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Old 01-21-2014, 11:43 AM
 
Location: Montana
37 posts, read 35,480 times
Reputation: 36
Default It's official. Montana at the bottom with hospitals.

Montana ranks 48th among states in providing emergency care | KXLH.com

You can see state by state results here: State Rank by Category

Or visit U.S. News and World Report U.S. News Best Hospitals 2013-14

I've been vocal about having bad experiences at St. Peter's in Helena. It's unacceptable in a region like this not to have competent emergency services. I lived in a more rural environment in Nevada which had better ER availability and medical options than Montana. I didn't move here for the medicine but it's rather disheartening to see the lack of it. As well as options and specialists for disabled kids. Heard from one too many moms, fed up, opting to leave the state to seek providers elsewhere.

Now, this isn't to bash Montana. It's a land where you better darn well figure out how to survive without services on every corner. But inept hospitals is no excuse.
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Old 01-21-2014, 12:46 PM
 
Location: Where the mountains touch the sky
2,590 posts, read 1,859,309 times
Reputation: 3210
In reading the article, the criteria used for the ratings were:

Access to Emergency Care:
In a rural state, access is going to be tough as it may be several hundred miles to the nearest major medical facility, and in some cases, you may have an hour or more wait for an ambulance to even get close to where you are especially if there is inclimate weather.

Quality & Patient Safety: That is going to vary between hospitals and between small town hospitals and larger facilities. To lump them together as we only have major hospitals in Great Falls, Kalispell, Butte, Missoula, Bozeman Helena and Billings.
All the rest are small facilities, some very small. Disengenous to lump them all together.

Medical Liability:
Not sure what they mean by this one unless it has to do with malpractice insurance.

Public Health & Injury Prevention:
Most small hospitals have very limited resources for these kinds of programs, and usually only put out health warning fliers or notices, and sometimes offer classes, but I don't see hospitals going into the workplace to talk about proper lifting techniques or checking to see if all safety guards on equipment are in place.
Again, this is a very rural area and our main industries are agriculture, timber and mining, all high risk jobs.
It seems to me it is more the responsibilty of State Fund to provide safety training etc. for injury prevention.

Disaster Preparedness:
I have worked in Emergency Services with local hospitals, and honestly, most of them don't have the time and manpower or funds to have huge data bases with contingency plans and people whose only job is to think up new emergency proceedures. Most of them comply with state and federal requirements, but can't dedicate the resources to go further.
The hospitals I have worked with for disaster preparedness are always willing to do everything they can, and make changes when problems are noted, but cannot allocate a lot of money to it.

Looking at the list of best hospitals also points out, we don't have major teaching hospitals such as the Mayo Clinic or Johns Hopkins. We don't have the size or numbers for that kind of facility.

I agree, I have had issues with St Pete's before as well, but most of that has been with the administration not the people actually working there.

I have had issues with Livingston Memorial as well, but had great service at Big Timber, Harlowtown, Bozeman, Great Falls, and Billings.

All the emergency people I have worked with from several hospitals, with only a couple exceptions, have been very dedicated and competent.

No, we don't probably measure up to states with denser populations and more money, ( I see that Wyoming actually scored as 51?), but aside from burns especially where the patient would have to be airlifted to Salt Lake City for example, I think most of our medical facilities do just fine.

Could they do more? Probably, but the same could be said for nearly every industry.

Personally, I usually go to the smaller towns for medical care if I can, like Townsend or Big Timber because the people that work there seem to have the time to treat you as a person, not an insurance card number.

I have had proceedures done at St Pete's, as have my wife and father, the medical work was done just fine, the administrative stuff was a morass of bureaucracy at best.

I dont' have a problem going to any specific medical facility in the state, certain doctors yes, but overall I think most of our hospitals do a good job for the resources they have.

Just my 2 cents.
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Old 01-22-2014, 07:51 AM
 
Location: Idaho
783 posts, read 342,862 times
Reputation: 1273
Veterans don't fare any better and can be worse; try 3 month waits for appointment at Kalispell clinic.

