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So you know those kinds of things need to be thought out ahead of time. Um but sometimes that planning doesn't happen in the right order. >> Yes. Thank you. >> Members questions. >> Senator. >> Thank you. Thank you Tammy. I always love when uh nominees walk in not knowing what to expect. I feel the responses are going to be much more genuine. I'm so nervous. >> Not as though anything is prepared in advance, but thank you. Uh I did notice uh on your resume you had worked at Wai Comprehensive Health Center. >> Um actually I I haven't worked there, but what I'm doing right now is I'm helping the Wii Comp just got a new residency program of family medicine. So I'm ve I'm working very closely. I have the honor of working with Dr. Bradley and um Dr. Megan Martelli and Dr. Jessica Euan to help them with their resident rotations at Queens.
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So, I just right before I got uh came here, I had a meeting with um Jess, Dr. Euan and Dr. Martelli over the phone to try to place their um incoming new family medicine uh residents at Queens. So helping them to do the rotations, the inpatient rotations at Queens Manamana and Queens West Oahu. That's great. >> Speaking her language. >> Yes. Thank you. Oh my gosh. No, this is so great. Um and the reason that I mentioned that is um not only the residency at the Wai comp, but also we have a health learning lab in Wai High School. Um, so have you seen I guess components of what the comp is doing and how it might help other rural areas like for example you had mentioned uh North Hawaii Island. So is that I'm not sure if you're referring to Kona Hospital. um North Hawaii.
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This is the North Hawaii hospital that's um affiliated with Queens >> and um I have actually gone out to um the Wii High School when I was working at Jabsum and I was um pleased that we could donate a lot of our computers to the students at Wii. So a lot of our computers that are um that we had purchased through um grant funds that was used for maybe about 2 three years and um we had a lot of extra computers. So at that time Dr. Randy Wada was actually um a pediatric oncologist who was also serving as a mentor in Wai. So we went out one day to donate our uh computers and monitors. Yeah, we have a lot of um very modern technology out in our health learning lab. Um so thank you very much for being a part of uh building that which will also broaden out to the rest of the state.
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But um but thank you. Thank you for that. Thank you Chad. >> Welcome. Anybody else? That's fine. If not, see that wasn't too bad, right? >> Yeah. Thank you very much. >> Oh, thank you. Thank you. >> Okay, we are on GM669. Uh this is for confirmation for um Maryanne Spadaro Antonelli for a term to expire 6:30 2022. Uh do we have anyone else wishing to testify on this in this room? If not, Maryanne, welcome. Uh you need to you're on Zoom. I mean, you're on mute. So >> I see that. Okay. Can you hear me now? It helps to unmute right. Sorry. Um I appreciate your you're allowing me to attend by Zoom. I was with patients this morning expecting to come at one and then it got delayed so I I I still came by Zoom. So appreciate appearing before you. Um my uh uh continued um time on this board has been for uh two previous um iterations and I have represented federal healthc care.
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Now Dr. Yulan who was here earlier is uh a tripler um uh uh educator. Um I we we as as part of the VA and I'm representing the VA healthcare as well as uh federal health care is my role at the VA is to um approach and promote education uh for the VA as well as for the nation. As you may know the VA is the largest provider of graduate medical education in the nation. We have about 120,000 GME positions across the nation and we also do education for all almost all other health professions here in Hawaii. We have um physician residents, we have nurse residents, we have APRN residents, we have pharmacy residents, we have psychology interns and residents, social workers, and I'm aiology is the newest one on the block. I think that's a that's our VA people who are all civilians who by virtue of them training at the VA there is no commitment to only work within the VA system.
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So we have a very unique opportunity to show the islands as a place to work for all of these different professions and I we try to promote that as part of the orientation and what we're doing. So we allow our own paid trainees to do training on other islands too at our VA facilities. Now, we also sponsor uh residents in the uh tripler psych uh psychiatry, radiology, and internal medicine programs. Um and if we're asked, we can also add um a civilian. These are all civilian uh trainees within their programs. We can also add a family medicine resident if they chose. They they don't have the opportunity to do that. So, not only do we have people who are trained to take care of um for us in the VA veterans who are mostly local, some of whom were military who decided to stay. So, they're the kind of motivated person is what made them come back to Hawaii and stay here.
