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Aren’t they rich? / Aren’t they a pair?… Send in the clowns.

Northern Westchester Hospital in Mt. Kisco, NY, concluded a successful solicitation at July’s end for a $50,000 matching grant donation.  Instead of begging, one wonders why the hospital simply didn’t put the arm on two people who have enriched themselves enormously in their association with the hospital.

Look no further than Rep. Nan Hayworth (New York’s 19th CD, Republican/Tea Party), MD, and her husband, Scott D. Hayworth, MD, president and CEO of Mount Kisco Medical Group (MKMG), one of the largest medical groups in the northeast. MKMG’s imposing headquarters is located near Northern Westchester Hospital, where Dr. Scott is also a director both of the hospital and the foundation that staged the fundraiser.

Rep. Nan Hayworth

Dr. Scott and Dr. Nan became founding partners of the Mount Kisco Medical Group (MKMG) in 1996. He joined as President and CEO of the group. Since the Hayworths’ ascendancy—she, a diminutive, wispy Ivy Leaguer, with an ingratiating voice; he, rangy, his face cracked with a perpetual geeky smile—the group has grown exponentially and boasts of having more than 250 primary care and specialty physicians.

Dr. Scott Hayworth

BLACK-OUT Curiously, only three MKMG physicians are black: Dr. Margaret E. Vaughan of Katonah, Dr. Tanya-Marie Sweeny of Carmel and Dr. Nikki L. Roberts, an OB/GYN in Fishkill.  By contrast, Hudson Valley Redistricting voter data, based on the last census, shows that the black population in the Lower Hudson Valley has grown significantly.

Blacks comprise between 25 and 50 percent of the populations of all or substantial parts of Poughkeepsie, Beacon, Newburgh, Peekskill, Spring Valley and Mt. Pleasant. Mt. Kisco, Yorktown, Fishkill, and the Highlands now have between five and 15 percent black population. Not only is this prime MKMG territory, but a huge hunk of Nan Hayworth’s Congressional District as well.

At Gannett Company’s lowhud.com editorial board meeting, webcast live on August 26, Dr. Nan said she just returned from Israel—“on business, of course,” though it’s not clear what House committee or caucus would pay for the trip. Asked by a black editor whether she would attend the opening of the Martin Luther King Memorial inauguration on the D.C. Mall, she begged off because of a “previous engagement.” The opening, however, was postponed by Hurricane Alice, and it will be interesting to see if Dr. Nan can find time to be at the rescheduled opening.

ONE-STOP SHOPPING MKMG refers thousands of patients from the Hudson Valley into Northern Westchester Hospital, the way “feeder” funds fattened Bernard Madoff’s hedge fund. In a Chamber of Commerce radio interview on Hudson Valley Talk Radio (www.dcrcoc.org), Dr. Scott said MKMG treats upward of 250,000 patients a year. He pleaded for “legislators getting out of way of medicine,” as well as for insurance liability and tort reform—which, of course, would impede patients’ rights to sue for malpractice. He doesn’t like “unnecessary x-rays” but contends they’re needed, even if it’s a “one in five or ten million chance” an X-ray may discover something, because, after all, docs must protect themselves against law suits.

Two fawning Chamber of Commerce interviewers praised the “one-stop shopping” capabilities of MKMG, “proud member of the Dutchess County Regional Chamber of Commerce,” and politely asked Dr. Scott about single payer health care schemes. Declared Dr. Scott: “We do not want a public plan; it would be a disaster,” echoing the right-wing sentiments of his wife, Rep. Dr. Nan.

In an Oct. 13, 2008 interview with HealthLeaders Media, a piece titled “Model for Success,” Dr. Scott spelled out the long-term strategy for MKMG: aggressive growth, consolidation of the medical market, and enticing physicians to buy into his growth philosophy. He discounted older physicians accustomed to having direct control over strategic decisions. “It’s a challenge getting doctors to give up hands-on, day-to-day management,” he said, explaining, “They’ve got to let financial and operations people run the practices so they can step back and be the great doctors they are and practice medicine.”

TRIUMPH OF THE BRAND That’s why he’s monomaniacal about the “right” kind of physicians he chooses for his monopolizing behemoth. “If you start taking physicians that don’t fit your culture and don’t match your quality levels, then you run the risk of hurting your brand,” Dr. Scott said.  For him the “brand” is everything, discounting the personal connection with doctors that patients seek in smaller community medical practices.

Dr. Scott advocates big, impersonal, factory medicine that uses expensive, sophisticated technology to generate high revenues. It’s a business and healthcare model that squeezes out such innovations as walk-in retail clinics staffed by nurse practitioners, which can provide high-quality care for routine illnesses, studies have shown. The clinics can be found at retail chain stores such as Target, Wal-Mart and CVS. Visits take not more than 15 minutes and costs range from $30 to $110.

