Ostracized in the workplace

December 19th, 2023 by Nick Jacobs No comments »

Why are things the way they are? The University of Eastern Finland recently released a paper by Sipra Manninen, Samli Koponen, Timko Sinervo, and Sanna Laulainen in the Journal of Advanced Nursing on the impact of ostracism in the workplace. We all have experienced this phenomenon in several ways, but my personal experiences pale when compared to those individuals who had a different skin tone, religious belief, any type of physical anomaly, or were just less self-assured people.

Ostracism is, as defined by Oxford, exclusion from society or a group, and it comes from the Greek ostrakismos which has the same meaning.  Although it typically causes no visible physical damage, the emotional and psychological impact can be intense and often heartbreaking. It most certainly can harm the individual’s mental health, self-esteem, and personal well-being in ways that are long-lasting and deep.

Many of our adult behaviors can be traced back to experiences relating to these exclusions or outright rejections from our peers.  Ostracism can occur in personal situations, the workplace, or on societal levels. It can be both unintentional and intentional and can influence the individual’s perception of the world around them for a lifetime.

Because we are inherently social human beings, finding one’s tribe and being comfortable in that scenario can provide a sense of emotional and mental well-being. Conversely, when someone is ostracized, it often triggers feelings of sadness, despair, and loneliness that can have a significant impact on feelings such as anxiety and depression.

The Finnish article was directed toward ostracism in the healthcare workplace, and it described examples like the impact of exclusion from social activities, lack of communication or the withholding of information, being overlooked in meetings, and how these slights can negatively impact the workplace. All of these actions can create what can only be described as a toxic work environment. This can result in decreased job satisfaction, underperformance in the form of less productivity, and even higher turnover rates.

Because our coping skills are less developed as children and young adults, that same behavior in school or social settings can result in academic underachievement, withdrawal, behavioral problems, and more prevalent actions recently due to the addictive and anonymous nature of social media, such as self-harm and even suicide that can be both intentional and unintentional.

If you’re the kid who is not invited to the party or gathering where all of your friends are. If you’re excluded from a club about which you were passionate. If you’re not part of the in-crowd at a dance or a meeting where you were previously a key player, you are being socially ostracized. The worst part of this is there may be no real concrete reason for being cut-out, and if there is a reason, it may be even more hurtful.

As we look at the numerous scenarios that have brought our country to this point in terms of philosophical separation, we can reflect on what contributed to the two political camps, and within those camps, we will find people who were ostracized at various times in their lives. There are reasons why certain groups feel more of an affiliation with others and this is often based more on the previously felt pain caused by being eliminated from situations that were meaningful to them.

If we could take a deep look at the personalities of the leaders that are controlling life and death decisions in our world, they are dealing with deep issues that have roots in their past. The desire to dominate, eradicate, decimate, and eliminate entire countries, groups of people, or societies is not normal.

Only through encouraging inclusivity, open communication, and the promotion of empathy can we help mitigate the negative impact of ostracism. By working to create a more compassionate and inclusive society through fostering understanding and empathy, we can create a world where everyone feels valued, accepted, and capable of reaching their full potential.

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Living Long Enough to Finally Figure Things Out

November 1st, 2023 by Nick Jacobs No comments »

In September 2019, a team of highly trained medical professionals implanted a new heart valve into the aortic opening of my heart. This TAVR (Transcatheter Aortic Valve) procedure involved placing the valve through my femoral artery. The physicians guided a catheter, carrying the engineered valve, through the artery to my heart. Inside the catheter was a folded replacement valve, which they securely positioned within the old valve, and opened like an umbrella in a tropical drink.

They informed me that my valve was made from both synthetic and bovine materials and was expected to last from seven to an undetermined number of years. If it failed, replacement was a viable option. A myriad of questions crossed my mind. Was the bovine donor raised in a specialized environment for medical purposes?

            Was it grass-fed? Did they treat it like the Kobe cows, with massages and special care? Heck, after reading about Kobe beef, I’m inclined to think that, except for their ending, I’d like to be a Kobe cow. These cows supposedly drink beer, get massages with rice wine, and listen to classical music. So, what about medical cows and pigs or bovine and porcine donors being prepared for humans?

