EDs in small towns continue to deliver more with less
Dahl Memorial Healthcare Association
Ekalaka, Mont.
Dahl Memorial’s emergency department in rural Montana relies on physician assistants (PAs) and nurse practitioners to manage critical cases. Patients requiring care beyond its capabilities are medevacked to Montana’s top hospital after stabilization efforts on-site.
This situation reflects a broader trend in rural emergency care, where staffing shortages and financial constraints have led more than 90% of small or critical access hospitals, like Dahl Memorial, to depend on advanced-practice providers.
Many contend that experienced PAs and nurse practitioners, with proper support and consultation access, can effectively manage ERs, especially in rural areas where recruiting doctors is difficult.
Dahl Memorial’s balanced approach includes strict hiring standards, remote physician oversight, and ongoing training for its staff, earning strong community support.
Ben Bruski is one recent patient who had to visit the ER after a cow on his family ranch kicked a gate, smashing it against his hand. And he knows other people who’ve been treated for more serious problems.
“We’ve got to have this facility here because this facility saves a lot of lives,” Bruski said.