Hawaii Experiencing a Shortage of Doctors

According to a report issued by the University of Hawaii John A. Burns School of Medicine's Area Health Education Center, Hawaii currently has a shortage of 890 doctors. Furthermore, with almost one-third of the state's doctors reaching retirement age within the next five years, this shortage is expected to increase to as high as 1,500 doctors by 2020.  Things are particularly bad on the neighbor islands, which seems to have a harder time attracting physicians then Oahu.

If someone were to look at the Hawaii medical want ads, things do not appear so bad as there are fewer then 40 positions currently open at larger hospital or medical providers. This is because traditionally a high percentage of physicians would open their own primary care practices in their neighborhoods.  However, many new graduates today prefer not to have the stress and headache of running their own business and prefer to obtain a "job" at a large hospital.  Large hospitals are simply not hiring enough new doctors to fill the needs of the Hawaiian islands.

Source: Honolulu Star Advertiser, 1-20-2015, www.staradvertiser.com
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Hawaii is the Healthiest State in the Nation

According a report released by United Health Foundation, Hawaii is the healthiest state in the nation for the second year in the row. The United Health Foundation uses a variety of factors in coming up with their rankings including state health policies, the lifestyle behavior of the citizens, availability of clinical care, and medical coverage.  Hawaii had the fewest percentage of smokers at 13.3 percent of adults, and the second lowest obesity rate at 21.8 percent of adults.  Rounding out the top five states are Vermont, Massachusetts, Connecticut and Utah.

Keith Yamamoto, the acting director of the state of Hawaii's Department of Health, stated, "I'm elated that we have gotten the highest ranking in the nation for the second year in a row. We do think it's a reflection of our community and their commitment to healthy lifestyles and environmental protection."  Governor David Ige added, "This is encouraging news and I look forward to working with our public health and health care communities to ensure access to care and strengthen prevention efforts to reduce chronic disease and injury in our state. I'm proud to say that Hawaii is the healthiest state in the nation, and we must continue to invest in our public health efforts."

For full details, please visit americashealthrankings.org

Source: Honolulu Star Advertiser, 12-10-2014, www.staradvertiser.com
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Hawaii's Public Hospitals In Financial Trouble

The Hawaii Health Systems Corps, which manages a total of 12 public hospitals in the state, has recently learned that they must contribute a total of $69.2 million to their retired workers' health benefits during the 2016 and 2017 fiscal years.  This would bring their projected budget deficit to $197.4 million after state appropriations during those two fiscal years. Edward Chu, the chief financial officer for HHSC, stated, "To understand the gravity of this, you could probably close half of the HHSC hospitals and you would not erase the deficit. To focus on cutting our way to solvency will not only require cuts of unrealistic magnitude, but also hurt the people we are charged to serve, and position us for closure within the next few years. The system is broken and we urge creative, patient-centered solutions to develop a sustainable model of care for our rural and neighbor island communities. Health care is unavoidably expensive and our current levels of service to our communities will require a greater commitment of resources than in the past, whatever the source."

Currently the largest provider of health care in the state, the Hawaii Health Systems Corp has already announced that they will be eliminating services and reducing staff in an effort to combat the $31 million budget deficit expected for the 2015 fiscal year.  However, now that they would be required to set aside money for retiree health benefits, it is unclear how they will stay financially solvent. Josh Green, the state Senate Health Committee Chairman, commented, "Once again this underscores the incredible challenges we have to make our community hospitals economically viable. This is additional evidence that we need to reform the system with a local partner that can simultaneously treat our workforce respectfully but get our system in the black. Otherwise we will see a loss of services and facilities."

Source: Honolulu Star Advertiser, 10-19-2014, www.staradvertiser.com
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Maui Memorial Hospital Seeking Buyer

The Maui Memorial Hospital in Wailuku has entered preliminary negotiations with Kaiser Permanente Hawaii and Hawaii Pacific Health, as a growing budget deficit makes it difficult for them to stay afloat.  Current estimates has the hospital facing an $11 million deficit in 2015, a $40.1 million deficit in 2016, and a $46.5 million deficit in 2017.  Wesley Lo, CEO of Maui Memorial, stated, "It gets way worse in 2016 and 2017. All of a sudden as we look to 2016 and 2017, revenues aren't projected to increase at all, then you have continued inflation and then also it appears there's going to be additional raises (for workers), The amount of losses over the next three to five years, I don't even know what you would do to stem those losses. At (a certain) point in time, what do you cut? (If) you start cutting services, you start cutting revenue."