Recent studies involving individuals in their final moments, explored the use of compassionate animal organs—particularly porcine organs—for human transplants. These studies provided valuable insights into the necessary adaptations for these animal organs to be effective in humans. Physicians and scientists meticulously reengineered these organs for compatibility with the human body.

Naturally, pig and cow organs must undergo testing in non-human subjects before human trials. The preparation of one of these organs for transplantation into a monkey, for instance, requires about 69 genomic edits. I’m not a scientist, but even writing this column takes about 39 edits.

Not that any of us reading (or writing this) can fully understand, but before these organs can function, they must undergo engineering to eliminate glycan antigens, to overexpress human transgenes, and to inactivate porcine endogenous retroviruses. Yeah, I know. I didn’t understand that either. It’s perfectly okay. I’ve been working with genetic scientists for about 20 years, and much of this is still very mysterious to me.

What they have discovered, however, is that including human transgene expressions in the reengineering process could enable successful preclinical studies of renal (kidney) xenotransplantation (pig transplants) in nonhuman primates. This single discovery could bring us closer to clinical trials of genetically engineered porcine renal grafts. What?

In other words, we’re getting closer to being able to use specially grown pigs with genetically altered kidneys to be implanted in humans. What would the impact of that be? Each year, more than 97,000 people in the United States need kidney transplants, but only about 10,000 to 15,000 people actually receive transplants from donors. Just like that cow who gave up its life to give me a few more years, there could be enormous positive strides in life-saving transplants from altered pig kidneys.

So, between AI connected to our brains, bionic limbs and eyes, and porcine and bovine spare parts, we might just be able to extend this life thing long enough to figure out our purpose. I think we have a long way to go before we stop the abhorrent behavior that has been so rampant recently.

The genetic difference between a chimpanzee and a human being is about 1.2 percent. There is a zero-percentage difference genetically between humans of different races, colors, creeds, and religions. When will we accept each other as one race, the human race? More importantly, when will we stop killing each other because of our stupid, man-made prejudices and bigotry?  What we are seeing in Gaza, Israel, Ukraine, and even in places like Maine in the United States is symbolic of our need to rip the scales from our eyes and admit that we are a single race that requires two things to thrive, the love and respect of our fellow human beings.

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Reality vs. delusion

October 25th, 2023 by Nick Jacobs No comments »

 

Reality and delusion are the terms used to describe two contrasting aspects of human perception and cognition, and they may be the root of most of the challenges we are facing as a species today. What’s real and what’s not?

When we analyze the meaning of reality, we are referring to the state of things as they exist. This state of existence can be objectively independent of our own prejudices, personal perceptions, or varied interpretations. Reality is the actual, precise existence of something.

This interpretation of reality typically refers to something that is consistent and shared by multiple observers who have measured and confirmed it via empirical, factual, verifiable evidence. The moon is round. So are Mars, Venus, Saturn, the Sun, and all the other planets. The earth is not flat. That would just be a total embarrassment to the rest of the universe.

Yet there exists an entire community of “flat-earthers,” who, in spite of confirmation by thousands of verifiable sources, do not believe the earth is round. Even taking into account the need to deny gravity, distorted horizons, and sun and moon rotation theories, they still hold on to their beliefs. Consequently, the flat earth concept might be a subject that could be described as a delusion.

The author, Philip K. Dick wrote, “Reality is that which, when you stop believing in it, doesn’t go away.”

When I used to query my leadership classes as to the color of my necktie, (That was when people other than morticians, bankers, lawyers, and television newscasters wore neckties.) there would be some variables regarding the description of the color. They would sometimes select shades and nuances of color based upon Crayola names. Generally, if it was blue, they would agree that it was blue. My point was that somewhere along the years of man’s existence, we agreed that blue was the color.

Now, even something so simple as that color decision has come into question. This is due to alternative facts, false narratives, and social media challenges. As a society, the fact that my necktie is blue has become a source of disagreement, and a point of contention. 

Albert Einstein said, “Reality is merely an illusion, albeit a very persistent one.”

