New Orleans Neurologists Are Hit but Not Down

In the wake of the severe hurricane season on the Gulf Coast, thousands of displaced physicians are looking for ways to keep practicing medicine.

For some, this means relocating to another part of the country or holding down a temporary job in the hopes they'll someday reclaim their practice from flood-ravaged areas and regroup with their patients.

Pediatric neurologist Carmela Tardo, M.D., director of the epilepsy center at New Orleans' Children's Hospital, didn't return to the city for nearly 6 weeks after Hurricane Katrina made landfall in late August.

“[In early October] we were given the go-ahead to return to Children's Hospital … which fortunately was located in an area uptown and did not flood,” Dr. Tardo, a clinical professor of neurology at Louisiana State University, said in an interview.

During those weeks in limbo, Children's Hospital stayed busy, opening up a temporary corporate office and an outpatient clinic in Baton Rouge 2 weeks after the hurricane. Another clinic was established in Lafayette. “We've had to adapt by becoming more mobile,” said Dr. Tardo.

Both of these facilities will remain in operation.

For now, the hospital in New Orleans is nowhere near full capacity, she said. “We had maybe 35 patients yesterday, where we normally would have 150. We're very pleased we're getting things [back to normal]. But many of our patients may not be here anymore.”

Faculty at LSU had dispersed “everywhere” after Hurricane Katrina—to Alabama, California, Georgia, or South Carolina—said Dr. Tardo. Evacuating the city before the hurricane hit, Dr. Tardo had stayed in Houston before temporarily relocating to Baton Rouge for a few weeks, then finally moving back home. “During this period, the seven pediatric neurologists, all LSU faculty, were in touch with each other through e-mail and phone calls,” she said. All have since returned to Louisiana to practice medicine.

Michael Happel, M.D., a neurologist who lost his practice in New Orleans, is trying to reestablish his practice and build up his referral base in a new area.

His home in Metairie, La., survived, but the private practice in Chalmette, in Orleans Parish, flooded, he said in an interview. The rented office “looks like the inside of a toilet bowl,” he said. Fortunately, his paper records escaped the flooding—they were being stored at a nearby office on the 10th floor. “I know some physicians who lost 20 years of records,” said Dr. Happel.

Whenever he needs his records, however, he has to hike up those 10 floors to carry down sometimes as much as 100 pounds of documents at a time. “I've been relocating records for patients, who are asking them to be forwarded to another doctor.”

Dr. Happel's private practice is part of a group of eight neurologists that share overhead and jointly negotiate managed care contracts. At press time, Dr. Happel is living in his home and commuting to one of the group's offices in Covington, La., on the north shore of Lake Pontchartrain. “My average monthly [patient] volume is 5%–10% of what it once was,” he said, referring to his current patient base. For now, he sees about 3–5 patients a day.

“I'm pretty much living day to day,” said Dr. Happel, who's looking to open a new practice in Metairie, to replace the one in Chalmette, and has applied for hospital privileges in that area. “I'm committed to trying to stay [in Louisiana] and make it work, but it's difficult,” he said.

Nancy Michaelis, M.D., an internist from Chalmette, La., obtained a temporary license to practice in Virginia. Overall, she's had three job offers, but in an interview said she's “desperately trying to get back to New Orleans.” For now, it looks like she'll be practicing in Virginia for quite some time.

“My house survived quite well … [but] St. Bernard Parish was completely destroyed. The two hospitals that I went to—Chalmette Medical Center in St. Bernard and Pendleton Memorial Methodist Hospital in New Orleans East—are not operational anymore. Furthermore, the population I used to see is not there anymore.”

If group practices felt the impact of the hurricanes, “the worst toll has been with physicians in individual practices, who have lost their house and practice,” Dr. Tardo commented.

Some physicians are considering a more permanent relocation. Otolaryngologist Michael Ellis, M.D., whose practice in Chalmette was flooded during Hurricane Katrina, is considering a move to North Carolina. Through his contacts in organized medicine, Dr. Ellis said he's been offered positions, both in private practice and in academic medicine, throughout the country.

“I've gotten job offers from North Carolina, Virginia, Tennessee, Chicago,” he said in an interview.

