Hawaii Talks About Concierge Medicine

The Health Beat: Emerging Health Care Model May Cost You More: Concierge Medicine

By James Ireland for the Honolulu Civil Beat, September 26th, 2013

It is estimated that the Patient Protection and Affordable Health Care Act, also known as Obamacare, will significantly increase access to doctors and health services for many people across the nation and Hawaii. This is good news — if you can find a doctor.

In states such as Hawaii, where there is already a well-known shortage of physicians, it is unclear how this increase in healthcare demand will be met. Researchers at the University of Hawaii John A. Burns School of Medicine estimate we are currently short nearly 750 physicians statewide.

Mid-level providers such as nurse practitioners and physicians’ assistants will help, but ultimately additional doctors are needed.

Medical schools, internship and residency programs that train new physicians have not yet collectively made significant enrollment adjustments to accommodate this increased need. After four years of medical school, all graduates must complete at least one year of post-graduate training, an internship, to see patients. A three-year internship and residency is required to become an internal medicine specialist, family practitioner or pediatrician.

Unfortunately, while medical school enrollment has increased nationwide, the required internship and residency positions that are federally funded have been capped for 16 years, creating a bottle-neck for new doctors. According to Dr. David G Kirch, the president of the Association of American Medical Colleges, in a release from the AAMC Reporter, “these (medical school) expansion efforts will not result in a single additional practicing physician until Congress lifts the 1997 cap on the number of residency training positions it supports through Medicare. Inaction will mean extensive shortages of both primary care physicians and a wide range of specialists.”

As this is happening, more physicians are feeling the frustrations of increasing costs, endless paperwork and declining insurance reimbursements. This reality coupled with a growing need for medical care has resulted in more and more patients being squeezed into a day’s clinic.

More patients are frustrated, too. Across the country, it takes longer to get a doctor’s appointment, waiting rooms are crowded and visits are shorter.

Some doctors are now saying enough is enough, and they are looking to a new practice model — one where they can spend sufficient time with their patients to deliver high quality health care. One Honolulu doctor I spoke with, who declined to be identified, felt he just could not deliver quality patient care in today’s environment.

In a sense, many physicians want to have the doctor-patient relationship that was common a generation ago. What has emerged is “concierge” or “boutique” medicine, which has now made its way to Hawaii.

READ FULL STORY for the details on Concierge Medicine Hawaii


About Concierge Medicine Journal

Concierge Medicine Journal (CMJ) curates breaking concierge medicine news, and editorial opinion on a wide variety of topics relevant to the practice of Concierge Medicine.

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