Idaho
Idaho’s physician shortage is here. Here’s what we can do about it. – Idaho Capital Sun

I love living in Coeur d’Alene. I graduated from Lake City High School, and when it came time to start a family, my wife – born and raised in Coeur d’Alene – and I were intentional about doing so where we grew up.
I’ve known from a young age I wanted to pursue a career in health care and that passion caught flame within the halls of my hometown hospital, Kootenai Health. I have both received care at Kootenai Health (appendix removal as a teenager) and have provided care in a number of capacities. First, as a nursing assistant in the emergency department while an undergraduate student, then as a fourth-year Idaho WWAMI medical education student, and today as an internal medicine hospitalist and emergency medicine physician.
At Kootenai Health I also carry the title of regional medical director of virtual care and the transfer center. Overseeing the virtual care program means I ensure local and rural populations have access to services they desperately need such as psychiatry, infectious disease, cardiology and rheumatology. As medical director of the transfer center, I help ensure timely transfer of the region’s sickest patients and strengthen relationships with our rural partners.
From this vantage point, I see the strain the physician shortage has on Idaho’s health care system and, more importantly, Idaho residents, including my own friends and family. The physician shortage is not just a rural problem, but a state-wide problem and one we are experiencing in Kootenai County as well. It is complicated to address and requires a multi-prong approach to remedy. Two solutions where I see promise are investing in Idaho WWAMI medical education and a virtual care approach to medicine.
Idaho WWAMI medical education: A pathway to practicing in Idaho
Supported by the state Legislature for 51 years, Idaho WWAMI is an established partnership between the University of Idaho and the University of Washington School of Medicine. It allows Idaho residents to attend a world-class medical school in their home state for in-state tuition.
As an alum, I can attest to receiving superb medical training in a wide variety of medical settings: from small primary care clinics in Lewiston, Moscow and Plummer, to surgery at the Boise VA, to neurology and palliative care here at Kootenai Health. Through immersive training experiences and clerkships, Idaho WWAMI students gain exposure to medical care in rural settings. This is important because medical students who train in rural sites are twice as likely to practice medicine in rural areas. Even if Idaho WWAMI students end up practicing in Coeur d’Alene, their medical school education helps shape their sensitivity to patients who live in rural Idaho, as well as their colleagues who practice there.
Kootenai Health has been a clerkship site for Idaho WWAMI since 2005 and is also home to the only family medicine residency in North Idaho, which prepares physicians to work in rural or urban settings. Most of the residency graduates stay in Idaho (20 out of 36 graduates are practicing in-state), just like most Idaho WWAMI alum opt to practice in the Gem State (51%, which is well above the national average of 39%). WWAMI medical students train where they were raised and as a result have a higher rate of practicing here, too. I’m proof the Idaho WWAMI physician pathway works.
Virtues of virtual care
Despite Idaho WWAMI’s decades-long presence in the state, Idaho faces a physician shortage, recently made more acute by factors such as burnout and baby-boomer retirement. Kootenai Health providers have always traveled throughout northern Idaho for patient care, but in recent years the demand has grown exponentially as these communities continue to lose physicians.
When I first started at Kootenai Health in 2020, I regularly worked in Orofino, almost three hours away. Today, some of my colleagues travel on a weekly basis to clinics as far north as Bonners Ferry and as far south as Grangeville. Depending on road conditions, it can be dangerous to make these trips. The time it takes to drive could be better spent seeing more patients, who face hardships themselves when commuting to in-person appointments. An appointment that requires a patient to travel is compounded by factors like requesting time off of work, child care, transport and costs associated with overnight travel expenses.
This year, the Idaho Legislature passed House Bill 162, the Virtual Care Access Act, to address the ongoing needs of Idahoans through virtual care. I applaud the Legislature for this decision to ensure the residents of Idaho are able to receive access to needed care. Virtual care covers a wide variety of care delivery modalities, including live video visits between a provider and patient, as well as asynchronous opportunities like paperwork submission and chart reviews. There are stipulations in place to ensure that a doctor-patient relationship is established; where that is not the case, in-person appointments would be encouraged. I’ve seen firsthand how virtual care expedites physician-patient communication without sacrificing level of care.
Idaho WWAMI medical education trains students to care for the communities which raised them. Paired with advances in virtual care, our homegrown physicians can help address gaps our health care systems are grappling with. Including more timely diagnosis, specialized treatment, and perhaps most importantly, better outcomes and quality of life for Idahoans.
