NEW YORK--Cancer treatment here moved a step closer to the "McDonalds-ization"
when Montefiore Medical Center announced a deal to open three 24-hour-a-day
clinics devoted to cancer care, in the New York area, as well as a network
of satellite offices.
The Center's new partner is Bentley Health Care of Beverly Hills, CA,
a decidedly for-profit company that was founded by Dr. Bernard Salick with
the money he got from his lucrative deal last year with Zeneca Pharmaceuticals.
Dr. Salick is a kidney specialist "who became a millionaire by pioneering
a national chain of round-the-clock cancer clinics," according to the
New York Times (2/9/98).
Naive observers might think that the main problem confronting cancer
centers is that they still cannot cure about half their patients. Not at
all. "The No.1 problem for not-for-profit institutions is capital
formation," according to Dr. Spencer Foreman, president of Montefiore,
which is based in the Bronx. "We saw Bernard Salick as an ideal partner
for marrying our clinical expertise with his financial, managment and delivery
expertise." The partners will also open an HIV-AIDS clinic.
"MULTIBILLION DOLLAR CANCER
CARE INDUSTRY"
With a drop in income caused by the introduction of mananged care, hospitals
are now scurrying to market and expand their most lucrative services. Not
surprisingly, cancer care is one of these. (Our own analysis shows that
the industry is now worth over $100 billion per year, nationwide.) Montefiore
is expected to have a particularly strong impact on "New York's multibillion
cancer care and H.I.V.-AIDS treatment industries," as the Times called
it, with exceptional candor.
The wealthy Dr. Salick will provide all of the capital financing. In
return, he will be paid a "consulting fee" for his services. Dr.
Salick said that he would invest about $300 million in the New York metropolitan
area in the next few years.
"This will be a real bombshell in New York," said Dr. Salick.
"My goal is to saturate the marketplace with cancer and AIDS centers.
I'm talking to all the players."
Dr. Salick's first venture into the New York cancer market came in 1995,
when he established a cancer center at St. Vincent's Hospital in Greenwich
Village. He lured several prominent cancer specialists to that center. Then
the British pharmaceutical manufacturer Zeneca (wealthy from its tamoxifen
profits) bought out his company last year for $450 million. Dr. Salick was
removed from his post at St. Vincent's and indeed from the company that
still bears his name.
So we have the rather scary prospect of breast cancer patients at St.
Vincent's receiving tamoxifen, without ever realizing that the company that
manufactures the drug also owns the cancer center!
PRESSURE ON MEMORIAL
Dr. Salick's "invasion" of the New York cancer scene is expected
to put additional financial pressure on non-for-profit hospitals that have
traditionally monopolized such care in the past. It will particularly interesting
to see how the giant Memorial Sloan-Kettering Cancer Center (MSKCC) as well
the other comprehensive cancer centers will respond to this challenge.
Salick and his allies are poised to take over the lower-middle-class
portion of the cancer patient spectrum. Memorial prides itself on "quality
care," and in many ways delivers such care. We have long speculated
that MSKCC will have to offer alternative and complementary medicine to
their patients, as a way of making their service more distinctive and attractive
to upscale patients.
This is precisely what is happening, with several initiatives in the
works, although no announcement has yet been so far.
