Pool of available doctors shrinks

Virginia Pressler, Hawaii Pacific Health executive, said she gets calls weekly from people who can't find a doctor either for Medicaid or QUEST services.

She said Kapiolani Medical Center for Women and Children "is having a harder and harder time finding specialists willing to see these patients in the emergency room."

Hawaii Pacific Health has employed physicians for critical inpatient coverage at that hospital and its three others -- Kapiolani Medical Center at Pali Momi, Straub Clinic and Hospital and Wilcox Memorial Hospital on Kauai -- so all patients are accepted, she said: "But private practice physicians out their on their own. More and more are saying they can't afford to do this."

The state Department of Human Services reports a drop in Medicaid and QUEST doctors the past two years for a variety of reasons -- because they no longer wanted to take those patients, closed their practice, retired, left the islands or died.

In the 2007 calendar year, the department had 10,682 active providers; 717 terminated their agreements.

In the 2006 calendar year, there were 11,966 active physicians and 2,002 ended agreements. Of those, 1,600 terminated because they had no activity for two years and had never requested Medicaid reimbursement, DHS said.

DHS Director Lillian Koller said any Medicaid or QUEST member having trouble getting access to a doctor should call the health plan or the department's Med-QUEST Division -- 692-8069.

She said the health plans are required to ensure an adequate network of providers for clients, and they're mandated to provide access within prescribed periods of time for immediate, emergency, urgent and specialty and routine care.

"If someone is not getting access in the time frames in the contract, they need to report it to us," she said, pointing out there are monetary penalties for nonperformance.