Evolution or Devolution?

July 16th, 2010 by Nick Jacobs 1 comment »

There’s a part of me that celebrates each and every day because I’m evolving. For example . . . being a mature person usually feels pretty good.  I’m more settled, less angry, less needy, less . . . well, you get the idea.  On the other hand, I would never want to own a, vintage car.  Why?  They usually don’t have air conditioning, air bags, seat belts, or CD changers. . .with auxiliary jacks for MP3 digital audio players.  Driving one would be taking several steps backwards in safety, comfort, and style.

How else have I evolved?  Let’s see.  I have air bags.  Okay, maybe they’re not air bags,  but I have a protective coating of extra stuff around my organs. (I’ve gained at least one additional pound a year for the past 30 years.)  Oh, and I am a lot smarter, too.  In fact, my IQ test gained at least 10 points over the last few decades.  (It would probably have been 20 points higher if I hadn’t been on cholesterol medication, but I’d probably be dead and that higher IQ wouldn’t help much.)  On the other hand, the fish oil is supposed to make your brain work better.  Mom used to say, “Nicky, eat your fish.  It’s brain food.”  (Forget the fact that it was deep fried and heavily battered.)

Nick Jacobs, FACHE at the beach with his grandchildrenThis evolution thing could all be summed up by saying that I’m finally starting to mature.  Even though I’ve missed it by decades; it’s happening now.  I’m wiser.  Honestly, there couldn’t be that many things left to learn about running stuff; four decades is a lot of  experience.  I’ve learned about politics, human relations, sociopaths and wonderful souls; and I’ve learned about construction, child birth, heart attacks and ground moles.  I’ve lived through the birth of my kids, my grandkids, and my friend’s kids.  I’ve lived through the deaths of every aunt, uncle, and a few cousins; friends, neighbors, mentors and a half dozen family pets, and I’ve held both of my parents in my arms as they passed, too.

Having observed all of this, what is the devolution?

On NPR the other day, there was a short story that the American public’s view of capitalism has deteriorated.  The exact percentage of those still embracing capitalism was about 44% and those who think it’s outlived its appropriateness was around 47%.  (I guess the other 9% might have thought that capitalism had something to do with that white building in Washington D.C.)  Interestingly, before I heard this story, my impression of capitalism had devolved as well.  In fact, the litany of sins observable to me because of the extreme capitalist approach that we have embraced is long and includes:  BP, Enron, Tyco, Bernie Madoff, and the fat food industry . . . I mean, the fast food industry.

But then I read a rant by Jonah Goldberg of National Review Online:

“Every good thing capitalism helps produce — from singing careers to cures for diseases to staggering charity —  is credited to some other sphere of our lives. Every problem with capitalism, meanwhile, is laid at her feet. Except the problems with capitalism — greed, theft, etc. — aren’t capitalism’s fault, they’re humanity’s. Socialist countries have greedy thieves, too.”

So, what’s the answer?  It seems simple enough.  Once again, from Mom, “It’s moderation.”  The far right and far left seem to be providing a daily whipsaw of entertaining cable news shows from Beck to Olbermann and from Hannity to Maddow, but these extreme views are not helping us solve the problems.  In fact their rhetoric contributes to this devolution.  Does Rush really believe everything that he says or does he say it because it’s so outrageous that he can continue to earn nearly $38 million per year?  And Keith? And Glenn?

I like my air conditioning, my air bags, and my computer assisted brakes, but I’m really getting tired of “bags of air,” greedy anybodys and anythings.

Let’s be less angry, less needy, and more settled . . . come on, guys, grow up.

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Posted in Boomers, Current Affairs, Public Policy

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Overexposure to Radiation

July 12th, 2010 by Nick Jacobs 2 comments »

When I saw this…

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Ever since a surge in cases of patient exposure to excess amounts of radiation during diagnostic procedures, pressure has been mounting for healthcare providers and equipment manufacturers. The FDA has already taken action, including a call for stepped-up training for practitioners and a more stringent approval process for radiation-emitting equipment.

