+ All Categories
Home > Documents > 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM...

1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM...

Date post: 17-Jan-2018
Category:
Upload: justina-harrington
View: 218 times
Download: 0 times
Share this document with a friend
Description:
Disclosures The presenter has no financial interests or relationships to disclose. Presentation based on public information and personal experience, does not represent USPHS, IHS This continuing education activity is managed and accredited by Professional Education Services Group in cooperation with AMSUS. Neither PESG,AMSUS, nor any accrediting organization support or endorse any product or service mentioned in this activity. PESG and AMSUS staff has no financial interest to disclose. Commercial support was not received for this activity.
48
1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director Bemidji Area IHS
Transcript
Page 1: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

1

2015 AMSUS MeetingThe Society of Federal Health Professionals

2 Dec 2015 – San Antonio, TX

RADM Dawn Wyllie, MD, MPHChief Medical Officer/Deputy Director

Bemidji Area IHS

Page 2: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

“Cross-Cultural Medicine in the USPHS: Caring for American Indian/Alaska Native Patients in the

Indian Health Service”

Page 3: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Disclosures• The presenter has no financial interests or relationships to

disclose.• Presentation based on public information and personal

experience, does not represent USPHS, IHS• This continuing education activity is managed and accredited

by Professional Education Services Group in cooperation with AMSUS.

• Neither PESG,AMSUS, nor any accrediting organization support or endorse any product or service mentioned in this activity.

• PESG and AMSUS staff has no financial interest to disclose.• Commercial support was not received for this activity.

Page 4: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Objectives

At the conclusion of this activity the participant will be able to:

• Compare 3 American Indian values/beliefs with contemporary Euro-American society and describe 2 American Indian wellness and disease concepts

• Describe a unique cultural aspect of American Indian/Alaska Native Heath Care

• Discuss cultural considerations in clinical practice in order to improve provider-patient relationships and health care delivery

Page 5: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Journey – Clinical Rotations• University of Washington, School of

Medicine WAMI Program (1981-1985):

– 1st yr Seattle Indian Health Board– 2nd yr - Community Health Advance Program

• Saturday free clinic - health care to underserved – 3rd & 4th yrs - Indian Health Service:

• Family Medicine - Nez Perce Reservation, ID• Psychiatry - Alaska Native Medical Center, Anchorage

& Dillingham, AK– 4th yr - McCormick Hospital, Chang Mai, Thailand

• Pwo-Karen Tribe, Mae Hong Son on Burmese Border• Hansen’s Disease @ McKean Leprosy Hospital

Page 6: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Journey – Clinical Rotations• UC San Francisco, Family & Community Medicine

Residency, CA– San Francisco Native American Health Center– SF General Hospital Refugee Clinic

• Primarily Latin American and SE Asian (limited/ non-English speaking) patients

• UC Davis, School of Medicine, CA– Clinica Tepati, Sacramento

• Saturday Free Clinic – health care to underserved, primarily Hispanics

• Mentorship and support are important components

Page 7: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Journey - Career

• National Health Service Corps - Scholarship Recipient

• 9/10/1988 Commissioned as a Medical Officer in the U.S. Public Health Service (PHS), assigned to IHS

• Call to active duty - Tohono O’Odham Reservation, Sells, AZ

• Active Duty 27 years, worked in 4 Areas: Tucson, California, Great Plains, Bemidji

Page 8: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Journey PHS Career in IHS

• Served in 4 IHS Areas – Tucson (AZ): 2 Tribes

• Tohono O’odham Nation: 28, 000 members– California: 103 Tribes

• Chapa-De IHP: Maidu, Miwok, Washoe, Wintun– Bemidji Area Office (MN, WI, MI, IL, ID): 34 Tribes

• Chippewa/Ojibwe, Sioux/Dakota, Ho-Chunk, Menominee, Ottawa/Odawa, Oneida, Potawatomi, Stockbridge-Munsee Mohican

– Aberdeen (IA, NE, ND, SD): 17 Tribes• Sisseton-Wahpeton Reservation

• IHS Delegate, 1998 “Healing Our Spirits Worldwide International Conference”, Rotorua, New Zealand– Maori Tribe

Page 9: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Indian Health Service

• An agency within the Department of Health and Human Services (HHS), established in 1955

• Mission... In partnership, to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level

• Goal... to assure that comprehensive, culturally acceptable personal and public health services are available and accessible to American Indian and Alaska Native people

