By North Carolina Health Care Association
North Carolina’s hospitals and health systems provide more than just healthcare services. They also blend medical know-how with community engagement and technology to help prevent and manage chronic conditions and to address factors affecting health like access to healthy food and transportation. Learn how health systems and hospitals work with local employers, schools, faith organizations and other partners to build healthier, vibrant communities.
Five rural healthcare leaders from across the state recently came together for a virtual town hall to discuss how their hospitals and health systems are creating healthier communities. This program is part of a series hosted by the North Carolina Healthcare Association.
Here are some key takeaways from the conversation.
Hospitals help support the livelihood of rural communities.
Hospitals are pillars in their communities and support economic development by providing education and employment opportunities that create stronger, more resilient citizens. “Our approach here at Northern Regional Hospital is to be engaged in all areas of community life. We recognize, like most hospitals, that we are the largest employer in the city of Mount Airy and one of the largest in the region,” said Chris Lumsden, President and CEO of Northern Regional Hospital. Lumsden emphasized that hospitals engage in a mutually beneficial relationship with the surrounding community. “If the hospital is healthy, the community [members] in a rural community will be healthy, and vice versa.”
Penney Burlingame Deal, President and CEO of Onslow Memorial Hospital, also touched on the relationship that hospitals share with their community. “In rural settings, hospitals play a part in community resilience,” expressed Burlingame Deal. Communities can support and sustain quality health and social services by attracting and retaining well trained healthcare professionals. This can then lead to a stronger economy, which in turn supports a stronger local healthcare system. “It’s recognition of that link between rural healthcare, economic strength, and overall vitality…it’s kind of this self-perpetuating feedback loop.”
John Green, President and CEO of Iredell Health System discussed how every hospital and health system is driven by a mission and vision statement, and while each is different, they all guide people towards optimal health. More importantly, this is not always done within the four walls of the hospital. Often times, hospitals are working outside of their brick-and-mortar establishments – directly in the communities they serve – to accomplish their goals. “We do that throughout the whole community, and we do it based on the needs of each part of that community,” said Green.
To that point, Annie Carpenter, Assistant Vice President of Community Engagement at Mission Health added, “We go beyond the hospital walls with our community approaches, and not just because we serve the community, but because we are the community.”
Hospitals invest in their communities to address the unique and diverse challenges they face.
Every community is unique, so it is important that hospitals listen to the needs of their community members when developing programs and initiatives. Patrick Woodie, President and CEO of the NC Rural Center, and the moderator of this conversation, shared a saying from his years of work in rural health, “when you’ve seen one rural community, you’ve seen one rural community.” This underscores that each community is characterized by its distinct array of challenges, and they must be addressed in their own unique ways.
Todd Hickey, Chief Strategy Officer of ECU Health mentioned how ECU Health is always assessing how they can invest back into the community. They do this by donating funds to support community partners, developing initiatives aimed at improving health, and through other avenues. “We see that as a role of a good steward of healthcare in a community, but also recognizing that it’s our partnerships that really connect our services to our patients, and if you will, our population,” said Hickey.
Hospitals also play a big role in strengthening the local workforce. Chris Lumsden noted that 85 percent of Northern Regional Hospital’s employees were raised and live within a 25-mile radius of the hospital. In addition, 85 percent of high school students that leave this area for work or college, do not return. “The message is, we have to grow our own. And that’s a theme that we have created through education assistance scholarship programs,” expressed Lumsden. To combat this, Northern Regional Hospital has stood up multiple programs that encourage students to not only pursue careers in healthcare, but to also stay and serve in their community.
Hospitals in rural communities use innovation to expand their reach and build more accessible health care.
Hospitals and health systems in rural communities are evolving with the changing landscape of health care. They are overcoming barriers to care and expanding access to care through innovative solutions, emphasizing a focus on maintaining good health for all.
Telehealth has blossomed as an accessible option to care, but internet connection can be sparse in some rural communities and hospitals are creating solutions to bridge the gap. “Working with our civic partners, counties and townships, trying to build out and create the funding through grants, through alignment of federal funding to help expand that [broadband] is a big deal,” said Todd Hickey. Hickey connects the availability to broadband with a greater opportunity for people in rural communities to get preventative care and early intervention for serious conditions.
Related to telehealth, Penney Burlingame-Deal said, “it is a great way of really thinking outside of the box and using innovation to make things happen that wouldn’t happen otherwise”. In addition, John Green touched on a need for stable internet access in all rural communities and technology training, especially for aging populations, highlighting the digital-based resources that will lead the future of health care.
Care options combatting opioid addiction are expanding and improving as well. Annie Carpenter mentioned a pilot program newly introduced to Blue Ridge Regional Hospital and Mission Hospital, where patients can receive medication-assisted treatment within the emergency department, an effective evidence-based practice to disrupt the addiction cycle. According to Carpenter, this care approach can impact the capacity and volume the health system while combatting the rise in opioid overdoses in the region.
“The community has been working together on responses at such a rapid rate to save lives. [The pilot] It’s something our partners in the community have been eager to see as well,” said Carpenter.
