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- Joeff Davis
- MAKING ROUNDS: Dr. Leon Haley Jr. (center) listens intently as doctors and medical residents discuss a patient’s medical status.
There's more talk about service excellence. I actually think that there's been so much increased attention to numbers and to following the rules that sometimes just really putting the patients first has gotten lost in the shuffle. For example, our patients don't really have money to pay these prescription co-pays. Patients used to get their prescriptions here for free. I have a lot of patients now that simply don't take their medicine because they can't figure out how to pay for it.
We are spending a lot of time doing other things and not as much time as we need to with our patients. Grady just closed its Child Mental Health Services in 2012. ... I don't personally believe that we have adequate mental-health services, outpatient mental-health services, for children in our community, so I think it's a serious loss.
Mike Lunney worked as a Grady paramedic from 2007 to 2012. While he provided care to the very sick and severely wounded, he also tended to uninsured patients who have no choice but to visit the ER for low-acuity ailments such as fevers, colds, and minor headaches. Grady provides for everyone, and that has its drawbacks. Caring for such a diverse swath of the population puts a huge burden on an already overloaded ER. At times, EMS even becomes a free transportation service for those who can't afford the bus or MARTA, occupying paramedics who could otherwise be focused on saving lives.
We would go into the housing projects, to $20 million houses in Buckhead, and everything in between. [Grady's patient base] is a really interesting cross-section of American life.
A good call for me is a bad day for someone else. We yearn for the opportunity to use the skills that have the potential to make all the difference, but you also have lots of low-acuity patients and 911 calls that didn't require lights and sirens. Taking people to the ER to get a medication ... that comes out of Grady's pocket. Although the chance to save someone's life is a large reason why EMTs do their job, more often than not, they are operating as a non-emergency transportation service to the disadvantaged and underserved.
Someone could say, "My back hurts." They just had gotten into a fender-bender on the Interstate. I'm not going to be able to tell you a whole lot. I can take you to the hospital. I can't tell you this isn't going to cost you money and I can't tell you it's going to be worth your time. I can give you all that information and let you make a decision on your own.
We can't deny them service. So even if it's a splinter in their finger or a baby that won't stop crying, it's like, "Get in the ambulance and let's go to the hospital."
Last December, George Chidi's mother, Jeanne, felt a sharp pain in her lower abdomen, along with some pelvic discomfort. George, a former Atlanta Journal-Constitution health care reporter, took her to Grady's walk-in clinic because she was uninsured after recently being laid off. They spent five hours in the facility that usually refills prescriptions and treats minor ailments before doctors sent Jeanne to the emergency room. George started live-blogging in the understaffed and overcrowded emergency room, which treated 438 people that night. The Chidis spent a total of 28 hours at Grady.
I began to hear other people talking about how long they had been waiting: eight hours, 10 hours. That can't be right. ... I knew what the averages were because of my prior reporting experience. We were starting to see the dysfunction pile up. They were running out of chairs.
It was scary and it felt dangerous. It felt like we were in a homeless shelter, not a hospital. I felt like I was at a bus station. People would pee on the floor, it really wouldn't get cleaned up [and] they'd throw like an oversize maxi pad on it. There had been a triage process, but people were just sitting there in pain and misery.
We thought [Jeanne's condition] might have been an ovarian cyst or cancer — something deadly. A serious diagnosis would have meant death because of her financial condition. My mother turned to me at 2:30 in the morning and said, "I'm not ready to die yet." Those were the circumstances in that room, where she felt that she needed to utter a statement like that.