Mankiller Health Center’s dental clinic to close temporarily
STILWELL, Okla. – The Cherokee Nation’s Wilma P. Mankiller Health Center will be temporarily closing its dental clinic for remodeling starting June 18.
The clinic will resume operations and begin seeing patients again on July 2. Patients who have appointments during the time of temporary closure will be notified and rescheduled.
Fore more information, call 918-696-8800.
TAHLEQUAH, Okla. – The Cherokee Nation’s Health Services is introducing a program to educate patients on alternative ways other than antibiotics to heal common illnesses.
According to recent information released by the U.S. Centers for Disease Control and Prevention, antibiotics are often misused for illnesses such as influenza and the common cold, and like other medications, they could have side effects.
According to the CDC, antibiotic resistance is a growing problem in the United States and across the world. The CDC states the main driving factors behind antibiotic resistance are the overuse and misuse of antibiotics.
Using the CDC guidelines, the tribe will more closely monitor antibiotic prescriptions and the use of antibiotics by patients throughout all CN health facilities.
Leadership at Health Services’ nine health centers and W.W. Hastings Hospital is also working to further educate staff on the proper use of antibiotics.
“We strive to educate our citizens and our doctors about the possible dangers of over prescribing medications and of building antibiotic resistance,” Health Services Executive Director Connie Davis said. “Throughout Cherokee Nation Health Services, we treat more than a million patients per year, and it is so important that we stay vigilant and educated when prescribing.”
In 2012, Hastings Hospital began the antibiotic stewardship program within its inpatient care, and this year the program will expand to the tribe’s nine health centers, positively impacting the health and treatment of even more CN citizens.
“Antibiotics can be a life-saving or life-threatening intervention depending on how they are used,” Health Services nurse practitioner Whitney Essex said. “We are committed to improving patient outcomes by using antibiotics responsibly.”
The CN operates the largest tribal health system in the country. In fiscal year 2016, the tribe had more than 1.1 million patient visits. For more information, visit <a href="https://www.cdc.gov/getsmart/community/index.html" target="_blank">https://www.cdc.gov/getsmart/community/index.html</a>.
TAHLEQUAH, Okla. – Cherokee Nation Public Health officials are conducting a health survey among CN citizens in northeastern Oklahoma as part of a partnership between a team led by CN epidemiologist Dr. Ashley Comiford and University of Oklahoma Health Sciences Center.
The survey aims to describe health behaviors of CN citizens living within the 14 counties of the tribe’s jurisdiction. The results will be used to address serious health problems among Cherokees related to chronic diseases and to help to improve public health services and programs within the CN.
The survey is being conducted over the phone and approximately 3,400 CN citizens will be surveyed. CN citizens will be randomly selected from a list of adults and asked to take 20 to 30 minutes to complete the survey. Responses are confidential and survey participants will not be named or identified on any reports. Participants will be compensated for their time. Participation in this survey is voluntary and does not affect the benefits and services received at CN.
The CN Institutional Review Board has approved the project, which is funded by a grant from the U.S. Centers for Disease Control and Prevention.
For more information, call Comiford at 918-453-5000, ext. 7076 or Dr. Sohail Khan at (918) 453-5602.
MUSKOGEE, Okla. – The Cherokee Nation’s Three Rivers Health Center and Dillard’s partnered on Oct. 12 to provide a free bra-fitting clinic at the health center as part of a “Fit For the Cure” event by the clothing brand Wacoal.
“You’d be surprised at the number of women who have never done this. We have some customers come in who have never had a bra fitting, ever,” Cynthia Acuff, lingerie business manager for Dillard’s in Muskogee, said. “They’ll come in to the store, try on something, then if it looks like it fits then that’s what they go with. And eight out of 10 women are definitely wearing the wrong size.”
Acuff has been with the company for more than 30 years and completes trainings twice a year to help women find correct bra fits, which only take 10 to 15 minutes.
“We go in and we do a measurement on you and once we do a measurement, then we use a specific bra that’s called our Wacoal fit bra to help determine your actual cup size that you will be needing for that bra,” Acuff said.