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Idaho
Appeals court lifts partial stay on Idaho abortion ban

The 9th Circuit Court of Appeals issued an order on Thursday lifting a lower court ruling that prevented the state of Idaho from enforcing parts of its near-total abortion ban.
Citing the Supreme Court decision Dobbs v. Jackson Women’s Health Organization that returned the issue of abortion to the individual states, Judge Lawrence VanDyke said Idaho is one of many states using “that prerogative to enact abortion restrictions.”
Idaho has some of the harshest abortion restrictions, with termination of pregnancy being banned except for cases that threaten the mother’s life, or in cases of rape and incest that have been reported to law enforcement.
Last August, the Justice Department filed suit against Idaho, temporarily blocking the state’s abortion ban from taking effect.
Following the suit, U.S. District Judge B. Lynn Winmill temporarily blocked the near-total abortion ban, writing that it violates the Emergency Medical Treatment and Labor Act (EMTALA), which requires providers to offer medically stabilizing treatment in an emergency, even in cases when that care is providing an abortion.
While most of the abortion ban took place, the state wouldn’t have been able to prosecute anyone who performed an abortion in an emergency situation while the lawsuit from the Justice Department is argued.
In the decision released Thursday, VanDyke disagreed. He wrote that the injunction “directly harms [Idaho’s] sovereignty.”
“Because there is no preemption, the Idaho Legislature is entitled to a stay of the district court’s order improperly enjoining its duly enacted statute,” he wrote.
“Ultimately, given our conclusion that EMTALA does not preempt Idaho’s law, the federal government has no discernible interest in regulating the internal medical affairs of the State, and the public interest is best served by preserving the force and effect of a duly enacted Idaho law during the pendency of this appeal,” VanDyke concluded. “Therefore, the balance of the equities and the public interest support a stay in this case.”
Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Idaho
New nighttime traffic signal pattern for drivers on US-95 in Coeur d’Alene
Since mid-September, drivers in North Idaho may have noticed a change to late-night driving on U.S. Highway 95 through Coeur d’Alene. Previously, signals through the corridor used to flash yellow or red during late night hours to allow drivers already on the highway more mobility while traffic volumes were low. That pattern is no more, having been replaced by a detection and activation system designed to improve safety and prioritize northbound and southbound traffic flow.
“There are a variety of factors that influenced this change,” said Damon Allen, the district engineer for the Idaho Transportation Department (ITD). “The primary driving factor behind this change is safety.”
In recent years local law enforcement agencies have reported an uptick in late night near-miss crashes at signalized intersections with more drivers entering US-95 from side streets failing to yield.
“If you look at the data, moving away from any sort of nighttime flash pattern is trending nationwide, and the reason is safety,” Allen said.
According to ITD Engineer Manager Lee Bernardi who oversees the traffic section, problems arose from drivers on side streets not realizing that northbound and southbound traffic on US-95 had a flashing yellow light, rather than a flashing red. Signals are not designed for other-directional traffic to be able to see the lit color, so it’s understandable for a driver attempting to cross US-95 with a flashing red to assume opposing traffic also has a flashing red, and would treat it as a four-way stop rather than yielding to oncoming vehicles.
Bernardi continued, “As drivers, we’re conditioned to treat flashing red lights one way, and flashing yellow lights entirely differently. Maintaining complex intersections that combine these two conflicting behaviors, coupled with the amount of growth this area has seen in recent years, it’s logical to transition to a solution that eliminates assumptions on the part of motorists.”
In addition, updating to a nighttime activation system will keep the corridor uniform with the functionality of other signals throughout the area managed by local highway districts and cities.
“It makes sense for drivers to have the same expectations on all primary roadways in the area regardless of jurisdiction or time of day, and eliminating the nighttime flash on US-95 through Coeur d’Alene does exactly that,” said Allen.
The good news for drivers is that, despite this recent change, there should be a relatively low impact to their late-night mobility. Thanks to recent radar and detection equipment upgrades at every intersection along US-95 between Interstate 90 and Lancaster Road, each signal can operate independently of timing cycles and relies simply on a ‘see it and serve it’ strategy.
