Some physicians have moved to rural Idaho to escape the crowds, but that is one reason they are having a difficult time surviving in their new home.
For Dr. Chris Christensen, the snowy peaks around his Silverton clinic offer skiing and a relaxed pace of life. But they are not enough to dull the sting of debt and disappointment of promises unkept.Still, the doctor who moved his wife, three children and established medical practice from Bakersfield, Calif., to the tiny Shoshone County town seven months ago does not plan to leave - yet.
"I'm quite literally staying here with a sense of anticipation that there will be lots and lots more Californians coming to this area," he said.
That may be a valid expectation. Shoshone County's motor vehicle department switched 300 California license plates for Idaho plates so far this year.
Christensen is one of several physicians recruited in the past 15 months to rural Panhandle towns. Drs. Mike and Leslie Stone were wooed from California to St. Maries with promises Idaho would pay their medical school loans.
Dr. David Kuhns left one of the Army's largest hospitals two years ago and now works the emergency room at the Boundary County Community Hospital in Bonners Ferry.
"You can't go back to work in a small town and say you won't work extra hours and you want five guys to back," Christensen said. "That's unrealistic."
He was recruited by the Shoshone Medical Center in Kellogg but eventually moved in next to the defunct Henry L. Day Medical Center. That hospital's board could not guarantee him a salary or even a patient load.
Henry Day administrator Fred Manthey said he doesn't believe the hospital misled Christensen, adding the facility will reopen someday.
"Doctors want to move from California," Christensen said. "But people in established practices are locked in financial entanglements, partnerships, practices. They need some help to pay off loans, wrap up finances."
Bonners Ferry came close to closing its emergency room when the town's four doctors found themselves at too great a risk for malpractice claims because of a lack of technology.
Idaho has the fewest number of doctors per patients in the nation and is ranked fourth in the nation for the oldest doctors, in practice over age 65.
Kuhns wanted to work emergency medicine more than family practice. After one of the Bonners Ferry doctors lost a malpractice case, the hospital board decided to staff it with an emergency medicine specialist.
But Kuhns found himself in the role of family practitioner more than emergency doctor.
St. Maries went through three surgeons in three years. They were not prepared to live in a town with no stoplight or movie theater.
The Stones are family practice doctors and among the first to take advantage of Idaho's loan repayment plan for attending medical school. They agreed to live in St. Maries for at least four years.
"This is what I anticipated my whole life," Leslie Stone said, adding she fills the need for women doctors.
Her only concern is the schools. She is not happy with the music and art programs in the grade schools but will augment the school programs at home.