Yesterday we converged at Emory University to present a letter to President Jim Wagner requesting that Emory join with other dialysis centers in Atlanta, GA to help provide care for the 33 dialysis patients whose extension of life-saving dialysis ends next week. We then traveled to the Fresenius Dialysis Center at 231 14th St in Atlanta, where treatment of the patients is ending Aug 31 2010, to present a similar letter. Today there was a protest at Grady Hospital. Time is running out for these patients and it is really disheartening that money is thrown after expensive medical procedures in this country that do not clearly work, while something like dialysis that means the difference between life and death is denied to some people.

Read prior posts on the history of this issue here.

 

I invite doctors and other healthcare workers to speak out about the death sentences being handed out to patients.

Sign the petition to save the Grady dialysis patients here.

After August 31, 2010, thirty three (33) uninsured End-Stage-Renal Disease patients of Grady Memorial Hospital will no longer receive their life-sustaining dialysis treatments.

- In September 2009, Grady Memorial Hospital closed its outpatient dialysis clinic. At that time the thirty three (33) uninsured patients, most of whom are immigrants, were promised dialysis for one year from Fresenius dialysis facilities as specified in the Grady Memorial Hospital – Fresenius contract.

- On August 31, 2010 the Grady Memorial Hospital – Fresenius contract expires.

- To date, no alternative source of dialysis treatment has been made available to the remaining thirty-three patients.

- The patients will die within weeks of the August 31st deadline if they are not provided with ongoing dialysis treatment.

As advocates for human life, please sign the petition below to encourage the private dialysis providers of Atlanta, Georgia, to supply the 33 indigent patients of Grady Memorial Hospital with life saving dialysis care.

Here are some facebook groups you can join to keep abreast of the issue.

Protest the Grady Dialysis Cuts

Protest Grady Hospital’s Sentence of Death for Dialysis Patients.

Advocates for Responsible Care – Group

Read all posts about the Grady dialysis situation here.

and imminent sentence of death for 33 patients on Aug 31 2010. Interview by Grady physician Neil Shulman MD

Part 1

Part 2

Part 3

Neil Shulman MD gave a talk at a recent Emory Cardiology Research Conference about the plight of the Grady Hospital dialysis patients. (Read all of the posts about Grady dialysis here). A year ago, we the Grady patients received a death sentence after the board of directors decided to close the dialysis clinic and told the patients to go back to their countries or bugger off in general. In conjunction with the Advocates for Responsible Care we filed the patients into the board rooms and subsequent court hearings filed by Lindsay Jones on behalf of the patients. With some effort we got them to provide a year of treatment through the private clinic Fresenius, but now their time is up on August 31. At the conference one of the doctors said that the power of doctors is eroding, and increasingly it is the situation where administrators tell the doctors what to do with their patients. Funny, I didn’t think they should have the power to do that, but what the hey…

Meanwhile, at least one woman went back to Mexico, where she died because she couldn’t get dialysis, another went to Florida and almost died, then came back to Georgia, and there are several other stories like that. There still are 33 patients who need dialysis who are still alive who will be affected.

Meanwhile, the CEO of Grady, Michael Young, got a $300,000 bonus for saving money at Grady, which is the priority these days.

Pete Correll is former CEO of Georgia Pacific who runs the board of Grady. 

Baxter sells supplies for dialysis and charges twice as much for the dialysis supplies here as it does in Mexico. Maybe we should smuggle some over the border. We are asking Fresenius, DaVita, and Emory to provide compassionate care for these patients.  Robert J Parkinson, Jr, is president and CEO of Baxter.

 Kent J Thiry is CEO of DaVita, a dialysis company which has recently come under scrutiny for milking the use of the drug Epogen in dialysis patients for treatment of anemia.

Thomas Lawley MD is the Dean of the Emory Schoo of Medicine and is on the Grady Board. I have gone to the meetings but he usually just sits there and doesn’t say anything. Emory supposedly has picked up a few patients but they could do more to get these other harbingers of corporate greed to do something.

 

Ben J. Lipps, PhD, is the CEO of Fresenius who is the largest provider of dialysis in the US. They pay Lipps $4,310,000 a year in salary and compensation each year. (Maybe he could donate some to dialysis patients) Although Fresenius is a German company, they have adopted well to the American system of putting profits over people when it comes to healthcare. If a situation like the Atlanta dialysis situation occured in their home country, the local population wouldn’t stand for it.

The problem is that medical decision making is slowly being taken away from the doctors and put into the hands of people who don’t have the experience of connecting with people about their healthcare. Witness how administrators at Grady asked the doctors there to sign a statement saying that it would be fine for dialysis patients to get their dialysis only through the ER and on an as needed basis. They refused.

