All psychiatrists at Sacred Heart, resign.

All of the psychiatric doctors at Sacred Heart Medical Center have turned in their resignations.

Sacred Heart provides (provided) critical in-patient psychiatric services in the Spokane area.

A comment to the story (unverified) says other psychiatrists in the area have also resigned from at least one other facility. No specific reason has been given for these resignations; several comments to the story note that except for the Inlander, local media has ignored these resignations yet this is potentially a serious crisis for the Spokane region.

Spokane Medical School: UW says WSU feasibility study is badly flawed

WSU hired a national consulting firm named MGT of America to produce a feasibility study for a WSU medical school. MGT’s report says Washington needs a WSU medical school.

The University of Washington responds that the consultant’s study done for WSU “contains a number of deep flaws”.

Many of the key justifications cited for starting, funding, and accrediting a second public medical school in Washington are based upon faulty assumptions, omissions, and erroneous data that draw into question many of the report’s central conclusions. These flaws raise significant concern about the actual feasibility of a WSU medical school and are important questions that require answers.

Local Spokane promoters and politicians previously relied on a consultant’s report on the economic impacts of the Spokane Medical School. However, that report was essentially a work of fiction, as pointed out in this blog’s analysis – “Forecast Economic Impacts of the Spokane Medical School“.

This blog would like to see a med school in Spokane and is supportive of WSU running such a med school. But both parties have engaged in flaky promotional efforts.

Update: WSU’s study may have left out the fully accredited Pacific Northwest University of Health Science’s, College of Osteopathic Medicine, in Washington, with another 140 or so medical students beyond those at the UW.


“Amgen’s exit a new blow for Seattle biotech industry”

Amgen’s exit a new blow for Seattle biotech industry | Business & Technology | The Seattle Times.

Seattle’s biotech sector has been in free fall for a decade, unfortunately.

The problem, obviously, is they never built a heated pedestrian/bike bridge! The Spokesman-Review assured us the essential requirement for a local biotech sector is the heated ped/bike bridge (really): Spokane’s biomedical economy will collapse without the heated ped/bike bridge

Seriously, if Seattle cannot retain its biotech industry, the likelihood of a huge biotech sector in Spokane is low. With or without heated pedestrian/bike bridges.



Seattle Times: State does not need a WSU Spokane med school

Now, as Washington State University tries to gain statewide support to build a new medical school in Spokane, some regional and national experts say there’s no longer a pressing national need for another one.

State might not need a WSU medical school, some experts say | Local News | The Seattle Times.

A lot of this is about market control. The UW, which has failed to provide adequate med school slots in the state, does not want WSU as a competitor in Spokane and would prefer to go down the WWAMI route of having med school students rotate through various locations. The UW argues its brand reputation is stellar and will attract top students while a first year start up med school run by WSU would start, on day one, with the lowest reputation of all med schools nationally.

WSU-Spokane argues that a med school is needed in eastern Washington to ensure doctors in rural areas even though there is no evidence this solves the root problem: pay is lower in small towns, which does not work for young doctors paying off med school debts, and the lifestyle may not be what young doctors are seeking.

Only a few years ago local Spokane promoters convinced us that a Spokane med school was essentially a done deal and would be opening shortly. Now its pushed out another decade or more (UPDATE: Should be accepting students in about 2017-2018 assuming all goes to plan – this is good news. Meanwhile, the UW has partnered with Gonzaga University on future medical student training in Spokane. There is zero justification for Spokane to have two medical schools –  but one makes sense.)

Our past posts on the Spokane med school including the outrageous lies told about the alleged economic impact of a Spokane med school. In Spokane, people just cannot stop lying. I have never seen a community where lying is conducted so openly and passionately.

WSU, UW in pissing match over future Spokane medical school

UW and WSU continue to argue over Spokane-based medical education or a med school.

Spokane promoters again point to an exaggerated and fictitious economic impact, and the parent of a Spokane WWAMI medical student rips the Spokane operation, saying facilities are inadequate and students are abandoning the program.

Spokane leaders point with pride to the city’s growing importance as a provider of medical services, and cite a 2010 consultant’s report which says that a new medical school there would have a $2.1 billion statewide economic impact — $1.6 billion of that in Eastern Washington.

via WSU, UW spar over future of region’s med schools | Local News | The Seattle Times.

