Ticket To Better Care Nurse Practitioner Lobbies For Funding To Upgrade Rural Emergency Medical Service

Marie Osborn got a $53 speeding ticket recently. She wishes it had been $56.

That’s because the nurse practitioner, a pioneer in Idaho back-country medicine, has been lobbying to get a $2 or $3 fee tacked on to fines for traffic violations. The money would be spent on training and equipping emergency medical teams.

“I would have gladly paid more, knowing that if I’d done something more stupid than speeding, there would be someone there with decent training to respond,” Osborn said on a visit to Spokane.

Emergency services are, she said, “a vital part of the medical system, especially in places like Idaho, Eastern Washington and Montana, which have large rural areas.”

Rural health care has consumed Osborn’s life for 25 years, nearly 24 hours a day.

She helped found and continues to run the Salmon River Emergency Clinic in Stanley. It faces all of the logistical challenges of rural health care.

Stanley sits in a valley amid the Sawtooth Mountains, which more than live up to their rugged name. It’s 63 miles from the clinic to the nearest hospital, in Sun Valley.

If that highway is closed by an avalanche or storm, it’s 121 miles to the next-closest hospital, in Salmon.

Winter can be brutal.

Summer is always busy. That’s when the valley population of 350 - not enough to support a doctor - swells with 1.5 million rafters, anglers, hikers and campers.

Osborn and her family formerly were among the vacationers.

While she was there in the summer of 1971, four teenagers were badly hurt in a car accident.

Help didn’t arrive for 2 hours, Osborn recalled Monday when she spoke to Veterans Affairs Medical Center staff members, including her son, Dr. John Osborn.

When Stanley folks donated equipment and a log house and asked her to open a summer clinic in 1972, she accepted. When they decided they needed her year-round, she moved from Boise permanently.

As a nurse practitioner, Osborn said, she’s “a supernurse, not a minidoctor.” But the job includes work commonly done by a dentist, an eye doctor, and a pediatrician.

She’s done clinic cleaning, laundry, and paperwork. She serves as coroner, operates laboratory equipment, and trains volunteer emergency medical technicians.

And she lobbies.

In the 1970s, she supported a bill that would allow for the development of clinic-hospital taxing districts. Its passage was, she said, “one of the great accomplishments of the Idaho Legislature.”

Stanley residents voted 98-0 to tax themselves. The ambulance the clinic bought was a military surplus 1958 Pontiac. Pavement was visible under the seats, Osborn said.

The clinic is ready for its fourth ambulance. Osborn expects it will cost $90,000.

Federal emergency services dollars have dropped off dramatically, and she doesn’t know where all the money will come from.

The state isn’t likely to help. Last year, 143 ambulance units requested help replacing their rigs, but only one received help, and that was $5,000, Osborn said.

She is determined to change the situation before she retires in 1999. Last spring, she worked for the passage of legislation that would increase traffic fines.

The bill was sponsored by the Idaho Rural Health Coalition.

“At $2, it would bring in at least $500,000 a year, which would provide for decent ambulances, good training and good equipment,” Osborn said.’ She spent a weekend during the legislative session calling every emergency unit in the state.

“One EMT started crying on the phone,” she recalled. “They were down to two people.”

The 1997 bill didn’t even get out of committee. But Osborn hasn’t given up.

“I’ll be back,” she said.

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