Gov. Kenneth Mapp has vetoed legislation [Bill No. 31-0324] to allow medical practitioners in private practice to apply for temporary licensure in the territory, saying he believes it will harm health care in the territory.
"I truly believe that all of us want to maintain a high quality health care system in the Virgin Islands and we will accept nothing less. Bill No. 31-0324 is a bad bill, bad public policy, and does not contribute anything towards a high quality health care system,” Mapp said in the transmittal letter sent to Senate President Neville James on Monday.
Mapp said there was debate on a similar bill when he was a senator in the 20th Legislature.
“We had this same debate and we decided then that we would not permit persons to practice medicine in the Virgin Islands via legislative fiat. Persons wishing to practice medicine on any of us must simply meet and pass the testing requirements to obtain a license to practice medicine. In addition, we agreed then that it would harm the people of the Virgin Islands to grant permanent medical licenses through an administrative process to persons who graduated from non-accredited foreign medical schools, and who could not pass the testing requirements to obtain a license to practice medicine. The bill before me seeks to do what we rejected in 1994, and we must reject it again in 2016,” he said.
Mapp also said provisions exist for people graduating from non-accredited medical schools to work in Virgin Island hospitals but, not as full-fledged licensed physicians. They cannot write an order for medication within the hospital or write prescriptions for patients, and they must work under the supervision of a fully licensed physician. This position is similar to the duties of a physician’s assistant (a person trained to perform under the supervision of a physician, able to perform many clinical procedures traditionally performed by a physician, such as diagnosing and treating minor ailments.)
He also said the bill did not limit the number of times a temporary license can be issued. The bill also would have lowered educational standards by removing the existing temporary licensure requirement to “have graduated from a qualified school of medicine, have at least one year of internship and meet other qualifications” and replace it with “has passed the Educational Commission of Foreign Medical Graduates (ECFMG,) is a foreign medical graduate and has NOT [emphasis added] passed the local professional examination and does NOT [emphasis added] have one year of internship in a hospital recognized by the American Medical Association."
“Which one of you would accept such a practitioner of medicine to attend to you or one of your family members in a critical time of a medical emergency? Which one of you would go to such a licensed physician for medical care? Which health insurance carrier would acknowledge such a licensed physician and pay for medical services under a current health insurance contract? Which one of you would attest that the Centers for Medicare and Medicaid Services would acknowledge and pay for medical services of Virgin Islanders provided by an unsupervised, unlimited temporary medical licensee?” Mapp asked.
When the bill was heard in committee, private practitioners and Dr. Anthony Ricketts, who works with Gov. Juan F. Luis Hospital, testified in support, saying there was an urgent need for more specialists and for temporarily licensed physicians who could take over when a doctor goes on vacation.
Hospital and Health Department officials testified against the measure, arguing it would pull money away from the hospitals and into private practice and take away from the hospitals an advantage in attracting physicians when they are already struggling to attract them.
Mapp approved a bill which requires healthcare providers employed by the V.I. government and engaged in private practice, and receiving government financial assistance towards medical malpractice insurance premiums, to accept Medicare and Medicaid. He also approved a bill which requires several professional boards to perform criminal background checks on applicants for a professional license in the territory, and appropriates $90,000 from the Interest Revenue Fund to the Department of Health for payment to Continuum Care, Inc. for uncompensated care.