Thursday, March 6, 2003

Health chief makes quiet impact

Chiyome Leinaala Fukino is hoping
to improve treatment for native Hawaiians

By Helen Altonn

Chiyome Leinaala Fukino said it's a family joke that she became a doctor because no one would pay her to sing.

Hawaii's new part-Hawaiian health director might have had a different career path if she had a louder voice.

Growing up in Kalihi, Chiyome Leinaala Fukino and her four brothers and three sisters were required by their parents, Richard and Julia May Kealalio Fukino, to sing or play the piano or both, she said. Some became entertainers.

"It's a family joke that I became a doctor because no one would pay me to sing," she said, laughing. "I used to play the piano, and I can sing backup but I have a very soft voice." Her deputy director, Jane Kadohiro, signals her if people cannot hear her when she's talking, she said.

Fukino, 52, said her father stressed education because he could not go to college as a youth. (He went to the University of Hawaii, earning a fine-arts degree, after suffering a stroke at age 46.) She said he would encourage his children: "If you want to be a nurse, why don't you be a doctor? If you want to be a secretary, why don't you be a lawyer?"

He did not live to see her become the first woman to head Hawaii's Department of Health, but he was "very happy" about her profession in internal medicine, she said. Her brother Wayne also went to medical school and is a primary-care physician on Kauai.

The new health director had a rocky introduction to the political and bureaucratic system when community health centers loudly protested a proposed $1.6 million appropriations cut by her department.

The money turned out to be in a fund the administration could not touch. Fukino said it is being released, and she plans to talk to the centers about sustained funding and ways to reduce costs.

She and Kadohiro consider it an early day if they leave the office by 10 p.m., but Fukino said: "I'm enjoying it, oddly enough. It's really challenging, and I'm serious about the opportunities to make a difference. All the years I worked on native Hawaiian issues ... although we did a lot of good work, ideas may not be advanced beyond a certain point."

She was instrumental in helping native Hawaiian health-care providers form the nonprofit organization E Ola Mau to improve access of native Hawaiians to the health system and traditional healing.

One of her goals now is to make systemic changes for long-term improvements in access and appropriate treatment for native Hawaiians and other ethnic groups.

"It will be very helpful to have a health director familiar with Hawaiian health issues," said Hardy Spoehr, executive director of Papa Ola Lokahi, nonprofit public and private group devoted to improving health care for native Hawaiians. "Chronic disease rates (among Hawaiians) haven't gotten any better."

While attending Kamehameha Schools, Fukino said she was advised against medicine because it was not a common field for women. She decided to be a psychologist when she went to Brandeis University on scholarships. Returning home, she worked for one year in speech pathology and audiology.

That changed when her father met a dean at the University of Hawaii John A. Burns Medical School who was starting a program to get more women and native Hawaiians into medicine. "My dad said, 'You need to talk to my daughter,'" she said.

She joined Imi Ho'ola (meaning "Those Who Seek to Heal"), which helps qualified disadvantaged students get into medicine.

Among her previous positions, she worked for Fronk Clinic, then went into private practice, became a consultant to Kahi Mohala, was on Leahi Hospital's medical staff, medical director of the Queen's Physicians' Group and medical director of Queen's Hawaii Kai outpatient clinic. She left private practice to take the state job.

Dr. Philip Hellreich, former Hawaii Medical Association president who chaired the search committee that recommended Fukino, said everyone they checked with "had wonderful things to say about her.

"She's a quick thinker, a very creative person, somebody who has a lot of empathy for the minority community and devotion and dedication to make sure underserved people in the community get adequate care."

"She's an amazing lady," said Dr. Emmett Aluli, Molokai General Hospital medical director, who has worked with Fukino on E Ola Mau. They are both board members of Kauka Hui, the Native Hawaiian Physicians Association, and she is also on the Queen's Medical Center's board, he noted.

"She has a wonderful 'talk story' style, which really brings people together and at ease," he said. "She certainly has challenges ahead to be able to make a difference to the barriers that still exist for access to medical care, but it's in her radar screen."

Fukino supports legislation this session to treat mental illness like any medical condition and to waive the 4 percent excise tax on health insurance companies coming into Hawaii to increase competition with the Hawaii Medical Service Association.

She is seeking authorization to automate death certificates, similar to birth certificates, because it takes four to six weeks to get them manually. The delay causes many complaints and costs the Social Security Administration millions of dollars, she said.

Fukino said she will explore possible legislative changes to authorize medical savings accounts and to allow patients to designate doctors for insurance payments so doctors are not forced to contract with HMSA to make a living.

On the controversial fluoridation issue, she said, "There is certain sacredness about water to people ... but the social benefit of fluoridation is very clear, and cost savings can be effective." Her 26-year-old son has perfect teeth because she gave him fluoride when he was a baby, she said.

On the home front, she said she used to walk every morning with her husband, Harold Cutler, retired Air Force navigator, and wants to get back to it. "We're going to work on being healthy ourselves."

State Department of Health

E-mail to City Desk


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