HomeMy WebLinkAboutCOM 0376.013 2006-2008 Dear Council members,
First, I want to say thanks for allowing the health care professionals and
patients who are affected by this rezoning request to share additional
information that the Council needs to concern carefully. I'm sorry we
didn't provide this information earlier in this process. I feel like I should also
apologize to some of our neighbors who have files complaints about the
medical clinics in the Punahele area. We could have done a betterjob of
addressing some of their concerns in the past.
The County Council doesn't need me to have tell them there is a crisis in
health care access in Hawaii. You can't pick up the paper or speak to a
neighbor, without hearing how hard it is to find a primary care doctor.
Patient care is suffering because of the lack of orthopedic doctors, general
surgeons, internists, OBGYN and women's health specialists. In short,
patients are having difficulty seeing the very type of health care providers
who practice at the Punahele Professional Building at 83 Pu'uhonu Place.
If any more OB doctors stop making deliveries on the Big Island, we'll have
to train our kids to deliver babies when they go to law school. "Well,
there's a shortage of doctors everywhere in the U.S. ,who cares? What's
the big deal?" The answer, of course, is that we live on an island in the
middle of the Pacific Ocean. Patients cannot get in their car and drive to
the next town or across the state border to find care elsewhere. If patients
can't see their doctor in Hilo, they often don't see anybody.
I'm a specialist in the detection and diagnosis of breast cancer. I co-wrote cq
the breast cancer practice guidelines which were published by the Hawaii ~
Department of Health and founder the Hawaii Breast Society. Our ~
mammography clinic should be screening about 2 to 3 thousand more
East Hawaii patients each year than we are now. We can save 2 or 3 more ~ ~ d
women annually if these patients have access to our mammography v
center. We need to accommodate these women as the only
mammography clinic on this side of the Island.
I guess one could reasonably ask "are you guys dummies? How come
you didn't move to a building with more parking?" Maybe with perfect
hindsight, we should have waited to see the new parking lot approved by
the County Council, but Hilo Medical Center needed our old clinic space
for other purposes and asked us to move. We really didn't think we were
being foolish when we moved to the Punahele Professional building. We
image and biopsy patients of others doctors ,who run back and forth
between their doctor's offices and our clinic. What better place to
practice in Hilo, then the outpatient medical complexes where most of the
referring doctors work? We help surgeons with breast localization, so we
needed to be close both to the Community Surgery Center and the
hospital. The rezoning for the additional lot, which was recommended by
the County of Hawaii Planning Department and the Planning Commission
was expected to increase the number of available parking spots by almost
30~. Since that parking lot has been chained off, we've seen women in
their 80's walking several city blocks to reach our clinic. How do these
patients feel, when they see an unused place to park a few yards away?
There are competing issues here, and we realize that. There is a large belt
of 9 separate medical office complexes that sees hundreds of thousands of
office visits annually. That has changed the character of the
neighborhood for the four residential homes sandwiched between these
medical centers and the Hilo Community Correctional Center. This is a
matter of balancing what is best for these home owners and the nearly
80,000 residents of East Hawaii. The Punahele Professional Building should
have and will do a better job of addressing the concerns that have
blocked the use of the parking lot. But let's be fair about things. The
decision by the County to turn Punahele Street into a major throughfare in
the morning has had far more impact on traffic and the quiet of this
neighborhood than the medical clinics. The sirens of ambulances traveling
to Hilo Medical Center disturb the peace all day long, surely we shouldn't
move or close down the hospital! Previous testimony has been presented
that loud disruptive behavior at night, prostitution, property crimes and
drug dealing have occurred on the vacant lot. I won't ask for a show of
hands, but does any Councilperson really believe that the patients, doctors
and nurses are responsible for that criminal behavior. Isn't it likely that the
County of Hawaii's decision to site a correctional institution in that
neighborhood more of a factor than the practice of medicine in the
middle of Hilo.
I really appreciate the time that the Council members have given to hear
me out. I was asked if it wasn't an option to close the exiting clinics and
medical practices down and reopen them somewhere in an undeveloped
areas. I can share from my recent experience of serving as Chief of Staff at
Hilo Medical Center that closing medical practices down is the easy part.
These medical practices are actually small businesses. The hundreds of
thousands of dollars lost in abandoning their current leases, building or
developing new practice sites and the loss of practice income during the
move, would likely bankrupt most doctors at the Punahele Professional
building. If the Council wishes the Rehabilitation Hospital of the Pacific and
other adjacent medical clinic s, that could potentially impact these four
homes, to move as well then the medical health care system in Hilo will be
devastated.
According to the Federal Food and Drug Agency about almost 10% of the
total number of mammography clinics in the U.S. were lost in the last 10
years mostly due to bankruptcy. Mammography is more or less a
breakeven business, with a high risk of lawsuits. Our mammography center
cannot afford the cost of another move, and if we are forced to close, it
will be hard to find other professionals to replace our mammography
services.
I was also asked if we could develop parking remotely and bus patients
and health care providers to the Punahele Professional Building. First, the
physicians who run back and forth to the hospital and ER, have to park
onsite. Can you imagine Dr. Gerald Lau or Dr. Raymond Lee being bused
to their vehicles when they are paged to operate on a patient with a
ruptured aorta or appendix? At some places like Disneyland, people do
park in remote parking lots and are bused in. We see 10,000 patients
annually for mammography alone. I will ask those women if they wish to
spend the extra half hour or hour being bused in for mammography, and
have then call the County Council with their opinion, but I won't give your
home phone numbers. It will be more convincing to hear the opinions of
your mothers, wives and daughters this offsite busing plan.
With this additional important information to consider, 1 think that there is no
reasonable alternative to approving the rezoning of this parking lot. The
County Planning Department approved the rezoning this lot because "The
County is responsible for general welfare of it's residents and must continue
to make every effort to ensure that adequate health services are
provided". If the Council approves rezoning, then privacy fences and or
green belts will be constructed around the lot, and the lot's access to
Punahele Street will be permanently blocked.
If the Council members vote against rezoning then the Punahele
Professional Building likely will be forced to divert funding needed for better
medical equipment into the concrete for a large parking ramp which will
tower over Punahele Street. Our fencing currently blocking access to the
lot from Punahele Street wil be removed and the control of the lot will
revert back to the previous owners. The Planning Department states "the
property does have a sewer line and water line that extends form
Punahele Street to the rear of the property, which renders the property
unbuildable". Therefore, this would forever remain a vacant lot, used for
unfenced, unauthorized parking with all of the associated criminal activity
that was described to the Council. In short, everybody loses, including the
homeowners and patients in East Hawaii.
The Council wanted to send a message that developments, even medical
projects, need to be attentive to the concerns of the neighborhood. That
message had been received. We have offered to meet with Councilman
Ikeda and all the neighbors. We've gone door to door to talk story about
what we can do to be better neighbors. Please, I beg you, do not punish
the women and patients of east Hawaii by banning parking and access to
Health care.