Here is a recent article that we found from Nevada:  http://lasvegassun.com/news/2007/sep/30/indentured-doctors-how-it-happens-j-1-doctors-must/  .  Every physician seeking a J1 waiver should read this and make sure it doesnt happen to them.  The J1 Physician Network insures that this never happens to its clients and there are steps to take to insure that this does not happen:

1.  Only work with a reputable placement firm.  Check them out.  Ask for references and call the references.

2.  Do not accept any opportunity in a private practice without support by the local hospital.  Support means money.  It al is another step insuring you are not taken advantage of and that you have recourse.

3.  Dont just talk to the physcians currently working for the perspective employer, ask to speak to former employees.  If they do not want you to do this, a red flag should come up.

There are alot of great employers throughout the US, but we know of many that we would never send a perspective client.  And they are not just in rural areas.  For example, Providence, RI; Baltimore, MD; Southern New Jersey; Chicago are all areas where we know of practices that take advantage of physicians. 

If you are working with a placement company, ask if they have placed anyone previously at that location.  If they have, ask to speak to that person to get information.  If the placement firm doesnt want you to do that,,,,,,,run away and dont use them. 

Just be careful, check it out.  Make sure that private practices are being financially supported for the hiring of your position.  Talk to people.  Dont let unethical employers take advantage.

Here are some other reported examples:

• A Florida J-1 doctor provided the Sun with time sheets showing that his boss forces him to work more than 100 hours a week, plus additional nighttime on-call shifts in hospitals. The hours far exceed the 80-hour-a-week threshold that research shows is safe for patients. The doctor complains, too, that uninsured and Medicaid patients are denied care at his boss’s clinic, a violation of the program.

• Three foreign doctors who worked for an Arizona physician said they were overworked, with one of them assigned 84 straight hours per weekend of hospital rounds and overnight on-call duty, in addition to long weekday shifts. Two said they worked full time in areas that did not fit the government’s definition of medically underserved.

• A foreign doctor in Michigan said he was paid about $30,000 less than federal law required and was pressured by his boss to bill Medicare fraudulently, which he refused to do.

• A J-1 doctor who worked in a small Georgia town in 2006 said he was fired for refusing to work in his boss’s clinic, which was not in an underserved area, and because he would not fraudulently bill Medicare and insurance companies. He preferred being fired because he didn’t have to pay a $250,000 penalty for breaking a contract. But then, to avoid being deported, he had to hustle to find a J-1 employer in another state who abided by the guidelines.

We have worked with approximately 10 physicians over the past 3 years to remove them from bad situations.  We just completed one and are in the process of another.  It isnt always easy.  And State Health Departments aren’t always willing to help.  It is always better to not get into the situation in the first place.