USC Employs Surgeon With Eye Trouble
The former neurosurgery chief at UCI Medical Center, who abruptly resigned in April citing worsening glaucoma that “limits my abilities as a surgeon,” will join the neurosurgical staff of Los Angeles County/USC Medical Center next month.
Dr. Michael Dogali, 52, who collected more than $419,000 from UCI for the six months remaining on his contract, says his condition has stabilized and that he will limit his surgeries at USC to computer-directed procedures that do not require full-scale vision.
“It’s not that I’m blind,” Dogali said, adding that he has excellent vision in his left eye with corrective lenses but has tunnel vision in his right. “It’s like looking down the barrel of a rifle,” he said.
A UCI official said Wednesday that Dogali told him in April that he had “a very serious condition” in the right eye that he was “very concerned about.”
“It took it out of the range of anything you would want to allow,” said Dr. Thomas Cesario, dean of the UCI College of Medicine.
“He was running a program that involved him having to teach a lot of procedures. We just did not feel comfortable ever saying he would do neurosurgery, which is probably one of the most delicate types of surgery, when there was the least opportunity for anything going wrong,” Cesario said.
Cesario said he does not know what “the considerations” are at USC, but that Dogali “may have worked something out with USC that they were comfortable with.”
A USC spokesman confirmed that Dogali will start as a staff physician and surgeon in neurosurgery on Oct. 1. No one at USC was available late Wednesday to comment on his precise duties, his salary or his vision impairment.
Dogali said he was hired to help develop a movement disorder program for USC. As part of that, he said, he will perform computer-driven surgeries on patients suffering from diseases such as Parkinson’s and cancer. The procedures are known as stereotacticsurgery, in which delicate instruments are inserted through a hole in the patient’s skull and guided by brain scanning to a particular area.
He will not perform open surgeries that require full visual scope, such as operations on aneurysms or tumors, he said.
It was Dogali’s talent in stereotactic surgery, especially his work with Parkinson’s patients, that made him attractive to UCI. He was recruited from New York amid much fanfare in late 1994, in a move that UCI officials described as a coup for the up-and-coming medical center.
He is one of the world’s foremost experts in functional neurosurgery, and was expected to bring patients and prestige to the UCI department.
Both Dogali and UCI officials agree that a sudden worsening last February of the low-pressure glaucoma in the doctor’s right eye was the primary reason he resigned. Such glaucoma can lead to blindness.
But much of his tenure was marked by frustration and acrimony, and the eye problems, apparently, were the final disappointment. Dogali said he was beset from the outset by financial woes, broken promises, and an absence of leadership at the medical center. Cesario said Dogali did not perform as many Parkinson’s surgeries, known as pallidotomies, as anticipated, despite an enormous university investment in his program.
After his eye problem worsened, Dogali said, he could have stayed at UCI to perform the same duties he will at USC, but he couldn’t bear the idea.
“I couldn’t do it batting my head against the wall,” he said. He cited absenteeism among staff members, inadequate equipment and a lack of patient rooms that rendered neurosurgery an “itinerant” program.
He said he was promised a $3-million high-technology gamma knife, which the university managed only to make a down payment of about $600,000 on. In letters to university officials, he complained that the situation was intolerable and “has the potential for personal and professional disaster.”
Cesario and some of Dogali’s employees had another take.
Dogali, in fact, had been transferred out of his top post and placed on administrative leave shortly before his resignation. Cesario attributed the transfer to the death of Dogali’s father and family illnesses.
But it came, as well, after seven staff members accused the doctor and others in the office of mistreating them. The employees had formally complained to the university’s affirmative action office and filed another complaint, through their union, that they were being threatened with layoffs because of their grievance, a union representative said.
“There was an advantage in giving him a little rest from administration,” Cesario said.
As for the alleged broken promises, Cesario said hospital administrators did change in the middle of Dogali’s tenure and a financial vise did tighten on the medical center. But the medical center was accused by employees of spending too much on Dogali’s program, not too little.
“That was one of the criticisms, that we spent a tremendous amount of money trying to upgrade our facilities,” Cesario said.
One surgical microscope for fiscal year 1995-1996, for example, was expected to cost nearly $1 million, according to financial documents obtained from UCI. Capital expenditures for neuroscience for that year alone totaled $2.8 million.
The department’s annual budget was about $1.5 million, Dogali said. He estimated that it would cost $6 million to $10 million to make it a top-notch department of neurosurgery, not including the gamma knife.
“The issue is, should the university have a special department of neurosurgery if it can’t equip it and can’t recruit for it?” Dogali said. “I don’t know that it should.”
Paying Dogali the $419,400 in fulfillment of his contract through October did not cost taxpayers, Dogali and university officials said. The money came from from hospital revenue and compensation plan funds.