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Hospitals look to expand neurosurgery care in Northwest Arkansas

by Alex Golden | January 5, 2020 at 1:00 a.m.
NWA Democrat-Gazette/BEN GOFF • @NWABENGOFF Alex Castellvi, Mercy neurosurgeon, speaks Dec. 20 in his office at Mercy Hospital Northwest Arkansas. "The goal of me starting here is to provide 24/7/365 care," Castellvi said. Castelvi recently began practicing at Mercy Hospital in Rogers. Go to to see more photos.

FAYETTEVILLE -- More neurosurgeons are slowly trickling into Northwest Arkansas, keeping more patients in the region, officials said.

Mercy Hospital Northwest Arkansas recently added its first neurosurgeon in several years and plans to add another in July, said Jennifer Cook, spokeswoman.

Fast fact

The Arkansas State Medical Board lists 33 doctors who specialize in neurosurgery in Arkansas. All but 10 of the doctors practice in central Arkansas.

Source: Arkansas State Medical Board website

"The goal of me starting here is to provide 24/7/365 care," Dr. Alex Castellvi said.

A staff of one neurosurgeon isn't quite able to provide that, but Mercy hopes to reach the goal as it adds more doctors and nurses, he said.

The hospital also added an advanced practice nurse practitioner, Paula Stephens, who specializes in neurosurgery.

Lack of neurosurgeons

The Northwest Arkansas Council -- a nonprofit organization of executives from the region's largest companies, schools and health care systems -- released a report a year ago estimating Northwest Arkansas is missing out on $950 million a year in the health care economy.

One of the major findings in the report was the number of specialty health care providers isn't keeping up with the region's growing population and isn't enough for the region to be a "health care destination," a place where patients are likely to travel to for health care.

Washington Regional Medical Center in Fayetteville has a 20-bed neurosurgical intensive care unit and is home to the Northwest Arkansas Neuroscience Institute, which provides services such as neurosurgery and minimally invasive surgeries for strokes and aneurysms.

Washington Regional has four neurosurgeons who regularly see patients from as far away as Russellville and Mountain Home, said Dr. Larry Armstrong, neurosurgeon. The hospital takes transfers, often by helicopter, of patients with hemorrhages and/or who need brain or spinal surgery, he said. The surgeons also see patients with brain tumors.

"While the Northwest Arkansas Neuroscience Institute provides a variety of highly specialized services, feedback from stakeholders indicated that many patients are leaving the region for neurosurgery," according to the Northwest Arkansas Council report.

Northwest Arkansas in 2018 had 0.37 neurologists per 1,000 residents, compared with a national average of 0.68 neurologists per 1,000 residents, according to the report.

Before hiring Castellvi and Stephens, Mercy transferred many patients to other hospitals, including Mercy Hospital in Springfield, Mo., Castellvi said.

Mercy still has to transfer some patients, but not as many, and should have to transfer even fewer when it adds another neurosurgeon, he said.

"Not having a neurosurgeon when you're taking care of trauma Xs out a whole lot," Stephens said.

She said some patients need to see a neurosurgeon even if they don't need surgery. Patients who come to the emergency room and have a small brain bleed, for example, sometimes need to be seen by a neurosurgeon to evaluate if they need surgery, she said.

Northwest Health and Washington Regional Medical Center also want to add to their neurosurgery programs, officials said.

Northwest Health's sole neurosurgeon, Dr. Quoc-Anh Thai, works at the Bentonville and Springdale hospitals, said Hans Driessnack, chief executive officer Northwest Medical Center Springdale.

Northwest Health is recruiting for another neurosurgeon, Driessnack said.

Thai is on-call most of the time, and the hospitals need another neurosurgeon so someone can be available at all times to take patients, he said.

Recruiting neurosurgeons

Several factors make having enough neurosurgeons a struggle.

"There's not that many of them," Driessnack said.

Neurosurgery is a highly specialized field relatively few people pursue, he said. Neurosurgeons often prefer to live in larger cities where they're less likely to be the only one or one of a few neurosurgeons taking all of the patients in their area.

"I think it's still an academic field, so the graduating neurologists -- they go on to fellowships or they want to stick with a university setting," said Dr. Mark Moss, an interventional neuroradiologist at Washington Regional Medical Center.

Neurosurgeons and neurologists are trained to treat the same issues, but neurologists don't do surgery.

Moss added many doctors would rather have the lifestyle of a neurologist who works in an outpatient clinic than a neurosurgeon who is on-call. On-call neurosurgeons do surgeries on people with brain injuries from vehicle accidents, for example.

Doctors are likely to practice near where they complete their residencies, according to the American Association of Medical Colleges. None of the area hospitals nor the region's only medical school, the University of Arkansas for Medical Sciences Northwest, offers residencies in neurosurgery or neurology. That means hospitals must recruit neurosurgeons and neurologists from outside the area.

Thai came to Northwest Health from Johns Hopkins University in Baltimore, Driessnack said.

The University of Arkansas for Medical Sciences in Little Rock offers 15 residency slots in neurology and 11 residency slots in neurosurgery, said Andrea Peel, spokeswoman.

Residencies for highly specialized fields such as neurosurgery tend to be in larger cities in part because the larger populations mean residents are more likely to see a variety of cases and get a more comprehensive training experience, Driessnack said. He said he wasn't sure Northwest Arkansas population could yet support residencies in neurosurgery.

"I think we'll get there," he said.

NW News on 01/05/2020

Print Headline: Hospitals look to add neurosurgeons


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