Launching more impactful programs that promote better health within rural communities often requires research and advocacy to accelerate the implementation of those programs. John Green mentioned at smaller rural hospitals, a detailed approach is necessary to implement new ideas in order to make the most of time and funding. It may be more difficult to find an effective solution using a trial-and-error approach. To advance new initiatives and programs, hospitals may glean successful ideas from other hospitals in areas with similar populations in communities with similar challenges, implementing what worked in the pilot program as a potential solution for their own community.
“I think research that allows us to see this is going to work, or we believe this should work is a huge difference to us,” said John Green.
The way Dr. Aundrea Oliver met Abby Coderre was, in Dr. Oliver’s words, “fortuitous.”
Abby was a sophomore at East Carolina University when she needed surgery for a mass in her thoracic cavity. Dr. Oliver’s colleague received the call about her situation, but couldn’t perform the diagnostic procedure on her, so Dr. Oliver was asked to step in.
“We just kept going”
At the age of nine, Abby was diagnosed with Crohn’s disease, so she was no stranger to hospitals. As she grew older, however, she began experiencing unusual symptoms.
In high school, she noticed bruising on her legs, but she attributed those to being a dancer. During the summer before her sophomore year, Abby experienced chest pain, but an initial doctor visit diagnosed her with a pulled muscle.
“The muscle relaxer the doctor prescribed didn’t help, so my sister insisted I go to the emergency department,” Abby said. “They did an x-ray and saw my esophagus was pushed off to one side, so they did a CT scan. That’s when they saw the mass in my chest.”
“Her mass was located next to her pulmonary artery and had invaded her pericardium,” Dr. Oliver said. What was supposed to be a four-hour surgery ended up taking Dr. Oliver eight hours to remove as much of the mass from Abby’s body as possible. “We tried to remove the majority of the mass and basically did a full resection.”
As a result, the doctors were able to correctly diagnose her with lymphoma and provide the right treatment.
That decision, Abby said, saved her life: “Who knows if chemo would have been able to get all of it?”
While Dr. Oliver has performed countless surgeries, she said Abby’s story sticks with her. “She was this young, vibrant college student who could have been my daughter, and her case was hard.” Dr. Oliver knew she wanted to do everything she could to help Abby. “We just kept going – we weren’t stopping until we got an answer,” Dr. Oliver said.
Abby’s recovery was, as Dr. Oliver put it, “slightly miraculous.”
“We cut through her phrenic nerve, so she shouldn’t have a voice at all. She should not be able to cough. But she still has great function.” Beyond the physical recovery, Dr. Oliver said it’s been gratifying to see Abby succeed in life: “To see her become this wonderful, exciting, vibrant caring woman and to go from being a happy college student to a mature individual – that gives in a way that I can only hope for is impressive.”
After surgery, Abby completed a two-and-a-half year chemotherapy regimen. Dr. Oliver was impressed by her commitment to her classes and studies while receiving treatment. “I was really proud of her. Whenever someone has to work twice as hard in order to achieve success, there is a greater depth of value in that education.” Dr. Oliver was doubly proud when she found out Abby wanted to be a nurse. “I was over the moon,” Dr. Oliver said. “She let me know she was interested in doing pediatric oncology, and I told her it was a perfect fit, that she was bright enough and she had the people skills to be a great nurse.”
A struggle worth the effort
Although it was challenging, Abby said it was important to her that she remain in school while undergoing treatment. “I needed to have some normalcy in my life,” she said. It became even more challenging when she transitioned to the actual nursing program. “I’d have to get chemo one day, and then the next day I’d be in the hospital as the student nurse and not the patient,” she said. “Then the next day I’d take a test.” As a result, Abby had to study extra hard and often took her notes with her to study during her chemotherapy treatment. She also took classes and tests online, even taking a few while she was in the hospital. “I took one final exam while I was in the ER, but it helped me get my mind off what was happening and gave me something else to focus on.”
Although Abby said she wondered when her cancer journey was going to be over, she advised anyone out there going through the same thing to remember it won’t last forever. “What you’re working for is worth it, no matter how hard the struggle. Just look at the end goal and do anything you can to make it good.”
Abby rang the bell to signify the end of her cancer treatment in November 2021, and when she graduated from college, she invited Dr. Oliver to the celebration.
“It’s not common to be invited to a patient’s graduation,” Dr. Oliver admitted. “To have someone years later have an important life event and say, I want you there – that means everything to me.”
Bridging two worlds
Now, Abby is a pediatric nurse working at ECU Health.
“When I first started nursing school, I didn’t want to stay in Greenville,” she shared. “But I really fell in love with the hospital. The team I was treated by was amazing, and I saw the impact they had on me as well as other kids. I couldn’t imagine working anywhere else.”
While their professional lives may not intersect much, Dr. Oliver is thrilled to have Abby as a colleague: “Abby is the perfect container for life, and she’s going to give it to a bunch of little kids who are scared life is going to be taken away from them.”
Coderre agreed that bridging the worlds of patient and nurse gives her a unique perspective that has helped her be a better nurse. “It gave me a lot of empathy toward my patients, because I know what they’re going through. I know what it feels like to be on the other side of things. I wouldn’t be half the nurse I am if I hadn’t been a patient also.”
As for Dr. Oliver, she said the value of her work has been solidified. “It’s easy to feel like what you do doesn’t matter or doesn’t have an impact. If I never have another patient like Abby Coderre – if Abby is my one Abby – then my career is complete. That was the best eight hours I could have ever spent.”
