Doing good, getting well - Salick's Health Care Inc. cancer clinic

Nation's Business, August, 1989 by Michael Barrier

Doing Good, Getting Well

Bernard Salick has told the story, as he says, "a million times," but it sounds fresh as he tells it again. The story resists the mechanical patterns that can come with repeated tellings; and in some ways, the story is not over yet.

Salick, 49, a native of New York City's Lower East Side, is a doctor who has lived in Los Angeles since going there to attend medical school. Trained as a kidney specialist, he became a successful businessman after starting a chain of dialysis centers in 1972. In June 1983, he had just won a contract to set up one of his centers at Cedars-Sinai Medical Center in Beverly Hills.

Elizabeth, the middle of his three daughters, was 6 years old. "She had been complaining the day before of some pain in her knee," Salick recalls. "I came from a family where there was not too much illness around, and even though I'm a doctor, you don't relate it to your family. But she was complaining of a little pain, and my wife said, `I'm going to take her to the pediatrician.' So she went there, and I was running around, with no concern."

Then Salick got a call from a radiologist, "who was very upset on the phone. He said, `You'd better come over here right away; we've got a problem with Elizabeth.' I came in, and the guy was in tears. He said, `It could be an infection'--but to anybody who looked at the X-ray, it was obviously cancer. My life flipped, on the spot."

Salick scrambled to the University of Southern California, where he had studied medicine, and to the University of California at Los Angeles, where he was teaching in the medical school. "Within three hours, everybody in the city had looked at the X-rays and said, `She's got to have an amputation, she's got bone cancer.'" The next day, he flew to New York to see Gerald Rosen, a cancer specialist at the Memorial Sloan-Kettering Cancer Center, and Rosen concurred.

Elizabeth's right leg was amputated above the knee in August 1983. Before the operation at UCLA's hospital, she went through chemotherapy, first at UCLA, and then as an outpatient at Sloan-Kettering. Salick was impressed by a difference between the two institutions: His daughter had to check into the UCLA hospital for a week to get the same chemotherapy she got in a day at Sloan-Kettering. In New York, she spent the night not in a hospital, but with her parents at a hotel. "I remember my wife and I sleeping in the hallways at UCLA," Salick says. "It was a terrible experience. Over the next few months, I was totally absorbed with the day-hospital approach, because, let's face it, I certainly didn't want to start thinking about whether my daughter was going to survive. It was much easier to think about what I could do about cancer therapy."

Salick soon became convinced that his success with having his dialysis centers open 24 hours a day, seven days a week, could be extended to cancer outpatient centers. (Where such centers existed, as at Sloan-Kettering, they were typically open only during normal office hours.) "I said to Jerry Rosen at Sloan-Kettering, `Join me, we'll raise a lot of money, we'll go public, and we'll build these cancer centers around the country.'"

It has happened pretty much that way. Rosen joined Salick as medical director of the new cancer centers in 1984. Salick Health Care Inc. raised $18 million through its initial public offering in March 1985, and an additional $30 million in 1986, through the sale of convertible bonds. Salick now has opened six cancer centers--one each in Beverly Hills and Philadelphia, and four in southern Florida--and a seventh is to open later this year in Palm Springs, Calif. Agreements have been signed that could lead in time to dozens more.

The company began operating its first center in 1985 at Cedars-Sinai, but it was not until January 1988 that the center occupied its permanent quarters there. Salick filled 53,000 square feet of mostly basement space with doctors' offices, laboratories, examination rooms, and radiation and chemotherapy facilities.

Patients enter past a reception desk at ground level, then take an elevator to a lower-level waiting room--which has no basement feeling to it, but is instead a two-story atrium, filled with light and color. The architects made the center open and even playful, snatching light and air at every opportunity.

In the wall next to the elevator that takes patients down to the waiting room, a large crack reveals a miniature building, receding in layers; one of the tiny rooms is filled with water and goldfish. In the chemotherapy section, where patients may spend 12 to 20 hours of a day getting treatment, the bed covers are in bright colors, and each cubicle has its own videocassette recorder. "Remember," Salick says, "the people who walk in here are very shaken up, and they've got to be here long periods of time, so you want to have it be an interesting environment."

The idea is to give cancer outpatients all the care they require, but conveniently and comfortably, so that jobs and daily lives are disrupted as little as possible. "In the old days," Salick says, "when you got cancer, you wrote your will and disappeared. Today, you say, `Hey, I've got a busy schedule, I can't give up my job, I can't sit around in a doctor's office all day long.'"