When Dale Marshall, a rancher from the Saco, Montana, area, suffered a heart attack, the 1-hour-and-15-minute drive over 15 graveled miles plus 50 paved miles of U.S. Highway 2 could have been deadly, and not just because of winter conditions. For more than half of Montana residents, medical care is distant.
The Department of Agriculture’s Economic Research Service’s 2016 figures show 674,907, or 65 percent, of Montana’s 1,042,520 residents live in rural settings. A University of Pennsylvania School of Medicine’s 2009 study found that only 8 percent of Montanans live within an hour of a major, higher-volume emergency-room facility.
WWAMI, Montana’s medical school program, is designed to help fill the gap by supplying more family doctors for rural communities. Through a partnership with University of Washington School of Medicine, Montana medical students study at Montana State University in Bozeman, and finish medical schooling rotations throughout the West. (WWAMI is an acronym for the states that participate in the cooperative – Washington, Wyoming, Alaska, Montana and Idaho.)
One of those WWAMI students, Justinn Marshall Lahaye, not only trains in Glasgow’s Frances Mahon Deaconess Hospital, she was born there 25 years ago—and her father, Dale, was initially treated there for his heart attack.
“I got into medicine mostly because of my dad,” says the 2010 Saco High graduate. “I was in the hospital visiting him when I became interested in the medical field.”
The University of Montana-Western in Dillon alumna like all WWAMI students initially paid Montana State tuition and then Washington’s in-state tuition, about $34,000 per year. Montana subsidizes tuition with $5.4 million annually for the 30 students per class year, about $5.40 per capita per year.
Lahaye joined the Targeted Rural and Underserved Track (TRUST) program, which sends doctors-in-training to rural primary care settings.
TRUST students return to the same rural hospital periodically throughout the four years of medical school, a unique long-term experience, nonexistent at most medical schools.
Lahaye finds “arching connections between growing up on a ranch and working in rural medicine. I grew up working hard. You don’t get weekends off until all the work is done. It’s the same in rural medicine. You can’t just leave a patient hanging, like a woman in labor. You stay for the delivery and beyond.”
While Lahaye’s father’s recovered from his heart attack, his experience remains common.
A study published in JAMA Surgery in 2017 found that “Most high-risk trauma patients injured in rural areas were cared for outside of major trauma centers and most rural trauma deaths occurred early (in treatment).”
Glasgow WWAMI lead preceptor, Anne Millard assures that her students, including Lahaye, experience all areas of medicine, trauma to obstetrics.
“The WWAMI program is very import to Glasgow because without exposure to the kind of medicine we practice, students wouldn’t think about coming to the high plains. Through the TRUST program, students see all the things we can do in a critical access hospital.”
She notes a need for more physicians.
“If you had to have an appendectomy and no surgeon was available, you’d be flown 280 miles to Billings,” says Millard. “Without the Montana WWAMI program and the new doctors it creates, everyone will be negatively impacted by a lack of physicians.”
Lahaye, stethoscope in hand, saddle, boots and rope in her truck, and her family’s ranch in mind, laughs, “I want to practice somewhere rural. I like the small-town feel.”
Jean Arthur is an author and writing instructor at Montana State University. Her most recent book is Top Trails: Glacier National Park. Must Do Hikes for Everyone, published by WildernessPress.
This article was submitted to the Daily Yonder by Montana WWAMI Clinical Education.