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AAOS Now

Published 1/1/2008
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Paula Arcena

Hawaii is no paradise for patients

Access to medical care is a major issue for islands

Public forums sponsored by the Hawaii Medical Association (HMA) last year highlighted the problems Hawaii’s residents are facing in accessing medical care. HMA held a series of forums across the state, including various locations on Maui, Hawaii, Kauai, and Oahu. Legislators, government officials, healthcare industry professionals, and the general public attended, and the events were attended by as many as 175 people.

“The ability for patients in Hawaii to find a physician is dangerously limited due to Hawaii’s lack of medical tort reform and low insurance reimbursements,” says Linda Rasmussen, MD, HMA immediate past president and vice president of the Western Orthopaedic Association. “In fact, access to health care in Hawaii is in a state of crisis.”

Panels of speakers representing health care, insurance, government, and patients affected by the crisis provided a variety of perspectives on the issue. Two of the forums also featured speakers from Texas and California, states that have successfully implemented medical liability reforms. In both cases, the reforms helped to improve access to care for patients. Several participants called for Hawaiian state legislators to pass similar reforms.

Citizen support
Each event included ample time for open dialogue with the audience. An overwhelming number of citizens came forward to share their concerns about the worsening statewide physician shortage. Participants affirmed that the crisis is a community issue, not a physician issue, and encouraged attendees to contact their legislators and express the need for resolution.

On Maui, William Kinaka, an attorney, told the crowd they need “a Paul Revere” to press the issue. He suggested the formation of a “booster club” to address the problem.

Broadcast and print-media coverage increased the exposure for the access-to-care problems and the viable solutions. The media coverage is expected to help highlight the issue to the decision makers in the legislature who can effect change.

Although Hawaii’s access-to-care crisis has been most evident on neighbor islands, the state’s only certified trauma center, located in Honolulu, has an alarming shortage of doctors willing to volunteer for emergency and trauma call. The shortage jeopardizes patients’ ability to receive urgent treatment in life-threatening situations. That the situation has reached Hawaii’s capital city, not just rural areas, helps confirm that the crisis requires immediate attention.

“Our patient access-to-care crisis has reached a critical stage, and we implore Hawaii’s legislators to take action and fix the problem,” says Cynthia J. Goto, MD, HMA president. “The forums highlight the issues and possible solutions so that Hawaii’s citizens have physicians available when they need them most.”

Making headway
In 2007, HMA made unprecedented headway on medical tort reform. Two of three state House committees voted to approve tort-reform legislation—the farthest a tort-reform bill has gotten in Hawaii’s legislature.

HMA will continue its forum series in 2008 to further highlight the barriers that prevent physicians from practicing medicine in Hawaii, while promoting medical liability reform as a possible solution.

The AAOS provided grant money to support HMA’s efforts in publicizing this issue.

Paula Arcena is executive director of the Hawaiian Medical Association. For more information, visit the HMA Web site at www.hmaonline.net