Antique X-Ray machine used to determine shoe size

Antique x-ray machine used to determine children's shoe sizes. Photo credit: desertsurvivor.blogspot.com

…I couldn’t stop thinking about it.  Overexposure to radiation is something I’ve thought about for many years.  In fact, I’m pretty sure that, short of cancer victims, I’d be the poster child for this for Boomers.  Let me count the ways.  Every time I went to my family doc as a kid for anything except a strain or a splinter, he’d zap me with the fluoroscope,  just for good measure.  Then, when we went shopping at Buster Brown’s, in order to determine my foot length and width,  I’d get my feet x-rayed.  After that, I played too much trumpet and had to have my lip radiated because of a blemish that wouldn’t go away.  There were at least seven radiation sessions with Dr. Jacob, a dermatologist who reminded me of Dr. Jekyll.  He zapped me because that’s what they did in “those days” for blemishes.  He would lay me on the table, cover me in lead, and zap my lip with radiation.  Thank goodness for the lead.

As a young adult, my Internal Medicine doctor had his own x-ray equipment and used to say, “Okay, time for your chest x-ray.”  Problem was, he did it every single time I went to him.   Once, however, when I went there, there was no x-ray.  I asked the nurse why and she laughed and said, “Oh, that old piece of junk…it was zapping all of us with radiation.”   Later that week I heard on the radio that he had donated his unit to a small hospital.

As a teacher, chest x-rays were a requirement.  We would be invited to go onto an old x-ray bus every two years and they would light us up on a piece of x-ray equipment that probably put out more radiation than the bombs dropped at Nagasaki and Hiroshima. All in the name of TB checks.

Bronchitis visited me regularly over the past several decades, and chest x-rays were always part of those visits. So were dental x-rays, over and over and over again. The MRIs do things a little differently, but I’m sure there’s still some type of telltale exposure there, and I’ve had three or four of those. Annual physicals now include chest x-rays, thallium stress tests, et al, and visits to the bone docs required x-rays, too.  Oh yeah, and the heart caths?  They fill you with dye and then they light you up with the ol’ fluoroscope… did that three times.

And don’t forget the “new fangled invention that’s perfectly safe,” the heart screening on the 2, 16, 64 and then 128 slice PET/CTs. Did that three times, too.

BUT let’s get to the real exposure — playing in the sunshine, sans any type of sun tan lotion or sun screen.  Okay, I guess that’s an exaggeration.  We used to mix Merthiolate with baby oil, or sometimes just use baby oil to ensure a nice brown cooked look.  Every year I looked like a half Italian coffee bean.  It was more than a tan.  It was a deep fried, make your teeth look whiter than snow, fun in the sun, ain’t wearin’ no shirt, nature is good for you, sun tan with burns that preceded the tans every year.

HealingHospitals.com - Overexposure to Radiation - Nick Jacobs, FACHE

So, when people tell me to eat organic, I smile and think, “Yep, that will erase all of those rads that filled me up like a Rocky Mountain boulder,” but I do what they say and just wait and pray that the radiation devil will not come my way.  If the sickness won’t kill you, the cure will, and that’s the truth.  At least you won’t ever need a night light.

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Posted in Future, Healthcare, Hospitals

Settling into what?

July 3rd, 2010 by Nick Jacobs 1 comment »

Healthcare reform will be phased in over the next several years, and when you ask the experts what their opinions are regarding this new legislation, the universal answer that I’ve received is, “I don’t know.”  There is one very fundamental reason that leads to this answer, bureaucracy.   Much like HIPAA, the law was actually written by young health policy scholars, 50% of whom will not be in their current positions two or three years from now.  In fact, many of them will no longer be in the Metropolitan Washington D.C. area.  Consequently, the policy wonks will take over and the fundamental premises upon which the program was built will be left for in-depth interpretation by the “bureaucrat du jour.” 

Having spent a decade working in a government related, subcontract situation, this fact alone sends cold chills down my spine at the rate of thousands per second.  Recently, it was my distinct displeasure to sit across from two of these individuals, detail splitters, at a meeting on Capitol Hill.  Prior to the “opening bell,” they had formulated their opinions regarding their preferred outcome of the meeting, and they had dug in to ensure that none of the facts presented by the opposing side would be considered relevant.  They had made up their minds that the greater good would be served by their pre-meeting decision making.  Interestingly enough, their decisions in fact would result in hundreds of families being destroyed as their loved ones were forced to languish so that studies of the studies could be performed over the next several years. 

