Kidney disease drives more than 13,600 treatments as SMMC specialist care delivers

CAY HILL--St. Maarten Medical Center carried out 13,641 hemodialysis treatments in 2025, while continuing to expand the specialist services available to patients through a combination of permanently based and rotational doctors. The kidney-care figures form part of a much larger volume of specialist treatment delivered at SMMC during the year.

The hospital recorded 67,619 outpatient consultations in 2025, up from 65,129 in 2024 and 63,487 in 2023. The annual report attributed the continued growth partly to increased activity in nephrology, urology, neurology, orthopedics, pulmonology, pediatrics, anesthesiology, gastroenterology and pain management.

Those figures should also be viewed against the hospital’s progress in attracting medical specialists to St. Maarten. Compared with the specialist capacity available around 2009 and 2010, SMMC has indicated that its permanent specialist complement has almost doubled.

The dialysis total increased slightly from 13,562 treatments in 2024. Of the treatments delivered in 2025, 1,077 were provided to patients from Saba and St. Eustatius, while four were administered to tourists. SMMC began the year with 85 dialysis patients and ended it with 90. The number fluctuated between 84 and 91 during the year as patients migrated, received donor kidneys, passed away or transitioned to peritoneal dialysis.

The figures underline the continuing effect of kidney disease on St. Maarten and the surrounding islands, but they also show progress in giving eligible patients an alternative to remaining on dialysis indefinitely. Four SMMC patients received kidney transplants in 2025 through the Trans-Atlantic Kidney Transplant Program. Eight patients were on the Eurotransplant waiting list, while another 20 were undergoing the screening process.

SMMC began exploring transplant opportunities with local insurers and Erasmus University Medical Center in 2011. The first direct family transplantation followed in 2012, and 11 patients were eventually transplanted through Erasmus.

The hospital later entered a Trans-Atlantic arrangement with Amsterdam University Medical Center, allowing eligible patients to be screened locally and placed on the Eurotransplant waiting list without first having to relocate to the Netherlands. That program began in 2016 and recorded its first transplant in February 2017. Eighteen patients have since received transplants through the arrangement.

The 2025 annual report does not provide the earlier staffing table for a direct numerical comparison, but it documents a considerably broader specialist structure currently operating at the hospital. The report lists 23 in-service specialist full-time equivalents and an additional 12 specialist full-time equivalents working on a rotational basis.

The in-service complement included three anesthesiologists, two cardiologists, one dermatologist, two general surgeons, three gynecologists, three radiologists and three urologists. Internal medicine was represented by an endocrinologist, an infectiologist, two nephrologists and a hematologist. The hospital also had one in-service pediatrician.

This means that several of the core specialties needed to operate a small-island hospital are now based at SMMC, including cardiology, internal medicine, nephrology, gynecology, general surgery, anesthesiology, radiology and urology.

The level of activity recorded in these departments demonstrates the importance of maintaining that specialist capacity. Urology handled 6,307 outpatient consultations in 2025, while internal medicine recorded 6,198. Gynecology and obstetrics accounted for 7,227 consultations, cardiology recorded 4,609 and general surgery handled 5,481.

Nephrology, which works closely with the dialysis department, recorded 959 outpatient consultations. Anesthesiology handled 3,639 consultations and pain management recorded 2,081. Other specialties also treated thousands of patients. Ophthalmology recorded 8,296 consultations, the highest individual total listed in the report, followed by orthopedics with 4,112, ear, nose and throat care with 2,771, pediatrics with 2,680, neurology with 2,504 and dermatology with 2,483. Oncology recorded 1,966 outpatient consultations, gastroenterology 1,546 and pulmonology 1,280.

The figures demonstrate that rotational specialists are not a minor part of SMMC’s care model. They help the hospital provide services in disciplines for which a permanently based doctor is not currently listed.

The report shows that neurology, oncology, ophthalmology, orthopedics, pulmonology, gastroenterology and ear, nose and throat care were supported through rotational specialist arrangements in 2025. Plastic surgery was also provided rotationally.

Some departments combined permanently based and rotational doctors. General surgery had two in-service specialist FTEs and two rotational FTEs, while pediatrics had one of each. A pediatric cardiologist and an interventional radiologist also served on rotation for periods of at least two to three weeks during the year.

The use of rotating doctors should therefore not be interpreted as evidence that SMMC has failed to build its specialist base. The report instead shows a mixed system in which a growing permanent complement is supported by rotational professionals in specialties where additional or periodic coverage is required.

The hospital’s ability to deliver 67,619 consultations across this range of specialties reflects the growth of that system. It also shows the amount of care being provided within St. Maarten, rather than judging the hospital solely by the specialties that continue to depend on visiting doctors.

Other numbers

Emergency Room visits increased by five per cent, from 10,455 in 2024 to 10,998 in 2025. The hospital also registered 4,342 clinical admissions, virtually unchanged from the 4,336 recorded a year earlier.

Hospital days increased by 12 per cent, from 16,949 in 2024 to 18,989 in 2025. Intensive Care Unit hospital days increased from 508 to 626.

General surgery accounted for 4,535 hospital days, followed by internal medicine, including nephrology, with 3,175. Neurology recorded 2,273 hospital days, gynecology and obstetrics 2,302, cardiology 1,295, urology 1,222 and pulmonology 882.

The average hospital stay increased from 3.9 days in 2024 to 4.4 days in 2025. Neurology recorded the longest average stay at 9.6 days, followed by internal medicine at 7.1 days, oncology at 6.4, pulmonology at 5.7 and cardiology at 4.9 days.

Cancer care was another significant part of the hospital’s workload. In addition to 1,966 oncology consultations, SMMC administered 520 chemotherapy treatments and recorded 578 oncology hospital days.

The hospital also completed 3,340 surgeries, 36,106 radiology procedures and 18,187 diagnostic procedures during the year. Radiology activity included 12,180 ultrasounds, 11,482 X-rays, 8,069 CT scans, 1,972 MRI examinations, 1,704 mammograms and 699 fluoroscopy procedures.

Building and retaining a permanent specialist workforce remains challenging. The annual report noted that lengthy governmental approval procedures affected the onboarding of medical specialists during 2025.

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