J-1 doctors at UMC: It could benefit both

By Marshall Allen (contact)

Thursday, April 9, 2009 | 2 a.m.

The subject came up randomly in a conversation with Kathy Silver, CEO of University Medical Center.

She said her bosses, members of the Clark County Commission, had suggested that she hire some staff doctors at the cash-strapped hospital. (The hospital contracts with outside doctors to see its patients.)

Why not hire foreign doctors seeking employment in the United States?

Hmmm ... She said she hadn’t thought of that.

She should.

The foreign doctors could save UMC money. Based on federal guidelines and depending on their specialties and experience, they would be paid about $200,000 a year, much less than what the hospital pays to contract with some private physicians. For example, the hospital’s contract for cardiology coverage is $4.25 million a year. A cadre of foreign physicians could do it for much less.

Plus, the foreign doctors might even pay for themselves because UMC would bill insurance payers for the doctors’ services. Such savings should be important at a hospital that cut its outpatient cancer program because of annual losses of more than $50 million.

Would the foreign doctors be qualified? They have proven their skills by having been admitted into a U.S. residency program. They have the same licensing and education requirements as American-born physicians.

And UMC would provide the physicians with incentive to come to Las Vegas. The guidelines for the J-1 visas that allow the doctors to complete their medical residencies in the United States require them to return home for two years. But if they agree to treat patients for three years in blighted urban or rural communities, they are allowed to immigrate to the United States.

Because UMC is in such an underserved area, it qualifies as a location where the physicians may work. The hospital also treats a large portion of Clark County’s indigent and uninsured patients, which is in keeping with the primary purpose of the program.

It’s likely the doctors would be eager to work for UMC, a publicly owned hospital. Employers sponsor the visas for the J-1 doctors, and the Sun has documented how some bosses, knowing the doctors would not complain, have systematically exploited them to make money. The unscrupulous employers have worked the doctors up to 100 hours a week, cheated them out of contracts and reassigned them from the underserved patients they’re supposed to serve to hospitals, where they can bring in more money for the boss.

J-1 doctors have grumbled — to one another and in online forums — about the abuses in the program, and it’s widely understood that it’s better to work for an established hospital or entity compared with a potentially abusive private practice. UMC might even hire current J-1 physicians in Las Vegas who want to shed abusive employers.

Lynn O’Mara, who manages the program for the Nevada State Health Division, said UMC could certainly apply to hire the foreign doctors. The program is mainly for primary care doctors, but she said UMC could apply for a variance that would allow them to hire specialists. That would broaden the hospital’s ability to utilize the program.

Perhaps the biggest payoff for Clark County would be the infusion of doctors. The state is allocated 30 slots under the program, but the program had been so mismanaged in past years that few are filled. If UMC decided to hire 10 doctors a year, it could create a stream of physicians who would save tax dollars while becoming established in Las Vegas. Once rooted, they likely would stay in the community after their J-1 service.

After considering the merits of the J-1 program, and its potential benefit to UMC, Silver promised to look into it.