Are doctors getting out of town?
Sobia Akmal, wife of and officer manager for Dr. Mateen Akmal of Ellijay, said she has had to call an ambulance to their clinic three times in less than a week and a half.
“We’ve been treated like an emergency room,” she said last week. “We have people walking in with open knees (requiring) stitching, and people are coming in weak and fragile and passing out in the waiting room, and we have to call 911.”
With the emergency room and North Georgia Medical Center completely shutting down in just over three months’ time, local physicians say they’ve been able to tell the difference by the seriousness of visits to their clinics. Others say doctors themselves are leaving the area, and Gilmer County is facing a health care crisis.
“Numbers wise, it isn’t all that bad – yet,” said longtime Ellijay Dr. Robert Bond of Blue Ridge Mountain Internal Medicine. “But the things that they’re coming in with are a little more serious. There’s been a slight uptick in people coming with things that are a little worse. They think they’ve broken something, cuts, (having) chest pains.”
Bond was asked how a clinic not set up for emergency care handles those visits.
“I’m glad we have a wonderful ambulance service,” he said. “If it’s chest pain, we’re adding in an extra ride – 20 minutes versus 5 minutes (to Piedmont Mountainside Hospital rather than North Georgia Medical) – so that’s a big amount of time.
‘Call the ambulance and get them going’
“If it’s anything possibly cardiac- or stroke-related, time is just so essential you have to call the ambulance and get them going. I think I’ve called the ambulance a lot more times than I have in many years.”
Dr. Thomas Ross, who recently had a clinic in the Medical Offices of North Georgia building on Industrial Boulevard, said not only have other doctors left town but patients are leaving also.
“I think health care is leaving the county,” he said. “The patients are ‘wigging out.’ They’re calling anybody they can get to answer a phone. They’re wanting to know where I’m going, and I’m getting calls from other doctors too, (asking) ‘Do you know where Dr. Pitman’s going?’ The county has been left with nobody to take care of the primary care stuff. The hospital closed ... (and) the surgeons will go away.”
Ross said at one time he had trouble finding a parking space at the medical office building, since he often had to leave to go to North Georgia Medical.
“Now there’s nothing but parking,” he said. “The physician encounters are gone, therefore the patient encounters are not occurring.”
Earl Whiteley, who is still chief executive officer at the Ellijay hospital since administrative offices are still open, was asked about the medical office building and its doctor tenants.
“At one time there were seven doctors over there, but that was two years ago,” he said. “We don’t know if Dr. (Nadine) Thomas (a pediatrician) has made a decision whether to stay or go, we don’t know what Dr. (Erich) Pearson is going to do yet. And we really don’t know what Dr. (Shannon) Pitman is going to do, although I think he’ll make a decision pretty quickly.
“There was a lease (that went into effect) July 1 in which (Piedmont Mountainside) leased the building in that regard and they are in the process of trying to negotiate with doctors to stay in the building. The only thing I’ve heard personally is that Dr. (Thomas) Ngyuen has decided to lease space and stay in the building.”
A call to the office of Pitman and Pearson went to a voice mail that said the clinic was closed and that patients could access their medical records at North Georgia Medical (see accompanying article on page 8A).
Nursing home patients affected
Ashley Pierce, office manager for Dr. Bill Raisig Sr., said their office has had “multiple phone calls” regarding things like suspected broken bones and other injuries normally seen at a hospital emergency room.
“We’ve realized that with the hospital being closed, it makes it hectiwc for us even though we want to see as many patients as possible,” she said. “Dr. Raisig doesn’t want to leave anybody out if they need to be seen, but it’s been phone calls that we take most of the day from patients we normally don’t see.”
Pierce noted nursing home patients “are not getting direct care because of the hospital being closed.”
“They’re having to be transported (elsewhere),” she said. “We have recently gained seven to eight new patients in the nursing home so they can get some primary care, (get) a physician in there to see them.”
Mateen Akmal said the county has “lost a lot of providers” of medical care.
“At one time I thought we were oversaturated with providers, which would include physicians, nurse practitioners and physician assistants,” he said. “But I guess most of them were employed physicians (by North Georgia Medical), so when these entities closed down we lost a lot.
“As far as impact goes, I don’t think we’ve noticed because a lot of people are still on summer vacation. Things aren’t in full swing yet.”
Akmal said before the hospital closed patients could go and get outpatient tests and procedures there.
“It was very convenient, because if we felt like the patient might be having an emergency or something that needed to be done right away, we’d just send them to the local hospital and know within that day what to do with that patient,” he explained. “The other day a patient just showed up in our lobby begging for help ... they may have normally gone to the emergency room just to get the care that they really need.”
Ross was asked if he had heard of patients overwhelming local doctors’ offices since the Ellijay hospital and its emergency room shut down.
Hospital situation ‘a long time coming’
“I can’t confirm or deny that,” he replied. “A lot of the people had already left the county to go elsewhere, and it was kind of trickling down, and I can’t say that my business went down. The point I’m making is that there’s not a lot of health care going on in the confines of Gilmer County right now.
“Within the last year a lot of people had left in anticipation of this. Now, that’s anecdotal. It’s not a fact that I can quote you a statistic on, but I just know at that (medical office building) there was a lot of patient encounters going on ... That was where most of the medical activity was, because at any given time you had a couple of specialty clinic physicians like myself there, you had 4-5 physicians whose offices were out of there (and) 4-5 nurse practitioners. So that was the hub of medical activity. And now we don’t have inpatient activity, so the only thing is outpatient – and it’s dead.”
Bond was asked if he would refer patients with chest pains to Fannin Regional Hospital above Blue Ridge or Piedmont Mountainside below Jasper.
“It’s still not that easy to get from Fannin to larger facilities,” he said. “From Fannin to Erlanger (Medical Center in Chattanooga) is a helicopter ride, whereas from Jasper you’re already heading in the direction of the nearest facility (below Piedmont), plus they have a hospital further in (to Atlanta) they have communication with.”
Bond said the situation with North Georgia Medical has been “a long time coming.”
“The avenues of preparation I’ve been doing for 10 years is about what I told (hospital administrators), that they were heading in the wrong direction,” he said. “So I’ve been anticipating this for some time, and have been setting up networks so things can be taken care of as expeditiously as possible.
“It’s really the people out there (in the community) who need to be prepared to look ahead. You shouldn’t, for instance, wait until rush hour hits in Atlanta before you decide to call the ambulance for your chest pain. Because I’m sure it’s going to take you a lot more than 20 minutes to get to a hospital anywhere in Atlanta during rush hour.”
Bond noted Dawson County has “somehow functioned for years without a hospital.”
“So there must be ways of getting these things done here,” he said.