Saturday, August 2, 2008

Tinian Health Care in the Saipan Tribune

Another article was in the Tribune yesterday. I appreciated Secretary Villagomez' viewpoint in all this. My PA license has been exempted from the CNMI regulations so that I can continue to practice here on Tinian and remain legal. Those exemptions are in place only until 31 August 2008. My fear has been that Tinian would be forced to make a decision on hiring a new MD too quickly and not adequately interview and screen to find an MD willing to work here for awhile.

Finding a doctor for Tinian poses challenges

The search for a new Tinian doctor could take six months to a year, according to Public Health Secretary Joseph Kevin Villagomez Thursday.

Villagomez met with several Tinian officials Wednesday to discuss the search for a new doctor after Dr. Ronaldo Toldeo unexpectedly resigned last week from the Tinian Health Center, Tinian's only source of medical care.

Alex Gorman, DPH legal counsel, said the Tinian Health Center is only required to have a medical doctor present 30 percent of the time. A nurse practitioner and physician's assistant are currently working at the facility.

“I want to be optimistic and hopefully within a matter of two to three months [there will be a replacement], but we need to also be realistic and recognize that it could be six months to a year,” Villagomez said.

There are extra obstacles in finding a doctor for Tinian, he said.

“You know it's very difficult to hire a physician for a community like Tinian because of its remoteness,” he said.

Even hiring for a place like Saipan can be difficult, Villagomez said.

“We have a hard time here and we have the population; can you imagine in a lesser populated area?” he said. “It's just more of a challenge.”

Most physicians are used to working and discussing cases with other doctors, something that is not as easy on Tinian, Villagomez added.

“They have to actually pick up the phone and call here,” he said. “Most [doctors] do not work independently by themselves and for Tinian you need to be able to do that.”

The Commonwealth Health Center is using several approaches to deal with and combat the problem, Villagomez said.

Immediately, CHC is keeping constant communication open between the Tinian facility to discuss cases or answer any questions the nurse practitioner or physician's assistant might have.

“They need to have access 24/7 to an emergency room to talk to a physician,” Villagomez said.

A physician from Saipan is regularly sent to Tinian to review charts, countersign prescriptions and perform other tasks, he said.

H. Christina Brown, a family practice doctor from Saipan and former physician at Island Medical Center, traveled to Tinian last weekend to provide care.

The long-term goal, Villagomez said, is to find a permanent replacement.

There are quite a number of locals who read our blog, so I wish to correct a few errors in the above. First of all, I am a Physician Assistant NOT a physician's assistant. Although the mistake may seem trivial, the latter title makes me sound like a person who stands in the room with the MD and helps him/her out. That's not my job. I see patients and then order diagnostic tests, diagnose, treat, and counsel. I also do procedures that are necessary.

Secondly, the regulations for PAs here say that I must have onsite supervision 50% of my time, not 30%. The people of Tinian are being examined, diagnosed, and treated every day by myself and the nurse practitioner. We seek guidance from MDs on Saipan when we need to but we are both well educated and are able to manage the health center for now. Tinian Health Center is still open 24/7 and patients are being seen and treated. Make no mistake about it. The community of Tinian is well cared for. We have not left them without medical care. I would never let that happen.

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