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BURNING BRIDGES: Rev. Timothy McDonald III (from left), Dr. Neil Schulman, and state Sen. Vincent Fort, D-Atlanta, rallied in defense of patient and community interests, which they thought fell by the wayside as administrators focused on the
  • Crossroadsnews photo
  • BURNING BRIDGES: Rev. Timothy McDonald III (from left), Dr. Neil Schulman, and state Sen. Vincent Fort, D-Atlanta, rallied in defense of patient and community interests, which they thought fell by the wayside as administrators focused on the hospital’s finances.

During his time at Grady, some viewed Young as an extraordinary fixer largely responsible for stabilizing the hospital's financial operations. He was also blunt to a fault, and at times condescending. The new CEO frequently had a short fuse and little patience for collaboration, says Correll.

But he got things done. In his first year with Grady, Young oversaw a more than $75 million turnaround, guiding the health care institution toward the black, even if his methods weren't always the most popular.

"He was absolutely the right guy at the right time," says Correll. "Nothing changed [upon his arrival], except we had capital dollars. We still couldn't make payroll. So Mike made some aggressive moves and saved the hospital."

With his eye on the bottom line, Young made major cuts while also developing select areas of the hospital. Major investments into new state-of-the-art centers and refurbished departments followed the initial wave of needed capital expenditures. Home Depot co-founder Bernie Marcus donated $20 million to build a Stroke and Neuroscience Center and overhaul the Trauma Center.

"We thought it was a good thing for the hospital because it would differentiate Grady from its past," says Frankel, who leads the Emory University-backed Stroke Center. "This was a golden opportunity built on the background of a lot of research that we had been doing since the early '90s." The center has become a top-of-the-line facility and a bastion of the region's stroke care. Because of such specialties, more patients with private insurance began coming to Grady.

Administrators also worked tirelessly to rebrand Grady as a hospital that does more than serve the poor or the critically wounded. Look no further than the institution's 2008 annual report, which used a "Really" theme to, well, describe what really happens in the hospital in an attempt to debunk some myths. In it, Young wrote: "Outside of Atlanta, Grady is a legendary hospital. We need to make that true inside." To do that, Correll says the hospital had to persuade citizens — including "rich people in Buckhead" who failed to see the importance of a hospital they didn't visit — to "give a damn."

Grady's initial overhaul between 2008 and 2011 also came with negative consequences. The hospital cut more than 300 jobs and raised patient fees. Fort says administrators balanced the books by slashing services instead of finding new cash. Dorothy Leone-Glasser, a health advocate for some patients affected by the reductions, thinks the cost-saving moves sometimes ignored Grady's longstanding mission.

"Their goal was to cut waste, what they considered waste, and get Grady into the black and make a profit," Leone-Glasser says. "That was their goal, with all disregard for the patients and that's the part that, to me, was most upsetting."

The number of neighborhood health clinics was reduced from nine to six without much input from the community. While Leone-Glasser recognizes that the Young administration was attempting to reduce its short-term expenses, she and other critics say that the move hurt patients and could cost the hospital more in the long run.

"You're not doing any preventative work if you're closing the neighborhood clinics," says Leone-Glasser. "These people are going to wind up in your ER only when they're so sick. It's going to cost you so much money to treat them. It makes no economic sense."

Correll admits that the hospital administration "should've had a lot more conversation" with community members. Young made strides in balancing the hospital's books, but he failed to build lasting relationships with local stakeholders. His autonomous management style led to its fair share of tense moments. "[Young] could pick a fight in a church," Correll says.

Among Young's most reviled moves was his decision to close Grady's dialysis clinic in September 2009. Patients with kidney failure must undergo the grueling procedure of cleansing the body's blood and fluids multiple times a week. Without dialysis, which at the time could cost individuals upward of $77,000 per year, those patients can die.

At first glance, these service cuts might seem like a drop in the bucket of the hospital system's 800,000 overall visits that year. But some of Grady's most marginalized individuals were affected by the clinic's closure. Frequently, dialysis patients were uninsured and often illegal immigrants with no other access to treatment. Fort says the decision countered the hospital's overarching mission and served as a prime example of how Grady's leadership "cared more about the profit than they cared about people."

Baani, a 29-year-old Fulton County resident, first received dialysis treatment at Grady in early 2009. After other metro Atlanta hospitals turned her away because she was uninsured and undocumented, she made numerous visits to the public hospital's emergency room before being "selected" by Grady officials to receive biweekly outpatient treatment. "Coming through the ER, it was really stressful," she says. "Regular dialysis ... was a blessing for me."

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