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‘What’s in Front of Them Is a Train Wreck’: Why Advisors Should Call John Samuels

The founder of Better Health Advisors, and former hospital administrator, shares his thoughts on the pandemic and why his services are needed.

John Samuels didn’t interact with financial advisors very often. Now, he does all the time.

Samuels worked at healthcare providers for more than 20 years, including as a hospital administrator at what is now the Northwell Health and Mount Sinai Beth Israel hospital systems. He was once at the helm of an organization that saw more than 800,000 patients each year.

But in 2016, eager for a change and to leverage what he knows about healthcare in the U.S., he started Better Health Advisors, a national healthcare advisory company based in New York City. Like wealth managers who now tend to many or all aspects of a client’s financial life, Better Health Advisors does the same for their health.

And especially amidst the spread of the novel coronavirus, health is top of mind for clients more than ever.

In an interview with RIA Intel, Samuels shared his observations of the pandemic, what exactly companies like his do, and why financial advisors should consider calling him.

Before we talk about Better Health Advisors, can you talk about what you did before you started the company?

Prior to starting Better Health Advisors, my job was in emergency medicine at a large hospital system in the Northeast and I was responsible for operations of our system, the emergency departments. They grew from 14 to 17 different hospitals when I was there. 

I worked to improve operations, quality, staffing, efficiency, safety, finance, compliance, and those kinds of things. I worked to improve patient care on behalf of the hospitals and the hospital systems. And a lot of the work that I did was also on the way hospitals are organized, to lead a lot of the emergency management and emergency responses of hospitals that I was at.

Tell me about what you have observed and learned about the pandemic. In your previous positions, did you ever see anything even remotely like what the healthcare systems are dealing with today?

The hospital leadership and myself are trained in understanding and creating a system to respond to emergencies with WHO, FEMA and the federal government. I trained at the Center for Domestic Preparedness in Anniston, Alabama.

Every year we would look at what the most common possible disaster scenarios would be and we would rate them and then prepare for them specifically, in addition to creating a format and structure that would help plan for a multitude of types of disasters. The biggest threat to hospitals is that staff aren't able to care for patients. That's always the biggest threat.

And secondly, and just as critically, I'm not surprised of the heroes that we're seeing day in and day out as first responders. I saw this all the time. I saw this during hurricane Sandy and 9/11. I see it the day after Thanksgiving; It's the busiest day of the year. A lot of ERs are really short-staffed and just swamped with patients.

You mentioned to me earlier you were not in New York City. Was that by coincidence?

I knew I had a pretty good sense of what was going to happen based on the predictive models. One looked worse than the other and there were lots of them. So, I left the city months ago knowing what was likely to happen.

So, what is Better Health Advisors and why did you start it?

Better Health Advisors is a boutique health advisory firm and we help individuals and family offices navigate the healthcare system. We help people find doctors, make treatment decisions, communicate among doctors and get people access to and organize the best care and treatment possible for them.

Our clients are all over the country. We work with all disease types and ages of patients. Our work is custom, it is hands on. It is very much aligned with a boutique, family offices and other practices.

Is there something specifically that a lot of clients are seeking help with? 

Many of our clients are frustrated with the healthcare system. Many of our clients have seen multiple doctors or are struggling with setting up and organizing care and are used to having high-touch service for the rest of their lifestyle. Our clients have everything from cancer or heart disease, diabetes, those kinds of chronic illnesses, to children, to substance abuse, and other types of illnesses.

What are some of the other things that clients ask for help with, especially that clients might not even know they could use help with?

A couple of things. One is health insurance. One of the things we do when we first start working with a client is to go through the discovery process to make sure they have not only the right medical team set up, but also the right doctors and the right health insurance. We help guide them and give advice and direct them to make sure that they have the right insurance plan.

We're not brokers, and I don't get paid X dollars from Aetna or Oxford or anybody. We're completely independent and we always will be. There's great financial risk in having the wrong insurance. You don't want to find out you have the wrong insurance while you're standing in the emergency room.

What else?

So many people, rightly so, spend a lot of time creating their financial plans but I don't know if they understand that there is a comparable and or thorough, thoughtful and appropriate venue to do the same planning for one's healthcare. 

For new clients we take on now, we create a Covid-19 plan for them. We're going to identify whose behaviors [in a family] are risky. We're going to talk about what we would do if somebody showed symptoms, which often is to isolate them. We're going to talk about when to go to the ER, and what they will bring with them, and which ER to go to, and those kinds of things. I think that creating plans ahead of time, and then working to execute them, decreases people's anxiety. Right now, anxiety is really high with Covid-19, and planning is something that can help alleviate some of that.

