At 9:00 p.m. on the evening of July 4, Jim Ruddy received an emergency phone call from a Nevada hospital room. Ruddy, president of the private family office Keswick Management Inc., is used to fielding calls from family members about financial matters. But this was different: A child in the family had badly damaged his leg and emergency room doctors needed his mother to consent to treatment. The Seattle-based family was on vacation in Nevada, knew little about local healthcare options and so
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