Boutique medicine: Specialty clinics flourish as area doctors step up their game

When I moved to Southeast Texas approximately five years ago, it was offered almost as an article of faith that whenever local doctors got sick, they traveled 90 west to Houston for treatment. The unspoken corollary was that their more affluent patients did the same.

To the extent that was true, it appears that recent years have seen a changing climate here in term of medical care. A new billboard erected near the intersection of Dowlen Road and Highway 69 proclaims, “Houston … You have a problem,” then touts “World Class Surgery. Personal Attention. Right here in Beaumont.”

The billboard was created by Cornerstone Media on behalf of Previty Clinic, located inside the Memorial Hermann Baptist Hospital in Beaumont. A visit to Previty takes you outside the realm of a normal physician’s office. You are greeted with a friendly welcome from Gail, who seems more like a concierge than a charge nurse herding you through a patient-processing facility. She offers you tea or espresso and invites you to perch on a comfortable settee for the doctor who will be right with you. Even the magazines and books seem a cut above the clinical norm.

To address the issue of why you called Previty Clinic in the first place, you will see Dr. Garrett K. Peel. Despite the welcoming atmosphere, he is the real reason Previty is a cut above. Peel is a Texas native and holds medical and public health degrees from the George Washington and Johns Hopkins universities. Prior to his arrival in Beaumont, he was chief resident at the Mayo Clinic in Rochester, Minn., where he was trained and mentored by world-renowned surgeons and gained expertise in complex surgical procedures.

The mellow vibe at Previty reflects his belief that restoring the mind and spirit is an important part of making the body well — art and science together play a role in the healing process. In addition, Peel is chief of the Division of Oncological Surgery at Baptist, ensuring his influence and healing touch are felt outside the walls of Previty.
The availability of specialized care and physicians like Peel is making trips to Houston increasingly unnecessary for local health care consumers.

“There’s no question we have quality health care in Southeast Texas because both hospitals have been recognized nationally – Christus and Baptist,” said one observer who closely tracks the local medical scene, and enumerates the points that are important to many patients. “You have a board-certified physician – you definitely want to know that, and there’s nothing wrong with asking doctors their clinical outcomes; you can go online and see that now. So if you have everything that’s necessary here to provide the service in the right atmosphere with the right clinical outcomes in a doctor’s office that meets your needs, why would you go to Houston?”

The recent opening of the Outpatient Diagnostic Center is another case in point. Owned by Dr. Brent Mainwaring, the ODC is a full service facility on College Street in Beaumont providing all diagnostic and women’s imaging tests in a single location designed to put the patient at ease during every stage of their visit.

“We designed the facility to be very warm and welcoming,” said Mainwaring. “We don’t have televisions; we keep soft music playing in the background. The colors are muted, and we have original art on the wall. We want our patients to be as relaxed as possible during the testing process.”

Our local medical observer told the Business Journal not all diagnostic facilities are created equal.

“Insurance companies are all about saving dollars,” said the observer. “If you need an MRI, they may send you over to the MRI place that used to be a movie theater that has a rejuvenated MRI machine that is probably 15 years old and you can get your MRI for half the price. Never mind they can’t see a tumor that’s in your liver – it’s half the price!”

That’s not an issue at ODC, said Ed Field, executive director. “We are a state-of-the-art facility,” he noted, then suggested telling the difference is not always easy. That’s one of the challenges for the medical consumer these days.”

Field said should an abnormality be detected, “ODC performs biopsies five days a week where a hospital might only do biopsies one day a week.”

Last week there was a groundbreaking for a new hospital in Beaumont on Dowlen Road. Victory Medical Center can be described as a boutique hospital with eight patient rooms and four surgical suites designed specifically to accomplish complex spine procedures. The new hospital is a partnership between Victory Healthcare and the surgeons of Golden Triangle Neurocare.

Although Victory will operate as an out-of-network provider – meaning many procedures will be covered at reduced rates or not at all under some insurance plans – founder and CEO Robert N. Helms Jr. said that does not automatically translate into greater costs and cited the recent spinal surgery of his wife as an example.

“Had her case been done the normal way, she would have ended up with all kinds of hardware in her back and been hospitalized for at least four days. Under the technique that was used for her, they used a device called an AccuraScope. It’s from France, a very, very tiny scope with tremendous capabilities,” said Helms.

According to the literature, the AccuraScope procedure uses a live X-ray for guidance and a tiny incision to insert the small scope through a small incision in the skin and into a natural opening at the base of the spine. The surgeon then uses a number of instruments, including a laser, to shrink the damaged disc and relieve pressure on the spinal nerve. This procedure is usually completed in 30 to 40 minutes. Patients are returned to the recovery area and are usually discharged approximately one hour after the surgery.