See “Forecast Economic Impacts of the Spokane Medical School” to learn why this claim is a work of fiction. Spokane is famous for its tall tales and lies. Also see “WSU-Spokane’s Diversity Problem” (enrollment is 73% female, 27% mail overall, and 87% female at the undergraduate level).

The parent of a WWAMI student at the Spokane campus (see comments of “user492056”) provides this feet on the ground perspective that the facilities are inadequate and most of the students are abandoning the program – something that Spokane’s propaganda shill media are not reporting on:

The current Spokane medical sciences education site is a cooperative venture between Eastern, Gonzaga, Whitworth, and WSU for the education of nurses, physical therapists, occupational therapists, dental students, and pharmacists.  The afterthought space left over for medical students is completely inadequate.  The lecture space accommodates at most twenty students without even providing electrical outlets to let students use modern technology.

Only nine of the past year’s twenty first year Spokane medical students are choosing to stay in Spokane for their second year.  This fact speaks volumes.  None of Pullman’s first year medical students are going to Spokane for their second year despite aggressive recruitment.  All of them are transferring to Seattle to complete their medical education.

If true[1], Spokane’s multi-zillion $ economic impact medical education program seems to have failed at launch. In real cities, these allegations would be the subject of the 4th estate keeping local government in line. But, you know the story, this is Spokane and we have Spokane promotional media.

[1] Since Confirmed as true. Buried in the Journal of Business on page 27 a few days after this post went live. Thank you JoB and SR (also) for eventually covering this story.

Keywords: Spokane medical school Hoopfest lilac festival parade

Deaconess Hospital ranked among nation’s worst for infections and complications

Really: “Deaconess Hospital places among hospitals with highest infection rates

Deaconess Hospital scored a 9.675 out of a 1 to 10 scale. Of the over 3,300 hospitals ranked, only about 60 have scores higher than Deaconess. According to Kaiser, hospitals scoring 9 or greater are likely to be assessed financial penalties.

Hospitals landing in the bottom quartile will lose 1% of every Medicare payment starting in October of 2014 (meaning they will charge everyone else more). They could lost up to 5.4% including the impact of other programs.

Given KREM’s past headlines, this should have been tilted “Deaconess Hospital staff among busiest in the nation at fighting infections“!

Related: Sacred Heart Medical Center had its own brush with management incompetence not long ago. The Spokane area has a hard time attracting and retaining world class talent, to put it mildly.

Police Shooting Propaganda Manual

Update:  Today, after this was published, another dead body was found and then SPD shot and killed someone near the dead body scene this afternoon. Well, we know how the press coverage will pan out over the next few days … read on … oh wait, the SPD PIO was  a witness to this shooting, … Welcome Bloomsday runners and walkers – yes, Spokane is a crime ridden mess. Oh well.


Every time there is an officer involved shooting, the public relations is predictable:

  • Make a statement about the person shot – he or she failed to comply with repeated orders, was seen as a threat, and was shot (and usually killed).
  • Over the next few days, dribble out information confirming the person shot was obviously a bad guy who deserved it. Probably on drugs, mentally ill, ex con. Impugn the subject’s reputation by press release. Never say a positive word about the deceased.
  • Make a statement that we should wait for the official investigation before passing judgement on the officer’s actions (but ignore it when it comes to making statements about the deceased).
  • Days later, release a press release with the officers’ names, their extensive training, awards, commendations, and their gold stars. Elevate them to pure saint hood.

Works every time. Very predictable.

The Sheriff issued a press release giving a one line bio for a deputy who has his own “topics” page at the local newspaper.  No attempt was made to hide the obvious propaganda spin.

With another shooting, the PR spin went down the usual path:

  • Police Chief Straub made a statement about how the suspect was given multiple commands from the police after stepping outside and the PD opened fire because they feared for their safety.
  • Then a video surfaced showing a different situation than what the Police Chief described. (See our analysis of the video and audio track).
  • The SPD dribbled out information about the suspect’s background: he’s a burglar, he’s had drug problems, he’s served time, he’s had mental health issues, he probably committed robberies. 
  • Then go for the kill: obviously the suspect was a bad guy who deserved and wanted to die! Local TV says he left a “suicide note” and quotes from a heroin-addict friend who “thinks” the suspect did not want to continue on. A  TV station photographs the suspect’s note – this would usually be evidence withheld from the court of public propaganda. (The SR refers to the note as an “apology letter” which seems accurate.).

