Hiring of foreign doctors opposed • Health officials say proposed legislation on hiring of nonresident medical practitioners not practical

Public Health Secretary Joseph Kevin Villagomez and Medical Licensing Board Chair Dr. Helen Taro-Atalig have strongly opposed a proposed measure that will allow foreign doctors to practice their profession in the CNMI due to the lengthy and expensive process of conducting background investigation to ensure that physicians do not have any previous or pending medical malpractice violations.

Both Mr. Villagomez and Dr. Atalig submitted their testimonies to Rep. Malua Peter, chair of the House Committee on Health and Welfare, who is reviewing SB 12-56, or the Foreign Doctors Licensure Act of 2000, which was already passed by the Senate.

Sponsored by Senate President Paul Manglona, the measure hopes to make the CNMI a haven for retirees from other countries and complement an earlier law signed by the governor creating retirement communities on the islands.

The practice of checking the background of these doctors are done to ensure that the Northern Marianas get credible and quality medical provider to serve the community.

Currently, the Medical Licensure Board is having difficulty in controlling the acupuncture clinics in the CNMI, according to Dr. Atalig. The board cannot check the authenticity of the acupuncturist’s diploma since there is no single agency that controls the licensure in these countries where they came from.

In the United States, the medical board has a system which inputs names, degrees, place of employment and cases against physicians in one system, which allows for easy verification of diplomas and licensure authenticity.

License

DPH endorses medical licenses from all 50 U.S. states, territories and possessions under a section of the Issuance of Reciprocity License. The department also endorses licenses from Canada.

“While I have no doubt that the Japan medical system is just as good if not better, we do not have a mechanism to again ensure the quality and credibility of the physician coming from Japan,” Mr. Villagomez said.

Even if the Japan-trained physician will only provide services to retirement community residents from Japan, they must be able to communicate with the physicians at the Commonwealth Health Center in case more medical attention is needed.

Mr. Villagomez recommended that a company or individual planning to set up a retirement community here in the CNMI for Japanese citizens, then they should actively pursue a U.S. or Canadian-trained provider who is a Japanese or speaks fluent Japanese and is familiar with the culture. There are a lot of these physicians in Hawaii and California.

If the physicians come from the United States or Canada, Mr. Villagomez said the medical provider is ensured of privileges at the CHC, which will allow them to follow the needs of the resident in the retirement home in case of hospitalization.

“If those retirees are so rich that they can boost the economy of the CNMI by living here, why can’t they hire Japanese or Chinese speaking doctors who have graduated in the U.S. or who have done residency in the US or Canada?” asked Dr. Atalig. Local doctors can also be encouraged to speak Japanese so that they can expand their clinics, thus boosting the CNMI economy.

Although the CNMI Legislature can amend the current Licensure Act to include foreign trained physicians and give reciprocity to medical providers from Japan, Mr. Villagomez said this will not mean that foreign-issued medications and/or medical devices will be allowed here.

In other words, the treatment protocol that ultimately will be practiced by the physicians who will come from Japan or China will be the ones approved in the CNMI, US and or Canada.

Complications

“Changing the Medical Act to satisfy the few rich people will not improve the CNMI economy. It will be an invitation for quacks to enter and establish clinics that we will have control over,” Dr. Atalig said.

The fake documents can easily be obtained in China and the Philippines which the licensing board had encountered several times in the past. In opposing any amendments to the Medical Act, Dr. Atalig said the rich retirees should not be treated as a secluded group of people with their own money and clinics but as people who are part of the whole community.

In fact, the CNMI can earn more if these rich retirees will spend their money at the local clinics or hospital. “We must stop legislating to entertain the few. We must legislate to benefit the majority, and like any retiree, we must benefit the same. Let us not introduce more problems but encourage those who intend to practice in the CNMI to observe our Medical Practice Act,” Dr. Atalig said.

Under the Pure Food, Drug and Cosmetic Act, the CNMI authorities will confiscate and either destroy or send back to the country of origin foreign drugs or medical devices that are not US-approved.

Mr. Villagomez said the law has decreased the importation of prescription drugs that are typically sold over-the-counter in Asian countries. Likewise, it has addressed the proliferation of illegally imported and improperly issued antibiotics that contributed to the high rate of antibiotic-resistant bacteria.

“Our public health inspectors have their hands full trying to address the importation of these drugs and/or devices and they will not be able to monitor and ensure that these retirement communities are not doing likewise,” he added.

Infrastructure

Establishing a retirement home in the CNMI will provide additional income for the islands but the government must first ensure that infrastructures are in place and can accommodate the potential demands on the medical system, Mr. Villagomez said.

CHC is a 74-bed hospital that is usually 80 percent filled to capacity at any given day.
The rate increases when there are visiting specialists who are treating patients.
Mr. Villagomez asked: “How are we to address the retirement home population if they should need immediate hospitalization or are too unstable to be put on a plane or be brought back to their point of origin? Who are to see their medical care if they should be admitted to the hospital? Who will have priority over the beds if we reach maximum capacity.?”