Recently, my youngest child —a wife and mom in her 30’s,  got a new job that came with a company cell phone, a Blackberry.  The problem was that she had a “Friends and Family” cell Phone plan, and didn’t need her old phone.  She called the wireless company, explained the situation, and they said, “We’re sorry, but the telephone bill is in your husband’s name, and only he can change this.”  She painfully explained that he is in the Army National Guard in the middle of a war zone.  The wireless carrier’s “Customer Care” representative replied, “I’m sorry, but he must call in, give us his Social Security number and the password or nothing can be changed.  There are no exceptions.”

American soldiers with the 101st Airborne Assualt Division at Camp Pennsylvania make phone calls from a makeshift, and often malfunctioning, phone center. – Photo by Benjamin Lowy/Corbis -Image © Benjamin Lowy/Corbis

She explained, ”He does not have a telephone to call you from his base in the desert.” The service representative said, “ Then he must send us his Power of Attorney.”  This frustrated young army wife and mother of three said, “We’re not adopting a child or buying a house, we’re trying to change a wireless plan?”   “Let’s see, Osama Bin Laden is still making DVD’s, but you can’t change a phone plan?,” she went on.   “That’s correct,” came the icy cold reply.

Undaunted by this setback, we went to the local wireless store hoping that we would find an employee who was not the Tin Man from the “Wizard of Oz.”  The young lady patiently waited the 20 or so minutes until her name was called, went up to the associate at the counter and said, “I’d like to take this phone off the family plan and move it over to my new company.”   “I’m sorry, he said.  “The bill is in your husband’s name.”  She explained that her husband was deployed.  The mystified sales associate said, “I’ll check with my manager.”

You guessed it,” the manager said, “Just have your husband call.” “He doesn’t have a phone,” she exclaimed.  By this time everyone was listening intently.  The young man said once again, “Have him call.”  It was at that point that I lost it and said, “He’s in the war! They shot at him today.”  A few stations away, a man who was obviously a veteran yelled out, “Give me his numbers, I’ll put a war movie in the DVD and call these jerks for him.”  The next woman over just shook her head.  Undaunted, the red faced associate stuck to his guns.

Clearly corporate America was making a point.  War?  What war?  Who cares?  “Rules are rules, and they will not be altered!”  This was the third time in as many months that she was greeted with this type of callous big business attitude.  Because it was in a new location, the local cable company would not put cable into their home to provide access for the family to communicate with their dad via the internet for under $3,000.  Even when she explained the desperation of a war mom separated from her husband for a year, their reply was simple, “No, it’s $3000,  or no cable.”

She then asked that her satellite TV be discontinued, and was told that she would be assessed another several hundred dollars because the contract had not expired.  She once again explained the Iraq situation and the need for high speed cable, but they replied, “Sorry, but that’s the way it is.”

So, let’s all take this opportunity to thank our wireless company, the cable company, the satellite company, and every other United States-based company who so fervently support our troops and their families. Sung to the tune of America the Beautiful:

The magnitude of gratitude expressed by corporate greed;
Tells all our soldiers everywhere we’re grateful, yes indeed.
We’ll fleece you here and fleece you there as you protect our homes
Just watch us help your families until you all come home . . . NOT!

In the words of Stephen Colbert, you’re on notice.

All week my search for pertinent topics for this blog were side-tracked by the deaths of numerous luminaries: Michael Jackson, Farah Fawcett, Ed McMahon, and even Billy Mays.  We’ll miss you all.

Then, during lunch today, the Pittsburgh Post Gazette reached out and grabbed me with this headline:  “The End of Male Rule.” The reason that this headline was so moving to me stems back to the Saturday of the week-end before 911 when Dr. Wayne London, an old metaphysical theorist friend of mine told me that:  1.) The American financial system as we know it would collapse.  2.) The center of the U.S. Military would come under attack, as would 3.) the patriarchally-controlled Catholic Church.  He then said, “All of this will happen as Mary Energy begins to lead toward the change, and women will take control of the world again.”  He went on to explain that this woman control is not a new phenomena, just one that has not been around for quite some time.

Pentagon 9/11 memorial service, September 11, 2008 – Photo credit: UPI

Well, after the Twin Towers were hit, our own American citizens did much more damage than anyone could have ever imagined possible to our financial system by setting up the elaborate mortgage and derivative schemes that nearly caused the entire U.S. financial system to collapse.

