Amarillo Clinic Expands into Neurology Education Role

By Jean Yaeger

Medical students and resident physicians in Amarillo will get more exposure to pediatric neurology thanks to a new and unique partnership between Cook Children’s and the Texas Tech University Health Sciences Center (TTUHSC).

The TTUHSC School of Medicine and Cook Children’s worked together for four years to design and implement their collaboration. It’s an innovative model of health care teamwork: Two Amarillo-based Cook Children’s neurologists serving as TTUHSC teaching physicians. Their job? To evaluate how students and residents interact with patients. 

“The main philosophy is to provide the best care for children in our community. This partnership provides accessibility to more providers,” said Shannon Herrick, M.D., regional chair for TTUHSC and associate professor of pediatrics. “At the same time, it allows learners who are going to go out to these surrounding communities in the future to learn from these providers. That's the goal.”

A little background helps put the partnership in context. Scott Perry, M.D., an epileptologist and head of Cook Children’s Jane and John Justin Institute for Mind Health, began seeing patients in Amarillo once monthly more than eight years ago, in an effort to bring pediatric neurology care closer to the children of West Texas. As the only pediatric neurologist coming to the area at the time, Dr. Perry formed strong relationships with local referring physicians.

Texas Tech Physicians group hired pediatric neurologist Diana Lebron, M.D. several years later to provide full-time neurology care to the area. Her role at the Headache Clinic and General Pediatric Clinic included giving feedback to TTUHSC medical students and residents during their neurology rotations. However, it was clear the demand for pediatric neurology services required another full-time provider.

Meanwhile, pediatric neurologist Rolla Shbarou, M.D. began seeing patients two years ago at Cook Children’s Pediatric Specialties Amarillo. Her fellow neurology specialists in epilepsy and movement disorders, along with doctors in other specialties, continued to come from Fort Worth periodically. But Dr. Shbarou was the clinic’s only full-time physician.

Now, with the new partnership, Dr. Lebron joined Dr. Shbarou at Cook Children’s Pediatric Specialties Amarillo, located at 17 Care Circle. Cook Children’s welcomes Dr. Lebron’s patients to her new location. It’s also a new site for the medical students and residents as they’re being mentored by both Dr. Shbarou and Dr. Lebron as clinical professors.     

Pediatric neurology involves treatment for babies, children and teens who experience seizures, stroke, cerebral palsy, movement disorders, brain injury, chronic headaches and other conditions. The partnership between TTUHSC and Cook Children’s is designed to make access to neurology broader and more convenient for patients in and around Amarillo. Dr. Lebron and Shbarou provide general neurology care daily, while Dave Shahani, M.D. and Dr. Perry provide specialized epilepsy services and Stephanie Acord, M.D. provides movement disorders/spasticity services during monthly trips to Amarillo.

Dr. Perry said the arrangement helps make neurology care available closer to home for families in the Texas Panhandle and beyond.

“Many people we take care of in neurology have complex needs, maybe developmental delays, mobility issues and equipment,” he said. “The kids might be having seizures, and you don’t want to have to travel long distances if you can avoid it for a 30-minute appointment.”

Here’s a closer look at the advantages for each group impacted by the merged approach.

Medical Students and Residents

TTUHSC uses a strategy called academic medicine. Dr.  Herrick explained that students and resident physicians go through weekly or monthly rotations in various specialties – not just neurology, but also cardiology, sports medicine, hematology/oncology and more. Clinical professors critique how the learners handle encounters with patients, such as taking medical histories or conducting physical exams. In the process, the learners pick up on delicate skills.

“It’s a lot of the nuances of bedside manner, the nuances of how do you handle a difficult case and help the family cope and do it in an understanding way,” Dr. Herrick said. “There’s a complexity with children who have seizures or chronic disease that is hard sometimes for families to handle. That’s the art of medicine, and we’re driven to teach that.”

Groundwork for the partnership dates back to 2019, when Dr. Herrick reached out to see if the neurology team at Cook Children’s might be able to support Dr. Lebron so that she wasn’t always on call. That initial conversation grew to a discussion of possible ways that TTUHSC could partner with Cook Children’s on a larger scale.

One advantage of this new collaboration is that students and residents will see an increased number of general neurology and complex neurology patients. They’ll also experience different teaching styles between the two neurologists. Students and residents will do the initial exams and other procedures, with Dr. Lebron and Dr. Shbarou repeating each step to make sure nothing is missed. Families are very understanding of the teaching process, Dr. Herrick said.

The arrangement provides students and residents with greater exposure to a diversity of disorders. And when neurologists from Fort Worth visit Amarillo, they could give lectures to TTUHSC classes on epilepsy, movement disorders or other subspecialties. The intent is to demonstrate the bigger picture of neurology to more prospective neurologists.

“I hope to inspire medical students and pediatric residents, encouraging them to consider a career in pediatric neurology,” Dr. Lebron said. “Introducing residents and students to Cook Children’s doctors could lead to more research and innovation that benefits our patients and inspires future health care professionals.”

Patient Perspective

Many neurology conditions can be treated at the Cook Children’s clinic in Amarillo. But it won’t eliminate long-distance travel in every case, because patients who need certain care might have to go to Fort Worth. Dr. Lebron specializes in headaches in part because she too suffers from migraines.

“We don’t have biological markers for this, and so it makes it challenging,” she said. “To me, it’s exciting to be able to strategize and treat headaches. We have so many tools that we use to try to improve their quality of life.”  

Dr. Lebron’s patients seek her out from as far as southern Kansas. She notified them in anticipation of her move to Cook Children’s in late 2023. A native New Yorker, Dr. Lebron has Puerto Rican and Cuban roots, and she speaks fluent Spanish.

“Being bilingual is a big plus because it helps me connect with more patients and their families. It’s about breaking down language barriers and making sure everyone gets the care and information they need in a way that makes them feel at ease.”

Physician Perspective

TTUHSC will pay teaching stipends to Dr. Lebron and Dr. Shbarou. They’re able to consult with one another as colleagues, plus enjoy the backing of Cook Children’s neurologists in Fort Worth and Prosper to share on-call nights and weekends. 

“It’s hard to get a specialist in rural areas and hard to keep a specialist in those areas until you have some amount of inertia, which is generally created by a team of people,” Dr. Perry said. “To have another provider in the office to talk to means you’re not off on your little island by yourself.”

He and Dr. Herrick expressed hope that this joint investment will strengthen and stabilize the long-term outlook for neurology care in the Amarillo area. The model could potentially expand to other specialties beyond neurology. They say it’s important to emphasize the cooperation and mutual benefit for both TTUHSC and Cook Children’s.

“We wanted to make sure we did it right and to make sure that everyone knew that this was a partnership. We're not competing,” Dr. Herrick pointed out. “This is to enhance the health care of the community.”