Dr. Jeffrey Akaka doesn’t work for the Hawai’i Convention Center, but he’s brought in bookings that have meant more than $65 million to the state. He does this through what he calls "mac nut diplomacy."

Akaka, a Honolulu psychiatrist, has plied gifts of chocolate-covered macadamia nuts into three American Medical Association annual conventions in Honolulu, the American Psychiatric Association annual meeting scheduled for next year, and close to a dozen meetings of societies of specialized medicine.

The inspiration came from Akaka’s uncle, U.S. Sen. Daniel Akaka.

"When he first got into Congress, he would go around and give people pineapples and macadamia nuts back in the days when you could give gifts," Jeffrey Akaka said. "He would make friends and in that way start to talk about what he wanted to do for the people of Hawaii."

Akaka became a member of the American Psychiatric Association assembly in the 1990s. Whenever he traveled for a meeting, he’d pick up mac nuts at Longs or Costco — just a little taste of Hawaii for the people he met.

When the Hawai’i Convention Center opened, he thought the big APA annual meeting should be held there. The initial reaction from the organization was akin to "nice idea, but it doesn’t look like it’s going to work."

Then the American Medical Association House of Delegates held a meeting in Honolulu in 1998. Akaka took the opportunity to host a reception for the APA board members at the Waikiki Aquarium. The physicians talked to Hawaii legislators about bills regarding patient safety. The legislators talked to the doctors about bringing the AMA convention here.

"It was a hit," Akaka said.

The message was that Hawaii is a beautiful place to do serious business.

In 2003 the AMA brought its annual convention to Hawaii, bringing in an estimated $50 million in revenue. Hawaii also got the 2007 AMA convention and will host it again in 2012. Meanwhile, the APA’s 2011 meeting is expected to bring 15,000 to 18,000 attendees to Honolulu.

Part of that winning technique is "The Akaka Handshake." Akaka palms an individually wrapped chocolate-covered macadamia nut and passes it along when he greets people. Sometimes the physicians send their spouses to shake hands with Akaka so they can get an extra piece of candy.

"I’ve seen him work the floor with the Akaka Handshake," said Joe Davis, convention center general manager. "It’s astonishing."

The convention center started picking up the cost of the macadamia nuts after landing the AMA convention. When Akaka goes to medical conventions, they ship cases of mac nuts to him for his goodwill lobbying efforts.

"It’s a small price to pay for a very large return," Davis said.

Lee Cataluna can be reached at lcataluna@staradvertiser.com.