Delusion is, however, a belief that is not in concurrence with objective reality. They are often defined as fixed or false beliefs that are resistant to reasoning or contrary evidence. The interesting thing about delusions are their complete subjectivity. On the far end of the mental health scale, because they involve distorted interpretations of reality, they would have typically been associated with pathological conditions such as schizophrenia or other disorders. Now, however, these oftentimes total distortions of truths have become a simple path to getting something you want, something that might not otherwise have been possible by embracing actual real facts.

The problems with this type of distortion acceptance or promotion is multi-faceted. Confirmation bias, cognitive dissonance, Isolation, strained relationships, functional impairments, emotional distress, and professional and legal consequences are just a short list of possible outcomes that result from delusional thinking.

Obviously, conspiracy theories rank very high on the list of feeders to delusional thinking. Recently, a 71-year-old man from the Chicago area who, according to his wife, listened constantly to talk-radio, decided that he had to murder a six-year-old Muslim boy by stabbing him 26 times. He also stabbed the boy’s mother about a dozen times. He had been their landlord, and the boy was running over to hug him when he was assaulted. Will this man use as a defense that talk-radio radicalized him? That he was delusional? Or will he say, “The boy and his mother deserved to die because their beliefs were not congruent with his?”

As we look in the mirror each day, make sure we take an inventory of what delusions we might personally be accepting. It could save a life.

 

 

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Meditation and Neuroplasticity

August 27th, 2023 by Nick Jacobs No comments »

           Back in the 1960s or as the Brits nicknamed it, The Swinging Sixties, lots went on that some of us would prefer to remember as interesting, youthful experiences that created lifetime memories.  Besides the British music invasion, drugs became popular and commonplace among the hippie generation, but I missed out on all of that because my education took place at a conservative school.

          Being a traditional student heading toward a teaching career also meant that my career would be significantly jeopardized had I not stayed within the parameters of expected behavior. Unfortunately, the movie, Animal House, was not a realistic depiction of my college experience.

          One phrase that did catch on during that liberal era of the late 60s and early 70s was “Don’t bother him, he’s contemplating his navel.” It’s thought that it became popular in Western culture during a time when the Beatles and other luminaries were practicing transcendental meditation.            This navel-gazing phrase related to introspective thinking and mindfulness through meditation. It  implied the person in question was engaged and completely focused on their own thoughts or mental silence. If done correctly, one’s emotions often feel disconnected from the outside world.

            Since that time, numerous well-known people have found meditation to be an important part of their lives. Meditation practicing entertainers include Hugh Jackman, Ellen DeGeneres, Jerry Seinfeld, Katy Perry, and the late basketball great Kobe Bryant who practiced meditation to enhance focus and mental resilience as part of a daily training routine. Of course, there are also thought leaders like the Dalai Lama, Drs. Deepak Chopra and Dean Ornish, publisher Arianna Huffington, the entrepreneur Russell Simmons, and former NFL player Ricky Williams who are famously recognized for using these mindful practices.

            Individuals who practice meditation regularly credit the practice with positive outcomes ranging from better sleep, stress reduction, relief from both anxiety and depression, much-improved focus and concentration, enhanced self-awareness, better relationships, lower blood pressure, pain management, enhanced creativity, spiritual growth, and one of my favorites, neuroplasticity.

            Several studies have shown that practicing and playing musical instruments can significantly contribute to neuroplasticity. Music can enhance fine motor skills, auditory processing, memory and pattern recognition, multi-sensory integration, cognitive flexibility, brain connectivity, and brain reserve.

            Neuroplasticity is the underlying property of the brain that includes learning, adaptation, and recovery from injuries. It truly represents the brain’s ability to rewire itself. With that in mind, neuroplasticity contributes significantly to education, therapy, and overall cognitive health.

            If I recommended that you meditate for 10 or 20 minutes in the morning and again at night, you might snicker and suggest that not only do you not have time, but more bluntly that you also think it’s a waste of time. If I told you that by doing so you could significantly impact the creation of new neural connections that would modify your brain’s function in ways that would permit you to improve and optimize your performance while adjusting to new circumstances, you also might suggest that I move on.

