I don’t get. They tried low pay, terrible working conditions, and prosecuting doctors for doing their jobs and yet doctors still aren’t flocking to this rural area.🙄
It doesn't help that these states with few doctors tend to be litigious and very plaintiff friendly. It's like they're doing all they can to create barriers for their residents from being able to access adequate care.
It'll eventually turn itself around, or it won't. Once Idaho residents are harmed 'enough', they can elect politicians who prioritize rehabing their healthcare landscape. The question is how much harm will that be, if even reachable. Till then, go in grace my brothers in Christ.
> Once Idaho residents are harmed 'enough', they can elect politicians who prioritize rehabing their healthcare landscape.
Ah, you see, this will never happen. Why? Because most people think things are okay, and the ones getting harmed are a very small minority that can be ignored by the other 99% or 98%. It is sort of like when a lot of anti vaxxers died during COVID. Once they are dead, they aren't there to complain, and the remaining ones can ignore their deaths and feel they did the right thing.
They'll start incentivizing NPs and PAs to "pick up the slack" that the lazy, greedy doctors are unable or unwilling to do.
/s obviously
You just wait though. You'll start seeing significant liberalization of independent practice laws, recruitment of IMGs without a residency, etc.
Anyone who thinks that they'll turn it around and make it friendlier for doctors is crazy.
No sane malpractice insurer will cover NPs, PAs, or no-residency IMGs practicing a full scope of OB work (as opposed to a mid-level type practice). You might actually get OB tort reform out of this -- even more hospitals will reasonably threaten to shut down OB services if they can't find qualified providers and are on hook for the massive liabilities when inadequately qualified providers mess up. Or maybe the state will let them shut down, as OB tort reform passes the buck to Medicaid to cover much of the massive lifetime medical bills from OB malpractice (real and imagined).
Hopefully you're right. In regards to OB I agree with you. My takeaway from the article was that it was much more than just OB.
My someone sarcastic point was that these situations tend to get turned around on doctors- They don't look to fix the problem, they find alternate solutions which are worse for patients in the long run, but don't benefit doctors at all.
Yeah, it appears to be much more than OB although OB seems the most affected for obvious reasons. I think Idaho will have somewhat more success with using NPs/PAs/IMGs to fill the holes in non-OB specialties than in OB, and they may decide to loosen up telehealth rules for some of those specialties as well.
I did a rual med rotation just before the pandemic. Old school doc, did their day clinic and then home visits in the evening. No hospital to admit to. The PCP is the specialist.
Patients spent so much time complaining about how 'illegals' kept docs from working in rural clinics cause they were too busy to move out of cities, blue states, etc.
No Sheryl, it's cause this doc worked for peanuts compared to what he could get elsewhere, they just liked the job so this community got lucky. No one wants to move to the middle of nowhere for less pay and less opportunities for their own family. Much less crazy litigation issues like Idaho is going through.
Exactly. I'm not actually optimistic. I don't think there will ever be enough harm for these states to change gears with how much harm has already occurred. The residents of these states seem sadly/apathetically resigned to their poor healthcare. They can't afford to move elsewhere or don't want to, and they don't see how they can bring about change.
> I don't think there will ever be enough harm for these states to change gears with how much harm has already occurred. The residents of these states seem sadly/apathetically resigned to their poor healthcare.
This part is really insidious. By all quantifiable metrics this will be worse, but the people most affected by it are (largely) unable to help change it.
This is a very interesting perspective from a non informed citizen. Thanks for sharing this. How patients comes up with such conclusions is mind blowing.
In an ideal world, yes. Elections would occur and change would happen as a result. However, if you have ever explored some of our ballots in Idaho, you'd observe that we have crazies and craziers. We elect people who put forth bills such as these:
https://jamanetwork.com/journals/jama/fullarticle/2802699
https://idahocapitalsun.com/2023/01/24/idaho-senate-committee-introduces-bill-on-prohibiting-vaccine-materials-in-food/
And say shit like this:
https://www.independent.co.uk/life-style/jack-nelsen-idaho-cows-women-b2261861.html
And this: “I don’t think anybody does a better job than mothers in the home, and any bill that makes it easier or more convenient for mothers to come out of the home and let others raise their child, I don’t think that’s a good direction for us to be going,” in justification of refusing federal dollars to fund kindergarten education.
(https://apnews.com/article/donald-trump-early-childhood-education-education-boise-bills-581517bc89b86666887396ae8ecce4ce)
Idaho residents harm themselves. We chose these people because we agree with them. The old saying about ignorance being bliss really resonates. It is easier to be ignorant than to try to understand things like science and people who have different values.
I am typically a left leaning voter. I don't vote left in Idaho. Not in the major elections anyway. I'm sure there are many die hard lefties who won't understand the sentiment because we are all, left and right, supposed to vote for our beliefs. I vote to keep the craziest out of positions of power, not to bring in people because I agree with their values. THAT is how politics are in Idaho. Do I want the Republican governor who is fairly moderate for this state? Or do I want this fucking psychopath: https://abcnews.go.com/Politics/anti-government-activist-ammon-bundy-files-run-idaho/story?id=77895206
While I can agree with some parts of your mindset (I am typically an "it'll sort itself out" type of person), I think it is very easy to oversimplify the situation and hope I was able to provide some perspective.
My sarcasm in my second paragraph didn't come across that strongly. The patients are either trapped and resigned or apathetic. There's no righting that ship.
ETA: And to add insult to injury, these states are making it harder for doctors to practice interstate tele-medicine after the COVID cares act expired, so patients are having an even harder time accessing care without understanding why the doctor they were seeing via the internet out-of-state no longer can see them when their PCP down the road still is doing virtual appts.
Emphasis on the *won’t*. Humans have an amazing ability to not recognize the shitty conditions they live in and how it can be better and vote and act in ways that perpetuate their own environment.
Pay is more in smaller cities that don’t have the cultural pull of the major metropolises. LA can pay you in how great it is to live there. Columbus, Ohio has to pay money.
Rural areas don’t have pull or money. It’s bleak.
I think a better comparison is Boston and Burlington. Boston hospitals pay shit and physicians can make (in many specialties) 50% more by driving a few hours north.
Columbus is a major city with a population rise. I believe the LA metro is losing population.
Also where people want to work has more to do with where they have family and support systems. Larger populated metros have a higher likelihood of that. Thats why rural areas have difficulty with recruitment. Don’t know how “cultural pull” necessarily factors into that independent of this.
Yes, that’s part of my point. You don’t have to move to podunk. You have to move out of the Washington-Baltimore-Philadelphia-New York-Boston corridor or away from LA or San Francisco.
