Hawaii’s Healthcare Options: Doctor Shortages, High Costs …No Access!

September 21, 2017
6pm   -   8pm
West Hawai'i Civic Center, Council Chambers

– the State of Healthcare on Hawai’i Island – 500 doctors short!

Living in a ”paradise” and in a first-world economy belies Hawaii’s limited outer island medical options — limitations that could be hazardous to your health.    If you’re lucky enough to have a family doctor, will he or she be there for you in the future?  If you need to see your local doctor, get in line, it may be a long wait.  Is there a doctor in the house?  Where do Hawai’i Island’s full time residents go as the availability of doctors (including those that will accept insurance) shrink?

Need to see a specialist, fly to Oahu or to the mainland, but who do you see once you get there, and what about your medical records and insurance coverage?  Healthcare in the United States has never been so costly and complicated for doctors and patients as it is today.

For the neighbor islands and Hawai’i Island, the annual addition of new doctors is in single digits, yet qualified doctors remain woefully in short supply.  In the last few years, the Big Island has added less than 7 seven doctors, while several others have retired and/or left the Island.   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 (1/20/17) 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.

Locally, Hawaii County currently 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.

Hawaii’s population is also one of the oldest in nation.   According to  Jerris Hedges , Dean of  UH’s John A. Burn School of Medicine, healthcare providers must focus on chronic disease management to “help elders maintain functionality”.   Trouble is he demand for services in this specialized field medicine is growing much faster nationwide, including Hawai’i, than the supply of specialists.

“Those of us who have come back to practice on the Big Island are from the Island”.   Melanie Arakaki, Family Physician (Hilo).  

It’s important to provide residency rotation, otherwise you’ll never get anyone to the neighbor Islands”.   Lee Buenconsejo-Lum, head of the Residency Program for UH’s John A. Burn School of Medicine.

What are the healthcare pressure points contributing to the problem of a physician shortage for Hawaii County?

  • Medicare (65+ health plans) for government reimbursements to doctors today is below insurance market rates and near break-even for doctors. Medicaid (the poor and special needs coverage) government reimbursements today for doctors is below break-even.   In both cases, doctors are limiting patients under these plans or refusing them altogether, and/or dropping out of he system altogether.
  • In 2019, all doctors will be required to have an electronic medical records system in place in order to quality for Medicare service reimbursements.  Many physicians will face added costs (on average) $40,000 plus implementing a qualifying billing system, and with added costs for personnel training.
  • After medical school graduation costs, new physicians must complete a three year residency training before being allowed to practice medicine. The bad news: a shortage of graduates. The good news: 80% of graduates perform their residency training in Hawai’i, stay in Hawai’i.

Underlying issues adding the overall healthcare services problem for Hawai’i Island and the state:  

  • Cost of living
  • Shortage of qualified support staff
  • Heavy caseloads (no time for family or to enjoy paradise)

Join us, as health experts from medical, government, and insurance sectors discuss the problems and solutions to healthcare access options for Hawai’i Island residents.  Learn how best to navigate through the Island’s inadequate health care options — and equally important, what the future may hold for County residents and healthcare providers.


This forum took place on September 21, 2017, at 6pm at West Hawai'i Civic Center, Council Chambers.

The event's featured speakers were:

Sen. Josh Green, MD
Senate, District 3
Rep. Richard Creagan, MD
House, District 5
Cary Koike
HMSA, Director, Strategic Network Relations

Speaker Presentation Materials

The presenters have graciously allowed us to post their presentation notes.

Subject Support Materials

Please see support material for this subject Forum.

Forum Session Video

View the recorded session here: