Keeping Care Close: Dr. Kaohimanu Dang Akiona’s Quiet Fight for Rural Hawaiʻi.
- David Isei
- Oct 14, 2025
- 3 min read
The Hawaii Medical Association typically confers its President’s Award in recognition of a physician’s lifetime of visible achievement. In the case of Dr. Kaohimanu Dang Akiona, the award recognizes her dedicated service in underserved areas and her tireless advocacy for enhanced healthcare standards for local communities.
Dr. Akiona initially trained as a researcher and subsequently developed community health programs, including a cancer patient navigation model tailored for Hawaiʻi. She later attended medical school through the Native Hawaiian Health Scholarship, which led her toward a career in primary care. This background fostered a career that integrates public health principles with direct clinical practice.
Dr. Akiona deferred alternative opportunities to participate in the inaugural family medicine residency on the Island of Hawaiʻi, a decision she described as a significant risk. The initial year presented substantial challenges, including community resistance, opposition from certain specialists, and the isolation associated with being part of the first cohort. She sought additional training in obstetrics, surgery, and procedural skills to ensure comprehensive competence in rural healthcare environments.
This adaptability has led to the establishment of clinics that enable patients to receive care on the island. Dr. Akiona operates a hybrid practice model that integrates urgent care, primary care, and specialty services, with a focus on accessibility and convenience. She founded Kohala Coast Urgent Care to accommodate patients from various insurance panels, including the Veterans Affairs (VA), Kaiser Permanente, and the Hawaii Medical Service Association (HMSA), and to provide mobile and community clinics during the COVID-19 pandemic. In May 2023, she expanded services to Molokai, addressing the need for local access to lifesaving care.
The award acknowledges not only clinical productivity but also persistent advocacy efforts. During the COVID-19 pandemic, Dr. Akiona and her colleagues were required to advocate for resources for the outer islands, often educating and urging peers and institutions to uphold the same standards of care as those in other regions.
The challenges identified are systemic in nature. These include extensive prior authorization and claims delays that disrupt clinic finances, additional administrative requirements imposed by insurers that divert clinical staff time, and a declining number of clinicians willing to practice in rural Hawaiʻi due to inadequate support systems. The resulting disparity between the standard of care clinicians aspire to provide and what is feasible contributes to professional burnout and moral injury.
Dr. Akiona employs pragmatic, community-based strategies to address these challenges. She has encouraged employers, including resorts and government contractors, to demand substantive value from insurers, recognizing that employers possess significant influence when employee access to timely care affects operations. Additionally, she has invested in integrated services, including behavioral health, substance use treatment, and occupational health, enabling patients to receive comprehensive care locally.
Yet amid the policy fights, despite ongoing policy challenges and daily clinical demands, Dr. Akiona emphasizes the intrinsic rewards of patient care. She values the opportunity to support families during critical life events, such as childbirth, end-of-life care, and cancer treatment, which sustains her commitment to the profession. Akiona’s work is this: honoring clinicians matters, but recognition without resources is a fragile consolation. The President’s Award is a spotlight, and she an
d her colleagues want that spotlight to become leverage: to raise funds for clinics, to recruit and support clinicians with real infrastructure, and to press insurers and policymakers to stop practicing “medicine without a license” through utilization controls and administrative roadblocks.
Dr. Kaohimanu Dang Akiona exemplifies the qualities required in physicians serving Hawaiʻi: a commitment to community, the development of practical solutions, and the insistence on equitable healthcare access regardless of geographic challenges. The President’s Award is merited and should also prompt action to ensure adequate funding, protection, and support for future clinicians.
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