You Belong Here
Indians Into Medicine Program alum Michael LeBeau, M.D., discusses INMED, belonging, and his new role in Bismarck.
Thanks for your time, Dr. LeBeau. First—congratulations on the new job title: President of Sanford Health - Bismarck. How is it going so far? We have unbelievable volumes. We’re struggling with a full house. I like to say it’s a good problem to have, but it’s still a problem. It’s going well, though. I’ve been part of the enterprise leadership team here for the past five years—was vice president of the clinic side. We have an excellent team in Bismarck, so there haven’t been a lot of new surprises around our operations table. I have lots of learning to do and lots of people to meet. As you serve the community, you want to meet all the main stakeholders, and it can be overwhelming.
I assume you have a vision for your organization? Are you looking to chart a new path or one similar to what former President Craig Lambrecht [M.D. ’87] followed? We’re working hard on that now. Nothing very new, but we’re hoping to continue our growth and want to be the premier tertiary care center in central and western North Dakota. That means we’re going to increase services offered, increase locations, commit to ongoing improvements in education and patient care. That is the mission here in Bismarck.
What would you say are the top two or three health issues in the Bismarck-Mandan region at this moment? Continuing to recruit physicians, nurses, and workforce in general is an ongoing challenge. That’s true everywhere, but it is easier for larger urban areas to recruit. It’s challenging in all of rural North Dakota, and even more so on the reservation— for all health professions. But in terms of health, the top two issues here are managing diabetes and its complications and continuing to work on the opioid crisis. The needs are similar between the American Indian and non-Indian populations. But [on the reservations] we need much more in the way of ancillary services: home health, hospice, and physical and occupational therapy.
I think the Indian Health Service has a figure that shows diabetes-related kidney failure is dropping for American Indians but is still double the rate of Caucasians, for example. I imagine a figure like that is part of the reason you chose to specialize in nephrology? My interest has always been diabetic kidney disease. I grew up on the Canadian border in Portal, North Dakota. But I think of New Town [on the Fort Berthold Reservation] as my home. Yes, we see a lot of diabetes and other kidney issues on the reservation. From a personal standpoint, I love the diversity of my practice. I’ve been in the ICU and spend a lot of time in hospitals. I’ve also done outreach in outlying communities—I spent 10 years in Fort Yates and Standing Rock doing nephrology care. I’ve also done outreach in kidney care in New Town and Jamestown. The unique thing about nephrology is those bonds you develop with dialysis patients, whom you spend much more time with than anyone else. It was always a really diverse day with lots of variety in it.
So you got your M.D. degree from UND in 2002, right, and you got there with some help from UND’s INMED team. What did that program do for you as a student? I was part of INMED as an undergrad and in medical school, and I appreciate the support they gave me throughout. They have resident experts to help you through the college or med school application process start-to-finish. Very supportive staff. One thing that has rang true from one grad to another in my experience is that the staff are there for you during tough times—they’re the shoulder you lean on. I was just at the INMED office on Friday and had a chance to speak to graduates. It was a good thing. I said all of this to the grads last week—that I took this fact for granted as a student many years ago. As I think back now, having a place to go where people pat you on the back and are there when you need help was invaluable.
And that’s a big deal, especially for American Indian students. INMED Director Donald Warne talks about how there are fewer American Indian medical students as a percentage of the total med student cohort in the U.S. today than in the 1970s— One thing I always preach to our students is that we’re all the same—it’s not a handicap to be American Indian in medical school. Our students do think a bit differently about where to offer care. There’s going to be a huge push for them to go to underserved areas with the Indian Health Service. I think a lot of it, too, is confidence—reminding these students that they belong here, with everyone else. That’s sometimes a challenge for American Indian students. INMED is very supportive of this idea—they really help a lot of people with this idea, that “You belong here.” When I spoke to these graduates I told them to take pride in who you are, act responsibly, and care for others. Use the gifts you’ve been given to serve others and be part of others’ lives. A lot of people work very hard and do great stuff but never really get invited into patients’ lives like a caregiver does. This is special.
That is special. I imagine that’s not a message students hear enough. I spend a lot of time speaking to med students. Any chance I get, I mention that we, as graduates of UND SMHS, are fortunate—we belong, whether here or at Mayo or Johns Hopkins. Some of the best candidates these places get are from North Dakota. My message to INMED students is exactly the same. When you graduate, you should be proud to be from the UND School of Medicine & Health Sciences. To me, that sets us apart and gives us the preparation we need to succeed when we get to the next level.