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+--- Thread: Doctor shortage worsens (/showthread.php?tid=18792)
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Doctor shortage worsens - Chunkster - 09-25-2017
One of the lead stories in the Star-Advertiser today is about the statewide shortage of doctors, and it seems particularly acute here on the Big Island:
http://www.staradvertiser.com/2017/09/25/business/doctor-shortage-worsens/?HSA=b509ab710c90be5ff8d97ef2b058e05b277dfa29
Hilo orthopedic surgeon Dr. Edward Gutteling is quoted as saying, “The community as a whole thinks they can go to Hilo Medical Center and they will be taken care of. That is their assumption but it’s not true,” he said. “They pretend to have a trauma system."
The article is free for now, but these typically go behind the pay wall later in the day.
RE: Doctor shortage worsens - kalakoa - 09-25-2017
had to travel to Honolulu several times a year to be treated by a specialist
"I wonder why my insurance premiums are so high?"
RE: Doctor shortage worsens - birdmove - 09-25-2017
We're with Kaiser Permanente. I have this year been diagnosed with advanced, aggressive prostate cancer. My urologist, of course, works on Oahu (but does come to Kona one day a month for lower tech stuff, meetings with patients etc. He is a surgeon also, and all the high tech stuff has to be done on Oahu. Makes it extra hard on patients like me to have to deal with round trip flights along with all the rest. Kaiser does arrange for the flights and pays for them too, and they do a good job of it, and have a shuttle to and from the airport on Oahu.
About two weeks ago, I flew to Oahu, had a surgery, and flew back the same day. The following Monday flew to Oahu for a post-op checkup, and flew home. It's not going to get any easier the sicker I get.But, right now, I'm more worried about health care issues at the federal level.
Jon in Keaau/HPP
RE: Doctor shortage worsens - leilanidude - 09-25-2017
had to travel to Honolulu several times a year to be treated by a specialist
"I wonder why my insurance premiums are so high?"
----------------
That is cheaper than having specialists based here, with such a low patient count.
RE: Doctor shortage worsens - Wao nahele wahine - 09-25-2017
quote:
Originally posted by birdmove
We're with Kaiser Permanente. I have this year been diagnosed with advanced, aggressive prostate cancer. My urologist, of course, works on Oahu (but does come to Kona one day a month for lower tech stuff, meetings with patients etc. He is a surgeon also, and all the high tech stuff has to be done on Oahu. Makes it extra hard on patients like me to have to deal with round trip flights along with all the rest. Kaiser does arrange for the flights and pays for them too, and they do a good job of it, and have a shuttle to and from the airport on Oahu.
About two weeks ago, I flew to Oahu, had a surgery, and flew back the same day. The following Monday flew to Oahu for a post-op checkup, and flew home. It's not going to get any easier the sicker I get.But, right now, I'm more worried about health care issues at the federal level.
Jon in Keaau/HPP
I can relate...I was diagnosed with ovarian cancer in January 2016...my gyn in Hilo didn't even refer me to a gyn onc...she gave me his number on post-it and told me to try to get an appointment. I ended up flying to Seattle to see a gyn onc who had treated my mom. Had surgery there and underwent half of my chemo there, then switched to a gyn onc in Honolulu. Currently NED, but flying to Honolulu for scans every three months.
Birdmove, I wish you all the best.
It would be helpful if the specialists could fly to the outer islands one day a month to see patients. I know my gyn onc flies to Maui to see patients there.
Wahine
RE: Doctor shortage worsens - kalakoa - 09-25-2017
cheaper than having specialists based here
Conservatively estimate that the specialist sees 10 patients/day. How is it cheaper to fly 10 patients to Oahu than to fly the specialist to a neighbor island?
Yes, I get the part where a surgical procedure might require facilities which don't exist outside of Oahu. I want to believe there's an actual cost/benefit study involved.
I can hardly complain: my "cadillac" insurance is so generous that my "primary care" physician is actually a first-year resident, so the expensive premiums are helping to finish their education so they can move away. Perverse incentives, anyone?
RE: Doctor shortage worsens - Chunkster - 09-25-2017
Conservatively estimate that the specialist sees 10 patients/day. How is it cheaper to fly 10 patients to Oahu than to fly the specialist to a neighbor island?
Yes, that's true, but the real calculation is about inconveniencing the patients (regardless of the high cost) rather than a rare specialist who probably already has all the business he/she can handle.
I sincerely wish birdmove well and have dealt with Kaiser urology myself. My original urologist came to Hilo regularly and wanted to keep coming, but Kaiser made him switch to Kona supposedly because of better clinic facilities that he told me he only rarely used. When this excellent doctor finally retired for good, he told me that Kaiser really wanted to close the Hilo clinic because of the large number of high acuity patients whom Kaiser management described as "unwilling to take care of themselves." They obviously never acted on this desire, but they did raise their Medicare Advantage premiums for Big Island patients 300% at one fell swoop. You can't tell me that all this stuff isn't related.
RE: Doctor shortage worsens - leilanidude - 09-25-2017
Conservatively estimate that the specialist sees 10 patients/day. How is it cheaper to fly 10 patients to Oahu than to fly the specialist to a neighbor island?
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The patients come from multiple islands and then you need nurses, etc, and the ability to have medical records available, computers, office space...
RE: Doctor shortage worsens - kalakoa - 09-25-2017
nurses, etc, and the ability to have medical records available, computers, office space...
HMSA and Kaiser both operate multiple locations...
Must be another one of those "cheap gas" problems. If interisland airfare were to double or triple, the answers would be very different.
RE: Doctor shortage worsens - KeaauRich - 09-25-2017
Hilo’s Aloha Nui Family Practice (Dr. Stefan Harmeling) recently announced that as of January 1, 2018 they will no longer participate in any insurance plans, and will only have a client phase of 400 patients, all of whom will pay a membership fee of $250/month (discounted for children, seniors and couples). This fee covers office services only, so patients will still have to pay for medical insurance to cover all other expenses.