Currently, Maui Memorial Hospital is a quasi-public hospital, and therefore if an agreement is reached, the legislature would have approve the deal.  Lo stated that he hopes to have proposals from both Kaiser and Hawaii Pacific Health in the next few months.

Source: Honolulu Star Advertiser, 10-14-2014, www.staradvertiser.com
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Attracting and Retaining Doctors Becomes Increasingly Difficult

According to the Hawaii Medical Association, the state of Hawaii is having an increasingly difficult time attracting and retain physicians.  While doctors in Hawaii get paid slightly more than the national average, the high cost of living has discouraged them from moving to the islands.  One of the biggest challenges is that Medicare payments do not reflect this cost of living differential. Christopher Flanders, the executive director of HMA, stated, "It shows when you make an adjustment for the cost of living, we're underpaid by about 30 percent. It's a substantial amount, and we've never been able to get a real clear idea as to why that is."

The state of Hawaii is facing a shortage of about 700 doctors and that number is expected to double by 2020. Hilton Raethel, the chief health officer for the Hawaii Medical Service Association, which controls about 65 percent of the state's health insurance market, stated, "Hawaii has excellent doctors and health care facilities. We know that it's important to pay these providers enough to give them incentive to continue providing high quality care to our members. But we also work very hard to keep health insurance affordable so we can make it available to everyone in Hawaii. It's a difficult balance to maintain."

Source: Honolulu Star Advertiser, 9-22-2014, www.staradvertiser.com
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Hawaii Facing a Physician Shortage

According to a report issued by the Hawaii/Pacific Basin Area Health Education Center at the University of Hawaii John A. Burns School of Medicine, the state of Hawaii is currently facing a physician shortage of approximately 700 doctors and that number is expected to double by 2020.  The report noted that Hawaii currently has 2,795 doctors but needs 3,537. Furthermore, the state has half the number of specialists necessary to support Hawaii's population.

The growing shortage is being caused by a high number of doctors from the Baby Boomer generation retiring, and the fact that the state of Hawaii does not train enough doctors in house to keep up with the demand.  As a result, Hawaii is constantly trying to recruit new doctors from the mainland, who are frustrated with the higher cost of living that Hawaii has to offer.  Josh Green, the state Senate Health Chairman, stated that he hopes to work with other lawmakers to expand the John A. Burns School of Medicine by at least 15 to 20 percent to help meet the needs of the Hawaii.  Green commented, "We need to work with a team to get more people to commit to primary care. If people continue to leave the islands, our system will crash."

Source: Honolulu Star Advertiser, 9-6-2014, www.staradvertiser.com
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Castle Medical Center to Spend $28 Million in Renovations

Castle Medical Center has announced that they will be spending approximately $28 million to renovate their hospital and expand its emergency room.  Jasmin Rodriquez, the Castle spokeswomen, stated, "We continue to not only grow with new programs and services, but our ER has gotten more visits than we ever had before. With the growth of the Windward side and, of course, the elderly population getting older, we needed to really expand our ER services to meet the needs of our community."  The emergency room will expand from 18 beds to 25 beds. Renovations will begin in November of this year.

Source: Honolulu Star Advertiser, 7-16-2014, www.staradvertiser.com
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St. Francis Healthcare System of Hawaii Scheduled to Reopen Liliha Facility

Over two years ago, the St.Francis Healthcare System of Hawaii was forced to close down its acute-care hospital facility in Liliha.  After a long company restructuring, they are now planning to reopen their Liliha location as a skilled-nursing facility with a total of 119 beds.  According to Jerry Correa, president and CEO of St. Francis, additional services would be added in the future, including a senior community center, assisted living, adult day care, and independent-living townhouses.  Correa stated, "We're repositioning this campus to what is the right fit for the campus in the community. We're targeting the population post-acute care. We met with caregivers, geriatricians and patients and clients in the neighborhood. We said, 'This is what we're going to build, what do you think?' Overwhelmingly what we got was, 'When? Hurry up.'"

