Reforming the CNMI healthcare system

Editor’s Note: The following is the testimony offered by orthopedic surgeon Dr. Grant E. Walker in reference to Senate Bill 19-04, which proposes to transform the Commonwealth Healthcare Corp. advisory board into a governing body. This testimony has been submitted to the Senate and House Health Care Committees.

First of a five-part series

Thank you, honorable representatives and senators, for this opportunity to address you regarding healthcare reform and Senate Bill 19-04, previously known as Senate Bill 18-52.

Sen. Teresita Santos has my résumé on file. In short, as an electrical engineer I had a large hand in designing the baseball stadium in Calgary, Alberta, and the Medicine Hat Hospital in Alberta. I was also the lead engineer for a children’s hospital, two schools, and a pregnancy home for teens.

I graduated from Albany Medical College, which has proudly educated six or seven Nobel laureates in medicine. An orthopedic surgery residency is five years and I graduated from the county hospital in Phoenix, Arizona. I did a yearlong fellowship in spine surgery under Gary Lowery, M.D., Ph.D., the finest surgeon I have ever witnessed. Dr. Lowery has published over 150 peer-reviewed scientific papers and his chapters are in more than 15 textbooks. For 25 years he has lectured at medical meetings both domestically and abroad. There is no one in spine surgery academia on the lecture circuit or actively publishing that does not know Dr. Lowery, inventor of many of our spine implants.

One of the proudest moments is when I see a resident orthopedic surgeon whom I trained perform a procedure the way I do it. It isn’t because I invented it; I was taught.

I have never had a malpractice suit even entered, after hundreds of spine surgeries and hundreds of orthopedic surgeries. I am board certified in the U.S. and am a sitting member of the 2014-2015 Orthopedic Certification Board ABPS.

An unusual series of events lad me into reading and understanding the current state of healthcare governance in the CNMI. What unfolded became a blessing in disguise. I was blessed to be professionally mentored by some of the finest academic medical minds in America and after 28 years in U.S. healthcare I had a unique vantage point to see the good and the bad of Public Law 16-51. SB 19-04 isn’t about me. It isn’t about some patch or quick fix between the CHCC CEO and board of trustees. What an opportunity it is to overhaul the governance and oversight of the CNMI healthcare and to address the underserved. Just as James Madison drafted the first 10 Amendments to the Constitution that became the Bill of Rights, each lawmaker that touches 19-04 has the ability, perhaps the responsibility, to put a legal set of rights in place to make sure that no one person or small group of persons can place their self-determined personal gains above your God-given right to healthcare access. Healthcare should be included in a government, “by the people, for the people” (Abraham Lincoln).

There are going to be discussions and some of these are going to lead to disagreements. Madison did not draft his work overnight but, from your state-of-the-art 75-bed hospital born 35 years ago until today, I think that everyone can agree that something has to be done. Diabetes is at an all-time high. The great people of Tinian and Rota do not have hospitals on their islands and seem to have been left behind as CHC chases its CMS Medicare woes. Medical specialists are absent from the healthcare portfolio and there is no reason whatsoever that any American should have to travel to the Philippines for an increase in the standard of healthcare delivery!

Good ideas come to people, great ideas are developed and mine aren’t afraid of heights. From the vantage of my eyes, I saw a patient in the emergency room that had fallen and broke his hip. This elderly man in his 70’s was of Japanese descent and was tough on people. He came from Tinian and the ordeal that his family went through to get him transferred to CHC was atrocious and painful. I began to see many like this from Tinian and Rota. I felt privileged to be there to help him and others this time, since there had not been an orthopedic surgeon at CHC for more than a year and there were stories about the one before that.

I was asked to use O.R. sutures that were expired in sterility date because that was all they had. The operating room was humble, respectfully embarrassed and apologetic. They were sincere beyond belief. They asked for supplies, knew that Medicare paid the same reimbursement as the mainland but somehow there were always excuses given of no money available.

I saw hardworking and caring Internal Medicine doctors seeing a patient load of 25 to 28 patients. I was told that I would be given a car in order to transport myself to the emergency room 24/7, which I then had to give my credit card and reimbursement was refused.

To be continued tomorrow.

Grant E. Walker, M.D.