Bold and collaborative approaches are needed to solve Idaho's physician shortage
Student Doctor Shannon Hall (right) performs a physical exam screening during the 2024 community health fair held by the Idaho College of Osteopathic Medicine. (Courtesy of the Idaho College of Osteopathic Medicine)
Idahoans are increasingly aware that Idaho ranks last in the nation in physicians per capita, and that our acute and growing shortage of physicians and limited access to medical care leads to sicker and less healthy populations. Today, 43 of 44 Idaho counties are designated health professions shortage areas.
In 1972 the state of Idaho entered into a medical education partnership with the University of Washington School of Medicine. In more recent years, a similar partnership was established with the University of Utah. Combined, the Washington and Utah medical education programs educate 50 newly matriculated Idahoans per year.
Public is invited to Idaho College of Osteopathic Medicine's free Community Health Fair in Meridian
Over the past several decades, hundreds of academically qualified Idahoans pursued their medical education and residency training out-of-state due to limited state-supported medical school seats and in state residency programs. Once they leave the state for these purposes, the probability of these student doctor-resident-physicians returning to Idaho is greatly reduced.
In 2016, the Idaho College of Osteopathic Medicine was established in Meridian in partnership with Idaho State University. The college became fully accredited in 2022, and since its inception has matriculated 1,134 student-doctors, graduated 439 doctors and placed 99.6 percent of those graduates into Accreditation Council for Graduate Medical Education accredited residency programs here in Idaho and across the country.
While Idaho ranks 50th in the nation in active physicians per capita, our state also ranks 47th in 'resident' physicians and 45th in total physicians who practice primary care. And while Idaho remains one of the fastest growing states in the nation, roughly one-third of our physician workforce are aged 60 or over and expected to retire in the coming years. Of special concern — and for a combination of reasons — roughly 25 percent of our OB-GYN physicians, and 4 of 9 (42 percent) Idaho perinatologists (experts in high-risk pregnancies) have retired or left Idaho since 2022.
Today there is not a hospital, health system nor community in Idaho that is not actively and urgently seeking to recruit one or many physicians. Remarkably, Idaho would need an infusion of roughly 1,400 primary and specialty care physicians and surgeons just to reach the national average of physicians per capita. Incidentally, the average economic impact of a single Idaho physician is roughly $2 million per year. Indeed, Idaho's medical and health care providers have and always will be central not only to the good health and welfare — but also to the economic well-being of our communities.
The ICOM board and leadership team maintain that Idaho needs an 'all-hands-on-deck' approach to both undergraduate (medical school) and post-graduate (residency) medical education. We believe the state needs both allopathic (MD) and osteopathic (DO) medical education providers, and that all players in this space must work together in a collaborative, collegial and professional way to address the acute and growing shortage of physicians locally and beyond.
I warmly commend the governor, our Legislature and the State Board of Education for prioritizing not only the funding, but also the planning needed to orchestrate an urgent, bolder and more balanced approach to preparing future generations of Idaho physicians.
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Maybe you have decided that the voice inside your head judging yourself or others for body size can be pretty mean, but at least it's encouraging weight loss, right? No, it's not, experts say. 'There has long been a misunderstanding … that if you shame people about their weight, then that will lead them to eat less or to eat more healthfully or to exercise more in order to lose weight,' said Dr. Rebecca Pearl, associate professor of clinical and health psychology at the University of Florida. 'What the research, though, has shown over and over again is that that is not true,' Pearl said. 'It actually has the opposite effect.' Stigma around weight and body size is everywhere: in US culture, messages from people around you and even at your doctor's office, Pearl said. One study found that after bariatric surgery, experiencing continued weight stigma was associated with higher risks of depression, anxiety and disordered eating such as binge eating. Those who experienced less weight stigma were more likely to continue losing weight and maintain weight loss, according to the study published Thursday in the journal Health Psychology. And not only are biases around weight damaging to mental health, they also are counterproductive if people want to lose weight or engage in more health-promoting behaviors, said first study author Dr. Larissa McGarrity, clinical psychologist in physical medicine and rehabilitation at University of Utah Health. Weight stigma centers around a pervasive public misconception: that what a person weighs is entirely within a person's control. 'As a result of that, people should just be able to eat healthy on their own, to lose weight on their own, to be physically active –– that's their personal responsibility to do that,' said Pearl, who was not involved in the study. When a person doesn't lose weight or comes up against barriers to that thin body ideal –– such as lack of access to nutritious and affordable foods, no place for physical activity, or their genetics –– the misconception says their body shape is a sign of a moral failing, said Dr. Alexis Conason, a psychologist and certified eating disorder specialist in New York City who also did not participate in the new research. Messages saying that a person has a responsibility to lose weight and is a worse person if they do not can come from images or storylines in television and social media, direct comments from people you know, and bullying or discrimination, Pearl said. It gets worse when a person absorbs those derogatory remarks from others about their body weight and applies it to themselves. 'Experiencing stigma from other people is harmful,' Pearl said. 