Atlanta Medical Center implemented a modern care model combining the strengths of community physicians with employed physicians across multiple specialties. Residency training was enhanced in internal medicine, family medicine, orthopedics and general surgery. The emergency room was one of the busiest in the city with more than 100,000 visits annually, according to FREIDA AMA registry data. Annual inpatient surgeries were above 3,100 and annual outpatient surgeries totaled more than 2,500.
Patients were seen and cared for no matter their financial situation or so-called station in life.
Given the size of the greater Atlanta metropolitan area, it seems clear that Atlanta needs a second Level 1 trauma center. The greater metropolitan area of Philadelphia has a population of about 6 million. Greater metropolitan Atlanta also has a population of about 6 million. Philadelphia has 4 adult Level 1 trauma centers; Atlanta has but one.
In 2019, Hahnemann Hospital in Philadelphia closed. Approximately 2,000 physicians and nurses were employed by the hospital. This hospital provided critical care for a large swath of the Northwest corridor of the city. The closure resulted in a major displacement of patients, physicians and nurses. The remaining hospitals experienced a significant increase in emergency room volume from 12% to 20%. Infant mortality increased. Patients were left without a medical home. They scrambled to find clinical services and continuity of care was thrown into disarray.
A similar pattern has unfolded in the Atlanta area with the closure of Atlanta Medical Center. Area hospitals initially noted an increase in emergency room traffic. Grady has shouldered the major trauma volume as it continues to provide stellar care. However Grady should not have to bear this added burden.
Physician offices closed as essential laboratory and radiology services provided by Atlanta Medical Center were no longer available to support their practice activity. Patients were forced to find new medical providers willing to assume their care. Some patients began to utilize remaining local emergency rooms to meet their primary care needs. This model of care is undesirable and repeatedly has been shown to be ineffective and costly over the long haul.
One can only speculate about excess mortality related to the closure but hard data should be forthcoming as this year ends.
We must also view the closure of Atlanta Medical Center within a broader context. Over the last decade there have been 9 rural hospitals that have closed in Georgia. Nationally it is estimated that 30 hospitals close annually. There are multiple factors associated with these closures. One recurring theme is declining reimbursement coupled with increasing costs of care. Those hospitals that provide care to the uninsured or those with Medicaid and Medicare often face costs that are not covered. In thinking about the future a secure financial plan must be an essential component of a revitalization effort.
As a trauma surgeon and concerned citizen of Fulton County, I encourage our elected leaders to revisit this issue and continue to marshal the political, social and institutional will to correct this devastating blow.
A hospital is a sacred place. A refuge. A safe haven where all can go to heal. Let us give renewed energy to the restoration of Atlanta Medical Center.
Mark L. Walker M.D., F.A.C.S, is a board-certified general surgeon with additional advanced training in trauma. He serves as medical director of the Surgical Health Collective in Atlanta and was formerly on staff at Atlanta Medical Center.