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Board chairman blames media for problems at LBJ

Lawmakers say CEO, CMO and board are not working together
joy@samoanews.com

Senator Nuanuaolefeagaiga Saoluaga Nua did not mince words when telling the LBJ hospital officials the Fono’s main concern is to improve the services at the hospital, however he noted the hospital board, Chief Executive Officer and Chief Medical Officer are not working together.
 
The Senate Health Committee called a hearing yesterday with the hospital board, the CEO and CMO yesterday on issues pertaining to the closing down of the Primary Care clinic and the hiring process at the hospital.
 
The issue came to light when Chief Medical Officer, Dr. Iotamo Saleapaga, recommended to the Hospital Board to discontinue services provided by the Primary Care Clinic, alleging low patient numbers, overstaffing, repetition of what the medical clinics are doing, and not being “cost effective”.
 
During the hearing, Chairman of the Hospital Board Mase Akapo stated to date the board has yet to decide on the closing down of the Primary Care clinic, pointing out the concern is that there are not enough doctors, which means people are sitting in the ER for several hours. He alleged the Primary Care doctors see only five to six patients a day.
 
“Currently the Primary Care clinic does not take walk ins, and so members of the public have to wait at ER if they have not set an appointment with the Primary Care.” He also stated this is the same for the Pediatric Clinic— they don’t take walk ins.
 
Mase also informed lawmakers they are currently on the hunt for doctors, given that there is available funding to hire physicians and it is a difficult task to recruit physicians from off island.
 
Senator Nua did not mince words and told hospital officials the Fono’s main concern is to improve the services at the hospital. He then further stated the board, Chief Executive Officer and Chief Medical Officer are not working together.
 
He asked Mase to explain the chain of command between the CEO, CMO and the board. Mase said the hospital board hires the CEO, the CMO and the CFO — however he made it clear that the CMO and CFO report to the CEO — who then reports to the board.
 
Mase also blamed the media for the mess going on at the hospital.
 
He said that currently they have put in place procedures wherein the media will email queries directly to the hospital board rather than to the CEO, CMO or CFO. Mase did not elaborate why he’s blaming the media and urged lawmakers that if they have issues regarding the hospital they should not read what the media is reporting on the issues, but instead, they should seek clarification from the board.
 
The Board chairman also noted he has emphasized to board members that when the board agrees on an issue, that’s the board’s decision — however there are other board members who go behind the board’s decision.
 
Senator Faletagoa’i Tuiolemotu noted that one time he was at the ER which was crowded and there was only one doctor. Then, EMS brought a patient, and this doctor had to tend to the patient leaving members of the public waiting long hours.
 
“How can this happen?” he asked, adding “it appears that maybe the physicians are not happy, that maybe their salaries are not enough, for them to be not working when they are supposed to.”
 
Hospital CEO Joseph Davis Fleming noted that he, the board and the CMO are examining these issues occurring within the hospital, not just at the ER, but with other clinics as well.
 
“We do have doctors on call, either on campus or near the area, however at the same time we are aggressively recruiting medical staff for the hospital,” he told lawmakers.
 
Senator Nua told the hospital board he’s puzzled as to why — when the doctors are on call — they don't show up to work. Mase responded that usually there are two doctors working on night shift and if one doctor is sick or something has happened then there will be only one doctor working.
 
“I don’t follow with where the hospital is going… there are policies in place for hospital employees and if they don’t follow the policies, then something must be done,” Nua stated. “It appears that you cannot control your staff, the CEO and the CMO. You have set policies and you must uphold those policies. Life is the most precious element there is and when there’s only one doctor working this is unacceptable.”
 
Senator Laolagi Savali Vaeao pointed out the FY2014 budget for LBJ is $52million, which is $17million higher than the previous fiscal year, so the hospital’s operation should run smoothly, yet it appears this is not the case.
 
Laolagi said he, too, sees the doctor at the Primary Care, and at times he goes to the ER and while at the ER, he saw the same doctor from the Primary Care. He pointed out that when visiting Primary Care he asked the doctor directly regarding reasons why Primary Care should be closed, however the doctor told him no, the information is inaccurate.
 
Senator Laolagi further stated they should be allowed to rotate between clinics and if the physicians don’t want to follow that then maybe they should look for another job.
 
“I’m not pointing fingers — we are here to work together for a better solution,” said Laolagi.
 
Samoa News will report on other issues that came out of the hearing in tomorrow’s edition.
 
BACKGROUND
 
Samoa News should point out Mase, during the Senate hearing, echoed the comments the Chief Medical Officer Dr. Iotamo Saleapaga made in his letter or memorandum to the LBJ board, recommending the Primary Care Clinic be closed.
 
As Samoa News reported in its Wednesday, Jan. 15, 2014 edition, Dr. Sean A. Stracensky, Chief of Primary Care Clinic, now known as Family Medicine Services is disputing the assertions made by the CMO.
 
In his letter to the board, dated Jan. 08, 2014, Dr. Stracensky said he disagrees with and disputes many of the assertions in Dr. Saleapaga’s letter regarding his department’s staffing and productivity. For reference he refers to an attached Annual Report 2012-2013, which details patients seen and staffing levels.
 
Again, Samoa News also points out whether or not the clinic stays open under LBJ may be a moot point — it could become an issue for the Dept of Health.
 
Governor Lolo M. Moliga in his State of the Territory Address at the Fono’s opening early January of this year said the hospital in 2014 will dedicate its energies to chronic care services.
 
As such, the governor said, hospital services like Dental, Primary Clinics, EMS and others identified subsequently will be transferred to the health department.
 
The DOH Director and the hospital board will collectively identify functions, which should be placed under DOH, the governor noted in his address. (See story in Monday, Jan. 13, 2014 issue of Samoa News for details)



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