From left: Michael Givertz, Arnold Ketchum, Nicolette McDermott-Ketchum and Lynne Stevenson

From left: Michael Givertz, Arnold Ketchum, Nicolette McDermott-Ketchum and Lynne Stevenson

At Northern Navajo Medical Center in Shiprock, New Mexico, physician assistant Nicolette McDermott-Ketchum, PA-C, cares for patients who are part of Navajo Nation, the largest Native American tribe in the U.S. at about 175,000 people.

About 37 percent of Navajos live in poverty. Access to specialty and preventive medical care is limited, with patients often having to travel a long distance to obtain medical services. Adding to these challenges is a lack of primary care physicians and specialists in New Mexico, Arizona and Utah, where Navajo Nation is based.

Clinicians like McDermott-Ketchum, who are part of the Indian Health Service (IHS)—a federal agency within the Department of Health and Human Services—provide care to nearly 2 million Native Americans at 35 hospitals and more than 300 health centers across the country. In 2008, the BWPO formed the Brigham and Women’s Outreach Program with the Indian Health Service. The outreach effort enables BWH clinicians to provide ongoing training and up-to-date clinical knowledge to IHS clinicians, with the goal of expanding IHS clinicians’ expertise in managing a spectrum of conditions.

McDermott-Ketchum and her husband, Arnold Ketchum, PA-C, a fellow IHS physician assistant, visited BWH last month to sharpen their cardiac care skills and heart disease knowledge in service to their patients in New Mexico. Many of their patients suffer from diabetes, high blood pressure and high cholesterol.

“I married into the tribe, and I love serving the Navajo people, who are kind, patient, resilient and family-oriented,” said McDermott-Ketchum.

During their visit, the couple shadowed Lynne Stevenson, MD, director of the Cardiomyopathy and Heart Failure Program, and Michael Givertz, MD, medical director of the Heart Transplant and Mechanical Circulatory Support Program.

“It was an amazing opportunity to observe Drs. Givertz and Stevenson in the Watkins Clinic and see the compassion and skill they demonstrated in every patient encounter,” said McDermott-Ketchum. “It is one thing to hear didactics about how clinical cardiology practice is supposed to operate, but viewing the interactions between BWH staff and their patients reinforced the knowledge with a human element. This is something I will keep in mind during my patient sessions.”

As part of the three-pronged Outreach Program, more than 100 Brigham clinicians have traveled to the Navajo Reservation in Shiprock and Gallup, New Mexico, and Chinle, Arizona, to care for patients and teach members of the local medical staff. Dozens more lead remote teaching and patient consultation sessions by video conference or volunteer to host IHS visitors here in Boston for more focused learning, says Ellen Bell, MBA, MPH, senior project manager for the Brigham and Women’s Outreach Program.

During the past seven years, 14 IHS clinicians have visited BWH to shadow clinicians across a wide range of specialties, including Emergency Medicine, Dermatology, Gynecology, Radiology and Cardiology.

“The Brigham and Women’s Outreach Program is the perfect reflection of the core values of the hospital in that we have been able to apply the expertise of our senior clinicians to improve the health of the community through teaching and clinical care,” said Tom Sequist, MD, MPH, medical director of the Brigham and Women’s Outreach Program. “Most importantly, this is not a one-way street, as our clinicians have been very vocal in expressing that they gain as much, if not more, from their experience volunteering in the program. In many ways, our program offers a life-changing experience.”

To learn more about the Outreach Program and how you can participate, visit