by Cindy Tumiel
San Antonio Express-News
(San Antonio - November 21, 2004) A year ago, trauma care in the San Antonio region perched on the edge of disaster.
All the full-time neurosurgeons at the UT Health Science Center quit because of job dissatisfaction, leaving University Hospital, the region's largest Level 1 trauma center, without a full-time staff surgeon to treat patients who arrived in its emergency room with brain or spine injuries.
A residency program for young neurosurgeons collapsed as a result, further depriving the trauma center of residents who provided much of the daily care to hospitalized patients.
University Hospital spent upward of $2 million to keep its trauma program afloat by hiring off-duty military neurosurgeons from Brooke Army Medical Center and Wilford Hall Medical Center.
But now hospital and university administrators are hoping to emerge from their crisis with a nationally recognized center where children will come for specialized craniofacial surgery and where doctors will come to learn the techniques.
Dr. David Jimenez, who came to the health science center this summer from the University of Missouri-Columbia, now heads the new Center for Neurosurgical Sciences. His wife and partner in pediatric surgeries, Dr. Constance Barone, is chief of plastic surgery.
Their techniques for correcting craniosynostosis, a congenital skull deformity in children, have generated some controversy among other surgeons. But the husband-and-wife team quickly became the top choice of a university search committee, said Dr. Celia Kaye, vice dean of the medical school.
"He had national and international recognition in his field," Kaye said. "He had the breadth of interest that we really needed in someone who is going to direct a whole program.
Jimenez is soft spoken, but an adept negotiator. He got hospital and university officials to loosen their pocketbooks, coming up with an additional $2 million in the coming year to bolster faculty and staff salaries and capital investments. The hospital is adding beds, physician assistants and nurses to operate a neurosurgical intensive care unit; the university has dedicated 2,000 square feet of laboratory space and added a faculty position for a research component.
Jimenez also got some new policies. Neurosurgeons now joining the faculty will have their own protected operating room and time to practice their specialties outside of trauma.
The neurosurgeons who left last year cited this as a major source of dissatisfaction. The heavy flow of trauma patients hampered their ability to practice the intricate subspecialties for which they had trained.
Three clinical faculty have joined the staff since August. Jimenez expects to ask the Accreditation Council for Graduate Medical Education next spring to resume the residency program at the medical school.
Jimenez sees a chance to start from scratch and build a first-class program.
"I really do believe in my discussion with the dean and the (hospital) administration that they believe and understood how important neurosurgery is to the whole piece," Jimenez said. "Their goal was not to window dress but to really address the problems they had."Back to top
Trauma care back on track in S.A. 