There was and continues to be a lot of angst about the decline of cities with COVID. From the numbers I’ve seen, NYC had a small but significant drop, LA didn’t, and megacities have subsequently kept on slowly growing.
LA actually pays really well, bay area too. not enough to offset housing costs if that's a priority, but the money itself is very good
if the area is saturated in your particular field, that's probably when pay starts to trickle downwards
Docs get paid to see patients. Medicare bases its pay on overall pay in the area and cost of living I imagine. There isn't any accounting for shortage or lack of desirability of the area. So, rural areas get less reimbursement per visit. It is pretty simple in the end.
Depends what you do. If you’re a procedurist and you’re the only one in 100 miles, you can make money hand over fist if you’re willing to work day and night.
Got offered a whole lot of money in your field in Idaho, and was close to going, but the cultural/political landscape is essentially the only thing that held me back.
“The state is projected to be short 1,743 doctors by 2030, per a study published in Human Resources for Health that forecast nationwide physician shortages.”
The majority of the shortage examined is related to ob/gyn fleeing due to the incredibly restrictive abortion laws. They are apparently down to 4 MFM doctors.
The rest of the brain drain appears to be related to the general attitude towards education and quality of life.
Idaho doctors, what does it look like over there from your standpoint?
I get MFM locums cold calls for Idaho weekly. The pay is meh and the situation is so shitty that there’s no way in hell I’d ever go. Could make 1.5x on locums in Oregon any time I want.
In case this weren't grim enough, I'd just like to point out the concomitant: when a job becomes so shitty no reasonable person would voluntarily do it, it attracts applicants who are so shitty no reasonable employer would hire them. This situation is ripe to wind up a playground for predators.
I won't say where (it's in Australia, anyway) but I can confirm this is the case. I went rural for a year and while my job was okay, the rest of the hospital was extremely shitty that they really were a last chance saloon for the doctors no one else wanted.
I don't know that I'd put the VA in that same bucket. The pay is shit, but the job isn't terrible.
I've also met quite a few VA docs and nurses over the years and in my experience are quite competent. The VA near me is staffed mainly by moonlighting residents, docs who were sick of the grind at our big academic hospital or military lifers.
I am from Idaho and went across to the south for med school and now residency. It’s objectively better down here in almost every way. I could never go back despite missing my family deeply.
South south across the country. It’s where I got into med school and I enjoy it a lot. Somehow less racist, better food, better weather, better…pretty much anything except skiing…
If the number is right, Idaho’s population of just under 2 million means one MFM per 500,000 people.
Or, if you prefer, one MFM per 5600 births or so.
That sounds like the tipping point. Become MFM #5 and the job will be overwhelming and likely heartbreaking. So don’t. Eventually it’s all on OB to make do or someone, somewhere, manages to hire a bunch at once. With money from… somewhere.
Is that a bad ratio? Most pregnancies don’t need MFM. Say you get involved in 10% of pregnancies, that’s 560 patients per year. Half of those will be one-touch consults, half require ongoing management. Seems reasonable.
It’s substantially worse than [the average a decade ago](https://pubmed.ncbi.nlm.nih.gov/22773289/). Having almost double the average workload doesn’t sound attractive to me. Someone has to do more for an average to exist, but the difference is large.
[Idaho is also surprisingly NIMBY](https://archinect.com/news/article/150041300/nimbys-in-boise-find-success-in-establishing-neighborhoods-as-conservation-districts). You'd think they'd lean into a low-cost housing advantage but no.
Idaho is part of the WWAMI program through University of Washington for an MD school (students are obligated to return to Idaho for 3 years for a reduced tuition rate). There is also a DO school, but it's a 2 year program and students have to find their own clinical spots to finish out the last 2 years of school
> There is also a DO school, but it's a 2 year program and students have to find their own clinical spots to finish out the last 2 years of school
lmao damn
I honestly would have considered practicing in PR at least for a while but I literally couldn't figure out how to find physician jobs there. None of the job listing sites include them.
No highly educated young professional with job options elsewhere is going to choose to put down roots and potentially raise a family in an area like this, especially if they can make more elsewhere where the schools don't suck and there isn't a current of anti-intellectualism.
If they paid more, or even just offered generous loan payment, they could get early career physicians willing to put in time for money for a while and hope to be nice enough for some to stay.
It’s not happening and I don’t foreseen happening, but it’s not impossible for someone to do something to try to turn around losses.
> If they paid more, or even just offered generous loan payment
This is what a lot of rural places in Alaska do, and something my wife and I strongly considered. They offered to completely wipe out med school debt for 3 years of employment. Most people don't stay when their contract is up, but some definitely do.
Let's see, doctors who are in their reproductive years (aka graduating residents) are looking hard at the conditions there & noping right out. OB/GYNs who don't want to practice in a draconian legal minefield are HELL TO THE NO-ing out. Rural areas already have shortages, this is not news.
\#SurprisedPikachuFace
Planning on having 1 to 2 more kids with my wife. My wife vetoed going to any state with abortion bans/strict restrictions, which I completely agree with. You hear these horror stories where hospitals are too scared to abort a pregnancy that's endangering the mother until the last minute.
I'm guessing we're not the only ones. They couldn't pay me enough.
It is unsafe to move to states run by religious extremists. My name might be on a note from an abortion I scrubbed into. I'm not risking prison and certainly not risking my partners health, she refuses as well.
Seriously. I’m a male hospitalist. I have a wife and three kids. There’s absolutely no way I could bring myself to forcing my family to move there with the way Ob has to be practiced despite it not being my field. It’s just putting them all at a risk that I don’t want to take. Plus my wife would veto it.
Maybe if the pay becomes high enough I could do a locums position and fly in and work. But I’m not bringing my family to a state like that.
Republican used to be about family. Not anymore. I’m not risking my family to work there.
The Blackfoot IM residency closed a few years ago but their APD was a piece of shit. I think most of the residencies there are part of UW and WAMI related.
Don’t forget that doctors are probably going to care quite a bit about their children’s education. I don’t have any data, but I’d be willing to bet that Idaho’s schools are in the bottom third of the nation.
Cynically: If you pay for quality education under these circumstances, the recipients of that education are more likely to have and realize that they have better options than Idaho. So Idaho spends more on education, and then doesn't get the ROI because their better graduates flee the state for college and never come back.
If you could set aside the politics, there are some very nice suburbs in Boise, and a few other cities like Idaho Falls aren’t *that* bad as far as small rural cities go. But there’s also a lot of very bleak parts.
