Emory in the community: Chapter 5




	In addition to charity care provided by Emory Healthcare through Emory’s own facilities, Emory physicians provide a substantial amount of charity care at Grady Hospital, where Emory and Morehouse medical school faculty provide 85% and 15% of care, respectively. The uncompensated care provided by Emory at Grady totaled $22 million in fiscal year 2004 alone. When Emory physicians do receive reimbursement for services to those Grady patients who have coverage, these funds are invested back into Grady via the Emory Medical Care Foundation, which was established by Emory physicians to disburse income for support of Emory’s mission at Grady. These funds, which totaled $39.2 million in 2004, are used for a variety of purposes, ranging from building new facilities and buying equipment and beds to research and salary support for vital patient services or providers. Despite the fact that Grady cares for some 100,000 indigent patients, it is able to provide extraordinary services, many of them offered statewide, many recognized nationally. The programs noted here, all established and headed by Emory doctors, reflect the long-standing partnership between Emory and Grady. Diabetes care: Keeping track of an arduous diet and medication regimen, remembering to pay attention to foot care and other potential complications, and handling all the other complexities of being diabetic are challenging enough for anyone, but particularly so for much of the patient population seen at Grady. The Diabetes Clinic at Grady was founded in the early 1970s by Emory doctors who pioneered a team approach to care as well as culturally oriented dietary management. The clinic follows more than 4,000 patients every year, including the largest patient base of African Americans with diabetes of any clinic in the nation. Emory doctors recently developed one of the largest computerized databases of its kind to track patients’ diabetes care. The clinic also is active in training health professionals from all over Georgia in diabetes care. Sickle cell disease: Imagine your red blood cells suddenly curving in on themselves, becoming entangled, unable to flow smoothly through vessels, causing excruciating pain, slowing the transport of oxygen. That’s what happens in a sickle cell crisis, mainly affecting people of African descent, and it’s the reason the Sickle Cell Center at Grady opened the world’s first and only dedicated 24-hour acute care treatment clinic. The center has the largest combined adult and pediatric sickle cell clinic in the world, actively following more than 1,300 patients. Before medical advances in recent years, sickle cell patients often died young. Now the center treats their disease and also helps them prepare for a long and productive life. The center has one of the first state-certified vocational rehabilitation training sites within a Georgia hospital, providing job training, education, and basic computer skills to sickle cell patients. Lupus: In 2003, Emory rheumatologists developed the state’s first and only clinic dedicated to systemic lupus erythematosus, in which the immune system suddenly attacks the body, causing achy joints, prolonged fever and fatigue, mouth ulcers, and steady erosion of heart, lungs, kidneys, and other organs. The disease primarily strikes women of childbearing age, and a disproportionate number are African Americans and Hispanics. Since establishing the clinic, Emory rheumatologists have seen 350 patients and now lead a CDC-sponsored Georgia Lupus Registry, working in partnership with the Georgia Department of Human Resources, physicians across the state, and patient advocacy groups such as the Georgia chapter of the Lupus Foundation of America. HIV: AIDS has changed a lot since 1986, when Emory’s Infectious Disease Program opened its first AIDS clinic at Grady with 10 patients. Today, close to 5,000 people (including 300-plus children) of all colors and ethnicities and from all walks of life—about half of all HIV/AIDS patients in Atlanta—receive care at the freestanding Ponce de Leon Center, a 90,000-square-foot facility that is home to one of the nation’s most comprehensive AIDS care programs. The center provides extensive outpatient medical, dental, and counseling services without regard to ability to pay. The Ponce Center also is deeply involved in prevention and research, including clinical trials unavailable elsewhere in the region. Emergency care: The safety net of safety nets, Emory’s emergency medicine physicians and surgeons are best known for providing trauma care at Grady, in the largest and busiest level I trauma center in Georgia. Emory emergency medicine doctors also established and manage acute care transports through Emory Flight, extending the reach of care to other Georgians for whom resources like the trauma center, burn center, and poison control center mean the difference between life and death. These doctors also go beyond what they call “resurrection medicine” (saving those near death). They take steps to prevent the horrors they see every day: child neglect and abuse, firearm violence, head injuries, and other trauma from car and bicycle accidents, to name a few. They talk at churches, synagogues, and community events. They volunteer in programs for the homeless. They seek funding and collaborate with the city and schools to develop awareness and risk-reduction programs. And they go to the Capitol, testifying in sessions or cornering legislators to explain why these problems matter and what can be done about them.

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