But no, says Dr. Scott, in US News’ HealthDay blog, dated Aug. 21, 2009. There is no supervising doctor present, he objects, adding, “Say a sore throat turns out to be something more serious. A PA may miss that diagnosis.” Of course, so too can a MKMG doc, and who is he to say there’s no place in our patchwork healthcare system for walk-in clinics?

IN BED WITH BIG PHARMA Most blog and article citations herein come from MKMG’s own web site under the rubric of “news.” Much of the news consists of Dr. Scott’s speeches, radio interviews, blog and article quotes. For example, on Dec. 13, in a lowhud.com piece titled “A prescription for profit? Local doctors make big bucks speaking for ‘Big Pharma,’” Dr. Scott sanctimoniously said, “I will not let a pharmaceutical company buy me meal or even a cup of coffee.” “When out doctors speak…they are providing medical expertise, which is used in a good way. We felt it wasn’t right to take that away. However, we don’t feel like they should profit from it.”

What he didn’t say is his wife was just elected to Congress and forced to leave a PR outfit serving Big Pharma to avoid the appearance of a conflict of interest. She worked simultaneously as an ophthalmologist and a huckster for Cline, Davis & Mann, as vice president of “medical and scientific affairs.” CDM is a New York based health-care marketing agency with over 750 employees. CDM promotes products for Schering-Plough, Bayer, Genentech, Pfizer and Novartis, creating “meaningful, business-building relationships with physicians, nurses, pharmacists, institutional customers, and every other decision maker in the healthcare food chain.”

MAY THE FARCE BE WITH YOU Northern Westchester Hospital is a general medical and surgical hospital with 163 beds, and gets about 10,000 admissions a year. Nearby Westchester Medical Center, in Valhalla, NY, has some 635 beds, with nearly 25,000 admissions annually. Despite MKMG’s boast of having 55 physicians named “top docs by US News,” Northern Westchester Hospital, which it practically staffs, is unranked by US News, while Westchester Medical Center is ranked 19th in New York.

Nevertheless, Northern Westchester Hospital does tons of business in Hudson Valley, thanks to the Hayworths. And that’s what the Hayworths are all about: business.

Dr. Scott is an OB—in fact, he’s the Obi-Wan Kenobi of New York State’s would-be Jedi OBs. His power flows from gelt, not a light-sabre. According to www.manta.com, Dr. Scott’s private OB/GYN business, likewise located close to the hospital, has annual revenues of “under $1 million and a staff of four.” National salary data suggest that the gross compensation for top OB/GYNs is just under $300,000. Medical Group Management Association’s 2010 data reports that OB/GYN compensation was $282,645.  Most recently, Dr. Nan, a retired ophthalmologist, saw her specialty’s total median compensation reach $330,208.  (And you wonder how she could retire at age 50 and “put in about $500,000 of my own money to launch [my] campaign,” as she told conservative Human Events blogger John Gizzi on July 13, 2011?)

Dr. Scott serves on the board of Community Mutual Savings Bank; this is not, I’d bet, a pro bono position. It’s not public what Dr. Scott earns at the Mount Kisco Medical Group, which is spreading through the Lower Hudson Valley like a galloping MRSA infection, but it is substantial, given his time and grade—probably well above a million dollars, judging by the stats provided by Cejka Executive Search, the nationally recognized Health Care Executive search firm.

Absent a huge fee needed to access Cejka’s data base, you can’t know for sure what Dr. Scott hauls in. But Cejka elucidates a compensation construct based on financial performance, clinical quality, and the size and the scope of the organization drive executive bonus distribution. Two-thirds of medical groups Cjeka monitors cite “financial performance, including cost containment and organization profit,” while “only 53 percent cite clinical quality.” That’s how medical group “leadership” is defined: dollars first, medicine second.

THE NEXUS IS CLEAR The gold vein that Dr. Scott mines may well be his position as “senior advisor” to Arsenal Capital Partners, a private equity firm (http://www.arsenalcapital.com/team/).  Arsenal Capital “invests in middle-market companies with revenues ranging from $30 (sic) to $400 million,” to quote its web pages, shooting money into “healthcare, specialty industrial and financial services companies.”

Arsenal Capital’s recent healthcare start-ups includes IMDS, “the only company that can take your product idea all the way from ideation and innovation to high-volume production.” “Through close partnerships with medical device companies and surgeon inventors, we bring market needs and clinical ideas to life,” the venture capital company brags. Typically, VCs offer key advisors discounted stock options, many times creating instant millionaires when the initial public offering of stock is floated.

