DOCTOR SHORTAGE: Legislature hears from JABSOM, health care partners

“We are headed for a disaster,” Deputy Hawai`i Health Director David Sakamoto told Hawai`i lawmakers today, describing the worsening physician shortage in the islands. Members of the House Health and Labor committees held an informational briefing at the legislature on April 5 to discuss the physician shortage, which is worsening on all islands, including the neighbor islands.

Statewide, Hawai`i is 600 physicians short of the number of practicing physicians it should have based on its population. That figure is from the Hawai`i Health Workforce Assessment, research which includes a survey of Hawai`i doctors, conducted annually by the University of Hawai`i at Mānoa John A. Burns School of Medicine (JABSOM) and supported financially by the Hawai`i State Legislature. On April 20, the latest figures covering early 2013 will be revealed at the 3rd Hawai`i Physician Workforce Summit in Waikīkī. The updated numbers will show that 33% of our active physicians are age 60 or over (retirement age), which will likely cause a sharp increase in the doctor shortage within a a few years.

“The writing is on the wall,” said Howard Ainsley, CEO of Hilo Medical Center, noting that the shortage of primary care physicians is a national crisis, too. “Every community in the country will be seeking primary care physicians,” Ainsley told lawmakers.

Hilo Medical Center is seeking funding this legislative session to establish the first Family Medicine Residency Training program on a neighbor island, in Hilo. “Residency” is the post-MD training new doctors must undergo to earn their board certification and licenses. The trainees work under supervision of other physicians while they hone their skills. Residency training for family medicine doctors usually lasts about three years.

Post-MD training is important in retaining physicians in Hawai`i, according to Dr. Allen Hixon, Chair of JABSOM Family Medicine & Community Health.

“Eighty-five percent of the medical students who graduate from JABSOM and then train as MDs here in our Residency Programs stay to practice in Hawai`i,” said Dr. Hixon. “That is the highest percentage in the country, number one”, Hixon added. JABSOM has Residency Programs in 14 different specialties, training about 240 board-eligible MDs per year.

An official from Hilo Medical Center also emphasized that point, when he told lawmakers that at one pint, 50 of the 63 graduates of JABSOM’s Family Medicine Residency Program were still practicing in Hawai`i (that number has since increased, with more graduates.)

“The Hilo residency will be important because this will be the first Residency Training Program outside of O’ahu,” Dr. Hixon said. “JABSOM’s Dean, Dr. Jerris Hedges, has said ‘we are the University of Hawai`i medical school, not the ‘University of Honolulu medical school,'” Hixon said. “Training on all the islands is our goal.”

In recent years JABSOM has expanded training opportunities for MD students to all major Hawaiian islands. The school hopes, with future legislative support, to expand post-MD Residency Training opportunities throughout the state, too.

Also testifying at the hearing today were representatives from the UH Mānoa School of Nursing and Dental Hygiene and the UH Hilo Daniel K. Inouye School of Pharmacy.

Our photograph shows Dr. Hixon testifying at the Informational Briefing. Story and photo by Tina Shelton.

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