The recent death of Hilo’s Dr. Djon Indra Lim highlights an ongoing shortage of cardiologists on Hawaii Island.
For 40 years, Lim — who died April 15 at age 77 — filled a vital role in East Hawaii, and his loss is a major blow, said Hilo Medical Center Interim CEO Dan Brinkman.
“Dr. Lim’s services to the community and the hospital have been invaluable for years. He was the role model of a ‘gentleman doctor,’” he said.
In addition to handling emergency cases one week a month in the HMC emergency room, Lim had about 1,600 regular patients.
“He saw 13 to 15 patients a day, on top of being on call,” said Mary Lynn Demerly, a receptionist in Lim’s office.
Finding care for Lim’s patients has become a priority for HMC as it works to recruit a new doctor to the island.
“Those are the ones we are making sure are cared for during the transition period,” Brinkman said. “We continue to provide cardiology services for those patients, and we continue to have two cardiologists working at the hospital to support them. … The hospital is fully committed to maintaining its current level of cardiology services.”
The hospital currently has one full-time cardiologist, Dr. Nathan Zilz, on staff, who is supported by private practitioner Dr. Don Matsuura. The two currently are splitting duties being on call to cover the hospital’s emergency room, Brinkman said.
Cardiology specialists are some of the most sought after physicians to fill the need of patients on the Big Isle.
Hawaii County has fewer than half the 14 cardiologists it needs to meet demand, according to a January report by the University of Hawaii Physician Workforce Assessment Project. The statewide shortage in 2014 was pegged at 33.2 percent, while Hawaii Island’s was 58.7 percent.
Patients in West Hawaii also have few options as they seek physicians who can perform ongoing care and monitoring of their heart conditions, according to Dr. Richard McDowell, medical director at Kona Community Hospital.
The hospital has no cardiologists on staff, he said, and only two on the west side of the island to whom they can refer patients.
“Our resources are limited,” he said.
The concern isn’t so much centered on emergent care situations, where patients might show up at the emergency room after a heart attack, he explained.
“Currently, we’re OK in that area,” he said. “When we have someone come in with an acute heart attack, we’ll do the same things that most hospitals around the country would do. We’ll treat them with thrombolytics (to dissolve blood clots) … and then transfer them to a center (such as Queen’s Medical Center on Oahu or Maui Memorial) that can do catheterizations.”
But patients who require regular follow-ups, testing and other ongoing care are left with little choice apart from seeing specialists on other islands, he said.
For years now, the hospital has hosted a regular clinic in which a cardiologist from Maui Memorial Medical Center’s Maui Heart and Vascular Health Clinic would visit Kona and provide on-site comprehensive and noninvasive services, McDowell said. However, as the Maui facility continues to wrestle with pressing financial woes, the hospital recently ended the Kona program.
“They would send a cardiologist to Kona once a week for a clinic and we would give them space. That clinic was fairly busy,” he said. “… But that service is now gone. They withdrew that service … three or four months ago. Since that time, we’ve been working to reinstate the cardiology clinic for outpatients. We’re talking to a number of cardiologists about that.”
McDowell said he’d like to form a partnership with Queen’s to provide visiting physicians on a regular basis for clinics similar to those previously offered by Maui.
Email Colin M. Stewart at cstewart@hawaiitribune-herald.com.