In HIPAA,  the Health Care  Insurance Portability and Accountability Act, the “wonks” took its well-intended core values and distorted them into a nightmare of implementation that forever changed health care in the United States, and, after literally billions of dollars of required implementation changes for thousands of hospitals, doctors, and health professionals, all one has to do to experience the absurdity of most of these privacy attempts is stand on the other side of a curtain in a surgi-center, a semi-private room, an emergency room, or even a registration area and listen.  What you will hear is hundreds of facts about the person beside you; condition upon admission, detailed diagnosis, phone numbers, et al, at which point you can lean back, smile and say, “HIPAA my A**. ”

So, conceptually, is healthcare reform what needed to be done?  The answer is an unequivocal, “Yes.”  Was it the right thing to do to reach out to the uninsured?  Absolutely.  Should we as a country move toward electronic medical records?  Yes.  Does it make more sense to bundle payments so as to encourage physicians and hospitals to work together more closely?  No question.  Finally, was the system broken?  Beyond a doubt. It was completely broken. 

As a country we have slipped out of first place now in so many categories that it is embarrassing to delineate those statistical changes, but healthcare should improve now that this legislation has passed.  You may have detected that the operative word is SHOULD.  Will it?  On PBS’s Nova last evening I watched the day by day analysis of why we were not ready for the attacks on 911.  It was because of the bureaucracy.  It was because the NSA (which now has about 35,000 employees and has a budget well over $20B annually.) was NOT willing to share the information that they were obtaining with the FBI, and the FBI was not working with the CIA, and the CIA was not working with the FAA, and the FAA was . . .  Well, you get the picture. 

Healthcare reform?  We’ll see.

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Posted in Healthcare, Public Policy

An Open Letter to Francis S. Collins . . . for Father’s Day

June 20th, 2010 by Nick Jacobs 1 comment »

Dear Dr. Collins:

In 1974 my father was diagnosed with a rare form of lung cancer, and our lives were changed forever.  He had stopped smoking back in 1960 when the Surgeon General had finally declared that cigarettes are “bad for your health,” but it was already too late.  My son had been born one year earlier and my daughter was born two months before my father’s death on July 5, 1975.  During his death watch he proclaimed that, “Had science been honest with us, he would never have smoked.” 

Dr. Collins, I was involved in running hospitals for over 22 years but did not realize the  depth of this science  problem until I helped to create a research institute in 2000.  Because my background was originally music performance , education, and then hospital administration, I did not have all of those preconceived notions about science that you and your peers have been strapped with over the centuries.  Upon interviewing our first three PhDs for positions at the research institute, it was very clear to me that the ”Calf Paths” (poem by: Samuel Walter Foss) of science completely controlled our journey to cures, or, as in my father’s case, to the lack of cures.

When I asked them why they had not won the Nobel Prize, their answers were open, honest, and priceless.  They were following the long established paths that had been put in place by the people who preceded them.  Then they explained to me that, not unlike the training that our Diva’s receive in music school, it was “All About THEIR INDIVIDUAL SKILLS and TALENTS.”  Heaven forbid that they share the ideas for their secret sauce because the person to their right or their left might take away their “NIH grant,” grants which have become suspiciously “Good Ole Boy” grants given primarily to members of “The Club.”   The rules of the system are:  “Don’t share information; don’t ever tell anyone the key to your secret research; don’t co-operate.”  The incentives are completely misaligned.

Until you approach science like a Ensemble with soloists rather than Soloists backed up by minions, the men, women, and children of this generation will continue to die needlessly as well.  Dr. Collins, it’s 2010, 35 years since my dad passed, and I miss him as much today as I did then.  The NIH and medicine knew well before the 60′s that cigarettes were killing people, yet we still manufacture them and push them into the hands of our children today. 

You know that “the system” that you oversee is “BROKEN,” but, unlike what is being attempted in healthcare reform, there is NO EFFORT to implement SCIENCE REFORM.  Not unlike the generals of wars past who must live the remainder of their lives remembering the blood that is on their hands from the decisions that they have made, unless you work to change this ridiculous system of science, you too will have to live the remainder of your days realizing that you allowed the Calf Paths to remain in place.  Step back; look at the insanity of a system that does not encourage people to truly share their data in meaningful ways; that embraces the status quo and tradition so completely that truly significant progress has not been made since Nixon declared war on cancer; that penalizes researchers financially for trying to change the Calf Path, and the mirror will still contain the images of the organizations that you direct.

