T
he surgeons with the Neurosurgical Group of Texas are being recognized
worldwide for their efforts in outpatient neurosurgery. Ask most people what
neurosurgeons do, and they will tell you; they operate on the brain. These medical
specialists however, are also trained to help people suffering from back and neck
conditions, as well as a host of other illnesses, ranging from carpal tunnel syndrome
to complex neurovascular problems. Many of these problems now can be managed
on an outpatient basis.
The Neurosurgical Group of Texas is also earning a reputation as medical industry
leaders with a distinctive approach to physician group management concepts that
provide superior medical care and achieve cost-effective objectives that
satisfy physicians, patients, and insurance carriers.
This outpatient surgery, well-publicized in both medical journals and consumer
press, is no doubt significant, but in many respects simply represents this group's
philosophical approach to neurosurgery, one of medical science's most challenging
specialities.
With a high success rate for patients undergoing this procedure, The Neurosurgical
Group of Texas is offering patients the advantages of lower cost and less time away
from
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The Neurosurgical Group of Texas has been a pioneer in performing outpatient laminectomies
for the treatment of cervical and lumbar ruptured discs. Their success with the procedure
represents a major step forward on several fronts.
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home and work. In many cases, patients are able to go home within four hours
after the operation is completed, avoiding an expensive two or three day hospital
stay.
Guiding Philosophy for This Group
The Neurosurgical Group of Texas is a group of experienced board-certified
neurosurgeons in private practice in the Texas Medical Center. This group
maintains a close relationship with the Baylor College of Medicine as members
of the voluntary faculty.
The Five experienced doctors who comprise this neurosurgery practice include:
Warren D. Parker, M.D.; Bruce Ehni, M.D.; David Allen Cech, M.D.; Alfonso
E. Aldama, M.D.; and Richard L. Harper, M.D.
The Mission of The Neurosurgical Group of Texas Emphasizes Medical Excellence
and Cost-Efficiency
"In our group, we emphasize high-quality efficient medical care," explains Dr. Aldama.
"Nowadays, with the changing trends in insurance and Medicare, patients and insurance
carriers are very interested in people who will deliver good, quality care, but can
do it efficiently and cost-effectively. We can do a procedure from which the patient
recovers quickly and stays in the hospital a minimal amount of time. The patient can
then go back to the work force shortly afterwards rather
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"We specialize and our philosophy is to utilize the most up-to-date imaging and
combine it with the most up-to-date micro-techniques to achieve the best results
possible - from both a medical and economic perspective."
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- Richard L. Harper, M.D.
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than staying in the hospital
for days and not returning to their normal life for several weeks."
"Quality and efficiency are important to this group of surgeons," said Dr. Cech. "My
practice has always been based on trying to build my reputation on the quality of my
results. I've always felt that quality of results should speak for itself. We provide
our patients the best, latest, state-of-the-art treatments to achieve the best
outcome possible."
"We specialize and our philosophy is to utilize the most up-to-date imaging and
combine it with the most up-to-date micro-techniques to achieve the best results
possible - from both a medical and economic perspective," Dr. Harper said. "We
have been innovative and in front of the curve in terms of spinal microsurgery, as pioneers
in outpatient spinal surgery, with very good long-term results and short hospitalization
times.
"We have extensive experience over more than two decades in the full range of
intracranial surgery, including brain tumors, aneurysms and other vascular problems,
including neurovascular compression syndrome," said Dr. Harper.
New Facilities Bolster Growing Practice
The group recently moved into its new facilities in the Scurlock Tower, 6560 Fannin,
Suite 1200. The new offices are designed for patient convenience and efficient overall
operations. A staff of 17 includes the new administrator, Jane Hill, a healthcare
industry veteran who worked closely with the architect to design the new space. Relationships
of patients to doctor and staff, as well as function were carefully considered in the
design layout. The new space physically brought three practices together for the first
time; the previously solo practices of Drs. Parker and Cech and the trio of Drs. Harper,
Aldama and Ehni.
Ms. Hill has worked to merge the operations of the three practices to improve efficiency
of all patient and physician needs. "We are lean and take pride in our low staff-to-physician
ratio," she said.
The new Scurlock Tower facility has 6,000 square feet of space - plenty of room for the
five physicians and their staff to comfortably conduct their business with patients in an
environment that features both privacy for patient consultation and easy access to administrative
services.
The group takes care of most types of neurosurgical cases. The group's philosophy is that
most neurosurgical problems have a straight-forward, cost-effective solution. Minimally
invasive microsurgical techniques are emphasized.
Group Formed to Meet Contemporary Needs
"We achieved an economy of scale when we formed our partnership, in which
we merged three practices. When you're striving for quality in a managed care
environment, you can offer competitive fees for insurance companies," according
to Dr. Aldama, managing partner of the group.
That The Neurosurgical Group of Texas has five physicians is, in part, a result
of professional associations which have developed over the years. However, the
intent of establishing a group of this size was deliberate and calculated to
achieve optimum results in delivering quality, cost-effective service to patients
during challenging times.
