In 2016, John Samuels chose to end his decades-long, high-stress career as a hospital administrator. At what are now the Northwell Health and Mount Sinai Beth Israel hospital systems in New York, he was responsible for their emergency rooms, which were seeing hundreds of thousands of patients every year.
Wanting a change of pace and a way to put his experience to use, he started Wellworth, a healthcare advisory firm that works with dozens of single-family offices and hundreds of other clients, either directly or through their wealth managers.
Today, almost 10 years later, Samuels has started applying more of what he learned and valued while working in hospitals, integrating processes and resources into his Wellworth that other consultants and healthcare concierge services lack.
Wellworth continues to grow as a business, but it will never be able to help everyone, Samuels said. On a mission to better equip others to make decisions about their clients’ health and their own, he’s written a book with practical guides, packed his calendar with dozens of speaking engagements this year, and is squeezing in the occasional sprawling interview with a journalist.
He’s witnessed financial and other types of professionals at family offices and wealth management firms offer healthcare insights well beyond their scope of knowledge. “Their recommendations can, in fact, be reckless and at times dangerous,” Samuels said. But he wants to help, not scold. “When they see an approach that we have that enhances the life of their client in a meaningful way — something they care about as much as their money or sometimes more — they want to use our service.”
Wellworth employs doctors, nurses and other experts to help its clients navigate everything from choosing the right primary care physician or specialist, to asking the right questions about their care, managing the tremendous costs and insurance, and more.
In this interview with Modus, Samuels shares more about Wellworth and why it’s hiring researchers; the questions he gets about Secretary of Health and Human Services Robert F. Kennedy Jr.; longevity medicine; artificial intelligence; and — having “lived it” — his take on HBO’s “The Pitt,” the acclaimed television drama about days of duress at an emergency room.
First, I think it's important that Modus readers understand that Wellworth is not taking healthcare opportunities from anyone and giving them to someone else. You’ve said to me in the past, “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.” Can you talk more about what you do, especially for family offices? The myth in the high-net-worth community is that access and money equal better care. Someone said to me the other day, “It's all about access.” And I said: You know, it's partially about access. But it's really, to me, more about how we get you the best care. Those two things aren't the same.
Someone might have access to any hospital they want to go to in the country, and any doctor, but they don't know which discipline to see. (There are over 160 subspecialties of medicine.) They don't know what information they need or who will be with them at the appointment. They don't know what questions to ask. They don't know what follow-up there will be, and so forth.
I don't think I would say to a wealth advisor, “I just had a $100 million event, and I need some stock tips.” They look at their entire portfolio, your insurance, your investments, your philanthropy, and your estate planning. Our work is also holistic in that regard.
What types of professionals do you employ? Give me a snapshot of the business today. We have 14 employees, and as we've grown, we've brought on more specialists: A primary care doctor in California, a research associate in California, an emergency medicine doctor in Boston, a pain specialist in New York, an aging care specialist, and a healthcare insurance specialist.
Because care and treatment are so complicated and so specialized, having individuals who are experts in their own domain increases our depth and breadth. Now, Wellworth assigns every client three individuals: a physician, a nurse, and a licensed social worker. So people have a team with different expertise, complementary to what's happening. Hospitals work in teams. So there's a pain team, there's a hospitalist team, there's a nursing team, there's a radiology team, there's all these teams and we have teams as well.
Wellworth is working with several hundred families and dozens of multifamily and single-family offices [to serve their end clients or whoever they are working for].
We got a call about a client recently who was in crisis. He was on the way to the ER. He was psychotic. He has substance abuse issues. The family wasn't sure which ER to go to, what the next steps would be, how hospitals work, or what an acute inpatient psychiatric visit looks like. We immediately helped. Once we got HIPAA consent, of course, we called the hospital, talked to the family, and spoke with the doctors in real time.
There's an established relationship with the family; you are already familiar with its members to at least some degree. And then you can really, not just be available but provide better-informed advice. Especially in an emergency when time really, truly could be of the essence. What typically happens is a single-family office, or even a multifamily office, will call us and say, “Last month we had this scenario. It was very difficult; we couldn't figure out what to do, we were scrambling, calling hospital trustees, and we weren't sure if we got great care. And we got huge bills. Do you help in scenarios like this?” And we say, “yes, we do.” Then they engage us for the future.
