Funding Rural | Episode #17: Kicking the Door Open with Erik Brodt, MD

Erik Brodt, MD (Ojibwe) knows that there are experts all around us — many of whom go unrecognized.  As a Native American Healthcare provider he works to ensure that American Indian/Alaska Native youth know they have a place in health care.  He challenges philanthropy to look beyond the typical expert, to ask questions differently, and to spend time getting to know the impact of programming —what and whom — thinking beyond the traditional model of scalability.

“If you show up and you ask questions differently, or if you ask the questions and then you pause to listen for an answer that might be different then what you were hoping for or expecting,  you might learn a lot that day.” —Erik Brodt, MD

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More about Erik Brodt, MD

 

Erik (Ojibwe) grew up near Chippewa Falls, WI and spent summers with family in the rural areas around Bemidji, MN. Dr. Brodt earned his M.D. from the University of Minnesota School of Medicine and completed residency in Family Medicine at the Seattle Indian Health Board – Swedish Cherry Hill Family Medicine Residency in Seattle, WA. Dr. Brodt is an Associate Professor in the Department of Family Medicine at Oregon Health and Science University. He practices in the OHSU Hospital inpatient setting and Warm Springs Tribal Health clinic, while also serving as the founding Director of the OHSU Northwest Native American Center of Excellence. Erik is a fierce believer in occasional magic working to eliminate Native health disparities and improve Native American Health Professions programming nationally through creative partnerships and collaborations. An entrepreneur at heart, Erik explores the fashion ecosystem as a co-founder of the global collection Ginew – featured in Vogue & GQ; culinary creativity and sustainable food systems; and the digital media non-profit WE ARE HEALERS. In his free time Dr. Brodt enjoys spending his time in Portland, OR with his wife Amanda, daughter Honukōkūlaniokauna’oa (Honu), son Malama’ōlinō’au’moe (Malama), their dogs Stinky & Pippa…in addition to a motley crew of friends comprised of change-makers, mavens, and creatives.

“If we’re truly going to solve some of the biggest challenges in the world, we need to ensure that the people who are best suited to answer those questions have an opportunity to be at the table.” —Erik Brodt, MD

Discussion Questions

  • Dr. Brodt discusses the importance of representation of folks in healthcare; and how mentorship can help students stay engaged in the process of schooling. What mentorship programs do you support?  Why is this important?
  • Dr. Brodt talks about ‘see one, do one, teach one’ as a learning model and he references birthing calves as a child.  How can you analyze who you think the experts are?
  • What questions do you ask to find the experts?  How can you ask them differently?

Resources

“There are people who are true experts who are existing in the classes, it’s just that the system might be asking the wrong questions to determine who’s an expert, or who’s a genius or who’s excellent.” —Erik Brodt, MD

Transcript:  Episode 17 | Kicking the Door Open with Erik Brodt, MD

Erin Borla:  0:10  

Welcome back to Funding Rural. I’m Erin Borla with the Roundhouse Foundation in Sisters, Oregon. I also have the privilege of serving as a fellow for the National Center for Family philanthropy. Today I want to introduce you to someone who’s changing the narrative around American Indian Alaskan natives in healthcare and changing the medical field for the better. I first met Dr. Erik Brodt when we were introduced by a development officer, he’s a physician from Oregon Health Sciences University, and the dean of Native American Health at the School of Medicine there. He’s also the founding director of the Northwest Native American Center of Excellence. Erik is Ojibwe and grew up spending time with his family around the Red Lake Leech Lake and White Earth Indian Reservation in northern Minnesota. Erik has dedicated his career to increasing the number of American Indians and Alaskan Natives in the medical profession, and has some really interesting thoughts about how philanthropist can help change the narrative around how young Indigenous people see themselves and their potential in the medical profession. Because the world needs more indigenous physicians. In fact, indigenous people make up just  .4% of the doctors in the United States, Erik is one of them. But that wasn’t always his plan. Growing up.

