As we prepare to publish our membership directory, we have finalized our 2019 membership numbers and I felt it would be a good time to reflect on the trends.
Total ACMS membership climbed to just over 2000 for the first time in our history and this was due in large part to the addition of the first medical student class of the Idaho College of Osteopathic Medicine. ACMS represents 60% of the Idaho Medical Association’s total membership and 55% of its physician members.
- The total number of ACMS physician members grew by 4.7% from the prior year. Disappointingly, in spite of overall population growth in Ada County, the total number of active physician licenses here (regardless of member status) appears to be an absolute flatline from 2018.
- Our market saturation of licensed physicians who are physicians jumped from 69 to 72%.
- The percentage of students out of our entire membership increased from 4% to 11%. As each successive class of ICOM medical students comes into town, we can anticipate this will skew overall membership numbers.
Exactly half of the 1091 actively practicing member physicians (not retirees or residents) are connected to a hospital system as employer or clinic owner. This represents virtually no change from the prior year in real numbers or percentage.
- However, the number of physicians from independent large practices, defined as 8 or more, jumped up 76 from 25% to 31% of members.
- Unfortunately, we also lost 31 independent solo practitioners dropping to just 10% of our member physicians.
Gender and Career Stage
In keeping with nationwide trends, the ranks of female physicians continue to grow, up a couple points over the prior year, and now representing 34% of member doctors.
- Early career doctors (under age 43) also made gains on overall representation in the membership.
The percent of ACMS’ actively practicing members in various specialties is closely representative of the 2017 AMA Master File. The only specialties locally that show more than a percentage point variance is Family Medicine (+6% in Boise), Emergency Medicine (+4%), Pediatrics (+3%) and Psychiatry (-2%).
As I reflect very briefly on these trends, my thoughts are:
- It appears that the number of active late career physicians took steep dives: among men age 58-84, more than 30% left active practice in Ada County this past year along with 20% of late career female physicians.
- We need to continue to work hard to keep our older physician population working, even if only part-time. As Boise’s population grows, the last thing we need is a mass exodus of physicians fed up by bureaucratic systems, endless amount of EHR clicking, and practices that exceed their ability to absorb change. This may means providing greater assists to older physicians who are slowing down, but still have a great deal of wisdom, knowledge, experience and mentoring to offer.
- Our independent physician groups provide a robust counterpoint to an industry that has grown so consolidated. I have said it for four years now, citing the book The Spider and the Starfish. Nearly every American industry has seen waves of consolidation and deconsolidation: airlines, media, telecom, automobile makers…and healthcare is just now experiencing the same. Eventually the pendulum will swing back and our medical society should anticipate those changes by helping both employed and independent minded physicians to practice where they feel best suited.
- With an increasing number of medical students coming down the pipeline, we need to continue to think about how to better introduce organized medicine to this population and how we can serve both WWAMI and ICOM.
- Helping connect the docs with each other in a membership of this size will remain an important goal of the medical society to build collegiality and bust up silos. We will need to diversify our events to include the large scale activities like Go Wild at Zoo Boise and Winter Garden Aglow, medium size events like our Physician Vitality Series and Annual Meeting, and our micro events, like Beers with Peers and affinity groups.
Thank you for your membership this year and being part of a vibrant local medical society.