Mick's blog

Today's Samoa News article

Talofa,   Thanks for the opportunity to join in this important effort.

Thought you all might be interested in today's Samoa News front page article entitled: "LBJ CEO says scholarship offered to ensure "Samoan" doctors continue at LBJ".  If you have access to Samoa News online you can read it in its entirely there.   Just a couple of interesting quotes here:

" The hospital CEO hopes that students who are interested will take up this opportunity as it's fully funded by the LBJ."    Don't know of any other hospital that uses its operational funds to finance scholarships for medical students.  I thought this was a function of government. (my comments) 

Samoa News reporter also notes: " (Samoa News should point out this is not the first time LBJ has offered a scholarship for medical studies.  During Taufete'e's first tenure as LBJ CEO a scholarship was awarded to one of his immediate family members)"

Also this:  "Last year July, Governor Lolo Matalasi Moliga in a letter to former hospital board chairman Mase Akapo, said the hospital needs to set up a scholarship program, specifically for students to attend accredited off island medical institutions or schools.

He said that is one way to ease the hospital's dependence on US and foreign physicians and improve LBJ's self-reliance and the board must reactivate the practice of sending "our people" to the Fiji School of Medicine with the provision that they will sit and pass their USMLE exam before a license is issued to practice in American Samoa".   Another example of political interference in the decision-making process of the hospital.  A fundamental problem with our Hospital Authority type organization, with Governor appointed board. (my comments).

"Samoa News asked Taufete'e about the hospital's requirement for physicians to be United States Medical Licensing Examination (USMLE) certified; and the CEO said that such certification is no longer required of physicians hired by the hospital for the time being.

He said the reason why its important for physicians to be USMLE certified is for the hospital to have "easy access" to Medicare and Medicaid funds, but its not required by the hospital itself."

Food for thought.  Just keeping up with the news.              Mick


Processes subject to medical favoritism

While I am on the subject of news, another article in today's edition of Samoa News caught my eye, and brought to mind a situation that others also have found troubling.  At Monday's Senate hearing on the status of the Government Retirement Program there was discussion on why retirement payments have been escalating. 

Here is a quote:  "Responding to questions from senators as to why the increase in payouts, Talia (Iaulaualo) explained that there are more retirees, including a lot of people taking medical retirement and qualifying for disability."  "Sen. Uti Petelo questioned if there is a physician used by the Fund to sign off on the paperwork qualifying a person for medical retirement and Talia responded that the Fund utilizes the service of LBJ hospital's Dr. Iotamo Saleapaga, who conducts the medical evaluation and signs off on the paper work". 

This brought to mind the problem I encountered with the medical off-island referral process when I was Director of Medical Services back in 1987.  Necessity for off-island medical referral was supposed to be determined by the off-island referral committee, of which Dr. Saleapaga was chairman.   I soon discovered that approvals for off-island referral of patients were being approved by the chairman alone in many instances without the approval of the other committee members.  I put a stop to this as soon as it was revealed to me. 

In a small island Territory like American Samoa, where family, and political connections play such a strong role in the decision-making of individuals in power, it is important that processes be enforced to ensure that medical related decisions are made in an unbiased manner based on medical merits only.  Having only one individual making determinations of medical retirement qualifications, like one individual making off-island medical referral approvals, subjects the process to family and political influences that should not be part of the approval/disapproval process.  

For this reason, and because of personal experience, I would highly recommend that medical retirement decisions be made by a committee of qualified persons, rather than a single individual.

Just keeping up with the news.             Mick