Vi Waln: Seeking more accountability from Indian Health Service

I understand that the Rosebud Comprehensive Health Care Facility will see a new Chief Executive Officer come aboard soon. I heard the name of the administrator mentioned at a recent Rosebud Sioux Tribal Council meeting. She is Lakota and a Medical Doctor.

I hear tribal officials talk about how we need our own people to be doctors. Now we will have a Lakota medical doctor running our hospital instead of treating sick people in the clinic. Why go to school to be a medical doctor only to take a job as an administrator? Still, I hope we don’t run her off in the same way we’ve chased away other employees.

The doctor will be tied up in administration instead of working in the clinic. Hopefully, she will straighten the place out. This doctor has worked at Rosebud Hospital before. I would bet money she is aware of the unhealthy cliques that thrive in the facility.

Still, I won’t cross my fingers waiting for change because they might have to stay crossed. If you don’t understand the concept of waiting, all you have to do is go into clinic to be seen. It’s a great lesson in patience.

While you are sitting there in the atrium waiting it gives you a lot of time to watch people come and go. It’s also a great opportunity to observe the staff at the hospital. Recently, I accompanied my family on a clinic visit and sat down to watch. Now I don’t have to tell you this but employees are downright rude at the Rosebud Hospital.

In fact, I remember reading a memorandum issued to all the Indian Health Service staff by Director Dr. Yvette Roubideaux. Her note to the employees stressed customer service.

What? I believe Dr. Roubideaux could be focusing her time on more important things, such as recruiting and retaining qualified medical providers who will come to our hospitals to stay more than just a couple of years. But instead she has to continuously remind the employees that they are to be polite and courteous to all the beneficiaries who use I.H.S. facilities.

Anyway, back to my observations. I saw a clerk who appeared extremely busy with paperwork answer the telephone and heard her say to the caller “please hold.” Then she went back to the papers. I watched to see when she would get back to the person on the telephone but she never did, she just continued writing on whatever was more important than the possibly ill person on the telephone. How rude. Soon a nurse came into the office and I saw her notice the telephone so she picks it up but by then the person had obviously hung up. Now I know what really happens when I am put on hold by a polite sounding clerk on the other end of the telephone!

Another thing I was made aware of recently was how some employees don’t pay attention to the patients like they should. For instance, one time I went in for a clinic visit to get my prescriptions refilled. The doctor I saw was looking at his computer when I went into the examination room. He asked me what I was there for. So I said I needed refills on my medication.

Still looking at the computer he rattles off several medicines he thinks I need. I didn’t recognize any of the medicines he mentioned. So he looks at my chart and then looks at his computer screen, it was only then that he realized he was looking at the wrong patient on his computer.

A friend of mine also has to visit clinic regularly for a chronic illness. Recently on a visit to clinic he was sent to the lab for blood tests. The employee took the blood samples and then called him by a different name. Huh? This made him wonder if the right tests were actually done on his blood. Sometimes we put ourselves in greater danger when we visit the clinic!

Consequently, my daughter always makes sure that all the grandchildren are seen and prescriptions are written for their ailments. When a clinic visit to Rosebud is a successfully one for her, she will say “they didn’t send us home to die.” I always know that means they got medicine for their illnesses.

And then there is always concern over money. Our Indian hospitals are never fully funded. Right now you cannot buy an appointment at Rosebud Hospital because there are no permanent medical providers. We recently ran off some good permanent doctors we had! Dr. Cozan is gone. Dr. Rotelli is gone. Both have moved on to other places, probably due to the internal politics at Rosebud Hospital. Now that is just pathetic because they were both excellent providers.

Also, I would encourage tribal officials to ask the I.H.S. administration how much income Dr. Cozan and Dr. Rotelli generated for Rosebud Hospital during the time they were here. There are ways to figure that out; right? How much Medicaid and Medicare reimbursements flowed into Rosebud Hospital because of the patients served by just these two providers? How has their leaving affected that income?

I would also like to know how much money we are paying the temporary staff to work at our facility. Oh and how much does it really cost to recruit temporary providers? Do temporary doctors get paid more money than permanent providers would?

It also seems more people are being flown out. Is this because we don’t have anyone who knows how to treat their illnesses or is it because we have an airport right next to the hospital? What about the astronomical charges for these flights? We cannot expect our people to pay bills for medical flights because most of them don’t even have income.

Rosebud just had an election. Another election is coming up next summer. Please ask your tribal council representatives for a comprehensive report on Rosebud Hospital.

Vi Waln is Sicangu Lakota and an enrolled member of the Rosebud Sioux Tribe. Her columns were awarded first place in the South Dakota Newspaper Association 2010 contest. She is Editor of the Lakota Country Times and can be reached through email at vi@lakotacountrytimes.com.

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