It is standard practice to start opinion pieces with a powerful anecdote that “hooks” the reader and lures them in, winning their attention by appealing to their humanity. However, this highlights the exact issue posed by the recent revocation of immigration rights in the U.S.; we do not know the stories that most need to be told right now. Instead, we have to tell of the patients who did not show up to their primary care appointments, of the individuals who did not seek care during medical emergencies due to the threat of Immigration and Customs Enforcement (ICE) raids at medical facilities, and of the gaps in care left by health care workers who have been detained or deported.

The current presidential administration’s anti-immigration sentiment is a health care issue with the potential to cause significant harm to patients and health care workers alike.

Since the inauguration of President Trump on January 20, 2025, the new presidential administration has announced several executive orders related to immigration policy, declaring that it will expedite “mass deportations” of undocumented migrants while also halting the processing of asylum seekers and intensifying border control efforts.

Of these anti-immigration efforts, the widely publicized ICE raids in particular have garnered significant public attention and created widespread fear for many immigrants living in the U.S. The Trump administration recently released an executive order with the goal of increasing ICE’s power to arrest, detain, and deport undocumented migrants by allowing the agency to “expedite” deportations by bypassing immigration courts. In addition to this executive order, the administration also rescinded a policy that previously protected individuals from ICE arrests in “sensitive” areas, which notably included health care facilities.

The U.S. health care system has already been impacted by these anti-immigration efforts. For one, undocumented patients are now forgoing essential medical care. CommunityHealth, a free clinic in Chicago with a high proportion of immigrant patients, has noted that hundreds of patients—roughly 30 percent of all patients they serve—have skipped appointments and failed to pick up prescriptions due to fear of ICE raids at the facility. For many patients who rely on clinics like CommunityHealth, missing health care appointments means running out of medications needed to manage chronic conditions like hypertension, diabetes, and heart disease. Without medication adherence and regular check-ups, these diseases can progress to significant morbidity and mortality that would have otherwise been avoided, thereby worsening existing health disparities.

This phenomenon can and will extend to emergency care as well. If patients are afraid of going to their provider’s office for a brief appointment or to their pharmacy to pick up a prescription, they are likely going to delay or forgo more lengthy interactions with the health care system during emergency situations as well. Given that emergency department visits have a national median length of 2 hours and 42 minutes and can potentially result in a hospital admission, patients may believe that the risk of encountering ICE officials during a long hospital visit outweighs the benefits of receiving medical care.

It is important to note that the impact of anti-immigration policies on the health care system extends beyond the fear of ICE raids at hospitals. Current “mass deportation” efforts also pose a significant threat to the health care workforce. Immigrants and children of immigrants make up an outsized proportion of health care workers; in fact, they comprise a greater percentage of health care practitioners than their overall share of the U.S. population. In recent months, the media has been awash with stories of green card and visa holders being detained and deported, including news of a Lebanese kidney transplant specialist with a valid visa being deported to Lebanon despite having proper documentation. Anti-immigration policy threatens to deprive the U.S. of innumerable skilled providers, ultimately decreasing the quality of health care in this country.

As we navigate these unprecedented times, it is of the utmost importance that we advocate for our patients in unprecedented ways:

It is essential that medical facilities establish and communicate institution-wide plans regarding how to protect patients in the event of an ICE raid. When discussing these plans, it is important to ensure that all workers understand their rights to protect their patients and themselves. Providers have the right to remain silent and are not required to give ICE officials access to any information or spaces without a warrant. If an ICE officer does present a warrant, hospitals should have a designated authorized representative to assess the validity and appropriateness of the document. If the warrant is not signed by a judge or magistrate, does not specify the exact address of the facility, and/or fails to detail the date and scope of the search, it does not necessitate cooperation.

It is also important to protect patients by refraining from documenting any information regarding a patient’s immigration status that is not pertinent to their care. If any documentation needs to occur, this information should be stored securely, out of public view, and separately from the electronic medical record. Communicating this information with all staff and providers allows for protection of patients.

Finally, all health care providers who are able to safely advocate against anti-immigration policies and laws should engage in this form of advocacy on behalf of their patients and colleagues alike. Providers—particularly those who have the privilege of knowing that their citizenship will not be questioned—should be writing to representatives, publishing op-eds and essays about how anti-immigration policies have affected their patients and themselves, and initiating conversations with leadership at their health care institutions about initiating institution-level changes to protect patients.

When we enter the field of medicine, we swear an oath to do no harm to our patients. In this era of anti-immigration sentiment, we cannot claim no harm if we fail to advocate for the protection and safety of our immigrant patients and providers alike in all health care settings.

This essay is cited in the KevinMD record on immigration and medicine.

Carlin Lockwood is a medical student.