KREM.COM goes straight to the punch:


KHQ.COM finds the friend who says “he wanted to die”:


THEREFORE, we can pat ourselves on the back and thank the police for executing the suspect. He was, after all, a low life, mentally ill, heroin addicted ex-con who wanted to die anyway – so no problem. He got what he deserved and what he obviously wanted.  A comment says “Sounds like a bunch of losers living in a house. The guy got what he deserved, quit defending the criminal.” Let’s pat ourselves on the back for another well deserved street execution! Hip hip hooray! Drinks all around!

Days later, we get the usual press release with the officer’s names, awards, commendations, training, medals, gold stars and saint hood.

Many commenters to the Spokesman-Review story saw through the propaganda stream:

  • “just adds to the public’s perception that the cops are trying to make a case that this was “Suicide by Cop” before the case is even investigated”
  • I can picture the perceptions and attitudes changing with every news story, and the local news media is as complicit in this cover-up attempt as anybody could be.”Oh, he was a drug offender”
    “Oh, he wrote a note that said he wasn’t going to prison”
    “Oh, he came out with a gun in his hand”.
    Yep, he got what he deserved. Cops are just doing their job.
    No need for a court. Saved us a lot of money, etc.”
  • How…given Straub’s comments…the questionable release of evidence to the media…a previous OIS case where a cop before the investigation was completed basically said in a sworn affidavit it was “Suicide by Cop”…does any cop expect the public to believe that OIS investigations aren’t bias?

Time To Rethink Police Shootings

There is zero question in my mind or most anyone’s mind that there is a need for police to shoot to kill in many situations. Both of the above situations were likely examples of those cases. But those events are not the point of this post.

The problem is we view these shootings as good outcomes! He deserved to die! He wanted to die! Yay! Let’s go have a party!

He probably wanted “suicide by cop”.  This assertion of “suicide by cop”  is common after OIS incidents – but it is just an assertion that goes along with excited delirium, a medical condition that exists solely in people in a fight with police. Both have become code phrases to justify a killing. Many of the “suicide by cop” claims are just a pop culture meme to justify shootings – rarely proven and definitely not a good outcome.

All of this is sick beyond measure.

In Spokane, each time a suspect is shot dead and no police officers are harmed, it is treated as a positive outcome. (Seriously, I do not want any police officers hurt. Ever.)

But we need to change our mindset – dead bodies are a sign of failure, not success.

We will not see a reduction as long as we view killings as a successful and desired outcome.

Is it possible to stop so many killings? NYPD used to kill 100 people a year but with improved training they cut that to about one-tenth to one-fifth that number. Yes, it is possible.

But until we change our mindset, the killings will continue.

The need for change is recognized elsewhere:

Until the SPD changes its mindset and adopts a new approach, the killings will continue, law enforcement will respond with the usual and predictable propaganda spin, and more people will die due to “suicide by cop” and “excited delirium”.


This post is not opposed to police shootings, as required.  This post is about the propaganda spewed forth and lapped up  – propaganda designed so that readers and viewers will relax in their easy chair and conclude “Good thing the police shot and killed this thug – he not only deserved to die, he wanted to die!”

That is a sign of a sick community and media. Look back at the killing of Otto Zehm or Quentin Dodd. Then look at how the NYPD drastically reduced officer involved shootings with a different approach and new training methods. The fundamental issue is that police killings need to viewed as failures (yes, many are justified) – and not viewed as successful outcomes.

Until the SPD and the community recognize these shootings for what they are – a sad failure – not a success – the shootings will continue. The media must stop playing along with this game – but press release reporting is easy so they continue to play along.

If you do not get what this about, read the full Use of Force Commission Report. Nearly every propaganda statement issued by the SPD after the murder of innocent Otto Zehm was a lie. The SPD hid and withheld evidence that contradicted their public statements. To this day, the SPD continues to spin and engage in propaganda. And that is a serious problem.