This dog is no longer in that hunt, but I want progress to be made for my kids and my grand kids.  I want you and everyone around you to admit that the status quo is broken, to begin to reward people significantly for opening their hard drives and notebooks, for exploring the hundreds of ignored orphan diseases; and for playing as an ensemble instead of making demands like a Diva. 

My Father was a wonderful, intelligent, caring man.  My children were raised without his input, his insight, his knowledge, and his ever present love.  He smoked cigarettes with asbestos filters.  Smoking and asbestos . . . two strikes, and you’re out!   Continuing on the current Calf Paths of science; three strikes and we’re all OUT.

Happy Father’s Day!

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Running to a Hospital

June 13th, 2010 by Nick Jacobs 1 comment »

Periodically, it brings me comfort to return to my home base, and that is a place where not enough of my former peers have still journeyed.  One of my more spiritual friends always stops my conversations by saying, “Nick, you need to let go, and ask to be directed to the place where you can do the most good.”  She is talking about spirituality, believing in the universe, allowing destiny to present itself to you.  Truthfully, I spend a lot of my time being frustrated, wondering why others can’t see the light regarding such simple issues as: Transparency, Kindness, Patient and Employee-centeredness.

U.S. Veterans Affairs Secretary, Hon. Eric Shinseki

U.S. Veterans Affairs Secretary, Hon. Eric K. Shinseki

Interestingly, the largest public health system, the U.S. Veterans Administration (which has 17,272 beds and 153 hospitals) began their journey of “change” about five years ago when several of their administrators first approached Planetree.  I’ve been writing about, involved in, and literally living Planetree for decades now, and my passion for this philosophy of care has not waned.  It is about humanizing the healthcare experience, being transparent, centering your focus on employees, staff, and patients in ways that have not been considered even before the United States universities produced more attorneys than physicians.

Unfortunately, our business-minded organizations continue to look upon kindness as weakness, upon transparency as stupidity, upon patient and employee centered activities as pandering, and the price that we pay because of this archaic thinking is very high for all of us.

So, why would the VA get involved?  They “saw the light,” and the light was pretty darn bright.  When you look at the statistics regarding infections, lengths of stay, litigation, and patient and employee satisfaction, there  appears to be no decision.  Of course we can achieve several of these “dashboard” goals by producing human widgets, by treating people like objects, by taking over entire geographies and making sure that no one has a choice about anything, and we can continue to rack up profits in the billions, but are we really doing our  job?

Generations of Valor - WW II meets IraqThe VA thought not and started their journey, hospital by hospital, toward a kinder, gentler world.  Will they be successful with a culture bred out of military medicine?  Can they change a system that has long since been openly criticized as broken?  I think they can and they will, and with pending legislation that will permit our military and retired military personnel to “seek care where it is best delivered,” it will be interesting to see how well they do.

If you are in hospital administration and have little or no competition, ask yourself what would happen if your new competition allowed the patients to access their medical records; if  loved ones were invited to stay and become part of care giving teams; if there was 24 hour a day 7 day a week visiting hours; if employees were always treated with diginty; respected, rewarded, and recognized for their work;  if patients were always at the center of their own care?

Hopefully, someday, the masses will get it, and we will go from treating “organs” to treating people; we will focus on prevention not cleaning up train wrecks; we will embrace kindness, openness, transparency, healing and respect; and finally, we will acknowledge that the value of a human being is not based upon the value of his or her estate.  When that happens your patients will be “Running to a hospital” …your hospital.

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Posted in Hospital Administration, Hospitals, patient-centered care

Big Bird vs. The Status Quo

June 4th, 2010 by Nick Jacobs No comments »

Feeling “funny,” is something that would describe me pretty well today. Not ha ha funny, stomach ache funny. I’m thinking that Abraham Lincoln, Franklin Roosevelt, John Wayne, Amelia Earhart, and even Hawkeye Pierce from MASH may have ruined me. They stood up for what they believed, right or wrong, left or right. They had chutzpah, nerve, and . . . well, you know.

So, what’s making me feel funny? It’s those darn birds. Those birds have touched my heart. Tell me this; how can you not feel empathy for the baby birds being oiled down in their nests, and how about the tiny little birds that are still flying around a few feet from the oncoming disaster with absolutely no clue as to how bad things are going to be in a very short amount of time. I’ll admit that, unlike my mom, I’m not a passionate bird lover, but those big, oil soaked birds are really getting to me.

