The Fort Smith region once again has 24-hour neurosurgery care after the early August arrival of Drs. Kenneth and Kate Czerniecka-Foxx from New York.

In their first couple of weeks on the job, the husband-wife neurosurgeon team at Mercy Fort Smith have performed about 30 surgeries that would have otherwise been transferred to hospitals in other areas.

Fort Smith had 24-hour neurological care between 1962 and 2016. The number of new neurosurgeons graduating is not enough to meet the need of attrition across the country, former Mercy Clinic President Dr. Cole Goodman told the Times Record in January.

Prior to the arrival of the neurosurgeons, about 2,200 neurological cases were required to leave the Fort Smith service area each year. More than 700 neuro trauma-related patients were transferred, and more than 1,500 spine cases were transferred annually, according to Mercy Fort Smith President Ryan Gehrig.

“We’re not planning on sending any cases out,” Kenneth Foxx said last week. “We can take care of everything right here. Mercy’s been a fantastic partner in that, and given us the tools to provide that high level of care right here in Fort Smith.”

Foxx, 33, went on to say he and his wife were “very well trained by some outstanding surgeons,” including Drs. Webster Pilcher and Paul Maurer at the University of Rochester Medical Center in New York. Foxx also studied with neurosurgeon Dr. Uzma Samadani at New York University.

Czerniecka-Foxx, 34, received her medical degree at the University of Krakow before earning a rare spot for neurosurgery training in Rochester. The two completed their six-year residency there before arriving in Fort Smith.

“We were lucky enough to train in a very, very strong program,” Foxx said. “We trained in a very high volume place … so this transition isn’t really much of a change.”

Dr. Webster H. Pilcher,chair of the University of Rochester Medical Center's Department of Neurosurgery, called Drs. Foxx and Czerniecka-Foxx an "extraordinary team."

"We were fortunate to recruit them to our residency program at the University of Rochester," Pilcher wrote in an email. "As chief residents in neurosurgery at Strong Memorial Hospital, they ran a busy and challenging neurosurgery service, presiding over 2,000 surgical cases per year. The breadth of their surgical skills is impressive. We were proud to have them on our team and will follow their careers in Fort Smith with interest. Their talent, their compassion for the patients they serve and their desire to make a difference, will make them a wonderful asset to the Fort Smith community.”

Foxx, who grew up in Endicott, New York, said Fort Smith was a good fit for the two neurosurgeons because it allows them to build a new practice.

Czerniecka-Foxx grew up in Yaroslav, Poland, near Krakow, and graduated with honors in 2010 from Jagiellonian University’s Collegium Medicum in Krakow. She also conducted her neurological surgery residency at Rochester beginning in 2012.

Only about than 200 medical students in the nation are accepted annually to train as neurosurgeons, Foxx noted. According to a 2016 article in AANS Neurosurgeon, the official socioeconomic publication of the American Association of Neurological Surgeons, the ratio for a sufficient neurosurgical workforce is now about one per 61,000 people. It was bumped up from one per 100,000 people in 1975. With a growing and aging population, one per 61,000 may even still be inadequate to meet current health care needs, the AANS article states.

"There are over 5,700 hospitals in the U.S. with less than 3,700 neurosurgeons," the AANS article adds. "To fill the gap created by a neurosurgical workforce, 102 accredited neurosurgical residency training programs in the U.S. with approximately 1,200 total trainees produce 160 graduates annually. At this current rate, the supply-demand mismatch will grow with time. Simply creating more residency positions will not close the gap quickly enough due to the prolonged length of time required to generate board-certified neurosurgeons. This is further complicated by neurosurgery’s shift toward sub-specialization, further delaying new arrivals to the workforce by an additional one to two years."

Kyle Parker, president of Arkansas Colleges for Health Education, said in January: “For Mercy to get not just one, but two, neurosurgeons is a big home run.”

Parker added that west Arkansas and east Oklahoma are dead center in the most underserved region in the nation and Arkansas is ranked 18th in the nation in spending because of issues with opioids, obesity and heart disease.

In 2010, knowing the trend of retiring neurosurgeons locally, Mercy Fort Smith began its recruiting efforts for neurosurgeons. At one time there were seven neurosurgeons in Fort Smith. Now there four including Drs. Arthur Johnson and Kenneth Tonymon. Baptist Health also has a neurologist, someone who can diagnose and test medical problems, and an advanced practice nurse.

The addition of a 16,000-square-foot neurosciences center at Mercy will have a “ripple effect” on the rest of the Fort Smith system to support the care that’s delivered, Gehrig said in January. The return to 24-hour neurological care is pushing Mercy to prepare additional support services in areas like the trauma and the emergency departments.