"It became evident to us as we planned the establishment of our practice,
that a group of five would be better than a group of one, two, or three - or
a big clinic with 100 physicians," Dr. Aldama said. "A good group of five is
manageable. You still have the personal touch of a small office
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"Smaller surgical incisions and dissections have led to decreased postoperative
pain, increased mobilization and a decrease in hospital time."
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- Warren D. Parker, M.D.
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practice, but
you have the capacity to cross-cover each other better, cover more hospitals and
take care of more people with equal efficiency."
This group works efficiently, but does not cut corners where the patient care
is concerned - a goal achieved, in part, by having a group this size.
"We're not going to overload our schedule where we cut our patient time
in half. I still take 45 minutes to an hour with a new patient. A lot of practices
take 15 to 20 minutes with new patients; and yes, you can see more patients that
day, but a doctor is going to do a better job in 45 minutes than a doctor of
the same skill who spends 20 minutes with the patient," Aldama said.
"Having a group of this size allows us to make decisions fairly easily,"
Dr. Cech said. "We're all personable and friendly and our new facility allows
us to consult with each other on a regular basis. With a group of 20 or more,
it's difficult."
"In the city of Houston, we're the largest private neurosurgical practice
outside a university setting and we offer the widest range of services of any
group in town - all the way from very advanced, state-of-the-art, minimally
invasive spine surgery to the most complicated vascular and aneurysm and
high-tech intracranial surgery. We offer the whole range of services, no one
has to go to the Mayo Clinic to get everything done," Dr. Harper said.
Distinguished Surgeons
The Neurosurgical Group of Texas represents five of the nation's top
specialists in all phases of neurosurgery.
Drs. Harper, Ehni and Aldama have been together since the 1980s. The
group was originally founded by the late Dr. George Ehni, father of Dr. Bruce
Ehni, in the 1950s. The senior Dr. Ehni died in 1986, and was the first
chairman of the
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Department of Neurosurgery at Baylor College of Medicine. He
is considered by many to be the "Father of neurosurgery in Houston." Dr. Parker
and Dr. Cech trained with the other members of the group and eventually became
part of the new partnership, established in 1996.
Warren D. Parker, M.D.
Dr. Parker has practiced neurosurgery in the Texas Medical Center since 1975. He was born
and raised in Eagle Lake, Texas.
He graduated with honors from the University of Texas at Austin and was a member
of the Sigma Alpha Epsilon fraternity. He completed medical school training at
Baylor College of Medicine, Houston, and a straight surgery internship and
residency in neurological surgery at the Baylor affiliated hospitals in the
Texas Medical Center.
Dr. Parker served in the U.S. Army in Korea as a captain and flight
surgeon. He is on staff at The Methodist Hospital, St. Luke's Hospital and
serves as a clinical assistant professor in the Department of Neurosurgery,
Baylor College of Medicine. He is a fellow of the American College of Surgeons.
Dr. Parker is active in civic affairs including service with the
Chancellor's Council at the University of Texas System, the College of Natural Sciences Advisory Council, and the
Texas Longhorn Educational Foundation of the University of Texas at Austin. He
has many published works in the Journal of Neurosurgery and in the
journal Spine.
Bruce Ehni, M.D.
Dr. Bruce Ehni received a bachelor of science in Mechanical Engineering and graduated with honors from the
University of Texas at Austin. He also did graduate work in Biomedical Engineering. He completed medical school at
Baylor College of Medicine, Houston, and a general surgical internship at Northwestern University in Chicago. He is
a visiting clinical fellow in neurovascular surgery at the University of Western Ontario, London, Canada; and a
neurosurgical resident at Louisiana State University School of Medicine in New Orleans. His hospital staff
appointments are at The Methodist Hospital, St. Luke's Episcopal Hospital, Diagnostic Center Hospital and Shriner's
Hospital.
Dr. Ehni serves the faculty of Baylor College of Medicine as a clinical assistant professor in the Department of
Neurosurgery. He holds several offices, including: president, Houston Neurological Society, 1993; membership
chairman, Texas Association of Neurological Surgeons, 1994, 1995; and is president-elect, Texas Association of
Neurological Surgeons in addition to being on the Board of Governors of the Doctor's Club.
Dr. Ehni's scholarly works include published works in Neuroradiology, Neurosurgery, Surgery of the Third Ventricle,
Youman's Textbook of Neurosurgery, Southern Medical Journal, American Family Physician, and Journal of Cerebral
Blood Flow as well as Spine Surgery - Techniques, Complications, Avoidance and Management.
David Cech, M.D.
Dr. David Cech gradauted from Pennsylvania State University with a Bachelor of Science degree with highest
distinction.
He completed medical studies at State University of New York, Downtown Medical Center, College of Medicine,
Brooklyn, NY, graduating cum laude. Dr. Cech had residency training at several institutions, including internal medicine
at the Medical College of Virginia in Richmond and general surgery and neurosurgery at the Baylor College of
Medicine affiliated hospitals in Houston.
