Hospital seeks solution to isle’s doctor shortage


By PETER SUR

Tribune-Herald staff writer

Hilo Medical Center officials will be heading to the state Legislature next year, hat in hand, hoping for a solution to Hawaii Island’s physician shortage problem.

Howard Ainsley, Hawaii Health Systems Corp.’s East Hawaii Regional CEO, pressed his case Tuesday before a committee meeting of the County Council, in an effort to enlist isle lawmakers’ support for a bill that would fund the HHSC Primary Care Training Program.

State Sen. Gil Kahele and Rep. Clift Tsuji have agreed to introduce the bill, which appropriates $2.8 million for each of the two fiscal years beginning July 1, 2013.

“The residency program is the top priority for us for bringing needed programs to the community,” Ainsley said outside a slide show presentation, which included a slide that predicted that Hawaii Island will have fewer than 300 physicians by 2020, or less than half the number needed to fill demand. A survey of island physicians released in February suggests that 32 percent of them will cease their practice within five years, adding to the urgency.

“We need a rallying call from the community to reach out to state legislators and the governor to encourage support of this program,” Ainsley said.

While members of the community might answer the call, the state government hasn’t always given the island’s physician shortage a priority in funding.

In addition to raising funds through civic organizations like the Hilo Rotary Club, as well as the Hilo Medical Center Foundation, the HHSC’s family practice residency program has stayed afloat thanks to a grant provided by TriWest Healthcare Alliance.

But with TriWest losing the federal Department of Defense grant, and its successor United Healthcare evaluating its level of commitment for the program, medical residency efforts remain on shaky ground. The residency program is in the process of being nationally accredited and will begin training physicians in 2014.

Initially, legislators had appropriated $4 million for the program, but after withholding the first funding installment for fiscal year 2008, then-Gov. Linda Lingle’s administration announced in November 2008 it would not be releasing any of the money because of declining state revenues. Since then, the local community has been left to largely fend for program funding itself.

While the current residency program is focused on bringing physicians to East Hawaii, an HHSC Primary Care Training Center would broaden the scope to include training for nurses, pharmacists and psychologists.

“It is really, really hard, particularly in East Hawaii, to find a physician,” said Kristine McCoy, HMC’s residency director, to lawmakers Tuesday. “We really see this problem as getting worse instead of better.”

McCoy’s presentation featured a number of sobering statistics showing that Hawaii Island residents have higher death rates from various causes, lower life expectancy compared to other counties and higher teen birth rates, all problems that are correlated with a lack of adequate health care access. Hospital administrators say a residency program will encourage health care workers to begin living and working in underserved areas, thereby ameliorating the crisis.

County Council members expressed support for the bill. Although only three of them are returning for the 2012-2014 session, council members-elect Greggor Ilagan and Margaret Wille watched the proceedings by videoconference from Waimea and Pahoa.

“I’m in 100 percent support of this program,” said Councilman Dennis Onishi, who pledged help in lobbying for it before the Legislature. He is the brother of state Rep. Richard Onishi, D-Hilo, Keaau, Volcano, Pahala.

In response to a question by Councilman Pete Hoffmann about reimbursement rates, Ainsley said the Affordable Care Act, also known as “Obamacare,” would likely result in lower reimbursements for the future, and the hospital would need to keep costs down.

Email Peter Sur at psur@hawaiitribune-herald.com.

 

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