Wellstar says the move to outpatient care is the best decision to meet community needs and will allow the facility to focus more on preventative care. Figures show that most patients at the East Point center only need urgent care, not a hospital stay.
For real emergencies, Wellstar CEO Candice Saunders said, there are other hospitals nearby, including Wellstar’s main AMC campus in Atlanta, not far from Grady. Four hospitals with emergency departments are located within 10 miles of East Point Hospital, three of which are clustered in Atlanta.
“We believe that with this new model, we will be able to provide the right care in the right place and more effectively meet the health care needs of the East Point community,” Saunders said.
The change in medical center services will have consequences, experts say, if it delays care for conditions such as strokes or heart attacks, where clinicians like to say “time is time.” fabric”.
Barriers to care
The impact could be wide.
“Every hospital is overwhelmed” as patients return to catch up on health care delayed by the pandemic, said Rebecca Cash, an assistant professor of emergency medicine at Harvard Medical School and a former paramedic. “If a hospital closes and surrounding hospitals have to absorb that volume…it affects the quality of care for everyone, not just emergency patients.”
“They may have had good reason to do so,” Dr. Daniel Wu, chief of emergency medicine at Grady Memorial Hospital, said of Wellstar’s decision to close some wards. “But from a medical point of view, it (will) cause delays, and we already have delays.”
Experts say southern Fulton County already lags other parts of metro Atlanta in access to quality resources, and Wellstar’s actions could make the problem worse.
“Distance matters. Place matters,” said Justin Moore, a Medical College of Georgia and Georgia Cancer Center epidemiologist who studies the link between geography and health.
Residents of low-income areas such as southern Fulton County already have greater challenges accessing and paying for health care. Unpaid sick leave, shoddy insurance and transportation issues are among them, Moore said.
“So there’s just barrier after barrier after barrier,” he said.
“So if you take a resource from a community that provides certain health services,” he continued, “I mean, it could result in…loss of life.”
Nationally, research has shown that response times for EMS are longer in low-income areasand that when African American patients complain of symptoms such as pain, they are less likely to be believed and receive adequate treatment. After calls to 911 by Phinnizee and her friends, it took over 90 minutes for an ambulance to arrive.
Some fear that the loss of services at the East Point center will hit black residents harder. U.S. Census figures show that South Fulton is heavily African American, and the East Point Hospital zip code has a median household income $20,000 lower than the North Fulton Hospital zip code of Wellstar in Roswell.
The value of location
Wellstar’s announcement of the closure, effective May 6, shook public opinion. To local politicians concerned about the changes, Wellstar made a strong case that the community itself made the choice. When patients need more extensive care and have time, they bypass AMC South to go to other hospitals, Wellstar officials said in interviews and public briefings.
This is particularly damaging to hospital finances, as emergency care can be a money pit, while surgeries and cancer treatment are more lucrative. Although Wellstar is non-profit, these hospitals work to make money just as much as the for-profit ones.
When Wellstar purchased the hospital from Tenet in 2016, the facility was part of a complex of hospitals. The profitable crown jewel of the package was North Fulton Hospital in Roswell, according to reports at the time.
Being in an area with higher incomes and employment means that patients who walk through the door are much more likely to be able to afford fees and have private insurance.
Brandon Reese, a Wellstar lobbyist, told the Fulton County Commission that Wellstar had spent more than $120 million on the hospital since 2016.
“We hoped with all our hearts that by implementing a marketing campaign, hiring full-time doctors instead of contract doctors, employed nurses instead of contract nurses, employed security instead of contract security, that we would get great membership. of the community,” he said. “And we had some, but the truth is it didn’t move the needle.”
Others say Wellstar spent money to buy the hospital but failed to invest in the kind of major upgrades needed to attract more patients.
A scathing 2021 summary from Lisa Medellin, chair of the Regional Health Council of AMC Hospitals in Atlanta and East Point, alleged a severe lack of investment in those two hospitals. “Evidence of a genuine plan and appropriate strategy appears to be non-existent to revitalize AMC Downtown and East Point hospitals,” said the report first obtained by Georgia Health News.
Wellstar is investing elsewhere, however.
In documents filed with financial agencies weeks before AMC South’s announcement, the health system argued for a $200 million loan to build a seven-story tower at Kennestone Hospital in the most affluent suburb of Cobb County.
The tower, which is expected to be completed in 2025, will attract patients. Plans include private rooms instead of semi-private, a women’s and children’s-only entrance, a chapel and other upgrades to make care more efficient.
Wellstar said it could afford the investment. Wellstar said it had $2.8 billion in net assets as of September and enough cash to keep the hospital system running for more than six months if needed.
The value of an RE
While Phinnizee is in the minority of AMC South’s ER patients because he was admitted, Justin Moore is in the majority: those who show up to the ER, get treatment, and go home.
Although Moore is now an academic at Augusta, he grew up in Fulton County and was familiar with this hospital.
As a high schooler playing second base, he once took a ground ball straight to his head. He was dazed and went to the bleachers to sit down, blood streaming down his face.
A friend came and told him he had to go to the doctor. They went to East Point ER. After an evaluation, he was told he had no serious head injuries. He had stitches and left, reassured.
Wu, the director of emergency medicine, said that’s how emergency medicine works.
“I get asked these questions all the time, when my kids are playing on the field: ‘Do I have to go to the emergency room?’ So I can make that decision. But you… That’s exactly the point is that this family won’t know about it,” Wu said.
“You don’t know if they have an emergency until you have a doctor or an emergency provider nearby.”