            Let’s, however, look at the list of positives related to further development of neuroplasticity beginning with the fact that it will allow you to acquire new skills, knowledge, and behaviors. It also enables you to adjust, and more importantly, to adapt to changes in your environment.  It contributes significantly to more efficient memory storage, the capacity to adapt and remain functional as we age, and the ability to shift perspectives and respond to new challenges. And the list goes on and on.

            If you’re a type A, hyper-active person, meditation may provide you with a welcome relief from yourself. Find a peaceful, quiet space, force yourself to focus on the present, breathe deeply and use that breath to anchor. Acknowledge external interferences but don’t dwell on them and remember that contemplating your navel by deep breathing alone will create a natural relaxation response that is good for your health. Try it. You might like it.

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Tops in Care in PA

August 14th, 2023 by Nick Jacobs No comments »

If you were to see a list that included UPMC Shadyside, UPMC Passavant, St Clair Hospital, Geisinger and Chan Soon Shiong Medical Center, but no other local hospitals in this immediate geographic region, your initial question might be something like, “What’s this list represent?”

Here’s the succinct answer to that question for people living in the Greater Johnstown Area. This is part of a list of the top rated hospitals in Pennsylvania.  

 Let’s be perfectly clear about this, too. When you consider every aspect involved in evaluating a hospital for elite status, it’s very relevant that this is not some type of purchased PR accolade meant to create a smoke-screen for publication. It is, in fact, the result of serious patient analytics by the Centers for Medicare and Medicaid. More importantly, it is a sincere recommendation meant to assist patients in their healthcare selections.

 No, Chan Soon-Shiong Medical Center is not in the same league clinically as the hospitals listed above in range of services, but the services offered there do contribute significantly to one very important aspect of evaluation. When patients are asked if they would recommend CSSMC, their sincere answer to many detailed questions is “Absolutely, yes.” In other words, the range and scope of services offered at CSSMC are top-notch.  

 If you’re wondering how an achievement like this is possible, there is only one answer, teamwork, teamwork under the umbrella of incredible clinical leadership that is endorsed at the very top by the CEO, Tom Kurtz. Dr. David Csikos, MD, Chief Medical Officer, and Sherri Spinos, Vice President of Nursing are two of the hundreds of members of the CSSMC staff who should be standing in the winner’s circle accepting this Gold Seal of approval.

 Not only did Tom Kurtz, CEO turn around a small rural hospital that, like all of its peers in the State at that time, was heading toward either merger or closure, he did it with a spirit of good humor, compassion, kindness and positive energy. His positive energy was passed on to CSSMC’s physicians and staff in ways that create patient satisfaction at the highest levels.

 Congratulations to Chan Soon-Shiong, to Tom Kurtz and the Windber clinical leadership, staff, and physicians involved in this significant accomplishment. They have achieved “Best of Show” as Blue Ribbon winners in this national recognition. As the former Windber Medical Center continues to achieve these incredible quality standards as a small, rural hospital, we need to recognize and thank them for their efforts to provide quality healthcare to our region.

 They’ve done it again. Keep up the magic.     

 

Becker’s Hospital Review

The top recommended hospitals in every state

Mackenzie Bean (Twitter) – Friday, August 4th, 2023

Becker’s has compiled a list of the hospitals patients are most likely to recommend in every state using Hospital Consumer Assessment of Healthcare Providers and Systems data from CMS.

CMS shares 10 HCAHPS star ratings based on publicly reported HCAHPS measures. The recommended hospital star rating is based on patients’ responses to the question, “Would you recommend this hospital to your friends and family?” Hospitals must have at least 100 completed HCAHPS surveys in a fourth-quarter period to be eligible for a star rating. Learn more about the methodology here.

The star rating is based on survey data collected from hospital patients from October 2021 through September 2022. The figures are from CMS’ Provider Data Catalog and were released July 26. Asterisks denote that CMS included a footnote about the organization’s data, which are summarized below.

