Options Available for Firing Physicians to Practice In Rural America
Summer 1996
Shifts in practice and specialty areas have resulted in a growing need for rural clinics and hospitals to consider hiring foreign physicians. The federal government and the medical community remain concerned about the unavailability of physicians willing to practice in rural America. Despite the government's efforts, areas classified as Health Professional Shortage Areas (HPSA) and Medically Underserved Areas (MUA) increasingly face the reality that sufficient medical care is not available due to the fact that many physicians are unwilling to practice in these communities.
One Option Available
In an attempt to deal with this crisis, the federal government implemented regulations allowing foreign physicians (subject to a two-year home residency requirement based on receipt of graduate medical training in the United States) to apply for temporary status (H-1B). Beginning in October 1994, foreign physicians who were or became subject to the two-year home residence requirement between October 25, 1994 and June 1, 1996, could seek a waiver of the two-year home residence requirement on the basis of an interested state agency. (Prior to this time, foreign physicians were required to return to their home country for a minimum of two years before they could accept employment in the United States or obtain a waiver of the residency requirement through a request by an interested federal agency.)
As a result, rural medical facilities located in HPSA or MUA areas will be able to recruit foreign physicians with the assistance of their state's Department of Health. The foreign physician seeking H-1B status must agree to practice medicine for at least three years in a HPSA or MUA area. Much documentation and lead time are needed to obtain permission to employ a foreign physician, so interested medical facilities should seek counsel early in the hiring process.
To date, a limited number of state-sponsored waiver applications have been filed in Minnesota. Fredrikson & Byron has successfully handled this type of submission.
Other Options Are Available
If hiring a foreign physician should be an option for satisfying your hiring needs, a variety of potential immigration avenues are open to you. The optimum route to pursue is determined by the immigration background of the physician you wish to hire, when you anticipate the physician will join your staff, and the long-term goals of the physician and your facility.
Pending Immigration Reform
As this Focus goes to press, immigration reform issues are being finalized by the federal government. Information on the outcome of this legislation will be provided to you when the terms of the bill become final. It is currently anticipated that the reform bill will reach the President in mid-June. If you are interested in hiring a foreign physician, please contact us.