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This is a good impact on those residents and trainees. Um for the my other military connections and I don't know if Dr. Yulan is still there. One of the things I can see is military has a lot of physicians who retire and have an experience in Hawaii and I think this is another um very valuable um group of people. Now my first time in Hawaii was in the military. I was in the army in the 80s. Prior to that, I was in American Samoa for one year as a volunteer physician and then I went back to the east coast for a while and I of course came back here and I've been on back on the islands for over 25 years. Now it's 26 years I guess. So I am one of those returnees in the sense I wasn't born here but I'm a returner here and I love the islands and I love the people and I love the character and I try to in and in and uh tell all the the the other traineees during their um training to look at this.
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It may not be ivory tower medicine that you might see in Boston but boy would you be happy if you could learn to practice here and learn to work with the lovely people in Hawaii. They're wonderful patients. They're very um respectful and they're very they they are excellent to work with and I I you know that's what makes my practice a joy even within the VA. I had two patients today. I had to kind of keep them from hugging me too much in front of the residents. No, we do teaching at our at our clinics. Um and um we we host uh residents from the University of Hawaii and that's who the residents we had in clinic today were. We have medical students when they come through particularly for our nursing home or what we call a a community living center and that's a a big proportion.
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I yeah I forgot to mention we do we're a training site for the uh uh geriatrics program and they have um contributed to people staying on the island. So all of these um opportunities for us at federal healthcare to impact on the various trainees um is an excellent opportunity and I've enjoyed meeting the people on um on the um uh the council through the years and learning about the challenges so I can bring that back both to our leadership in the VA and to the committees and in the graduate medical education committees over at Tripler. I don't need to bring that to J graduate medical education committee that I'm a member of also at uh because they know it all already and I learn a lot from them too but we can share where the challenges are and how to fulfill it. I think one of the biggest challenges that we do have is uh despite people interested um and I'll just talk about graduate medical education and maybe internal medicine which is one of the bigger programs on the islands and as a former governor for the state of Hawaii for the American College of Physicians which is the internists uh professional society um one of the challenges we have is that residents um are seeing medicine too strongly from the inpatient component.
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So I'm very proud that uh now has a ambulatory or primary care internal medicine focus so that they can we can uh en encourage more to do primary care in the community because currently those residents I ask them when they come in we have two third-year residents in my clinic now and one is going to be a hospitalist staying on Hawaii that's nice and the other is going to go into a fellowship program and I suspect we'll lose that person from Hawaii eventually. So, um, to show our residents what it's like to practice in the community, it's a little scary. You know, maybe they don't really know how to take care of all of the patients in the uh, in a situation where it's not inpatient and you don't have 10 nurses around every bed and you don't have every specialist as your beck can call it.
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You have to make decisions. You have to be the doctor. And sometimes I think this is scary to the residents. So showing them how to practice medicine in a community either any of the VA clinics we have across the islands or even American Samoa or Guam and to see that these are not only um uh academically focused bring the quality up but also how you can really integrate into those communities and really appreciate being a doctor. It's almost like old-fashioned medicine, but it's really isn't because you got the at least in the VA, you have the support system of a huge federal uh group. Just so you know, I don't know if you know the vision mission of the VA is to train health care professionals for the VA and for the nation. So the VA is not not just focusing on our own workforce, but we want to train for the nation and in Hawaii, of course, is for Hawaii, too.
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So, I'm open to any questions you might have. Um, please feel free. >> Maryanne, thank you very much. Thank you for the insights you've given us. Uh, appreciate you coming back to the islands and practicing here and also bringing us the perspective um from the veterans point of view as well. Uh, so all of that and I really think we need to look at focusing on attracting uh retire retirees from the military military physicians. I don't think that's something that we really focused on, but you bring up bring up a good point and I think that's something that we'll we'll look forward to pursuing.
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So, with that, members, any questions? >> Senator Dort, >> I just wanted to make a comment. Uh, thank you for bringing up that idea of uh retirees. I I think that's a good conversation for us to put on the table and see where that goes. So, I really did like that um that idea. So, thank you for that. Thank you, Chair. >> Senator Kani, >> I think there can be some data collected on that. I'm sure we I know a lot of retirees who are here practicing. So we we can collect that. >> Yeah, maybe if you're of this group can collect that information and then share it with us, that would be helpful. >> Okay, Senator Kani, >> thank you. In question eight of the questionnaire, you stated an area of improvement is collating information on why providers leave Hawaii and seeing how the state can help address those challenges is important.