The hospitals that received five stars for patient recommendations in every state:

Pennsylvania
Advanced Surgical Hospital (Washington)
AHN Hempfield Neighborhood Hospital (Greensburg)
Bryn Mawr Hospital
Chan Soon-Shiong Medical Center at Windber
Chester County Hospital (West Chester)
Doylestown Hospital
Edgewood Surgical Hospital (Transfer)
Evangelical Community Hospital (Lewisburg)
Geisinger Jersey Shore Hospital
Geisinger St. Luke’s Hospital (Orwigsburg)
Hospital of the University of Pennsylvania (Philadelphia)
James E. Van Zandt VA Medical Center (Altoona)
Lebanon VA Medical Center
OSS Orthopaedic Hospital (York)
Paoli Hospital
Physicians Care Surgical Hospital (Royersford)
Rothman Orthopaedic Specialty Hospital (Bensalem)
St. Clair Hospital (Pittsburgh)
St. Luke’s Hospital-Anderson Campus (Easton)
Surgical Institute of Reading (Wyomissing)
Troy Community Hospital
UPMC Passavant (Pittsburgh)
UPMC Presbyterian Shadyside (Pittsburgh)

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Patient Centered Care

July 5th, 2023 by Nick Jacobs No comments »

The moves on my personal career chess board went something like this: Band director to arts manager, then tourism director to health care executive. Looking objectively at my employment progression, one might struggle to identify some type of intelligent connectivity and continuity that makes sense, but it was indeed a rich experience pathway that resulted in a unique brand of leadership that could not have been predicted.

First and foremost, it armed me with a very deep level of understanding and experience in human relationships that addressed things like personal growth, happiness, and positivity. As a junior and then senior high school band director, I learned compassion, patience, and persistence, and was forced to become a master counselor to help my students achieve sometimes incredibly challenging goals.

When I entered healthcare management, my most often replicated thought was “Why do they do things this way?” It took me a while to find the answer to my question. The vast majority of the individuals involved in healthcare were adept in things like math, science, and other left-brain skills. My career path was heavily weighted in emotional quotient skills, and human interactions that nurtured my students, encouraged artists in creativity and uniqueness, and promoted entrepreneurial activities through our tourism business membership.

One of my first healthcare administrative fellows quoted a line from one of his professors that became our mantra, “Don’t give people what they will like. Give people what they will love.” There was also a masculine/feminine component to this philosophy as well because the vast majority of healthcare leaders were men, but the majority of employees were female, the majority of healthcare decision-makers were women, and the road to recovery and healing always included nurturing. These realities resulted in my taking a very different view of what healthcare leadership should look like, and it was opposed to many of the traditional “Dr. House” approaches that had been followed for many years.

The absolute power of humanness in healthcare had to be the core of the relationships between the patients and caregivers. That human touch is what fostered healing. This meant developing programs with empathetic understanding relating to the patient’s emotional needs. It also meant encouraging genuine connections between our healthcare professionals and their patients. That required pointing out over and over again that it may be the employee’s 127th tumor, but it was the patient’s first, and that meant compassion, tenderness, and empathy had to be part of the care.

The capacity to understand and share the feelings of others represented a very challenging new world order because that sharing also meant vulnerability, personal exposure to emotional pain, and transcendence of traditional roles as the caregivers embrace the holistic care of their patients. The acknowledgment and validating of patients’ emotions, fears, and concerns, allowed our healthcare professionals to create an environment that promoted healing. It also reassured the patients that they were being seen, cared for, and heard. Most importantly it instilled hope and reduced anxiety. That alone allowed white blood cells to do their work.

It didn’t take long to realize that with the establishment of provider-patient relationships, healing could begin more quickly. These relationships required the providers to understand their patient’s uniqueness. What were their cultural backgrounds, family circumstances, and personal preferences? By doing this type of homework and then allowing patients to actively participate in their healthcare decisions, a bond was formed that resulted in a patient-centered type of care that created incredibly positive statistical outcomes that still hold today.

By our acknowledging the psychosocial impact of illness, healthcare professionals were able to offer support, guidance, and resources to help the patients get through their challenges. By addressing these spiritual and emotional needs, our patients experienced resilience which facilitated their recovery and added to the overall quality of their lives. Honestly, as the neurosurgeons used to say, “This is not rocket science.”