Looking back, Abby said she wouldn’t be here if not for her ECU Health team working together.
“I couldn’t say anything better about ECU Health. It’s amazing, with the best nurses and doctors.” She also holds a special place in her heart for Dr. Oliver: “She is just an amazing human being.”
In her ECU Health profile, Abby wrote that her role model is “Dr. Aundrea Oliver, the most amazing surgeon and person that has ever graced my life by saving my life.”
Health and well-being are at the very heart of creating economic vibrancy in a community. That is why Brian Floyd, chief operating officer of ECU Health and president of ECU Health Medical Center, joined a group of statewide health care leaders at the NC Chamber Health Care Conference on a panel titled “Working Together to Create Healthier Communities” on Sept. 14 in Durham.
Speaking to a packed room of health care, business, industry and government leaders from across the state, Floyd spoke about ECU Health’s unique position in eastern North Carolina as both the largest health care system and employer in the 29 county region, and the importance of maintaining high quality and high value care in rural communities.
“Thinking about the NC Chamber and what we’re here to talk about today, it’s important to remember North Carolina is the second largest rural state in the country,” said Floyd. “One-in-three people in North Carolina lives in a rural community so rural health care is a very critical and very personal endeavor. At ECU Health, we take our mission seriously to improve the health and well-being of eastern North Carolina, which is a region with some of the highest levels of poverty in the state.”
ECU Health is a leader in rural health care, Floyd said, and is constantly exploring new ways to improve access to care for rural communities. Speaking to topics such as improving mental health resources, partnering closely with schools, colleges and universities and investing in the health and well-being of team members, Floyd made it clear ECU Health’s role in the East goes far beyond just delivering health care.
“ECU Health is a health care provider, an educator and an economic engine for our 29 county region and we understand that collaboration is key to solving health care challenges,” Floyd said. “When I think about what we do, the reason we have a 974 bed hospital in a town of more than 80,000 people is because of the tremendous burden of disease in the communities we serve. Improving quality and cost is our goal and our clinical care component certainly plays a role in that, but we know that value is created by improving wellness through initiatives that tackle social determinants of health.”
Floyd was joined on the panel by Dr. Art Apolinario, board president of the N.C. Medical Society, Dr. Creagh Milford, senior vice president of retail health for CVS Health and Jennifer Sacks, associate director of the clinical operations program lead for Biogen. The panel was moderated by Gary Salamido, president and CEO of the NC Chamber.
KENANSVILLE – You could say Jon Kornegay was born to be a rural doctor. His father was a physician in a small town in Duplin County in eastern North Carolina. His mother was a graduate of East Carolina University’s first nurse practitioner class in 1976.
But it was his experience at ECU’s Brody School of Medicine that sealed the deal.
“Even early on in my medical school I saw the emphasis on service. You see other members (at the school), attending physicians and professors, who live that life and lives of service,” he said recently during a break from his job as a hospitalist at ECU Health Duplin Hospital in Kenansville. “Then you get exposed early on to underserved areas and populations and see how rewarding that can be.”
ECU’s medical school was established in 1974 after successfully making the argument – contentious at the time – that it could fill a need in North Carolina to train more primary-care physicians, rather than medical specialists, and find more doctors willing to serve in places like Kenansville.
Since then it has made good on that promise: according to the American Academy of Family Physicians, Brody ranks second in the nation among medical schools in the percentage of family physicians it graduates. The school admits 86 students to each class, all from North Carolina; this year, 52% of Brody’s graduates entered primary-care residencies.
“Developing great primary-care providers for rural areas is at the core of what we do at Brody and within ECU Health,” says Dr. Michael Waldrum, dean of Brody and CEO of ECU Health. “We have students, professors, residents and doctors who really understand that side of health care, and their work in that space leaves a legacy that we can all be proud of.”
A reliable supply of physicians and medical professionals is a critical part of the economy of any rural community:
- Having primary care close to home means residents are more likely to seek treatment for medical problems before they become crises and less likely to have to leave home to get treatment, resulting in fewer missed days of work and better quality of life;
- A healthy medical community is an important selling point for developers recruiting new businesses and for families trying to decide where to move;
- Rural hospitals are among the biggest employers in a county; since 2005, 12 rural hospitals have closed across the state, part of a troubling national trend;
- And medical professionals contribute in other ways. Kornegay also serves as the county’s EMS medical director; one of his colleagues also serves as county health director; other medical professionals serve on chambers, chair charitable boards, and coach sports teams.
Kornegay knows work in rural health care is not for everyone: Physicians can generally make more in cities in highly specialized fields; rural areas don’t offer the same amenities. Overcoming those barriers, he says, will require a variety of approaches, including improved salaries, help with loan repayment, retention bonuses and Medicaid expansion.
But in the meantime, Kornegay finds some people fall in love with work in rural areas, for the quality of life, the chance to get to know patients and neighbors in a deeper way, and for the opportunity to solve a wide range of health concerns.
Kornegay, certified as both an internist and a pediatrician, will often move from a geriatric patient in an ICU to a newborn down the hall.
“If you can get doctors into rural settings for a little while – get to know the environment, get to build their social network, get that experience … you have a chance to keep ‘em,” he says.
