How's the healthcare in STX?

I'm an American trained EM physician considering a move to STX from Italy (working for the Navy). Looking for options from the patrons of the hospital on STX. As patients what is your experience with medicine there, both emergent and routine? Thank you.

The ER does not have pillows.

They are staffed by off-duty police officers because of the propensity for violence.

It is a horrible, horrible, horrible place, and I would give all my money and then some to see it bulldozed. If they EVER send me a bill I will respond with a lawsuit.

they don't have blankets either, just sheets in the er. my husband spent 2-3 days in the er. the only thing that got him a room was surgery.

or was it an emergency procedure? oh, i cant remember/. i just know he spent way too long in the er before he got a real room. and the beds suck

Hmm, thanks for these responses. What you two have described seem to be hospital issues and not so much medicine issues. Most ERs don't have pillows, blankets usually yes. The goal is to have patients in and out quickly. Sometimes patients are "housed" in the ED due to staffing issues with the hospital floors.

But how are you finding the care? What is the average length of time you waited to see a doctor? How clean is the facility?

When I was admitted for three days after emergency surgery a few years back, I found the care I received was generally quite good. The nursing staff was attentive and I really was impressed after hearing a lot of horror stories. The facilities are old and a new hospital in order but most staff do thier best with limited resources. It was only after the injured gang member in the room across from me was assasinated in the middle of the night that I became concerned. True story!

Hmm, thanks for these responses. What you two have described seem to be hospital issues and not so much medicine issues. Most ERs don't have pillows, blankets usually yes. The goal is to have patients in and out quickly. Sometimes patients are "housed" in the ED due to staffing issues with the hospital floors.

But how are you finding the care? What is the average length of time you waited to see a doctor? How clean is the facility?

No pillows when you have a head wound and a condition that requires you to be in an a non-existent ICU? Horrible. Beyond horrible. I'd rather be treated by Sean Penn in Port au Prince. Never saw a doctor. I showed up with a severe head wound and it took them FOUR DAYS to show me the results of my CT scan, and then only by flashing the piece of paper in front of me for three seconds because I insisted I had no recollection of the procedure. I'm afraid to ask for my records because I don't want them hounding me for cash.

People are shot and killed there. I would no more admit myself to JFL again than I would move into one of the public housing complexes.

Look into the PR medflights people.

When I was admitted for three days after emergency surgery a few years back, I found the care I received was generally quite good. The nursing staff was attentive and I really was impressed after hearing a lot of horror stories. The facilities are old and a new hospital in order but most staff do thier best with limited resources. It was only after the injured gang member in the room across from me was assasinated in the middle of the night that I became concerned. True story!

Talk about burying the lede!

Talk about burying the lede!

An outdated term but how so? The response seems appropriate to the OP's question.

Talk about burying the lede!

An outdated term but how so? The response seems appropriate to the OP's question.

SO not an outdated term if you work in media. How old are you again?

She told this lovely story, and then finished it off with: "OH BUT THEN THE GUY ACROSS THE HALL WAS ASSASSINATED!"

Really? I need to explain it more than that?

If you don't recall your CT scan, perhaps your head injury precluded you memory of other on-goings during your hospitalization? I assume you are now discussing the hospital floor and no longer the Emergency Department since you stayed for four days.

The "gang murder/assassination" at the hospital was in May 2008. Security has improved. The Emergency Department at JFL hospital is saving lives on a daily basis these days.

It appears that Continentals with no health insurance complain about the Health Care given and they don't want to pay for it either.*-)

Reviews on the hospital experience tend to be very mixed. Since the doctors and nurses rotate through every so often, consistency isn't common. There is a reported hierarchy and sometimes animosity within the nursing staff, depending on whether they are a direct hire or a travel nurse.

