Industry experts discuss workforce challenges in health care at latest Breakfast Series

A severe shortage of health care workers, including doctors and nurses, providing rural communities comprehensive medical services, and acquiring the resources to train and retain homegrown medical personnel were some of the biggest concerns that topped the exam chart regarding the future of health care in Idaho.

The long-term assessment of the Gem State’s health industry came from a panel of local medical professionals during a recent Health Care Workforce discussion hosted by Idaho Business Review August 15 at The Grove Hotel in Boise , the fourth installment of the yearly five-part IBR Breakfast Series .

Panelists included: Brooke Thrasher, vice president of human resources, Saint Alphonsus Health System; Jennifer Raley, clinical site director, Velocity Clinical Research; Malia Miyamura-Heuman, senior director of workforce planning and innovation, St. Luke’s; Dr. Mary Barinaga, assistant clinical dean, Idaho WWAMI Medical Education; and Gabe Bargen, executive director, Idaho State University Meridian campus, and Interim Dean, College of Health.

With a lengthy career practicing medicine, and a wealth of experience teaching medical students and residents, Barinaga quickly shared her outlook on future health care for Idahoans, noting how recent statistics project a staggering shortage of health care professionals in Idaho and nationwide by 2030.

“The health care shortage we are in right now is not something we are going to be able to train ourselves out of,” Barinaga said. “Medicine or health care is a team-based sport. We need to work to the top of our licenses and making sure it is a team effort.”

For Miyamura-Heuman, understanding workforce needs and developing innovative solutions for filling gaps in the workplace are a huge part of her expansive role at St. Luke’s. The challenge, she said, is providing a variety of opportunities that extend beyond entry-level positions.

“Whether it’s medical assistants, CNAs or pharmacy techs, there are lots of roles available with limited education or certification requirements that are in high need within the industry,” Miyamura-Heuman said. “We need to create opportunities to promote and to develop within, and then we need to work to move them along and to train them in a career path.”

However, here in Idaho, as is the case in many parts of the country, inflation’s impact on the cost of living creates barriers when it comes to filling a variety of much-needed health care jobs.

“With the cost of living, we really struggle filling entry-level positions, jobs that have a huge impact within the health care environment,” she said. “A lot of the roles we are looking for are not the types of jobs that someone would relocate their family.”

At the ISU Meridian campus, providing students a bevy of learning opportunities and pathways in the medical field is a prescription for helping to fill jobs in high demand, such as nurses, physical and/or occupational therapists and counselors for mental health issues.

“We have over 40 health programs at ISU and we are one of the few schools that offer programs from certificates all the way up to doctorate-level programs,” Bargen said. “Students can pick and choose their pathway, and we work with all the major hospital systems across the state, both rural and urban.”

To help address the state’s dire need for nurses, the school’s accelerated nursing program has now expanded into both Coeur d’Alene and the Magic Valley. This program targets students who have completed a bachelor’s degree, who can then work to obtain a nursing degree in as little as 12 months.

According to Bargen, the response to the program has been “overwhelmingly positive” and students must be “dedicated to handle the intense and fast-paced training.”

Having served in human resources for Saint Alphonsus in facilities in both Idaho and Oregon, Thrasher has experienced firsthand the widespread shortage of nurses throughout the region.

“Bureau of Labor and Statistics report earlier this year showed that Idaho ranks 50th for the number of nurses per capita,” Thrasher said. “And we’re dead last as well for physicians per 100,000 residents. It’s an unfortunate distinction we have held since 2001.”

Other factors impacting the shortage of qualified medical personnel statewide include the growing population, early retirements and a reduction in the workforce from those who left the field during or after the COVID-19 pandemic.

And while it may be easy to assume a lack of qualified nurses is an issue that most commonly impacts urban environments, Barinaga, whose vast medical experience covers both rural and urban settings, said she knows better.

“Hospitals close because they can’t get nurses to staff their facilities,” she said. “Often times you’ll hear people say there are no beds. But there are beds. The problem is there are no nurses. Doctors can keep admitting patients but there is no one to care for them in the hospital.”

