Comprehensive Patient Care

By Dr. Owen Nishikawa
Interviewed by Melissa Moniz
Wednesday - October 22, 2008
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Dr. Owen Nishikawa
Family Medicine

Interviewed by Melissa Moniz

What is your medical background?

I attended the John A. Burns School of Medicine and graduated in 1999. I then did my residency training with the UH Family Practice Residency Program until 2002. I served for three years as medical director of the Kuakini Family Practice Center in Moiliili. In 2005, with the help and guidance of Dr. George Suzuki, I started my private practice at Kuakini Medical Plaza.

Did you go to high school here?

Yes, I graduated from Kalani High School.


What is family medicine?

The whole purpose of family medicine is to be a comprehensive specialty. As family medicine physicians, we take care of children, adults and the elderly. In a rural setting, a family medicine physician would be delivering babies, taking care of seniors, doing minor surgeries and handling medical emergencies.

Do you find it difficult because you have to be an expert in so many areas?

I think it’s definitely challenging. But that’s medicine, and that’s what makes it exciting. The medical field is constantly evolving and changing with the development of new diagnostic tools and treatment modalities. It’s good to know a lot of different things because people oftentimes don’t just present one complaint. The more you know, the more you can manage on your own. But at the same time, it’s just as important to know your limitations and when to refer to a specialist.

Dr. Owen Nishikawa (seated) with his staff (from left) Eley Faulk, Dani Nishikawa, Niranda Hartle and Karen Toda

If you had to choose one area you are most knowledgeable in, what would it be?

I’d probably have to say general adult medicine and geriatric medicine, because that’s primarily what I see in my office. The majority of my patients are young adults and seniors. But I really do enjoy taking care of kids as well.

In regard to adult medicine, what are the most common ailments/problems you see?

With regard to chronic problems, I see a lot of diabetes, high blood pressure, obesity, high cholesterol, heart disease and dementia. Day to day, I see a lot of colds, upper respiratory infections and skin problems.

From what you see, are a lot of the problems with adults and geriatric patients preventable?

I’m really glad you brought that up because that’s really an interest of mine - preventative medicine. That’s a big part of the family medicine philosophy. There are so many people out there with high blood pressure, diabetes, dementia and other chronic health problems. I believe that if you intervene early and provide appropriate education and training, then a lot of these health issues may be preventable, or at least controllable. It really helps when you can do something early, so I try to encourage the preventative medicine aspect.


Are you a big advocate for eating healthy and exercising?

Yes, I believe a healthy diet and regular exercise are the basic and the fundamental lifestyle choices people need to make. I always advise a low-fat, lowcholesterol, low-sugar and low-starch diet in conjunction with regular exercise before turning to medications. You’d be surprised how much of a positive impact healthy lifestyle choices have on blood pressure, blood sugar and overall health.

Just from my own observations, I notice women are better about going to see a doctor regularly than men. Is there truth to that and, if so, why do you think that is? And lastly, why is it important for men to see a doctor regularly?

I think you’re right. Women have been conditioned from an early age to see an OB/GYN regularly and, as a result, are much better at getting regular health care. Men in general, especially when they’re younger, have this feeling that they’re fine and don’t need to see a doctor. But as men get older, into their 30s, 40s, and 50s, that’s when blood pressure, blood sugar, cholesterol and weight start increasing, and they start paying the price for eating whatever they wanted when they were younger. That’s why preventative medicine and screening exams are so important. We can intervene at an earlier stage, when lifestyle modification can still have a significant impact, and before medications are necessary.

Since you started, what do you feel has changed the most within your field?

Two things come to mind. First, electronic medical records (EMR) have revolutionized the office visit. In the medical field, patient privacy, confidentiality, accurate record-keeping and documentation are of utmost importance. Minimizing errors is equally important. EMR helps us achieve these goals.

Second, the hospitalist movement has become more popular and accepted over the past 10 years. On the plus side, decreased length of stay benefits the hospital, and immediate accessibility of the hospital physician helps the patient and primary care physician. On the downside, it creates a dichotomy between inpatient and out-patient medicine, and there is potential loss of continuity of care with the primary care physician.

With election season upon us, there’s a huge issue with our presidential election about health care. One big thing is making health care available to everyone. Do you think that’s possible?

Yes, I do. Each presidential candidate has his own plan for health-care reform. But the bottom line is that the system needs to change, and this will take time. I believe that the government, insurance companies, pharmaceutical companies, medical centers and physicians need to work together in order to provide health care for everyone.

You are also a hospitalist. Can you explain what a hospitalist is?

There are several definitions, but in the truest sense of the word, a “hospitalist” is a hospital-based physician whose primary focus is to provide care for patients in the hospital. He/she admits the patient to the hospital, takes care of the acute medical problem, then transfers care back to the primary care physician. But for me personally, it’s difficult to say I’m just going to take care of my patients in the outpatient setting and if they happen to get admitted to the hospital, have some other doctor take care of them. I feel it’s important for my patients to know there’s continuity of care. My patients are like family. I care for them when they’re healthy or sick in both outpatient and inpatient settings.

You also are a consulting physician for REHAB. Can you discuss what that involves?

I am one of several doctors who provide medical consultation services at REHAB. When a patient is admitted to REHAB, he/she will sometimes have active medical problems in addition to his/her rehabilitation issues. Several examples are diabetes, high blood pressure and kidney problems. So the attending physiatrist will consult one of us to assist with management of the patient’s medical problems. We work as a team to provide full service medicine and rehabilitation to expedite the healing process.

 

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