The year is 1953, and the air is ripe with change. Dwight Eisenhower is beginning the first of his two terms in the White House. Edmund Hillary is preparing to conquer Everest. James Watson and Francis Crick are unravelling the structure of DNA. And in Atlanta, with encouragement from Coca-Cola chairman and benefactor Robert Woodruff, Emory launches a new entity known as The Emory Clinic.

For the first time, faculty physicians in the School of Medicine form a partnership, with a business structure to support them in billing, collections, record-keeping and other office functions. Their goal is to generate clinical income that will cure the school’s annual deficits while helping it become a major national teaching facility.

Flash-forward half a century. From modest beginnings, the clinic has become the largest and most comprehensive group medical practice in Georgia. And the School of Medicine is nationally ranked.

With 671 Emory faculty physicians and 2,029 staff members, the clinic now hosts nearly 700,000 patient visits each year. Its physical complex has grown dramatically since the first clinic building opened in 1956; facilities now include Clinics A and B (located on Clifton Road across from Emory Hospital) along with the 1525 Building, which houses primary care and programs in preventive medicine and wellness.

Clinic physicians also practice in a number of health care centers throughout the metropolitan area including Crawford Long Hospital, Northlake, Perimeter, Smyrna, South DeKalb, Wesley Woods and Emory Medical Affiliates at Sugarloaf.

But through all its growth, the clinic’s essential quality has remained constant—its physicians still are working at the leading edge of medical practice to bring to their patients the latest and best drugs and procedures.

“What we really have to offer is the high quality of our physicians, who are known not only nationally but internationally for their skills,” said Rein Saral, an oncologist and bone marrow transplant specialist who has served as clinic director since 1993.

In fact, Saral’s appointment reflects one of the clinic’s principal strengths over its half-century of existence. The first full-time director, Elliott Scarborough, also was a cancer specialist whom Woodruff recruited to Atlanta from what is now Memorial Sloan-Kettering in New York.

“Over the past 50 years, untold millions of people have passed through the Emory Clinic to receive some of the very best health care in the country,” said Michael Johns, executive vice president for health affairs and director of the Woodruff Health Sciences Center. “Many dedicated and compassionate physicians and staff members have contributed to the efforts of the clinic. They are to be congratulated for what was created half a century ago, and for what they continue to accomplish for their patients today.”

Cancer treatment has been a clinic strong suit from the beginning, though Saral noted the clinic has many other distinguished centers and departments, attracting patients from Georgia and beyond. These include world-class specialists in surgery, heart disease, eye disease and disorders, infectious disease, organ transplant, neurology, orthopaedics, psychiatry, kidney disease and urology, among others. Emory’s Heart Center, long known for its pioneering research and innovative patient care, is the only U.S. News & World Report Top 10 cardiology department in the state.

“The Emory Clinic reflects the intellectual capital of the School of Medicine translated into patient care,” Saral said. “We have the doctors’ doctors here—the ones who train the physicians—and we continually advance new knowledge in medicine that is applicable to the day-to-day care of patients.”

Equally important to the success of the clinic has been its ability to navigate the nation’s changing health care system, said John Fox, president and CEO of Emory Healthcare, the University’s clinical arm that embraces both the clinic and Emory Hospitals.

“In an ever more complex health care arena, we are fortunate to have a superb operating team led by clinic COO Don Brunn and CFO Sarah Dekutowski,” Fox said. “It has become apparent that the future of academic medical centers such as ours depends on our ability to offer world-class specialty and subspecialty care while delivering an unsurpassed patient experience, working in partnership with payers and physicians in the community.

“That’s a tall order,” Fox continued. “It means you have to be on top of your game with both state-of-the-art medicine and business administration.”

Some of the clinic’s bigger challenges include the rising cost of malpractice insurance for physicians in Georgia, continuing cutbacks in Medicare reimbursement from the federal government, and ongoing negotiations with managed-care organizations and other private insurers.

“We are dealing with all these issues,” Saral said. “We have mechanisms in place to try to address all of them.”

As Saral looks to the next half-century, he sees an unchanging focus on delivering a better quality of care. That will mean integrating the new knowledge coming from basic science laboratories at Emory and elsewhere into day-to-day medical practice, and it also means an ever-growing emphasis on multidisciplinary care—harnessing the combined insights of different disciplines to attack complex diseases and disorders.

More diseases will be approached through better understanding of their genetic roots, Saral predicted, and not only will this enable new forms of treatment, it will allow many diseases to be diagnosed earlier when they can be more easily treated or even prevented.

Saral said major growth areas at Emory will include heart and vascular disease, the whole spectrum of cancer diagnosis and treatment, and the neurosciences, combining neurology, neurosurgery and psychiatry in new approaches to neurodegenerative diseases and other disorders of the mind.

“We will build on the theme of excellence in areas for which we have long been known,” Saral said.