I received an email today from an Emory University doctor expressing support for my Senate Resolution 748 concerning Grady’s employee health benefits plan. He writes:

I have been based at Grady for 11 years as a trauma surgeon. About 8 years ago, a close friend of mine and who was a full-time Grady paramedic (and had health insurance through Grady), was involved in a serious motor vehicle crash and was admitted to the trauma service at North Fulton Hospital (closest trauma center to the site of his crash). When I explored the possibility of having him transferred to Grady, I was shocked to learn that Grady didn’t take his insurance — despite the fact that he was insured through Grady. How absurd! I believe this has since changed… but there is good reason to encourage Grady employees to seek care there.

My resolution points out that Grady’s financial problems stem in large part from a patient mix that is devoid of insured or paying patients and urges Grady to encourage its own employees to use the hospital. Obviously, we need to first make sure that Grady accepts its own insurance. But lower co-pays or deductibles to encourage employee utilization is the logical and next step.

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I was surprised learn about the sudden departure of Otis Story as CEO of the Grady Health System.  I have found him to be open, responsive and seemingly an agent for reform.  In fact, he and I have been working closely on a funding and competitiveness initiative that was to be formally proposed next week.  We were scheduled to meet tomorrow to flesh out some of the remaining details.

Perhaps there was a good reason for this decision, but I frankly doubt it.  Whatever the long term plan for the hospital, now is not a good time to be switching CEOs.

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Grady Health System spends $18 million annually in health care benefits for its 5,000 employees. But unlike virtually every other large hospital employer, Grady makes no effort to encourage its employees to utilize Grady for their primary health care needs.

With bipartisan support, I today introduced Senate Resolution 748 which calls on Grady to consider changes to its health care benefits plan to encourage utilization of its services by its own employees, among other measures to improve the patient mix.

This is the third piece of Grady related legislation that I have introduced in this session.  The Senate Government Oversight Committe which will begin holding Grady hearings on Thursday.  I am hopeful that we will be able to move these bills to the floor next week.

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I today introduced two pieces of legislation addressing problems at Grady Memorial Hospital.

Senate Resolution 722 creates a Grady Oversight Committee. First proposed in 1999 by then Senator David Scott, legislative oversight has been persistently opposed by those who run Grady. Of course, their resistance to legislative oversight has not stopped them from crying the same old lament of legislative neglect whenever the coffers run dry.

The language of the resolution is drawn from legislation creating MARTOC, the highly successful legislative overview committee for MARTA. It will allow the General Assembly to continuously monitor Grady and help make sure that public funds are properly spent.

Senate Bill 353, the Public Hospital Integrity Act, prevents those with a financial tie to either Grady or a major vendor of Grady from serving in a governing capacity for the hospital. This bill will help make sure that Grady’s board gives its loyalty to Grady as an institution and not to those who do business with Grady. Senator David Adelman, Vicent Fort and Kasim Reed are among the Democrats who cosponsored the bill.

As important as they are, governance reform and legislative oversight are just the beginning. I will shortly be unveiling additional proposals for Grady concerning funding, staffing and competitiveness issues. I will keep you posted.

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Georgia State University and the Georgia Institute of Technology are cosponsoring a seminar on stem research tomorrow, Thursday, January 10, at Georgia State’s Student Center in downtown Atlanta. I will be making a presentation at 2:00 p.m. on alternatives to embryo destructive research.  The seminar is open to the public.

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I spent yesterday morning visiting with Dr. Matthew Schure, President of the Philadephia College of Osteopathic Medicine, at the school’s 2 year old campus in Gwinnett County.  Although new to Georgia, the 108 year old medical school is older than Emory, Mercer or Morehouse.

Georgia ranks 40th in the number of doctors per capita, and particularly in rural areas, is confronted with serious doctor shortages.  PMOC is playing an important role in facing this challenge.  Its new campus in Suwanee, by design, draws over half of its students from Georgia and almost 90% from the southeast.  It will graduate its first class in 2009.

However, most doctors settle not where they graduate medical school but where they complete their post-graduate residency programs.  That means that we must expand residency training opportunities in Georgia.

