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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.”

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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I guess one question is, what is the long-term prognosis for the jobs of the doctors at the med-centers? If the residents don't have jobs or an economy that will support the facility, forcing people into debt will serve no purpose - as they will not get any income anyway. The economy needs to rebuilt quickly, or at least have a plan for economic reconstruction that includes the medical professionals.

Art Davis says, "Unfeeling Mountainfolk", as a description for the VA doctors, hummmmm....I wonder if his loved one needed medical care and had no money, would these "Unfeeling Mountainfolk Doctors" be good enough for his loved one? I bet so! Thanks to the VA Doctors and hurry home once your job is complete there.

I am ashamed for those MD's for thinking of themselves and not what really matters,which is helping these people who have lost everything and have nothing. Maybe they should donate some of their time instead of being worried it will affect their pockets. I think it's time they reviewed their hypocratic oaths!

This is a sad situation. I guess when those that are doing well loose everything then it will become clear that is better to give than receive.Free Clinics are the work of the spirit and must continue as long as there is a need.I believe the physician's anger is really to be viewed as fear.The only thing that overcomes fear is love and knowledge so invite them down to do service to their community before it is to late for them.

Thank God for the free clinic and the great volunteers who came halfway across the country to misister to the health care needs of not only the residents, but the workers. My son worked in Bay St. Louis for about 2 months and is helping to restore St. Stanislaus school and he got a cut and had to have stitches and they were given tetnus shots and antibiotics. God bless them. There was another time he had to go to the 'depot' and get medical care. Thank God some people in this world do things 'just to help' and the almighty dollar is not the main focus. This mom says, 'Thanks to all at the depot for caring for all the people'.

As a member of a team from Kansas that spent three weeks helping towards the recovery process in Hancock County I was a recipient of needed care at the Clinic. At that time it was one of the few Care Providers that were available. As we know the recovery process is not going to take days, weeks or months it is going to take years and part of that process begins with the economic recovery of the County. I would suggest that a screening process be established to identify who can and/or cannot afford to pay for the health care services that are provided. Once that process is established than both the Free Clinic and Hancock County Medical Facility must work together in helping the local doctors in re-establishing their patient base. As we all know, human nature tells us to take advantage of a situation that allows us to get something for nothing but at some point in time those free services need to be removed. Until then as the famous words of Rodney King we spoken "can't we all just get along".

Many of the respondants to this article seem to believe that the doctors of Hancock County are sitting in their mansions, counting their money, and thinking of ways to "stick it to the poor and downtrodden." These men and women have lost everything--their homes and businesses--too. Is it wrong for them to want to protect their livelihood? I think not. They,like many of the residents, are dealing with insurance companies, who may or may not pay their claims. They are struggling to reestablish their practices in an area that has been completely devastated. It is unfair to criticize the doctors for not "volunteering" their time. Before the hurricane, many of our physicians volunteered in a many areas of our community. Some were publicized, but most did this service anonymously, without much fanfare. These physicians could have called it quits after the hurricane (and truthfully some did). They could have packed up and moved to another city where they wouldn't have to struggle. They decided to come back to their community, to their patients. If these doctors leave, where is our community's health care going to come from? The doctors in the free clinic will not be here forever.
There is no need for another permanent free clinic in Bay St. Louis. Would this group consider working with Coastal Family Health Center to assist in expanding their services? They could ensure that those who can pay do and those who are truly in need of free care receive it. It would seem that this would be a helpful solution for both "sides" of this issue.


