Bernard Salick, the man some call a medical visionary, does not brood
on his setbacks. A mere 24 hours after Zeneca Group PLC had assumed total
control of Salick Health Care, the Southern California nephrologist had
launched yet another medical enterprise--Bentley Health Care.
(Zeneca Group PLC is a multinational bioscience company, which, through
its separate Pharmaceuticals business, is the second largest maker of cancer
Zeneca Take-Over Raised Ethical Issues
When Zeneca completed its purchase of Salick Health Care, the British
In a front page story on April 15, 1997, in the New York Times, well-known
"It is quite possible that Zeneca's motives are pure, but I think
In response, Michael O'Brien, head of Salick, said that Zeneca would
"It never entered Zeneca's mind that this would be a way to sell
Before the telephone company had even been notified of the name switch,
Dr. Salick was already courting potential investors, whom he hoped would
sink up to $300 million into his most ambitious venture ever.
Just like his old model of cancer care, Dr. Salick envisions Bentley
Health Care as a provider of user-friendly outpatient centers that offer
such amenities as valet parking and round-the-clock, integrated medical
services. He also intends to continue to provide medical treatment through
affiliations with top-flight academic medical centers.
"If I can't treat a member of my family there, I don't want anything
to do with it," is a refrain Dr. Salick likes to use. But his plans
far exceed that mission. He envisions establishing centers that would not
only continue to specialize in cancer and renal failure, but would also
branch out into the fields of AIDS and HIV treatment, as well as organ
transplantation. And he fully expects to establish Bentley beachheads,
in conjunction with government health services systems, in Europe and Asia.
Dr. Salick believes that catastrophic illnesses, which are by their
very nature chronic and long-term, can be treated as carve-outs (in which
an HMO or a managed care organization refers all patients with a specific
disease to an allied specialty health care provider). Noting that 40% of
each health care dollar ends up paying for catastrophic illnesses, he said
the main drivers in his operation will be specialists not primary care
With an initial focus on cancer and AIDS, Dr. Salick said he expects
his first centers to open within the next three months in California, Florida,
and New York City.
He has already created quite a stir in New York City by continuing his
practice of luring away big name medical stars to his facilities. (Last
year, for instance, Dr. Salick enticed Ronald Blum, MD, of New York University;
Timothy Gee, MD, of Memorial Sloan-Kettering; and Geoffrey Herzig, MD,
of Roswell Park Cancer Institute, to the new cancer facility that Salick
Health Care opened at St. Vincent's Hospital.)
In his most recent move, Dr. Salick announced in May that he had engaged
as a consultant the renowned AIDS researcher, Dr. David Ho, who will retain
his position as director of the Aaron Diamond AIDS Research Center.
New AIDS Center Planned
Even more amazing is the spectacular hire for an enterprise that doesn't
even have a New York address yet. In April, Dr. Salick lured Luc Montagnier,
the French co-discoverer of the AIDS virus, to set up shop in the most
unlikely of places--Queens College in Flushing, NY.
Dr. Salick donated $4.5 million to his alma mater to create the institution's
first endowed chair for Dr. Montagnier, who is leaving the Pasteur Institute
in Paris. Dr. Montagnier will run a new AIDS research facility at the college,
which will be funded with government, corporate, and private donations.
While Dr. Salick said he would have no say in how the college's new
Center for Molecular and Cellular Biology would operate, he hopes that
Drs. Montagnier and Ho, as well as other of the world's preeminent AIDS
researchers, could collaborate under the Bentley banner.
Toward that goal, Dr. Salick has even been talking with Dr. Robert C.
Gallo, director of the Institute of Human Virology at the University of
Maryland and a chief rival of Dr. Montagnier. (Dr. Salick said representatives
of Dr. Gallo had contacted him first.) If the California kidney specialist
manages to bring the two AIDS researchers together, cracked one Salick
insider, he should be awarded the Nobel Peace Prize.
A Fateful Meeting
Dr. Salick's frenetic efforts to launch his new enterprise were triggered
April 10 in Los Angeles when Zeneca's chief executive, Sir David Barnes,
and Thomas McKillop, chief executive officer of Zeneca Pharmaceuticals,
told him that his long-term contract for roughly $5 million would be bought
The partnership with the $9 billion multinational corporation had begun
in 1995, when Zeneca bought a half interest in Salick Health Care for $195
million. This deal included an option to buy the other half of the company
At the time, Dr. Salick saw the partnership with the British conglomerate
as a way to generate capital for his ambitious push to expand his cancer
empire that ultimately grew to 11 cancer centers, seven breast facilities,
and 10 kidney dialysis centers. He assumed that when Zeneca bought the
rest of the company, he would remain as chairman and chief executive officer.
But when Zeneca exercised its option in April, bringing the total purchase
price to $450 million, Dr. Salick was offered the advisory position of
chairman emeritus, which would pay $800,000 a year. Infuriated at the prospects
of a figurehead advisory post, Dr. Salick, who said he was caught completely
by surprise, declined the offer.
What led to the change at the Salick helm and all the resulting acrimony?
