Wednesday, November 15, 2000

On Nov. 1, a letter to clinic patients as well as a newspaper article announced the closure of Emory's Fayetteville clinic. In both the letter and newspaper article, the Emory Clinic said that their decision to close the Fayetteville health center came because of changes in their strategic plan. In the letter to patients, Emory stated, "We feel it (the closure of the clinic) is required for Emory Primary Care to remain viable in today's health care environment."

That is the business side of the story. Now I would like to share with you the human side of the story.

As one of eight health care providers at The Emory Clinic (this includes physicians, nurse practitioners and nurse midwives), I feel that it is important for all of my patients to know that the providers had no voice in the decision to close the clinic.

In fact, both the clinic administrator and medical director were informed of the clinics' closing at the same meeting in which the providers were informed. In all the meetings before that, Emory administration indicated to our clinic that we were operating within our budget, and that our patient volume was the highest within the Emory Primary Care system.

The Fayetteville clinic even underwent a complete internal reorganization in 1999. During this reorganization, all the employees took an active role. Throughout this period employees sat on various committees which met during lunchtime. During these meetings various aspects of patient services were discussed and redesigned. These changes included reducing hold time a patient may experience while placing a call to the clinic to expediting prescription refills. This was all accomplished on the employees' personal time.

In fact, the reorganization was so successful that the Fayetteville clinic was used as a pilot and example for other clinics within the system.

The Emory Clinic has offered positions to clinic employees within the current system. However, most positions are at the north end of Atlanta. In addition, some providers who currently live in Peachtree City will be commuting as far as Lawrenceville. Many of our top nurses have moved on to other clinics because of the long commute or for other personal reasons. Several providers however, have chosen to go to other group practices within the community.

So, why don't the current Emory providers open private practice here in Fayette County? And, why should patients be forced to commute into Atlanta or further to continue seeing their provider? The answer is simple: Payment.

In order for a provider to receive payment by the insurance company, the provider must first pass a rigorous credential review. In most instances, if a private or small group of providers requests to be named on an insurance plan, the credential and payment approval could take up to a year.

In other words, if a provider is not affiliated with a large health care corporation, credentialling by the insurance carrier is very difficult to acquire. Just another case of the insurance companies dictating what patients can and can not do, or in this case where they can and can not go for health care.

Needless to say, the closing of the clinic has been an emotional roller coaster ride for all involved, including patients. Personally, I am very sad that such a great team of medical staff has had to part company. I have always regarded the staff at the Emory Clinic in Fayetteville as some of the nicest, hardest working and professional people that I ever worked with.

I know first hand, that at this clinic, the patient truly does come first. Many providers and nursing staff could show letters written by patients and their families expressing thanks and appreciation. In fact, one of my favorite letters, which came from an 8-year-old patient, hangs on my office wall as a reminder of why I am a family nurse practitioner.

Finally to all my patients, I would like to say thank you for all your support and for trusting me with your most valuable possession, your health. Unfortunately, my name as well as my colleague's name was not included in the letter sent out to clinic patients. For this, I apologize for the oversight by the Emory Clinic administration. I hope to join another practice somewhere in this area in the coming New Year.

Perhaps I have shed some light on this unfortunate situation.

Jane Peterson, MS, RNC, FNP

Family Nurse Practitioner

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