Native American emergency physicians make up 0.1 percent of physicians in U.S. emergency departments, according to research published in 2020 in Annals of Emergency Medicine. Three Native American emergency physicians in Oklahoma—three of five in the state—discussed with ACEP Now their approach to health care and how their careers in medicine began. Brent O. Hale, MD, (Creek), Oklahoma ACEP President James R. Kennedye, MD, MPH, FACEP, (Kiowa), and Brandon Postoak, DO, (Chickasaw), also talked about how they recognize Native American Heritage Month each November.

ACEP Now: What got you into medicine and why emergency medicine?

DR. POSTOAK: I didn’t always know I was going to go into medicine. I’m a little nontraditional. I didn’t get into medical school until I was about 25. Before that, I wasn’t sure what I wanted to do. I had a lot of different experiences before finally getting into science. Once I started learning about medicine, things fell into place, and I realized it was my path. You know, growing up, I didn’t see many Native doctors, so I didn’t think it was something I could do. But when I looked back at my family history, I saw we had a lot of medicine men and women, so it was kind of in my blood. Pursuing medicine felt like it was the right thing to do.

It’s an honor to come back and serve my community, but even now, my direction in medicine keeps evolving every six months or so. I think that’s part of the journey.

Dr. Hale

DR. HALE: I was nontraditional, too. I didn’t go to med school until I was 30. I grew up in Okmulgee, on the Muskogee reservation. Like Brandon, I didn’t know what I was going to do for a long time. I tried a lot of different things—served in the Army, worked as a cook. I got married young and had kids, so I had responsibilities. I finally realized that if I was going to do something meaningful with my life, I needed to take a big step. I always knew I was good at math, but I didn’t know how to apply that skill until I saw an article in the Kansas City Star about an ER physician’s weekend. It was written like a diary, detailing what he did during a weekend shift: codes, traumas, you name it. I thought, “That’s what I want to do.”

I quit my job, went to KU for undergrad, and then went to med school. I did my residency in the ER program at OU. From the beginning, I knew I wanted to be an ER physician. But, like Brandon, there weren’t many Native American doctors to look up to. We had one: Don Bowen, a Muskogee physician who worked for the tribe. I always admired him. He passed away when I was young, but he left a big impact on me. When I graduated from medical school, we honored him by giving his widow and daughter a beaded belt. It was our way of saying thank you for the example he set.

Editor’s Note: Adoniram (Don) Van Bowen, MD, was the first American Indian doctor to gradate from Harvard Medical School.

Dr. Kennedye

DR. KENNEDYE: Like a lot of Native kids, I didn’t have doctors or other professionals in my family to look up to. In my tribe, the Kiowa, we didn’t start sending people to college until the 1920s, and our first doctor didn’t come until the 1950s. By the 1970s, there were only a handful of college graduates. That’s a big difference from other groups that have generations of professionals to encourage them. Growing up without those role models, it’s easy for Native kids to feel lost, especially in reservation or rural areas where poverty and other issues are prevalent.

I didn’t grow up on a reservation, but I did grow up in a poor area, and my parents didn’t go to college. I was good at math and science, but I didn’t think I was “doctor smart.” I wanted to be a Navy pilot at first, but life happened. I had a kid, and my plans changed. I joined the Navy. It took me two years into college before I realized I wanted to be a doctor. I had a mentor from my tribe, Dr. Everett Rhodes, the first Native American director of the Indian Health Service. He helped me learn about pioneers like Charles Eastman, the first male Native American physician, and he gave me the confidence to pursue medicine.

Jennifer Turner (left), Welana Queton, and Ivy Kennedye, the 8-year-old daughter of Oklahoma ACEP Chapter President James Kennedye, are shown at the 2024 Kiowa Black Leggings (Ton Kon Gyat) Ceremonial on

Oct. 12–13 in Anadarko, Okla. More than 200 years old, this event honors those who currently serve or have served in the military. (Photos KJ’S Flashed and Photography. Click to enlarge.)

