Philipsburg:--- The Windward Islands Medical Association (WIMA) dispatched a letter to the Minister of Health Dr. Cornelius de Weever expressing their concerns about having a Medical Tourism Hospital built on St. Maarten. The WIMA in their letter dated November 7th, 2012 said that after many verbal and media announcements about the plans of setting up an American Medical Tourism Clinic on St. Maarten they were given a detailed picture of the plans by Dr. Hess on Thursday October 18th, 2012. President of the WIMA, Dr. Dekkette said in his letter that while there are several positive arguments for the Medical Tourism Clinic, the WIMA doctors still have some serious concerns.
Local and regional patients can be referred to medical specialists and have diagnostic tests done we currently do not have on the island of SXM would be of great benefit to the local patients and potentially save money in travel expenses.
On the other hand, the medical specialists coming to St Maarten are coming from the USA. This means that they do also bring their 'defensive' medicine of litigation- prone- USA with them, which leads to over-diagnostics and potentially to enormous health care costs. This is in sharp contrast with the European conservative approach and therefore much more economic health care practices. Even without the litigation pressure while working in St Maarten, it is not to be expected that these US medical specialists will suddenly change their habits after working for decades in the very expensive US system.
Dr. Hess stated that the planned American clinic will not only cater exclusively to American Medical tourists but that they also plan to deliver emergency medical care! St Maarten has about a total of 3 million visiting tourists by air and by sea on a yearly basis. Some of these 3 million will seek some kind of medical attention thereby forming a substantial part of income for the SMMC and GP practices. Also other private patients and AUC students will consider going to the new clinic as well. Opening a second emergency department St. Maarten for these patient groups will result in direct and serious competition for the local health care providers and this is in violation to the promises made by Dr. Hess et al. that the basis should on NON-COMPETITIVE GROUNDS!. The WIMA will only agree with the construction of such a clinic on the condition that only elective patients go to their elective outpatient appointments and undergo elective surgeries unless local patients should be referred by the local medical specialists at SMMC.
WIMA said to keep the costs manageable they also believe that the SMMC should not be by-passed when referring patients to the new clinic. Local specialists and not the family doctors should decide for the necessity of such referrals. In doing so, the SMMC will not have a negative effect of a competitive situation. Also it keeps the door open for locals to be trained as medical specialist abroad and have the opportunity to come back to St Maarten and serve the local population. This way continuity of care is better secured while safeguarding the future of our SMMC.
WIMA said in their letter that they understand that a lot of the American specialists will rotate their duties between the USA and St. Maarten, thereby not delivering on a very important aspect of good quality health care: continuity of care. To illustrate potential problems of this issue: If a newly diagnosed epileptic has to be stabilized on anti-epileptic medications, it does not help if there is another Neurologist attending to him/her every time he/she goes to the new out- patients clinic. Other example: if you get complications from some kind of surgery, it is desirable that the surgeon who operated on the patient is still on the island and available.
To have a good basis of medical specialists at SMMC is of utmost importance for SXM with or without such a new medical facility.
The situation of hiring local nursing staff should be avoided as there is a shortage already at local health care facilities. Competition for medical staff is undesirable.
WIMA said they were told during the presentation by Dr. Hess that they will attend to the local population charging SZV rates. But if the SMMC will go down financially, because of the competition with the American Clinic, they suddenly have a monopoly. You know what companies do when they have a monopoly.
In conclusion: opening such an American medical tourism facility could be of benefit for the population of St. Maarten but should be done under strict conditions and with transparent written agreements, safeguarding the position of SMMC, the GP Practices and ultimately the population of St. Maarten.
SMN News learnt that Dr. Hess already replied to WIMA where he addressed their concerns, However, the chairman of WIMA Dr. Dekkette could not be reached on Monday as he is currently off island. SMN News also understands that while the letter was sent to the Minister of Health Labour and Social Welfare Cornelius de Weever, he is yet to send an official response to the WIMA on their concerns.
Click here to view the letter sent by WIMA to Minister de Weever.