The event also assisted in highlighting Breast Cancer Awareness Month, which is in October. For every complimentary Wacoal bra fitting Acuff completed $2 was donated to the Susan G. Komen for the Cure organization. An additional $2 donation was possible for every Wacoal or b.tempt’d piece purchased at the fitting.
Since 2000, Wacoal has donated more than $4.7 million to help fund breast cancer research and community programs while raising awareness for screenings.
Acuff said she helps raise breast cancer awareness because her family has been affected by it.
“My grandmother had breast cancer,” she said. “She was a survivor of it. There’s a lot of people who have not survived from it, so if just coming in, that $2 may just be what needs to be done to find the cure for breast cancer.”
Acuff sad she can complete about 45 fittings in a five-hour event like the one at the health center.
“When they come in, they leave their bra on,” she said. ‘They just have to take their shirt off for us. We do the measurement, then we go out and collect bras that we believe is going to be their size. We will take in three different cup sizes, that way we can see which one is going to fit her better to make sure that the wire is in the right place for her.”
She recommended women look for several factors when bra shopping.
“You always want to make sure your bra is tacked in the middle, in the center, that way it separates you and then your wire needs to be back past your breastbone,” she said. “We want to make sure that your band does not move up and down because if it does chances are your straps are not going to stay on correctly. If you get the right support, the wire is doing the work. The straps are doing the work. If you are a bigger-size bust, the right bra is going to help you from not having back issues too because you’re going to be letting that bra do the work for you, rather than your back carrying you around.”
For those interested in a fitting, Acuff was expected to hold another fitting from 10 a.m. to 8 p.m. on Oct. 18 at Dillard’s located within the Arrowhead Mall in Muskogee. Each of the complimentary fittings and bra purchases will also be eligible for the $2 donation.
According to the Komen organization, American Indian and Alaska Native women have lower breast cancer rates than other groups, though it is the second-leading cause of cancer death among them.
From 2010-14, American Indian and Alaska Native women saw 82.2 new breast cancer cases per 100,000, compared to 127.7 for Caucasian women and 125.1 for African American women. In the same time period, American Indian and Alaska Native women averaged a morality rate of 10.8 per 100,000 cases, while Caucasian women averaged 21.2 and African American women averaged 29.2 cases.
According to the Komen organization, mammography screening rates are also “lower than rates among non-Hispanic white, non-Hispanic black and non-Hispanic Asian women.”
For more information, visit <a href="http://www.komen.org" target="_blank">www.komen.org</a>.
OKLAHOMA CITY - Oklahoma City Indian Clinic, a non-profit clinic providing services to American Indians in central Oklahoma, is raising mental health awareness during October.
Approximately 1 in 5 adults in the U.S. (43.8 million) or 18.5 percent of adults experiences mental illness in a given year. Mental Health Week is the first week of October and raises awareness about mental health conditions and the importance of good mental health for everyone.
Mental health is essential to everyone’s well being, and mental illnesses are common and treatable. Yet, some people experience symptoms of mental illnesses differently and engage in potentially dangerous or risky behaviors to avoid or cover up symptoms of a potential mental health problem. Specific populations of people, like Native Americans, experience mental health concerns at a higher rate than the general population.
“It is important to understand early symptoms of mental illness and know when certain behaviors are potential signs of something more,” said Summer Welcher-Duke said behavioral health director of OKCIC. “We need to speak up early and educate people about risky behavior and its connection to mental illness and do so in a compassionate, judgment-free way.”
According to the American Psychiatric Association, Native Americans experience serious psychological distress 1.5 times more than the general population, experience PTSD more than twice as often as the general population, and use and abuse alcohol and other drugs at younger ages as well as at higher rates than all other ethnic groups.
There is help available for people suffering with mental illness. Substance Abuse and Mental Health Services Administration offers information on mental health. People may call 1-877-726-472 to locate treatment services in your area.