Erik Brodt, MD:   1:16  

My plan was to go to college to play football. And one thing led to another and my, the team’s academic support services and advisors ensured that I was in pre medicine because that was a major that would keep a fire under my feet, to go to classes and to stay in the major because they would kick you out if you didn’t perform well. And that is why I went to college, was to play football. Not to be a physician. And it was actually a center, just like I run now. That it was called the Center for American and Minority Health. That cold called me one day, about a summer program they had at the medical school. Someone from the community had told them that I was doing well in science classes, and they reached out and man, it has totally changed my life. Instantaneously changed my life, that call.

Erin Borla:  2:08  

I still remember the first time that we chatted and you told this story about going into a classroom and asking students to talk about fish. {Yeah.} And helping them understand that they, that made them a scientist. Remind me of that story. 

Erik Brodt, MD:   2:24  

Yeah, so I actually went into one of the tribal middle schools in the region here. And I was there to talk about health careers and my path and my journey into healthcare as a physician. And it’s unfortunate for American Alaskan Native youth that they, it’s more likely that they’ve never seen an American Indian health provider than having seen one. And many times, I am one of the first American Indian health providers, and often the first American Indian physician they’ve ever met before. So I went to this middle school. And I was talking about health careers, real short presentation. And what I wanted to do was help students understand that where they come from, is special and an asset. And so I showed a picture of a fish and I do this and I’ve done this in urban areas, too. And I had just done this in Portland. And I put a picture of this fish up. And every kid in the classroom knew it was a fish. And one or two kids out of everybody in that class knew it was a salmon. And so I got to this school in rural Oregon, which was a tribal serving school. And I believe it was an eighth grade class that I was talking to. And the teacher said, don’t mind Jimmy, who’s sitting over there. We’ll use we’ll use the name Jimmy for anonymity here. Don’t mind him. He he just does his own thing. And he was sitting staring out the window, he doesn’t really engage much in class. It’s like, okay, fine, if that’s what the teacher said, I’m not gonna like rock the boat. I put up the picture. And I asked the students, what is this? Now I’m in the Plateau Region. I’m in a salmon culture based region, right? So, of course, every kid knows it’s a fish. Every kid knows that it’s a salmon. What I really wanted to see was who was the expert in the room. And by serendipity, Jimmy piped up and he said, that’s a Spring Chinook Salmon. And that is a Spring Female Chinook Salmon. And here’s why I know that and he pointed out things about the fish that I didn’t even know with markings on the face and the lip and counting the tines on the rear ventral fin to be able to determine the, the type of fish, the type of salmon, and to the sex of the salmon. And what was even more important was that he could tell it was from the spring based on the surroundings in the rocks, and the way that the mud looked at the time. Right then and there, it, it just like proved the point to me that there is excellence. Right? There are, there are people who are true experts who are existing in the classes. It’s just that the system might be asking the wrong questions to determine who’s an expert, or who’s a genius or who’s excellent. And that, that was a really awesome moment for me. And I still get like goosebumps. And I’m glad you asked about it. Because it, it’s like one of those really proud moments I have where that student actually taught me more about this work than I taught them going in to share about my health career and my path. So, I think that’s something that that education and philanthropy can learn a lot from. Is that if you show up, and you ask questions differently, or if you ask the questions, and then you pause to listen for an answer that might be different than what you’re hoping for, or expecting, you might learn a lot that day.

Erin Borla:  6:13  

That’s my favorite story. I love that story so much. And partly because I love middle school students, and I think they’re just amazing human beings. But how did that experience you’ve touched on a little bit like help define what you’re doing with programs at NNACoE?

