New Doc on the Block
Planned Parenthood's Kahului clinic gets a boost
March 29, 2007
Seated in her modest Planned Parenthood office in Kahului, Dr. Ann Rahall's eyes light up when she talks about what she does for a living. Rahall, who has worked with Planned Parenthood of Hawai`i (PPH) for more than a decade, recently moved to Maui to become the first physician in PPH's Kahului clinic.
"I love taking care of women," she says. "It's very satisfying to not only help them with medical problems, but to educate them on taking care of themselves. To do this, it's important to know about the woman's life in terms of relationships, family, work, stress, exercise and eating habits. I prefer a holistic approach to health care."
Rahall's credentials are impressive. She's a Board Certified OB/Gyn (Diplomat of the American Board of Obstetrics and Gynecology) as well as Fellow of the American College of Obstetricians and Gynecologists.
On Thursday, Feb. 22, the Kahului Clinic held an open house to publicize Rahall's arrival. It began at 3 p.m., and by 4:30 p.m., the clinic's small waiting room was packed with people. Among them were several PPH officials who had flown from Oahu.
The mood was festive as potential patients and others who stopped by were greeted warmly at the door. Everybody got a full tour of the clinic. Afterwards, attendees headed to the snack table, where a smorgasboard of food awaited them.
As the sun began to set, several of the visitors from Oahu gathered around a window to gaze at the West Maui Mountains. The sky was streaked with hues of orange and purple.
"Well maybe we should just move the headquarters out here," says Melinda Wood, President of the PPH's Board. "There's less traffic, it's more relaxed, and it's so beautiful."
Mention the name Planned Parenthood to most people, and the first thing they'll probably think of is abortion. PPH officials would like to change that.
"I think the hardest thing is to reduce the stigma about going to a clinic," Wood says. "People assume that if you're going to a clinic it's about sex. It can be about other things as well."
"We really have a three-pronged approach," said Barry Raff, PPH's Chief Executive Officer. "The clinic provides health services, and then we have the sexual education in schools and a public policy office… A lot of people think that we are just a place that performs abortions, but in reality that is only about 15 percent of what we do."
Planned Parenthood of Hawai`i (Disclosure:they advertise in this publication) was founded in 1966. Since then, it has grown to three clinics on Oahu, Maui and the Big Island. They have an annual budget of $2.5 million, 85 percent of which comes from the patient fees. The other 15 percent comes from donations. They see 7,500 patients a year.
"Most of our services are geared towards the cash-paying patient, those who don't have health insurance," Raff says. "We do accept almost all insurance and half of our patients do use their insurance."
Among the services provided are annual exams, a wide variety of contraceptives, HIV and other STD testing and counseling, pregnancy counseling, midlife/menopause services and abortions. Payment for all services is on a sliding scale.
This year Planned Parenthood Hawai`i wants to pass four pieces of legislation. The goals of these bills are to provide state funding for family planning, add a requirement for emergency rooms to offer emergency contraception to rape victims, require organizations receiving state funding for sex education to only teach medically accurate sex ed and require insurance coverage for the HPV vaccine.
"Hawai`i is fourth in the nation in laws, legislation, services, etc.," Raff says. "We are given an 'A' rating by Planned Parenthood in those areas." Though he added that they still have work to do in implementing legislation.
Other states apparently have it much harder. "We have no targeted regulation of abortion clinics here," he says. "In states that are anti-choice, they regulate everything—the size of the bathroom, the amount of airflow in the clinic. And it's only for the abortion clinics, nothing else. They have regulations requiring that women wanting abortions come in to see a physician, and then they have to go home to think about it for 48 to 72 hours. Even then, 85 percent of counties don't have abortion providers. Women have to travel hundreds of miles. It's an access issue. Here, we have a provider in every county."
"The culture here is very accepting," Wood adds. "They let people make their own decisions. People here are very socially progressive."
In fact, it's hard to think of a more desirable place for a family planning doctor than Maui. Rahall moved here from Oahu two and a half months ago with her two sons. "It's wonderful here," she says. "There's less traffic, it's more relaxed, and the wind is better for windsurfing." She added that she's happy with the great variety of yoga available, which she's been practicing for 12 years.
Rahall knew she wanted to be a doctor by the time she was in junior high. "I just knew I wanted to help people," she says. That realization took her from her hometown of Beckley, West Virginia to Loyola University Chicago Stritch School of Medicine. After that she completed her residency at the University of Southern California.
"At that time, it [the residency] was probably my biggest accomplishment," Rahall says. "Four years at one of the busiest hospitals in the country. In that four years we delivered 45,000 babies."
It was that residency that brought her to Hawai`i. "I had a two month rotation at Kaiser on Oahu during the third year of my residency," she says. "I really fell in love with the place and wanted to come back."
A year later, with her residency completed, Rahall did just that. When she arrived on Oahu in 1996, she found an opening at Planned Parenthood and has been there ever since. Within a year she had moved from a staff position to take over as part-time medical director. She still holds that title, which brings her back to Oahu one day a week.
Rahall has been seeing patients at the Kahului clinic and is available for appointments three days a week. Before she took appointments here, patients sometimes needed to see other hospitals for certain procedures. Now they have more flexibility.
"It's exciting to be able to expand reproductive health care services for the women of Maui," she says. "We see clients of all ages, from teens through post menopausal women."
Lots of clients. So many, in fact, that it's stretching the clinic's resources.
"At first I thought it would be difficult to get into places, but it really isn't," says Sonia Blackiston, PPH's sole full-time sex educator. "If you look at the stats, parents and teens support [the education]."
Recently Blackiston hired a part-time assistant, but she still says her biggest challenge is being understaffed. "My assistant is a huge help, but she can only really work for 16 hours a week," Blackiston says.
She says requests for her program should be made two to three months in advance, and schools should call even earlier than that. "With schools, I would like them to call as soon as possible," Blackiston says. "I had people last August making appointments for May. But if we can fit them in at the last minute, we will."
Blackiston provides what she calls "medically accurate" sex ed. It teaches that abstinence is the only 100 percent effective way to prevent unwanted pregnancies and sexually transmitted diseases (STDs), but also provides information on contraceptives and health questions for those who don't practice abstinence.
"We help anybody who needs info," she says. "Public and private schools, community organizations, and even faith based organizations… None of the information is directive or fear based. We help each person define sex and abstinence. Your definition of abstinence should be based on your own personal values and beliefs. You need to know what your values and limitations are for your definition and be able to communicate that with your partner."
She added that Hawai`i's federally funded "Try Wait" program—which is run by Catholic Charities and tries to convince teens to wait until marriage before having sex—does nothing to address these issues. Raff agrees.
"We teach abstinence-based education," he says. "Abstinence is the only 100 percent sure way to prevention, but we don't ignore kids who will have sex. For those kids we teach the benefits of contraception and the prevention of disease and unwanted pregnancies. One of the tenets of the federally funded 'abstinence only' program states that if you have sex before marriage, it will cause harm to a person's mind and body."
Blackiston says there's no research to support the notion that sex before marriage is harmful.
"We are not out there to teach people how to have sex," she says. "We are teaching them how to make healthy choices. Medically accurate sex education actually delays [teens] beginning to have sex."
Raff added that the Hawai`i is already ranked 12th in the nation for unwanted pregnancies. "Education is key to reducing them," he says. "If we do that, abortion goes down."
For more information or to make an appointment, call the Kahului Clinic at 871-1176. MTW
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