Of course we all remember the horrible hit that the Pentagon endured on 911, and now we face the huge financial burdens of continuing two wars and trying to rebuild a completely exhausted military that has been over-stretched and nearly wiped out emotionally by the last several years of redeploying both our all-volunteer army and their equipment over and over again.  When you begin to see more suicides than casualties of war, something is obviously very wrong with the System.

The Church went through what has come to be recognized minimally as a very difficult time with millions and millions of dollars in lawsuits and structural challenges over sexual abuse issues that had been closeted by numerous U.S. Bishops for years and years.  The celibacy thing seemed to have been much more destructive for the men of the Church than the women.

So, what was Reihan’s interpretation of this metamorphosis, this change in traditional male dominance?

PTA President Charles J. “Chuck” Saylors

Before we go there, on NPR this evening, I heard about Chuck Saylors, the first male president of the National Parent Teacher’s Association since its inception in the late 1800’s, and it all started to make even more sense, a guy in a predominantly female organization deserving to become president because so many men have assumed more house dad roles.

Reihan’s article started with the line:  “The era of male dominance is coming to an end.  Seriously.”   He went on to describe the fact that the Great Recession has turned what was a quiet evolution into a revolution…a mortal blow to the macho men’s club.  He quotes the fact that 80% of job losses or over 7 million jobs have been lost by men in this recent massacre, and the predicted number of male jobs lost by the end of 2009 is estimated to be around 28 million worldwide.  He adds to the fact that soon there will be three women for every two male college graduates in the U.S.

One of his most interesting revelations was that Iceland threw out the entire men’s club in their last election, as did Lithuania.  Could this be the beginning of a trend?

Of course the article went into much more depth, had numerous other examples to support these claims, and was compelling in its support of Dr. London’s theme.  The bottom line, however, is not easily denied.  We macho, risk-taking, aggressive guys have done a lot of damage over the years, and it will be fun watching this predicted shift in the next decades.

I’ve always felt that a world run by women might have a little better chance of having less warfare. Let’s hope that the female leaders of our future will have the attributes that will make them better than the men that they are replacing, and the world will be a better place.

Healthcare Reform? The premise and the incentives are wrong.  We treat sickness (which can be a good thing), however, we do it to the almost total exclusion of encouraging and incenting wellness. While in the Netherlands a few years ago, I asked a very comfortably-situated business person why she and her entire family all rode bikes. She smiled and explained that the millions of bikes in the Netherlands are a way of life because they keep people healthy.  Of course, we don’t have to ride bikes, but why not?  “It is much less costly.  It gets us where we want to go, and it is so much better for our bodies,” she said.

Photo credit: Amsterdamize

After going to doctor after doctor in my early thirties and then again in my early forties for a recurring and seriously painful back problem, someone suggested a Chicago-trained chiropractor.  After a very quick, one time manipulation, he said, “Follow me, please.”  When we descended the stars of his office, in front of me was literally an entire homemade work out facility.  This particular center seemed to emphasize strength training.   The Doc walked me over to a row of three machines and said, “If you use these three machine or their equivalent, just the way I show you, you will never have to come back here again.”  Then he said, “Oh, and if you drop fifteen pounds, you may be able to get off those blood pressure pills, stop taking that stomach medicine, and feel better about yourself in the process.”

The Dr. Dean Ornish Coronary Artery Disease Reversal Program is completely about health and prevention.  It is about wellness; treating yourself with the love and respect that you deserve, being kind to yourself, yet being disciplined enough to get you where you need to be in order to enjoy a healthy, pain free life.

We spend only 4% of our health care dollars on prevention.  That may sound like a lot to some of you, but do the math.  Take 4% and multiple it times $2.2 trillion …or possibly soon $3 or $4.0 trillion.  Every physician should endorse a workout facility and work to send you there, and every physician should receive bonuses for having you use it.  A primary care physician in Britain can make about $320K a year, which includes incentives directed toward encouraging healthy living for their patients.  Our primary care docs make, what, $130,000, $150,000, $180,00 in comparison?   Would you really care if your physician could make almost twice as much if you were living a wonderful, healthful, reduced stress life?

