Dr. James Fortson had been providing emergency ear, nose and throat services at Atlanta Medical Center’s downtown and East Point campuses for nearly 15 years before both of the hospitals closed this year.
He said he was devastated personally by news of the closure, but he also worried about the effects on his patients. There were few doctors that would come downtown and south of I-20 to provide medical services in his specialty.
“I chose to work there because there were not many people in my specialty there. There were a lot of lower socioeconomic patients, but I didn’t dwell on the financial reimbursement because I figured that if I did a good job and I took care of people, I would make an income,” Fortson said.
The medical field, like a range of other professions, is reckoning with workforce diversity concerns, but Atlanta Medical Center stood out nationally for its staff diversity. With its closure, the city lost a number of doctors and providers who are Black or non-white, a key to providing care to similar patient populations.
Fortson has been on the staff at other area hospitals such as Emory University Midtown Hospital and Piedmont Atlanta Hospital, but says his experience differed at those facilities. He said that at Atlanta Medical Center, he got to know other staff members, including nurses and doctors in the operating room, many of whom were people of color, like himself.
“One of the reasons I stayed at Atlanta Medical Center is that, regardless of ethnicity, the doctors there were a pretty close group. They had a pretty decent working relationship,” Fortson explained. “I always had somebody that I could go to for different specialties.”
When Dr. Mark Waterman arrived at Atlanta Medical Center 39 years ago, the physician workforce was predominately male and white. Over the years, Waterman, who is white and was president of the medical staff at the downtown hospital, watched his colleagues become more diverse.
“The physician diversity reflects the patient diversity and how diverse medical schools have become over the last 40 to 50 years,” Waterman said. “Great efforts have been made, better than it was 50 years ago to say the least. It’s a welcomed change. "
Data released in 2020 by AMC’s owner, Wellstar Health System, showed that 26% of AMC’s physicians were Black, 63% identified as Black or multi-racial and 73% were non-white.
Nationally, just 5.2% of physicians are Black and 18.4% of physicians in Georgia are Black, according to data released by the Health Resources and Services Administration for 2015-2019. A Journal of the National Medical Association study published in 2019 found that diversity can help health organizations improve patient quality care and financial results.
What sets Atlanta and Georgia apart from other places in the county is the presence of one of the nation’s four historically Black medical schools: Morehouse School of Medicine. Along with the Charles R. Drew University of Medicine and Science in Los Angeles; Howard University College of Medicine in Washington D.C.; and Meharry Medical College in Nashville, Morehouse has produced a large number of the nation’s Black physicians.
For Dr. Randall Morgan, Atlanta Medical Center’s physician diversity provides proof that the hospital “was serving the community.” Morgan, an orthopedic surgeon, is the president and chief executive officer of the W. Montague Cobb/National Medical Association Institute, an organization that leads research focusing on the elimination of health disparities.
“When you have a large population, you have a diverse population,” Morgan said. “People have better health outcomes and tend to be more [medically] compliant when they have providers that share their ethnicity.”
He went on to explain that other shared factors, such as being from the same city or community and attending the same church as a medical provider makes patients from underrepresented communities feel more comfortable in the healthcare system.
Hospitals located in a downtown like Atlanta Medical Center “provide opportunities for physicians of color to work and serve the community,” Morgan said.
“Once that hospital closes, the access becomes so much more difficult. The community loses the ability for immediate access to care where they can walk, ride a bicycle, take a taxi, whatever they have to do to get to been seen.”
Dr. Garrison Whitaker, a hand surgeon, said it felt like the ground was moving from underneath him when he learned of plans to close the downtown hospital on Nov. 1.
“There was no early discussion,” Whitaker said. “It really came out of the blue.”
Dr. Whitaker co-founded ATL Orthopedics with Dr. Alonzo Sexton, and they operated on their patients at AMC.
“We set up our practice near the airport and Camp Creek to take care of people in that part of town. We were literally the only orthopedic practice in that area,” he said. “Our main support system was AMC, and it is gone.”
According to Morgan, hospitals not only support patients, but also the communities were they are located.
“I think it’s a stabilizing factor for communities because it supports other business. It supports a neighborhood. It’s just like having a major department store or university,” Morgan said. “People, for generations, have counted on jobs at that place, and hospitals hire a lot of people.”
Whitaker says that to a large degree, the doctors at AMC were physicians of color that catered to populations located on the south side of the city.
Whitaker decided against joining Wellstar Kennestone Hospital in Marietta because he felt it was too distant for his patients who formerly were cared for AMC. And he didn’t think that relocating to Kennestone would serve the mission of taking care of patients of color in the south part of the city.
Yet, for complex cases, Whitaker has admitting privileges at Northside Gwinnett Hospital, a 42.9-mile drive from his office, which still creates a travel burden for his patients.
“It’s an inconvenience to patients. The patients are almost being taxed,” Whitaker said.
To Fortson, Wellstar never showed a commitment to serving the patients that AMC historically catered to, the city’s most underserved populations.
Credit: Natrice Miller / Natrice.Miller@ajc.com
Credit: Natrice Miller / Natrice.Miller@ajc.com
“I don’t think that Wellstar ever really wanted to be in the health care arena in the inner-city,” Fortson said. “I think as a result of that there were all types of strategies developed around seeing that come to pass.”
He recalled a lack of equipment and necessary medications during his time at Atlanta Medical Center’s East Point location. Now, Fortson is working at Southern Regional Medical Center.
Wellstar Health Systems denied all suggestions that the health care organization intentionally made decisions that led to the closure of AMC. According to Wellstar, 70% of the AMC physicians that were employed by Wellstar Medical Group chose to remain in the company.
“With regard to the physicians who were employed by Wellstar Medical Group, we were committed to doing what was best for each particular individual,” Wellstar said in a statement given to The Atlanta Journal-Constitution. “For those who preferred to continue practicing in the community, we worked to support that transition as well.”
Currently, Whitaker is speaking with Grady Memorial Hospital and other area hospitals to begin admitting his patients there. Still, he is concerned for what AMC’s closure means for patient outcomes.
“Grady is already over capacity and stretched. You’re going to have patients that are going to have a hard time getting in. Patients that would show up to Atlanta Medical Center,” Whitaker said. “I don’t know where they are going to get care from.”
“There are patients that just aren’t going to get care.”
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