The island's only orthopedist practiced in the United States for almost 40 years, and retired to SXM. He tried for many years to start a practice on the island, but despite the fact that they didn't have any orthopedic surgeons, they made it as difficult as possible for him. After a few years of jumping through hoops and bounds, they finally let him. Imagine the "government" would have rather had the citizens fly to Curacao than give this guy a license. Now he has a pretty big practice, and it's practically a charity.