Sunday | September 25, 2016
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Doctor shortage in Hawaii worsening


  The physician shortage in Hawaii is growing, says a John A. Burns School of Medicine researcher.

  A number of factors cause the shortage, said Dr. Kelley Withy, director of the Hawaii/Pacific Basin Area Health Education Center, which is part of the medical school.

  “We don’t have enough training positions to train enough doctors here,” Withy said. “We have to recruit them from the mainland. About half of the ones who do come here leave within a few years.”

  Other reasons doctors don’t stay include the inability for a spouse to find employment, the need to care for ailing parents on the mainland or finding the medical community in Hawaii isn’t what they expected, particularly with regard to available technology and specialists, Withy said.

  On Hawaii Island, the latest report showed a 194-doctor gap. That’s up from a 150-doctor deficit, according to a report from Withy released last year. The statewide doctor deficit in the older report was 669 physicians. In this year’s report, the gap increased to 747 doctors.

  Doctors also don’t earn as much in Hawaii as they do on the mainland, Withy said.

  Dr. Alistair Bairos, who has been practicing in Kona since 1985, said he’s seen a lot of doctors come and go over the years. The last family practitioner to come, and stay, other than ones working for Kaiser Permanente or federally qualified health centers such as West Hawaii Community Health Center, arrived in 1991, Bairos said.

  The impacts of the physician shortage hit people who move to Hawaii and need a doctor, Bairos said.

  They call around trying to get a doctor’s appointment and they can’t get one,” he said. “A lot of doctors just do not take new patients. They’re swamped.”

  Waits to see a specialist can be even longer than the wait for a family practitioner, Bairos said. Specialists who are based on Oahu might see patients here, but require those patients to travel to Oahu for surgical procedures, Bairos said. That ends up taking away revenue from local hospitals.

  A major factor, mentioned by both Withy and Bairos, is the student loan debt with which doctors now graduate. Bairos said a hospitalist — a doctor who works for a hospital, seeing patients there — might have $250,000 to $400,000 in debt after 10 years of schooling.

  Withy said the state began offering this year a loan repayment program for doctors who agree to practice in rural areas here. This year, the program is limited to six physicians. Next year, she’s hoping to expand it to 15. It’s not a huge number, she said, but it may slowly make a dent in the shortage.

  Withy is putting on a conference today on Oahu to talk with doctors, other health care providers, hospital administrators and government officials about the physician shortage.

  “My goal is to help doctors who are here be happy and stay here,” Withy said.