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Pilgrimage to Little Rock.

Top Arkansas Doctors Are Attracting Clients From All Over the World

FROM THE FARTHEST reaches, they are coming to Arkansas.

They are searching for the finest physicians and medical facilities, and distance is no object. Daily they arrive from far-flung places like the Indian subcontinent, the Swiss Alps and even Texas.

For the most part, they are coming to Arkansas Children's Hospital and the University of Arkansas for Medical Sciences in Little Rock.

One of the main attractions is South African-born Milton Waner, an ear, nose and throat doctor at Arkansas Children's Hospital and the University of Arkansas for Medical Sciences who specializes in performing laser surgery on skin lesions.

At the Children's Vascular Lesions Clinic, Waner has treated several patients from other countries, including two from Australia, one from Israel and one from Hungary. Many of his foreign clients learn of Waner's skills from his extensive overseas travel and lecturing.

Late last week, in fact, Waner was said to be in Thailand performing laser surgery on the daughter of a government official.

Children's is one of very few hospitals in the region to have a laser-based vascular lesions clinic, and was the first hospital in the state to offer the service.

For the nearest comparable clinics, patients must travel to St. Louis, Dallas or Baton Rouge, La.

All in all, Children's saw 426 patients from outside the state in fiscal year 1991-92, for a total of 4,772 patient days.

The vascular lesions clinic has become invaluable to families with children suffering from port wine stains, which is the overgrowth of blood vessels; telangiectasias, a term for enlarged blood vessels; and hemangiomas, a collection of blood vessels in the skin that grows rapidly during the first months of a child's life.

Since opening clinics at Children's and UAMS, Waner has seen about 400 patients, roughly 60 percent of them children.

Doctors have sometimes recommended that parents let a hemangioma run its course. But left to its own, these lesions can affect a child's eyesight, eating and breathing. Extremely large hemangiomas can result in heart failure.

In most cases, Waner gently heals the lesions with a pulsed dye laser.

The laser allows the doctor to destroy the problematic blood vessels without injuring the top layer of skin.

This special treatment can be remarkably inexpensive. For a minor surgery that takes less than a minute and requires no anesthesia, the cost could be as little as $135. For a 15-minute outpatient surgery, the price is around $550.

But the surgery can get very expensive for some patients such as children with port wine stains needing slow, repeated treatments over several years.

Nearby, two of the hottest medical attractions are cancer specialists Dr. Bart Barlogie and Dr. Sundar Jagannath of the Arkansas Cancer Research Center on the UAMS campus.

Barlogie of Germany and Jagannath of India both specialize in treating multiple myeloma cancer with bone marrow transplants.

Both doctors came to UAMS from the prestigious M.D. Anderson Hospital & Tumor Institute in Houston, bringing referrals from physicians the world over.

These two men are the primary reason why patients come to UAMS from outside the state.

The medical center makes about $10 million in gross revenues from out-of-state residents, $1.9 million of it from foreigners. Since the bone marrow transplant program began more than two years ago, ACRC has been visited by residents of 41 other states and 11 foreign countries.

"These are usually highly motivated patients," Jagannath says. "Many have come to know about our program by researching and asking questions themselves. It's much easier to work with these patients."

Foreign patients must often receive special treatment because they can't afford to stay an entire week in Arkansas for testing. Their schedules usually are compressed into an intense, two-day period.

Marrow Changers

Many of the travelers come for bone marrow transplants, bringing a sibling as a marrow donor. In these cases, the entire procedure can cost upward of $150,000. The price tag is less if the patient decides to donate his own marrow in advance, but that means a longer stay in Little Rock.

After the procedure, patients must remain in Little Rock for as many as 100 days of recuperation.

Jagannath was at M.D. Anderson for 10 years before coming to ACRC.

"When we first moved here, 40 or 50 patients came with us," he says. "All the patients are really struck by the casual, friendly atmosphere. They tend to stay here simply because the staff really gives them extended support and treats them as individuals."

The out-of-town activity is raising a lot of eyebrows.

"I think it helps the reputation of the medical center," says Richard Pierson, vice chancellor of clinical programs at UAMS. "It also facilitates recruitment of other people."

Other major draws for the out-of-state medical dollar:

* Dr. James Suen, head-and-neck cancer surgeon at UAMS who is known for salvaging the speaking ability of his patients through surgery that many others would not attempt. Suen also is President Clinton's doctor.

* Dr. James Aronson, a pediatric orthopedic surgeon at Children's who performs the Ilizarov bone lengthening surgery. He has treated several patients from surrounding states and currently has a patient from Ohio.

* The mobile extracorporeal membrane oxygenation unit at Children's, which has treated many patients from other states. The special "bypass" machine allows the heart and lungs to rest while they heal.

It is often used for premature infants whose lungs haven't fully developed and for patients who have suffered heart and lung injuries.

And there's more on the horizon.

In July, UAMS will be joined by a new chairman of neurosurgery, Dr. Sam AlMefty, who specializes in removing tumors from deep within the skull, taking 18-28 hours for each surgery. AlMefty is now at Loyola University in Chicago. Fully 30 percent of his patients come from other nations.
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Title Annotation:Health Care Update; Little Rock, Arkansas' hospitals
Author:Haman, John
Publication:Arkansas Business
Date:Apr 26, 1993
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