There’s no question Hawaii County has a physician shortage, Kona Community Hospital Medical Director Kathleen Rokavec said.
How big of a shortage is a matter of interpretation, however.
A report, issued by the Hawaii/Pacific Basin Area Health Education Center, says Hawaii Island could use another 152 doctors, mostly primary care physicians. That’s a 32 percent shortfall.
Rokavec said fluctuating demand makes it more difficult to quantify the shortage. She added the report’s statistic that the Big Island needs another 17 anesthesiologists doesn’t match the hospital’s experiences, which don’t include a significant lack of anesthesiologists.
“You can’t just take a point in time and look at it,” Rokavec said. “If our (operating room) was running 14 hours a day, we’d definitely need (more).”
According to the report, which looked at demand and availability in 2010, the statewide shortage is 669 doctors, a 19 percent gap.
The methodology behind the report, Hawaii Medical Service Association’s Senior Vice President Hilton Raethel said, was to take the number of particular types of doctors and determine how many of those doctors are available per 1,000 people. Researchers then applied that ratio to Hawaii’s population. The results were more of a “macro” picture than an exact calculation for the physicians needed, he said.
Rokavec, who was aware of the report but not familiar with the methodology, noted another figure that seemed to far overestimate the number of certain specialists, in this case neurology, needed. The report suggested Hawaii Island needed six additional neurologists. West Hawaii does have a new neurologist, she said.
“The population just would not support (seven),” she said.
Rokavec said Kona Hospital and Alii Health are working with other Hawaii Health Systems Corp. hospitals, such as Maui Memorial, to find ways to offer enough of a population base to support some specialities the islands individually could not.
Raethel said HMSA has also stepped in over the last several years, flying HMSA members from neighbor islands to Oahu for treatment or flying doctors from Oahu to the neighbor islands. In 2010, HMSA paid for 1,200 flights from Hilo and 770 flights from Kona to Oahu. The same year, he said, the insurance provider paid for 1,200 physician flights from Oahu to neighbor islands.
Kona Hospital and Alii Health have had some recent recruiting successes, Rokavec said, including signing a contract with a urologist who should begin working at Alii Health by late summer. Officials are also talking with a cardiologist, an obstetrician/gynecologist, an orthopedic surgeon and a pulmonologist.
Those aren’t just potential leads, she added, but “are actual people we’re talking to. We’re very optimistic.”
The recent recruiting successes, she said, is mostly the result of the hospital’s and Alii Health’s “focused efforts” and a bit of good luck.
HMSA since 2007 paid $1.8 million in recruiting and relocation costs for doctors moving to Hawaii or from Oahu to neighbor islands, Raethel said.
The most-needed doctor for all the islands, based on the mainland ratio, was primary care physicians. Raethel said HMSA is in discussions with the University of Hawaii’s John A. Burns School of Medicine to see what the insurance provider, the state’s largest, can do to guarantee all of the primary care slots in each incoming class are filled, and that graduates, especially those with Hawaii ties, choose to stay in-state to practice medicine.
“It’s not just about the money,” Raethel said. “There is a variety of factors that make a place attractive.”
Messages left with the study’s author were not returned.
