If Congress doesn’t act, there will be a healthcare crisis, says AAPI President.
By Deepak Chitnis
WASHINGTON, DC: Dr. Jayesh Shah is the president of the American Association of Physicians of Indian Origin (AAPI).
Originally from Gujarat, India, Shah graduated from Baroda Medical College in 1992, then came to New York for his residency, which he completed at St. Luke’s/Roosevelt Hospital. He moved to Texas in 1996, and now resides in San Antonio, with his wife, Neha, who is a Certified Lymphedema Therapist. They have two children: Prachi and AJ.
Dr. Shah is a renowned clinician in Wound Management and Hyperbaric Medicine, and is credited with the formation of the Hyperbaric Medical Society in India. He is a two-time recipient of the Jefferson C Davis Memorial Award.
On Wednesday, AAPI held its first ever Symposium on Capitol Hill, during which immigration reform and healthcare policy became the main topics of discussion. After the Symposium, Dr. Shah gave an exclusive interview to The American Bazaar, in which he talked about what sorts of policy changes he’d like to see lawmakers enact, the goals he has in mind for his presidency, and how successful the AAPI symposium was.
Excerpts from the interview:
When you took over as President this year, you advocated a five-year strategic plan for AAPI. What are the key things you want to achieve through the plan?
Well we’ve had our first strategic planning meeting, and the five key areas that we are really looking at are:
- We are looking at the way AAPI governs; how we can structure it, and help the organization for the next 20 years;
- We are looking for ways that our legislative agenda can be broadcast to more Congressmen and Senators;
- We want to make sure that we do more charitable work not just in India – which we have been doing for the past 22 years – but also starting some new projects here in the United States, such as our “Be Fit, Be Cool” awareness program for childhood obesity, which was launched in May;
- We want to make sure that we have a constant source of income for AAPI, so that we can function;
- We want to determine what our role in India is and whether or not we want to have an office [in India], to assist us in carrying out our charitable work there.
So that’s basically the five-point plan in a nutshell.
Lobbying for meaningful legislative agenda at the federal level, on Capitol Hill, has been a priority for the AAPI over the years. What were some of the measures AAPI wanted in the Affordable Health Care Act?
Well, the Affordable Health Care Act (AHCA) is law now; we just have to accept that. But there are a few things in the AHCA where having an Indian physician’s viewpoint on a possible amendment would be better for America. Number one is that, under the AHCA, we are going to have 37,000 new patients who will be uninsured, and there just aren’t enough physicians in this country to take care of that many patients. So we have been advocating an increase in residency positions by 15,000 seats. Number two is that we want to see patient care stays with the physician. With the AHCA and the way the healthcare industry is headed, a lot of bureaucrats are coming in and taking control of healthcare. We at AAPI believe that physicians should be 100% responsible for the care of the patient; there should be a direct relationship between a physician and [their] patient, without some third party saying what should be done.
Over the years AAPI has collaborated with other organizations like the AAHOA and the NFIA to further the interests of the Indian American community on Capitol Hill. What are some of the achievements that have occurred through those joint collaborations?
The main one that we worked on previously was the US-India Civil Nuclear Deal, which we supported and [participated in] a joint collaboration with other Indian-American organizations. Now we are working together with AAHOA on the immigration bill. Another important thing we are working on with AAHOA – and I went to one of their leadership meetings for – is promoting “Be Fit, Be Cool” awareness programs in [the US].
AAPI has supported the Gang of Eight immigration bill passed by the Senate. What are your lobbying efforts in the House for the bill to become reality?
We are in support of the comprehensive immigration bill because there are many things in the bill that will make it easier for physicians [from India] to come here for residency training. For example, one of the things that is in the bill is making J-1 visas permanent instead of having to keep getting extensions every one or two years. Another thing in the bill that is very beneficial to AAPI physicians is making F-1 and J-1 visas [so that] they can be used towards getting a Green Card in this country. And number three is that we are trying to see if the STEM [Science Technology Engineering Math] bill that is out there can include physicians in it as well, so that physicians go through the same pathways as people in the STEM professions to secure a Green Card.
The perfect example of our lobbying efforts is what happened today [the Symposium]. AAPI physicians went to Capitol Hill, there were at least 20 Senators and Congressmen waiting to talk to us – we were discussing with them, questioning them, asking their opinion, [and] lobbying to make sure that they continue to support the comprehensive immigration bill. We went to Republicans and Democrats because we want all of them to support the bill. Through that bill, Indian physicians can get residency and once they get it, their hardships will be decreased.
There are numerous studies out there that cite the shortage of physicians in this country, especially in the rural areas. How bad is the situation really?
