Idaho has about 170 pediatric primary care doctors — to care for about 450,000 children.
That’s why the state ranks 50th in the U.S. for pediatricians per capita.
But amid Idaho’s rapid growth, health care leaders have a plan to recruit and train more health care providers. One major missing piece of the health care puzzle will be filled, starting next July: a pediatric residency program.
The Pediatric Residency of Idaho is a partnership between the Family Medicine Residency of Idaho and St. Luke’s Health System.
Residencies are post-graduate training programs for doctors who have completed medical school but, before they can become licensed physicians, must complete three or more years of training under the supervision of more experienced “attending” physicians.
“There is not a pediatric residency that exists between the Pacific Coast and the Minnesota border,” FMRI pediatrician Dr. Perry Brown said in a news release announcing the program. Brown spearheaded the residency after leading the family medicine residency’s pediatric training section. He will serve as its director.
There are pediatric residencies in Utah, Nevada, Oregon and Washington. But the upper Mountain West and Great Plains states are “a vast, empty pocket, completely void of pediatric residencies,” he said.
Idaho’s pediatric residency program will start small, with four residents per year. It may add more spots in future years.
“Some of that will depend on how popular it is — which, I expect it will be exceptionally popular, and people will be really interested in coming here to be trained, and to live and to stay,” said Dr. Kenneth Bramwell, system medical director for St. Luke’s Children’s.
St. Luke’s Children’s in downtown Boise is a pediatric hub for Idaho. The next nearest children’s hospital is about 350 miles away, in a different state.
St. Luke’s expanded a few years ago to add a children’s pavilion to the hospital campus.
But the residency won’t be attached to just the hospital. It will be the first pediatric residency based out of a community health center that serves patients regardless of their ability to pay. The FMRI program’s clinics often serve low-income and refugee patients.
A large share of Idaho’s children aren’t simply going without medical care — they’re seen by family doctors who are trained to care for people of all ages. But Idaho needs more pediatricians, Bramwell said, because they’re specialists in the health of tiny humans.
“This is not meant to denigrate the care that family physicians provide, because they provide a great service as well,” he said. “But if your entire focus is on people who are, in essence, 17 and younger, you are able to catch (unusual growth or development) earlier, because you’re just an expert in childhood development.”
The pandemic has only underscored the importance of pediatricians, Bramwell said.
“Oddly enough, one of the things that pediatricians spend a lot of time doing is helping families understand vaccines, and helping (them) avoid the illnesses that used to kill our grandparents that have largely been wiped from the face of the earth because of vaccines,” Bramwell said. “That’s certainly one area where pediatricians, I think, are really critical for the health of society …”
How will the pediatric residency work?
Boise is home to the Family Medicine Residency of Idaho, a three-year residency program that trains doctors in clinics and hospitals, in urban and rural areas.
St. Luke’s will supply the hospital, supervising pediatricians and pediatric specialists. St. Luke’s also committed $1.7 million to support the launch of the program. The Family Medicine Residency of Idaho will supply faculty, including several pediatricians, and “the framework for their education similar to what they’ve already done” with family medicine, Bramwell said.
It’s hard to predict how many pediatricians the residency will ultimately bring to Idaho, Bramwell said.
On average, about 50% of residents stay where they are after the program ends.
“We’ll have sort of a conveyor belt of new young doctors that we, hopefully, can convince that this is a great place to live and be and raise a family,” he said.
“But the other thing — that’s maybe a little more immediate — is they will have to set up a home clinic where each of these four doctors and their supervising or attending doctors are watching their care.” And that clinic will open up “thousands” of pediatric appointments that currently do not exist, he said.
The appeal of working as a doctor in Idaho
Bramwell said he tries to be up-front about some of the challenges of practicing medicine in Idaho. While housing costs used to be rock-bottom, attracting young doctors, they’re now high and rising.
And there’s a cultural resistance, sometimes, to traditional medical care.
“We tend to be at the bottom of every measurable outcome, whether that’s vaccines or seatbelts or number of doctors per capita,” he said.
But it’s a place where physicians can make a difference — giving testimony to a legislative committee, or speaking directly to elected officials, or forming partnerships with relative ease.
When physicians come to Boise to interview for a job, they fall in love with the place, Bramwell said.
That’s what it was like for Bramwell himself. He came to interview for a job as a pediatric emergency physician in 2002.
“Halfway through the interview, which was two days long — which is really long, but that’s what it is — my wife and I went for a walk,” Bramwell said. “And she said, ‘Well, I hope you like the job, because the kids and I are moving here.’”