Erik Brodt, MD:   6:27  

Yeah, so I think within the US educational system, and the medical education system, there are certain narratives that people want to adhere to. They want to adhere to the like poverty porn narrative. They want to adhere to the pull yourself up by your bootstraps narrative. They want to, they want to show that there’s like, these, these unicorns that are out there, right. And so we will accept you, from your community, to go back and serve your community only one day if you come and become a primary care physician only. And you must have come from a family where it was a broken home and all these challenges, right. And so what becomes this narrative of you are so great, you’re a unicorn, you survived all these challenges and these hardships, you must feel so lucky to be here. And you must be so special, because you’ve done this all by yourself. And that narrative is dangerous. That narrative is false. Now, it does take initiative, right. But there is a huge community effort here. And there’s so many people that have the skill and the aptitude and the passion to become health professionals. It’s just framing people from a deficit right away. Like already, like puts them or it already puts them at a point where it’s harder to achieve that, right. And so what I’ve learned from from students like this is, is to utilize their experiences, utilize the things that they’ve seen, or to recognize the things that they’ve seen as experience as strengths and not as weaknesses. And the system, the current educational system, and even like how we do admissions, I think a lot of times they focus on, like looking for, and ensuring that those weaknesses and deficits are there, and then the person’s story becomes this, like, rising from the weaknesses and deficits. When, when, in fact, American and Alaska Native youth, I think, and rural youth, frankly, I think some of these people are the best suited to become the health leaders of tomorrow, because they know how to address challenges differently. Because of the things they’ve seen, the experiences they’ve had, it makes them better at becoming a doctor, just because you can answer a multiple choice test really well doesn’t make you a great doctor. But if you know how to show up, you know how to listen, you know how to be you know how to work creatively in a situation where you may or may not have all the resources right at your fingertips. Like those are things that foster like genius. And those are the people that we need in the system, if we’re truly going to answer the questions. If we’re truly going to solve some of the biggest challenges in the world, we need to ensure that, that the people who are best suited to answer those questions have the opportunity to be at the table.

Erin Borla:  9:30  

 You and I have had multiple conversations about narrative change, right? How do we, how do we control the narrative? How do we turn, turn what we think reality is or what it happened, what a physician has to look like where they have to come from, who gets to be successful, how they get to be successful, how they get to be a part of the program. How do we change that? And that’s something you know, it’s one of those buzzwords in philanthropy as well. Right? How, how do we change the narrative? How do we tell this story a little bit better? How are you doing that? In the work that you’re doing.

Erik Brodt, MD:   10:03  

I think some of the some of the main ways that we’re doing narrative change is showing American Indian Alaska Native youth, like who they could become. By, you know, like you you the Roundhouse Foundation helped us make short video vignettes of American Alaskan Native health professionals from the region, who are truly outstanding and excellent in their field. The youth see themselves, see people from their tribes, see people from their similar backgrounds who are truly excellent in these things. That I think goes beyond narrative change to transformational change within the mind, like someone has never seen before in their life. An American and Alaska Native in that role, who is a American Alaska Native youth, it just like, opens up a door in a way where it’s not just like this slow little creek, it’s like, it kicks the door open. Right. And I think that that’s one of the ways that we’re doing narrative change, real specifically with you guys is through messaging. Right? I think from the educational system, it’s trying to help people understand that folks who grow up in rural and tribal areas, there’s a different way that education is taught in the home. It’s more aligned with what I would call the residency model of: see one, do one, teach one, rather than the didactic model, which is when you’re sitting in a classroom, and you’re memorizing a book and whatever. Prime example, I was not alpha, omega alpha, which is the Honor Society, of medical school, but I delivered almost 100 babies as a third year medical student. When I got to residency, I had peers that were alpha omega alpha, because they had answered on their test questions. How to deliver a baby. And when it got time to do this, on the floor, I had already done this almost 100 times. Like see it, do it, teach it. That’s what I was taught growing up in a rural area, right? Whether it’s by tribal people, or not tribal people, there’s just that fundamental value around education that looks differently. But it’s still education. And I think if you can get past this idea that a quantitative test that is used to gauge somebody’s ability to binge and purge information is more important than someone’s ability to show up, sit down, read body language, listen to somebody, and then to not have the fear up to like, see, do and teach. I mean, I think the first thing I actually delivered was a calf. I think I was taken to I think I went to a I think it might have been three. And it just like, really, it’s a profound memory in my mind, because the farmer, called my dad, my dad’s really strong. And they’re having a problem with a calf. And middle of the night, we went to the Ginder farm and helped deliver a calf. I was three years old, my dad took me for that. You know, like, that’s not a weakness. And I think we need to, we need to shift the narrative to realize that the life of being a rural tribal person is not a weakness. It’s a strength. And I think that’s something that you guys at the Roundhouse Foundation, see. And that’s why you show up for these kinds of things, right? Like, it’s not like you’re checking a box to work with a rural organization and your portfolio, it’s not like you’re checking a box to make sure you’re working with an American Indian organization and your investment portfolio. You care about this place, and you care about these values, and you care about this way of life. And it’s, it is an important way of life you know. I think philanthropy in general, at least the philanthropy, the spaces that I’ve been in, I do not counter encounter many people who are from rural tribal areas. Almost everybody that I’ve encountered in the philanthropy space, is from a major city where they’ve run a major organization. And I think it involves a tremendous amount of almost exhausting education where people truly do not understand. And it’s okay to have differences and to not understand things. I think, as a person who’s trying to, to advance initiatives in the rural tribal space, it just puts you like that much more as a disadvantage when most of the funders have little to no understanding around American and Alaska Native communities or health issues. So you’re, you’re almost like at a disadvantage from the moment you, you approach folks like that. Because you seem so novel or outside of what their funding, outside of what they’re looking for. Like I, I’m in discussions with another foundation right now. And the thing that keeps coming up is, well, how is this even transformational? And it’s like, if you don’t understand that only 37% of American Alaskan Native youth in this region graduate from high school. And we’re talking about a program that has like 100% graduation from high school, and those who participate in it, like, if we have to help you paint that picture to why that’s transformational. Like, we’re already at a huge disadvantage. So {yeah} here I am like staring off into the, into the mountain like trying to solve, solve the challenges that we’re all working to solve, but.

