In 2022, when Dave Fields first launched Fields Psychiatric Consultants — a private psychiatric services practice with its Mililani flagship and locations in Nuʻuanu/Chinatown and Wailuku, Maui — he remembers reaching out to community organizations and saying, “I will see your sickest patients.”
The response was a resounding, “Yes!”
“A lot of practices don’t want to see those patients because they can be very high-liability, low reimbursement, because they are on government insurances. So, [patients] are either out there not being seen or being seen by someone on the Mainland. To help bridge that gap, I started my own practice to provide high quality, evidence-based care to everyone, regardless of insurance or ability to pay.”
Some in the health field said this model was “unsustainable,” he recalled. “I’m not a businessman and I’m not here to make a profit. Things are going OK three years later. Our bills are paid.”
Born and raised on Oʻahu, Fields is a psychiatric nurse practitioner and student at The William S. Richardson School of Law at the University of Hawaiʻi at Mānoa. He got into the profession for several reasons, he said, including a deep interest in the study of psychiatry, life events and a desire to serve local communities.
“I had a really close friend pass away through suicide. I saw mental illness going on, and my own family has some history of addiction, so mental health has always been a part of my life in some way, shape, or form,” he told Aloha State Daily.
When asked what he hopes to gain from obtaining a law degree by May 2027, he noted that his main goal is “to combine clinical credibility with legal leverage.”
“I see a lot about rules around reimbursements fail patients. ... I want to push parity, reforms, legislation, things like that to be able to fight and represent people with severe mental illness, even with issues regarding housing and other social issues.”
Fields, a Mililani High School graduate, has prior experience serving at the Institute of Human Services, The Queen’s Medical Center and Hawai‘i State Hospital.
Fields Psychiatric Consultants employs three staff members, in addition to clinicians who come on as contractors, he said. Services include psychotherapy, consultation, medicine management and more, according to its website. Patients do not need a referral to be seen, Fields noted.
“We’re excited to open our fourth location at Hawai’i Kai Towne Center in October, with a psychiatrist from the community offering in-person appointments. … It’s kind of like me and my connection to Mililani; we can relate better to our patients that way.”
Hiring hasn’t been an issue, Fields said, adding, “In regard to the provider shortage, the providers are there. It’s just pay well, treat people right, give them work-life balance and a good company culture.
"I’m a clinician myself, so the business is a vehicle for me to see patients and earn my own income. I’m not relying on this company to pay me to survive. I’m going to see patients until I’m 90 years old because the clinical part is the most fun part for me and the reason I got into this. I just want to make a difference and to help people.”
He said working on his own terms was “the biggest step toward mental wellness for me.”
“I’ve always prided myself on seeing the bigger picture for the patient. There’s no price that should be above someone’s life, in my opinion. … At the end of the day, its someone’s family member or friend over the money,” Fields said. “I also never want to get to the point where someone has to wait two-to-three months to see a provider. And to date, we’ve been able to get patients seen within two weeks at the most.”
When asked what advice he’d give to mental health providers in Hawaiʻi, Fields said, “You’ll never have a better boss than yourself. Follow your passion. I saw this need and felt moved to do it and it just kind of propelled from there. You may not have the same calling. … There are a lot of community orgs that are wanting certain specialties. Don’t be afraid to go for its and ask for help along the way."
Fields also is ramping up his year-old nonprofit called Therapy Plus to help make psychiatric therapies more accessible. “One goal is connecting patients to treatments and subsidizing the cost. Housing is another area of focus; group homes, for example, could help fill that gap between the acute care of the hospital and being committed to the Hawai’i State Hospital, or these long-term institutions, because a lot of times these things can be caught beforehand.”
He is looking to build its funding through grants, donations and partnerships. (Its own website is coming soon).
For the latest news of Hawai‘i, sign up here for our free Daily Edition newsletter.
Kelsey Kukaua Medeiros can be reached at kelsey@alohastatedaily.com.
