All the Governor's Men

Kapila recalls that, in 2000, when he was a Lwin partner, the company books seemed off. Kapila says he learned that money was being withdrawn from corporate accounts. He says he could never ascertain how the money was spent but suspects some it went for political contributions. Kapila claims that Lwin told him the political activity was necessary to keep the contract.

Kapila may have personal reasons for speaking out -- he was expelled from North Broward Orthopedic Associates in 2002 after losing his malpractice insurance. The surgeon sued the company for reinstatement last year, and the case is pending.

Regardless of the infighting, Kapila's information is telling. Scherer and Lwin are definitely skilled at funding campaigns. During a 2002 race for state representative, the district backed challenger Franklin Sands over incumbent Roger Wishner, a Sunrise Democrat who was an outspoken NBHD critic. In all, Scherer and his family members gave $2,925 to the losing Sands campaign; he also raised tens of thousands of dollars more from legal and medical sources. Lwin gave $1,000 personally and $500 from his firm. Though Florida law sets a $500 contribution limit, the state elections database shows that he chipped in $500 on two different dates under the names "Sein Lwin" and "Lwin Sein."

"I think what is very obvious across the board is that if you have the connections, you do well at Broward General," Kapila says. "That is what counts, not medical expertise."

Lwin's connections have compensated him well. The NBHD contract, which includes $350,000 to help with malpractice insurance, pays his practice roughly $4,650 per 24-hour on-call period at the emergency room. To understand how high that number is, consider that Hollywood's Memorial Regional Hospital, which boasts the busiest emergency room in the county, pays just about a fourth of that, $1,200, to eight contracted surgeons for essentially the same service.

A handful of local orthopedists alleges that Lwin's lavish compensation allows him to subcontract much of the work to other doctors, freeing up his time for political functions. "The culture at the district is to feed at the trough," Kapila declares, "so you make as much money as you can while doing as little work as possible."

Lwin's qualifications as a surgeon certainly don't justify the contract. His curriculum vitae is bleak: A graduate of a Burmese medical school, he's been the subject of at least a half-dozen malpractice complaints during the past decade and has failed to become certified by the American Board of Orthopaedic Surgeons, the benchmark national organization. This despite the fact that the NBHD contract requires Lwin either to be board-certified or "eligible to be board-certified and in the process of obtaining such certification." Apparently, Lwin has been in the process of obtaining certification for at least the past 15 years.

"The joke is that he carries the suitcases of the district commissioners," says Dr. Michael Reilly, a board-certified orthopedist with a thriving practice in north Fort Lauderdale.

Reilly says Lwin's overcompensation is more the rule than the exception at the district. Back in September, Reilly complained at a monthly district board meeting about a deal between the district and Dan Kanell, who is the chief doctor for the Miami Dolphins and the Florida Marlins, and two of Kanell's partners. Reilly contends the contract violates federal law.

And it wouldn't have been possible without the behind-the-scenes work of Scherer and Blosser.

December 10, 2003, was signing day for Dan Kanell. He penned his name on contracts with NBHD that will likely pay him about $6 million, or $660,000 a year, for the next nine years. That figure represents about 65 percent more than the average pay for a sports medicine surgeon -- and it's just a part of a bigger mess of money.

His partners, George Caldwell Jr. and Erol Yoldas, also will make $660,000 and $502,000, respectively, from the district. Included in those salaries are $75,000 each for Kanell and Caldwell, the new sports medicine directors for the district. Another doctor, Kevin Kessler, also holds that title, NBHD now has three such directors.

Also included is $290,000 that NBHD will pay the doctors for taking care of the Dolphins and Marlins. The teams pay just $125,000 a year to the district, which means NBHD is subsidizing Kanell and his partners $165,000 to take care of rich athletes. This by a health system that was set up to care for the poor and uninsured.

After 18 months, the partners will be paid according to the number of patients they see and surgeries they perform. In the medical industry, every procedure is worth a commensurate number of "relative value units," or RVUs. The average sports medicine orthopedist pockets $28.10 per RVU, according to the Medical Group Management Association, a leading trade group. The district will pay Kanell $55.20 per RVU for his clinical work -- nearly twice the national average. But if you total his entire salary, it comes out to a whopping $79.10 per RVU, verging on three times the average.

Add another $2 million for a planned sports-medicine facility, $879,000 a year for support staff, and other benefits like rent and insurance, and the deal will cost the district more than $35 million by the time the contracts expire in 2012.

Kanell, who lives in Fort Lauderdale, does have a big name. After 35 years in in sports medicine, he's well known, having worked not only with South Florida teams but also with the Yankees and Orioles during spring training. The fact that his son, Danny Kanell, is a backup quarterback for the Denver Broncos only adds to the doctor's semifame.