Isle doctors propose new way to attract more physicians
Big Island physicians are starting a nonprofit designed to encourage doctors-in-training to pick the Big Island as a place to live and practice medicine.
Physician-advocates addressing the county’s worrisome doctor shortage met Saturday to review bylaws, draft articles of incorporation and prepare to file an application for nonprofit status.
It is to be called Hui Kahu Malama (“caretakers group”).
Flights, rent and transportation are costs that could be covered by the nonprofit, helping doctors in specialty training come to the Big Island.
The doctors who are forming the nonprofit want to create a pipeline of new physicians who like Hawaii County and its people so much that they’ll stick around once medical residency training is complete. Often, physicians end up practicing near the location they last trained, which is why county officials consider residency programs essential.
Medical residents are physicians who finished medical school. They train at least three years after medical school to specialize, on the Big Island, in disciplines such as family medicine and obstetrics.
Internal medicine, psychiatry and surgical residencies are now at various stages of planning and implementation.
Dr. Sydney Tatsuno practices internal medicine in Hilo. He’s one of five doctors who developed Hui Kahu Malama, hoping to mitigate the physician shortage.
Already, two medical residents have done rotations on the Big Island, Tatsuno said.
But it became clear to Hui Kahu Malama that it’s a hard sell to convince medical residents to do a rotation in elective rural medicine without financial assistance.
Medical residents look through their electives handbook “and they say, ‘This looks interesting,’” Tatsuno said. But the Big Island’s high cost of living compared to the mainland is a barrier.
In July, Mayor Harry Kim wrote to the University of Hawaii’s John A. Burns School of Medicine in Honolulu in support of creating the nonprofit.
“Please know that the County of Hawaii stands ready to support this initiative with funding, and any other means appropriate to mitigate this doctor-shortage crisis,” Kim said in the letter to Dr. Elizabeth Tam, chairperson of the UH-Manoa Department of Medicine.
The county has $20,000 of grant funding available to kick-start the nonprofit.
Dr. Mark Hiraoka, who oversees the JABSOM obstetrics residency program now offered in Hilo, said the Big Island-focused nonprofit will be broad enough to accommodate various specialties.
But, he said, an initial top priority will be internal medicine residency.
Typically, internal medicine residents get hospital-focused training. Hiraoka said the program will help internal medicine residents also get community-based experience during the program’s third year.
Internists focus on chronic disease management in adults, whereas family practice physicians treat all ages, and often practice primarily in hospitals.
“We want more internal medicine physicians as primary care physicians delivering care in Hilo,” Hiraoka said.
Tatsuno said medical residents will apply for the elective rural medicine rotation on the Big Island through JABSOM.
One doctor currently completing internal medicine residency on the mainland, Hiraoka said, is from Keaau and wants a rotation in a rural care region such as Hilo.
The nonprofit could help physicians like that one come to a community clinic on Hawaii Island for a rotation and, Hiraoka hopes, make it more likely they’ll stay on the Big Island to practice medicine when training is complete.
Tatsuno said the rural medicine elective isn’t only to teach physicians the specialty of internal medicine. It also will teach them how to sustainably operate a rural medicine practice, he said.
Hawaii County Managing Director Wil Okabe said the county wants to get the nonprofit started “as soon as possible.”
It’s an unusual effort “for county government to get involved in,” he said.
But because many physicians in Hawaii County are already in their 60s and 70s, he said the doctor shortage crisis requires county attention.
“We need to reach out and try to get these young doctors to come,” Okabe said.
“The bottom line,” Hiraoka said, “is we want more physicians in Hilo, and we will use all avenues to attract them.”
Board members of the new nonprofit include Tatsuno and Dr. John Uohara, Dr. Curtis Lee, Dr. Henry Lee Loy and Dr. Rodney Ono, who all practice in Hilo.