I've had several friends who worked at Juan Luis as travel nurses and they also had different experiences depending on the department they were in. Pediatrics tends to be very slow but the ER is often over-loaded. There are nights when multiple shooting victims and multiple people hit by cars all are brought in within an hour. I sold a house to an ER doc and her husband. They stayed here a few years but have now moved to Florida. She had enough of the hospital and found another opportunity.

We do need good doctors and nurses in the islands. The trick is getting them to stay.

Most people I know will avoid going to the hospital if there is any way to do so. It wouldn't be a place to go voluntarily for "routine" care. When I had Dengue Fever 3 years ago, I didn't visit the hospital and chose to take care of myself at home. My step-grandson has some medical issues that are likely related to neo-natal issues that occurred when he was born here nearly 7 years ago, but the hospital has so far failed to release his birth records to his mother and current doctors so that a full examination into his case can be done by the specialists where he lives now. Many babies are born at the hospital, but there are also a lot of women who fly to the mainland to deliver if they have the financial ability to do so.

Life flights to San Juan and Miami occur fairly often, some for true emergencies and some just to gain access to specialists who can properly address something like a severe orthopedic situation. With so many people living here without insurance, the ER winds up with all kinds of patients who are suffering from not having received basic care in a timely manner.

@ Alexandra: Thanks for the feedback on the hospitals. That is exactly the info I'm looking for. I know working in the ED can lead to burn outs, if the pace isn't right for the physician. Are there really so many shooting on such a small island? What I've gathered thus far is that it doesn't seem much different from some of my training at USC-County LA. But of course we feed from a much larger community.

We had 5-6 shooting deaths in January this year. That's a LOT for such a small island to have in a full year, much less within the first month of the year. And that's the ones who die, not the only ones who are shot. There are also knife wounds, etc. With so many living in poverty in the housing projects, there is a drug/gang culture among young men that inevitably leads to violence. Life doesn't seem to have much value to many of them.

Diabetes is rampant in the island population, so there are a lot of other medical urgencies that occur beyond those created by violence. And people live active lives here doing physical outdoorsy things, which leads to accidents of all kinds. You'd see a full gamut of patients streaming into the ER. Since the hospital is government owned, many uninsured people do still go there when they need care and most just walk into the ER even if it's not truly an emergency.

Wow! that is a lot for a little place. One tends to expect Diabetes. Unfortunately that tends to follow poverty. Accidents also to be expected in a "outdoor" active community. thanks again for the info. The guns don't worry me medically, but in regards to lifestyle for my family, that is more were the concern would lay.

Wow you guys are scaring me. I may be moving there as a new grad nurse. It sounds like it could be dangerous. Would Roy Lester on STT be a better option? I am interviewing with both nurse recruiters and can choose.

Which do you guys think would be better? I think the hospital on STX has a little better program for new grad nurses. It has more training for new nurses then the hospital on STT.

The BF had to take an ambulance to the hospital on STX in December. We found everyone we worked with to be good people committed to his health. I really enjoyed the nurses who are here on rotating assignments - they treated him quite well.

I think it's like an ICU in a bad part of town in some ways - you will get the gang shootings and so on. But other nights it will be nothing. This island is pretty much anything at any time, so you just roll with it. 🙂

If you don't recall your CT scan, perhaps your head injury precluded you memory of other on-goings during your hospitalization? I assume you are now discussing the hospital floor and no longer the Emergency Department since you stayed for four days.

That's character assassination. Stop.

JFL is horrid. I spent time on a floor and in the ER/ICU. Both were atrocious experiences. I'm aware that others have had better experiences and that's great for them. This was mine. Stop belittling it.

It appears that Continentals with no health insurance complain about the Health Care given and they don't want to pay for it either.*-)

Just so you know. NO ONE is underwriting individual insurance policies in the VI right now. I'm happy to pay for health care. Someone wanna write me a policy if I live here and am not part of a group plan? NOPE.

It appears that Continentals with no health insurance complain about the Health Care given and they don't want to pay for it either.*-)

Just so you know. NO ONE is underwriting individual insurance policies in the VI right now. I'm happy to pay for health care. Someone wanna write me a policy if I live here and am not part of a group plan? NOPE.

