Do the math, build at Oka

By David Lubofsky

 I have had an interesting, intimate relationship with the medical field and related issues on Guam over the last 5 years advocating for medical care accountability that the rest of the country already has and improved medical care on Guam. I have read the CMS reports, have spoken with many doctors, have spoken to patients or their families many times at GMH and online, have done research on medical issues on Guam including reports of harassment of nurses on Guam by superiors and the questionable care that Micronesians feel that they get at GMH and in general on Guam. I have interacted with the Licensing Boards on Guam often and have seen how protecting the people of Guam is supposedly their mission but IN REALITY isn’t their priority, actually quite the opposite.    

 It’s basic accountability that is missing in health care on Guam with personal agendas overriding patient care, including among island leaders. The new hospital decisions have to be made that benefit all of the Guam community, not just a few. It’s my opinion, that the Tamuning Oka Point area is the best location for the medical complex. Dr. Shieh and others have laid out exactly what that means in terms of number of clinics in the area etc. Tamuning is Guam’s medical hub, established and that is not going to change now and will not change in 5 years when or if the new hospital is finally built. Travel time from the clinics is extremely important and of essence in terms of being near the hospital which is now represented by the majority of clinics on Guam being in Tamuning and being near the new proposed Oka point hospital site as they are near to the current hospital. Building the new hospital in Barrigada away from Tamuning, our medical hub, would make as much sense as building tourists hotels in Barrigada away from Tumon and the beach.

If you walk out of SDA clinic (before the road construction started) and head to the ER at GMH, barring any unforeseen issues, you will be there in 5 or 6 minutes, which would be the same for the Oka Point location. I know this from personal experience when I rushed my son there. If the hospital was located in Barrigada there is no way from these clinics that you can get there quick enough in an emergency. I heard testimony by others who stated to just use an ambulance. This is an uninformed recommendation when it can take 30 or 40 minutes OR LONGER for an ambulance to arrive or get to you as your family member is dying in front of you from any of these nearby Tamuning clinics. Most would rather drive to the hospital, if possible, than wait 30 minutes for an ambulance only to have to go the extra distance to Barrigada. In this scenario, your loved ones may die. Do the math. 

Many of our Policy Makers seem oblivious to this and appear to have their own agendas. They have no idea what the average person on Guam goes thru with medical care. They have no idea what is like to have a dying child in their arms, knowing they must get to the hospital immediately. I lived that, others have lived that. Time was of the essence. There is not one of you that would not have driven to GMH, if possible, minutes away. This is not about me; it’s about your children or loved ones. It’s about any emergency need identified at the clinics, including Maternal Health Care clinics which are near Oka. IT’S A LIFE AND DEATH. SITUATION CARRYING YOUR CHILD OR LOVED ONE OUT OF A TAMUNING CLINIC AS THEY ARE DYING. Ask yourselves, Oka Point or Barrigada, which location has a better chance to save your loved ones life, or our future generations lives? I hope you never have to face this or our leaders do not make us face this, do the math. 

Veterans who have bought into the belief that a veteran medical center will be built or they will have doctors or be able to get their medications easier have been sold a blank slate. If the Government of Guam had this magical ability, then why has it never happened in the past until now or why has there been no attempt to do it? Veterans have asked for this help for decades, but nothing. The Governor has been in office for 5 years and I have not seen any substantial initiative to improve medical care for our veterans. Veterans on Guam have not received services that they need and deserved for decades and are now being used as pawns in a political game that can’t be fulfilled. I have worked with Guam Veterans with disabilities decades ago and the issues are the same now as then. 

Dr. Nyugen, a veteran himself, was very clear about this. He is also a businessman and if it was possible to improve veteran’s services as stated, ahh promised, by the Governor, Dr. Nyugen would know how to do it and have the incentive. Veterans need better medical care, but it will not happen with shallow promises. 

Guam has the highest maternal deaths in the country and by some estimates one of the highest in the free world. There are many reasons for this, but the largest OBY GYN clinic on Guam is 5 minutes away from the Oka Point location. The doctor who has delivered perhaps the most babies on Guam is 5 minutes away from Oka point. Moving the hospital to Barrigada puts these mothers at increased harm’s way and further increases the likelihood of maternal tragedies, which already tops the nation statistically. Do the math.

