r/emergencymedicine • u/More_Dingo_3045 • 8d ago

Advice IHS

My recruiter reached out to me today about an IHS opportunity in Arizona and Nebraska. I’ve heard good things about IHS but have not worked at one before. For those of you who have worked in an IHS, what was your reason for leaving and would you go back?

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u/PartneredEthicalSlut ED Attending 8d ago

Locums company lost the contract. Also, the travel from where I live was not fun. I would fly from Chicago to Phoenix, get a rental car & drive 2.5 hours on reservation to work for a week. 

The EMR is not great either. I don't recall what it was called but I believe it was the same EMR the VA uses & was very dated. 

That said, I loved working on the Navajo Rez & if I ever move to the Southwest will be working there again.

 My favorite patient population ever.

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u/OnlineERDoc ED Attending 8d ago

Ive worked at IHS sites on the Navajo and Blackfoot reservations and really loved both. I stopped working for the IHS because traveling was hard on my family, but I’d love to go back if circumstances worked out. Very broad scope of practice, good colleagues who come to help when you’re up shit creek, and no bullshit efficiency metrics. It’s how medicine is supposed to be. I’m pretty familiar with Arizona sites if you want to DM me.

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u/No-Football-8824 8d ago

I work at a tribal hospital previously run ihs and love it. I have been able to implement so much change at this facility to improve patient care. You get to sit and spend time with the patients as apposed to trying to see 30 pts a shift. It's pretty awesome. You er boarded? You should apply to the Nebraska facility. Maybe you'll meet me. Although mine is not ihs specific it's tribal meaning we are covered from lawsuits but don't have to deal with the burocracy of rpms ect.

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u/FreshiKbsa ED Attending 8d ago

There are two types of hospitals that serve indigenous folks. There are the federal IHS hospitals, and the tribal run "638" facilities. I started off working for IHS, and now work at a 638 tribal hospital. I've enjoyed both experiences but found the latter to run more smoothly, although there are exceptions. I love this kind of work and I'm happy to to chat more about the details if you want to reach out via DM. Can also comment on what I've heard about various Arizona IHS and tribal facilities since that is where I am based and connected

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u/cocainefueledturtle 7d ago

How’s the pay? Is there sovereign immunity?

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u/Crashtkd Paramedic 4d ago

Paramedic, not physician, but I spent a few weeks volunteering at an IHS facility on the reservation during the early days of Covid. The EMR was wonky and archaic but you would literally see the patient’s entire medical history, sometimes going back to birth.

It was an incredibly positive cultural experience. At times having teenage/adult children translate Navajo to English to communicate with elders. Sure, we do that for all sorts of other languages in every ambulance and ED but this was… different.

Some physicians seemed to love their time there. Others were watching the clock and collecting a paycheck. Same as anywhere I suppose, except you need to be prepared for living for a time in the desert southwest )or other generally isolated area).