Erin Borla:  16:12  

But it’s education across the board, right. It’s education for funders, it’s education for governmental leaders. It’s education for education professionals, especially our higher ed professionals, of just how to be present anymore. We’ve transitioned to a sort of box checking society. Tell me a little bit more about how I know that’s things we’ve discussed of like, well, I know why I’m here. I know what you want to hear about. Right? But what comes after that? 

Erik Brodt, MD:   16:40  

Yeah. And I think, you know, to build on that a little bit. The thing that makes roundhouse so different, as you guys show up. That there’s another funder I’ve been working with now. And I’ve been asking them every single year to come visit us, they funded us, I’m very grateful for the funding. They don’t really ask for too much from us, as far as reporting whenever it’s great. But I want to show them what we’re doing. I want them to see why this is special. And finally, after seven years of asking, seven years, right, and some people is like, great, you don’t have to, like you got your back, you know, like, they’re nobody looking down, you’re breathing down your neck. But it’s just like, if we don’t tell these stories, if we don’t tell these stories, and if we don’t show philanthropy and funders, what it’s like to work in Indian country, especially in like the health education sector in Indian country, it’s gonna keep being an enigma to them.

Erin Borla:  17:41  

Ya know, and it comes back to the young man, that middle school, right? If we don’t see the potential, by being present, and having a conversation and learning about that young person, all we hear is oh, they don’t pay attention. Don’t, don’t worry about them. And that’s how we lose kids. It’s how we lose systems.

Erik Brodt, MD:   18:04  

And even, even being mindful of the questions that you ask that determine who is excellent or determining who’s a genius. Like, who’s asking the questions to determine who is worthy. I think that’s something to really, to really consider. You know, a lot of times philanthropists, because people on their investment councils come from, you know, entrepreneurial tech backgrounds, family legacy stuff, like the questions that get asked around, if something is scale trouble. Like, is it, is it, is it scalable? Can you actually measure the impact, like all of these kinds of questions, and, and I think if people started listening more to the stories of impact, and the stories of scale, and the context of scale. So you helped us, Roundhouse funded us to expand a program where our pilot had three participants in it. Three. That doesn’t sound like a lot. But the fact that all three of those students from that private, that first, not private, from that first pilot experience, continued through higher education, continued to follow their dreams, continue to have contact with us and continue to pursue like health careers. It’s amazing. It’s amazing considering the statistics on paper in black and white. The story is where the power comes in. And I think you heard that when you showed up and you invited us to come and meet with you in this place. And the, I’m like super proud to be able to tell you that our first pilot, we had three applicants. And this last cohort, we had 20 times the applicants that we had that first pilot group, right. And some people may look at the numbers like, well, you had 60 applicants, that’s really not scale. It’s a big deal out here. It’s a big deal out here. {Yeah.} So. 

