Big Isle doctor residency program nears milestone


When Lt. Gov. Shan Tsutsui released a one-time appropriation of $1.8 million last month to help fund Hawaii Health Systems Corp.’s Primary Care Training Program at Hilo Medical Center, it represented a major boost for the fledgling program, organizers said.

“That was a big thing for us, to get that support,” said program director Kristine McCoy.

The program, which has struggled to get off the ground as organizers searched for funding, is now on the verge of welcoming its first class of physicians — the final piece of the puzzle — pending a decision on the program’s accreditation, which is expected by the end of October.

“We submitted for accreditation in November, and we had our site visit in March,” McCoy said. “Next, the committee will review the application at a meeting Oct. 14 to 16, and then we should hear about two weeks after that. I’m telling people around Halloween is our big day. Then, hopefully, we’ll have the go-ahead to recruit the students for our first class.”

Once participants have been recruited and accepted, the first class of four medical residency students would begin in July 2014, marking the end to a protracted ramping-up period for the Primary Care Training Program.

Since 2006, the training program has received $6.1 million from various sources as organizers have worked to establish the Hawaii Island Family Health Center — which serves as the primary training ground for program participants — as well as to hire health care professionals who will serve as the program faculty and staff.

Just last month, the program completed those hires by welcoming two new physicians — K. Nordling and Brian Williams — as well as nurse practitioner Lauren Butcher.

But, with a full contingent of faculty and staff, as well as students, the program will have an annual budget of $2.8 million.

Program organizers have worked with partners across the island, state, and nation to find funding — including through a TriWest Education Grant, to the tune of $1.25 million, the HMSA Foundation, which has so far donated $685,678, and the Hilo Medical Center Foundation, which to date has provided the program with $419,000.

Just this week, program organizers announced that program partner UnitedHealthcare had awarded them a grant for $250,000. Among the attendees at Monday’s announcement was Gov. Neil Abercrombie.

“The collaboration among the Hawaii Health Systems Corporation Primary Care Training Program, Hilo Medical Center and its educational partners provides critical care for our local residents and families on the Big Island,” he said. “The UnitedHealthCare grant is part of a public and private partnership that will greatly improve our local health care system, especially in rural, underserved areas.”

Lori Rogers, executive director of the HMC Foundation, said that she and other members of the community will continue to work to find funding for the training program, but added that regular support from the state Legislature will be an important part of funding the program while it is getting off the ground. The recent appropriation of a one-time boost of $1.8 million was huge, she said, and was the result of a great many people working together.

“Signing that bill was a really momentous occasion, when you look at how long we’ve been fighting for funds from the legislative body,” she said. “I really have to thank the community. Without them, and our Big Island legislators, as well as other representatives, this wouldn’t have been signed. … Someone that we especially have to recognize is Sen. Josh Green. He introduced the bill to the Senate, and without his hard work in this, it wouldn’t have happened.”

Once the Primary Care Training Program and the health center are running at capacity, the plan is for federal reimbursements for health services to eventually fill the gaps and make the program pay for itself. But until then, and without the state stepping in to include the program as a regular line item in its annual budgets, HMC will have to cover the difference from its own revenues.

At a time when costs are rising sharply and reimbursements are dwindling, it’s an expense that is tough to cover, admitted Boyd Murayama, the hospital’s medical group practice director.

“It’s something Hilo Medical Center is willing to take on, because we know how important it is to address the physician shortage on the island,” he said. “It’s just something that we have to do.”

The Primary Care Training Program is an interdisciplinary program in collaboration with the University of Hawaii at Hilo’s School of Nursing, The Daniel K. Inouye College of Pharmacy, the University of Hawaii at Manoa’s School of Nursing and Dental Hygiene, and I Ola Lahui — a health care provider focused on Native Hawaiian and rural community health disparities.

Family medicine residents will train at the Hawaii Island Family Health Center, gaining valuable on-the-job experience while providing primary care services to those in need.

The hope, organizers said, is that providing such a learning experience will not only help to educate health care providers, but will encourage them to stay and build their careers here on Hawaii Island, where access to health care is an oft-repeated concern. Studies have shown that up to 80 percent of medical residents will remain where they received their training.

Email Colin M. Stewart at cstewart@hawaiitribune-herald.com.