Foreign therapists may flood U.S. market
Congress considers increase in work visas
Just at a time when physical therapists (PTs) and occupational therapists (OTs) are facing a dwindling supply of jobs in skilled nursing, home health, and even rehab because of managed care and prospective payment system pressures, there’s another cloud hanging over the industry.
Employment recruitment companies and other major health care employers — joining forces with computer and accounting firms — are pushing for an increase in the number of work visas issued to foreign-born therapists, according to testimony at Congressional hearings held last summer and statistics from the Washington, DC-based U.S. Department of Labor.
If the increase is approved by Congress, employment recruitment companies could flood the rehab market with foreign OTs and PTs who work on a contract basis, replacing domestic OTs and PTs at a lower cost.
Congress approved an increase of 50,000 of these professional visas, called H-1B visas, in October 1998. Recently, it has been considering increasing that number to 200,000 from the current 115,000 visas. When Rehab Continuum Report went to press, Congress had not passed legislation on the increase, but it appeared to be on a fast-track because of support from Senate Majority Leader Trent Lott (R-MS) and Sen. Phil Gramm (R-TX).
The rationale for the increase is that high-tech industries need many more skilled workers than can be found in the United States. But the statistics show that the therapy industry, which has no current labor shortage, had the second greatest number of visa requests last year. (See chart, p. 136.)
| Top 10 Industries Requesting H-1B Visas | |
| 1. Computer industry | 399,563 |
| 2. Therapists (OT/PT) | 181,665 |
| 3. Accountants/auditors | 35,665 |
| 4. Electrical engineers | 16,859 |
| 5. Physicians/surgeons | 11,264 |
| 6. Architecture, engineering, surveying | 11,175 |
| 7. College/university faculty | 9,028 |
| 8. Professional, technical, management | 8,964 |
| 9. Misc. managers and officials | 8,824 |
| 10. Mechanical engineers | 7,115 |
| Sources: U.S. Department of Labor and Immigration and Naturalization Service, Washington, DC, and American Occupational Therapy Association, Bethesda, MD. | |
"What we’re saying is that while the high-tech industry has an undersupply of qualified domestic-trained workers, the health care community generally, and the rehab industry specifically, has the opposite trend," says Kathryn Pontzer, Esq., senior legislative counsel of the federal affairs department of the American Occupational Therapy Association (AOTA) in Bethesda, MD.
AOTA submitted testimony in August to the Subcommittee on Immigration and Claims of the House Judiciary Committee, requesting that workplace visa policies be amended in consideration of changes in the health care market.
The H-1B visa program typically works this way: An employer applies with the Department of Labor to sponsor a foreign-trained worker. Their attestation of need states that they have tried to recruit domestic-trained workers and failed. The labor department then approves or disapproves these applications, and the visas are issued on a first-come basis.
Ironically, while the number of U.S. OT jobs number around 65,000, and PT jobs are expected to reach about 130,000 next year, employers have filed applications to hire 181,665 foreign-trained PTs and OTs.
The therapy industry’s predictions of a labor surplus in coming years run counter to the requests for foreign workers. For instance, the American Physical Therapy Association in Alexandria, VA, sponsored a workforce study in 1997, which predicted that by 2000, there would be an oversupply of 16,238 physical therapists. By 2005, there will be 159,523 PTs to supply 108,575 jobs, according to the study prepared by Vector Research Inc. in Ann Arbor, MI.
The volume of requests has led organizations like AOTA to contend that the visa program may be encouraging the development of businesses dependent on low-cost foreign-trained labor to replace the higher-paid U.S.-trained therapists.
Pontzer says many of the H-1B visas are used by temporary agencies and recruitment agencies that replace therapy employees with contract temporary workers, most of whom come from Asia. "With the current marketplace trends in the rehab industry, how is it that employers could not recruit domestic-trained workers?" she says.
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