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Dr. Roubideaux goes to Washington

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WASHINGTON – In a textbook case of local girl makes good, Dr. Yvette Roubideaux cleaned out her desk at the University of Arizona in Tucson, packed her belongings, and made her way to Washington, D.C. as the new director of IHS.

Excited about what lies ahead? Yes. Sad about what is left behind? Yes. Daunted by the challenge of taking over a massive organization with 14,000 employees at 700 health facilities overseeing health care at 562 federally recognized tribes with a proposed budget of $4.5 billion? No.

“There’s more excitement at the opportunity than apprehension at the enormity,” said Roubideaux, a 46-year-old medical doctor and Harvard-educated member of the Rosebud Sioux Tribe, who has devoted her career to tribal health issues.

“My experiences as a medical officer and clinical director in Arizona will be critical to my understanding of how this organization works and some of the challenges patients face. I learned a lot about day-to-day patient care and problem solving at the San Carlos Reservation and the Gila River Indian Community. I saw first-hand, both as a patient and a provider, the many challenges to the system.”

Roubideaux is the first woman to lead IHS in the agency’s 54-year history.

During her confirmation hearing, Senate Committee on Indian Affairs chair Sen. Byron Dorgan, D-N.D., blasted IHS as “a broken system, unbelievably bureaucratic, headed by incompetent directors and endemic with serious management problems.”

Roubideaux isn’t quite so harsh: “I believe IHS service response faces challenges that are also reflected in current national issues – increased need, obscene costs – and it’s clear that in the past the organization has been underfunded and had difficulty meeting its mission. But some programs are doing an exceptional job in working around a lack of resources and coming up with creative solutions. I don’t want to discount all the hard work the employees are doing, the best they can under the circumstances.

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“I do want to look at what we’re doing well and spread that secret around for others to emulate. When Indian Health Services, tribal, and urban program step up to the plate, they can deliver positive outcomes that exceed expectations. IHS has the potential to markedly improve the quality of health care it provides and while that work will not be completed right away, I’m ready to begin the task of bringing about positive change.”

The new IHS leader spent more than a decade at the University of Arizona with scads of local and regional involvement ranging from director of the UA/Inter-Tribal Council of Arizona Indians into Medicine to receiving the Outstanding American Indian Faculty award at the university. Roubideaux served as the co-director of the Special Diabetes Program for Indians demonstration projects, in which 66 American Indian and Alaska Native communities are implementing diabetes prevention and cardiovascular disease prevention initiatives.

“I’ve partnered a lot with the council which was established by tribal governments to provide member tribes a united voice, and I’m confident that good work will continue. I can take these experiences in working with the 21 federally recognized tribes in Arizona and various tribal organizations throughout the state and apply those lessons going forward. Probably one of my greatest joys has been working with young American Indian and Alaska Native students who have a dream of becoming a health professional and going back to serve their community. It’s been an honor to work with the next generation, their enthusiasm, hopes and dreams of what they can do to help their

communities.”

As she looks forward to the cherry tree blossoms in the nation’s capitol, she is already remembering the smell of desert foliage following a monsoon rain.

“I think I’ll miss most the sunny days and wide open landscapes. I also have a feeling that the cold winters in D.C. will cause me to miss the warm weather in southern Arizona.”

Her experiences in the Grand Canyon State have helped her amass a large playbook on overcoming difficulties.

“Arizona tribes face unique challenges – long distances, very rural communities with wide-ranging needs – as well as issues of obesity, cardiovascular disease, and a rate of diabetes highest in the Southwest,” Roubideaux said. “As part of my new duties, I’ll travel often to visit various tribal communities. I’m looking forward to meeting again with tribes that I am acquainted with and those I have not yet met and listening to their ideas and recommendations of how to improve health care in their respective communities.

“While I’m sad to go, I’m very excited about what lies ahead. I’m pulling at the reins and very anxious to get started. And while I’m moving physically and will be operating in a different capacity and at a higher level, my basic mission and mantra will still be continuation of the ongoing quest to improve health care for those in need.”