A study showing that Hawai'i has a relatively high physician-to-resident ratio is being questioned given anecdotal and other information about a shortage of doctors in the state.

The report by the Association of American Medical Colleges found the state was seventh-best nationally in terms of active physicians per 100,000 population. That worked out to about one physician for every 293 residents.

The ranking, however, is sure to be criticized by residents and health officials who either have experienced or are working to find a solution to what they say is a troublesome doctor shortage. Community health centers on the Neighbor Islands report they sometimes serve people who otherwise could afford to see a regular doctor but can't get appointments because physicians aren't accepting new patients.

Health officials say there is a shortage of specialists in many parts of the state and a series of forums were held recently by the Hawai'i Medical Association to discuss the physician deficit. A number of factors, including medical malpractice insurance costs and higher pay elsewhere, have resulted in the shortage, experts say.

Paula Arcena, Hawai'i Medical Association executive director, said she hadn't seen the study but typically such reports overestimate the number of physicians here because they look at the number of doctors licensed to practice in the state.

Precise numbers are difficult to come by because many physicians who are licensed here practice in other states. She said a study under way at the University of Hawai'i's John A. Burns School of Medicine is attempting to quantify the correct number.

"There's a shortage here all the way around, even for primary care," Arcena said. She said the problem is more acute when it comes to surgeons and others providing trauma and emergency medicine.

"Doctors are really, really busy. Everyone is carrying very heavy loads right now."

The study also found that a quarter of Hawai'i's physicians are more than 60 years old, also one of the highest percentages in the country. Arcena said this appears to be the case on an anecdotal basis.

If true, that would indicate the state's doctor shortage could worsen if more physicians don't start practicing in the state as others retire.

Earlier this year, Douglas Suhm, a visitor from Tacoma, Washington, was stricken with a life-threatening staph infection while on the Big Island. Suhm said he almost died because no orthopedic surgeons were on the Big Island and had difficulty getting a doctor in Honolulu agree to accept him.

He finally was able to get someone to take his case, a friend of his daughter who lived in Honolulu. He said the surgery saved his life.

"We were thinking this is highly strange," Suhm said in a March interview. "In many places in the country if it's serious you're able to get to some kind of facility.

"I don't know what would have happened if we didn't have the contact through our daughter."

Reach Greg Wiles at gwiles@honoluluadvertiser.com.

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