Med­i­cal prac­tices in area re­bound­ing from Har­vey’s havoc

Dis­rup­tion still im­pacts doc­tors and pa­tient care

Houston Chronicle Sunday - - CITY | STATE - By Todd Ack­er­man

Dr. Lind­sey Jack­son couldn’t bring her­self to visit her of­fice for two and a half weeks after the flood­ing from Hur­ri­cane Har­vey, fear­ful she would be over­whelmed by emo­tion at the sight of the dev­as­ta­tion.

Jack­son had opened the prac­tice a year be­fore, a dream eight years in the mak­ing, only to have it wiped out. She choked up just view­ing the dam­age — wa­ter that rose 4½ feet high, $500,000 worth of equip­ment, fur­ni­ture and sup­plies ru­ined — in pho­tos sent by em­ploy­ees who had kayaked to the of­fice the first few days.

“It was unimag­in­able, a dream lit­er­ally washed away, ev­ery­thing we had gone,” said Jack­son, a Friendswood gen­eral prac­ti­tioner who spe­cial­izes in in­fu­sion ther­apy. “I won­dered if it was a sign — was hav­ing my own prac­tice not meant to be?”

The evac­u­a­tion of 44 hos­pi­tals, nurs­ing homes and as­sisted-liv­ing fa­cil­i­ties re­ceived most of the at­ten­tion in the days and weeks after Har­vey hit, but the greater dis­rup­tion to pa­tient care was the flood­ing’s im­pact on physi­cians, solo and group, many of whose prac­tices bore the full brunt of Har­vey’s wrath.

Nearly 140 prac­tices were de­stroyed or suf­fered ma­jor dam­age, ac­cord­ing to the Texas Med­i­cal As­so­ci­a­tion, and nearly as many suf­fered lesser dam­age. The as­so­ci­a­tion based its es­ti­mate on data from the Fed­eral Emer­gency Man­age­ment Agency. The res­i­dences of more than 300 physi­cians also suf­fered ma­jor dam­age.

All told, some 65 per­cent of doc­tors who re­sponded to a TMA sur­vey said they tem­po­rar­ily closed their prac­tices be­cause of flood­ing. Thir­ty­five per­cent said they sub­se­quently re­duced hours or ser­vices. Six per­cent had to re­lo­cate. A small

num­ber called it quits.

Such re­duced ser­vice equated to tens of thou­sands of pa­tients left with­out their doc­tors, TMA of­fi­cials said.

“Har­vey was in­dis­crim­i­nate in the toll it took — physi­cian prac­tices, free­stand­ing ERs, ur­gent care cen­ters, night clin­ics,” said Dr. Car­los Car­de­nas, TMA pres­i­dent and an Ed­in­burgh gas­troen­terol­o­gist whose of­fice closed for 24 hours out of con­cern the storm would come its way. “Things are im­prov­ing, but lots of doc­tors are still strain­ing to get their prac­tices up and run­ning again.” $1 mil­lion out­reach

TMA jumped into ac­tion as soon as the storm hit, rais­ing funds to add to its dis­as­ter re­lief pro­gram al­ready in place as a re­sult of Hur­ri­canes Ike and Rita. Last week, the as­so­ci­a­tion handed out nearly $350,000 in aid to 28 prac­tices, the first al­lo­ca­tion of a planned $1 mil­lion out­reach. The 28 prac­tices rep­re­sent 107 doc­tors.

TMA of­fi­cials also con­tacted in­sur­ers to make sure they com­ply with a Texas De­part­ment of In­sur­ance re­quest they waive out-of-net­work penal­ties and re­stric­tions for those seek­ing care in ar­eas de­clared a dis­as­ter area. They also con­vinced the Cen­ters for Medi­care and Med­i­caid Ser­vices to re­lax rules so doc­tors can tem­po­rar­ily re­lo­cate with­out hav­ing to re-en­roll in the pro­gram.