Keywords: Bloomsday, Lilac, Festival, Parade, Marching, Bands, Spokane, Police, Sheriff, County, shooting, shootings

Spokane Medical School postponed by 10 to 20 years?

Sold locally as a done deal, the Spokane medical school now looks like it will open about the same time the North South Corridor [1] freeway is completed, meaning, perhaps some time in the 21st or may be 22nd century:

Washington State University Spokane Chancellor Lisa Brown told the panel that a second publicly funded medical school is coming in the next 10 to 20 years, and “I believe it should be in Spokane.”

via Medical school task force convenes – – April 22, 2014.

Did you know that Spokane once had a medical school? Two of them in fact!

Sort of. Both were frauds, which is fitting for the Scam and Fraud Capitol of the America:




Reminder: the claimed $1.6 billion economic impact due to a Spokane medical school is a wild stretch. The economic study that arrived at the $1.6 B figure was for a comprehensive health science program, including nursing, pharmacy, medicine and other activities. The medical school impact is a minor part of the total (see the link, above). Half of the economic impact is due to the ordinary growth of the health care industry in Eastern Washington – and this was included in the $1.6 B figure by assuming the growth would occur solely due to the health science campus. Why not just say that the $1.6 B economic impact is due solely to the construction of a heated pedestrian/bike bridge?

In Spokane, concepts like reality or truth or very flexible concepts.

[1] The North South Corridor freeway is presently an unfinished “North North” freeway that goes from nowhere to somewhere. Conceived in 1946, it might be completed by 2046.

Keywords: Spokane medical school, wsu, uw, washington, university, health science, bloomsday, lilac, festival, parade

Spokane Area Economic Update Charts

(Update: By request I have turned comments back on for some recent posts. They were turned off, mostly, a year ago, since I spend little time on the blog now, and comments require monitoring. Hope that helps and thank you for your suggestions, ideas and corrections.)

The State’s “adjusted” employment data for Spokane County (thru November 2012) shows an upward spike:


The US government’s Bureau of Labor Statistics “raw” data for Spokane County  (through November) shows a subdued seasonal rise in jobs. (Data is from the US BLS “One Screen” database). In a traditional post recession recovery, we should be seeing a job growth rate similar to how it was before the recession took hold (pre-2008).


Hospital, Manufacturing, Education, Convention Center Attendance and More, after the break …

Read more of this post

Affordable Care Act may harm Spokane’s economy

There is an assumption that the Affordable Care Act (ObamaCare[1]) will lead to an increase in health care usage and this will be a boost to Spokane’s economy, which has a large health care segment.

Based on recent news reports, ObamaCare might be an economic mess for Spokane as there are forecasts that low wage jobs will see loss of employer provided health care benefits. That does mean this will happen for sure – it is just one hypothesis that some have proposed. Read the full set of headlines, below (and click through to read the original articles). Updates are added at the top of the list as recent news seems to confirm this trend.

Updates December 2013:

Updates April 24 2013:

Since this was originally written:

Updates Feb 5-9 2013:

Original Items

How might this impact Spokane? Read more after the break…

Radiation Monitoring in Spokane

Hey – its a chart! Spokane, WA Real Time US Gamma And Beta Radiation Monitoring 

Why the recent spike in radiation?

Read more of this post

Spokane MSA health care employment continues to shrink

Health care services is supposed to be the future of economic growth in Spokane. A new medical school is alleged to create billions in economic growth, for example. But look at what is happening in Spokane MSA health care employment – the number of jobs are in a steady decline, perhaps a steepening decline.

Bureau of Labor Statistics Data. Their data table combines health care and some education sector jobs – but not public schools, which are the largest component of the education sector.

Anyone else a bit nervous about this trend?

Spokane’s Deep Recession Continues in 2012

The current estimate for non-farm employment as of April 2012 is for 204,200 jobs. As you can see in this chart and data table from the State’s Employment Security Department, this is the lowest number of non-farm jobs since the recession started for April.

Stated another way, Spokane remains stuck in a down sliding economy four years after the recession began and 3 years after the recession ended at the national level. Read the April line from left to right, and then add the latest number: 204,200.

