Las Vegas Sun

November 13, 2018

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Indentured Doctors:

Exploited J-1 doctors urged to speak up

The lone doctor who complained to state legislators six weeks ago about being exploited by his employer in a government-sponsored program says it’s time for other foreign physicians to air their complaints publicly.

The appeal by Dr. Shaji Mathew, a pediatrician from India who now lives in Reno, comes as state officials resume their review Friday of alleged abuses of the “J-1” waiver program.

The program offers U.S. residency to foreign doctors who agree to practice in medically underserved rural or urban areas. A Sun investigation of the program found that some doctors were overworked, underpaid and assigned to clinics in areas not medically underserved, in violation of state guidelines and federal law.

The state is bolstering its oversight of the program and Senate Majority Leader Harry Reid, D-Nev., and Sen. Kent Conrad, D-N.D., who authored the enabling legislation, have called for an investigation.

Nevada officials launched their review of the program after the Sun’s stories were published in late September. At an Oct. 31 legislative hearing, Mathew said his employer leveraged his insecure immigration status to financially cheat him, and then threatened to have him and his family deported if he refused to extend his employment contract and guarantee a loan to finance the clinic where he worked.

There are about 55 J-1 doctors in Nevada, among 250 who have worked in the state over the decade. State health officials say they want to hear from the doctors and employers Friday as they consider ways to shore up the program to prevent abuses.

J-1 doctors have been extremely reluctant to complain publicly — many spoke to the Sun only on the promise of anonymity — for fear that if they publicly criticized their employers, who sponsor their visas, they could lose their jobs or be deported.

It’s easier for Mathew to speak out because he has his “green” card permitting legal residency and his resolve was hardened when his former employer sued him. He said he hopes other doctors will come forward to protect future international medical graduates who come through the system.

“Someone needs to speak out,” he said. “Nobody needs to be belligerent about it, but just speak the truth.”

State officials know the foreign doctors are needed and seem to be willing to make changes that will prevent abuses, Mathew said.

Other former J-1 doctors are shaking their heads at the suggestion that they speak in public about the abuses they’ve suffered. One physician who previously worked for Summit Medical Group called it ridiculous to expect anyone to come forward at a public meeting for fear of professional reprisals. State officials should personally contact the J-1 physicians if they want the candid truth, the doctor said.

“They have to call and visit doctors and find out if (the Sun’s reports of abuse) are authentic or not,” the doctor said. “It has to be done correctly and confidentially, on a one-to-one basis.”

The J-1 visa waiver program is administered by state officials, who receive no federal funding for oversight or to monitor compliance with the law.

So far, state legislators and health officials have not spoken individually with foreign doctors who might be having problems with their employers. In one case, health officials asked foreign doctors — with their boss present — whether they were being treated fairly.

Judith Wright, the Nevada Health Division’s family health services bureau chief, said Friday’s 9 a.m. meeting, which will be videoconferenced from Carson City to Elko and Las Vegas, is an initial step toward bolstering guidelines and oversight to prevent abuses.

State officials are visiting the 38 clinics statewide where J-1 doctors are supposed to be working at least 40 hours a week. They are reviewing the guidelines and procedures in other states. Wright said even if doctors don’t come forward Friday they will have the information needed to contact state officials to suggest improvements.

Dr. Ikram Khan, a retired Las Vegas surgeon who sits on an advisory committee that reviews proposed agreements between J-1 doctors and employers, said it would be wrong to expect many current or former J-1 doctors to testify at a public meeting. He said state officials should have been able to speak to doctors one-on-one by now.

“I don’t know what the holdup has been,” Khan said.

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