A lawsuit brought by a foreign national doctor earning a six-figure income against the physician owner of his former employer alleging violations of a federal forced labor statute is being allowed to go forward, with the recent denial of the defendant's motion to dismiss the case for failure to state a claim.

In Antonatos v. Waraich, pending in a South Carolina federal court, plaintiff Antonatos is a Panamanian citizen who attended medical school and completed his residency in the U.S. In 2010, he applied for a physician position with Palmetto Hospitalists Associates, P.A. (PHA), a firm owned by Waraich, after having seen a written advertisement for the position which noted that the firm had "sponsored a number of J-1/H-1 physicians." After interviewing with Waraich, Antonatos and PHA entered into a five-year contract for Antonatos to practice internal medicine and emergency medicine. Because the position with PHA was in a medically underserved area, it offered the opportunity for Antonatos to remain in the U.S. under the sponsorship of PHA and to apply for legal permanent resident (green card) status under an immigration program that grants such status to an alien physician who has worked full time in a medically underserved area for five years.

In his suit against Waraich (as the alter ego of PHA), Antonatos alleges that the written advertisement for the position made representations about the terms and conditions of the position and that Waraich induced Antonatos to sign the five-year contract by personally verifying the representations described in the written advertisement and by making additional promises about the position and conditions of employment, including promises relating to working hours, travel requirements, support assistance and patient load, among others. Antonatos alleges that Waraich's promises were false and that Antonatos was given duties and responsibilities far different than promised and far different than the American doctors working for Waraich in the same positions. Antonatos asserts that when he complained to Waraich, he was reprimanded and threatened that he would be subject to a lawsuit and to having his visa revoked and being deported if he did not do everything Waraich asked him to do. After continuing in the position for a period, Antonatos found new employment with a facility that would assume the sponsorship of his immigration status and allow him to continue the green card process. Antonatos asserts that upon learning the news, Waraich threatened to revoke his visa and then brought a $250,000 contract suit against him in state court.

Antonatos later commenced this suit in federal court alleging that Waraich violated the Trafficking Victims Protection Reauthorization Act (TVPRA) by knowingly obtaining Antonatos' services by means of false inducements, by forcing him to work under the condition of "peonage and servitude to his great damage" and by threatening to abuse the immigration laws. While acknowledging that the "facts of this case, involving a well-paid, educated professional with no allegation that his freedom of movement was restricted stands in stark contrast to the cases brought pursuant to the TVPRA reviewed by this court," the court concludes that Antonatos' allegations nevertheless fall under the protection of the TVPRA. (Forced labor cases more commonly relate to uneducated individuals, often domestic servants, forced to work in poor conditions, who are underpaid, mistreated, restricted in movement, and under constant threat of deportation.)

Whether Antonatos will ultimately prevail remains to be seen. While physician employers should not be unnecessarily alarmed about the prospects of their foreign national physicians bringing forced labor lawsuits against them, care should be taken to ensure that expectations are accurately conveyed to foreign national physician recruits and that, once on board, their conditions of employment are fair and no different than similarly situated physicians in all respects, including hours worked, number of patients seen, call schedules given, types of services required to be performed, staff assistance provided and travel required.