You may know Dr. Tom Sequist as a high-up exec at Partners HealthCare — he’s chief quality and safety officer. Here’s what you might not know: He’s a member of the Taos Pueblo tribe in New Mexico, and when he’s not dealing with painful electronic health records transitions, he works on two programs relating to American Indians and medicine. He’s also a doctor at Brigham and Women’s Hospital, where I met up with him last week.
Where is your family from?
A Pueblo reservation high up in the Rocky Mountains, made of “adobe buildings that look like little hotels stacked up.” That’s where his mom grew up. The village is surrounded by modern housing built by the federal government. Sequist, whose dad is Caucasian, grew up outside New York City, but he would visit the reservation to see his grandma. He also saw a lot of poverty, unemployment, and chronic disease. A third of people didn’t have electricity or indoor plumbing. “It was just this world that was so different,” he said. “It’s something that drives what I do today.”
What’s the summer program you run?
The Four Directions Summer Research Program at the Brigham and Harvard Med takes eight American Indian undergraduates per year and helps them build confidence, network with top scientists, and develop skills for graduate school. Sequist is also medical director of a program that sends Brigham specialty doctors to work in rural hospitals in Navajo Nation.
What’s the biggest misconception about American Indian health?
“People overfocus on two things: the burden of alcohol abuse and diabetes,” he said. “Those are important problems.” But the leading cause of death is accidental injury — often fires, gun injuries, or motor vehicle accidents on dark, unpaved roads. Those are preventable public health problems, he said.
What can Massachusetts learn from the reservation?
Indian Health Service, the federal agency that pays for reservation hospitals, “is a very efficient organization,” he said. (Partners, by contrast, is under attack for driving up costs.) In part because it’s severely underfunded, IHS got an early start using video for long-distance eye exams. “The first time I saw telemedicine was on an Indian reservation,” he said. “If you squeeze people, they either focus or they crumble.” IHS has not crumbled, he said: “I’ve learned a lot from them.”
