Emory physicians at Grady do receive reimbursement for services to Grady
patients who have coverage, these funds are invested back into Grady via
the Emory Medical Care Foundation. The foundation supports Emory's
mission at Grady, and its funds are used for a broad range of activities,
from buying equipment to research and salary support for vital patient
services. In 2005–2006, the EMCF provided $35 million to support
the work of Emory faculty at Grady.
At publicly funded Grady Memorial Hospital, where 85% of the physicians
are Emory medical faculty, the uncompensated care provided by Emory was
$24.7 million in fiscal year 2005–2006 alone, a total that is up
$2.7 million from the previous year. (This is in addition to the $70.7
million that Emory Healthcare provided in 2005–2006 in charity care,
which is mentioned on page 12.) An important part of Grady's mission
is to provide care to the uninsured citizens of DeKalb and Fulton counties,
and the hospital struggles to stay solvent as these numbers rise and support
stays flat. Despite the fact Grady cares for more than 145,000 self- or
no-pay patients each year, it continues to provide extraordinary services,
many offered statewide, many recognized nationally, thanks in large part
to the extraordinary talents, efforts, and generosity of the faculty physicians
from Emory and from Morehouse School of Medicine.
The last thing on your mind when you see a dying child
One sunny day in South Georgia, 14-year-old Sean Thomas was examining
a 50-caliber shell from a friend's gun when it exploded, sending
shrapnel into his chest. An Emory Flight helicopter, carrying a flight
nurse and paramedic, was dispatched to transport him to Grady, the nearest
level-1 trauma center, 100 miles away. Level-1 means, among other distinctions,
that trauma surgeons are in-house around the clock. Not on call. There.
Minutes after the helicopter set down on
the Grady helipad, surgeon Jeffrey Salomone opened Sean's chest
and managed to control the bleeding from his punctured lungs. The shrapnel
had punctured the boy's aorta, going straight through but miraculously
not severing the connection to the heart. The wrong move by the surgeon
could send blood spurting like a geyser and mean instant death. This was
nothing Salomone hadn't seen and fixed before. The delicate, painstaking
surgery took hours. But Sean eventually recovered and went home for his
Did Sean's doctors receive compensation
for their heroic work? No idea, says Salomone. "I get a letter once
a year from the Emory Medical Care Foundation saying we billed this much
for your services and we collected this much money, which we are placing
in the fund to improve services at Grady. The money collected usually
represents about 10 cents on the dollar for what was billed. But money
is the last thing on your mind when a dying child arrives in the trauma
center. When I saw Sean, all I could think about was what I needed to
do to keep him alive."
support for patients and their doctors: Four times a year, trauma
surgeon Jeffrey Salomone volunteers to teach Advanced Trauma Life Support
to physicians who cover emergency rooms in suburban and rural Georgia.
Many of these doctors, especially in smaller communities, are trained
in family practice, internal medicine, or other nonemergency medicine
fields. The patients who show up in their ERs, however, are victims of
car wrecks, gunshot wounds, work accidents, and the other catastrophes
that Salomone and his colleagues deal with on a daily basis. More than
100 Georgia physicians a year take the trauma course, developed by the
American College of Surgeons, coordinated in the Atlanta area by Salomone,
and taught by him and his Emory colleagues in surgery and emergency medicine,
with support from community physicians who know its value firsthand. These
physicians say that the course is a lifesaver, both for ER doctors working
outside their area of training and for their patients.
A rock of Gibraltar in the storms of a difficult diagnosis
Shortly after 17-year-old Belinda discovered she was pregnant, she also
found out that the baby's father had infected her with AIDS before
he left town. She thought she knew the end to this story. She had watched
her best friend's happy, bubbly baby grow steadily sicker, weaker,
quieter, and then die two years before his mother also succumbed to AIDS.
But Belinda's story, and that of baby
Steven, now a feisty second-grader, has turned out differently, thanks
to the Grady Infectious Disease Program (IDP) founded by Emory physicians
in the 1980s. During her pregnancy, Belinda's Emory obstetrician
at Grady made sure that she had the medicines needed to treat her own
infection and lower the chances that her baby would be infected. Soon
after Steven was born, Belinda and the baby were sent to the IDP clinic,
more often referred to as the Ponce Clinic because of its location on
Ponce de Leon Avenue, to meet their case manager and a team of Emory doctors.
The Grady IDP would become their Rock of Gibraltar.
If Belinda had felt alone and overwhelmed
by the prospect of handling a complex disease, she no longer felt that
way after her first afternoon at the clinic. Selected by the University
HealthSystem Consortium as one of the nation's top three HIV/AIDS
outpatient clinics, the IDP works to provide as many clinical services
as possible under one roof, from medical and mental health to social and
nutritional. While Belinda receives care from her doctors, Steven plays
with a special IDP babysitter, until it's his turn to receive care.
"Thanks to my Emory doctors, Steven is not HIV-positive,"
says Belinda, "and I was given my life back to make something of
it. Steven and I can enjoy life together and make plans for the future,
knowing that we will have many, many more years together."
Grady Infectious Disease Program (IDP) was established by Emory
physicians in the mid-1980s when the impact of AIDS was first beginning
to be felt. It moved to the 90,000-square-foot Ponce de Leon facility
in 1993, and it now serves over 4,000 men, women, adolescents, and children,
a high figure even for a major city. The IDP is particularly vital to
those most vulnerable in society, those with alcohol or drug problems,
the mentally ill, or those for whom simply surviving in a new country
leaves little time to try to penetrate the mysteries of the American medical
to cutting-edge care: Because of the highly specialized services
provided at Grady, including trauma care, the hospital is sometimes the
site of major national clinical trials conducted by Emory physicians.
This gives Grady patients early access to cutting-edge therapies and accelerates
application of these treatments to the population as a whole. Emory physicians
reported results of an NIH-funded trial using progesterone to treat traumatic
brain injury, for example, in the October 2006 issue of Annals of
Emergency Medicine. They found a 50% reduction in death rate in the
group treated with progesterone as well as significant improvement in
functional outcome and level of disability. Progesterone is a promising
treatment because it is inexpensive and widely available and has a long
track record of safe use in humans to treat other diseases.