The goal of the Native American track of the Physician Assistant Program is two-fold. The first and primary goal is to increase the number of culturally sensitive health care providers in Indian country by training American Indians to become PAs. Currently, the AAPA reports that less than 1% of PA providers in the U.S. are American Indian. The second goal of the program is to develop and successfully implement a distance learning model for physician assistant curricula, with the ultimate plan to provide training of American Indian PA students within their local communities.

Success has come in many forms over the past 3+ years. Most notably the graduation of the Native American PA track Charter Class in August, 2003. Six graduates received their Masters Degree in Physician Assistant Studies.*

Other successes in 2003 included the program recipient of the APAP award for Excellence through Diversity. This was the first time the APAP has given this award. It was an honor for the program to be acknowledged. Most notably, it reflects that the APAP, and the PA community at large, are committed to improving diversity in PA students. The award was truly a reflection of the success of the American Indian students to excel in this type of PA training program.

The application for continuation of the HRSA grant, which funds a significant portion of the program, was approved in 2003 for an additional three years. This allows the program to continue the current goals and consider additional ones, such as expansion of recruitment for the August, 2004 matriculating class, and additional focus on retention of students in the program.

The 9th Annual Innovations in Health Care grant was submitted by Linda Knutson, MEd, MS, PA-C, Director of the Physician Assistant Program at the Arizona School of Health Sciences and Janné Croll, MS, PA-C, Past Director of the Native American Track of the PA Program. The application was funded. The money will be used to upgrade of existing technology for the program.

Currently, the students attend classes off site at the Williams campus 3-4 days a week. Classes are broadcast at the Williams campus via interactive television.

Students are able to ask questions and interact with their on-site classmates and instructor during the class. Additionally, a physician assistant is available at the Williams campus to answer questions and provide educational support when needed.

Clinical training in the second year is focused on sites that are located within the Indian Health Service or Tribal health care facilities. The program has been fortunate to have the support of several facilities in the Phoenix area. Phoenix Indian Medical Center, under the support of Dr. Anthony Dekker, has provided invaluable clinical training to students in the areas of Family Medicine, Internal Medicine, Surgery, Pediatrics, Women’s Health (OBGYN), and Emergency Medicine. Additionally, other health care facilities have provided training such as Gila River Health Care Corporation (Hu Hu Kam Memorial Hospital and Gila Crossing Clinic), Sage Memorial Hospital in Ganado, and Whiteriver IHS Hospital. There are three students in our second class to graduate in August, 2004.

Our largest class is in their first year of didactic training. Seven students are more than halfway through their first year. They anxiously look forward to the excitement of the second year when clinical training begins.

Although the program faculty changed in 2004, the commitment for success of this program continues. 

Randy Danielsen, PhD, PAC
Chair, Dept of Physician Assistant Studies
Linda Knutson, MEd, MS, PAC 
Director, Physician Assistant Program
Cynthia Wilson, MA, MFA
Director, Native American PA Program
Bryan McCleney, MEd
Recruitment Native American PA Program
Janné Croll, MS, PAC
Coordinator, Native American PA Program

There is no doubt about the growing acceptance of alternative and complementary medicine in this country and this trend is almost certain to increase. The number of medical providers as well as patients who have become aware of the safety and efficacy of alternative therapies is increasing. More and more people no longer seem to be afraid to express their discontent about the limitations of western medicine and want to hear more about something that goes beyond the pure “scientific”. 

Alternative medicine which is not an innovative trend for American Indians, is reaching out past the confines of its ethnic roots.   For some of us, traditional Indian medicine has always been the norm and western medicine has been a second choice. Traditional healing beliefs and practices are integrated into our everyday lives so thoroughly that we are only occasionally conscious of them. Similarly, healing is seldom distinguished from prevention; an entire approach to life is involved not merely a response to a particular disease. In fact, some of us are hardly aware of our traditional healing practices because they are so pervasive in our everyday way of thinking. 

Although we are aware that there are variations in healing practices from tribe to tribe, we know that there are certain basic beliefs which are nearly universal among Indians and are practiced across tribal lines. American Indians believe that health is a state of harmony in the mind, body and spirit and we see medical treatment as a combination of medicine and spirituality. 

Also, for many years, the integration of traditional tribal practices with western medicine has been practiced in Indian country.   The most well known of these integrated systems is probably the hogan-style facility used for traditional healing purposes built on the grounds of the IHS hospital in Shiprock, New Mexico. Needless to say, such integration has been successful because the two systems are not in competition. Rather, trust and rapport have been established with mutual respect, and the two systems have complemented each other benefiting both providers and patients. 

During our AAPA Conference in Atlanta, First Nations sponsored a CME lecture presented by James Cannon (First Nations President) and this author on alternative medicine with an emphasis on American Indian Medicine. Our CME presentation in Atlanta, which emphasized the integration of the mind, body and spirit as part of the healing process, was well received. It emphasized only general principles without going into details about our sacred practices. We were very pleased with a nearly full room of attendees and the positive reaction that the presentation evoked. People approached us several times during the entire conference expressing their desire to hear more about our traditions. 

Similarly, First Nations has periodically received requests for publications on American Indian medicine. However, when it comes to putting in writing our traditions, my response has been skeptical. I am always willing to teach people who have a genuine respect for our traditions. Nonetheless, I inform people that traditional medicine is not easily spoken of among my people because we consider it sacred and a gift from the creator not to be misused. To many of us, traditional healing practices remain guarded oral traditions. Sharing this knowledge without care and discretion is to weaken the spiritual power of our medicine. Because of this, it is always easier for me to orally teach our beliefs rather than disseminate information in writing not knowing where and whom it might reach. Needless to say, I would want to be sensitive about acting against the general wishes of my own people particularly the elders.

Further, in informing others about our traditional health practices, I am also aware and quite convinced that we could not effectively teach others about our traditions if we attempt to do it in a westernized/scientific dispirited form.  If we treat alternative medicine like any other health technology, we will be creating just another form of dispirited medicine.  Further, we would fail in our purpose of giving health providers some of the vast potential found in our traditional health beliefs. Alternative medicine to American Indians is spiritual based medicine.  It would be impossible to attempt to explain it in a mechanistic, scientific oriented manner.  Hence, when teaching others about our traditions, it only makes sense that we attempt to do it in a way that matches our worldview and spirit orientation.  Doing it otherwise could result in the compromising of our sacred traditions and cultural principles.