The employees who are researchers, what are those people doing? We're bringing on a PhD researcher who's also a nurse, who will be able to dig deeper into the literature and data on patient outcomes before they make treatment decisions. I'm applying strategies that work in hospitals to our clients. Hospitals and healthcare have research divisions and people who have focused their career on medical research and we're applying that to the individual for our work, so they get better care and treatment.
For example, we've worked with clients who need clinical trials, and our approach has been to engage a company that does clinical trial vetting for investments, but we repurpose it for individuals.
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How is working with single-family offices different from other clients, advisors and organizations? A single-family office is not looking to gain new clients, right? They're looking to support the family only. Structurally, it's a little bit different. There's a single point of contact. Because we're working with one family, there are times when we can identify hereditary factors, genetic factors, that impact the entire family. There are times when we can look at health insurance for an entire family. We can really dig in deeper. Wellworth is organized to support a family intergenerationally. We do a lot of work, and have deep expertise in aging care, emergency medicine, primary care, pain management and substance use and addiction.
What have you learned over the years of working with these clients? Or about your own business didn't you know, or wasn't as clear, in the past? High-net-worth individuals and single-family offices are often magnets and targets for snake oil: expensive longevity pitches, miracle solutions, and concierge promises with no evidence. Wellworth has the independence, judgment and structure to help.
You wrote and recently published “Wealthcare: How to Minimize Risk and Maintain High Net Health.” Every book is a laborious project. What were the reasons that you wanted to do that? Every wealthy family manages financial risk, but very few manage health risk. And that's the reason. Advisers can open the book and use it with a client the same day because it has step-by-step guides, checklists, risk screens, red flag guides, snake oil filters, and conversation starters. It values healthcare the same way it values wealth management.
Have you noticed any trends or interesting developments in healthcare that aren’t getting talked about enough, or at all? Yeah. One is, of course, AI.
You're talking about potentially harmful things, like self-diagnosis, right? It's much easier now to open an AI app, explain your symptoms or ailment, and get something in return. That was always possible with the internet, but this is a new extreme. Yeah. The judgment is complicated and high-stakes. I don’t think that families need more data; they need applied discernment.
AI can be great in the hospital to help improve efficiency and to help doctors have greater specificity around diagnostics. But when patients use AI for treatment or for guidance? That can become reckless.
Another trend is that healthcare is expanding horizontally. So, more concierge doctors, longevity centers, men's health and testosterone centers, and all these things are coming up, which makes healthcare more complicated, because where do you go? How do you share information from one place to another? Who you know and so forth. It has made it easier for us clinicians to offer more treatment options to people, but it can be more complicated for patients.
The third trend is, fortunately, there's a lot more happening in women's health, and it's about time. It's about time that the medical community has woken up to: Half the population are females, and we need specific education, treatment, providers, research and so forth around women's health.
I know this is a huge rabbit hole that we could fall into, but since Robert F. Kennedy Jr. became the Secretary of Health and Human Services, much has changed at the department. Is this something that clients are asking you about? Are you fielding a lot of questions about policy, regulation, research, and healthcare more broadly? Our role is to follow evidence-based medicine and we have the expertise to understand the evidence and give that information to our clients. So if a client asks about a vaccine or a certain treatment, irrespective of who the leadership is in the country or in a state, our job is to come up with the best evidence for treatment for them and give them that information and let them make determinations. Some state councils are making recommendations that are not congruent with what the federal government is doing. Our team can help dissect that and get people good information.
What is something you and your team are most optimistic or excited about right now? I do think there are a lot of opportunities for what technology can do for treaters and providers. That's certainly exciting; the things happening in robotics and drug development.
I feel like I would be a bad journalist if I didn't ask: Have you watched “The Pitt” on HBO, and if so, what is your take on it? I lived “The Pitt.” I slept in my ER.
I've seen some of the show, and let me say this: While I think the episodes are often overstuffed and overdramatic, which is what happens on TV often, the scenarios are real. There's a push-pull, a dynamic tension around resources and complexity of patients, which is what's happening in healthcare. Unfortunately, I think one thing “The Pitt” certainly demonstrates is that our system is broken. Healthcare is extraordinarily complex, and often it all just goes to the ER. There are a lot of ways in which our health-care system fails, but that's one of them.
This interview was edited and condensed.
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