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GUTTELING: Thank you, Commission. I’ve been in practice in Hilo since 1992 as an
<br />orthopedic surgeon. I’m the longest, continuous serving orthopedic surgeon on the island in that
<br />regards. As you may be aware, we are facing a declining physician population and increasing
<br />physician shortage and more difficult access to care. There was a recent article in the Tribune
<br />Herald that pegs the doctor shortage for this island at 225. And, I think this is a continuing trend.
<br />The principal reason for this is because it becomes a less desirable practice location for the
<br />doctors. The expenses go up, and the reimbursements have gone down, and the squeeze makes it
<br />less and less attractive. More and more private practices are folding.
<br />
<br />Presently, I share rental office space with my orthopedic practice with the primary care clinic of
<br />the Hilo Urgent Care. We rent a fairly expensive space. By combining space, we have
<br />efficiencies of scale, both by allowing optimal use of the floor plan by combining an area for
<br />joint uses of administrative services, sharing an x-ray facility and such.
<br />
<br />The lease is expiring, and it is also very expensive, and it’s becoming prohibitively so. I have
<br />searched extensively for appropriate similar space in which we could transfer our operations.
<br />This requires minimum 3,000 square feet or more, and there is no such space available in Hilo,
<br />nor has there been for years. And it’s up to the doctors basically to construct their own if they
<br />wish to be in such a facility. With that in mind, my goal was to purchase these properties,
<br />combine them, which has been done, with the sole purpose of transferring both my orthopedic
<br />practice and the Hilo Urgent Care, primary care doctors, over there. There would be two to three
<br />doctors total, including myself working there. And, this transition would then allow us to stay in
<br />practice and be profitable. Without this project going through, I’m not sure it would be
<br />financially feasible for me to continue in practice quite frankly. And, it’s my hope that you, the
<br />Commission and the Council, would help to improve access to medical care by allowing us and
<br />other similar, to go forward in this regards. Thank you.
<br />
<br />MIYASATO: Thank you.
<br />
<br />FUKE: Mr. Chairman, then you know just from a planning standpoint, I think as the staff had
<br />indicated from an infrastructure standpoint, you know, basically, you know there all covered, the
<br />water, the sewer—sewer line fronts the property so you know, that’s not gonna be an issue.
<br />There’ve been some, as far as the General Plan, as the staff indicated also that this falls within
<br />the Medium Density area, but the kind of use that Dr. Gutteling is proposing to have on the
<br />property is kind of like from our standpoint rather consistent with the evolving change you know
<br />that’s in, going on in that area. You know, you have some mixture of commercial, mixture of
<br />light industrial, mixed commercial industrial as well as residential.
<br />
<br />Fortunately, the, because it’s a corner property you know it’s, it’s not a use that he’s proposing
<br />that’s heavily traffic inducing. For example, it’s not a gas station. If you have a gas station, then
<br />obviously you know you have a lot of traffic movement. If you have like a fast food
<br />establishment whether it’s a McDonalds or Wendy’s or whatever, you know, your traffic pattern
<br />changes.
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<br />EXHIBIT A
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