There is absolutely NO DOUBT in my mind that the reason I’m typing this here today and not deceased at age 58, like my father, is because of the work of people like Drs. Ornish, Benson, Jonas, and Weil.   It is not because of my old donut shop, the nachos and cheese, the automobiles, my Lazy Boy, or the grueling work habits that we Americans think of as normal.

And what about death?  I have to tell you that death happens to all of us.  (Sorry.)  When it happens may depend a great deal upon our recognition of that fact, but it is not avoidable.  So, why is it that we, as a society, reject death as evil, and ignore its possible existence?  How could we cut billions and billions of wasted healthcare dollars?  Hospice is the answer.  Don’t commission oncologists for drug use when there is absolutely no hope that the patient will live.  Don’t pay radiologists for radiation treatments that will not work in preventing death.  Don’t reward hospitals financially for readmission after readmission for people who should have been told to mark  their DNR’s months earlier.  Face death as part of life.

Finally, look at the food and restaurant industry.   For every restaurant or food company that pulls a killer food and replaces it with the reasonable alternatives, reward them through the $3 or $4 trillion health budget.  You can buy veggie hot dogs on the streets of Toronto.  (Try Morning Star Farms brand veggie hot dogs.  They rock.)

In closing; diet, exercise, stress management, balanced lives, less capitalistic rewarding of killer diets, higher reimbursements in healthcare for the “right stuff,” and acknowledgement that this will eventually end, can make it all work so much better, so much cheaper, so much easier.  Did you have your pneumonia shot yet?  Well, actually, you may not need one if you start taking care of yourself.  I’m going downstairs to workout now.

Next time?  Tort reform.

Recent news:

WASHINGTON, DC — James von Brunn, the white supremacist who allegedly opened fire Wednesday at the U.S. Holocaust Memorial Museum in Washington, D.C., suggest that a lifetime of hatred had reached a critical mass. The 88-year-old is charged with murdering a security guard at the building.

LITTLE ROCK, Ark.  —  A Muslim convert charged with fatally shooting an American soldier at a military recruiting center said Tuesday that he doesn’t consider the killing a murder because U.S. military action in the Middle East made the killing justified.

NBC News is reporting that at Camp Liberty, the main U.S. military base in Iraq, which is located near the Baghdad International Airport, a yet unnamed serviceman walked into a “stress clinic” in the camp, opened first, killing at least five. Contrary to earlier reports, the soldier did not kill himself but is now in custody.

When things like this happen, we all stop and ask what went wrong?  In two of the three situations, we had relatives or friends nearby.  My daughter-in-law’s friend was working at the museum, and my son-in-law is stationed beside the stress clinic at Camp Liberty.

I’ll never forget when the Reagan administration began the movement to close down  mental hospitals.  A friend worked at the mental hospital nearby.  We had had a rash of threatening letters, some very upsetting encounters, and a several other incidents in the community when this friend said to me, “You know, we had 2,000 inpatients and 500 outpatients at the mental hospital.  Now we have 2,500 outpatients. Nobody’s left town, and when they don’t take their meds, there can be problems.”

Pfc. Joe Dwyer carried a young Iraqi boy injured during a heavy battle between the U.S. Army’s 7th Cavalry Regiment and Iraqi forces near the village of Al Faysaliyah, Iraq, on March 25, 2003. Dwyer died of an apparent overdose at his home in North Carolina on June 29, 2008. Photo credit: Warren Zinn / Military Times file

When you consider that there are about 6.5 billion people in the world, if only 5% of the total people living on this planet are suffering from some type of mental illness, we’re potentially talking about the equivalent of the entire population of the United States with some mental health issues. ( Sorry if  my math is slightly off.)  Point is, that’s a lot of people.  So, what are we doing for them?

The Rand Corp. released a study of returning service members and is estimating nearly 20 percent of the 1.6 million who have served since this war began will develop Post-Traumatic Stress Disorder (PTSD). That is nearly 320,000 PTSD sufferers – more than the population of Pittsburgh.

White supremacists are such old news.  We have had to hear about their beliefs over and over during the past sixty years or so.  Maybe when they are arrested,  as James von Brunn had been more than once, it would help them to serve their time doing community service as tour guides at Auschwitz?

