Monroe’s Children’s Special Health Services

Dr. Timothy Mickel, is medical director of Monroe’s Children’s Special Health Services , where he performs cleft lip and palate procedures at no charge.

The first time Dr. Timothy Mickel shows a mother her baby following surgery to repair a cleft lip and palate, she usually cries. In that moment, he knows he is fulfilling his purpose.

“When a child is born with a cleft lip, it is devastating for the family, and fixing that abnormality is one of the most satisfying things I can do as a plastic surgeon. When we reunite the mother and her baby following the procedure, it’s an emotional experience for both of us. It’s one of those things that makes a surgeon certain he is doing what he was meant to do.”

Perhaps even more rewarding is the fact that Mickel, a board-certified plastic surgeon, is performing the surgery free of charge to his patients. Mickel is the medical director of the regional cleft lip and palate clinic for Children’s Special Health Services in Monroe – a position he has held since 1992. The state and Medicaid subsidized the procedure until Mickel decided to perform the surgery at no charge. The state now funds only the clinic visits.

“Cleft cases are a relatively small percentage of my practice, but my office staff was spending a disproportionate amount of time getting these cases pre-certified and then trying to collect after the surgery was done. The red tape was exasperating. Once I started doing these cases for no charge it was liberating. Not only did it free up my office staff to focus on more productive things, but it made me feel even better about doing the surgery. I guess God let me stumble into a lesson on the joy of giving,” he said. “Everybody in the practice enjoys getting to know the families and watching the children progress after their transformative surgeries. When we decided to do the surgery for free, it changed the whole perspective and it became much more satisfying professionally – even a lot of fun. When you realize what you are giving back to the community and to these children who didn’t ask to be born with that congenital defect, it makes you feel good.”

It is unusual for a town the size of Monroe to have a clinic like this one, Mickel says. Located on DeSiard Street, the cleft lip and palate clinic is unique in that a team of health professionals—specializing in ENT, orthodontics, oral surgery, pediatric dentistry, and plastic surgery—all treat the patient. The doctors work collaboratively and provide patients—from birth to adulthood—with a wide spectrum of care in dental hygiene, jaw surgery, and ear surgery, all of which are connected to cleft lip and palate repair.

The challenge is treating the babies afflicted with cleft lip and palate before the medical condition affects the child’s speech, Mickel says. A cleft lip is either a small notch in the lip or a complete split in the lip that spreads all the way to the base of the nose. Usually the child’s cleft lip is treated between 6 and 12 weeks of age. A cleft palate can occur on one or both sides of the roof of the mouth and may go the full length of the palate. Treating the child’s cleft palate before three years of age ensures the child will experience normal speech.

Mickel, a Monroe native and one of the physician owners of P&S Surgical Hospital in Monroe, has performed hundreds of cleft lip and palate surgeries through the Monroe clinic since finishing his plastic surgery training in 1990. He has performed surgeries for two generations of families born with this medical condition.

It was during Mickel’s residency at Children’s Hospital in Dallas, Texas, that he learned the craft of cleft lip and palate surgery under the tutelage of Dr. Steve Byrd, “one of the most renowned cleft surgeons in the world,” according to Mickel. Shortly thereafter, he traveled several times with colleagues to Belize and the Dominican Republic where he performed cleft lip and palate repairs for underserved children.

Cleft lip and palate conditions tend to occur in the lower socio economic population, Mickel says. It is his hope that more families will learn of the Monroe clinic, which was started several years ago by Monroe plastic surgeon Dr. Eugene Worthen and orthodontist Dr. Robert Devenny.

“We need to make sure the clinic remains in existence so that kids in this area who can’t afford to travel to New Orleans or Shreveport can still get this care. And, I need someone to eventually take over for me. We want to find people who can carry this forward. As much as I love what I do, at some point I’ll have to pass the torch.”