The Prairie Doc: Rural medical systems are in crisis in South Dakota, across nation

Dr. Matthew Owens
The Prairie Doc

Emergency medical services in rural America are in a state of crisis.

Difficulty recruiting emergency medical technicians and the financial constraints of emergency medical service agencies are the major causes of this crisis.

The majority of South Dakota is considered a medically underserved area, indicating too few primary care providers, high infant mortality, high poverty or a high elderly population. Most of the area are also designated as rural or frontier, increasing the likelihood of prolonged transport times to hospital-based medical care.

Rural and frontier medically underserved areas are historically served by volunteer emergency medical services. Seventy-three percent of emergency medical service agencies in South Dakota use volunteers. In 2016, 32% of volunteer agencies reported missing calls due to staff shortages. These conditions have led to a disparity in mortality rate for traumas for rural residents.

An ad hoc group comprised of the University of South Dakota School of Medicine, South Dakota State Medical Association, Northeast and West River Area Health Education Centers, Sanford Academic Affairs EMS Outreach and Community Memorial Hospital in Redfield has received funding through the U.S. Department of Labor and Substance Abuse and Mental Health Services Administration to combat the emergency medical service crisis in South Dakota and improve health outcomes for rural residents.

For many students, grant money is available to cover costs of the EMT training available at Sanford EMS Outreach. The synchronous online classes can be completed by the student at home, while the hands-on portion may require weekend travel.

In addition, members of the ad hoc group developed the Dakota Responder class curriculum, the goal of which is to train more people. Through a unique collaboration with Agtegra, a farmer-owned grain and agronomy cooperative with more than 6,300 members-owners in eastern North Dakota and South Dakota, the Dakota Responder classes will initially be made available to Agtegra employees. Those who attend the classes will be trained to provide emergency care for serious bleeding, opioid overdose and use of automatic defibrillators. Agtegra employees in rural areas of the Dakotas are well-positioned to provide life-saving care until EMS personnel arrive on scene.

Ultimately, the goal is to increase the number of trained EMTs to staff rural emergency medical service centers and improve emergency response times. To encourage this endeavor in your community, share this information with your neighbors and contact your legislators and county commissioners to urge their support for local emergency medical service centers where you live.

Dr. Matthew Owens practices family medicine in Redfield. He is a contributing Prairie Doc columnist. For free and easy access to the entire Prairie Doc® library, visit