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MD Workforce Report: More than 150 doctors left Hawaii in 2019; Extended local training helps ease some gaps

Date: December 23rd, 2019 in AHEC, Rural, Workforce Development    Print or PDF

Graphic says Doctor Shortage and shows stethoscope on a table

The Lead Investigator of the Physician Workforce Assessment sees improvements from a cardiovascular disease fellowship started on Oahu and a family medicine residency program established in Hilo. She says both have eased former shortages in those specialities in those regions.

By Tina Shelton, JABSOM Communications Director

The exodus of doctors from practice in Hawaii this year was much worse than was indicated in preliminary figures released just a few months ago. In 2019, 152 doctors moved away from Hawaii, nearly four times the impact that was visible earlier. The new figures are contained in the final Hawaii Physician Workforce Assessment Project Report for 2019, which was filed on December 20, 2019 with the Hawaii State Legislature.

Other losses came through retirement or reductions in hours of practice. Ninety-one physicians retired in 2019; 123 decreased their hours, and four passed away. Currently, 245 physician jobs are open, waiting to be filled, statewide. The workforce need is much greater as only a minority of physicians in the state are employed.

Physicians leaving practice in Hawaii is only one side of the story. In terms of physicians entering practice in the state versus leaving practice, Hawaii had a net gain of 47 doctors overall in 2019. Unfortunately, the need for physicians continued to grow, nullifying this net gain in doctors. Thus the statewide physician shortage remains somewhere between 519 and 820 doctors based on the average U.S. use of physician services by a population like ours. The higher number (820) is projected when researchers accounted for island specific needs.

Learn about State Educational Loan Repayment, Preceptor Tax Credit and other incentives JABSOM has successfully advocated for to support local physicians at http://www.ahec.hawaii.edu/

County results, specialty shortages
The Oahu shortage decreased from 384 (in 2018) to 377 (in 2019); the Hawaii Island shortage increased from 213 to 230; On Maui, the shortage increased from 141 to 153; and on Kauai, the shortage increased slightly from 59 to 60. Primary care represents the largest shortage statewide (300 FTEs needed), and on all islands, with Infectious Disease, Pathology, Pulmonology, Colorectal Surgery, Hematology/Oncology, Thoracic Surgery, and Allergy & Immunology being the largest subspecialty shortages statewide by percent of estimated unmet need.

Kelley Withy, MD, PhD, Principal Investigator of the Workforce Assessment, said physicians who leave cite a number of reasons, including the high cost of living, lower compensation in Hawaii and — if they are not from the islands — difficulty finding jobs for spouses or the need to care for aging parents on the U.S. Mainland. However, she said the reports have also shown some hopeful signs, especially about the impact of increased local training opportunities.

“We used to have a severe shortage of cardiologists appearing on the top of the shortage list on Oahu, but that has eased somewhat because heart specialists are now being trained locally through a fellowship established by the John A. Burns School of Medicine (JABSOM) and The Queen’s Medical Center. Similarly, the Hawaii Island Family Medicine Residency` program has eased the shortage of Family Medicine doctors there.”

Dr. Withy, Director of the JABSOM Hawaii/Pacific Basin Area Health Education Center, said the proposed creation of a Maui-based JABSOM medical student training site, and eventually a residency training program on that island, as proposed by the University of Hawaii and Governor David Ige, shows great promise for growing the supply of physicians on Maui.

Research by both UH and the Association of American Medical Colleges has shown that medical students who attend school in Hawaii and complete their advanced training here are more than 80% likely to remain in-state to practice their profession.

The Physican Workforce Assessment survey is conducted by the University of Hawaii medical school with proceeds from a small fee placed on doctors’ licenses, which must be renewed every two years. More than 10,000 physicians hold Hawaii physician licenses, but only 3,484 are practicing in civilian settings.

To access the report in full, go to: https://www.hawaii.edu/govrel/docs/reports/2020/act18-sslh2009_2020_physician-workforce_annual-report.pdf

An additional resource for information, which focuses on the UH medical school’s graduate medical education, can be found at https://www.hawaii.edu/govrel/docs/reports/2020/hrs304a-1704_2020_hmec_annual-report_508.pdf


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