As an employed physician at the Myrah Keating Smith Community Health Center on St. John, who is one of those on the front-line of delivery of healthcare to residents of the Virgin Islands, I hope for the day when the chronic, adversarial relationship between the DOH and SRMC will cease.
We must remember that the STT-STJ district is a small community, and as we grow, ensuing growing pains will occur. We must realize that new paradigms will form which may initially appear to be detrimental to the healthcare of the USVI. Being a short-timer in the territory (6 years), I have seen the improvements to the Hospital's physical structure. I have also evidenced the focus on stringent efforts to provide the best care we can, especially in the area of patient safety.
Being a resident of St. John, I must work closely with the healthcare providers employed by the DOH. These include Emergency Medical Services personnel, Certified Nurse Midwives, Immunization Nurses, Public Health Nurses, WIC program coordinators, etc. We work closely together because we focus on what is most important in the field of healthcare–the patient. We do not have time to think of reasons of why not to cooperate with each other. We also do not have specific guidelines on how our interactions must be. We are guided by what the patient needs. On St. John, there are far too few of us to rekindle the embers of feuds that originated who knows when.
What I do know is that continuing the relationship of negative stereotyping and passive-aggressiveness that goes on between the DOH and SRMC is a detriment to the efforts of those who strive to provide the most efficacious, up to date, and comprehensive care to the residents of the USVI. Duplication of services, lags in renewing of equipment, personnel shortages, etc. need to be addressed in a manner that does not focus on "that's somebody else's job". By approaching it this way, we can hope for a more expedient way in solving the district's health issues as they relate to direct patient care as opposed to having the patient involved in a tug of war between the DOH and SRMC.
I try to stay out of the political arena, but what would have been the outcome of withholding a license to SRMC? Would SRMC have to cease operations? That would mean that the individual patient, who may be in need of emergency care, would not receive it. As far as I know, the DOH does not have a healthcare facility on STT or STJ that can provide direct emergency care.
I have no idea if SRMC' senior leadership is withholding information. Frankly, it is none of my concern. As an employed physician, there have been many times that I felt decisions by the higher ups were not in the best interest of patient care. Fortunately, we are able to work through those issues together. It is disheartening to continuously have to see, hear, or be told about the problems between DOH and SRMC. Cooperation could lead to a great improvement in the development and implementation of innovative healthcare delivery that the residents and visitors of the USVI deserve,
Until then, I would like to reassure the residents of St. John that those of us at Myrah Keating Smith Community Health Center (SRMC) and the Morris DeCastro Clinic (DOH) continue to work together to provide the best possible care we can to those who seek it.
Joseph DeJames, MD, FAAFP
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