One of the major challenges is that federal regulations discourage the expansion of existing residency programs.  Therefore, hospitals which wish to begin residency programs must start with a as large of a program as they can envision (the so-called “big bang”).  They must be willing to accept two or three years of large, unreimbursed expenses before the federal funds that pay for most residency programs begin to flow.

I have developed some ideas of my own on how to deal with this problem.  You will hear more from me as I work through the details. 

After the meeting, I joined President Schure and his top administrative staff in serving a Holiday dinner to the faculty and students of the College.

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I have refrained from commenting on Emory’s now defunct abortion clinic at Grady other than to say that I supported Grady’s decision to shut it down.  Given its financial difficulties, Grady should be focused on treating injury, illness and disease, not elective procedures of any sort.

Several members of the House have been attempting to get answers from Grady and Emory about how the clinic was funded and operated.  They hit a stonewall earlier this week with the startling and wholly inaccurate declaration by Emory that it is not subject to state laws concerning the handling of public documents.

The House members have now called for audits, investigations and hearings.  Emory has responded by suggesting that these House members are interfering with the urgent effort to save Grady.  That is nonsense.  The problem is not with the questions, but with the refusal to answer them. 

Pro-life or pro-choice, surely we can all agree that questions about the funding of Grady deserve honest answers.  Evading those questions undermines confidence in the management of this public institution.  Unlawfully withholding documents raises even more unsettling questions.

Public funds come with accountability and no one is above the law.  These are two basic lessons that Grady and Emory must learn, and learn fast, if there is to be any hope of saving this hospital. 

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Last week I was interviewed by Steve Goss of WABE 90.1 FM about the problems at Grady Hospital.  The interview was broadcast this morning. 

The station is airing a number of interviews this week as part of its “Saving Grady” series.  Interviews with Lieutenant Governor Casey Cagle, the deans of the Emory and Morehouse medical schools and others are all available at the station’s website. 

Also, WABE’s Odette Yousef did a good job presenting the pros and cons of the proposed governance change in this segment. 

For trivia buffs, the letters ABE stand for Atlanta Board of Education.  The station is owned by Atlanta Public Schools and is a local affiliate of National Public Radio.

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It has been almost a month since Judge Wendy Shoob unsealed court records related to the case of Grady whistleblower Dr. James Murtagh.  But our review of the thousands of pages of documents has only just begun.  First, it took the Clerk almost two weeks to locate the court records and make them available.  Second, many of the records are not in the courthouse but the hands of a court-appointed arbirtrator.  Third, the confidentiality provisions of the settlement agreement, which remain in force even though the other records have been unsealed, have discouraged the parties from talking with us.

Here is what we know.  In 1999, Dr. Murtagh, a once promising young researcher, Grady doctor and tenured Emory faculty member began cooperating with fraud investigators from the National Institute of Health.  They were apparently looking into the use of federal grant money by Emory at Grady.  Once his superiors learned of his contact with the NIH, Dr. Murtagh almost immediately found himself accused of violating Grady’s do-not-resuscitate policies.  He was subjected to one or more “peer reviews” in which he was found guilty of the DNR violations and then told to undergo a psychiatric examination if he wanted to keep his job.  He was given the option of either quietly resigning or being exposed as a crazed DNR violator.  Instead, Dr. Murtagh sued, contending among other things that the peer review was conducted in bad faith with the retaliatory objective of either halting his cooperation with the NIH or discrediting him.

In 2001, after a federal judge rejected Emory’s and Grady’s motions for summary judgment and ruled that Dr. Murtagh was a protected whistleblower, Emory and Grady opened up settlement negotiations.  They agreed to pay the “crazed DNR violator” $1.6 million, give him positive job references, assign him ownership of three patents and subject their “peer review” policies to an outside review.  In return, Dr. Murtagh agreed to resign his faculty post and stay quiet.  

Dr. Murtagh did not stay quiet.  In the recently unsealed case, Dr. Murtagh trades allegations with Emory and Grady over compliance with the settlement agreement.  Although many of the facts are in dispute, it is clear from my reading of the court records that Dr. Murtagh anonymously emailed the new President of Emory University in 2004 and offered confidential information about alleged wrongdoing at Grady and Emory. The new President wrote back, thanked him for his offer and invited him to send the information.  After receiving the information, the President turned it over to Emory’s lawyers, who traced it back to Dr. Murtagh and accused him of violating the confidentiality provisions of the settlement agreement.  For this and similar “violations,” Dr. Murtagh was found in contempt in late 2005 by Judge Gail Tusan, who later was replaced on the case by Judge Shoob.