Many physicians like Dr. Michaelis thought they'd practice at a temporary location then come back to New Orleans, “but that's less likely to happen as time goes on,” said internist and infectious disease specialist Michael Hill, M.D.

Telephone service has been spotty in some areas, and it's been difficult for patients to navigate around the New Orleans area and get care, Dr. Hill said. His practice is trying to communicate with patients through newspaper ads and its Internet site, “which has updated where we are.” At press time he was working at his group practice's offices in Covington, located north of Lake Pontchartrain, and in Slidell, La. Two other physicians in the practice are working in the North Shore.

He and Dr. Ellis have been trying to organize a summit with members of Congress to establish a medical health care system within New Orleans. “We want to make sure that organized medicine has a voice” in this effort, he said.

6,000 Physicians Displaced in Gulf Coast Region

A recent study from the University of North Carolina at Chapel Hill estimates that Hurricane Katrina and flooding in New Orleans may have dislocated up to 5,944 active, patient-care physicians, the largest single displacement of doctors in U.S. history.

It's expected that Hurricane Rita may boost the total to an unknown degree, according to the as-yet-unpublished study.

Approximately 6,000 “physicians doing primarily patient care in the 10 counties and parishes in Louisiana and Mississippi have been directly affected by Katrina flooding,” said the study's author Thomas C. Ricketts III, M.D., deputy director for policy analysis at the university's Cecil G. Sheps Center for Health Services Research.

Data for the analysis were drawn from the American Medical Association's master file of physicians for the month of March and FEMA-posted information, as well as data from the American Association of Medical Colleges, Tulane University and Louisiana State University medical schools, the Texas Board of Medicine, and the state of Louisiana.

In an interview, Dr. Ricketts said most of the calls he's gotten to date have either been from physician recruiters or from practices in various parts of the country, asking for names of physicians who need a job.

Locum tenens or temporary positions have been an option for many of these physicians, according to Phil Miller, a spokesman for Merritt, Hawkins & Associates, a physician search firm based in Irving, Tex.

Staff Care Inc., the locum tenens agency of the Merritt, Hawkins group, has been placing physicians all over the country—in Texas, Oklahoma, the Carolinas, and Florida—Trey Davis, executive vice president for the agency, said in an interview. Hospitals and state licensing boards have facilitated this effort by making some exceptions to normal guidelines to process state licensing and hospital privileges, he said.

“We had a physician who contacted us a couple of days after Katrina hit. He flew his small, private plane to a location in Oklahoma and did a face-to-face interview with a government facility. Within 4 days, we pushed his privileges through, and he was seeing patients in less than a week.”

Not every physician is looking to reestablish a practice or begin a new one, Dr. Ricketts pointed out. Some will decide to retire instead. “We don't know what this is going to mean to health care. We've never had to deal with something like this before.”

Mr. Davis said his agency has been receiving a large number of calls for physicians to extend their contracts in their locum tenens jobs for as long as 6 months.

In the wake of the severe hurricane season on the Gulf Coast, thousands of displaced physicians are looking for ways to keep practicing medicine.

For some, this means relocating to another part of the country or holding down a temporary job in the hopes they'll someday reclaim their practice from flood-ravaged areas and regroup with their patients.

Pediatric neurologist Carmela Tardo, M.D., director of the epilepsy center at New Orleans' Children's Hospital, didn't return to the city for nearly 6 weeks after Hurricane Katrina made landfall in late August.

“[In early October] we were given the go-ahead to return to Children's Hospital … which fortunately was located in an area uptown and did not flood,” Dr. Tardo, a clinical professor of neurology at Louisiana State University, said in an interview.

During those weeks in limbo, Children's Hospital stayed busy, opening up a temporary corporate office and an outpatient clinic in Baton Rouge 2 weeks after the hurricane. Another clinic was established in Lafayette. “We've had to adapt by becoming more mobile,” said Dr. Tardo.

Both of these facilities will remain in operation.

For now, the hospital in New Orleans is nowhere near full capacity, she said. “We had maybe 35 patients yesterday, where we normally would have 150. We're very pleased we're getting things [back to normal]. But many of our patients may not be here anymore.”

