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Rising from Ruin is an on-going MSNBC.com special report chronicling two coastal Mississippi towns, Bay St. Louis and Waveland, as they rebuild after Hurricane Katrina.

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This project is evolving. Our daily dispatches coverage has been retired. Click here to see what happened in the area between mid October and January 1, 2006.

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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.”

051231_clinic_09_1
The clinic is housed in the ground floor of the railroad depot in Bay St. Louis. (John Brecher / MSNBC.com)

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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55 COMMENTS

Thank God for the free clinic! Is there something we can do to help? Send donations, etc?

I can see both sides. Doctors do have an overhead that must be met to pay their bills and earn a living. But, if you can't pay for medical coverage of any kind, what do you do.....go to a free clinic. Janet McQueen says no one will be turned away, but for how long? This tragedy will not be solved in 1 or 2 months. What a mess, and how can everyone start to win? Dan and John, thanks for keeping these agonizing problems in front of our faces. Hopefully our memories will be longer this time. Unfortunately, there will always be a need for paid and free medical service in this country.

Thank God, Mayor Favre has stepped in.I know Hancock Med. Ctr. and the local physicians will not treat anyone for free. As a resident of Hancock county,I am embarrassed by the behavior of our local physicians. Thank you Louden Medical Group for being here.

THANK YOU, THANK YOU, THANK YOU, Dr. Currier for treating me and my upper respiratory infection!!!! As a resident of Bay St. Louis who has lost her job and healthcare benefits due to Katrina, I am QUITE aware that the hospital does not turn anyone away from treatment. However, with no job or healthcare insurance, how does Ms. McQueen expect people to pay for the treatment that one receives? I am not asking for a handout, just some assistance until I find a new job. As far as Medicaid is concerned, I was told that I did not qualify due to my age (mid 30's) and that I do not have children. So, what is the alternative? And, believe me, I am not the only one who is facing this predicament without the luxury of relocating to another city due to financial strains of the loss experienced. And, before the judgements may pour into the blog, I have never seeked assistance before....I am college educated....I have been gainfully employed since 15....And, I have paid taxes for that same period.

I think that they need more clinics as of your to let the people know that you really care and are not just a number. Good Luck and Bless you for all the help that you have already given.

I have had to visit the Free Clinic multiple times since I returned to the Bay at the end of September. They gave me a free hepatitis-A shot and antibiotics. Allergic reaction to the mud has caused my friends and me numerous upper respiratory infections, a constant cough from the dust, and depression because we are overwhelmed by our losses and the work of rebuilding. The doctors and health care staff at the clinic have treated us all multiple times.

I went to the hospital's emergency room once. They sent me a bill for $150. Even though I no longer have my full-time job, I was able to retain heath insurance at over $300 per month. I don't know how long I can keep paying that amount becasue I'm only working part-time, I have a home equity loan that I haved been paying, and rebuilding my home has cost over $12,000 so far for gutting, wall repair, appliances, and kitchen cabinets. Insurance and FEMA have paid less than half. I've applied for an SBA loan, but despite a lot of questions and inspection of my home, I've heard nothing from them and I have run out of savings. And, I'm one of the very lucky ones. I have a home to rebuild. Most of my friends lost everything!

Dr. Currier and the other staff at the clinic are the most caring, nurturing people I have met. In addition to medical care, they give and give and give the emmotional support that is so needed here. So far, my "own" physician is nowhere to be found.

I can only hope that Dr. Currier stays here a long time. SHe and her staff are very much needed.

Doctors complaining about free clinics? Maybe they should have donated their services...Don't worry doctors....soon enough you will be in control again...After all, isn't that what has made them mad...Loss of control! Bravo to the free clinics!

Doctors fussing....thats redicules...all that should matter is people being able to obtian healthcare...thanks to the hospital....but God bless the free clinic...and it's staff!!!

I agree with the opinion that those seeking free health care are those without money to pay for the services. Keep the free clinics open for as long as the people need them, after all, that's what they're for!

If you have no job or insurance how will you be able to pay those ungodly bills that the hospital will charge you? They will not turn you away but they sure will bill you. Just the thought of no medical bill can relieve some of the stress of those in the area. Less stress can help the person recover more quickly. I was fortunate to have my employer continue my insurance until we reopened, but my copays for both doctor and medicine are so high I could not afford to use my doctor until I was back on payroll. The 210.00 a week for unemployment was helpful but it did not go far. I utilized the free clinic in Biloxi and was very thankful for their service. Do not close the clinic!!! It is extremely good for both physical and mental health of the people of the Gulf Coast.

