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Oil patch health-care facilities stressed as populations grow

An architect's sketch shows the Ambulatory Care Center under construction at Mercy Medical Center in Williston an addition driven by the increased demand for services that's been generated by the oil boom in western North Dakota.

WILLISTON -- Mercy Medical Center is dealing with a baby boom and a sharp increase in medical emergencies and clinic visits resulting from the area's oil boom.

The medical center at the hub of the thriving Bakken Formation has $25 million in expansion projects in the pipeline as it scrambles to handle the spike in demand for health services.

"We just were not equipped for the influx of young people and families," said Matt Grimshaw, chief executive of Mercy Medical Center.

Health-care administrators throughout North Dakota's Oil Patch echo that comment as their staffs strain to handle the tide of new patients.

Many report they are struggling to hire at all levels, provide affordable housing for their employees, and keep up with soaring medical emergencies from accidents in oilfields and roads clogged with truck traffic.

Trinity Health in Minot has seen its emergency department caseload double in six years to 40,000 visits a year.

"Our volume is increasing exponentially," said Dr. Jeffrey Sather, director of Trinity's emergency department. "We see a pretty heavy shift to trauma."

Trauma cases run the gamut: burns, falls, explosions, chemical inhalations, crushing injuries, traffic accidents. It's not uncommon for Trinity's helicopter air ambulance to make three or four runs a day, Sather said.

Also, three of every four burn transfers from North Dakota to Minneapolis are transports from Trinity, Sather said.

Williston's Mercy Medical Center illustrates the dilemmas of growth that have become common among health providers in the Oil Patch.

Only three years ago, the health center's hospital downsized to a 25-bed critical access facility to address what administrators then predicted would be a dwindling and aging population.

Combined, urgent care and emergency room visits have doubled in the past three years, Grimshaw said.

"That's an incredible statistic," he said, noting urgent care services weren't even offered three years ago. "Trauma cases have gone up


Williston's population now is estimated at 23,000, much higher than the 14,716 census count in 2010. It's expected to climb to 40,000 in six or seven years, Grimshaw said.

To provide affordable housing for health-care workers, the medical center is working with other nonprofits and local governments.

Affordable housing programs have income guidelines set below those of many health-care workers, yet their paychecks often fall well below those paid by the oil industry, Grimshaw and other health administrators said.

The pay gap also is making it difficult to keep and attract staff, as employers in other sectors have reported. Medical centers are paying signing bonuses as well as lots of overtime, and resorting to hiring temporary doctors and nurses as they search for permanent hires.

Temporary replacements are expensive, said Dan Kelly, chief executive of McKenzie County Healthcare Systems in Watford City.

"We are aggressively recruiting," Kelly said, including nationally. Also, some inquiries are coming from people aware of the labor shortage in the Oil Patch.

Emergency medical staffs, which often rely on volunteer ambulance crews, also are feeling the strains.

A recent case in point: the emergency department at Watford City had to handle four trauma cases at the same time.

A medical transfer case can easily last six or eight hours, consuming an entire work day for volunteer ambulance crews, Kelly said.

To help meet the demand, Kelly said health providers likely will turn to oil industry companies for help to maintain services.

"I'm reaching out to the oil companies because they need us," he said. "I'm just putting my foot in the water."

At the Mountrail County Health Center in Stanley the influx of new people to the area also has meant an increase in bad debts, said Lowell Herfindahl, interim chief executive.

"We're trying to collect money when the patient is here," he said. "We don't refuse service to anybody, but we're going to be more aggressive about collecting money upfront."

The increase in uncollectable medical bills is common in the Oil Patch, and could threaten some small hospitals already caught in a squeeze between reimbursements and costs, said Jerry Jurena, executive director of the North Dakota Hospital Association.

"At facility after facility the bad debt has gone up two- or three-fold," he said.

Administrators at St. Joseph's Hospital and Health Center in Dickinson, 132 miles south of Williston, are experiencing a less intense version of the boom.

"We're about a fourth the activity that's going on in Williston and we think we're busy," said Reed Reyman, the medical center's chief executive.

Still, with predictions that the oil boom will head south, with development of the Tyler Formation, St. Joseph's wants to be prepared.

"It's filtering down this way, definitely," Reyman said. "We're starting to feel that."

He added, "We're working on a master facility plan," noting that plans are in early stages for a new hospital on a site near Interstate 94.

The hospital, which next year will observe its 100th anniversary, is not as efficient as more modern facilities, Reyman said.

"It's a balancing act without the energy boom," he said. "It's like juggling. We feel we have six or seven balls in the air all the time."

Minot's Trinity Health is also expanding its clinical space and adding locations to better handle its sprawling service area in northwestern and north-central North Dakota.

Trinity is mulling two locations for a possible new hospital, as well as recruiting physicians and other health professionals. It's main hospital, downtown, has no room for growth, Sather said.

Minot's population, 40,888 according to the 2010 census, now is estimated to exceed 50,000 and could double to 100,000 in the next five or 10 years, he added, as the city is becoming a hub for the oil industry.

"You've got to see it to believe it," he said of the traffic congestion, waiting lines and growth that are associated with the oil boom.

Trinity Health, the second-largest hospital system in North Dakota after Sanford Health, added 80 doctors and mid-level practitioners in the last two years and is trying to hire more than 60 nurses.

"We have a whole wall of job openings," Sather said.

By all indications, health administrators in western North Dakota expect the energy boom to continue for at least two or three decades.

"We've got to learn to live with this," Kelly said. "It's overwhelmingly good, but it's not all positive."

Springer is a reporter for The Forum of Fargo-Moorhead, which is owned by Forum Communications Co.