Our soldiers, however, are an entirely different story.  We have spent the past several years meeting with experts in mental health who do know what to do for them.  That’s the good news.  The bad news is that this care is not being rendered.    The military has strict guidelines on the treatment of PTSD, but, if you ask our returning soldiers how faithfully these guidelines are implemented, the general answer is that “There’s not enough money to provide this care for our Guardsmen and women.”

We don’t pay our school bus drivers a living wage, and they are in charge of our most precious loved ones.  We couldn’t afford to send armour with our early troops deployed to Iraq and have had more amputees than in any war since the Civil War, and now we don’t have enough money to treat PTSD.

That type of rationalization makes me tired.  We have enough money, we just don’t have our priorities and incentives in line.

Did anyone notice that James was boiling over with insanity?  How about Mohammed?  Our PTSD patient in Iraq knew that he was in troble, but we busted him, and then put him beside a driver with a gun on his hip.  That weapon became his killing tool.

This blog was not intended to be depressing.  It is intended to reemphasize that we in healthcare should be about caring. It is about teaching caring, love and respect.  It is about helping those who need help, and detaining those who won’t accept that help.   We have drugs, but, as the Virginia Tech shootings demonstrated, in certain phenotypes the receptors are not there to allow those drugs to be absorbed into the body.

Mental health help has a long way to go, and we all need to be part of that journey.  Telepsychiatry, PTSD clinics, screenings for radicals?  Surely someone cares.

Everyone has seen the media reports on the $1.7 trillion of cost cuts being projected by health care leaders over the next decade, but does anyone really believe it? According to this group, the premises embraced that will lead to these cuts are based upon improving care for chronic diseases, reducing unnecessary care, and streamlining administrative costs. Included in this wish/promise list are cutbacks, commitments to permit fewer Caesarean sections, better back pain management, less use of antibiotics and a reduction in diagnostic imaging tests.

U.S. President Barack Obama meets with healthcare executives at the White House on May 11 (Photo credit: Pete Souza)

The groups involved have made commitments to try to reduce medical errors, begin the use of common insurance forms, to initiate a reduction in patient re-admissions, to improve the efficiency of drug development, and to promote the expansion of in-home care. (The majority of the preceding information comes from an article by Janet Adamy entitled “Health Groups Detail Plans to Reduce Costs,” in the June 2nd Wall Street Journal. )

If you are reading this, and you are a health care professional, it may be reminiscent of listening to your three hundred fifty pound, five foot tall neighbor describing how he is going to get back into his size 34 Levi’s. It also reminds me of a conversation that I had about 22 years ago when a hospital vice president said to me, “We are going to begin putting  computers into the hospital, and they will reduce costs, lower the need for staff, and contribute to much higher efficiencies.” What part of this equation didn’t happen? Even at the little hospital from which I just retired, we went from two, to three, to four… to about a dozen experts in every aspect of computer technology, and IT has been a dominant part of the capital budget for over a dozen years. So, what’s wrong with this scenario? As the equipment became more sophisticated, more well trained experts were needed. The higher the cost of the equipment, the greater the overhead required for maintenance, and the larger the demand became for everyone in the facility to be computerized.

It is not my intention to be a complete cynic, but isn’t it true that tens of thousands of people who have become used to a certain standard of living will be controlling these cuts? If we could have improved chronic disease care, why wouldn’t we have done that already? It’s all about the reimbursement system. We are still reimbursing for sickness rather than wellness. How do we line up the incentives so that statements like “we will permit fewer Caesarean sections or we will initiate better back pain management” will not ring hollow as words directed toward placating the new President? Nowhere in the equation is there any reference to initiating tort reform. As long as doctors, hospitals, and other clinicians have to practice defensive medicine, we will not be able to reduce tests. We will not be able to reduce unnecessary costs.

Yes, of course a reduction in medical errors would be great. So would common insurance forms, and fewer re-admissions. I’m sure we will see our peers work diligently toward those ends, but, unless or until incentives are aligned, the system will continue to roll along pretty much as is. I’m not sure why the President hasn’t called me yet. Maybe it’s because he knows how I feel about tort reform. Maybe it’s because he knows that I’ll say that the list articulated in the opening paragraph is filled with smoke, or maybe it’s because, like all government-touted initiatives, it’s not supposed to actually come completely into play until two and possibly six years after he leaves office. That philosophy certainly didn’t work for our former Presidents, and, unless someone gets really serious about changing the way healthcare is delivered in the United States, these pledges will be just what they appear to be, “Tinker Bell dust!”

