Rural emergency rooms are increasingly run without doctors

Nurse practitioner Alex Lovec examines Ben Bruski during a visit to the clinic at Dahl Memorial Healthcare Association in Ekalaka, Montana, for help with his allergies. He says he's happy with the care he's received from the hospital's emergency room and that he knows people who were saved by its providers. (Arielle Zionts | KFF Health News

EKALAKA — 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 tr