It does not appear that Judge Shoob ever ruled on the merits of many, if any, of Dr. Murtagh’s allegations. They were all thrown out earlier this month because Dr. Murtagh was found in contempt again, this time for emailing a newspaper article that made reference to Emory.  In addition to having his claims thrown out, Dr. Murtagh was fined $15,000, ordered to pay Emory’s (but not Grady’s) attorney fees and threatened with jail if he spoke out again.  Emory has submitted motions demanding $1.7 million in attorney fees from Dr. Murtagh.

Sealed settlements and confidentiality agreements are common in litigation involving private businesses and individuals.  They are less common when government entities or public institutions are involved.  In fact, it is my view that they violate public policy on their face.  For this very reason, the Attorney General will not enter into a sealed settlement on behalf of the state or any state agency. 

Former Grady trustee Bill Loughrey tells me that the settlement with Dr. Murtagh was never approved or even accurately described to Grady’s board of trustees.  He says that he was stunned to learn that tax dollars were paid to Dr. Murtagh, conditioned on his silence.  He thinks the agreement is invalid and that the judicial process has been misused. 

I am reserving judgment on the underlying issues of this whistleblower case until our review of the documents is complete.  But one thing is already clear in my mind.  I am convinced tht Grady’s problems stem in part from a culture of secrecy that conceals problems instead of solving them.  It is an issue that must be addressed head on if Grady is to be saved.

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Last Thursday night I attended a fundraising dinner for the Gwinnett Pregnancy Resource Center, a Southern Baptist ministry that helps women who have unexpectedly become pregnant.  My friend Kathy Schraeder serves on the board of the ministry.

The featured speaker, Gianna Jessen, was described in the program as an “abortion survivor,” and I assumed we would be hearing from a woman who had an abortion that she now regretted.  But I assumed wrongly.  Our speaker was a former unborn baby who had survived her own abortion.

Thirty years ago, her mother underwent a “saline abortion,” a procedure in which a toxic saline solution is injected into the womb, causing the baby to die over a 24 hour period and then be stillborn.  But in her case, eighteen hours into the procedure, she came roaring out of the womb, scalded by the saline, but very much alive.

In 1977, it was legal for the abortion doctor to suffocate a newborn baby who survived an abortion.  Fortunately for Gianna, he was away from the clinic, not expecting her arrival for another six hours.  The panicked nurse called an ambulance and she was taken to the hospital. 

Two pounds in weight and badly burned by the saline, she was given almost no chance of surviving.  But survive she did.  She made it out of the hospital and into the loving arms of a foster family. 

At eighteen months, she was given another obstacle.  She was diagnosed with cerebral palsy, a result of her prenatal brain being deprived of oxygen during the abortion.  Her doctors said she would likely never be able to hold up her head, sit up, crawl or walk.

But I watched her walk, with a slight limp, to the front of a hotel ballroom Thursday night.   She sang three beautiful songs and told us a mesmerizing story of love, hope, perseverance and forgiveness. 

Her foster mother, Penny, taught her to walk at age 3.  Penny’s daughter adopted her, and Penny, her “queen,” became her grandmother.  She has traveled the world, done indoor rock climbing and “run” marathons. 

She is thankful that she has only had three surgeries for her cerebral palsy.  Most suffering from cerebral palsy have had more. 

In 2002, she met President Bush when he signed the Born-Alive Infant Protect Act, which extended legal protection to infants born alive after a failed abortion.

Her speech, obviously, was intended to make a point about abortion.  Believe me, it did.  Loud and clear.  But her speech was not about abortion.  It was about overcoming obstacles, persevering against adversity and finding the blessing in everything — good and bad — that comes our way.

I think about the setbacks, rejections and defeats that have frustrated, discouraged and at times demoralized me.  Even the most painful losses — my Dad dying twelve years ago — pale in comparison to what Gianna Jessen has been asked to bear.

Gianna was hurt badly by a poor decision.  She lives with it every day, not just the emotional hurt but the physical.  But live with it she does. There is a lesson in her story for all of us.

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