Plus, an aging population of doctors will have an impact on the future of medical care in Idaho as well. “A large percentage of Idaho doctors over age 60 will be retiring in the next five years with not enough replacements,” Barinaga said.

At the Velocity Clinical Research facility, the importance of Idaho’s pharmaceutical industry is a central factor. Like many other medical outfits, the group relies heavily on maintaining a full workforce for conducting its research and trials.

“This industry gives back to Idaho. There are about 11,000 jobs related to the industry here in our state,” Raley, the site’s director said. “We’re just a small segment. But our company hires from the entry level.”

Plus, the ties Velocity maintains to large-scale medical groups are crucial for the operation, a site that houses both a full lab and full pharmacy.

“The challenge for us is attracting candidates who know about this field,” she said. “We’ve done over 550 trials involving over 1 million people, and we get a lot of entry-level staff who started at Saint Al’s or St. Luke’s who are interested in research and inpatient settings.”

Compounding the projected shortages of medical workers across the board, Barinaga said, is the fact that Idaho is “such a rural state,” despite its large geographical size.

“Nearly 98% of the state is considered to be in what we call health care shortage areas,” she said. “The whole state is classified as a behavioral shortage area with lots of needs.”

Another checkmark on the state’s chart projecting future medical care is the need to train and retain medical students from its own backyard. One method to accomplish this goal is the state’s partnership the past five decades with WWAMI, the University of Washington School of Medicine’s innovative multi-state medical education program. The program encompasses medical students from Washington, Wyoming, Alaska, Montana and Idaho.

Each year, Idaho appropriates state funds to send 40 students into the program, where they spend their first 18 months studying at the University of Idaho. After this initial period, students can then access schools throughout any of the five states in the WWAMI program.

The goal of the program is to make public medical education accessible to residents across the five states and encourage future medical professionals to remain close to home once they begin practicing medicine.

“We know there is about an 80% chance they will stay within about 100 miles of where they trained, Barinaga said. “We’re trying to expand residency programs into those rural areas with great needs.”

However, the problem in Idaho, she said, is when it comes to residencies for certain medical specialties such as for OBGYN students. In Idaho, students can complete their medical portion here at home, but the closest residency opportunities for this field lie in Portland, Seattle and Salt Lake City.

Currently, Idaho only offers residency programs for internal medicine, psychiatry and pediatrics.

“I think we have had very good support from the legislature and the governors, both Gov. Otter and Gov. Little with funding residency programs in our state,” she said. “But we have a long way to go.”

Beyond state funding, there is also the issue of finding qualified faculty for such programs. Doctors who transition into academics typically make less money than those who maintain a full-time practice.

Pediatric audiology is another area the medical field in which Idaho lacks. But recent funding awarded to ISU from the U.S. Department of Education will allow the school to quadruple the number of students the school can train as audiologists to help children with hearing loss issues.

“The funds will cover over 42 scholars during the next five years,” Bargen said. “We’re excited because a lot of research that happens in this field is clinic-based research.”

Finally, advancements in technology also play a big role in the future of health care in Idaho. St. Luke’s is piloting a program called Ambient Listening, technology which aims to accurately capture conversations during visits between patients and doctors.

The result is to use the technology to free up more time for doctors, who can then spend less time dealing with medical records and more time seeing more patients.

“This allows us to create more access and to see more patients and the engagement is more meaningful,” Miyamura-Heuman said. “And it reduces one of the less-desirable parts of the job.”

Telehealth visits, using electronic or telecommunication technologies to provide patients access to doctors online, is also having an impact statewide, especially in the rural communities.

According to Miyamura-Heuman, the online access “tends to work better with patients of a younger generation,” but she believes it will catch on with those who are “less tech savvy.”

“When you get into the older generation of patients who are more accustomed to face-to-face contact, it’s more about education and making sure they know what is available to them,” she said. “The walls will start to slowly come down but it will take some time.”

Just as time will play a key role in the direction and advancements of the medical field throughout Idaho. For Barinaga, it all comes down to providing the best access for training and retention, and providing patients with the care she believes they deserve.

“Idaho has a great track record and ranks about seventh in the country for retention rates,” she said. “If we can get them here and train them here, we can keep them here.”

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