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.

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

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 I attended a protest going on at Grady Hospital over dropping dialysis for non-US citizens and then we attended the open board meeting at Grady Hospital. You can get some background by reading ““Grady Hospital Tells Dialysis Patients to Leave or Die” in which I explain how Grady sent letters a couple of weeks ago telling people that their dialysis is over and they should go back to their home countries (which often don’t have dialysis) or move to Virginia, and “Should I Watch My Father Die Now” in which a daughter described how her father would die because although he had a green card he needed to live in Georgia for five years and he had only three.
Today concerned doctors, social workers, community activists and the dialysis patients and their families convened on Grady Hospital to protest and voice their concerns to the board.

Giving dialysis as an emergency event only is a death sentence as your potassium goes up and everyone knows that these people will soon die from a cardiac event or something like that. The board claimed that they would give followup but none of the patients can get treated at private clinics because they don’t have private insurance or medicaid. Several people expressed the outrageousness of the situation of dumping people in the streets and the medical unethics of just telling people get lost, go die.

Grady administrators claimed that they were providing follow up but the clinic closes this week and there is no plan for these patients!
Elbert Tuttle, MD, who is 88 years old, brought dialysis to Atlanta, and whose father of the same name brought desegregation to the South, appeared to express his view that Emory and Morehouse Schools of Medicine should get involved with local medical centers to help out.
A dialysis patient from El Salvador who works cleaning houses in DeKalb County and who has children, said “I Need the Dialysis. I Think I Will Die.”

Indeed.
Afterwards we waited for an hour and a half for the Chief Operating Officer, Denise Williams, to come talk to us about how these people are going to be taken care of. She never showed up. I guess she doesn’t really give a crap.
It really makes you wonder when all our local paper can cover is the angry people being bused to Washington to protest healthcare reform. How can any humane person allow this to happen? One sign said “Healthcare is a human right”.
I couldn’t agree more.
For more information contact Dorothy Leone-Glaser of Grady Advocates for Responsible Care, (404) 633-5843, dlg [at] wisdomofwellnessproject.com.