Family Physician and Educator
“I always wanted to be a physician,” Dorscher remembers. “When animals were hurt, I took care of them. When my friends and I played army, I was always the medic.” Dorscher, however, had little or no support for fulfilling her dream. “I’m from a blue-collar background,” she explains. “Our family is hard working, but I didn’t have many opportunities growing up. College wasn’t highly valued. We were expected to go out and get a job.”
In spite of the odds against her, Dorscher did go to college immediately after high school. “I had no idea about how to go to college,” she admits. “My parents didn’t know what to do. I got into the College of St. Scholastica in Duluth, Minnesota by filling out the same forms that my friend filled out.”
Although Dorscher did well in college, she didn’t think that she had what it took to become a physician. So in 1981, she graduated from St. Scholastic with a degree in medical technology and took her first job in Duluth rather than applying to medical school. Her second job was in Little Fork, Minnesota in a 10-bed hospital in a 30 bed attached nursing home with an outpatient clinic. “There was one physician there,” Dorscher recalls and then with a smile adds, “I took over as the head of a tiny little lab. I was the full-time person, and I supervised the part-time person.”
While working at Little Fork, Dorscher became pregnant. When she was 6 months pregnant, the hospital closed. “So here I am with child, without a job. Although there was some interest in marriage, I was better off being a single parent. I decided that medical technology wasn’t for me. I wanted to go into a different line of work. I decided to go back to school and become an accountant. However, the day school started, my daughter was born, so I didn’t go to school.”
While she was still in the hospital with her baby, Dorscher was offered a job in medical technology in North County Hospital in Bemidji, Minnesota. This job gave her the opportunity to make a home for her daughter Cherelle and herself. She also met three people who supported her in pursuing her dream to become a physician.
“Pat Rock a young man from Leech Lake Reservation was working his way through Bemidji State University as a phlebotomist in the lab. He kept saying, ‘You know, Joy, you’re exactly what medical schools are looking for.’” (Rock became the Medical Director of the Minneapolis Indian Health Board.).
“Another important person was Ranae Womac, who worked in the Native Americans into Medicine Program at Bemidji State University. Once I told her about my interest in medicine, she made sure that I kept on task and met all the deadlines for the applications. Now she is Dean of the College of Social and Natural Science at Bemidji State University. Quite a phenomenal woman.
“Another person who was sort of put in my path was Hugh Ranier, the physician who delivered my daughter and became a colleague at North Country Hospital. He told me that I should go back to school. I think that he contacted the Dean of Admissions at the University of Minnesota at Duluth and pleaded my case.”
Finally, Dorscher took the courageous step of applying to medical school. “I figured once I got rejected, I’d be satisfied to live the life I was living. I never thought I’d get in. I thought it was a dream I couldn’t attain.”
Entering medical school
To her amazement and delight, Dorscher was accepted at both schools to which she applied. She decided to go to the University of Minnesota at Duluth (UMD). Her desire to be a rural family physician fit perfectly with UMD’s mission to educate students, who will practice family medicine and other primary care specialties in rural Minnesota and in American Indian communities.
UMD has a two-year curriculum of basic medical and clinical sciences with an emphasis on rural family medicine and its interrelationships with other medical specialties. Full-time and part-time family medicine practitioners and other primary care physicians serve as role models. UMD doesn’t have its own teaching hospital, but Dorscher and the other students had clinical opportunities in local hospitals that care for a diverse patient population from the northern regions of Minnesota, Wisconsin, and Michigan.
What was it like to be a single mom and a medical student? Dorscher answers, “As a single mother I have to admit it was easier for me than it was for other students. Don’t get me wrong. It was tough. But my daughter kept me grounded. She reminded me about what is important and why I was in school. I think she was a huge asset in my education.”
Another major source of support was CAIMH (the Center of American Indian and Minority Health). “I honestly believe that if it had not been for the CAIMH, I wouldn’t have made it. Dr. Gerald Hill, Klamath Tribe of Oregon, was the director then. He was a great support. Going to AAIP [Association of American Indian Physicians] meetings, meeting role models etc., it was all important to my success.”
