SMMC

[schmita1]

Someone from AUC has been posting inflammatory items about SMMC. He then suggested that we post here and see the responses.

Can any of you give us first hand stories about Sint Maarten Medical Center? Treatment, lack of hygiene etc.

Much appreciated. Just moved on island and wanted to know what to expect. :?:

[WantMD]

I don't know much about SMMC but I would like to point out that there is also a French hospital in Marigot, so I would not say that quality of healthcare on the island is limited to SMMC.

I am still investigating both. So in case of need, I'll know where to go. At this time though, I'd go to the French side if I needed to.

When I find more, I'll post it here.

WantMD :-)

[schmita1]

Thank you. Keep me informed.
i

[msbee]

I'm curious too because I saw that post from that AUC student too.

the student talked about things like all SXM doctors are corrupt, that the poster personally knew a girl who went to the OB/GYN and the exam took place with no gloves.
Poster states there is only one antheseologist who works to 5 PM and after that time a p[rocedure like childbirth is entirely natural like it or not.

the poster told readers to come here and ask about universal precautions or sanitation in the hospitals… Ask why few is any of the spouses who are nurses, surgical techs, and PTs would consider working at the hospital (other than money)… Ask about the seriously ill student that the school paid to have rushed off the island because of the horrifying low quality of care he was getting... Ask why all the wives chose to leave their husbands for a few months to have the babies in the US… Ask about anything else I’ve mentioned. It’s common knowledge there. And people will tell you worse stories in far worse a tone.

That poster says all AUC medical students and faculty will tell the same stories so I want to know if that is true.

[schmita1]

MsBee,
That is exactly what I read. Who is this medical student? I personally know ob/gyn on island who said that examination without gloves is unheard of.
What about the other issues, like sanitation and the fact that the faculty at AUC tells students not to go to SMMC?

[levator]

I'm curious too because I saw that post from that AUC student too.

the student talked about things like all SXM doctors are corrupt, that the poster personally knew a girl who went to the OB/GYN and the exam took place with no gloves.
Poster states there is only one antheseologist who works to 5 PM and after that time a p[rocedure like childbirth is entirely natural like it or not.

the poster told readers to come here and ask about universal precautions or sanitation in the hospitals… Ask why few is any of the spouses who are nurses, surgical techs, and PTs would consider working at the hospital (other than money)… Ask about the seriously ill student that the school paid to have rushed off the island because of the horrifying low quality of care he was getting... Ask why all the wives chose to leave their husbands for a few months to have the babies in the US… Ask about anything else I’ve mentioned. It’s common knowledge there. And people will tell you worse stories in far worse a tone.

That poster says all AUC medical students and faculty will tell the same stories so I want to know if that is true.

anyone know the url address of the post that everyone is referring to?

thanks

[tRmedic21]

I've never been to the medical center (though I've heard lots of stories), but I have friends who have witnessed GYN exams (on suspected STD patients) with no gloves, and no post-exam handwashing before the next patient, either. Has happened more than once at more than one place. But I'm not here to slam anyone, it's a different culture, and I don't plan on practicing medicine that way. It's enough for me to know it happens, and to know I'll never do the same.

[WantMD]

My wife actually e-mailed the person to whom this happened about 6 months ago. This is not a myth it actually happened. This happened at the dutch hospital. I have not heard much of the French hospital. Next time I drive through Marigot, I'll follow the signs and visit the hospital. I have heard that it is new.

On a related issue. Two weeks ago, I needed to see a physician. I went to Mullet Bay clinic and saw Dr. Deketh. I thought he was great. He was knowledgeable, concerned, took plenty of time to talk things over with me, ...etc... I came out of there slightly relieved. I would not hesitate seeing him again. Mullet Bay clinic is only a small FP type of office. Van Der Waag, I know nothing about except that he teaches at AUC.

To those of you using this to make your decision between schools. The health care here is about as good or better than what you would get on many other Caribb. islands with the exception of Puerto Rico.

WantMD :-)

[anencephalic]

One must take everything you hear with a grain of salt...I know the individual who had her OB/GYN exam done without the benefit of gloves on the practitioner's part. I have personally witnessed things that would make an OSHA/CAP/JCAHO accreditation committee's head spin, but you must remember that THIS IS ST. MAARTEN, NOT THE USA!!! Standards of care are DIFFERENT! People come here with expectations (myself included) and freak out when they find that the standards of care are not what they are used to. I have had the pleasure of talking/visiting with 4 docs at SMMC and all were competent, caring physicians in my assessment. The locals have babies, go to the emergency rooms, have minor surgical procedures, have labwork done, and life goes on.

