Doctor shortage fears in American Samoa

This article from Radio New Zealand point out a very serious problem but, unfortunately, the problem is much more severe than just the lack of a few medical staff. 

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Medical sector workers in American Samoa say there is an urgent life and death situation with the hospital relying on a single pediatrician.

Two doctors from the Department of Health have been sent to help out at the Pediatric Department of the LBJ Hospital, after the sudden death of long serving pediatrician, Dr Tagilima Iatala, last week.

A replacement is due on island next week.

The chief medical officer at the LBJ, Iotamo Saleapaga, said the two public health doctors would mean they could manage until then.

But some medical staff said the situation was more serious than what the LBJ management is making it out to be.

They pointed out that the work load for the remaining pediatrician was too much and had been for a long time.

They said it had taken the hospital more than a year to recruit new pediatricians and one additional doctor was not enough.

They said some inpatients had conditions where the pediatricians had to keep an almost 24-hour watch because of seizures and other complications.

The medical staffers said this was an urgent life-and-death situation and the leaders needed to come and see for themselves and not take the management's word for it.

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Dr. Jim Marrone's picture

Status of Medical Licensing Law in AS/current update?

Does anyone have more current information on where the Fono stands with regards to their own Administrative Rule since 1987, which essentially requires all practicing physicians in the Territory (who are not from a pretty short list of specific nations included at that time) to become qualified via US National Licensure testing?

Does the ASHRSB (Health Regulatory Services - i.e. "Licensing" - Board) remain effectively silent on this issue?

Is LBJ still not using the rather expensive and detailed PACE Program results from a few short years ago for what they were designed, which was to justify the clinical competence of its own Medical Staff (instead of relying on standardized test results which were meant to be taken in or around medical school, therefore up to several decades earlier for some folks, and which likely have very little to do with current clinical practice standards in any given specialty and/or sub-specialty)?

If anyone has an update on these matters, please feel free to post here, and/or in the linked Facebook page.

The good people of AS deserve so much more from their leaders, especially in healthcare!

Regards, Dr. JIM MARRONE

Dr. Jim Marrone's picture

It saddens me greatly to hear

It saddens me greatly to hear again of the passing of yet another Samoan physician, my former colleague of many years in Pediatrics - Dr. Matagiese Tunoa.

My thoughts, prayers, and condolences go out to all of his family and friends, as well as to his remaining colleagues on the Medical Staff at LBJ.

Unfortunately however, Dr. Tunoa's passing at too young an age brings immediately back to mind the very precarious status of American Samoa's healthcare workers...  What if anything is being done (by LBJ, DOH, and/or ASG) about the aging and presumably tiring practitioner and nursing workforce in the Territory?

To my knowledge, Dr. Tunoa was one of the younger members of the last major cohort of local physicians recruited out of (and contractually obligated to serve in) the Territory under ASG's scholarship program.  Thankfully there are a number of them still working, but if I am not mistaken that group largely finished their education and training in the early to mid-1990s, and several of them have already retired and/or passed away!  Plus for some, it was not their first career (which means that they shouldn't be reasonably expected to work say, 30-40 years).

So this begs the question, who is going to replace them?  And where is the sustainable funding for the hiring of that next generation of local citizens who might be interested in entering these career tracks going to come from (not to mention their education)?

It must be remembered that it takes a minimum of 7 years (after college) to fully educate and train physicians these days (including a minimum of 3 years of formal Residency training, which has never been available in AS).

Clearly these things must be more carefully thought about well in advance of the time in which they are expected to be most needed...  So while I was encouraged to hear that there has been a couple of scholarships for medical school advertised through LBJ again recently, that's a very small "drop in the bucket" compared to the needs of a population of 60,000 with very serious ongoing levels of disease!

Any comments, criticisms, suggestions or even just alternative viewpoints on these matters are always welcome.  But the people of AS clearly need this discussion about the ongoing loss of healthcare workers in AS to take place.  Again, I send my heartfelt condolences to Dr. Val Tunoa along with her family and in-laws.

A blessed and Happy New Year to you all, JIM M.

medical license

Great information about the current state of health care in Samoa. I have always been interested in serving the underserved. I am an ECFMG certifed physician in Chicago who has passed all USMLE including STEP 3. I am interested in working inn Samoa but really can not find enough information online.

Dr. Jim Marrone's picture

Dear spartan2010:

Dear spartan2010:

     While regrettably I have not worked nor lived in American Samoa for over 2 years now, I trust that you can still directly contact the LBJ Tropical Medical Center by telephone at (684) 633-1222, and simply ask for "Human Resources" to express your interest in possible employment there as a physician.

Regards, and best of luck!  Dr. JIM MARRONE