In New Orleans, flooding swamped more than 80 percent of the city, including the Louisiana State University Charity Hospital pictured here.
Courtesy of Duane Belongie, MD

AAOS Now

Published 10/1/2015
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Jennie McKee

Orthopaedics in New Orleans, a Decade after Katrina

Although challenges remain, orthopaedists laud the city’s resilience

On Aug. 29, 2005, Hurricane Katrina slammed into the Mississippi Gulf Coast, causing massive flooding that destroyed homes and left more than 1,000 people dead. As the storm plunged New Orleans into chaos, orthopaedic surgeons and other medical professionals evacuated patients from the city’s hospitals and provided desperately needed medical care. Later, New Orleans’ orthopaedists rebuilt their personal and professional lives, opting either to stay in the city or begin again somewhere new.

Ten years later, New Orleans has come a very long way, according to AAOS members who call it home. Although they agree that the disaster left an indelible mark on the city, Felix H. “Buddy” Savoie III, MD; George F. Chimento, MD; and Andrew G. S. King, MD, assert that New Orleans and its people have rebounded from the dark days of 2005. They point to a number of successes, including the recent construction of the $1 billion Veterans Affairs Medical Center and the $1.1 billion University Medical Center, a level 1 trauma center whose academic partners include the Louisiana State University (LSU) and Tulane University Schools of Medicine. Both institutions will employ thousands of medical professionals and other workers and will provide medical care to the city’s patients.

Dr. Savoie, a Louisiana native, serves as professor of clinical orthopaedics and chief of sports medicine at Tulane University School of Medicine. Dr. Chimento chairs the department of orthopaedics and is section head of adult reconstruction and joint replacement at Ochsner Health System. Dr. King serves as professor of orthopaedics at LSU Health Sciences Center, and recently stepped down as head of the institution’s department of orthopaedic surgery.

All three spoke with AAOS Now about where things stand for orthopaedists and other medical professionals in New Orleans 10 years after the storm.

AAOS Now: Can you give a ballpark estimate of how many orthopaedists stayed in the city after Katrina, and how many relocated?

Dr. Savoie: Prior to the storm, I had been living in Jackson, Miss., but I moved to New Orleans right after Katrina. At that time, it seemed like only about 40 percent of the population had come back, and there were not very many surgeons. Now, about 70 percent to 80 percent of the population is back on the south shore of Lake Pontchartrain, where we are. The number of orthopaedic surgeons is definitely back up. Although many surgeons never came back, others did, and new surgeons have come to town. So, I think the overall number of orthopaedic surgeons is probably the same as it was before the storm.

Dr. Chimento: After the storm, I know of five orthopaedic surgeons who did not return, but most groups and private practices are growing now. In the 10 years since the storm, I think we’re probably net positive, as far as the number of orthopaedists at private groups and academic centers, although I don’t have the exact number.

AAOS Now: After Katrina, there were some significant shortages of medical personnel, such as nurses and medical assistants. Are shortages still an issue?

Dr. Savoie: It was a problem for a long time. Many people commute from outlying areas. Several moved to Baton Rouge, about 60 miles away, and a fair number of them are still commuting. But people have been really good about moving to town. The city has managed to recruit and pay well enough at different hospitals.

Some areas of health care are still deficient, such as mental health beds. From an orthopaedic standpoint, we have actually done pretty well, with people coming back and new young orthopaedists coming to the city. It took until about 2011 before people realized the city wasn’t under water anymore, and the younger guys started coming.

It was an uphill battle. Some physicians wanted to come because they thought it was a mission, but their spouses and families didn’t want to come because they thought it was a disaster area, which is understandable, given the news coverage. But the last 3 years have been terrific.

Dr. Chimento: I think you can always have more medical assistants and nurses, but I don’t think we’re at a crisis level.

AAOS Now: Are orthopaedic residency programs back up to full speed in New Orleans?

Dr. Savoie: We’re still at about half the number of residents at Tulane. We used to take six residents a year. After the storm, we went down to two. Now, we’ve got three most years, and we’re asking the Residency Review Committee for Orthopaedic Surgery to let us go to three every year, and then to four. I don’t think we can go back to six residents per year, because we want to keep residents here. So, I think four would be a good number
for us.

