Every year, as part of the Montana Town Project, University of Montana School of Journalism students pick one little rural town in Montana and descend upon it to discover what unique stories it might hold. In this year’s target, a town surrounded by mountains with the incongruous name of Plains, Mont., (population 1,126), student Amy Fox stumbled upon the Clark Fork Valley Hospital.
By definition, CFVH is considered “frontier medicine” rather than rural medicine because of its size. The hospital only has 16 beds. To be considered rural, a hospital must have over 100 beds. The number of beds in a hospital typically represents the kinds and number of services the hospital can offer. With its own cardiologist, surgeon, anesthetists, and a full nursing staff, Clark Fork Valley Hospital is far from what one may think of as “frontier”.
In what I assume is a tribute to both the hospital’s size and small-town Montana accessibility, Fox was able to get an unusually candid portrait of the difficulties of administering a hospital on the edge of sustainability. I can’t embed her photographs here, but be sure to take a look. The hospital has trouble recruiting doctors, not because of their location, which is actually quite desirable, but because it’s difficult for doctors’ spouses and families to find work in the tiny community where the hospital is the largest employer. And those employees they do retain have to do more with less.
“We have found ways to be more resourceful,” says Tanya Revier- Marketing Director. “We just switched propane companies and saved over $25,000 that way. Or if someone leaves the hospital to retire or take a different job, we spread the staff we have to cover the vacant position, rather than hire someone new.” Another way they have been able to sustain is by offering more services in order to keep people from travelling elsewhere for their care.
Dr. Damschen says that often, people feel that frontier medicine is often thought of as a lesser practice, as compared to urban medicine. It does not take a person long to understand that, in fact, the opposite is true. Physicians and nurses alike are required to have skills that excel far outside the reaches of what is normal in large hospital settings. It is all about which hat to put on.