Earlier quoted context omitted.
Seems like such a simple issue to fix: the only condition for getting a specialist visa should be to find an employer willing to pay a specialist salary, say above 150K. Doctors included, I see no reason to protect them from competition. Hop jobs at will but need to maintain within 85% of that level. If a company can't find workers, it should pay more up until a level that puts the competitiveness of the economy unde…
This is such a one-sided point of view. Imagine that you're immigrating to a country, and after a few years you get fire, or you want to take a sabbatical, or you want to change industry for a lower paying job. Now under your rules you cannot do that. What do you do? You've created your life in the US, you have friends, perhaps a girlfriend, maybe even a house. Now you have to leave?
That's part of the deal. Any immigrant arriving on a visa knows what they've signed up for, and it doesn't involve taking a sabbatical. It also really should not involve buying a house, if you're being sensible. Being fired 100% sucks, but you can transfer an H1B to a new employer. H1B is at least a dual intent visa, so after some years you can apply for a green card, get one, then take all the sabbaticals you want.
(Also, if your life is settled enough to have friends and a girlfriend you don't want to leave, US immigration does offer an answer: marry her!)