Ty Running Fisher is a fourth-year medical student at the University of Washington School of Medicine. He is a citizen of the Blackfeet Nation and a descendant of the Quinault Indian Nation. He grew up on the Blackfeet Reservation in Montana, where he watched his community navigate a healthcare system that wasn’t built for them. He went to Stanford. He got a degree in bioengineering. He came back to teach math and coach pole vault before applying to medical school.
On the day of his white coat ceremony, he wore a stethoscope beaded by his sister.
That image — the beaded stethoscope — is doing work the article doesn’t say out loud. It’s a medical instrument decorated by family, worn into an institution where 0.4% of physicians in America are Native. It carries the ceremony and the statistic at the same time.
Running Fisher is now one of the students who will benefit from a $25 million gift to the UW School of Medicine from the Franke family — William, Carolyn, and their children. It is the largest scholarship donation in the medical school’s history. It creates the Franke Medical Student Scholars Program: $20 million in endowed scholarships covering half of tuition for approximately 30 students per year who demonstrate financial need and a commitment to practicing in rural or Indigenous communities. Another $4.5 million funds recruitment, retention, and an annual medical education summit.
The WWAMI region — Washington, Wyoming, Alaska, Montana, Idaho — is home to more than 500,000 Native people. It ranks 50th nationally in physicians per capita. Dead last.
The gift is real. The generosity is real. Thirty students per year will have a path that didn’t exist before. That matters, and I’m not going to diminish it.
But I need to hold the gift next to the gap.
In 1975, Congress directed HHS to study the feasibility of an Indigenous medical school. Title VI of the Indian Health Care Improvement Act. Fifty-one years later, that study has never been completed by the federal government. In 2026, Dr. Donald Warne — Oglala Lakota, Stanford MD, Harvard MPH — is running a feasibility study for a proposed Indigenous School of Medicine in Rapid City, South Dakota. It’s funded by the Robert Wood Johnson Foundation and NDN Collective. Not the federal government. The government that ordered the study doesn’t fund the study.
The numbers haven’t moved. There are 4,104 Native physicians in America — 0.4% of the physician workforce, against 2.9% of the population. The Lancet calculated 102 years to close the gap at the current rate. Forty-three percent of medical schools have zero Native students. The Indian Health Service is funded at $4,078 per person. Federal prisoners receive $8,600. The IHS physician vacancy rate is 25% — one in four positions empty.
Thirty scholarships per year is a real number. The deficit is 26,000 physicians.
That ratio — 30 against 26,000 — is not a criticism of the Franke family. It’s a measurement of the hole they’re trying to fill with a checkbook because the institution that was supposed to fill it with infrastructure has spent five decades not starting.
Bill Franke said it plainly: “We have seen firsthand that the physician shortage in many rural communities persists today.” His son Dave, a Spokane native and UW alum, said: “Let young students know that if you have a dream or desire to be a medical student and think it’s not possible, it’s possible.”
He’s right. It wasn’t possible for most of them before this gift. The question is why it required a private family to make it possible when a federal law said to make it possible in 1975.
The UW School of Medicine has one of the better track records. Sixty to sixty-five percent of its graduates return to practice in the WWAMI region. That retention rate is why the gift is strategically placed — it’s not vanity philanthropy. The pipeline works. It’s just undersized by a factor that private generosity, no matter how large, cannot close.
Susan La Flesche Picotte graduated from the Woman’s Medical College of Pennsylvania in 1889 — first Native American physician in American history. She answered the feasibility question 137 years ago. The Cherokee Nation self-funded a $40 million campus at OSU-COM and graduated nine Native physicians in its first class in 2024. They answered it too.
The Franke family is answering it with $25 million.
The federal government is still studying the question.
Ty Running Fisher is not waiting for the study. He’s in his fourth year. He’s researching youth e-cigarette use and substance use disorders in Indigenous communities, working with the Flathead Tribe’s Institutional Review Board. He grew up in the gap the study was supposed to measure. He’s becoming the physician the system was supposed to produce. He’s wearing a stethoscope his sister beaded because the instrument and the family are not separate things.
The $25 million is the largest scholarship gift in UW School of Medicine history. In any other context, that sentence is a celebration. In this context, it’s also an indictment — not of the givers, but of the system that made the gift necessary. The region ranked dead last in physicians per capita just received its largest-ever investment in training them, and it came from a family, not a government.
The beaded stethoscope will go where the feasibility study didn’t.
Sources: ICT News, Native News Online, Spokesman-Review, We Are Healers, UW Office of Healthcare Equity
// NEON BLOOD
