On Tuesday, Sept. 13, health care professionals, residents, and community activists joined together to protest the unanticipated announcement of Atlanta Medical Center’s (AMC) upcoming closure. Convening at the intersection of Boulevard and East avenues right outside the hospital, AMC physicians and staff expressed their anguish to the protesters.
“It’s been a pillar of the community, you know, a landmark,” said Monica Johnson, an Atlanta-based community organizer who attended the protest. “It just doesn’t make sense for a supposedly nonprofit to shirk the responsibility of serving this community.”
At the end of August, Wellstar Health System confirmed its plans to cease operations at AMC beginning Nov. 1. The 120-year-old facility, which Wellstar has owned for the past six years, contains 460 hospital beds and serves nearly 50,000 low-income patients from over 74 different zip codes. It is also one of two Level 1 trauma centers in the city, a designation that requires a wide range of specialists, organized teaching and research, a program for substance abuse screening and intervention, and a minimum annual volume of patients. Due to AMC’s impending closure, most patients will be diverted to Grady Memorial Hospital; in a statement, Grady Health System officials expressed disappointment in Wellstar for closing its second hospital in the past six months and for not having a sound transition plan.
According to Wellstar, the closure comes as a result of decreasing revenue and inflated costs for maintaining staff and supplies. The company cites having invested over $350 million since 2016 and losing nearly $107 million in the past 12 months. And yet, in 2021, they had $5.7 billion in assets and announced construction plans to expand Kennestone Hospital in Marietta, Georgia.
“The point of medical care is to save lives, regardless of if there’s money after it,” said Johnson. “They pay their CEO $2.47 million, they have investments, they have various ways to access funding. The city and the state were blindsided by this—[AMC] did not ask for help.”
Community members have responded with petitions, protests, and social media backlash. Politicians have also criticized the sudden closure: Democratic gubernatorial candidate Stacey Abrams held a press conference in light of the announcement; Sen. Raphael Warnock wrote a letter to Wellstar President Candice Saunders urging her to rethink the decision; and Gov. Brian Kemp announced Sept. 15 that Grady Health System will receive a $130 million aid package to create 200 additional inpatient beds.
Unfortunately, the AMC closure is just one of many that have occurred in the U.S. in recent years. Since 2010, hospital closures have taken place in nearly all major cities, including Los Angeles, Phoenix, Houston, Chicago, New York, and Miami.
“It’s leading to this point where you just have to hope you’re in the right zip code, [that] you have the right job. And [for] a person born and raised in a lower-income community, the outcomes on health [and] longevity are just night and day,” said Johnson.
According to the Lown Institute Hospitals Index, AMC was ranked the second most inclusive hospital in Georgia and the 24th most racially inclusive in the nation. Compared to the rest of the state, AMC serves a community that is younger, more racially diverse, and more likely to have limited English proficiency.
Atlanta Democratic Socialists of America co-chair Kelsea Bond grew up in Atlanta and lives within a mile of AMC. Having watched a close friend spend weeks in AMC’s care, they know how essential the hospital is to members of the community, especially for the 1.4 million Georgians who are uninsured, most of whom are Black and Latinx.
“Given the fact that we’re in the middle of a pandemic, abortion rights were just overturned, and we have a governor that refuses to expand Medicaid, this is the most devastating timing for this to happen,” Bond said.
AMC’s closure will also have resounding effects on pregnant incarcerated individuals in the Georgia prison system, all of whom are sent to AMC to deliver their babies.
Amy Ard, the executive director of Motherhood Beyond Bars, has been working with her team to support pregnant incarcerated women following their labor. After birth, the mothers have 24 hours to spend with their newborns—a hard-fought win from the few hours they used to have—before a caregiver picks up the babies and the mothers are sent to the hospital basement to await their return to prison. AMC’s closure signifies a great loss for these patients and the relationships they forged with the hospital staff.
“They have been treated with compassion; they have been talked to like human beings. In unspeakably horrible circumstances, there have been some bright spots, and those bright spots have always been the Atlanta Medical Center staff,” said Ard.
AMC’s closure affects not only its patients, but also its staff. While Wellstar has helped transition some of the hospital’s 1,700 workers to alternate Wellstar or affiliate facilities, others encounter barriers to seamless relocation, such as longer travel times, increased gas costs, and inconvenient work hours.
AMC volunteer Caleb Jun feels empathetic toward his coworkers, who were already experiencing high levels of stress prior to the announcement. The hospital was severely understaffed, he said, with each nurse attending to six-to-seven patients on average per day.
“Atlanta mortality rates will rise with Wellstar closing—nobody is debating that,” said Jun. “Grady Health System workers will be further burnt out. There’s already high rates of suicide in health care, especially [among] doctors. Grady can’t handle more trauma patients than it already receives.”
AMC’s announcement follows a pattern of hospital closures nationwide, most of which disproportionately affect lower-income communities of color. Boston University professor Alan Sager has tracked hospital closures in nearly every major U.S. city for the past 12 years and calls this phenomenon the “survival of the fattest”—in which larger hospitals located in wealthy neighborhoods attract more patients and doctors, making it harder for hospitals with less prestige, typically serving lower-income patients, to compete.
In 2020, Hahnemann University Hospital in Philadelphia, a facility serving primarily Black patients, closed its doors, despite community pushback. Other closures such as Shelby Regional Medical Center in Texas and Westlake Hospital in Chicago reveal a divestment in the longstanding community and a prioritization of profitability. Rural hospitals have been especially susceptible to shut downs, with nearly 181 rural hospitals closing between 2005 and 2021.
“When a hospital closes, the people in charge are the ones who selfishly decide that the lifestyle they live is more important than the lives of people in their own community. A hospital shouldn’t have to fight to survive; it’s a necessary service [for] everyone to use,” Jun said.