With a physician shortage in Hawaii, which is worse on the neighbor islands, it is often challenging for parents to find specialists for their children — particularly in rural areas. Some families have no choice but to fly to Honolulu, but many can’t afford the travel and cannot access specialized medical care for their children. Shriners Hospital in Honolulu is now expanding its expert care to the neighbor islands with a focus on orthopedics, which includes bones, joints and muscles, and neurodevelopmental issues such as autism, epilepsy, attention deficit hyperactivity disorder and learning disabilities.
Hawaii’s doctor shortage is profound. It is estimated that with the current population, the state needs 3,690 doctors but has only 2,800. The shortfall has worsened nearly 20 percent compared with estimates a year ago. The problem is expected to grow as the state faces an impending wave of retirements with one-third of its doctors reaching retirement age in the next five years. An estimated 18 percent of doctors already are 65 or older.
Shriners Hospital physicians have been traveling to neighbor islands for more than 20 years and have often needed to be creative with space, using the back of churches, community centers, hotel conference rooms or the local Shriners fraternity hall.
A new location in Honokaa now gives Shriners physicians an opportunity to care for children in a clinical setting.
"Shriners Hospitals is a proud partner with Hamakua-Kohala Health in improving access to much-needed medical care for Hawaii island keiki," said John White, CEO/administrator of Shriners Hospitals for Children — Honolulu. "We are thrilled more children in our community can receive pediatric orthopedic and neurodevelopmental services regardless of their family’s ability to pay."
The first outreach clinic at Hamakua-Kohala Health will be lead by Shriners pediatric neurologist Ryan Lee, who is director of the Neurodevelopmental Clinic at Shriners Honolulu. He is the only pediatric neurologist with special emphasis in neurodevelopmental disabilities in Hawaii and the only pediatric neurologist in Shriners’ 22-hospital system in North America. On July 16, children with orthopedic needs will receive care at the Hamakua-Kohala Health provided by Shriners pediatric orthopedic surgeon Jonathan Pellett, who was named 2014 Physician of the Year by the Healthcare Association of Hawaii.
Shriners’ physicians conduct outreach clinics all over the Pacific Basin. However, the majority of the patients they help are children from Hawaii. The goal is to help as many Hawaii keiki as possible. The first-rate physicians at Shriners are employed full time and dedicate 100 percent of their time to Shriners patients.
There is additional growth at the Honolulu hospital that will help children who are seen at neighbor island outreach clinics. Some children require added care that requires a hospital stay. The hospital is expanding its Family Center, which is on the hospital campus and used as a facility that gives a parent and his or her child a place to stay while undergoing treatment at Shriners Hospital. There are 10 rooms on the campus for visiting families. The organization is building seven additional rooms and will have a total of 17 rooms for families who need to travel to Honolulu for care. It’s a $2 million expansion that will allow it to help more families outside of Oahu.
Sharing in the drive to ensure improved access, the Legislature passed a landmark autism insurance reform bill during the 2015 legislative session, which now heads to Gov. David Ige for his signature. The legislation, which received overwhelming support, has aligned Hawaii with 41 other states guaranteeing insurance coverage for those with autism.
SB 791, sponsored by state Sen. Josh Green (D, Kohala-Kona), requires state-regulated insurance plans to cover medically necessary treatment for autism, including behavioral health treatment, psychiatric, psychological, pharmaceutical and therapeutic care. The bill also requires plans to cover applied behavior analysis with a maximum of $25,000 per year through 13 years of age.
Shriners Hospital has followed the changing times in health care and continues to support the orthopedic and neurodevelopmental needs of Hawaii’s keiki across all islands. The autism bill just passed is evidence that the Legislature is also committed. Still, the race is on to ensure timely access to quality care to meet the health needs of people of Hawaii for years to come despite a growing shortage of physicians.
Shriners Hospitals for Children has been improving the lives of children throughout Hawaii and the Pacific Basin for more than 90 years. To learn more about Shriners Honolulu, visit ShrinersHonolulu.org.
Ira Zunin, M.D., M.P.H., M.B.A., is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Please submit your questions to info@manakaiomalama.com.
