Data from the 2014 National Emergency Department Inventory survey showed that only 85% of the 34 IHS respondents had continuous physician coverage. Of these 34 sites, only 4 sites utilized telemedicine while a median of just 13% of physicians were board certified in emergency medicine. The majority of IHS emergency department from the survey reported operating at or over capacity. Tribal reservations are often sequestered in unfavorable and isolated locations.US Department of Health and Human Services. (2016, October). INDIAN HEALTH SERVICE HOSPITALS: LONGSTANDING CHALLENGES WARRANT FOCUSED ATTENTION TO SUPPORT QUALITY CARE. Office of Inspector General. (OEI-06-14-00011). According to a study of provider vacancies in the IHS, conducted by the Department of Health and Human Services (2016), about half of the clinics studied identified their remote location as a large obstacle for hiring and retaining staff. Issues surrounding isolation, lack of shopping centers, schools, and entertainment also dissuades providers from moving to these areas. Such vacancies lead to cutting of patient services, delays in treatment, and negative effects on employee morale.United States Government Accountability Office. (2018, August). INDIAN HEALTH SERVICE: Agency Faces Ongoing Challenges Filling Provider Vacancies. Indian Health Service Workforce. (GAO-18-580). Studies show that such problems surrounding Native Americans and reservation inequality may be addressed by growing a Native American healthcare workforce.