I am a Katrina evacuee from Bay St. Louis. The main reason we left after the storm was to get medical help. Even before the hurricane I would not use the greedy self-serving physicians in Hancock County. The first question they asked when called was how you were going to pay the bill. I guess the storm did not change thier outlook ! Hurrah for the "free clinic". Thanks God someone cares for those who need the assistance. We received the medical care we needed in another state and no one asked how we were going to pay the bill. There are doctors who care about thier communities and patients more than thier bank accounts - just not many in Hancock County.

If the doctors would donate a portion of their time to the clinic, they could get to know the people that are in need of this service. Then they might understand the plight of their situation and needs a little better after a few weeks of the experience. They might also soften up a little and gain the respect and confidence of the patients, seeing them as people instead of business opportunities. They may even gain a couple new patients when the free clinic closes.
I do hope that the clinic stays in place until the residents and local businesses can get on their feet.

OF COURSE THEY NEED TO KEEP THE FREE CLINICS OPEN FOR AS LONG AS POSSIBLE...ALWAYS, REALLY...MOST PEOPLE THAT CAN'T AFFORD HEALTH INSURANCE CAN NOT AFFORD MORE BILLS FROM BEING TREATED AT THE HOSPITAL...I BELIEVE THAT ALL POOR FOLKS SHOULD HAVE FREE HEALTH CARE IN THIS COUNTRY!

The doctors complaining need to reassure the people that they will be able to get medical care even if they can't pay. I believe this is true for all emergency rooms anyway. They may have to take a pay cut untill people can get back on their feet again. It will come. Would they take $25.00 instead of the $75.00 fee they normally charge for an office visit? Are they willing to give medicine away for free? I think not. If people really have no income or a job, just how do they expect people to pay? There is no easy answer to this problem; the doctors need to make a living also. Do the people of the Pass or the Bay really want all of their doctors to leave? That's not the answer. How about the goverment steppin in and helping these physicians out with supplemnets for indigent patients that they end up treating?

Thank you Mayor Farve!! Maybe the doctors should take a few lessons from the Mayor-
It makes one wonder if the doctors from Bay St Louis would donate their time in VA -- (if the shoe were on the other foot) -God Bless those doctors that have left their families to help the Gulf Coast-
You have obviously taken your oath very seriouslY!
Thanks again for everything!

I was part of a volunteer team staffing a medical clinic in New Orleans in Dec. I agree with the need for free medical clinics. I do understand also that you need to bring doctors back into the area. Perhaps we need a program need to reimburse doctors for giving away services during a transition period and not just those in the free clinics. This needs to be something like what they do for Rite Aid which has provided free drugs using gov't funds. This program requires minimal paperwork. The physicians would need the same thing. Otherwise they will not be able to come back into the area.

Seems unfortunate that citizens from around the country can see the local doctors are not as caring as the free clinic docs. Local docs need to rebuild as well, however kindness and giving goes a long way to attracting new patients and retaining old ones.

I am the CEO of the group that has been providing free services to the wonderful people of the Bay St. Louis area in the train depot. We were welcomed days after the hurricane by the community leaders and we were asked to remain until the need to provide free services reduced. We went to the area with supply, physicians, nurses and other volunteers. We went with no plan except to help the people who were in need. We have provided services to 10,000 people and have only been able to do so with the volunteers of docs who have put their practice on hold and the many medical surgical vendors who have provided us with supply free. We believe we have provided a valuable service which has come at significant effort and cost which the people of our group and community in VA have supported readily and without reservation.

We have always said we would remain as long as the community needs us. We have defined the community as (1) the local elected leaders (2) the citizens and (3) the local health care providers. We are supported by the local elected leaders and much of the community. We are supported by some of the physicians. Dr. Chevis has been very supportive and has worked in the free clinic. I personally offered other local physicians the opportunity to use the facility to provide services to their own patients as well as to patients who require health care services free from charge.

As a CEO of a medical group I understand the need to generate income to pay overhead of the practice and I also understand the need to provide free services to people who cant afford to pay. We are hoping to facilitate the assurance that people without a source of income to pay health care costs will continue to receive care free from charge or at a reduced fee after we leave. I have personally offered assistance in development of a permanent free clinic and am researching other opportunities to provide free care through Federal and State Grants.