Dr. Cech's medical career has included practice in Fort Worth, Texas and as an assistant professor in the
Department of Neurosurgery at the Baylor College of Medicine, where he is also a consulting neurosurgeon to the
Department of Neurosciences, King Faisal Specialist Hospital and Research Center in Riyadh, Saudi Arabia. He is
currently clinical assistant professor, Department of Neurosurgery, Baylor College of Medicine.
Dr. Cech began his current neurosurgical practice in Houston in 1990. His hospital affiliations include The Methodist
Hospital, St. Luke's Epicopal Hospital and Texas Orthopedic Hospital. His published works include articles in
Clinical Neurology and Neurosurgery, Journal of Neurosurgery, Cancer, Surgical Neurology, British Journal of
Neurosurgery and Journal of Clinical Epidemiology.
Alfonso E. Aldama, M.D.
Dr. Aldama earned a bachelor of science degree from Baylor University. He completed medical school at Baylor
College of Medicine, Houston, and an internship at Baylor College of Medicine Affiliated Hospitals. He then
completed residencies in general surgery and neurological surgery at Baylor College of Medicine Affiliated Hospitals.
Dr. Aldama started his practice with the Neurosurgical Group of Houston in 1980. He is a Clinical Assistant
Professor in the Department of Neurosurgery at Baylor College of Medicine.
Dr. Aldama's medical writings include published materials in Texas Medicine and The Journal of Neurosurgery. Dr.
Aldama is currently president of the Houston Neurological Society. Originally from Mexico, Dr. Aldama is bilingual
and his native language is Spanish.
Richard Harper, M.D.
Dr. Harper graduated magma cum laude. Phi Beta Kappa in Plan II Honors Program, earning a Bachelor of Arts from
the University of Texas. Harper graduated from Baylor College of Medicine, Houston, with honors, and completed an
internship in straight surgery in the affiliated program at Baylor. Harper served in the U.S. Navy, as a lieutenant in the
Medical Corps. He also received specialty training at the Baylor College of Medicine in a neurosurgery residency
from 1974 - 1978, beginning his affiliation with the group of physicians with whom he is now a partner.
Harper's hospital staff appointments include: The Methodist Hospital, St. Luke's Episcopal Hospital and the
Diagnostic Center Hospital. He serves as clinical associate professor, Department of Neurosurgery and Department
of Surgery, Baylor College of Medicine.
Since 1990, Dr. Harper has served as a chairman of Quality Management at
the Methodist Hospital of Houston.
Harper's extensive scholarly writings include published articles in Advances in Neurosurgery, Journal of
Neurosurgery, Cancer Drug Delivery, American Academy of Otolaryngology -
Head and Neck Surgery Foundations, Inc, and many others.
Leaders in Outpatient Spinal Surgery
The Neurosurgical Group of Texas has been a pioneer in performing outpatient
laminectomies for the treatment of cervical and lumbar ruptured disks. Their
success with the procedure represents a major step forward on several fronts.
While this procedure is not recommended for all persons suffering with
ruptured neck disks, it is believed that a
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"In the city of Houston, we're the largest private neurosurgical practice
outside a university setting and we offer the widest range of services of any
group in town."
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- Richard L. Harper, M.D.
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substantial number of persons
can be safely managed as outpatients with this operation.
Although spine surgery has been done since the 1930s, members of the
Neurosurgical Group of Texas were the first group to publish results of
outpatient cervical surgery in the prestigious peer review journal, The
Journal of Neurosurgery in the July 1997 issue. That article noted
excellent long-term results comparable to the inpatient surgical management
of nerve root compression syndromes.
"With the laminectomy," Dr. Parker says, "the surgeon makes an incision
posteriorly and removes only the degenerative portion of the disk, leaving
the remainder to perform its normal function. The incision is less than one
inch long on the neck or back for the one to one-and-one-half hour operation and
the patient can go home three to four hours later. This saves an expensive
two or three day hospital stay for inpatient surgery. For example, fees for
cervical radiculopathy treated in this fashion are roughly one-half the cost
of an anterior cervical fusion and a quarter of the cost of an instrumented
fusion."
Dr. Parker explains that the outpatient process evolved over the years
by gradually decreasing the postoperative hospitalization days. Eventually
the best and healthiest patients were done as an outpatient. This was so
successful that now over 90 percent of the group's spine cases are done as an
outpatient.
"People are often suprised when we tell them that neurosurgeons are spine
specialists," said Dr. Parker, "but we are trained to understand brain,
peripheral nerve and spine disorders and their role in the body's health."
The majority of what the layman calls spinal surgery is actually surgery
to decompress the spinal cord and spinal nerves. Most neurosurgeons are
uniquely qualified to evaluate and treat these neurological problems of the
spine. Exceptional cases may involve fusion techniques, but most cases are
effectively treated without elimination of motion segments.
"We feel that fusions in the long-term create a lot of extra wear and
tear on the disks above and below the fusion, resulting in the need for
additional surgery years later. Most people have a one-level, one-sided problem that does not require
multiple-level fusions."
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