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Q&A: CDR George Ceremuga, D.O. (í93)

Family medicine practice in the United States Indian Health Service

Interview by Colleen Kiphart

June 8, 2009 

After graduating from West Point in 1980, CDR George Ceremuga, D.O. (í93), FAAFP, served in the Army for nine years before attending OU-COM. Since then he has served in the Air Force and, most recently, in the Indian Health Service, where he provides care to Native American populations and enjoys life on the open range.   

OU-COM: Why did you choose to specialize in primary care?

Dr. Ceremuga: Iíve always wanted to be a family doctor, since I was a kid. It was just a dream and passion, and I never lost sight of. I still love it.  

I love the challenge of cradle-to-grave medicine, from delivering babies to caring for nursing home patients. You never know who will walk in the door, and you have to be prepared to offer services and medical care for different conditions and age groups.

The general practice is where you get to see a lot of variety of cases and patients. Itís challenging and rewarding, and I believe to be ďthe gatekeeperĒ is an honorable way to practice medicine.

How do you feel the primary care field fits with the mission of osteopathic medicine? 

Well, I think in primary care we treat with the holistic approach. We osteopathic physicians offer a little bit more diagnostically to our patients because of our additional training. Weíre like a one-stop shop. We really can treat 90 percent of the problems that come through our door, and the other 10 percent we refer on to specialty care.

For the past nine years you have worked near or on Native American reservations. Have you always been interested in working in underserved areas?

That passion for service started in the military, and moving out here -- to the Dakotas -- there are a lot of Native Americans. The exposure to their culture fueled that passion. They donít need another doctor in the bigger cities like Rapid City [South Dakota]. They need them in the smaller, rural areas where I can make the biggest difference.

Do you feel that in cases such as an Indian reservation, where there is such a concentration of one ethnic group, that cultural sensitivity impacts how you practice?

It does. Each reservation is different. Iíve practiced on two and worked near one. It is important to be mindful and respectful of each culture and its traditions, and if youíre not sure of traditional medical practice, ask. Be sure youíre at least willing to learn or understand the importance of traditional Indian medicine in the patientsí health and well-being. You need to look at some of the traditional medicine with ceremonies and herbs and healers. Some of the people embrace that as part of their culture, and to some it isnít important. I think it is important to be mindful of how we treat mind, body, and spirit.

What opportunities have presented themselves to you in Montana that you might not find elsewhere?

I think where I practice Iím expected to be able to utilize all the skills Iíve been trained in. If I was in a more urban setting, I might be restricted by the number of specialists. Here I have to be able to set bones and cast, which is something some primary care physicians donít get to do because the orthopedics are right next door.

You have a monster commute of two and a half hours each way. What do you do in the car with all that driving? What is your radio tuned to?

Variety. I sometimes just pray and meditate and listen to Christian music. Or I listen to CDs that my kids make or public radio. I have no routine; itís whatever Iím in the mood for. Sometimes I just like watching the wildlife as I drive. Iím out on the road by 5 a.m., and thatís when everything is waking up. I just pray and meditate and enjoy the scenery. 

What are your future plans? Do you think you could ever go back to the city? 

No, I couldnít go back to the city. Iím not a city boy, but I donít know if Iíll be out here the rest of my life.  

One of my goals is to learn Spanish and live in a developing country or in an underserved area that is predominantly Spanish-speaking. I usually accomplish what I set out to. I am looking at going to Guatemala and Peru, but I also know there are a lot of underserved areas in our own country.

 
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