Building Clinician Diversity: Helping Indigenous Communities Take the Healthcare Reins

One of the most pressing issues in tribal healthcare is the extreme shortfall of Native American providers and lack of clinician diversity.

The Association of American Medical Colleges reports that fewer than 1% of students identify as American Indian or Alaska Native. Not surprisingly, physician vacancy rates are nearly 30% in some areas of Indian Country, according to the U.S. Government Accountability Office.

There aren’t nearly enough Native Americans nurses, either. A report from the National Council of State Boards of Nursing and The Forum of State Nursing Workforce Centers indicates that just 0.4% of registered nurses are American Indian/Alaska Native.

Why the lack of clinician diversity in healthcare?

Among the most common reasons:

  • Disparities in K-12 education and a lack of academic support in indigenous communities leave students underprepared for higher education.
  • Widespread financial challenges make higher education unaffordable for many students and their families.
  • Students have limited experience with Native American clinicians and may not think of healthcare as a possible career path.

At Tribal EM, we are working to address the Native American clinician shortfall. We actively recruit within the communities we serve and support new employees in furthering their education. When they’re first hired, they typically only qualify for lower-level positions – but not for long. Today, nearly 90% of our medical assistants are from the local community. Even more exciting, we’re paying tuition expenses for staff and their family members who want to pursue degrees in nursing, advanced practice, or other clinical paths.

In addition, we’re now rolling out a scribe employment program for tribal members. This achieves two purposes: First, scribes focus on recording patient notes while the doctor focuses on the patient visit. Meanwhile, positions like this increase the healthcare knowledge and experience of community members. 

Why the extra effort?

It may sound funny, but our ultimate goal is to create a healthcare system so sustainable that tribal communities no longer need outside support. On the one hand, we know that hiring from within the tribe improves the local economy. In addition, we want to transform the system from the inside out – and that means encouraging education and filling the pipeline with Native American medical talent.

We know that Native Americans can provide care that’s perfectly consistent with the cultural values, lifestyles, and spiritual beliefs of their communities. Most importantly – they can make a real and lasting difference in patient care for tribes and nations. Given the drastic disparities in healthcare and outcomes among Native populations, this is absolutely crucial.   

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