The creation of Medicare and Medicaid in 1965 enabled millions of Americans to meaningfully access healthcare for the first time — and dramatically increased demand for doctors. The passage of the Hart-Celler Immigration and Nationality Act a few months later enabled tens of thousands of immigrant physicians to migrate to the US. Since then, immigrant physicians have comprised between 25 — 40% of the physician workforce.

Our guest on this episode is Professor Eram Alam, associate professor of history at Harvard. Alam specializes in the history of medicine, race, migration, and health during the twentieth century. In 2025, she published The Care of Foreigners: How Immigrant Physicians Changed US Healthcare.

Over the course of our conversation, Professor Alam traces the legal, economic, and geopolitical factors that led to the US depending on immigrant physicians to care for many of the country’s most vulnerable populations. We explore how American attitudes toward immigration have shifted over time and how the current state of politics has created a jarring disconnect: many patients depend on care from immigrant physicians and yet continue to view immigrants as un-American. Finally, Professor Alam reminds us how remembering everyone feels a little out of place, can help us see the person in front of us more fully.

In this episode, you’ll hear about:

3:00 - Dr. Alam’s work as a professor and historian of healthcare and medicine

7:30 - The background for Dr. Alam’s book The Care of Foreigners.

13:00 - The story behind the 1965 legislation that led to the mass employment of physician immigrants in the US

22:10 - How the role of immigrant physicians in the US healthcare system complicates the idea of meritocracy in medicine

29:00 - The ways in which US immigration policy has changed the experience for foreign-born doctors over time

33:45 - Dr. Alam’s view of how current immigration crackdowns fit into the larger historical narrative of US immigration

45:36 - How dehumanizing political rhetoric surrounding immigrants can blind us to the humanity of those who care for us

53:26 - The unifying power in acknowledging discomfort in ourselves and others

If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.

Immigrant Physicians and American Healthcare | Eram Alam, PhD