Delta Native Working to Make a Difference in Rural Healthcare
Dodie McElmurray, RN, MSN/ MBA, grew up in rural Belzoni, got a nursing degree from Delta State University in 1997 and went on to get advanced degrees in nursing and healthcare administration from the University of Phoenix. After working about twenty years in healthcare administration in Mississippi, Arkansas and, most recently, in New Orleans, in early 2020 McElmurray took over as chief executive officer of the University of Mississippi Medical Center Grenada and its sister hospital, UMMC Holmes County in Lexington.
McElmurray grew up seeing firsthand how residents of Humphreys County struggled to get healthcare. A combination of poverty, a poor diet, lack of access to healthy food, inadequate or no health insurance, and a shortage of healthcare providers has led to a population in the Delta with a high prevalence of obesity, stroke, diabetes and hypertension. It was a tough situation even before COVID hit, killing many of the most vulnerable and putting unprecedented pressure on hospitals and healthcare providers.
McElmurray took over right before COVID hit.
“It has been one of the most challenging times for healthcare in history,” says McElmurray. “Even before COVID we were struggling to deliver healthcare in Mississippi, especially in the Delta, because of inadequate reimbursements. There is a big gap between the cost of delivery versus reimbursements, especially in underserved areas. What we knew was coming was compounded by the pandemic.”
One of the biggest struggles throughout the pandemic and continuing today is the premium costs of labor. The stress of an unprecedented number of very sick patients and fatalities put major strain on healthcare workers. McElmurray said some of the workers retired early or moved to other jobs because of the stress.
McElmurray could have worked in other regions that have fewer challenges but says she wanted to get back to the Delta and make a difference in the area where she grew up.
“I want to bring more cohesiveness to healthcare by working with other CEOs and health systems to better meet the current needs of the community, and to make sure that we are positioned to meet the healthcare needs of the future,” she says. “There is a high percentage of elderly people in rural areas that have prominent health disparities, and we have to be ready to serve the needs of our aging population.”
In general, rural healthcare is struggling nationwide, and Mississippi is at the top of that list.
“I don’t think right now we have one definitive answer to the rural healthcare challenges we face,” she says. “Our social determinants of health are probably some of the most challenging in the nation. Inflation, the cost increases of everything including food is having a negative impact on the ability of our rural community to eat better and take care of themselves. It is hard when people have to make a decision about paying the electricity bill or buying food.”
One important factor is having the support of the business community in promoting both health and healthcare.
“We need to work together to promote preventive wellness programs that help long-term to improve the overall health of the workforce and community,” says McElmurray.
It continues to be a difficult time for healthcare systems with the winter surge in COVID, Respiratory Syncytial Virus and flu. The mix has put a strain on hospitals throughout the state.
“It is challenging to both meet the demand locally, and also find tertiary centers for patients who need a higher level of care because those beds at larger facilities are often full or over extended,” she says. “It is a staff issue more than a bed issue for the most part. We don’t have enough healthcare workers to staff all the beds that are available.”
The need to provide care for people with COVID, other viruses, diabetes, strokes and heart disease is now compounded by the opiate/fentanyl crisis. McElmurray said that oftentimes contributes to the behavioral health problems being seen. It is a difficult challenge.
“It breaks my heart that you see young people getting exposed to these dangerous drugs really early,” says McElmurray. “You see it in adults, too. That is devastating.”
One thing that is positive about being associated with UMMC is patients can get the pre- and post-transplant kidney care in Grenada. The transplant surgery occurs in Jackson, but patients are able to get care before and after near home.
“The numbers are pretty astounding for the renal failure we see in this area because of hypertension and diabetes,” says McElmurray. “Kidney transplants can extend someone’s life for many years.”
Mississippi has the highest rates of death from renal disease in the country with an estimated 798 deaths in 2020, according to the National Center for Health Statistics. Mississippi had about 22.2 deaths per 100,000 people compared to only 2.7 percent per 100,000 for Vermont—the state with the lowest death rate from renal disease.
Going into the fourth year of COVID, there is a new variant nicknamed Kraken that is reportedly much more transmissible, but not as likely to cause serious illness as earlier variants. Some people still use the same precautions recommended at the height of COVID by wearing masks, social distancing and avoiding crowds indoors. But most have gone back to near normal, something that is important for many businesses such as restaurants that took one of the biggest hits from the COVID disruptions.
“I think everyone is realizing COVID is something we have to learn to live with, and each individual is trying to find out what that looks like for him or her,” says McElmurray. “We continue to try to encourage vaccinations and educate people about all of the things that help COVID and flu from spreading such as staying home when you are sick.”
Prior to moving back to the Delta, McElmurray was COO at the West Jefferson Medical Center in New Orleans, a 435-bed community hospital. Earlier she held top positions at long-term care facilities in Ruleville and Fort Smith, Ark., and worked at UMMC in Jackson, serving as administrator of clinical support services from 2006-14. She then moved to take a job as COO of the Greenwood Leflore Hospital. She is on the board of the American College of Healthcare Executives, and the board of the Mississippi Hospital Association.