The service you’re helping clients get, it’s not really in place of treatment that someone else could be getting or should be getting, right? I feel like that's an important thing for you to have an opportunity to address.

Right. Well, of course, nobody gets worse care because we are helping people identify the right doctors for their treatments and get them in front of and support the right medical care for our individuals. We deeply believe that people should get care and that's why we're so committed to this work.

Are there a lot of companies like yours?

I think there are a lot of individuals, a lot of folks on the West Coast doing this kind of work. I don't know the answer to why more people don't do it. I think it's a wonderful field. Personally, I get great satisfaction about helping people and helping them manage their care. I find it to be an incredibly warming experience.

We hear our clients say it to us all the time, "I never knew there'd be somebody who would find you the right doctors and go to an appointment with or to telemedicine these days, or call the doctors in between the appointments, or take notes, or help make treatment decisions, or explain to my family what's happening medically.” All those things.

Do you work or interact with a lot of financial advisors, the people helping clients manage and ease financial anxiety?

Yes. Often, financial advisors will identify us as a key member to the team in addition to an attorney or someone's accountant. Often a wealth advisor will bring us in to help support the needs of their clients. And now, we've been asked to do talks for specific family offices or financial advisory groups to talk with their clients en masse about Covid-19 and about planning and about things that they could actually do to decrease their risk of getting it.

How has the pandemic impacted Better Health Advisors?

We've been quite busy. For us, every time we take on new clients, we're always providing hands-on, custom work. Often, when people realize that there's a loved one at home who's very high-risk and others in the family could be putting them at risk, then we get called to help manage their care and develop a plan for them around Covid and such. 

Some of the residual benefits of the work that we do, sometimes we’re helping a mother with cancer, but we're also talking to the daughter about how she can set up telemedicine visits for herself, which maybe they weren't aware of. So, there's lots of knowledge that we bring not just to the immediate situation, but to some of the broader, personal things as well.

Will the pandemic materially change how you do business, or how clients might want to work with you, in the future?

I think that people will be more attuned to their healthcare, and that's a very good thing. I think that for health advisory and for people who want to and rely on experts to help them navigate tricky and complicated things, I think they're seeing the value that we bring. 

I certainly think things like telemedicine will grow, and we'll have more of that. I hope that there will be additional resources, federally and on the state level, for prevention and emergency management and mitigation of these kind of situations. I hope that there's some shifting in policies.

The other thing that's happened is a lot of people are talking about their anxiety, and that's a good thing. My perspective is that there was an anxiety epidemic prior to Covid-19 that wasn't talked about as much as it could have been, and maybe now that people are talking about it more, this will help people address and recognize what's happening around our feelings and emotions, which I think helps people with some of the anxiety that we've been managing.

Some of the concerns I have are around alcohol abuse and, of course, disparities in care, which, unfortunately, we've known for a very long time, and how nursing homes are sort of struggling with some of this and some of the resources that are available to them.

Is there anything else that you wanted to talk about, either related to Better Health Advisors, yourself, or pandemic?

If a financial advisor has to ask themselves this question: Would a health advisor potentially improve my client's situation? If you even have to ask that question, the answer is, it's worth a phone call to myself at Better health Advisors, or a really good, experienced health advisor, because often we don't even know when to refer and how to do that.

Often, other experts, like financial advisors, are only seeing the tip of the iceberg of what's happening to somebody medically, and when we get in there and start to sort of dig in and figure out what's happening, we're able to really make a very significant contribution and help someone's life.

Can you give an example of that?

A financial advisor asked us to talk to a client of his who was in the Midwest. He said his client’s fingers looked bad.

We spoke to [the client], and we identified he had really serious medical problems, and mental health, substance abuse, and a lot of other things going on. We got him to the right treatment, and actually, we urged to get him a really thorough primary care work-up, which identified that he had a serious medical condition outside of those two I just mentioned, and we got that addressed, which really might have saved his life from a catastrophic event upcoming that wouldn't have been addressed otherwise. 

This only happened because his financial advisor stood up and said, "I'm worried about this guy. I want you to meet with him and see what's going on." And then we did a really thorough assessment, and found out a lot was happening, and got him on the right course of treatment, and supported him going forward.

I tried to create that for wealth advisors, for financial advisors. Because I think it happens so often, someone will see someone and not realize what's in front of them is a train wreck.