Glad to see that you feel so strongly about this situation. Apparently, you must either have the health insurance to cover your bills or the cash in hand to pay the doctors and/or hospital. I do not have either. When you consider the unemployment rate prior to the storm and now, you should be able to understand that those who were working prior to the storm and had insurance, no longer do. If one was to base the qualifications for your suggestion on last year's income, the majority of those who had it prior to the storm would not qualify at Coastal Family HEalth Center. Now, I understand that there are physicians who are facing the same problems that myself and my family are facing. And, I sympathize with their fates. However, closing the clinic or combining the clinics should not be an option. As I stated in my post earlier, I DO NOT qualify for other options of medical care. I checked into a private insurance plan that cost over $400 per month for myself. After taxes, my unemployment compensation would be cut in half with that type of premium leaving not too much for other bills that I am trying to stay current. The only option if the clinic closes is the ER at HMC that would result in unpaid hospital bills. Please think of those that are not in a situation that allows for expendable income on health insurance premiums. While trying to rebuild homes and/or start over, people need to focus on themselves and their families, not medical bills. It is bad enough here trying to make ends meet. Do not add fuel to the fire!

Hi Lisa, Originally from Buffalo myself. I think you misspelled it, Hypocrite oath. Even though I hold the medical field in high regards as many of us do, it's sad to see a few doctors unable to make house payments on their summer homes in the Hamptons. I'm not saying that doctors have to be humble all the time, but to blatantly speak about how greedy these doctors are is a disservice to the whole field of medicine. The public holds certain groups in society in very high regards, doctors (and nurses!!) being one of these groups. I hate to see them drag other doctors down. I am from Loudon County and am very proud of our doctors who are down there.

People need to understand that the "free clinic" or any of the other "free" services are only free to the recipients of the care. Indeed, providing these "free services" is costing many individuals, companies, and organizations plenty. From the physicians and other healthcare workers who donate time (i.e. not getting paid for their work) to the pharmaceutical companies who take losses to donate medications, to civic and government organizations who have to come up with yet another check to keep things going, all this is certainly not free to them. I hope the very deserving recipients of the "free" services recognize that someone down the line is giving up something so that they may provide for them. A noble act, truly, but what a shame if those who benefit now feel entitled and expect others to do without so that they may have. Doctors, nurses, etc., all have personal financial obligations, too. What good will it do the region if we bankrupt all the physicians and hospitals so that they are unable to continue to provide any care at all?

I think what is probably most disturbing about this article is the way the private physicians insinuate that people who CAN pay for their healthcare will simply go to the free clinic, rather than using their healthcare benefits.

While there may be a small percentage of people who receive free services when they could pay for it, there's a larger percentage who couldn't pay for it, and who would incur a large debt load (that is no longer dischargeable by bankruptcy, FYI) if free services were not available. These folks would have liens put on their properties and salaries to pay off the medical bills they incurred with the private physicians and local hospitals if they did not pay them. The impression I get from the story is that the private physicians and the local hospital are upset that are not getting the opportunity to suck these patients dry financially. And given that the local physicians screaming the loudest won't talk to the media, they certainly reinforce that impression.

I can only say, "Thank God for Mayor Farve!" and the other politicians who remain steadfast in their committment to care for the people of their city.

I am appalled at the behavior of this small group of doctors in BSL. Insisting on the closure of a clinic where medical services are provided to needy people is not only greedy, but also shows a lack of care for the overall population of the city of Bay St. Louis. If these people remain sick because they can't afford medical care, it endangers EVERYONE.

As Bay St. Louis rises from the ruin, I know the citizens will remember who supported them in their time of need and who was ready to take advantage of them.

My advice to the MD's who are complaining is to donate some of their time to help the citizens who are in need who used to be their patients. Afterall, they are the ones who were responsible for your former success, when they are back on their feet, they will be responsible for your future success---if they choose to be.

Thumbs up to Dr. Currier and the people of the Loudon Medical Group.

Our daughter and her church group spent part of their Christmas vacation (and their own transportation costs from VA)helping out in Bay St.Louis,including in the free clinic. God bless them; their fresh energy and enthusiasm gives everyone a boost. May God especially bless and sustain those who are working at the clinic for many more than just a few days but "for the duration". My impression, and I am a nurse myself, is that it is very important to continue providing the free clinic -- there are so many for which it is their only recourse.
At the same time I very much agree with Anna of Dallas, and Karen of Bay St.Louis, that we should not be ABUSING the community's physicians in the way many comments are doing -- very unChristian. I do also believe that most of the suspicion and anger on both "sides" is due to fear. Working together, for kindness' sake, will dispell that, and what miracles will be wrought in everyones' lives!

