H-1B visa fees pose a dire threat to patient care in the US

The US government’s policy imposing a $100 000 fee on employers submitting H-1B visas for skilled overseas workers will have consequences that extend far beyond US borders.1 But US physicians and patients are likely to feel some of the most substantial impacts.The US faces a projected shortage of up to 86 000 physicians by 2036,2 and already this is making it harder for patients to access care, with growing waiting times for appointments3 and greater travel distances for patients.4Rural and underserved areas are disproportionately affected,5 and these communities typically struggle to attract and retain US medical graduates because of lower rates of pay and geographical isolation. International medical graduates often step into roles that would otherwise remain unfilled.H-1B visa holders play an essential role in the US healthcare landscape. About 25% of licensed US physicians are international medical graduates.6 These practitioners contribute clinical expertise and serve as lifelines for rural…