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The signature Sanford blue lights illuminate the night sky on Monday, Nov. 21, 2016, during a lighting ceremony at the new Sanford Medical Center under construction at 5225 23rd St. S. in Fargo.David Samson / The Forum

Immigration restrictions could create ‘critical gaps’ at Sanford, Essentia

FARGO — An executive at Sanford Health said immigration restrictions imposed by President Donald Trump’s administration could prevent filling “critical gaps” in care by keeping out some doctors from foreign countries.

Sanford has seven physicians who, if they returned to their home countries, might not be unable to return to their jobs under travel restrictions announced by the administration. The travel ban has not been allowed to take effect because of a federal judge’s ruling.

Another 14 physicians now in training who are waiting to join Sanford could be caught up in a six-month suspension of paperwork for visas that would enable them to work in the United States.

Sanford has rushed to file the paperwork for a group of physicians — up to 50 could be entangled in the six-month processing hiatus — to get in ahead of an April 3 deadline for the six-month suspension, which the administration is imposing to allow officials to catch up on a paperwork backlog.

“These foreign physicians fill critical gaps in shortage areas and rural areas,” said Cindy Morrison, Sanford’s chief marketing officer.

The expedited paperwork processing is allowed under an option called “premium processing,” which calls for employers to pay about $1,255 for each case to speed up the visa application review.

“Without the premium processing, we’ve waited as long as seven or eight months” to process visas enabling foreign doctors to work in the U.S., Morrison said.

Because of a requirement that the visa applications must be made six months before they would be needed, some physicians in training are not yet eligible to file applications, and therefore will be delayed, Morrison said.

Sanford has identified two such cases. “Both of these physicians are specialists, so we likely will have a gap,” she said.

In fact, most of the 14 foreign physicians Sanford plans to hire this summer are in hard-to-fill medical niches. “These are mostly specialists,” Morrison said.

The specialists include neurologists, pulmonologists, hematologists, pediatric intensivists, interventional cardiologists and neurologists, gastroenterologists and physical medicine and rehabilitation.

Essentia Health declined to provide details about how the immigration restrictions might impair physician staffing. But Essentia’s top executive said maintaining and improving access in rural areas is a challenge that the health system meets by recruiting physicians and other health professionals, including doctors from abroad.

“Essentia would not be able to meet our obligation to our patients without colleagues who were born outside the United States and have dedicated their expertise and service to our communities,” Dr. David Herman, Essentia’s chief executive officer, said in a statement.

The visa waiver program for physicians has existed for many years, probably at least two decades, and many of the foreign doctors end up staying permanently and becoming citizens, Morrison said.

“These are people that have been parts of the communities for years,” she said. “They come from all over the world.”

Sanford, which has a service area of 150,000 square miles centered in the Dakotas, employs about 1,400 physicians, and hires about 100 physicians each year, Morrison said.

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