Foreign Medical Graduates: Providing Critical, and Quality, Care

For many, the term “talent gap” conjures up an image of rows of empty seats in IT, engineering, and manufacturing. But the talent gap is also felt in healthcare. With the high cost of medical school, and the attractive salaries of physicians that specialize, the U.S. is simply not producing enough physicians to meet demand, especially in primary care.

This shortfall is expected to rise. The Association of American Medical Colleges found that the demand for doctors will continue to outpace supply, leading to a projected shortfall of between 46,100 and 90,400 doctors by 2025, many in primary care. These shortages are compounded by the fact that large numbers of physician ‘baby boomers’ will be retiring in the next few years.

Foreign Medical Graduates (FMG’s) are filling this crucial gap. Today, they comprise nearly 30 percent of all primary care doctors in the United States and provide quality medical care that equals or exceeds that of doctors who graduated from medical schools in the U.S.

Several leading hospitals are embracing the diversity of their medical staff while ensuring seamless communication between FMG’s and their patients. Knowing that pronunciation proficiency is an essential part of communication, these hospitals are providing English pronunciation training for their providers. The results have been transformational: better patient-centered communication due to greater understandability of their physicians, increased physician confidence and engagement, and higher Press Ganey HCAHP patient survey scores.

With a fully empowered physician workforce, these hospitals are filling the talent gap while delivering excellent medical care and the quality experiences their patients demand.

Dictators Promote Understanding

It’s been almost seven years since I received our first inquiry from the American Association of Medical Transcriptionists (AAMT).  These are the folks who listen to dictations by physicians and nurses (who, I came to learn, are fondly referred to as ‘dictators’).  They then transcribe the audio dictations to written format.

The AAMT had a problem and they wanted to know if the Accent Reduction Institute could help.  With nearly 35% of our U.S. practicing physicians being non-native English speakers, understanding some of the dictations could be quite a challenge.  A medical transcriptionist (MT) could hit ‘rewind’ repeatedly, but without an actual process for deciphering unfamiliar speech patterns, they’d be stuck.  The MT’s compared it to the well known analogy of rocking in a rocking chair.  It gives you something to do, but you don’t get anywhere.

Thus, accent comprehension was born.

Last week I provided our process for understanding accented speech to an organization whose workforce comes from all around the globe.  Afterwards, one of the attendees sent me the following note.

My name is Kathleen and my father was a second generation American of Polish descent, his parents only spoke Polish and he only went up to the 6th grade.  He could not pronounce the “th” in Kathleen – he always called me Katleen. Now I understand why.  It is worth it just to have that understanding.  I have to confess that when people would use the term “dumb Polak” I thought they were referring to my father because he did not know how to pronounce my name.

I gasped when I read this.  Very painful.  The prejudicial slur is intolerable; the misunderstanding it created is heartbreaking.  BTW, my grandmother is also of Polish descent, and the immigrant experience in America is both a personal and professional one for me.  Perhaps this is one reason why helping people find their voice has been my lifelong passion.

When the AAMT made that first call nearly seven years ago, I’m not sure they meant to have such a far reaching impact on people’s personal lives.  To this day, I’m grateful for that call.

Diversity, Prosperity, and Immigration: Can They Go Hand in Hand?

Have you ever known a time in American history when the topic of immigration wasn’t center stage in the City of Your Choice Times? I certainly haven’t. And this is a good thing. It’s productive and healthy for democratic societies to have ‘national conversations’ that impact us all in unique ways. Like many hot topics, feelings and ideas about immigration and diversity seem to be divided into two diametrically opposed views: either immigration is a powerful tool that contributes to our uniquely American success story or, conversely, we’ve reached a tipping point where immigration is about to do us in and be our kiss of death.

My sense is that, many people on both sides of the equation drive their arguments from an emotional standpoint, as well as sound academic and political research. They either set their gearshift in ‘fear’ mode or ‘touchy-feely’ mode. I’d like to present a few pieces of hard data that may help us sort through the emotional draw and focus on the facts. The following is based on The Global Detroit Study, a research initiative that sheds light on the role and impact foreign-born residents have on one of the most economically depressed regions of our country. The findings reveal why it may be our new immigrants who help move Detroit out of its current state of economic despair and usher it into a new age of prosperity. Key findings of the study show:

  • Immigrants residing in southeast Michigan are 150 percent more likely to possess a college degree than the non-immigrant population (37 percent to 23.7 percent). In addition to being educated, immigrants predominate the science, technology, engineering, and mathematics (STEM) fields that are critical to technologies, innovations, and businesses that power the New Economy jobs and firms. In fact, while the foreign born comprise only 12.5 percent of the U.S. population, they possess half of all new Ph.D.s in engineering; 45 percent of all new Ph.D.s in life sciences, physical sciences, and computer sciences; and 40 percent of all new masters degrees in computer sciences, physical sciences and engineering.
  • The National Venture Capital Association estimates that 25 percent of all public, venture-backed firms launched in the U.S. from 1990-2005 were started by immigrants. These are the most commercially successful of all new economy firms. Similarly, Vivek Wadhwa’s work at Duke University uncovered that 25.3 percent of all high-tech startups in the U.S. from 1995-2005 had at least one immigrant founder.
  • Throughout urban American, immigrants have played a critical role in stabilizing neighborhoods and bringing population growth to central cities that haven’t seen growth since the first half of the Twentieth Century. Immigrant entrepreneurs have shown an innate ability to provide commercial retail services in core city neighborhoods that are in desperate need of jobs, retail offerings, and investment. Ethnic enclaves in central cities are often characterized by lower crime rates, reduction in blight, increasing property values, and new energy.

With the next round of elections about to unfold, the immigration debate will surely get louder and hotter. I’d like to encourage all of us to remember to look at the data when assessing how we can continue to create a prosperous, diverse, and noble America.