A new study published in JAMA on Tuesday highlights just how dependent the American health care work force is on foreign born workers. In fact, the study, an analysis of U.S. Census Bureau data, finds that nearly one third of U.S. physicians were born somewhere else.

Some other striking figures from the analysis? Nearly 20% of health care workers across two dozen medical fields in 2016 were foreign-born. The percentage of pharmacists, dentists, and general physicians who came from another country numbered anywhere from 20% to 29%.

And home health aide workers and nurses—the front line soldiers in the medical industry—also had major international representation. In fact, nearly one in four of them were foreign-born, according to the analysis.

The study did not break out which of these international workers were trained abroad rather than in the U.S. But it does suggest, as Harvard Medical School’s Dr. Anupam Jena tells the Philadelphia Inquirer, that a lower rate of skilled immigrant workers coming to America could have a noticeable effect on the medical workforce.

Read on for the day’s news.

DIGITAL HEALTH

Aetna signs on to health care blockchain challenge. Insurer Aetna and health system Ascension have signed on to a blockchain-focused alliance that already includes the likes of Humana, Quest Diagnostics, and UnitedHealth. Dubbed Synaptic, the alliance is attempting to use blockchain tech (a connected-yet-decentralized digital ledger system) to try to improve the chaotic morass of health care provider directories (data that include, say, whether or not a certain doctor has moved over to a different hospital or health group). (FierceHealthcare)

INDICATIONS

FDA issues guidance on liver disease drugs. The Food and Drug Administration (FDA) is proposing new guidance for developing NASH drugs—a hotly sought liver disease space being pursued by the likes of Allergan, Gilead, and others. The whole thing is fairly technical—it involves the underlying criteria and biomarkers that clinical investigators should, according to the regulators, focus on while developing new treatments—but is critical for the industry and therapeutic space generally. “Currently, there are no approved drugs for the treatment of NASH. Given the high prevalence of NASH, the associated morbidity, the growing burden of end-stage liver disease, and the limited availability of livers for organ transplantation, FDA believes that identifying therapies that will slow the progress or, halt, or reverse NASH and NAFLD will address an unmet medical need,” wrote the agency in its guidance.

THE BIG PICTURE

Oregon could legalize psychedelic mushrooms. As we've previously noted, psychedelic drugs have been making a bit of a comeback in the medical world, being tested as potential treatments for conditions such as anxiety, depression, PTSD, and others. In 2020, Oregon voters could become the first in the nation to legalize mushrooms' use in official therapy, particularly for the treatment of depression. No word on whether such a statute, if passed, would also pass federal muster for a controlled substance in the same way that marijuana somewhat has. (Fortune)

REQUIRED READING

The U.K. May Have Just Found a Way Out of Brexit. Here's Why, by David Meyer

For U.S. China Watchers, the New Watchword Is 'Vigilance', by Clay Chandler

USDA Recalls Another 5.1 Million Pounds of Beef, by Chris Morris

All the Hypertension Drugs That Have Recently Been Recalled, by Brittany Shoot