Experts say rural emergency rooms are increasingly run without doctors

Physician assistant Carla Dowdy (left) takes notes while treating a patient in the Ekalaka, Montana, hospital as nurse Willow Meyer works nearby. (Arielle Zionts/KFF Health News)

EKALAKA, Mont. — There was no doctor on-site when a patient arrived in early June at the emergency room in the small hospital at the intersection of two dirt roads in this town of 400 residents.

There never is.

Dahl Memorial’s three-bed emergency department — a two-hour drive from the closest hospital with more advanced services — instead depends on physician assistants and nurse practitioners.

Physician assistant Carla Dowdy realized the patient needed treatment beyond what the ER could provide, even if it had had a doctor. So, she made a call for a medical plane to fly the patient to treatment at Montana’s m