LBJ board member says public missing big picture


The feedback from members of the public on the resignation of the head of Primary Care Clinic at the LBJ Medical Center, Dr Sean Stracensky, did not sit well with hospital board member Faimealelei Anthony Allen, who stated that the public is missing the “bigger picture which the hospital board is looking at — is it cost effective? it is not,” said Faimealelei.
For the past several years, Dr. Stracensky, who is a U.S. board certified physician, has been the head of the Primary Care Clinic (since renamed the Family Medicine Clinic) and Chief Medical Officer Dr Iotamo Saleapaga last year moved for the hospital to close the clinic down, alleging low patient numbers, overstaffing, repetition of what the medical clinics are doing, and saying it was not “cost effective”.
Stracensky disputed the assertions by the CMO. Samoa News points out that to date, the Hospital Board has yet to decide if the clinic will remain open, while Gov. Lolo M. Moliga in his 2014 State of the Territory Address noted that such clinics should be moved to the Department of Health and the LBJ Medical Center left to the business of treating sick people.
Faimealelei first stated that he’s more than grateful for the services that Stracensky has provided for the public in his years with hospital, however he also says he agrees with CMO Saleapaga that the Clinic is not cost effective.
“Dr. Stracensky is the second highest paid physician on the Medical Team at the hospital yet the Primary Care Clinic is only open for appointments. Members of the public cannot walk into the Clinic unless they have an appointment so he sees about five patients a day, maybe more.” 
“Now for the Emergency Room, where there are physicians who are taking in every type of patient, these doctors at the end of the day see about 30 patients yet they make half of what Dr. Stracensky is making. Do the math, is it cost effective? No.”
"Financially, the hospital is not generating that much revenue due to less people seen at the clinics,” said the outspoken hospital board member. Faimealelei said last year alone the Primary Care treated close to 5,000 patients yet the Emergency Room physicians saw triple this number. However, he noted, Stracensky made much more money.
“Not only that, he has three physicians and a physician’s assistant, when he was seeing not even 500 patients a month. When I was evaluating these numbers it indicates very low numbers mainly for the primary care clinic compared to all the other outpatient clinics.”
Stracensky’s last day of employment will be March 12, 2014, under the terms of section 9.1.1 of his Physician Employment Agreement.
Samoa News should point out that Stracenky’s duties were not for the primary health care clinic alone, which is what Faimealelei seems to indicate. In addition, the doctor served in the Emergency Room, as part of the hospital doctors’ rotation schedule, and was also a part of the ‘on call’ rotation schedule for Internal Medicine.
Further, Stracensky stated in his letter to the Board, in January, that he disputed the assertions made by the CMO Saleapaga, something the Board has not addressed — other than Faimealelei now indicating (as a board member) that he believes the CMO’s assertion that the clinic is not cost effective.
In his letter, Stracensky wrote the clinic cares for patients with chronic medical conditions such as diabetes, hypertension, gout, chronic cancer pain, and skin conditions such as fungal infections and psoriasis and also provides care for acutely ill patients, who do not require immediate urgent attention in the Emergency Room.
Additionally, their staff members perform physical examinations for the military, federal and territorial government agencies, ASNAP, and students attending various schools both on- and off-island and they are involved in preventative health issues, including employee health screening and treatment, immunization review, and rheumatic heart disease prophylaxis.
“The primary care model of health care delivery is based on the idea that any given patient is assigned a health care provider who then becomes ‘their doctor’. The bottom line … this system is aimed at providing health care which helps our patients become healthier, more satisfied with their treatment, and more connected with the people providing their health care,” he asserts in the letter, dated Jan. 8, 2014.
The doctor continued, “Our clinic operates on a scheduled appointment basis precisely to achieve these goals and… regularly scheduled appointments help ensure that: 1) the patient will be seen on the day and time they expect to be seen, 2) the patient has dependable access to the healthcare provider that they have come to know and trust, and 3) healthcare providers can review and prepare for appointments ahead of time, optimizing medical testing and treatment, and minimizing wasteful use of hospital resources.”


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