Faculty at LSU had dispersed “everywhere” after Hurricane Katrina—to Alabama, California, Georgia, or South Carolina—said Dr. Tardo. Evacuating the city before the hurricane hit, Dr. Tardo had stayed in Houston before temporarily relocating to Baton Rouge for a few weeks, then finally moving back home. “During this period, the seven pediatric neurologists, all LSU faculty, were in touch with each other through e-mail and phone calls,” she said. All have since returned to Louisiana to practice medicine.

Michael Happel, M.D., a neurologist who lost his practice in New Orleans, is trying to reestablish his practice and build up his referral base in a new area.

His home in Metairie, La., survived, but the private practice in Chalmette, in Orleans Parish, flooded, he said in an interview. The rented office “looks like the inside of a toilet bowl,” he said. Fortunately, his paper records escaped the flooding—they were being stored at a nearby office on the 10th floor. “I know some physicians who lost 20 years of records,” said Dr. Happel.

Whenever he needs his records, however, he has to hike up those 10 floors to carry down sometimes as much as 100 pounds of documents at a time. “I've been relocating records for patients, who are asking them to be forwarded to another doctor.”

Dr. Happel's private practice is part of a group of eight neurologists that share overhead and jointly negotiate managed care contracts. At press time, Dr. Happel is living in his home and commuting to one of the group's offices in Covington, La., on the north shore of Lake Pontchartrain. “My average monthly [patient] volume is 5%–10% of what it once was,” he said, referring to his current patient base. For now, he sees about 3–5 patients a day.

“I'm pretty much living day to day,” said Dr. Happel, who's looking to open a new practice in Metairie, to replace the one in Chalmette, and has applied for hospital privileges in that area. “I'm committed to trying to stay [in Louisiana] and make it work, but it's difficult,” he said.

Nancy Michaelis, M.D., an internist from Chalmette, La., obtained a temporary license to practice in Virginia. Overall, she's had three job offers, but in an interview said she's “desperately trying to get back to New Orleans.” For now, it looks like she'll be practicing in Virginia for quite some time.

“My house survived quite well … [but] St. Bernard Parish was completely destroyed. The two hospitals that I went to—Chalmette Medical Center in St. Bernard and Pendleton Memorial Methodist Hospital in New Orleans East—are not operational anymore. Furthermore, the population I used to see is not there anymore.”

If group practices felt the impact of the hurricanes, “the worst toll has been with physicians in individual practices, who have lost their house and practice,” Dr. Tardo commented.

Some physicians are considering a more permanent relocation. Otolaryngologist Michael Ellis, M.D., whose practice in Chalmette was flooded during Hurricane Katrina, is considering a move to North Carolina. Through his contacts in organized medicine, Dr. Ellis said he's been offered positions, both in private practice and in academic medicine, throughout the country.

“I've gotten job offers from North Carolina, Virginia, Tennessee, Chicago,” he said in an interview.

Many physicians like Dr. Michaelis thought they'd practice at a temporary location then come back to New Orleans, “but that's less likely to happen as time goes on,” said internist and infectious disease specialist Michael Hill, M.D.

Telephone service has been spotty in some areas, and it's been difficult for patients to navigate around the New Orleans area and get care, Dr. Hill said. His practice is trying to communicate with patients through newspaper ads and its Internet site, “which has updated where we are.” At press time he was working at his group practice's offices in Covington, located north of Lake Pontchartrain, and in Slidell, La. Two other physicians in the practice are working in the North Shore.

He and Dr. Ellis have been trying to organize a summit with members of Congress to establish a medical health care system within New Orleans. “We want to make sure that organized medicine has a voice” in this effort, he said.

6,000 Physicians Displaced in Gulf Coast Region

A recent study from the University of North Carolina at Chapel Hill estimates that Hurricane Katrina and flooding in New Orleans may have dislocated up to 5,944 active, patient-care physicians, the largest single displacement of doctors in U.S. history.

It's expected that Hurricane Rita may boost the total to an unknown degree, according to the as-yet-unpublished study.

Approximately 6,000 “physicians doing primarily patient care in the 10 counties and parishes in Louisiana and Mississippi have been directly affected by Katrina flooding,” said the study's author Thomas C. Ricketts III, M.D., deputy director for policy analysis at the university's Cecil G. Sheps Center for Health Services Research.