Dr. Scott has been an advisor to Arsenal Capital—lauded in venture capital circles as a “private equity superstar”— since he signed on in 2003 as a member of the Physician Advisory committee of Aetna Inc., the insurance company (Business Wire press release, on behalf of Aetna, Dec. 15, 2003). On the VC’s web site (above Senior Advisors, which includes Dr. Scott), Alan J. Weber, former Aetna chief financial officer, is listed as one of the investment company’s 14 “Operating Professionals.”  On April 14, 2001, The New York Times reported that Weber left the then-financially troubled Aetna, without the customary farewell press release, noting that “some [financial] analysts criticized Mr. Weber for failing to strike a balance between finance and medicine.”  The nexus is clear: medical institutions, insurance companies and venture capital speculators feed off each other.

THE MBA-MD DILEMMA  A review of the medical literature (http://contemporaryobgyn.modernmedicine.com/obgyn/author) suggests Dr. Scott occasionally writes about his specialty. While the medical profession debates whether MBAs or physicians should run hospitals and medical groups, the MBA-bereft Dr. Scott, has penned such articles as “Practice Management in the Trenches,” “Nontraditional Malpractice Insurance,” “When You Merge Your Practice into Larger One,” and “Mergers, Audits and Self-inflicted Injuries.” The record indicates the man is an MBA in a starched white cloth coat.

Dr. Scott does write about the medicine underpinning OB/GYN. He has a column titled “PAUSE: Your complete guide to midlife health” on a web site sponsored by The American Congress of Obstetrician and Gynecology. Among its topics, you can learn more than you need to know about vaginal itching. But guess what? The organization is the lobbyist front for the OB/GYN industry.

A NATURAL AYN RANDIAN Stoked by a passionate involvement in her husband’s industry, Dr. Nan fights in Congress to replace Medicare and Medicaid with a denatured “voucher” system.  A voucher system would be fine for Dr. Nan, who retired last year at 50 to “be with her family.” Then she ran for Congress, a job that offers the kind of medical coverage everyone in this country would—and may well—die for.

Embraced by the Tea Party, like Dr. Ron Paul, that other cockeyed ophthalmologist in Congress, Dr. Nan admires the schlock novelist Ayn Rand. So, too, does Congressman Paul Ryan, whom Hayworth ardently supports, and Rush Limbaugh. A self-affiliated member of the Hudson Valley Patriots, a Tea Party cell, Dr. Nan, always the equivocator, won’t actually come out for Ayn Rand.

Rather, as she recently told Human Events’ John Gizzi, the one book her father insisted she read, at age 16, was Henry Hazlitt’s 1946 conservative tome “Economics in One Lesson.”  In an interview with the New York Times (Nov. 7, 2010), Dr. Nan seemed to quote from it like the Bible: “Private enterprise must thrive. It must flourish. And it must do so without the federal government putting a finger on the scale.”

Hazlitt, unsurprisingly, is adored by Ayn Rand who, along with Ron Paul, endorsed the book on Amazon.com.  Dr. Nan has declared that “Friends gave her copies of Rand’s ‘Atlas Shrugged’ because they said I was a ‘natural Randian.’” Disarmingly candid, she told Right-Winger Gizzi her British mother “just hated the National Health Service,” which was a “big reason for her decision to emigrate here in the 1950s” [to be] where “she could choose her own physician and get decent treatment for her teeth.”

Can that be what Dr. Nan’s philosophy hinges on, the Brits’ famously bad teeth?

In her recent interview with Gannett editors, Dr. Nan came out unequivocally for a flat tax, a fantasy indulged by the likes of Steve Forbes, Hoover Institute’s Alvin Rabushka and former Texas Republican House Majority Leader Dick Armey, who believe everyone should pay the same tax rate. Some former Soviet bloc countries have adopted flat tax systems in their transition from communism to capitalism. Ayn Rand would approve.

HYPOCRISY V. HIPPOCRATES Officially Lutheran, Dr. Nan suddenly became a “Jewish mother” when stumping the Hasidic enclaves of Rockland County. Ayn Rand, however, believed in no religion, demonized poor people as “parasites,” called altruism a “basic evil,” and proclaimed the dangers of tobacco a “hoax.”

Yet, under the name of Ann O’Conner (she was married to Frank O’Conner), Ayn Rand collected Social Security and Medicare in her last years. A two-pack a day smoker, Ayn Rand died in 1982 of lung cancer. We all can lay plastic flowers at her grave in nearby Kensico’s Valhalla cemetery.

A final irony. The distinguished attorney David Boies and his wife, Mary, have generously underwritten the newly opened Emergency wing at Northern Westchester Hospital. A decent man of conscience, Boies, together with conservative lawyer Ted Olson, has for years worked to overturn California’s Proposition 8, which limits marriage to people of the opposite sex. Many in the Tea Party and Republican party fulminate at the idea of same-sex marriage.

So how much did the Hayworths donate to Northern Westchester Hospital, their cash cow? Is there any altruism evident in their family? Has Hypocrisy trumped Hippocrates?

 August 27, 2011



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