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Report finds Hawaiʻi physician shortage exacerbated by the pandemic

Date: January 2nd, 2021 in AHEC, IN THE NEWS, JABSOM News, UH Manoa    Print or PDF

Graphic says Doctor Shortage and shows stethoscope on a table

By Deborah Dimaya, Interim Communications Director

Already in dire need of more doctors, Hawaii’s physician shortage was exacerbated by the COVID-19 crisis. The pandemic has challenged continued physician practice in Hawaiʻi and is expected to increase the relative shortage of physicians for the state for the next several years as older physicians leave their practice. Out of the 989 physicians offices questioned, 44% said that the coronavirus pandemic disrupted their practice in the form of temporary and permanent clinic closures, early retirement, increased telehealth practice, altered operating hours and locations and reduced patient volume. This data and more was provided in the final Hawaiʻi Physician Workforce Assessment Project Report for 2020, which was submitted to the Hawaiʻi State Legislature in December 2020.

The statewide physician shortage remains between a range of 710 and 1,008. The higher number (1,008) is projected when researchers accounted for island and specialty specific needs. This year the supply of practicing doctors (in full-time equivalents) is 2,812, down from 2,974 in 2019. At least 110 physicians retired in 2020, at least 139 left the state, 120 decreased their work hours and 8 passed away. Of the active physicians, 46% are ages 55+, 21% are ages 65+ and one is 90 years old. In addition, women make up more than ⅓ of the workforce.

County results
The physician shortage saw a rising trend across all counties. On Oʻahu, the shortage increased from 377 (in 2019) to 475 (in 2020); on Hawaiʻi island there was an increase from 230 to 287, the Maui county shortage increased from 153 to 185 and on Kauaʻi the shortage increased from 60 to 61. Primary care, which includes Family Medicine, Internal Medicine, Pediatrics and Geriatrics, continues to represent the largest shortage statewide (412 FTEs needed) and on all islands, along with Colorectal Surgery, Pathology, Pulmonary, Infectious Disease, Allergy/Immunology and Hematology/Oncology being the largest subspecialty shortages statewide by percent of estimated unmet need.

This year, due to COVID-19, many physicians elected to retire or decrease their practicing hours. Although the number of active physicians may rebound when the pandemic is contained, the shortage of 1,000 physicians will be difficult to mitigate even if all the physicians returned to full-time practice. In addition, efforts such as loan repayment have been thwarted by legislative disruptions and state funding challenges. The loan repayment program may have to end, despite great need and proven value to the state.

Moving forward, there are many efforts being done to assist doctors through the ongoing pandemic as well as efforts to both grow and retain the physician workforce in the state.

Tripling the size of the medical school (with medical school branches on all islands) and residency programs is the long term solution, but is expensive.

“Until this can happen, we need to make practice more enticing for physicians in Hawaii. This means better reimbursement (which has been decreasing over the last few years), less busy work or administrative requirements, incentives to work in Hawaiʻi (such as loan repayment or housing stipends) and a supportive environment (from patients, institutions, and colleagues),” said JABSOM Director of the Hawaiʻi/Pacific Basin Area Health Education Center Dr. Kelley Withy.

The Hawaiʻi Physician Workforce Crisis Task Force is working with federal legislators to increase Medicare payments to Hawaii’s physicians, as well as working with the local legislature to exempt physicians from having to pay their patients’ general excise taxes for their Medicare and Medicaid visits. “Hospitals don’t have to pay this double tax, but independent offices do. Finding jobs for spouses who move to Hawaiʻi is also important so that families stay here. This is being tackled by the Hawaii Physician Recruiters Group,” said Dr. Withy.

“Loan repayment has helped to recruit and retain 39 healthcare professionals over the last 8 years, but without local matching funding for the hundreds of thousands provided by the federal government, the program will be scratched. But one thing that everyone can do for their doctor is say, ‘Mahalo,’” said Dr. Withy. “It’s not easy to be a physician in paradise, but the patients make it worth it!”

The Physician Workforce Assessment survey is conducted by the University of Hawaiʻi 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 3,920 are practicing in civilian settings.

To access the report in full, go to:

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