10 things to know when working for the Indian Health Service
June 21, 2019)
Sonya M. Sloan, MD, shares her experiences and insights working for the Indian Health Service as a locum tenens surgeon.
Healthcare does not just lie within the corridors of the newly constructed clinic or hospital. In fact, some would say that the practice of medicine is experienced at its’ best when one is challenged with out-of-the-ordinary surroundings, unexpected conditions, and serving an underprivileged population. If you have ever had the opportunity to work on an American Indian reservation, you should jump at the chance and be honored. But with this type of experience also comes a few things that you should know when working at an Indian Health Service (IHS) hospital.
What makes IHS different
When I was offered a proposed contract to work on an Indian reservation, I did not hesitate. I saw the challenge as an adventure like most of my other locum tenens contracts. But honestly this was quite different. Working for the Indian Health Service is not something most people can ever train for. There is a different atmosphere of care and an air of expectation from a people who have been slighted by racial disparities for generations. Furthermore, there are boundaries and traditions that a healthcare professional should know, acknowledge, and respect.
What I learned working for IHS
Allow me to share a few of my observations as a doctor and a fellow human being that may help you be a better caregiver if you ever find yourself on an Indian reservation. I offer these as suggestions after working for nearly two years with the Navajo Nation, Zuni, Acoma, and Hopi Indians on the largest American Indian reservation in the country.
Respect the Natives (they can see and feel right through you).
Understand the highly spiritual culture and ask questions about what may be customary for Native Indians.
Remember you are in a government facility (need I say more).
Bureaucracy knows no boundaries. There are office politics like any other place but everyone here takes their job very, very, very seriously (even more than other places you may work).
Lunch is sacred (don’t mess with the 30 minute lunch break).
Navajo reservation police are different from the local town police (jurisdiction sometimes overrides physical boundaries).
Always be aware of your surroundings…at ALL times.
Ask local Natives about the best hot spots to eat and events (not always advertised or on the beaten path).
Try to learn a few words of the Native language (uh’ten…all done) and understand it is one of the oldest languages spoken not written.
And lastly…did I mention respect the American Indians and their culture.
What’s different and what is the same…everywhere
As a traveling orthopedic surgeon, a.k.a. locum tenens doctor for over 12 years, I think it’s safe to say I have been a few places and seen a few things. I have been in a level I trauma center in metropolitan city and operated all night for several days in a row. I have traveled to locations in the central, southern, and eastern United States to cover call for doctors on vacation, fill-in at hospitals that recently lost a doctor, and even stepped in as extra help after some natural disasters. I have been in remote small towns in which I had to call the hospital operator to make sure they knew I was on call. I have worked in very nice, new-and-shiny, state-of-the-art facilities as well as a few hole-in-the-wall places that I won’t go back to.
But working on a Native American Indian reservation is unlike any other place where I have contracted to work. However, there is one constant that is the same no matter where I travel or operate. That constant is the practice of medicine and the privilege to care for and treat another human being; it is and always will be the same no matter where I am.