Despite plenty of talk about the problem, not enough is being done to address the critical shortage of physicians in the Islands, a panel of medical experts said last night.

"This is a problem that we've been discussing for several years now," said Dr. Cynthia Goto, president of the Hawai'i Medical Association, which sponsored the forum.

"It is becoming more and more of a crisis."

More than 75 doctors, healthcare professionals and others attended the forum yesterday at The Queen's Medical Center. The forum rounds out a series of public meetings the association has held around the Islands to discuss the shortage of physicians.

Experts say the shortage is not only leaving patients with fewer choices of doctors and longer waits for appointments, it is also endangering lives, especially in emergency care.

The panelists focused on several barriers to recruiting and keeping doctors in Hawai'i, including low Medicare and Medicaid reimbursement rates, salaries that don't take into account the high cost of living and the lack of changes to medical malpractice laws to stop frivolous claims.

Several of the panelists said putting a fair cap on damages in medical liability cases would benefit both patients and physicians.

"The lack of medical liability reform is a major obstacle" to recruiting doctors, said panelist J.P. Schmidt, the state insurance commissioner. "It is one of the most important issues we face."

Dr. David Teuscher, of the Texas Medical Association, said a cap on noneconomic damages approved in his state helped attract thousands of doctors. The $250,000 cap affects damages for emotional pain and suffering, not medical or other costs.

Critics of caps say they favor doctors and insurance companies.

The forum comes as healthcare experts are forecasting a worsening shortage of physicians on the Neighbor Islands and in rural O'ahu. Statewide, there is also a shortage of specialists.

"It is the beginning of the perfect storm," said Dr. Stephen Wallach, former president of the association and a physician at The Queen's Medical Center. "The average age of physicians in town is over 50. We can't recruit young people." He added that some nights Queen's has no neurosurgeon on call.

Panelist Dr. William McKenzie, an obstetrician/gynecologist, said there also are shortages in his speciality and in orthopedics.

"It's sad," he said. "I think we really do have to wake up."

Many doctors shared their stories at the forum.

Dr. Helen Ing, of Kailua, told attendees she retired three months ago after her husband was involved in a medical liability suit.

She said he is still practicing, but is more selective about the patients he accepts. "I think it's tragic when you really want to try and help people and you kind of get nailed for it," Ing said.

Dr. Raydeen Busse, of the Hawai'i section of the American College of Obstetricians and Gynecologists, said she was on the panel of a similar HMA forum in February.

"I was here on the panel ... and I feel like it's deja vu," Busse said, addressing the crowd during the question-and-answer session. "I'm really charging the legislators to just make a difference."

Reach Mary Vorsino at mvorsino@honoluluadvertiser.com.