Her husband said the experience of Mrs. Helms was a textbook case.

“They were able to repair three discs that she had damaged very badly,” he noted. “After her procedure, she remained in the hospital in the recovery room for about an hour, and another half hour to get her to the point where she was dressed and ready to go home – and I took her home,” he said.

Helms said the costs of the procedure were much less because conventional surgery could have easily required four days hospitalization. “Not only that, but the hardware that would have been installed in her back would have come fairly near the overall cost of the procedure, so it’s far, far more cost effective,” he said.

In addition, for most Medicare patients with a decent supplement policy, the out-of-network proviso would not make Victory Medical Services a prohibitively expensive option.

Business Journal editor James Shannon offers a weekly column of business news for readers of The Examiner. For more details, see the editions of the Business journal published monthly in Beaumont, Port Arthur and Greater Orange. Check out the blog at setxbiz.blogspot.com or e-mail james@beaumontbusinessjournal.com.

Mardi Gras economics

Easter is a moveable feast that falls somewhere between March 22 and April 25 depending on the vernal equinox. The Roman Catholic Church mandates the 40 days before Easter as a period of fasting and penance called Lent. To get in as much fun as possible before Ash Wednesday ushers in the Lenten deprivations, the tradition of Mardi Gras arose – the term literally means “Fat Tuesday.”

The annual bacchanal that is Mardi Gras in New Orleans is a legendary party known around the world, perhaps rivaled only by the similarly themed Carnival in Brazil. Several cities along the Texas Gulf Coast have established Mardi Gras traditions of their own in recent years

Galveston Island celebrated Mardi Gras as early as 1867, but the party had died down until it was revived in 1985 by Galveston-born developer George P. Mitchell, who had a new hotel complex and other properties he figured would benefit from an influx of off-season tourists. In the 27 years since the revival, the event has grown to impressive size. The celebration in Galveston this year runs from Feb 10-21 and will feature 26 concerts, 24 parades, 19 balcony parties and five elegant masked balls.

According to Leah Cast, public relations manager for the Galveston Island Convention & Visitors Bureau, “Mardi Gras is our biggest event – it’s an event that defines the city and everyone gets involved in it. Economically, it’s huge for us.”

Cast said the event kicks off on Feb. 10 with big festivities on the weekends and Fat Tuesday, which falls on Feb. 21. She said the crowd estimates for that period approach 300,000 with an economic impact around $30 million.

“A lot of people don’t realize that outside Baton Rouge and New Orleans, Galveston has the largest Mardi Gras in the country,” noted Cast.

The success of the 1985 Mardi Gras revival in Galveston did not escape the attention of civic boosters in Port Arthur, some 80 miles to the east. The traditions associated with Mardi Gras of Southeast Texas date back to the year Bill Clinton became president. The first festival in 1993 was relatively small in size as compared to more recent events. Mardi Gras here has not just survived but flourished thanks in large part to support from elected and administrative officials, public works, police and fire departments and about 1,200 volunteers.

When they block off Procter Street in downtown Port Arthur from Feb. 16-19 for Mardi Gras, the residents of the city by the sea will brace for the annual invasion of 250,000 of their closest friends and neighbors. Area businesses will roll out the welcome mat for the visitors who will leave a large chunk of change in cash registers around town. Exact calculation of the dollars spent is an inexact science, but we’re talking millions in a span of only four days.

“Based on the formulas from economic development groups and chambers of commerce, a dollar turns over six times,” said Mardi Gras Southeast Texas (MGSET) co-founder and past president Floyd Marceaux in a 2011 interview with the Business Journal.

“Whenever we total up all the income – say, $500,000 – we said $3 million was the economic impact; we tended always to be conservative, but we’ve seen other festivals that stretch that number,” reported Marceaux.

Tammy Kotzur is executive director of the Port Arthur Convention and Visitors Bureau. She said Mardi Gras is one of the highlights of the city’s annual calendar.
Like Marceaux, she is conservative when trying to estimate the economic impact of Mardi Gras – or any other event.

Although she won’t put a number on it, Kotzur knows Mardi Gras has Port Arthur cash registers singing. “Direct economic impact includes hotel rooms, because the hotels are always sold out Mardi Gras weekends; restaurants because despite the fact (visitors) go down to Mardi Gras they don’t spend the entire time there; gasoline for their vehicles. Shopping? You’d have to say yes,” she said.

The good will from the Mardi Gras of Southeast Texas continues as the nonprofit festival makes significant annual contributions to local nonprofit groups. “In 2010, MGSET contributed $100,000 to the nonprofit organizations that sponsor the event,” said Marceaux. “The board makes the annual allocations based on revenue, expenses, and what our needs could be next year. The contribution to each group ranges from $1,000 to $5,000 each year.”