If each of these entitities would take on a few charity cases, like they used to in the old days, the problem would be solved.

Note: the post was updated one day after the initial posting.

See this article by UW-Seattle nephrologist Rudolph Rodriguez MD arguing that physicians have an ethical imperative to help these patients.

This weekend we had the Emory International Medical Volunteerism Conference here in Atlanta, GA. George Lundberg MD was the keynote speaker and there were sessions on volunteering in third world countries, advocacy for patient rights and a range of other topics.

Lindsay Jones, the attorney who took on the case of the Grady Hospital dialysis patients who got yanked off dialysis with a certain death sentence, talked about advocating for the uninsured (See “Grady Hospital Tells Dialysis Patients to Leave or Die” and my posts from the court room “These are Real People” and “Healthcare is a Right“). Well, at least it is a right in most of the world, but not in the US, I guess, where a convicted mass murderer at least has the chance to have his day in court before they take his life away, unlike the unisured in this country, who get yanked off of dialysis with no due process. The Europeans who joined the Grady facebook page (see links in my prior posts, we got a couple hundred members) thought we were complete barbarians for acting like that.

Lindsay made the point he argued in court that healthcare is a right, and that you can’t deprive a person of their life without due process.

The Grady patients are currently getting dialysis with the private treatment program Fresenius until September of this year.

I gave a lecture about advocating for victims of medication related problems along with other members of the Grady Coalition who banded together to advocate for the dialysis patients who had no voice, and were being deprived of life as victims of the corporate medical model where sickness is viewed as a way to make money and making profits is put ahead of people’s lives.

Isn’t it great to live in America!

The situation at Grady Hospital in Atlanta of cutting off dialysis for poor patients without insurance (which will make them, um, die) is an echo of the national political farse of throwing out public option health insurance and throwing more good money after bad (Karen Ignagni and her group of health insurance criminals). I am glad to see that Max Baucus (D-Mont) who was the author of the bogus healthcare reform bill (and a top recipient of pharma contributions) was able to get some extra healthcare money for some miners from Libby, Montana, as well as shell out even more profits to the pharmaceutical industry, health insurance, etc. Here he is in action shelling out the pork.

Here is an update on the Grady story from Neil Shulman MD:

IT IS SAD.  I had a meeting with the woman who wrote the book THE GRADY BABIES and a woman who works at Channel 11 and the nurse from Nigeria who has been here ten years, Is married to an American and just got her Green card.  SHE NEEDS TO BE HERE 5 MORE YEARS BEFORE GEORGIA MEDICAID PAYS FOR HER DIALYSIS.  The Channel 11 lady and the author (WROTE A GREAT BOOK WITH DICK GREGORY) are connecting with Dorothy to get the book on the dialysis crisis rolling (30 people who may lose their lives after Jan 3rd when the inner city hospital stops supporting dialysis for their kidney failure.)  They are planning on putting personal stories about the patients on the internet.

In the meantime,  there is a movement by some docs within Grady Hospital to change things such that humanization takes precedence over monetazation. ALSO,  THERE IS A PLAN TO TAKE A BUS LOAD  OF THE DIALYSIS PATIENTS TO A HOSPITAL EMERGENCY ROOM ……….ALL AT ONCE…EVERY FEW DAYS ……after Jan 3rd.

 ON another front,  the medical volunteerism conference WWW.EMORYIMVC.ORG  is MOVING ALONG VERY WELL…………..we have some fantastic presenters,  the first edition of the book about  these heroes is almost ready,  the White House is sending folks………….AN OUTPOURING OF SUPPORT FROM HUMANIZERS.

IF YOU HAVE SOME TIME,  WE SHOULD AT LEAST CHAT ON THE PHONE TODAY.  I AM AT 404-321-0126.  IF NO ANSWER,  JUST LEAVE YOUR NUMBER AND I WILL RETURN YOUR CALL SHORTLY.

NOW A SHORT OVERVIEW OF THE CURRENT CIVIL WAR IN THIS COUNTRY:

We are in the middle of a war in this coutry between the monetizers and the humanizers.  Sadly,  the victims of this war are poor sick people.  IF everybody was a humanizer as the folks involved in the medical volunteer activites………….there would be no problem.  We would have peace and poor sick people would not suffer and die……. One of the major obstacles to winnning this war is the barrier between the poor sick patients and everybody else.  The caring nurses and doctors AND LAY FOLKS who are on the front lines Understand the current atrocitIES.  The further one is away from connecting with poor sick people,  the less likely you can empathize with them.  It is easy to use words like “ILLEGAL ALIENS”  OR “LIMITED RESOURCES FOR POOR SICK AMERICANS”  and just let people suffer and die when you don’t have to look in the eyes of these people or hear their stories. 

