Gulf Coast hospitals seen unprepared for new storms

By Kim Dixon

CHICAGO (Reuters) - U.S. Gulf Coast emergency rooms could not cope if a hurricane the size of Katrina strikes this year, according to a survey of the region's emergency physicians released on Thursday.

A third of Gulf Coast emergency room doctors polled, most of whom stayed on during the floods and breaching of levees in New Orleans after Hurricane Katrina, said they would leave the area if things do not improve within a year, the report said.

"The report serves as a warning: If working conditions are such that you can't have a viable practice and provide good patient care, you will leave," said Frederick Blum, president of the American College of Emergency Physicians, which conducted the poll.

Katrina tore into the Gulf Coast on August 29, 2005, inundating New Orleans and parts of Mississippi and Alabama, killing more than 1,300 people and causing $80 billion in damage in one of the worst natural disasters in U.S. history.

About 50 million U.S. residents live in hurricane-prone coastal communities, according to the National Hurricane Center. The U.S. hurricane season runs from June through November and peaks from mid-August to late October.

The survey of about 60 area emergency doctors, with an average of 13.5 years of experience, highlights the fragile state of medical care in the Gulf, doctors said.

About 43 percent of all hospital visits begin in the ER, according to national data, but Gulf Coast facilities are overtaxed. Two-thirds of the Gulf Coast doctors surveyed feel patient care is being harmed by overcrowding and lack of resources.

Two of the area's public hospitals have not yet re-opened, pushing more uninsured patients to emergency rooms. Seven of 22 hospitals remain closed.

Current estimates put New Orleans residents at 1 million people, compared to 1.2 million before Katrina struck.

The survey said the average wait in New Orleans emergency rooms is about 3 hours, but many patients wait longer if it is not urgent.

"The whole system is on life support," said James Moises, an emergency room doctor at Tulane University hospital, one of the only hospitals open in downtown New Orleans.

Once patients see an ER doctor, there is a dearth of specialists to send them to, he added.

"It is a very dangerous thing if you have cancer right now in New Orleans," he said, noting a lack of places administering chemotherapy.

Just 1,200 doctors remain from about 4,500 before Katrina, the physicians' survey said.

Tulane is owned by HCA Inc., the biggest publicly traded hospital operator in the country. Tenet Healthcare Corp has sold or put up for sale most of their New Orleans facilities.

Moises said he worried that HCA would also leave New Orleans because of the financial pressure of handling a rising number of uninsured patients.

"When you are a for-profit hospital, every patient that may not pay their bill is a concern," he said.

The survey also polled doctors in the hurricane-hit Biloxi, Mississippi, region, where most hospitals have re-opened, but a shortage of doctors is leading care to be diverted 60 miles across the state to a trauma center.

"We were at capacity before the storm. God forbid we should have any type of major catastrophe," said Matthew Emerick, president of the Mississippi emergency room doctor group, who lost his house in the storms and took part in the survey.