On a smaller scale but just as much fun is Mardi Gras on the Sabine, the annual parade sponsored by the Greater Orange Area Chamber of Commerce. A one-day event held this year on Feb. 11, the parade attracts thousands of participants and viewers from Orange County and beyond, with fans driving in from the Houston area and throughout Louisiana.

“This is our ninth year for Mardi Gras on the Sabine,” said Ida Schossow, Chamber president. “We don’t charge admission so the exact economic impact is harder to measure, but we’ve got thousands of people coming in and staying in our hotels, eating in our restaurants and shopping in our stores, so it’s a definite shot in the arm for the Orange economy.”


Business Journal editor James Shannon offers a weekly column of business news for readers of The Examiner. For more details, see the editions of the Business journal published monthly in Beaumont, Port Arthur and Greater Orange. Check out the blog at setxbiz.blogspot.com.

Strike Averted

The negotiations went down to the wire on Jan. 31 as the United Steelworkers union and Royal Dutch Shell reached a tentative agreement on a new three-year contract averting a possible strike that could have idled as many as 69 refineries in the United States, including many of the petrochemical facilities in Southeast Texas.

The union negotiated with Royal Dutch Shell, which operates as Shell Oil in the U.S. and operates Motiva as a joint venture with Saudi Refining. The negotiations were also conducted on behalf of Valero, Exxon Mobil, BP, ConocoPhillips, Chevron, Marathon, Sunoco, Tesoro and PBF Energy. The Jan. 31 agreement was subject to ratification by USW local unions whose members work for those companies.

The USW represents 30,000 workers at 168 production, refining, marketing, transportation, pipeline and petrochemical facilities nationwide, including the aforementioned 69 refineries representing about 64 percent of U.S. refining capacity.

For most of the 20th century, refinery workers were represented by the Oil, Chemical and Atomic Workers Union (OCAW). In 1999, OCAW merged with the United Paperworkers International Union to form the Paper, Allied-Industrial, Chemical and Energy Workers International Union (PACE). In 2005, PACE merged with the United Steelworkers to form the United Steel, Paper and Forestry, Rubber, Manufacturing, Energy, Allied-Industrial and Service Workers International Union.

The merged union is still more commonly known as the United Steelworkers. Overall, the USW is the largest industrial union in North America with 850,000 members in the U.S., Canada, and the Caribbean. It represents workers employed in metals, rubber, chemicals, paper, oil refining, renewable and atomic energy, plus the service sector.

Thus it fell to members of USW locals to ratify the tentative agreement reached on Jan. 31. In Beaumont, Local 13-243 represents workers at the ExxonMobil plants here.

Local 13-243 President R.A. “Pet” Petkovsek was on the USW National Bargaining Council that guided the union during the negotiations.

Although officials were tight-lipped about releasing some details of the proposed three-year contract prior to ratification, the Business Journal learned it includes pay increases of 2.5 percent in the first year and 3 percent in the second and third years.

“This contract negotiation wasn’t really about those small pay increases,” said Petkovsek. “We were more concerned with health and safety issues.”

The union rejected four earlier contract offers from Shell that didn’t include changes on safety the union wanted.

“The plant manager sitting in his office is not going to get anything worse than a paper cut; it’s our guys on the firing line that face real danger,” said Petkovsek, noting that 18 workers died while working at U.S. refineries between 2009 and 2011.

The union sought – and won – a provision mandating a full-time employee for overseeing safety standards for each bargaining unit representing more than 150 people at a plant. Petkovsek said this was important because it guaranteed workers would have a place at the table when safety measures were being determined.

The last nationwide strike by refinery workers was in 1980 and lasted three months. A strike could have boosted prices for gasoline, jet fuel and other refined products at a time when crude oil prices above $100 a barrel have been a drag on the global economy.

In 2009, refiners agreed to a 9 percent pay increase over three years in the last round of talks with the union. In 2011, however, it was health and safety standards that were the main obstacle to a deal, but the parties were able to reach a compromise.

The timeline was tight, with many contracts due to expire at midnight on Jan. 31. The 11th-hour agreement averted a strike, pending approval by USW members. At 1:30 p.m. on Feb. 2, Local 13-243 recommended approval of the deal to its members.

On Tuesday, Feb. 7, they gathered at the Union Hall at 2490 S. 11th in Beaumont. Three meetings took place that day after the shift changes at the plant. The last meeting at 6:30 p.m. saw hundreds of men and women in blue coveralls and Nomex suits pack the hall for discussion and a vote. Their mood appeared serious but upbeat before the meeting started. Reporters left before the doors closed.
In a phone call after the meeting, a weary but relieved Petkovsek told the Business Journal that the members had “overwhelmingly approved the contract.” He said it was not unanimous, but that was to be expected from a diverse membership.

