Maui’s lone neurosurgeon is nearing retirement

Kaiser is actively seeking another but they’re ‘hard to find’

Maui Memorial Medical Center's lone neurosurgeon is nearing retirement and possibly cutting back on his practice with incoming operator Kaiser Permanente and hospital officials saying that neurosurgeons "are hard to find."

None of the Kaiser or Maui Memorial officials said that there will be a gap in neurological surgical services at the Wailuku hospital but some red flags were raised. Maui Memorial chief of staff, Dr. Ron Boyd, said Tuesday that many physicians "feel very strongly" that the hospital needs two neurosurgeons; Dr. Thomas Rogers is the lone neurosurgeon and is on-call 24/7.

Avery Chumbley, Maui Region board chairman of the quasi-public organization that is turning over control of the county's three public hospitals to Kaiser on July 1, said the hospital ideally would have two neurosurgeons who can rotate being on-call. He said neurosurgeons handle many "critical, time-sensitive acute trauma surgery" and that it is important to the region board to have one on staff.

Kaiser did not give a definitive answer when asked if it will hire a neurosurgeon if Rogers retires.

"In neurosurgery, Maui has been blessed with an amazing provider," Kaiser spokeswoman Laura Lott said in an email Friday. "Surprisingly, Hawaii is a difficult place to recruit, especially when you're seeking the highest-quality physicians.

"Maui health care leaders will need to work together to recruit and retain these providers to ensure the best care for all Mauians and visitors to the island."

Lott said that she could not share any more specifics, "but please know that there are discussions and work happening."

Chumbley said that Kaiser is "actively seeking" a second neurosurgeon but noted the recruiting challenges.

"We are in need of another neurosurgeon for the Maui community," Chumbley said Tuesday. "Kaiser is actively seeking one and trying to recruit, but it's a difficult service line to fill. It is a very sophisticated and complicated job, and it's typically hard to find, but they are still looking for one."

Boyd, who added that Kaiser is interviewing neurology assistants, concurred with Chumbley.

"I don't think the average individual has any understanding or appreciation of the amount of effort it takes to work like he (Rogers) does," Boyd said. "I feel a little like Avery Chumbley, where I want to have some warm, fuzzy feeling that neurosurgery will be covered, but there's going to be some gap there until Kaiser is able to hire somebody and makes a commitment to hire somebody."

Chumbley said one of the reasons why the Maui Region board of the Hawaii Health Systems Corp. selected Kaiser over Hawaii Pacific Health to run the three county hospitals -- Maui Memorial and Kula and Lanai Community hospitals -- was its vision for handling development of care, continuity of care and expanding specialty line services. That included improving the neurology, gastroenterology and trauma center departments.

"I acknowledge that it would be difficult, if not impossible to have all those things in place on day one of the transition, and we acknowledge it takes time," Chumbley said. "I'm just anxious that some of this move forward sooner, rather than later, and that we have some increased level of certainty to ensure these services are in fact going to be covered."

Boyd said he didn't think Kaiser "anticipated that Dr. Rogers might be cutting back his scope of practice. That's come along as a little unforeseen, while they're madly working for the transition next month," he said.

He said that having a neurosurgeon on Maui is crucial because "there are cases that are not transportable and the patients are unstable." This could include ocean trauma and motor vehicle accident patients and elderly people on blood thinners, who fall and suffer inter-cranial bleeding.

"It's a misnomer that you can transport everything to Oahu," Boyd said. "To me, that's not a realistic thing to expect."

It is Rogers who determines whether a patient needs surgery or not, Boyd said. Without him, patients would have to fly to Oahu for the determination.

Rogers, who could not be reached for comment Wednesday, sees all the head trauma and nearly all the neck injuries on the island, which includes "tossed-by-wave" victims, Boyd said. He said the emergency room gets a "surprising number" of injuries during the wintertime, particularly at dangerous shore-break locations like Big Beach in Makena.

He also performs a "fair number" of spinal, cervical and other spine-related surgeries and is the only surgeon on staff who can perform back surgeries, Boyd said. He said Rogers does a "huge number" of back consultations because of his expertise and experience in the field.

"He's going to retire sometime in the not-too-distant future," Boyd said. "We're very lucky to have somebody like him."

Lott said that "it is vital for stroke patients to receive care quickly."

"Maui has an award-winning stroke program that combines the skills of emergency room doctors and staff with neurologists and interventional radiologists," she said.

Last month, Maui Memorial earned the Gold Plus Quality Achievement Award from the American Heart Association and American Stroke Association. The hospital also received recognition for "Target: Heart Failure Honor Roll," making it the only hospital in the state to earn both awards.

The awards recognized Maui Memorial's "commitment and success in implementing a high standard of heart failure and stroke care by ensuring that patients receive treatment that meets nationally accepted, evidence-based standards and recommendations," according to a hospital news release.

A story about the public-private operational transition published on Page A3 on May 19, quoting Dr. David Ulin, Maui Health System's chief medical director, should have said that "neurology services" will be increased. Ulin made his comments at a Kula Community Association gathering May 18. The Maui News apologizes for the error.

• Chris Sugidono can be reached at csugidono@mauinews.com.