Grady is able to provide the vast quantity of excellent care it does because of the hospital's longstanding relationships with Emory University School of Medicine and Morehouse School of Medicine, providers of nearly all physician care at Grady. Emory and Morehouse physicians working at Grady, many of them nationally known, have nearly 545,000 outpatient visits each year and more than 164,000 inpatient days each year, including some of the most complex cases seen anywhere in Georgia.
"Grady doctor" means Emory or Morehouse doctor. All doctors at Grady are faculty or residents from Emory University School of Medicine and Morehouse School of Medicine. Almost 700 Emory medical school faculty, almost one-third of all faculty members at Emory, spend all or part of their time at Grady. This represents the full time equivalent of approximately 294 Emory physicians. In addition, 366 Emory residents and fellows – young physicians continuing their training in medical specialties – also provide patient care at Grady, under the supervision of the faculty. Together, these Emory physicians provide close to 85 percent of all physician patient care delivered at Grady.
As Grady faces mounting financial pressures in today's healthcare environment, the medical schools continue to be the hospitals' best bargain. Looking at the 2010 budget (the last year for which full figures are available), Grady's total budget was $675 million and Grady's payment to Emory University School of Medicine was $66 million. Because state and federal agencies directly reimbursed Grady for $40.8 million of that $66 million, the unreimbursed cost to Grady for all Emory physicians and services is approximately 3.7 percent of the hospital's entire budget. In addition to direct reimbursement from State and Federal Government for services provided by the Medical Schools, Grady also received approximately $120M in funding from Fulton and DeKalb counties and Federal Disproportionate Share Funding (DSH) for hospitals providing a disproportionate share of Medicaid services.
Graduate medical education by Emory and Morehouse continues to be a major asset for Grady – and the biggest bargain of all. The 365 medical residents provided to Grady by Emory (and additional residents provided by Morehouse) are indispensable for the outstanding care of the patients seen at Grady. These physicians' salaries and fringe benefits cost Grady nothing: they are reimbursed directly to Grady by federal and state programs. Without the medical schools, this reimbursement would simply vanish, along with more than 400 of these young physicians and the revenues Grady receives from hospital services derived from the care they provide to patients.
Emory (and Morehouse) provide more services to Grady than those funded by the Grady budget. The balance of Emory’s cost is funded from professional billings generated from patient care provided to Grady patients (billed and collected through the Emory Medical Care Foundation) as well as funding from the School of Medicine and its Departments.
The total cost of the Emory footprint at Grady in 2010 was $109.2M.
The Grady budget accounted for $66M of the total $109.2M total cost of Emory’s presence at Grady. The $43.2M balance was paid for from funds derived from current patient care activities ($31.2M); EMCF reserves ($7M) and contributions from the Medical School and its Departments ($5M). In addition, our faculty provided $22.3 million in uncompensated patient care, $8 million in research funding (direct and indirect costs) for clinical research in support of improved patient care, and were instrumental in assisting Grady in securing $70.4 million in state and federal grants for patient care.
Since its founding, Grady Memorial Hospital has been a vital part of Emory University School of Medicine's commitment to Atlanta and Georgia. Physicians in the Atlanta Medical College, the precursor of Emory's medical school, were the earliest physicians providing care at Grady when it was founded in 1892, and this connection – and commitment – has continued unabated unto the present. Emory and Morehouse School of Medicine assist the Grady Memorial Hospital Corporation Board of Directors, the Fulton-DeKalb Hospital Authority Board of Trustees and the Grady Health System (GHS) in providing outstanding health care to residents from Fulton and DeKalb counties and, increasingly, throughout Georgia. For the medical schools, Grady also serves as an excellent resource for training the next generation of physicians and improving the health of all Georgians. One of every four physicians in Georgia first began practicing medicine as a resident at Grady. (The medical schools pay all expenses related to the medical students trained at Grady).
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A brief history of the Emory Grady relationship: a shared commitment since the beginning.
Emory and Grady were joined from the beginning. In fact, Emory's shared history with Grady Memorial Hospital actually predates the founding of Emory University School of Medicine. The doctors in the Atlanta Medical College, the city's most established private medical school since 1854, had cared for patients at Grady ever since the hospital opened in downtown Atlanta in 1892. When Emory University moved from Oxford to Atlanta in 1915, the Atlanta Medical College asked if it could join the Emory University to become the Emory University School of Medicine. The Emory School of Medicine and its faculty members would go on to establish many other healthcare components such as The Emory Clinic and the hospitals Emory owns, but they never abandoned their commitment to Grady and its patients.
In the 1930s this arrangement was made more formal, with the understanding that the medical school would train doctors at Grady and, of course, that those young doctors would help with the growing number of patients seen there. Today, as then, the patient care at Grady would not be possible without those young physicians.
The agreement between the two institutions was made even more formal in 1951, with the first contract between Emory and Grady, and thirty-three years later, in 1984, with the current contract. This has been a tremendously successful arrangement for all parties, including Atlanta and Georgia. It has allowed Emory to provide excellent medical care to literally millions of patients over the years and excellent medical training to many thousands of young physicians. Approximately one of every four physicians now practicing in Georgia spent time in Grady through the Emory and Morehouse programs.
For years Emory had the entire responsibility for care at Grady. In 1975 Morehouse School of Medicine was founded to train family-care physicians to practice in medically underserved inner city and rural areas with large populations of minorities and the poor.
As Morehouse got started, Emory was there to help. In the school's early years, Morehouse students moved to Emory and other schools for their clinical years. And like the Emory students, they too all rotated through Grady. In 1985 Morehouse began granting its own M.D. degrees, and the 1984 contract reflects Emory's voluntary sharing of work at Grady with this newer medical school.
Over the years Emory expanded its efforts from simply making certain the city's poorest or most severely injured patients received health care services. It created and maintains several esteemed centers of excellence. Thanks to these centers of excellence headed by Emory physicians with growing involvement by Morehouse physicians, Grady Health System has one of the nation's leading trauma centers, a nationally known burn center, centers for HIV and AIDS, poison control, sickle cell, community mental health, tuberculosis, pediatric asthma, perinatal care, a neonatal ICU, Angel II neonatal transport, hazardous materials detoxification, teen pregnancy and the new Marcus Neuroscience Center, dedicated to treatment of brain injury and stroke.