Physicians inform state of mistreatment in survey

By Marshall Allen

Thursday, Nov. 6, 2008 | 2 a.m.

Five foreign doctors working in Nevada have complained to state health officials that their employers have breached contracts, threatened them with deportation and asked them to perform duties that could have put them at risk of committing fraud and violating federal laws.

The complaints were made to the Nevada State Health Division, which is trying to gauge the physicians’ concerns after the Las Vegas Sun found that a government program encouraging foreign doctors to work in medically needy communities had been corrupted.

In its two-year investigation the Sun found, for instance, that foreign physicians were overworked, paid less than what the government requires and/or given assignments that financially benefited their bosses at the expense of needy patients.

The findings from the anonymous state survey will test the mettle of the state, which has pledged to restore trust in the program. In 2001 and 2002 the health division ignored similar complaints, but officials have said recent reforms would not allow the same to happen again. Some of the doctors who complained said the state has done little to address their concerns.

An advisory group of experts will discuss the survey results at a health division meeting today.

The problems with the so-called J-1 waiver program stem from the fact that employers, often immigrant doctors, sponsor the visas for the foreign doctors, giving them leverage to exploit the physicians.

The five doctors with complaints were among 21 who responded to the survey, which was sent in July to all 42 foreign physicians involved in the program.

Some of the reported problems raise questions about patient care and, if verified, may violate labor and immigration law.

The physicians were identified only by numbers.

According to the survey report, which was obtained by the Sun:

• Physician 6, who identified the employer to the state, said several contract clauses were not met, including payment of malpractice and health insurance and promised lunch breaks. In addition, “I was seeing patients beyond the scope of my practice and was not adequately compensated,” the doctor said. “I actually called the (health division) about this and they did not prove to be helpful.”

• Physician 8 said, “I work for someone who was not honest about the work requirements and monetary compensation.” Bonuses have not been paid, the doctor said, and “I was asked to see pediatric patients (I refused) even though I am not a pediatrician.” The doctor also said there is not enough time allowed during appointments to give proper care to patients. The doctor, who described the employer as “very shady,” said: “I was constantly encouraged to order a lot of diagnostics and always told that I need to see more patients, and numbers have to go up.” The doctor added that the health division has been “indifferent” when informed of the complaints.

• Physician 19 said, “Unfortunately, my employer is abusive, the management and the employer remind physicians almost on a daily basis that they are ‘J-1 Physicians’ and they have to work extra hours (up to 100 hours a week) otherwise they will lose their jobs and be deported.” The physician also said the employer ordered J-1 doctors to see patients in hospitals that were 15 miles away from the underserved area during clinic hours until the Sun published its reports. This would be a violation of the immigration law that allows the doctors to work in the United States.

• Physician 20 said there are great opportunities for foreign doctors to start their own practices in North Las Vegas but “I want to go as far as I can from Las Vegas or Nevada or any other place my employer would be ... Employer uses his political status and threatens to take legal action against any physician who will stay in town.”

Gregory Siskind, a Tennessee-based immigration attorney who has helped write federal legislation related to the J-1 waiver program, said the health division should take the complaints seriously. The minor gripes could be used to determine whether an employer should be allowed to hire any more J-1 doctors, he said, and the serious and objective complaints should be thoroughly investigated.

The complaints that are violations of labor or immigration law and may need to be referred to federal agencies for investigation, he said.

One of the five doctors who complained in the anonymous survey was reached by the Sun and urged the health division to investigate the complaints or refer them to an agency that will.

Any time the state receives a complaint it is “bound to investigate,” the doctor said, “and the investigation needs to be official.”