In a strongly worded letter on Friday, Atlanta Mayor Andre Dickens called for “immediate answers” from Wellstar Health System officials to address the “crisis” caused by the planned shutdown of a Level 1 trauma center in the city — Wellstar’s second such closure this year.

Dickens said city leaders are scrambling to gather resources for patients and medical staff who would otherwise be stranded by the Nov. 1 closure of the Atlanta Medical Center main campus, located in Old Fourth Ward. Writing that he has “serious concerns” about the long-term impacts of the closure, Dickens called on Wellstar to detail plans to address possible gaps in patient care as well as help staff and medical students whose jobs and training are at stake. 

“We have cumulatively spent hundreds of hours engaging stakeholders — including members of the community and your own employees whose jobs are now in jeopardy — just to fully scope the potential aftershocks of your decision,” Dickens wrote in the letter, addressed to Wellstar President and CEO Candice Saunders. “Wellstar needs to provide immediate answers to the community about what you are doing to mitigate the harm to the community of this closure.”

Wellstar’s announcement last week came just months after the health system shut down its emergency room in East Point, leaving the majority-Black Tri-Cities region southwest of Atlanta without a hospital. Wellstar officials said the emergency services at the facility, formerly known as Atlanta Medical Center South, were being underutilized. Nearly 80% of the population meant to be served there instead chose to go to AMC’s main campus or to Grady Memorial Hospital. The East Point site is now operating as an urgent care facilty.

The dual punch of the closures has put communities in this underserved region of metro Atlanta on edge, as officials turned their attention to the hospital’s location and the people it serves. 

“Wellstar’s decision to close Atlanta Medical Center will most adversely impact low-income populations in the metro Atlanta community — just as your closure of Wellstar Atlanta Medical Center South did,” Dickens stated in his letter. 

Dwindling health care options

Many communities surrounding the medical center have among the “sickest patients in the city,” as one employee said. People in Atlanta’s Southside, where many of the hospital’s patients live, have an average life expectancy up to seven years shorter than the state average. With Atlanta Medical Center poised to close, officials worry that the gap could be exacerbated. 

The closures add to a trend of dwindling health care access in Black, rural, and other underserved communities in Georgia. In addition to the emergency room shutdown in East Point in May, Southwest Georgia Regional Medical Center closed in Cuthbert, a rural city in southwest Georgia, in 2020.

Read more: ‘This Doesn’t Make Sense’: Black Residents Southwest of the City Left Without an ER

“We know that when you don’t have a health care facility or provider nearby, one of the things that happens is that people delay or forgo treatment that they need,” said Rodney Lyn, the dean of Georgia State University’s School of Public Health. “That leads to more severe illnesses and chronic diseases that become unmanaged. And the result is greater complications and greater medical costs later on.”

Lyn added, “The planned closure of Atlanta Medical Center will disproportionately burden people of color, and people with limited access to health care, and that’s really concerning.” 

Wellstar employs nearly 1,700 people at Atlanta Medical Center’s main campus. In an email obtained by Capital B Atlanta, Saunders told employees that many AMC staffers would be able to get new jobs within Wellstar, which has the largest network of trauma centers in the state. But while AMC is centrally located in the city, many of the health system’s other locations are outside of Atlanta, including in Marietta and Roswell.

Saunders’ plan to relocate employees doesn’t ease the concerns of Elva Johnson, a certified surgical technician at Atlanta Medical Center. 

“It’s not just about finding out from a news article we’re closing. It’s about the community,” said Joseph. “It’s about the patients that we serve, the type of patients that we serve. We serve some of the sickest patients in the city.” 

The diversity of the staff at AMC will be a particular loss for the area, Joseph said, and the closure could deepen mistrust of the medical field among Black residents.

“I know when I was growing up, we were told, ‘Don’t go to the doctor or you’ll die,’” Joseph said. “We didn’t have people that look like us. Now we do — thank God things have changed. … And now that we’re in a place where we have people that actually care about us, it’s unfair to take that away.” 

‘They saved my life’

The hospital sits in Atlanta’s rapidly gentrifying Old Fourth Ward, the childhood home of the Rev. Martin Luther King Jr. In 2018, an economic equality study on Old Fourth Ward found that 21% of the Black people living in the neighborhood did not have health insurance, a rate four times higher than white residents. The study also found that 33% of the neighborhood’s Black residents were living in poverty, as opposed to 7% of white residents. 

Wellstar purchased Atlanta Medical Center, along with other facilities, from Tenet Healthcare in 2016. Saunders told Wellstar employees in her email that officials have “pursued every opportunity for an alternative path forward” to keep AMC open. Those attempts, she said, included nearly $350 million in investment, including $107 million in operating losses. 

Robb Pitts, chair of the Fulton County Board of Commissioners, said he was unsurprised by the closure since Wellstar officials previously told him AMC’s main campus faced financial struggles similar to those at the south campus. Pitts said he explored legal options to force the hospital to remain open, but found none. 

“They’re able to close that facility, and there’s nothing that we can do to prevent them from closing,” Pitts said. 

Pitts said he’s working on a short-term plan to divvy up 200 additional beds between Grady, Piedmont Atlanta, and Emory hospitals. Even if that plan goes into effect, much of the brunt of AMC’s emergency room services would fall on Grady, he said. 

Atlanta City Council President Doug Shipman said he also worries about losing Atlanta Medical Center’s residency program. 

“The loss of a training hospital in AMC means we will have less doctors trained in the urban center of Atlanta, which means that long term we probably have less doctors who are going to be working in our city,” he said. 

The diversity of the staff at Atlanta Medical Center was key for patient Gena Clements, who credits the doctors there for saving her life three years ago, when an abusive relationship nearly turned fatal. Clements had left her husband and moved in with her mother, but he showed up at the salon where she worked as a hairstylist full of anger.

When I tried to close the door [to the salon] … that’s when he pulled a gun out. And he started shooting,” she said. 

Clements says she was shot three times, once in her face, damaging her jaw. She remembers having only six teeth left after she was shot. Her husband was found dead hours later.

Clements was transported to Atlanta Medical Center, where she remembers being greeted by a Black doctor, who gave her reassurance that she wouldn’t die. 

“He touched my hand. He said, ‘God got you here. I’m gonna make sure you go home,’” she recalled. “I really believe they saved my life.”

When Clements thinks back to her time at Atlanta Medical Center, she worries that the loss will harm Black people more than anyone. 

“When you’re Black in a metro city, and if you don’t have people that are the same ethnicity to aid or speak for you, it’s gonna be really hard to get anything,” she said. “It’s sad. I just think we need the hospitals to stay open so people have a fighting chance to live.”

Kenya Hunter is Capital B Atlanta's health reporter. Twitter @KenyaTheHunter