среда, 3 октября 2012 г.

Coast physicians rebuilding and caring for patients - The Mississippi Business Journal

Imagine losing your home and medical office in Hurricane Katrina, and then learning that most of the community thinks that you are dead.

Dr. Ben Kitchens and his wife lost their home in Katrina, and it wasn't the first time the Kitchens have had to start over. They also had major damages to their home in Hurricane Camille in 1969, but at least had enough of the house left to rebuild. After Katrina, they came back to only a slab. Ditto for the office; the only thing left was a slab.

Adding insult to injury, it was reported far and wide that Kitchens and his wife died.

'It is a funny thing,' Kitchens said. 'The media reported both of us dead. It said we had drowned in the storm. Our bodies were identified and we were certified dead. This went throughout the whole Coast and beyond. A lot of my patients were disturbed by that. They felt they had not just lost things in the storm, but their family doctor. Fortunately, that proved to be false.'

Kitchens, who has been a family practitioner for 47 years, left on Saturday afternoon before the storm hit. He and his wife were staying in Waco, Texas, they thought safely out of harm's way. Then Hurricane Rita came, and hurricane force winds were predicted in Waco. The storm dodged Waco, and the Kitchens family was okay. But dodging the false rumors of their demise was harder.

Despite the challenges of Katrina, rebuilding a home and a practice, Kitchens wouldn't dream of leaving or retiring now when his community needs him the most - especially since his small town doesn't have that many doctors. He and his wife have found a home in Long Beach they are remodeling, and a temporary office has been set up at the Long Beach Community Church while he continues to look for new permanent quarters.

After his fifth week back in practice, Kitchens is seeing a lot of patients with upper respiratory problems, but nothing beyond what he considers normal for this time of year. He is also listening to his patients, helping them process their losses.

'Most of the patients I see have a horror story of going through the storm,' Kitchens said. 'They may have been in water up to their neck for several hours. Quite a few of them are depressed and anxious. They are somewhat disoriented, but not to the point of not functioning. They are just stunned. When feeling comes back, it hurts. Many people are fighting over insurance coverage, and are frustrated with how slow things are moving. But most have a very positive attitude. They plan to rebuild and start over. I have been impressed that most of the people have a very good outlook.'

'I consider my patients my friends. I have been here long enough that we have more than a professional relationship. I have a friendship with my patients, and feel a real obligation and desire to keep going and take care of them. People ask why I don't just retire. I don't want to retire, and certainly not at this time when the community is in such dire need of help.'

Another Coast physician who lost his home is Dr. Mahmoud H. Zayed, a cardiologist with the Southern Mississippi Heart Center, PA. He and his family lived in his medical offices on Bienville Boulevard until they could make other arrangements.

Still, Zayed said he was lucky because with a few exceptions most of his office staff survived without serious damage to their homes.

'The effects on our practice were to some extent minimized by the support of family members, as well as office staff,' Zayed said. 'Luckily, we have a very dedicated office staff who returned to the office within 10 days after the hurricane in order to be available for patient's needs such as refilling prescriptions and also calling drug reps to obtain samples for patients unable to get their medications from pharmacies because of damage and distribution problems. We knew it was going to be difficult for patients to get medicines for a while because of the circumstance.'

From the standpoint of practicing medicine, Zayed said the main challenge is to have patients refocus again on health problems. Unfortunately, a lot of patients with horrendous losses seem to neglect their health.

'It becomes less of a priority,' he said. 'We have been trying to motivate patients to take control of their health issues and adhere to a healthy lifestyle. I think we have unmasked quite a lot of coronary artery diseases from people going out trying to clear the yard and remove debris. This has actually led to a lot of patients experiencing symptoms such as shortness of breath or chest pain. They came for checkups and that led to a diagnosis of coronary artery disease that was undiagnosed in the past due to limited activity levels.'

After a natural disaster like this, substance abuse increases. People drink more, and tend not to cut back to pre-disaster drinking levels after recovery from the disaster. Zayed reminds his patients that going back to smoking and drinking is not going to help fix the problem.

He also encourages his patients to keep their faith, and remember what is most important.

'Our health is the most important gift from God, and as long as we are healthy, we can always rebuild and bounce back from these major disasters,' Zayed said. 'I am amazed at how people are pulling together. I see patients who are in their 80s ready to rebuild their homes on the water. We do have a very resilient community in South Mississippi, and I think we will ultimately overcome this major challenge and prosper.'

Many Coast residents are facing the most difficult times they have ever experienced.

'What I see in practice is a lot of people are depressed,' said Dr. Don LaGrone, Gulf Coast Children's Clinic, which has offices in Biloxi and Ocean Springs. 'Most people are still waiting to hear from insurance companies, so they are in financial limbo. A lot of people are still struggling with primitive living conditions. There are traffic snarls and prolonged difficulties getting across town. Everything takes more time and is more difficult.'

Physicians aren't immune from the problems. Many are suffering the same problems as patients in terms of anxiety and depression.

'Half the people I know, their homes were either completely destroyed or damaged by the storm,' LaGrone said. 'Outside of their practices, physicians are having to struggle with the same problems that everyone else does.'

LaGrone's office in Ocean Springs flooded, and he didn't have flood insurance because it was out of the designated flood zone. He and his staff did most of the repairs themselves in order to reopen two weeks after the storm. His office in Biloxi opened a week after the storm.

Another problem: many patients have left the area. For example, about 15% of Ocean Springs High School students relocated out of the area after Katrina.

'Many of our patients are no longer in the area, so initially our patient flow was very slow,' LaGrone said. 'We kept all employees on full salary through the storm and aftermath. So, it has been a little difficult with cash flow problems.'

Thus far the Gulf Coast Children Clinic's patient shortfall has been made up because Kessler Air Force's medical facilities have been closed due to hurricane damages. Military dependents have been going to private physicians.

'When Keesler comes back online and takes the business back from the community, it is going to put a lot of stress back on us,' LaGrone said.

The current concern is some of casino employees are losing their health insurance and there is no interim coverage in place. LaGrone is concerned families will leave the area because there is no health coverage, as well as no jobs.

Many of the casinos gave employees 90 days pay and medical benefits after the storm, but that has now run out. Some of the casinos are considering an interim agreement to provide coverage for casino employees who want to remain in the community during the period while the casinos are being replaced. An independent practice association of 75 Coast doctors has offered to see casino employees and their dependents at a discounted rate during the interim period while the casinos are closed. Details are still being worked out.

Like most people, after the devastation of Katrina, LaGrone and his family questioned if they should stay, having lost their home and everything they owned.

'But we feel like we are part of the community, and it just wouldn't be right to leave at the low point,' said LaGrone, who practices with two other physicians. 'We aren't going anywhere. Our clinic will be open, active and available to everybody.'

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