Montana’s lack of family physicians impacts patients’ financial wellbeing

Dr. Christina Marchion, who was out delivering a baby when photos for this story were taken, is the only obstetrician serving a 100-mile radius.

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News-Argus file photo


Three years ago, 120 newborns arrived at Lewistown’s Central Montana Medical Center, yet only one full-time family physician who practiced obstetrics worked at the Central Montana facility – the only full-time family physician practicing obstetrics within 100 miles.

“Last September, we did five births within 24 hours,” said that physician, Christina Marchion, an Anaconda native and full-time family physician. She is a graduate of Carroll College and Montana’s medical school, the WWAMI program, an acronym for states participating in the medical school cooperative: Washington, Wyoming, Alaska, Montana and Idaho Medical Education Program.

“I’m the only OB in town,” she said, noting that a retired physician works occasional weekends so Marchion has time off. “Burn out is huge in rural healthcare. We are sticking a bandage on a festering wound.”

Today, 686 primary care doctors practice in the Big Sky state, an insufficient number. Currently, 12 of the state’s 56 counties lack a single physician, and 10 counties have only a single primary care doctor each.

Montana’s current physician workforce data reveals a critical shortage of primary care physicians in many underserved areas of the state. That acute lack of primary care physicians ultimately impacts not only patient health but the scarcity of doctors affects patients’ financial security as well.

National Institutes of Health finds that “About 20 percent of the U.S. population – more than 50 million people – live in rural areas, but only 9 percent of the nation’s physicians practice in rural communities,” resulting in higher patient costs for medical, travel, lodging and food if no primary care physician practices near home.

In fact, Kaiser Health News found that often, patients pay more at rural hospitals than urban hospitals; a fact that could worsen as rural physicians retire and new physicians stay in cities. Kaiser Health News’ statistics reveal that in particular, rural Medicare patients pay 20 percent more for the same services provided in an urban outpatient center.

Marchion is among 638 WWAMI-graduate physicians who are countering the dire statistics since WWAMI was founded in 1971. Notably, 41 percent of the Montana WWAMI grads returned to the Treasure State to practice – beating the national average of 38.7 percent who practice in the state where they were educated. When graduates from the four other WWAMI states are added to this Montana return data, the number rises to 57 percent returning to practice in Montana.

Marchion is helping to alter that profile of Montana as both a WWAMI graduate and a WWAMI faculty member.

Every August, 30 Montana WWAMI students begin 18 months of medical school training in Montana. The University of Washington School of Medicine curriculum is taught synchronously across all five WWAMI states. Students complete clinical rotations throughout the Northwest; 17 Montana communities host more than 40 clerkship opportunities, including the clerkship in Lewistown, where the students experience all aspects of rural medicine.

The state supports WWAMI through $5.4 million in annual funding, which saves taxpayers’ dollars by placing physicians in rural communities, costing $5.40 per year per capita.

There are births and deaths and illness and wellness, yet, said Marchion, “There are not enough docs. We need more providers.”



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