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Living costs, lack of housing hurt medical recruiting locally

Maui Health CEO calls it ‘most challenging era’ in 40 years

Maui Memorial personnel gather on the hospital’s helicopter landing pad on May 14, 2020 during a flyover to honor their efforts during the pandemic. Recruiting health care personnel has long been a struggle for Maui but has proved especially difficult in recent years due to the high cost of living, lack of housing options and fatigue amid the pandemic, among other challenges. The Maui News / MATTHEW THAYER photos

Recruiting medical personnel to help meet demands in Maui County has not been easy, with health care providers pointing to obstacles like the high cost of living, medical student shortages, scarcity of specialized qualifications, lack of housing options and fatigue.

“Finding medical professionals, finding young people to enter the field is challenging — it’s probably the most challenging era that I’ve ever seen in my 40 years in health care. The pandemic has not helped us; it’s made it worse,” Michael Rembis, chief executive officer of Maui Health System, said last week. “A lot of people are leaving the health care industry, they are tired, they’re burned out, and in a time when we need more people.”

The main focus right now is “finding people on Maui to take care of people on Maui,” Rembis said, though Maui Health has resorted to recruiting from other islands and the Mainland to meet staffing demands for nurses, radiology technicians, physicians or laboratory technicians, for example.

“We still have a deficit in medical personnel,” he told the Maui County Council’s Human Concerns and Parks Committee last week. “Across the board, it’s just a huge need.”

Even before the COVID-19 pandemic demanded more hands, getting health care workers to work in Hawaii was tough because of the high cost of living or lack of housing options.

Maui Memorial Medical Center COVID-19 unit registered nurse Leigh Ringstad dons protective gear with help from hospital aide Reynita Franco before going into a patient’s room in May 2020. Recruiting health care workers to small communities like Maui with a high cost of living is a challenge for local health officials, who have sought solutions such as hiring homegrown, locally educated nurses.

Even with salaries ranging from $100,000 to $500,000, depending on the specialty, Rembis said that housing has been the biggest obstacle deterring people from moving or temporarily living on Maui.

“I have surgeons that I’m trying to recruit to this island to provide care for us and I have two of them that can’t come because they can’t find a three- or four-bedroom house for their families that is under $1.5 million or $2 million,” he said. “My number one concern is that housing will impact our ability to recruit medical professionals to take care of us on Maui.”

Administrator Cliff Alakai of Maui Medical Group said that “we share similar concerns,” noting the need for more psychologists, oncologists and physiatrists, for example.

He pointed to the obstacles created by the “outrageous” number of loans and student debt typically associated with medical school.

“It’s hard to find doctors nationwide. … We don’t get a lot of resumes,” Alakai said. “From our perspective, it just looks like not a lot of people are graduating from medical school.”

Fortunately, the cost to attend the University of Hawaii Maui College’s competitive nursing program is on average much lower than others, said Anne Scharnhorst, nursing professor and Allied Health Department chairperson.

However, it’s been challenging for the school in recent years to produce 40 registered nurses annually because UH-MC doesn’t have enough faculty to teach, Scharnhorst said.

Another obstacle that could be hurting the island’s ability to recruit medical staff is the price of doing business and providing services on Maui, such as costs associated with using land, infrastructure or supplies, which means workers’ compensation is generally lower than the rest of the nation, Alakai said.

“We are fortunate to have good physicians on Maui, but we need more,” he added. “If we lose one or two in a specialty, we’re really in a bad way.”

To keep up with demands, Maui Memorial Medical Center five years ago started to hire every student graduating from the UH-Maui nursing program and has offered various jobs to the past three graduating classes, which has “made a huge difference,” but still isn’t enough, Rembis said.

Maui Health has also created its own training and certification program for nurse assistants in various specialties.

“When we can’t find the skills we need, we’re trying to develop our own skill labs and teach and train our own staff and we still don’t have enough,” Rembis said. “We think we can get there if we continue to train staff and encourage people to come into the profession, but you won’t believe what the biggest challenge I’m having to get health care professionals to come to Maui and work, and that’s housing.”

The best case scenario would be to create a situation where residents earning an education outside the state could return to Maui to work, Alakai said, which could mean offering county debt assistance programs or offering affordable housing options for those practicing medicine.

Scharnhorst said that UH-MC is working to expand its educational programs to help boost preparedness in nursing students in specific fields before being hired at Maui Memorial and are looking to revisit opportunities for primary care providers to complete their residency on Maui.

UH-MC has also worked with the state Department of Education for the past three years to conduct outreach at local high schools to expose youth to health care careers early on — a nurse aide class is being hosted this month at Lahainaluna High School, Scharnhorst said.

“Our biggest goal is to take Maui County citizens and put them into jobs that they can have a sustainable wage in,” she said.

Rembis also said that Maui Health is working with the Mayor’s Office and collaborating with others to find solutions.

Council members during the committee meeting last week mulled ways to support Maui’s medical field, like creating possible housing options for medical staff, and plan to have ongoing discussions to come up with other solutions.

Committee Chairperson Tasha Kama said that the meeting brought up “really stark realizations with where we’re going in our medical industry.”

* Dakota Grossman can be reached at dgrossman@mauinews.com.

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