I’ll be the first to tell you that I’m allergic to shell fish, and even though, according to some oil company spokesperson, “Louisiana isn’t the only place that has shrimp,” according to my memory, their shrimp was some of the best in the world. So, if you’re not a big bird fan, how about a big shrimp fan, or a big fan of places where people live? How about a big fan of being able to sit on the beach or of jobs; fishing jobs, tourism jobs, even oil jobs? What will it take to get our leaders to show some real passion? I’m thinking Sesame Street.

We all know that getting the kids involved has helped remind us to start wearing our seat belts and bike helmets, to stop drinking and driving, and now texting and driving. Maybe we need Sesame Street to get our country to finally scream out from the top of their lungs, “S-T-O-P it.“ Could you imagine Big Bird or better still the President of that oil company dressed as Big Bird all soaked in oil being pushed out into the Gulf and gasping for air as he slowly is washed away forever? It would make the time they did the “Mr. Hooper is dying thing” seem tame.

One of my favorite sayings is “The problem is never the problem,” and the problem here is, once again, the status quo. It’s that philosophy of “don’t change ANYTHING because I’m personally comfortable with my life.” Just this week, a group of scientists who literally have brought 44 people out of deep, irreversible comas; soldiers, policemen, firemen, coal miners, and little boys and girls had their federal grant blocked because the status quo scientists and doctors involved said that “It was not the traditional methodology for treating coma patients.” Yikes, tell that to the people who lived, many of whom are back to leading functional lives. Come to think of it, that would be a good Sesame Street show, too. Oscar the grouch in Critical Care with tubes, the Cookie Monster administering the Last Rites, and Bingo Bango he’s awake and grouchy again.

Is it possible that no one wants to stand up for what they believe in and take it on the chin anymore? Somewhere there still must be some lines, some sacred requirements that we must meet in order to qualify as human beings on this planet? Could you imagine how different those John Wayne movies would have been? “It’s okay, pilgrim, let ‘em rob the bank. We need their support for re-election.” How about Neil Armstrong? “You want me to do what?” “Are you crazy?”

I still feel funny. Where the heck is Big Bird and Hawkeye when you really need them? We’ve had seagull management in this country for far too long now as they “Fly in, squawk, poop on our heads, and fly back to D.C. “ Pelicans UNITE!

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Posted in Current Affairs, Leadership, inspiration

I Remember Stephen

June 2nd, 2010 by Nick Jacobs No comments »

In the 1970’s, my career was wrapped completely around teaching, not just teaching, but teaching and playing music.  It was during that decade that my trumpet playing reached its peak, and between the numerous big bands in the area, I could play at least two weekend and one weekday nights every week.  The music was good, the musicians were friends, and the audiences were appreciative.

Johnstown Pennsylvania - A History - Part 2 - Randy WhittleThe Lemon Drop, Casa Romani, Mynderbinders, Bimbo’s, the Holiday Inn, the Ramada Inn, and a dozen other clubs with mostly ethnic or fraternal names were the sites of many a part-time playing job.  Be it the Johnstown Jazz Workshop, the Barnum and Bailey Circus, the Ice Capades, or Disney on Ice, my playing salary for the year often rivaled my teaching salary; neither of which came to more than $500 a month.

Along with those playing “gigs” there was one other primary, part -time employment opportunity and that was teaching private trumpet lessons.  It was my choice to teach at the Johnstown College of Music which was owned by Peg and Bob Hornick.  My schedule there was always packed full from 5:30 PM until 9:00 PM Tuesdays, Thursdays, and Saturday mornings.  There were kids of all ages from all school districts, and in the 1970’s those kids helped me pay the mortgage.  Even though I was usually pretty tired by 9:00 PM and often dreamed of learning to sleep with my eyes open, I never did.

One of my smallest students was Steve.  He was a little toe-headed, 7th grader from Forest Hills when he came to me, and he loved music.  He loved the fact that he was learning to play the trumpet from a professional and each week he got a little better.  Steve understood what it meant to work for something that he loved, and he didn’t mind getting an occasional tongue lashing if he hadn’t focused enough on his practicing that week.

Well, one night in 1976, I rushed through dinner, grabbed my jacket, and started for the door when my son, then three years old, stopped me and said, “Daddy, where are you going?”  I explained that I had to go to work.  He very slowly replied, “Daddy, you just came home from work.”  I signed and said, “I know, buddy, but I have to make some extra money.”  He looked at me quizzically and said, “What for, Daddy?”   To which I countered, “To buy you shoes.”  At that point he looked up at me and said in a very stern voice, “Daddy, I have shoes; please don’t leave me.”