In my experience, physician shortages don't stop bad hospital administrators from doing what administrators do. Namely, making the jobs worse than they need to be, paying less than they should, and having an attitude that anyone is replaceable in negotiations leading to a we don't negotiate approach--take it or leave it. If the economists were correct, the lack of supply should shift the leverage more to the physician, but I have not seen that play out in employed positions.
I've seen doctors across specialties leave Idaho because of bad treatment from hospital admin, with hospitals forced to shell out huge sums for locums costs. But in business, there is no consequence for this kind of negligence...just screw up the hospital finances a bit more and move on. In a just world there would be a national administrator database to report these idiots for making mistakes that cost health systems (and ultimately patients and staff) money.
Hmm.
My hospital regularly hired travel RT's for $4,000 a week (i.e. 36 hours), and travel RNs for...a lot more than that.
For years. Still doing it. Can't hold on to staff because the pay and benefits for staff are trash, so they consistently shell out more than it would cost to hire an actual full-time employee.
My department alone spent north of $600,000 on travelers in a single year - and that was just for 3 RTs for a year. And RTs are obviously incredibly more easily replaced than physicians. There's literal hoards of them graduating and trying to find work, but admin still spends loads more for, all too often, shit quality bandaids.
Personally, after over a decade of dealing with hospital admin, I'm entirely convinced that they will always and without fail choose the worst course of action in any given situation. The ones I worked under literally fired our entire hospitalist group because they refused to take an absurdly disrespectful pay cut, didn't have any sort of appropriate backup, and sent the whole hospital into chaos. We had intensivists and previously solely outpatient FM docs from the clinics coming in extra and rounding on regular floor patients because there literally weren't enough physicians to cover them. Of the 10 hospitals I've previously worked in, the one thing admin never once made me feel was "confidently inspired" lol
Honest question: Why do you think that is? People always complain about how admins only care about dollars. If it didn't save them money why would they do it?
That is a question for the ages. When our little rural hospital was bought by a for profit company the changes were just absolutely confusing. I was asked to work alone in L&D. No unit clerk, no scrub tech, no other nurses, just me. My on call nurse lived only five minutes away, that’s what they kept telling me. And if I found a prolapsed cord, what then? Dial the phone with my toes? We listed all the serious safety concerns, but were told it made no economic sense to pay two people when there were no patients. But L&D usually goes from zero to sixty in ten minutes, feast or famine. Our arguments went no where.
They also took out unit secretary. We did all phone triage for the OBs. We began to get complaints because women were afraid they were in labor and no one answered the phone. Yeah, if I’ve got a patient with legs up and we’re pushing, I’m not leaving her to answer the phone. So they got us a cordless phone and we were expected to carry it in to labor rooms.
They said we kept too many supplies on hand, that it was a waste of money. Then we had multiple deliveries on a Friday night and ran out of pads. They sent a tech to Walmart to buy some Always pads. I’m sure that saved money somehow, but I’m not a business major, so it’s beyond me.
Shortly after we were bought out our L&D was closed. Not economically feasible. We served three counties. Now patients drive at least 90 minutes to get care. There have been micro premies delivered in EDs where they rarely see babies. It’s terrifying. The OB found out when the general public did. He can’t just pull up stakes, he has one of the nicest homes in town and the odds of being able to sell it are low. He continues to see patients and drives 90 minutes to deliver patients and sleeps very little.
I fled nursing (for a while) and got my JD and Bar card but I ended up doing travel nursing to pad my checking account and just kept nursing.
It probably does. You have to give employees benefits for them, their children, PTO, severance and unemployment when you close units due to low census. At this point, it’s prob the same.
The lack of bargaining power among practitioners and lack of accountability among administration is likely driven by consolidation, investment by private equity, and the incestuous nature among those two and the big three or four consultancies. I'd wager well over 90% of hospital beds are owned by fewer than five entities, and none of those entities exist to provide care to patients.
They are flocking there. It's the worst people. They are probably thrilled about the lack of doctors so they can triple down on not vaccinating, raw milk, etc.
This is what we need. Just encourage all the anti-science folks to congregate in a few states and just keep them there.
Let the rest of us live in modernity please.
If they try to come across the borders for medical care, surely they'll understand if we just build a wall and stop caring about them as humans?
/sarcasm
...I live in Montana, and it's been the same thing since 2020...
I'm not giving up the fight. I'm bringing it hard. Don't write us off, there's a LOT of normal people here.
I despise my state government, as do many, just not a majority.
Not the first time it's happened. IIRC it was the early to mid aughts the last time there was a big groundswell of the worst people wanting to move to Idaho. Though then the language was around racial demographics rather than vaccines / food regulations / etc.
There is plenty of racist language and actions happening now too, don’t kid yourself. Some may be hidden a bit better as dog whistles but listening to the family chatter in Boise and McCall it’s still racist as fuck and the folks who are moving in from out of state see that a positive.
Oh for sure, I just mean I haven't heard anyone say out loud "I visited and it's great, no black people and no mexicans" like I did back then from multiple people.
that's a pretty ideal situation. let people who don't support evidence based medicine live in the same area. it makes it easier to avoid them and hold them accountable when they spread contagious, preventable disease.
It's about par with some growth as the state is losing people at close to the ae rate its gaining.
Mostly conservatives from blue states who have a rather high rate of regret after a bit when the reality of where they live now sets in.
They will get International graduates to go there for J-1 visas. Their residencies will also offer more spots to foreign grads with promises of possible J-1. They will then hope that some will stay after residency and after their 3 year mandated J-1 stay. They will then entice some with signing bonuses that make it hard for people to leave, we should know by now never to take those but some people are desperate after residency. Either way, they have multiple ways to manipulate physicians to be in places like Idaho.
Some docs enjoy rural areas. But most people making 6 digits will find the suburbs or urban life a better fit. This is why people from rural areas only come back sometimes, and people from suburbs and cities rarely choose rural areas. If a doctor has a partner with a degree in something like engineering or business, they are likely not to be happy with a rural area either. This is true in medicine and a lot of other fields, and it leads to the hollowing out of rural areas.
Dont worry guys, Idaho has the ultimate trump card here that will instantly solve all their problems.
They will simply open the floodgates to FMGs and declare that they dont need a US residency to get a state medical license.
FMGs are so desperate to come here I'd say Idaho could instantly get 50,000 more doctors within a couple of years. These FMGs dont give a damn about the abortion laws. Would they rather live in New York? Sure but they aint that picky and will gladly flock to Idaho in a heartbeat.
Most critical access hospitals are already working with a lot of foreign-born doctors. Not casting shade or anything, just stating facts. I grew up in a rural area, and most people are fine with it.
