A sudden exodus of four surgeons from the Hawaiian islands has local providers concerned about stemming the loss of qualified physicians.
Earlier this month, three of the Big Islands five orthopedic surgeons said they would no longer practice there, and the two who remain dont work full time. The orthopedic community is shocked, says Linda Rasmussen, M.D., immediate past president of the Hawaii Medical Association and an orthopedic surgeon on Oahu. Its that domino effect.
Doug Hiller, M.D., named incoming president of the Hawaii Medical Association, is instead leaving his solo orthopedic practice for a job in Wyoming later this month. William Park, M.D., chief surgeon of North Hawaii Community Hospital, where Hiller treats patients, also is leaving the Big Island.
I work harder and harder every year and make the same amount of money every year, says Hiller, who grew up on Oahu and has practiced in Hawaii for 19 years.
Both depart the 40-bed North Hawaii Community Hospital in Kamuela amid administrative turmoil. Last summer, the hospital laid off 59 workers and fired its chief executive officer after just two months on the job. The hospital has since retained a new board, and Hiller attributes his decision to leave to the states low reimbursements, high cost of living and high insurance payments.
Two other orthopedic surgeons also are leaving the Big Island. John Bellatti, M.D., on staff at 88-bed Kona Community Hospital in Kealakekua, which has also suffered recent layoffs, is shuttering his practice by year-end. Vivian Chang, M.D., who began practicing last year on the island, won a specialty fellowship in Paris in January 2009 and likely wont return. Remaining are two orthopedic surgeons on the island. Barry Blum is at Kona Community Hospital. Peter Matsuura, on the other side of the island, in Hilo, is often not available because he serves in the Army Reserves and is deployed to Iraq for six months out of the year, Rasmussen says.
There are only a few orthopedic surgeons practicing in Hawaiimostly on Maui and Oahubut theres not a single hand surgeon on the island of Oahu, Rasmussen says, adding that she is doing more hip replacements every day as Hawaiis population ages. I did three yesterday and am doing nine tomorrow, she says.
Orthopedic surgeons in Hawaii typically make about a third of those working on the mainland, and medical malpractice insurance can cost them about $44,000 annually, Rasmussen says. Nationally, orthopedic surgeon compensation ranged from $372,400 to $512,500, according to Modern Physicians 2008 Physician Compensation survey, which is based on data from 2007-08. In Hawaii, orthopedic surgeons make between $100,000 to $150,000 annually, Rasmussen says.
Hawaii has lost physicians to states that have enacted malpractice reforms, such as Texas and California. The Hawaii Medical Association has criticized the Hawaii Medical Service Association, the states Blues plan, for inadequate reimbursements. The HMSA is operating in the red, according to the insurer.
Comment on todays news or other matters. Submit your letter to Modern Physician at [email protected]. Submissions must include name, title, affiliation, city and state. Modern Physician reserves the right to edit all submissions.