You're a lawyer and work with a Law Firm, I assume you can get small group insurance but you gotta PAY. Since you have no isurance you have to PAY not hide.:P

@ Alexandra: Thanks for the feedback on the hospitals. That is exactly the info I'm looking for. I know working in the ED can lead to burn outs, if the pace isn't right for the physician. Are there really so many shooting on such a small island? What I've gathered thus far is that it doesn't seem much different from some of my training at USC-County LA. But of course we feed from a much larger community.

Yes, the un-insured demographic is similar to County-USC. (VI has one of the highest murder rates in the world---about 90X higher than CA). County-USC is arguably the best ER facility in the nation with access to expert staff and docs from Keck, the most advanced technology and every well trained specialist in Southern California. Both facilities in the VI are decades behind what a well trained professional would expect to find in 2012.

In my opinion the staff at both VI hospitals work hard--some very good, well trained, detailed oriented, caring Md's and some some really bad Md's--like criminally bad. Many traveling nurses doing excellent work under crappy conditions. Lots and lots of turn over. Possibly the highest turn-over of medical professionals under the US flag (for a non-teaching hospital). Highly trained docs with no family or community ties don't last long on average (a handful of exceptions).

You will not have access to state-of-the-art facilities: limited diagnostics, labs, specializing Md's and techs, meds, ect. You will suffer through frequent shortages of supplies: latex gloves, paper products, pharmaceuticals. Not uncommon for well trained specialist to leave in frustration after two years of losing patents because of administrative mis-management. You may or may not get paid on time. Every so often Medi-care threatens to stop making payments because of lazy protocols in certain departments.

As far service in the ER goes...whelp it depends on who's rotaing...much like any ED. If you come to the ER with an acute complicated condition (GSW to abdomen, TBI), you better hope the attending can stabilize and pull strings for an off island air lift. I rolled a family member out (after 7 hours waiting---i.e. no triage) on to a commerical flight. $$$ and the correct friends help. He was in surgery within 4 hours of landing in Miami.

You may love it and take on extra shifts and never want practice anywhere else. Or you may run out the door like your scrubs are on fire... Definitely a solid opportunity to care for a population in need of expert attention.

@ Alexandra: Thanks for the feedback on the hospitals. That is exactly the info I'm looking for. I know working in the ED can lead to burn outs, if the pace isn't right for the physician. Are there really so many shooting on such a small island? What I've gathered thus far is that it doesn't seem much different from some of my training at USC-County LA. But of course we feed from a much larger community.

Yes, the un-insured demographic is similar to County-USC. (VI has one of the highest murder rates in the world---about 90X higher than CA). County-USC is arguably the best ER facility in the nation with access to expert staff and docs from Keck, the most advanced technology and every well trained specialist in Southern California. Both facilities in the VI are decades behind what a well trained professional would expect to find in 2012.

In my opinion the staff at both VI hospitals work hard--some very good, well trained, detailed oriented, caring Md's and some some really bad Md's--like criminally bad. Many traveling nurses doing excellent work under crappy conditions. Lots and lots of turn over. Possibly the highest turn-over of medical professionals under the US flag (for a non-teaching hospital). Highly trained docs with no family or community ties don't last long on average (a handful of exceptions).

You will not have access to state-of-the-art facilities: limited diagnostics, labs, specializing Md's and techs, meds, ect. You will suffer through frequent shortages of supplies: latex gloves, paper products, pharmaceuticals. Not uncommon for well trained specialist to leave in frustration after two years of losing patents because of administrative mis-management. You may or may not get paid on time. Every so often Medi-care threatens to stop making payments because of lazy protocols in certain departments.

