Anesthesiologist Dr. Jeff Fowler spoke a language U.S. Rep. Cynthia Lummis could understand.

The Mountain View Regional Hospital doctor compared the facility to working at a ranch during Lummis' recent visit to the hospital.

Fowler spoke about how doctors at the new surgical hospital have control and don't have to continuously answer to administrators and board members just like a rancher has no one to answer to but himself.

"The owner takes better care of the ranch than the ranch hands," Fowler said. "When the owner has input, he takes better care of it."

The environment at Mountain View allows him to choose the best methods to provide the best patient care, he said.

"You begin to think of it more as a family than just a job to go to," he said.

Mountain View Regional Hospital treated its first patient a year ago this week. It has served Casper patients and doctors well, providers at the hospital said.

The hospital opened last summer amid controversy. It was unclear how the for-profit speciality hospital would affect the nonprofit Wyoming Medical Center. Some of Mountain View's founding doctors, the neurosurgeons with Central Wyoming Neurosurgery, announced a major lawsuit against WMC several months before the opening.

The first few months were rough and Mountain View's chief executive officer admits it had some "growing pains."

Don Burris is the hospital's second CEO. The hospital's first CEO resigned after about a month.

A few months after opening, Mountain View laid off a group of employees.

Nadia Mansour-Fries, a registered nurse, said actual layoffs were minimal, but several people were moved around due to a slow start. In the beginning, there were days when the hospital had only one or two patients, she said

"It started out with a lot of uncertainty," Burris said. "As tough as it is to start a new facility from dirt, not only are we profitable but we are busting at the seams."

In its first year, Mountain View treated 5,000 patients.

The hospital has been at full capacity several times recently, but Burris declined to give more specific numbers.

Starting as a neuorsurgical hospital, Mountain View has since added general surgery, orthopedics, otolaryngology, plastic surgery, bariatrics and pain management. More than 50 doctors have operating privileges at the hospital. Many have privileges at WMC, too.

Some nurses work at both facilities, Mansour-Fries said.

Mountain View strives to focus on patient care, Burris said. A boss once told him that patient care is the bull's-eye and if doctors take their eyes off the bull's-eye, they will fail.

One way Mountain View hopes to improve patient care is by improving its relationship with Wyoming Medical Center.

Burris said the often-heated relationship between the two entities has not had time to change yet, especially with the lawsuit. The trial was supposed to start this week, but a judge dismissed the lawsuit several weeks ago. The neurosurgeons at Mountain View plan to appeal the ruling.

Burris said he might be optimistic but thinks WMC should look at the lawsuit as separate from the hospital. Only a few doctors at the hospital are involved.

Wyoming Medical Center officials declined comment for this article.

"This community would be much better served with cooperation versus competition," Burris said. "It's going to take time with all the water under the bridge."

Nancy Brandt, WMC's chief financial officer, told Natrona County Commissioners during a recent meeting the new hospital has not affected patient volumes or business. Previously, WMC said a specialty hospital would hurt it by "cherry-picking" the most profitable patients.

Burris said about 33 percent of its patients have either Medicaid or Medicare, historically low-paying insurance, and the hospital does not refuse a patient based on ability to pay.

The hospital recently signed with KidCare, Wyoming's version of the State Children's Health Insurance Program.

Patients tell Dr. Todd Hammond, a pain specialist at the hospital, they are excited to have a choice.

"It raises the bar," Hammond said. "Competition makes everyone better. If you don't have competition, you don't have to change."

During her visit last week, Lummis said competition in the election made her a better candidate.

"Wow, this is impressive," Lummis said. "The equipment, the atmosphere, the cleanliness, the people - everyone is just happy."

Fowler can attest to it.

He had surgery at Mountain View several weeks ago.

Though his surgery was rescheduled four times, he still felt cared for like a family member.

Contact health reporter Allison Rupp at (307) 266-0534 or allison.rupp@trib.com.