Full Circle

Since starting this blog, I’ve been hoping to receive contributions from others in the tribal setting. And fortunately, we’ve had a taker. Our first guest blog comes from Steven Lee, DPT, PT, a recent graduate, experienced tribal health consumer, and new employee of a tribal health center. Steven has seen tribal health from a variety of aspects and has chosen to share his story. Thank you for the contribution, Steven.

Growing up, I frequented Native healthcare clinics within my own tribe. Everything from a simple cold, to a grade III ankle sprain (basketball, it will get you) drew me to the free and available healthcare provided at such facilities. Sometimes it meant waiting 4 hours to see the provider for 5 minutes; other times, I found myself waiting 5 minutes to spend 4 hours in the emergency room. Simply put, it varied. Similar to any healthcare facility or corporation, so did the care.

During my undergraduate tenure, I spent two years volunteering within a Tribal physical therapy department. I learned a great deal from the therapists, staff, and patients alike. Learning moments ranged from understanding why patients needed therapy, to what the Tribal healthcare system entailed. It did not take long to realize Tribal healthcare differs, slightly, from other healthcare systems, and as always there is potential for improvement. Understanding the needs of patients is vital for any setting, but being able to truly discern those needs within a Tribal healthcare system is an absolute must.

Recently, I graduated from physical therapy school as a Doctor of Physical Therapy (DPT). To supplement this, my medical training was funded by a health professions scholarship through Indian Health Services (IHS). This generous scholarship aids Native students in becoming medical professionals by assisting with not only the expense of tuition and fee’s, but the costs of living as well. Given this, students have an opportunity to focus entirely on their education and development as clinicians. To make trade for this (pardon the Native pun there) recipients of this scholarship sign a contract with IHS pledging to work for an IHS or Native/Tribal facility for the same number of years in which the scholarship was received. Such a situation is a win-win for both sides: students do not acquire the massive burdens of debt, and IHS ensures fresh waves of healthcare providers flooding their facilities each spring.

Given my graduation, I recently accepted my first job. It is located in South-central Alaska, within a drivable distance to Anchorage. My family and I are thrilled to begin our Alaska adventure and I’m quite ready to put my thinking cap on and get to work in the clinic. As a student, I was fortunate to train with some excellent clinicians and hope to incorporate the skills they bestowed on me in my own clinical practice. Lastly, I am beyond excited to begin my career in the very place I discovered my passion for physical therapy, the Tribal setting.

Often times the Tribal population can be tedious to work with; it does vary from patient to patient, but the overall culture is unique, and so the care should be as well. Too often, though, the care is not reflective of the culture and things get ‘off track.’ I only unearth these issues to mention this is one, of several, areas I plan to address through my care. Having been a patient, I’ve seen their side of the curtain; having been a volunteer, I’ve stood in the curtain; and as a healthcare provider, I hope to remove the curtain. Being Native is certainly not a requirement, or even pre-requisite to working within Tribal healthcare; there are many great providers from near and afar that are not Native and make excellent clinicians within this population and culture. Sometimes, however, it really pays to come full circle.

– Steven Lee, DPT, PT

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