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No One Can Do This Alone

May 10th, 2023 by Nick Jacobs No comments »

            My career has been a roller coaster ride, but I learned early on that persistence, patience, creativity, and luck are all factors in business survival. So is blood pressure medication, Tylenol, and an occasional glass of something that does not emanate from the spigot in the sink.

            If you trace my work history, it was rather interesting. My first adult full-time job was in an already successful program that had been established in the Pittsburgh area. Because it was a fully functional program, all I had to do was maintain what I believed to be a good thing. Then, when I first moved to Johnstown, I landed in an incredibly successful program that, in comparison, made that initial job look mediocre at best. My new challenge there was to attempt to find ways to make this amazing organization even better. That’s when the persistence, patience, creativity and luck really came into play.

            For the next two decades, however, I was thrust into at least four failing, failed, or forgotten organizations that were described in my graduate program at Carnegie Mellon as “dogs.” I’m not sure why they chose such a noble descendant of the wolf to describe a deteriorated or destroyed business situation, but their teaching revolved around what you might do in order to turn a dog-like corporation into a winning one. That, my friends, became my life’s primary work, and thank goodness, it forced me to develop skills that were hidden deep within me. Fortunately, I had mastered a formula from my teaching days that was replicable and allowed me to do just that.

            That plan involved having an open door and an open mind, allowing people to enter my office and my life with sometimes outlandish, over-the-top, and even bad ideas. My secret was to never assume that any idea was a loser until I had a chance to hear it out and, in some cases, to implement it.

There was one very good idea I had stolen from a former CEO who, due to his hubris on both sides of the equation, first built and then destroyed a business/healthcare empire. According to legend, when he became the CEO for the first time, he cancelled all of his meetings and spent weeks interacting one-on-one with every one of his employees to introduce himself and get their input. Well, that was an amazing idea that had broad implications. (I didn’t steal his other idea of eventually misappropriating donated funds.That’s the one that resulted in his eventual imprisonment.)

            On the first day of my new job, I had my assistant clear my schedule, asked that she arrange for each employee to come into my office where I invited them to sit across from me at either my desk or the conference table while I introduced myself and my philosophy of transparency and openness. Then I got up and had them change seats with me as I asked them what they would do if they were president.

Not only did I hear a boatload of amazing ideas, but when I also got around to implementing many of the good ones, I gave them credit for it being their idea. Many of their suggestions were things I had planned to implement anyway, but having their name attached to the implementation of those ideas was a tremendous hit.

            Over the next 11 years, I received a lot of professional kudos that sometimes resulted in my own personal misappropriation of hubris. In fact, near the end of my CEO tenure, I began to believe my own press and sometimes failed to recall that had there not been a powerful local Congressman, an incredibly supportive staff and family, and a least three or four amazing local civic leaders who also contributed to this success.

The take-away? None of us, not one of us can do this alone. It truly is a team effort.

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Gen Z

April 19th, 2023 by Nick Jacobs No comments »

Many of us are counting on the Gen Z kids to fix this mess, to help make this world a better place for everyone. It really is up to them. So, here are a few things to consider that may help them on this journey.

            First, and foremost, it really is all about choice. We spend our days making choices. We pick out the clothes we want to wear, and we decide how we want to fix our hair. Well, here’s a secret. Each and every day, we can decide if we want to be happy, angry or sad. It is absolutely a choice, sometimes a tough or complicated one, but it is ours to make.

            When someone says something hurtful, we can decide to let it hurt and react accordingly, but that’s a choice we are making. Just because one thing goes wrong, we don’t have to decide to allow that to dominate our feelings. How often have you heard, “That ruined my entire day.” One sentence, one comment that took seconds ruined hours of time. Don’t let someone kidnap your feelings.

            Also, purposefully seek out the things that make you happy, that make you feel okay about yourself, and make you smile. Life is so much better when you’re not throwing yourself against a brick wall and making yourself  miserable.

            Surround yourself with people who are nice, who care, who are loved and give love. The more time you spend with negative people with low self-images, the more miserable you personally will be. Seek happiness, but you also need to be honest with yourself and learn to manage your expectations.

            Take advantage of every opportunity that comes your way to better yourself. Everything will not always go your way. Look for opportunities that will allow you to grow and to learn. That will give you an edge, by making you better at what you’re doing.

