The pain was intense as Kirk Wade hurried to the Shore Medical Center here, where staff told him he might need emergency surgery for a possible intestinal tear.
But there was a problem: The rural hospital had gone through so much downsizing since joining the University of Maryland Medical System there was no surgeon available that day last summer. The closest hospital with a surgeon was more than an hour away in Easton.
And there was another problem: The hospital’s ambulance service wouldn't be available to take him there for hours.
“I could have ended up dead,” said Wade, 74, a retired tax lawyer. “If you live in Chestertown and have a medical emergency that requires...