The biggest puzzle of all of this, at least for me, is that the doctors are against putting the new medical complex in Barrigada and favor Oka, but in past hearings or other proposed legislation, the Governor said we need to listen to the doctors when it came to malpractice law reforms. They are the experts she said. She and others were adamant about that. Now, the Governor doesn’t want us to listen to the same doctors for location of the hospital which the doctors have stated would put patients at medical risk due to their location and if the hospital is in Barrigada. So, Governor, for an old guy like me, when do we listen to the doctors to be clear, when you agree with them only, as in essence it’s the same issue regarding saving lives? Based on what the doctors stated, patients will die with the Barrigada location while Tamuning is the medical hub near the Oka location. This is very clear from personal experience. Again, do the math

As the Governor and GMH administrator have said in the past, we need to listen to the doctors. It’s not about when it’s convenient. 

 (A caveat to this, that I need to add here to be honest, is that one of the people who gave testimony regarding the Barrigada location spoke about how long it took for a doctor who was nearby to GMH to actually get to GMH. This is a big issue on Guam due to lack of medical accountability in my opinion and will be an issue no matter where the hospital is located, but a different issue to deal with later. Some doctors will not get out of bed to see patients in crises with multiple calls from nurses allowing patients to possibly die. Some nurses fear bothering doctors at night. This is a documented factual statement and a discussion for another time.)

Build it and they will come has been stated about doctors coming to Guam. I have to laugh loudly at this preposterous statement. It’s a joke surely. Guam has no accountability for medical malpractice based on the Mandatory Medical Malpractice Arbitration Act. Doctors on Guam, island leaders, the GMH administer, the Governor and others have repeatedly said we can’t change this law or Guam won’t be able to get doctors. Guam has no accountability per se for medical negligence saving doctors much in malpractice insurance etc. Well, with all of that said, here we are still in need of doctors and will be more so especially if the huge complex is built in Barrigada. For some reason the governor thinks a new hospital will attract doctors, but I can tell you now that will not happen, especially with the needed specialists. Ask local clinics how hard it is to recruit for Guam, even if not working at GMH. 

According to the Asst. AG Rob Weinberg, Guam has the reputation for being the place to go to if a doctor is washed up from the states. On top of that, the Guam Board of Medical Examiners has licensed doctors with medical negligence and sexual misconduct histories seemingly justifying it due to island needs. Even with all of that, and no real need to pay malpractice insurance on Guam, we still can’t get enough doctors on island. On top of that, with Guam’s population, specialists can’t make a living here. According to Dr. Shieh in an interview in the media, he said Guam doesn’t need doctors just specialists. If Guam doesn’t need doctors just specialists, a huge complex in Barrigada will not be fully utilized. One person who gave testimony spoke about a Pediatric Cardiologist who came to Guam that stated the limited population on island won’t allow her to open a practice. This is a sad reality that everyone knows, except perhaps those who have an overruling alternative reality in order to build in Barrigada.

Doctors on Guam’s have justified for years the need for the MMMAA or Mandatory Malpractice Medical Arbitration Act because they need to work outside of their specialties to help people on Guam due to a lack of specific specialist on island. Actually, the Governor stated the same thing in the past to justify the lack of accountability to get doctors to Guam. It has NOT worked as the island still needs specialists and will need them more so when the new hospital is built. This justification of the MMMAA goes back more than 30 years or so, even to the better days of GMH, but hasn’t worked to get the needed specialists or doctors here. 

If you build this oversized medical complex in Barrigada you will not be able to get doctors even if you let the so-called washed-up doctors or those with negligent histories work here. You will not be able to get enough nurses. If the hospital is built in Tamuning, you do not need the proposed offices as described in the plan for doctors as the clinics are nearby.  We do not need a new mental health center as Guam Behavioral Health is there near Oka and I believe is looking to expand.

I support building the hospital at Oka point of course based on real experience, but with that I suggest that our leaders look at the Public Health facility in the south to make it into a real primary care center to address those who need to be stabilized before heading to Oka or to provide needed medical care to offset the need to go to Oka. This can also be accomplished by working with a local Guam clinic to sublease space to them with an incentive so that the people in the south are served as they need to be. A smaller medical complex as discussed at OKA can offset costs for improving services in the south. 

No matter where the hospital is built, I plead with our leaders to get a professional management team to run it. It’s a shame to build a beautiful new state of the art complex to only be run by the same mismanagement that has led to deaths per the CMS, Guam doctors, nurses and patients and their families.

IF A DRUNK DRIVER BUYS A NEW CAR, HE IS STILL AN IMPAIRED DRIVER PUTTING US ALL AT RISK. IF THIS SAME GMH MANAGEMENT TEAM RUNS THE NEW HOSPITAL, THEY ARE STILL IMPAIRED AND AGAIN STILL PUTS US ALL AT CONTINUED RISK. PEOPLE WILL DIE.  

Our future generations, our grandkids will be the ones to suffer with GMH failed status quo management that we all suffer with now if they get their blood stained hands on the new medical facility. 

Thank you. 

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David Lubofsky is a resident of Tamuning.