As far service in the ER goes...whelp it depends on who's rotating... If you come to the ER with an acute complicated condition (GSW to abdomen, TBI), you better hope the attending can stabilize and pull strings for an off island air lift. I rolled a family member out (after 7 hours waiting---i.e. no triage) on to a commerical flight. $$$ and the correct friends help. He was in surgery within 4 hours of landing in Miami.

You may love it and take on extra shifts and never want practice anywhere else. Or you may run out the door like your scrubs are on fire... Definitely a solid opportunity to care for a population in need of expert attention.

It appears that Continentals with no health insurance complain about the Health Care given and they don't want to pay for it either.*-)

Just so you know. NO ONE is underwriting individual insurance policies in the VI right now. I'm happy to pay for health care. Someone wanna write me a policy if I live here and am not part of a group plan? NOPE.

I would never ever go uninsured in the sates but I am uninsured here in Puerto Rico after my university dropped their health care plan after the first year. I pay 50 to 90 USD for a doctors visit. A friend of mine went to the ER and spent 36 hours in the hospital. She happened to be at Ashford which is in the gringo area and the best hospital in the San Juan metro area except for perhaps the VA. Her bill was 600 USD for the 36 hours including the prescriptions. You don't really need health insurance here as it is almost like socialized medicine.

Is it the same there? Is it affordable. Though if I move to STX or STT it will be to work as an RN and I would surely hope that includes medical insurance.

Thanks blu4u for the detailed description. After spending a few yrs on a aircraft carrier and being stationed overseas in Italy, I can appreciate how to work in environment with less than state-of-the-art equipment. My main issue is burn-out. I just hope somewhere along the way I'd have a pt or two show some sign of appreciation. Amongst the thousands that I have seen, a few pt have "stuck" with me. I even have a wonderful letter/poem one wrote for my life-saving interventions. Those are the cases that bring you back day-in day-out. County-USC was great for medical school and the Navy was awesome for residency and life experience. I've worked in both new and old facilities. It's your colleagues and the occasional pt "thanks" that keeps you coming back for more beating! LOL!:@)

@ Alexandra: Thanks for the feedback on the hospitals. That is exactly the info I'm looking for. I know working in the ED can lead to burn outs, if the pace isn't right for the physician. Are there really so many shooting on such a small island? What I've gathered thus far is that it doesn't seem much different from some of my training at USC-County LA. But of course we feed from a much larger community.

Yes, the un-insured demographic is similar to County-USC. (VI has one of the highest murder rates in the world---about 90X higher than CA). County-USC is arguably the best ER facility in the nation with access to expert staff and docs from Keck, the most advanced technology and every well trained specialist in Southern California. Both facilities in the VI are decades behind what a well trained professional would expect to find in 2012.

In my opinion the staff at both VI hospitals work hard--some very good, well trained, detailed oriented, caring Md's and some some really bad Md's--like criminally bad. Many traveling nurses doing excellent work under crappy conditions. Lots and lots of turn over. Possibly the highest turn-over of medical professionals under the US flag (for a non-teaching hospital). Highly trained docs with no family or community ties don't last long on average (a handful of exceptions).

You will not have access to state-of-the-art facilities: limited diagnostics, labs, specializing Md's and techs, meds, ect. You will suffer through frequent shortages of supplies: latex gloves, paper products, pharmaceuticals. Not uncommon for well trained specialist to leave in frustration after two years of losing patents because of administrative mis-management. You may or may not get paid on time. Every so often Medi-care threatens to stop making payments because of lazy protocols in certain departments.

As far service in the ER goes...whelp it depends on who's rotating... If you come to the ER with an acute complicated condition (GSW to abdomen, TBI), you better hope the attending can stabilize and pull strings for an off island air lift. I rolled a family member out (after 7 hours waiting---i.e. no triage) on to a commerical flight. $$$ and the correct friends help. He was in surgery within 4 hours of landing in Miami.

You may love it and take on extra shifts and never want practice anywhere else. Or you may run out the door like your scrubs are on fire... Definitely a solid opportunity to care for a population in need of expert attention.