The healthcare worker shortage was in full force before the pandemic, but the delays, closures, and labor shortages around the world as a result of the COVID-19 pandemic have made things worse. During an interview with Irina Plumlee, a shareholder for Munsch Hardt, we discussed how immigrant labor can be a solution to labor shortages. But the pandemic and US law is making it more difficult to fill these positions.

How has the pandemic impacted highly skilled immigrant labor?

“Since the beginning of the pandemic, our has been busier than ever. I’ve been doing immigration work for over 24 years, and I can tell you that last year and a half have been among the busiest in my history. The fact that it became harder to travel across the borders to come to the US to satisfy employers’ needs and travel to workplaces in the US has only made our clients busier and further challenged us to solve those problems. In addition, there has been a lot of work in the last year and a half or two years in maintaining the status of individuals who are already here in the US and switch employers.”

What makes these types of placement difficult?

We’ve been helping employers bring onboard employees working for a different employer, often in different parts of the country. Immigration wants to know, at least for certain types of visas, where the workers are. So for a US worker, if an employer said, ‘Starting tomorrow, you’re working from home,’ then that’s all good and well. But for an immigrant worker, there are steps that have to be undertaken before an employee can switch to work from home. There are a lot of those things that don’t meet the naked eye.”

How is the employment process different now than it was before?

“In every industry, there’s a shortage of labor and workers. The government allocates 65,000 new H1B’s (which allows US employers to employ foreign workers in specialty occupations that require specialized knowledge and a bachelor’s degree or the equivalent of work experience) each year, and an additional 20,000 allocated for individuals with US graduate degrees. All of that occurred as planned as this last April, so for workers already in the US, that made life a bit easier. But individuals who were abroad and were identified by US employers as qualified individuals those individuals essentially got stuck there. Many are still waiting for their appointments because appointments have been severely delayed. The workers who got approved last spring joined the ranks of the individuals who have been waiting for visa appointments since last year because the people who were approved in the lottery in 2020 never got any appointments due to the travel bans in effect. There is a not-so-small army of people out there waiting for their appointments to be scheduled.”

How are companies coping?

Many potential employees have been scheduled for an appointment for six months from now. The employer wants the individual to come here sooner because they have been waiting for them for eight months and six months, which has been detrimental for the business. The other part of the process is when we transfer employees between companies to bring them on board or help students who are here to change from a temporary status to a more permanent one. Those things have been as busy as ever. Intercompany transfers are a hugely beneficial visa category and have always been for international companies. It allows them to address their needs in highly specialized employees or high-level managers, executives, both of those categories fit into the broad categories.

The healthcare industry is one of your specialty areas. How has that industry addressed these challenges?

For Dallas, Houston, and major metro areas, satisfying the need and medical personnel is easier than outlying areas, which often have a huge underserved population and need certain specialists. During the pandemic of the most in-demand categories has been hospitalist physicians, who are the unsung heroes. A lot of doctors from India have been valuable for the industry. They bring high-quality training and professional requirements that they need to comply with to practice in the US, but they also bring dedication to the profession.

Is it the same for all healthcare employers?

I anticipate that the need for physicians and healthcare professionals in those outlying areas will only increase. My clients are having a hard time filling positions, like specialists, hospitalists, and primary care physicians in the outlying areas, and I suspect it’s only going to increase. 

What makes nurses especially difficult to bring to the US?

The H1 B visa is the culprit. It’s reserved for professionals with college degrees, where the job minimally requires a college degree. The problem with nursing positions is that there is not an industry standard. Many hospitals have the requirement that the nurse has an associate’s degree and then completes a bachelor’s degree within a certain amount of time from the hiring. That phases these nurses out of that critical visa opportunity. They do not nominally meet the requirement. That’s why there’s no good visa for nurses.

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