While teaching at the Quaker Mission School on the Omaha Reservation, Susan La Flesche nursed the ill ethnologist and advocate of the Omaha, Alice Fletcher. Fletcher urged La Flesche to go back to school to get a medical degree.
In 1886, La Flesche attended the Women's Medical College of Pennsylvania at Philadelphia. In 1889, she graduated with a medical degree, not only one year early but first in her class of thirty-six members as welll.
After earning her medical degree, it was back to the Omaha Reservation for long, hard work. Dr. La Flesche was the reservation's only doctor, and she cared for more than a thousand people.
As a doctor, it was easy for Dr. La Flesche to see how changes brought about from having to live in a white world were hurting her people. She did a great deal to help her people understand that they needed to make corresponding changes to protect their health. Dr. La Flesche wrote to the Commissioner of Indian Affairs about alcoholism and tuberculosis.