Honors Study

The Effect on the Supply of Physicians in Health Professional Shortage Areas of Removing the H1-B Cap

Lance Weaverling

Lance Weaverling
HPA Schreyer Scholar

Purpose

In the year 2000, the cap limiting the number of foreign doctors under an H1-B visa was removed. This study examines the effect of this change in legislation on the supply of general practice physicians in Health Professional Shortage Areas (HPSAs).

Data and Methods

Data were collected from the Area Resource File. The number of general practice physicians in counties across the United States was used in conjunction with the population estimates to determine the physician per capita ratio for each county. The HPSA ratio was applied to each county to determine whether they were underserved or non-underserved. The average ratios for each group were graphed to analyze their trends. A t-test on these trends was applied to determine if the change was significantly different from zero. A secondary hypothesis as to whether a majority of the underserved counties were rural was tested by calculating the percentage of each group that was classified as rural by applying each county's Beale code.

Findings

There were significant changes in physicians per capita ratio from the year 2000 to 2004. The trends between underserved and other counties went in opposite directions, with a downward trend in underserved counties and an upward trend in other counties. These findings suggest that removing the cap on the H1-B visa had a significant effect on the physician per capita ratio across the United States. Applying the Beale code to each county also determined that a majority of all underserved counties were indeed rural counties.

Conclusion and Policy Implications

It appears that legislation related to the H1-B visas enacted in the year 2000 affected the supply of physicians in HPSAs. Legislation affecting the J1 and H1-B visas could be developed by policymakers to counter this trend and help to increase the supply of general practice physicians in underserved areas where access to healthcare is not always readily available.