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+--- Thread: Cardiac care (/showthread.php?tid=513)
Cardiac care - astridf - 07-09-2006
Desperately seeking information on cardiology in Hawaii. My husband and I are thinking of moving to Hawaii, but we need to know the healthcare situation and specifically cardiac care. Any comments?
RE: Cardiac care - Kapohocat - 07-09-2006
All I know is that my former boss had a heartattack less than a month ago and testing for the cause had to be done on Oahu.
Anyone else's thought?
-Cat
Catherine Dumond
Blue Water Project Management
808 217-7578
"We help make building your dream home a reality"
RE: Cardiac care - Howard - 07-09-2006
We loved Puna and would be happy to live there, but the state of health care on the island is the main reason we are unwilling to do so. Limited cardiac care is only one of the problems; at least as of March there wasn't a single neurologist practicing anywhere on the Big Island.
If you have no pre-existing conditions, and no known factors making you predisposed to develop any in the near future, you may feel that the obvious joys of living in Puna are worth the risk of dealing with an unexpected emergency some time in the future. If you already have significant health problems, it is a lot safer to live somewhere else.
Howard
RE: Cardiac care - Punamom - 07-09-2006
Health Care? Mangle care maybe.
I've heard so many horror stories about the health care on the Big Island.When my husband broke his wrist we went to the hospital they wrapped it up gave him lots of pain killers and a number to a Orthopedic Dr. He had to wait 5 days to see the doctor to get the bone set and have a cast put on.
UNBELIEVABLE!! Apparently there is only one maybe 2 bone docs around.
One of my sons has a heart murmer that needs to be checked yearly and every year we have to fly over to oahu to have this done.Our health care provider is KAISER if you can believe that one (but at least they pay for the plane ride).
I'd say its pretty 3rd world here.
RE: Cardiac care - huligirl - 07-10-2006
Thanks for the heads up Punamom. A friend who broke a finger was told to buy a popsicle eat it and tape the finger to the popsicle stick! That would be called a 3rd world solution but it did work much to my friends amazement and horror of the suggestion!
What type of specialists are there? Pediatricians, Internists, GP's, urologists, gynecologists?
My physician offered to transfer our records to a medical school friend in Hilo, no problem. Well he emailed me two weeks later to say his friend couldn't possibly accept us as patients as he already had 12,000 patients! My physician says that 6,000 patients is the absolute limit for health care to be efficient and manageable.
Mahalo, huligirl
RE: Cardiac care - JerryCarr - 07-10-2006
Aloha, all. The healthcare situation here on the Big Island is one of the biggest downers, if not the biggest, to living here for some people. The shortage of physicians willing to live and work on the East side baffles me. It seems like more doctors would catch on to all the great reasons to want to live here, but the lack of primary care resources seems to get worse as our population grows. The politicians occasionally shake their heads and moan along with the rest of us, but seem unable to do anything. Is the cost of doing medical business here outrageous for some reason?
Also, it seems odd that there are apparently several plastic surgeons on the island who feel a need to advertise in the paper for business, but no cardiologist. It impresses me as somewhat unfair for HMSA, the local Blue Cross entity, sells policies to folks when none of their doctors in Hilo (or anywhere nearby) are accepting new patients.
Thank goodness my partner and I have only "nuissance" medical issues and no major problems. I chose Kaiser because they were available, and I have to say that my care after a year and a half has been acceptable. This is despite their reputation for being cost-obsessed. I should add that it helps to be assertive if you need to be seen right away by the doc rather than wait for the next available appointment. If you are really ill and need to be seen right away, you have to make it very clear to the triage nurse.
To their credit, all the insurance/treatment entities liberally ship folks to Oahu for things that can't be handled here. One wonders, however, how many people could have been saved irreparable harm by being served more quickly locally.
Do other isolated communities of similar size in the USA have the same sorts of issues? Would we feel as put upon if we could simply drive to Honolulu? Lots of room for discussion here.
Jerry
RE: Cardiac care - Lee DeJongh - 07-10-2006
I am currrently on the medical advisory board for an HMO and yes these are problems faced by others. In our HMO we require and are required by national accrediting agencies (Kaiser is the same) to have certain levels of access. It is sometimes difficult here on the mainland to achieve these levels but our task is relatively easy compared to yours.
I don't have the figures in front of me but a neurosurgeon, for example, requires a population of 80,000. So the BI should have two. But if there are two then they are on call 50% of the time, which is unacceptable. Call should not be more than 1 in 4 . and so it goes. Rural, isolated areas on the mainland have a lot of difficulty. And alot of patients are medflighted from rural areas.
On top of that, there are significant shortages of certain types of physicians, for example, cardiologists. A good cardiologist requires a hospital with cardiac cath capabilities and a heart surgeon and a population base that is big enough to keep their skills current and the BI popiulation is just not big enough and it never will be.
Right now there is a nationwide shortage of a lot of different specialists. Add to that that the salaries for docs in Hawaii are about 50% the mainland and the workload 2 to 3 times greater, there is powerful incentive for doctors not to come to Hawaii to practice.
Edited by - lee dejongh on 07/10/2006 09:28:15
RE: Cardiac care - Carolann R - 07-10-2006
Hi all...I actually stole this quote from the dark side from Phyllis...it seemed pertinent:
_______________________________________
My husband and I are members of Kaiser and he has coronary arterty disease post a triple bypass and placement of 4 stents. He sees a Kaiser cardiologist in either Kona or Hilo every 6 months, or whenever he needs to. This and other specialists fly over from Maui or Oahu once a month to see their Hawaii Island patients. The angiograms and surgeries were all done at the Kaiser hospital at Moanalua (Honolulu). Our primary care physician is at the Waimea Kaiser Clinic. She has sent my husband to the No. Hawaii Community Hospital several times prior to being flown over to Honolulu and he received great care there. I can't speak for the cardiologists in private practice, but we are confident in the care that he receives for his heart disease from Kaiser. I have to say that in addition to heart disease, he has 2 other serious, chronic, health conditions that he also receives great care for from Kaiser specialists. We are very grateful that we have Kaiser. I hope that this information is helpful to you.
____________________________________________
Carrie
http://www.cafepress.com/dreamhawaii
http://www.hellophoenix.com/art
RE: Cardiac care - Lee DeJongh - 07-10-2006
Kaiser is a good outfit with a good reputation nationally. They have been in the business along time and have an interesting philosophy of care. They must believe that it is most cost effective for them to deliver care the way they do, by either sending the physicians periodically from island to island or transferring the patient.
RE: Cardiac care - JerryCarr - 07-10-2006
Thank you, Lee, for some very helpful information and perspective. Any ideas why docs in Hawaii only make 50% of the income of mainlanders? From what I can tell from very limited observation, insurance premiums and service fees seem comparable to the mainland, so your take on this particular piece of the puzzle might again be enlightening.
Aloha,
Jerry