ACEP Now: Native Americans were the first to practice healing arts in America, yet they make up just 0.4 percent of physicians and 0.1 percent of emergency physicians. Does it surprise you that the number is so low?

DR. HALE: It’s extremely low, but it doesn’t surprise me. All three of us have the same story. There was nobody around to show us the way, maybe one person if we were lucky. I know most of the Native ER doctors in the country because there are so few of us. We’re just such a small population to begin with, so it makes sense that there aren’t many Native physicians.

ACEP Now: When it comes to patient care, what do you take from your heritage into the emergency department?

DR. POSTOAK: I think back to when I was younger. My grandma and great grandma would take herbs or jars from the back of the house when someone was sick. They’d not only give medicine, but also sit down and talk, trying to figure out what was really going on. That’s something I try to carry into the ER—looking beyond just the immediate complaint and seeing the whole person. A lot of times, especially for Native patients, the ER is their primary care because they can’t access other services. We’re not always the best fit for those issues, but we do our best to help, to figure out what’s really going on. It’s tough when you see your own people come in. Some are homeless or dealing with addiction, and it hurts to hear their stories. It’s a blessing to be able to treat them, but it’s also heavy.

DR. HALE: Yeah, we see a decent number of Native patients, and it’s always a different feeling. It’s special to be able to treat your own people, but it can also be heartbreaking because you know the deeper context behind their struggles.

ACEP Now: Why did you choose emergency medicine over other specialties?

DR. POSTOAK: I feel like emergency medicine found me. I was doing rotations, and when I tried emergency medicine, I loved it. I realized I could be functional in any setting: at a ball game, in the wilderness, wherever someone needed help. I wanted to be that jack of all trades. My dad was a mechanic, and he always had an answer when something went wrong. I wanted to be like that—a resource in any scenario.

ACEP Now: Native American physicians in Oklahoma are working to reverse some of the cultural, social, and health issues caused by years of marginalization. What are some of those challenges?

DR. KENNEDYE: There’s a deep historical context to keep in mind. Native people have been here for about 25,000 years, but in the last few hundred years, we’ve been marginalized and pushed to the edges. My tribe, the Kiowa, were roaming free until about 1872, and we weren’t made citizens until 1924. That’s not ancient history; it was relatively recent, and the trauma from those events are still reverberating today. The damage wasn’t just physical; it was cultural. We were told we couldn’t speak our language, wear our traditional clothing, or practice our customs. That kind of deep cultural loss doesn’t go away in a generation or two. It’s still affecting our communities today, and you can see it in the social determinants of health: poverty, education gaps, and health care access.

I do public health and policy work, and we focus a lot on social determinants of health. It’s hard to address those in a busy emergency room, but it’s crucial because if you don’t, you’re just putting a Band-Aid on a much bigger issue.

ACEP Now: As leaders in your community, how do you recognize Native American Heritage Month?

DR. HALE: I celebrate Indigenous culture every day, whether it’s speaking my language, attending ceremonies, or even having conversations like this. But I’d like to see people stop celebrating Columbus Day. Celebrating what he did is an abomination.

DR. KENNEDYE: I participate in the Black Leggings Ceremony every year. It’s one of the last remaining Native American warrior societies, and it’s been part of our tribe for centuries. We honor our veterans and our warriors. It’s a big cultural event with songs, dances, and ceremonies passed down through generations. It was banned twice in our history but revived by World War II veterans, and we’ve kept it going ever since. It’s a visual spectacle, and it’s about remembering our past and honoring our people. My brother is a documentary filmmaker, and we filmed the ceremony last year. It’ll air on PBS soon, so more people can see it.

DR. POSTOAK: I’m honored to learn from leaders like Dr. Hale and Dr. Kennedye. I also watch my dad, who’s in the Chickasaw Honor Society, and it reminds me of our warrior spirit. It’s a blessing to carry forward those traditions and continue growing in my heritage. Working alongside these two doctors, especially treating Native patients, is one of the most rewarding parts of my job.