贬补飞补颈驶颈’s Physician Shortage Hits Maui Hardest
Doctors were scarce before the Lahaina fire, which burned medical facilities, displaced health care workers and patients and heightened financial stress.
Doctors in 贬补飞补颈驶颈 are in short supply and the problem is most severe in Maui County where last year’s wildfires worsened the housing crunch and spurred some financially strapped medical workers to leave the area.
The devastating Aug. 8 wildfires dealt a blow to an already struggling medical workforce, destroying several West Maui health care facilities that have not been rebuilt.
Some medical workers and patients who lost their homes or jobs in the fires have moved to South or Central Maui, other islands or the mainland. As a result of this population shuffle, a published Thursday by the University of 贬补飞补颈驶颈 says the doctor shortage is likely worse than the latest state estimate, which pinpoints the amount by which Maui鈥檚 physician workforce needs to grow at about 41%.
Worries among medical workers over the high cost of living, especially housing, and the inability to accrue savings is worse now than right after the coronavirus pandemic, according to a report published in July. The research found that nearly half of Maui residents say their financial situation has worsened since the Lahaina fire and one in five are 鈥渟eriously considering鈥 leaving the state.
More than 2,000 county residents and 1,000 fire survivors participated in the assessment, which also drew on four online focus groups with medical workers and an online survey of 57 health care workers in Maui County. The vast majority of respondents 鈥 including primary care and behavioral health providers 鈥 said they were more worried than hopeful about their future in 贬补飞补颈驶颈.
鈥淚t鈥檚 Christmastime and our doctors are saying, 鈥業 can鈥檛 really afford to do Christmas this year,鈥欌 said Dr. Malia Purdy, executive director of Native Hawaiian health care clinic in Wailuku. 鈥淚f doctors can鈥檛 afford to live on Maui then what would make anyone think a normal person who鈥檚 not a doctor can afford to live here?鈥
Physician salaries at the clinic range from $135,000 to $209,000 for full-time equivalent positions, Purdy said. Some of the clinic’s part-time doctors juggle two or three jobs to get by.
The highcost of living crisis long predates the Maui fires, but the devastation in Lahaina worsened the housing crisis, causing prices to skyrocket and the availability of rentals to plummet.
鈥淚 know that in my neighborhood, the houses are going for $2 million, which I wouldn’t be able to afford as a doctor now,鈥 said Dr. Felicitas Livaudais, a pediatrician and the Medicaid medical director for Maui.
Andrew Van Wieren, chief medical officer at in Wailuku, said it can be particularly hard to afford the going price of housing, groceries and other basics on typical nurses鈥 wages.
鈥淚 feel like we see folks do the calculations and not be able to make it work and realize this line of work is not in line with their long-term financial goals,鈥 he said.
Barriers, Solutions To Recruitment
贬补飞补颈驶颈 has the equivalent of about 3,075 full-time doctors, according to . But it needs an additional 768 physicians to meet patient demand, up from 757 in 2024. Primary care accounts for the deepest shortages.
These calculations account for differing needs on neighbor islands and the unique demand for medical specialties like endocrinology, pulmonology and pediatric gastroenterology. In rural areas residents must board a plane to access specialized care, and routine treatment is propped up by a revolving door of fly-in physicians.
Experts say filling the gap is practically impossible, as it would require that the state increase its physician workforce by 21%. Luring new doctors to 贬补飞补颈驶颈’s complicated by myriad factors, not the least of which is the state鈥檚 isolated geography, high cost of living and relatively low rates for insurance reimbursement. The state’s only medical school, the University of 贬补飞补颈驶颈 John A. Burns School of Medicine, would need to triple in size to produce enough physicians to meet all of the patient need.
Recruiting health care workers 鈥 and keeping them 鈥 has never been easy, said Dr. Chris Martin, assistant area medical director at Kaiser Permanente, but prospects are particularly poor now. The pandemic deepened the state’s medical workforce shortage, with some physicians choosing to retire or reduce their hours due to exhaustion or burnout. The Lahaina fire dealt another hit, tightening the housing crunch, scrambling the West Maui health care system and revving up the needs of behavioral health patients.
In the last six months alone, Martin said he knows of five primary care doctors who stopped practicing on Maui, an exodus that amounts to a county workforce reduction of roughly 12%.
鈥淎 lot of people are thinking about leaving,鈥 Martin said. 鈥淚 have a provider that鈥檚 leaving Lahaina because he realizes that if he moves to a rural place in Pennsylvania he鈥檒l have a house five times bigger and the cost of living will be a third less. So that鈥檚 one less provider in Lahaina in 2025.鈥
Experts say doctors from 贬补飞补颈驶颈, as opposed to those recruited to 贬补飞补颈驶颈 for work, are more likely to stay in the islands, even in the face of so many challenges. Efforts are being made to ease those challenges and entice more local people to pursue a medical career.
In March, a first-of-its-kind project by Maui Health Foundation broke ground on 16 rental homes for health care workers in Kahului. All but one of the houses will have an accessory dwelling unit for a total of 31 residences. Last month a nurse who lost her home in the Lahaina fire was one of the first medical workers to move in.
Martin, who’s seeking solutions to workforce development issues as a member of the Maui Economic Recovery Commission, said he’s developing career fair and internship opportunities to introduce Maui youth to the possibility of medical careers. It’s not enough to create programs for high school and college students, he said, and several of his initiatives would plant the seed of a medical career in younger children.
A number of industry committees and work groups in recent years have identified ways to simplify burdensome prior authorization requirements and improve time-consuming electronic health record systems 鈥 two primary contributors to physician burnout.
There’s a tax credit for health care workers who agree to train or supervise medical students. Certain high schools are offering new opportunities for students to graduate with health care training certifications that could jumpstart a medical career. The 贬补飞补颈驶颈/Pacific Basin Area Health Education Center now foots the bill for 贬补飞补颈驶颈 doctors who attend conferences on the mainland and take potential recruits out to dinner.
The state Legislature this year is funding medical for hundreds of health care workers.
“The critical point is we import medical professionals from the continent and that’s wonderful 鈥 if they’ll stay,” said David Tumilowicz, senior director of community heath at Kaiser Permanente. “But a lot of times they don’t stay. And so I think there has become more and more of a focus on growing our own.“
Civil Beat鈥檚 coverage of Maui County is supported in part by a grant from the Nuestro Futuro Foundation.
Civil Beat鈥檚 community health coverage is supported by the , and .
