Guest Viewpoint for Sunday — October 09, 2005

  • Bottom-line approach raises concerns about future of health care delivery

Bottom-line approach raises concerns about future of health care delivery

By Peter H. Kim, MD

I would like to comment on Andy Gross’ article regarding the recent resignation of Dr. Bill Evslin as CEO of Wilcox Hospital. I would also like to express my opinion on the future of health care delivery on Kaua’i.

People in this community who care about health care in our community should also be concerned.

I have known Dr. Bill Evslin since he first joined Kauai Medical Group 27 years ago. He is a person with highest integrity. He is always deeply concerned about the health care needs of this community. His basic principle was to improve and maintain quality of care in our community. We will certainly miss his leadership and caring touch.

In your article you stated his “irreconcilable differences with HPH (Hawaii Pacific Health) management.” This should immediately raise concerns about the future health care delivery on Kaua’i.

Kauai Medical Group was formed in 1968 to fill the obvious gap in medical care on Kaua’i. The dream was to develop a multi-specialty group so that such services could be available to the people here without traveling to Honolulu. The impression is that the HPH management will be trying to change our current pattern of health care delivery by reducing access to our primary care specialists and sub-specialists such as gastroenterologists, cardiologists, etc. This would meet their “bottom line.” Their corporate philosophy seems to forget that we are a not-for-profit organization dealing with human lives and suffering.

The “irreconcilable differences” on financial matters have been a bone of contention since inception of the affiliation with HPH. There has been no transparency between us and HPH on this matter. It becomes frustrating when you don’t know the true facts on allocation of expenses such as over-head of our medical organizations. An independent audit would be helpful.

This “bottom line” approach by HPH appears to be the driving force in reshaping the pattern of our current health care delivery system and one of the reasons behind Dr. Evslin’s resignation. In essence, it means reducing access to the number of our primary care specialists and sub-specialists. It reverts back to itinerant sub-specialists like the old plantation era.

In retrospect, I feel that the affiliation with HPH has been a mistake. Promises made were never kept. We lost our autonomy and control of our destiny. Local doctors and health care workers are in a better position to know the needs of our community than some top management from Honolulu.

It is time to consider disaffiliation with HPH. I am sure that the local community can find a better solution to the problems and needs of Kaua’i, than some distant management team.

  • Peter H. Kim, MD is a longtime Kaua’i physician and administrator
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