The ancient mariner feels sad for all of you in the US. You don't have a national health system you deserve. Did you know that you only have to be elected one time to the US House or Senate to be eligible for lifetime medical cover at military hospitals. Some of these same, in fact most of he former and many of present august public servants defeated a Clinton proposal to give all Americans a similar health plan to those in Europe. People in Europe work and pay taxes like you, but they get better value for their money. I imagine a lot of you would like to live in DC for two years, vote yea or nay and if you are sent packing you still get the red carpet if you want a doctor. And the clowns you have now!!!! Seems like every day georgie picks another know next to nothing pal for some important post. But he wants to teach your kids Urdu and Farsi. Be happy with that. I DO NOT mean to be sarcastic and I hope all of you get all that you need to get back to living for the future.

I always believed that health care has been like a runaway freight train. So much so that it has gone beyond any type of control. Do Americans realize that Health care has more freedoms than any other service, industry, and business in America and we let it happen and it is something that we could have controlled ourselves as patients?

Why is it when you repair your home that has a broken window and needs replaced you call contractors and you get prices and estimates of what it will cost to fix or replace it and you go with the lowest bid. You ask questions about warranty on the work and how long that window should last and by goodness is they so much as scratch the paint replacing that window we scream and holler at them and demand it be repaired or a replacement free of charge.

When you break an arm, you go to any doctor, walk in, basically sign a blank check and agree to pay whatever that Doctor wants to charge you. Do we ask the question what it will cost to fix? Do we ask the question what is the warranty on this broken arm that your about to fix? No. 3 months later when complications have set in, you go right back to the same doctor and write another blank check and say fix it. He or she says, now let’s try this. Another attempt is made to fix that broken arm. 3 months later you are now at the well it looks like we need to do surgery on it, you write another blank check and agree to pay for it. By that point, tons of prescriptions later, doctor’s visits, x-rays, blood work, hospital costs that are outrageous.

Now let’s throw in the key word. Insurance. If you have insurance on your house you know that is exactly why you want the lowest bid because you’re insurance demands it. Did you ever wonder why your health insurance doesn’t? How many times have you ever had a telephone call from your health care insurance agent who says to you…we just paid out a huge amount of money to this doctor and hospital so we want to know did you have this done?
It is never questioned. Then when our insurance rates go up, we scream at the insurance company. The insurance companies scream it the cost of health care that has gone up, then it’s the doctors who scream, the overhead has gone up. Somebody is always controlling somebody. Why don’t we as patients? In otherwords, maybe it’s time we REGULATE our own HEALTH CARE and COSTS. We need to put competition into our medical profession. In otherwords, hey DOC, you’re charging to much this DOC can do it cheaper.

Exactly what is happening in Bay St. Louis. Maybe we should fight tooth and nail to keep the free clinics here and force our own local physicians to start fighting against that overhead cost and start a reverse roll. How many times have you ever heard a doctor say…I need to fight the band aid company on behalf of my patients? Maybe it’s time we force our insurance companies to stop writing out checks without random investigations when Doctors submit bills? Maybe it’s time we take back control of our own health care.

