Pearl City, HI – Our guest has made it her mission to encourage others that seeking help for mental health should not be stigmatized. “We have all been sad and we have all been scared,” she assures. In addition, she has also been fighting the good fight when it comes to the treatment of mental health patients. While it is currently an uphill battle for her, she remains hopeful. This is the story of Dr. Doreen Fukushima.

Dr. Doreen Fukushima is a respected psychiatrist and the founder of Ho'ola Pono. Based on the island of Oahu in Hawaii, Ho'ola Pono, which is Hawaiian for “to make well”, offers unique psychiatry services in addition to standard talk therapy.

One specialty treatment that Dr. Fukushima offers is Transcranial Magnetic Stimulation (TMS). “It’s an FDA-approved procedure that treats depression, anxiety, and obsessive-compulsive disorder without medication,” explains Dr. Fukushima. “It’s a magnet that goes outside of the head, and it gives an electrical pulse, similar to an MRI machine. It wakes up the neurons of the frontal part of the brain. Usually with depression, anxiety, and obsessive-compulsive disorder, the neurons are not functioning the way they are supposed to. It’s a safe and effective way to jump start the neurons to have them function the way they are supposed to be working.”

Another specialty treatment that Dr. Fukushima also offers is Spravato. Also known generically as Esketamine, Spravato is a form of Ketamine, which is an anesthetic medication. One of the unique side effects when people received intravenous Ketamine is that they would wake up very happy. Some have used Ketamine off-label to treat depression. However, it was not covered by insurance and is administered intravenously. Janssen (Johnson & Johnson) eventually created Esketamine, which is a nasal spray. The results are very good in that it helps people get through their past traumas and significant depression. “This makes people feel less guarded and more open to talking, when they are dealing with their traumas,” summarizes Dr. Fukushima. “It also improved the malleability of the brain.”

“Very few insurances cover it, but you can fight to get it covered,” she notes.

Dr. Fukushima has been enduring considerable legal difficulties regarding the insurance coverage surrounding the use of Spravato as a treatment for her patients, which was approved by the FDA. She even suspects that there may even be some corruption involved regarding the Hawaii Medical Service Association (HMSA) and some legal firms that handle healthcare disputes.

The FDA approved Spravato as a mental health treatment in 2019, and HMSA approved its usage in 2020. Also in 2020, Dr. Fukushima received clearance from HMSA to use Spravato as a treatment for her patients. After about a year-and-a-half, Dr. Fukushima gets a nasty letter from HMSA saying that she allegedly used the wrong billing codes and that HMSA would like a full refund of the money they paid her to provide all of these services. Dr. Fukushima maintains that she used the right billing codes, as instructed by HMSA.

Dr. Fukushima eventually got an attorney, and the firm called Cades Schutte, assured her that she was compliant with the instructions from HMSA. With the law firm, they went to arbitration to which one of the attorneys working on Dr. Fukushima’s behalf had a panic attack. This led to a chain of unfortunate events where the law firm forced Dr. Fukushima to work with the attorney, despite her reservations. “I lost as badly as anyone could lose,” states Dr. Fukushima. The arbitrator who also happened to be a friend of one of the attorneys in the law firm ruled entirely against her.

Much of the corruption that Dr. Fukushima observes is the errors on the part of HMSA, the law firm she hired, who later abandoned and attacked her. The law firm filed a temporary restraining order against her when she asked for help as their poor performance cost her almost $500,000. This poor performance from the law firm also resulted in her being cut off from reimbursements from her biggest patient population – military families who have Tricare insurance. Currently, she has not been paid for eighteen months despite having authorizations for every Tricare patient. However, she continues to treat them and pay for these treatments out of her own pocket. She was also recently put on restriction from Kaiser Permanente after trying to advocate for them to cover Spravato for one of their patients for the first time in Hawaii, even though it is covered by Kaiser Permanente in California.

Despite all of that, she remains optimistic regarding the future of her psychiatry practice. Ultimately, she would like to expand – most notably by getting the funds together to purchase her own building. “I want to build something that no one has ever seen before,” Dr. Fukushima notes. Included in this building would be her own pharmacy, a trampoline room, a food court, and even a patient store.

“Despite the craziness, I overall love everything that I do in psychiatry,” declares Dr. Fukushima. “It’s a fascinating field.”

“There shouldn’t be a stigma with psychiatry,” Dr. Fukushima concludes. “You should come to your psychiatrist when you are having mental health struggles. It is not a weakness to see a psychiatrist. It’s a strength”

For more information, please visit https://hoolaponotmshawaii.com/