Is there a doctor in the house?

COEUR d'ALENE - North Idaho, like much of the nation, is facing a major shortage in primary-care physicians within the next five to seven years, but local medical professionals are working on building a system to replace them.

Dr. Richard McLandress, director of a new primary-care residency program at the Kootenai Clinic, traveled to Boise this week to ask state lawmakers to help support that effort.

He joined Dr. Mary Barinaga in testifying before the Joint Finance and Appropriation Committee about the need to fund more physician training in Idaho.

Idaho does not have its own medical school, but the state partners with universities in Washington, Wyoming, Alaska, Montana and Idaho to fund a medical school at the University of Washington in Seattle to educate doctors.

Idaho students wanting to become doctors can participate in the WWAMI program and pay in-state tuition.

Historically, Idaho has funded roughly 20 doctors' positions for Idaho students in the University of Washington's WWAMI program, but the State Board of Education has recommended doubling that number.

Idaho ranks 49th in the nation for the number of physicians per capita.

"Last year the Legislature agreed to expand the program from 20 to 25 students," Barinaga said in an interview Wednesday, explaining that she was testifying before JFAC to request they continue that funding for another year.

"I had two new budget requests," she said. "The first one was to let those five students continue on to a second year, and that was pretty much a no-brainer."

Barinaga said she has the support of Gov. Butch Otter on that $252,000 request, which Otter included in his budget proposal, but her second request didn't make it into the governor's budget.

So, she made her case before the JFAC committee to consider an additional $113,000 to increase Idaho's WWAMI program by five more slots for a total of 30 students in the upcoming fiscal year.

The total cost for maintaining those five new slots through the four-year program is approximately $740,000, Barinaga said.

But, she said, it is important to start educating doctors because it takes 11 years at a minimum to educate a doctor. One key to a doctor's training is three to four years of residency training after medical school.

Barinaga said the members of JFAC wanted to know if there were enough residency slots available in Idaho's hospital system to accommodate the new students.

That's where McLandress comes in. Kootenai Health has created a new residency program and is asking the Legislature help fund that program with a $200,000 appropriation, which Otter also supports in his budget request.

Kootenai Health is funding the remainder of the cost of $475,000 a year.

"The key component in a community is having physicians who want to teach," McLandress told state lawmakers on Tuesday. "And we have never been organized in North Idaho regarding our teaching of medical students."

Now, however, there's a list more than 150 physicians of the 250 on staff at Kootenai Health that want to volunteer to teach, he said.

"We're on a big mission in North Idaho to change education regarding medicine in North Idaho," McLandress said.

To try to help counter Idaho's shortage of medical doctors, the new program at Kootenai Clinic makes residencies available, but more needs to be done, he told the members of JFAC.

"Our community support is huge," he said. "Many people want to try to donate. We're going to be creating a foundation for a process as we develop over the next few years."

Retiring physicians have become an issue in the doctor shortage, McLandress said.

"Because of the generational gap," he said after his testimony. "See, so many physicians are over the age of 55. And so fewer physicians are between age 40 and 55. We have to study why that is."

Statistics from the University of Idaho indicate that 25 percent of Idaho's doctors are older than 60.

McLandress said the shortage will hit in the primary care or family physician workforce the hardest.

"We know that in the north, and actually in the state, and actually nationally, that about 50 percent of currently practicing family physicians will retire in five to seven years," McLandress said. "In North Idaho we're in the 50 percent (retirement) zone in five to seven years.

"And that really matters to all of us, in our communities, because the value of having primary care and family medicine in your community is exponential," he added.

Barinaga said McLandress' program will be a key component to getting more physicians in the pipeline, and added that physicians tend to stay where they do their residencies.

"We need more residency programs like the one in Coeur d'Alene," she said. "Right now all we have are the programs in Pocatello and Boise."

She said Idaho has one of the best retention rates in the nation. When it comes to retaining resident doctors, 51 percent stay in Idaho to practice. That compares to a national average of 38 percent.

- Press correspondent David Goins contributed to this report.