'But for the individuals who really internalize that, that seems to be a really strong predictor of these negative eating and physical activity outcomes, but also kind of broader mental and physical health outcomes.' Physical activity is so important to many aspects of health, including healthy aging, management of depression, better sleep and lower cancer risk. People often have a hard time going to the gym or getting outside for exercise, because it can feel intimidating or overwhelming, said Dr. A. Janet Tomiyama, professor of psychology at the University of California Los Angeles who was not involved in the study. It is particularly hard if you know you will get comments, judgment or even just extra attention because of your weight, Conason added. Research has linked experiencing and internalizing weight stigma to less motivation and enjoyment of physical activity, less confidence about exercising, and less time spent exercising, Pearl said. 'A gym is a location where a lot of weight stigma and fat shaming can happen,' said Tomiyama. 'If you've been stigmatized for the way you look, the last thing you want to do is put on some tight clothes and go to a gym.' Being judged for your body can be distressing, which can impact food choices. 'When someone is teased or criticized, or even just feels like they're getting negative looks from other people around them, that is stressful,' Pearl said. 'We know that one of the very common ways that everybody copes with stress is by eating more and eating more unhealthy kinds of foods.' Stress eating isn't a behavior we need to shake our finger and shame people out of either, Tomiyama said. It is in our own biology as well as that of other animals, she added. Physical or psychological stress signals your body to release the hormone cortisol, Tomiyama said. 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ANAD runs a helpline at 888-375-7767 from 9 a.m. to 9 p.m. CT and provides links to support groups and treatment providers. A call center at 800-334-673 and online chat run by the Butterfly Foundation is open 8 a.m. to midnight AET every day except public holidays. Helplines for England, Scotland, Wales and Northern Ireland are open 9 a.m. to midnight weekdays and 4 p.m. to midnight weekends, every day of the year. Unfortunately, weight stigma is pervasive, and it isn't something you can snap your fingers and rid yourself of, Conason said. One step the medical field can take is to de-emphasize body mass index, or BMI, as an important marker of health, especially because it often classifies healthy people as unhealthy and those with health issues as falling into a healthy weight class, Tomiyama said. When working with clients, Conason also focuses on creating resiliency, she said. 'We may not be able to change the entire culture, but we can try to understand that the problem is the culture, not our bodies,' Conason said. 'That can provide resiliency around moving through the world and experiencing weight stigma and trying not to internalize the stigma.' Conason does this by helping clients build greater self-compassion, educating them on the ways in which a culture of weight stigma has influenced them, and encouraging the practice of acceptance. If you notice an internalized weight stigma is affecting your behavior, contacting a disordered eating mental health counselor or a weight-inclusive dietitian may be a helpful first step.
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2 days ago
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Weight stigma isn't just cruel — it makes losing weight harder
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When a person doesn't lose weight or comes up against barriers to that thin body ideal –– such as lack of access to nutritious and affordable foods, no place for physical activity, or their genetics –– the misconception says their body shape is a sign of a moral failing, said Dr. Alexis Conason, a psychologist and certified eating disorder specialist in New York City who also did not participate in the new research. Messages saying that a person has a responsibility to lose weight and is a worse person if they do not can come from images or storylines in television and social media, direct comments from people you know, and bullying or discrimination, Pearl said. It gets worse when a person absorbs those derogatory remarks from others about their body weight and applies it to themselves. 'Experiencing stigma from other people is harmful,' Pearl said. 'But for the individuals who really internalize that, that seems to be a really strong predictor of these negative eating and physical activity outcomes, but also kind of broader mental and physical health outcomes.' Physical activity is so important to many aspects of health, including healthy aging, management of depression, better sleep and lower cancer risk. People often have a hard time going to the gym or getting outside for exercise, because it can feel intimidating or overwhelming, said Dr. A. Janet Tomiyama, professor of psychology at the University of California Los Angeles who was not involved in the study. It is particularly hard if you know you will get comments, judgment or even just extra attention because of your weight, Conason added. Research has linked experiencing and internalizing weight stigma to less motivation and enjoyment of physical activity, less confidence about exercising, and less time spent exercising, Pearl said. 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ANAD runs a helpline at 888-375-7767 from 9 a.m. to 9 p.m. CT and provides links to support groups and treatment providers. A call center at 800-334-673 and online chat run by the Butterfly Foundation is open 8 a.m. to midnight AET every day except public holidays. Helplines for England, Scotland, Wales and Northern Ireland are open 9 a.m. to midnight weekdays and 4 p.m. to midnight weekends, every day of the year. Unfortunately, weight stigma is pervasive, and it isn't something you can snap your fingers and rid yourself of, Conason said. One step the medical field can take is to de-emphasize body mass index, or BMI, as an important marker of health, especially because it often classifies healthy people as unhealthy and those with health issues as falling into a healthy weight class, Tomiyama said. When working with clients, Conason also focuses on creating resiliency, she said. 'We may not be able to change the entire culture, but we can try to understand that the problem is the culture, not our bodies,' Conason said. 'That can provide resiliency around moving through the world and experiencing weight stigma and trying not to internalize the stigma.' Conason does this by helping clients build greater self-compassion, educating them on the ways in which a culture of weight stigma has influenced them, and encouraging the practice of acceptance. If you notice an internalized weight stigma is affecting your behavior, contacting a disordered eating mental health counselor or a weight-inclusive dietitian may be a helpful first step.
