Writing a Prescription for Tribal Health Care

Sokolic has been providing healthcare for the Three Affiliated Tribes for three years.

Here in the “echinacea capital of the world,” where medicinal herbs are harvested by the handful, Dr. Larry Sokolic CGS’83 coordinates the delivery of a scarcer resource: modern medical care for 13,000 people scattered across 2,500 square miles of rural North Dakota.
    Sokolic was hired by the Three Affiliated Tribes to set up an independent healthcare system for its members, who belong to the Mandan, Arikara and Hidatsa nations. Until 
recently, the tribes had contracted with an outside corporation to provide the service. Sokolic came out here from the Northeast three years ago to work as a physician and has stayed on as medical director. (Rather than take his children out of school, he commutes home to Livingston, N.J., one week a month, and his family visits him during school breaks.)
    In his new job, Sokolic finds himself blending modern medical practices with aspects of traditional Native-American medicine, such as the therapeutic use of echinacea, to gain the trust of his patients. But more challenging than cultural differences is the geographic isolation that must be overcome. The main clinic, the Minne-Tohe Health Center in New Town, is situated approximately 80 miles from the nearest significant hospital—which poses a problem when “somebody is trying to die on you,” Sokolic says. “You might have somebody with a heart attack or somebody with asthma who needs to be intubated—or a trauma you have to stabilize, so you can either fly them out if the weather is good or drive them out. I’ve had experiences where we were snowed in and we had to get the National Guard to take somebody out with acute appendicitis.”
    The long-term goal is to create a local hospital so such travels won’t be necessary; for now, Sokolic and the two other doctors are stretching their resources to develop a system for 24-hour health care at the main clinic. They also staff three other clinics in outlying communities on a part-time basis.
    About half of the tribe’s members carry private health insurance. The tribe also receives funding through the Indian Health Service and contributes money of its own toward medical care. Even so, says Sokolic, “Things are pretty tight financially. There is a kind of overwhelming need. We’re always looking for equipment to be donated.”
    The health center received about 35,000 visits last year, up 5,000 from the year before. Over that time, Sokolic has watched cases of serious illness and the mortality rate drop dramatically.
    “The most rewarding thing,” he says, “is to see the improvement of health in the community and know that the tribe is taking responsibility for the health care of its nation here. It’s no longer going to be dependent on [the federal government] or an outside company to help run it for them.” In fact, Sokolic says, “One day I’d like to see [one of the other doctors, a Hidatsa] take over, and have all the physicians here” be tribe members.

Penn-affiliated people who’d like to visit the clinic or donate used medical equipment are encouraged to contact Sokolic at (701) 627-4701, ext. 252 (phone), or (701) 627-2817 (fax).

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