Latest Katrina aftermath: Louisiana medical schools lay off faculty doctors

Pathologist Jane Dry, MD, is stunned, angry and anxiously starting a job search. She is one of 180 of Tulane University School of Medicine's faculty laid off amid sweeping changes that include a 32% cut of the medical school's full-time faculty.

Louisiana State University School of Medicine also instituted widespread layoffs in December 2005, slashing 150 medical school faculty, a 23% reduction.

The cuts leave a large number of physicians newly unemployed with few employment options. An estimated 6,000 physicians were practicing in the area before Hurricane Katrina displaced them, a recent study said. It's unclear how many have returned.

The faculty reductions also have some in the medical community concerned about how the schools' residency programs will fare. "There's a lot of anger about this whole thing," said Dr. Dry, whose last day is Jan. 31. "I'm frantically trying to look for another job. It's not possible to stay. There's nothing in Louisiana."

The local market is flooded with doctors, said Dr. Dry, a Tulane alumna who would like to stay in the area. The national market in her field also has few openings. She's worried about the time her search will take and about the lengthy process of getting licensed in another state.

The job search is over, for now, for New Orleans general surgeon Mike Townsend, MD. He flies to Cape Girardeau, Mo., where he is working at a locum tenens job for an indefinite period, returning to New Orleans every other week to see his family.

It's not ideal, but Dr. Townsend counts himself lucky to have a job. He lost his part-time job at Tulane Sept. 1, 2005, when the university laid off all part-time and adjunct faculty members. The December 2005 layoffs were the first, and administrators said the only, reduction of full-time faculty.

"The atmosphere is really fearful," Dr. Townsend said. "The people who got the terminations are almost despondent. There's no new employment for physicians in New Orleans."

Family physician Kim Edward LeBlanc, MD, PhD, chair of LSU's Family Medicine Dept., called the layoffs disheartening but necessary.

Seven of the school's teaching hospitals have closed. Shifting staff to existing hospitals created redundancies.

Some worry about resident training

The cuts also raise questions about medical education. LSU produces the majority of the state's physicians, with more than 70% of the school's medical students and residents staying to practice, LSU said.

Before Katrina struck, the LSU Health Sciences Center in New Orleans was home to 650 full-time faculty members, 700 students and 570 residents. A university spokeswoman said displaced faculty and staff are still returning. If all return, there would be 500 full-time faculty after the layoffs. The students temporarily moved to LSU's Baton Rouge campus. Faculty, including those recently laid off, and residents are distributed among sites around the state.

Larry Hollier, MD, acting chancellor of the LSU Health Sciences Center and medical school dean, said resident training should remain strong because the layoffs spared physicians key to LSU's educational mission.

Fortunately, Katrina's turmoil has not stopped applicants from interviewing at LSU for next year's residency positions or for the next medical class, Dr. LeBlanc said. "We were worried about that, but interestingly, this hasn't affected interviews."

Ultimately though, he's unsure how LSU will continue. The university has asked the state for $90 million to offset lost revenue.

"If [state legislators] don't continue to fund us, there will be less resources to provide patient care, and it snowballs from there," Dr. LeBlanc said.

Fewer resources would mean fewer patients and thus fewer cases for residents. That could result in resident programs shrinking. If that happens, there would be fewer new physicians in Louisiana, Dr. LeBlanc said.

While LSU waits for state funds, Tulane is waiting for New Orleans' population to return.

The medical school had 560 full-time faculty (both physicians and PhDs), 600 students and 475 medical residents before Katrina. Like LSU, Tulane's administration is not certain of its precise number of full-time faculty. If all returned after a late December 2005 deadline, 381 physicians/ PhDs would be left after the layoffs. While LSU has faculty in several cities, Tulane's faculty were back in New Orleans, where inpatient volume had fallen to a quarter of pre-Katrina levels. Tulane's medical students are at Baylor University's campus in Houston and should return to New Orleans this fall. Residents are at four centers in southern Texas.

The day the school announced the layoffs, the medical school dean resigned. New Dean Paul Whelton, MD, said the departure was amicable. "The revenue streams just aren't there to meet the expenditures," he said about the school's layoffs and cutbacks.

Nephrologist Lee Hamm, MD, head of Tulane's Dept. of Medicine, said the department laid off 20 to 30 physicians out of a staff of 140. Less than half of them were in teaching, and Dr. Hamm believes the internal medicine residency program will stay strong.

Former Tulane faculty member Dr. Townsend was less optimistic.

"This will seriously impact training in New Orleans. The largest amount of training was in the Charity Hospital system, which is gone. The residency programs are going to be significantly smaller, at least in the short term," he said.