Warning to the west side

Have you been following Eileen Chao’s coverage in The Maui News of the plan to close Molokini II, the child/adolescent psychiatric ward at Maui Memorial Medical Center? You should, especially if you live on the west side and fantasize about having an emergency room there, so you won’t have to lose that “golden hour” riding an  ambulance to Wailuku if you have a stroke.

It ain’t ever going to happen, and the reasons are right there in today’s story:

1. Molokini II had 124 patients last year. Considering that psychiatric admissions last only for the acute attack and seldom last more than a few days, that means that much of the time the unit was empty.

Yet it still had to have staff ready around the clock.

There is no adolescent psychiatrist practicing on the island, and not likely to be any time soon either.

2. No other hospital on the Neighbor Islands has an adolescent psych unit.

Now, consider an emergency room. It requires, at the barest minimum, 5 ER physicians, one for each 8-hour shift each weekday and 2 more to cover weekends, vacations etc.

Plus nurses and other helpers.

Most of these cannot be used on other tasks whenever there isn’t an emergency case, because they have to be ready to respond STAT as you have seen so often on the TV doc shows.

But there won’t be many patients from the west side, and if you have been around ER physicians you’ll have noticed that they are not shrinking violets. They are not going to sit around playing hanafuda waiting for the next big car crash (and how many of those does Lahaina generate? not even one a day).

If you have a condition requiring Level 3 care, you’ll have to leave Maui anyway.

As medical care gets more complicated and equipment becomes more specialized and expensive, economic factors force concentration. Health treatment is not immune to the same forces that have closed down full-service gas stations in favor of gasoline0-dispensing stations one place and car repair shops somewhere else.

There are other reasons the west side (or South Maui) will never have an ER but those are sufficient; we don’t need to go any further.

#mauihospital #westmauihospital #mauimedical