Dr. Carol Currier explains the dosage schedule for a course of antibiotics she prescribed for a patient's bronchitis at the free medical clinic in Bay St. Louis. Click 'play' to hear Dr. Currier describe the health problems common in the aftermath of Hurricane Katrina. (John Brecher / MSNBC.com)
BAY ST. LOUIS, Miss. -- The prognosis for the only medical clinic still offering free treatment to locals whose world was rocked by Hurricane Katrina brightened considerably Tuesday after Mayor Eddie Favre stepped into an increasingly acrimonious dispute between doctors who say it is undercutting their business and community leaders who maintain it is necessary to meet the health care needs of many storm-battered residents.
The clinic run by the Virginia-based Loudon Medical Group will remain open at least through the end of the week and "probably for a lot longer," Dr. Carol Currier, a physician at the clinic, told MSNBC.com after talks with city officials that apparently led to an 11th-hour reprieve.
“We let the mayor and the city council decide what to do and we base our actions on that," she said. "We don’t live here, they do, so we have to listen to them. And they want us to stay and so that’s what we’re going to do.”
Housed in the city's handsome train depot, the free clinic has by its count treated more than 10,000 patients since it opened in mid-September, mostly for respiratory problems, rashes, boils and depression. Original plans called for it to remain open through the end of March, but that timetable was called into question when what Loudon Medical CEO James Lapsley called a "vocal minority" of area physicians urged its closure at a Dec. 13 meeting.
The doctors maintained that they would be able to provide full service for patients in Hancock County by Jan. 3 and urged the clinic be shut down by then, according to Lapsley.
The two doctors who reportedly argued most vociferously against the clinic at the private meeting did not return phone calls from MSNBC.com seeking comment. But one of them, Dr. James Crittendon, told the Sea Coast Echo newspaper that physicians here are “well prepared to handle the members of the community.”
“I think Hancock Medical has really stepped up with bringing doctors in and getting things going again,” the newspaper quoted him as saying. “This community is going to need the hospital for the future ... (and) the longer that we keep the clinics open then the harder it will be to keep doctors here.”
Hal Leftwich, administrator at the Hancock Medical Center, took a similar line in a recent interview with MSNBC.com, saying that he hoped “as doctors return, the (free) clinics go away.”
But Currier, the clinic physician, said many people left homeless and jobless by Katrina can't afford medical services yet.
'These people are in crisis'
“These people are in crisis," she said. “They don’t know what they’re going to eat today. They don’t know what they’re going to eat tomorrow.”
Currier and other clinic doctors say that in addition to health care, many residents need help navigating the notoriously
labyrinthine network of state Medicaid, including special benefits available for survivors of Hurricane Katrina.
That applies to a large pool of residents who lost homes and jobs when their employers went out of business after the disaster. Hancock County had the state’s highest unemployment rate in November at 20.6 percent, compared to 8.8 percent for the state as a whole, and city officials estimate that up to 50 percent of Bay St. Louis residents currently lacks health insurance.
Mayor Favre, in an interview with MSNBC.com, said figures like that make it clear that closing the free clinic at this point would be premature, adding that “greed could be starting to creep in, just a little.”
“People who are going to be affected by closing this clinic are not the ones who are going to be putting money in anyone’s pockets because they don’t have any money,” he said.
But Janet McQueen, marketing director of the Hancock County hospital, said no area residents would be left uncovered if the clinic were shut.
'Our hospital doesn't turn anyone away'
“There won’t be anyone who won’t have medical care," she said. "... Our hospital doesn’t turn anyone away. I hate (for) people to be frightened that there won’t be care for them, because there will be.”
The hospital and doctors also would be supplemented by a medical clinic operated Coastal Family Health, a nonprofit group used by many low-income patients prior to the hurricane that charges patients on a sliding scale based on their ability to pay, McQueen said.
A third-party assessment of the situation comes from Dr. Elizabeth Gallup, founder of the Gulfport-based Mississippi’s Forgotten, an organization that aims to bridge the gaps between the needs of area patients and physicians.
In a phone interview, she described the regional health care situation as “abysmal” and said it is imperative that the transition from free medical care to for-pay care be handled "in a way that everybody understands what is going on, everybody has a hand in what is going on."
She also said that city officials have to realize that physicians are "in a bad way because they still have their practice overheads and their employees and yet the number of paying patients has fallen."
Asked about their argument that the free clinic should be shut down, she replied, “Who can blame them? They want their practices to survive.”
The debate over the clinic's fate echoed other recent controversies surrounding food and clothing giveaways and other no-charge services provided to hurricane victims. Distribution of many of those "freebies" have been scaled down or discontinued after business owners and local officials argued successfully that they were harming rebuilding efforts by preventing commerce from re-establishing roots in the historic Mississippi Gulf town.
But the debate over the clinic reached new levels of acrimony, and left storm-battered residents like Leboria Sager distraught over the prospect of losing access to the free services offered by the clinic.
Patient 'can't bear' thought of closure
“I just can’t bear to think of it closing,” says Sager, a retiree who lost her home to Katrina.
Although she has health insurance, Sager was unable to reach her doctor in the chaotic weeks after the storm and found the clinic to be a lifeline for her prescription drugs.
She also found the visiting docs to be caring, and said she would switch to one as her primary care physician if only they would stay in the area.
“Every new shift, new group of people (who have staffed the clinic) has been the same – just the nicest people, friendly and warm,” Sager said after gratefully hugging the nurse who tended to her on this day. “You come in here feeling low and, by the time you leave, you’re not feeling low anymore.”
Another patient, Bay St. Louis resident Lydia Keller, said one of the clinic’s psychiatrists was like “a ray of sunshine” for her in the dark days following the hurricane.
The feeling is mutual among the 75 or so staff members, most of them from Virginia, who have served rotating tours of duty in Bay St. Louis. During their time on the Gulf Coast, they lead lifestyles very similar to many of those they treat, living in trailers parked alongside the depot.
But at the end of another long, grueling day, Currier said the difficulties pale compared to the rewards.
“I just love these people,” she said. “I charge my batteries on them."
Despite the hard feelings that have erupted over the free clinic, McQueen, the hospital’s marketing director, said that while the two sides disagree on the timing of the transition they are united in wanting what’s best for Hancock County and its people.
“We all have the same goal: We want to provide healthcare for the community,” she said.
If you are a Mississippi resident who survived Hurricane Katrina and are unsure whether you qualify for emergency Medicaid benefits, call the Mississippi Division of Medicaid's toll-free hot line -- 1-800-884-3222 -- to determine your eligibility.
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