And there is peace in the petrochemical valley today – and for the next three years.

Business Journal editor James Shannon offers a weekly column of business news for readers of The Examiner. For more details, see the editions of the Business journal published monthly in Beaumont, Port Arthur and Greater Orange. Check out the blog at setxbiz.blogspot.com or e-mail james@beaumontbusinessjournal.com.

Al Sabor de Mexico

The trim red trailer parked in front of the H-E-B on Highway 347 in Groves has the name “Al Sabor de Mexico” emblazoned on the side and offers the usual assortment of tacos, tortas, burritos and tamales. It meets the definition of the familiar Tex-Mex menu, but owner Lupe Reynoso’s take on the flavors of Mexico also pays tribute to the cuisine of that country well beyond the region along the U.S. border.

In addition, his story has a decidedly American flavor as the Reynoso family has cast their lot with this country as surely as anyone named Smith, Jones or Washington. With his wife, Rosa Maria and their four American-born children, Lupe works hard from 11 in the morning to 10 at night dispensing food that is tasty and healthy.

“We try not to use oil,” said Lupe. “We don’t like it – and we serve no fried food.”

Their commitment to Mexican regional dishes is apparent in many of the meat options on the menu.

Birria is shredded beef that has been steeped in a marinade that includes cinnamon, chocolate and bay leaves, usually prepared as a treat for weddings and other special events.

Cochinita Pibil is marinated shredded chicken from Yucatan with a unique flavor that includes sour orange and achiote, a spice derived from the plant that grows in the tropical areas of South America. It has a red fruit with bright red seeds.

“We grind the seeds ourselves,” said Lupe, a testament to the care taken in preparing what some might consider “fast food.”
Al Pastor is shepherd-style pork that is marinated and cooked to order in a skillet.

Other meats include the more familiar carne asada, lengua (beef tongue), barbacoa, and chorizo (Mexican sausage).

Rosa makes tortillas fresh to order, but they are homemade corn tortillas from masa.

“Flour tortillas are from Northern Mexico; in most of Mexico, tortillas are corn,” explains Lupe.

One exception to the Mexican rule are pupusas, a staple from El Salvador. A thick, corn pancake stuffed with meat or cheese, Lupe explains the pupusas recipe came to the family through a Salvadorian sister-in-law. The family pastor is also from El Salvador. The business is closed on Sundays when the Reynoso family travels to worship at Iglesia de Cristo, a Pentecostal church on the north side of Houston.

Lupe Reynoso came to the United States as a teenager in the early 1980s. Like so many immigrants from south of the border, he was drawn here by the lack of opportunity in his home country. Never afraid of hard work, he first labored in the fields picking peaches, plums and grapes in California. Through a relative, he found other work in landscaping and in a factory where he assembled videocassettes.

The Immigration Reform and Control Act, signed into law by President Ronald Reagan in 1986, was an important milestone for the Reynoso family. It granted amnesty to illegal immigrants who entered the country before Jan. 1, 1982, and had resided there continuously. Lupe got his green card then and would become an American citizen in 2002. The tests he had to pass to attain citizenship gave him a greater understanding of his adopted country than many native-born high school seniors.

Lupe developed his skills and worked in the construction industry in California for 27 years before the building boom there finally burst, leading the family to Texas. Lupe found steady work on refinery construction projects with a platform contractor, but the food service business was something he had always wanted to try.

“I would help out cooking in the church kitchen,” he explained. “I would get inspired, trying out little things.”

That inspiration and the careful attention to detail practiced by Lupe and Rosa are what elevates the food produced in the little red trailer to another level. This is not your usual taco truck parked outside a cantina or plant gate.

The four Reynoso children – ages 23 to 6 years old – help with the family business when they can, but Al Sabor de Mexico is mostly a genuine mom-and-pop affair.

The kids lead busy lives of their own. Eldest son Jerry followed Lupe into construction work at refineries with a platform contractor, Daughter Ruth is an 11th grader at Port Neches-Groves who plays on the school soccer team. She works part-time as a cashier at the H-E-B store across the parking lot from the family but wants to study forensic science in college, inspired by the television shows CSI and the Scooby-Doo mysteries.

The Reynoso family invites you to come taste a little of what Mexico has to offer. If you don’t want to dine on the single picnic table with torches alongside to ward off the seasonal mosquitoes (and when are mosquitoes not in season in Southeast Texas?) order your food to go. These delicacies can be served on your dining room table on your finest china.