Categories: HEALTH & WELLNESS

Review of Central Montana Medical Center in Lewistown, Montana

Like most small towns, Lewistown, Montana prides itself in its hospital. Central Montana Medical Center serves a huge area, over 17,000 square miles, as it is the largest hospital between Billings and Great Falls. They are one of the major employers in Lewistown, and pride themselves in hiring qualified staff. Their seventeen resident physicians and fourteen visiting/consulting staff members offer services including inpatient surgery, rehabilitation, diabetes management, nutrition education, and diagnostic imaging. To the outsider, CMMC looks like a typical rural hospital.

The story goes deeper than that. Many of the locals do not realize what goes on within the walls. While the medical staff- including nurses, physicians, and EMTs- are well trained, they lack many of the critical life saving tools commonly found in more urban areas. Many locals are not aware of this, and their health and survival depends on them becoming educated about what they need to do to protect themselves.

The ambulance service includes crews in most rural communities, and they claim that they can reach most emergencies in seven to nine minutes. While this is certainly true in town, the rural areas are another story. When an emergency call comes in, the ambulance crew must first be paged to respond. Because the rural communities receive so few calls, many of the ambulance crew members are living their every day lives at the time of the call, whether this involves haying, calving, fixing fence, or performing many other ranch chores. The crew must then respond to the barn (yes, it really is a barn) and prepare the ambulance for the call. Once everyone on the crew has arrived, the ambulance must head to the location of the call, which may be many miles from town, and may not necessarily even be on a road. After they retrieve the patient, they drive to the hospital, which may be fifty or seventy five miles away. Often, in critical cases, they ask Lewistown Ambulance or Mercy Flight out of Great Falls to intercept.

Lewistown Ambulance’s crew is dedicated and well trained, but, unlike ambulance crews in larger cities, they do not have any paramedics. They do have some Intermediates, but the majority of their responders are EMTs. While being treated by an EMT in an ambulance is certainly better than transporting in a private vehicle, many advanced life saving techniques cannot be performed until the patient reaches the hospital. In town, arrival may take only a few minutes, but in rural areas, arrival can be a half hour or more.

The emergency room staff is well trained to handle any emergency, however, the emergency room is small and patients are categorized according to the severity of their symptoms. Some patients who are not critically injured may be left waiting for hours before a physician is available to see them. During that time, the patient could have driven to Billings or Great Falls. If a patient is admitted to the hospital after an emergency room visit, they are no longer cared for by the physician who initially treated them. For those who do not have a local physician, this means they are being treated by someone who does not know their medical history and who may not understand all of the symptoms the patient is having. This leave room for error, and this is where many patients are hurt, rather than helped, in the hospital.

The stories are tragic. A woman with sleep apnea who was admitted to the hospital for a back injury stopped breathing during the night. Nurses did not notice until it was too late. The patient suffered severe brain damage and was taken off life support a week later. A man with severe burns did not have his bandages changed in a timely manner, in fact they did not bandage him at all. The nurse covered him in silvadyne cream and did not wrap it. He suffered infection, and recovery was a long journey. He still has severe scars from his ordeal. The tragedies are kept quiet. Like any hospital, people will die, but some deaths can be prevented.

The best way to prevent these tragedies is for the public to educate themselves. After they are diagnosed, they should learn everything they can about their condition. WebMD provides information on many conditions and appropriate treatments for them. If a physician is not treating a condition appropriately, they should be informed and another physician found. This may require moving to another facility. People go to the hospital to be helped, not harmed, even inadvertently. Education is the best prevention.

CMMC’s story is not unique. Small hospitals across the nation have the same problems. Nurse shortages, exhausted physicians and overcrowding all contribute to errors. The public needs to know their hospitals strengths and weaknesses. The hospital administrator will have this information. Patients need to be aware of who will be responding when they have an emergency and who will be treating them with what methods when help arrives. The best way for the public to stay safe is to know what to expect. This is the only way to prevent future tragedies.