This wasn't long ago:

"At least 300 Montana veterans who need orthopedic surgery are on a waiting list while the Department of Veterans Affairs Montana Health Care System works to recruit a full-time surgeon to help ease the growing backlog of disabled and often disgruntled veterans.[LEFT]
To receive surgery, Montana veterans without private insurance must travel out of state for care or pay for it out of their pockets. To compound this problem, Montana veterans are being told that the VA facilities in Denver and Salt Lake City are too busy to accept Montana patients. Subsequently, they are being placed on a waiting list that is approaching two years..."[LEFT]
300 Montana veterans wait for orthopedic surgery as VA tries to recruit surgeon

.
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Old 01-22-2014, 08:06 AM
 
Location: Spots Wyoming
17,164 posts, read 20,715,102 times
Reputation: 10385
Quote:
Originally Posted by MTSilvertip View Post
- snip -

( I see that Wyoming actually scored as 51?)


Well, according to President Obama, there are 57 states, so at least Wyoming isn't last.
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Old 01-22-2014, 08:13 AM
 
Location: Spots Wyoming
17,164 posts, read 20,715,102 times
Reputation: 10385
Quote:
Originally Posted by notoriouskelly View Post
Veterans don't fare any better and can be worse; try 3 month waits for appointment at Kalispell clinic.

This wasn't long ago:

"At least 300 Montana veterans who need orthopedic surgery are on a waiting list while the Department of Veterans Affairs Montana Health Care System works to recruit a full-time surgeon to help ease the growing backlog of disabled and often disgruntled veterans.[left]
To receive surgery, Montana veterans without private insurance must travel out of state for care or pay for it out of their pockets. To compound this problem, Montana veterans are being told that the VA facilities in Denver and Salt Lake City are too busy to accept Montana patients. Subsequently, they are being placed on a waiting list that is approaching two years..."[left]
300 Montana veterans wait for orthopedic surgery as VA tries to recruit surgeon

.
VA???? A 2 year waiting list, doesn't sound too bad.

My doctor, at the Sheridan VA, sent me to Sturgis South Dakota, Ft. Meade, for "Immediate Knee Replacement". that was because Sheridan doesn't do surgery's, and Cheyenne was booked solid and so was Denver. The Sturgis VA has a 16 month back log for Knee replacement. That is because the VA only allows Sturgis to do ONE knee replacement per week. 16 month back log.

Did I mention that my doctor sent me to Sturgis for "Immediate Knee Replacement"? In 2010. Yup, 4 years ago. I have an appointment on the 5th of February and at that appointment, my surgeon is going to determine if I should be added to the list, or if he is going to send me out of system. If they send me out of system, they will be sending me to Billings. By the way, that is for a "Service Connected" injury.
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Old 01-22-2014, 09:36 AM
 
634 posts, read 461,234 times
Reputation: 463
Very few places in Montana will be able to have a 10 minute response time for emergency anything; police, fire, ambulance or lifeflight helicopter.
Everyone needs know rudimentary emergency care methods and have solid kits of first aid supplies on hand at a minimum.
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Old 01-22-2014, 10:55 AM
 
Location: Where the mountains touch the sky
2,590 posts, read 1,859,309 times
Reputation: 3210
Quote:
Originally Posted by historyfan View Post
Very few places in Montana will be able to have a 10 minute response time for emergency anything; police, fire, ambulance or lifeflight helicopter.
Everyone needs know rudimentary emergency care methods and have solid kits of first aid supplies on hand at a minimum.
I completely agree.
I was a first responder on a fire department for 12 years, my advise is for everyone to know first aid / CPR.

Much of the state is wilderness with no access to extraction by road. A friend of my father's was dumped when his horse shyed at a grizzly. My father had to leave him, ride 3 miles to get to phone service, then wait for the search and rescue, lead them back and even though they had one of those 6 wheel things, he had to hook his rope to them and drag it part way up there with his horse. Took about 4 hours for medical help to arrive. While the friend was lying there with a broken hip, he could hear the bear still circling the meadow. Long wait.

I know of cases where folks were injured in wilderness areas, so they couldn't even land a chopper to get them out due to the stupid wilderness rules.

When you have a big state with a small population, you won't have the services available you would in a more densly populated place.

Although I hear it is taking upwards of 45 minutes for a response from emergency services in Detroit these days...
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Old 01-22-2014, 02:44 PM
 
Location: Small town Montana
1,168 posts, read 1,194,631 times
Reputation: 2282
Having lived in the Seattle area for most of my life and then moving to a small town in Montana, I take studies like this with a grain of salt.

Of course, larger cities with higher populations are going to have better (usually) healthcare facilities. There is more money, more need, more demand, etc... for those things when there are many more people in the area.

