Malpractice Insurance Costs Behind Hawaii Doctor Shortage

Associated Press

The Big Island of Hawaii will soon lose three orthopedic surgeons, leaving the island with only one full-time and one part-time bone surgeon, and none in West Hawaii.

Dr. Doug Hiller, president-elect of the Hawaii Medical Association, is among the doctors who are leaving for various reasons, including low insurance reimbursements.

The other doctors are John Bellatti and Vivian Chang. The three are all scheduled to be gone by the end of January.

“The tough part is I can’t tell patients where to go. There is nobody to refer them to when I’m gone,” said Bellatti, who has practiced in Kailua-Kona for 21 years and is looking for jobs in California and Minnesota.

Patients will be forced to travel to Honolulu, or more doctors will have to make more trips to the Big Island.

Hiller and Bellatti say the rising cost of malpractice insurance, low reimbursements and huge workloads are the main reasons for their leaving. Chang is leaving for a fellowship.

“I’ve been practicing medicine in the islands for 20 years and I feel horrible, absolutely horrible about leaving my patients, my friends and my home,” said Hiller, who is closing next month to practice medicine in Lander, Wyo.

Hiller works at North Hawaii Community Hospital in Waimea, which is also losing chief surgeon Dr. William Park.

Paul Dunne, a spokesman for the hospital, said he’s holding out hope the two will change their minds.

“One thing we fight in recruiting is the lack of reimbursement for doctors,” Dunne said. “That’s the obvious reason many doctors leave or don’t come. You’re looking at one of (the lowest), if not the lowest, reimbursements for doctors for all of the states. That gets difficult to battle when you put it up against having one of the highest costs of living.”

The doctors also face large workloads and the rising cost of malpractice insurance.

Hiller said it has gotten harder and harder to practice medicine in Hawaii every year.

“At some point, your income and costs hit a crossroads. I’m there now. I would love to stay here, but I can’t,” he said.

Dr. Josh Green, a state representative and a state senator-elect from the Big Island, said changing Hawaii’s climate for doctors could be easy if lawmakers compromise on tort reform and reimbursements are increased.

“If you do that you’ll be able to attract doctors to the state, the greatest place in the world to live,” he said.

Copyright 2008 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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