An article in the Twin Falls Times-News last month brings into sharp relief a major hurdle rural Idaho communities must overcome. The story focused, in part, on Dr. Keith Davis, who serves the people of Lincoln County. He has been doing so since 1985. However, that was just the setup to the story.
Dr. Davis is the county’s one and only doctor. He has been for 33 years.
The article points out that Lincoln County is roughly the size of Rhode Island. The difference is, a search of “doctors in Rhode Island” produces thousands of hits. There are more board members with the Rhode Island Medical Society than there are doctors in Lincoln County.
The question the article begs is: what happens when Lincoln County’s only doctor chooses to retire?
Rural counties like Lincoln, Camas, Gooding and others face similar questions. Idaho ranks 49th in the nation in doctors per capita. One-third of Idaho’s doctors will retire in the next 10 years. Anyone living in rural Idaho doesn’t need to look at a list to know this. Securing even a routine doctor’s appointment can sometimes require weeks of waiting. According to the story, Doctor Davis saw over 50 patients on his first day – including one who gave birth. There are 27 critical access hospitals (25 beds or less) servicing rural Idaho. Nineteen out of the 27 are operating below margins, writing off millions of dollars to provide care for those who can’t pay. This is unsustainable.
Idaho is investing in WWAMI (University of Washington School of Medicine Idaho) which allows medical students to train all four years in their home state. This allows students to get familiar with rural Idaho and increases the likelihood they will stick around after completing their training. The Idaho Legislature currently reserves 40 seats in the University of Washington School of Medicine for its residents. This program is not enough to address our declining availability of doctors while the state population continues to grow rapidly.
Prior to the 2018 legislative session, Dr. Ted Epperly, Idaho’s General Medical Education Coordinator, laid out a 10-year Strategic Plan (“Plan”) to dramatically increase the number of medical residencies in Idaho. Medical students perform residencies after graduating from medical school and prior to entering private practice. Under the Plan, the number of residency programs in Idaho would sky-rocket from nine to 21. The number of residents and fellows in training would more than double. The number of graduates would increase 237-percent.
What does this have to do with rural Idaho? The report noted that medical residents tend to practice in the areas where they complete their residencies. Between 50 and 75-percent of residents set up shop within 100 miles of where they do their residency training. If you draw a 100-mile radius around the center of Lincoln County, that opens up a lot more possibilities beyond the county’s lone doctor.
Beyond the obvious health benefits the Plan could bring to rural Idaho communities, this sensible investment and projected economic growth makes the Plan a smart business move. The cost of training hundreds more doctors in Idaho would be $16 million over ten years. The estimated economic impact: $1.3 billion and 10,000 new jobs! Along with providing quality healthcare, doctors create decent-paying jobs and more money gets spent locally. For common-sense, business-minded Idahoans, a $16 million investment over ten years that produces hundreds of new doctors, thousands of jobs and more than a BILLION dollars in economic activity is a no-brainer.
However, our governor recommended initial funding of only $1 million. The Joint Finance & Appropriations Committee had a better sense of the Plan’s upside and voted to budget nearly double that amount. That still falls well short of the start-up investment requested under the Plan.
I have represented four rural Idaho counties in the Idaho Senate for years. I know the challenges all of my constituents face. Idaho needs bold, strong plans to provide quality healthcare for our residents no matter where they live. Instead, we have patched together incremental improvements. For a place like Lincoln County, that has had one doctor for 33 years, “incrementalism” isn’t going to cut it.
Tell your elected officials to vote for rural Idaho’s health, its communities and its economic future. Tell them to get with the “Plan” now so our communities can thrive!
Written by Sen. Michelle Stennett, Democratic leader in the Idaho Senate. She Represents Lincoln, Gooding, Camas and Blaine counties in District 26.