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Facility to take burden off emergency room

By Teri Hunkin

PAGO PAGO, America Samoa (Samoa News, June 17, 2009)—For many years, and for most of us, a visit to the hospital meant a long wait at the Emergency Room. Whether or not our case qualified as a true emergency, that was the first place we headed. LBJ Medical Center wants you to know that those days are officially behind us.

There’s a better way to visit the hospital in order to be seen by a physician now... and it doesn’t involve waiting for hours in the Emergency Room (often surrounded by people ready and able to pass on contagious ailments)

In an ongoing effort to deliver better health care to the territory, LBJ has opened a Primary Care Clinic, and as the name implies — it is — and should be — the primary source of health care for the residents of the territory, and the very first place we go for health care.

Anyone 17 years old and over is welcomed at the new clinic, which is located next to the Administration offices at the "top" of the hospital compound.

The clinic can be reached by calling 633-4572, and while appointments are not necessary, they are recommended, and patients will be seen according to their appointments. "Walk-ins" will be seen as they can be fit in between regular appointment patients.

It is a truism in the health care profession that having a medical "home" for your records and health care promotes better health overall.

Primary Care doctors have more time to spend with patients, more time to discuss concerns, and more time for education and imparting important knowledge — the life-saving and health promoting information that can make a difference between a vigorous and energetic life, and one weighed down with medical problems.

Practitioners at Primary Care are under the direction of David Bouslough, MD, and include another MD, Dr. Sean Stracensky, who is the clinic manager, and three Certified Physician Assistants, or PA-Cs: Katrina Hoke, Timothy Brinker and Jamie Stevens.

Speaking to Samoa News, Dr. Bouslough noted, "the Primary Care clinic is a wonderful addition to the health care system here in American Samoa, and provides a need that has been neglected for decades."

While both the Emergency Room and Primary Care are part of one department headed by Bouslough, the acuity of care and different needs are better addressed by separating the areas of concern. They are not competitive, but rather, they complement one another, and according to Bouslough, they are meant to assure "seamless care" for patients.

Bouslough also noted that If an ER visit is required, follow-through can be done at Primary Care to ensure medical issues have been resolved. In cases where ongoing treatment is necessary, Primary Care clinic fills that need.

Dr. Bouslough noted, "We hope to expand upon this clinic which has been successful since its inception nearly one year ago."


‘Primary care’ is a term used to describe the activity of a health care provider who acts as the first point of consultation for a patient. It is designed to treat patients who are not having a life-threatening emergency, and its advantages are numerous.

One of the clearest advantages of using the Primary Care clinic is a reduction in waiting time —because patients can call ahead and schedule an appointment — rather than waiting an average of two to three hours to see a physician in the ER.

In addition, utilizing a Primary Care clinic ensures that patients’ chronic medical conditions are better managed, thus preventing multiple ER visits.

This is a savings realized in time and money, not just by the patient, but by the hospital as well. Cutting down on non-emergencies, the ER physicians have more time to spend managing and treating authentic medical emergencies.

According to LBJ, 91% of the ER traffic does not qualify as an emergency; instead they are patients who would be best served by Primary Care.

Primary Care emphasizes continuity of care and health maintenance, and involves a wide scope of health care concerns — from non-emergency acute illness to managing multiple chronic diseases.

In American Samoa, the most commonly seen chronic illnesses include hypertension (high blood pressure), diabetes mellitus, asthma, gout, and chronic back pain. Other examples of illnesses, injuries and general health concerns that can be managed in the Primary Care Clinic are: flu-like illnesses, sore throat, high cholesterol problems, knee pain, urinary tract infections, headache, rashes, and problems associated with tobacco abuse.

The clinic also takes care of one of the most irritating and timely tasks for a ‘patient’ — medication refills. Establishing a ‘home’ for your records and a relationship with the primary care doctors will allow you to get medication refills based on your ‘current’ condition, allowing for a ‘fine tuning’ of your health needs.

Yearly check-ups, one of the best tools for maintaining optimum health — can be done in Primary Care as well.

A patient seen in the Primary Care clinic who needs a referral to other specialty clinics will receive the appropriate referral, again bypassing the ER.

The Primary Care clinic was begun by Dr. Matt Davies, after which Dr. Stracensky took over, and the PAs have been here since January, 2009.

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