There were some very bright people involved who confirmed my suspicions, but it was my persistence, my explorations, and my perseverance that took me to those scientists, doctors, and pharmacists. You see, the prognosis that I was given involved a very much dreaded series of events that played heavily in the death of my paternal grandmother – kidney failure.  Okay, it was mild.  Yes, it was just the very beginning stages, but, like surgery, when it involves my body, it’s major!

After an E-mail to a very well known and highly respected physician at one of the mostly widely recognized medical facilities in the world, my suspicions were even more intensified.  Phone calls to two different pharmacist friends resulted in me getting the information that I had been seeking.  There were at least three recent studies that confirmed that ARB’s (Angiotensin Receptor Blockers) could cause renal (i.e. kidney) dysfunction, resulting in the doubling of serium creatinine, leading to death.

“Reports in the medical literature reinforce the importance of recognizing that angiotensin-converting enzyme inhibitors should be used with caution in patients with bilateral renal artery stenosis . . . Clinicians should be aware that renal failure might occur when using ARBs in these patients”…

…read one website.   Like I said, I’m not a doctor, and I’m sure that there will be plenty of opinions about these studies.

From another website:

“Chicago, IL – The addition of an angiotensin receptor blocker (ARB) to ACE-inhibitor therapy makes treatment noncompliance due to side effects more likely and ups the risks of symptomatic hypotension and renal dysfunction, suggests a pooled analysis of four randomized trials [1]. The findings are consistent with current treatment guidelines that express reservations about routinely combining the two drug classes, the authors write in the October 8, 2007 issue of the Archives of Internal Medicine.“

Well, to add insult to injury, last year I had my upper and lower GI work up, just for old times’ sake.    At the end of that procedure, the doc suggested one of those purple pills.  Tonight on the news, right after the GM bankruptcy, the story went something like this: According to the Associated Press…

“Taking such popular heartburn drugs as Nexium, Prevacid, or Prilosec for a year or more can raise the risk of a broken hip markedly in people over 50, a large study in Britain found.”

Well, okay, it was Britain.  We all know that they are generally much more healthy than we Americans.  Maybe the study should have read:  “If you are healthy, you will break your hip in England.”

I know, I know.  We all have to die of something, but darn it, why does it have to be the result of stuff that is supposed to be helping us stay alive? I hate the thought of spending the equivalent of a Mercedes car payment each month to load my body up with chemicals that do more damage than Jack and Coke or Goose and Tonic.  Seriously, Aunt Martha really seemed to have it together:  Don’t take anything stronger than an aspirin.  For heaven sakes, don’t get a physical if you can avoid it, and live your life in moderation.  She’s still going strong in her eighties.

Oh, well, it’s time for my Niaspan, Plavix, Nexium, Lotrel, Toporol, Zetia, Crestor and fish oil cocktail …with a chaser of mulivitamins. To your health!

1979 was the year in Johnstown, Pennsylvania when I decided that it was time to leave teaching and transition into business.  For those of you who don’t remember that year, it was the beginning of some serious financial challenges for our country, but it was also two years after the Johnstown Flood of ‘77, and there was an unemployment rate of 19.5% in Cambria County, PA.

In 1980, when I accepted a job with a then bankrupt nonprofit organization in Somerset, PA, what had been a booming coal industry went into the skids. My house mortgage was about the same as the unemployment rate, 19%.  The job that I took was in the arts and Ronald Reagan was interested in cutting funding to the National Endowment for the Arts.

In 1985, my new job was with a tourism agency, and that was the year that then-PA Governor Casey cut funding to tourism.

In 1988, when I entered healthcare, it was clear that Johnstown could no longer support four hospitals, and the next decade and a half resulted in the closing of two (and almost three) of the four hospitals in that area.

Turn the clock forward to last October, when I announced my decision to become a healthcare consultant.  The stock market crashed, eight of every ten hospitals stopped, postponed, or scaled back needed capital projects, 58% of hospitals are now reporting  increases in uninsured patients using the emergency departments, 48% of hospitals have cut staff, and 80% have reported cutting expenses that include consultants.

