Joy Dorscher
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.”
Getting
support
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.”
Giving
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.