Dr. Nabil El Sanadi – Rest in Peace!

Dr. Nabil El Sanadi died unexpectedly this past weekend in what the police reported was an apparent suicide.  It is likely that the official cause of death will be consistent with conclusions by the police.  Dr. El Sanadi recently underwent a triple bypass surgery and some notable cardiac physicians told me that patients going through this procedure sometimes experience depression. Beyond these facts, it is not appropriate to speculate.

Whenever death surprises us, it is natural for those closest to the deceased to feel a profound sense of personal loss as they seek closure.  When the deceased is a public official, organizations and institutions feel a similar loss as they try to regain their balance.  When the cause of death confuses us, getting closure and regaining balance become particularly challenging.

I attended the January 27th 2016 Broward Health Board meeting last night, and was moved by the many personal stories of those who knew Dr. El Sanadi differently than I did.  I did not know the personal side of Dr. Nabil El Sanadi, but I respect the feelings of those that did and they have my sincere condolences.

After hearing about Dr. Nabil El Sanadi’s apparent suicide, I was quoted correctly saying,

“He [Dr. El Sanadi] has decimated the professional and competent senior staff and put in place people that will give him the answers that he wanted… While I’m sensitive and sorry for people’s loss, the damage he [Dr. El Sanadi] has done to Broward Health is almost incalculable.”

I stand by that quote.  My position has not changed, see my articles “I’m Back with Tidbits” and OMG – Nabil El Sanadi’s First 5 Months!”

Even the most stalwart defender of Dr. El Sanadi’s tenure as CEO must be troubled by his apparent suicide and the possibility, no matter how remote, that something at Broward Health contributed to his state of mind and death.  Surely, a physician of his stature would recognize post-operative depression and know that there are successful treatments and help readily available.  Suicide is a serious matter and I would refer you to and encourage you to support the great work of NAMI .

It should be noted that though my last real post was in October 2015, there have since been rampant rumors of ongoing investigations at Broward Health, including the apparent seizure of computers by the FBI.  Further, based on Broward Health’s’ financials, the loss from operations for the six-month period ending December 31, 2015 is $87.4 million compared to the same period 2014 was $37.6 million. Under Dr. El Sanadi’s management, 2015 is worse by $49.8 million. 2014 was low due to the implementation of the health exchanges whereby more people were insured and revenues and operating results improved. That program continued in 2015 and should have produced the same or better results. Instead, revenues decline $20.4 million and expenses increased $29.4 million.  Serious CEO candidates will want to know what caused this dismal financial performance.  Of course, there is the whole matter of the Zimmerman Advertising contract, which probably illustrates Dr. El Sanadi’s financial mismanagement best and in part provides at least a partial answer to the question of what is going wrong financially at Broward Health.

During Dr. El Sanadi’s tenure, long-term relations with Nova Southeastern University, and the University of Miami were overtly severed, and Broward Health entered into an ill-conceived expensive multi-million dollar agreement with The Cleveland Clinic, a direct competitor, to provide transplant services when Broward Health failed to receive a certificate of need for this duplicative and apparently unnecessary service.

Corporate senior staff in marketing, quality assurance finance, purchasing, physician staffing and operations all “retired” or were part of “work-force reductions” shortly after expressing alarm or opposition to Dr. El Sanadi’s actions or the actions of his elevated “inner circle”.

The heart and soul of a hospital system are its physicians, nurses and healthcare professionals – and according to many, their relationship with Broward Health corporate leadership during  Dr. El Sanadi tenure have never been worse.

Under the existing circumstances, it is appropriate for the Board of Broward Health to take a sober and hard look at the last 13 months under Dr. El Sanadi and the lessons it teaches for the future of the organization.  This is particularly true if issues or conflicts at Broward Health contributed to his apparent suicide.

I have previously written about how the Broward Health Board politicized the appointment of Dr. El Sanadi, who was objectively unqualified without any previous experience running a hospital let alone one of the largest hospital systems in the country.  See my articles The Best Broward Health CEO contract politics can buy!,    “Bumbling Inexperience of Dr. Nabil El Sanadi at Committee Meeting”  and OMG – Nabil El Sanadi’s First 5 Months!” .

I have also previously written about just some of Dr. El Sanadi’s extra-curricular business dealings that appeared to be in direct conflict to his fiduciary responsibilities for Broward Health as CEO.  Business dealings that are ongoing and continue to this day.  It is noteworthy, that more of Dr. El Sanadi’s business dealings have come to light including some nasty business with a medical air transport firm, and medical directorships for cruise lines that, I am told, have been the subject of some litigation and ongoing investigations.  The lesson here is the necessity to vet potential future CEO candidates and any existing business investments or relationships they may have to avoid even the appearance of impropriety.  This important step was skipped for Dr. Sanadi’s selection. See my articles “Has the Office of Inspector General seen Dr. El Sanadi’s CEO Contract with Broward Health?”  and “Nabil El Sanadi – Broward Health’s Million Dollar CEO!” 

The Board gave new member Christopher Ure the task of recommending the process for the selection of the next CEO and I was immensely impressed with his professionalism and assurances that any process he recommended would be transparent, exhaustive and ethical.  I take him at his word and wish him success in this endeavor, but I’m not sure I’ll hold my breath just yet.

Two final points that it is impossible to over emphasize:

  1. Broward health is a public organization. It was born public, publically nurtured , and is publically ownedBroward Health is not a private hospital that does some public service in return for its taxing authority.  The public is the system’s strongest ally, its secret competitive weapon – not its burden. See my article.  “Broward Health – It’s Our Hospital”
  2. Dr. El Sanadi often spoke of transparency while taking every possible step to operate in secret, and behind closed doors. Consider the example of the Memorial system that conducts its strategic planning meetings in public, with public participation.  Contrast that with Broward Health that does so behind closed doors, and in secret, hidden from the public– yet has virtually every item on their Board agenda assert that its expenditure is consistent with the District’s “strategic Plan” the public never gets to see.  I wrote a few articles on this subject; “It’s none of your business!  Really?” , and “Bombshell – Broward Health Non-Agenda Item stinks of insider Double Dealing” 

I did know the official Dr. El Sanadi as CEO of Broward Health for 13 months and what I knew, I did not like. In fairness, I do not know whether his official conduct to which I objected was his or was in part orchestrated by meddling board members. We will never know.

The living must go on, and organizations must continue to serve.  Rest in peace Dr. El Sanadi.  Your burden is now squarely on the Board’s shoulders.   We will be watching, and hoping for their success.