Dr. JCinda Bitters is one of the women who make up a new generation of Idaho physicians. The 31-year-old family doctor was surprised when she moved here in 2008.
I came from Texas, where I did not feel a gender gap at all, she said. It was rare to see male gynecologists.
Men make up 63 percent of the active obstetricians and gynecologists in Idaho.
The practice that Bitters joined in 2011 at West Valley Medical Center in Caldwell is almost entirely male. Perhaps due to her gender, or perhaps due to her more of a hand-holder approach, Bitters has become a magnet for female patients.
About 85 percent of her patients are women, even though I dont try to do that, she said.
A female doctor working in a small town is far from the norm in Idaho though thats changing.
About 21 percent of doctors in Idaho are female, compared with 30 percent nationally, according to the Association of American Medical Colleges. The runners-up are familiar statistical neighbors to Idaho: Utah, Mississippi, Alabama and Wyoming.
Women in Idaho who want another woman to see them through pregnancy, or who are simply uncomfortable with a male doctor, have about 600 options statewide, the association found.
The Idaho Department of Labor recently took a microscope to that statistic. It found that women made up about 9 percent of the general and family practice doctors in East Idaho, 38 percent in Southwest Idaho and somewhere between the two extremes in the rest of the state.
DOES IT MATTER?
Yes. Though not in the ways you might imagine.
Theres the obvious problem: Some women might have no choice but to get a Pap smear from a man.
But beyond that, a physician workforce of aging males and younger females is tricky in a state facing a primary-care shortage. The Department of Labor said women tend to gravitate toward primary care, while working fewer hours than their male counterparts.
A survey released by the American Medical Association found that 44 percent of female doctors and 22 percent of male doctors worked less than full time in 2011. The men, though, have vastly outpaced the women in becoming part-timers since 2005.
Female physicians interviewed said they work at least as much as their male colleagues. Dr. Ted Epperly, who runs a family residency program, said research shows that male and female doctors work equally as much over their lifetimes. Women tend to take time off earlier in their careers, while men tend to stop practicing earlier in life, he said.
But female doctors still might make less money. A recent study of physicians salaries in New York found that newly trained female doctors on average earned $16,819 less than their male peers regardless of their specialties, workplace, hours they put in and other factors.
Female doctors interviewed said their pay is on par with their male co-workers in Idaho, but that might not be universal. Men dominate the list of top-paid hospital doctors in the Treasure Valley. They also dominate many of the health care leadership positions.
The women interviewed said they dont feel treated differently. One young woman said a yearlong stint in India introduced her to workplace sexism, but she hasnt experienced that in Idaho.
Epperly, whose medical school student body in the late 1970s was about 10 percent female, said the average now is more than one-half female. He sees the same trend with new Idaho doctors.
I think thats good, because it adds an increasing sense of humanity to this, and compassion to the profession, he said. Not that men cant have those, but I find theres a tremendous amount of both empathy and compassion that female doctors bring to medicine.
WHY ARENT THERE MORE WOMEN?
Doctors in the Treasure Valley think there are a few possible reasons.
Idaho is a rural state. That might repel young, single women who want to start a family because rural medicine is all-consuming. And Idaho is more cowboy than glitz, according to one female doctor.
Those who are married often have spouses with career goals, too, and that limits where they live, doctors say, noting that this seems to be less of an issue when the husband is a physician.
Patrice Burgess, a Saint Alphonsus Health System family doctor, said she originally planned to practice rural medicine, but her husbands job in politics required them to be near the Capitol.
Bitters and her husband illustrate the female-breadwinner household that is increasingly common for young couples.
Her husband, who has a business and marketing background, stays home with the children. He plans to rejoin the workforce when the youngest child enters kindergarten, Bitters said.
In a city where there are 3,000 people, he might not have as many opportunities, she said, explaining one of the reasons they stayed in the Treasure Valley instead of moving to another part of Idaho.
Christina Marchion, a Montana native who is completing a family residency in the Magic Valley, jokes that she has dragged her husband across three states in pursuit of her medical career.
I depend on him; he makes the coffee, he makes the dinners, she said. Her husband plans to teach high school biology but is waiting until they settle in one place to get his teaching certificate, she said. They want to start a family, and she wants to find a place to work where its OK for her to take maternity leave.
Meanwhile, Idahos medical workforce is getting gray. Nearly one-fourth of the doctors in 2010 were 60 or older. That group a large and growing share in Idaho is skewed male.
The gender gap is reversing as younger doctors enter the workforce.
Almost two-thirds of the doctors in Epperlys program, the Family Medicine Residency of Idaho, are women. And just for the class of 2013, the figure is even higher: 83 percent.
Paddy Kinney, a 30-year-old whose career plans include advanced training in C-sections, is one of the two men in that class. He said more than half of his class in medical school was female.
Kinney said he first planned to go back to Alaska, where hes from, after the residency. But he fell in love with a local woman a physician assistant who plans to cut back her hours when they have children and now expects to settle in a small town within a half-day drive of Boise.
He and others think that the statewide gender gap is driven by rural areas and therefore is not as prevalent in a place like Ada County.
WHICH FEMALE DOCTORS STAY?
There are those who grew up here, or somewhere similar to Idaho, and those who have a burning desire to live in a state like this.
Mo Ferguson, 30, is in the second year of a three-year family medicine residency. She was born and raised in Grangeville. Like a great many female doctors in Idaho, Ferguson was educated through the WWAMI program, which sends students to the University of Washington from Idaho and other Western states that lack medical schools of their own.
Ferguson has always wanted to be a family doctor in a place like her hometown.
For me, it was finding a partner who was OK with living in a rural community, she said.
Ferguson got married in August. As she nears the end of her residency, shes hoping to settle in a place where she can work and raise a family simultaneously and comfortably.
How does that community respond to a female physician being a mother, taking time off for child care and to have a baby? she said. Its probably harder to do that in a rural community versus a city, because you are one of the few taking care of that community.
As for the future of Idaho women in medicine, Ferguson knows its changing: I think if you look at this 10 years from now, I think the numbers will be very different.
Audrey Dutton: 377-6448, Twitter: @IDS_Audrey