It broke my heart to leave that night, but I did because I knew that I had an obligation, and when my first student walked in the door, I took a deep breath and thought to myself, “Steve, I’m here for you tonight, “ but those words were never spoken.
Ironically, there was an obituary in the newspaper last week, and it was an obituary for a 47 year old man who also left behind a son.  The age and the picture drew me further into the printed word where I read a name that seemed strangely familiar to me, Stephen Yanzetich.  It was Steve, my Steve, little 7th grade, toe-headed Steve who shared me that night.

Unbelievably, after 34 or so years, in his parting recognition, the author acknowledged that I had taught Steve trumpet, and as I sat back and read my own name in that obituary, I realized, once again, that it had been worth it, that 34 years later my time with Steve had been important to both of us.  That simple acknowledgement said to me, “Thank you, Mr. Jacobs, for caring enough about me to teach me all of those nights.”  To which I can candidly reply,”Thank you, Steve, for being such a good kid, and may God bless you.”

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Posted in Children, Music Education, inspiration

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Moving Through Healthcare’s Version of the BP Oil Spill

May 27th, 2010 by Nick Jacobs No comments »

Who could have ever guessed that the United States of America would fall so far behind in education, childhood death statistics,  scientific research, manufacturing jobs, and even overall, general healthcare?  Yes, of course, we are still a wonderful, strong country with incredible resources, but somewhere along the line, the train seems to have jumped off the track just a little, or is that like being a little pregnant?  No one would ever have conceived that a spark plug would be worth more than GM stock, but that’s exactly what happened last year.  Or how about the fact that large investment banks responding to the mandate to increase home sales by spreading the risk internationally could have helped put this entire world on the verge of a national depression?

For years now I’ve written about the need to provide some type of safety valve for the uninsured, underinsured, and those struggling to make it from layoff at age 58 to Medicare at age 65.  Not unlike the Kennedy-Katzenbaum bill, (you know, that HIPAA bill that was just meant to provide health insurance portability), we have healthcare reform legislation.  The really challenging thing about this new bill is that it was primarily written by policy wonks fifty percent of whom will not be working in Washington D.C. in a few years, and worse than that, it will be interpreted by policy wonk lifers who will be there long after we are all dead.

So, the “Healthcare Oil Spill” has been addressed.  What will it mean?  What does it mean?  How will it impact all of us?  That remains to be seen.  The good news is that 30 million more people will finally have a safety net. The bad news is that there are still two wars going on that are draining our treasury.  There is still financial chaos among the countries lovingly referred to by the EU as the PIIGS (Portugal, Ireland, Italy, Greece, and Spain), and, along with this group,  spending in the United States  has been out of control for at least nine years.

What will happen is anyone’s guess.  How things will be interpreted is anyone’s guess.  How the law will be enforced is every one’s guess, but in  a recent round table discussion at the Mid-State HFMA meeting, we heard four CFOs discuss the challenges that they currently face and will continue to face as life becomes even more complex.  After that session, I’m thinking that lots of mud pushed in the head of the well might just be the cure!  Goodness knows there was enough mud thrown around during this last election cycle.  Maybe we could redirect it back to the source?  I do know for sure that one thing is clear: CHANGE is INEVITABLE, the train is back on the track, and it’s coming straight toward our physicians, hospitals, and nursing homes.

How do we cope with that change?  Make sure that every ounce of fat is cut from the system.  Take a look at the list below and contact SunStone Consulting for the next steps:

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Posted in Current Affairs, Future, Healthcare

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Speaking This Year

May 20th, 2010 by Nick Jacobs 1 comment »
Nick Jacobs, FACHE - F. Nicholas Jacobs - Healing Hospitals - Sunstone Consulting

Nick Jacobs, FACHE

As some of you may have noticed, last year was a tough year for education, travel, and some forms of consulting. It was “the economy, stupid.” A number of our major public speaking engagements were canceled or postponed, because hospitals stopped sending employees to educational conferences. In fact, at one of the leadership conferences where we spoke last year, there were only 90 people in attendance. The previous year, there had been nearly 500.

