Dr. Ramesh Adhikari: Here’s one way to address health care worker shortage

Keywords Opinion / Viewpoint
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For 30 years, the Conrad 30 federal waiver program has incentivized international physicians like me to serve in rural and underserved areas that struggle to recruit American physicians. We go places where communities desperately need access to primary care or where there is not another specialty physician for hundreds of miles. We bring health care back to communities that need it most.

States operate their own programs to prioritize the needs of their rural and underserved areas. They work with hospitals and health care systems that recruit these physicians to fill critical gaps in health care. My journey from JJM Medical College in India to working in the heart of Indiana’s health care system underscores the critical importance of this program in alleviating health care shortages across the country.

The Conrad 30 program allows international physicians to waive the home country return requirements of their J-1 visa required for residency in exchange for working in a rural or underserved area for a minimum of three years. This waiver opportunity exists to entice U.S.-trained physicians to continue practicing in areas that have worse health outcomes because they are underserved. The program offered an incredible opportunity to continue my training here, working with patients in a place that desperately needed my expertise.

Since 2014, I have worked in numerous hospitals across Indiana as a hospitalist. I have spent the last seven years working across three hospitals with Franciscan Health, ranging from critical-access hospitals to larger facilities. In more rural areas like Crawfordsville and Terre Haute, where recruiting physicians is a constant struggle, Conrad 30 is a vital crutch. In one 100-bed rural hospital, the availability of hospitalists through the Conrad 30 program has been instrumental in maintaining critical services that could otherwise be delayed or in jeopardy.

While this incredible program should be celebrated, the program needs to evolve to continue to attract top-tier talent to underserved areas. The program is a great recruitment tool, but it does not fully address the challenges of retaining physicians in underserved areas long term. Because of the green card backlog, every few years I find myself in the precarious position of renewing my visa, which is burdensome and disruptive to seeing patients. This situation is largely unique to individuals from India, even though I have been here for 15 years and serve a critical role in my community. Despite these hurdles, my dedication to Indiana remains strong.

As I wait for my green card, a process that could extend another decade or more, I am limited in how I can grow my practice or support other local health care settings. This uncertainty affects not just me but also the communities we serve. A reauthorization of Conrad 30, as contained in the bipartisan Conrad State 30 and Physician Access Reauthorization Act, would significantly enhance the program’s effectiveness in retaining physicians and recruiting prospective Conrad physicians. But more than anything else, it will help patients.

As we celebrate the program’s 30th anniversary this year, we also mark the opportunity to strengthen the program in a way that will benefit communities that struggle with accessing health care. The Conrad 30 program helps us build a more resilient and equitable health care system for all. Congress must not miss this window to act.•

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Adhikari is a member of the Franciscan Physician Network and specializes as a hospitalist.

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