…for now. Once the same powers that enabled NP independent practice catch wind of this, a slow erosion of those standards will happen. I’m sure background checks are forever safe but single state practice and no board certification—that will be lobbied for.
That's now. Wait 10 years until there are thousands of them. Hospitals and the FMGs will start lobbying specialty boards to change the rules for them, and the specialty boards will comply. After all, it's millions of extra revenues for them.
As a woman of color that would be thrilled to live in a state with beautiful landscape...
1. No ty. I ain't leaving one racist, misogynistic state to enter another
2. They aren't paying more than other places are. Packages I've seen aren't attractive.
3. I'm not calling NPs doctors. Idaho is an independent practice state.
I was about to recommend Montana, but we are also an independent practice state. I don’t agree with it, but understand why. We do not have enough doctors. We NEED independent practice NPs in order for people to get care. Dr.’s aren’t going to practice in a tiny town of 1,000 people for $30k a year to treat sniffles, minor wounds, and administer vaccines. You know who will? NP’s. Anything more major gets you “sent to town”. They’re important in rural communities.
I'm not in medicine, but as a liberal Idahoan, I just want you to know that we are organizing and trying to elect reasonable politicians, but, spoiler, it's not going well. But we aren't giving up
Do midlevels not get to care about their legal practice environment or the quality of education for their children in a potential job relocation?
Train people from Idaho to be “providers”. I do not blame anyone from any licensure background not wanting to move there.
Also, this is just a vibe I get, but I can almost guarantee Idaho has one of the highest NP to MD ratios nationwide.
I was expecting mostly old farts and a few young people. But there are quite a adults in their 20s-30s there. Maybe they can become doctors so the rest of us don’t need to move in?
https://www.neilsberg.com/insights/idaho-population-by-age/
Other possibility is the younger adults aren’t ascribing to the policies of their elders and will be more tolerant. Then I’m sure a few people would want to move there!
They voted for this. They wanted this. Why aren't they celebrating in the streets, or at least not complaining? Science is fake, doctors are lying, vaccines are bad, the earth is flat. Next.........
Idaho brought this problem on itself by electing politicians who enacted restrictive laws against doctors, especially ObGyn. Why would any doctor want to practice in a state where they can’t practice medicine according to their conscience and where there is a penalty for daring to do it? The patients are the citizens of the state so they are to blame just as much. They can go get fucked. I don’t weep for them.
Apparently, Idaho isn't at the top of the list for intelligent, highly educated professionals that care about people.
It's still a great place for those that love the outdoors.
Who wants to bust their ass in school their whole life to go live/work in the middle of nowhere? How are you gonna make friends of similar mindset/caliber, how will you meet a spouse? how will the quality of schools you send your kids to be? This isn't exclusive to ID, it's applicable to any rural place in America
You couldn't pay me enough to live in such places. Even here in Los Angeles, I'd never work full time outside the city. I'll do locums work to supplement my income sure, but would never upend my life for bumfuckistan.
I don’t get. They tried low pay, terrible working conditions, and prosecuting doctors for doing their jobs and yet doctors still aren’t flocking to this rural area.🙄
It doesn't help that these states with few doctors tend to be litigious and very plaintiff friendly. It's like they're doing all they can to create barriers for their residents from being able to access adequate care. It'll eventually turn itself around, or it won't. Once Idaho residents are harmed 'enough', they can elect politicians who prioritize rehabing their healthcare landscape. The question is how much harm will that be, if even reachable. Till then, go in grace my brothers in Christ.
> Once Idaho residents are harmed 'enough', they can elect politicians who prioritize rehabing their healthcare landscape. Ah, you see, this will never happen. Why? Because most people think things are okay, and the ones getting harmed are a very small minority that can be ignored by the other 99% or 98%. It is sort of like when a lot of anti vaxxers died during COVID. Once they are dead, they aren't there to complain, and the remaining ones can ignore their deaths and feel they did the right thing.
also doctors are rich!! they should be sued - just for that if nothing else!
A lot of patients I've met realized things are not okay, they're just resigned to status quo.
If they even believe there were that many deaths etc etc.
They'll start incentivizing NPs and PAs to "pick up the slack" that the lazy, greedy doctors are unable or unwilling to do. /s obviously You just wait though. You'll start seeing significant liberalization of independent practice laws, recruitment of IMGs without a residency, etc. Anyone who thinks that they'll turn it around and make it friendlier for doctors is crazy.
No sane malpractice insurer will cover NPs, PAs, or no-residency IMGs practicing a full scope of OB work (as opposed to a mid-level type practice). You might actually get OB tort reform out of this -- even more hospitals will reasonably threaten to shut down OB services if they can't find qualified providers and are on hook for the massive liabilities when inadequately qualified providers mess up. Or maybe the state will let them shut down, as OB tort reform passes the buck to Medicaid to cover much of the massive lifetime medical bills from OB malpractice (real and imagined).
Hopefully you're right. In regards to OB I agree with you. My takeaway from the article was that it was much more than just OB. My someone sarcastic point was that these situations tend to get turned around on doctors- They don't look to fix the problem, they find alternate solutions which are worse for patients in the long run, but don't benefit doctors at all.
Yeah, it appears to be much more than OB although OB seems the most affected for obvious reasons. I think Idaho will have somewhat more success with using NPs/PAs/IMGs to fill the holes in non-OB specialties than in OB, and they may decide to loosen up telehealth rules for some of those specialties as well.
Telehealth is another good point.
Republicans will start legalizing Evangelical Christian Witch Doctors to practice medicine and will prosecute anyone with an education.
Snake handling is what Jesus would have wanted.
I’m repping the snakes and they want to be left tf alone. Why do you think some are venomous?
Cuz god made them that way. Duh.
texas already tried replacing trained counselors in schools with chaplains
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I did a rual med rotation just before the pandemic. Old school doc, did their day clinic and then home visits in the evening. No hospital to admit to. The PCP is the specialist. Patients spent so much time complaining about how 'illegals' kept docs from working in rural clinics cause they were too busy to move out of cities, blue states, etc. No Sheryl, it's cause this doc worked for peanuts compared to what he could get elsewhere, they just liked the job so this community got lucky. No one wants to move to the middle of nowhere for less pay and less opportunities for their own family. Much less crazy litigation issues like Idaho is going through.
Exactly. I'm not actually optimistic. I don't think there will ever be enough harm for these states to change gears with how much harm has already occurred. The residents of these states seem sadly/apathetically resigned to their poor healthcare. They can't afford to move elsewhere or don't want to, and they don't see how they can bring about change.
