">>>>"VULNERABLE SMALL RURAL HOSPITALS SEEM TO BE MORE RELIANT ON IMGS THAN LARGER OR MORE STABLE RURAL HOSPITALS, AND THERE ARE SUGGESTIONS THAT IMG PHYSICIANS MAY BE PLAYING AN INCREASING ROLE IN STAFFING CRITICAL ACCESS HOSPITALS.
IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: The presence of one or more IMGs in 45% of CAHs indicates our smallest, most rural hospitals are significantly reliant on graduates of foreign medical schools for medical staffing."<<<
From: nih.gov
http://gateway.nlm.nih.gov/MeetingAbstracts/ma?f=102275557.htmlInternational Medical Graduate Physicians in America's Smallest Rural Communities.
Hagopian A, Thompson M, Kaltenbach E, Hart G.
Abstr AcademyHealth Meet. 20: abstract no. 586.
University of Washington, Family Medicine, Box 355330, Seattle, WA 98195-5330 Tel. (206) 616-4989 Fax (206) 616-4990
RESEARCH OBJECTIVE: This study describes the numbers and characteristics of foreign-born international medical graduates (IMGs) staffing America's small, rural 'Critical Access Hospitals' (CAHs). CAHs are a federal category of hospital licensure for rural facilities with 15 or fewer acute care beds that receive cost-based reimbursement from Medicare. STUDY DESIGN: We asked chief executive officers (CEOs) of CAH facilities to complete a survey about the IMGs practicing in their hospitals. The telephone survey, conducted in the winter of 2002, included all CAH facilities in the U.S. certified as of May 1, 2001. We achieved a 96 percent response rate, for a total of 388 CEOs. POPULATION STUDIED: as above PRINCIPAL FINDINGS: A typical CAH community has only four physicians, and we found that one of these is a graduate of a non-U.S. medical school. While 24% of the total number of physicians across all CAH communities are IMGs, the number of CAHs that have at least one IMG is much greater (45%). The use of IMGs may also have increased since 1994, a year of significant pro-IMG legislative changes, as we found almost of half of CEOs said their first IMG came to town during or after that year. Additionally, the typical IMG had been in the community three years or less. IMGs were more likely to be found in the most vulnerable of the CAH communities. We found 62% of hospitals in counties classified by the U.S. Department of Agriculture as 'persistent poverty' had one or more IMGs, compared to 42% of other communities (p=.007). IMGs were also significantly more likely to be found in places reporting trouble with physician recruitment generally, and in CAH facilities with smaller medical staffs. Hospitals east of the Mississippi River rely more heavily on IMGs than hospitals in the west. The majority of IMGs are internists (59%), and 26% are family practitioners. Hospitals with IMGs were less likely to have obstetrical services, perhaps reflecting the specialty distribution of IMGs. The majority (61%) of IMGs come from India, the Philippines and Pakistan. As evaluated by hospital administrators, IMGs were rated an average 4.35 on a scale of 1 to 5 in clinical skills, and 4.02 on interpersonal skills. CONCLUSIONS: Comparing our results with national averages, we confirmed that IMG presence in small, rural CAH communities is no different than in the U.S. generally - about 24% of physicians are IMGs in both CAH communities and across the U.S. as a whole. Nonetheless ...
>>>>VULNERABLE SMALL RURAL HOSPITALS SEEM TO BE MORE RELIANT ON IMGS THAN LARGER OR MORE STABLE RURAL HOSPITALS, AND THERE ARE SUGGESTIONS THAT IMG PHYSICIANS MAY BE PLAYING AN INCREASING ROLE IN STAFFING CRITICAL ACCESS HOSPITALS. <<<
>>>IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: The presence of one or more IMGs in 45% of CAHs indicates our smallest, most rural hospitals are significantly reliant on graduates of foreign medical schools for medical staffing.<<<
This finding, coupled with decisions by Congress in the fall of 2002 to expand programs designed to attract IMGs to health professional shortage areas in the U.S., signals that the presence of IMGs in rural areas is likely to grow.
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Meeting Abstracts