The inability of the Spokane area to create new jobs is shown graphically in this chart of percentage  year over  year job changes, from 2005 to 2012. As you can see,  job growth began falling as far back as 2005. Now that the recession has officially ended at the national level, close to zero new job positions have been created in the Spokane region.

Health care employment, when broken out separately, also continued to slide since last year. The health care category has declined from 34,100 last year to 32,800 this year, or a decline of 3.8%. Spokane leaders have proclaimed Spokane’s future to be centered on regional health care delivery.

Update May 28, 2012

This is not a valid survey but I scanned the Craigslist ads on Memorial Day and there are quite a few more job openings across a wide variety of fields. This is very encouraging – I have not seen this growth in Craigslist job openings in several years.

Spokane County health care industry employment trend

As you know, Spokane’s main growth industry is health care and our region’s future is now tied to a regional health care economy and a new academic health science center that will generate thousands of jobs and create billions of dollars in economic activity.

Here is a chart of the combined health care + non-government education sector employment in Spokane County, from the U.S. Bureau of Labor Statistics. Unfortunately, they combine the health care and education industries together, although private education makes hardly a blip in the total. Data is through March of 2012.

This category stopped growing in early 2009 and has been falling steadily ever since. 

Related, in Davenport, Lincoln Hospital nursing home and the Vista Manor Assisted Living Center in Wilbur are both being shut down and the workers laid off.


Independent online resources where you can monitor the long term trends yourself. They have the data used in the charts on this web site, and often have the same charts too.  This blog has brought up nothing new – everyone else knows what is going on!

Due to a recent Court ruling in Oregon, I may take this entire web site offline in the future. If the government provides more First Amendment protections to “journalists” than to citizens and the government decides who is a journalist, then what happens to the First Amendment  freedom of the press concept?  Basically, the First Amendment is thrown away as the government selectively choose who is a journalist and who is not.

“Spokane is a great place….Things are good in Spokane.”

We wish it were true!

But back in the reality-based world and this last post on this blog … by the numbers, Spokane is not getting better, it continues its long downward slide.

Spokane’s Economy In Easy to Read Charts

For decades, wages in Spokane have grown at half the rate of the rest of the state, falling further behind every year. Spokane wages average about 20% behind the rest of the state. Government and health care workers make close to King County wages – but everyone else here earns much less than the -20% wage  differential implies.

Every year, Spokane residents fall further and further behind their counterparts in the rest of Washington and in the nation. This chart shows that Spokane per capita income was at 90% of the State’s level in the 1970s, but has declined to less than 80% of the State’s level by 2008 (the orange line). In 2010, average wages rose 2.7% nationwide, but rose only 2.3% in Spokane County. Stated another way, average wages rose 17% faster everywhere else while and Spokane residents’ income fell relative to everyone else.

The next chart highlights the wage differential for those working in higher skilled jobs in Spokane.  Education and health care, which are shown, are similar to King County. (Government wage data was not available for this specific comparison). As we move to the right into higher skilled jobs like manufacturing, finance and engineering, the wage differentials are enormous. Spokane will never attract a national or world class high skilled workforce when wages in Spokane are up to 50% less than across the state. Which is why the State and local power brokers have identified Spokane as the low wage, low skilled industry cluster for the state.


Tons more data after the break …

Read more of this post

Comparison of average wages between Spokane and King Counties

A sample of job categories was selected from the Workforce Explorer web site for Industry Trends. A few were dropped out because the job category did not exist in both counties.

