IUP College of Osteopathic Medicine

June 14th, 2024 by Nick Jacobs No comments »


America’s healthcare system prioritizes sickness over wellness and prevention. According to the Commonwealth Fund, despite spending the highest percentage of GDP on healthcare, the US ranks last among 11 of the wealthiest countries in the world.

Their findings show that we continue to lack access, quality, efficiency, and equity. To understand better, we can look at COVID statistics in Japan where their citizens suffered exponentially less and had a much lower death rate per capita than in America.

The focus on sickness rather than wellness and prevention in the United States also explains why less than 20% of all physicians in our country are Primary Care physicians, while the majority of medical schools orient their programs toward specialties.

Some may say, “Follow the money,” which explains a system that is inundated with illness caused by successful lobbies in the fast and junk food, alcohol, and tobacco industries. These companies prioritize profits and refer to the physical destruction caused to our population in the form of obesity, diabetes, heart disease and cancer as collateral damage.

The Association of American Medical Colleges (AAMC) projected a continuing shortage of primary care physicians across the United States through 2033 with rural areas being particularly affected. A Graham Center report found that as specialist training continues to grow, the number of family practice physicians dropped by 31%.

The perfect storm of our aging population, more physicians heading toward retirement age, and an increased demand for healthcare will all contribute to this gap. The National Center for Healthwork Analysis showed that in 2021 only 17.5% of our physicians were classified as Primary Care and that 17,400 more primary care doctors are needed.

The OECD iLibrary notes that when the European Union faced a similar lack of primary care physicians, countries like France dedicated at least 40% of all new postgraduate training places to general medicine. Even with this effort, attracting a sufficient number of candidates to fill these positions has been challenging.

What’s one answer? In 2020, after initial discussions with key external stakeholders followed by a pre-feasibility study in 2022, and with support of the Indiana University of Pennsylvania Council of Trustees, IUP moved forward to explore the possibility of a College of Osteopathic Medicine at IUP.

Osteopathic medical schools have a long tradition in rural communities, and physicians who are trained in osteopathic medicine are more likely to select family medicine as a specialty than those trained in allopathic medicine (46 percent vs 11 percent) and to practice in rural areas (18.1 percent vs 11.5 percent). The Proposed IUPCOM is centered around an osteopathic-focused foundation in accreditation—tailored to meet the needs of Indiana and Pennsylvania’s rural communities—to create a flagship model for rural health training throughout the country.


What does this mean for the region? IUP’s College of Osteopathic Medicine will be uniquely positioned to provide Family Practice physicians trained specifically to provide care in Rural Health areas with significant emphasis on wellness and prevention. The uniqueness of this training will include techniques in both integrative medicine and genomics. Graduates serving underserved, especially rural communities, are projected to contribute to healthcare cost savings in excess of $136.8 million annually.

Creating a College of Osteopathic Medicine is no small undertaking. As the only public university-based College of Osteopathic Medicine in Pennsylvania located in a rural community, IUP’s proposed College of Osteopathic Medicine could offer lower attendance costs and reduced student loan burdens.

As part of the State System of Universities, Pennsylvania’s retention of these primary care physicians will also be enhanced. Besides creating over 400 jobs, the IUP College of Osteopathic Medicine will bring nearly an additional $70M into the local economies.

Founding Dean, Dr. Miko Rose and President Michael Driscoll, are committed to finding the $103M in funds necessary to start the project and identify the individuals and organizations that will help underwrite the cost of tuition for the medical students.  Dean Rose and IUP have answered the call for action.

Achieving this vision, however, requires the support of the health systems, foundations, legislatures, leaders, and engaged citizens of this region and State. We stand on the precipice of a rural healthcare crisis, and this initiative offers one potential local solution.


