A crowd of at least 25 people forced the regular monthly meeting of the board to be held in an expanded conference room on July 28. On hand were a number of patients and supporters of Dr. Randy Jacklitch, a chiropractor in Paynesville, as well as a number of hospital system employees, including several members of the medical staff.
After 80 minutes of sometimes heated discussion, the board voted unanimously to approve the recommendation of their Joint Management Committee, which was to hire Dr. Jason Peterson on an hourly basis to provide chiropractic serv-ices at the clinic.
The hospital system and Jacklitch had discussed his joining the system and staffing the chiropractic portion of a complementary clinic up until last winter. For a while, the hospital planned to provide complementary medicine out of its Belgrade clinic and Peterson was hired to provide chiropractic services there.
Last month, the system reversed its direction and agreed to purchase the Lakeview Clinic building on Highway 124 in Paynesville for a complementary clinic.
The Joint Management Committee, which consists of doctors and board members, had met on Tuesday morning, July 27, and recommended hiring Peterson. Jacklitch attended that meeting with his office manager.
The regular board meeting Wednesday night opened with Jacklitch addressing the board by reading a letter. "Unfortunately, I found out that no matter what I or anybody else here has to say, you already had your minds made up," Jacklitch said to the board. "You have decided to hire Dr. Peterson, from Willmar, to work with the hospital in the complementary medicine clinic. I guess this was a ‘done deal' a while ago, but nobody was going to say so until after tonight's vote."
In his address, Jacklitch proceeded to outline the events between himself and the hospital system in what he called a "courtship." After March, though, direct contacts with the system dwindled. "Many of these problems could have been avoided had there been better communication and negotiation, and less assumptions," he said.
He said that he still believed in the complementary clinic, or he wouldn't have put so much effort into joining it. "I will continue to treat my patients as I always have and will continue to refer them to their medical doctors in Paynesville," he stated. "I hope the medical doctors here in Paynesville will continue to work with me, as they have in the past. I believe strongly that medical doctors and doctors of chiropractic can coexist and work together successfully for the benefit of the patients we share."
After Jacklitch read his letter a number of audience members addressed the board. "The way this all came about, to me, seemed very underhanded," said Christi Higgins, who explained that she had been overmedicated as a child and that, consequently, she relied on complementary medicine.
"I believe in Dr. Jacklitch," she continued. "If you're going to have a clinic in Paynesville, I think you should utilize the successful people here."
Another Jacklitch supporter, Cliff Rossler, said that his mother had had five miscarriages before conceiving him, but visited a chiropractor regularly while pregnant with him. "Complementary medicine brought me into this world," he said. "It makes me a little disgusted that you're going to waste someone's experience in complementary medicine," he added.
"I respect him as a fellow business owner in the community, as a chiropractor, and as a fellow human being," said Linda Liestman of Jacklitch. She said she feared for Jacklitch's practice if he was excluded from the hospital's clinic. She commended the hospital system for working with the existing medical structure in town in the past, but couldn't understand why Jacklitch was being excluded when he wanted to participate.
Jacklitch's wife, Ann, said her husband was a good listener as a result of his seminary training and had acted in good faith. "The sad thing is he trusted this board," she said.
"He's the only chiropractor I have encountered who is not anti-medicine," said Kim Ellis McKigney, a nurse who has worked with Jacklitch and been his patient.
Dr. Tom Sult, who will be the medical doctor in the complementary clinic, responded to the pro-Jacklitch testimonials. Sult said that he likes Jacklitch, thinks he is a good chiropractor, and wishes him well. "I've also been clear that he is not the person to work with me in a complementary medicine clinic," he added.
"Nothing I've heard tonight has changed my mind," he said to the crowd. "I agree with most of what you've said: he is a good chiropractor."
"I will tell you that I've referred patients to Dr. Jacklitch, and I'll continue to do so," Sult added. "I don't think this is a death sentence for Dr. Jacklitch."
One disputed issue was insurance contracts. In their checking, the hospital system had received nothing but assurances that both the hospital-based clinic and Jacklitch's clinic would have insurance contracts. Clinic manager Rosemary Devlin said she had called a number of insurance companies again that morning and had been reassured that Jacklitch's contracts were safe. Bending over backwards to be fair, she said that she didn't try for those insurance companies that give exclusive rights, currently held by Jacklitch. "I didn't want to take advantage of being a hospital-based clinic," Devlin told the board.
Some of Jacklitch's supporters were far less trusting of the insurance companies' responses. A patient of his had called two insurance companies and had not been reassured that his contracts were secure. (One positive result of the meeting, Jacklitch said Friday morning was that the attention seems to have secured his contracts, as a follow-up call after the meeting elicited a much stronger reassurance.)
Several board members then addressed the audience, all giving reasons for supporting the hiring of Dr. Peterson.
Dr. Mike Hansen said that although complementary medicine was a growing field, it was not a guaranteed money-maker, calling it a "high-risk venture." Hansen said that Jacklitch joining the hospital system did not fit financially, based on a salary proposal by Jacklitch and considering that salaried positions don't motivate increased patient visits.
Diane Rothstein said that she sees Dr. Jacklitch but her husband sees another chiropractor. She had been reassured by the medical staff that patients could see whatever chiropractor they want. "I firmly believe once you're established and have your patients," she said, "(that) you will not lose those patients."
Jacklitch's supporters were dubious of claims that patients wouldn't be steered away from Jacklitch's practice. Liestman thought sending patients away from the hospital clinic would be counterproductive for doctors who are partners with the hospital.
Sult said in the short-term it might seem better to hoard all revenue, but in the long-term maintaining a healthy relationship with a patient is more important. "The most destructive thing you can do is interfere with the doctor-client relationship," said Sult. "It would be very detrimental to me to dissuage (patients) from seeing (their chosen chiropractor)."
Board member Doug Ruhland said he doesn't believe steering is possible. He cited a statistic that 80 percent of chiropractic patients don't even tell their doctor that they see a chiropractor. "The patient is going to make that choice (of chiropractor)," he said. "I firmly believe that."
Ruhland added that the decision to hire Peterson had been a difficult decision for him, and he denied any underhanded tactics. "Had we known six months ago what we know now," he explained, "we might have done things differently or been clearer."
If Jacklitch's client base was so secure, Liestman asked why the hospital system wouldn't be interested in hiring Jacklitch and acquiring that base to help get the complementary clinic off the ground.
To responses that the finances of hiring Jacklitch didn't work, Mary Janotta asked if there were any negotiations and how recently they were held.
In response to that, Willie LaCroix, hospital system administrator, outlined financial information from Jacklitch's clinic, an initial salary proposal by Jacklitch, and concerns about his working hours.
Jacklitch said he based that proposal on getting 36 percent of the revenue he generated, as he believes the doctors' salaries are based. He also said his hours were vastly under-rated.
"I'm not here tonight to beg (you) to bring me on," he said. "I just wanted to let you know that I felt disappointed that there wasn't better communication."
"I'd like to apologize to you. I'm a direct person," Dr. Sult responded. "If you don't feel like you were dealt with directly, I apologize."
Soon after that, an argumentative exchange broke out in the audience between supporters of the two sides. Board chairman Don Thomes calmly restored order and called for a vote, which was unanimous for hiring Dr. Peterson.
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