HILO — State Sen. Josh Green, D-Kohala, Kona, says he’d never even heard of Ka‘u before considering taking his first job as a primary care physician there as a young doctor, fresh from completing his medical residency.
“I came straight from Pittsburgh. It was my first real job. Most of my friends and I, we had between $150,000 and $200,000 in debt. Typically, you’re 30 years old when you finish your residency. You’ve never had a job, no money to buy a house or a car, and you’ve got this debt,” he said. “A lot of physicians, they try to make a big living immediately in a specialty to pay off that debt.”
Instead, he says, he was lucky enough to qualify for a four-year, National Health Service Corps scholarship that provided him with between $25,000 and $30,000 a year to help repay his medical school loans. That allowed him to take a lower-paying job as a general practitioner in an underserved, rural community that was in desperate need of health care options. He dove into his work in Ka‘u, and soon was amazed by the sheer number of patients he was seeing on a daily basis.
That was in 2003, and he hasn’t looked back since, he said. Without that scholarship, he added, Green likely would never have come to the Big Island, chosen to make a life here, or ended up serving Big Isle residents as their doctor and senator.
It’s an experience that made a huge impact on his life, he said, and he hopes to recreate that with many more doctors through a new loan repayment program launched Thursday by Gov. Neil Abercrombie, leaders from the University of Hawaii at Manoa John A. Burns School of Medicine, School of Nursing and the Hawaii health industry.
The Hawaii Health Corps has been a labor of love for Green for the last five years, he said, and it finally came to fruition with the approval of his bill, Senate Bill 596, this past legislative session. The new law allows for the state to provide up to $40,000 per year, tax-free, to pay physicians’ educational expenses if they elect to work in Hawaii’s most needy communities.
“Now, as a state, we’ll have a weapon in our arsenal to recruit doctors better than almost any other state,” Green said.
At a press conference in Honolulu on Thursday, Abercrombie announced partnerships between the state and federal governments, as well as private donors, would help to get the loan repayment program off the ground. Together, The Queen’s Health Systems and the Hawaii Medical Service Association have pledged $150,000 each year for two years to match funds requested from the U.S. government through the Health Resources and Services Administration.
“This new program will help address a critical shortage of health care providers in our state in front line, primary care, where it is most needed,” Abercrombie said. “We are building on federal initiatives to transform health care and working with community and industry partners to create opportunity to expand health services.”
Green explained that the plan is to start off small, with three scholarships the first year, more than 12 the second year, and more than 25 the year after that.
“In the coming years, it’s going to have a gigantic impact,” he said. “We hope to expand this to dozens of positions. … I hope to eventually have up to 100 physicians participating in the program.”
UH medical school professor and Hawaii Area Health Education Center Director Kelley Withy will oversee the loan repayment program. She said Thursday that loan recipients will be chosen by a committee made up of representatives of the Director of Health, the school and the UH-Manoa nursing program dean.
“Primary care is the area of most need and fortunately, most of (the medical school’s) students (64 percent of M.D. Class of 2012) choose to practice in primary care fields. Yet, for many students, primary care can seem the least attractive option — at least financially,” she said. “Physicians serving in primary care usually earn less than M.D.s in specialties. Students burdened by heavy educational debt may be less likely to choose primary care for that reason, adding to the physician shortage.”
According to data provided this year by the Hawaii Health Workforce Assessment, the state is suffering from a shortage of 600 physicians, half of which are needed in primary care. Additionally, the state lacks about 150 primary care nurse practitioners and physician assistants.
