Lewis Associates e-Newsletter

Volume 4 Issue 10
October 2005

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GME Update
Last week, CMS updated its online "Q&A" related to Medicare resident cap adjustments for hospitals that temporarily take on the training of displaced residents from hospitals that closed programs due to Hurricane Katrina. The updated information is more detailed than the original and largely follows existing regulations concerning closed hospitals and closed programs. For more information, go to http://questions.cms.hhs.gov/cgi-bin/cmshhs.cfg/php/enduser/std_adp.php?p_faqid=5696&p_created=1126804397&p_sid=ItBYWgQh

ACGME posted a new guidance for J-1 visa physicians, program directors, and TPLs (training program liaisons) on procedures and documentation required for both temporary relocations and permanent transfers due to Hurricane Katrina. For more information, go to http://www.ecfmg.org/evsp/letter4.html. Displaced J-1 visa physicians can contact ECFMG at gulfcoastaid@ecfmg.org.

Patient Care Update
Yesterday, on the AHA's Hurricane conference call, it was reported that federal and private relief and recovery efforts are now focused on areas hit by Hurricanes Katrina and Rita. Although the government does not have information available on which medical teams will be called up, officials anticipate that teams will be needed in the upcoming months throughout the relief area. The teams will provide personnel until regular staff are able to return, and give a respite to those individuals who have been working during this time.

Last week, HHS reported that it continues to assist with the reestablishment of the New Orleans hospital infrastructure. The five open hospitals within the New Orleans region are East Jefferson General Hospital, West Jefferson Hospital, Ochsner Foundation Hospital, North Shore Regional Medical Center in Slidell and St. Charles Parish Hospital. Secretary Leavitt has activated the entire U.S. Public Health Service (USPHS) Commissioned Corps to respond to Hurricanes Katrina and Rita. A total of 525 USPHS Commissioned Corps Officers are currently deployed.

In response to Hurricane Rita, HHS sent liaisons to the Florida and Texas state operations center and the federal regional operations centers in Atlanta and Denton, Texas, an HHS Secretary's Emergency Response Team was deployed in advance to Austin, and the Strategic National Stockpile was on alert with packages of medical supplies and materials ready to ship. The equipment and supplies for two Federal Medical Shelters, each with a 250-bed capability, also were established in Texas prior to the hurricane.

The Markle Foundation has announced a new Web resource, KatrinaHealth.org, a new, free, and secure online service, which can connect Katrina evacuees, doctors, and pharmacists with important information about the prescription drugs evacuees from Louisiana, Mississippi, and Alabama were taking before they were forced to flee their homes. This site was built with the support and assistance of several federal agencies, many national organizations, and IT companies. Licensed physicians interested in the site's free and secure Hurricane Relief Prescription Network may sign up by calling the American Medical Association's Unified Service Center at 1-800-262-3211. More information about this new service can be found at http://www.katrinahealth.org/.

The Care Fund, developed by the Louisiana, Mississippi and Alabama hospital associations, is urgently seeking donations in order to provide financial assistance to hospital workers from those states affected by Hurricane Katrina. Donations are tax-deductible and 100 percent of the donations will be provided to hospital workers in need, as all administrative costs are being covered by the three state associations. With the first round of checks scheduled to be issued next week, the Fund is working to raise as much as possible by Sept. 30. For more information about the Fund, go to www.thecarefund.net.

Research Update
The Office of Science Technology and Policy has published information on federal agency relief for investigators and institutions at http://www.ostp.gov. The information provides links to agency points of contact and agency-specific Web sites, where available. More specific information will be added this week on steps agencies are taking to respond consistently to those affected by the storms. Among the topics addressed at the site are no-cost extensions, salary and stipend charges, application deadlines, planned project funding increments, prior approval requirements, required reports and project close out.

The AAMC has received more than 100 offers to assist researchers who were affected by Katrina. This week, the AAMC received an announcement from the National Cancer Institute (NCI) at Frederick, Maryland, which is offering aid (lab/office space, technology training, etc.) to displaced colleagues and their families. For more information, go to http://web.ncifcrf.gov/news/spotlight/sl_sept05.asp or contact Cheryl Parrot, parrottc@ncifcrf.gov at the NCI. To access the AAMC's full listing of research assistance, go to www.aamc.org/katrina.htm.

For the latest information and links to Hurricane Katrina and Rita related resources, go to www.aamc.org/katrina.htm

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Their families believe their confessions are an indictment of the appalling failure of American authorities to help those in desperate need after Hurricane Katrina flooded the city, claiming thousands of lives and making 500,000 homeless.

'These people were going to die anyway'

The doctor said: "I didn't know if I was doing the right thing. But I did not have time. I had to make snap decisions, under the most appalling circumstances, and I did what I thought was right.

"I injected morphine into those patients who were dying and in agony. If the first dose was not enough, I gave a double dose. And at night I prayed to God to have mercy on my soul."

The doctor, who finally fled her hospital late last week in fear of being murdered by the armed looters, said: "This was not murder, this was compassion. They would have been dead within hours, if not days. We did not put people down. What we did was give comfort to the end.

"I had cancer patients who were in agony. In some cases the drugs may have speeded up the death process.
"We divided patients into three categories: those who were traumatized but medically fit enough to survive, those who needed urgent care, and the dying.

"People would find it impossible to understand the situation. I had to make life-or-death decisions in a split second.

"It came down to giving people the basic human right to die with dignity.

"There were patients with Do Not Resuscitate signs. Under normal circumstances, some could have lasted several days. But when the power went out, we had nothing.

"Some of the very sick became distressed. We tried to make them as comfortable as possible.

"The pharmacy was under lockdown because gangs of armed looters were roaming around looking for their fix. You have to understand these people were going to die anyway."

Mr. McQueen, a utility manager for the town of Abita Springs, half an hour north of New Orleans, told relatives that patients had been 'put down', saying: "They injected them, but nurses stayed with them until they died."

Mr. McQueen has been working closely with emergency teams and added: "They had to make unbearable decisions."

©2005 Associated Newspapers Ltd

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