Linda Halderman is a senior policy advisor to Sen. Aanestad and a surgeon. Last week, she got a call asking her to go to help with the relief effort in American Samoa following the devastating tsunami that hit the region on Sept. 29.

 

Tell me about the phone call you received the other day.
This was unexpected. I’m not someone who gets a lot of phone calls from FEMA or the office of the Governor of American Samoa. In fact what they said was “Can you go?” Since I have been in the Capitol working in Sen. Aanestad’s office, I’ve kept my surgical credentials by doing short stints in general and trauma surgery around California. I had always been interested in doing international assignments. One of the places where I had sent my credentials awhile back was to American Samoa, to the hospital that is in the territory. It is the only hospital there. It was built in 1969 under Lyndon Baines Johnson, and in fact it’s called the LBJ Tropical Medical Center.


What I had anticipated was that at some point in the future I would do a stint over Christmas break in the Legislature in that territory. What I didn’t expect was to receive a call from a gentleman who described himself as one of the directors of response for FEMA. What he said was “Are you still able to come? We’re deploying the U.S. Coast Guard, the American Red Cross is there.” Their surgical systems are down. Essentially they have dialysis and no other outpatient services. Their emergency system obviously was overwhelmed and it’s going to take some rebuilding.


I then got contacted through the governor of American Samoa. The chief of the hospital contacted me and said “We’re ready when you are. There are two flights a week. Can you take one?” The next one, it turns out, is Thursday [last week]. It’s a pretty dramatic change. The only thing  I wish I’d been able to do was get an H1N1 vaccine, but they only just came out today, so that’s not in the cards. I did get a flu shot, though.


Tell me more about your background.
I was a general surgeon in a little rural community called Selma, CA. I did that for five years, in the raisin capitol of the world. My practice was essentially rural, a ton of farm workers. They were between 90 and 95 percent uninsured and MediCal. It was pretty much run into the ground by MediCal reimbursement. It wasn’t even sustainable. I hit about $100,000 in debt. I identified the source of the problem as being in the state Capitol, so I started knocking on doors saying “Can I help? Can I let you know what’s going on in the front lines? Maybe we can do something better than what’s happening right now.” The person who answered the door was Senator Aanestad. He said “I’m an oral surgeon. We’ve been looking for you.” So that’s where I’ve been since April of 2008 when I closed my practice.


Obviously, I’m still a surgeon. I need to remain that. That’s why I do these short stints around California in such glamorous places as King City and Needles. What I do with the Senator’s office is help draft legislation based on some common sense principles for healthcare reform, things to improve the affordability and patient access to care. We focus on patient safety and on preserving patient choice.


Our fundamental idea is that there are tremendous strengths of our healthcare system, funding and delivery, but there are areas that need improvement. Rather than throwing out the baby with the bathwater, we’ve tried to diagnose the problems and treat those problems correctly instead of just starting over or addressing what is really not the problem. What is not the problem is just handing out more cards with the words “MediCal” on them. Cards are not access to care. That is painfully demonstrated in Selma. When I was there, there was a 70 mile radius with no breast cancer surgeons accepting MediCal. That number went down to zero when I left. You can do all you want legislatively to say “Everybody’s covered. Everybody’s got MediCal.” Without doctors, without clinics and hospitals, that doesn’t mean anything.


So on the Senator’s proposals: we’ve worked hard, it’s been difficult. Often they don’t see the light of day. Or maybe they see it for a brief moment in committee then are immediately shot down. So we continue. We have some victories. The Senator has joint-authored SB 820, which is a patient safety bill, improving the peer review process, how doctors are evaluated in our state. But those victories are few and far between.


Tell me more about what you’re going to do when you get to American Samoa.

My first goal is to try to assess what’s needed. I do have some wonderful friends in the Coast Guard and in Congress who volunteered to kind of smooth the way so that supplies can get where they’re needed. That’s my first priority, see what’s missing. My next priority is working with the team of doctors there to see what holes we have to fill in with services. Just because there’s a tsunami it doesn’t mean there’s not also people with malignancies. There are people who need diagnosis and treatment for life-threatening illnesses that are not tsunami-related. After that, I’m hoping I’ll be able to share some surgical techniques, and to learn from the doctors who are there.