One of the free clinics in South Atlanta struggles with getting patientsurgent health care by specialists every day.  Recently, there was a case of a man needing back surgery before “he became paralyzed.”  The community clinic (docs, nurses, and pastors) FOUGHT HARD AND got the patient into Grady Hospital for the surgery.  On the other hand, there are folks like the 23 year old woman who recently died in Grady because she was shut out of her access to steroids for her Lupus.  She did know how to overcome the new barriers (more paperwork and more upfront fees to be seen for a few minutes so she could get her refills).  She ended up in Grady’s ER very very sick. She was admitted and died. Medical students and staff docs told me the story.  Many folks are familiar with this recent tragedy.  There are many folks in similar situations every day who die at home without even getting to the emergency rooms.

In developing countries where there is lack of access to health care………..at least there is not a COVER-UP.  When we brought a little girl from Kenya to Univ of Alabama Med Center for heart surgery…………..the Kenya media, the local Kenya politicians,  the local roatary club,  THE HAVES AND THE HAVE NOTS…..ALL JOINED TOGETHER AND HELPED SAVE THIS LITTLE GIRL’S LIFE.  IT WAS AN ENTIRELY DIFFERENT CULTURE.  THERE WAS NO HIDING OF “THE FACTS.”  THERE WAS NO INTIMIDATION OF THE CARING FOLKS BY  MONETIZERS.  We are experiencing a larger and larger class of HAVE-NOTS in this country because of the economy.

DAILY MEDIA ATTENTION SHOULD BE FOCUSED ON EFFORTS OF THE HUMANIZERS TO HELP POOR SICK PEOPLE.  THIS WOULD GALVANIZE EVEN MORE PEOPLE TO JOIN IN.  THIS WOULD GALVANIZE MORE PEOPLE TO ADVOCATE FOR LEGISLATION TO ELIMINATE THESE ATROCITIES.  Maybe we could even get the Georgia Legislature to allow poor people to get medicaid coverage BEFORE THEIR CANCER SPREADS.  THE MEDIA WILL NOT INFOMORM THE PUBLIC THAT IF YOU HAVE A MALIGNANT MELANOMA ON YOUR SKIN AND YOU ARE POOR…………..THE STATE MEDICAID EMPLOYEES ARE FORCED TO TELL YOU “SORRY MEDICAID DOES NOT COVER YOU UNTIL YOUR CANCER SPREADS THROUGHOUT YOUR BODY.” 

 We need more media attention, legal action, and MORE folks EDUCATED AND involved.  IT IS A STRUGGLE WHICH CAN ONLY BE WON WITH AN ARMY OF HUMANIZERS.  I have found that people with resources who are humanizers are MUCH HAPPIER than people with resources who are monetizers.  You are surely one of the humanizers.

 IF THE MAJORITY OF MEMBERS OF THE US CONGRESS WERE NOT MONETIZERS………….THEN TRULY MEANINGFUL NEW LEGISLATION WOULD BE PASSED TO ELIMINATE THE BASIC HEALTH DISPARITIES BETWEEN  THE HAVES AND THE HAVE-NOTS.  WE CAN STILL HAVE PEOPLE WITH BIG HOUSES AND SMALL HOUSES, PEOPLE EATING AT FANCY RESTAURANTS AND PEOPLE EATING BASIC HEALTHY FOOD AT HOME,  PEOPLE GOING ON  EXPENSIVE VACATIONS AND FAMILIES DOING MEDICAL MISSIONS………..BUT AT LEAST WE WOULD HAVE A COUNTRY WHERE POOR SICK PEOPLE HAD ACCESS TO BASIC HEALTH SERVICES AND BASIC MEDICAL THERAPIES……….WHICH ARE AVAILABLE TO MOST PEOPLE IN EUROPE, CANADA, JAPAN, KOREA, ETC.

AND BY THE WAY,  IT WOULDN’T HURT IF MEDICAL LITERACY WAS AN INTEGRAL PART OF OUR EDUCATIONAL SYSTEM………..WHY DO JUST DOCTORS AND NURSES LEARN HOW TO EXAM THE HUMAN BODY, WHAT SYMPMTOMS ARE IMPORTANT, HOW TO PERFORM SIMPLE PROCEDURES LIKE TAKING BLOOD PRESSURES?……………..WHY NOT EMPOWER CONSUMERS SO THEY CAN USE THE HEALTH CARE SYSTEM MORE EFFICIENTLY.  READING, WRITING AND ARITHMETIC ARE IMPORTANT BUT YOU CAN’T DO ANY OF THOSE IF YOU ARE DEAD.  MARTIN LUTHER KING EMPOWERED FOLKS BY TEACHING THEM HOW TO VOTE.