• Foundation... to uphold the Federal Government's obligation to promote healthy American Indian and Alaska Native people, communities, and cultures and to honor and protect the inherent sovereign rights of Tribes

Page 10: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

IHS Agency Priorities

10

Renew and strengthen our partnership with Tribes and Urban Indian Health Program

Bring reform to the IHS

Improve the quality of and access to care

Ensure that our work is transparent, accountable, fair, and inclusive

Robert Mc Swain

Page 11: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Special Government to Government Relationship

• Direct Federal Government relationship with 567 sovereign Tribes

• Relationship established in 1797 based on Article 1 Section 8 of US Constitution: – “Congress regulates commerce among states…and

with Indian Tribes.”– Given form and substance by numerous treaties,

laws, Supreme Court decisions, and Executive Orders

Page 12: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

American Indian/Alaska Native History

• Extermination < 1871• Broken Treaties

• Assimilation > 1871• Boarding Schools• Reservation dissolution • Federal Termination of Tribes

• Relocation 1950’s – 1960’• Tribal Self-Determination 1970’s to current• Re-Affirmed Tribes and New “Federally Recognized” Tribes

Page 13: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Passage of Landmark Legislation • 1921 Snyder Act was passed by Congress authorized

funding for the health care of Indian people

• 1954 PL 83-568 transferred health care from the Bureau of Indian Affairs to the Surgeon General of the USPHS within the Department of Health, Education and Welfare • “…all functions of the Secretary of the Interior relating to the

conservation of the health of Indians…”• However the budget or appropriations from Congress remain

under the Department of Interior

• 1975 Indian Self-Determination Act • 1976 Indian Health Care Improvement Act (IHCIA)• 1991 Self Governance

Page 14: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

IHS Agency Today Relationship with Congress

Congress is the legislative branch of the U.S. Government Congress passes appropriations, allocating funding to IHS HHS executes and implements laws passed by Congress

Relationship to U.S. Department of Health and Human Services (HHS) IHS elevated to Agency status,

is one of eleven Operating Divisions within the HHS which is an Executive

Branch of the U.S. Government Budget Formulation, PFSA, Tribal Mgmt

14

Page 15: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

The 2nd - 25+ Years of IHS ~1980-present

Federal budget process

Addressing health disparities

Professional excellence

Modern health facilities

Tribal consultation

Organizational change

Growth of Tribal Management15

Page 16: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

CALIFORNIA

TUCSON

BEMIDJI

NASHVILLE

ALBUQUERQUE

NAVAJO

ALASKAAK

TN NC

MS AL SC

LA

FL

PA

NY

ME

MACT

RI

**

NVUT

AZ

BILLINGSMT

WY*

OKLAHOMACITY

KS

OKTX **

IN

MN

MI

WI*

CA

*

*

CO

NM

Note:Texas is administeredby Nashville, Oklahoma City,and Albuquerque.

*Area Office

WA

OR

ID

*PORTLAND

PHOENIX

*

ND

SD

NE IA

*

ABERDEEN

Indian Health Service Area Offices

Hospitals Health Centers Urban Programs

16

Page 17: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

A Rural Health Care System in 35 States

Page 18: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

IHS DemographicsWho We Serve

567 Federally Recognized Tribes Long process for official Federally recognition of Tribes: Re-cognized & newly recognized

2010 Census: 2.3 million people AI alone = 09% total US population User Population ~ 1.2 million Tribal size ranges from ~200 to ~40,000 Staff = Civil Servants, PHS Commissioned Corps Officers, Direct Tribal or Urban Program Hire

18

Page 19: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Indian Health Care

Primary Concerns • Health Disparities of this underserved population• Limited Access (specialty care, high cost medications, etc) • Inadequate funding to address health care needs

Priorities• Close the health care gap, maintain & improve patient care• Strengthen Public health and Environmental infrastructure• Community based primary care; Culturally relevant care• Enhance opportunities for tribal participation and control• Partner with Tribes and collaborate with other entities to

enhance resources, support to tribes

Page 20: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Health Disparities• Leading causes of death

– Cardiovascular Disease– Cancer

• Colorectal• Lung• Gyn: Cervical, Breast• Prostate

– Unintentional Injuries and Suicide– Diabetes– Chronic Lower Respiratory Disease

• Lifestyle Contributors: Obesity, Smoking 20

Page 21: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Health DisparitiesCardiac Disease

