HMC adds cardiologist

Hilo Medical Center’s cardiac program has expanded once again, with the addition of a second interventional cardiologist.

Dr. Jamison Wyatt, who said he treats people with coronary heart disease, structural heart disease and peripheral vascular disease, officially began June 1. He has started seeing patients in the hospital and already performed stent procedures.

Prior to coming to Hilo, Wyatt worked for the past 6 1/2 years in a private practice in New Braunfel, Texas.

He said Hawaii was a “natural fit” for he and his wife.

“Fortunately, with my specialty, we kind of have the ability to live almost wherever you want to live, and so this was one of the places that was very high on our list for having ocean access and good weather,” he said.

It also was an opportunity to serve an area underserved in terms of cardiologists, “where you’re having to fly people with heart attacks over to another island to be treated — and there’s this huge time delay with doing that — instead of being able to treat them here on-island. We know that that’s associated with much poorer outcomes and increased risk of death.

“So the opportunity to be able to come in and start a program here where we can care for all these folks on the island and save lives and make a big impact on the community — there’s not many places left like that in the United States where you can have the opportunity to start a program (like this).”

HMC has long been working to treat cardiac patients closer to home and earlier this year hired its first interventional cardiologist, Carl Juneau.

Prior to Juneau’s arrival, HMC could administer clot-busting medications and perform diagnostic catheterizations to determine if a patient needed to be transported off-island, usually to Oahu.

The hospital can now perform interventional catheterizations to stop a heart attack in progress and insert stents to maintain blood flow.

Stent procedures have only been performed on nonemergent patients at HMC since January, starting shortly after Juneau’s arrival, and Juneau began performing such emergency interventions March 1.

A third interventional cardiologist, Dr. James Smith, is set to start at HMC in August, and a general cardiologist is set to start toward the end of the year.

“I don’t think it’s an understatement to say it’s a dream come true to have (the interventional cardiologists) finally here,” said HMC spokeswoman Elena Cabatu. “It feels almost surreal, because we’ve been waiting and hoping for (them) to come. We know of so many people already who have had the service and have their lives improved … or even saved.

“It’s just been remarkable.”

Since January, more than 100 stent procedures have been performed.

With Wyatt’s arrival, Cabatu said interventional cardiology coverage increased but is not yet available at all times.

Wyatt said it’s easy to see the time and effort that has gone into getting the program established.

But as HMC works to grow its cardiac program, other specialists recently left the hospital.

A nephrologist, or kidney specialist, informed HMC in mid-April that the doctor would discontinue providing care for patients at the hospital.

According to Cabatu, there was a two-week gap in coverage, during which about 30 patients were sent off-island for emergency nephrology care, “but then we had bridged the coverage with a traveler doctor until we were able to shore up” a long-term solution.

HMC, which does not provide outpatient nephrology care, secured permanent tele-nephrology care with Sanderling Renal Services last month, which provides the hospital access to more than 50 board certified nephrologists, four of whom are licensed in the state.

A vascular surgeon resigned in early May, and Cabatu said HMC is actively trying to recruit a new surgeon.

In the interim, HMC is using interventional radiologists for some procedures, while patients requiring more advanced vascular care will be transferred to other facilities off-island, “as we’ve been doing before,” Cabatu said.

Cabatu said both doctors left voluntarily.

“Sometimes, that’s just the nature of rural medicine, in which we have one specialist per specialty,” Cabatu said. “And so, when and if that happens, like in this case, we have to hustle to start filling the gaps, whether it’s starting to recruit or bring in traveler or (temporary) specialists to fill the coverage, or we’ll have to look, in our case, for other resources, other specialists, like how we use the interventional radiology just to help us do some vascular procedures.”

But HMC has seen success in recruiting other specialists to Hilo, and in addition to the interventional cardiologists, has hired orthopedists, an obstetrician-gynecologist, a psychologist, psychiatrist, pediatrician and family medicine physicians, and is currently recruiting for a urologist in addition to the vascular surgeon.

Recruitment is “a lot of hard work, it’s a lot of investment, but in recent times, I feel like we’ve had great success with personality fit, as well as skill-set fit,” Cabatu said. “And I give a lot of credit to every single person that takes time out of their day to welcome or educate any visiting physicians considering coming to work here.”

Lifestyle and personality fit are “really big drivers” in determining whether someone stays, she said.

Email Stephanie Salmons at ssalmons@hawaiitribune-herald.com.
Source: Hawaii Tribune Herald