Hawaii Doctors Warn Aging Population Is Outpacing Geriatric Care Capacity

Hawaii County is short 224 full-time-equivalent physicians, a 43% gap that medical professionals now describe as a crisis eclipsing the Neighbor Islands' already chronic shortage of doctors.

Dr. Scott Grosskreutz, a breast cancer specialist in Hilo and president of the Hawaii Healthcare Task Force, said the situation has moved beyond the baseline problem that has long defined rural healthcare on the Big Island. "In talking to many Neighbor Island healthcare professionals, there is clearly a crisis in our ability to continue to provide patient care in Hawaii's rural communities," Grosskreutz wrote in an email. "This is not simply another same old, same old 40% plus shortage of doctors, that our Neighbor Islands have suffered from for years."

He said many rural practices either have already closed or will soon close.

The Hawaii Physician Workforce Report 2025 documents the scale of the losses driving that collapse. In 2025 alone, at least 81 physicians statewide retired, 14 died, and more than 88 moved away. Those numbers arrive as demand accelerates: Hawaii's aging population is straining a geriatric-care system that was already understaffed.

The shortfall is severe across every county, but Neighbor Islands bear the worst of it. Honolulu County is short 379 FTEs, a 15% gap. Maui County faces a 179-FTE shortage, a 41% gap. Kauai County is short 50 FTEs, a 28% gap. Hawaii County's 43% gap is the deepest in the state on a percentage basis.

A professor at the University of Hawaii's John A. Burns School of Medicine, identified in the reporting as Withy, pointed to two converging forces that accelerated physician departures. "They didn't want their health to be at risk, so some of them retired," Withy said. "And then there was a cliff for electronic health records. Senior doctors who didn't want to adopt the electronic health records retired."

The attrition has exposed a deeper structural gap in how Hawaii counts its physician workforce. An annual report to the state Legislature found that of the 12,688 physicians licensed in Hawaii, only 3,647 are currently providing patient care. The report does not detail why such a large portion of licensed physicians are not in active practice, a question that warrants further investigation into inactive licenses, administrative roles, and part-time or research positions.

State officials are reportedly doubling down on recruitment efforts, but those efforts are running against rising costs, federal funding cuts, and a population growing older faster than the care system can adapt. Specialist shortages compound the problem, though the workforce report does not yet provide specialty-by-specialty breakdowns for geriatric physicians specifically.

For a county like Hawaii, where communities from Kohala to Ka'u already face long drives to reach care, the closure of rural practices does not just mean inconvenience. It means patients managing multiple chronic conditions, dementia, and mobility limitations lose access to the providers who know them. The workforce data suggests that pressure is only increasing.