All Races AI/AN Asian / Pacific Islander Black White0.0

50.0

100.0

150.0

200.0

250.0

300.0

171.3

121.4

92.7

212.0

169.8168.7

199.2

76.8

257.2

162.3

Age-Adjusted Deaths due to Diseases of the Heart (ICD-10 I00-I09,I11,I13,I20-I51; per 100,000)

2011-2013

United States Bemidji Area

Page 22: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Health DisparitiesCerebrovascular Disease

All Races AI/AN Asian / Pacific Islander Black White0.0

10.0

20.0

30.0

40.0

50.0

60.0

37.0

25.6

30.6

49.7

35.736.1

31.4

36.2

49.3

34.9

Age-Adjusted Deaths due to Cerebrovascular diseases (ICD-10 I60-I69; per 100,000)

2011-2013

United States Bemidji Area

Page 23: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Health DisparitiesCancer

All Races AI/AN Asian / Pacific Islander Black White0.0

50.0

100.0

150.0

200.0

250.0

166.2

110.4103.3

193.8

166.3168.6185.5

103.2

210.2

166.2

Age-Adjusted Deaths due to Malignant Neoplasm (ICD-10 C00-C97; per 100,000)

2011-2013

United States Bemidji Area

Page 24: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Health DisparitiesDiabetes

All Races AI/AN Asian / Pacific Islander Black White0.0

10.0

20.0

30.0

40.0

50.0

60.0

21.3

35.8

15.8

38.9

19.521.2

54.0

21.1

36.4

19.8

Age-Adjusted Deaths due to Diabetes Mellitus (ICD-10 E10-E14; per 100,000)

2011-2013

United States Bemidji Area

Page 25: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

What Contributes to Health Disparities ?

• Social barriers• Education level• Economic barriers• Inadequate

appropriations• Health Literacy

level

• Geographic barriers

• Access barriers• Resources/

Financial• Lack of personal

health insurance• Cultural

Awareness

Page 26: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

LNF

26

Page 27: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Health Disparities – Education

Page 28: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Health Disparities

Teen Education and Employment2006

7%11%

8% 6%

16%

5%

0%5%

10%15%20%

U.S. All Races U.S. White U.S. AI/ AN

% teens who are highschool dropouts% teens not attendingschool and not working

Notes:

% teens who are high school dropouts: % of teenagers between ages 16 and 19 who are not enrolled in school and are not high school graduates. Persons who have a GED or equivalent are included as graduates in this measure

% teens not attending school and not working: % of teenagers between ages 16 and 19 who are not enrolled in school (full- or part-time) and not employed (full- or part-time).Source: Annie E. Casey Foundation 2008 “Kids Count” Project

Page 29: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Health Literacy•What is it?

“ The ability of an individual to access, understand, and use health-related

information and services to make appropriate health decisions.”

•Health History Forms•Medication Bottles•Appointment Slips•Informed Consents•Discharge Instructions•Health Education Materials, Food Labels•Insurance Application

Page 30: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Who Are American Indian/Alaska Native People?

• The original inhabitants of this country• Diverse people from many tribes• Distinct history, languages, cultures, traditions,

social networks, governments• Dual citizenship in any one of many different

tribes• May have red or blonde hair, be blue or green

eyed, look like another ethnic race, as well as having the prevailing stereotypical characteristics

Page 31: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

DIVERSITY!Indian people have differing:

• Identity: tribal, cultural, bi-cultural, non-traditional orientation

• Cultures, values, and practices;• Language/communication styles; • Lifestyles; geography; • Incomes, employment rates, education;• Health & illness beliefs; • Family structures/kinship relationships;• Spirituality & religious customs

Page 32: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Importance of Spirituality

• Spirituality• Ritual• Dreams• Healing Practices• Inter-Tribal Celebrations

Page 33: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Cultural ConsiderationsReligion/Spirituality

• Presiding religious/spiritual official• Ceremony (may be a blending Christianity &

Traditional Spirituality)• American Indian Symbols - the use & practice of:

– Tobacco * Cedar– Eagle Feathers * Sacred Pipe– Medicine Bag * Smudging– Sweat Lodge * Indian Names

Page 34: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Expression of Voice

• Language

• Stories–Oral Tradition

• Drum and Song

Page 35: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

The Next Generation

• View of Children– Blessing/Gift

• Number of Children• Child Care Customs

– Experiential learning• Role of Parents/Grandparent/

and Extended Family– Woman’s role as family caregiver

Page 36: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

General American Indian Values

• Show Respect to Others  -  Each Person Has a Special Gift• Share What You Have  -  Giving Makes You Richer• Know Who You Are  -  You Are a Reflection on Your Family• Accept What Life Brings  - You Cannot Control Many