Foremost, Zeneca wanted its own team in place to operate the day-to-day
management of an increasingly complex network. Under Dr. Salick, the driving
force was expansion, and as far as the British corporation was concerned,
he wasn't spending as much attention on the existing network.
To ensure that growth would be sustained, Zeneca replaced Dr. Salick
with Michael J. O'Brien, who for the past 2½ years had been heading
up Zeneca's specialties division, which produces high-quality inks and
dyes and various industrial coatings, such as resins.
Prior to that job, Mr. O'Brien had worked for many years as the director
of marketing for Zeneca Pharmaceuticals for countries outside the United
States. In that capacity, he was heavily involved as a liaison between
marketing operations and research and development. And for two years, he
was based in Wilmington, Del, serving as vice president of sales and marketing
for Zeneca Pharmaceuticals in the United States.
"I've seen Salick Health Care make a big splash of a new relationship
and then move on to the next relationship, and I want to be sure that the
relationships that have been established are very solid," Mr. O'Brien
said. He believes it was "too much" to expect Dr. Salick to actually
run a complex business while spending 50% to 60% of his time out looking
for new opportunities. "We felt we needed to put in professional managers
to improve the day-to-day operations to create a strong platform for growth,"
Dr. Salick responded that his organization had 2,000 employees to run
the day-to-day business. "If they acknowledge I'm a great visionary
and a great strategic planner, would they really want me to be arranging
for the installation of computer systems?" he asked "Clearly,
the company has to have one person at the top to define what the company
does and hire the very best people."
Mr. O'Brien was quick to emphasize that Zeneca wants to continue "as
strenuously as possible" Dr. Salick's legacy of cancer center expansion,
including expansion overseas.
Said Mr. O'Brien: "My objective is to make sure that Salick Health
Care continues to grow. I would say there is absolutely no change in the
strategy except that I want to do it in a more organized way. When we establish
relationships with, say, hospitals or physicians, it's clearly on a partnership
basis; it isn't a win-lose approach."
The change in management has not hampered the talks under way with other
health care institutions to establish new major cancer centers. In fact,
Mr. O'Brien said that many people have approached him since the change,
saying they want to do business with the corporation. New York was the
only area where officials detected a hesitancy to talk with Salick Health
Care. But he characterized the hesitancy as only slight and said that it
has dissolved. "I personally think there are a lot more opportunities
for Salick Health Care to grow here in this country and eventually outside
the United States."
Mr. O'Brien also indicated that he wants to place a greater emphasis
on the managed care portion of the business. Back in 1994, Salick Health
Care signed its first and only capitated treatment agreement with Physicians
Corporation of America, which covers 115,000 persons in South Florida.
Before Zeneca took over, Salick Health Care had been in serious negotiations
with CIGNA in Arizona. When asked if that was still in the works, Mr. O'Brien
said that discussions were continuing and that other new opportunities
had emerged as well.
To fuel his ambitious expansion plans for the fledgling Bentley Health
Care, Dr. Salick has been closeted with potential investors, including
major mutual fund companies, hospital chains, European and American pharmaceutical
and biotechnology companies, and those who have helped bankroll Salick
Health Care in the past. "I've been doing extremely well and making
great progress in getting the $300 million," he said.
Bringing AIDS Doctors Together
At the outset, one of Dr. Salick's major efforts has been laying the
groundwork for a chain of for-profit AIDS clinics. As he sees it, his success
will be incumbent upon involving three different groups--the scientists
who are developing an AIDS vaccine and working on other breakthroughs;
top-notch doctors who are involved in patient care and clinical trials;
and the leadership in the AIDS community.
He says his talks with AIDS leaders have been critical so he can avoid
a "political nightmare." Said Dr. Salick: "I've been saying
to them, I'm not interested in politics, I'm just trying to cure AIDS.
I will in my naïve way try to bring Montagnier, Gallo . . . and other
great AIDS doctors together. Some might laugh, but I am very good at bringing
Dr. Salick is also wasting no time trying to establish a presence in
Europe. Next month he will visit several European countries where he will
talk with, among others, a key AIDS physician in Italy and a physician
who, he said, has been nominated to head the World Health Organization's
cancer efforts. "You can be very sure that I'm going to try to persuade
him not to join WHO but to join me," he said.
Future of Salick Health Care
What will happen to Salick Health Care without its namesake remains
to be seen. But some of the physicians who were recruited by Dr. Salick
to run the original centers believe that the transition should proceed
smoothly. One of those making that prediction is John S. Macdonald, MD,
chief of medical oncology and medical director of the Temple University
Calling Dr. Salick an "idea-a-minute person," he said that
the Southern California physician was the lifeblood of the company, as
he took risks to develop a medical concept that no one else had tried.
But now with the organization more mature, Dr. Macdonald thinks the
enterprise can exist without Dr. Salick. "His creative talents were
very well used for implementing start-up concepts," Dr. Macdonald
observed. "With the course of the future development and growth of
the company now firmly charted, his leaving is not as critical."
Whether all the old Salick centers stay in the Zeneca constellation
remains to be seen. When asked if any of these medical centers were talking
with him about an affiliation with Bentley, Dr. Salick uncharacteristically
had nothing to say. Observing that it was a "tricky" area, he
simply said, "I can't comment."