WILLISTON, N.D. -- If you're not an established patient at Williston's Mercy Medical Center, it can take weeks to get an appointment for an acute need.
The clinic starts each day with open slots on the schedule for current patients who need to get in, but those usually are filled by 10 a.m., said CEO Matt Grimshaw.
The medical provider is rapidly changing to meet the demands of the population growth driven by oil development, but the lack of affordable housing and available day care is making it tough to fill staff shortages.
Grimshaw said there is enough demand for 10 new physicians right now.
"We simply can't hire them fast enough," Grimshaw said. "We have highly qualified applicants from all across the country who are willing to pick up and move to Williston, N.D., for the opportunities here, but the lack of available reasonably priced housing is a huge barrier."
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A group of western North Dakota health care officials meet monthly to share best practices and discuss potential solutions.
"As the business of health care has changed with this significant influx of population, we have to change our business practices," said Dan Kelly, CEO of McKenzie County Healthcare Systems in Watford City, who leads the group.
Among the changes McKenzie County Healthcare Systems has implemented to recruit more physicians is to partner with St. Alexius Medical Center in Bismarck. The arrangement would have doctors work three weeks in Watford City and one week in Bismarck so they would have the camaraderie and access to resources of a larger facility, Kelly said.
While McKenzie County hasn't yet signed a new doctor with that arrangement, it seems to have potential.
"It does seem to be bringing about a heightened interest in Watford City," Kelly said.
A challenge for many of the oil-impacted communities is responding to an increase in volume and severity of trauma cases, many traffic-related.
McKenzie County recently began using technology in the emergency room that allows doctors to push a button and be immediately connected to emergency room physicians in Sioux Falls, S.D., who can provide guidance or get consultations from specialists.
That is particularly helpful when the ER is handling multiple trauma cases at once, which is happening more often, Kelly said.
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In Williston, Mercy Medical Center is in the midst of a $30 million expansion, which includes tripling the size of its emergency room and adding a new birthing center. Mercy expects to break ground soon on a cancer center that would open next year.
"We are likely the fastest-growing hospital in the country at this point," Grimshaw said.
One new approach Williston is implementing is to offer out-patient births in its new center for mothers who have no complications. It will be the first out-patient birthing program in the state, Grimshaw said.
About 300 babies were born each year in Williston before the recent boom in oil activity brought thousands of jobs and new residents to the region. Next year, 800 births are projected Willistion, he said.
Mercy Medical also has recently recruited an occupational health specialist and is adding a pain management specialist, Grimshaw said.
Also Minot-based Trinity Health is constructing a new clinic in Williston that will consolidate its services into one location and provide additional space. The 60,000-squre-foot facility, expected to open by this fall, will have space for seven physicians, three opthamologists and five optometrists.
In Dickinson, St. Joseph's Hospital and Health Care Center -which, like Mercy, is part of Catholic Health Initiatives - has seen some similar challenges, but is unique compared to some of the other oil-impacted communities, said CEO Reed Reyman.
St. Joseph's was not operating at peak capacity before the oil activity and had infrastructure in place to accommodate new patients, Reyman said.
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Leaders in Dickinson also were able to watch some of the changes happening in Williston, Watford City and other areas and be more prepared, he said.
Plans St. Joseph's had in place for future expansions were accelerated to meet the needs, Reyman said.
St. Joseph's has seen turnover, but the provider has been able to fill those positions more quickly, he said.
"We're a lot different in so many ways," Reyman said.
As the group of health care leaders continues to meet, they'll begin talking more about proposals to bring to the Legislature in areas the state may be able to help, Kelly said.
In the meantime, they're looking for new and creative ways to meet what they consider the "new normal," he said.
"We've got to continue to look outside the box," Kelly said. "We've got to try new things to keep our doors open."
Dalrymple is a Forum Communications Co. reporter stationed in the Oil Patch. Reacher her at adalrymple@forumcomm.com or (701) 580-6890.