Imo, it is like comparing AAAA school districts to C districts. You can hardly compare the Willow Creek school to one in Beverly Hills.
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Old 01-22-2014, 05:20 PM
 
Location: Tulsa, OK
964 posts, read 1,143,941 times
Reputation: 722
The VA hospital, or lack therof, in Montana has been a sore spot with Montana veterans for years. For whatever reason, the VA just believes that Montana doesn't deserve one. Not really sure why. Maybe that particular beurocrat is related to the one that forced that eye-sore of a Federal Courthouse down the city of Billings throat.

Montana Senators have been trying to get one for years without success.
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Old 01-23-2014, 01:11 AM
 
2,674 posts, read 1,521,536 times
Reputation: 3652
Quote:
The 2014 Report Card evaluates the conditions under which emergency care is delivered during a time of mounting pressure it does not attempt to measure the quality of care provided by hospitals and emergency providers.
If they don't evaluate the quality of care provided by hospitals and emergency providers, then as far as I can seel it is a worthless study and evaluation as the above quote is from their study.

I ended up in the local emergency room this morning, due to my heart went out of rhythm. It is back in rhythm now. I arrived at the emergency desk, and taken immediately to an exam room within 1 minute after arriving and within 10 minutes was out of clothes and into a gown and hooked up to test machines. In that time, they had pulled up on the computer all my medical records for several specialists I have, as well as my primary doctor. I had extremely excellent care. I know I would not have had this fast treatment from those big city hospitals they rate so highly.

When you consider that Montana is the 4th largest state in the nation, with less than 1,000,000 people, you have to realize that there are many parts of the state, where it is a long way from a hospital. The same can be said for some other large states with few people. Montana has some great hospitals, but only in the populated areas. Small hospitals in very small towns a long ways apart. In Billings the largest city of only 100,000 people, they have two outstanding medical systems. Billings Clinic, and St Vincents. Billings Clinic is a huge medical facility suitable for a much larger city. Reason it is the major center for part of Southern Canada, Montana, Northern Wyoming, western sections of North and South Dakota. They are affiliated with the Mayo Clinic system. Different specialists train nurses at the small medical clinics around the state, to have video conferences with the specialists in the major hospital, with the nurses taking the tests for the doctors. This way even a small town medical clinic can work with the best doctors in the system, or hook into Mayo Clinic System as needed.

They have won a few awards,

https://www.billingsclinic.com/awards

Billings Clinic TCU Receives Highest Rating from U.S. News and World Report

Billings Clinic Joins Mayo Clinic Care Network Mayo Clinic News Network

U.S. News rating is better than national average.

Billings Clinic in Billings, MT - US News Best Hospitals

It covers a lot of area, much more area than the entire North Eastern United States, in providing service.

To get people to the hospital, they have 2 helicopters and and for over 150 miles, they have 3 twin turbo aircraft. They are one of the few hospital systems that own their own fleet of helicopters and aircraft. Each staffed ready to go, with pilots, and trauma nurses. If the ambulances cannot get the people to the hospital fast enough, they send out the air fleet to bring them in. I know as we live 50 miles from the hospital in Billings, they stabilized my daughter at the local hospital, and sent her down to Billings to the bigger hospital by helicopter.

When you live a long way from any population centers such as happens in Montana where the cows far outnumber the people, you don't have ambulances that can get them to a hospital in 10 minutes. You don't have all services you would like in every tiny town.

We do have in the larger cities great hospitals, with dedicated staff. Billings Clinic has smaller medical facilities around the eastern part of the state. Smaller hospitals, and medical clinics. Ours has a newer hospital, 2 full time doctors in the clinic that have been her for over 20 years their first place after school, and are both top doctors with different specialties. There is also a Nurse Practitioner. And specialists come in multiple times month, from Cardiologist to Orthopedic Doctors. There is a great staff of doctors that come into the clinics as relief for the regular doctors when one will not be in the office. Excellent long time nurses, and excellent Rehab Facility. The doctors, nurses, and rehab staff are all here long term, not just to get some experience and leave.

They have been fully into computer data systems for years, so a doctor in one office, can see the entire medical file on any patient anywhere in the system so if referred to a specialist as an example, they can pull up your entire record, not just part you may hand carry in. Go to X-Ray and 5 minutes later you can be in your doctors office and he is reviewing the records.

Remember the report that the OP posted, says in their report...... it does not attempt to measure the quality of care provided by hospitals and emergency providers. I think quality is what is important.
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