New Orleans -- Hurricane Katrina may have splintered many of the New Orleans dermatology community's facilities and practices, but local dermatologists' spirits remain intact. Sources say the camaraderie among practices, universities and physicians that existed pre-storm is serving as a cornerstone for what some are calling a "new normal" in and around New Orleans.
While much of the city continues to struggle with rebuilding, "The dermatologists have come full force. A few have left and relocated. But probably at least two-thirds of them are back and seeing patients," says Erin Boh, M.D., Ph.D., professor of dermatology, chief of the dermatology section (temporarily under the department of medicine) at Tulane University and president of the Louisiana Dermatological Society.
As for medical schools, Dr. Boh reports that both Louisiana State University (LSU) and Tulane are operational, albeit altered. Tulane sent its 13 residents to work at either the University of Texas, Houston, or Baylor University. Dr. Boh reports that five residents had returned by March, and the rest planned to do so in April (though three expected to stay in Dallas for personal reasons).
"We're picking new residents for next year," she adds, "and we've met a lot of people who are still interested and want to help be part of our recovery."
New residents will attend a drastically different department. For instance, Dr. Boh reports that Lawrence E. Millikan, M.D., the Tulane dermatology department's former chairman (and now professor emeritus), took early retirement, as did a colleague who had been on leave.
"The whole university had to downsize, and the medical school took drastic cuts in terms of medical faculty," Dr. Boh says. From more than 500 members pre-Katrina, the university eliminated 122 full-time School of Medicine faculty and took several administrative actions to reduce overhead, according to Paul K. Whelton, M.D., M.Sc., dean of Tulane University School of Medicine.
Additionally, Tulane's dermatology research has decreased by about one-third because many patients have scattered, reports Dr. Millikan, who now practices at Tulane's Meridian, Miss., clinic.
"The biggest concerns are for our colleagues in internal medicine and pediatrics especially, because they need inpatients for training their residents," he adds.
As for Tulane's dermatology section, Dr. Boh says, "We have six faculty members including two Mohs surgeons." At press time, the department was exploring new patient practices for its residents, such as temporarily expanding into private (Charity) hospitals outside New Orleans, to add to rotation opportunities at locations including Tulane's Lakeside (Metairie) and Covington clinics and at Ochsner Clinic Foundation.
Before Katrina, "We had lot of exposure to everything," including opportunities to perform procedures such as excisions during twice-weekly shifts at the Veterans Administration Medical Center in Biloxi, Miss., says Ashley N. Counce, M.D., a second-year dermatology resident at Tulane. "After Katrina," she says, "everything went awry."
Changes for residents
As one of two Tulane residents who remained in New Orleans, Dr. Counce says she spent October through December at Ochsner Clinic shadowing senior staffers. Nevertheless, she says she saw a wide variety of diseases - including Stevens-Johnson syndrome - she might not otherwise have observed. Dr. Counce says that although she and chief resident Matt Mittlebraun, M.D., missed out on lectures and conferences due to Katrina, "I gained a lot in terms of seeing patients."