Each night, when the signals change over to the activation schedule, northbound and southbound lights are designed to rest on green, prioritizing the primary flow of traffic. Typically, the only time the flow of US-95 should be interrupted is when the signals detect either turning or cross-street traffic waiting at an intersection. The lights will quickly transition to serve those waiting vehicles and then get right back to green, rather than having to wait through a timing cycle for each lane. Likewise, cross street traffic should notice a decrease in wait times to get through an intersection.
“Our primary goal is to keep traffic moving,” said Allen. “We want drivers to remember that we are also in the business of efficiency, while maintaining a balance between mobility and safety for everyone on the road.”
Idaho
Festival celebrates Idaho’s sheep migrations and helps preserve age-old traditions – The Boston Globe
As complaints from bikers mounted, local ranchers Diane and John Peavey had the idea to invite residents to walk with them and their sheep through town that fall so they could educate the cyclists — and all residents — about the age-old tradition of moving the flocks and about the industry that had supported this region for generations.
It worked — dozens of people showed up, including teachers with their students — and the town (led by the Peaveys’ efforts) soon launched the Trailing of the Sheep Festival, an event that celebrates this biannual migration and invites people to be a part of living history. What started as merely a “trailing” (moving) of the sheep seasonal occurrence has evolved into a lively and culturally rich family-friendly event that draws more than 25,000 people and stretches over five days (the sheep migrate twice a year, but the festival only happens in the fall).
This year’s festival — now in its 27th year — runs Oct. 4-8 with events taking place in the towns of Ketchum and Hailey, located about 20 minutes from each other, in central Idaho.
“I was insistent that the festival really tell the story of sheep ranchers,” said Diane Peavey, who is originally from Greenwich, Conn., but moved to the Ketchum area in the early 1980s and started documenting ranch life through her writing and photography. “We look at this event as a three-legged stool,” she added. For it to work, “it needs the storytelling, the celebration of the Scottish, Basque, and Peruvian herders (who came to live here over the years), and the sheep.”
The festival includes all that and more. It features the Championship Sheepdog Trials, when more than 100 of the nation’s top handler and border collie teams compete on grassy open fields just north of Hailey with the mountains as a backdrop; an insightful storytelling event (this year it’s Voices from the Land — Unique Stories of Women in Ranching, with three women from western sheep ranches who share their tales and perspectives); and a Wool Festival with workshops and classes on Navajo-style spinning, wet felting with power tools, creating animal sculptures from wool fibers, and other creative skills.
Head to the Folklife Fair in nearby Hailey and you can watch professional shearers use steady hands and electric blades to shave wool off dozens of sheep, sample everything from artisan sheep cheese to lamb burgers and lamb meatball parm, enjoy face painting and kids’ crafts, and watch traditional folk dancing performances by talented local Peruvian, Basque, and Scottish groups.
The many culinary events include lamb cooking classes (when you can watch a chef prepare dishes, ask questions, and then eat the creations); three farm-to-table lamb dinners during which you’ll dine family-style at a large table with locals and out-of-towners, several of whom will be ranchers who can answer your questions; and a townwide food-tasting event called For the Love of Lamb, when Ketchum restaurants and food truck vendors offer mouthwatering small bites with lamb as the main ingredient.
The festival culminates in the Big Sheep Parade, when more than 1,500 sheep — now the stars of the event — descend from the hills and funnel down Main Street in Ketchum. Here, thousands of people line the streets to watch the sheep as they click along the pavement. Typically, at least one priest and often a rabbi stand in the middle of the road to bless the sheep as they dash past. The flock continues onto the bike path, along county lanes, and over a small bridge — still leaving sheep droppings along the route — while being followed by curious walkers and cyclists. The sheep will rest for the night and then head for their winter ranches up to 60 miles away.
Many people go out early on parade morning to see the sheep in the fields. If you know where to look in nearby forests, you may find carvings on the bark of aspen trees in places where herders have camped over the years or stopped in the shade to escape the hot sun. These “arborglyphs,” as they’re called, often show herders’ names, dates, poems, or images of sheep wagons or hearts.
We found a carving just north of Ketchum in the Sawtooth National Forest, on a trail next to a canvas sheepherder’s tent. It depicted an image of a Basque boarding house (or community center), a name, and the date “1969″ — a herder leaving his mark on the landscape, much like the sheep still do, during a migration that’s now appreciated and celebrated by all, even those pedaling or in-line skating along the bike paths.
Kari Bodnarchuk can be reached at travelwriter@karib.us.
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