Indian Health Service – A Unique Career Fit
Ask an Indian Health Service (IHS) dentist or dental hygienist to describe a typical workday and you’ll discover there’s no such thing. Every day is different and the experience is best described as an adventure. The word “ordinary” isn’t in the vocabulary when you’re living and working in some of the most beautiful locations in the country with Native people and cultures rich in tradition.
The staff of Impressions asked two IHS dentists and a dental hygienist to describe what it’s like to work in IHS facilities and live among Native people. LT Ben Brown, DDS, a USPHS Commissioned Corps officer, works at the Warm Springs Dental Clinic in Warm Springs, Oregon. An IHS dentist for six months, he says his days are never boring and are filled with learning experiences.
LT Ben Brown, DDS
“I wanted to live and work in the Pacific Northwest, and I was very optimistic when I arrived at Warm Springs. This is quite different from anywhere else I’ve lived. The atmosphere is relaxed, both at work and in the Tribal community. There are three Tribes here – the Wasco, the Warm Springs and the Paiute – and I’m learning about their cultures and traditions. I’ve gone to social gatherings and pow-wows, and I sometimes hear Native languages spoken.
“On a typical day, I do extractions and operative procedures on patients of all ages. Some mornings I’ll take walk-ins – mostly emergency patients – and the rest of the day I have regular treatment plans scheduled. I also do preventive work in the community, screening kids for sealants and other treatments, giving them toothbrushes and toothpaste, and teaching them how to brush properly.
“My days are never boring, as I’m constantly seeing things I’ve never seen before, especially with the walk-ins. It’s a real learning experience treating patients that have all kinds of medical conditions. The clinic is a friendly place and my immediate supervisor is my mentor - the person I go to if I need advice. He’s helped me out a lot with no pressure and no stress. A lot of dental graduates feel they need to go into residency programs after graduation to continue their education in a hands-on environment. But from what I’m told about residencies, I think working for IHS is similar to that experience. I can concentrate on seeing patients, and I have different dentists to consult with to fill any void in my dental understanding – a pediatric specialist, for example, and a generalist retired from private practice.
“I’ve gone to CE courses on endodontics and next year I’ll be attending an oral surgery course. I didn’t have that much in the way of specialty skills when I arrived here, but with the CE and the amount of specialty care I do in this facility, I’m getting more exposure than I did in dental school and am gaining specialty skills.
“The job is 8 to 5 with weekends off and lots of vacation – 30 days annual leave – so I have plenty of free time. I spend it in outdoors activities like snowboarding. There’s a ski resort an hour away that’s rated in the top ten in the country. The rivers here are amazing for rafting and fly fishing. If I want some night life, Portland’s only an hour away.
“My parents, both physicians, told me if I ever wanted to have a life outside of work, don’t go into medicine. But I liked dentistry and working with my hands. And working at IHS lets me do the work I enjoy and have a life outside of work.”
LCDR Colleen White, a dental hygienist, has been with IHS for more than 12 years. She has worked at five different IHS sites in Oregon, Wyoming and her current position at Gallup Indian Medical Center in Gallup, New Mexico. A Commissioned Corps officer, Colleen talks about public health and her experiences working on reservations in the western US.
LCDR Colleen White, MPH
“I’m the Perio Prevention Officer at Gallup, supervising two other dental hygienists. We’re responsible for dental prevention programs, such as providing sealants and fluoride varnishes for children from kindergarten through 8 th grade, and cleaning and preventive services for mostly adult diabetic patients. I also work with pre-natal women, and I like being able to take care of whole families. Between the clinical work and community activities, there’s a lot of variety in my work.
“In private practice, where patients tend to be healthier, I almost felt like I wasn’t providing those patients much of a service. But at IHS, there are so many people with so many health care needs, and I can really make a different in their health. I motivate people to take better care of themselves, and when patients totally change their habits, it’s a great success. Just a few successes like that makes it all worthwhile.
