1. Background information
a. Over the past 20 years there had been a neurosurgeon in Hilo on the island of Hawaii and Wailuku on Maui.
i. These neurosurgical providers were often overburdened and worked long hours without vacation or time off.
b. None of the other Outer Islands have a neurosurgeon in practice.
c. A significant percentage of patients who needed neurosurgical care had to travel to Honolulu because of the shortage of neurosurgeons.
d. Though there is been a recent influx of neurosurgeons in Honolulu and also Wailuku, Maui, a state-wide shortage still exists today.
2. Neurosurgical out-reach services
a. Dr. Graham has been traveling to the Island of Hawaii for the past 20 years to provide neurosurgical services.
i. Initially provided services were outpatient clinic office visits and those patients requiring surgery had to be transferred to Honolulu for neurosurgical care.
ii. In 2011, he began performing minimally invasive spine surgeries at North Hawaii Community Hospital.
iii. He continues to provide both outpatient clinic visits and surgery on the island of Hawaii with his main office located in Kona.
iv. Patients with more complicated problems requiring more specialized care are transferred to Honolulu for their surgery.
3. Advantages of Outer Island services
a. Minimally invasive outpatient spine surgery can usually be performed at a facility near the patient’s home without the need to travel to Honolulu to receive surgical care.
b. Minimally invasive spine surgical procedures, quality of care is the same as could be offered in Honolulu.
c. Patients do not have to spend extra time and travel expense to obtain care in Honolulu.
d. Providing local care keeps medical businesses active and provides jobs for the community.
4. Future of minimally invasive neurosurgical care
a. An increasing number of surgeries will be performed in ambulatory surgical centers in Hawaii compared with surgery performed in hospitals.
b. Advances in surgical techniques will allow for improved results and less complications.
c. Hospital care will still be necessary for complex problems.