H-1 is a good point. Where are the H-1 lawyers and doctors?
https://www.americanimmigrationcouncil.org/research/foreign-...
> Just over one-quarter of doctors in the United States were “foreign-trained” as of 2017, meaning that they received their medical degrees from schools outside of the United States.
This is one of the challenges of the H-1B visa and that tech specialities are dominating the lottery it makes it more difficult for other areas to get doctors willing to work at, well, rural doctor rates.