The inventor of the first wearable pacemaker, who founded North Hawaii Community Hospital but then severed ties last summer, has once again thrown his support behind the embattled facility.

Earl Bakken, who founded the community-owned, nonprofit hospital in May 1996, has sent out letters asking for contributions to support the hospital's future.

He said the hospital's 2009 budget will require $1.9 million from donors to retain four physicians on staff and recruit four more to replace those who have left.

The eight positions include specialties in obstetrics/ gynecology, general surgery, orthopedic surgery and anesthesiology, he said.

The hospital will need another $1.5 million to recruit four more physicians in the areas of primary care, ENT (ear, nose and throat), neurology and cardiology, he said.

Referring to newspaper stories about his breakup with the North Hawaii hospital in July, the renowned inventor and president emeritus of the hospital said: “;My heart has always been with our community and our hospital. My difficulty was with what I perceived as slow movement toward much-needed change.”;

He said in his letter that he is comfortable that progress is being made.

However, he said the island is facing a crisis, with doctors leaving because of low reimbursement; the rising, often prohibitive cost of malpractice insurance; and quality- of-life issues.

“;Those remaining are not only underpaid, but they are also overworked.”;

Doctors leave because “;the risk is too high, the hours too long, and the workload necessary to make ends meet is overwhelming,”; he said, adding that physician retention and recruitment is the hospital's highest priority.

North Hawaii Community Hospital was ranked in November as No. 1 in Hawaii and one of the top 10 percent of hospitals in the nation among those reporting in the 2007 Hospital Consumer Assessment of Healthcare Providers and Systems survey.

“;It is a clear indication that we are fulfilling our mission, which is to improve the health status of the people of North Hawaii by improving access to care and providing high-quality services at a reasonable cost,”; interim Chief Executive Officer Ronald J. Vigus said in announcing the ranking.

However, Bakken said in his letter, “;Our hospital is in real danger of not being able to continue to provide quality patient care if we don't have enough physicians with needed specialties.”;

The hospital not only serves North Hawaii residents, but also many seasonal visitors and part-time residents, he noted.

“;Its future is in our hands,”; he said. “;We can't sit back and wait for system reform or for the economy to improve. Accidents, illness, disease and newborns don't wait.”;