Bruce Bottorff, the spokesman for AARP Hawaii, commented, "As Hawaii ages, access and affordability of long-term care services become increasingly important. Most Hawaii residents tell us they want to stay in their homes for as long as possible, but when the preferred option of remaining independent at home is no longer practical, it can be daunting for families to find the living environment that best meets the needs of an aging loved one. We welcome the development of affordable options that deliver the high quality of care our seniors deserve."

Source: Honolulu Star Advertiser, 6-14-2014, www.staradvertiser.com
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Health Care Clinic in Kalaheo, Kauai to Close in September

The Hawaii Health System Corp. was announced that they will be closing their primary care clinic at Kala­heo, Kauai in September 2014.  Services and patients will be transferred to their facility at Port Allen, approximately four miles away.  Interim Chief Executive Officer for Kauai for HHSC, Scott McFarland, explained that the inadequate funding from the state of Hawaii and the rising costs of medical expenses forced the company to make this decision.  McFarland stated, "Neighbor island health care as a result of this lack of funding and financing is in jeopardy. The region requires a very high level of subsidy currently. Kauai is more of a canary in the coal mine for the fiscal health of the statewide system."

Alice Hall, the President and CEO for the entire Hawaii Health System Corp., added that medical companies can no longer sustain the rising costs of health care while continuing to provide the same levels of service.  Hall stated, "The state can't afford to come up with more and more money, and we can't absorb these costs. We're going to have to explore all plausible ideas on how to cut expenses, which may include cutting services and reductions in force. We believe all our services are essential, but we must examine all options in order to make up for the huge deficit that we're anticipating for next year."

Source: Honolulu Star Advertiser, 5-20-2014, www.staradvertiser.com
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Queen's Medical Center West Campus Scheduled to Open on May 20, 2014

The Queen's Medical Center has announced that they will be opening their Ewa hospital location on the west side of Oahu on May 20, 2014.  The $100 million newly renovated facility will have over 80 beds including 23 beds in the emergency room.  They will also offer inpatient and outpatient surgery, imaging, cardiology and specialty clinics.

It has been over two years since the Hawaii Medical Center-West facility was closed their doors due to bankruptcy, leaving many residents on West Oahu concerned about emergency care.  Queen's acquired the facility in December 2012 and, at tat time, planned to invest over $70 million in the property.  However, Queen's ended up spending close to $30 million more than expected do to the fact that they needed to repair plumbing and wiring, and add new elevators and a new roof.   Chief Operating Officer for the West Oahu campus, Susan Murray, stated, "As the needs of the community grow, we'll grow right along with it. Our partners in health in this community are thrilled that we will be opening, because their ER departments have been overburdened and the length of time getting from (West Oahu) all the way into town is really an extensive distance. It can really add 30 minutes if you had to go past this site. Time is health, so when you urgently need care, the sooner you get to that care, the better."

Source: Honolulu Star Advertiser, 5-14-2014, www.staradvertiser.com
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Kapiolani Medical Center for Women & Children Plans Massive Expansion

The Kapiolani Medical Center for Women & Children has announced that they have already raised a total of $34.9 million to expand and rebuild their facility in Honolulu.  Kapiolani Medical Center is the state's only full-service children's specialty hospital, and hopes to create a new facility with 207 beds and 66 bassinets. Chief Executive Officer, Martha Smith, stated, "As a not-for-profit hospital, we rely on philanthropic support to help us carry out our vital mission. Our generous donors have demonstrated that with the help of our community, Kapiolani can make even greater advancements to improve health-care access and quality of life for all of Hawaii's keiki and their families."

Construction of the new neonatal and pediatric intensive care unit has already broken ground.  It is scheduled to open in March 2016.

Source: Honolulu Star Advertiser, 5-3-2014, www.staradvertiser.com
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Hawaii Healthiest State in Nation in 2013

According to America's Health Rankings, Hawaii is the healthiest state in the nation in 2013. The study is sponsored by the United Health Foundation in partnership with the American Public Health Association and Partnership in Prevention, whose goal is to improve health across the country.  This top ranking is welcome news to Loretta Fuddy, the state Health Director.  Fuddy commented, "Hawaii's No. 1 ranking is encouraging and reminds us how fortunate we are to live in the Aloha State.  I really think it's a testament to the support that we do have from Gov. Abercrombie and the Legislature in helping us build back services. No one receives these awards by themselves. All of what we do is in partnership with the private sector."

