Patrick Rock
Patrick
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
of Minneapolis.
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.
Career
Decision
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.