ALoha,

[beach bum]

Here’s the site/link-

http://www2.gobeach.com/sxm/read.php?f=1&i=44186&t=44186

Basically it’s a tourist website and it was me actually me who posted. I used it allot back when I was trying to find out more about SXM and they answered a bunch of my annoying questions about moving here and island life(before I found the valuemed site). So now, I try (with varying sucess and popularity) to answer things there. It’s actually a great site, with a lot of info on SXM that people here might find helpful. Check it out.

Essentially, the 'flaming remarks' were in respoce to how great the med system was in SXM, so I thought I should give the other side and share a few of the stories I had heard. Reading back over it, perhaps I was too harsh. Check it out and decide for your self.

Some of the stories in question are listed below. Can I get any type of verification? (or a smack for being dead wrong..)

- there are several nurses and 'med people' (that are spouses ) that do not work at the hospital due to the lack of universal precautions and quality issues

- there are teachers here would prefer to check out your problems personally rather than having you go to an island doc of questionable quality

- The gloveless story..

- The hurt student a few semesters back that the school paid to have sent off the island after a few teachers when in and saw the hospital was doing a bad job

-Most (99%?) wives choose leave their husband and to go back to the US to give birth because the hospitals are much better. Also-the lack of epidurals after the 9-5 guy goes home...

-The school only accepts sick notes (for missed exams) from certain doctors on the island b/c of problems with doc’s ‘selling sick excuses’

There are a few other things, but basically everyone on that site seemed to think I made it all up… I thought I’d direct them here for some verification, as many of these things had been discussed here.

I hope it was all right to send them here. I didn’t think anyone here would mind. Please do point out if I was wrong on anything above.

BB

[anencephalic]

One must take everything you hear with a grain of salt...I know the individual who had her OB/GYN exam done without the benefit of gloves on the practitioner's part. I have personally witnessed things that would make an OSHA/CAP/JCAHO accreditation committee's head spin, but you must remember that THIS IS ST. MAARTEN, NOT THE USA!!! Standards of care are DIFFERENT! People come here with expectations (myself included) and freak out when they find that the standards of care are not what they are used to. I have had the pleasure of talking/visiting with 4 docs at SMMC and all were competent, caring physicians in my assessment. The locals have babies, go to the emergency rooms, have minor surgical procedures, have labwork done, and life goes on.

ALoha,

I must add that my wife and I were impressed with the diagnostic skills of a private clinician in Simpson Bay, as well as the amount of time he spent with us (a far cry from the 7 minutes US doctors are "allotted" due to managed care). As for "Universal Precautions"...the phlebotomist/technician:
1) Drew my blood without gloves
2) Recapped the needle
3) Placed an ALCOHOL SWAB on my wound immediately after withdrawing the needle :evil:
4) Didn't label my blood draw immediately after it was collected (could've been racked with anyone's blood)
5) Took my urine specimen from me (again, without gloves)
6) Discussed the management of other patients with the RECEPTIONIST in the waiting room in full earshot of everyone there (see if that flies with HIPAA).

Just my personal experiences (good and bad).

Aloha,

[schmita1]

I am not interested in Doctor's procedures all around the island. I am interested in what the poster wrote about SMMC.

The fact that AUC faculty tells medical students not to seek medical care there is what concerns me. That is what I am interested in.

[beach bum]

Actually, my post was primarily about doctor's procedures all around the island. Go back and look. if you want. There was very little specific mention of SMMC, other than the student who school shipped off the island due to the care he got and the lack of epidural thing..

It's certainly NOT the "official position" of the school to tell students not to the hospital. Sorry if I may have implied that.

That being said, you will find some faculty members who will have told students that in passing or off the cuff (and certainly off the official record..). I didn't think this was going to be a witch hunt of certain faucilty members for opinions they may have expressed, but rather a verification of some of the other stories. I really have no intention to "name names" if that's what you were pushing for...

[tRmedic21]

Well, about the student who was shipped off the island, I was here at the time, and from what I remember, it was not so much due to the poor care he was recieving (although he wasn't getting much care from what I hear, just laying there with docs debating about if he had a fracture or not).

He actually had a vertebral fracture, so he needed to be shipped off the island regardless, just to be examined by a nuerosurgeon to make sure everything was fine. He didn't have the money to pay for the flight, so the manager of the business office stepped up and wrote a check out of the school's account to make sure he got flown out. It wasn't an approved decision, but she did it, and it turned out very well, and was very appreciated by the student body. If she wasn't part of the **** family, it's anyone's guess as to whether she'd have still had a job on Monday morning. :?