LET’S EMPOWER AMERICANS BY TEACHING THEM MEDICAL LITERACY………….LET’S EDUCATE THE SCIENCE TEACHERS SO THEY ARE MEDICALLY LITERATE, SO THEY CAN TEACH OUR FUTURE GENERATIONS ON HOW TO EFFICIENTLY USE THE HEALTH CARE SYSTEM.

BEST,

NEIL SHULMAN

INFRINGEMENT: FREEDOM OF SPEECH: MEDICAL PROFESSIONALS

The United States is a country where freedom of speech is supposed to be a basic right. Administrative power and personal wealth should not give any American the right to infringe on one’s freedom of speech. MANY DOCTORS FEEL THAT a downturn in the economy can create an UPSWING IN VOLUNTEERISM. LACK OF MONEY DOES NOT HAVE TO MEAN A LACK OF SERVICES. MANY OF THESE DOCTORS
ARE VERY CRITICAL OF BLATANTLY INSANE POLICIES BUT ARE AFRAID TO SPEAK OUT FOR FEAR OF PERSONAL REPERCUSIONS.

There are many caring doctors and other health care professionals who intentionally take lower paying jobs and/or volunteer their services because their goal in life in NOT TO MAXIMIZE THEIR BANK ACCOUNT OF MONEY BUT RATHER TO MAXIMIZE THEIR BANK ACCOUNT OF GOOD DEEDS. Many of these people have more global insights into the life-threatening impact and economic inefficiences of certain institutional and political policies. HOWEVER, IN MANY INSTANCES, THERE ARE ATTEMPTS TO INFRINGE ON THE FREEDOM OF SPEECH OF THESE HEALTH CARE PROFESSIONALS. Even well meaning journalists who wish to expose certain inefficiencies in humane health policies are often restricted from reporting.these stories. The executives of these media outlets are too often fearful of “losing revenue” from advertisers when such ‘CONTROVERSIAL” news stories are reported.

THE FOLLOWING ARE A FEW EXSAMPLES OF INSANE POLICIES WHICH FRUSTATE MANY “CARING” HEALTH CARE PROFESSIONALS EVERY DAY:

1. Medicaid rules which DO NOT ALLOW COVERAGE TO REMOVE AN EARLY CANCER BUT REQUIRE PATIENTS TO WAIT UNTIL IT SPREADS THROUGHOUT THEIR BODY.

2. Managers of health care institutions who prohibit cooperative institutional volunteeerism in order to address health care needs of the poor. Example: Executives of dialysis clinics NOT JOINING TOGETHER to keep uninsured patients with kidney failure alive.

3. Executives of hospitals not joining together to provide a few weeks supply of free essential medications to hospitalized uninsured poor patients upon discharge. The reality is often that these patients DO NOT HAVE INSTANT ACCESS TO MONEY OR TRANSPORTATION TO OBTAIN THESE MEDS thus they bounce back to hospital emergency rooms …………uneccesary personal suffering and avoidable expensive rehospitalizations.

4. Incremental increases in upfront fees for outpatient visits with NO EXCEPTIONS.
Therefore patients with VERY LIMITED RESOURCES can’t get essential refills of medications thus they suffer/bouncing back for expensive emergency room visits when their chronic illnesses become life-threatening.

5. Pharmaceutical companies often blast the public with PR CAMPAIGNS about
free medication programs for the poor HOWEVER the companies often create so many time-consuming roadblocks for instant access to these medications that health care professionals cannot get the meds to the patients in a timely manner.

I DO NOT SPEAK FOR MYSELF ALONE BUT FOR MANY HEALTH CARE PROFESSIONALS WHO ARE AFRAID OF NEGATIVE PERSONAL CONSEQUENCES IF THEY SPEAK OUT ON THESE ISSUES.

