Health Care in New Orleans: Leaner but Stronger?
LSU had 802 residents at 12 teaching hospitals around the state before the storm. Most were moved to other hospitals in Louisiana, and 100 have been granted permanent transfers.
But just because Tulane and LSU found positions for its residents doesn't mean the schools are going to be paid for their salaries and upkeep. Under the federal graduate medical education program, schools are required to have affiliation agreements. The schools sought a waiver from the Centers for Medicare and Medicaid Services to receive payment for those new slots.
In April, CMS announced its intention to grant the waiver, which would let schools receive payments retroactive to the storm for residents at any institution and will become final later in the year.
Since the hurricane, 132 medical faculty members at Tulane and 270 at LSU have lost their jobs. LSU faculty members were furloughed, but most are not expected to return, according to Dr. Hollier.
Primarily supported by the state, LSU has more of an uphill financial battle than does Tulane, which has benefited from its hospital being owned by HCA Inc.
In the months after the storm, LSU was losing $13 million a month, and at the end of 2005, it was facing a $50 million deficit even after $63 million in cutbacks. In February, LSU received $50 million in federal hurricane relief, distributed by the state-run Louisiana Recovery Authority to help cover resident and faculty salaries.
On a bright note, the medical schools and residency programs are experiencing intense interest. At LSU, 76 of the 172 students in their graduating medical school class decided to stay in-state for residency. Tulane's 70 residency slots were easily filled; 20 are from the medical school's 2006 graduating class.
“This is one of the most successful matches we've had in decades,” Dr. Amedee said. “We really hit it big.”
Tulane aims to reopen its medical school in July. Tulane had moved all 155 of its first- and second-year students to Baylor College of Medicine in Houston, where they are taking classes from the 150–200 faculty still on the Tulane payroll. The third and fourth years are taking electives in Louisiana, Texas, and elsewhere.
Dr. Hollier said he expected LSU medical and nursing students to start attending classes in the city in July; medical school applications are on par with previous years.
At Tulane, about 8,000 students have applied for 155 positions. The school attracted top-tier candidates. But they were different than those in years past—many have done charity work in developing countries or with organizations like Habitat for Humanity, and many are seeking a dual master's degree in public health and an MD degree.
“This is a group of people that came here and did not see water marks on buildings and debris piled up in the street as a negative—they saw it as a positive,” Dr. Amedee said.
“I've got an overfilled class,” said Barbara Beckman, Ph.D., dean of admissions at the Tulane Medical School, noting that Tulane always has a large number of applicants, but “what's different this year is the enthusiasm level.”
Dr. Beckman added: “I wouldn't be anywhere else, and I think that's what the students feel.”
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