If you look at the literature, you can see that by 2050 there will be around 100,000 fewer physicians than what will be needed for the population. So this is the critical time; if Congress doesn’t act, there will be a healthcare crisis. We have nurse practitioners and PAs [Physician Assistants], but they are not enough because they are mainly going into specialties. They are not choosing primary care, [and] having a physician to supervise every nurse and PA is equally important. We at AAPI believe that every citizen has the right to see a physician, so we need to increase the number of physicians by a lot.
So is granting more J-1 visas really the solution for this?
No, the solution is multi-fold, and that’s how the United States is acting. They’re increasing the number of medical schools, but by the time these med school graduates get out of school, it will be another five to ten years, and you don’t want healthcare to reach a crisis during that period. So [the US] has to open up the doors, that’s the only way. If you look at the history of the US, immigrants and immigrations laws have made America prosper. Since 1940 – when Indian physicians started coming to this country – every time there was a crisis, the immigration policies were made easier to overcome the crisis. The important thing now is for lawmakers to see that the crisis is coming, and create a plan to confront it. There are 5,000 US citizens who are physicians but unable to get residency spots; that’s not even including the physicians here on visas who can’t get residency spots, either.
With the implementation of the Affordable Health Care Act, the health sector will see a boom in jobs. What are some of the new career options that people who join the medical field can look forward to?
Any healthcare-related career is going to be in-demand as we go along with the AHCA. So you don’t have to be a physician, you could be a PA, nurse practitioner, physical therapist, occupational therapist, or a medical assistant. On every level, you will see an increase in job opportunities if the job is in the healthcare field.
AAPI has been doing philanthropy in India, has done a lot for disaster relief work. What are some of your objectives when it comes to doing work for the poor and needy in India?
Well [charity] was the main reason that the AAPI was formed. A group of physicians got together because they wanted to give back to their home country, India, and they started initially with little things – sending equipment, things like that – but now that the AAPI name is becoming a brand in India, we are able to achieve much more because of how cooperative the Indian government has been with all the AAPI initiatives. Whatever we want to do to help those in India is much easier to accomplish now than it was years ago.
There are many areas that we are involved in to help India. Yesterday I was talking with the new DCM [Deputy Chief of Mission] at the Indian Embassy to discuss the three new things we can do to help India. Number one is the Seva Project, which we have launched in Gujarat and has been very successful. When we train a high school graduate to be a basic healthcare worker for their village, they can screen the villagers for chronic disease, they can identify people with hypertension [and] diabetes, and these patients are getting treatment. The project has launched in 30 villages, and we are asking the Indian government to help us expand it to even more villages across the country because it is such a success.
Number two is that [AAPI is] are having this global summit in Ahmedabad on January 2-4 . Our goal is to develop an international training center in Gujarat much like the one we have in Andhra Pradesh. What that will do is connect all the [Indian] medical schools to this training center, where we can teach basic and advanced cardiac life support to all medical students, residents and fellows, so that by the time they graduate they will have this basic education on how to do CPR, ECLS [Environmental Control and Life Support system], etc., which are critically needed.
The third, which is mainly in the conceptual stage and which we’d like to give more attention to, is to use technology as a means to give better healthcare in India. This would connect our healthcare center with community healthcare and academic centers across the country. We have a model for this that we have drafted, we have sent it to the Gujarat government, as well as to the health minister. Connected healthcare professionals through technology will help the healthcare industry there tremendously.
The Prime Minister of India and a huge delegation will be in town next week. What do you intent to discuss with him when you meet him?
Well, we will try to get an appointment to meet him, and if we do, we will try to advocate for AAPI, and how AAPI physicians – which is a very strong body of over 100,000 physicians – can collaborate to help India as it projects its path to its future, which is a very bright one.
You are the youngest AAPI President in the history of the organization. What are your personal goals in this one-year tenure of yours?
Personally, my goals are to do what’s best for AAPI. I have presented [to AAPI] my strategic vision, my strategic plan, in my 110-days report to all the members, and we have achieved on many fronts, as I have discussed. Everything I had envisioned for AAPI, from the day I took my office, is progressing as expected
And finally: you touched on this briefly before, but can you give us your thoughts on how you think today’s event went overall?
It was an absolutely phenomenal event, and we were able to achieve what we set out to do. We were able to broadcast our advocacy views on our main three issues that we came to Capitol Hill with: to get Congress to pass the comprehensive immigration bill, to increase residency seats by 15,000, and looking at a final solution for MSGR (Medicare Sustainable Growth Rate) and Medicare cuts in this country.
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