KevinMD December 23, 2025
Today I am a urologist, a cardiologist, a psychiatrist, a rheumatologist. But truly, I am a rural family medicine doctor in one of the most underserved counties in the country. And I am tired.
I do not pretend to have the depth of each specialist. What I have is necessity, a toolkit built on scarcity. Practicing medicine on an island, where specialists are rare, calendars are full for months, and visiting clinics are as fleeting as rainbows, means my boundaries dissolve. My role stretches, bends, sometimes nearly breaks, to fit whatever shape my community needs. Yet, insurance companies deny authorizations, not for medical reasons, but because I am not the specialist who is hours or islands away. In rural Hawaii,...
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