Indian Health Services

Brandon Barnes of San Angelo, Texas, and Madeline A. King of La Porte, Texas, both fourth-year professional pharmacy students at the Texas A&M Rangel College of Pharmacy, will be on a six-week advanced pharmacy practice experiences elective rotation in February and March 2014 at an Indian Health Service (IHS) unit at Ship Rock, N.M.

They will practice clinical knowledge and skills at the Northern Navajo Medical Center more so than in many other settings.

“They will have access to the Indian Health Service Electronic Health Record,” said U.S. Public Health Service Lt. Justin Markley, Pharm.D., M.S., a pharmacist for the IHS at the Northern Navajo Medical Center. “They will learn how to review patients’ medical and medication history and suggest interventions to the medical staff.”  

In addition, they will spend time at decentralized pharmacy stations during clinic hours as well as fielding drug information and formulary questions from the providers seeing patients in the outpatient clinics.  

Markley, who graduated in the inaugural Class of 2010 at the Texas A&M Rangel College of Pharmacy, coordinates advanced pharmacy practice experiences with a variety of colleges of pharmacy that give students the opportunity to see the way clinical pharmacy is practiced with the IHS. 

“They will also receive a lot of patient counseling opportunities, as we counsel on all new and/or adjusted medications including any over-the-counter medications we may dispense,” Dr. Markley said.

The Shiprock Service Unit is the largest unit serving The Navajo Nation in the Four Corners area of the U.S. where New Mexico, Arizona, Colorado and Utah meet.

The IHS provides health services for 2.1 million American Indians and Alaska natives residing on or near reservations. 

Indian Health

“I am looking forward to a unique experience during my rotation with the Indian Health Service,” Barnes said. “IHS uses a computer system which allows pharmacists to see complete histories of patients including past medical history, medications, immunizations and any lab values from hospital visits. This access allows pharmacists to use their clinical skills in a way that improves patient care.”

Barnes is also looking forward to learning about a culture that is different from his own. 

“I feel that a pharmacist should be compassionate and understanding of the practices and beliefs of different cultures, and should understand how these beliefs can impact medication use and patient-provider interactions,” he said. 

The Texas A&M Rangel College of Pharmacy has a strong commitment to cultural diversity and to meeting the needs of the culturally diverse student population.

“He will have a variety of opportunities to learn about the Navajo culture,” Dr. Markley said. “In general, the Navajo are a very friendly and welcoming group. He will have interactions with Navajo staff and patients every day. He will be encouraged to spend some of his time off traveling the reservation and learning more about the culture, taking in the beautiful landscape, and enjoying the abundance of Navajo art.”

King spent six weeks in summer 2012 at the El Reno Indian Health Center, an outpatient clinic, in El Reno, Okla.

“I think it’s interesting and important to understand cultural diversity because it makes you a well-rounded pharmacist,” King said.

King’s favorite part of pharmacy practice is the interaction with patients and with other health care providers. She was part of a team where she could facilitate the exchange of information to physicians to optimize patient care. 

Both Barnes and King look forward to patient interactions to benefit them professionally and personally. 

“I want to work for public health,” King said. “I think preventive health is important, especially vaccines. It’s important to educate people about preventative care.”

According to the IHS, the American Indian and Alaska Native people have long experienced lower health status when compared with other Americans. Lower life expectancy and the disproportionate disease burden exist perhaps because of inadequate education, disproportionate poverty, discrimination in the delivery of health services, and cultural differences. These are broad quality of life issues rooted in economic adversity and poor social conditions.