Shutting Grady Would Swamp Other Hospitals, Many Say

By GAYLE WHITE / gwhite@ajc.com Published on: 11/25/07

Consider these possibilities:

A well-insured woman's long-awaited hip replacement is postponed. Her bed has been taken by a homeless woman in need of emergency surgery for a broken hip.

A house in Buckhead bursts into flames, and several people are burned. Helicopters airlift them to Augusta to the state's only burn center.

A late-night pileup occurs on the Downtown Connector. Ambulances race the most severely injured passengers to Macon, where the specialists they need are available around the clock.
Those and other images of metro Atlanta without Grady Health System have brought business leaders, elected officials, doctors and clergy together in a historic effort to save the state's largest public hospital.

Having Grady healthy is in the best interest of all metro Atlanta residents and all other hospitals, said Dr. Robert Albin, chairman of the board of the Medical Association of Atlanta.

"There's no doubt in our minds that the medical delivery system in Fulton and DeKalb counties is entirely incapable of absorbing the inpatient, outpatient, emergency and referral load if Grady is not there," Albin said.

"People would be naive to believe there wouldn't be a logjam in the emergency rooms in all our hospitals. They would be naive to believe there wouldn't be a shortage of beds. The access to health care people have taken for granted may be severely compromised."

Hope for survival

Months of studying, meeting and negotiating could come to a head Monday when the Fulton-DeKalb Hospital Authority is scheduled to vote on restructuring management of the Grady Health System.

A task force of the Metro Atlanta Chamber of Commerce proposed turning over day-to-day management to a private nonprofit corporation run by a board independent from county politicians.

Leaders of the task force, which was created at the request of the hospital authority, said the shift is mandatory to attract the money needed to keep the hospital afloat.
Grady has lost money every year since 2000 and faces a projected record deficit of about $55 million this year.

Chamber leaders say they have a $200 million commitment for capital improvements at Grady if the proposal is approved.

Critics argue that county, state and federal governments should fund the hospital adequately under its current management system and warn that creating a private corporation could endanger Grady's commitment to the poor.

Both sides say Grady must be rescued. At stake is a range of medical services, from a neonatal intensive care unit that cares for babies from throughout Georgia, to Crestview, the state's largest nursing home.

Right now, Grady is the front-line hospital in the event of a plane crash at Hartsfield-Jackson International Airport, a major influenza outbreak in metro Atlanta or an assassination attempt on a visiting presidential candidate. And, as a teaching hospital for Emory University and Morehouse schools of medicine, Grady Memorial Hospital trains a quarter of Georgia's physicians.

"Grady doctors go all over the state," said Ben Robinson, executive director of the Georgia Board for Physician Workforce. "Grady is servicing rural Georgia as well as Atlanta."
Selling point for business

Any threat to Grady threatens not only medical care across metro Atlanta but possibly the region's economy, business and medical leaders say.

"Atlanta hosts over 3 million people a year in conventions and trade shows alone," said Bill Howard of the Atlanta Convention and Visitors Bureau. "Trauma centers are probably not at the top of the mind for meeting planners, but they become top of the mind if an emergency comes up."

Georgia Tech economist Thomas Boston, who conducted studies in 2001 and 2006 on the economic impact of Grady, said Grady is an essential part of the social infrastructure that draws businesses to Atlanta.

"Major corporations will not move to an area they perceive has overcrowded and inefficient health care services," Boston said.

Business aside, some Atlanta area clergy are saying Grady is essential to the moral vision of the city because of its role in indigent care.

Grady is there, said the Rev. Gerald Durley, co-chairman of the Regional Council of Churches of Atlanta, "for the least, the lost and the left out."