Idaho currently ranks 49th for physicians per capita, and the strongest predictor of where physicians practice is where they train. Not coincidentally, Idaho also ranks 49th in the number of resident physicians per capita. Physicians are called residents when in specialized training programs (family medicine, psychiatry, surgery) after they graduate from medical school but before they begin independent practice. This lack of physicians has health and economic impacts for our state. Simply put, Idaho must train more physicians.
Last year the governor requested that the State Board of Education develop a plan to grow Idaho’s residency programs. The plan would more than double the number of physicians trained in Idaho each year, adding nearly 2,000 over 10 years. This is especially important because 27 percent of Idaho’s physicians are older than 60 and will be retiring soon.
This plan is now before the Legislature, and the state’s commitment represents only about one-third of the costs required to train these new doctors. The remainder of the funds must come from partnering hospitals, the residency programs themselves, clinic revenues and other sources. The request for next year is $5.2 million, a tiny fraction of the $3.66 billion state budget.
One might question what the investment in physician training will bring to Idaho. It is important to recognize that physicians are important economic drivers in our communities. The latest data indicate that each physician creates 12 jobs. Pharmacies, home health care companies, nurses, and other health care providers flourish when partnered with a physician. Estimates of the economic impact, when keeping just half of the new doctors in Idaho results in a return on investment of $15.9 for every $1 invested by the state. Idaho’s existing residencies have been successful at keeping greater than 50 percent of their graduates in-state.
The impact of physicians is even more pronounced in our rural communities. These small towns struggle to attract new businesses if health care is not available. In addition, a lack of access to physician services may force some individuals to move and seek care elsewhere. Substance abuse, obesity, smoking and many chronic illnesses are more common in rural populations, likely related to lack of access to health care. This translates to increased premature death in our rural communities.
Idaho ranks among the lowest states for rates of screening for cervical, breast and colon cancer. This is indicative of a lack of access to preventative care. In addition, high rates of care through hospital emergency departments increases costs and decreases the continuity of care, which is important to maintaining good health. Finally, Idaho’s suicide rate is currently the fifth-highest in the nation, and Mental Health America ranks Idaho 47th for the delivery of mental health services, highlighting the need for more psychiatrists in our state.
The investment in residency programs makes sense for Idaho. Training more doctors will lead to healthier Idahoans, economic benefits to our communities and returns on investment that far outweigh the costs.
Rex W. Force, PharmD, is the vice president for health sciences at Idaho State University, the sponsoring institution for the ISU Family Medicine Residency Program.