Medical practices still recovering from Harvey

Dr. Lindsey Jackson couldn't bring herself to visit her office for two and a half weeks after the flooding from Hurricane Harvey, fearful she would be overwhelmed by emotion at the sight of the devastation.

Jackson had opened the practice a year before, a dream eight years in the making, only to have it wiped out. She choked up just viewing the damage - water that rose 41/2 feet high, $500,000 worth of equipment, furniture and supplies ruined - in photos sent by employees who had kayaked to the office the first few days.

"It was unimaginable, a dream literally washed away, everything we had gone," said Jackson, a Friendswood general practitioner who specializes in infusion therapy. "I wondered if it was a sign - was having my own practice not meant to be?"

The evacuation of 44 hospitals, nursing homes and assisted-living facilities received most of the attention in the days and weeks after Harvey hit, but the greater disruption to patient care was the flooding's impact on physicians, solo and group, many of whose practices bore the full brunt of Harvey's wrath.

Nearly 140 practices were destroyed or suffered major damage, according to the Texas Medical Association, and nearly as many suffered lesser damage. The association based its estimate on data from the Federal Emergency Management Agency. The residences of more than 300 physicians also suffered major damage.

All told, some 65 percent of doctors who responded to a TMA survey said they temporarily closed their practices because of flooding. Thirty-five percent said they subsequently reduced hours or services. Six percent had to relocate. A small number called it quits.

Such reduced service equated to tens of thousands of patients left without their doctors, TMA officials said.

"Harvey was indiscriminate in the toll it took - physician practices, freestanding ERs, urgent care centers, night clinics," said Dr. Carlos Cardenas, TMA president and an Edinburgh gastroenterologist whose office closed for 24 hours out of concern the storm would come its way. "Things are improving, but lots of doctors are still straining to get their practices up and running again."

$1 million outreach

TMA jumped into action as soon as the storm hit, raising funds to add to its disaster relief program already in place as a result of Hurricanes Ike and Rita. Last week, the association handed out nearly $350,000 in aid to 28 practices, the first allocation of a planned $1 million outreach. The 28 practices represent 107 doctors.

TMA officials also contacted insurers to make sure they comply with a Texas Department of Insurance request they waive out-of-network penalties and restrictions for those seeking care in areas declared a disaster area. They also convinced the Centers for Medicare and Medicaid Services to relax rules so doctors can temporarily relocate without having to re-enroll in the program.

Among the doctors to receive TMA's first slate of funding was Dr. Esteban Berberian, a Channelview internist who shut down his practice for nine days following the flooding, then reemerged in cramped, makeshift digs a couple miles away. Six weeks out, his old office remains gutted.

"It's pretty devastated - mud all over, walls damaged six feet up, floating furniture, a really bad stench," Berberian said. "I'd look at it and think, how much is it going to take to get this cleaned up and in working order?"

Berberian still has no idea, partly because the office building is attached to and relies on power from East Houston Regional Medical Center, which remains closed as a result of flood damage. HCA Gulf Coast, its owner, has not decided whether to renovate or rebuild somewhere else.

Berberian, whose patients largely followed him, remains in limbo, trapped in a lease from which the building owner at the old site will not release him. He expects that eventually he will return to the old office, but probably won't know until HCA decides its own fate. In the meantime, he cannot take out a new lease.

Not all doctors have been as fortunate. Too busy to do any marketing and lacking even a proper business phone until last week, Jackson estimated she is seeing 30 percent of her former patients after re-opening last week. She says her return mostly was about the needs of patients, many with cancer, but acknowledged the significantly smaller revenue is complicating recovery plans.

'We have to stay'

She is not the only doctor Harvey has forced to start over.

Dr. John Soule had maintained a practice in Victoria for 28 years when Harvey took out his roof and soaked his fourth-floor office, including all his computers, patient charts and furniture.

"It was stunning when I went back," said Soule, 60. "I'd stand in the office, look up and see blue sky and clouds floating by."

Soule, a general practitioner, does not use expensive equipment so he figures his start-over costs will not be prohibitive, probably around $20,000. He had no flood insurance, however, so the TMA aid is crucial. He knows his share of doctors who decided to retire because of Harvey damage, but said he never really considered the idea because "I wouldn't know what to do with myself. This is what I do."

Soule said a few of his patients, accustomed to nice surroundings, are appalled at his temporary lodgings, but most are philosophical. He tells them to "keep plugging away, we'll make it one way or another."

Jackson is finding that out first-hand. She considered returning to her old job treating critical care trauma cases at a hospital, but was overcome by the community's response to her plight - TMA funding, a check from the Friendswood Chamber of Commerce, competitors offering office space and, most of all, patients donating couches, chairs, microwaves, ice machines, even IV poles.

"I was ready to throw in the towel, but seeing the community step forward to help us rebuild changed all that," said Jackson. "I thought, they want us, they need us, we have to stay."

Jackson now is optimistic she will be back to business as usual by December.