Something’s working in Duplin County. All five full-time physicians in Kornegay’s group at Duplin Hospital either went to med school or did their residency at Brody. They join a cadre of other ECU grads in health care and other fields who put down roots in the county.
“There’s a lot of purple and gold here,” says Kornegay. “That’s for sure.”
Further reading on Higher Ed Works
“Eastern North Carolina needs us”: The economic impact of ECU
Lifelong dreams came one step closer to reality for the newest class of students in the Brody School of Medicine at East Carolina University as they were officially welcomed during the school’s annual White Coat Ceremony on Friday.
The 90 members of the Class of 2027 — all North Carolina residents — were helped into their white coats during the traditional celebration at the Health Sciences Student Center and regaled with messages and well wishes from Brody faculty and leadership.
Kristel McLawhorn, transplant nephrologist and 2005 Brody alumna, gave the keynote address, urging the Class of 2027 to stop, listen and absorb the knowledge and experiences they gain in the coming years.
“You have earned this opportunity,” McLawhorn said. “My charge to you is this: Be prepared for anything: to be challenged, to be afraid, to be humbled, to serve and to change. Know where your support is and know what is mission-critical in the big picture. Have the grace and wisdom to know when you don’t know, and the drive to do something about it.”
McLawhorn told the students that during her intern year at Brown University after she graduated from Brody, she got an early-morning phone call that her father was gravely ill. Knowing what she did about medicine, she jumped in her car and drove 700 miles south, knowing the odds were stacked against her father. But with her medical knowledge, she held out hope.
“My dad survived that event,” she shared, “and is actually sitting here with us today. Can you stand up?”
The crowd cheered and applauded as McLawhorn’s father, John Jernigan, stood and waved from the first row.
“I was clinically sound before; I left ECU with a strong base of medical knowledge, and I was working hard to hone and craft my skill at Brown,” she said. “But his illness taught me a great deal about life and even more about doctoring that no institution can teach you,” including empathy, ability to listen, sharpened knowledge and agile teamwork.
“My dad taught me that every day is a good day, and some days are better days,” McLawhorn said. “Today is one of the better days. It’s a marker in your life and education, a point at which you are living the consequences of your previous choices. You’ve worked hard for the opportunity.”
The Class of 2027, the largest class in Brody history, hails from 36 North Carolina counties and 26 undergraduate institutions; 61% of the class is female, 16% are first-generation college students, and 21% are from minority groups — Black, Native American and Hispanic or Latino — that the Association of American Medical Colleges considers “underrepresented in medicine.” Four are veterans, and four were collegiate student athletes. The class speaks a total of 23 languages.
Jason Higginson, executive dean of Brody, formally welcomed the class and voiced confidence in the students’ future contributions to medicine.
“Today we welcome you to the study and art of medicine, a profession symbolized by the white coat,” he said. “We know you will do great things.”
Onolunosen Abhulimen
Onolunosen Abhulimen — her family and friends call her Ono — doesn’t have time to wait for things to happen.
The Brinkley-Lane and early assurance student, the daughter of Nigerian immigrants, graduated from high school in Winston-Salem with an associate’s degree under her belt — the first in her school to do so. Since she pioneered the path, other family members have followed in her wake, including her two younger brothers, who are also Brody Early Assurance students — one a sophomore and the other a junior. Her youngest brother will start fourth grade in the fall of 2023.
Abhulimen played basketball on her school team and a travel team. She did the same with track, where she ran the short distances. That wasn’t enough, though. She picked up the shot put and then the discus, which she fell in love with and would have broken the school record had the COVID-19 pandemic not shut sports down.
She excelled in the classroom as well. Having to navigate traditional high school classes, driving to the community college, and juggling sports and clubs taught her life lessons that would set her up for success in college: discipline, organization and commitment.
“It was hard for me to seek help, to ask for advice. There were some barriers that had to overcome,” Abhulimen said. “I definitely had to learn time management.”
During high school she knew she wanted to pursue some kind of medical career. She attended a medical student symposium at Wake Forest University and heard a presenter talk about health care disparities, which was a new concept for her. Investigation and research solidified her plans — she wanted to be a doctor, enough so that during her undergrad years at ECU she founded a Students for Equitable Health Outcomes organization.
“I want a leadership role, to use my experience in helping those in rural communities get better health outcomes,” Abhulimen said.
Because she graduated high school with a pocketful of college credits, she was able to graduate from ECU summa cum laude in December 2022 with a degree in biology with honors in five semesters. She’ll start her first year of medical school at 21— most of her peers who will be a few years older — and after a semester’s break that she used to get her head in the game.
“I wanted to make sure I was really prepared and I was familiar with people that I could seek help and advice from. Brody is a very welcoming environment where it’s easy to ask for help or advice from other students,” Abhulimen said.
When she donned the white coat for the first time it was with pride and a sense of accomplishment. And her family beamed from the audience — her parents, all three brothers and a slew of aunts, uncles and cousins.
“It’s a representation of everything I’ve had to do to get to this point, even before high school. All the sacrifices that I made, being able to really study for those hard classes, some of the all-nighters I had to pull — I’m finally here,” Abhulimen said. “It’s like a breath of fresh air. I’m starting a new journey.”
Jose Robles Arvizu
Learning to navigate opportunity has given one first-year medical student a layered perspective from which to change the lives of his future patients.
