Dr. David McRay and his wife Joan McRay

Alive’s Chief Medical Officer

Published on May 11, 2020

Super-powers: Calm and Compassion
Guilty Pleasure: Doughnuts (any kind, but Krispy Kreme preferred)
Hometown: Murfreesboro, Tennessee

When Dr. McRay joined Alive a year ago, he had no idea one of his first major assignments would be to help lead the organization through a pandemic. Fortunately, he was uncommonly well-suited to the task.

A Murfreesboro native, Dr. McRay spent twenty years practicing family medicine at a nonprofit community health organization in the Appalachian Mountains of Eastern Tennessee. That was just the start of his community health experience.

Dr. McRay’s desire to give back on a global level gave him first-hand experience working within overwhelmed systems during a crisis. In the past decade, he led nearly twenty trips to developing nations for medical students. His crisis experience includes providing medical care in post-Katrina New Orleans, three visits to Haiti after the 2010 earthquake and during the cholera epidemic, and time spent in Latin America and African communities where poverty and inadequate care amount to a public health crisis even in the best of times.

The COVID pandemic at home has revealed what Dr. McRay’s colleagues consider to be his “super-powers”. He has a unique talent for leading with calm, compassion, and positivity during a crisis. These same personality traits are incredibly helpful when it comes to end-of-life care which represents a crisis on an individual family level. We spoke with Dr. McRay to find out more about what drew him to hospice care.

What brought you into hospice and palliative care?

I had several pivotal end-of-life experiences with grandparents and an uncle, none of whom had access to hospice and each of whom would have benefited from the services. In our family, my children are the fourth generation to promise to help their elders access comfort care when the time is right. As a family, we have seen the pain that happens when treatments are maintained past the point of a possible cure, and we don’t want it.

When my father passed away in August 2018 under the care of Alive, I was so impressed by the care he received and by Alive’s reputation that I sought out an opportunity to work here.

What has been most difficult about providing care during COVID?

Social distancing is by far the hardest part. Having to close our residences to visitors. Not being able to embrace a grieving family member or hold the hand of a patient. This causes all of us great sadness.

What experience most prepared you for this?

I’m not sure anything can really prepare a physician for something like this. As everyone says, this is truly unprecedented, at least in our lifetime. However, my time in Haiti during the cholera epidemic made me aware of the dangers of being too close to people with highly contagious diseases. Also, my close friend and former resident was the first American suffering from Ebola to be brought back to the US. As I spoke with him immediately after his diagnosis in Africa and then while he was being treated in Atlanta, I felt the pain that his family was experiencing and the urgency of finding ways to mitigate the spread of these diseases.

Tell us about your professional background.

I am a family physician, in practice for 30 years. I spent 20 years working for a non-profit community health center in a town of 2,700 in the Appalachian Mountains of East Tennessee. I served as Medical Director and CEO. In addition to general family medicine, my special area of interest was obstetrics. I then spent six years in Fort Worth, Texas, at a public hospital creating and directing a one-year fellowship in obstetrics for family medicine residents. I also helped develop a program in global health. I returned home (to Murfreesboro) in 2015 to help start the new University of Tennessee family medicine residency at Saint Thomas Rutherford. I left there in April 2019 to join the team at Alive.

How does hospice care differ from your prior training?

My training was in family medicine with a special focus on obstetrics. My residency and practice provided much “real life” training in hospice and palliative care as did my trips overseas. Many doctors and nurses who have provided obstetrical care find similarities in the life transitions of birth and death. As a family physician, I have always participated in end-of-life care with my patients. I knew that at some point in my career I wanted to be more involved.

What do you want the public to know about hospice?

The word “hospice” shares roots with “hospital” and “hospitality.” It comes from a Latin root meaning “guest” or “stranger” and was first used to describe places of rest and safety for travelers or pilgrims. And so, “hospice” as we use the term now, refers to a place of rest and safety as we travel on the journey through the end of life.

We want our hospice care to provide for all the needs of our patients on this journey – their physical symptoms, emotional and spiritual concerns, and social needs.

What do you want medical professionals to know about hospice? 

Hospice is not a last resort. It should be a foundational component of the medical care we provide to our patients who have life-limiting illnesses. Too often the transition to hospice care occurs very late in an illness when a patient only has hours or days to live. If hospice care is initiated much earlier, it can be more beneficial for the patient and the family.

Providing comprehensive, compassionate, and competent care includes not only treating illnesses and injuries with a focus on a cure. It also includes knowing when that focus should shift to providing comfort and managing symptoms. This should happen when one becomes aware that there is no legitimate hope that the disease process can be slowed or reversed.

Learn more about Dr. McRay
Video interview with Dr. McRay and his brother.
Dr. McRay’s trip to Palestine and presentation at Palliative Care Conference

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