Cardiac care

[HADave]

There's an article in the newspaper today regarding doctors leaving the Island because of cost of living reasons. I viewed it on West Hawaii Today-online but can't link it here because of the password thing. Included are annual salaries for specialists both on The Islands and State-side. The interesting part is comparing what was said today versus what was said back in May by a Orthopedic Surgeon....30.00 bucks an hour net... 400k gross..hmmmm The fact that they claim housing is so expensive is absurd to me. Just because one gets paid 400k doesn't mean they have to have ocean front property....or 5000sqft...IMO The U.S. should get out of the military business and get into the health-care business where some real good could be done and medical costs could be better controlled by the American People. end of rant

The Star article from May can be found here http://starbulletin.com/2006/05/16/news/story04.html

There are those here who are better versed at this discussion than I and I'm anxious to hear those thoughts.

Aloha HADave

[Lee DeJongh]

Aloha HADave

I think it is hard to know too much from that article anything other than a particular doctor is frustrated and wants out of his current situation.

But in terms of government helping, I have some thoughts.
1. Is there any other situation where a person is told what they will be paid? Do you go to an auto repair and when the bill is 200 dollars tell them you are paying 74 dollars because that is what you think is enough? Do you pay 74 dollars for 200 dollars worth of groceries? And next year tell the grocer you will be paying less? That is what our government and Medicare do.

2.In 1990, our government issued warnings of a drastic physician oversupply. In reaction, medical schools cut enrollment and residency programs dropped slots. Guess what? No oversupply. Now we have a nationwide shortage. And it is projected to last for 20 years. Also a shortage of nurses and other health professionals.

3. In the mdid 90's the government changed rules and made it extremely difficult for residents to change residency programs. They can change, say, from a GP to a surgeon but they have to pay a large amount of money to do so. It used to be common for residents to change their minds and careers. What that means is that people are less willing to give some programs a chance.

4. The costs of schooling has become an issue. Debts of 250K are not uncommon. This tends to push people into the higher paying jobs.

5. Malpractice situations do have some effect. Just what, I don't know. But in Pennsylvania last year for the first time ever, NONE of the graduating medical student went into OB-GYN. Nationally every OB-GYN can expect to be sued at least every other year.

6. California has some difficulties recruiting because of housing costs.

7. In the case of this surgeon, it is pretty hard to argue with a decision that nets him as much money as he was making AND allows his time in Hawaii to be OFFCALL.
who wants to live in Hawaii AND work all the time?

8. You might be interested to know that the average work week for a resident physician 20 years ago was 110 hours per week. Now, by law, it is limited to 80 hours per week. That is still a lot.

9. I don't know what the answers are but I wouldn't look to government to improve things. Even the Canadian and British systems are begining to incorporate private medicine to cover some of the weaknesses they are experiencing.

10. It is hard to know what role housing costs play. I think the more important things are the 24/7 call situation and lack of collateral medical and logistical support. (Cited last month by the Kona oncologists who announced he was leaving to go to Texas. He was given one office person by his facility to handle calls, appointments and all billing. Impossible!)

Lee



Edited by - lee dejongh on 08/10/2006 09:10:39

Edited by - lee dejongh on 08/10/2006 09:12:18

[aline]

I have to agree with Lee, I work in an emergency room and we face the same problems .Staff shortages,retaining doctors and nurses and a lack of specialists who will take call and family practictioners who cant fit patients in so they tell them to go to the emergency room for things they should be treating.It is a vicious circle everywhere. I do think that the health care there could be improved but I used to work at Hilo Medical and I found the staff there to be very professional and caring about their patients and their care. I work at a level 2 trauma center now and if you came in with a broken finger you would probably get a splint and you would still wait days to see an orthopedic surgeon.