Jose Robles Arvizu was born in Rio Verde San Luis Potosi, Mexico, and moved to Hendersonville when he was 2 years old. Over the years, he observed the challenges facing those around him and started formulating plans to make improvements in his community.
“Growing up, I saw how people in my marginalized communities, particularly farm workers and migrant farm workers, were often spectators in their health needs as a result of their lifestyle and barriers to accessing health care,” Robles Arvizu said. “I knew there had to be something I could do to bridge this gap and empower these communities to become stake holders in their health and make it a priority. This fueled my desire to become a physician with the goal of returning to western North Carolina to make a positive impact in the communities in the place I call home.”
He later attended UNC–Chapel Hill as a first-generation undergraduate, then went to Wake Forest to get his master’s in biomedical sciences, research track.
“One of the things that I am most excited about is being part of the incoming Brody class is becoming a member of a larger family that has a common goal of improving the health of communities across North Carolina,” he said. “Even within the last few days getting to know more people, it is more evident that we all have a ton in common, and I’m excited to embark on this journey with the rest of my classmates.”
Robles Arvizu has come to view education as a lifelong opportunity that can benefit those around him, making health care — and education — more accessible.
“Being a first-generation college and medical student brings both challenges and opportunities,” he said. “I would aim to use my experience as a first-generation student to advocate for others in similar situations. Understanding the unique challenges faced by first-generation students, I could contribute to making the education system more inclusive and accessible.”
Because of his motivation and perseverance, Robles Arvizu was named a Gates Millennium Scholar. The program, funded by the Bill and Melinda Gates Foundation, provides a full scholarship to any undergraduate institution to students from underrepresented groups. The scholarship also covers master’s and doctoral studies in the disciplines of computer science, education, engineering, library science, mathematics public health, and the sciences, where these groups are severely underrepresented.
“Being named a recipient of the Gates Millennium Scholarship one of the largest blessings that allowed me to peruse my dream of becoming a physician without the immense financial barrier that many first-gen students encounter,” he said.
As he begins medical school, Robles Arvizu plans to use his life experiences to be empathetic to his future patients’ barriers and circumstances.
“Having faced my own challenges and adversities, I would use these experiences to relate to my patients and their struggles,” he said. “This empathy would help me provide better care and make a positive impact on my patients’ lives.”
Grant Irons
The Class of 2027 includes a student whose family has already built a legacy in eastern North Carolina health care.
Grant Irons is the great-grandson of regional health care pioneers Fred and Malene Irons and the grandson of Tom Irons, professor emeritus of pediatrics at Brody, medical director of Access East and the N.C. Agromedicine Institute, and interim medical director of physician assistant studies.
Grant Irons was born and raised in Greenville and attended UNC–Chapel Hill, where he earned a degree in biology with minors in chemistry and health and society.
“It is truly humbling to carry on my family’s legacy here in eastern North Carolina,” he said. “I was lucky enough to spend time with my great-grandparents, Drs. Fred and Malene Irons. As I’ve grown up, I continue to learn more about their work and the impact they had on health infrastructure in eastern North Carolina. Their legacy demonstrates the impact of servant leadership. My late grandmother and grandfather, better known as Carol Irons and Dr. Tom Irons, continued this tradition of selfless service. I would not be the man I am today without their guidance as I aim to hold myself to their standard; a life lived with compassion, and humility.”
Tom Irons said he could not be prouder of his grandson’s desire to serve as a physician.
“I’m Grant’s only living grandparent, but I like to believe that today the other three are wearing smiles as big as mine,” he said. “His parents and I could not be more grateful that he has been given this opportunity, or prouder that he has chosen to come to Brody and eastern North Carolina.”
He added that he encourages his grandson and Grant’s classmates to follow their hearts.
“There is nothing easy about this journey you have undertaken, but if you put your heart into it, the rewards will be immeasurable,” he said. “Keep your head down these first two years, lean on each other, ask for help when you need it and never forget that there is no life more noble than a life of service.”
Grant is eager to live out a legacy and mirror his grandfather’s ideals and impact in medicine — but he is also ready to make his own name through the medical school that represents a life goal.
“The opportunity to be a student at Brody means the world to me; it has been a dream of mine for some time,” he said.
Grant Irons sees the bigger picture of eastern North Carolina’s health care landscape and also plans to make a difference through policy.
“Regardless of my career path, I have long been interested in health policy,” he said. “Initially, I was exposed to the importance of institutions through my family. Since I was old enough to understand, I have been fortunate enough to learn about care disparities and their impact on health outcomes.”
As a student at UNC-Chapel Hill, Irons explored the relationship between power, policy and differential health outcomes. He helped lead a chapter of PIH-Engage, a global health organization dedicated to building sustainable health infrastructure. That experience has led him to lead on a variety of fronts.
“As a physician I want to be more than a care provider; I hope to be a leader in my community,” he said. “While significant progress has and continues to be made, care expansion efforts are far from over. There are far too many people still in need.”
Lachlan Younce
Something about home — both places and people — helps to decide our futures for us.
Lachlan Younce is about as eastern North Carolina as a guy could get. His father’s family is from Belhaven and his mother’s is from Vanceboro. He played football and lacrosse at J.H. Rose high school in Greenville. He was a sailing counselor at a YMCA camp in Arapahoe, on the Neuse River, which will become important to his story.
