Nestled between mountain passes, Missoula, Mont., is surrounded at a distance by scattered farming towns and two First Nations reserves. People here who need medical care can face treacherous drives through winter storms, white-knuckling their way 300 miles to the town of 72,000—which, despite the vast distance, is home to the hospital nearest them.
When it comes to GI care, Missoula gastroenterologists typically do not go beyond performing procedures.
“The gastroenterologists of old were intellectual and loved the medicine part of things. They did endoscopies, but their passion was treating the disease,” said Nicole Finke, MD, chief of staff and medical director of laboratory services at Community Medical Center, in Missoula. “In general, younger gastroenterologists tend to have a real passion around doing scopes and ERCPs [endoscopic retrograde cholangiopancreatography] and are less focused on holistically managing disease long term.”