Temple University Hospital, Philadelphia, PA, USA.
Pediatric Group of Acadiana, Lafayette, LA, USA.
J Prim Care Community Health. 2021 Jan-Dec;12:2150132721994018. doi: 10.1177/2150132721994018.
To examine the reasons contributing to the physician shortage in the country's medically underserved areas using the state of Delaware as a focus state.
A literature review regarding the shortage of physicians with data compilation from Delaware Department of Public Health (DPH) and Delaware Health and Social services (DHSS) was performed. A review of the "Conrad 30 J1 VISA waiver program," the most important and primary supplier of physicians to underserved areas of the state was performed. A survey interviewing the physicians recruited through this program to identify any challenges faced by them was designed and conducted.
The number of primary care physicians providing direct patient care in Delaware in 2018 had declined about 6% from 2013. The average wait time to see a PCP was 8.2 days in 1998 as compared to 23.5 days in 2018. Forty-six percent of physicians serving in HPSAs in Delaware are IMGs recruited through the J1 VISA waiver program. Eighty percent of these IMGs are actively considering leaving the United States due to anxieties around physician immigration policies, mainly "Immigration backlog."
The existing programs to recruit physicians to underserved areas seem to be inadequate. The state and the hospital systems should be able to utilize the J1 program to its full potential and focus on retaining these physicians after their assigned services. As the challenges of IMGs continue to worsen every day; the medical societies, hospitals, the state and federal government should advocate for policies that resolve these challenges.
以特拉华州为重点州，研究导致该国医疗服务不足地区医生短缺的原因。
对与医生短缺相关的文献进行了回顾，并从特拉华州公共卫生部（DPH）和特拉华州卫生和社会服务部（DHSS）收集了数据。对“康拉德 30 J1 签证豁免计划”进行了审查，该计划是该州向服务不足地区提供医生的最重要和主要来源。设计并进行了一项调查，采访通过该计划招募的医生，以确定他们面临的任何挑战。
2018 年，在特拉华州提供直接患者护理的初级保健医生数量比 2013 年减少了约 6%。1998 年，平均等待时间为 8.2 天，而 2018 年为 23.5 天。在特拉华州 HPSA 服务的医生中有 46%是通过 J1 签证豁免计划招募的 IMG。这些 IMG 中有 80%由于对医生移民政策的担忧，主要是“移民积压”，正在考虑离开美国。
现有的向服务不足地区招聘医生的计划似乎不足。州和医院系统应该能够充分利用 J1 计划，并专注于在这些医生完成指定服务后留住他们。随着 IMG 的挑战每天都在恶化，医学协会、医院、州和联邦政府应该倡导解决这些挑战的政策。
