Rock, Leech Lake Band of Chippewa, MD, is Medical
Director and CEO (Chief Executive Officer) of the
Indian Health Board (IHB) of Minneapolis. When the
following article was published in
Winds of Change,
Dr. Rock was Medical Director, but not yet CEO, of the IHB
Family Physician and Medical Director
“I enjoy my work very much,” declares Rock, a family physician. “I’ve been here about 8 years. Each morning as I get out of bed, I’m very happy to come to work. I look forward to how the day will develop, what new challenges I will encounter.”
The Indian Health Board of Minneapolis was established in 1969 as the first urban health care program in the United States for Native people. There are 34 programs throughout the United States.
Rock says, “People think that Native people who live in urban center have a better level of health care than their rural counterparts. I don’t think that’s true. I think that the urban Native population is probably one of the most underserved populations in the U.S.
“About 61% of the Native population lives in urban setting, but the Indian Health Services gives only about 1% of its budget to urban programs. The rest goes to reservations or tribal entities. That’s why at our clinic we see so many preventable problems and unnecessary complications.
“One of the interesting things about an urban practice is that you see people from all walks of life and all races. Most of our patients are Native. Some non-Native people in the local neighborhood also access our services. Some people have insurance; some don’t. We don’t turn people away if they’re unable to pay for the service. We see them.
“The Indian Health Board of Minneapolis is a primary care clinic, providing a wide range of services for people, ranging from infants and children to elders. "The agency is housed with a dental service and also a counseling support clinic where we provide psychological and psychiatric services" he elaborates. "We have a nutritional support program for women, infants and children (WIC). We have 5 medical doctors. Three of us are Native doctors. I’m a family physician and the other two Native doctors are internists. In addition, there are two other family physicians.”
Practicing Family Medicine
Rock finds family practice stimulating: “No day is the same. You usually don’t know what to expect or what is waiting for you.” His day might start with a well baby check – an examination to make certain that the baby is progressing normally and has needed immunizations. Rock says well baby and well children checks are important opportunities to educate families and to do preventive work.
Rock’s next patient might be someone with a laceration that needs to be sutured. The following patient might have had had a tragedy in her life and need Rock’s empathy and his listening and counseling skills. And so his schedule goes all day long - babies, mothers, children, teenagers, single people, fathers, and elders. Some people come alone; others come with family members or friends. Some have long-term chronic problems; some have acute problems, such as a severe earache, that have to be addressed immediately. Some want annual check-ups; others don’t feel good, but don’t know what is wrong.
Rock experiences continuity of care: “I do obstetrics and prenatal care,” he says. Now I see 8-year olds who I took care of when they were in their mother’s womb. They point to me and say, ‘Dr. Rock is my doctor.’ That is very heart warming.
“My practice is challenging. There’s a fast change of pace,” Rock observes. “My practice is often very rewarding in the sense that I feel that I’m doing what I’ve always wanted to do – promote wellness and provide health care for my people.”
Traditional Health Care
Unlike the patient populations in clinics on a reservation, the Native people who go to IHB are members of many tribes (mostly in the upper Midwest and Canada). “This makes it more difficult to provide traditional care,” says Rock. “ Offering one service wouldn’t fit many people’s beliefs and traditional ways. We do make referrals, though,” he adds. “And traditional medicine is talked about very freely. For example, during the initial interview we ask people if they practice traditional beliefs.
“ I had a patient who had a significant social-based problem. She was having a significant grief reaction and depressive symptoms. I didn’t think that medications were warranted. I felt there were other avenues to help this person process her recent experiences. I asked her if she practiced traditional methods/ ways and whether she could look to these ways to help with this process. She agreed that she could turn to these ways, so we didn’t have to use medication. She successfully navigated the issue.”
From Army “Brat” to Medical Student
“I was an army brat. I was born during the Vietnam era. My father is Native. He met my mother in Europe, and I was born in Germany. Subsequently, we lived throughout the U.S. because my dad was transferred all the time. Finally we came back home to Leach Lake Reservation in Minnesota where my dad worked for Cass Lake Indian Hospital for many years. During that time I had a lot of interaction at the hospital with a variety of providers.
“During college I did emergency medicine and then paramedic training, and I volunteered for the Leach Lake Tribal Ambulance Service. I felt a strong draw to practice medicine and work with my people. I had always wanted to be a doctor, but working with my people on the home rez gave me direction.”
While attending Bemidji State University, Rock had 3 or 4 jobs at a time. He worked as a phlebotomist and an orderly at North Country Hospital. He also did counseling and summer programming at the university.
With the support of his parents, Rock applied to and was accepted at the University of North Dakota School of Medicine. He was part of the INMED program and attended the INMED summer program for matriculated medical students. “It was a very helpful program,” he remembers. “Typically when you start medical school, you’re out of the chute the first day of class. If you fall behind, it’s very hard to catch up. The summer program gave us a picture of what to expect in medical school, including the intensity at which you’re expected to study. We learned that you need to know the material in detail.”
After his first year of medical school, Rock helped teach biochemistry in the summer program. He recalls that INMED provided excellent mentoring and tutoring throughout medical school. Rock was grateful to be on an INMED linked scholarship, so that he didn’t have to juggle outside work and an intense medical student schedule.
After graduating from medical school, Rock thought he might like to be a pediatric surgeon. “When I was looking at surgical residency programs, a surgeon asked me to tell him about the most interesting case I had been involved with as a medical student. I described a 90-year-old man who was a former professor at the UND when they used to teach Latin in medical school. The professor tried to teach me some Latin words. I enjoyed him and visited him multiple times each day."
Rock learned that the surgeon and his colleagues weren't interested in Rock's relationship with the patient. They wanted to know what procedure the patient had undergone. “That’s when I had my epiphany," says Rock. "That experience told me that since I focused on the human part of health care, family medicine is probably where I needed to be."
Rock is still happy with his decision to do his family practice residency at Hennepin County Medical Center. “Some doctors will tell you that their residency was hard on them because of the lack of sleep or the level or intensity of work that they do. I enjoyed it every second. When I look back, I wish I could do it again.”
One of the things that Rock enjoyed about his residency was working in an inner city center with Native people. That’s what led him to his current work at the Indian Health Board. “People at home ask me when I’m coming to practice medicine in our clinics. I feel an incredible sense of need here, though. People don’t get the level of service they need. Some don’t have insurance or don’t feel comfortable accessing the large health centers. They fear they might be looked on differently or they feel that they don’t belong in that health care setting.”
Clearly, Dr. Rock and his colleges at the Indian Health Board have created a place where Native people feel at home. And, perhaps, IHB is something of a second home for Rock.
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 conformation, contact American Indian Art from the Pacific Northwest.