How to Fix Hawaii's Doctor Shortage

Hawaii has hundreds fewer physicians than it needs, particularly in primary care. Here's what's being done to fix the growing shortage.


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Loan Repayment for Rural Doctors

What it does: Provides loan repayments for health care providers who agree to work in the most underserved parts of the state.

How it helps: Puts primary care doctors—as well as nurse practitioners and physicians assistants—where they’re needed the most.

Details: Provides up to $40,000 a year, for two years, toward the repayment of school loans for health care providers who work for at least two years in rural parts of the state. Seed money from HMSA, Queen's Medical Center and AlohaCare, matched by federal funds available under the Affordable Care Act, got the program rolling last year. To date, six doctors and nurse practitioners have taken the loan repayment deal. Next year, nine more people could join the program. Eventually, up to 50 people a year could participate.
 

The Practice in Paradise Campaign

What is it: A recruitment campaign aimed at doctors who trained in Hawaii and now practice on the Mainland.

How it helps: Could boost the number of doctors in the state.

Details: In 2012, the Hawaii Physician Workforce Assessment Project sent postcards to all the Hawaii medical school and residency graduates it could find, asking them to take a quick survey on what it would take to bring them back to Hawaii, and also alerting them to a website with job postings. Of 1,100 physicians contacted, 40 responded. Their main requirement for returning? A high-paying position with lots of perks.
 

Make the Doctors Happy

Why aren’t doctors happy? Malpractice suits, out-of-control paperwork and the unfulfilled promise of electronic records.

How it helps: A happy doc is a doc who isn’t scaling back her practice, moving to the Mainland or taking early retirement.

Details:

Paperwork and electronic records: Every insurance company has its own unique system for claims submissions, denials, coding and so on. This amounts to a time-consuming pain in the butt for doctors. The federal push to get doctors to use electronic records isn’t helping. There’s no standard electronic records system, and, as it turns out, doctors have the same computer problems as everyone else. The Hawaii Workforce Assessment Project has issued a call for easing these administrative burdens on doctors so they can spend more time doctoring.

Tort reform: The state recently revamped its Medical Claims and Conciliation Panel, the advisory body that hears malpractice claims against doctors before they can be filed as lawsuits. No longer do lawyers outnumber doctors on the panel, and more malpractice claims are now expected to be settled out of court.
 

Expand the Health Career Pipeline

What it means: Outreach to Hawaii kids in primary and secondary schools to spark interest in medicine and other health careers.

How it helps: A long-term solution.

Details: The outreach efforts include visits by doctors and medical school students to classrooms, career fairs and teen health camps. At the annual teen health camp held at Kealakehe High School in Kona, students have “speed-dating” career talks with doctors, nurses and other health care practitioners. They also learn how to suture wounds on a rubber arm, and how to put plaster casts on each others’ arms. “It gives them a taste of a day in the life of a clinic,” says career educator Nem Lau. “The idea is, Try it, you might like it.”

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