Las Vegas Sun

September 2, 2014

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SUN FOLLOW-UP:

Protect foreign doctors who work in Nevada, colleagues urge

Win-win sought to protect doctors

Indentured Doctors

Across the United States, foreign doctors are being worked to exhaustion, cheated out of wages, coerced into unfair contracts and diverted away from the medically needy patients they're supposed to serve. Their bosses can bully them because they sponsor their visas.

This series takes a look at these physicians

An association of about 1,400 Nevada physicians is calling for whistleblower protection for foreign doctors who complain of being exploited by their bosses, and for the government to more aggressively monitor the program that allows them to work in the state.

The Nevada State Medical Association’s recommendations for reform came in a letter to the Nevada State Health Division, in response to a Sun investigation of the “J-1” visa waiver program, which is designed to bring foreign doctors to medically needy communities, but in some cases has been abused by employers.

The Sun found foreign doctors being forced by their bosses to work up to 100 hours a week, which is dangerous for patients, cheated out of their salaries and diverted from the -- patients in underserved areas they’re supposed to help. The abuses are possible because the foreign doctors are reluctant to complain about their employers, who sponsor the visas allowing them to stay in the United States.

Larry Matheis, executive director of the association, made four recommendations in the letter. The first is to adopt the guidelines that govern the J-1 visa waiver program as regulations, which carry the weight of state law. He says the step would not require legislative action and would allow for clear action and investigation when there are violations.

Matheis also said an advisory group that makes recommendations about the program should be expanded to include anyone who is interested and the meetings should be made public.

“There’s a sense that things may have gotten out of hand because neither the public -- nor the regulators could monitor what was going on,” Matheis said. “It was a problem that had been developing for some time and it really was time to resolve it.”

A third suggestion is to remove noncompete clauses -- which restrict where a foreign doctor can work after he leaves his employer’s practice -- from current contracts between employers and foreign doctors so they’re in line with federal guidelines.

Finally, Matheis said Nevada’s current whistleblower protection laws should be expanded to protect physicians, their families and others who might report violations in the program. This may require legislative action in 2009, Matheis said.

Drs. Ikram Khan and Amir Qureshi, who are on the J-1 advisory committee, said they were pleased to hear about Matheis’ letter and that the process of implementing changes needs to continue.

“They’re still in the process of evolution,” Khan said of the reforms. “They should continue to the point where it’s absolutely foolproof.”

Khan and Qureshi said they’re in favor of eliminating existing noncompete clauses in contracts and expanding the whistleblower legislation to include doctors. But they said they need to hear more details before they can form opinions on the other recommendations.

Qureshi said his primary concern with turning guidelines into regulations is for the foreign doctors, who may be forced by their employers to violate the rules of the program. The foreign doctors must be protected, Qureshi said.

Lynn O’Mara, health planning program manager for the state health division, said all of Matheis’ recommendations are being discussed. The goal is to move forward with improvement as soon as possible so the program “is a win-win all around,” she said.

The Sun’s findings that some U.S. doctors bully their foreign employees were cited by Senate Majority Leader Harry Reid in calling for an investigation by the Homeland Security Department.

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