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Finding solutions

Lessons From Everyday Life By Theodore Lewis

Bridgman, MI— During my time on Guam, I got to know several healthcare workers in the Philippines, and learned of the talent and huge numbers of healthcare professionals residing there who have been trained in excellent schools and are fluent in English.

There are more than 900,000 registered nurses in the Philippines, but only about 500,000 are working in their profession due in part to the very low wage rates for nurses.

After returning to Maine from my engagements on Guam, I had the opportunity to attend the Maine Hospital Association (MHA) Summer Forum at the beautiful Samoset Resort in Rockport right on the gorgeous Maine Coast.

During the forum, I played in the MHA golf tournament with my friend Art Blank, who was the long-standing CEO of Mount Desert Island Hospital in Bar Harbor, Maine. The fund-raising tournament was on the spectacular Samoset course overlooking Penobscot Bay and the Atlantic Ocean. During the golf round, I shared with Art my newfound knowledge of the talented healthcare professionals in the Philippines and the amazing fact that so many of them work overseas. Many of these overseas workers send money back home to their relatives. Overseas remittances account for over 9.6 percent of the Philippines’ gross domestic product.

After losing my fourth golf ball on the course to Penobscot Bay, Art joked that my consistent problems in keeping my ball in play reminded him of the consistent problems he was having finding enough lab techs at his hospital. We both laughed, but I told Art if they couldn’t fill their lab positions to give me a call, and I would help them recruit from the Philippines.

Art couldn’t offer me any suggestions for my golf game, however, a few months later, he did call and request my help in recruiting.

David De Hass, MT (ASCP), lab director of the MDI Hospital, was a joy to work with. We came up with an ad which we called "A Job Opportunity in a Garden of Eden" and I sent it out to my contacts. Very quickly, one good candidate was identified, then two. It took months and months to work through the immigration and certification hurdles.

Today, five years later, David has an excellent, fully staffed laboratory with 50 percent of his 15 full-time equivalent professional staff from the Philippines.

David De Hass and the MDI Hospital Lab have bucked the experience of many U.S. hospital labs that just can't find enough workers.

As I'm reflecting on the severe shortage of workers in America right now, especially in healthcare, I wonder if David's success can be an example for some of our future solutions.

But before identifying solutions, we must better understand the underlying reasons for the shortages.

The current shortage of workers has been caused by the demographic changing trends of births, deaths, aging and migrations to the U.S., all converging at the same time. Birth rates in the U.S. have been dropping for years. Between 1976 and 2018, the mean number of children born per woman has dropped from three children to two.


Unexpected deaths have increased among working-age Americans due to the pandemic, drug overdoses, alcoholism, and other factors.

The graying of America is in full force with retirements at record levels. By 2030, 90 percent of baby boomers will have stopped working.

Legal immigration slowdowns in the last few years because of policy changes, along with huge bureaucratic backlogs in processing, have significantly increased the wait times employers have for recruiting foreign workers.

In the healthcare industry, which I'm most concerned about, this perfect storm of four negative trends has resulted in the most intense worker shortages I've ever seen. There just aren't enough nurses, home health aides, nursing assistants and other healthcare workers to meet the demand and need in the U.S. currently and for the near future.

When looking at the increased demand for healthcare services in coming years, many nursing homes will close and many hospitals will be less safe, unless solutions are found now.

Turning around the trend lines of births, deaths and aging would take decades. However, it is possible to solve some of the shortages through changes in legal immigration policies.

The history of our country reinforces the notion that legal immigration is a viable solution. When the need for labor in the U.S. seemed overwhelming after World War II, especially in health care, changing immigration policies and facilitating legal immigration provided the answer for employers. It's now time to utilize legal immigration to help save and bolster our healthcare industry.

The H1-B visa route, which has been used by many hospitals to recruit experienced foreign nurses into positions requiring a college degree, is now taking up to two years to work through the bureaucratic process. The EB-3 Part 3 visa route, which some nursing homes and assisted living communities have used to recruit nursing assistants from other countries, has untenable backlogs.

The only news I hear about immigration relates to illegal immigrants at the southern border.

It's time for our representatives in Washington to start championing legal immigration revisions that will facilitate the recruitment of excellent foreign-born workers into the jobs our healthcare providers are not able to fill.

Our health depends on it.

Theodore Lewis is the former CEO of Guam Memorial Hospital and has a healthcare consulting business in Bridgman, MI. He is collecting stories about lessons learned in life. Send feedback to theodorelewis@yahoo.

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