Indian Health Services Northern Navajo Medical Center Shiprock, New Mexico

1. Indian Health ServicesNorthern Navajo Medical CenterShiprock, New Mexico Mark Huffman, MD, MPH University of Michigan Department of Internal Medicine

2. Indian Health Service • Branch of the Department of Health and Human Services (DHHS) • Free care to Native Americans • Hospitals, clinics, outreach, prevention • Most run by IHS, some by tribes

4. Northern Navajo Medical Center • Northern Diné: NM, Utah, Arizona, Colorado • Full-service hospital • 75 beds • 60,000 patient base • Four outlying clinics

6. Barriers on the Navajo Nation • 78% of public roads unpaved • 60% of homes lack telephone service • Many lack electricity and running water • Lack of transportation

8. Common Diseases in NNMC… • Diabetes and its complications • Coronary artery disease • Rheumatologic diseases • Cholelithiasis • IgA nephropathy • Nonalcoholic steatohepatitis • Alcoholism and alcohol-related disease

9. …and Some Not Seen in Ann Arbor • TB (endemic) • Plague • Rheumatic heart disease • Hantavirus • Uranium mining related diseases • Rattlesnake bites

10. Work Logistics • 4.5 days/week of outpatient clinics • 1-3 inpatients/day • ~1 call night/week • Limited services at NNMC (no HD, e.g.) • Open ICU • Great attendings

11. Free Time Logistics • Wednesday afternoon/weekends free • State/national parks: Arches, Canyon de Chelly, Mesa Verde, Canyonlands, Monument Valley • Skiing: Taos, Durango, Telluride

12. Administrative Logistics • Primary costs: flight, car rental, fun • Lodging covered by IHS • Stipends available through IHS/AMA • Contact person: Brandy Allen (brandy.allen@ihs.gov)

13. Monument Valley National Park

14. Balanced Rock, Arches National Park

15. Telluride, Colorado

16. Shiprock, New Mexico