Neil Shulman MD
Atlanta,Georgia

Indeed. Words spoken today by Lindsay Jones, attorney representing the dialysis patients who have been given a death sentence by the decision to close Grady Dialysis Clinic in Atlanta, GA (see “Do I Have the Right To Live?” and the original post on this story “Grady Hospital Tells Dialysis Patients to Leave or Die.”). Last week the judge in the case ruled that the patients didn’t have any constitutional rights (what about the ones with green cards? You have to be a citizen to have rights? Oh really? What about the right to LIVE?) and pulled the temporary restraining order. Today at the Fulton-DeKalb Hospital Authority (which oversees the Grady Memorial Hospital Corporation, which runs the hospital) run by Pamela Stephenson the Authority announced that it supported the decision to pay for three months of dialysis and then cut themselves loose from patients without insurance or Medicaid. One of them made a little speech about how we should get the other counties in Georgia to help pay for Grady. They said that they were going to make sure that everyone would get appropriate transition, and when we said that the patients had not been told that, Michael Young the CEO of Grady started shouting at us. But then four women stood up who said that they had not even been informed that they got three more months let alone would get help transitioning to other care! (whatever that might be). One of them had already bought her ticket back to Honduras. Last week A.D. “Pete” Correll, ex-head of Georgia Pacific Corporation, shouted at us that Grady was losing too much money. All of this is of course cruel and inhumane and makes me ashamed to be part of a community that just tosses human beings aside like so much garbage. As Dorothy Leone-Glasser of the Grady Advocates for Responsible Care, said, “I don’t know how anyone involved in Grady can sleep at night because I can tell you that none of the patients that we know about — 34 of them — and their families will be able to sleep at night. I dont’ know how they can do it.”

Today in Fulton County court the courtroom was packed with dialysis patients and advocates who were scheduled to have their dialysis turned off last week but for whom a temporary restraining order had kept the Grady clinic in Atlanta GA open until today, I guess. Lawyers for Grady Hospital argued that the patients don’t have a right to healthcare (that one made me kind of wonder) and that Grady (whose mission is to care for the sick and indigent poor) didn’t have any obligation to them. They provided an affidavit saying that 88 patients had been provided with followup. Now I am not a math major, but originally there were 95 patients and there were at least 25 in the court and 95 minus 25 equals…

Oh, and their “followup” was to send at least two to Mexico which doesn’t have long term dialysis, and therefore they will die there.

The lawyer for the patients argued that closing the clinic was sentencing them to death, therefore depriving them of the right to live. I mean, doesn’t the US Constitution give us the right to live? If we have someone on death row for killing someone we spend millions to give them due process, but if they are a Grady dialysis patient we just turn off the plug. People go nuts over pulling the plug on brain dead Terry Schiavo but we have no compunction turning off dialysis.

One of the patients has a green card and is short of one year to qualify for Medicaid. But, I guess, she must die. One was sent to Florida because they said he could get dialysis there but couldn’t get it, had a stroke and came back to Atlanta.

There is something seriously messed up with a country that allows people to die like this. The Judge is supposed to give a ruling today or tomorrow.

Join the FB cause “Protest Grady Hospital’s Death Sentence for Dialysis Patients” here.

Last week I wrote about the situation of the Grady dialysis clinic which the Grady Board voted to close last week. This means certain death for patients treated there without insurance as the private dialysis clinics won’t treat the patients, and emergency rooms will only treat them if they are within two days of death (see “I Need the Dialysis. I Think I will Die.”) This struck some of us in the healing professions as particularly cruel and inhumane, and some of our readers from other countries said we didn’t have the right to call ourselves a civilization if we treated people like that. The 90 or so patients represent a mix of undocumented aliens, people waiting for their green cards, and those who haven’t lived in Georgia for five years and don’t qualify for Medicaid. So far efforts to get private clinics and local teaching hospitals to provide compasionate care have been to no avail.

Last Wednesday local attorney Lindsay Jones, working pro bono, was able to get a court injunction to keep the clinic open. Last Friday the local AJC did some slam dash journalism by picking up the phone and getting someone from the New Jersey Medicaid department who said that they did not provide care for undocumented aliens, in spite of what a spokesman for Grady said. His response was “Nah-ah”.

Tomorrow there is a court date at Fulton County court on Central Ave between Prior and Martin Luther King Blvd in downtown Atlanta. There will be a protest at 8:15 am on the courthouse steps.

This afternoon we met with the lawyer and the dialysis patients.

I spoke with a woman from Nigeria named Ade Abner. She is 43 years old and has been on dialysis for 10 years. She is married to an American who was born in Georgia who is also on dialysis. She works as a registered nurse and is waiting for a green card. She is therefore not an undocumented alien.

Ade Abner
Some of the patients from Mexico said that some people had already gone back to Mexico. The Mexican Consulate, who Grady has been working with, told one woman that she had to leave now or she wouldn’t be able to return later. Feeling pressured to leave she went back. One woman went to Birmingham AL and is currently getting dialyzed in an ER. Others had been offered $2,000 to go back to Mexico, where they would be dialyzed for only three months.