F E AT U R E S T O RY
A S K ING T HE
TOUGHEST QUESTIONS
A new SMHS Internal Medicine Residency Program-led committee on health equity looks to help balance the scales of health access and outcomes in the region. “Are you racist?” The question stopped Dr. Laura Nichols in her tracks years
Health Equity Committee The conversation stays with Nichols to this day.
ago when she was an internal medicine (IM) resident in
This is why, among other reasons, she didn’t hesitate last year
Milwaukee, Wis.
when residents in the Fargo-based SMHS Internal Medicine
Fumbling through a response, the now Sanford Health internist in Fargo, N.D., and IM clerkship director for the UND School of Medicine & Health Sciences (SMHS) Southeast Campus
Residency Program asked her to serve as a faculty mentor to a new committee they were forming to address health inequity in the region.
remembers reflecting on what in this particular African
After a number of discussions about often complex questions
American patient’s history would produce such a bold question
of inequality within American healthcare—why do systemic
to a white, female physician.
inequalities persist and what is their origin? at what level are they best addressed?—these residents, mostly graduates of the
“I’m passionate about being an advocate for minority groups in the Dakotas and Minnesota.” DR. CICILEY LITTLEWOLF
SMHS, established the region’s first Health Equity Committee. One of these young physicians is third-year resident Dr. Ciciley Littlewolf, who, like her colleagues, was looking for a vehicle to address persistent issues like the three times higher hospitalization rate among the American Indian/Alaska Native people (AI/AN) suffering infectious disease relative to the nonNative population—for the same conditions. “I’m passionate about being an advocate for minority groups in the Dakotas and Minnesota,” explained Littlewolf, who helped found the equity group in 2021 with Drs. Jessie Bjella and Stephanie Melquist. “We had some great conversations, recognizing that there are healthcare inequities that we could
“I don’t really remember what I said to him, but I did ask him, ‘What was it that made you feel you needed to ask me that
bring attention to, and help educate our colleagues and prepare them to provide more and better healthcare to minority groups.”
at the beginning of the appointment?’” Nichols recalls. “And
After Bjella, in Fargo temporarily as a one-year transitional
he told me, ‘Well, I’ve had bad experiences in the past with
resident, left North Dakota, Littlewolf and Nichols recruited
physicians who I felt were not treating me equally because of
first-year IM resident Dr. Hallie Thompson and transitional
the color of my skin.’ I hope I said something to the effect that,
residents Drs. Anastasia Schroeder and Rhianna Rubner,
‘I’m going to do my best to treat you as I would anyone else,
among other interested physicians.
based on the evidence, but I understand that inequities exist in medicine.’”
“The health disparities in our country are pervasive and desperately need to be addressed,” shared Rubner, who North Dakota Medicine Spring 2022
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