New scaled-back Trump travel ban, same healthcare worries

Worries about the negative impact on the healthcare industry have not gone away with President Donald Trump’s new scaled-back version of his travel ban.

The new executive order, signed Monday and already sparking protests, did nothing to allay the fears of some of the groups that represent physicians, hospitals and medical students that the order that restricts travel to the U.S. will have a negative impact on the healthcare community.

“We remain concerned by the new executive order’s implications on hospitals, health systems, medical professionals and patients,” Rick Pollack, president and CEO of the American Hospital Association, said in an announcement.

Of particular concern to healthcare leaders is the potential negative impact of the travel ban on international medical school graduates scheduled to start work in the country’s teaching hospitals this summer. The hospital group recommended an immediate case-by-case waiver review for accepted residents from the six affected countries—Sudan, Syria, Iran, Libya, Somalia and Yemen.

A major change in the new order is that it restricts people from six Muslim-majority countries rather than seven—with the removal of Iraq from the list at the urging of the State and Defense departments—for 90 days. It also exempts people with valid visas as of the March 16 effective date.

The Association of American Medical Colleges had the same concerns about new medical school graduates who will match to residency programs on March 17 and are scheduled to begin training in residency programs around July 1. “We are deeply disappointed that the revised executive order and accompanying fact sheet do not explicitly recognize the importance of international medical graduates, physicians and medical researchers to the nation’s health security,” said its president, Darrell Kirch, M.D., in an announcement.

Doctors from those six banned countries already provide care to millions of Americans, especially in Rust Belt states and Appalachia, according to a new analysis by a team of economists at Harvard University and the Massachusetts Institute of Technology.

The researchers found there are more than 7,000 physicians working in the U.S. who trained in those countries and who provide about 14 million patient visits each year, according to their post on the Health Affairs blog. Those doctors are more likely to provide care in underserved areas where American doctors are reluctant to work and more likely to practice in areas of medicine facing shortages, such as pediatrics and psychiatry.

Many healthcare groups spoke out vehemently against Trump’s original order in January that was blocked by federal judges and are no happier with his latest ban on travel revised in a bid to weather any legal challenge.

The American College of Physicians said the revised order will cause healthcare crises and encourage discrimination with its 120-day ban on new refugees and allowance of a decreased number of refugees accepted to the U.S. While it clarifies that people from the six listed countries with existing visas, including doctors and medical students, will be able to enter and re-enter the United States, the order will still open the door to discrimination against Muslims, disrupt medical education, hinder travel by physicians and others, and exacerbate a public health crisis for refugees, the group said in an announcement.