Monday, December 15, 2003

Ross has a post commenting on two stories; the first from Connecticut investigating the possible shortcomings of offshore medical grads, the other about the new enthusiasm of the medical licensure authority in Massachusetts to punish physicians for sexual abuse of patients. Ross does an excellent analysis of the situation in the Commonwealth, which I will not attempt to improve upon. The other article begins with a description of a patient rendered comatose after prolonged hypoxia due to an esophageal intubation. The anesthesiologist was a graduate of an Caribbean medical school. The question that I have is:
Why did the hospital credential this guy as a member of its' medical staff?!?
It seems that he had some red flags:

(Dr.) Paul spent the previous four years in a post-medical training limbo. The stretch included time spent building a house in Haiti, working as an administrative assistant in Queens and tutoring students back at Spartan, Paul testified. It did not, however, include treating patients or gaining experience in the delicate procedure he needed to perform on Humphrey.

It used to be that a physician that moved around a lot was considered "suspect" because it was felt they couldn't hold a job or had been "run out of town". Over time that has become less of an issue, especially for anesthesiologists and radiologists. Hospitals are very reluctant to deny privileges or revoke them because they are wary of being sued by a physician for "restraint of trade".
If physicians are going to hope to have any credibility in a debate about tort reform, we need to get serious about cleaning up our own house, as they are doing in Texas (via Rangel). But some libertarians feel the state should have no role in the regulation of physicians. (see my thoughts here{7/17 post})

Anyway, I've got to go to the ER now but the Hartford Courant has a series about "problem" medical schools. Today's story has tales from the Spartan Health Sciences University (spartan referring to their facilities, I'm sure). Ironic that St. Lucia, where the medical school is located, will not license its' graduates to practice medicine there.

For years, government officials and hospital administrators in St. Lucia have refused to license Spartan graduates or allow the school's students to train in local hospitals out of a "deep skepticism" of the school's educational standards.

When I was in school we had a few students who transferred from Caribbean medical schools (not this one) to the Medical College of Georgia after two years due to the strength of their step 1 boards. They told us of long periods without reliable power or clean water. I admired their tenacity in the face of adverse circumstances, and they were good students. From the interviews in the articles linked to above, I don't think the same applies here.
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