Category:Overview of YKHC Medical Practices

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Overview of YKHC Medical Practice

General Overview

The Yukon-Kuskokwim Health Corporation (YKHC) is a Native owned and operated health care system. It is located in Bethel, off the road system, which makes it “Bush.” It is 400 miles west of Anchorage. Bethel is the regional medical hub for the Yukon-Kuskokwim Delta. YKHC provides health care for over 27,000 Yup’ik Eskimo and Athabascan Natives living in 50 villages scattered over an area the size of Oregon. Subsistence is a way of life for most village families. The culture is largely intact; many village preschool children and elders speak Yup’ik only. The population of the region has recently re-achieved the numbers that existed before the measles, influenza and TB epidemics of the 1950s. The result is that over half the population is less than 18 years of age.

Overview of YKHC Medical Practices

A medical staff of over 80 physicians, midlevels, dentists and optometrists provide comprehensive inpatient, outpatient, obstetrical, and emergency services in Bethel. In the villages, Community Health Aides are integral in the delivery of care. Five villages also serve as subregional clinics in conjunction with village health aides and midlevel practitioners. YKHC is an exciting place to work. It is remote but not isolated. Medicine stays vibrant and on the cutting edge of quality with clinical rounds, telemeradiology, clinical research, telemedicine, use of local and statewide evidence-based guidelines, and the opportunity to train and mentor students and residents.

Practicing medicine in this region presents unique and interesting challenges (and frustrations). Working in a remote region spread out over a large area, Bush medicine has inherent travel and outreach issues. Working in our health care system is similar to practicing medicine in a third world country with a high quality infrastructure of well trained and experienced clinical staff; a comprehensive electronic medical record system; CT scanner, full laboratory services, level four trauma center, medevac systems, OR back up and tertiary services available a plane ride away.

Medicine at YKHC is unique and interesting. It runs the gamut from primary care to subspecialty co-management of patients to critical care with NICU/PICU/ICU patient stabilization and transport. Our physicians, midlevels, nurses, clinical pharmacists, physical therapists, respiratory therapists, dentists, optometrists and support staff all work closely as a team to provide excellent patient care. We all depend on each other and support each other to provide the best care possible. We try to orient our new medical providers as well as we can before and after they start working here, but there are so many unique and uncommon challenges that it takes at least a year to get comfortable with how handle the many of the medical challenges that come up. This is why we expect all new staff to ask lots of questions and consult more experienced providers with any care, follow up, referral issues that come up. More experienced providers are also expected to help new providers and give them advice and feedback in a timely and constructive fashion.

Team Work

In our environment of limited resources and staffing, a culture of good teamwork is critical to providing good patient care especially at a busy facility such as ours. The nurses, RTs and pharmacists caring for our patients are very good clinically and they know our patient population well. If a team member communicates that they are concerned about a particular patient you should take their concern seriously. They will often be your eyes and ears as you will rarely have time to spend a lot of time with your patients. Treat the staff with respect and consider them a valuable member of your healthcare team. Praise them for a job well done.

A Glimpse of YKHC Bush Practice

Presentation with pictures of YKHC facilities, staff, and people of the region. pdf 2 mb

Practicing Medicine in Bush Alaska—Some ABCs

A Guide to Common and/or Unique Clinical Issues

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