Lt. Gov. Josh Green knew it irritated people when he sign waved for his 2018 campaign in hospital scrubs.

And he admits he’s not following typical government protocol when he jumps ahead of the state Department of Health to announce new and sometimes alarming COVID-19 case numbers on social media, hours ahead of the official data release.

But Green, 51, doesn’t care. He insists that as a Hawaii island emergency room physician, his first goal is to solve problems while alerting the public about important health information.

Green also has contradicted his boss, Gov. David Ige, and has apologized twice to Ige “for getting ahead of my skis.”

“David Ige and I are not a natural couple,” Green told the Honolulu Star-Advertiser. “While I respect his engineering thinking, I’m a shoot-from-the-hip physician and he provides the cautious checks and balances.

“Sometimes it works and sometimes it doesn’t. Our governor is very analytical and that is a strength. But he’s not a dynamic communicator and that leads a lot of people to get frustrated. Sometimes I’m way out ahead of a story and that’s not typical of government communications. Does he always love having me as lieutenant governor? You’d have to ask him.”

Ige’s office did not respond to a request for comment about Green’s gubernatorial aspirations and their relationship.

If Democratic voters pick Green to be their gubernatorial candidate in the primary election a year and almost one week from today, and voters eventually make him governor in November 2022, Green said he expects to behave the same way he does now.

“I’m not going to change,” Green said. “It’s just the way I am.”

Asked about legislators’ perennial complaint they are not always consulted on a governor’s intentions and plans, Green — a former member of both the state House and Senate — said he understands but doesn’t necessarily care.

“In the state Capitol, people will sometimes criticize me for that,” Green said. “But across the state I have not had one person ever be upset for sharing information and being transparent or open about what is really going on. There are two different cultures: the Legislative culture and the regular world, Hawaii.”

GREEN shot ahead last week as the early front-­runner in what is currently a two-person race for the Democratic primary for governor.

Former Honolulu Mayor Kirk Caldwell raised a total of just $9,760 in campaign contributions over the past six months from just six individuals and one company, according to campaign disclosure statements filed last week. Caldwell’s campaign told the Honolulu Star-Advertiser in a statement that Caldwell was more focused on meeting people on all islands and less on raising money.

During the same period, Green raised $424,212 through more than 230 donations, including several movers and shakers who sometimes donated more than once.

Colin Moore, director of the University of Hawaii’s Public Policy Center, said it’s Green’s race to lose. He called last week’s financial disclosure information “pretty decisive.”

“It’s pretty hard to imagine who could run a campaign who could beat Josh Green at this point,” Moore said.

But he cautioned the lieutenant governor not to become cocky or arrogant, or else risk alienating voters.

Moore’s advice to Green?

“Be humble and don’t make any obvious errors,” Moore said. “You’ve got to work for it. People want to see you work hard for the office. Work hard — and be humble.”

Political analyst Neal Milner said Green’s role as a physician during a global pandemic — one who’s not afraid to contradict his boss — gives him credibility among voters while positioning himself to succeed Ige.

“The pandemic is so scary and complicated, and he’s highly visible and doing important work,” Milner said. “The fact that he’s a real working stiff doesn’t hurt at all.”

Milner’s advice to Green?

“Keep wearing your scrubs and doing what you’re doing. Don’t screw up,” he said. “It’s hard to see how Josh would screw up so badly that it would really make a difference.”

With only two white, male Democrats to choose from so far, the potential gubernatorial candidacy of former Hawaii first lady Vicky Cayetano could add another dimension to the 2022 race.

Cayetano is married to former Gov. Ben Cayetano and is a successful businesswoman in her own right.

Native Hawaiian trial attorney Crystal Glendon, who was among those who recently spoke out against Ige’s nomination of Daniel Gluck to the Intermediate Court of Appeals because there were women of color among the candidates with far more experience, said she would welcome a more diverse gubernatorial ballot in 2022.

As it stands, “there are no other applicants so we don’t have a choice,” Glendon said. “But I wouldn’t mind seeing another female candidate for governor, one who’s qualified.”

Tort attorney Rick Fried, former chairman of the Hawaii Tourism Authority, has donated to Green’s campaign and finds him sincere.

Fried was particularly impressed by Green’s effort to organize a medical mission in December 2019 to fight a measles outbreak in Samoa. The original plan was to bring five people and 500 pounds of supplies. Fried said that at the request of Samoan officials, Green needed only 48 hours to recruit 75 health care workers armed with 50,000 measles vaccinations.

Two days after landing, the team had administered 33,997 doses.

“There was no one else to help,” Fried said. “I don’t think he makes decisions based on political considerations but based on what he feels is right. He’s guided by humanitarian interests.”

And during the start of the COVID-19 pandemic in early 2020, Fried said Green “was one of the first to say, ‘We need to be panicked,’ when other people were taking it lightly.”

GREEN’s circuitous route into medicine, Hawaii and island politics was not supposed to happen.

He was born Feb. 11, 1970, in Upstate New York. His family moved to Pennsylvania while he was still an infant and, before he was 2 years old, Green was misdiagnosed with severe developmental disabilities — “otherwise known at the time as mental retardation,” he said — and was going to be institutionalized along with children with autism and Down syndrome.

According to Green, a family friend and general practice physician correctly diagnosed that he had undeveloped eustachian tubes in both ears that left him deaf, which surgery eventually corrected.

“I was months away from not having a normal life,” Green said. “As a physician now, when I see children, I think about what can happen if they don’t have access to proper health care when they are young.”

Green went on to get his medical degree from the Pennsylvania State College of Medicine in 1997 and served his residency at the University of Pittsburgh, Shadyside Family Practice.

In 2000 he was offered an opportunity to pay off his medical school bills by serving in a rural community and working in Hilo through the National Health Service Corps. After accepting, Green was assigned instead to a four-year commitment as the Kau Family Health Center’s only physician, with a load of 8,000 mostly Filipino and Native Hawaiian patients.

He said his experience there informed many of his beliefs about the need to help low-income patients and drug-plagued families, especially in underserved communities.

Green told anyone who would listen about his concerns for neglected children and parents addicted to methamphetamine when Democratic Party officials suggested he run for the Kona House District 6 seat held by Republican Mark Jernigan.

“I was complaining and they said, ‘Why don’t you run for office if you know so much?’” Green said. “So I started going door to door in my scrubs, which I know drives people crazy when I sign wave now. But people, when they see me in my scrubs, don’t see me as a Republican or a Democrat. They see me as a doctor.”

Even while taking shifts at Kau Hospital and now Kohala Hospital, he served in the House from 2004 to 2008, then moved over to the Senate through 2018, serving as chairman of the Human Services Committee.

After being elected lieutenant governor for Ige’s second term, Green said he’s had to apologize twice to the governor: Once for pushing his nascent “kauhale” concept of building tiny home villages for homeless people. One is underway in Kalaeloa and another in Waimanalo.

“In his mind I was not inclusive enough with other members of the team,” Green said. “I saw homeless people suffering on the street. I don’t tolerate bureaucracy when people are suffering.”

Green also drew an Ige scolding for speaking to the White House directly about clamping down on cruise lines as the COVID-19 pandemic took hold last year.

“I had to stop the spread to the neighbor islands,” Green said. “That caused a little brush-up and some to question about whether I would get kicked off of the team.

“I understood his upset and I was appropriately apologetic but still proud of that decision. … I know it was the right call. I do have a reputation for being a lone wolf. It’s not true, but it’s the emergency physician in me going after problems.”