My Top 5 Lessons in Medicine From Standing Rock

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Written By: Dr. Lauren Wilson ND, LMP

Last week I traveled to the Standing Rock Reservation in North Dakota to volunteer my services as a primary care naturopathic physician. Health care is severely limited at the camps along the Missouri River, and the community there is continually in a state of emergency.  With the blessings and support of my work colleagues at Gumshoe Health in Seattle Washington, I headed East with a fellow naturopath, Dr. Patrick Donovan

Providing medical care to underserved areas is a personal passion of mine and I believe it to be an important social responsibility. More importantly, I learned some ways that I can improve how I practice back home. There is nothing comparable to practicing medicine in a challenging and dangerous environment to teach us what really makes health care work.

 

The five lessons I learned from Standing Rock follow:

  1. Communication Between Providers:

In a world where electronic records streamline communications, it is easy to take communication for granted, or assume it has occurred when it has not. When a communication infrastructure is not in place, a medical consult often comes with an invigorating run across the prairie. What is lost in efficiency however, is offset by the quality of communication. The face-to-face discussion of patient cases creates a rapport between providers that improves collaborative care outcomes. In Seattle there is currently no way to make face to face collaborative care the norm. However, as medical providers we can do our best to make our communications as personal and collaborative as possible. In my practice at Gumshoe Health, we dedicate time specifically for collaboration via our meetings with providers from both inside and outside of the organization. You can be assured that at Gumshoe Health we will work with your other healthcare providers like the team mates they are. When your doctors are friends, you win.

  1. Seamless Modality Application:

In the camps at Standing Rock, all available health care providers are needed to reach out to as many people as possible. This means that an herbalist might provide a treatment plan for an MD, or that they might be the one providing emergency medical care and triage. Just as people do the best work when the communication is solid and providers work together, modalities work best when treatment is truly integrated. In the field this means that safety is provided first, with the level of intervention necessary, and health is promoted by all modalities in conjunction. Naturopaths are trained specifically in this juggling of many available tools, but nothing teaches better than a little extra pressure. When you share your concerns with a good doctor he or she will start assessing the level of intervention required to get you on track with your healing process while at the same time providing necessary natural treatments to help keep you there.

  1. Outreach/ Follow-Up:

A major challenge with the work in the Camp is quality follow up. With the chaotic environment and poor telecommunications, it is easy to lose track of patients. A great deal of time is spent going from tent to tent, trying to find patients for follow up. In Seattle the necessary follow up is easy, we have your phone number! We care about how you are doing and if we see something that we are worried about, you will receive a call.

  1. Environmental Assessment:

In the Missouri River Camps, respiratory problems are a major concern. People are camping in cold weather who are not accustomed to the environment, or how to compensate for it. Trying to stay warm can also lead to smoke exposure when heating systems are limited and not always in good condition. This is a blatant reminder that the environment you live in is very important to your health. You probably live in a house, but there may be exposures at home, or at work that are affecting your health. We will work with you to sort out what those exposures are, and help you find ways to avoid them.

  1. Cultural Interest:

With approximately 300 different tribes present and groups from around the world, cultural competence is a dream that won’t come true for any individual in the Missouri River Camps. All one can do is treat others with respect and learn fast. People are better understood if we assume less.  So what does this mean when you come in for a visit? This means that we won’t assume we understand what your life means to you. We won’t assume that we know what you need to thrive. Our experience may provide a starting point, but your values and your experience will remain at the center of your experience with us and at the center of your treatment plan.

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