Comments on: The Federal Government’s Medical system still needs improvement (and money)

By: poorhealth

poorhealth — Thu, 29 Apr 2010 21:02:00 +0000

Hello! The IHS in Fort Yates, ND is in poor situation because at our hospital we have so many people in a job that they all do the same job with very high pay. and the speciality clinics that people are being sent to don’t get the medications they need because you know why! IHS sends our people to these clinics and get to see the dr’s. but when they come back to the IHS clinic pharm. we don’t have the good proper medications here because of the high drug problem of selling their drugs, because of this those who need this medications because of ill health dont get that much needed help.IHS in Fort Yates, ND NO LONGER CARRY GOOD MEDICATIONS WE ARE DOWN TO ZERO WITH HEALTH CARE.

By: Wakaju

Wakaju — Thu, 03 Dec 2009 19:50:49 +0000

Boy she hit the nail on the head. My short and limited experience with IHS (6 years) has shown me the turnover is too rapid for doctors and nurses forced into service as part of medical funding programs that the “smart” doctors got out of and so IHS got the ones who weren’t clever enough too dodge their governmental loan stipulation. This reluctance coupled with overwork shows on the faces of the health care professionals and the patients see it and act accordingly bad. So you have an adversarial relationship between doctor and patient to start with, throw povert and cultural insensitivity into the mix and you have mini disasters all over the place.
The high rate of turnover evidences itself in lack of follow up, proper files and medical history and surely a lack of “concern”. My wife had high blood pressure for 15 years, saw a different doctor each time and no one told her she had it!! They just assume she knew, but not one doctor asked if she was doing ok on her medication (which she didn’t have because she wasn’t told) which should be a standard question. I have lived in elsewhere in the past with an HMO and the doctors and nurse pester you about meds all the way down to your weight and diet. Not even this “routine pseudo-caring” happpens at IHS.
The bureaucracy is a nightmare. I have tried several times to get a position in the medical labs and the red tape makes me give up and seek employment elsewhere. I am no superstar but I have skills that are needed and I am going to be on the reservation the rest of my life and I CARE about the people. I have chosen to help in other ways.
IHS needs to find health care workers that will stay in place and find a faster track to fill empty positions.

By: DavidQ

DavidQ — Thu, 03 Dec 2009 16:33:59 +0000

Dr. Reyes does an excellent job of summarizing the process for recieving care, particularly speciality care through IHS. She also touches upon the most difficult problem faced by IHS and indeed rual communities in general and that is the recruitment and retention of qualified providers willing and able to work in remote areas. The remoteness of of work sites, without amenities and sometimes even housing coupled with inadequate resources, staff shortages creates challenges that are almost and in some cases are insurmountable. Many facilities rely upon Locum Tenum Contract Companies, to fill out their schedules, this has the advantage of getting fairly well qualified providers, with the disadvantages of higher costs and the fact that many of these providers are only at the facility for short periods of times, one month to perhaps a year.
What are solutions to this problem, I think that a revamping of the IHS HR system, including policies and procedures is a necessary first step. Look at those areas that have more success, such as Phoenix and Navaho and adopt their practices. standardize recruitment practices and PD’s, ie… why does one position in one area only qualifies as a GS 12 and in another area as GS 13?
Overall, given the resources that IHS has to work with, IHS does a good job, can they do better, of course they can, are there areas and facilities that needs major overhauls, yes, but there are also areas and facilities that deliver execeptional care, and those are the ones that have systems of care that needs to be models for the whole IHS system.

By: Wablosa

Wablosa — Thu, 03 Dec 2009 15:12:56 +0000

What the IHS needs is real doctors who care and don’t just wait for their paycheck. My wife was diagnosed wrong two times by some creepy IHS doctor. They don’t even want to wear rubber gloves and are always in a hurry.
Most time spent waiting at the IHS Hospitals is because nurses and doctors are too busy visiting eachother.