The number of patients referred off-island from LBJ Tropical Medical Center for medical care has increased by 22% since fiscal year 2023, according to figures shared with Talatala Le Ta'ui.
The rise is driven largely by a shortage of specialist physicians — particularly in cardiology, oncology, and orthopedics — combined with delays in replacing aging diagnostic equipment.
LBJ CEO Faumuina John Faumuina acknowledged the trend in his recent interview: 'Every off-island referral is a family disrupted, a patient frightened, and a cost the territory and the patient both absorb.'
The average cost of an off-island referral, including transportation, accommodation, and care coordination, now exceeds $12,000 per case. Federal Medicaid and local government funds cover a portion of this, but families often absorb significant out-of-pocket costs.
Hospital administration has outlined a plan to recruit four specialist physicians by the end of FY26, but observers note that recruitment to American Samoa has historically been difficult.