OKCIC offers counseling to its patients for a wide range of mental health and substance abuse issues through its behavioral health department, which is a multi-faceted department of licensed mental health professionals including a psychiatrist, mentors and prevention activity specialist that addresses the physical as well as the mental, emotional and spiritual needs of the Indian community.
“Prevention, early identification, early intervention and integrated services work,” said Robyn Sunday-Allen, CEO of OKCIC. “When we engage in prevention and early identification, we can help reduce the burden of mental illness by identifying symptoms and warning signs early.”
TAHLEQUAH, Okla. – The Cherokee Nation’s Health Services has increased base pay for many physicians in primary care by $35,000 as part of a new compensation package that took effect Oct. 1.
Included in the package are quarterly bonuses based upon relative value units or RVUs.
The package raises the base-pay threshold for nearly 120 doctors at the tribe’s W.W. Hastings Hospital and nine health centers, according to CN Communications.
“Ideally we never want to lose any of our physicians, but we know there are times they leave for larger cities or higher paying jobs just like any other industry. So we hope this move is one that will have a lasting impact,” Health Services Executive Director Connie Davis said.
Additionally, all physicians, advanced practitioners and physician’s assistants above the base-pay threshold will receive a 2 percent raise after CNHS compared regional market salaries with information provided by the Medical Group Management Association, according to administration officials.
Quarterly RVU bonuses will be awarded to providers who meet the MGMA 25th percentile in service to patients. According to a leading physician search and consulting firm, RVUs calculate the volume of work or effort done by a physician when treating patients. The more complex the visit, the more RVUs a physician earns.
For each RVU achieved over the standard, the dollar value of the RVU increases. According to administration, it will now be possible for providers to see a bonus ranging anywhere from $500 to $30,000 each quarter. The amount of the final quarterly bonus is dependent on several varying factors.
Bonuses were previously awarded semi-annually, based on a merit of 2.5 percent and not incentivized.
Providers will also be eligible for a 3 percent annual merit increase after meeting health compliance standards.
The raise’s cost is outlined in a budget modification that increases the IHS Self-Governance Health budget by $3.4 million.
The changes come after a year of discussion and an April 21 letter signed by the Health System Provider Compensation Committee asking Health Services officials to increase provider base salaries and incentives to “recruit and retain top quality (health care) providers.”
The letter states CN providers are paid $48,000 less annually than the $218,000 base salary outlined in a 2016 physician compensation report and that an increase in base salaries has happened only once in eight years.
The letter states lower salaries have led to recruitment difficulties, a loss in providers and increased wait times for patients as remaining providers “experience the undue burden of taking on the additional workload for those many empty positions.”
The new contracts are currently being distributed to providers throughout CNHS including compensation committee member Dr. Johnson Gourd, a physician at Three Rivers Health Center in Muskogee. He called the new contracts “a step in the right direction” for providers and would be watching closely to see how bonuses are awarded.
Gourd had previously voiced concerns about implementing the RVU-based system due to “inefficiencies” with the electronic health records system, which he said does not allow him “control of all variables” to complete his job efficiently.
“That adjustment to getting to those RVU goal numbers will have to come once they’ve implemented it and we see where we’re at in the real world work environment and then we try to make appropriate changes,” he said. “One clinic may have inherent advantages for a provider over others with staff issues or whatever. That I think will work itself out once people are trying to work with that goal and they can identify perhaps the things that are impeding them.”
Dr. Katherine Hughes, D.O and Emergency Room director, said she has yet to see a new contract but is “excited” that it is forthcoming.
“My hope is that it increases our ability to be able to recruit new physicians coming in and retaining the ones we have.”
Hughes has not worked at a facility that uses RVUs, but is “all for anything” to better serve patients.
“I think it has the potential to be really good for everybody,” she said. “As a supervisor, I’m all for anything that’s going to make everybody more productive and decrease our wait time for our patients. We were having a hard time recruiting people on the salary and when they’re coming to a small town, you have to overcome that. It was a lot to overcome, but I hope this will help us be able to attract really good people out here to our system and keep them.”
