## Facts

- Billy Jones underwent orthopedic leg surgery in November 1979 performed by Dr. John H. Chidester.
- Dr. Chidester used a tourniquet during the operation to create a bloodless surgical field, elevating and releasing it at intervals.
- After surgery, Jones developed leg problems and was evaluated by a neurosurgeon and other physicians, who concluded he had nerve injury resulting in “drop foot.”
- Jones and his wife sued for medical malpractice, alleging the tourniquet technique caused permanent nerve damage.
- At trial, both sides presented expert testimony: defense experts described the tourniquet technique as medically acceptable in this case; plaintiffs’ experts characterized it as unacceptable practice.
- The trial court instructed the jury on physician negligence and the “two schools of thought” doctrine, framing the defense as available if the physician followed a course supported by a body of reputable medical experts despite contrary expert views.
- The jury returned a verdict for Dr. Chidester.

## Issues

1. What is the proper standard for the “two schools of thought” defense in a medical malpractice case: endorsement by a “considerable number” of experts, acceptance by “reputable and respected” practitioners, or a combined formulation?
2. Whether the trial court’s jury instruction, stated in purely qualitative terms (“reputable and respected” body of experts), misstated the defense and required a new trial.

## Decision

- The Pennsylvania Supreme Court reexamined and clarified the “two schools of thought” doctrine due to inconsistent formulations in prior cases.
- The Court held the defense applies only when competent medical authority is genuinely divided and there is more than one accepted method of treatment or procedure.
- The Court adopted a combined standard: a physician is not negligent if, in the exercise of judgment, the physician followed a course of treatment advocated by a considerable number of recognized and respected professionals in the relevant area of expertise.
- The Court treated the doctrine as a complete defense when properly established.
- The Court remanded for a new trial with jury instructions consistent with the clarified standard.

## Legal Principles

- A physician has a complete defense to negligence when competent medical authority is divided and the physician selects an accepted approach supported by a considerable number of recognized and respected professionals.
- The doctrine applies only where more than one method of accepted treatment or procedure exists; it does not protect unsupported departures from accepted practice.
- The “school of thought” must satisfy both quantity and quality: not merely a small group of prominent supporters, and not merely a large group without recognized professional standing.
- The defendant physician bears the burden of proving the existence of qualifying competing schools of thought, typically through expert testimony sufficient to show both acceptance and substantial support within the relevant medical community.
- Proper jury instructions must convey the combined “considerable number” and “recognized and respected” requirements so the jury can determine whether the defense is established.

## Conclusion

The court clarified Pennsylvania’s two-schools-of-thought doctrine by requiring proof that the challenged treatment was advocated by a considerable number of recognized and respected professionals, and it ordered a new trial because the jury instruction did not clearly reflect that combined standard.


Jones v. Chidester, 610 A.2d 964 (Pa. 1992)