  • Most Spokane County workers are paid less and professional high skilled private sector workers are paid a lot less.
  • While we have come to expect lower pay in Spokane, some of the differences are shocking.
Table of average wages in $s in Spokane versus King County. The difference is shown in the right most column. Bright green is higher. Dark green is “close”. Bright red is -24% or worse difference.
Occupation Spokane King County Spokane Pay
Public Schools/Education
Teacher 33207 36051 -8%
Elementary Teacher 58227 55921 4%
Education administrator 100703 102037 -1%
Government workers
Firefighter 61987 72591 -15%
Police and Sheriff 64560 72205 -11%
Zoologists and wildlife biologists 57261 62254 -8%
Health Care
Pharmacist 107792 95782 13%
Registered Nurse 65735 77800 -16%
Physician assistant 88684 100508 -12%
Dentist 147660 159630 -7%
Nursing aides 24342 30917 -21%
Private Sector Jobs
Science and Technology
Industrial engineer 69391 83122 -17%
Mechanical engineer 62946 82890 -24%
Software engineer, apps 70504 94071 -25%
Software engineer, systems 74135 99318 -25%
Computer programmer 54288 95782 -43%
Chemist 50917 73321 -31%
Chemical technician 38653 35160 10%
Law & Business
Lawyer 90215 118674 -24%
Paralegal 35344 53588 -34%
Marketing manager 108781 125807 -14%
Sales manager 82235 119374 -31%
Advertising/promotions manager 48198 101550 -53%
Architect 83145 72237 15%
Editors 58218 61492 -5%
Reporters and correspondents 40346 54105 -25%
Roofer 35953 46263 -22%
Truck Driver 39584 43626 -9%
Sheet metal worker 35946 57792 -38%
Cooks, all other 23731 29322 -19%
Retail sales 21486 24151 -11%
Bus and truck mechanic 42489 51252 -17%
Hairdresser, stylist, cosmetologist 33459 32702 2%
Mobile heavy equip. mechanic 41968 59303 -29%

Wage data from the State’s Workforce Explorer Industry Trends section.

What It Means
  • Education sector pays about the same.
  • Government and health care pay some what less.
  • Private sector highly educated workers are paid remarkably less.
  • Those considering moving to Spokane need to consider the income ramifications of their career sector.
  • At present pay levels, there will not be a science or technology cluster in Spokane. With extraordinarily low pay, Spokane will have difficulty attracting high quality scientists and engineers needed to create a regionally or nationally competitive science and technology cluster.
  • At present pay levels, the same issue impacts creation of national classes businesses.
  • “Editors” average is about the same in both counties. This may account for why there is little news coverage of the chronic low wage problem in Spokane – low wages do not affect them!  But reporters’ pay – ick!
Would be interesting to compare pay scales to Benton-Franklin counties, and to Clark County (Vancouver, Wa) area.

Related articles

Spokane’s economic plan du jour

Picture of the Duncan Garden at Manito Park an...

Image via Wikipedia

Spokane’s future industry clusters:

  1. Retirees and transfer payments
  2. Health care services and health care academics
  3. Government, including education
  4. Manufacturing
  5. Low skill, low wage categories including retail, restaurants, hotels, recreation, trucking, warehousing.
  6. Various small categories including low skilled and high skilled workers.

Categories 1, 2 and 3 will account for 60+% of the local economy. Here’s the number of workers, per category, flipped from horizontal to vertical to present the relative size differences.  Retirees and transfer payments are not shown in the chart but would be in the top 3.

Here is the impact of transfer payments. As you can see, transfer payments are a large component of the local economy. For more information on transfer payments please see “Trend of Transfer Payments into Spokane County“.

Data Data from


Previously, many people retired from Southern California and took their large real estate capital gains to low cost Spokane. That source of retirees is diminished due to the housing collapse and its return in the future is not predictable. This is an important driver for health care, housing and service sectors.  Inbound migration may be at reduced levels for a long time.


The State adopted an industrial clustering policy where the state selects the industry clusters to be supported in each region. The primary clusters for Spokane are health care, education, and trucking and warehouse operations. Manufacturing has been in a slow national decline for 30 years.

Health care is on a growth streak due to retirees, a doubling in individual use of medical services over the past 30 years, and more recently by expectations of “ObamaCare” leading to an expectation of increased demand for services primarily paid for by someone else.


The loss of retirees from Southern California produces risks to the area’s current strategy and may be why the 2011’s local economy continues to remain stuck well below 2007 levels. On the plus side, the nation’s overall large “baby boom” approaches retirement years. However, where they choose to settle in their retirement years will have a big impact – and some think relocating as part of retirement may be thing of the past, not of the future.

There is a risk that the health care act might not play out as expected. It is possible that court challenges may limit the growth in the health business sector.

There is a risk that shifting more money into health care services without addressing the exorbitant prices charged and excess consumer demand for health services paid for by other people means less money for the production side of the economy. This is not a sustainable path.

