As many of you know, I chair the FMG Taskforce, the coalition of physician immigration law firms that handle the bulk of the nation's physician immigration matters. If you are a doctor and your immigration lawyer handles physician cases regularly, the odds are pretty good that he or she is a member of our group.

We've been working on legislation to address what the AP is describing in their story from this morning. The article is on the mark in describing the problems associated with fewer foreign doctors going to rural areas. Rather than rolling out the welcome mat to foreign doctors to make them interested in staying in the US and working in areas really needing them, Congress and the White House have been doing a lot more to discourage them.

Case in point - the Department of Health and Human Services. In the story, HHS says that the reason it's program approves less than ten doctors a year is because of a lack of interest because of too few doctors seeking positions in rural areas.

That is a absolutely untrue! HHS killed its waiver program for all intents and purposes in 2002 when it changed its rules to only allow communities with "super-shortages" to apply. HHS promised after 9/11 to take over the Department of Agriculture's waiver program in 2002 after a meeting was held at the White House regarding the future of the waiver program. It opened a relatively good program in the summer of 2002 and had a number of applicants. Then it abruptly shut the program down in September 2002 and reopened in December with a number of rule changes that all but shut the program down completely.

I did an analysis that was cited in a Congressional Research Service report that showed that this rule change alone eliminated more than 80% of qualifying rural facilities. They also barred hospitals and private medical practices from applying and that effectively eliminated almost all of the rest. Senator Conrad recently introduced legislation to force HHS to open up its waiver program - to specialists, to private employers, to ALL shortage areas. Pass that legislation and then let HHS tell us there is no interest in the physician population.

I can't tell you exactly why HHS did what it did, but I can only assume the worst - that it wanted to kill the waiver program all together, but knew politically it could not. So they did the next best thing - make it so unattractive that no one would apply. And they have accomplished that. Hopefully, Senator Conrad will succeed in forcing them to do their jobs.