'We're At Our Breaking Point'

The doctor called back an hour later. He said North Fulton had rejected the patient, even though the hospital wasn't on diversion and was 20 miles closer to Dahlonega. "That was not an appropriate decision," said Kellerman, fuming. (A North Fulton spokesperson said afterward that the trauma surgeon on call that night insisted that he never heard back from the Chestatee physician after an initial conversation and did not reject the patient.) Soon thereafter, Grady officials reluctantly agreed to take the patient. At 7:30 a.m., as the sun rose over the city, a helicopter buzzed into view and landed on Grady's rooftop. Paramedics and Grady staffers unloaded the patient onto a gurney and rushed him down to the trauma bay, where the next shift of doctors and nurses was already getting deluged. As stressed as it was, the system somehow worked and saved the man's life. But what if Grady were to collapse? Or what if, as hospital executives have contemplated, it were to downgrade to a Level II trauma center? "Can we continue to be all the things people want us to be?" asks Haley, the chief of emergency medicine. "No, we can't. … Society has to decide what it's willing to support." And, he might have added, it will have to live with the consequences.

Postscript: since the time of this report, Grady's condition has worsened. The institution has had to slash costs to remain viable. Earlier this year, it offered buyouts to 560 older and more experienced personnel; 420 of them accepted. With the help of the consulting firm of Alvarez & Marsal, which specializes in rescuing companies, Grady is studying a host of other potential cuts, including its dialysis program and its neighborhood health centers. It has also reached out to the Metro Atlanta Chamber of Commerce for help in addressing its funding challenges. In response, the chamber convened a task force of top business leaders in April, co-chaired by A.D. "Pete" Correll, former chairman of Georgia-Pacific Corp., and Michael Russell, CEO of H.J. Russell & Company. The group expects to issue its recommendations in the next few months.

© 2007