By Paul Kaplan / Staff

The Grady Health System has been trying for decades to turn its hospital into a profitable venture.

They tried CEO’s of all sizes, shapes and colors, they tried lobbying, they tried cutting services, they tried public relations, they tried suburban outreach, they even tried a health clinic at the airport.

None of it worked.

Grady Memorial Hospital just keeps bleeding cash – and a lot of it.

PAY AS YOU DON’T GO

Through it all, taxpayers in North Fulton dutifully wrote their annual property tax checks, knowing they were unlikely to get anything concrete in return from the significant portion that goes to Grady. Many have never been to Grady, and wouldn’t know how to get there if they needed to.

The tradeoff is that Grady provides services that come with being in a big city – a trauma network, a burn unit, a medical lifeline to the poor, the illegal and the unwanted.

Through much of its struggle, Grady has maintained a quiet little outpost in North Fulton that has served a significant purpose. The health clinic sits inside a non-descript one-story building on Alpharetta Street in Roswell. You could drive by the dour building and its quiet little sign a hundred times and never notice it was there.

But a lot of needy North Fulton residents know exactly where it is.

GIVE ME YOUR POOR, YOUR DOWNTRODEN…

Grady’s clinic serves mostly the working poor and their children, dispensing low-cost medical care and prescription drugs to a non-stop stream of people who might not otherwise be able to afford it.

But now Grady has a new plan, and soon the clinic will be closing.

The new idea is to create medical “super centers” in four quadrants of the county, including one in North Fulton. It will be a joint effort that combines Grady medical services and the Fulton County Health Department into one large facility.

The super center on the Northside will be at the Fulton County Annex on Roswell Road in Sandy Springs, an aging compound that will undergo a $1.5 million renovation over the next several months.

The idea is to save money on one hand and generate more of it on the other.

A joint arrangement at the Annex could save millions because both parties will move into an existing facility rather than building new ones to replace the overburdened Grady clinic in Roswell and the run-down Health Department outlet in Sandy Springs.

“It will allow them to be in one place and let them refer people back and forth,” said Ralph Daniels, the chief of staff for Fulton County Commissioner Tom Lowe, who was instrumental in moving the project along. “It will let us play off one another.”

GRADY: BRING IT ON!

For Grady, there is potential for a far bigger prize – exposing all of those paying customers on the Northside, and in the other quadrants, to Grady‘s specialty services.

“Long-term, Grady has to be in the business of competing for customers who have a choice,” said Matt Gove, Grady‘s senior vice president for strategic planning. “We‘ll always be committed to our historic mission of serving indigent patients and those who need us, but Grady’s long-term survival hinges on service to people who have the resources to pay for their care.”

The Northside already has successful hospitals that cater to the well-heeled in North Fulton and in surrounding areas like East Cobb and South Forsyth. Does Grady actually plan to come in here and compete for those customers?

“In a nutshell,“ Gove said, “yes.“

Grady provides primary health care to more than 200,000 patients a year, and in many of those cases it receives little or no compensation. But, Gove said, Grady also has skilled practitioners in high-dollar specialty areas like neurology, trauma, stroke, burn and orthopedics.

“We have incredible expertise in these areas, and if we help educate people in the community to the level of care that we’re providing here, more patients who choose to go to other hospitals might choose to come to Grady,” Gove said.

“There are things we do better than anyone else in the city, and most people just don’t know it.”

When the Grady super center opens in Sandy Springs – the target is June – the competition for North Fulton’s coveted health care dollars will intensify.

But it won’t be easy for Grady to change the habits of the well-to-do.

Many of them know Grady only as a downtown Atlanta hospital where poor people go, and guess who pays for it.

Insured Northsiders have their choice of doctors and hospitals, and they may not be drawn to the Fulton County Annex for health care. For decades it has been a place to wait in line to pay taxes and renew car tags. It will take a serious sales job to get Northsiders to re-imagine the Annex as a quality health care facility.

But the insured also tend to be educated consumers, and if Grady’s level of care is as good as they say it is, the word will spread. That’s when the battle will really be joined.

The working poor have no dog in that fight. All they’ll know is that their little clinic in Roswell is closing, and the larger Old Post Office site in Roswell, which Grady bought from the city to upgrade and enlarge the clinic, will sit unused.

For Grady, and for the taxpayers who fund it, the new strategy becomes a winner if it transforms Grady into a profitable health care operation. That won’t be easy, at least on the Northside. It will happen only if those who conceived this new model can succeed where those who preceded them failed, time and time again.

Email Paul Kaplan at paulhkaplan@yahoo.com.