A recent headline in the Magic Valley Times-News declares "Idaho's doctors are the most overworked in the United States." What? OK, OK, we all know that Idaho has been at the bottom of the stack for a long time if you measure physicians per capita. And in fact, this is the data that the headline is based on. It cites a MedicareHealthPlans.com article reporting just 1.7 physicians per 1000 Idahoans. But does that necessarily mean that they are the "most overworked?"
Earlier this year, I poured over a copy of the 2016 Physicians Foundation "Practice Patterns and Perspectives" report for Idaho, conducted by the physician search and consulting firm Merritt Hawkins with 17,236 survey respondents nationwide. When it comes to the self-reported number of hours worked per week, 69% of Idaho physicians work 60 hours or less which is right on point with the national average. When asked if they were "overworked or overextended," Idaho docs are within two-tenths of a percentage point of the national average as well, at 28.4%. In fact, 25% said they had time to see more patients and assume more duties. One concern I have with this study, though, is that only 70 Idaho physicians are represented in the sample; depending on who they were, the realities of the 50% who practice in Ada County versus the rest of the state are vastly different.
If you look at WalletHub's ranking of "Best and Worst States for Docs," Idaho scores within the top three this year and has moved up from #5 in 2016. Woot woot!! The nice thing about their survey is that they openly explain their methodology and sources, detailing how they weight various items like wages, quality of hospital systems, and malpractice award payouts. This ranking is corroborated by Medscape's state rankings in 2016 where Idaho placed fourth (and sixth in 2015).
For 2017, Medscape chose to report on the best and worst places to avoid burnout, a topic near and dear to my heart. I'm probably biased, but I think Boise got shafted for placing 19th. Their factors include cities with a "calmer and happier life, fewer lawsuits, least punitive medical boards, teamwork with advanced practitioners, cultural attractions, golf amenities, bike, pet and walk friendly settings." Come on! Boise has all that in spades! (Well, maybe not cultural attractions so much, hence the dig by Ryan Gosling's jazz piano playing character in 'La La Land.')
Speaking of movie references to Idaho: did you see the trailer for the soon to be released thriller/drama "The Mountain Between Us." Kate Winslett is a woman engaged to be married and along with a busy surgeon (Idris Elba) is forced to take a charter plane home from Idaho after their flight is delayed because of weather. As the prop job takes off from some rural airport, Winslett's character asks 'Dr. Ben Bess' why he came to Idaho. His response: "A medical conference." I'm pretty confident they must have heard about our very own Winter Clinics CME conference in February in McCall!
Idaho portrayed by Hollywood as hosting a medical conference attracting out of state doctors? Dang! Our medical community really must have something going for it!
So, in spite of the abysmal physician rate per capita, lower compensation, and less than amazing Medicaid coverage and Medicare reimbursements, I would hazard a guess that it is as much about perspective as anything. Here's the thing: physicians don't end up in Boise or Idaho by accident; they come here on purpose. So, whether it is falling in love with Idaho's natural beauty and fantastic people on at a medical conference, choosing to attend our great medical residencies and then staying, or returning home to be near families and old haunts, lifestyle and community trump deficiencies by a landslide.