To protect themselves from total devastation from a disaster such as a hurricane, doctors should have backup plans, according to Dr. Prather.
Elizabeth McBurney, M.D., a dermatologist in private practice in Slidell, La., and a clinical professor at Louisiana State University and Tulane University, New Orleans, is trying to start over.
Her home and the homes of her dermatologist partners, Deborah Hilton, M.D., and Patrick Ragland, M.D., were severely damaged when Hurricane Katrina's eye passed over Slidell and the levy broke. More than 50 percent of her staff lost everything material, Dr. McBurney tells Dermatology Times.
Their Slidell practice, on the fourth floor of a building, is back up and operational, but patients are dribbling in.
One elderly woman, who was trying to pick up debris in her yard, suffered a laceration (which became infected) on her cheek when a branch fell. In fact, many of the patients Dr. McBurney and her partners are seeing now have lacerations and skin infections as a result of storms.
The reality of being in Slidell hasn't, however, broken the dermatologists' spirit to rebuild.
Dr. McBurney reports to the office and cares for patients, then returns each night to a personal life in shambles. During the three weeks before being interviewed by Dermatology Times, Dr. McBurney and her 16-year-old daughter were moving from one friend's house to another, living for a week or two in each place.
They had just returned to their home, with the electricity on, when they were told they would have to move out for at least six months so that contractors could repair the severely damaged structure.
Dr. McBurney had to regroup and turn her attention quickly to finding a trailer that she and her daughter could live in and park in the front yard. The day of this interview, she had stood in a Red Cross line for most of the day, trying to apply for aid. The Red Cross could only see 1,200 people a day, the dermatologist says, and, that day, she was turned away.
Nevertheless, there is little time to worry about her personal woes because she has her staff to worry about. Her practice's office manager - one of the only staff members whose home was spared - had a breast biopsy the day before the hurricane and could not get her results until three weeks after the storm.
"It came back positive for cancer," Dr. McBurney says. "So, we are all struck."
Dr. McBurney and her partners reached into their own pockets to pay the entire staff for the month of September, and hope to continue to pay their wages until the practice is up and running - though she acknowledges that she cannot pay indefinitely.
"We told the staff that we needed them and we hoped they would be here. We are a team, and we all work together. I truly believe that this area is going to come back. But it is going to take a while," she says.
Dr. McBurney is not alone in her quest. William P. Coleman III, M.D., says his Metairie, La., practice vanished in the storm, and he and his family had to evacuate to Jackson, Miss.
Dr. Coleman, the editor in chief of Dermatologic Surgery, clinical professor of dermatology and adjunct professor of surgery (plastic surgery) at Tulane University Health Sciences Center, New Orleans, has since returned home. The dermatologist, known for his work in fat transfer and liposuction, is seeing patients and vows to rebuild at his original practice location, even though he acknowledges that some of his colleagues have already relocated around the United States. But for him, Metairie is home, he says.
Physicians stay, physicians flee
Many doctors are choosing to leave for, perhaps, higher, more isolated ground. About 150 dermatologists have been impacted in the devastation areas of Katrina, according to the American Academy of Dermatology.