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um how soon can you accomplish this task and um make it available to our committee? >> Well, I don't think I'm in a position to be able to get that for you. Um but I have encouraged Kelly WY who has that uh that database uh to to try to help us know that um exactly how we can and whether or not we can fix what their issues are for leaving. as others have said, housing uh the cost of living for uh a lot of things here um are are kind of a little difficult but a lot difficult for the providers especially when they talk to their friends who are you know who have two or three very expensive cars and a very expensive well not as expensive as a Hawaii houses but it's a much larger house for the same cost in in another part of the the nation maybe even uh Lancaster, Pennsylvania but um so yeah there's this um for for the value of working here.
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This is what I love. I love working in Hawaii and um I'm not I I'm not complaining that I'm underpaid, but um I think um it's a struggle for those in private practice and um the health care systems now are hiring are, you know, uh being employers for the physicians. Whether that's what someone really wants to do or not, I think we have to look at that. Is your only opportunity to work in Hawaii to be an employed physician or do you want to try to do private practice and do we need to do more support for private practice which is tough um with the Medicare reimbursements etc. So, I think that we've got to look and see what it is they would like to do in Hawaii and why is it they couldn't and is it the social circumstances, the housing costs, the schooling costs, the travel costs just to go visit family is huge.
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So, it's not, as you all know, I'm not saying telling you anything new, but what is it that that might interfere with their lifestyle that they perceive they should have had or would like to have that might be easier on the mainland? Maybe there won't be as happy on the mainland. I think we have to look at the happiness part. We are a happy state. >> So, um collecting that is not easy. >> Members, any last questions?
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Hearing none. Thank you again. Uh we appreciate you willing to serve and look forward to seeing you. Thank you. >> Thank you. Thank you. >> Okay. Finally, last but not least, GM670, uh confirmation for Russell Wu. Uh let's see for a term to expire 6:30 2029 and we have in addition to Dr. Buenjo. Uh, Tiffany Yajima in support. Anyone else wishing to testify on this measure?
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Hearing none. Uh, Russell, we have you on Zoom. Yeah, we see you. >> Welcome. >> Aloha, Chair Kim. Can you guys hear me? Okay. >> Yes, I think so. >> Hopefully, you're not driving. >> Aloha, Chair Kim. And I am not. Uh, I appreciate your patience with me on Zoom. I'm traveling between locations. Um, >> Kim getting into an accident. No, not at all. I'm I'm parked. I've been parked for uh since 1:00. >> Oh gosh. Okay. >> No, it is okay. Uh so, aloha, Chair Kim, Vice Chair Kadani, and committee members. Um I uh like Tammy, I am actually a firsttime nominee, and this is my first experience with a hearing such as this. So, I have uh been very eye openening and learned a lot and very appreciative. Um just a little bit about myself. I'm I'm really honored to be considered to serve on the Hawaii Medical Education Council.
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Um I've been practicing as a pediatric surgeon here in Hawaii for 17 years. Pretty much my entire medical career has been here as an attending. And I had really the privilege to teach both medical students and residents and fellows here. Um, and over the last couple years, I've served in a dual role as the chief academic officer for Hawaii Pacific Health, coordinating much of their educational efforts for our four hospitals and clinics and the medical group. And then as an associate dean for clinical programs at HBH at the John Burn School of Medicine. Um, so I I'm very passionate about medical education. I think I've experienced uh firsthand some of the challenges of delivering uh highquality care to our people here in Hawaii. Um we've talked about the shortage and then there are certain focuses with respect to the physician shortage on our neighbor islands.
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And then we have short uh very kind of acute shortages in certain specialties and certain populations and locations. And um I've tried to really understand some of the factors around this. I do think medical education is one of the one major tool to address this and there are some other things that we can do. Um RHTP is one of the promising new resources that we have uh to help us. Uh but um not to say that we are any more or less but we do have unique challenges here with respect to our workforce and delivering care to our population um that we have to really dive into and tackle.
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