At the camp he made friends with another counselor, a young man who ran a lot and worked out. Younce asked his friend why he was so fanatical. The answer — he was getting ready for the U.S. Naval Academy. Younce isn’t from a military family and had no idea what that meant but got very interested.
Younce applied for an appointment to the Academy and received one from the late Representative Walter B. Jones, who Younce recalls fondly. His initial attempt to get into Annapolis didn’t work out, so after graduation he headed west to Raleigh where he was part of the ROTC program at N.C. State, which he said was a blessing because he learned about military culture, which was completely foreign.
The next year his fortune changed and the Navy accepted him as a Midshipman.
Like many young men entering the academy, Younce wanted to be a pilot. He had his mind on studying political science; instead he took his first physics class, majored in chemistry and applied to the medical corps track.
He graduated in May 2023 as an ensign, and the Navy told him he could apply to any medical school in the country. He applied to three, but there was only one he really wanted to receive an acceptance letter from.
“I had the best interview experience here at Brody, I just felt like I was at home. This community raised me, built me and I think that learning medicine here is going to be extremely rewarding,” Younce said.
He’s not completely sure about what specialization he might pursue after graduation, but Brody’s mission of educating the next generations of primary care physicians impresses him.
“I think it’s great that a school so oriented towards primary care can train a physician to go into the military and provide care that service members need,” Younce said.
The winding route that brought him home means more than just place. Health care is a thread that is beginning to be woven into the fabric of his family. His mother is a registered nurse with ECU Health and a proud Pirate Nurse. His sister, Fallon Younce, has a year and a half until she graduates from the College of Nursing as a Pirate nurse herself.
“We’re going to be able to overlap these two years, and one thing I’ve learned is that nurses know what’s going on, so I’m going to use nurses’ knowledge to be successful,” Younce said.
After graduation, he’ll owe the Navy a number of years as an active-duty Navy doctor, which he is excited for, but is ultimately unsure about a career in uniform. Regardless of when is his time in uniform ends, he’s sure he’ll return to eastern North Carolina to use his Brody training to improve access to health care in underserved areas.
Family, service, and leadership were key themes of Dr. Jason Higginson’s presentation to nearly 100 first year ECU Brody School of Medicine students at the 15th Annual José G. Albernaz Golden Apple Distinguished Lecture Thursday, July 27 at the East Carolina Heart Institute at ECU.
Funded by the Albernaz family in partnership with the ECU Health Foundation, this lecture was established in 2006 with the goal of providing support for physicians to share their expertise with the medical education community. In a presentation titled “Learning to Lead: Lessons from My Military Life and Beyond,” Dr. Higginson, executive dean of Brody and chief health officer at ECU Health, outlined how his experience in the U.S. Navy, alongside the lessons he learned from his family, mentors and patients, has shaped his journey as a leader and medical doctor.
“Leadership is about finding what you do best and using that to help the people around you,” Dr. Higginson said. “You cannot achieve anything in life without the people around you. A good leader finds a way to use their knowledge and skills to solve problems for others.”
Dr. Higginson has been at Brody since 2012, following 13 years of active duty in the U.S. Navy, where he now continues to serve in the U.S. Navy Reserve holding the rank of captain. His previous roles include chair of Brody’s Department of Pediatrics, Pediatrician-in-Chief of Maynard Children’s Hospital, chief of neonatology and medical director for the Neonatal Intensive Care Unit and Newborn Medicine.
“Being a medical doctor is not about self, it’s about a calling to serve a higher need,” ECU Health CEO and Brody Dean Dr. Michael Waldrum said in his introduction at the lecture, “Dr. Higginson is a shining example of that. He is a highly engaged and highly purposeful leader who is helping us build something special at ECU Health. We’re excited that you, our students, have an opportunity to learn from him today.”
Despite his prestigious rank in both the military and the clinical field, Dr. Higginson said the lessons learned early on taught him the skills he needed to successfully lead others. He recalled joining the Navy shortly after getting his medical degree and being told to master the skills of a broom as he swept floors during his first week. That experience taught him that everything, even the simplest tasks, matters in the organization.
Those lessons, Dr. Higginson said, will serve Brody’s newest cohort of students as they embark on their own personal journeys through medical school.
“All of you are going to stand up and take the oath to be a doctor,” Dr. Higginson said. “As you are reading the words for the first time in front of those you love, I encourage you to pause and reflect on the words and what they mean to you. If you take that oath seriously, you will succeed.”
ECU Health Chief Executive Officer and Brody School of Medicine at East Carolina University Dean Dr. Michael Waldrum recently joined the Raise the Line Podcast to discuss rural health care, his personal journey in medicine and how ECU Health and Brody are advancing the shared mission of improving the health and well-being of eastern North Carolina. Hosted by Osmosis from Elsevier, Raise the Line is a podcast about strengthening global health care systems through education, training and optimizing the workforce to support health care workers.
A passion for rural communities
During his time on the podcast, Dr. Waldrum talked about his background in medicine, from his decision to pursue a medical degree, to his clinical career as an intensivist in critical care medicine, and his robust experience in health system leadership roles. He credits his time growing up in Minnesota near the Mayo Clinic for his rural health care passion.
