Editorial: Program needs investigating

Wednesday, Oct. 3, 2007 | 7:01 a.m.

Many medical clinics in rural or low-income urban areas of Nevada are served for 40 hours a week by a foreign doctor enrolled in a federal immigration program.

At least this is how it looks on paper.

An investigation by Las Vegas Sun reporter Marshall Allen, however, revealed allegations by many foreign doctors that they are often diverted to hospitals, vastly reducing the time they spend at clinics.

The reason why this could happen is clear: Foreign doctors generally work for local sponsoring doctors, who stand to profit more from their employees' time spent in hospitals than from their time spent with poor people.

The federal program is a theoretical win-win. Only top graduates of foreign medical schools qualify to serve their resident training in the United States. Following their training, program participants stay here on a special visa in exchange for working three years in a disadvantaged area. After that, they become eligible to apply for U.S. citizenship.

Participants are called J-1 doctors, after the type of visa they need, which requires them to have a sponsor. For many, the sponsor is a doctor whose practice includes ownership of a clinic.

That doctor becomes their employer and has power over their futures - if he fires them, they lose more than their job. They lose their sponsor, without which they cannot fulfill their dream of living here permanently.

Allen interviewed 25 former or current J-1 doctors. The most common form of abuse alleged involves assigning the foreign doctors to work more hours in hospitals than in clinics.

One Southern Nevada clinic cited by Allen is staffed by a J-1 doctor just one afternoon a week. The rest of the doctor's time is spent making hospital rounds.

Other complaints made by J-1 doctors, recounted in Sun stories published on Sunday and Tuesday, included having to go months without pay, losing out on promised bonuses and being required to work more than 80 hours a week. Fearing the loss of their sponsorship, they hesitate to complain.

Allen found that neither the federal government nor Nevada provides active oversight of the J-1 program. Employers of J-1 doctors are required to submit periodic statements to the state that all of the program's rules are being followed. That's it.

Assemblywoman Sheila Leslie, D-Reno, said her Health and Human Services Committee will take up the allegations at a meeting this month. And Assembly Speaker Barbara Buckley said, "The state should step in and do a thorough examination ."

We agree. If the allegations are true, as they appear to be, then the program is a lose-lose - for the foreign doctors, and for all the people entitled to their full-time services.