In 2007, neurologist Kim Hutchison moved with her husband and two kids to Saipan, the island in the U.S. Commonwealth of the Northern Mariana Islands in the Pacific Ocean. She had no intention of practicing medicine.
But not only did she end up opening a neurology and sleep medicine clinic, she also expanded her ability to practice medicine in ways that would unknowingly prepare her for a worldwide viral pandemic.
Hutchison moved more than 10 years ago because her husband, also a physician, got a year-long contract job there.
“I was going to take a year sabbatical with my kids, who were very young at the time.” Hutchison said in a recent phone interview. “But once we got over there, they just started calling me. There was no other neurologist on the Island. I started picking up on the horrible end-stage renal disease, high blood pressure, and stroke there, and put it together with my training that sleep apnea was way underdiagnosed and undertreated.”
She soon re-opened a one-bed sleep lab and founded the Pacific Sleep Center. When it was time to go home, Hutchison couldn’t see abandoning her Saipan practice altogether.
“I was going back to a city [Nashville] where there were a hundred neurologists, and that island had zero. That didn’t make a lot of sense,” she says. “So, that’s when I started doing telemedicine and remoting in.”
She and her husband eventually moved to Portland, Oregon, where she took a job at Oregon Health and Science University (OHSU). This, she says, made it easier to go back and forth to Saipan, where she still sees patients in-person two weeks each year.
That’s what Hutchison was doing last February, when COVID-19 hit.
“The island was a bit of a ghost town,” she says. “But people were still very much in the dark at that point.”
Several weeks after returning home, the pandemic hit the U.S. healthcare system, and like most neurology practices, OHSU made the big switch to telemedicine. While many of her colleagues struggled with this transition, she had the advantage having practiced via telemedicine for years.
“Because of my work in Saipan, I have been a big proponent of telehealth,” says Hutchison. “I was on the university’s telehealth advisory board. We made more progress in two weeks than I had seen in the last five years.”
There were also other advantages she had gained from her decade of work in Saipan. One was dealing with communication barriers. In Saipan, those barriers were cultural and language-based; during the COVID-19 pandemic, those barriers came in the form of e-visits and PPE.
“Body language and facial expressions are not as clear, and there is a dropoff in the quality and level of trust in your communication,” Hutchison says. “I’ve gotten used to practicing with those barriers in place. When I run into a wall, I can quickly switch directions. I’ve become more flexible in the way I take my history and come up with care plans.”
Another way Saipan has prepared Hutchison to work during the pandemic is in dealing with reduced resources. Everything isn’t accessible all the time in Saipan.
“There isn’t even an MRI machine on the whole island,” she says. “I’m used to working in that environment. So, now that I’m here and my patient can’t get an MRI, that’s OK, we just move on and move forward.”
Working in a third-world country has taught Hutchison to think on her feet and to deal with disruptions in norms of care. She says she has become more adventurous, and curiosity is helping mitigate the fear introduced by this pandemic.
“The uncertainty and the lack of control doesn’t really get my core uncomfortable,” Hutchison adds. “I think I have a unique ability to cut through all the fat and get down to what’s important and what matters.”
Special thanks to Kimberly Hutchison, MD, FAASM, Associate Professor of Neurology and Sleep Medicine at Oregon Health & Science University in Portland, Oregon. You can learn more about her on her website. We also interviewed Dr. Hutchison for our story, The Joy of Joy Rounds.
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