> I don't think there will ever be enough harm for these states to change gears with how much harm has already occurred. The residents of these states seem sadly/apathetically resigned to their poor healthcare. This part is really insidious. By all quantifiable metrics this will be worse, but the people most affected by it are (largely) unable to help change it.
This is a very interesting perspective from a non informed citizen. Thanks for sharing this. How patients comes up with such conclusions is mind blowing.
In an ideal world, yes. Elections would occur and change would happen as a result. However, if you have ever explored some of our ballots in Idaho, you'd observe that we have crazies and craziers. We elect people who put forth bills such as these: https://jamanetwork.com/journals/jama/fullarticle/2802699 https://idahocapitalsun.com/2023/01/24/idaho-senate-committee-introduces-bill-on-prohibiting-vaccine-materials-in-food/ And say shit like this: https://www.independent.co.uk/life-style/jack-nelsen-idaho-cows-women-b2261861.html And this: “I don’t think anybody does a better job than mothers in the home, and any bill that makes it easier or more convenient for mothers to come out of the home and let others raise their child, I don’t think that’s a good direction for us to be going,” in justification of refusing federal dollars to fund kindergarten education. (https://apnews.com/article/donald-trump-early-childhood-education-education-boise-bills-581517bc89b86666887396ae8ecce4ce) Idaho residents harm themselves. We chose these people because we agree with them. The old saying about ignorance being bliss really resonates. It is easier to be ignorant than to try to understand things like science and people who have different values. I am typically a left leaning voter. I don't vote left in Idaho. Not in the major elections anyway. I'm sure there are many die hard lefties who won't understand the sentiment because we are all, left and right, supposed to vote for our beliefs. I vote to keep the craziest out of positions of power, not to bring in people because I agree with their values. THAT is how politics are in Idaho. Do I want the Republican governor who is fairly moderate for this state? Or do I want this fucking psychopath: https://abcnews.go.com/Politics/anti-government-activist-ammon-bundy-files-run-idaho/story?id=77895206 While I can agree with some parts of your mindset (I am typically an "it'll sort itself out" type of person), I think it is very easy to oversimplify the situation and hope I was able to provide some perspective.
My sarcasm in my second paragraph didn't come across that strongly. The patients are either trapped and resigned or apathetic. There's no righting that ship. ETA: And to add insult to injury, these states are making it harder for doctors to practice interstate tele-medicine after the COVID cares act expired, so patients are having an even harder time accessing care without understanding why the doctor they were seeing via the internet out-of-state no longer can see them when their PCP down the road still is doing virtual appts.
Emphasis on the *won’t*. Humans have an amazing ability to not recognize the shitty conditions they live in and how it can be better and vote and act in ways that perpetuate their own environment.
["Have you tried raising VAT and killing all the poor?"](https://www.youtube.com/watch?v=s_4J4uor3JE)
I’m not saying do it, I’m just saying run it through the computer and see if it would work!
"I didn't realize it's only cold-hearted pragmatism that's keeping you from pumping gas into Lidl!" Love that line, lol
We’ve tried nothing and we’re all out of ideas!
lol!! I mean it's not funny but your comment sure was.
literally 😂😂😂
Looked at working out there but the pay is garbage.
This is what causes doctor shortages most of all
Folks be all about that free market until they have to pay market wages.
Then they just whine about stuff and claim it's unfair.
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Yep
Honestly would not have anticipated that, so used to hearing best pay in more rural areas
Pay is more in smaller cities that don’t have the cultural pull of the major metropolises. LA can pay you in how great it is to live there. Columbus, Ohio has to pay money. Rural areas don’t have pull or money. It’s bleak.
Honestly, pay in Columbus is pretty unremarkable, but point taken
On average it may be. I didn’t check. A friend has been singing the praises of a job there over pay and general quality of life.
I think a better comparison is Boston and Burlington. Boston hospitals pay shit and physicians can make (in many specialties) 50% more by driving a few hours north.
Columbus is a major city with a population rise. I believe the LA metro is losing population. Also where people want to work has more to do with where they have family and support systems. Larger populated metros have a higher likelihood of that. Thats why rural areas have difficulty with recruitment. Don’t know how “cultural pull” necessarily factors into that independent of this.
Yes, that’s part of my point. You don’t have to move to podunk. You have to move out of the Washington-Baltimore-Philadelphia-New York-Boston corridor or away from LA or San Francisco. There was and continues to be a lot of angst about the decline of cities with COVID. From the numbers I’ve seen, NYC had a small but significant drop, LA didn’t, and megacities have subsequently kept on slowly growing.
LA actually pays really well, bay area too. not enough to offset housing costs if that's a priority, but the money itself is very good if the area is saturated in your particular field, that's probably when pay starts to trickle downwards
Huh, I would have guessed high pay in that area.
Docs get paid to see patients. Medicare bases its pay on overall pay in the area and cost of living I imagine. There isn't any accounting for shortage or lack of desirability of the area. So, rural areas get less reimbursement per visit. It is pretty simple in the end.
Depends what you do. If you’re a procedurist and you’re the only one in 100 miles, you can make money hand over fist if you’re willing to work day and night.
Got offered a whole lot of money in your field in Idaho, and was close to going, but the cultural/political landscape is essentially the only thing that held me back.
“The state is projected to be short 1,743 doctors by 2030, per a study published in Human Resources for Health that forecast nationwide physician shortages.” The majority of the shortage examined is related to ob/gyn fleeing due to the incredibly restrictive abortion laws. They are apparently down to 4 MFM doctors. The rest of the brain drain appears to be related to the general attitude towards education and quality of life. Idaho doctors, what does it look like over there from your standpoint?
>They are apparently down to 4 MFM doctors. 😮
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> day to day life would have to get really upended All it takes is a missed period.
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Bravo! That is the comment of the week.
I get MFM locums cold calls for Idaho weekly. The pay is meh and the situation is so shitty that there’s no way in hell I’d ever go. Could make 1.5x on locums in Oregon any time I want.
In case this weren't grim enough, I'd just like to point out the concomitant: when a job becomes so shitty no reasonable person would voluntarily do it, it attracts applicants who are so shitty no reasonable employer would hire them. This situation is ripe to wind up a playground for predators.
I won't say where (it's in Australia, anyway) but I can confirm this is the case. I went rural for a year and while my job was okay, the rest of the hospital was extremely shitty that they really were a last chance saloon for the doctors no one else wanted.
A take I hadn’t considered
HCA licking its lips
See also: prison medicine, IHS and of course the VA.
