Atlanta's Great Divide

        While there has been a large amount of media attention paid to the “Occupy” protests, coverage of the issues spawning these protests has taken a backburner to coverage of arrests and clashes with police. One of the more poignant stories receiving what seems to be a passing mention was reported in the Atlanta Journal Constitution, describing recent census that data have shown the city of Atlanta to have the greatest income inequality rate in the nation. This fact is not lost on any healthcare professional that either is training or practicing in the Metro Atlanta area. The amount of indigent care provided in the metro Atlanta area at all hospitals is on a steady incline, and in 2010, Grady Memorial Hospital provided 33% of it’s adjusted gross revenue in indigent care, more than twice that of any other hospital in the Metro area (Georgia Watch's Hospital Accountability Project).  At the same time, calls for cuts in funding to both Medicaid, the state-run program designed to serve as a safety net for the neediest, and cuts to Grady’s budget from both the indigent care trust fund and Fulton and Dekalb counties’ coffers, mean access to care for those at the bottom will become increasing harder.
     While outrage over this income disparity is apparent in the “Occupy” protests, very little meaningful media attention has been paid on productive ways to address the problems these gaps create, let alone the true scope of problems in health, housing and education. This lack of focus in also exists in our healthcare system and our health education system, where often only lip service is paid in addressing issues of health disparities. We are not taught what to do when the “standard of care” is unobtainable by our patients due to their economic means, nor even what Medicaid and Medicare provide, who funds them, and who qualifies. Even more lacking is an academic focus on resolving the issues of health disparity in clinical medicine, how to bridge the areas of public health, clinical medicine, and health administration, and a funding mechanism for that research.
   While I, myself, will not be erecting a tent in Woodruff park to protest my city having the largest income gap in the nation, neither do I think simply showing up at Grady to provide care is enough of an effort to address this injustice. The demands of medical education and medical practice are immense, and often overwhelming.  We must remember, though, that we are so often overwhelmed in medicine by the breakdown of an often underfunded, overburdened system, which we are the only ones who have the insight to truly fix. If there is one thing, as the future clinicians and healthcare professionals of Atlanta and of Georgia, that we must “Occupy”, it is the dialogue of how we reform and shape our healthcare system.

Clint Kalan, PA-S