Well, thank goodness, things have picked up a bit, and we will be speaking a few more times over the next several months. The following is an up-to-date list of locations, dates, and topics currently scheduled:

  1. Lake Erie Regional Cooperative/Amerinet Conference, Toledo, OH, May 7th, 2010
    “Redesigning the Patient Experience”
  2. Risk Management and Patient Safety Institute, Lansing, Michigan, August 27, 2010
    “Blogging and Transparency -Increasing Patient Satisfaction through Web 2.0″
  3. Planetree Conference, Denver, Colorado, October 8th, 2010
    “Navigating the challenges faced while transitioning to the Planetree model of care”
  4. Central Peninsula Hospital, Soldotna Alaska, October 14, 15th
    “Planetree”
  5. Waverly Health Center, Waverly, Iowa, October 20-22,
    Topic: To be announced
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Posted in Healthcare, Leadership, Travel

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IBRF – The International Brain Research Foundation

April 23rd, 2010 by Nick Jacobs 1 comment »

Popular Science in their March 2010 Edition published an article entitled “Waking Up the Brain Dead.”  the sub-title read “A Cocktail of Therapies Jump-Starts Patients’ Brains.”  Then, the May 2010 Ladies Home Journal is publishing an article entitled, “World Leaders in Translational Clinical Research for Alzheimer’s Disease,” (The International Brain Research Foundation – IBRF; in November of 2009, The Clinical Neuropsychologist published an article “The New Neuroscience Frontier: Promoting Neuroplasticity and Brain Repair in Traumatic Brain Injury” that was co-authored by at least two members of the IBRF, Dr. Philip DeFina and his associate Dr. Rosemarie Scolaro Moser, regarding the future of treatment for Traumatic Brain Injury (TBI).

Philip De Fina, M.D.With an 84% success rate in waking up patients from deep, irreversible, persistent vegetative state comas traditional neurologists, neurosurgeons, and neuroscientists have called these “wake ups” flukes, but once you have nearly 45 flukes, the question becomes, “Are they real?”  As the Popular Science article states, Dr. DeFina and his team apply already approved medications, electrical stimulation, and nutraceuticals to the patient, but they do it in a virtual cocktail that has had a dramatic impact on these patients.

After having spent several days working with the folks at the International Brain Research Foundation, my personal heart strings began making their own music.  Not unlike the work that we did at my previous employer, DeFina’s Research Foundation is blazing new trails, not necessarily by inventing all new methodologies, but by applying new approaches to  well-established and FDA-approved drugs and protocols.  They are making unbelievable progress with highly nuanced protocols that will potentially change neuroscience forever.

In typical “small science” fashion, the traditional approach to these patients has been to apply one protocol at a time, and when that fails, move on to the next.  Dr. DeFina appropriately points out that this unconventional approach is effective because it goes to the source of numerous highly complex brain centers.  He asked me to imagine the Wright brothers trying to fly an airplane one “part” at a time.  ”Orville, do you think this propeller will fly?”  Of course, that concept is absurd, but that is an appropriate description of how  Traumatic Brain Injuries are currently addressed.

Image from Popular Scince - Waking the Brain DeadNearly a dozen years ago, when we were beginning our work at the research institute, it was obvious that the reason that cancer had not been cured was because science takes a very laser-like approach to everything;  let’s call it small science.  When we determined that we should have a pristine, highly-annotated collection of specially-collected breast tissue, that we should have a central data repository, and that, heaven forbid, we should have ensemble-type multi-disciplinary teams of scientists and MDs working together, it was as if we had suggested that all science be trashed.  It was so controversial.  To think that one scientist did not keep total  and complete control over all of the data generated by his work.  It was heresy.

Bottom line?  I believe that the International Brain Research Foundation will have us rethinking our living wills not to many years from now as they continue to awaken deep, irreversible coma victims and help them find their lives again.   Not unlike the activities at the Windber Research Institute, where the “Platinum Quality Tissue” is currently being used to map the breast genome.  We are looking into the future of science, and it is very exciting indeed.

IBRF Banner - Dr. Philip De Fina - Nick Jacobs - HealingHospitals.org - Sunstone Consulting

The very difficult news is that the IBRF is totally and completely dependent upon donations and grants for their work, and traditional granting organizations do not favor nontraditional approaches to curing disease and saving lives.   So, after you do your due diligence, if you are as moved as I was, check out the IBRF’s website (including their excellent videos) at www.ibrfinc.org, and help them change history.

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