Maybe it's because all four of my grandparents were immigrants, or maybe it's because I grew up in a neighborhood created for United Nations diplomats and their families, where I was surrounded by people from around the world — but anything that stifles the free flow of communication among different countries sets off my internal alarm. And that alarm has been sounding continuously as I read about the ever-growing list of security measures for inbound visitors rolled out by the government since 9/11.

The roadblocks to obtaining visas are formidable, and getting more so. I am concerned that physicians from poorer countries, unable to afford the costly visa application process, will lose the invaluable opportunity of attending U.S. conferences.

The good news, as we report in the story on page 30, is that the medical meeting planners interviewed say that their international attendance is actually increasing. However, one organizer adds a cautionary note. She helped plan a meeting that brought 600 Chinese healthcare professionals to Boston in June 2001. The logistics of organizing a similar event in today's environment would be daunting, she says. I remember how excited I was when MM covered the conference — its purpose was to give Chinese and U.S. participants the chance to forge partnerships that would improve healthcare in both countries. How sad it would have been if that historic meeting had been canceled.

The effect of the “culture of no,” as it is called, extends beyond meetings to the wider healthcare community. The UCLA Medical Center had to replace one of its pediatric heart surgeons, a Pakistani, because of visa delays, according to a November 11 article in the Washington Post. The same article reports that at the Mayo Clinic, foreign physicians and scientists have been prevented from traveling abroad to professional conferences. An April 21 editorial in the Boston Globe warned that the United States may lose its preeminence as a center for science researchers. According to the National Science Foundation, 57 percent of post-doctorate research fellows in the United States are foreigners with temporary visas. But those numbers are declining, as researchers now choose to work elsewhere.

Of course, security is a paramount concern, but I think it's important to question the measures taken in the name of safety and to take action if the rulings threaten medical advancement and patient care. I hope you will join forces with the International Association for Exposition Management and the other travel organizations that are lobbying for a fast-track visa program. Don't wait until you see a dip in international attendance, get complaints from foreign doctors trying to travel to your meetings, or run into problems collaborating with sister societies around the world. Pay attention now. Disease knows no boundaries — neither should medical education.

CONGRATULATIONS to Executive Editor Sue Pelletier whose article “Checking Up on Docs,” (March/April 2003) earned a national award from the American Society of Business Press Editors. This honor comes on top of her regional ASBPE award last year for her June 2002 cover story “New Funding Frontiers.” Way to go, Sue!