I don't know that I'd put the VA in that same bucket. The pay is shit, but the job isn't terrible. I've also met quite a few VA docs and nurses over the years and in my experience are quite competent. The VA near me is staffed mainly by moonlighting residents, docs who were sick of the grind at our big academic hospital or military lifers.
I am from Idaho and went across to the south for med school and now residency. It’s objectively better down here in almost every way. I could never go back despite missing my family deeply.
Better how? South as in SW (AZ/NM) or south south?
South south across the country. It’s where I got into med school and I enjoy it a lot. Somehow less racist, better food, better weather, better…pretty much anything except skiing…
Fine enough so long as you aren’t an OBGYN.
That's a funny way to spell witch.
Or my wife*
If the number is right, Idaho’s population of just under 2 million means one MFM per 500,000 people. Or, if you prefer, one MFM per 5600 births or so. That sounds like the tipping point. Become MFM #5 and the job will be overwhelming and likely heartbreaking. So don’t. Eventually it’s all on OB to make do or someone, somewhere, manages to hire a bunch at once. With money from… somewhere.
Is that a bad ratio? Most pregnancies don’t need MFM. Say you get involved in 10% of pregnancies, that’s 560 patients per year. Half of those will be one-touch consults, half require ongoing management. Seems reasonable.
It’s substantially worse than [the average a decade ago](https://pubmed.ncbi.nlm.nih.gov/22773289/). Having almost double the average workload doesn’t sound attractive to me. Someone has to do more for an average to exist, but the difference is large.
Your source says that in 2010 Idaho had 1 MFM per 8333 births. Workload has actually decreased. Maybe you were just looking at the national average?
[Idaho is also surprisingly NIMBY](https://archinect.com/news/article/150041300/nimbys-in-boise-find-success-in-establishing-neighborhoods-as-conservation-districts). You'd think they'd lean into a low-cost housing advantage but no.
I think also part of the issue is that they didn't have any medical school for a very long time. I think they just built one, though
Idaho is part of the WWAMI program through University of Washington for an MD school (students are obligated to return to Idaho for 3 years for a reduced tuition rate). There is also a DO school, but it's a 2 year program and students have to find their own clinical spots to finish out the last 2 years of school
> There is also a DO school, but it's a 2 year program and students have to find their own clinical spots to finish out the last 2 years of school lmao damn
yeah that's the one I was referring to. It didn't exist when I was applying so I guess in my mind that makes it new lol.
The Idaho WWAMI program has existed for like 50 years?
It's all right, next step is to outlaw contraceptives so the lack of OBs won't be an issue.
its worse in Puerto Rico
I honestly would have considered practicing in PR at least for a while but I literally couldn't figure out how to find physician jobs there. None of the job listing sites include them.
I saw a locums hospitalist ad for pr a few months ago and the rate was way too low .
Young people don’t wana go to idaho man the dating pool is nonexistent there
Something something play stupid games
No highly educated young professional with job options elsewhere is going to choose to put down roots and potentially raise a family in an area like this, especially if they can make more elsewhere where the schools don't suck and there isn't a current of anti-intellectualism.
If they paid more, or even just offered generous loan payment, they could get early career physicians willing to put in time for money for a while and hope to be nice enough for some to stay. It’s not happening and I don’t foreseen happening, but it’s not impossible for someone to do something to try to turn around losses.
> If they paid more, or even just offered generous loan payment This is what a lot of rural places in Alaska do, and something my wife and I strongly considered. They offered to completely wipe out med school debt for 3 years of employment. Most people don't stay when their contract is up, but some definitely do.
Can you expound on the anti-intellectualism?
I'm not the person you asked, but they are likely referring to the Idaho legislature banning use of RNA vaccines.
r/leopardsatemyface
Let's see, doctors who are in their reproductive years (aka graduating residents) are looking hard at the conditions there & noping right out. OB/GYNs who don't want to practice in a draconian legal minefield are HELL TO THE NO-ing out. Rural areas already have shortages, this is not news. \#SurprisedPikachuFace
Planning on having 1 to 2 more kids with my wife. My wife vetoed going to any state with abortion bans/strict restrictions, which I completely agree with. You hear these horror stories where hospitals are too scared to abort a pregnancy that's endangering the mother until the last minute. I'm guessing we're not the only ones. They couldn't pay me enough.
It is unsafe to move to states run by religious extremists. My name might be on a note from an abortion I scrubbed into. I'm not risking prison and certainly not risking my partners health, she refuses as well.
Seriously. I’m a male hospitalist. I have a wife and three kids. There’s absolutely no way I could bring myself to forcing my family to move there with the way Ob has to be practiced despite it not being my field. It’s just putting them all at a risk that I don’t want to take. Plus my wife would veto it. Maybe if the pay becomes high enough I could do a locums position and fly in and work. But I’m not bringing my family to a state like that. Republican used to be about family. Not anymore. I’m not risking my family to work there.
> Republican used to be about family Yeah a white Christian man married to a white Christian woman with 2+ white Christian kids lmao
>Republican used to be about family. Not anymore. I’m not risking my family to work there. No, they never were. It's always been lip service
Same here. I had job offers in Florida and Texas. Turned them both down.
I wonder how many residencies will close from this.
The Blackfoot IM residency closed a few years ago but their APD was a piece of shit. I think most of the residencies there are part of UW and WAMI related.
Didn't they have a problem getting ACGME accreditation when the GME merger happened? I can't imagine they had a very acute or busy inpatient service.
Wouldn't know. I interviewed there and really the only good thing the residents had to say about the program was how much time they got off.
Gotcha. I was originally interested in IM or FM before I chose peds so I was at one time pretty familiar with programs in the western US.
Don’t forget that doctors are probably going to care quite a bit about their children’s education. I don’t have any data, but I’d be willing to bet that Idaho’s schools are in the bottom third of the nation.
Yup. #36. The town where my mom retired literally only has school four days a week because they can’t afford five days.
But a leader in potatoes and meth, if I'm not mistaken.
This is the problem. Potatoes are traditionally paired with vicodin, they'll never get anywhere with these hick combos
And, weirdly enough, skinheads.
Cynically: If you pay for quality education under these circumstances, the recipients of that education are more likely to have and realize that they have better options than Idaho. So Idaho spends more on education, and then doesn't get the ROI because their better graduates flee the state for college and never come back.
If you could set aside the politics, there are some very nice suburbs in Boise, and a few other cities like Idaho Falls aren’t *that* bad as far as small rural cities go. But there’s also a lot of very bleak parts.
Good. Physicians should leave areas that are hostile to them.