I am a physician supporter and I understand the frustration of the local docs. They lost their business and many their homes. They have suffered too. I remain willing to coordinate services of the free clinic with local doc offices in ensuring a smooth transtion while ensuring free or reduced fee services to patients in need. I am at the clinic on a regular basis and am willing to continue to meet with local docs and others in understanding their needs and ensure we are not causing difficulties for their practice redevelopment.

Our goal: to provide services to citizens in need after this horrific storm and to ensure access to services after we leave in an effective and comprehensive transition.

You can learn more about what we have done and our organization at www.virginiacares.org

Thank you to those who have been supportive on this site as well as the phone calls we have received.

75$....C Miller?...the last DR. i saw was 195$....for about 10 minuites...i felt as if i had been bent over a stump....i'm not sure i wasn't?????

oh....and i guess i'll die before i pay something like that again.....dammit!!!

Bay St. Louis was my home town, and as a spouse of a medical professional, and the administrator who pays the bills for the practice, I can sympathize with both the doctors and with the patients. While we don't live in Mississippi, I know what it takes to pay the overhead where we live. We pay more in overhead a month, than we made in year when my husband was an educator. There are 8 employees and their families depending upon my husband for their livelihood. We have medical school loans that could have paid for a nice home, no retirement built up, and while others were saving and building equity, we were living on next to nothing, working 60-80 hours a week and having very little family life. Now that he is in private practice, my husband does medical missions overseas every year, lives on very little sleep, and is constantly attending to the needs of others, and not his own. If we had settled back in the Bay, we would also have lost our home, still had our loans on both the home and the medical school to pay off, in addition to loans on the practice. In that situation, we would want to stay, but I don't know how we would have been able to. I guess it just is hard to hear people talk about greedy doctors, when I live next to one who has sacrificed for years and continues to. I know the situation is desperate for everyone and I am glad that help has come to the Bay. But have you ever stopped and wondered where that help comes from? It may just come from someone like my husband.

I am so glad that there are some people out there that are thinking of those in need instead of making money. So many people lost homes, jobs, and loved ones from this storm. I understand that everyone has to make a living, but at whose cost. These money hungry doctors need to put themselves in the shoes of the not so fortunate ones and realize that many of those in need don't have large bank accounts or large savings as many of these doctors have. Show a little respect and generosity to these people. As the Bible says "Do unto to others as you would have them do unto you." That in a nutshell says alot. One day when you doctors get your practices started back up, I can assure you the people will remember who helped them in a time of need and who didn't. Here in Philadelphia, Ms we had one gas station that never went up on their gas price during the store. I remember that gas station and drive across town just to use it because they didn't take advantage of those in need. Just remember what goes around comes around. Your actions speak for the type person you are.

If they have a need for a free clinic before the hurricane, what makes the complaining doctors think that after a disaster they don't need more of them? I would like to see just one doctor get in front of a microphone and talk to the media about the clinic taking money away from his pocket and his plan to serve all the needy people in that area in a efficient manor... Seems the best they can do is talk to a local newpaper and phone interview. If people can't afford treatment, they can't afford it. Charging people on a sliding scale is still charging them. He'd either get laughed at or torn apart by a crowd of his "patients"... Then I'd like to see that footage go out nationally...

Shame on those private physicians! Instead of criticizing the free clinic they should be donating their time. What a bunch of greedy boodsuckers. I have no doubt that they were able to afford sufficient insurance for their problems anyway. Why do the wealthy always want to skim the last dime of the poor? Shame Shame Shame.

Coastal Family Health was the only option for health care for many in Hancock County before the storm. They're just now up and running again with a very limited staff. Before the storm, they did a fine job, but they were always overwhelmed - it was impossible to get an appointment for emergencies. I know because I used their services many times. And now, with so many people out of work and without insurance, we need accessible medical care more than ever.

The free clinic has been a godsend. I've been myself and taken several friends. The staff has been friendly, efficient, caring - Dr. Currier and the rest of the group are true heros. They are merely filling the gap that CFH used to provide. If someone here has a regular physician and the money or insurance to pay, they're not going to go to the free clinic. And at this point, does the hospital really want hoardes of residents with minor ailments tying up their emergency room?

By the way, I just tried calling Dr. Crittendon's office. There was no answer. Not even an answering machine.

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