A Medicine Warrior: Dr. David Baines

TC:  What are some of the barriers between delivering good health to community villages, say from the clinics or the hospitals either working together or not working together? Is it always money that prevents it, or is it sometimes just non-cooperation?

DB:  I'd say mostly it's distance, which then translates into money and it also can be weather. Some places can get weathered in. There was a family doctor that did an emergency ectopic pregnancy surgery this last winter up in Kotzebue. He actually had to do it twice – the first time he did it by telephone and the second time they hooked up their telemedicine stuff so that they could use that to transmit the images back to the surgeons at the Native hospital and they walked him through.

TC:  What about some of your teaching activities? Tell me more about that and some of the students, and what the promise of the future looks like in terms of Native health, the docs, the nurses, and so on.

DB:  Well, from my standpoint mostly we're trying to teach these guys to be good family docs so that they can go out to rural sites and deliver good medicine. But my role here, too, is also to bring the traditional side we have to native healers that are on faculty with our program and they are part of the initial orientation to our program. They're part of the graduation and then they, at various times throughout the residents' training, are part of their training. They teach them about native culture, they teach them about native traditions, and they help deal with stress. They have great ways of helping the residents deal with stress. I also provide the sweat lodge ceremonies for the residents during that trans-cultural rotation where they're working with the native healers. Most of our residents aren't Native, but a significant number of them are working with Native populations and I really think those two elders are a big reason why that's true.

Plus, I mean the residency really tries to expose them a lot to those villages and things, and the experiences out there. So they get the six week rotation at Bethel in their second year, and in the third year they have two required rural sites that they can pick in the state. It can be anywhere, it doesn't have to be a Native site. It can be Kodiak, Valdez, Cordova, Sitka, Barrow – they can pick sites where they want to go out. A lot of times they use that to see if there's a place that they might be interested in practicing once they graduate. So they get at least two and a half or three and a half months of exposure to rural sites in Alaska. I think that's a reason that a little over forty-percent of our graduates are working in Native or tribal clinics or hospitals and over seventy percent are working in under-served populations. So I think we're doing a great job. The people that set up the residency, that was their goal, to get people out to rural sites and under-served populations.

TC:  And how long has this residency been in existence?

DB:  I think we're going on our eighth year.