Editor’s note: This is the first of two stories about an exodus from Kaua‘i of healthcare professionals. Despite facing a number of challenges that are shared by hospitals nationwide and some specific to Kaua‘i, the Wilcox Health ohana is in
Editor’s note: This is the first of two stories about an exodus from Kaua‘i of healthcare professionals.
Despite facing a number of challenges that are shared by hospitals nationwide and some specific to Kaua‘i, the Wilcox Health ohana is in pretty good health and looking to get stronger.
According to Dr. Lee Evslin, president and CEO of Wilcox Health, which includes Kauai Medical Clinic (KMC) and Wilcox Memorial Hospital, there are enough specialists to serve the medical needs of Kauai’s community.
“Kauai has been very fortunate in terms of orthopedic and obstetric coverage,” Evslin said. “Among Wilcox Hospital, Kauai Veterans Memorial Hospital (KVMH), and their respective parent companies, Hawaii Pacific Health (HPH) and Hawaiian Health Systems, there have been no breaks in 24-hour seven-day-a-week coverage,” he said.
As to reports of several doctors leaving Kauai Medical Center, Evslin said a certain amount of turnover was to be expected.
He said nationally, many new residents spend two years at a hospital before moving on.
Evslin acknowledged the community will lose a gastrointerologist and obstetrician-gynecologist (ob-gyn) soon.
But he said surgeons will be available on call 24 hours to handle endoscopies needed to control gastric bleeding, and that a gastrointerologist would be available for scheduled appointments.
He said a second dermatologist, a second cardiologist and third hospitalist (doctor specializing in hospital care) will be joining KMC.
Ken Pierce, Chief Medical Officer for Wilcox Health, said the national annual turnover rate was about 7 to 10 percent for medical groups.
He said the rate under the aegis of Wilcox Health was somewhat below the national average.
Pierce said Wilcox Health was always recruiting new physicians. In 1990 there were 35 doctors on board. Now, there are 65.
Evslin conceded there are issues facing physicians in Hawaii that might impact the length of their tenure.
Chief among them are low reimbursement rates from insurers.
On some charges, the commercial insurers pay less than Medicare.
Another factor is the cost of living on Kaua‘i, notably the price of homes.
Evslin said the malpractice climate is also a consideration. While malpractice rates are not nearly as high as they are in Florida, Maryland and many other states, the absence of tort reform in Hawai‘i, leaves the door wide open for potential malpractice charges and litigation.
The rising cost of medical malpractice insurance and fears of lawsuits are forcing some doctors in Hawai‘i to leave their fields, according to the American College of Obstetricians and Gynecologists and the Hawaii Orthopedic Association.
The number of obstetricians has dropped nine percent in the past two years. The number of orthopedic surgeons has fallen 29 percent in the past decade.
Evslin said the economics of medical care have changed.
He said the Balanced Budget Act of 1997 took a lot of money out of hospitals and began to impact most healthcare institutions by 1999.
“The medical system ran into increasing financial difficulty,” he said, which meant many hospitals and clinics were seeking partners with deep pockets for capital improvements.
In 2001, Wilcox Memorial Hospital and KMC, which had been sibling organizations sharing a common board of directors, became a “satellite” under HPH.
Evslin is Executive vice president for HPH.
HPH has invested $35 million over a seven-year period to Wilcox Health for major improvements, including a magnetic resonance imaging camera, one of the newest in the state, and a new CAT scanner ready by June 15 and five new operating rooms.
Another $35 million has been dedicated to creating a comprehensive online information system shared by Wilcox Health and its satellite partners.
Evslin said “there have been changes forced by the economic climate and factors bigger than us.”
Among those are reimbursements from various contracts that have not at all kept pace with rising inflation and costs.
He added, “both Wilcox and KVMH have gone through some difficult times, but both feel optimistic about the future. “The goal, the dream and plan for both medical care systems, despite the financial, strains, is to be absolutely wonderful places to receive medical care and a wonderful place to work.”
And part of what he and Orianna Skomorach, regional CEO for the Hawaiian Health Systems Corp., are trying to do utilize the positive aspects of association with corporate entities while maintaining the identity of a community hospital in a modern age of both financial restraint and technological advances.
“The work place has gone through a lot of changes. But I think we offer surprising care for a rural community,” he said.
The hospital was named one of the top 100 hospitals nationwide in 1998.
Its emergency room has earned a 90 percent satisfaction rate from its clients.
- Andy Gross, business editor, may be reached at 245-3681 (ext. 251) or agross@pulitzer.net.
