Originally published September 16, 2014 at 5:12 PM | Page modified September 17, 2014 at 11:16 AM

THE University of Washington School of Medicine created the WAMI program with the federal Washington-Alaska Regional Medical Program in 1971. One of its purposes was to address the physician shortage and distribution of doctors in four states.

Now called WWAMI for the five states it works in, the UW medical program trains physicians in Washington, Wyoming, Alaska, Montana and Idaho in conjunction with other educational institutions and rural medical groups.

Washington State University, a participating school, is now considering building a new medical school in Spokane to address the shortage of doctors in rural areas.

The question that has not been addressed is why the WWAMI program has not been successful and how an expensive new medical school in Spokane would solve the physician-distribution issue.

There are frustrations in rural practice associated with the lack of modern technologies readily available to practitioners and their patients, compared with doctors in more populated environments. Coverage for attendance at medical conferences, vacations and the 24/7 demands of medical practice are major issues.

The business management confrontations with insurance companies, litigators and bureaucratic government regulators are an increasingly time-consuming, major frustration that will worsen with the Affordable Care Act.

Not addressed is the spousal factor. Even though WWAMI students are exposed to small rural communities and might enjoy benefits practicing there, spouses find employment opportunities difficult and cultural living options limited.

In Whatcom and Skagit counties, some of the frustrations of rural practice are being addressed by the Family Care Network. The networks chief executive, Marcy Hipskind, is a WSU graduate. She, one of her sisters and I are graduates of the private Washington University School of Medicine in St. Louis, at great savings to Washington state taxpayers.

The networks members total more than 75 family physicians. Billings, contractual agreements with insurance carriers and regulators are conducted for the members by the network. All are on electronic medical records. For members who are retiring, Family Care Network recruits replacements and provides coverage for conferences, vacations and on-call care.

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Guest: Why a WSU medical school would not address doctor shortage in rural areas