Community profile: Wolf Point, Montana

NAME:  Mark Zilkoski, M.D.

PRACTICE:  Listerud Rural Health Clinic in Wolf Point, Mont.

Wolf Point, Mont., is the largest community on the Fort Peck Indian Reservation (population 2,600) and is located in Roosevelt County in the historic Missouri River Valley.

The nearest large city is Billings, Mont., which is 320 miles away with a population of approximately 100,000. It’s 92 miles from Williston, N.D., which has about 16,000 people. Approximately every 55 miles, there’s a little town with anywhere from 3,000 to 5,000 people.

Mark Zilkoski, M.D., a native of upstate New York, is a family practice physician in rural Montana. After completing his family medicine residency in Stockton, Calif., he practiced in Wolf Point, Mont., for four years then left to teach at a medical college in Ohio until 1992. Zilkoski returned to Wolf Point in 1992 and has practiced there ever since.

The Listerud Rural Health Clinic, named after a physician who grew up in the area and returned to practice surgery there, is a federal rural health clinic in an underserved area. The clinic was built beside the hospital and was attached later. The hospital owns and runs the clinic.

What role does Listerud Rural Health Clinic play in the community?

In terms of providing health care, it’s pivotal. We have the Indian Health Clinic in town but they don’t do anything in the hospital. They provide only clinic-based health care. Anything more complicated than that is referred to our clinic or the hospital.

How many people are employed in your facility?

Two doctors, two midwives, a nurse practitioner and a physician assistant.

Are you currently recruiting?

We just had two midwives sign. We had another physician but his wife did not like the area, so they ended up leaving. I’m a family practice physician who does mostly internal medicine now, but I’m the only surgeon in town. I do C-sections and occasionally deliver babies when I have to.

The physician who is leaving is in family practice with two years of OB fellowship. So it will be up to me to be the primary surgeon with two midwives doing the deliveries.

Will you be looking for another physician?

Maybe at some point in the future. I think our administrators are always looking for one. We have a sister clinic in Poplar, which is 22 miles away, and they are looking for a physician. It has a population of 800 people.

The one doctor that works with me occasionally goes over there. They currently have two nurse practitioners. We are a part of Northeast Montana Health Services, Inc. Within the 22 miles, there are two clinics and two hospitals.

What are some advantages for physicians to practice here?

I was here from 1980 to 1984 and practiced with the Indian Health Services. I owed them time because they put me through medical school. I left and taught in Ohio for eight years. I came back for a sabbatical and just stayed.

I love it here and I love the type of detailed medicine I am able to practice. If I need help from another physician or specialist, it’s just a phone call away. I love the area, the Badlands. I live on the Missouri River.

I’m a brewer and own a pub (see sidebar). This is a wonderful community in terms of people being united together. Thirty-two miles away is Fort Peck Reservoir and Dam, which is the largest earth-filled dam in the country. It has more coastline than the coast of California. If a person is a hunter or fisherman, there are tons of places to do both things.

What is your typical day like?

On Mondays, I see patients from 8 to 5:30. I see around 22 patients. Tuesday mornings, I do procedures such as C-sections, colonoscopies, breast biopsies, etc. Tuesday afternoons, I see patients.

There is a nursing home not far from here, so on Wednesday mornings I see those patients. Wednesday afternoons, I see our clinic’s patients. Thursday is dedicated to patients unless an emergency comes up.

On Fridays, I do paperwork, charts, fill prescriptions and make phone calls. I try not to schedule patients. I will make hospital rounds if I have a patient in the hospital. I will also do endoscopic exams if needed.