I hope my colleagues listened carefully to his story. As the demand for health care professionals continues to grow, we have an opportunity to fill these roles with thousands of immigrant nurses and doctors who are ready to serve.  

Durbin is Senate majority whip.