Letters for Friday, February 8, 2008

We meet community’s needs 24/7

I feel compelled to respond to Anne Brookstone’s of Kapa‘a letter to the editor “Flexibility at Wilcox?” published Feb. 6.

The crisis in health care in Hawai‘i is a long-standing problem, and sadly does not have an easy or clear solution.

The alliance between the Wilcox Hospital and the hospitals on Maui and the Big Island is only one measure whereby hospitals and healthcare providers have worked together to provide health care to Hawai‘i’s citizens.

We all must work together.

What I must clarify however is the impression that the Wilcox Hospital and its surgical facilities are unstaffed or unavailable for emergency care after hours or on weekends.

This is quite the contrary.

In order to serve both the community’s needs as well as the requirements for various licensing/accrediting agencies, there are more than one operating room teams available 24/7. This is to provide for both emergency surgical needs as well as for emergency obstetric surgery for the Labor and Delivery unit. If one team is operating, another team is ready to be mobilized. This coverage is 24/7, 365 days a year, and has been in place for many years. In order to meet this level of care, it means that not one but two anesthesiologists are on call at all times, two registered nurses, and two operating room technicians, as well as at least two post anesthesia care nurses. We currently have four full time anesthesiologists at the Wilcox Hospital. With two anesthesiolgists on call at all times, it means that the anesthesiologists are on call 50 percent of the time.

I am one of those anesthesiologists. I have been at the Wilcox Hospital for almost 18 years, and have seen our hospital go from a busy community hospital to a very busy community hospital. Like any hospital in Hawai‘i we have had problems in recruiting and retaining specialty physicians such as orthopedic surgeons, obstetricians, internists and anesthesiologists. It is difficult to recruit and retain new physicians in the face of reimbursement less than what can be made on the Mainland, the costs of malpractice insurance, real estate prices and the long hours worked.

Despite all of this, I myself and a host of other physicians such as Dr. Arnulfo Diaz, Dr. Monty Downs, Dr. Jim Scammahorn, and Dr. Roger Netzer have served the Wilcox Hospital and the people of Kaua‘i seven days a week, 365 days a year, for many years.

More specifically, our operating room operates 365/24/7. Our days, nights and weekends are very long. Our operating room staff are some of the hardest working people in the hospital, with each staff member putting in many hours of overtime, all of the time. Speaking for them as well as for my anesthesia colleagues, we have never, and can not ever see ourselves balking when emergency surgery is needed.

Yes, there is a health care crisis in the state of Hawai‘i. The health care system is strained almost to the breaking point. Wise and prudent use of health care resources is one way to lessen that strain. Non-emergency surgery at night and during the weekends utilizes those finite resources which should be reserved for true emergency needs.

However strained we are, my colleagues and the staff at the Wilcox Hospital operating room have never, and will never give less than everything in the face of a surgical emergency.

Michael Johnston, MD

Department of Anesthesia, Wilcox Hospital

Is this a dream?

While it’s impressive many of us are engaged in the election process I have to pause after reading “Aspirations for Change,” Letters, Feb. 7, touting the dream of Barack Obama.

I too have a dream that Barack Hussein Obama Jr. is the next John Fitzgerald Kennedy. The country needs a savior to prevent it from toppling over the abyss into the very real potential of oil scarcity, economic depression, nuclear chaos, flash point wars, massive terrorism strikes on our children, etc.

Now those are changes.

Let’s see who has the track record and tested wisdom to be the CEO of our massive economy, commander in chief of the most powerful armed forces on earth, and leader of freedom worldwide? Who has earned the position and should be anointed the most powerful person on earth? Despite the fact Baracka (his given first name?) has never run a company, created a job, or made any real money outside of the political feeding trough, has not authored any impressive legislation during his brief tenure as a senator, has openly discussed his past drug abuse, has a life resume that is somewhat unknown to the general population and struts around the stage like the proverbial black man with dark glasses in a dim-lit inner-city bar, Barack Hussein Obama just may be the answer to all our dreams.

Huh?

But wait. Oprah says he’s the one. Maybe he could even be as wonderful as her last creation, Dr. Phil. Oh well, we do “have a dream.” Don’t we?

Gordon Oswald