HAWAI`I MD SHORTAGE WORSENING: Steps being taken by JABSOM, Hawai`i leaders

Researchers at The John A. Burns School of Medicine (JABSOM), University of Hawai`i Mānoa have found the MD shortage statewide is worsening. Our state is an estimated 747 physicians short of the number we should have currently treating patients, based on Hawai`i’s population. There are currently 2,894 physicians practicing in Hawai`i. One third of them are 55 or older, approaching retirement. The shortage of 747 MDs statewide is expected to increase to a deficit of 1,448 physicians by 2020, only seven years from now. Hawai`i’s population as a whole is aging at one of the highest rates in the nation, which means the doctor deficit is increasing at the same time that patients’ need for health care from age-related illnesses will become more acute.

A growing problem
The latest estimated supply and shortage numbers, by county:
O`ahu’s 2013 supply: 2127 MDs; Current need/demand is 2494
Hawai`i’s 2013 supply is 336 MDs; Current need/demand is 530
Kaua`i’s 2013 supply is 130 MDs; Current need/demand is 199
Maui’s 2013 supply is 301 MDs; Current need/demand is 418

“A local solution is the only answer”
“The University of Hawai`i medical school is overwhelmingly the major source of physicians for our state, both through our education of MD students (90% of whom are Hawai`i residents) and our Hawai`i Residency Programs, where our faculty oversee the training of more than 240 MDs while they work to obtain licensure or board certification,” said Dr. Jerris Hedges, JABSOM Dean. “These MDs in Residency and Fellowship training are actually employed at our partner health care training institutions helping to treat patients,” Dr. Hedges explained. “Meeting the crisis in the Hawai`i health care workforce is going to have to be a local solution,” said Dr. Hedges. “We are grateful for the foresight of Hawai`i’s leaders who nearly 50 years ago established Hawai`i’s medical school and continue to support us. Their leadership in this area is a daily source of inspiration to many of us.”

About the Workforce Assessment:
The Hawai`i Physician Workforce Assessment, supported by the Hawai`i State Legislature, surveys doctors at the time of each physician’s licensure (every 2 years) and is funded by a $60 fee attached to that license. The assessment reports annually to the Legislature about where physicians are practicing, what their specialty and age is, and whether they accept Medicare and Medicaid patients. The project this year launched an on-line database to advertise physician openings in Hawai`i, at MD JOBS IN HAWAI`I.

The workforce team, JABSOM’s AREA HEALTH EDUCATION CENTER (AHEC) also launched the State’s first-ever Education Loan Repayment Program last year, helping MDs, nurse practitioners and other health care providers repay their educational loans if they commit to serve at least two years treating patients in a rural setting (where health care workforce shortages are acute). Funded by the U.S. Affordable Care Act and gifts from The Queen’s Medical Center, HMSA and Aloha Care, the Loan Repayment Program was also considered by lawmakers this session for some state funding, which would allow it to attract and retain more health care workers. Although the lawmakers did not choose to fund the loan repayment program this session because of other spending priorities, JABSOM hopes they will revisit the issue next year.

Third Annual Physician Shortage Conference

A conference sponsored by JABSOM’s Physician Workforce Assessment team on April 20, at the Hilton Hawaiian Village, emphasized how Hawai`i can maximize the benefits of changes created by the Affordable Care Act and how we can make Hawai`i an ideal place to practice medicine. Topics included the Patient Centered Medical Home, care coordination, telemedicine, and working as part of an interprofessional medical care team. In addition, the team provided education on local payment reforms and the new Medical Inquiry and Conciliation Panel.

The keynote speakers were Dr. Len Nichols, Center for Health Policy Research and Ethics and Carl W. Taylor, Executive Director Fraser Institute for Health Research. Other topics of the conference included: Addressing Interprofessional Teamwork Models that work, Telehealth solutions for Hawai`i, Hawai`i Specific Solutions to Improve Your Bottom Line and Medical Malpractice Changes in Hawai`i – Demystifying the Medical Inquiry and Conciliation Panel Experience.

The Hawai`i Consortium for Continuing Medical Education (HCCME) is accredited by the Accreditation Council for Continuing medical Education (ACCME) to provide continuing Medical education for physicians.

The John A. Burns School of Medicine (JABSOM), named for a visionary governor, was established in 1965 and has trained more than 4,500 medical doctors through its MD or residency program. Half of Hawai‘i’s practicing physicians are faculty or graduates of JABSOM or its Hawai‘i Residency Programs. Annually, we have more than 450 students, and an additional 240 post-MD trainees. In addition to medicine, we also confer degrees in Biomedical Sciences, Public Health, Medical Technology and Communication Sciences and Disorders. Pictured is Ashley Marumoto, 2nd year JABSOM medical student, monitoring a geriatrics patient.

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