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2 days ago
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Those who experienced less weight stigma were more likely to continue losing weight and maintain weight loss, according to the study published Thursday in the journal Health Psychology. And not only are biases around weight damaging to mental health, they also are counterproductive if people want to lose weight or engage in more health-promoting behaviors, said first study author Dr. Larissa McGarrity, clinical psychologist in physical medicine and rehabilitation at University of Utah Health. Weight stigma centers around a pervasive public misconception: that what a person weighs is entirely within a person's control. 'As a result of that, people should just be able to eat healthy on their own, to lose weight on their own, to be physically active –– that's their personal responsibility to do that,' said Pearl, who was not involved in the study. When a person doesn't lose weight or comes up against barriers to that thin body ideal –– such as lack of access to nutritious and affordable foods, no place for physical activity, or their genetics –– the misconception says their body shape is a sign of a moral failing, said Dr. Alexis Conason, a psychologist and certified eating disorder specialist in New York City who also did not participate in the new research. Messages saying that a person has a responsibility to lose weight and is a worse person if they do not can come from images or storylines in television and social media, direct comments from people you know, and bullying or discrimination, Pearl said. It gets worse when a person absorbs those derogatory remarks from others about their body weight and applies it to themselves. 'Experiencing stigma from other people is harmful,' Pearl said. 'But for the individuals who really internalize that, that seems to be a really strong predictor of these negative eating and physical activity outcomes, but also kind of broader mental and physical health outcomes.' Physical activity is so important to many aspects of health, including healthy aging, management of depression, better sleep and lower cancer risk. People often have a hard time going to the gym or getting outside for exercise, because it can feel intimidating or overwhelming, said Dr. A. Janet Tomiyama, professor of psychology at the University of California Los Angeles who was not involved in the study. It is particularly hard if you know you will get comments, judgment or even just extra attention because of your weight, Conason added. Research has linked experiencing and internalizing weight stigma to less motivation and enjoyment of physical activity, less confidence about exercising, and less time spent exercising, Pearl said. 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ANAD runs a helpline at 888-375-7767 from 9 a.m. to 9 p.m. CT and provides links to support groups and treatment providers. A call center at 800-334-673 and online chat run by the Butterfly Foundation is open 8 a.m. to midnight AET every day except public holidays. Helplines for England, Scotland, Wales and Northern Ireland are open 9 a.m. to midnight weekdays and 4 p.m. to midnight weekends, every day of the year. Unfortunately, weight stigma is pervasive, and it isn't something you can snap your fingers and rid yourself of, Conason said. One step the medical field can take is to de-emphasize body mass index, or BMI, as an important marker of health, especially because it often classifies healthy people as unhealthy and those with health issues as falling into a healthy weight class, Tomiyama said. When working with clients, Conason also focuses on creating resiliency, she said. 'We may not be able to change the entire culture, but we can try to understand that the problem is the culture, not our bodies,' Conason said. 'That can provide resiliency around moving through the world and experiencing weight stigma and trying not to internalize the stigma.' Conason does this by helping clients build greater self-compassion, educating them on the ways in which a culture of weight stigma has influenced them, and encouraging the practice of acceptance. If you notice an internalized weight stigma is affecting your behavior, contacting a disordered eating mental health counselor or a weight-inclusive dietitian may be a helpful first step.
