Kootenai Health is always busy. 

Over the past 12 months, its primary care clinics served 42,622 patients. The 10 northern counties of Idaho, including locations in Washington and Libby, Montana, have also averaged 275 transfers to Kootenai Health every month.

The high traffic coming to Coeur d’Alene is a product of an ongoing physician shortage in rural Idaho, according to Kootenai Health.

“That’s an immediate need, which will only be exacerbated by ongoing growth moving forward,” said Dr. Jonathan Shupe, a Kootenai Health family medicine practitioner. “In the state of Idaho, that’s kind of the same story.”

Shupe sits on the graduate medical education subcommittee for the Idaho Board of Education. For the past 10 years, the mission of this group is to close the local and state gaps of needed practitioners by creating more medical residency slots in Idaho.

A study conducted between Kootenai and Panhandle Health District organizations shows a need for between 40-50 more physicians needed in the five northern Idaho counties in which they cover.

“We’re always recruiting in primary care,” Kootenai Health spokesperson Andrea Nagel said. “For certain specialties, there's always gaps.”

The root of this problem stretches as far back as the 1970s. 

Idaho officials began discussing the possibility of supporting a state-sponsored medical school. Financing such an expensive project, however, prompted legislators to place the idea on hold. In its absence, Idaho decided to purchase medical program seats at universities in Washington and Utah.

This sort of hybrid way of training prospective practitioners is partly why, like other Idaho healthcare providers, Kootenai Health offers a medical residency program. That program graduates seven people per year. 

In total, Idaho medical providers account for 12 accredited medical residency programs. On the flipside, state-sponsored support has created between 60-90 accredited medical residency programs in Washington state.

“If we were to hire 1,400 positions tomorrow, it would only get us to the national average of physicians per capita, and my program graduates seven per year,” Shupe said. “What we need is an expansion of graduate medical education in our state.”

A lack of medical residency spots in the Gem State not only means more students of healthcare can’t come here for graduate education, but those also who graduate from programs elsewhere aren’t coming here either.

Shupe said where people get their medical training is the highest indicator of where they’ll likely practice. Although Shupe did his medical residency at the University of California Los Angeles, Kootenai Health counts its lucky stars that he’s originally from Moscow.

“We have tens of thousands of people in North Idaho looking for primary care physicians,” he said.

There are not only wellness benefits to increasing the amount of healthcare professionals in rural Idaho. There are economic benefits, as well.

Shupe said one practicing physician alone creates $1.9 million of economic input each year. Statistically speaking, it costs the system 50% less if residents can identify having a personal physician. Meanwhile, it costs ⅓ less for people to use a family physician rather than seeking specialty care.

“We know there’s a huge financial return when you have a local physician practicing,” Shupe said.

This past Idaho legislative session saw Gov. Brad Little set aside $1 million for medical residency programs. But with the need for more physicians in mind, Shupe agrees more can be done.

He said the medical community needs to show the Idaho legislature that, although the economic impacts of adding physicians are delayed, “it really does shine out in tax paying money.” 

“What we’re doing is working,” he said. “But it’s not working enough. We need to expand.”