CMS and our USMLE physicians

i know a few years back we were cited for lack of US licensed physicians, and there was even a movement to no longer hire physicians non USLicensed, and to assist current physicians to get their US license.  Now, we have lost most of our USLicensed physicians and  I wonder,

1.  How many physicians at LBJ currently have a US locense

2.  Will this affect our Medicare standing?


Some of you may remember me from my tenure there as General Counsel under CEO Patricia Tyndall in 2007/2008.  While there I attempted to work with Ms. Tyndall and the Board on the United States Medical Licensure Examination (USMLE) issue.  The goal was to bring all physicians up to modern-medicine standards by establishing passage of the USMLE as a requisite to practice medicine at LBJ.  It was extremely unpopular with the LBJ Medical Staff, in particular, those too arrogant to accept the imposition of a test to prove their competence to be allowed to treat the people of American Samoa.

I came to American Samoa in 2004, not because I needed a job, but for what I saw as an opportunity to help Samoan people.  Before the Hon. Chief Justice would allow me to practice law, I had to prove that I possessed the requisite credentials, i.e. a law license in good standing.  I was also required to provide references that were checked to insure I was truthful in representing my character and background.  Would the people of American Samoa tolerate lawyers working for the people of American Samoa in government, or private enterprise, without having passed a bar examination and providing legitimate references?  The USMLE and a Bar Examination are both arduous tasks.  They require hard work and study.  By passing an exam you demonstrate that you have the necessary skill set to practice in the modern world.  Law and medicine are dynamic professions subject to change.  The curriculum taught in medical school 10 or 20 years ago is likely dramatically different today.

LBJ's Board is different today than when it was under Ms. Tyndall as CEO. Our efforts to institute an acceptable USMLE program failed, even after many attempts to negotiate a reasonable compromise.  I'd respectfully ask the current Board to reevaluate its position on the USMLE and consider making it a requirement.

As for the members of the 2007/2008 Board, with a few exceptions, the blame rests with you.  And the people of American Samoa have suffered and will continue to suffer.  The time for change and accountability has come.  For those who have sown the wind, prepare to reap the whirlwind.  Respectfully,  Terry J. Lovelace, Esq. 

I want to contribute to this effort!

Hello, everyone.  My name is Dr. Jim Marrone, and I am a U.S. Board-certified pediatrician originally from California who lived and worked in American Samoa and at LBJ for over 14 years, from 2001-2015.  From 2008 until late last year (when the Hospital Management and I could not come to an agreement on the renewal of my contract), I was also the Chief of Pediatrics there.  So I feel like I should definitely have a whole lot to add to this site...  I also agree that it is clearly high-time that some of these things be not only thoroughly discussed in public, BUT FINALLY REMEDIED!

Despite the incredible warmth and generosity and spirit of the Polynesian culture and its people on island, there are also undoubtedly heaps of problems in American Samoa ranging from educational, to governance, to financial and of course medical, which is not even to mention a decaying infrastructure much like there is in many other parts of the U.S. as well.

In any case, I firmly believe that one of the highest, if not THE HIGHEST priorities of the "powers that be" in the Territory absolutely must be THE HEALTHCARE OF ITS PEOPLE.  After all, what kind of society or civilization for that matter do we really even have, if basic healthcare provision cannot be guaranteed for our people?  And certainly I would not absolve the U.S. Government of its serious responsibilities there, since it promised this in writing to the residents of AS all the way back in 1901.

Furthermore, I am of the belief that the LBJ Hospital in its current state is tragically but only a window into a very messy house that is the Territorial Governance of American Samoa, obviously under the auspices of good ol' Uncle Sam.  So I want to hereby pledge to do my part in cracking open these rusty older doors and windows, and at least trying to help let some "fresh air" into the place!

Happy blogging and forum-posting to all, and I look very much forward to your thoughts and observances (and potential solutions!) here.

Cheers, JRM

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