Things• Have Patience  -  Some Things Cannot Be Rushed• Live Carefully  -  What You Do Will Come Back to You• Take Care of Others  -  You Cannot Live Without Them• Honor Your Elders  -  They Show You the Way in Life• Pray for Guidance  -  Many Things Are Not Known• See Connections  -  All Things Are Related

Page 37: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

American Indian Concepts of Health / Wellness

• Results from harmony with nature• Is a balance between mind, body, emotions, & spirit/soul,

not the absence of disease• Relationships are an essential component• Spirituality/religion & medicine are inseparable• The spirit existed before it came to the body & will exist

after the body dies• Each of us is responsible for our own health• “Life-ways” are necessary to maintain health

Page 38: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

American Indian Concepts of Disease

• Damage to mind, body, emotions, &/or spirit can produce disease in same or different realm

• Illness is an opportunity to purify one’s soul

• Natural un-wellness is caused by the violation of a sacred or tribal taboo

• Unnatural wellness is caused by evil

• Dis“ease” is felt by the individual & their family

Page 39: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

American Indian Concepts of Healing

• Healing of one realm can bring about healing in another

• Spiritual realm is the most important

• Total treatments heal the mind, body, emotions, & spirit/soul

• Life comes from the Great Spirit from which all healing begins

• Mother Earth contains numerous remedies for our illnesses

• Traditional healers can be either men or women, young or elder, recognized by their community

Page 40: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

American Indian Concepts Traditional Indian Medicine (TIM)

• Openly practiced until 1887 when the Dawes’ Act was passed by the US Congress, a provision made TIM illegal

• Today, a majority of the 2+ million Indians consult traditional healers

• 70% of Urban and 90% of Reservation based Indians use TIM

Page 41: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Cultural ConsiderationsTraditional American Indian Healers

• What traditional healers do best & different from contemporary clinicians: Pray, Listen, Time

• Native patients often go to traditional practitioner before seeking contemporary medical care

• Native patients seldom reveal their use of traditional healing methods and medicines

• Native patients value the healer’s advice over the physician’s if a disagreement arises

Page 42: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Cultural Considerations in Clinical Practice

Native American and Euro-American Cultural Values and Behaviors

• Please review handout comparing Native American and Euro-American Culture and Behaviors

Page 43: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Cultural Considerations

Language and Communication (verbal & non-verbal)

• Bilingual &/or Interpreter-translator• What is not said is also important• Word Phrasing - words have power to shape

reality• Individual speech style/pattern

Page 44: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Guidelines for Health Care Professionals

• Understand the culture of the people you’re caring for

• Understand your own cultural beliefs, biases, communication style

• Listen, be open-minded, avoid labeling• Ask rather than assume• Be respectful, courteous, & have a

cooperative attitude• Respect the therapeutic partnership of

traditional healers and medicines with contemporary medicine

Page 45: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Journey – Closing Comments • Medicine is art, science, life-long experiential learning• Spirit of adventure, create opportunities, own path• Be adaptable, open to change, take a risk• Maintain a positive attitude, optimism, enthusiasm,

passion, realism, self-confidence • Strive to stay in balance, use humor• Develop positive support systems early, along the

way• Listen to constructive feedback, avoid negative

energy• Seek out mentors, become a mentor, inspire • Be compassionate and culturally attuned• Contribute in ways that make a difference in the lives

of those you serve

Page 46: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Obtaining CME/CE CreditIf you would like to receive continuing education credit for this activity, please visit:  

http://amsus.cds.pesgce.com

This information may also be found in the 2015 program

Page 47: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Resources/ Websites• Indian Health Service: www.ihs.gov

• Trends in Indian Health: 2014 Edition• https

://www.ihs.gov/dps/index.cfm/publications/trends2014/

• U.S. Public Health Service Commissioned Corps:http://usphs.gov/

• U.S. Surgeon General: www.surgeongeneral.gov

47

Page 48: 1 2015 AMSUS Meeting The Society of Federal Health Professionals 2 Dec 2015 – San Antonio, TX RADM Dawn Wyllie, MD, MPH Chief Medical Officer/Deputy Director.

Contact Info• Dawn Wyllie, MD, MPH, FAAFP

RADM, US Public Health ServiceChief Medical Officer/Deputy Area DirectorBemidji Area Indian Health Service522 Minnesota Ave, NWBemidji, MN 56601Email: [email protected]


Recommended