The small town, friendly atmosphere of Neah Bay and the unique culture and history of the Makah people offer a fulfilling experience for medical providers. An ideal setting to practice patient-centered, integrated primary care, Sophie Trettevick Indian Health Center has a full set of services available to meet patients’ primary care needs, including easy access to allied health professionals and patient support services. We are working hard to create collaborative care teams that ensure patient safety and continuity of care despite occasional provider turnover. Currently there are two patient care teams with four total providers (two on each team). These providers include one pediatric MD who is our clinical director, three Nurse practitioners. The practice environment typically allows providers to spend at least 20 minutes and sometimes up to an hour with their patients, which is a benefit rarely allowed in many managed care environments today. Walk-in care is also provided and heavily used by the patient population. Walk-ins make up 35%-45% of a typical day in the family practice clinic. The medical staff provide care for a challenging and varied range of health conditions with approximately 15,000 patient visits annually. In addition to the regular in-clinic schedule, the 4 medical staff share a rotating call schedule to provide 24 hour a day/7 day a week urgent care coverage, with time off from clinic when you are on call. The call volume is typically light and it is rare to get a call for unstable chronic conditions after hours. The EMS program is strong with dedicated volunteers and staff to assist in emergency situations. The clinic has a full pharmacy, a full dental clinic, partial in-house laboratory (with regular pickups for outside labs), and an x-ray technician. The clinic utilizes an Electronic Health Records system and providers enter patient visits into the computer or dictate notes. Our newest addition to the organization is the Integrative Medicine Department where our providers can refer patients for massage, acupuncture, hypnotherapy, physical therapy or bio-feedback. In 2013 the Integrative Medicine, Behavioral Health, Chemical Dependency, and Community Health departments moved into a new facility, called The Wellness Center, that is approximately 2 miles from the ambulatory family practice clinic. The Makah Tribe in 2018 has dedicated funds to plan a new family practice clinic near the above the Tsunami zone next to The Wellness Center. The STIHC staff are actively working with consultants to get this project moving to provide easier collaboration between all of the departments. The clinic was formally compacted by the Tribe in 2006 and is now a Tribally operated health center. The Sophie Trettevick Indian Health Center is fully accredited by the Accreditation Association for Ambulatory Health Care (AAHC).