More than 150 Hawaii doctors left the state this year - roughly 5% of workforce (how much, to buy)

[rya96797]

Originally Posted by terracore

Eventually human doctors will be obsolete. AI doctors won't make mistakes and can't be sued. We are in the early stages where AI is assisting doctors, on the horizon human doctors will be assisting AI, and after that, doctors will themselves be diagnosed or treated by AI.

https://fortune.com/2016/11/02/ibm-w...ealth-doctors/

"Athenahealth CEO Jonathan Bush, however, disagreed. “It’s OK—we’re friends here—of course you’re going to replace me!” he exclaimed, noting the limitations of traditional doctors.

“The human is wrong so freaking often, it’s a massacre,” said the co-founder of Athenahealth, which sells cloud-based electronic health records software to hospitals and doctors’ offices. “Nobody ever goes after the radiologist—they’re wrong so often we don’t blame ’em.”

While less enthusiastic about artificial intelligence’s current contributions to healthcare, Bush suggested a perhaps more radical vision of the future, in which machines do indeed supplant many rudimentary medical functions..."

Outer islands has it the worse bro. For anything more serious than a sprain or simple ailment, you need to fly to oahu to get comprehensive care. Pretty soon, need to fly to the mainland.

[mxg67]

I have plenty local friends/family that are doctors, spanning in age from 30's to 70's. Like every other field here, transplants are an unknown commodity, most leave within a few years. I've heard some depts/hospitals have issues with turnover because of this while others seek out local doctors to prevent this. Of the local docs I know, some stayed or returned from the mainland due to family, being home, etc. and are willing to deal with COL, pay, etc. Others couldn't be convinced to stay because they don't want to deal with those issues, like the mainland, career growth/opportunity there, mainland spouse, etc. Then there are a few who want to practice here but the conditions aren't right. There's no position in their specific specialty. There's no good job available (abysmal pay, toxic conditions, etc.). And others don't want to start their own practice. Hawaii was largely private practice docs and many young docs don't want to deal with that. It's slowly moving towards employed setups with either Kaiser, HPH or Queens (and VA), but that limits options too. Some of these employers don't make an effort to higher or cater to local doctors. We worry about the brain drain and the best and brightest leaving, but some hospitals and such aren't really doing much to attract or keep them. I had a local friend looking to practice back here coming from the mainland and one hospital told him no positions available but we'll let him know. Another one said said they don't really have a need but will create a job for him. Doctors leave/retire and he'll be right there to pickup where they left off. It's not entirely about pay, if older docs, employers, etc. reached out to local doctors, supported them, helped them out and provided good jobs beyond pay, I think that could go a long way to helping.

[Grassyknoll]

Is 5% of doctors leaving in any given year higher or lower than other professions? Maybe 5% is actually a low rate, without more data it is hard to say that this is much to get worked up about.
Yes, it sucks to lose physicians when we already have a shortage of qualified medical professionals, but the same is true for teachers and any number of other industry professionals.

[whtviper1]

Originally Posted by Grassyknoll

Is 5% of doctors leaving in any given year higher or lower than other professions? Maybe 5% is actually a low rate, without more data it is hard to say that this is much to get worked up about.

Yes, it sucks to lose physicians when we already have a shortage of qualified medical professionals, but the same is true for teachers and any number of other industry professionals.

There is a huge difference between losing physicians and practically any other industry professional. And losing 5% of the workforce without replacements is huge.

It takes barely more than a college degree to be a teacher in Hawaii - so while it may be a revolving door, teachers get replaced - a bunch of them may suck, but they get hired.

I'm hard pressed to think of any profession in Hawaii where losing 5% of an already diminished workforce has more of an impact. And it isn't just the reduction of 5% - it is the elderly physician workforce that should be just as concerning as they retire.

[Grassyknoll]

Originally Posted by whtviper1

There is a huge difference between losing physicians and practically any other industry professional. And losing 5% of the workforce without replacements is huge.

