UPH Government & External Affairs

Immigrant Workforce Resilience – Ponnada

by | Jan 27, 2021

UnityPoint Health employs more than 80 physicians on temporary visas waiting for green cards. These physicians are vital to our mission and communities. To remedy the administrative backlog of temporary visas, we strongly encourage the re-introduction and passage of Congressional proposals, like those from the 116th Congress – the Healthcare Workforce Resilience Act (S.3599 / H.R.6788) and the Conrad 30 Program and Physician Reauthorization Act (S.948/ H.R.2895). This is an important issue for all regions of UnityPoint Health – our hospitals, clinics and communities – and is part of our federal action list.

Here is one provider’s personal story: 

Dr. Vara Ponnada, a native of India, is a board-certified Internal Medicine physician practicing in Waterloo, Iowa.

“I have worked as a Hospitalist physician for the past 8 years since completing my medical residency in the United States in 2012. I’ve lived in the United States for 11 years and I view it as my home.  As a Hospitalist, I take care of very sick patients, including those who require critical care. We serve patients from the surrounding three or four rural counties who do not have higher-level medical care locally available.

There are twelve Hospitalists on the Allen team; nine of them are on temporary visa status. Our normal work pattern is providing hospital care for five days at a time with 12-hour shifts, then five days off. Being a Hospitalist is a very fulfilling role, as we apply our Internal Medicine training to care for the ‘whole patient’ while they are in the hospital. But we are a relatively small group, considering the number of patients we typically care for, and the Waterloo/Cedar Falls geographical area has lower-than-average physician coverage.

Currently, we have six physicians working alongside one ARNP (Advanced Registered Nurse Practitioner), but it is getting very difficult to find enough physicians to cover all of the shifts. Recently, we have needed a seventh physician to be available because of the recent rise in COVID-19 patients.

UnityPoint Health filed for my permanent residency five years ago.  Since then, I have been stuck in the “green card backlog” with little likelihood of being granted permanent residency in my lifetime. 

More than 80 percent of our Hospitalists are international medical graduates who utilize the Conrad Waiver program, providing three-year temporary visas at a time.

Visa restrictions limit our ability to practice in other UnityPoint Health clinics or outpatient sites outside the hospital, and we cannot participate in research grants or investigations.

Visa restrictions also can interfere with something as simple as renewal of my driver’s license, as it is set to expire at the end of my current visa; a new license cannot be granted until the visa is renewed. Also, UnityPoint Health must find other physicians to cover shifts whenever our Hospitalists are out for personal reasons, at a time when our hospitals are struggling with many other staffing issues.

COVID-19 has created additional concerns for us, both professional and personal. In the hospital, we are currently seeing many COVID-19 patients and patients who have undefined respiratory problems, so additional time must be spent every shift getting in and out of personal protective equipment. I am at risk of being infected, as is every other front-line healthcare provider during the pandemic.

As an alien physician on visa status, every day I have the fear in the back of my mind that if I were to become sick and as a result become disabled, I will be deported to India, my country of origin, where I have no immediate family who can take care of me. I am a breast cancer survivor, underwent a bilateral mastectomy in 2018, and currently use hormone therapy. Despite these health problems, I work diligently every day to take care of COVID-19 patients and other Allen Hospital patients.

Improvement in our ability to practice and overcome visa restrictions is very important to me. Since 2017, I’ve used some of my time off to travel to Washington, D.C. three times to meet with our senators and representatives about the issue. I feel it’s very important for legislators to know the many challenges we face in trying to provide the best healthcare possible for our patients and to put a face to the issue.

Key Statistics:

  • 78 UnityPoint Health physicians are currently on H1B visa status
  • In 2019, more than 95,000 UnityPoint Clinic (UPC) visits occurred with these physicians, or about every 1 in 10 UPC visits that year
  • They practice in 12 medical specialties as well as in primary care (family medicine, internal medicine and pediatrics)
  • These medical specialties include Anesthesiology, Cardiology, Emergency Medicine, Endocrinology, Hospitalist Care, Infectious Disease, Neurology, Obstetrics/Gynecology, Oncology, Pediatric Specialties, Pulmonology and Rheumatology
  • For COVID-19 care, these specialists serve in the critical areas of Pulmonology, Infectious Disease and Hospitalist care. They provided care for 39% of UPC Pulmonology visits in 2019 and 36% of Infectious Disease visits. More than 25 of our Hospitalists are currently on H1B visa status


For more information about UnityPoint Health’s position, please contact: Cathy Simmons, Executive Director of Government & External Affairs or Stephanie Collingwood, Government Relations Specialist.