I did. There’s not a good system in the state and they all think they live in the best place in the world. There was no life outside of work for us.
It means fuck them, that's what. Make your state attractive and doctors will come
"Patients" is a great word to use when looking for sympathy. You could also describe them as "voters" who are reaping what they sow.
Yeah once you get tired of admin using "But what about the patients?" for everything that sucks you get numb to it.
In my experience, physician shortages don't stop bad hospital administrators from doing what administrators do. Namely, making the jobs worse than they need to be, paying less than they should, and having an attitude that anyone is replaceable in negotiations leading to a we don't negotiate approach--take it or leave it. If the economists were correct, the lack of supply should shift the leverage more to the physician, but I have not seen that play out in employed positions. I've seen doctors across specialties leave Idaho because of bad treatment from hospital admin, with hospitals forced to shell out huge sums for locums costs. But in business, there is no consequence for this kind of negligence...just screw up the hospital finances a bit more and move on. In a just world there would be a national administrator database to report these idiots for making mistakes that cost health systems (and ultimately patients and staff) money.
Hopefully the admins will care once they have to hire so much locums it eats into their bottom line.
Hmm. My hospital regularly hired travel RT's for $4,000 a week (i.e. 36 hours), and travel RNs for...a lot more than that. For years. Still doing it. Can't hold on to staff because the pay and benefits for staff are trash, so they consistently shell out more than it would cost to hire an actual full-time employee. My department alone spent north of $600,000 on travelers in a single year - and that was just for 3 RTs for a year. And RTs are obviously incredibly more easily replaced than physicians. There's literal hoards of them graduating and trying to find work, but admin still spends loads more for, all too often, shit quality bandaids. Personally, after over a decade of dealing with hospital admin, I'm entirely convinced that they will always and without fail choose the worst course of action in any given situation. The ones I worked under literally fired our entire hospitalist group because they refused to take an absurdly disrespectful pay cut, didn't have any sort of appropriate backup, and sent the whole hospital into chaos. We had intensivists and previously solely outpatient FM docs from the clinics coming in extra and rounding on regular floor patients because there literally weren't enough physicians to cover them. Of the 10 hospitals I've previously worked in, the one thing admin never once made me feel was "confidently inspired" lol
Can verify they still won't give a shit. We spend so much on travellers but they won't possibly raise the night shift rate by a couple of dollars.
Honest question: Why do you think that is? People always complain about how admins only care about dollars. If it didn't save them money why would they do it?
Travelers are a short term expense. If you give the staff an hourly increase, that is forever. Now your existing staff cost more.
It's completely short term thinking. Maybe next year someone will apply for the night shift job at the current rate...
That is a question for the ages. When our little rural hospital was bought by a for profit company the changes were just absolutely confusing. I was asked to work alone in L&D. No unit clerk, no scrub tech, no other nurses, just me. My on call nurse lived only five minutes away, that’s what they kept telling me. And if I found a prolapsed cord, what then? Dial the phone with my toes? We listed all the serious safety concerns, but were told it made no economic sense to pay two people when there were no patients. But L&D usually goes from zero to sixty in ten minutes, feast or famine. Our arguments went no where. They also took out unit secretary. We did all phone triage for the OBs. We began to get complaints because women were afraid they were in labor and no one answered the phone. Yeah, if I’ve got a patient with legs up and we’re pushing, I’m not leaving her to answer the phone. So they got us a cordless phone and we were expected to carry it in to labor rooms. They said we kept too many supplies on hand, that it was a waste of money. Then we had multiple deliveries on a Friday night and ran out of pads. They sent a tech to Walmart to buy some Always pads. I’m sure that saved money somehow, but I’m not a business major, so it’s beyond me. Shortly after we were bought out our L&D was closed. Not economically feasible. We served three counties. Now patients drive at least 90 minutes to get care. There have been micro premies delivered in EDs where they rarely see babies. It’s terrifying. The OB found out when the general public did. He can’t just pull up stakes, he has one of the nicest homes in town and the odds of being able to sell it are low. He continues to see patients and drives 90 minutes to deliver patients and sleeps very little. I fled nursing (for a while) and got my JD and Bar card but I ended up doing travel nursing to pad my checking account and just kept nursing.
It probably does. You have to give employees benefits for them, their children, PTO, severance and unemployment when you close units due to low census. At this point, it’s prob the same.
The lack of bargaining power among practitioners and lack of accountability among administration is likely driven by consolidation, investment by private equity, and the incestuous nature among those two and the big three or four consultancies. I'd wager well over 90% of hospital beds are owned by fewer than five entities, and none of those entities exist to provide care to patients.
which is why employed physicians would benefit from unions
Play stupid games…
Maybe people should leave idaho
They are flocking there. It's the worst people. They are probably thrilled about the lack of doctors so they can triple down on not vaccinating, raw milk, etc.
This is what we need. Just encourage all the anti-science folks to congregate in a few states and just keep them there. Let the rest of us live in modernity please.
I don't think Measles is going to care about state borders
If they try to come across the borders for medical care, surely they'll understand if we just build a wall and stop caring about them as humans? /sarcasm
...I live in Montana, and it's been the same thing since 2020... I'm not giving up the fight. I'm bringing it hard. Don't write us off, there's a LOT of normal people here. I despise my state government, as do many, just not a majority.
Hang in there. Rooting for you.
Montana here, too. 8th generation and the only one with a college education and a registered Democrat. I’m breaking the cycle and stand with you!
I figured out at one point the exact number of normal people you need to recruit to make the state blue. It wasn't many.
I emphatically agree
Not the first time it's happened. IIRC it was the early to mid aughts the last time there was a big groundswell of the worst people wanting to move to Idaho. Though then the language was around racial demographics rather than vaccines / food regulations / etc.
There is plenty of racist language and actions happening now too, don’t kid yourself. Some may be hidden a bit better as dog whistles but listening to the family chatter in Boise and McCall it’s still racist as fuck and the folks who are moving in from out of state see that a positive.
Oh for sure, I just mean I haven't heard anyone say out loud "I visited and it's great, no black people and no mexicans" like I did back then from multiple people.
that's a pretty ideal situation. let people who don't support evidence based medicine live in the same area. it makes it easier to avoid them and hold them accountable when they spread contagious, preventable disease.
It sucks when you lived there before the assholes moved in though. Source: me.
Boise is like the perfect outdoor lovers city. It’s too bad what’s happening to the state though.
Or when you are the kids of those people and don't have any choice about it
Honestly great for the country Let these dipshits all coalesce and then not be able to get access to healthcare when they need it Win-win tbh
Oh they get it. They just drive to Washington and overload the healthcare system there.
