Maui Medical Group losing two OB-GYN physicians | News, Sports, Jobs

WAILUKU – Maui Medical Group, one of the island’s largest health care providers, is referring 100 pregnant patients to other island doctors because its obstetrics and gynecology department will be down to one part-time physician and one nurse practitioner on Aug. 1.

Two full-time OB-GYN doctors will be departing Maui Medical around July 31, leaving only the part-time physician. The health care group decided to refer pregnant patients to outside doctors to ensure that they will receive nine months of continuous care through birth, said Dr. William Mitchell, Maui Medical Group’s president and chief executive officer.

Hiring of new doctors, even temporary ones, could take up to six months, he said. Compounding the staffing shortage is that the nurse practitioner currently is on emergency leave but is expected to return before Aug. 1, said Mitchell.

“We saw we could not guarantee with certainty (that) we could guarantee OB care of the newly pregnant women. We really had to say we cannot have OB patients,” Mitchell said.

So Maui Medical is assisting pregnant patients due after July 31 to find other providers. After July 31, Maui Medical only will be taking gynecology patients, Mitchell said.

Maui Medical Group serves about 4,000 obstetrics and gynecology patients.

The Maui News received reports earlier this month about pregnant women not being able to see an OB-GYN doctor at Maui Medical. A post-menopausal woman reported that her OB-GYN doctor, during her June visit to Maui Medical, told her that she was leaving Maui and that the patient would need to find another OB-GYN physician.

Mitchell said that there may have been some misinformation presented to patients and circulating among the staff. Maui Medical continues to see gynecological patients, he said.

Maui Medical’s Administrator Cliff Alakai said last week that Maui Medical has been notifying patients about the vacancies and changes in the department for the last couple of weeks. Most of the notifications were being done personally, such as when patients come in for a visit or when scheduling appointments. Letters will be sent out as well.

Maui Medical is working with insurance providers and reaching out to other doctors for assistance in taking on Maui Medical patients, he said.

The one doctor could not handle the obstetrics duties for Maui Medical patients, said Mitchell. In addition to taking daytime office visits, the doctor also must be on call for deliveries whenever they occur.

Recruiting obstetricians is a competitive business, especially with many of those physicians gravitating to larger organizations with more doctors, including “nocturnists” who only take the night calls, he said.

The larger practices offer more staff for sharing calls and backup, said Laura Lott, director of communications and public relations at Kaiser Permanente Hawaii. This makes recruiting OB-GYN doctors on the Neighbor Islands with smaller practices more difficult, especially when competing against cities and towns with larger group practices.

Kaiser, the second largest health insurer and largest multi-specialty health care provider in the state, has eight OB-GYN physicians on Maui, serving 18,885 members ages 18 to 64, she said. Lott added that OB-GYN staffing on Maui has been stable the last several years.

For Maui Medical, the OB-GYN practice can be financially “OK” with three physicians “working hard” and taking night calls, said Alakai.

Malpractice insurance rates are higher for OB-GYN doctors than other practice specialties. The rates for OB-GYN doctors are from $55,000 to $75,000 annually. In addition, health care organizations need to provide “tail” coverage for departing physicians to cover post-departure lawsuits from care already provided. That coverage runs two to 2 times higher, Alakai said.

In comparison, the annual malpractice cost for a primary care physician in family practice or internal medicine ranges from $12,000 to $20,000, Alakai said.

Maui Medical Group began in 1961 and has five clinics on Maui, the main one in Wailuku, along with Kahului, Lahaina, Pukalani and Kihei.

* Melissa Tanji can be reached at mtanji@mauinews.com.

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