Dr. Esther Tailfeathers wins Dr. Thomas Dignan Indigenous Health Award
Esther Tailfeathers, MD, CCFP didn’t initially plan a career in medicine.
“I didn’t think I had the capacity to do it,” she says. “So I ended up doing a Native Studies degree, which was really important to me at the time.”
But things changed in 1987.
She was living in Norway when her brother, a third-year medical student at the University of Alberta and the medical school’s first self-identified Indigenous student, was killed in a car accident.
“We had talked on the phone a week before and he said, ‘Es, you really need to try medicine. It’s really rewarding and you can do it.’” He stressed the need for more Indigenous people in health care.
“I came home for the funeral and realized how necessary it was to have our own physicians and our own people doing medical work—nurses, doctors—because they understand the living situation and the health of our people,” she says.
Advancing health equity with a ripple effect
Dr. Tailfeathers is a family physician in her home community of Standoff, Alta., and served Fort Chipewyan, where she flew in for one week a month to provide 24-hour service for seven days. She is Indigenous Medical Lead with the Indigenous Health Program, Alberta Health Services, and an emergency room doctor in Cardston, Alta.
“She is the epitome of the ripple effect; her career continues to inspire other generations of Indigenous physicians to do more,” says Cara Bablitz, MD, CCFP, of the Indigenous Wellness Clinic at the Royal Alexandra Hospital in Edmonton. “She has inspired me and a whole generation of Indigenous physicians to work together with a common goal of improved health for our people.”
In recognition of her substantial contribution to improved Indigenous health care in Canada, Dr. Tailfeathers is this year’s recipient of the Royal College Dr. Thomas Dignan Indigenous Health Award.
Trailblazer in the ongoing opioid crisis
One of the biggest challenges that Dr. Tailfeathers has faced in her medical career is a fentanyl crisis in her community. She led the fight against the epidemic, before the scope of the problem was recognized in the rest of Canada.
At the height of the crisis in Stand Off, in 2014, there were six to eight overdose-deaths a month.
“[W]e brought in the naloxone kits, when no other Indigenous community in Canada was doing that,” she recalls.
Dr. Tailfeathers helped drive overdose rates down from 45 to 11 per month. Strategies included the introduction of opioid replacement therapy, prescribing suboxone, opening a safe-withdrawal site and community initiatives to address the social problems behind the crisis.
Her experience dealing with this crisis reinforced her commitment to improving health care providers’ recognition and understanding of the social determinants of health. More attention must be paid to the emotional and mental trauma behind addiction and other illnesses, she argues, including the continuing impacts of the residential school system.
“Emotional pain coming out as physical pain is being treated with opioids,” she says. “We still need more mental and emotional health supports. People are basically self-medicating their trauma.”
Embracing tradition while moving forward together
Today, Dr. Tailfeathers is encouraged by the enthusiasm young Indigenous people have for traditions, language and culture—a respect she says will help build healthier communities.
“There’s a lot of learning happening by young people about the value of old ways, and the importance of compassion and caring for others. There has been a real shift in our communities.”
She is also encouraged by emerging models in Indigenous health care across Canada. A good example is the new B.C. Indigenous Health Authority where Indigenous people are involved with decision-making and health care delivery.
Dr. Tailfeathers embraces her position as a role model for Indigenous youth and others around her.
“I think it’s really important to see those visible role models. Until children actually visualize someone in their community doing it and see there’s someone ‘just like me,’ they don’t realize they can do this too if they focus.”
More Indigenous health care providers will also lead to better health outcomes, she says, because of an inherent, enhanced level of trust.
“Watching her serve the community that she grew up in made me recognize the impact that I could have as an Indigenous physician in my own town,” explains Nicole Cardinal, MD. She credits Dr. Tailfeathers’ influence as “one of the reasons I returned home to my community in Saddle Lake to practise medicine.”