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Practicing and Adapting Medicine in Rural Hawai’i

Genexa Genexa 2018-10-11 12:07:00 -0700

By Dr. Doede Donaugh-Rae, DO

It might go without saying, but rural life can be both simple and beautiful. When you don’t have as many daily distractions as others do, there is great potential for overall healthier living. And what’s not to love about black and green sand, frequent rainbows, and perfect weather? Personally, I love the Aloha spirit here in Hawai’I, and the more relaxed lifestyle that comes with it.

But rural island living can have its drawbacks. My clinic is very small: just myself, a part-time, part-retired nurse practitioner, and just two staff members do the best we can to offer basic primary care to our local community. As an osteopath, I also perform osteopathic manipulation and I have only recently started to incorporate some lifestyle medicine into my practice. However, there is only so much that one small office can do for a geographically expansive region.

Being in a rural area is already a challenge when it comes to access, as the nearest medical “facilities” (like an emergency room or pharmacy) are easily 40 miles away. Many people have additional barriers when it comes to getting there, since many don’t have vehicles and public transportation isn’t an accessible option due to cost, time constraints and other reasons. Living on an island adds yet another complication, as access to specialists and certain services may be a plane ride away! 

In addition, healthcare professionals have a high turnover rate; i.e., they come and go often. Even though it really is paradise here, living on an island is not for everyone. So, consistency in care can be a concern.  We do the best that we can at our small location, and when there is greater need than we can provide, we assist in care coordination with other providers. Currently, I’m actively looking into telehealth opportunities that we can start incorporating into our services to increase accessibility for remote patients.

Telehealth options and lifestyle medicine are just two examples of how I have had to adapt my practice to meet the needs of my community. In fact, ever since completing my medical training, I’ve felt something big is missing in modern medicine, and I’ve been in search of it ever since. I believe healthcare means helping people get well, as opposed to simply managing their chronic diseases. I have had to learn so much about different kinds of medicine on my own here in rural Hawai’i. And there is still so much more about integrative, alternative, or functional approaches that I have yet to learn! I really believe there’s a better plan and path than what we consider “medicine” offers now.

Personally, I really want to get to the root causes of illness and help my patients learn (if they are willing!) how to change their lifestyle for overall better living. My brief experiences into the functional and lifestyle medicine realms have inspired me to keep going down that route. And incorporating technology to reach farther and broader populations also has exciting potential. I’m so thankful for companies and brands like Genexa that actually think through what matters most when it comes to health and wellness.

Eventually, I believe that the holistic functional medicine approach will spread like wildfire and we’ll see a huge shift in our world.

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