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Experts say rural emergency rooms are increasingly run without doctors

SOUTH DAKOTA, UNITED STATES, AUG 7 – A 2022 study shows 7.4% of U.S. rural emergency departments lack 24/7 attending physician coverage, mainly affecting small, low-volume hospitals, experts say.

  • Researchers found that many rural emergency departments lack 24/7 attending physicians, with some Montana hospitals operating without on-site doctors during early June, sparking concerns.
  • In Ekalaka, Montana, the three-bed ER depends on physician assistants and nurse practitioners, with patient volumes averaging one or two daily, and has not had a physician on-site for at least 30 years.
  • Experts suspect rural emergency rooms increasingly operate without doctors, supported by some health providers and advocates noting the role of experienced physician assistants.
  • In response to coverage gaps, Dowdy said the ER will acquire virtual reality glasses for remote physician assistance, with no mention of Sanford Health launching a residency.
  • In the Dakotas, experts suspect ERs without doctors are increasing, although data shows at least 7.4% of U.S. emergency departments lacked 24/7 physicians in 2022, with Camargo urging lawmakers to fund coverage mandates.
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Pennsylvania Capital-Star broke the news in on Wednesday, August 6, 2025.
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