Visa program feedback sought

Foreign doctors working in Nevada under the federal J-1 Physician Visa Waiver Program soon will be able to file anonymous complaints about the program's operation through a state-based Web site, said Alex Haartz, administrator for the State Health Division.

The Web site, which is expected to be up and running within a few weeks, also would be available to employers or sponsors of the physicians, Haartz told the state's Legislative Committee on Health Care during a meeting Wednesday.

Haartz and staff from the Bureau of Family Health Services within the health division were asked by Assemblywoman Sheila Leslie, D-Reno, to give a report on the J-1 physician visa program.

Leslie said concerns have been raised about some of the physicians being taken advantage of by their employers. In addition, she said, there are concerns that some of the doctors aren't working 40 hours a week in underserved areas as mandated under the federal program's guidelines.

Started in 1994 under a federal law, the J-1 Physician Visa Waiver Program allows international medical graduates who have completed a residency or fellowship in the United States to remain in the country for three years if they sign a contract to work in a clinic in an identified Health Professional Shortage Area.

Typically physicians not born in the United States but who complete a medical residency or a medical fellowship in the country are required to return to their country for two years.

"They seem so vulnerable to abuse,'' Leslie said about the doctors.

However, in the past five years, the state's Health Division has received no complaints from J-1 physicians or their employers, said Martha Framsted, a spokeswoman for the health division who will monitor complaints on the Web site.

To answer some concerns raised by Leslie about future oversight of the program, Judith Wright, chief of the bureau, said the agency plans to conduct unannounced visits to clinics to ensure physicians are working the required minimum of 40 hours a week in underserved areas.

As the system stands now, J-1 physicians and their employers are required only to submit letters of compliance to the health division twice a year.

"It is apparent that we need to move from an honor system,'' Haartz said. "It doesn't appear to work for everyone at this point.''

In addition to the Web site, the health division also plans to include an exit interview for J-1 physicians "completing their three years to be able to give unvarnished feedback about what went right and what didn't,'' Haartz said.

Under the J-1 visa program, states are allowed to provide 30 waivers per year. Since 2003, Nevada has approved 51 J-1 visas.

In 2007, nine have been approved.

During Wednesday's discussion, representatives of several Las Vegas clinics that hire J-1 visa physicians said they agreed with the health division that there needs to be systematic oversight over the program. They also indicated that more attention needs to be focused on addressing the state's growing physician shortage.

"Unfortunately, there's a national shortage of primary care physicians, and everybody is scrambling,'' said Steven Hansen, chief executive officer of Nevada Health Centers. Nevada Health Centers is a not for profit, federally funded corporation that provides health care to the poor.

John Hickok, chief operating officer of the Eldorado Medical Center in North Las Vegas, which also hires J-1 physicians, made similar comments.

About a month ago, he said, the clinic interviewed a J-1 visa physician who had six offers from six other states.

"He had five more interviews scheduled,'' Hickok said.

"Suffice to say, we didn't hire that physician.''