It’s not exactly a smoking gun, but the latest revelation in the Grady hospital saga — that Emory may be taking advantage of its influence with the struggling trauma center — raises questions the University must answer soon.

State Senator David Shafer (R-Duluth) went on the attack in a recent blog post (www.davidshafer.org), implying that Emory doctors improperly bill Grady for their services. Similar allegations have already been made, but Shafer outlines the most compelling critique of Emory yet.

Shafer, who based his blog post on a two and a half year old audit of Emory’s record keeping he acquired through an open records request, writes: “[I]n a practice that is denounced by the auditors, its faculty physicians record their time at Grady a mere four weeks each year (one week per quarter) and then make a guess at how much time they spend at Grady for the remaining 48 weeks of the year, using the four weeks of recorded time as a guide. Emory then bills Grady for the full 52 weeks of work. Doing the math, that means there is no documentation for 92 percent of Emory’s bills for supervisory and administrative services.”

Shafer then asks two questions central to the debate: Is this standard practice and can this method of billing be accurate? The answer to both questions, he determines, is no. He notes that Morehouse physicians must provide more documentation than Emory doctors, and that Emory has refused to allow a “retrospective historical audit” of its time keeping records. Although Shafer doesn’t say so outright, he is basically asserting that Emory is trampling over standard practices because it holds the upper hand in its relationship with Grady.

Most damning, however, is Shafer’s argument that Emory reneged on promises it made to auditors. The auditors recommended that Emory record hours more frequently and that Grady conduct spot checks to make sure the hour are accurate.

According to Shafer, Emory promised to make these changes but never followed through. Shafer writes: “In a press release issued last week, Emory proudly declared that the institution remains in compliance with the contract — something that is true only in the tortured sense that Emory persuaded Grady not to change the contract by making and then breaking a promise to voluntarily improve its record keeping.”

Last week I argued that criticism of Emory was unfounded, and that Emory’s involvement with Grady is unquestionably positive. I stand by this position. Emory’s relationship with Grady has been beneficial to both organizations, and without Emory’s generosity and patience, Grady’s doors might already be closed.

Moreover, the issue at hand isn’t Emory’s relationship with Grady, but how to ensure that one of the most important hospitals in the Southeast stays open. Criticism of Emory distracts from that goal.

But this doesn’t excuse Emory from addressing the concerns raised by Shafer — even if the University is in compliance with its contract with Grady. To clear itself of impropriety, Emory must forthrightly answer the following questions:
• Are four weeks of record keeping enough documentation for an entire year?
• Why are the standards for record keeping different for Emory physicians and their Morehouse counterparts?
• Assuming Shafer’s portrayal of the audit is accurate, why has Emory not followed through on recommendations made by the auditors?

As Shafer put it: “Both Grady and Emory are important institutions, important to Atlanta, to the region and the state. But their importance does not excuse sloppy business practices or justify a refusal to be held accountable, especially where public funds are concerned.”

Senior Editor Steven Stein is a College senior from Los Angeles. He is co-editor in chief of the Emory Political Review.