Spokane’s future is based on retirees and health care – but that future has risks. And a big risk is there is no plan B.

Low Wages Are By Design

Greater Spokane says our region’s primary competitive advantage is low wages and low land and housing costs (or stated another way, poverty). Per Greater Spokane, our region’s competitive advantage is low prices. And no one in power wants that to change.

Spokane will be the state’s low wage, low cost housing and low cost land destination. This appears to be by design.

Outside of the key clusters, wages and opportunities will be limited.

The substantial quantity of data collected on this web site, and reviews of all the economic plans going back to the 1980s show that the chronic low wages and limited opportunities are endemic to Spokane. Every one of the plans mentions these problems. These problems remain because not many people want to embrace change – low wages are a feature and are by design.  The area is settling into a future as a comfortable government-funded enclave of government and health care workers, and retirees collecting benefits.

Everything on this website has been mentioned before, often many times, in prior economic studies about Spokane. What I present on this website is not my opinion but is backed by data and numerous studies. This view is shared by business leaders of the past, by various politicians, current and former academic administrators and many more. The data tell this story, not me.


See the recommendations links at the right of this page. Lots of bad decisions were made in the past.


It’s been an interesting experience to go from wondering why so many businesses disappeared to finding out what really happened. The answer was not at all what was expected.

Unfortunately, no one cares. It’s always been this way in Spokane. As a friend said to us in the 90s, “It’s just a big small town, only bigger.” So true. (Well, at least one other person gets it…)

And nothing will change.

This web site will now be updated primarily for major events or changes.

Health care now the number one employer in Spokane

Government is no longer the largest employer – health care is:

Here is the same chart, but rotated vertically, since our eyes and brain process relative sizes better vertically than horizontally. Due to scaling – the horizontal chart would not fit at full size – the vertical dimension below is larger, but that is the actual chart size.

  1. Healthcare
  2. Government
  3. Retail
  4. Hotels and restaurants
  5. Manufacturing

And after Manufacturing, the categories fall in to the noise level.

This is not a sustainable trajectory. I was just looking at billing data for some procedures at hospitals outside Spokane.

  • $6,600 – Doctor’s surgery fee for 2 1/2 hour surgery that is normally an outpatient procedure
  • $40,700 – Overnight hospital stay (routine), agreed to a $14,000 payment from the insurance company
  • $12,000 – 45 minute outpatient tonsillectomy procedure
  • $24,000 – 45 minute outpatient bunionectomy

Most of the above do not represent the total set of fees associated with the service.

The more we grow health care locally, the less money we have available for productive business pursuits.  The health care pricing trajectory is not sustainable and will eventually consume the entire country if continued.

Forecast Economic Impacts of the Spokane Medical School

Update: The original economic study has largely imploded. As of 2014, its bogged down in politics and in fighting between the UW and WSU. There is no longer a target date by which the  Spokane med school would open.


It is pouring down rain again today so guess I will make some charts.

Data for these charts comes from “America’s Next Great Academic Health Science Center“, part of the economic study to justify a Spokane medical school.  I chose to create some charts in a different form than those that appear within the consultant’s report. The new charts tell a somewhat different and unexpected story than we’ve heard from the promoters.

According to the study, conservative and aggressive models were created for the estimates. It is not clear whether these charts represent the conservative, aggressive or a combination model.  The report section that I could see does not provide the range of potential forecasts.

As will be explained in a moment, local promoters appear to be counting growth that would occur whether there is a medical school here or not. This discovery was unexpected. While there are issues with the economic study, the larger problem is that its conclusions have been presented in a misleading way by local promoters.

Here is the chart from the study showing the overall economic impacts of a health science center (not a medical school per se).

I created a new chart to break out the components of this forecast economic impact. This chart is not available in the study:

The chart above shows the estimated economic impact of the different components of having a health science center in Spokane.  The largest single component is growth of the health care industry (the pink area labeled “Industry g..” but cut off in the legend) and the second is the nursing school growth. These account for half of the total 2030 estimate – and will almost certainly happen with or without the medical school.

