Psychiatry and mental health counseling are the Big Island’s two most needed types of health care, according to an islandwide survey completed in March by Community First Hawaii, a nonprofit with a goal of improving access to health care throughout the state.
The survey polled more than 2,248 community members and health care professionals from Hawaii County, revealing staffing shortages and low morale within the medical community. The results are intended to help expand access and guide potential improvements for the Big Island’s health care industry.
“The takeaway is that the time for talk is long past,” Community First Hawaii Executive Director Randy Kurohara said about the results. “Our community is calling for urgent action to improve access to care for all of us.”
Roughly 76% of health care professionals believed there was a short supply of mental health counseling, and 70% reported an ongoing need for psychiatrists.
“It’s an imbalance that is deeply troubling,” said Kurohara. “Especially as the need for services continues to grow in the fallout of the unprecedented strain and trauma of the pandemic that many experienced.”
The survey also addressed medical staffing shortages, with 76% of those polled believing a lack of physicians was the biggest barrier when accessing health care services.
“The physician shortage is a tremendous problem, and one of the highest priorities for us to address as a community,” Kurohara said. “It’s particularly acute on the neighbor islands and in rural communities, which is also where folks have the biggest barriers around transportation.”
The staffing shortage impacted patients, with just 21% reporting they could see a provider “when wanted,” as opposed to waiting for available appointments, openings or having to travel off-island.
Community First Hawaii plans to use the results from the survey to take a holistic approach to improving the statewide health care system.
“But that’s no small task,” Kurohara said.
Initial plans include addressing legislation and the health system to expand the state’s preceptor tax credit, which could support more clinical training and expand the overall workforce. Additional goals include establishing a loan repayment and loan forgiveness program for primary care providers and specialists, eliminating the general excise tax on health care services, and increasing the Medicare.
“Hawaii is the only state in the nation that taxes health care,” Kurohara said. “Hospitals and Federally Qualified Health Centers do not pay GET, and it is an unfair burden to tax solo and small health care practices with this.”
Staffing shortages could worsen in the coming years due to the number of health care providers expressing a desire to leave their field — and the island. The report stated roughly 49% of health care providers considered reducing their hours, 47% considered leaving medicine altogether, and 44% considered moving to the mainland.
“Health care professionals find it hard to look at the high cost of living here compared to other places,” Kurohara said. “With the rates of compensation being lower than the mainland, the economic picture doesn’t always make sense. We knew that was the case, but we didn’t understand what a big percentage of our health care providers are close to the edge of leaving medicine or leaving Hawaii.”
An additional statewide report will be released on July 26, where Community First will partner with the Hawaii State Rural Health Association. Together, the groups plan to unite leaders in health care, social services, government and community based organizations, which Kurohara believes will help “identify and implement solutions to some of these complex issues that can only be solved by working together.”
Email Grant Phillips at gphillips@hawaiitribune-herald.com.