            Also, if you work outside your comfort zone in some areas, you will grow both emotionally and intellectually. That way, you’ll have a better chance to be successful at whatever it is that makes you feel good about you, too. Remember, you must like you before other people can or will. Everyone likes a positive person.

            Nothing and I mean nothing, lasts forever. The only thing we can count on in life is change. Change is that one constant that will be with us from the time we are born until we are gone. Don’t fight change. Learn to embrace it, to understand it, and to go with it. Make sure you try to ride the wave rather than fight the ocean. Life can change in a milli-second. You can hold onto the things that make you feel comfortable like those old shoes, or your favorite sweater, but understand that everything changes no matter if you want it to or not.

 Sam Walter Foss once wrote a poem about a medieval calf that went for a walk. The next day a dog followed the trail made by that calf. Then a bellwether sheep came along with all the other sheep behind it. Finally, a person saw the path and walked that same meandering trail that innocent little calf had made.

            The difference was that the person assumed it had been made by other humans. And even though his complaints were never-ending, he continued to follow it. Later the winding path became a road, and towns were built along it.

            We’ve all followed calf paths both physically and intellectually. You need to question the paths you take. Make sure you’re not wasting your life following some nonsensical path, and be sure the paths you create make sense, too.

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Cobalt Red

March 27th, 2023 by Nick Jacobs No comments »

           Under the category, “There’s no free lunch,” Siddharth Kara, a British Academy Global Professor, has written “Cobalt Red,” the ultimate expose about the underbelly of today’s progress.

            Like historical books regarding the human toll movements like the Industrial Revolution represented in the name of progress, this book reveals the hidden cost of our current technological advances. It also exemplifies and uncovers the brutal realities that accompany this current technological transition.

            All our battery powered devices require cobalt. As the author states, “Although the scale of destruction caused by cobalt mining in the name of renewable energy is without contemporary parallel, the contradictory nature of mining is nothing new.”

            When I first became the CEO at a small hospital originally built for coal miners and their families, it seemed like a good idea to create an historic wall of fame featuring the portraits of the original presidents of the hospital. Immediately after having our maintenance employees hang those pictures of the leaders from the height of the Industrial Revolution, I began getting complaints.

            I was angrily informed that some of the still-surviving widows of deceased coal miners objected to any glorification of these men. They accused them of having hired some physicians to lie and say their husbands had died of asthma rather than black lung. That was done, according to them, so the families would not get black lung insurance benefits post-mortem. Some of the offended spouses even told me they had to have their husband’s bodies exhumed to prove they had died of black lung disease.

            Of course, the gory details of progress created by the Industrial Revolution as it related to the humans involved in mining coal or making steel were often either taken for granted, overlooked, or simply accounted for like the first wave of warriors in a war involving only bows and arrows. They were considered “the arrow catchers,” collateral damage, the price of progress.

            “Cobalt Red” does a deep dive into the current horrors our contemporary revolution is causing. With climate change deniers on one side and world ending climate catastrophe predictors on the other, it feels like the rock and hard place we’re currently faced with regarding the future of mankind has once again put us in a no-win position fed by greed in the name of progress. This journey to create a new world order sans fossil fuels, though potentially unavoidable, is also creating enormous levels of suffering and dying.

            Because internationally, most of these mines are considered artisanal or small-scale mines, they are referred to as ASM mines. Unfortunately, these are not small, well controlled and properly run mines. Not unlike the little coal mines that were all over Western PA at the turn of the Twentieth Century, these mines are typically staffed with a workforce that is exposed to hazardous conditions with only rudimentary tools.

            There are currently about 45 million people around the world directly involved in ASM mining which, according to Kara, represents about 90 percent of the world’s total mining workforce. Of course, their work does not just involve cobalt. They are also mining for tin, gold, diamonds, sapphires, and tantalum.

            The author states his findings in this book very clearly, “There are many episodes in the history of the Congo that are bloodier than what is happening in the mining sector today, but none of these episodes ever involved so much suffering for so much profit linked so indispensably to the lives of billions of people around the world.”

