HPSA designation will help recruit doctors

Did you know the average medical student loan debt upon graduation is more than $260,000? It’s no wonder loan repayment is the No. 1 concern of medical students across the country, and one of the highest priorities for new doctors while deciding where to practice. But our community has something to celebrate.

After years of work, Hawaii County has been designated a Health Professional Shortage Area, or HPSA, for primary medical care. This designation will help our Big Island communities actively pursue the recruitment of primary care physicians, specialists, advanced practitioners, psychiatrists, core mental health care workers, dentists and hygienists.


The HPSA designation supports these efforts by providing doctors with access to significant funds for medical education loan forgiveness. In addition to improving patient welfare by relieving the shortage of health care providers, HPSA status benefits the entire community in many other ways. The HPSA designation is a prerequisite to other programs because it defines the shortage area of needs within a community.

The HPSA designation qualifies the community for other designations and services, such as the Rural Health Clinic designation, and allows the designation to advance in line for priority consideration. HPSA status provides an important platform for writing applications for grants, financial assistance and a variety of other health care supportive programs.

As a benefit to the community, any primary care physician who accepts loan repayment through the HPSA program is required to see any patient, regardless of insurance status. This will alleviate some of the burden on health clinics, urgent care centers and hospital emergency rooms. Most importantly, improved access to care should improve the general health of our friends and neighbors.

Two years ago, the East Hawaii Regional Health Improvement Collaborative made the recruitment and retention of physicians on the Big Island a prime objective. A task force was created with representatives from the community and local businesses, the East Hawaii Independent Physicians Association, Hilo Medical Center, several insurance companies and the Hilo Medical Center Foundation.

The task force quickly realized that to effectively compete with other communities for health care professionals, we had to offer loan repayment options to doctors considering our island, as well as those already in practice here. The first step in this effort was to obtain the countywide HPSA designation. Our task force worked on this project with the state Department of Health Primary Care Office, local physicians and organizations, the Hawaii/Pacific Basin Area Health Education Center and many volunteers.

To accurately tell the story of the countywide primary care shortage, our volunteers put “boots on the ground” to verify the address of each doctor listed as a primary care provider. Our work was rewarded Oct. 27, 2017, with the designation of our entire island as a Health Professional Shortage Area.

With the HPSA designation, doctors on the Big Island now have access to the Hawaii State Loan Repayment Program, which provides up to $30,000 annually toward medical education loan repayment. This program is not just for “new” physicians; practicing doctors with medical school debt are encouraged to apply. This helps us to attract new primary care physicians while providing support to those who are already part of our community.

The loan repayment program is making a difference on our island right now and is a “game-changer” for recruiting and retaining doctors in the future. But the task force did not stop there.

We established a New Physician Subsidy Program to be administered by Community First. The East Hawaii IPA, Hilo Medical Center, Hilo Medical Center Foundation, HMSA and University Health Alliance each contributed to a pool of funds meant to subsidize some of the costs incurred when a new doctor begins his or her practice.

A selection committee was formed to develop an application process and review applications for the program. After hundreds of volunteer hours, Community First is accepting applications from primary care doctors and specialists for the New Physician Subsidy Program.

The HPSA designation, Hawaii State Loan Repayment Program and Community First funding are a “win-win” for doctors and patients. The subsidy funds should provide some relief to our doctors and allow more time to practice medicine, while patients should enjoy better access to primary care and more time with their doctors.

For more information about the HPSA and the loan repayment program, call the Hilo Medical Center Foundation at 932-3636. For information about the New Physician Subsidy Program, call Community First at 675-2750.


Lisa Rantz is the executive director of the Hilo Medical Center Foundation. She also serves as vice president of the Hawaii State Rural Health Association and is a member of the Hawaii Medical Education Council.

This column was prepared by Community First, a nonprofit organization led by KTA’s Barry Taniguchi and supported by a volunteer board of local community leaders. Community First was established in 2014 to help the community respond to the health care cost crisis and support initiatives that change health care from just treating disease to caring for health. To learn more about Community First, visit www.communityfirsthawaii.org.