First printed in Orthopedics Weekly

Biloine W. Young • Wed, December 4th, 2013

How did a 78 bed rural hospital in an economically depressed region of upstate New York end up with a world-class spinal surgeon? The answer lies in the power of human relationships to influence career decisions, the willingness of a hospital administrator and board to invest in equipment for a surgeon who was a continent away and the skills of a Beijing-born doctor, a former molecular biologist, who was just beginning his career as an orthopedic surgeon.

The story began when two orthopedic surgeons approached Lawrence E. Kelly, president and CEO of the Nathan Littauer Hospital in Gloversville. New York. They wanted to increase the coverage in orthopedics they were providing the hospital. To do that they needed a third partner—a spinal surgeon.

“Great,” Kelly replied. He arranged for the hospital to fund the search and cover the recruitment costs and assigned a staff person to handle the paper work. When the search firm told them about Dr. Jian Shen, a 42-year-old former molecular biologist who was finishing up a residency in orthopedics in North Carolina, they all flew down to meet him.

WMAC’s Alan Chartock

Something significant happened at that face-to-face meeting. The two upstate New York orthopedists and the hospital administrator found they really liked this novice surgeon. They flew him up to Gloversville to take a look at their hospital and the surrounding Adirondacks. He promised to come but he could not begin work for a year because he had agreed to serve a year-long fellowship in San Francisco.

As Kelly explained, “It was a personal connection that we made. We all hit it off. There was trust there.” Kelly told Shen, “When you get here our commitment to you is we will do everything that is possible to be done to make sure you are a successful spine surgeon.”

Kelly was in constant contact with Shen during Shen’s year in San Francisco. Kelly wanted to know what Shen was learning, what equipment he was using there that he would need in Gloversville. As Kelly explained, “We did not wait until he got here to buy a bunch of stuff for him. We bought it before he came, anticipating his arrival.”

Looking back on that year Kelly remembers, “We were a small community hospital that was buying all of this equipment for a surgeon who was still 3.000 miles away. The only assurance we had that he would come was his name on a piece of paper. There was a lot of trust involved.”

The hospital had also promised Shen that it would have spine patients waiting for him when he arrived. To help fulfill that promise prior to Shen’s arrival the hospital put large “Spine Rejoice” billboards on the highway. The local Northeast Public Radio station WAMC featured Shen on a call-in program and WAMC’s CEO, local celebrity Alan Chartock, had his bad back successfully treated by Shen. Shen had patients waiting for him from the first week of his arrival.

Kelly remembers when Shen returned from a medical conference with information about the Mazor Robotic System. He explained to Kelly that, with this system, he could improve the accuracy of his surgery and shorten the recovery time for his patients.

For Kelly, the administrator, “It was a hard one to swallow, but we invested. In a big place it would take me a year to get something like that. Here it took three weeks.” Shen, too, noted, “At a major medical center I would be a nobody. I could say, ‘get me a robot’ and it might happen in a year. Here I got it in a week.” As Kelly put it, “The trustees went out on a limb with my recommendation to invest that way and it has worked out for everyone.” Each hospital has invested about $1.75 million in robotic and other specialized equipment for Shen.

What attracted Shen to Gloversville? He said it was very important to him to serve in an under-served area. While the two hospitals where he works are rural, they are on the edge of the capitol area of New York with more than a million population. Shen also credits the hospitals and operative room staffs. “We really get along well,” he said. “We have been on the same page from the beginning.”

Shen performs the full spectrum of minimally invasive spine surgery thus minimizing damage to soft tissue. Two years and 1,500 patients later he has had no major complications and an infection rate of zero. He says, “Half of my patients leave the hospital from the recovery room, they do not need to be admitted.” He has performed several surgical firsts in the region, including the first robot-assisted spine surgery, and two surgical firsts in the United States.

Shen’s goal is to create a “minimally invasive spine surgery destination” in upstate New York. Patients are already coming to Shen from New England and from states such as Texas and Florida. The waiting time to see Shen is now weeks long. He is looking for a partner and interested parties can contact him or the hospital by email at spines@nlh.org. “It is getting so busy that I cannot handle it all by myself,” he said.

Cheryl McGrattan, vice-president for marketing, communication and community relations for the Gloversville hospital, says the surgery department is now a crowded place with representatives from medical device companies and other surgeons—including some of Shen’s own medical school professors—coming to watch him perform surgery. “It is very exciting for us to have this going on,” she said.

Shen lives with his wife Wencui and their seven-year-old daughter in Loudonville, New York. He is a graduate of Weill Cornell University Medical College.