Vermont, which ranked first in 2012, dropped to second.  Minnesota was the third healthiest state.  The three least health states were Louisiana, Arkansas and Mississippi.

Source: Honolulu Star Advertiser, 12-11-2013, www.staradvertiser.com
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Two Kauai Hospital in Desperate Need of Funding

Kauai Hawaii Health Systems Corporation is requesting $7.3 million in emergency funding from the state of Hawaii to keep two rural hospital on Kauai afloat until the spring of 2014.  The two hospital are the Samuel Mahelona Memorial Hospital, which has the only inpatient psychiatric unit on the island, and the Kauai Veterans Memorial Hospital.  The Kauai Hawaii Health Systems Corporation also manages three clinics in Waimea, Kalaheo, and Port Allen.  The Mahelona hospital and the Kauai Veterans Memorial Hospital serves approximately 7,000 emergency room patients at each facility per year.  Both hospitals also have long term care patients and some acute care patients as well.

According to the acting president and CEO pf the Kauai Hawaii Health Systems Corporation, Alice Hall, services may be cut if state lawmakers are unable to approve the funds. Hall commented, "They're not going to make it through spring without the money."  Long-term financial solutions are currently being discussed including the possibility of creating a public-private partnership with another hospital system.

Source: Honolulu Star Advertiser, 10-30-2013, www.staradvertiser.com
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Second Hospital to Be Built on Maui

Newport Hospital Corp has announced that they will be building a new hospital on West Maui.  According to plans, the 14.9 acre medical facility will include a 25-bed critical access hospital, a 40-bed skilled nursing facility, a 24-hour emergency room, and a 30,000 sq ft medical office building.  This will Maui's second hospital and will still transfer critical cases to Maui Memorial Medical Center, about an hour drive away. President of West Maui Hospital and Medical Center Foundation, Joseph Pluta, commented, "I've lived here in this community, and I've seen people die unnecessarily because of the isolation from emergency medical services.  If you live here and your family was living here, you'd be scared to death because it's not safe." Pluta has been pushing for the building of a hospital in West Maui for the last 15 years.  The center is expected to cost between $65 to $70 million to construct and will open in the middle of 2016.

Source: Honolulu Star Advertiser, 10-8-2013, www.staradvertiser.com
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CVS Decides to Open In-Store Clinics

CVS Caremark Corp. has announced that they will open "MinuteClinics" in seven of their Longs stores on Oahu. MinuteClinics will treat minor illnesses and provide preventative health services such as flu shots and tetanus shots, and will be staffed by nurse practitioners.  They will be open seven days a week and no appointment is necessary to see a nurse practitioner.  The Longs Drugs Store location that will have MinuteClinics will include Moiliili, Kahala, Aiea, Kapolei, Hawaii Kai, Kaneohe and Kailua.  The company stated, "Hawaii's Long's locations are an important milestone in MinuteClinic's national expansion plan to open 150 clinics nationwide in 2013."

Source: Honolulu Star Advertiser, 9-24-2013, www.staradvertiser.com
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Kaiser Unveils New Pearlridge Center Clinic

Kaiser Permanente Hawaii will be opening a new $12 million clinic at Pearlridge Center in Aiea on October 4, 2013.  The clinic will be approximately 7,000 sq ft large and will offer family medicine and pediatrics, as well as a pharmacy and laboratory services.  The property is located on 98-1005 Moanalua Road and would have about a dozen full-time employees there initially. A Kaiser spokesperson added that the long term goal would be to expand the clinic to 12,000 sq ft.

Source: Honolulu Star Advertiser, 9-3-2013, www.staradvertiser.com
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Hawaii Has Low Obesity Rate, But Trend is Still Not Positive in Some Communities

According to a report released by the Trust for America's Health and the Robert Wood Foundation, a total of 23.6 percent of adults in Hawaii are considered to be obese, which is defined as having excess body fat that could have an adverse effect on health and life expectancy. This number actually ranked Hawaii has one of the top five states in country with the lowest obesity rate (47th lowest), but experts warn that the rate is still climbing in general.  Furthermore, obesity rates among some communities, especially the Native Hawaiians and Pacific Islanders, are extremely high.  According to the study 40.8 percent of Native Hawaiian adults are obese.

