By Kevin Murphy
For the Marshfield News-Herald
MADISON
- Was a former Marshfield Clinic neurosurgeon an overly aggressive
practitioner whose zeal to heal resulted in unnecessary and risky
surgeries, or did his colleagues' professional jealousy force him out
of a lucrative practice?
Federal
jurors will be considering those opposing perspectives as they hear
testimony this week in a breach of contract lawsuit brought by Dr. Jay
Schindler, who contends the clinic fired him in December 2003 without
adequate investigation or good cause.
Schindler,
was a "Midwestern farm boy," an Eagle Scout, valedictorian at Yale
University, and trained at Mayo Clinic, before coming to Marshfield in
August 2002 to specialize in spinal surgery, his attorney William
Hinnant Jr. said.
Schindler
quickly became a rising star in the neurosurgery department; taking
patients other doctors declined and seeing his gross billings exceed
those of most of his colleagues. Schindler's highly complex cases were
more likely to develop complications because of their pre-operative
conditions, but he advised his patients of risks and they wrote him
thanking him for his compassion and quality of care, Hinnant said.
Schindler
began to get job offers from locations better suited to his family but
by October 2003 Marshfield increased his salary to $724,840, an amount
unprecedented for a new employee, Hinnant said. Dr. John Neal used
Schindler's raising salary to procured raises for other department
members, Hinnant said.
Despite
his success, Schindler ruffled some feathers among colleagues who
didn't think he was "team player," said Hinnant. Schindler preferred to
work at the better staffed and equipped Saint Joseph's Hospital than
clinic's ambulatory surgery center.
"He put patient care above profits," Hinnant said.
However,
the clinic's shareholders made the important employment decisions and
when an instrument slipped, touched a patient's spinal cord and caused
an injury during a surgery Schindler was performing in December 2003,
his privileges were summarily suspended pending an investigation by the
Peer Review Committee.
The
patient recovered and even drove 90 miles to continue to be treated by
Schindler after he was dismissed and worked at a clinic in Eau Claire.
However, after a 70-meeting hearing, the PRC recommended Schindler be
terminated after an inadequate investigation, said Hinnant.
The
clinic's attorney, Donald Schott, presented a different picture of
Schindler's employment in his 45-minute opening statement, telling
jurors that the safety of patients required Schindler's dismissal.
After
a patient's spinal injury during Schindler's December 2003 surgery, Dr.
Paul Liss, Marshfield's chief medical officer, gathered three other
case files that generated concern about whether surgery was appropriate
for four patients Schindler operated on, Schott said.
The
files showed that two patients sustained extensive blood loss, one was
equal to twice their entire blood volume, which Schott said occurs
during some surgeries but also carries the risk of the patient
"bleeding out," due to lack of blood clotting.
"These were complicated multi-level surgeries ... one required two surgeons and 13 hours," he said.
One patient had back pain for months after the surgery; another required two additional surgeries, Schott said.
When asked by the PRC if he would have done anything different, Schindler replied, no, said Schott.
"The
committee was most concerned with the four cases in 18 months that
didn't go well and when Schindler offered no indication of doing
anything different given the opportunity they were concerned about the
possibility of having another four cases, which is why they let him
go," Schott said.
The clinic's executive committee and board of directors agreed with the PRC's recommendation, Schott said.
Schindler
is practicing in South Dakota and earns nearly the salary he had at
Marshfield, making the trial "not about money but pride, self respect
and principle," said Hinnant.
The trial is expected to last a week.