Debate continues
in House over USMLE test requirement
by La Poasa
Samoa News Staff
The debate on
whether non-U.S. certified doctors should take the U.S. Medical
Licensing Exam (USMLE) as required by the LBJ hospital board
of its physicians continued yesterday in the House when the Health/Hospital
Authority Committee reviewed Senate legislation to 'grandfather
in' physicians affected by the policy.
LBJ board and
management came out against the proposal saying it would lower
the standards of health care if physicians are not required to
take the USMLE.
"There is
a culture of low expectations at LBJ TMC [Tropical Medical Center]
which will be exacerbated if this legislation passes," said
Dr. Fred Uhrle, a member of the LBJ board. "I implore you
to place the safety of patients first and not the convenience
of physicians. Passage will likley affect federal funding at
our ability to provide for the health and welfare of our families
for years to come."
He told the committee
that members of the Fono have questioned why there are so many
malpractice cases coming out of the hospital.
"How then
can you turn a blind eye with the stroke of a pen state that
all are fully qualified physicians," he asked.
Jennifer Joneson,
who represents the American Samoa Medical and Dental Association
(ASMDA), said the organization supports the provision of the
legislation providing that all current LBJ physicians who graduated
from a foreign school of medicine prior to Dec. 31, 2007 will
not be required to take the USMLE.
She made clear
that the physicians are not refusing to take the USMLE and they
are not legally required to take the exam. However, she said
if the hospital believes taking the USMLE will improve the physicians'
professional development, then the hospital (ASG) should pay
for the exam as part of the physicians ongoing training.
She also pointed
out that language of the bill will not jeopardize Medicare/Medicaid
funding. She said applicable Medicare regulations only require
participating hospitals such as LBJ to assure that its personnel
are licensed to practice medicine in their state.
She said as long
as LBJ's employee physicians hold licenses to practice medicine
issued by Health Service Regulatory Board (HSRB), the LBJ is
in compliance with Medicare regulations.
On the other
hand, Uto'ofili Asofa'afetai Maga, chairman of the Health Services
Regulatory Board - which oversees the licensing of physicians
- said before anything else happens, the regulations should be
first amended to include the USMLE requirement because as it
stands, the USMLE is not in the language of the licensing policy
for physicians.
He said the two
exams that are currently in the licensing rules and regulations
including the Foreign Medical Graduate Examination in the Medical
Sciences (FMGEMS) are no longer being administered.
(The hospital
contends that the UMSLE replaces the FMGEMS.)
Uto'ofili also
revealed that while the regulatory board had voted in May last
year to grandfather-in physicians affected by the USMLE policy,
then requiring physicians that apply for a license this year
to start taking UMSLE, he said the board had "a change of
heart".
He said after
a meeting last week, the board has decided to reverse their decision
to grandfather-in physicians "based on what happened to
the governor as you all know."
No one asked
follow-up questions and Uto'ofili didn't offer an explanation
to what he meant by the statement.
And while the
regulatory board did vote in May last year to grandfather in
physicians, there was never a move to make this official, such
as following the Administrative Procedures Act (APA) which involves
publishing public notices and calling for a public hearing.
Majority of House
members did comment in support of having the physicians take
the USMLE, however, they made several suggestions, such as doing
the test in a cycle or having the physicians meet with the LBJ
board management to come to a compromise.
After the hearing
yesterday, the committee decided to have another hearing tomorrow
where the Fono attorney will be called to testify.
Reach the
reporter at la@samoanews.com.
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