Edward Ruhland, M.D., understands the importance of establishing trust with his patients. But as an emergency physician in Hilo, it can be a challenge.
“We’re trying to make decisions with limited information in a short amount of time,” he explains. “So, we try to build rapport as quickly as possible.”
That connection is important to help patients open up and be honest with their physician. While the time Dr. Ruhland spends in the exam room is sometimes brief, he’s still found a way to bond with his patients.
Edward Ruhland, M.D. Photo courtesy Dr. Ruhland
“I may not look like I’m from here, but as soon as we start talking, they know I’m from Hilo, too,” he says. “That resonates with them, and they drop their guard. Patients often tell me, ‘Thank you for coming home.’”
Home sweet home
Dr. Ruhland went to the Mainland for college and medical school, but he always knew he wanted to return home.
“I’ve dreamt of working in Hilo, and we knew the area needed doctors,” he says. “But of course, the cost of living is so high.”
He and his wife, who is also a doctor, learned about the state’s Healthcare Education Loan Repayment Program (HELP). The John A. Burns School of Medicine helped develop the program, which repays up to $100,000 of health care professionals’ student loans as long as they practice and provide care to patients in Hawaii for at least two years.
“My student loans are my biggest monthly payment, and they have been for the last seven years. It’s bigger than my mortgage,” Dr. Ruhland says. “But HELP is allowing me to get out of debt five to seven years faster. And it’s helping us focus on other expenses, so we don’t feel as pressured every month.”
Drawing physicians to the Islands
Though the lower cost of living on the Mainland is pulling health care professionals away from Hawaii, HELP is a way the state is trying to even the playing field. A recent study found Hawaii is short about 800 physicians.
“The need for doctors is palpable. Growing up here and having a father who was a medical assistant here, I’ve witnessed that my whole life,” says Dr. Ruhland. “So, this loan repayment program can help attract physicians.”
Since HELP launched last year, nearly 900 health care professionals have been accepted into the program. 488 are in primary care and behavioral health, and 466 serve rural areas or on Neighbor Islands, which are in the highest need of physicians. 240 recipients are from the Big Island.
“It’s a big commitment to get people to come here. Even if someone’s living on the West Coast, they could work at any of hundreds of hospitals. Picking up their life and flying out here is a big step,” says Dr. Ruhland. “But I think a lot of physicians who have received these loan repayments have found them very helpful. It gives us a nice boost, given the challenges of our jobs.”
Connecting with his community
Dr. Ruhland sees dozens of patients every day in the ER. He goes from room to room, not quite knowing what to expect. Cases can range from fevers to heart attacks to issues with mental health.
“You just take care of whoever’s in front of you and try to guide them. A lot of it is problem solving,” he says.
Since Hilo is such a small town, Dr. Ruhland often knows his patients. And even if he doesn’t, someone else he knows does.
An aeriel view of Hilo.
“There’s one degree of separation from everybody you take care of,” he says. “You’ll see the person you took care of yesterday in the grocery store, or your dad will call and say, ‘Oh, I heard you took care of my friend today.’ You’re 110% invested in every patient because you’re connected to everybody.”
He wouldn’t have it any other way. He feels lucky to be able to work in his own community and raise his family there.
“The HELP program has helped us stay in Hawaii and be able to do what we’ve always wanted to do,” says Dr. Ruhland. “It was a blessing. We love it here, and we’re going to stay here forever.”
Taking care of your health
For more stories on health care in Hawaii, check out the stories below:
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