Does Hawaii have enough doctors?

The short answer is "no."

Nor do we have enough nurse practitioners, physician assistants, nurses, medical technologists, speech pathologists — and the list goes on.

In 2009, the Hawaii Legislature passed a law that allowed for a voluntary survey of physicians when they renew their licenses, to ask where and how much they practice.

With this confidential information, insurance provider lists, Web searches, community contacts and the telephone, investigators in the John A. Burns School of Medicine-Area Health Education Center have developed the most accurate estimate of how many physicians of different kinds work in each area of the state.

The Lewin Group, a firm that creates projections of physicians for the federal government, created a model for how many physicians Hawaii needs. This research indicates we are short more than 650 physicians and if we don’t take action, we could double our shortage by 2020.

National estimates of physician supply base their findings on national databases using numbers of physicians licensed (not necessarily seeing patients) or surveys of a portion of providers, not all of them. These mainland assessments consistently overestimate our supply of physicians.

In fact, when we divide the actual practicing primary care physician numbers by population, we have between 66 primary care physicians per 100,000 people — this is on the Big Island — and 73 primary care physicians per 100,000 people — that’s on Kauai.

On Maui, its 70 primary care physicians per 100,000 people and on Honolulu, 72 per 100,000.

These numbers show our physician-to-patient ratios are significantly lower than the estimate of 93-123 per 100,000 reported recently by the United Health Center for Health Reform & Modernization.

Although that group underestimated the magnitude of Hawaii’s shortage, it is true that rural areas in Hawaii have less access to health care than urban areas.

That said, all areas of Hawaii are feeling the lack of physicians more and more, and many people are unable to find a regular physician, specialist or other provider to help them with their health.

So, what can we do?

Health care is a growing field because as we get older, we need more of it, not less. So for people thinking about starting or changing a career, or if you know someone who is, our advice is to think about health care.

We all must work together to help expand needed health care training programs, simplify the extensive paperwork requirements for care providers, create more health care teams to meet community needs, implement electronic health records and distance health visits (telemedicine), and empower communities to get involved in recruiting and retaining health care providers, including physicians.

Dr. Jerris Hedges is dean of the John A. Burns School of Medicine (JABSOM) and Dr. Kelley Withy is director of the Hawaii/Pacific Area Health Education Center at JABSOM. For more on Hawaii’s Physician Workforce Assessment, go to www.ahec.hawaii.edu.