Immigrants make mark in healthcare work force
Physicians, paramedics, and other healthcare workers in Massachusetts increasingly have something in common, according to a new study: Significant percentages of them were born in another country.
Foreign-born workers are now represented at all echelons of the state's healthcare sector, from elite research laboratories to overflowing emergency rooms. Immigrants now make up more than a quarter of the workforce in several key jobs, including pharmacists, medical scientists, and surgeons, according to an executive summary for a new statewide study by professors from the University of Massachusetts at Boston, Tufts University, and the University of California, Berkeley.
The findings, based on census data, suggest that immigrants have gained a strong foothold in a sector that is vital to the state's economy and is projected to provide thousands of jobs in coming years. Yet the study's authors say Massachusetts should find more ways to move immigrants into the healthcare field to meet a growing demand for care, fueled partly by a state campaign to make sure almost every resident has health insurance.
"They play a really important, but largely invisible, role," said Donna Haig Friedman, director of the Center for Social Policy at the University of Massachusetts at Boston, one of the authors. "At all of the various levels, there is a tremendous contribution being made in this state by foreign-born workers."
The study was commissioned by the Malden-based Immigrant Learning Center Inc. and will be presented to the public in May.
The authors analyzed census data from 2000 and 2005 to identify foreign-born residents of Massachusetts who reported that they were employed in healthcare. Researchers used weighted averages to account for small sample sizes and crafted estimates from the results. They did not draw any conclusions from fields that had fewer than 10 people in them.
According to the study, the percentage of foreign-born pharmacists doubled from 20 percent in 2000 to 40 percent in 2005. Physician assistants rose from 11 percent to 28 percent and paramedics increased from 4 percent to 14 percent.
Other occupations with significant numbers of immigrants included foreign-born physicians and surgeons, who were 28 percent of their field in 2005, opticians (22 percent), licensed practical and vocational nurses (21 percent) and dentists (17 percent).
State Public Health Commissioner John Auerbach welcomed the study but cautioned that some of the statistics, such as the percentage of foreign-born pharmacists, seemed high. A more precise study would track foreign-born workers who were licensed in those fields, he said, but the state did not have those figures available.
In the case of pharmacists, the state collects information about their place of birth, but has not entered it into a computer database for analysis.
Immigrants make up just 10 percent of registered nurses - one area the study's authors said could benefit from increased recruitment as demand for care increases.
"We're going to need every single worker that's out there," said Ramón Borges-Méndez, the study's lead researcher, based at the Gastón Institute at UMass-Boston and an assistant professor at the McCormack graduate school. "You either decide to leave them outside of the job market or you decide to integrate them. They have already, as the numbers show, a very good footing."
Mark Krikorian, executive director of the Washington-based Center for Immigration Studies, cautioned against policies that would seek to increase immigration, which could depress wages and prevent employers from finding innovative ways to provide services.
Across the state, immigrants in healthcare come from an array of backgrounds, talents, and aspirations.
At Massachusetts General Hospital, the chief of emergency services, British-born Alasdair K. T. Conn, says a "30-second" encounter with a friend who invited him to the United States in the 1970s changed his life. The 60-year-old physician loved the fast pace here and the ability to get things done quickly.
He helped start a shock-trauma unit in Baltimore, Boston MedFlight operations, and emergency services at Mass. General.
"America has been good to me," he said. One striking difference: In England he rarely saw gunshot wounds. Here, he sees that almost every week.
"It does not scare me," he said. "But I've never got accustomed to the violence."
In another area of the hospital, phlebotomists in white coats draw blood, soothing needle-phobic patients in English, French-Creole, and Hindi. More than half of the 30 staffers are from other countries.
Nitish Trivedi, an ebullient 18-year-old who arrived three years ago from Bombay, said he hoped his work in the lab will help him achieve his ultimate goal: to become a doctor. On workdays, he dons a pressed white coat and draws blood in the lab for $12 an hour. At night, he studies nursing at a community college. On weekends, he takes orders at Wendy's restaurant for $9 an hour.
He said his parents want him to get an education. "They think - become anything you want, but get number one," Trivedi said.
At the Notre Dame Long Term Care Center, a cozy brick compound in Worcester, immigrants from Ghana, Brazil, and other countries make up more than half of the 65 certified nursing assistants. They care for more than 123 residents - all of whom are white.
As the workforce changed, so did the care center. It created an educational center to help workers improve their English skills, study to become licensed practical nurses and earn better pay, and to apply for US citizenship.
"The immigrant population is going to where the jobs are, and the jobs are in healthcare," said Patricia Campbell, director of the educational center at Notre Dame.
The center also had to address cultural differences. Workers are not allowed to speak foreign languages in front of residents, to avoid excluding them in their own home.
In most cases, the residents and the nursing assistants have intimate friendships.
"My very best friends work here," said Elizabeth LaMarche, an 83-year-old French-Canadian woman who has lived in Worcester all her life. "When I think of what they've gone through and what they've given up to make life better for their family, you feel kind of selfish."
They also share a sense of loneliness. LaMarche rarely gets to see her daughter in California. Agnes Asare, a 48-year-old certified nursing assistant who sometimes guides LaMarche to lunch, dearly misses her brothers and sisters in Ghana.
"They become your family," Asare said. 