[ Our side of the story ]

Lax management
threatens future of
Kuakini Health System

Many in our community probably were surprised to see a group of prominent physicians speak so critically, so boldly and so publicly about our problems with the management of the Kuakini Health System ("Docs' survey cites discord at Kuakini," Star-Bulletin, July 8).

We think it is important for the public to know that the decision to conduct a management survey and to release the results was a last resort after nearly a decade of frustration with the Kuakini management. In our hearts, Kuakini is an important institution, one that deserves greater leadership and vision, and we fear for its future.

In 1994, an internal survey was conducted by Kuakini. The results indicated a growing problem with communication between management and physicians, a lack of trust and confidence in senior management, and a lack of clarity on the vision or direction of Kuakini.

Kuakini management ended up questioning its own consultant, attacking the method of data collection and claiming that the negative comments were coming from a "few malcontents." We believed that the board of directors, president and senior management deserved an opportunity to address the problems. Nine years later, the problems have only worsened.

In 2001, Dr. Robert Oishi was removed from the board of directors. He believes he was improperly kicked off the board because he raised serious concerns about the Kuakini management. Because of pending litigation, we cannot discuss the details. However, physicians have rallied around Oishi, and think he may have been the only person on the board to advocate for the needs and viewpoints of the doctors who practice at or are affiliated with Kuakini.

Oishi's absence from the board exacerbates the already poor communication between management and physicians, the lack of trust of senior management, and the lack of confidence that the board will ever implement changes for much-needed improvements.

This is why the survey was needed. SMS Research surveyed 275 physicians who practice at the Kuakini Medical Center or have staff privileges. Three lists prepared by Kuakini itself entitled "Kuakini PHO," "Kuakini Medical Plaza" and "Kuakini Physician Tower" were the basis for the mailing. These are the physician listings found on the Kuakini Web site at The survey was undertaken because a group of physicians who had the same concerns felt strongly enough to take action. These are all doctors who have personal and professional commitments to Kuakini and could not sit back and watch it crumble.

The results verified what many of us have felt for a long time. In addition to the data, nearly 40 doctors included handwritten comments.

These were particularly revealing, displaying a sense of anger, frustration and bitterness quite unexpected from a group of physicians. The vast majority of physicians surveyed cited "poor communication from management", "do not believe that the administration will do what it says," "do not believe that management understands the problems physicians face," and a significant number do not feel comfortable expressing their views to management.

We fully expect that management once again will attack the methodology or claim that the survey was mounted because of two pending lawsuits against the Kuakini Health System. We emphasize that 94 physicians took the time to respond, and only four are involved in the litigation. If Kuakini is to survive as an organization, history must not repeat itself as in 1994, and we believe that the survey results should be immediately addressed and used to improve the situation for all.

What do we expect from the board? As a first step, to acknowledge the results of the survey, and then take immediate action to include the physicians as a group to implement a plan, set priorities and make specific changes.

Frankly, in the past the board has been complacent, and there is concern that the board members themselves were appointed by the current administration. However, we hope that they acknowledge the seriousness of the situation and focus on the issues outlined in the report. Kuakini will not survive another nine years without addressing these problems. We are asking the board members to perform their fiduciary responsibilities for the good of the entire organization and to address the critical situation before them now.

Kuakini is important to the community and to the state. We suspect that questionable management decisions and the relationship between the physicians and management has deteriorated to a point where the future of the organization is threatened. And, of course, we are concerned about the ability of Kuakini to provide the very best health care to patients.

At this point, the physicians are providing the best health care they can. But we can see down the line that medical advancements and patient care will require planning, investment and input from the physicians themselves. We already are at the point where it is difficult to keep good doctors and to recruit a new generation of doctors to Kuakini. Given that the communication between the physicians and the management is so bad, we would say that yes, the future of health care at Kuakini certainly is in jeopardy.

This commentary was signed by the following physicians: Elenita Alvarez, Richard Ando Sr., Richard Ando Jr., Osamu Fukuyama, Nancy Furumoto, Michael Hee, Edwin Ichiriu, Melvin Inamasu, Warren Ishida, Mark Kanemori, John H. C. Kim, Lance Kurata, Gilbert Korenaga, William Lau, Eugene Lee, Kenneth Lee, Junji Machi, Dennis Maehara, Derek Matsushige, Eugene Matsuyama, Calvin Miura, Henry Minatoya, Carl Minatoya, Stuart Nakamoto, Mari Nakashizuka, Mark Nishijo, Andy Oishi, Eric Oshiro, Alan Suyama, Masao Takai, Robin Takata, Curtis Takemoto, Dennis Wachi, Charles Yamashiro and Dan Yoshioka.

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