Data for the analysis were drawn from the American Medical Association's master file of physicians for the month of March and FEMA-posted information, as well as data from the American Association of Medical Colleges, Tulane University and Louisiana State University medical schools, the Texas Board of Medicine, and the state of Louisiana.

In an interview, Dr. Ricketts said most of the calls he's gotten to date have either been from physician recruiters or from practices in various parts of the country, asking for names of physicians who need a job.

Locum tenens or temporary positions have been an option for many of these physicians, according to Phil Miller, a spokesman for Merritt, Hawkins & Associates, a physician search firm based in Irving, Tex.

Staff Care Inc., the locum tenens agency of the Merritt, Hawkins group, has been placing physicians all over the country—in Texas, Oklahoma, the Carolinas, and Florida—Trey Davis, executive vice president for the agency, said in an interview. Hospitals and state licensing boards have facilitated this effort by making some exceptions to normal guidelines to process state licensing and hospital privileges, he said.

“We had a physician who contacted us a couple of days after Katrina hit. He flew his small, private plane to a location in Oklahoma and did a face-to-face interview with a government facility. Within 4 days, we pushed his privileges through, and he was seeing patients in less than a week.”

Not every physician is looking to reestablish a practice or begin a new one, Dr. Ricketts pointed out. Some will decide to retire instead. “We don't know what this is going to mean to health care. We've never had to deal with something like this before.”

Mr. Davis said his agency has been receiving a large number of calls for physicians to extend their contracts in their locum tenens jobs for as long as 6 months.

In the wake of the severe hurricane season on the Gulf Coast, thousands of displaced physicians are looking for ways to keep practicing medicine.

For some, this means relocating to another part of the country or holding down a temporary job in the hopes they'll someday reclaim their practice from flood-ravaged areas and regroup with their patients.

Pediatric neurologist Carmela Tardo, M.D., director of the epilepsy center at New Orleans' Children's Hospital, didn't return to the city for nearly 6 weeks after Hurricane Katrina made landfall in late August.

“[In early October] we were given the go-ahead to return to Children's Hospital … which fortunately was located in an area uptown and did not flood,” Dr. Tardo, a clinical professor of neurology at Louisiana State University, said in an interview.

During those weeks in limbo, Children's Hospital stayed busy, opening up a temporary corporate office and an outpatient clinic in Baton Rouge 2 weeks after the hurricane. Another clinic was established in Lafayette. “We've had to adapt by becoming more mobile,” said Dr. Tardo.

Both of these facilities will remain in operation.

For now, the hospital in New Orleans is nowhere near full capacity, she said. “We had maybe 35 patients yesterday, where we normally would have 150. We're very pleased we're getting things [back to normal]. But many of our patients may not be here anymore.”

Faculty at LSU had dispersed “everywhere” after Hurricane Katrina—to Alabama, California, Georgia, or South Carolina—said Dr. Tardo. Evacuating the city before the hurricane hit, Dr. Tardo had stayed in Houston before temporarily relocating to Baton Rouge for a few weeks, then finally moving back home. “During this period, the seven pediatric neurologists, all LSU faculty, were in touch with each other through e-mail and phone calls,” she said. All have since returned to Louisiana to practice medicine.

Michael Happel, M.D., a neurologist who lost his practice in New Orleans, is trying to reestablish his practice and build up his referral base in a new area.

His home in Metairie, La., survived, but the private practice in Chalmette, in Orleans Parish, flooded, he said in an interview. The rented office “looks like the inside of a toilet bowl,” he said. Fortunately, his paper records escaped the flooding—they were being stored at a nearby office on the 10th floor. “I know some physicians who lost 20 years of records,” said Dr. Happel.

Whenever he needs his records, however, he has to hike up those 10 floors to carry down sometimes as much as 100 pounds of documents at a time. “I've been relocating records for patients, who are asking them to be forwarded to another doctor.”

Dr. Happel's private practice is part of a group of eight neurologists that share overhead and jointly negotiate managed care contracts. At press time, Dr. Happel is living in his home and commuting to one of the group's offices in Covington, La., on the north shore of Lake Pontchartrain. “My average monthly [patient] volume is 5%–10% of what it once was,” he said, referring to his current patient base. For now, he sees about 3–5 patients a day.

