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.”