What good would it do if the unemployed masses accrue bills and obligations that they have no idea where the money is going to come from? No one wants to see the doctors and/or hospital close or go bankrupt, but, again where is the money for the services supposed to come from when FAMILIES are unemployed with no healthcare insurance? Even the most frugal, "saving for a rainy day" person can not afford out of pocket expenses at this time. It is quite apparent that some posters have no idea the dire straits in this community. So, let me spell it out......Imagine your home nicely furnished and providing the needed shelter for you and you family. OK??? NOW, imagine a piece of concrete that was your slab foundation being the only thing standing????? Nothing else where you once lived. Nothing....no personal effects, no trees, shrubbery, etc. How much more of a description do you need????? Some people have NO MONEY to buy food. Do you understand that there are families living in tents????? Tents, you know camping equipment???? And, that's putting it mildly. Where will the money come from for physician and/or hospital bills? Come to the Coast for a few days. Take in the devastation, the mud, and stench that can still be found. Maybe then, you will understand that your opinions are not necessary and are just opinions.

gee i guess if i were sick and didn't have a home{only a slab and a pile of rubble} i would let the greedy hospital and doctors have it to fix me up....let them pay for the clean-up....Man they will probably own most eveything there before this is over....WHAT A SHAME

I am so glad to see some kind of aid reaching Hancock County, MS. My home is in Pearlington, MS, but I was dislocated to Salina, KS. All I have seen is footage of New Orleans and Biloxi. Hancock County was the brunt of the storm, so I hope that others will recognize that New Orleans and Biloxi, though they were hard hit areas, were not the only ones affected by the storm. Please help the Hancock County residents in any way you can. They need your prayers, thoughts, and concerns.

I am praying for everyone on the coast. I know it's devastatingly hard and I am so grateful that the clinic is there to help. Our healthcare system is crazy, and I say that from the inside. We can't help patients in need out right, because that would require charging them less than Medicare...which is Medicare fraud. So we treat them, and tell them to ignore the bills for three months and then we write them off, and before we do that, we're supposed to have proof of hardship and income, which is more paperwork. It's just part of doing business and of caring for people, no matter how much they can pay. It would be much cheaper for us to say, it's no charge, but we can't. How nuts is that? Anyway, please hang in there, everyone. A better day will surely come. Please don't lose hope.

I don't think that anyone is trying to verbally abuse the local physicians in this situation; however, they have put themselves in a bad position by speaking only privately to town officials and not to the media. Perhaps if they cared to give a public explanation of why they were trying to do what they did, people could gain a deeper understanding of the situation. Those who cannot afford healthcare have offered their explanations; it's time for the physicians to explain their side. Maybe they have a legitimate argument. Unless they speak, no one will know. The citizens of this area at least deserved a public debate on the topic. The fact that the doctors backed down reinforces the negative impressions.


No longer a Disaster....that's idiotcrasie...welcome help...from anyone willing to give it....THANKS...to da doc's from Virgnia!!!!....bless ya'll

Dear Dr. Currier
I am an RN,Interested in volunteering at your facility after the first week in Feb.Should you or another facility be interested in the services I could provide, Please e-mail me.


Mark D. Donaldson

hi, i lost my casion job after the hurricane which means that i lost my health insurance also. i have been going to the same local doctor for years and can no longer afford to go to him anymore. the free clinic is the only place that i can recive health care right now. i am thankful that they are there and doing a wonderful job. i came in a few weeks ago and they took great care of me. i worked at casino magic so that i could get health insurance. there arent many places out there that will provide insurance for a young highschool grad working her way through college. thank you guys!

p s if i had my health insurance. i wouldnt go to the free clinic because like my regular doctor and he knows me and my problems. but i cant afford him now and the free clinic is my only choice for the minor things like the katrina crud. i have a disc problems in my lower back and was going to start rounds of shots in my spine to help with the pain. that same week katrina came through. 4 months later i still havent been able to do anything about it and am in constant pain. i called my regular doctor to see if he would give me something to help me since i no longer have insurance. and really really cant afford the shots now. he said no. id have to come and see him. this is the same problem that i have been suffering from for almost a year way before katrina. he knows about my back problems hes been my doctor from 16 now im 25. im not the type of person to abuse pain pills and he knows that. i need help that the free clinic cannot provide. to me that is what makes me mad i am a loyal patient and if i could afford to go see him i would. what do i do?

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