YKHC

I've completed my first week of work and I have learned so much! One thing I have learned for certain is that the people who work for this company love what they are doing.  After two days of orientation I listened to lectures from nearly every department at the hospital.  It did not matter if the individual has worked here for two weeks or twenty years, they all love this company.  Perhaps my favorite part of orientation was learning how the Yukon Kuskokwim Health Corporation, known just as YK to locals, came to be.  
Bethel was home to the only medical facility for southwest Alaska, an area about the size of Oregon.  In the 1950s this area  suffered a terrible outbreak of TB.  (To this day the area has double the rates of TB than the lower 48.)  So many people from the surrounding villages flocked to Bethel for treatment that the doctors soon got overwhelmed.  As the outbreak continued on tribal leaders offered to help the Bethel doctors by dispensing medicines and monitoring patients in their own villages.  Since these leaders had no formal medical training they would communicate back and forth with the doctors for advise via radio.  This system worked so well for both the doctors and the patients that we still use it today.
The region we serve has 58 nationally recognized Eskimo tribes ranging from 1200 to 50 people.  The average population per village however, is 300.  Out of these 58 villages 43 have small health clinics run by community health aides.  These health aides are professionally descendant of those original tribal leaders from the 50s.  Health aides come to Bethel for a crash course in basic diagnostic skills.  The course only lasts a few weeks and then the aide returns to his or her tribe.  They are the first point of contact for ANY medical issue that arises in their area.
We still communicate back and forth with the health aides, only we've upgraded from radios to fax machine and the internet.  Each patient seen by the health aides has a report faxed to the on call provider back in Bethel.  The provider evaluates the report and can either agree with whats being done, recommend alternate treatment or request the patient be seen by a provider.  
Just because a provider visit is requested does not mean the patient has to hop on a plane and fly to Bethel.  There are five sub regional clinics scattered throughout the region.  These clinics are run by physician assistants and nurse practitioners. They have x-ray capabilities as well as a small pharmacy.  They are sort of like all the urgent care clinics down in the lower 48.  
Patients who require more care come to Bethel.  The hospital has more imaging capabilities, an ER, OR, inpatient services and labor and delivery.  I work in the outpatient clinic within the hospital.  I also serve two villages, Russian Mission and Lower Kalskag.  A couple times a year I will travel to these villages and when people from these villages come to Bethel for care, they will see me.