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Hawaii doctor shortage getting worse
#1
http://www.hawaiitribune-herald.com/news...ge-worsens

More than half of the doctors in Hawaii will reach the retirement age of 65 within the next decade, according to a new report submitted Thursday to the state Legislature.

The University of Hawaii Physicians Workforce Assessment says of the 8,900 physicians licensed to practice in Hawaii, roughly 2,903 full-time physicians are actually practicing medicine. The report emphasizes that supply of new physicians is not keeping up with demand and Hawaii is at a critical juncture.

“Demand grows by 50 … per year, and we lose 50 physicians per year, so we need 100 per year to maintain the current staffing levels,” the report concludes.

Who, then, will be your doctor if about half retire or cut the amount of time they serve patients in the next decade?

“We do have this big population of physicians that will be at retirement age fairly soon,” said Dr. Christopher Flanders, executive director of the Hawaii Medical Association.

Flanders, 60, has himself taken on an administrative role with the HMA, meaning he isn’t currently treating patients in his specialty of neurological pathology — something that likely will be increasingly true in the next few years for many of the state’s physicians near retirement.

“I live on the Big Island. So I live with that shortage. It’s concerning,” Flanders said.

According to the report, 15 percent of the state’s physicians already are between ages 66 and 75. The university estimates Hawaii needs the equivalent of an extra 707 full-time physicians in order to meet current patient demand.

In Hawaii County, it is estimated the population needs three allergists, but there is only one. Six infectious disease specialists, three neurosurgeons and three neonatologists are needed. But there are no physicians in the county with those specialties.

Primary care physicians are among those who will be in the biggest demand statewide. And, in Hawaii County, the university estimates there’s already a shortage: the need is for 180 to meet patient demand, but there are only 143.

Flanders said part of the reason is the cost doctors pay to complete medical school.

“When they walk out of medical school with a quarter-million dollars in debt, they have to be careful about what positions they take,” he said.

Flanders said the medical association thinks the Legislature should take a dual approach.

First, he said, legislators should consider the long term and start a rural-medicine education program.

Even if that were to start tomorrow, he said, “it’ll still be seven years down the road” because it takes four years for medical school and then a three-year (at least) residency program to begin treating patients independently.

Secondly, Flanders said, the Legislature should look short term at where Hawaii is falling short in terms of recruitment and retention.

The Legislature and medical organizations will need to figure out how to make jobs more available for physicians’ spouses and to address student debt new physicians typically carry.

“It just doesn’t compete in recruiting. A lot of times they don’t stay very long,” Flanders said.
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#2
Doctors don't stay here because the majority of the patients have either Medicaid (QUEST) or Medicare, which has reimbursement rates well below what private insurance reimburses. You cannot run a real practice on those reimbursement schedules without extra help. Bay Clinic is a good example. They receive a majority of their funding from grants.
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#3
Hawaii is not the only state having this problem, it's everywhere in the U.S. More government involvement in healthcare, the less your going to get. Couple that with the huge increase in malpractice insurance, sky high medschool debt and you can see being a doc just isn't worth it anymore.
Best you can hope for is a doc with a name you can't even pronounce.
Puna: Our roosters crow first
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#4
More government involvement in healthcare, the less your going to get.

Government mandates insurance, not actual "healthcare".

It would be cheaper to just pay for the healthcare directly, rather than maintain the massive overhead of "insurance".
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#5
Government mandates insurance, not actual "healthcare".

Case in point:
My insurance company, HMSA, requires that I see my Primary Care Physician for a referral to another doctor. This involves all of the driving, and waiting involved with two appointments, not the one I need.

When I called HMSA to ask whether I could simply call my Primary Care Physician and have him send the referral, they said no. The reason given was that with a phone call the Primary Care doctor doesn't get paid. I pointed out that my medical care would be cheaper if this step was simplified, they assured me that it wouldn't because this is how they act as "the gatekeeper." The insurance customer care representative actually used those words.

Meaning for many patients, they, as an insurance company pull up the drawbridge, lock the gates, and leave their policyholders standing on the other side staring at the moat.

"Only fear real things, such as minds full of delusions." -Last Aphorisms
"I'm at that stage in life where I stay out of discussions. Even if you say 1+1=5, you're right - have fun." - Keanu Reeves
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#6
It is cheaper for them rather than allowing you to go straight to a high priced specialist based upon your own internet diagnosis.
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#7
upon your own internet diagnosis.

Perhaps for some of their customers.
In my case, it's a recurring condition. It's in my records. I'm not self diagnosing, I'm recognizing and remembering.

Preemptively edited to add:
And no, I'm not too stupid to follow the doctors orders as a way to avoid recurrence. If it were that simple I'd do whatever necessary.

"Only fear real things, such as minds full of delusions." -Last Aphorisms
"I'm at that stage in life where I stay out of discussions. Even if you say 1+1=5, you're right - have fun." - Keanu Reeves
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#8
We're not serious about controlling health care costs here in this country. If we were, we'd get the insurance companies out of it. The insurance companies have to make a profit, so it's self explanatory. And, of course the big pharma companies are paying off the politicians to keep us from buying our meds from, say, Canada. Bernie just submitted a bill to allow Americans, and punatics, (notice the Puna reference) to buy their meds from Canada, and it was voted down of course. We'll be waiting for a certain party to come up with their wonderful health care plan.

Jon in Keaau/HPP
Jon in Keaau/HPP
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#9
Ive been pleased with the local kaiser ...they have added a bunch of GP's ...access to specialists no issues - they fly them in or me out...

Ive paid out of pocket for a high priced second opinion with a non affiliated expert in my condition ......concurred with Kaiser and the treatment plan

good enough for me...
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#10
birdmove@10:14:49-
Exactly.
"Free" Markets do not work for health care.
Medicare for All.
That solves our problems in Hawaii.
kalakoa @ 08:17:09-
Exactly right.
Healthcare and insurance are two different things.
I want healthcare, not private insurance- and that includes private insurance mandated by Obamacare, otherwise known as "Heritage Foundation Care", or Romneycare or also known as "market" governed medical care.
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