Pamela V. Brown

Write Path, an L.L.C.  

Photo by Ron Kosen / Photo-Spectrum

   Kauai Business Report, March 2004

Doctor's Risk Pays Off in New Lihue Clinic

Practice is a blend of Western and alternative medicine

By Pamela V. Brown

LIHUE - As a rice farmer turned nurse turned doctor, Dr. Constante "Paul" Flora has always successfully bucked conventional wisdom. So when he decided to buy a half acre of prime Lihue land and build his own medical clinic - even though Kauai real estate prices were steep and climbing - he knew it was the right thing for him to do.

Photo by Pamela V. Brown

Aloha Medical Centers has only been open since last December, but already Flora's patient count is nearly 3,000. To date he's the center's only MD, though he's actively looking for an internist and a family practice doctor to join him. He has several nurses on staff, his sister - who is a nurse practitioner - will be joining him from San Francisco soon, and a pain management specialist began work in early February.

The clinic will also soon house a pharmacy to be operated by Home Infusion. Diagnostic Laboratories already has a small office in operation.

Having worked at Kuhio Medical Center in Lihue for more than seven years, Flora said he felt compelled to open his own clinic out of frustration and his desire to serve his patients better. At the HMSA-owned clinic, Flora said he felt hampered by certain regulations that weren't helpful to patients. For example, he said was prohibited from starting earlier in the mornings or staying later in the evenings to accommodate people just getting off work. "I couldn't even work an extra Saturday to catch up with new patients because then they'd have to bring in a nurse," Flora said.

One of his pet peeves was that even when patients were standing in pouring rain outside the front door, he wasn't allowed to let them in before the clinic's regular hours began. For that reason, and to help his disabled patients, Flora purposely designed a large porte cochere in the front of his own building.

He's willing to go to great lengths to make life easier for his clients, and the favor is returned.

"My patients are great," Flora said. "During the opening [of the clinic] it bought tears into my eyes. I never thought I had that much support and love from the community and I was taken aback."

Flora also had the confidence of his bank which lent him funds to construct the one-story, 4,875-square foot, $1.3 million structure using his patients as collateral, literally. "They know how busy I am. They looked at my production and said, 'Yes, you can handle the loan on your own,' " Flora said. "I know that my patients will follow me. They're worth more than money."

The new center features 12 patient rooms, doctors' offices with windows - Flora said his windowless office at the prior clinic gave him a headache - and about $350,000 worth of state of the art equipment including a bone density scanning machine. One piece yet missing is his own X-ray machine, though the office space is allocated and the electrical connections are there. Flora is holding out until he can afford a digital version of the machine which will produce X-rays immediately.

In the meantime, Flora keeps very busy seeing about 175 patients per week, plus time spent visiting his patients at Wilcox Hospital. He works six days a week, usually works through lunch and does his dictation for patient files at home in the evening. Though he misses working in his garden and tending his orchids, he sees the long hours as part of his calling.

"When I looked and evaluated the clinics that we have on this island, I found that the accessibility of the doctors is quite limited," Flora said. "I never quite understand that because as a doctor, you really need to make yourself available."

On a recent Saturday, Flora lived up to his words, greeting a patient at the door, chatting with him in his native tongue, even thought the lights were off and the clinic was closed for the day. Shortly thereafter Flora left to make a home visit to a blind patient whom the doctor said doesn't have anyone to drive him into town.

Long days are nothing new to Flora who worked as an intensive care nurse for 19 years in Honolulu and in the San Francisco area, including at Stanford University Hospital. Sixteen hour days, six days per week were de rigeur. "When I was in my 15th year of nursing, I thought to myself, 'I think I can do a little more than I'm doing now,' " he said. "I was then 34 and to get into medical school when you're past 30 at that time was pretty difficult."

Not one to skirt a challenge, Flora was accepted to the American University of the Caribbean in British West Indies, where he studied for a year then returned to California to take his national board exams and complete his studies. Eventually, with his family living in Honolulu, he found his way back to Hawaii.

"I always wanted to come back not to Honolulu, but to Kauai," he said. "When I came for my interview it wasn't the Kauai that I remembered however it was still better than Honolulu."

And it was a far cry from his years in the Philippines, where he remembers being only three or four years old and already tending the pigs, goats, cows and chickens. "But I think what I hated most about the farm was the sugar cane - we had a small sugar cane plantation," Flora said. "We had to cut those canes with a machete. No gloves. The edges of the cane are very sharp. Your face, your hands, your arms are cut."

As he got older, he dreamed of coming to America while working the family's rice farm. "I tilled the land with the water buffalo pulling the harrow," he said. "It's so fresh in my mind I can still see it. A lot of my patients, when I tell them they are surprised. I'm very proud of it."

Now that he has his own center, Flora is glad to be able to practice his special blend of medicine - a mixture of Western techniques and alternative approaches, including spiritual and energy healing. He believes that his openness to other options is one of the things that sets him apart from some other physicians.

Edmund Freeman, who has been offering Healing Touch energy work at Wilcox Hospital since 1996 and now does the same at Flora's office, says Flora is quite knowledgeable about energy work but doesn't have the time to do it himself.

"He is extremely precise and is very, very, very caring about his patients," Freeman said. "He's very intelligent and very quick. He just doesn't miss much."

And, Freeman said, Flora thinks big.

Indeed, barely three months after opening his medical center, Flora is already envisioning several satellite clinics across the island, specifically in Kapaa, Poipu and maybe in the Hanapepe/Eleele area. They'd be much smaller - probably only one doctor and one nurse each - but Flora would like to design and own those buildings, too.

"I'd give it a good 1-2 years for this clinic to really get going," Flora said. "But during that time I'll look around for good locations and talk to people. In the U.S. if you want to work hard, the sky's the limit of what you can do."

Contact Information:

Pamela V. Brown

(808) 651-3533 cell

(808) 821-1027 fax

pam@writepath.net

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