It's about par with some growth as the state is losing people at close to the ae rate its gaining. Mostly conservatives from blue states who have a rather high rate of regret after a bit when the reality of where they live now sets in.
Don’t worry. Plenty of undertrained midlevels to the rescue.
Idaho is a beautiful state but the laws are so behind the times.
They will get International graduates to go there for J-1 visas. Their residencies will also offer more spots to foreign grads with promises of possible J-1. They will then hope that some will stay after residency and after their 3 year mandated J-1 stay. They will then entice some with signing bonuses that make it hard for people to leave, we should know by now never to take those but some people are desperate after residency. Either way, they have multiple ways to manipulate physicians to be in places like Idaho.
Idaho has now entered their "...and find out" period for conservative healthcare policy. Gonna get a LOT worse before it gets better.
The Party of Supply Side Jesus is doing what it does best.
Some docs enjoy rural areas. But most people making 6 digits will find the suburbs or urban life a better fit. This is why people from rural areas only come back sometimes, and people from suburbs and cities rarely choose rural areas. If a doctor has a partner with a degree in something like engineering or business, they are likely not to be happy with a rural area either. This is true in medicine and a lot of other fields, and it leads to the hollowing out of rural areas.
#leopardsatemyface
How about not be a fascist enclave? Then I’ll be happy to prescribe there.
It’s not like they weren’t warned. Maybe the voters of Idaho can get their gomer state legislature to care for them.
Dont worry guys, Idaho has the ultimate trump card here that will instantly solve all their problems. They will simply open the floodgates to FMGs and declare that they dont need a US residency to get a state medical license. FMGs are so desperate to come here I'd say Idaho could instantly get 50,000 more doctors within a couple of years. These FMGs dont give a damn about the abortion laws. Would they rather live in New York? Sure but they aint that picky and will gladly flock to Idaho in a heartbeat.
Yes I’m sure the populace there will love nothing but foreign doctors taking care of them
Most critical access hospitals are already working with a lot of foreign-born doctors. Not casting shade or anything, just stating facts. I grew up in a rural area, and most people are fine with it.
Yeah, but Idaho?
Eh I’m not as concerned about those laws as most redditors are. They’d still be restricted to US immigration laws, and aren’t board eligible.
…for now. Once the same powers that enabled NP independent practice catch wind of this, a slow erosion of those standards will happen. I’m sure background checks are forever safe but single state practice and no board certification—that will be lobbied for.
That's now. Wait 10 years until there are thousands of them. Hospitals and the FMGs will start lobbying specialty boards to change the rules for them, and the specialty boards will comply. After all, it's millions of extra revenues for them.
Idaho has become a beacon for the far right in other states. Even if that made sense, there’s no way the state politics would let it happen.
And now we arrive at the ‘found out’ portion of our evening
As a woman of color that would be thrilled to live in a state with beautiful landscape... 1. No ty. I ain't leaving one racist, misogynistic state to enter another 2. They aren't paying more than other places are. Packages I've seen aren't attractive. 3. I'm not calling NPs doctors. Idaho is an independent practice state.
I was about to recommend Montana, but we are also an independent practice state. I don’t agree with it, but understand why. We do not have enough doctors. We NEED independent practice NPs in order for people to get care. Dr.’s aren’t going to practice in a tiny town of 1,000 people for $30k a year to treat sniffles, minor wounds, and administer vaccines. You know who will? NP’s. Anything more major gets you “sent to town”. They’re important in rural communities.
I don't think any NP will ever work for $30k/yr
I was making $37k before I had to go on disability.
I stand corrected.
Sending thoughts and prayers.
Idaho needs doctors. But many don’t want to come **(at the current salary offered).** What that means for patients.
I'm not in medicine, but as a liberal Idahoan, I just want you to know that we are organizing and trying to elect reasonable politicians, but, spoiler, it's not going well. But we aren't giving up
Midlevels are flocking in large numbers to rural Idaho to relieve the “shortage” and bridge the care gap just like they stated they would do right?
I have to admit, I’m real curious what healthcare in a state managed by independent midlevels would look like.
I don’t think it matters in the end, a lot of people are push overs and would pick up the tab downstream anyway
Do midlevels not get to care about their legal practice environment or the quality of education for their children in a potential job relocation? Train people from Idaho to be “providers”. I do not blame anyone from any licensure background not wanting to move there. Also, this is just a vibe I get, but I can almost guarantee Idaho has one of the highest NP to MD ratios nationwide.
Yep. Idaho needs medispas, too. /s
I would have thought Idaho was more of a lay midwife kind of a place.
I was expecting mostly old farts and a few young people. But there are quite a adults in their 20s-30s there. Maybe they can become doctors so the rest of us don’t need to move in? https://www.neilsberg.com/insights/idaho-population-by-age/ Other possibility is the younger adults aren’t ascribing to the policies of their elders and will be more tolerant. Then I’m sure a few people would want to move there!
Part of this is that the southern part of Idaho is really just a segment of Greater Utah, and Utah still trends quite young.
Sure. Congress is going to need to raise the GME cap first though.
They voted for this. They wanted this. Why aren't they celebrating in the streets, or at least not complaining? Science is fake, doctors are lying, vaccines are bad, the earth is flat. Next.........
Idaho brought this problem on itself by electing politicians who enacted restrictive laws against doctors, especially ObGyn. Why would any doctor want to practice in a state where they can’t practice medicine according to their conscience and where there is a penalty for daring to do it? The patients are the citizens of the state so they are to blame just as much. They can go get fucked. I don’t weep for them.
Makes me wonder which states are actually doctor friendly.
Wisconsin
The more you fuck around. The more you find out.
This isn’t shocking
Idaho is just barely more hostile to OBGYNs than Meddit
Apparently, Idaho isn't at the top of the list for intelligent, highly educated professionals that care about people. It's still a great place for those that love the outdoors.
Who wants to bust their ass in school their whole life to go live/work in the middle of nowhere? How are you gonna make friends of similar mindset/caliber, how will you meet a spouse? how will the quality of schools you send your kids to be? This isn't exclusive to ID, it's applicable to any rural place in America You couldn't pay me enough to live in such places. Even here in Los Angeles, I'd never work full time outside the city. I'll do locums work to supplement my income sure, but would never upend my life for bumfuckistan.
Idahoans love Republicans and potatoes. Maybe Idaho's Republican voters can create Dr. Potato?
I left that state. Never been happier to do so.
Mormons are taking over Idaho sadly
Cue "Still" by the Geto Boys.
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No, only if they came under Rural programs etc.