The student recovered well, returned to the island and has finished basic sciences. If I remember right (of course, lots of rumors flying around) he had a T4 fx and a possible injury to the brachial plexus. He was slammed into the sand while bodysurfing at Mullet. The ambulance crew at that time was less than professional, not taking his injuries seriously, and then of course, he turned up with a vertebral fracture! :shock: I personally have witnessed them working a few times and being a former medic, I kept my distance and just watched. I was appalled by their lack of concern, their unprofessional manner, and their lack of either training or inclination in proper prehospital care. Just my $.02

BTW, I've seen the same on other Caribbean islands, and I don't think it's any different most other places (except the obvious, Puerto Rico and prolly the Dominican Republic).

Just don't get hurt down here. :)

[teratos]

Why are we discussing a post made on another forum. If a poster alludes to a problem and then dodges follow-up by saying that you should seek clarification here, don't you see a problem with that? G

[Faith]

He actually had a vertebral fracture, so he needed to be shipped off the island regardless, just to be examined by a nuerosurgeon to make sure everything was fine. He didn't have the money to pay for the flight, so the manager of the business office stepped up and wrote a check out of the school's account to make sure he got flown out.


Again, you guys, I will emphasize the importance of having medical evacuation insurance ANYTIME you are away from the US.
You could either end up trying to recover in a place where there is no specialist or you could bankrupt your family as they try to get you home. Trying not to get hurt isn't the strategy you should depend on. Imagine getting to 5th semester, having an injury like this and never being able to practice medicine because you're paralyzed from the shoulders down - and you had a treatable injury.

There are many foreign hospitals that will also require you to pay your bill in full before you are taken away - the insurance covers that as well.

OK, enough preaching.

I was treated at the hospital on the Dutch side for a laceration. Universal precautions were used, the wound was scrubbed with betadine, sterile technique was used (which we now know isn't really that necessary with clean wounds), and the scar is barely noticable.
Best of all, it only cost me $90, which I sent in to my insurance company and they covered in full. I wonder how much we charge for a 4cm lac. and a tetanus imm. I know it's not 90 bucks.

Faith

[AUCMD2006]

things have certainly changed at smmc since you were there. having tried to start rotations with both the french and dutch hospitals i went to both. the dutch hospital is in financial disaster right now, both times i went no one was on staff in the ER other than the attending. as far as precautions i don't know but the place was unkept. the french hospital is new and at least had people there. now given the choice of impending death or owing my life to the french...well tough decisions.... :lol:

[t-tongson]

If there is one thing that I've heard many times since coming here, it's DON'T LISTEN TO RUMORS! I used to listen to rumors and trust me, there are some scary ones out there. And I'm sure some of them could be true. But then what made me wise up is the need to think for myself. I'm not sure if the original poster has personally had any bad healthcare experiences. Is that such a "bad" experience to be given a prescription for a medicine that you ask for? Or is it similar to healthcare in Europe where many drugs are OTC? Shouldn't we really be more responsible for our own health anyway vs. not knowing what kind of drugs we are on? Have you had any other personal "bad" experiences or are you just gossiping on this and other forums?!

I will relay my own personal experience with a physician at SMMC. This doctor is very personable, knowledgeable, and put me at ease immediately. I'm sure there are both good and bad doctors here in SXM just like in the U.S. Why else would there be doctor referral lines set up in most cities...it's certainly NOT because all the U.S. docs are the greatest and you want to get the best of the best!

So please, next time, remember that you are not in the U.S. and keep the insulting of locals to a minimum.

[schmita1]

Teresa,
Thank you for your post. It is what I was looking for here. Joe or Beach Bum or whatever his name is, decided to balance good medical experiences on island with his "rumor" experience on island.
I posted this on the other board, in order to tell "Joe" that he should be careful about what he posts online. My husband recently retired from New Your University Medical School as Clinical Professor of Psychiatry. This as you know is a Medical Position.
"Joe" decided to entertain us with horror stories of medical care on Sint Maarten. My husband knows many doctors on island and was quite confused as to what this "medical student" was posting. We have since spoken to many doctors on island and told them about this medical student's post. All did not care. Apparantly the opinion of a medical student on rumor control does not carry any weight. No doctor would admit or agree with seeing a patient without gloves (OB/GYN).
On another post, someone mentioned having blood drawn and the practioner did not wear gloves. What is the point of that? The practioner is at risk, not the patient.
Then there was the post from "Joe" about how after 5PM there was no anesthisiologist available. Guess what? They make babies on island just fine. Is this person saying "what"? If you need brain surgery at 2AM there is no one there? SMMC is like a small town hospital. They don't do the big stuff.
So my question is? Is the faculty of AUC telling students either obviously or secretly that medical care at SMMC is not adequate, or scary?
This is the part that concerns me. "joe" has opened a can of worms.
Thanks
i