Among the doc­tors to re­ceive TMA’s first slate of fund­ing was Dr. Es­te­ban Ber­be­rian, a Chan­nelview in­ternist who shut down his prac­tice for nine days fol­low­ing the flood­ing, then reemerged in cramped, makeshift digs a cou­ple miles away. Six weeks out, his old of­fice re­mains gut­ted.

“It’s pretty dev­as­tated — mud all over, walls dam­aged six feet up, float­ing fur­ni­ture, a re­ally bad stench,” Ber­be­rian said. “I’d look at it and think, how much is it go­ing to take to get this cleaned up and in work­ing or­der?”

Ber­be­rian still has no idea, partly be­cause the of­fice build­ing is at­tached to and re­lies on power from East Hous­ton Re­gional Med­i­cal Cen­ter, which re­mains closed as a re­sult of flood dam­age. HCA Gulf Coast, its owner, has not de­cided whether to ren­o­vate or re­build some­where else.

Ber­be­rian, whose pa­tients largely fol­lowed him, re­mains in limbo, trapped in a lease from which the build­ing owner at the old site will not re­lease him. He ex­pects that even­tu­ally he will re­turn to the old of­fice, but prob­a­bly won’t know un­til HCA de­cides its own fate. In the mean­time, he can­not take out a new lease.

Not all doc­tors have been as for­tu­nate. Too busy to do any mar­ket­ing and lack­ing even a proper business phone un­til last week, Jack­son es­ti­mated she is see­ing 30 per­cent of her for­mer pa­tients after re-open­ing last week. She says her re­turn mostly was about the needs of pa­tients, many with can­cer, but ac­knowl­edged the sig­nif­i­cantly smaller rev­enue is com­pli­cat­ing re­cov­ery plans. ‘We have to stay’

She is not the only doc­tor Har­vey has forced to start over.

Dr. John Soule had main­tained a prac­tice in Vic­to­ria for 28 years when Har­vey took out his roof and soaked his fourth­floor of­fice, in­clud­ing all his com­put­ers, pa­tient charts and fur­ni­ture.

“It was stun­ning when I went back,” said Soule, 60. “I’d stand in the of­fice, look up and see blue sky and clouds float­ing by.”

Soule, a gen­eral prac­ti­tioner, does not use ex­pen­sive equip­ment so he fig­ures his start-over costs will not be pro­hib­i­tive, prob­a­bly around $20,000. He had no flood in­sur­ance, how­ever, so the TMA aid is cru­cial. He knows his share of doc­tors who de­cided to re­tire be­cause of Har­vey dam­age, but said he never re­ally con­sid­ered the idea be­cause “I wouldn’t know what to do with my­self. This is what I do.”

Soule said a few of his pa­tients, ac­cus­tomed to nice sur­round­ings, are ap­palled at his tem­po­rary lodg­ings, but most are philo­soph­i­cal. He tells them to “keep plug­ging away, we’ll make it one way or an­other.”

Jack­son is find­ing that out first-hand. She con­sid­ered re­turn­ing to her old job treat­ing crit­i­cal care trauma cases at a hos­pi­tal, but was over­come by the com­mu­nity’s re­sponse to her plight — TMA fund­ing, a check from the Friendswood Cham­ber of Com­merce, com­peti­tors of­fer­ing of­fice space and, most of all, pa­tients do­nat­ing couches, chairs, mi­crowaves, ice ma­chines, even IV poles.

“I was ready to throw in the towel, but see­ing the com­mu­nity step for­ward to help us re­build changed all that,” said Jack­son. “I thought, they want us, they need us, we have to stay.”

Jack­son now is op­ti­mistic she will be back to business as usual by De­cem­ber.

Lind­sey Jack­son

Dr. Lind­sey Jack­son lost $500,000 worth of equip­ment after her prac­tice took in 4½ feet of flood­wa­ters. The Friendswood prac­tice re­opened last week.

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