Physicians offered incentives to practice in New Orleans

The Greater New Orleans Health Service Corps has $50 million to rebuild the region's health care work force.

By Myrle Croasdale — Posted Aug. 6, 2007

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Michael Wilson, MD, is ready to come home. A Louisiana State University School of Medicine graduate and New Orleans native, he looks forward to practicing in the city he was forced to depart following Hurricane Katrina.

He will be leaving a custom-tailored psychiatry research position at the University Hospitals in Cleveland for a city where he has no job yet. His incentive is a loan-forgiveness program that will pay off his $98,000 in medical school debt in exchange for a three-year commitment to work in New Orleans.

"All my family is still in New Orleans," Dr. Wilson said. "They told me about the program to lure me back. It worked."

The program is the Greater New Orleans Health Service Corps, which has $50 million from the U.S. Dept. of Health and Human Services to recruit and retain doctors and other health care professionals to work among the region's underserved. Last year, the federal government declared the city and some of its surrounding parishes a health professional shortage area. Since the corps opened in April, the agency has awarded $6.5 million in grants to 81 health care professionals, including 37 physicians.

The corps offers each physician:

  • Up to $110,000 in loan repayment or income guarantees.
  • As much as $40,000 for a sign-on bonus or medical liability insurance premium payments.
  • A maximum of $20,000 for relocation expenses.
  • Up to $10,000 for continuing medical education on health information technology.

In exchange, physicians must work in New Orleans for three years, accept Medicaid patients and have a sliding-fee scale for low-income, uninsured patients. A representative for the corps said there was no required minimum number for Medicaid and uninsured patients, though priority would be given to practices with 30% or more Medicaid or uninsured patients.

Internist Ricardo Febry, MD, president of the Orleans Parish Medical Society said he was hesitant to apply for the grant, even though he has been trying for a year to recruit another physician to his two-doctor practice. "Once you open the practice to Medicaid and the uninsured, over two to three years, you will have an office full of uninsured patients and no one responsible for their bills."

Physicians in the private sector are already seeing a large number of uninsured patients and are not getting reimbursed for their care, Dr. Febry said.

For family physician Sarat Raman, MD, seeing Medicaid and uninsured patients is not a problem because he works for a nonprofit. More than 90% of his patients are uninsured at the newly opened Daughters of Charity Services clinic in New Orleans' Bywater neighborhood.

He was working in West Virginia when a colleague told him about a job in New Orleans. While physicians were still packing up and leaving the city, Dr. Raman was undeterred. He took the job, and after he arrived in March, he heard about the corps. He qualified for the corps grant and will be reimbursed for his relocation expenses. He also will receive the sign-on bonus and money for CME.

"It's a great situation to have," Dr. Raman said of the health service grant. "New Orleans is the soul of America. I love this city, and it's a great place to practice."

Meanwhile, Dr. Wilson has six months to find a job in New Orleans or his service corps grant will expire.

He is unsure about his prospects. He would like to practice inpatient care, but knows the number of public hospital psychiatric beds has been sharply reduced since Charity Hospital moved to a temporary facility. There may be a big need for psychiatrists and primary care physicians in the city, he said, but whether the grant's requirements will mesh well with opportunities among area employers is unclear.

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Post-Katrina shift

New Orleans continues to lose physicians while Baton Rouge is showing an increase, but Louisiana as a whole has fewer physicians now than two years ago. Here is a look at the number of licensed physicians in the state's southeastern and southwestern parishes before and after Hurricane Katrina.

Parish 7/2005 10/2006 3/2007 Change
St. Bernard 49 8 7 -86%
West Carroll 8 6 5 -38%
Orleans 2,463 1,663 1,582 -36%
Assumption 7 6 5 -29%
Jefferson Davis 27 23 23 -15%
Plaquemines 13 11 11 -15%
Webster 45 45 43 -4%
Jefferson 1,800 1,800 1,755 -3%
St. Landry 146 147 143 -2%
Ouachita 391 402 387 -1%
Ascension 62 80 78 26%
Tangipahoa 120 143 146 22%
Lafayette 615 675 680 11%
St. Tammany 698 763 766 10%
Terrebonne 194 213 213 10%
East Baton Rouge 1,284 1,418 1,399 9%
Caddo 1,149 1,226 1,199 4%
Rapides 379 395 390 3%
Calcasieu 366 381 376 3%
Louisiana totals 11,025 10,713 10,499 -5%

Note: Total includes data from parishes not listed.

Source: Louisiana State Medical Board of Examiners.

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Grant recipients

The Greater New Orleans Health Service Corps has given retention or loan forgiveness grants to 37 physicians. Here is the breakdown by specialty:

Adult and pediatric dermatology1
Family medicine 9
Internal medicine 8
Obstetrics and gynecology 3
Pediatrics 6
Psychiatry 9
Urology 1

Source: Greater New Orleans Health Service Corps

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