All the Governor's Men

When the Legal Review Committee passed the Kanell contract in April, Scherer was there to explain it. Just days later, the district board passed the deal without any discussion or debate.

Then, in September, Reilly complained about the contract at a board meeting. "I think the biggest financial fallout that the district fails to consider is the impact of alienating physicians such as myself, who are disgusted with the inveiglement of the public health care system," Reilly told the board before criticizing the pro forma.

From his seat on the dais, Scherer addressed Reilly. "We are doing due diligence, and the information you are giving us is helpful," Scherer said. "We are listening. If you have something that shows that we are operating on incorrect assumptions, I'll look into it."

Look into it he apparently did. According to district CFO Mark Knight, it was Scherer who determined that the original pro forma was, in fact, improper. A new pro forma was drawn up last November -- and nearly $700,000 disappeared from Kanell's projected practice revenues.

The original pro forma indicated that the district would lose $23,000 during the first year of the contract. The second pro forma lists an astounding $900,000 loss to the district -- and taxpayers -- on the deal. Call it voodoo orthonomics.

Though district spokeswoman Sara Howley asserts that the old pro forma is "null and void," the new one never went back before the board or any committees, leaving commissioners clueless about a $900,000 bath. The new pro forma also still includes possibly illegal extra rehab and ancillary revenues.

Most suspicious is Scherer's insistence that he had nothing to do with the Kanell contract. The general counsel contends that Bill Eck, a lawyer with the firm of Greenberg Traurig, handled the entire contract for the district. But Eck says he wasn't hired until late 2003 to look into it -- after it had already passed the board. He also asserts the high salaries are based on the "marketing power" of the Marlins and the Dolphins. That explanation, however, isn't reflected in any significant way on either of the pro formas. "In our view, there is no legal problem with that," Eck says. "It's not paying the doctors for MRI procedures. It's a marketing issue."

Even NBHD Commissioner Paul Sallarulo, who was present during the April Legal Review Committee meeting, contradicts Scherer's claim that he was uninvolved: "The general counsel [Scherer] worked a lot on that contract."

Reilly believes there's a reason Scherer is attempting to shield himself from the Kanell agreement. "The pro forma is an indictment -- it shows how the district uses referrals to work up these contracts," Reilly says. "And Scherer is deadly afraid of that."

The doctor says he refuses to take patients to NBHD hospitals, which he claims amounts to a loss of $3 million in revenues for the district. Another prominent orthopedic surgeon, who asked not to be identified, concurred with Reilly and added that the district's unfair contracts had cost the public hospital system tens of millions of dollars in revenues.

"The commissioners are all basically stooges for the Blossers and the Scherers," the surgeon said. "Blosser gets a success fee to deliver the contract. Guys like me and a half dozen guys around town are pissed off about [unfair district contracts], so I go out of my away to direct knee scopes away from the district."

Like the Kanell contract, the Lwin deal has cost Broward General millions in business, contends Dr. Kevin Shrock, one of only a few orthopedic surgeons active at the hospital who are not connected to the ER contract.

Shrock, a Stanford-trained physician and assistant professor at Nova Southeastern University, says Lwin's concession has driven away numerous physicians and destroyed any chance of building a thriving orthopedic department at the hospital. "There have been essentially no orthopedists who have come to Broward General and stayed other than myself and my partner," he says. "And the reason for that is they are excluded from the contract. It has been impossible for them to build a practice there. There is just no credibility."

Shrock has remained loyal to Broward General for a decade, even designing a new operating room for the hospital's ongoing $163 million expansion. But the doctor says he may not be there in the future if the district doesn't put health care concerns over its preoccupation with politics.

"I'm not sure I'm going to be around when that hospital is finished," Shrock declares. "You lose patience. Sein Lwin takes precedence. We bring $4 [million] to $7 million in revenue, but the hospital has not done much to help us. We need young physicians to have access to this revenue and bring in patients and get busy. We need to open up [emergency room] calls to all doctors."

But Lwin's ER monopoly is just a symptom, Kapila says, of a larger disorder that is afflicting NBHD. "The district does not reward excellence in medicine; it does not reward excellence in patient care -- it rewards the political handshaking and the sucking up and the going for campaign contributions," the vice chief of surgery says. "And that eventually has to be to the detriment to the institution and the public. The mandate to find a cost-effective way to deliver the best possible care has been lost in the political shuffle of fundraising and contact-making."

The responsibility to change things at the district lies, of course, with the governor -- but it may take a grand jury to really make a difference.