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SHM Supports Fairness for High Skilled Immigrants Act

June 06, 2018

SHM's Policy Efforts

SHM supports legislation that affects hospital medicine and general healthcare, advocating for hospitalists and the patients they serve.

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The Honorable Kevin Yoder
U.S. House of Representatives
2433 Rayburn House Office Building
Washington D.C. 20515

Dear Representative Yoder:

The Society of Hospital Medicine (SHM) is pleased to offer its support for the Fairness for High-Skilled Immigrants Act (H.R. 392). This legislation will ensure that highly-skilled medical professionals and their families will not be turned away from working in the United States based on per-country limitations.

SHM represents the nation’s nearly 61,000 hospitalists, who are front-line clinicians in America’s acute care hospitals. Hospitalists focus on the general medical care of hospitalized patients, and manage the inpatient clinical care of their patients, while working to enhance the performance of their hospitals and health systems. Their unique position makes them leaders both within their hospital and across the healthcare system.

Many highly trained hospitalists have come to the United States on an employment-based visa such as the H1-B, and find themselves stuck in decades-long backlogs waiting for employment-based green cards. These hospitalists work in every part of the United States—rural and urban areas alike, and caring for patients in academic medical centers, community hospitals, and critical access hospitals. Many of them have been in the United States for many years working as doctors, nurses, and other health professionals on these high-skilled temporary visas, and they are qualified to do more in their facilities once they have green cards. However, the decades-long green card wait-times create severe quality of life issues for their families and their uncertainty around residency status impacts their morale and ability to care for patients.

The most recent study by the Association of American Medical Colleges indicates the shortage of physicians in the United States will be upwards of 120,000 by 2030.[1] Many hospitalists come from China and India, two countries that are at or near the per-country caps. Not only would many hospitals and hospitalist group practices be unable to meet patient demand without these physicians, but many physicians, including hospitalists, who come to the United States on an employment-based visa serve patients in rural America, where the shortage of physicians is most acute. 

With this bill simply converting our employment-based immigration system into a “first-come, first-served” system that does not discriminate based on country of origin, we would be taking a significant step towards retaining a highly skilled hospitalist workforce.  

We appreciate your efforts on this important issue and stand ready to work with you on its passage.


Nasim Afsar, MD, MBA, SFHM
President, Society of Hospital Medicine

[1] Association of American Medical Colleges. The Complexities of Physician Supply and Demand: Projections from 2016 to 2030: 2018 Update.