Director for the state of Hawaii's Department of Health, Loretta Fuddy, stated, "While Hawaii has a lower obesity and chronic disease rate relative to many other jurisdictions, our state is following the same troubling path as the rest of the nation.  Nearly one-quarter of Hawaii adults are obese, and some population groups have much higher rates. Obesity is an epidemic and we cannot afford to sit back idly on this issue.  Obesity is costly to our state and can lead to diabetes and other chronic conditions later in life."  Fuddy noted that the state spends about $470 million on obesity-related medical costs and $770 million on costs associated to diabetes.

For strategies designed to curb the obesity epidemic, go to: health.hawaii.gov/wp-content/uploads/2012/11/DOH_PAN2020_LO.pdf

Source: Honolulu Star Advertiser, 8-22-2013, www.staradvertiser.com
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Kaiser Permanente's Moanalua Hospital Allows 24-Hour Visiting Hours

The Kaiser Permanente's Moana­lua Medical Center & Clinic has created a new policy allowing friends and family members to visit patients 24-hours per day. Previously, the hospital only allowed visitors from 11 AM to 8 PM, but new research has shown that access to friends and family increases recovery time significantly.  The hospital staff issued a press release that stated, "Research shows giving family members and close friends greater access to patients throughout the day helps speed up the recovery and increases satisfaction with the overall treatment process.  In addition, loved ones can provide important information to hospital staff when the patient is unable to communicate."

Kaiser spokeswoman, Laura Lott, added, "It's just kind of the evolution.  Every industry is kind of going more towards putting customers at the center of what they do. Our patients are our customers, so we need to understand what a good experience looks like from their point of view. That's going to deliver better care and make patients happier. If they're happier they're going to heal faster."

Patients will have a right to state who they want to have visiting them, when they can come by, and how many visitors they want.  Furthermore, doctors and nurses will have the authority to determine what is best for a patient and may limit visiting hours on a case by case basis.  Children will be required to accompanied by an adult when seeing a patient.

Source: Honolulu Star Advertiser, 8-20-2013, www.staradvertiser.com
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Big Island Hospital May Enter Partnership with Queen's Medical Center

The Northern Hawaii Community Hospital, located in Kamuela, Big Island of Hawaii, has announced that it may request a formal affiliation with The Queen's Medical Center on Oahu.  The Big Island of Hawaii hospital stated that new requirements from Medicare and insurance companies, as well as the need to improve their information technology system and create more overall financial stability has lead to this request.  If Queen's agrees to all of the terms, they would be given the responsibility for appointing the hospital's board.  The Northern Hawaii Community Hospital hopes to make a final determination on a partnership by the end of this year.

Source: Honolulu Star Advertiser, 8-3-2013, www.staradvertiser.com
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Learning Hula Has Great Health Benefits

A new study done by researchers from the University of Hawaii's medical school and Queen's Medical Center has discovered that learning hula can help lower blood pressure for people with persistent hypertension and help rehabilitate patients after heart attacks or cardiac surgery.  Mele Look, the director of community engagement at the medical school's Department of Native Hawaiian Health, stated, "It is both appealing as well as effective. We found that they were affected not only on the physical front, by all that movement, but there was evidence of emotional and maybe even spiritual benefits that participants were getting.  Hula has never been used before as an intervention in a scientific research study.  We wanted to understand it both from the cultural side as well as from the Western scientific side."

In one study, patients leaving the hospital after cardiac events such as heart surgery or heart attacks, were assigned either usual medical care of 12 weeks of hour long hula classes, three times a week.  The study showed that those taking the hula class had better physical improvement as well as the feeling for increased social support.  Mele Look added, "People in the group often felt no one else really understood what they went through or how they were feeling, how vulnerable, facing their mortality.  In the environment of a hula class, they felt supported, and it happened very fast and it lasted."

Mapuana de Silva, the kumu hula (hula teacher) for the cardiac patients, noted that 95 percent of her students had no prior hula experience.  De Silva stated, "Most of them are older, they think, ‘I'm too old, it's too late. Because they were getting hula as a result of their heart incident, I think it just helped them relax and enjoy the exercise and the atmosphere of hula. Through that, they almost didn't realize how much their health was improving.  We weren't sure, going into the study, if the students were going to be able to have a halau kind of family, spiritual, emotional experience, but they all did."

Source: Honolulu Star Advertiser, 8-2-2013, www.staradvertiser.com
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