WASHINGTON -- Organized medicine's response to the Trump Administration's executive order on immigration has been overwhelmingly negative, with many groups expressing concern over the order's potential effects on healthcare providers from other countries who are working or studying in the U.S.
The Association of American Medical Colleges (AAMC) was among those expressing concern about the order. "International graduates play an important role in U.S. health care, representing roughly 25% of the workforce," Darrell Kirch, MD, the association's president and CEO, said in a statement. "Current immigration pathways -- including student, exchange-visitor, and employment visas -- provide a balanced solution that improves healthcare access across the country through programs like the National Interest Waiver and the Conrad 30 J-1 Visa Waiver."
"In the last decade, Conrad 30 alone has directed nearly 10,000 physicians into rural and urban underserved communities. Impeding these U.S. immigration pathways jeopardizes critical access to high-quality physician care for our nation's most vulnerable populations."
The executive order, signed by President Trump on Friday, says that "immigrant and nonimmigrant entry into the United States of aliens from [seven specific] countries ... would be detrimental to the interests of the United States" and that persons from those countries -- which include Syria, Iraq, Iran, Yemen, Libya, Somalia, and Sudan -- cannot come into the U.S. for 90 days. The order excludes "those foreign nationals traveling on diplomatic visas, North Atlantic Treaty Organization visas, C-2 visas for travel to the United Nations, and G-1, G-2, G-3, and G-4 visas."
The order also says that "the entry of nationals of Syria as refugees is detrimental to the interests of the United States" and suspends Syrian refugee immigration into the U.S. until the federal government can "ensure that admission of Syrian refugees is consistent with the national interest."
The American Medical Student Association (AMSA) also weighed in. "The attack on immigrant communities through the signing of an executive order by President Trump last week has added yet another, unnecessary, deplorable barrier to accessing healthcare," the group said in a statement. "Furthermore, we recognize that many of our peers, physicians, and scientists, are members of the immigrant community working hard to provide services and skills to those who need them and to advance the health of our nation. We will work just as hard to stand in solidarity with our colleagues and offer them our full support." AMSA called on the president to retract the order.
The Committee of Interns and Residents also spoke strongly against the order. "As a union of 14,000 resident physicians, we suffer from acute repercussions of President Trump's actions on immigration on many fronts," the organization said in a statement posted on its website. "Their effects are wide-ranging and endanger the public's health, the healthcare safety-net, the well-being of physicians who are immigrants, and the fabric of our communities."
The statement also noted the effect that the order will have on patients. "It will cause patients in dire need to shun local hospitals and clinics where a police officer is stationed out of fear for themselves or their families, turn a trip overseas for a foreign-born physician into a nightmare of uncertainty, and threaten to withdraw millions of critically-needed and properly allocated federal healthcare dollars from our cities, counties, and states. Simply put, lives will be put at risk by these actions."
The American College of Cardiology was among those lamenting the ban. "The ability to share ideas and knowledge necessary to address this epidemic is imperative. Policies that impede this free-flow of ideas will have a detrimental impact on scientific discovery, as well as the lives of patients around the world," read a statement from ACC President Richard A. Chazal, MD. He also noted the substantial portion of the U.S. healthcare workforce hailing from the affected nations. The American Society for Clinical Oncology issued a similar statement.
And the American College of Physicians (ACP) criticized the order's effects on Muslim physicians. "It is already clear to us the executive order is resulting in discrimination based on religion against physicians and medical students from the designated countries who are getting their training, and caring for patients, in the United States," ACP president Nitlin Damle, MD, said in a statement.
Damle noted that "In 2016, 3,769 non U.S. citizen international medical graduates obtained first-year residency positions. If the executive order prevents medical residents from being able to come to the U.S., this could potentially affect the care for thousands of patients. The College is greatly concerned about the devastating impact on public health of a ban on refugees from war-torn countries that are most at risk of injury, death, persecution, and deprivation."
"By targeting certain countries with refugee populations it directly assaults those who are most in need of our support and protection -- the very population that many of our physician members work with on a daily basis," read a statement from the National Physicians Alliance, a group of physicians that supports affordable healthcare. "Aware that refugees reaching the U.S. already go through an extensive 20-step, 2-year-long vetting process by multiple agencies, we note there is a complete lack of evidence that any refugees had been convicted in domestic terrorism."
"Furthermore, we are deeply concerned with any risks that may be faced under this order by our colleagues – physicians and scientists -- who themselves are immigrants from the targeted countries," the statement continued. "We stand with them and offer them our full support. We also recognize the negative impact this order will have on the available professional health workforce in the United States. This negative effect will be amplified in low population areas and rural hospitals and health clinics, as they are much more likely staffed by physicians, and especially nurses, who hail from developing countries."
The American Medical Association was more cautious in its response. "The American Medical Association is assessing the administration's executive order and how it may affect physicians, medical students, residents and patient care," AMA president Andrew Gurman, MD, said in a statement. "Guidance is urgently needed from the administration to clarify that this order will not impact patient care or prevent travelers' access to timely medical treatment."
Some universities with medical schools also stated their own opposition to the executive order. "We are deeply concerned about the impact of this Executive Order," wrote Tufts University president Tony Monaco. "We take great pride in the global nature of our community and have always embraced and valued our international members from around the world."
"As we have stated previously ... we will not provide information or assist in the enforcement of immigration laws except as mandated by a subpoena, warrant, or court order."
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