Erin Borla:  20:31  

I think that’s the story in rural communities across the country, specifically here in Oregon, where we work. And it’s just, it’s so hard to be able to share that to quantify that, to folks that, that are really truly just looking at statistics and looking at numbers, and not understanding what distance means right? Now, some of those kids are riding 45, 60 minutes each way on the school bus to get to school. So I think there’s, there’s definitely a bigger story here. But yeah,

Erik Brodt, MD:   21:00  

I agree. And I think when you look at rural communities, I kind of think of rural communities as like a three legged stool, where you’ve got like the, like the civic, or the government leg, you’ve got the educational or the school leg, and then you’ve got the health care system or clinic like and, and we teeter. Our existence is so tenuous, in America and rural and tribal communities right now. Because if we lose our school, we lose all the kids. If we lose the hospital or the clinic, we lose the elders. That’s a great way to kill a community is if you do not have the resources and the foresight in place to ensure that you can continue to have a functioning health system, a functioning educational system and a functioning governance system. So it’s, it’s crazy, {yeah} but like, I’ve seen this, like over and over, and I was actually visiting a community in North Dakota, and their population had just boomed to 36. Yet, if you look back to the 70s, their high school, 1978, or 79, their high school won the boys basketball state tournament. And now the only thing that went through the, the high school was wind. It’s completely empty. You know, they lost their clinic, lost their school, they lost their town. So I think a lot of what we’re doing is, it’s important, and in ways that other people may not talk about in mainstream media, or in popular narratives, or however you want to talk about it, but we’re doing something different. We’re sitting here with our microphone.

Erin Borla:  22:54  

It’s a story of hope, I think is what it is to though, to tell that story of rural we so often in rural and tribal communities, we hear that story of despair. But yours is a story of hope. And I think it’s a great spot to end on today. So thanks for being here.

Erik Brodt, MD:  23:08  

You’re welcome. Erin. Thank you for having me.

Erin Borla:  23:16  

philanthropy has its favorite words, transformational scale. How is this transformational is what one Foundation asked Erik, how was what you’re doing to impact American Indian, Alaska Native youth in health care careers, transformational? What a ridiculous question. It’s actually changing the lives of these young people, which then changes the lives of those communities and changes the communities. We hear that question a lot. We heard it throughout the series as well about scalability, well, you just can’t scale rural it doesn’t work. There’s not enough people you can’t make any impact. What does that say? It says, well, those people that are there don’t matter. So I think we need to think about asking questions differently. Let’s think about the word scale differently. Let’s think about transformation, differently. How are you asking those questions and then listening to the response, being open to the answer that you’re not expecting? And maybe, just maybe, success in an application, or success in a grant partner looks different than you might expect? You know, sometimes the grammar is not perfect. Sometimes the application isn’t perfect. Sometimes folks just don’t even have internet. So how are they going to do your online application? This reminds me so much of the Chiloquin Trust, Trust Republic Land Project that we talked about with Barton Robeson. And I just remember when that when the Chiloquin schoolyard, when that community came together over that project, that community thrived. And the downtown area started having impact and other projects kept coming up at the school and the next thing and the next thing and that community came together. Because of that infusion from one project. It’s a group of people believing in that community for one thing, trying one thing. My hope in having these conversations and making this show is to share some of the incredible people that I’m lucky enough to learn from in this work. I don’t know anything. But I’m smart enough to be able to surround myself with people that are the smartest people in the world, and the kindest, and they know communities inside, outside and upside down. There are so many people on the ground in rural communities and in Indian country doing incredible work that’s worth celebrating and supporting. I’m so grateful to all these incredible leaders who joined me for interviews for this whole series. I hope that no matter where you are in your philanthropic journey, that these conversations provided helpful ideas and insights for you. Thank you so much for tuning in and listening to Funding Rural.

Transcribed by A.I. Please forgive any errors.

Published On: June 17th, 2024 / Categories: Funding Rural Podcast /