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AAOS Now

Published 5/1/2011
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Linda J. Rasmussen, MD

“Save our doctors Hawaii”

Patient, physician coalition focuses on access to care

Hawaii is the only state in the country with mandatory employer-provided health insurance for employees who work more than 20 hours per week. The result is that most Hawaiians have health insurance; however, Hawaii has a significant shortage of physicians due to low insurance reimbursements.

A recent study conducted by the University of Hawaii Medical School revealed a shortage of 644 physicians—primarily primary care physicians—in the state. As a result of the workforce shortage, access to primary care physicians and specialists is difficult, and wait times for patients are significant. For example, patients in Honolulu must wait 3 months to see a neurologist, and colonoscopies need to be scheduled at least 6 months in advance. Access to medical care on the neighbor islands is also critical.

Save our doctors
For years, the Hawaii Orthopedic Association has worked with the Hawaii Medical Association (HMA) and their lobbyist on efforts to increase patient access to health care throughout the islands. Because almost half of state legislators have a law degree, efforts to pass medical tort reform have been met with resistance.

Three years ago, with the help of the HMA executive director, a group of patients formed “Save Our Doctors Hawaii,” a nonprofit organization that educates the public on the link between the declining access to health care and the need for medical liability reform in the state. Save Our Doctors is a coalition of physicians and concerned citizens who have been adversely affected by the ever-increasing shortage of physicians.

The organization’s Web site has been a critical component of its success. The Web site provides access to healthcare news items, media links, information on upcoming events, patient testimonials, and sign-up for the Save Our Doctors newsletter. Interested parties can also follow the organization via social networks such as Facebook and Twitter.

The Web site has enabled us to involve patients in a variety of activities. We can notify patients of legislative hearings, enable them to e-mail state legislators, and provide links to resources and information. Social networking enables us to quickly organize lobby days and letter campaigns.

Tips for success
State societies that want to form similar coalitions in their state can benefit from the following tips for success:

  • Create a user-friendly, professional Web site and assign a dedicated individual to be responsible for continually updating the site.
  • Involve physicians in educating patients.
  • Work with your local medical association and other specialty societies to establish a clear message that is easily understood by the public.
  • Urge the public to bring this message to the legislature and the press.
  • Get to know members of the press and television news anchors. Be available when they need a story and feed them information, but do not overwhelm them.
  • Use patient stories to spread your message.
  • Enlist speakers from other states who have had success with your proposed legislation. (The AAOS can be helpful with this.)
  • Get to know your legislators and get involved in elections.
  • Hold public forums to provide information to the different communities.

Linda J. Rasmussen, MD, is the Board of Councilors representative from Hawaii. She can be reached at lindamd1@juno.com