“When you’re a new hire at IHS, there’s always someone to help you. Even in remote places, I could call a hygienist in the next service unit, or one working a hundred miles away if I needed advice. Everyone wants to help each other and share ideas. I’ve found that hygienists and IHS dentists have more of a colleague relationship, rather than the boss/employee relationship of private practice. Everyone is working together for the service with the same goal of improving public health.
“I’ve been blessed to work with many different Tribes. There are mostly Navajo here in Gallup, and they’re wonderful people with a great sense of humor, and appreciative of the care we give. Their culture is very traditional, and I’ve attended a few ceremonies, including a days-long “coming of age” ceremony for a 13-year-old girl. Many elderly patients don’t speak English, so I’ve used interpreters to communicate with them, though I’ve learned a few words of the language. I’m also sensitive of Native beliefs. The Navajo believe that saying something might happen in the future will cause it to occur. So when I discuss diseases with patients, I don’t use the word ‘you’ and speak only in the third person.
“In my IHS career, I’ve lived in some of the most beautiful places in the US. I’m an outdoors person, and everywhere I’ve lived had plenty of activities for me, like whitewater rafting, rock climbing, mountain biking, cross-country skiing and sea kayaking. A nice thing about IHS is that I always have options to see new places. Though I like where I am now, I’ve always wanted to go to Alaska, so I just might try it.”
The call to public service isn’t always heard right after graduation. Dr. Cynthia Edwards, DDS, left 15 years of solo private practice to join IHS in February of 2007. A grandmother of four, she moved from the city lights of Nashville to her IHS assignment on the rolling prairies of South Dakota. As a new hire at Rosebud Indian Health Services in Rosebud, South Dakota, Cynthia tells us her first impressions of working on a reservation.
Dr. Cynthia Edwards, DDS
“I was in my 30s when I started dental school. After 15 years in solo practice – being a dentist and a business person – I decided public health dentistry was what I wanted to do. There’s always been a part of me that wanted to help people who really are in need.
“This is the first time I’ve worked with a group of people who are fairly isolated. I’m still feeling my way around the community, introducing myself to people, visiting the churches on the reservation. It’s so interesting – they sing Amazing Grace in the Lakota language. The Lakota Sioux are a very loving people with big hearts. They realize the importance of the work we do and really appreciate it. They make an effort to make me feel comfortable and welcome – I know they want me to stay here. I live on the reservation in a housing compound for medical and dental staff. None of the streets have names, and you get to know where you’re going by landmarks and buildings.
“At the clinic, we see patients of all ages. I’m doing restorations and extractions – mostly emergency patients, but now we’re scheduling patients for more comprehensive work. I used to love doing cosmetic dentistry, and here I can do a little of that working on front teeth and doing crowns. So many of our patients are missing a lot of teeth, and some of them are so young. I’m trying to catch them early with preventive dentistry, help them change their habits so maybe there won’t be so many with missing teeth. I’ve had some unusual cases already, but the chief of the clinic, an oral surgeon, is always there to help and consult.
“I’m an adventurous person, and there’s plenty here for me to do. Lots of outdoor sports, but sometimes I like just riding around the wildlife preserves, where I can see buffalo, prairie dogs and herds of deer. Doing this type of dentistry at this phase of my life allows me time to stop and smell the roses, and I’m more appreciative of that. It’s also allowing me the freedom to pursue other interests, other dental studies that being in private practice won’t allow. I fully plan to take advantage of the continuing educational opportunities IHS offers.” More About IHS Continuing Dental Education Courses.
“Coming to Rosebud is truly an adventure for me, and the best part is living and working with the wonderful people. I’m a big city girl, yet I haven’t missed the city at all. I already feel a bond with the people of Rosebud and this area.”
Ben, Colleen and Cynthia are just three of the 550 Indian Health Service dentists and dental hygienists who are experiencing the rewards and satisfaction of a public health career, caring for the needs of underserved communities in fascinating, picturesque locales. Are you ready for the adventure? For more information about IHS Division of Oral Health, visit: www.dentist.ihs.gov .
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