Daily Briefing Blog

'This is our mission. This is the reason we exist.' Why Emory wanted the Ebola patients.


Dan Diamond, Executive Editor

The Daily Briefing regularly runs interviews with some of health care's most prominent CEOs, and we recently spoke with John Fox, CEO of Emory Healthcare, about his leadership lessons, his thoughts on the industry, and his big decisions—including the decision to accept several patients who had contracted Ebola in Africa.

That interview was scheduled to run later this week. But given the news that CDC on Tuesday confirmed the first case of Ebola diagnosed in the United States, we thought it made sense to bring this part of the interview forward. (The full interview with John Fox will still run later this week.) 

I think it offers essential context on why and how Emory took on several patients with Ebola—and a reminder that the disease can be well-managed, in the right care setting.

Also see: Ebola arrives in America, and CDC vows to stop it

How Emory responded to Ebola

Q: Take me through Emory's decision to accept three patients with Ebola. What did your leadership team consider? How long did it take to decide, yes, we're going to do this?

John Fox: We made the final decision to go forward on Tuesday, July 29. I remember that night clear as a bell.

And we anticipated some controversy around it, some negative reaction.

But the key for us came down to two questions.

One—clinically, can we make a significant difference for these patients? Especially since flying them halfway around the world can be disruptive and dangerous for the patient. They've got a progressive disease, which can be exacerbated by the stress of travel.

We had to get our arms around that.

The second key question—could we do it safely?

We had to have a yes to both of those questions before we had a final decision to go forward. And be prepared to live with whatever the consequences.

Q: The day that Dr. Kent Brantly arrived at Emory, it captured national attention. There was a helicopter following the ambulance, broadcasting the scene on cable TV. And some folks in the media were asking if it was a good idea to bring Ebola patients to Atlanta.

Fox: We knew it would be somewhat of a media event, but it was larger than we expected. Close to 30 media trucks the day Kent Brantly arrived. And you know, the helicopters might've been a bit much.

It's certainly the biggest media event that Emory's ever been through.

There was some initial negative attention, for sure. But it all turned on that Sunday, after Kent got here. It all turned overwhelmingly positive.

Very importantly, it has turned out to be a very affirming experience, a magic moment for the entire health system.

It also engaged a lot of Americans in the main issue—how do you get help to West Africa, which is really where that help is needed, to contain the disease, to “put the genie back in the bottle.”

Q: There's a chance that other U.S. hospitals might have to grapple with treating Ebola patients. Has anyone come to ask guidance on dealing with Ebola, or at least on addressing infectious disease?

Fox: We're working with the CDC and others to make sure that our experience produced improved guidelines for hospitals to handle patients possibly suffering from this disease. And we're working with the state hospital association to do a training program for other hospitals in Georgia.

We have an obligation to share what we learned. Hopefully, that's useful to others if they encounter something similar.

Our unit is extraordinary, but only has a limited capacity. And the reality is that if an Ebola patient presents in Tallahassee, in Charlotte, etc. —they need to be taken care of in those cities, not thrown in an ambulance and sent to Atlanta.

Q: I'm not hearing any of the trademark John Fox sarcasm right now.

Fox: Well, on this issue, there's no joking around. This is incredibly serious.

But since you asked, I'll share a story.

The morning [Dr.] Kent Brantly was due to arrive, I was in a morning meeting with leaders talking about logistics, when I got a text message.

It was just a text to tell us that the plane had cleared customs in Bangor, Maine, much faster than expected.

We all got a bit of a laugh out of that—we imagined the plane sitting out there on the runaway, the customs staff waving them through maybe a little quicker than they're used to. "You guys look good – go ahead!"

Q: Your story's pretty revealing though—when the Ebola patients were being transported to Atlanta, even some folks in health care were getting nervous. How did you get Emory's staff comfortable with the idea that Ebola patients would be in the hospital?

Fox: First, we have outstanding and courageous physicians, nurses, and staff.  However, beyond that, it came down to clear and very transparent internal communication – that’s the only way to get people comfortable.

We explained how we were handling it, the capability of the special unit—how it's segregated physically and we put extra security around it —and the precautions we're taking everywhere.  That all the staff were volunteers—and we were over-subscribed for volunteers, actually— and patient care would confined to that unit. They wouldn't be mixing with med/surg, for example.

But here's the biggest thing: This is our mission. This is the reason we exist.

If we can help people—if it's effective and if we can do it safely—we have a moral obligation to do it.

Q: You've made lots of big decisions—lots of tough calls—over your career. Where does this decision rank?

Fox: You know, I'm not sure I can rank them.

In every person's professional career, there are magic moments where everything comes together. Where you're either guided by your moral compass or you're not.

For us, this was a magic moment. It was part of our mission and values.

And it required us to not be afraid, to help these people because we can, because we can do it well and safely.