A Medicine Warrior: Dr. David Baines

TC:  Are the majority of the native doctors within AAIP working for native clinics and hospitals or are they working in the majority kind of system?

DB:  No, I would say there has been an increasing number, especially since the tribes have taken over control and it's not the IHS. The IHS in the past has been a barrier for us. Like I tried to work for the IHS, and I couldn't get a job. So I ended up in private practice on a reservation and I managed to work out a niche where I worked for the tribe. But now that the tribes control a lot of that, that barrier is really significantly lessened. But it's still very hard to go back to your own people, because a lot of the tribes are small, everybody's kind of related. I think the vast majority of people in AAIP do not work for Indian organizations. But, the vast majority of them do have some contact with doing things with the communities. They might be working, like myself, for Providence Hospital, but I work with traditional healers at the native hospital, I work in the community to promote cultural stuff, you know the dances and songs for ceremonies.

A lot of times working for the tribes, they still retain a lot of that government kind of approach to things where there's just a lot of lethargy. And after training in all these great institutions, like me at the Mayo Clinic or the people who came through here at the University of Washington, where things are run pretty efficiently, a lot of people get burned out with that. So I think a significant number of us have worked for tribal or IHS sites but got burned out.

TC:  The national organizations such as National Congress of American Indians, they have a health committee, and the National Indian Health Board. They primarily advocate for tribes. What about the special programs for the urban Indian side?

DB:  Well they get a special little niche in the reauthorization of the Indian Health Care Improvement Act, so they get some funds. Certainly, it's even more under-funded than for the reservation sites since now over half of the people, Indians, live in urban areas. Most of those places, there are other resources unlike on the reservation. If you have Medicaid, you can go to any clinic or hospital in the area that takes Medicaid, or if you're on Medicare. But if you're on the reservation, regardless of what you’ve got, that might be the only place that you can go. I think the urban Indians are way under-funded. Part of it is that kind of the way the government is acted, it's been like if you leave the reservation you lose your Indian rights. I don't know exactly where that started. In Alaska, since almost all the country's federal or native people can get health care almost anywhere, when our Alaska people come down here, they're floored. Even at the Indian Health Board, if they make over a certain amount, then they get billed. And they haven't seen a medical bill in their whole life. There's this huge culture shock when those people come down here. A lot of them end up moving back up to Alaska just for the health care issues so they can get coverage because they can't afford it down here.