HomeMy WebLinkAboutCOM 0083.011 2012-2014 J.Yoshimoto, Chair
and Members of the Hawaii County Council
January 23,2013
West Hawaii Civic Center,Building A
Support of Hawaii Health Systems Corporation Primary Care Training Program
Wayne Kanemoto
As a EAST HAWAII REGIONAL BOARD MEMBER of the Hilo Medical Center, I resolve to strengthen the
state's provider workforce through the HHSC Primary Care Training Program (HHSC PCTP).
Support of this program and of family medicine graduate education will generate greater numbers of providers
practicing throughout the islands. We endorse the HHSC PCTP as a Means of Closing the Provider Gap in Hawaii.
Investing in training family practice residents in the neighbor islands is expected to yield a meaningful return on
investment.
• Increasing the number of family practice physicians is expected to decrease the number and rate of
"potentially avoidable hospitalizations,"which the state now pays for through both its Medicaid program
and unreimbursed care by state's public hospital system, Hawaii Health Systems Corporation.
• In rural areas of the state the impact of the Residency Program and greater access to family medicine
physicians is projected to have a profound impact on lowering the costs of treating expensive and
debilitating conditions. For example, diabetes and coronary heart disease have reached epidemic
proportions in Hawaii County compared to Oahu and other areas of the state where there is greater access
to primary care.
• The known economic multiplier effect of additional physicians in Hawaii means each additional physician
is expected to generate 5 new jobs and new tax revenue. (Source: The Lewin Group).
I recognize that the HHSC PCTP uses an advanced model of care delivery that eliminates the need to train or attract
unrealistically high numbers of physicians. The current predominant model of care throughout the country involves
one primary care physician caring for 2,000-2,500 individuals with a small staff, usually including a medical
assistant and receptionist. The team model of care in which the HHSC PCTP is training Hawaii's future providers
allows one physician and their team to care for up to 10,000 patients. Critical team components include a nurse
practitioner or physician assistant and specialists in chronic disease management such as pharmacists, certified
diabetes educators, behavioral health providers, licensed nurses, and well trained non-licensed staff.
I recognize that it is well documented throughout the nation that physicians attending rural training programs are
much more likely to practice in a rural area. More than half of residents trained at rural sites stay and practice in
this setting after they completed their residency. The same can be expected for advanced practice nurses,
psychologists, and clinical pharmacists.
I recognize that a more robust primary care base will attract physicians in other needed specialties to the islands as
they will be guaranteed appropriate referrals. The opportunity to teach residents and other health professions
students on the outer islands will also attract physicians who might otherwise not stay or come to Hawaii.
I strongly urge your support of a resolution for the Hawaii Health Systems Corporation Primary Care Training
Program.
?3.
CCom N �f
Ref. Date