When Dorscher completed the two-year UMD program, she and the other successful students transferred to the four-year program at the University of Minnesota School of Medicine in Minneapolis. She found the big city campus to be “intimidating” and so chose to do her rotations at hospitals off campus. Finally, after completing her third and fourth year of medical school, Dorscher realized her long time dream and became a medical doctor.
Selecting a Residency Program
Dorscher went to medical school to become a rural family physician. She “tinkered” with the idea of becoming an internist, but ultimately she chose family medicine because she felt that family medicine programs would accept “all of her,” including her status as a single parent.
Indeed, both she and her daughter felt welcome at the family practice residency program at St. John’s Medical Center in Minneapolis. “It was the best fit for us. When I was on call in the evening my daughter stayed with me in the on-call room. Families were welcome there. Usually the spouse would come in with the children and the resident, and family would have dinner together. If the resident had to leave the room and take care of the patient, the spouse would look after the children. It was different for me. When I had to leave to take care of a patient, however, I knew my daughter was in good hands. She got to know everyone there. The janitors, nurses, and the doctors welcomed her.”
Dorscher loved caring for patients and their families: “The best part of medical practice is the family connection. Taking care of all family members and understanding their health and illness in the context of their family is very satisfying. It‘s a great honor and it’s humbling to be allowed into their lives.”
In recognition of her capabilities, the faculty and other residents honored Dorscher and one other intern with the “Intern of the Year” awards
Despite her love of patient care and the support she received Dorscher says, “I have to admit that there were multiple times when I thought I was going to have to quit. I couldn’t get day care or something wouldn’t fall into place. However, every time this happened, someone was there to help me. Someone watches out for me. Don’t ask me why. I feel very strongly that I have a responsibility to give back.”
As soon as she completed her three-year residency program, Dorscher took two positions. Her primary appointment was as Associate Director of CAMIH under Dr. Hill. Her tasks included negotiating contracts with consortium schools, overseeing the staff, mentoring students, and developing summer programs and course work.
Dorscher’s secondary appointment was as Assistant Professor of Family Medicine at UMD. In a community clinic she saw her own patients and supervised medical students. She also taught family practice residents in the hospital, did obstetrics, and was on call.
“Splitting my time between two jobs was challenging,” she recalls. Over time Dorscher decided that the best way she could give back was by giving more of her energy to bringing more American Indians into medicine, so in 2003, she became the Director of CAMIH.
More recently, in addition to recruiting and supporting American Indian health professions students, Dorscher is working to develop American Indian medical educators – academic physicians. “We need to develop faculty to work within a university setting. Students need role models. They need a safe place. Sometimes when students talk with me, they revert to a different form of language – a different way of accenting their words and putting their grammar together. This tells me that sometimes they may have to keep themselves in check when talking with others. Students can say things to me that don’t make any sense in Western medicine. Or they can say, ‘I have a patient who I think needs a traditional healer. How do I go about doing that?’
“Medical education can be a very difficult environment. This is especially true for rural students and students who are the first ones in their family to go to college or medical school.”
Faculty members are expected to do research. Dorscher feels strongly that we need American Indian faculty who “are cognizant of traditional values, understand western medicine, and can blend and meld the two.” She continues, “Minority faculty are also needed so they can bring forth the agendas of minority populations. Women in medicine are bringing forth women’s issues. African-Americans in medicine are bringing forth African-American issues.”
As an example, Dorscher mentions African-American Ann Taylor’s breakthrough work on heart failure in African Americans. “Someone who didn’t have her background and her focus probably wouldn’t have thought of this study,” says Dorscher. “Ultimately we are experts on ourselves. That’s what we know.”
Because of the horrendous way that too many researchers in the past have used American Indians, Dorscher contends that it is even more important that American Indians be leaders who can ensure that Native people approve of and are active participants in any research involving their communities.
This article was originally published in the Winter 2006 issue of Winds of Change. The cover artist, Roxanne Chinook, is a tribal member of the Confederated Tribes of the Warm Springs Indian Reservation in Oregon. "My art emulates a personal and cultural experience, from the spirit of the trickster to healing from the traumas of my past." For more information, contact American Indian Art from the Pacific Northwest.