Tuesday, January 10, 2006


Hawaii's medical infrastructure deteriorating, unready for disasters

According to the National Report Card on the State of Emergency Medicine, released today bye the American College of Emergency Physicians, Hawaii was ranked C- due to its lack of support for an emergency care system to meet the needs of its residents (via the Progressive Review).

In the face of pressures including decreasing reimbursements and increasing costs, doctors are leaving the state. On the Big Island, for example, there is no guarantee that an orthopedic surgeon will be available in an emergency to treat broken bones. In a May, 2005 op-ed in the Honolulu Advertiser, Dr. Barry Blum, an orthopedist working on the Big Island, warns readers "Don't get hurt on Big Island" because there may not be a doctor to take care of you.

Emergency rooms are often operating at capacity with no statewide emergency.

There were some bright spots in the report, but serious problems as well (only a D+ for Quality/Patient safety, for example). Recommendations included the need for additional registered nurses and emergency departments.

According to the report, Hawaii has a shortage of hospital space and trained professionals. Additionally, the state was deficient in these areas:The legislature has conducted hearings into emergency preparedness. This report card should be a wakeup call for the legislature to move rapidly into a problem-solving mode. The hospitals cannot and will not strengthen their own preparedness on their own; and doctors will continue to leave if insurers are allowed to build up reserves at the expense of medical reimbursements.

Hawaii needs to get its act together beforehand--when the tsunami or tropical storm hits, it's too late to plan an effective medical response system.


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