As a fourth-year medical student at Emory, I've received most of my clinical training at Grady. Over the years, I have developed a very good perspective on what does and doesn't work in this hospital, but most importantly on what obstacles this hospital faces that are incredibly difficult to change. Having just finished a month in the Grady ERs, I've seen people incur those incredibly long wait times but I don't think this piece touches on any of the reasons why. Sometimes we wait for consult teams who are experts in a particular problem to assess a patient. Let's say we have a patient with an arterial bleed in the hand and are waiting for the plastics expert to come downstairs and ligate the artery. While we're waiting, the plastics doctor is upstairs tending to a list of thirty burn patients who have unstable vital signs and are in critical condition in the intensive care unit. The person in the waiting room who would get the bed of the patient with the hand injury is waiting, just as the person with the hand injury is waiting for plastic surgery to evaluate him. The only people who aren't waiting are the ones who are critically ill and that's simply the way hospitals run. The busier the hospital, the larger the metropolitan area it serves, the more acute the presenting issues are... unfortunately you're going to wait for a while if your condition is less serious. Also, sometimes our computer systems flicker off or the radiology network goes offline. Sometimes a trauma rolls in... sometimes ten traumas roll in. Sometimes the labs lose samples that have to be re-drawn and re-tested. These things affect wait times. And it seriously sucks. I hate seeing a patient who has been there all day for the first time, but I and the wonderful people that staff Grady compensate as best as we can by giving excellent care.
A walk-in clinic for medication refills is an extraordinary addition to the Grady construct. Our patients have way too many social stressors to keep up on their medicines, let alone the resources from which to regularly obtain them. I can't tell you all how many times I ask a patient why they're out of their meds and I hear so many good reasons. A son or daughter is working or just not getting along and an elderly patient is stranded at home with no support during a scheduled clinic appointment. Maybe there's no cash in the house to afford MARTA or the prescription co-pay (which could be as low as $5 but it's still too much). Maybe the patient has been stuck in a rut, homeless and stranded on the other side of town without much of an inclination to believe that things could get better, let alone that they should drag themselves to Grady for more blood pressure meds. These are some of the reasons why we need this clinic for med-refills and doesn't begin to touch on everything else. Rest assured, every patient is evaluated by a doctor in this hospital and going to the walk-in clinic does not ensure that the patient will get substandard care.
I hate how long Grady patients have to wait for acute care, but an uninformed article that points to all the wrong things leaves a bad taste in my mouth. Next time, ask someone who actually understands the problem. The reasons why this was a 28 hour wait are the same reasons why our healthcare system is broken. They are beyond complex, but worth talking about how they affect our Grady in particular.
(Also, tuberculosis is aerosolized. You can't catch it from someone's tie.)
Creative Loafing Atlanta
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