As a consultant, the first thing I would tell anyone is that “No matter how bad things appear to be, you can do it.”

• Our successes as a teacher continue to remain evident as former students ranging in age from 38 to 58 continue to remind me of great memories of our time together.
• The arts organization became the largest and most successful rural arts organization east of the Mississippi.
• The Convention Bureau went from almost closed to the fifth largest agency in the State, and most of you have tracked the successes that we experienced at Windber.

Not unlike the little engine that could, we focused on the positive, forgot about the negative, and never dealt with “Mr. In-between.”

There are those who approach life cautiously, carefully, and very conservatively, and then there are those of us who drink from that same cup in big gulps and dream about how things could be rather than how they are.  There are those who are afraid of failure, and those of us who embrace failure because we know that it is getting us closer to more dramatic successes.

The only boundaries that we have are between our ears.

Because the future is a design function. Let me close this blog post with the ending from my commencement address to the graduate students of St. Francis University (with the help once again of Dr. Leland Kaiser):

• Nothing has to be the way it is.
• We can invent (or prevent) our future, because all limitations are self imposed.
• We can empower ourselves to create a new world.
• Reframe any limitations to become opportunities because…
• Tremendous limitations breed success. They open doors.

So, as we design our future, remember that we should not work to create what people will like, but instead work to create what people will love!

…and we will know success beyond our wildest dreams.

So, here’s the story: I got to the airport my normal two hours early because I’m obsessed about being on time. Worked on my computer, grabbed a salad, got on the plane, talked to the flight attendant, buckled up, and just as we were pulling out of the gate, all of the power went off. We lost the air conditioning, and the flight attendant and I looked at each other and said, “That’s not good.”

As it turned out, the young pilot on this commuter jet forgot to turn on the auxiliary power and when the ground crew unplugged the plane, everything went down; all of the computers and the air conditioning. In fact, the entire plane was roasting, and it took the ground crew over an hour to restore the power. Seven people got off of the plane because they missed their connecting flights to places like Germany and Kuwait; one poor guy was AWOL

We took off in plenty of time to make my flight to Pittsburgh, but when we landed in Dulles we had to sit at the gate for another 20 minutes for the absent ground crew. Then we waited twenty more minutes for the bus/room that takes you to the correct part of the terminal for the next flight. Of course, I missed my flight by about 30 minutes, walked about two more miles, stood in lines for another hour, finally got a ticket for the first flight out this morning. Then had to stand in another line to get a hotel room. Walked for another three or four miles through Dulles, got lost, stood in the rain for about 20 minutes, got to the Holiday Inn compliments of the airline, was placed in a handicapped, smoking room . . . (they must have recognized me), and slept for about three hours. I guess that makes me a real road warrior!

I’m back at the gate waiting for my flight and today’s excitement.

(Could this be a possible air travel alternative in our future?)

Okay, who wants to be the first one to have written about a pandemic?  Unfortunately, I know way too much about this stuff.  Guess it’s that old hospital CEO mindset.  Prepare for the worst, and expect it.  Well, let’s all pray that this thing settles down before more people die.  My friend, Dr. Matt Masiello wrote an E-mail today that could probably help a lot of people.  A public health message with a level of calm urgency.

Based on the cumulative experience of the scientific and health promotion/disease prevention staff at WRI, we began a more active approach in  preparedness then what had been recommended by WHO/CDC and the local EMS. We feel that with WHO now raising the alert level to 5 our actions were appropriate. May I suggest the following.

1.    Prepare and distribute a letter to parents asking them to keep their children home if they have a cough, fever, headache. If someone in the family has the same signs and symptoms the children should also stay home until  the illness by the family member is confirmed not to be Swine flu.

2.    Place a small table with sanitizer bottles at the entrance ways of the school buildings.

3.    Encourage staff to carry on their person the small hand sanitizers.

4.     Instruct your teachers to review with the students advice on handwashing and use of the sanitizers. Teachers should remind students throughout the day of the importance of handwashing as well as keeping their hands away from their face and the importance of coughing into their sleeves. Wash/sanitize hands afterwards. I would encourage formal, scheduled trips to the BR to wash hands and when ever necessary.

