JFAC hears plan to address Idaho's physician 'crisis'

BOISE — The Joint Finance-Appropriations Committee heard a special report Thursday that put forward a plan on how the Legislature can address Idaho’s physician shortage, which puts it among the worst in the nation. 

Rep. Dustin Manwaring, R-Pocatello, delivered a report from the Undergraduate Medical Education Working Group on Thursday, providing quantitative data on Idaho’s need for physicians that he said put the state at “crisis” levels.

The report comes after the Idaho Legislature passed House Bill 368 in the previous session. That bill’s predecessor initially intended to cut 10 seats from Idaho's regional partnership with the University of Washington’s medical school, known as WWAMI (Washington, Wyoming, Alaska, Montana and Idaho). 

House Bill 368 is a compromise to keep the WWAMI program whole while directing the state to pursue alternative medical education partnerships. Starting this coming academic year and continuing for the next two years, the state has committed to adding 10 new non-WWAMI seats at other medical schools for undergraduate students.

In addition to directing the expansion of medical education seats, it also created the Idaho Undergraduate Medical Education Working Group, which met while the Legislature was out of session to gather data on the need for physicians and to lay out a plan to address the current shortage. 

At present, the state ranks 50th in physicians per capita, and to catch up to the national average, it would need to add about 1,400 physicians today. When looking to 2030, this number grows to 1,800 if the state keeps the “status quo,” Manwaring said.

“Just to catch up, we would need to graduate approximately 175 physicians a year to fill our anticipated need,” Manwaring said, “just to net 93 physicians that would stay here."

In an effort to improve the state’s physician standing, the working group put forward several recommendations, including maintaining the Idaho State Board of Education’s 50 seats for undergraduate medical education, fulfilling the 10-seat increase for non-WWAMI undergraduate medical students, and meeting a budget request for 15 new graduate medical education seats.

Manwaring said there were two options for adding 10 undergraduate medical education seats: the state could purchase seats from the Idaho College of Osteopathic Medicine (ICOM) or expand its relationship with the University of Utah’s medical school. Depending on the route taken, the cost for the next fiscal year could range from $350,000 to $485,000, with coordination for clinical placements adding $350,000 to that total.

Both Manwaring and Jennifer White, executive director of the Idaho State Board of Education, expressed a desire for a dedicated coordinator to fulfill this clinical placement function. White said the goal of this personnel addition is to "replicate the success" of the graduate medical education committee by assembling committees for undergraduate medical stakeholders and "allied health professions" that can report to this individual.  

Whether or not the Legislature finds room to fund additional graduate medical education seats and a dedicated coordinator remains to be seen. What was made clear at JFAC's meeting is that physician struggles in Idaho could be felt across the state.

"I'm extremely concerned about the rural areas in my district and the doctors that are not there," Rep. Rod Furniss, R-Rigby, said. "Health care is declining in those rural areas."

Rep. Brooke Green, D-Boise, who represents one of Idaho's most urban districts, said she sought to ensure physicians who remain in the state stay accessible to the average Idahoan with private insurance. Citing her personal experience, Green said her last four physicians have moved to private practice because they no longer want to work with insurance.

"We're losing physicians, not only to out-of-state but we're losing them to average-day Idahoans as a result of that," Green said.