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Health Care in USVI  

 

flatlander
(@flatlander)
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Joined: 10 years ago
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September 23, 2010 6:31 pm  

My wife and I have visited the Caribbean a few times on vacation and like everyone else we love it there! We are both health care professionals and are contemplating relocating to the Caribbean. However, we have never been to the US Virgin Islands, and to be honest knew nothing about the USVI. We had looked into foreign islands, but had reservations because of all that is involved and how "different" it would be as far as laws and governments are concerned. Earlier this year we learned of the USVI and how much easier it would be to relocate there versus a foreign island and are very excited about the possibility of relocating there. If we decide to relocate to USVI it won't be for another 2-years because we are waiting for our kids to graduate high school and settle into college. Therefore, we have plenty of time to learn more and visit to help our decision.

Anyway, we both have clinical experience in health care and have moved into health care administration. We were wondering if anyone was familiar with the health care system there? We will search for information pertaining to health care, and may be contacting health care organizations there directly, but we were wanting to hear what anyone else has to say based on their experience. Thanks!


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Linda J
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September 23, 2010 9:10 pm  

Other peoples experience will be of limited value to you. Your best bet is to plan at least a 2 week visit to either St. Thomas or St. Croix. Do some research and decide which sounds better to you and come on down. Stay someplace that's relatively cheap and has a kitchen, I'd suggest Waves at Cane Bay on STX. Rent a car, get a good map and check things out. Go over to the hospital and have lunch in the cafeteria (Sounds odd, right? Great local food!). Take a long look at the hospital, maybe make an appointment with HR to discuss future employment. Go to the grocery, the bank, the post office (most residences don't have mail delivery). Go to local bars and restaurants, sit around and read the papers, talk to other partons. Everyone will be delighted to tell you his/her story and answer questions.

Do this before you do too much planning. No need to plan a move for 2 years, and then get here and realize it is not for you.

Good luck.


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East Ender
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September 23, 2010 9:38 pm  

Well, because we are a US territory, we have Medicare, oversight by CMS and Joint Commission. We have insurance companies, but they have to be approved territorially, so have few options. We have one local PPO. We have two hospitals, one on St Thomas and one on St Croix. We have a dearth of physician specialists. We have one 20 bed CMS approved SNF. There are territorial long term care facilities, but the demand far outstrips supply. There is a clinic on St John. There is home health on both St Thomas and St Croix. There is home hospice (no inpatient hospice) There are no private psychiatric facilities, but the territorial government runs an acute and a long term care facility on St Thomas (I am not as familiar with St Croix.) There is a cancer center on St Thomas and a cardiac center on St Croix. Because of the way Medicaid is funded, and because of the large indigent population (as well as illegal population), there are some very serious challenges to the provision of health care. Most administrative jobs will go to locals, but if you are willing to get back in the trenches, there may be more leeway. They did select a new CEO for Schneider Regional from the states, but many are still in shock.

While you have some time, read up on the on-line papers: Virgin islands Daily News and The Source. A couple of interesting stories would be the Rodney Miller case, anything about Medicaid, the territorial budget, etc. And Linda is right. A longish visit to network and meet people is a great idea.


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flatlander
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September 24, 2010 12:40 pm  

Hi Linda,
I appreciate the very logical response! We are looking into doing just as you say next year, and possibly visit again the year after depending on what we think about our first visit. Meanwhile, we are trying to gather as much information as we can. I just received the "Settler's Handbook for the USVI" in the mail yesterday, but haven't had the opportunity to open it yet.

I am excited about this forum that I also just joined yesterday to ask and read questions, and the responses, to get a better idea from those who have visited and/or live there. We are just ready, and very eager, to relocate from where we are now, which we know we are going to do, God willing. Living on an island will be such a big change for us because of what we are use to doing, and realize we will have to make sacrifices, but also believe there is much to gain. We currently reside in Ohio and are weighing the pros & cons of moving out west or to the Caribbean. Thanks again for taking the time to respond!