Dr. Chimento: The first year after the storm, it was a bit difficult to attract residents, but I don’t think that’s an issue now. At Ochsner, our program has remained the same, as far as the number of residents. We get resident applications from all over the country, and we have a pretty diverse group.

Dr. King: The LSU program has the same number of residents as it did before the hurricane. We are having no problems attracting a lot of resident applicants every year—in fact, we are getting as many as I can ever remember in the 35 years I’ve been in New Orleans. And the quality is good. New Orleans has regained its position as the training ground for medical professionals in Louisiana and in the southern Mississippi region.

In New Orleans, flooding swamped more than 80 percent of the city, including the Louisiana State University Charity Hospital pictured here.
Courtesy of Duane Belongie, MD
The new University Medical Center New Orleans was dedicated on Aug. 1, 2015, and offers comprehensive primary care and specialty care, cutting-edge research, and the region’s only Level 1 Trauma Center.
Courtesy of NBBJ/Sean Airhart

There has also been huge interest by young surgeons just out of their residency or fellowships who want to come and work here. This is a fun place to be right now due to the young-person vibe around the city. Many older people have left and been replaced by young people. Every week I receive a curriculum vitae from someone who wants to work in New Orleans.

AAOS Now: What are the biggest challenges healthcare professionals face in New Orleans?

Dr. Chimento: We have our own set of issues in Louisiana, and in New Orleans, specifically, but I don’t think any are Katrina-related. I think they are just related to the healthcare and political environments here. Psychiatric care really took a hit after the storm and never ramped back up, which has created its own set of issues.

Dr. Savoie: It’s a big city, with a fair number of indigent people and folks with small levels of health coverage, which stresses the system. Our tax base is not as good as it should be and we don’t have a lot of big industry, so paying for health care for everyone has always been a problem. I think it’s that way around the country.

The new University Medical Center hospital is simply beautiful. We think it will make a huge difference in being able to render care. It is being run by Children’s Hospital, which has a strong track record of providing good care, regardless of a patient’s ability to pay. I have very high hopes for that hospital.

Dr. King: During the 9 years I chaired the department at LSU—beginning one year after Katrina—the storm was definitely the “number 2” problem on my list. My “number 1” problem involved the cuts made by the state of Louisiana to health care and education. State funding for medical schools went from more than 40 percent to around 5 percent, and that’s been the biggest challenge.

The Federal Emergency Management Agency (FEMA) and the country were extremely generous to New Orleans; the new University Medical Center Dr. Savoie mentioned was built with FEMA funds.

AAOS Now: What have been some of the most significant milestones since the storm?

Dr. Savoie: From my perspective, some of the biggest successes have been the return of the New Orleans Saints and the reopening of Tulane University. We have more students both in the medical school and the university than we ever had before the storm. We have many wonderful, service-minded students. Xavier University of Louisiana, a historically black college, has rebuilt and has done amazingly well, too.

Dr. Chimento: Some hospitals did not reopen, but Ochsner went from being one medical center to a health system that encompasses portions of Louisiana and Mississippi.

One big gain from pre- to post-Katrina is that we have a greater ability to manage crises. Ochsner now has a fleet of boats. We corrected some of the problems—locating generators higher up to avoid floodwaters. If a disaster of Katrina’s magnitude occurs again, we will be much more prepared. Citywide, all of the hospitals have much more robust disaster plans in place now.

We’re also benefiting from the sense of collaboration among Tulane, LSU, and Ochsner. We work well together, enhanced by the fact that, after the storm, we were training one another’s residents for a little while. Even though that has stopped, a sense of collaboration with research projects and patient care continues.

AAOS Now: Any final thoughts?

Dr. Savoie: The first big conference that came to town after the storm was the 2010 AAOS Annual Meeting. That meeting spearheaded more convention business, which has fueled the growth of the city. Without that first convention from the AAOS, I’m not sure other organizations would have given us a shot, so we give the Academy a lot of credit.

New Orleans is never going to be a huge business center comparable to Houston, Dallas, or Atlanta. But as a tourist destination, it is far and away the best place in the country to come to for food, music, dancing, and family-oriented activities. Everything you could want is here.

Jennie McKee is a senior science writer for AAOS Now. She can be reached at mckee@aaos.org