In 2005, healthcare in New Orleans was siloed with multiple independently operated hospitals across the city.
Then Hurricane Katrina — one of the costliest and five deadliest hurricanes in the history of the United States — tore through the area. The storm formed on Aug. 23, 2005 and did not dissipate until Aug. 31.
Immediately things changed. Most hospitals flooded leading to significantly fewer beds and healthcare facilities in the city right after Katrina. Only three hospitals remained open during the storm and post-storm — Ochsner Medical Center in New Orleans, East Jefferson General Hospital in Metaire, La., and West Jefferson Medical Center in Marrero, La.
Over the past 10 years, though, New Orleans healthcare organizations have continued to expand, build and develop alliances.
Before Warner Thomas was named president and CEO of New Orleans-based Ochsner Health System in 2012, he was COO of the system when Katrina struck.
Here, Mr. Thomas talked with Becker's Hospital Review about healthcare in New Orleans and how it has evolved since Katrina.
Note: Responses were lightly edited for length, style and clarity.
Question: What was healthcare like in New Orleans before Katrina?
Warner Thomas: Healthcare was relatively fragmented in New Orleans. I think there was a lack of primary care access in New Orleans if you go back to 2005. You had several players in the marketplace — ourselves, Children's Hospital of New Orleans, a lot of freestanding independent hospitals. But you also had [Dallas-based] Tenet Healthcare Corporation and [Nashville, Tenn.-based] Hospital Corporation of America in the marketplace. So it was very fragmented, not as collaborative as it is today.
Q: When did things start to change?
WT: Things really started to change immediately after Katrina. In 2006, we actually made a large move and acquired three hospitals from Tenet Healthcare Corporation (now Ochsner Medical Center-Kenner (La.), Ochsner Baptist in New Orleans and Ochsner Medical Center-West Bank Campus in Gretna, La.), and that really started our move to be more of a system throughout New Orleans, but really more of a system regionally as well.
The other thing that happened post-Katrina is certainly there were several hospitals that were flooded that did not reopen immediately, so there was significantly [decreased] bed capacity and facilities in the market right after Katrina. Our move into buying these other hospitals certainly started our progression, and then over the years you've seen other organizations continue to move and develop and build relationships or alliances around the city.
I think the other thing is there were many physicians whose offices had been destroyed or facilities they worked in had been destroyed, so there was a real movement of the physician community around as well. We certainly saw a lot of folks come to our facilities, and we brought many physicians into our Ochsner Clinic Physician Group.
But definitely there was really a lot of movement around the city as people kind of came back and figured out which hospital they were going to align with and where they were going to practice after the storm.
Q: What was the most challenging part of being a healthcare executive in New Orleans during and post-Katrina?
WT: First of all going through the storm was a very challenging time and immediately after because there was a lot of infrastructure challenges. Literally I lived in my office for three months because my house didn't have power. You had a disrupted workforce — a lot of people had evacuated, some came back and some didn't, others didn't have housing. There was that whole kind of reconfiguring your workforce, rehiring people, hiring new folks that were looking for jobs because their facilities had not reopened. We lost a lot of people.
So there was challenge through the storm — to actually make it through the disaster itself. There was challenge to kind of reopen and get our clinics and hospitals reopened. Then there was the challenge immediately after the storm of really being able to help people come back to the city [and] find housing if their house was destroyed or significantly damaged. We had a lot of events to help people gut and renovate their houses. We provided housing for a lot of people for months. I remember we offered free meals [to employees] in our cafeteria for a year after Katrina, because a lot of people didn't have kitchens and were having to go out. It was a very difficult and challenging time.
Then several months after [Katrina] there was just the whole rebuilding and the fatigue of going through that ongoing challenge, helping your employees go through that, helping employees get relocated back here. It took months or even a year or two for many [people] to get back into their home, so it was a very difficult and challenging time for a lot of folks.
Q: What were things like one year after Katrina?
WT: Anytime you go through a difficult time or disaster, there's opportunity. We really tried to take a positive attitude on what was the opportunity to work with new physicians, to work with new hospitals, to hire new employees who were committed to our mission and our vision. We looked at it as an opportunity to stand up and play a huge role in bringing healthcare back to New Orleans. That's why our board made such a big bid in 2006 to purchase Memorial Medical Center in New Orleans (now Ochsner Baptist), Meadowcrest Hospital in Gretna, La., (now Ochsner West Bank) and Kenner (La.) Regional Medical Center (now Ochsner Kenner) from [Dallas-based] Tenet Healthcare. We're a New Orleans-based organization. They wanted to make the commitment to bring healthcare back to New Orleans. It was rewarding in that we played such an important role in that redevelopment and that we were a key leader in helping bring much of the medical infrastructure back as well.
And beyond that, we kept looking for opportunities. We found after Katrina, a lot of people wanted to become part of the rebuilding in New Orleans. People from all over the country who said, "I have a purpose. I want to be helpful." And these were physicians, nurses, people from all walks of life that said "I'm going to go to New Orleans and be part of that redevelopment." We hired a number of these healthcare workers who moved to New Orleans after the storm for employment and to help rebuild the city, and it really has helped make us be a better organization today than we were 10 years ago. And I think that has helped New Orleans be a better city today than it was 10 years ago.
Q: How has healthcare in New Orleans transformed in the years since Katrina?
WT: You've got a lot more organizations that have partnered together, so I think you've got stronger organization, better coordination of care, whether it's ourselves or some of our competitors in the marketplace. There was a big focus by Karen DeSalvo, MD, who previously served as New Orleans Health Commissioner and New Orleans Mayor Mitchell Landrieu's senior health policy advisor, to rebuild and make investments in primary care. She did a great job in helping build a much stronger primary care infrastructure, especially with a lot of federally qualified health centers.
I think organizations like ourselves are much stronger today than we were 10 years ago. Our clinical outcomes are better, our range of services is better [and] we're a destination healthcare center today, much more so than we were in 2005. We've more than tripled our revenue and doubled the size of our physician group over the past decade. And we serve tens of thousands more patients today than we did going into Katrina. And that's serving people locally, but also drawing more people into New Orleans for destination healthcare, much more so than we did in 2005.
Q: Where do you see healthcare in New Orleans going in the next 10 years?
WT: I think you're going to see healthcare in New Orleans continue to get stronger. Certainly with the investments we're making and what others are doing, I think you're going to see it continue to be a destination center. Last year we took care of people from all 50 states in the United States and 99 different countries, so New Orleans is certainly a destination center, and I think you'll see that continue to expand and grow in the future.
The ability to recruit to New Orleans is much stronger today than it was in 2005, and the economic base and the government effectiveness has increased dramatically. All of those things point to a much brighter future for the city. We're very optimistic about the future. Katrina was a very difficult situation, a very traumatic disaster for all of us. I think the strength of the city and the resilience of the people here have helped make New Orleans a better place.
Q: What is one lesson you learned?
WT: Our effectiveness as an organization is all about our people, and we saw during Katrina time and time again great people stood up, took on the challenges and just did an exceptional job. People who were marginal or were not as good as a performer just did not do well in that adverse situation. You've got to have great people in your organization. You've got to have great leaders around you, and if you do, you can go through virtually anything. We went through the largest natural disaster in the history of the U.S. because we had great people who got on their feet, always stayed positive, had courage and just did what they had to do. It was an honor to work beside them and go through that with them.
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