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Unsigned letter to Lt Gov calls for hospital board to be dissolved

Dr Malouamaua Tuiolosega
Doctors want to raise major issues, concerns and grievances, it saysDoctors want to raise major issues, concerns and grievances, it says

Pago Pago, AMERICAN SAMOA — There is an unsigned “grievance” letter floating around, calling on the Governor to dissolve and dismantle the current hospital Board of Directors. While unsigned, it seems to identify the grievances as coming from local Samoan physicians of the LBJ Tropical Medical Center medical staff.

Dated February 13, 2023, the letter was addressed to then Acting Governor Talauega E. V. Ale and cited a number of issues with the current board of directors, namely the Chairman Dr Malouamaua Tuiolosega and Vice Chair, Dr Jean Anderson.

According to the letter a positive effect can come after changing leadership in an organization such as the LBJ Tropical Medical Center.

 “Effective leadership matters because it represents a system needed to achieve the desired delivery of high-quality, safe patient care for our people.

 “If our healthcare system and its only hospital lack effective leadership, it could be a prescription for a disastrous outcome for the Territory. With this being said, on behalf of the local Samoan physicians at the LBJ via the Medical Executive Committee (MEC), we request your urgent consideration to the subject cited above.”

Samoa News reached out to Chairman of the hospital, Dr Tuiolosega, and he declined to comment citing that he never received a copy of the letter despite being “copied” or cc:ed on the letter.

Last week, Samoa News published a series of letters from medical professionals calling on the Governor to re-appoint the Chairman and the Vice Chairman, whose terms in office will end this month.

Several letters addressed to Governor Lemanu P. S. Mauga came from ER Doctors, Pediatricians, other physicians and dentists and The Church of Jesus Christ of Latter-day Saints missionaries supporting the changes made by the board to ensure the continuity of their work and implementing the “necessary changes”.

The unsigned letter, on the other hand, states that there are doctors, that want to raise some major issues, concerns and grievances in detail. 

 “We have stood by and witnessed quietly while the American Samoa Medical Center Authority (ASMCA) Governing Board made haste decisions that have inflicted mayhem for the stakeholders of LBJ within the last year.

 “Without notice, they restructured the Organization Chart, which aggressively changed the reporting relations within departments. 

 “They changed key positions for the Medical Staff, and appointed an Interim Chief Medical Officer (CMO) – twice. 

 “They contributed to the chaos of low-morale when they prematurely announced pay raises for the nurses, medical staff, ancillary and other support staff. 

 “They have made other questionable decisions that may not be in the best interest of the hospital.

 “Observation, Reason, Human Understanding, Courage; these make the physician.” The local Samoan physicians of the LBJ Tropical Medical Center medical staff met on February 13, 2023, “because of what we have been observing.”

 “It is our love for our people (o le alofa mo tagata a le atunu’u) and our passion as physicians that a collective decision was made to bring this matter forward.”

The grievance letter alleges that the board has engaged in micromanaging of hospital operational decisions.

 “Rather than focusing on policies, they are openly involved with day-to-day operational decisions that should be handled by the CEO.

“They have bypassed the CEO and ordered directives to employees. “They communicate directly to LBJ staff via emails, or at non-Board meetings  (Chairman Dr. Malouamaua Tuiolosega, and Vice Chairwoman Dr. Jean Anderson).

 “The local Samoan physicians have lost absolute confidence and trust with the ASMCA Board because of the incompetent decision-making with recent actions, such as the selection process of the last CEO Moefa’auo William T. Emmsley and the burden of cost to the hospital after his recent resignation settlement.

“Also the removal process of the last Medical Director/ CMO Iotamo Saleapaga, MD.

“Via a memo on the LBJ email system, the Medical Staff and hospital were informed that Dr. Akapusi Ledua was named the Interim Chief Medical Officer (CMO) of LBJ on November 4, 2022. 

“The memo stated it was the instructions of the Board rather than allowing the CEO to make this decision. Per Dr. Saleapaga, he never received any formal written notice, or new job description from the CEO, Board, or Human Resources Department for any personnel action for this new position.”

The grievance letter also cited the selection process of the new CMO/Medical Director Joseph Shumway, MD.

 “The job announcement that was advertised in local newspapers/ media for the Chief Medical Officer (CMO) vacancy closed on February 10, 2023 at 4pm.

 “At a Press Conference hosted by the ASMCA – LBJ Board, Dr. Shumway announced the he was hired by the Board about 6 months ago (see Press Conference on February 7, 2023 aired on KVZK TV).”

They believe this is no fault of Dr. Shumway, but the Board did not adhere to due process. “No acknowledgment of the Medical Staff Bylaws, policies and procedures.”

Furthermore the letter noted abuse of authority by the board.

 “The many haphazard decisions that have required major damage control; creation of the Non-Urgent Service without consulting key personnel.

 “Press Conference aired on KVZK TV on February 7, 2023 that was sponsored by the ASMCA Board.”

There was absolutely zero representation from a single local Samoan physician at this press conference.

 “The Board neglected to invite the Chief of Staff Dr. Abraham Le’iato to represent the voice of the Medical Staff Physicians.

Lack of Due Process with recent decisions for the following Physicians, Dr. Annie Fuava, Dr. Manuel Fernandez and Dr. Seakerise Tuato’o.”

The grievance letter says that with the latest trend of sudden removal of employees, and/ or restructuring of the organizational chart, there is a general feeling of fear of retaliation, targeting, or harassment from employees, and especially the Medical Staff.

 “If they do not conform to the ideology of the Board The MEC local Physicians seek your consideration with the following recommendations/ actions to dissolve/ dismantle the ASMCA Board Immediately and the American Samoa Medical Association (ASMA).”