            The next time you look at your smart phone, your smart pad or watch, or you fire up your computerized car, just understand that the billion- and trillion-dollar companies who are buying the products of these miners must be aware that there is no clean supply chain that ameliorates the “suffering from oppression accompanied by unimaginable barbarities responsible for the destruction of life.” Once again, corporate greed is a matter of life and death. 

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A Possible Solution to Local Rural Physician Shortage

February 23rd, 2023 by Nick Jacobs No comments »

The Association of American Medical Colleges (AAMC) projects that a physician shortage could reach a high of 124,000 by 2024. The strain this will cause will not be borne equally.

“The COVID 19 pandemic has highlighted many of the deepest disparities in health and access to health care services,” said AAMC President and CEO David Skorton, “and exposed vulnerabilities in the health care system.”

Gerald E. Harmon, president of the American Medical Association, also raised alarms about the future of U.S. health care.

 “Because it can take up to a decade to properly educate and train a physician,” Harmon said, “we need to take action now to ensure we have enough physicians to meet the needs of tomorrow.”

He added, “The health of our nation depends on it.”

This bleak scenario recently was presented to Indiana Regional Medical Center, Indiana University of Pennsylvania (IUP), and Indiana County leadership.  As a local response, it was suggested that IUP, as one of the larger state universities in Pennsylvania, should take a lead role in creating a rural family practice medical school. Such an initiative would be a game-changer for not only the university but also for the entire Commonwealth.

Over the past ten years, universities throughout the United States have seen declines in student enrollment. These decreases have led to painful programming cuts as well as other downsizing initiatives. Still, most of the exceptionally strong programs still thriving at IUP are heavily directed toward STEM (Science Technology, Engineering, and Math). These programs have had continued robust enrollment numbers in healthcare and science-oriented degrees.

In December, IUP President Dr Michael Driscoll confirmed that the IUP Board of Trustees has approved exploration of this medical school initiative. The caveat? Funding will be a major factor in determining a “go or no go” decision.

The financial challenge may be exacerbated by Duquesne University’s decision to build a College of Oseopathic Medicine, which has garnered support from some Pittsburgh-based granting organizations. This might limit those organizations’ enthusiasm or capacity for an IUP medical school. That would be unfortunate because, although Duquesne University’s medical school is a positive addition to the area, the reality is that urban-trained physicians tend to remain in urban areas, and city training and resources are not always ideally suited for a rural setting.

Therefore, the most critical major potential source of support for this project is the Pennsylvania State System of Higher Education (PASSHE). Working with state legislators,  PASSHE could muster resources that would help create a Western Pennsylvania Medical School based at IUP.

Moreover, each year entry-level seats could be held for students from each of the 14 state universities that come under the PASSHE umbrella: West Chester, Slippery Rock, Shippensburg, Millersville, Mansfield, Lock Haven, Kutztown, Edinboro, East Stroudsburg, Clarion, Cheyney, California, Bloomsburg, and IUP

Numerous potential critical players in this scenario. Including private and community foundations, have not yet fully realized the extent to which a school like this would improve our region. The primary question they should ask is “How do we fill the dozens of physician openings we already have in this area?”

Without a plan to address this challenge, the number of openings will only grow.

Another regional asset that could provide significant depth and impact to this medical school is the Chan Soon-Shiong Institute for Molecular Medicine. CSSI currently houses not only 500,000 donated tissues samples for research, but also has on staff talented PhDs in genomics, informatics, and tissue banking who could contribute extensively to the educational research needed to support a medical school.

Finally, consider the cost we all bear when hiring physicians locally. Because the competition is intense, we must employ recruiters. Other expenses including advertising for the position; fees to locum tenens (substitute docs) during the hiring process; candidate interview costs; time spent on interviewing, onboarding and credentialing the doctor; candidate relocation costs; primary care physician salary and benefits, and incidentals. This list, according to the UNC Solutions blog, totals about $341,000.

Being able to locally source and train physicians from 30-plus graduates a year over a ten-year period would pay for itself three-fold.

We desperately need physicians in our region. We need this medical school. We need to support IUP in this initiative to help give students from Pennsylvania an opportunity to go to medical school in our region because that will ultimately benefit everyone in our region.

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