The Island Family Surgeon

08/20/2025

PHARMACY BENEFIT MANAGERS have got to go. Antitrust lawsuits to break up these pharmaceutical giants.

Anti-trust lawsuits to break up insurance monopolies.

Antitrust lawsuits to break up healthcare systems' monopoly in communities and cities.

All three of these have driven healthcare costs through the roof. While they pay the media to say it's those greedy physicians, when physicians' pay has decreased 20 to 40% in the last decade!!!! That's why we have long waiting lines in our market system, it's designed to limit services and have shortages of doctors to maximize insurance and healthcare system profits.

Imagine if one company owned all the plumbers or electricians in your city or state, how fast would the cost of these services go up!!@

07/30/2025

Water shut off in wailuku around 6:15pm

07/28/2025

This!

07/28/2025

07/24/2025

Today was a good day!

07/21/2025

📉 When I ask patients how much they think I get paid to do their surgery... they’re usually off by 5 to 10 times. They usually day 1000s of dolars.

In the 1990s and early 2000s, my mentors were paid $2,400 just to perform a gallbladder surgery — not including the consultation or post-op visits.
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Today, I get around $700 total for:
✅ A 30–45 min consultation
✅ A 2–3 hour surgery
✅ All follow-up care for 90 days — office visits, phone calls, wound care, complications, coordination
About 5-7 hours of work not including wait times for the operating rooms to be ready.

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That’s one flat fee for months of work, risk, and responsibility.
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And out of that, I also cover:
🧾 Staff salaries
🏥 Overhead
📋 Administrative time
⚖️ $40,000/year in malpractice insurance
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👉 How is this sustainable?
It’s not.
That’s why many surgeons are leaving, and patients are left with longer wait times and fewer options.
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In contrast, my lights went off in the kitchen and I called an electrician. He said he will come and take a look for $400 after he goes surfing....

🎯 It’s time to talk about fair pay for physicians.
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06/10/2025

Its 945pm, i just finishedc my last case of the day, i just stopped by the grocery store tonight to buy champagne. Tonight we toast to Dr Nitta's Victory tomorrow over the powers that be that want to silence doctors for speaking up for our patients. Then... after tomorrow we keep on!!! We rage against our silencing!

📰 FACT SHEET: Nitta vs. HMSA

Hawai‘i Supreme Court Oral Arguments – June 10, 2025 1030am at Hawaii Supreme Court, come join us support!

🔍 What the Case Is About

Dr. Frederick Nitta, a Hilo-based OB-GYN, filed a lawsuit against HMSA in 2022.

He alleges that HMSA repeatedly denied coverage for medications and treatments he deemed medically necessary, forcing patients to either forego care or pay out-of-pocket—despite having insurance.

Dr. Nitta claims HMSA retaliated against him for advocating for patient care.

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⚖️ Lower Court Ruling

A Kailua-Kona Judge ruled that three of HMSA’s contracts with Dr. Nitta were "unconscionable" and "unenforceable."

The judge found that HMSA’s arbitration clauses and practices unfairly shielded the insurer from accountability.

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🏛️ What's Happening Now

HMSA is appealing the lower court’s decision.

The Hawaiʻi Supreme Court is hearing oral arguments on June 10, 2025.

HMSA is attempting to limit the case to a technical dispute over arbitration—but advocates say the real issue is corporate obstruction of care.

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📌 Why This Matters

This case could determine whether doctors have legal protection when they challenge insurance denials on behalf of patients.

A ruling in favor of Dr. Nitta could:

Force insurers to reform denial and prior authorization practices

Make whistleblower protections stronger for physicians

Improve access to timely care for patients across Hawai‘i and beyond

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