“As a young person being surrounded by physicians and other health care professionals in a rural community, it was just transformative for me. It was unbelievable,” said Dr. Waldrum. “I lived on Mayo Wood Road. I knew a number of the Mayo family, and to see what that organization did in this rural northern community in Minnesota was incredible. So, it just was something as a young person that I became very interested in because I could make a living taking care of people, which was just an unbelievable opportunity that I still have so much respect for and love for.”
Health care delivery through education
Dr. Waldrum said delivering health care in rural areas is a challenge ECU Health is uniquely positioned to solve, thanks in large part to the Brody School of Medicine, which is a leader in training primary care providers for the state. By training the next generation of providers, many of whom go on to practice in rural communities, the educational component is as important as the health care delivery component.
“I like complex problems,” Dr. Waldrum said. “I like working on these systemic complex issues and so that’s what led me to come to eastern North Carolina. We cover a geographic area the size of Maryland. People aren’t really familiar with the coastal plains of North Carolina, but it’s a huge geography and our organization serves this large geography and is really the safety net anchor institution across this region. Part of that is the academic component, which is the Brody School of Medicine, a great organization whose mission was created to primarily educate primary care physicians to take care of North Carolinians, to improve the health and well-being of this region, and to offer medical education to diverse populations.”
The Brody class of 2023 is a snapshot of Brody’s mission to serve North Carolina by increasing the number of primary care physicians who serve the state. Fifty-two% of the 2023 Brody class matched into primary care residencies — including obstetrics and gynecology — and 44% matched to residency programs in North Carolina. What’s more, Brody’s most recent class features the most medical students who will begin their residency at ECU Health Medical Center in July, which is no coincidence, according to Dr. Waldrum.
“As for ECU Health and Brody School of Medicine, we are creating the model for rural health care by creating a trusted premier education and health care organization that’s a regional-based delivery system and education system,” said Dr. Waldrum. “We have a great team of professionals doing that — multidisciplinary teams. Anybody that wants to join us — that wants to be creating a future for a great region that’s beautiful in eastern North Carolina — if you can get behind that mission, we welcome you because we are in the process of transforming health care for rural America to become that model.”
Looking for more?
Find and listen to the Raise the Line Podcast, Episode 398 – Creating a Model for Healthcare in Rural America wherever you get your podcasts.
A 2008 alumnus of the Brody School of Medicine at East Carolina University and current ECU Health physician detailed his experiences as a doctor in rural and underserved eastern North Carolina during a July 12 webinar.
ECU Health Duplin Hospitalist Director Jon Kornegay presented “Perspectives on Underserved Care: Being a Physician in Duplin County” through the ECU Global Health and Underserved Populations Program. He also serves as ECU Health Duplin vice chief of staff and Duplin County EMS medical director.
A native of Duplin County and part of a family of physicians, Kornegay has served Duplin County since 2012, creating the hospitalist group that has increased local patient volume and kept Duplin County residents closer to home for quality care. He was named one of ECU’s 2022 “40 Under Forty” honorees.
Kornegay began the talk by saying he reminds medical students and residents that practicing medicine in an underserved area is a unique experience that can enhance their views of medicine.
“It’s a good thing, at some point in your career, to spend a little bit of time in community hospitals,” he said.
Kornegay guided the audience through details of the challenges of health care delivery in a rural county, the expertise of his colleagues that blend to provide a more complete level of care to patients and how ECU Health Duplin, in Kenansville, has grown over the years. He also detailed how the Brody School of Medicine has influenced the approach to care.
Duplin County is nearly two hours from Greenville, with a population of around 50,000, making it a target area for Brody’s mission to serve rural eastern North Carolina and underserved communities.
“Brody had several mission statements when it was developed,” Kornegay said, “and one of the main mission statements was to train providers for eastern North Carolina. Primary caregivers are a really big issue, and we hope we’re addressing that somewhat.”
Kornegay said the health care landscape and its indicators — including that many providers are near or at retirement age — mean recruitment to rural communities needs to increase. Other challenges include patient insurance coverage and the geographical access to complex care facilities.
Kornegay praised ECU Health Duplin’s strong ties to the Brody School of Medicine, including current students and residents as well as seasoned physicians.
“We take kind of a plethora of Brody learners,” he said. “We have third- and fourth-year residents that come to do community rotations with us. This past year, we’ve also started taking ECU rural family medicine residents. All of our attendings have interactions with Brody learners and are kind of staying connected.”
Kornegay’s brothers, who also practice in eastern North Carolina, went to medical school or completed residencies through Brody. Chad Kornegay helped start the medical group in Duplin County in 2010.
“My dad’s been a family practitioner in the area for over 50 years,” Kornegay said, adding that his father retired a few years ago.
The family ties also help build a sense of kinship among the professionals that has resulted in a steady increase in patients served and a reputation for quality care.
In 2011, Kornegay said, there were 5,800 patient encounters through ECU Health Duplin; over the past three years, that number has stayed around 15,500.
“So we’ve almost tripled the service there in about 12 years,” Kornegay said. “We’ve grown the service quite a bit. As a pretty strong group clinically, we’ve had a lot more of a comfort level taking patients than they previously had had here.”
Kornegay shared firsthand accounts of what it was like to be a rural physician in a large, rural county. He told stories about bad car accidents, deliveries of premature babies,
and other emergencies that are made more challenging by remote locations. He also shared his experiences serving during several hurricanes that rendered many areas of Duplin County as islands.
