About The Codes

Why are the Codes Necessary?

For-profit recruitment firms are interested in meeting the needs of shifting labor markets as a natural by-product of globalization. International recruitment poses public policy challenges such as:

  • Information asymmetry (i.e., the different amounts of information) that exists between the recruiter and the applicant places the latter in an inherently vulnerable position. When the recruited individual does not fully understand the terms of their contract, or when those terms change, the recruited health professional may not feel empowered to fully protect his or her rights. The Codes outline fair contract practices to which all recruiters should adhere.
  • Active international recruitment increases the “pull” from low- to high-income countries for personal and professional reasons. Some governments view active recruitment of healthcare workers as beneficial to their economies in regards to remittances. Others, however, have expressed concern that it exacerbates their own shortages. The Codes suggest potential “best practices” that should be sought by subscribers.
  • While licensure and language ensure some degree of preparedness to practice in the U.S., foreign health care professionals report that professional and cultural orientation programs are critical to ensuring success in their new workplaces. Currently different recruiters and employers have managed these challenges in very different ways. The Codes outline numerous ways certified ethical recruiters can support the professional’s transition into the workforce.

In this initiative, stakeholders with divergent interests and viewpoints have partnered to ensure that, to the extent that international recruitment exists, it operates in a manner that is sensitive to all three of these issues. The principles of the Code encourage respect for the needs and interests of all parties: the source countries, the migrant health professionals themselves, and the communities these professionals will serve in the United States.

Voluntary Codes of Practice

The following depict realistic scenarios where application of the Code is necessary:

  • Information asymmetry: The lack of professionals’ knowledge of standard wages, working conditions, and labor and immigration laws—relative to recruiters and employers—can hamper their ability to protect their own rights.
  • Power imbalance: The desire of professionals for jobs in the United States may lead to the acceptance of unfair contracts.
  • Insufficient transition programs: Besides visas and licensure preparation, foreign professionals report that professional and cultural orientation programs are critical to ensuring their success in the U.S.
  • International labor practices: Migrants travel for economic and professional opportunities. Stakeholders understand both the pros and cons of benefits from remittances and workforce migration dilemmas.

Corporate Social Responsibility

While the specifics of international recruitment make this initiative somewhat unique, the effort forms part of a broader international trend towards Corporate Social Responsibility (CSR). According to a study conducted by KPMG, one third of the top performing American businesses publicly report on their efforts to conduct their activities in a socially responsible manner. A key strategy for companies operating in a global arena has been to participate in the development of multi-stakeholder voluntary Codes of Ethical Conduct that include monitoring of participating companies.

See for example:
  • Blair, M., A. Bugg-Levine, and T. Rippin. “The UN’s Role in Corporate Social Responsibility,” McKinsey Quarterly, 4 (2004).
  • Corporate Social Responsibility Initiative
  • Ethics World.  “KPMG International Survey of Corporate Responsibility Reporting 2008.”
  • Schipulle, H. (2002). Lessons Learned from Multi-Stakeholder Approaches. Presented at the Second International Global Compact Learning Forum Meeting, Berlin. 11-13 December.
  • U.S. Department of State. The Voluntary Principles on Security and Human Rights.