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flatlander
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September 24, 2010 12:52 pm  

Hi East Ender,

I appreciate your response! Sounds very political, which is pretty much the case regardless of where we go. What do you mean by "wiliness to get back into the trenches?" You also mentioned a scarce population of physicians, so do you think that has a lot to do with very low reimbursements physicians receive from Medicare because of the poverty levels, which based on your reply must be pretty high? One last question, what would you like to see happen with health care there? Thanks again!


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East Ender
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September 24, 2010 9:59 pm  

You said you have clinical experience, but have moved into administration. If you are willing to go back to service provider status, depending on the service you provide, you might have a better chance.

It is not so much a scarce population of physicians, although there is that, too. But there is a complete lack of some specialty areas- neurosurgery, cardiac surgery, rheumatology. Then there are the areas where there is only one specialist, for example, one endocrinologist for a place that is fraught with diabetes. Part of this is the population base- there are only around 150,000 people in the entire territory. For government physicians, there is actually relief in tort reform; liability is limited to something like $25,000.

Most of the problems are very complex. In some ways health care here is like it was stateside in the 70s. Sometimes like the 1870s and sometimes the 1970s.;)


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Ric
 Ric
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September 25, 2010 1:12 am  

Flatlander,
Don't read the "Settler's Handbook". MEMORIZE it. Linda J & I went thru two editions before we moved here. It contained the best information we could find. Of course, that was before there was this message board.

Ric


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DUN
 DUN
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September 26, 2010 2:10 am  

You said you have clinical experience, but have moved into administration. If you are willing to go back to service provider status, depending on the service you provide, you might have a better chance.

It is not so much a scarce population of physicians, although there is that, too. But there is a complete lack of some specialty areas- neurosurgery, cardiac surgery, rheumatology. Then there are the areas where there is only one specialist, for example, one endocrinologist for a place that is fraught with diabetes. Part of this is the population base- there are only around 150,000 people in the entire territory. For government physicians, there is actually relief in tort reform; liability is limited to something like $25,000.

Most of the problems are very complex. In some ways health care here is like it was stateside in the 70s. Sometimes like the 1870s and sometimes the 1970s.;)

Interesting!
Though I can see that here.
I'm not involved in medicine, but I can agree with the above settlements as I have experienced it here.
Well done & said EE!


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flatlander
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September 27, 2010 2:11 am  

I really appreciate all of the responses! I will continue my research and will do my best to memorize the Settler's Handbook! The more information I gather, the more excited I become! I am looking forward to a visit next year! My clinical experience consisted of 15-years as a Computed Tomography (CT) Technologist and my wife as a Nuclear Medicine Technologist & Information Technology. I do not have any problem going back to the clinical aspect of health care as long as we are able to meet our needs financially. Thanks again for the information!


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East Ender
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September 27, 2010 10:47 pm  

Then you definitely need to talk to George Rosenberg at St Thomas Radiology. They have the monopoly on imaging here. He might have some ideas for you, too.


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flatlander
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September 28, 2010 12:01 am  

Then you definitely need to talk to George Rosenberg at St Thomas Radiology. They have the monopoly on imaging here. He might have some ideas for you, too.

Thanks a lot!


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Drlove
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September 29, 2010 5:56 am  

Two JCAHO accredited rural hospitals, chronically underfunded but decent care, Level 3 Trauma, cardiothoracic, plastics, urology, ortho, maternity and Level II nursery, cardiac catherization,dialysis, all but one physician (US) board certified or board eligible,
Community, two large public health centers, numerous doctors offices, appointment dates sometimes longer with specialists, unless your situation is urgent and you tell the front office that.


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STXBob
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September 29, 2010 1:43 pm  

Two JCAHO accredited rural hospitals, chronically underfunded but decent care, Level 3 Trauma, cardiothoracic, plastics, urology, ortho, maternity and Level II nursery, cardiac catherization,dialysis, all but one physician (US) board certified or board eligible,
Community, two large public health centers, numerous doctors offices, appointment dates sometimes longer with specialists, unless your situation is urgent and you tell the front office that.

This is the answer to what question?


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