5.    Place the attached sign in key locations and encourage staff and familes to take them and post at home as a reminder. Wash hands prior to and returning from work/school/play.

6.    Get plenty of rest, eat well and exercise.

7.    Open windows for better movement of air, when and if possible.

8.    Minimize social gatherings. The canceling of social events may come as  a formal recommendation via the CDC in the very near future.

Matt

So, that’s the official word from the United States’ representative to the World Health Organization.

Now, onto life.  Last night we completed a list of services that we are helping to provide to hospitals, schools, hotels, newspapers,  businesses and anyone else that might be interested.  Rather than list each business individually, let me list their services, products, and work, and, if you’re interested, give me a call.

• Technology Solutions for Government
• Sophisticated market research
• Physician billing/Pre-certification and approval of payments for doc offices.
• Telemedicine and medical device marketing analysis and launch
• Food Services for hospitals and long term care centers
• Education Programs and Leadership Solutions
• Continuing Medical Education for physicans and nurses
• State and Federal Lobbyists and Business Development Experts
• Personal Healthcare and Corporate Wellness
• Crisis Response Communications
• Construction solutions (REIT)
• HR and House Wide Quality System for Job Descriptions
• Translation services (Contract pending)
• Specialized Cancer Laboratory Services
• Removal and disposal of hazardous waste, a green company
• Economic Development and ECAP green initiative
• The Doctors’ Doctor – Physician office mergers, acquisitions and general business operations consulting, and Hospital Physician strategic planning

Obviously, each line represents a company that we represent, and even more obviously, SunStone Consulting is your answer for all of the financial challenges that hospitals face.

In August 2006, I was inspired to write a disconcerting blog post regarding the potential outbreak of the avian flu.  It was a disturbing post not only because it contained potentially negative statistical mortality outcomes on an international basis, but also because, as a relative insider, it was clear to me that we were not ready at all for this type of pandemic.

Churchgoers in Mexico City Sunday | Photo Credit: AP

With new grandbaby Zoey safely here on earth less than a week ago as the youngest member of the family,  today’s opening story of a potential influenza pandemic made my blood run cold.  The rate and speed with which this type of pandemic could overtake our world is almost immeasurable, and, having flown from San Francisco, to San Diego, to Richmond to Pittsburgh in the last week, it was clear that,  if I had been a carrier, literally hundreds of people could have been infected simply by my presence.

Those who are realists or pragmatists will simply say, it is Mother Nature’s way of “thinning the herd,” but herd thinning in our case is something that is uncomfortable, especially in such a random way.  During the pandemic of 1917/1918, mass graves were dug not ten miles from my home, and undertakers were not even permitted to prepare the bodies for burial.

My previous blog focused on the avian virus, but this morphed virus that appeared in Mexico, not China, not the Far East as originally predicted, is a combination of human, swine, and avian viruses.  No one has ever seen or found cures for this type of radical new flu yet.

View H1N1 Swine Flu in a larger map

The World Health Organization came out today with only a level three warning, but when they described this level of warning, they indicated that it was simply because they did not yet have enough information to take it to level six.  There are confirmed cases in San Antonio, San Diego, and one report even indicated that New York had two cases, and over 68 are known dead in Mexico.  Fever, sore throat, coughing, nausea, body aches, headaches, chills and fever are some of the symptoms presenting with this flu that can result in pneumonia and respiratory failure.

Mexico City closed it schools on Friday, and more such initiatives are expected as this powerful force of nature begins to take on a life of its own.

How can you avoid getting this flu?  Wash your hands, stay away from infected people, cover your nose and mouth.

In children, emergency warning signs that need urgent medical attention include:

• Fast breathing or trouble breathing
• Bluish skin color
• Not drinking enough fluids
• Not waking up or not interacting
• Being so irritable that the child does not want to be held
• Flu-like symptoms improve but then return with fever and worse cough
• Fever with a rash

In adults, emergency warning signs that need urgent medical attention include:

• Difficulty breathing or shortness of breath
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting

Let’s all hope that this never gets any worse than it did in the 1976/77 cycle when only a very few people died at that time…mortality rate was low with swine, but this is swine, avian and  human combination.

Tonight, say a little prayer.

Also by Nick Jacobs:

Are We Ready for the Avian Flu?
Hospital Impact
August 8th, 2006