July Fourth Reminder: Freedom should include your choice of doctor

by Keli'i Akina, Ph.D., President / CEO, Grassroot Institute of Hawaii

The Fourth of July is just around the corner, and for many of us, it’s an occasion to reflect on the many freedoms that we have — or don’t have, as the case may be.

When it comes to healthcare in Hawaii, it is clear there is room for more freedom.

Imagine, for example, that you are suffering from a rare medical condition, but because of Hawaii's ongoing doctor shortage, you need to seek advice from a specialist on the mainland. You could arrange an appointment with such a doctor, fly on a plane for six or more hours to get to his or her office, then ideally get the information you are seeking.

But, hey, this is 2025. You could save all that time and money and simply consult with that specialist using your phone or computer.

Unfortunately, you might have the technology to consult with mainland specialists, but you don’t have that freedom. Under Hawaii law, it doesn’t matter if the specialist you want to see is a world-renowned expert who teaches classes at Harvard Medical School. If that doctor doesn’t have a Hawaii medical license, you can be treated only in person.

The main argument for denying this freedom is that cross-border telehealth is allegedly a risk to public health — that Hawaii is a special place, and patients here should be seen only by doctors who have been vetted by our local officials.

Fortunately, studies have demonstrated that the public safety argument is unfounded, and that instead, interstate telehealth can improve healthcare outcomes, especially for patients in rural areas and people in need of specialty care.

Currently, 27 states have some form of exception or alternative to full-licensure for out-of-state telehealth. I would love to see Hawaii join the crowd.

For lawmakers who might be interested in considering how interstate telehealth could be safely implemented in Hawaii, the Grassroot Institute of Hawaii offers some suggestions in a white paper it published earlier this month titled “Why Hawaii lawmakers should adopt interstate telehealth.”

Hawaii residents deserve to be able to see the doctor of their choice, even if that doctor is on the mainland. Maybe by next Fourth of July, it will be an additional freedom that we all can celebrate.

E hana kākou! (Let's work together!)