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Hurricane Katrina: Now the real work begins

During the first terrible days and weeks after hurricane Katrina slammed into the Gulf Coast, physician volunteers from all over the country traveled to Louisiana and neighboring states to help in any way they could.

"We received hundreds of calls from out-of-state doctors asking what they could do," says Anne L. Shirley, director of public affairs at the Louisiana State Medical Society. Officials at the society put physicians in touch with the Louisiana Department of Health & Hospitals, which was in charge of medical relief and coordination.

In New Orleans, the physician volunteers worked alongside emergency personnel near the few roads leading outside of the flood-ravaged city. In Baton Rouge, the state capital, which had sustained wind damage but not the apocalyptic flooding that had overtaken the coastal cities, the volunteers helped staff the 800-bed, acute care field hospital that state and federal agencies had set up on the campus of Louisiana State University. And after the acute crisis passed, those who could stay longer fanned out with new recruits to the evacuee shelters, which even now house the thousands of storm victims who have no other place to go.

The current AMA president, J. Edward Hill, an FP in Tupelo, MS, who treated scores of evacuees in his hometown, has also congratulated his fellow physicians for their "outpouring of caring and concern." At the end of his video message on the AMA Web site, Hill says, simply, "I'm proud to call you my colleagues and friends."

But as laudable and crucial as this volunteer relief effort has been, it still leaves doctors in the hardest hit Gulf Coast areas with the monumental task of rebuilding their own lives and practices.

The problems they face are staggering: Many have lost their homes or seen them severely damaged. At the Palmisano house, located in Metairie, a suburb of New Orleans, Katrina tore off roof tiles and tarpaper, "and the driving rain caused multiple ceilings . . . to collapse-a true mess." Fortunately, Palmisano got a contractor friend to nail a plastic tarp to the roof to prevent further rain damage until it could be repaired. Other doctors were unable to make even that much progress.

Lost office space is also a problem, especially in New Orleans, where most doctors practice in one- or two-story facilities. Pediatrician Floyd A. Buras Jr., the president-elect of the state medical society, used to practice in a single-story office building that was under water up to its eaves. Physically, Buras has no place to go back to.

The water that inundated doctors' offices also swept away their paper medical records, leaving many of them with the near-impossible task of having to reconstruct years of medical histories for hundreds, even thousands of patients.

And that assumes, of course, that there will be patients to reconstruct medical histories for. Many patients of Gulf Coast doctors have fled or been evacuated to other parts of Louisiana and Mississippi-or other parts of the country. "Even doctors who didn't lose their office space or medical records, perhaps because their offices were a little higher up, still don't have a practice because they don't have any patients," says Dave Tarver, executive vice president of the Louisiana State Medical Society.

Doctors with deep roots in the region will undoubtedly tough it out, whatever it takes. But for many in the hardest hit areas, the thought of rebuilding, if they think about it at all, is a dream for another day. Meantime, they need to earn a living, and that means finding a job-perhaps in the same region, perhaps not.

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Jennifer N. Lee, MD, FAAFP
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health