DICKINSON, ND-As small, quaint prairie towns such as Dickinson continue to boom amid North Dakota's oil-producing “gold rush,” everything seems to be expanding. From the size of the schools and retail stores to the number of housing units, growth is necessary to keep up with a population that has almost doubled – now estimated at about 30,000 – since the 2010 census.

It would seem to make sense, then, that North Dakota would be one place where replacement hospitals might actually be larger than their predecessors, bucking a strong nationwide trend of reducing the number of inpatient beds.

Yet even amid the boom, it seems as if the shift toward outpatient care is even stronger than North Dakota's incredible growth. As the scheduled opening date for the future St. Joseph's Hospital replacement in Dickinson draws closer – now a year or so away – officials find themselves explaining the outpatient trend to curious townsfolk.