Neurologist Attitudes on Practicing in Hawai'i

Abstract

There is a shortage of neurologists nationwide, and the demand for neurologists is expected to increase in the upcoming years while the pool of practicing neurologists dwindles. Per Hawai'i Neurological Society, there were 44 practicing neurologists in the state of Hawai'i in 2019, representing a shortage of approximately 28 neurologists. Considering that Hawai'i is geographically, demographically, and culturally distinct compared to other states, a concern is that practicing neurology in Hawai'i poses unique challenges that may contribute to the low numbers of neurologists. An anonymous online survey was sent via email to all members of the Hawai'i Neurological Society from February 2019 to June 2019, inquiring about aspects of their practice they considered unique to Hawai'i. Twenty-three neurologists completed the survey, representing 52% of Hawai'i's neurology workforce. One neurologist completed a portion of the survey. Twenty-five percent of participants were born and raised or completed their medical education in Hawai'i. Self-reported reasons for practicing in Hawai'i included family, lifestyle, and patient population despite financial challenges and limited resources and opportunities. Participants suggested introducing a mandatory neurology rotation for Hawai'i medical students and creating an instate neurology residency program to combat the growing neurologist shortfall in Hawai'i. This survey identified local strengths and challenges in the field of neurology, potential ways to improve the practice environment in Hawai'i, and neurologists' perspectives on ways to address the neurology shortage.

Keywords: Hawai‘i; burnout; neurologists; physicians; shortage.

Figure 1.

Participant motivations for practicing in Hawai‘i listed in descending order. Blue indicates primary motivations (n = 24). Green indicates secondary motivations, of which respondents could choose more than 1 answer. Twenty-three neurologists completed the survey; 1 neurologist completed a portion of the survey.

Figure 2.

Self-reported neurology subspecialty. Blue indicates the participants’ subspecialty (n = 20). Green indicates participants’ board certification (n = 16). ^aEEG = Electroencephalogram; ^bTBI = Traumatic Brain Injury

Figure 3.

Perceived benefits of practicing neurology in Hawai‘i compared with the rest of the US, listed in descending order (n = 23). Twenty-three neurologists completed the survey; 1 neurologist completed a portion of the survey.

Figure 4.

Challenges (participants had the option to select up to 3) indicated by neurologists when they first started practicing in Hawai‘i (green) versus their current practice in Hawai‘i (blue) (n = 23). Twenty-three neurologists completed the survey; 1 neurologist completed a portion of the survey.