There is a critical shortage of physicians in Hawaiʻi. Our physicians are an endangered species. The future battleground of competition in healthcare will not be for covered lives, it will be for available providers. This crisis is occurring throughout our country, but it is more pronounced here in Hawaiʻi.
The University of Hawaiʻi Physician Workforce Assessment Annual Report to the Legislature for 2022 showed that we need 20% more physicians than what we currently have. For 2021, we had 2857 FTE physicians. We needed 3395. In addition, the demand for physicians is increasing to meet the increasing needs of the growing aging population.
The physician shortage is forecasted to persist. The Association of American Medical Colleges commissions annual reports of physician workforce by independent experts. In the best case scenario, the shortage will remain the same, in the worst case scenario, the shortage will triple.
The physician shortage is fueled by high burnout rates. The physician burnout rate was already high when it was exacerbated by COVID-19. Medscape reports that the average burnout rate for physicians has increased to 47% for 2022.
The high burnout rate is leading to physicians leaving clinical practice. An American Medical Association survey in 2020 of 20,665 respondents at 124 institutions reported that 23.8% of physicians were intending to leave their current practice within the next two years. For nurses, that statistic is 40%. Burnout and not feeling valued by one's organization were predictors of intent to leave.
As the population is aging, our physicians are also aging. Almost half of Hawaiʻiʻs physicians are over the age of 55 and 22% are age 65 or older. Current data are not finding that the addition of advanced care practitioners and the emergence of new healthcare delivery systems are offsetting the physician supply shortage.
Hawaiʻiʻs physician supply shortage is most severe in primary care. A NursingEducation study ranked United States counties by their shortage in primary care. Kauai County was ranked #13, Maui County was ranked #5, and Hawaii County was ranked #3. https://nursingeducation.org/counties-with-the-biggest-primary-health-care-worker-shortages/
There are significant financial factors contributing to Hawaiʻiʻs physician shortage. Medical Economics ranking by state for Hawaiʻi physician salary is #50, tax burden is #49, and cost of living is #51. Hawaiʻiʻs overall score for best state to practice is #50 out of 51.
When coupled with high medical school debt young physicians contemplating starting practice in Hawaiʻi finds the situation unfeasible. Hawaiʻi is the only state in the union to tax healthcare and Medicare benefits.
Loretta Lynch stated “We all have a responsibility to protect endangered species, both for their sake and for the sake of our own future generations. Our physicians need our protection, both for our sake and for the sake of our children.
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