{"id":462495,"date":"2026-09-13T11:44:12","date_gmt":"2026-09-13T11:44:12","guid":{"rendered":"https:\/\/www.newsbeep.com\/us-ca\/462495\/"},"modified":"2026-09-13T11:44:12","modified_gmt":"2026-09-13T11:44:12","slug":"how-trumps-immigration-policies-can-leave-doctors-feeling-powerless","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us-ca\/462495\/","title":{"rendered":"How Trump\u2019s Immigration Policies Can Leave Doctors Feeling Powerless"},"content":{"rendered":"

When a patient comes into Dr. Miguel San Miguel Benavides\u2019 exam room at San Francisco General Hospital<\/a> with a cough, a rash, diabetes or high blood pressure, he knows where to start.\u00a0<\/p>\n

But over the past year, people have been bringing him a problem he feels less equipped to tackle as a primary care physician: their fear over immigration enforcement.\u00a0<\/p>\n

Among other actions, the Trump administration has rolled back protections keeping immigration agents away from healthcare facilities and sought to give ICE access to Medicaid data<\/a>. Since then, San Miguel and colleagues at SF General who work with immigrant patients say they\u2019ve watched with a sense of powerlessness as people avoid or delay treatment, and as mounting stress exacerbates their underlying conditions.<\/p>\n

A 2025 survey<\/a> of healthcare workers who serve immigrants echoes that experience: Among hundreds of respondents across 30 states, 84% said patient visits were down substantially; many said their ability to provide preventive care and manage chronic conditions suffered.<\/p>\n

\"\"Miguel San Miguel Benavides, a resident physician at the Zuckerberg San Francisco General Hospital, poses for a portrait at the hospital on Aug. 26, 2026.\u00a0(Gina Castro for KQED)<\/p>\n

Now, a small study from UCSF suggests that immigration policies can force some doctors to practice in a way that\u2019s at odds with their sense of moral or professional duty, taking a toll on them.\u00a0<\/p>\n

The experience has become routine for San Miguel as he finishes his residency.<\/p>\n

\u201cThis is the type of care that I always wanted to give,\u201d he said of working with patients who, like him, immigrated to this country. \u201cBut I think part of that has become realizing that the amount of support we can give isn\u2019t necessarily enough.\u201d<\/p>\n

Researchers call that kind of ethical conflict \u201cmoral injury<\/a>,\u201d a term coined by a Department of Veterans Affairs psychiatrist working with Vietnam War veterans.<\/p>\n

\"\"The Zuckerberg San Francisco General Hospital and Trauma Center on Aug. 26, 2026.\u00a0(Gina Castro for KQED)<\/p>\n

In some cases, the interviewees reported their clinics had stopped accepting undocumented patients altogether, for fear of losing federal funding.\u00a0<\/p>\n

Those experiences, day after day, are what can lead to moral injury.<\/p>\n

What surprised study co-author Dr. Alicia Fernandez was how much doctors changed the way they practiced in response to immigration policy changes. \u201cWhat we saw was many physicians and practices, entire practices, altering their patterns of care,\u201d the UCSF professor and SF General primary care doctor said.<\/p>\n

Some transitioned to telehealth appointments. Others switched medications so patients didn\u2019t have to go into the clinic or pharmacy as often.\u00a0<\/p>\n

But Fernandez said the changes can come at a cost \u2014 both for the patients and the doctors who care for them.<\/p>\n

\"\"Miguel San Miguel Benavides, a resident physician at the Zuckerberg San Francisco General Hospital, and Alicia Fernandez, a UCSF professor and general internist at SF General, talk at the hospital on Aug. 26, 2026.\u00a0(Gina Castro for KQED)<\/p>\n

\u201cWe definitely feel that our patients are getting worse, and we feel that the care that we are giving is an inferior form of care, and that\u2019s why it\u2019s associated with moral distress,\u201d Fernandez said.\u00a0<\/p>\n

She points to a recent experience with an undocumented patient who\u2019d avoided being seen out of fear. \u201cHe came in already having damage from his diabetes,\u201d she said. \u201cThat\u2019s a terrible feeling.\u201d\u00a0<\/p>\n

This kind of distress isn\u2019t just bad for individual doctors.\u00a0<\/p>\n

\u201cMoral injury can contribute to burnout,\u201d said Dr. Robert Pearl, a physician and Stanford professor who served as CEO of the Permanente Medical Group for nearly two decades. And data show burnout affects doctors\u2019 quality of care.<\/p>\n

\u201cIf the patient before you required all this extra work, has had this added fear, had all these challenges,\u201d he said, referencing the study, \u201cwhen the clinician sees you, he or she may not be as good and sharp as you would like them to be.\u201d<\/p>\n

\"\"Individuals walk towards the Zuckerberg San Francisco General Hospital and Trauma Center on Aug. 26, 2026.\u00a0(Gina Castro for KQED)<\/p>\n

Burnout and moral injury can also lead doctors and other healthcare workers to leave their professions, he said, with particularly dire effects in primary care.\u00a0<\/p>\n

\u201cWe already have a shortage,\u201d he said, so \u201cwhen you need a primary care doctor, that individual might not be there. And we\u2019re certainly seeing that in many communities across the United States, where it\u2019s almost impossible to find a primary care physician with an open panel.\u201d<\/p>\n

For doctors in the study who were themselves immigrants, the distress was compounded. That has broad implications given that almost half of the country\u2019s internal medicine doctors are foreign-born, according to a study<\/a> released last month.\u00a0<\/p>\n

While the UCSF study on moral injury is small and qualitative, it points to ways healthcare institutions can support staff in an increasingly difficult environment. Doctors whose clinics protected patients\u2019 immigration-related information and expanded telehealth, for example, described ways those changes helped them care for patients.<\/p>\n

\u201cWe live in fear of losing our patients, because we know that their physical health will suffer, the health of their kids will suffer, and the health of the community will suffer,\u201d she said.<\/p>\n","protected":false},"excerpt":{"rendered":"When a patient comes into Dr. Miguel San Miguel Benavides\u2019 exam room at San Francisco General Hospital with…\n","protected":false},"author":2,"featured_media":462496,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[30],"tags":[101,103,102,104,106,105],"class_list":["post-462495","post","type-post","status-publish","format-standard","has-post-thumbnail","category-san-francisco","tag-san-francisco","tag-san-francisco-headlines","tag-san-francisco-news","tag-sf","tag-sf-headlines","tag-sf-news"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts\/462495","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/comments?post=462495"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts\/462495\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media\/462496"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media?parent=462495"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/categories?post=462495"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/tags?post=462495"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}