More than 150 doctors left the state this year, while another 91 retired and 123 decreased their work hours, contributing to the ongoing physician shortage throughout Hawaii, according to a report from the Hawaii Physician Workforce Assessment Project that was recently submitted to the state Legislature.

The losses comprised about 8% of Hawaii’s physician workforce. Overall, the state needs to add as many as 820 doctors to satisfy the need for services, with the highest shortages occurring in primary care.

There are 3,484 physicians actively providing care to patients in Hawaii, but because not all of them work full time, this equates to having just 2,974 doctors, according to the report.

The shortages mean that people throughout the state are having to wait longer for health care with sometimes life-threatening consequences, said Dr. Kelley Withy, lead investigator for the report. While Hawaii island has the greatest shortages, Withy said that even in Honolulu there can be long wait times for doctor visits.

She said doctors are leaving Hawaii for various reasons, including the high cost of living and lower than average pay, limited job prospects for spouses and dissatisfaction with the medical community. They also might relocate to the mainland to care for parents.

The report also found that the physician population in Hawaii is aging and not enough new doctors are being recruited. About half of active physicians are at least 55, and nearly 1 in 4 are age 65 or older.

Withy said the state wasn’t training enough physicians to make up for its annual losses and increased demand for services. The University of Hawaii’s John A. Burns School of Medicine would need to double or triple its class size and residencies to train enough doctors.

“The dean is trying to do that by expanding training on neighbor islands which is really exciting, but it is expensive and labor intensive,” said Withy by email.

The report found some positives. Hawaii’s severe shortage of cardiologists has eased with heart specialists now being trained locally through a fellowship established by the medical school. The Hawaii Island Family Medicine Residency program has also added to the pool of doctors specializing in family medicine.

Studies have shown that investing in medical training locally pays off with 80% of medical students who attend school and complete their advanced training in Hawaii remaining in the state.