The sum total is $1.6 Billion for Eastern Washington by 2030 and over $2 Billion for the state. As will be shown in a moment, much of this growth would occur whether a medical school was here or not.

The study itself is about the proposed economic impacts of the WSU-Spokane Health Science Center, of which the medical school is one part.  Local promoters have focused on the medical school and claim up to $2 billion in economic benefits from the medical school. That is misleading. Much of the growth described in the study will happen regardless of there being a medical school in Spokane.

The next chart is the same information, but in a form that makes this more obvious. Almost all of the economic impact by 2030 comes from the continuing growth of the health care industry (which would almost certainly happen without a medical school here) and WSU Nursing, which would also likely happen without a medical school here. They also include WSU Pharmacy in the total, which is moving to Spokane. The move was approved before the State approved half the funding to start construction on a new health science building that would house a future medical school.

Next, we look at the employment impact forecast.

Same information as the above chart, but in a different form to make this more obvious.

And again, we see the the large component of employment growth is the hospitals and health care industry itself, followed by a more than doubling in WSU Nursing and Pharmacy program employment in the last few years of the 20+ year forecast period.

They assume that a percent of graduates of the program will stay in Eastern Washington and thereby, increase employment and economic impacts. That’s fine. The implied argument is that health care workers would not come to Eastern Washington unless they were trained here. Interesting argument to put in a promotional study …

However, this thinking is flawed in terms of measuring medical school impact: whether or not there was a medical school here, the market will determine the number of health care workers needed in Eastern Washington. Whether they are produced here or not, most of this health care sector job growth and economic impact will occur anyway.  This is apparent from the pink line in the charts, above – it goes straight up from the very beginning, even though the other parts of the plan are still being implemented.

Don’t confuse what I just wrote – I support having the medical school here – but parts of this economic impact study, and specifically, how it has been presented to the public, are misleading. Major components of this growth would occur with or without the medical school.

Let’s state this another way if you do not understand. Demands for health care services drive the number of jobs. If there is no demand, there would be no jobs.   The medical school does not just create thousands of health care worker jobs unless there is market need. There is a market need and we would prefer to have the benefit of producing those workers locally. But ultimately, whether we produce them locally or not does not matter – if there is a market need, those workers will be trained somewhere and they will fill the available jobs. It does not matter if we have the medical school here or not.  Those jobs will occur anyway if the market demands them.

The genuine economic impacts are those of the health science center and WSU-Spokane itself, not the growth of the health care industry overall.

Finally, the statewide impacts.  And once again, the largest single component is growth of the health care industry. The following chart title is incorrect – this chart refers to the employment impact and the vertical scale is the number of jobs created state wide due to the Spokane Riverpoint campus health science program.

Outside of health care industry growth (which I argue will happen whether or not there is a medical school here), almost all of the growth in the other categories is in the last 7 years of the forecast period. The next chart shows the sum total economic impact for Eastern Washington.  As can be seen, about half the forecast impact occurs in the last 7 or 8 years of the 20+ year period – when the growth curve accelerates.

This puts most of the big growth way into the future when:

  • The ability to forecast accurately is the least likely due to it being impossible to make assumptions 14 to 20+ years in the future with any accuracy.
  • No one will look back at the original forecast

It appears the economic impacts of a Spokane medical school will be less than that advertised by promoters.  A reasonable guess is that the actual impact will be less than half of the top line number – which is not a bad result either.

Please read past comments on the art and difficulty of forecasting here.

I could be completely wrong but there is a lot of wiggle room in this economic impact forecast.  It would be better to see and understand the full range of forecasts and assumptions. Unfortunately, local promoters have misled the community about the impact of the medical school. An accurate statement would be that the WSU-Spokane health science center will have many economic impacts on the region, but the impact of the medical school is just one component of that.

The first sentence of this news article: “Jun. 11–A four-year medical school in Spokane would support more than 9,000 new jobs by 2030 and generate $1.6 billion in new economic activity, a new study says.” illustrates the effectiveness of misleading public relations. The statement appears to be completely wrong – and twisted into a lie.

Update: Controversy as UW bad mouths the WSU-Spokane medical school program and fails to recruit sufficient 2nd year students for the WSU-Spokane located  UW-WWAMI medical school program.

Data Tables

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