An Interview with AAIP President Dr. Jim Thompson

TC: Do the national Indian Health Boards across the country help in giving Indian medical students the kind of cultural and other training they may not get in medical school?

JT: Yes. Part of medical school is rotating through local community settings and practices. If the urban clinics or even the rural clinics – the IHS and tribal clinics – are interested in it, and there is somebody in the medical school to make that kind of contact, those kinds of things are wonderful. I know that happens in New Mexico and Seattle, and there are other places where it happens too.

TC: Speaking of IHS, they have had some challenges in the past that I think the new IHS Director, Dr. Charles Grim, would like to address. I wonder how you feel about the leadership of that department over the years?

JT: Actually, I don’t fault their leadership. I think they’ve done a good job over the years of trying to maximize their budget and trying to really serve Indian people. There has been infighting at times of course, as there is in any bureaucracy, but I really think that IHS has come a long way. And we tend to forget that IHS only started in 1955. If you look at the statistics on acute diseases, they've done a marvelous job since 1955. What the challenge is, and I think they're starting to recognize this, are chronic diseases such as diabetes, chronic kidney disease, and certain mental diseases. They're harder to address, no question about it. I think also that integration of services is an awfully important thing; that is, integrating general health care with mental health care with substance abuse treatment with social services. I think it's more and more the case in medicine that institutions are trying very hard to do that kind of integration, and I think the IHS has a long way to go in doing that. There’s still a lot of separation that IHS is trying to address. It's a real challenge.

TC: Senator Tom Daschle went on record recently saying the United States has not fulfilled its promises to Native Americans in regards to providing adequate health care. He thinks the government can do better. Do you have any thoughts on what the federal government could do in response to the senator’s comments?

JT: Fully funding the Indian Health Service would be a good start. It has been chronically under funded. In mental health, if they had twice as many staff they would be up to a staffing ratio that would be reasonable, and I think that's true in a lot of other health areas as well. Another thing that IHS could really help with a lot is specialty programs for special populations; there are very few programs available specifically for elderly Indian people and their needs, for example.