Idaho’s doctor shortage isn’t going to cure itself

Analysis

The bill to pull Idaho out of the WWAMI medical school partnership is sitting in legislative limbo.

It’s on the House calendar for a vote. But it’s been there for more than a week, with House leaders in no apparent hurry to take it up.

No matter. To put it mildly, the WWAMI bill has been disruptive — which might have been the whole idea in the first place.

“We’re talking to see if there’s a path forward that people can be OK with,” said House Speaker Mike Moyle, R-Star, after the House ended its Wednesday floor session with no action on WWAMI.

Let’s recap where we stand, and what the WWAMI bill would do. A deeply divided House Education Committee sent House Bill 176 to the floor on Feb. 14. The bill would end Idaho’s 53-year relationship with WWAMI — named for the member states of Washington, Wyoming, Alaska, Montana and Idaho.

The bill sets a hard deadline and lays out a vague Plan B. By 2026-27, Idaho would no longer pay for subsidized medical school seats through WWAMI and the University of Washington. Meanwhile, the State Board of Education would partner with unidentified medical schools in Idaho or neighboring states “located wholly within the Mountain Time Zone.”

Disruptive? No argument there.

The UW responds — somewhat. On Feb. 14, the same day of the heated House Education hearing, the UW signed a statement asserting that it uses no Idaho taxpayer dollars “for abortions or abortion-related activities.” It’s taken a while, but UW has said, in writing, that is complying with a 2021 state law forbidding the use of tax dollars for abortion.

The timing of the move wasn’t lost on Moyle, a co-sponsor of HB 176. “The fact that we had to go that far to get UW to do it … is kind of concerning.”

One of Idaho’s other concerns remains unresolved: limited WWAMI space. The UW accepts 40 Idaho medical students per year, and a 2022 legislative resolution called for an additional 10 seats per year. The UW says it cannot take on more Idaho students, saying it is struggling to find clinical space for the students already in WWAMI.

The WWAMI community mobilizes. After a half century, WWAMI’s roots run deep in Idaho’s medical sector. More than 1,600 Idahoans — including 213 current or former WWAMI students, 138 WWAMI residents and faculty and 197 physicians who provide clinical training for WWAMI students — signed an open letter this month arguing to save the program.

“We are profoundly concerned about the long-term impacts of defunding the WWAMI program, especially because the legislation does not describe an actual plan for continuing the kind of program WWAMI provides,” the letter reads, in part. “Without WWAMI, our students, residents, teachers, patients, friends, families, and communities will suffer.”

The State Board enters the fray. At the end of a two-day meeting at Boise State University, State Board President Linda Clark went somewhat off script. Taking what she termed a “personal privilege,” Clark announced that the board would create a committee to attack the medical education issue.

“Idaho needs to have a medical pipeline with a partner that is willing to work with our state and provide us with the seats, attention, and compliance with Idaho laws that all Idaho institutions must abide by,” Clark said. “WWAMI has not always given us this.”

For the record, the State Board is taking no position on HB 176, Executive Director Joshua Whitworth told Idaho EdNews Monday. The board is already talking informally about what its medical education committee will look like — and the committee will come to fruition, regardless of what happens with HB 176.

“We can’t stay where we’re at,” Whitworth said Monday. “The entire marketplace needed a jolt.”

Where Idaho is at bears repeating — because here, at least, everyone is in agreement.

Idaho ranks No. 50 in the nation for physicians per capita. As the state grows, and as its limited number of doctors grows older, this is a crisis that isn’t going to get better all by itself.

The central question surrounding HB 176 — if and when it ever gets a vote — is whether it provides a cure, or comes with side effects that will make the patient sicker.

WWAMI isn’t the only game in town for Idaho. But the $7.5 million program is still the state’s primary medical education program. (Idaho has a $3 million program that pays for 10 seats a year at the University of Utah.)

If Idaho walks away from WWAMI, the state might turn to University of Utah to pick up the slack, and the University of Idaho is exploring that option. Or the state might turn to the private, for-profit Idaho College of Osteopathic Medicine in Meridian, or the not-yet-opened Brigham Young University medical school. Several options, but no done deals.

On Tuesday, Gov. Brad Little didn’t come right out and say he wants to stay with WWAMI. But he also said he hasn’t heard many complaints about the quality of physicians coming out of the program — and he said he wasn’t sure other medical schools could pick up the slack for Idaho.

“I want the state to continue to increase the number of doctors we have available,” he said during an Idaho Press Club Q&A session with reporters.

On Wednesday, Moyle emphasized that everybody is talking. “I think there’s a place for us to keep UW and other places. I think there’s a path there.” But he chuckled when asked if HB 176 was dead, saying he has the votes to get it off the House floor.

Legislative season is always disruption season.

Senior reporter and blogger Kevin Richert specializes in education politics and education policy.