Alii Health Center welcomed the first full-time urologist to practice in West Hawaii in nearly 10 years. Previously, patients would have to wait for visiting physicians to hold a clinic in Hilo or Kona and fly to Honolulu for procedures.
Dr. Jeffrey Palmgren has been a practicing urologist since 2009 and began treating patients September in Kona.
“I finished my urology residency in 2009, and after graduation, did a three year stint in the Navy — the last year in Afghanistan,” Palmgren recalled. “My wife, who was a Navy nurse, said it was time to get out, so we started a practice in Oregon.”
When they knew it was time for a change, they considered Kona since they previously vacationed here. Even though Alii Health was not actively recruiting a urologist, Palmgren approached executive director Clayton McGhan to see if he was interested in having him join their team.
“He (McGhan) told me about his vision for Alii, bringing good quality specialty care to Kona, without people having to travel. We wanted to go somewhere where we could make a change and make a difference. We looked at mission trips and third-world places, but after talking to (McGhan) we saw the need and knew we could do a lot of good here.”
Palmgren has three daughters, ages 3, 5 and 15.
“My family really pushed the idea of coming to Hawaii. The community atmosphere is something we really wanted to raise our kids in,” he said. “We wanted them to be outdoorsy. We are into surfing and fishing and we are outside all the time, so this really fit for us.”
His practice has been booming. His first referrals came from physicians in Honolulu who were treating West Hawaii men.
“We got flooded with all of those referrals and I’m seeing how much disease and how much people have been putting off urology health care for a while,” he said after only working for eight weeks.
He is also doing outreach, educating primary care providers in some of the things they can do.
“Now we are already booked into December and are already talking about expansion,” Palmgren said. He added they are hoping to add another urologist and perhaps a physician assistant in the future.
“You’re dealing with men and multiple different cultures and a lot of times, urinary symptoms are something people just don’t talk about,” he explained. “I always congratulate the guys who come in, usually by the urging of their wives, eventually they come in but for a good portion of them, I wish they would have come in a lot sooner.”
He explained that a lot of men start having the problem of frequency of urination, start seeing a lot of urgency to get to the bathroom and getting up several times throughout the night with a weak stream and think it’s just part of aging.
“I want people to know when you start having those symptoms, don’t wait. Talk to your primary doctor and see what your options are because when we are talking about urinary symptoms you can have things as bad as prostate cancer, but benign enlargement of the prostate (BPH) is far more common,” he stated. “The sooner you can get treatment for cancer or an enlarged prostate the easier the treatments are and the impacts on your life is so much better.”
He said if left untreated, patients could start getting bladder damage, become susceptible to infections, develop stones and advance to kidney damage.
“I recommend routine check-ups sooner than later,” he said.
Palmgren recommends a first time PSA (prostate specific antigen) screening at age 45. Besides setting a baseline for future testing, if something develops, there is a better chance of finding it sooner.
The vast majority of treatments can be done here on the island. Besides performing services in his office, Palmgren performs surgery at Kona Community Hospital and Kona Ambulatory Surgery Center.
He also manage kidney stones. He recalls having a lot of issues with people going to the emergency room where they had an obstructing kidney stone but couldn’t get treatment.
“I’m finding so many people who have had kidney stones for weeks or months without treatment, and you can loose your kidneys with that,” he said.
He also stressed blood in the urine is always a reason to see a urologist. That could indicate kidney or bladder cancer.
Palmgren wants to let patients know that they should not be putting off health care because of COVID.
“I definitely don’t want people to put off their health care. We are finding cancer diagnosis and treatment that have been delayed because of COVID,” he said. “We offer telehealth for those who don’t want to or cannot travel. We have a vigorous screening procedure at Alii. There’s not much of a reason to put off your health. The rooms are thoroughly cleaned after each patient. Just call. We have options for everybody. Most of the initial screening is done through telemedicine.”
Palmgren said 40% of men in their 50’s have BPH by the time they get into their 70’s, 80% of guys have it. Only a small fraction go see a doctor.
Another reason he hears about why men put off seeing a urologist is memories of older family members having very invasive procedures in the past.
“There are a lot of guys who think about their dad or grandfather who had the old Roto-Rooter procedures and don’t want to face that fate. I tell them that procedure was invented in 1901,” he mused. “Things have progressed since then.”
Palmgren is the only urologist on the island to use the Urolift, a minimally invasive treatment for enlarged prostates. Performed as a same-day outpatient procedure, including the office setting under local anesthesia. The length of the procedure varies based on the patient’s anatomy and number of prostatic implants required. It is a proven, minimally invasive approach to treating enlarged prostate that may allow men to get off BPH medications and avoid major surgery. Patients can experience rapid symptom relief, recover from the procedure quickly, and return to their normal routines with minimal downtime, patients can return to normal activity in days.
“Since coming to Kona, the outreach and welcoming from the community has been amazing,” he said.