It takes barely more than a college degree to be a teacher in Hawaii - so while it may be a revolving door, teachers get replaced - a bunch of them may suck, but they get hired.

I'm hard pressed to think of any profession in Hawaii where losing 5% of an already diminished workforce has more of an impact. And it isn't just the reduction of 5% - it is the elderly physician workforce that should be just as concerning as they retire.

Again, is 5% something to get our underwear in a knot about though?
What is the attrition rate for the mainland? Is this skewed by Oahu departures or is it 5% for all islands?

If you assume that the statistics where 70% of transplants to Hawai'i leave within the first 3 years, well then, how much of the loss is due to new physicians leaving that are in that category (less than 3 years)?

I can sympathize with the concerns about having inadequate acceea to medical professionals, but absent any data that gives perspective to what 5% means in the greater context, these numbers are meaningless and I don't see how it could even spark a debate regarding how to address the problem (if 5% attrition IS an actual problem).

[whtviper1]

Originally Posted by Grassyknoll

Again, is 5% something to get our underwear in a knot about though?

Did you even read the article and the specifics?

[Grassyknoll]

Originally Posted by whtviper1

Did you even read the article and the specifics?

Yes, and it was short on much that would shed light on WHY we are losing physicians. The report speaks to all the programs the taskforce is working on, but are those initiatives focused on actual causational factors? Who knows, but how hard would it have been to contact departing physicians query them on the reasons for their departure and include that data in the report.

Other questions I would want to know, are they including military physicians in that count? If so, that skews the data right there doesn't it.

Hawai'i population has increased from 1.3 ml in 2010 to 1.4 ml in 2018. Not a huge increase, and on page 6 of the report it shows that the number of physicians in Hawai'i has remained rather flat 2860 in 2010 vs. 2974 in 2018. With increases in technology, there should have been some gains in physician efficiency between 2010 and now, so in my opinion, the crises seems perhaps a bit overblown or at least, no worse than it has been for the last 10 years.

[whtviper1]

Originally Posted by Grassyknoll

Who knows, but how hard would it have been to contact departing physicians query them on the reasons for their departure and include that data in the report.

Of course it doesn't include military - they don't have a shortage because they are ordered to Hawaii.

https://jabsom.hawaii.edu/hawaii-doc...for-the-worse/



Dr. Withy said in her summits, which draw upwards of 500 physicians from all over the state annually, doctors repeatedly mention that what they need most urgently is increased reimbursements from Medicare, Quest and private insurers.


Technology has slowed things down:

"Some of the changes began with increased documentation expectations required for care reimbursement and use of Electronic Medical Records to provide that detailed and often redundant documentation. Additional requirements for process based “quality metrics” attached to government regulations or reforms imposed by providers of health insurance have added to physicians’ administrative burden. Increased patient care reporting requirements (some unique to each insurance company) take additional time away from seeing patients, in some cases requiring practitioners to hire additional staff to help with those tasks. “For example, there are five different Medicaid insurance carriers in Hawaiʻi alone,” Hedges said, each with its own physician credentialing and patient documentation/quality metric requirements to be met."

This should be of concern:

On Kauaʻi, the data show there are no island-based specialists in infectious disease, critical care, neonatal-perinatal care, neurological surgery, geriatrics, allergy/immunology, rheumatology, endocrinology, or physical medicine and rehabilitation. Maui had no island-based neurosurgeons (though reports it just recently added two), but still lacks colorectal surgeons; Hawaiʻi Island has no island-based neonatal-perinatal care doctors, none in infectious disease or colorectal surgery.

[Grassyknoll]

I'm not saying there isn't a physician shortage, but data doesn't support that it is markedly worse than it has been at any point in the last 10 years.

Secondly, I have no faith in any Hawai'ian governmental agency or taskforce to do anything about it.

It's just not something that keeps me up at night.

[whtviper1]

Originally Posted by Grassyknoll

Secondly, I have no faith in any Hawai'ian governmental agency or taskforce to do anything about it.

Well - the government shouldn't be doing anything about it. It isn't their responsibility.