Hurricane Matthew in 2016 presented Kornegay with an opportunity to adopt new skills for future storms.
“I grew up in Duplin County, so I’m used to kind of being around tropical storms and hurricanes,” he said. “But we had never seen anything like this in my lifetime, the amount of water that we got with Hurricane Matthew. And so that presents some challenges, some unique challenges, for us in the health care delivery at the county.”
That experience helped prepare Kornegay and other providers for unforeseen circumstances — and for continuing to live and work the mission of Brody and ECU Health to serve rural eastern North Carolina through challenges from geographical access to natural disasters.
“We really as a county had not recovered from Matthew before Florence came,” he said of the 2018 storm. “We had kind of rehearsed a little bit with Matthew, but one of the things we learned during Florence is you can try to prepare for everything, but you can’t. So you’ve got to be ready to modify and change your game plan when data changes and things change a little bit. When you get that curveball, you may have to pivot a little bit.”
Ahoskie, N.C. – ECU Health Roanoke-Chowan Hospital has earned recertification as a primary stroke center by The Joint Commission and the American Heart Association/American Stroke Association, recognizing the hospital’s preparedness and expertise to care for stroke patients.
“I am proud of ECU Health Roanoke-Chowan’s team members and their commitment to provide high-quality stroke care to our patients and community,” said Brian Harvill, interim president of ECU Health Roanoke-Chowan, president of ECU Health Chowan Hospital and ECU Health Bertie Hospital. “Our hospital’s stroke recertification as a primary stroke center from The Joint Commission – and stroke readiness at each ECU Health hospital – represents ECU Health’s dedication to bringing a comprehensive stroke network to care for all patients across eastern North Carolina.”
Stroke is a leading cause of death in North Carolina and the leading cause of long-term disabilities. As a primary stroke center, ECU Health Roanoke-Chowan can treat and stabilize patients experiencing an acute stroke and care for more complex cases. Located in Ahoskie, North Carolina, ECU Health Roanoke-Chowan serves a rural community and is the closest emergency department for surrounding communities. As a resource for emergency care, ECU Health Roanoke-Chowan’s recertification ensures local community members have access to timely stroke care and extends the comprehensive stroke network capable of meeting the needs of all patients across eastern North Carolina.
The likelihood of having a stroke in North Carolina is significantly higher than the rest of the country as a whole. North Carolina is about 8 percent worse for stroke mortality than the national average, and in eastern North Carolina, that risk is even greater.
“Time is the most important factor when treating a stroke, so it is critical to provide stroke care close to home,” said Dr. Barry Bunn, regional emergency department medical director, ECU Health. “With eastern North Carolina’s high rates of stroke, ECU Health Roanoke-Chowan’s stroke recertification, combined with a network of stroke readiness at all ECU Health hospitals, reduces the time of treatment, the risk of mortality, permanent brain damage and other side effects including memory loss, difficulty speaking and potential paralysis.”
During the certification process, ECU Health Roanoke-Chowan was evaluated on performance measures in stroke care, including education for patients and families on stroke risk factors and recognizing symptoms of stroke. Other performance measures included staff education on stroke protocols and the appropriate prescription of medications to address stroke risk factors such as elevated cholesterol and blood pressure.
Roanoke Rapids, N.C. – The Joint Commission and the American Heart Association/American Stroke Association has recertified ECU Health North Hospital as a primary stroke center by recognizing the hospital’s preparedness and expertise to provide timely and high-quality care for stroke patients.
“I am grateful to our team members across all levels and services for their commitment and diligent work that allows ECU Health North to continue to be designated a primary stroke center,” said Jason Harrell, president of ECU Health North Hospital. “Providing high-quality stroke care close to home is central to our mission of improving the health and well-being of eastern North Carolina. We are proud to be part of the top-notch neurological services provided at ECU Health across the region, which includes a strong network of expert stroke care.”
Stroke is a leading cause of death in North Carolina and the leading cause of long-term disabilities. According to the North Carolina Department of Health and Human Services, both Halifax and Northampton counties have higher incidences of strokes compared to the North Carolina average. As a primary stroke center, ECU Health North can treat and stabilize patients experiencing an acute stroke and care for more complex cases. As part of stroke readiness by all hospitals in the ECU Health system, this certification is symbolic of a comprehensive stroke network capable of meeting the needs of all patients across eastern North Carolina.
The severity and likelihood of having a stroke in North Carolina is significantly higher than the rest of the country as a whole. North Carolina is about 8 percent worse for stroke mortality than the national average, and in eastern North Carolina, that risk is even greater.
“Immediate treatment of strokes can minimize the long-term effects of a stroke and even prevent death,” said Dr. Barry Bunn, regional emergency department medical director, ECU Health. “With our region’s high rates of stroke and mortality from stroke, ECU Health North’s stroke recertification demonstrates our proven results of reducing the time of treatment, risk of mortality, permanent brain damage and other disabilities.”
During the certification process, ECU Health North was evaluated on performance measures in stroke care, including education for patients and families on stroke risk factors and recognizing symptoms of stroke. Other performance measures included staff education on stroke protocols and the appropriate prescription of medications to address stroke risk factors such as elevated cholesterol and blood pressure.