ClickCare is based in Binghamton, NY, a small city surrounded by small towns, a place where folks tend to leave their house doors open and you can't run down to the grocery store without seeing a lot of people you know.

It's a place like most places in our country.It's not, however, a homogenous place.

The Binghamton area has always been a region of immigrants and diversity. Boeing, IBM, Binghamton University, and Endicott Johnson are all companies important to the backbone of the US, and they are intertwined with the immigrant story. In fact, Endicott Johnson is probably the most important foundation of our town -- and was known for giving a "square deal" to new immigrant families working for the company, receiving support far beyond just a fair paycheck.

My experience as a healthcare provider is rooted in my practice of reconstructive surgery in this community setting. Yes, my experience was "American" -- with local farmers paying for their care in eggs when their money didn't quite stretch. But it was also very much an experience of collaboration across and within many cultures. Almost all of my partners in my practice were not born in the US. Many of our patients were from a rainbow of backgrounds, many of those new arrivals to our country. Most of the colleagues I respect most deeply are immigrants, from a variety of religious backgrounds. So many other providers across the continuum of care and support staff have been born in other countries. And we are all responsible for creating the texture and strength of the tapestry of care and community that we all benefit from.

We have respect for many of the policies of both parties, and wish our new President -- who has a lot of dynamic ideas for the future -- a lot of success in guiding our country to greater prosperity, health, moral leadership, and greatness. Much of President Trump's executive order on immigration, however, runs contrary to our experience in our community, in medicine, and as people. 

First, much of the order isn't smart for our healthcare system or our economy. International graduates represent 25% of the medical workforce. And with shortages in many groups of healthcare providers, immigration continues to be an important source of our smartest doctors. The ban, and other related immigration limitations, will have some negative consequences for science and innovation in this country as well -- limiting a flow of qualified and dynamic innovators. As Medpage Today reports, many groups within medicine have expressed concern about the ban, including The American Medical Student Association (AMSA) and The Association of American Medical Colleges (AAMC). The concerns relate to access for patients who need it, limitations to the providers who can work in our country, and other key parts of the operation of our medical system. 

Second, we believe that this type of policy is detrimental to the respect, collegiality, and collaboration among all providers and patients in this country that is so important to successful healthcare. 

Finally, as healthcare providers, we've taken an oath to "do no harm" -- which the extreme exclusion of refugees is arguably inconsistent with.

All in all, we believe that diversity, collaboration, and inclusion is crucial to our health, safety, innovation, and thriving as a country -- but what is an individual to do? Well, even small actions can have a big impact. 

3 Ways to Support Diversity, Collaboration, and Inclusion as Healthcare Providers: 

• Express support of your colleagues, wherever they were born. It can feel awkward, trying to express support to colleagues who have been here for decades. But for people whose place in the US -- or whose families' place in the US -- may not be guaranteed, a comment of support may make a world of difference.
• Reach across borders in your community. Whether it is visiting the local mosque, or getting out of your media bubble, sometimes the people we need to connect with most are right down the street or in our own families. 
• Collaborate. We believe that medical collaboration is one of the most important drivers of good care, patient satisfaction, and healthcare provider satisfaction. Medical collaboration and conversation with colleagues have positive ripple effects, even if it's just on one case. Of course, to collaborate effectively with our colleagues -- from different linguistic, cultural, and educational backgrounds -- we need to have tools to communicate. And we've certainly found that a picture is worth far more than a thousand words when you're communicating across cultural or language barriers. 
  
  
  We're all tired of politics. But this week, in whatever small way, I hope we build bridges, not walls -- in whatever ways are feasible, within reach, and safe -- for each of us.

Photo from wocintechchat on Flickr, used under Creative Commons rights.