[wolfvgang22]

I must add that my wife and I were impressed with the diagnostic skills of a private clinician in Simpson Bay, as well as the amount of time he spent with us (a far cry from the 7 minutes US doctors are "allotted" due to managed care). As for "Universal Precautions"...the phlebotomist/technician:
1) Drew my blood without gloves
2) Recapped the needle
3) Placed an ALCOHOL SWAB on my wound immediately after withdrawing the needle :evil:
4) Didn't label my blood draw immediately after it was collected (could've been racked with anyone's blood)
5) Took my urine specimen from me (again, without gloves)
6) Discussed the management of other patients with the RECEPTIONIST in the waiting room in full earshot of everyone there (see if that flies with HIPAA).

Just my personal experiences (good and bad).

Aloha,

Interestingly enough, I've seen the EXACT same procedure take place in several rural clinics many times here in the good ol' USA. Ditto for the gloveless exam. At least hands were always washed thoroughly before and after. Dunno if that makes me feel better or worse about Sint Maarten.
Go figure. :wink:

[beach bum]

My Apologies

I was just going though some of my recent post to determine where things went so horribly wrong and found a big error on my part that I should have noticed earlier. It seems to what is causing a lot of the problems. Here it is, in part-

MY Quote->
“I’m not trying to be insulting or arrogant by asking those type of questions because I can’t answer those questions either! (well, one of the them..) Instead I listen to what doctors I know and trust (and can give an insider’s comparison) say about it and the ones I talk to say the hospital is bad.”

First off, my thoughts got jumbled and I should NOT have put “hospital”. I should have said the “health care”. While I mentioned thoughts and stories about the hospital in a diff part of the letter, I need to make it clear that this was a mistake on my part to imply that AUC staff are singling out or specifically mentioning SMMC as a place to avoid . Further more-nstead of ‘doctorS”, I should have said ’people’. There is no panel of doctors certifying my opinions and Faculty at AUC has NOT told me to avoid SMMC. Again I’m sorry I may have implied that. (or obviously, directly said it…)

I have heard things about SMMC from a variety of OTHER sources (many of which are NOTdoctors. This I failed to properly state.) These sources and stories make me personally question whether SMMC is a place who’s hands I want to put my life into. The main doctor in this case that I was referring to was a family member (NOT AUC staff) who recently visited me and read of the news about the SMMC strikes. He remarked that a strike of that kind “is symptomatic of a huge problem in the hospital and should be a big red flag to everyone to avoid.” With the well known cash flow problems at SMMC, I have a hard time be leaving that they have somehow turned things around and become a ‘state of the art facility’ in the past few months as some had implied.

If there were other errors in some of what I said (and there no doubt are), please accept my apologies for a series of posts that should have been better thought out and thoroughly review by the author.. They may have come to reflect badly on AUC and portrayed SMMC in a light I had not intended.

Sorry again. Choking on some humble pie….

Beach Bum

[FLK]

[quote=anencephalic]As for "Universal Precautions"...the phlebotomist/technician:
1) Drew my blood without gloves
2) Recapped the needle
3) Placed an ALCOHOL SWAB on my wound immediately after withdrawing the needle :evil:


Aloha,

he's probably already HIV and Hep C positive.
so what does he care if he touches blood? :lol: :lol:

hopefully, what experiences you guys are getting in a 3rd world hospital setting ( I would argue that these are light years ahead of real 3rd world hospital settings though---where there are NO hospitals at all ) will make you appreciate how wonderful we have it in America
big money
prestige
lots of technology and the ability to cure things that were you practicing in a real 3rd world place, you would be powerless to treat.

take EVERY good and bad experience at AUC and turn it into a positive. you guys are living an experience that US medical students would sign up for an elective to learn

[AUCMD2006]

"you guys are living an experience that US medical students would sign up for an elective to learn"

and they are living an experience i'd donate appendages for...hehe

you are right it really does give us a perspective that will come in handy in the future...i know for a fact i will never complain about the united states again when i am back home even if bush wins again....

[msbee]

Beach Bum
It is always good to read posts before you post.
thanks for the apology.
and it's always good also to be a little humble..especially if you are going to be a physican. It sure comes in handy!