Dr. Charles Grim, Health Services deputy executive director, said Health Services employs 250 providers, of which 160 are physicians and mid-level providers.
Davis said in a Sept. 11 Health Committee meeting that the Health Services’ turnover rate is 12 percent compared to the nationwide rate of 14 percent. She also said that in the past year Health Services has lost nine full-time physicians, 11 PRNs or “as needed” workers, five advanced practice registered nurses, two physician assistants and one certified registered nurse anesthetist.
Records from Cherokee Nation state that in the six-year time frame from of 2012 to 2017, there were 130 providers who separated from CNHS. In that same six-year time frame from 2012 to 2017, there were 159 providers who were hired to CNHS.
The jobs included in both these figures include; physicians, physician PRN, physician assistant, physician assistant PRN, certified nurse midwife, certified nurse midwife PRN, certified RN anesthetist, certified RN anesthetist PRN, podiatrist.
The number of departures in large measure are doctors who are PRNs, who are temporary by nature.
CNHS anticipates losing 6 PRN staff annually through its family practice residency program or as temporary docs working in urgent care.
Since 2012 of the 73 PRN, 36 have left due to their residency status ending.
Of course, other providers leave for various reasons, including jobs in urban health facilities, family reasons and retirement.
According to Indian Health Service, the vacancy rate for IHS was 28 percent, while CNHS vacancy rate for just physicians was 23 percent in 2016.
Currently physician vacancy is 17.6 percent and below the previous year.
Total provider vacancy rate for CNHS in 2017 is 12.5 percent while the base-pay increase and bonuses come before the projected September 2019 opening of a CN outpatient facility in Tahlequah that is expected to create more than 800 jobs. In the 2012 fiscal year the total budgeted full-time physician was 76 and the number budgeted in the 2017 fiscal year is currently 92.
“As we build onto our health system and create new jobs, this compensation plan will have great timing,” Davis said.
CATOOSA, Okla. – Sixteen Cherokee Nation nurses were honored Sept. 26 at the state’s Great 100 Nurses awards dinner at the Hard Rock Hotel & Casino Tulsa.
The national Great 100 Nurses Foundation honors standout nurses for their contributions to health care each year. The state participated in the celebration for the fourth straight year.
The winners were chosen based on their contributions to the nursing profession and for serving as role models after being nominated by patients, peers, administrators or their communities.
“I’m very humbled to be recognized with such talented and caring individuals,” CN Health Services Executive Director Connie Davis, one of the tribe’s 16 honorees, said. “I’m also very proud of the Cherokee Nation nurses who were also honored. They are the backbone of our health care system and help us provide the first-class level of health care that our citizens expect and deserve.”
The 16 CN recipients of the Great 100 Nurses of Oklahoma honored were:
• Connie Davis –Health Services administration – Tahlequah,
• Kimberly Costilow – formerly W.W. Hastings Hospital – Tahlequah,
• Christy Fees – Will Rogers Health Center – Nowata,
• Jordan Fielden – W.W. Hastings Hospital – Tahlequah,
• Colinda Guthrie – W.W. Hastings Hospital – Tahlequah,
• Lindsey Huffman – W.W. Hastings Hospital – Tahlequah,
• Rebecca Kidwell – Will Rogers Health Center – Nowata,
• Janie Mendenhall – W.W. Hastings Hospital – Tahlequah,
• Melinda Moten – Wilma P. Mankiller Health Center – Stilwell,
• Lorrie Pinkston – Will Rogers Health Center – Nowata,
• Debra Proctor – Cherokee Elder Care – Tahlequah,
• Aubrey Richardson – W.W. Hastings Hospital – Tahlequah,
• Lindsey Springsteen – W.W. Hastings Hospital – Tahlequah,
• Ryan Stilwell – W.W. Hastings Hospital –Tahlequah,
• Melissa Whitchurch – Cooweescoowee Health Center – Ochelata, and
• Susan Wood – W.W. Hastings Hospital – Tahlequah.