Rural Idaho's doctor shortage is easing, thanks to lots of hard work and a little luck.
"We have been doing really good in the past couple of years," said Jim Przybilla, project director at the Idaho Rural Health Education Center. "I think it's because we gave it a lot of attention."In the past three years, the number of physicians applying for Idaho licenses has increased 75 percent. By 1994, 1,776 physicians were practicing statewide, according to the Idaho State Board of Medicine.
The board does not track how many of those doctors work in rural areas. But an informal study by the Idaho Rural Health Education Center found 39 vacancies for family-practice doctors statewide in March 1994. By December, the number of vacant positions had fallen to 28.
Idaho health-care experts say among the reasons is that federal and state programs are paying off the medical-school loans of doctors and other health workers who agree to practice in areas strapped for medical care.
Doctors also are fleeing states where managed care is big. Idaho, especially rural Idaho, remains relatively free of managed care.
Managed care, intended to control skyrocketing health-care costs, requires patients to go to specific doctors or hospitals. If they go to a doctor outside the system, they pay extra.
Small, rural Idaho towns also are getting more sophisticated about luring doctors and keeping them by guaranteeing reasonable salaries and trying to make sure they are not on call all the time.
Ironically, one of the biggest obstacles rural doctors face is persuading local townspeople to get their medical care at home instead of traveling long distances to big cities.
"We call it outmigration," Przy-billa said. "People leave their small community, thinking . . . bigger is better - if the doctor is any good, why are they in our town?"
Small-town people often will say they want their local doctor and hospital to stay in business just in case they have a heart attack, a serious accident or some other emergency.
But true emergencies are relatively few and far between, Przybilla said. If small-town residents really want to keep their local medical providers in business, they also have to patronize them for routine care.