When Tim McCreary, MS, PA-C, looks back at the decisions that led him to leave Alaska, become a PA with the Commission Corps of the U.S. Public Health Service (USPHS), and serve in the Indian Health Service (IHS), he knows he took the right path. As the IHS’ national PA recruiter, it’s one he would like more PAs to consider. McCreary recently talked to PA Professional about recruiting, managing a clinic and serving the underserved on the Goshute and Ute Indian reservations in rural Utah.
What’s your average work week like?
I’m a primary care PA, operating under the funding of a diabetes initiative. And so I wear a few different hats, but much of my week is spent planning, preparing and collaborating with our community volunteer group to perform diabetes activities on behalf of the Skull Valley Goshute tribe out here in Tooele, Utah. But I also work with the Ute tribes out in the Great Basin of Utah in their ambulatory clinic in Fort Duchesne and I’m the field recruiter for the agency (in my free time).
How serious is diabetes among American Indians?
As many people have come to realize, our American Indian/Alaska Native population has a higher incidence of diabetes. They also suffer more from the complications of diabetes. It affects the lives of Native Americans every day and profoundly affects our community. The Indian Health Service has found that when they dedicate specific resources to the treatment and prevention of diabetes, they can save these communities a lot of heartache as well as saving the taxpayer the extraordinary cost of emergency medical care attributable to the acute and chronic treatment of MI, CVAs and retinal and renal failure that often results from unrecognized, or uncontrolled, diabetes.
How did you get this job?
Back in PA school I attended an NHSC scholarship conference, and while there attended a presentation conducted by a very impressive PA in a military uniform. It was my first introduction to the little known branch of government known as the U.S. Public Health Service. I remember, while he spoke, thinking that this might be just the thing for me.
Since joining the USPHS five years ago, I have been able to work with several different Indian Health Service programs, live and work in some of our country’s most scenic countryside and enjoy serving in a unique and welcoming culture. Because the Indian Health Service clinic system is community based, we have the opportunity to really get to know our patients, and treat the entire family, often all at once, often in the same exam room.
In this capacity, I’ve been provided remarkable autonomy—writing my own grants, managing clinic assets and participated in the hiring selection process. I’ve even been allowed to start and direct a small clinical program in my current position here in Utah.
What are the challenges of working in such an austere setting?
Sometimes, you have to be inventive and figure things out for yourself. I like that kind of challenge. You have to be resourceful. This is a job where your whole intellect is brought to bear, where you can be creative, where you can be innovative, where you can use your unique background to benefit a population that you’re passionate about. That’s the thing I probably like the best about the work I do. I don’t have ready access to everything that you would have at a tertiary care center. So it’s about a good physical exam, really good history taking. It’s coming to understand your patient’s situation and listening to what they have to say. You have to use what you have, and, often to my surprise, more often than not, it’s all that you need.
What about your job as the agency’s national PA recruiter?
I love it. I’ve been doing it now for almost three years. I get the chance to talk to PAs every week from all over the country who might be thinking about working with the Native American population. Maybe they’ve got some loans and they want a place to take care of those and go on an adventure for two or three years. The Indian Health Service is a great place for that, but for many, including myself, it’s the career we never knew we would enjoy so well. It’s a home for that part of you, the best part, that yearns to be of use in the world, where your voice actually counts and every helping hand actually does make a difference.
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