Local hospitals feel the brunt of AMC’s emergency room closure

Credit: Natrice Miller / Natrice.Miller@ajc.com

Credit: Natrice Miller / Natrice.Miller@ajc.com

Hospitals that already have full emergency rooms will continue receive additional patients.

On Monday, just three days after the emergency room at Wellstar Atlanta Medical Center was closed, officials at nearby hospitals report they have seen more patients but that it’s hard to know how many were formerly served by AMC.

Piedmont Atlanta Hospital reported Monday afternoon severe overcrowding in its emergency room requiring all ambulances to be diverted elsewhere. It also reported no room for new patients needing psychiatric care, emergency care, or critically ill ICU patients.

The full effects of the AMC closure are still brewing at Grady Memorial Hospital, Emory University Hospital Midtown and Piedmont Atlanta, hospital officials say, and may only worsen.

Dr. Robert Jansen, Chief Medical Officer at Grady Health System, said Grady can’t count how many patients they are seeing who would otherwise have been at AMC. However, Jansen said he has seen the shift mounting for weeks both at Grady and in data he sees for other hospitals.

“I mean, if you are accustomed to go into a hospital, and you know they are closing, there’s a message there,” Jansen said. “The message is that we’re not going to be here for you.”

Wellstar Health System announced that they were shutting down AMC in downtown, but the hospital’s emergency room began diverting ambulance traffic to other hospitals on Oct. 3 and the emergency room was first to close on Oct. 14. Hospital operations will continue to wind down until the full closure on Nov. 1.

In addition, 19 primary and specialty care offices affiliated with Wellstar AMC are shutting down completely, leaving patients to find new providers.

Wellstar executives have blamed revenue losses for their decision to close both AMC locations, both of which served the city’s uninsured and low-income populations.

Grady Memorial Hospital is metro Atlanta’s only other Level 1 trauma center besides AMC and was expected to see the biggest impact from AMC closing.

In terms of distance from AMC, Emory Midtown is 1 mile away, Grady is 1.1 miles away and Piedmont Atlanta is 4.4 miles away — these three hospitals were expected to take the greatest impact from AMC’s closing.

“The first event really was when they stopped taking EMS traffic,” or ambulances, Jansen said, particularly with trauma cases. However, Jansen said the growth in Grady’s trauma patients has amounted to 25% to 30% more since Wellstar’s Aug. 31 announcement of the coming closure of AMC downtown.

The AMC downtown hospital is the second to be closed by Wellstar this year. AMC South, located in south Fulton County in East Point, was closed in May.

“I think what we’re going to see is a seismic shift of citizens in Fulton County and the city of Atlanta that used to seek care at Wellstar AMC to now seek care at local hospitals,” said Daniel Owens, chief executive officer of Emory University Hospital Midtown. “That’s going to put additional strain on the hospitals that are already experiencing capacity issues, workforce issues and financial challenges, plus the additional EMS volume that having one less hospital in our city is going to push that volume on to all of us that are still here in the community.”

According to Owens, Emory Midtown had already experienced a 15% increase in emergency department visits following Wellstar AMC South’s closure.

Gov. Brian Kemp announced in September that the state would provide $130 million in funding to Grady Health System to help offset the effects of AMC’s closure. DeKalb County commissioners have also approved a total of $20 million to support Grady and Emory Hillandale hospitals.

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“The emergency room is often the first point of contact for patients to healthcare systems, especially people who are uninsured or underinsured, or lack access to care,” said Dr. Bonzo Reddick, chair of the community medicine department at Mercer School of Medicine and a family physician. “Now, that’s not going to be available, so I do worry about the potential for overcrowding, long wait times and patients leaving without being seen or just not even going because they know it’s going to be a tremendously long wait.”

Even before the closure, emergency rooms across the metro area have experienced frequent overcrowding. Information gathered from the Georgia Coordinating Center, which tracks hospital capacity to receive ambulances, showed that local emergency departments experienced severe overcrowding this weekend.

“It’s going to just continue where people are out in the hallways in emergency rooms waiting for beds,” Reddick said. “I’m hoping that the silver lining will be that this is a wake-up call in Georgia, and that we start to look at Medicaid expansion and better ways to reimburse for health care.”

Piedmont Atlanta would not grant an interview for this article but issued a statement saying: “Piedmont Atlanta stands ready to serve our community during this time of transition. We are continuously assessing our capacity to ensure appropriate resources and increasing clinical staffing to continue providing high quality care.”

According to data released by Wellstar in 2020, more than two-thirds (67.3%) of the 4,281 emergency room patients that AMC saw in its downtown and East Point locations in 2019 were Black, and over half (51.5%) were Medicare and Medicaid recipients.

Health equity advocates are concerned about how the closure will affect patients in a state where Medicaid expansion remains up in the air. They say that individuals are already reluctant to seek out care until circumstances are dire.

“The burden is too much on the person who is in distress, who is in trauma, who is in a health care crisis. It is not enough on a system that should be designed around them for care,” said Jeff Smythe, president of the Atlanta Regional Collaborative for Health Improvement.

“Our concern is that there will be real and perceived barriers to care, even greater than there have been.”

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