A shortage of physicians isn’t a problem limited to Mississippi. Physician availability is an issue across the country. But Mississippi remains last in the country when it comes to the number of doctors per capita.
Generally urban areas have less difficulty with physician availability than rural areas, so the Coast of Mississippi has been better staffed than rural areas of the state, particularly the Delta. Then came Hurricane Katrina. In the worst hit area of the Mississippi Gulf Coast, Hancock County, few physician’s practices or homes were spared damage.
“Hancock Medical’s physicians suffered a devastating blow from Hurricane Katrina,” says Janet McQueen, marketing director for Hancock Medical Center. “But while most lost both their homes and offices, most have chosen to stay in the community. Shortly after the storm, the hospital developed a temporary employment plan to assist physicians in critical areas until they were able to re-establish their practices.
The decline in Hancock County’s population, coupled with a dramatic increase in uninsured residents posed daunting challenges for those in private practice.”
Despite that, McQueen said Hancock County now has ample coverage in most primary care areas, including family medicine and pediatrics.
“We are proud to say we have continuous coverage in general surgery, with a surgeon on call seven days a week,” McQueen said. “Orthopedics is one specialty not available at present. We are also recruiting hospital-based anesthesia coverage and are working with The Hattiesburg Radiology Group to provide an on-site radiologist.
Most physicians who practice at Garden Park Medical Center in Gulfport stayed following Hurricane Katrina and many continue to rebuild, said Garden Park CEO William Peaks.
“New physicians have also come on board to help the Coast,” Peaks said. “Tamara Harper, M.D., was working in Alabama at USA Children’s Hospital when Hurricane Katrina hit in August of 2005. Her Ocean Springs residence that she shared with her husband was significantly damaged by the hurricane just months after they moved in that year. The Moss Point native decided that she needed to come home and work while rebuilding her home. The Pediatric Center next to Garden Park in Gulfport gave her that opportunity.”
“I was happy to come home to work and help the people in Mississippi, especially during this time of recovery on the Gulf Coast,” Harper said.
Peaks said the Mississippi Gulf Coast, much like other parts of the country, does have a shortage of physicians in some specialties, as well as a shortage of physicians willing to take calls for trauma patients. Garden Park Medical Center is working to help maintain and improve access to healthcare services for the community.
“The hospital offers numerous programs to help physicians locate to the Coast, as well as help physicians who are currently in the area and need assistance,” Peaks said. “We work with physicians on our medical staff to help identify physician needs in the community, recruit new physicians to the area, and retain existing physicians. In the past, we have also worked with other area hospitals to help recruit physicians to the market.”
An example of the ongoing recruiting and support process by Garden Park is a program that continues to help staff physicians obtain affordable malpractice insurance through the hospital and its parent company. Currently more than 50 physicians participate in the program, with the hospital subsidizing over half a million dollars to the program for malpractice premiums. Peaks said this program has helped numerous physicians remain in practice and has ultimately helped to stabilize the malpractice insurance market.
The hospital has also helped meet community needs by financially supporting a nurse midwifery program in conjunction with the Gulfport OB/GYN Clinic which provides obstetrical/diagnostic care to women, including Medicaid patients and those uninsured as a result of employment losses due to the hurricane.
“Garden Park will continue to work with our physicians and other healthcare providers to identify issues limiting access and availability of healthcare in our community and when possible, provide resources to address those needs,” said Peaks.
Memorial Hospital in Gulfport had 270 physicians on staff representing about 40 specialties prior to Hurricane Katrina. While the hospital lost 25 members of its medical staff, the overall scorecard is good, says Memorial Hospital resident/ CEO Gary G. Marchand.
“We were starting to see signs of physician availability being a problem before the storm,” Marchand said. “What Katrina did was amplify the problem temporarily. Mostly we have it under control at this point.
“To date we have replaced 14 doctors, and we are still looking to replace the other 11. We have also prevented another nine physicians from leaving the area by basically bringing them in through employment. They are now employed by the hospital instead of in private practice. We provide medical malpractice insurance for them as employees.”
Many physicians are worried about the financial stability of their practice in an unknown market. The month following Hurricane Katrina the average physician lost about 70 percent of his or her business.
“Hospital volumes dropped 30 or 40 percent that first month,” Marchand said. “It has come back ever since. A lot of healthcare demand is driven by age. Not only is it difficult to get an accurate population loss projection, it is also difficult to get an estimate of the population shift from one part of the county to the other. It is also difficult to find the age brackets of what is going on in terms of lost population.”
Some people left during the storm, came back and got discouraged, and decided to permanently relocate. Anecdotally, it seems that was predominantly elderly people. But how many elderly people, who use health services more, have left permanently is anyone’s guess.
One positive is that the State of Mississippi has gotten involved in efforts to attract and retain physicians.
Approximately $10 million in funds have been allocated for that effort.
“That is a good start,” Marchand said. “That social services block grant money will be distributed among all the Coast hospitals. That is a fair and generous thing for hospitals. That will help hospitals with new costs for retaining doctors or recruiting new physicians to the area. Obviously, from Memorial’s point of view, we will continue to recruit in key specialties until we feel our community needs are met.”
Marchand feels things could be far worse. If you had asked him a week after Katrina hit the likelihood of recruiting physicians to the Gulf Coast, he would have probably said “zero.”
“But we have found something completely different,” he said. “We have been able to find physicians who have interest in attaching themselves to the Gulf Coast region. Even though we are finding interest, it is a 90- to 120-day process to get physicians licensed by the state and credentialed by the hospital. So it is not the fastest of processes.”
Marchand prefers to look at the progress that has been made rather than concentrate on what has been lost. New Orleans had 5,400 physicians before Katrina compared to 1,400 today.
“Along the Mississippi Gulf Coast, all hospitals in operation prior to Katrina are now operating again in some form although they may have limited some beds,” he said. “Compare that to New Orleans where less than half of the hospitals have come back. We need to recognize some of our blessings on the Gulf Coast. Hospitals have responded, physicians have made a decision to stay, and other employees have stayed. Health care workers are hard to replace, too. There are a lot of blessings we need to start recognizing and counting particularly as it compares to New Orleans. My point is there are problems we need to work through. But we need to work through them in the context that in reopening hospital beds, and keeping nurses and doctors from leaving, Mississippi is getting it done.”
Singing River Hospital, which operates hospitals in Ocean Springs and Pascagoula, lost 12 doctors out of a staff of 200 after the storm.
“One thing we worked hard to make sure of is that there was no compromise of medical care at our hospitals,” said Richard B. Lucas, director of communications, Singing River Hospital System. “For this to happen, some physicians had to work even harder and longer, and we are grateful to them for doing so.
“We continually recruit new physicians to come to Jackson County, and that process has only intensified in the past year. Gov. Barbour has assisted all Coast hospitals by identifying some grant money to help in this effort. It is very important that the Coast reestablish a proper number of trauma surgeons, among other specialists, for our citizens.”
Contact MBJ contributing writer Becky Gillette at firstname.lastname@example.org.