“I'm pretty much living day to day,” said Dr. Happel, who's looking to open a new practice in Metairie, to replace the one in Chalmette, and has applied for hospital privileges in that area. “I'm committed to trying to stay [in Louisiana] and make it work, but it's difficult,” he said.

Nancy Michaelis, M.D., an internist from Chalmette, La., obtained a temporary license to practice in Virginia. Overall, she's had three job offers, but in an interview said she's “desperately trying to get back to New Orleans.” For now, it looks like she'll be practicing in Virginia for quite some time.

“My house survived quite well … [but] St. Bernard Parish was completely destroyed. The two hospitals that I went to—Chalmette Medical Center in St. Bernard and Pendleton Memorial Methodist Hospital in New Orleans East—are not operational anymore. Furthermore, the population I used to see is not there anymore.”

If group practices felt the impact of the hurricanes, “the worst toll has been with physicians in individual practices, who have lost their house and practice,” Dr. Tardo commented.

Some physicians are considering a more permanent relocation. Otolaryngologist Michael Ellis, M.D., whose practice in Chalmette was flooded during Hurricane Katrina, is considering a move to North Carolina. Through his contacts in organized medicine, Dr. Ellis said he's been offered positions, both in private practice and in academic medicine, throughout the country.

“I've gotten job offers from North Carolina, Virginia, Tennessee, Chicago,” he said in an interview.

Many physicians like Dr. Michaelis thought they'd practice at a temporary location then come back to New Orleans, “but that's less likely to happen as time goes on,” said internist and infectious disease specialist Michael Hill, M.D.

Telephone service has been spotty in some areas, and it's been difficult for patients to navigate around the New Orleans area and get care, Dr. Hill said. His practice is trying to communicate with patients through newspaper ads and its Internet site, “which has updated where we are.” At press time he was working at his group practice's offices in Covington, located north of Lake Pontchartrain, and in Slidell, La. Two other physicians in the practice are working in the North Shore.

He and Dr. Ellis have been trying to organize a summit with members of Congress to establish a medical health care system within New Orleans. “We want to make sure that organized medicine has a voice” in this effort, he said.

6,000 Physicians Displaced in Gulf Coast Region

A recent study from the University of North Carolina at Chapel Hill estimates that Hurricane Katrina and flooding in New Orleans may have dislocated up to 5,944 active, patient-care physicians, the largest single displacement of doctors in U.S. history.

It's expected that Hurricane Rita may boost the total to an unknown degree, according to the as-yet-unpublished study.

Approximately 6,000 “physicians doing primarily patient care in the 10 counties and parishes in Louisiana and Mississippi have been directly affected by Katrina flooding,” said the study's author Thomas C. Ricketts III, M.D., deputy director for policy analysis at the university's Cecil G. Sheps Center for Health Services Research.

Data for the analysis were drawn from the American Medical Association's master file of physicians for the month of March and FEMA-posted information, as well as data from the American Association of Medical Colleges, Tulane University and Louisiana State University medical schools, the Texas Board of Medicine, and the state of Louisiana.

In an interview, Dr. Ricketts said most of the calls he's gotten to date have either been from physician recruiters or from practices in various parts of the country, asking for names of physicians who need a job.

Locum tenens or temporary positions have been an option for many of these physicians, according to Phil Miller, a spokesman for Merritt, Hawkins & Associates, a physician search firm based in Irving, Tex.

Staff Care Inc., the locum tenens agency of the Merritt, Hawkins group, has been placing physicians all over the country—in Texas, Oklahoma, the Carolinas, and Florida—Trey Davis, executive vice president for the agency, said in an interview. Hospitals and state licensing boards have facilitated this effort by making some exceptions to normal guidelines to process state licensing and hospital privileges, he said.

“We had a physician who contacted us a couple of days after Katrina hit. He flew his small, private plane to a location in Oklahoma and did a face-to-face interview with a government facility. Within 4 days, we pushed his privileges through, and he was seeing patients in less than a week.”

Not every physician is looking to reestablish a practice or begin a new one, Dr. Ricketts pointed out. Some will decide to retire instead. “We don't know what this is going to mean to health care. We've never had to deal with something like this before.”

Mr. Davis said his agency has been receiving a large number of calls for physicians to extend their contracts in their locum tenens jobs for as long as 6 months.