Early Detection Lowers Risks
January 21, 2009
By Dr. Stephen Oishi
Dr. Stephen Oishi
Internal Medicine
Interviewed by Melissa Moniz
Where did you receive your schooling and training?
I graduated from Iolani School. I got my BS in biology from University of Hawaii, my MS in physiology from Georgetown University, and MD from Georgetown University School of Medicine.
I completed my internship and residency at the University of Southern California - LAC Medical Center in internal medicine.
How long have you been practicing?
I’ve been in practice for 21 years.
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Has your practice always been in Hawaii?
Since I was fortunate to receive a full National Health Service Corporation Scholarship, which financed my entire medical education, I was obligated to serve in a health manpower shortage area, and that is how I ended up spending the first four years practicing general medicine in Idaho. My four-year tenure was very rewarding, as well as challenging, as the experience enabled me to sharpen my diagnostic skills caring for all ages (infants as well as the elderly), as access to diagnostic services were very limited. Once I completed my four-year obligation in Idaho, I returned home to Hawaii and was very fortunate to join Central Medical Clinic and begin practicing in 1991. I accept patients age 18 and over now.
What are the most common problems you see in patients on a daily basis?
Diabetes, hypertension, hyper-lipidemia, obesity, coronary artery disease, kidney failure, asthma and heart failure.
Of the different problems you see, which are easily preventable?
Colon cancer can conceivably be preventable with proper adherence to screening. But one can only lower risk for heart attack, stroke, etc., by controlling blood pressure, lowering cholesterol, controlling diabetes, and with lifestyle changes such as losing weight, exercise and quitting smoking.
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What is a lipid profile?
Lipid profile is a blood test that consists of LDL (bad cholesterol), HDL (good cholesterol), total cholesterol and triglycerides. I usually have patients obtain this as early as possible, even at age 18. My philosophy is that early detection and awareness coupled with early intervention will ultimately reduce a patient’s risk for suffering a medical event such as stroke and heart attack.
Have there been any significant medical advancements that have really helped you in treating your patients?
I feel that advancements in the medical science of diabetes, hypertension and hyperlipidemia coupled with the development of newer medications have revolutionized my approach as well as treatment of these various disorders.
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As far as lowering cholesterol, is that done usually by changing your diet along with medication, or can it be lowered with just diet alone?
Yes, in some patients, lifestyle modification may be enough to control cholesterol. But in the majority of patients, I feel that there is a hereditary component and that the tendency for high cholesterol is in the patient’s genes. Thus, one can only lower cholesterol to some point, but to get a patient to current established goals base on heart-disease risk factors, medication is almost inevitably necessary.
Do you find that even after being diagnosed with high blood pressure or hyperlipidemia, many people still refuse to make the proper lifestyle changes?
Yes, I see this in my practice at times. There are patients who are very motivated and adhere to the treatment plan, there are those who partially adhere to the treatment plan relying more on medications and there are those with different variations of the theme.
Sometimes, unfortunately, what motivates a patient is when a close friend, co-worker or relative suffers a stroke or heart attack. Otherwise, with proper counseling about risk-factor modification and proper use of medications, most patients will adhere to the treatment plan.