Day 4: CIHA

The people of Cherokee always remain at the center of the healthcare system. The healthcare team within the Cherokee health model is set up a little bit differently than what we are used to seeing. On their healthcare teams, they have most of the same team members we are used to seeing. However, the way they work together is different. Working together, you will find the physician, certified medical assistant, case manager, case manager’s secretary, licensed practical nurse, and so on. In our healthcare systems, it is not uncommon to find each of these team members sitting in different places, or even in their own offices. In the Cherokee healthcare system, the entire team sits side by side. In their practices, specifically primary care, are several pods. Within each pod, you will find a team. The CMA sits next to the physician and works directly under their license, continuously reporting to them throughout the day. Sitting directly behind the CMA and the physician are the case manager and the case manager’s assistant. Being together in such close proximity allows everyone to coordinate patient care more effectively.

When someone comes in with a need, they are immediately triaged. The triage system that has been implemented at Cherokee helps staff to identify the severity of an individual’s needs and the steps they should take with the patient in their care plan. It is also important to know how Cherokee an individual is to determine the amount of care they can receive. If they are not from a federally recognized tribe, they can be treated in an emergency, but then they will be transferred to another hospital once they are stabilized. The Cherokee Indian Hospital Authority does not have specialty care units, such as cardiology, neuro, orthopedics, or respiratory, so it may be necessary to transfer someone anyway, depending on their status.

I also found it very interesting to hear about some of the complementary and alternative medicines used within this culture. Within the hospital, there is a complementary inpatient clinic, where patients can receive services such as acupuncture and chiropractic care. It is also common for this culture to use natural remedies to prevent or cure different health issues. There is a root found in nature called the bullnettle root that is used to help infants and children through the teething process. The root is taken from the ground, made into a necklace, and placed around the neck of a child to help dry up secretions and relieve pain. It has proved to be extremely effective and is sometimes left around the child’s neck for several years.