Women are not LITTLE MEN

April 16th, 2024 by Nick Jacobs No comments »

As National Women’s Month drew to a close and faded into the other 11 months that are not dedicated exclusively to Women, I received a solicitation from an Email friend regarding a new book written by author, Phyllis E. Greenberger, titled “Sex Cells.”  The author had a list of credentials regarding advocacy for women’s health that was as long as my forearm, and the fact that her latest book was published by Mayo Clinic Press was all I needed to respond positively to read and comment on her work.

The core of her book is that, despite all the work that has been done during the past thirty or so years, women are often still treated medically like men. She maintains that “Every woman can point to a time her pain wasn’t taken seriously or a medical professional didn’t seem knowledgeable about women’s health.” With her focus on biological sex differences, Ms. Greenberger, “continues to be struck by the lack of understanding of the topic, even among medical professionals.”

Consequently, the book provides the readers access to “the wide-world of sex-specific medical issues . . .how women pay the price, with a close look at the impact that it has on minority populations. “Told with humor, ferocity, and passion, ‘Sex Cells’ appeals to anyone interested in health, women’s rights, and public health policy.”

Having personally been involved on the administrative side of healthcare for nearly four decades with a focus on research directed primarily toward women, this topic captivated my interest. During my time at our research institute, the work was focused on breast, cervical, endometrial, and ovarian cancers plus heart disease, diseases that the author referred to as “bikini medicine” because it was limited to breast and genital health.  Interestingly, however, our research not only looked at the genomic differences, we also studied the impact of behavioral modification on these various maladies.

It was during this time that we began asking female patients suffering from these diseases to visit the researchers and explain what they were going through. This was intended to personalize their challenges and encourage the scientists to look at individual women instead of just numbered test tubes and aliquots. In other words, we attempted to personalize, humanize, and feminize their work.

We found genetic differences associated with race, ethnicity, and sex that would alter not only the severity of the disease but also the detection and eventual prevention and cure of certain diseases that were very different than those formerly acknowledged in the field.

During this time, as the author so skillfully pointed out, it was clear to us that generally, research on an international level was challenging in its history due to its lack of inclusion of women and minorities in clinical trials. Ms. Greenberger also addressed how women can begin to advocate for themselves in the doctor’s office.

She elaborated on the disparities women face in medical treatment that continue to this day. These disparities are even more prevalent among female minorities. Equal but not the same as the primary thesis of “Sex Cells.”

Her chapter titles ranging from “The History of the Mystery, The Heart of the Matter, Neurological Stew, to a Brighter Tomorrow,” address topics and content that display the gravity of the challenges which are all carefully explored and amplified.

Phyllis Greenberger has been at the forefront of advocacy for women’s health for decades, and this book is a strong example of her dedication to enlightening her readers about the challenges of women’s health.

As Louse Otto-Peters, a German suffragist and women’s rights activist said, “The history of all times, and today especially, teaches that . . . Women will be forgotten if they forget to think about themselves.”

This book “. . . is a comprehensive tale of scientific stonewalling, intrepid advocacy, and the still-pitched battle to get the scientific and medical world to recognize that women are not small men.”



March 19th, 2024 by Nick Jacobs No comments »

Dan Buettner, a New York Times bestselling author, has spent two decades studying places in the world where longevity seems to be a given, and people simply forget to die. They live into their late 90’s and early 100’s as healthy, productive participants in their communities. The other thing he discovered was that the vast majority of them were happy people leading happy lives.  

In his first book, Dan found that only 10 percent of longevity is dictated by genes, and the centenarians did not live longer because of workout gyms, fad diets, supplements, or whatever. “Long life was not something they pursued. It was something that ensued” because of their environment, their support systems, and several other naturally connected things.   

They had a great sense of purpose to their lives, were nudged into physical movement about every 20 minutes because of where they lived, and were completely energized by being in what he described as “Like-tribes” in the right communities that helped keep them on the right track. They lived in interconnected, mutually supportive clusters of people allowing them to do the right thing long enough not to get disease            .

He also attempted to determine where the happiest places were in the world. What he found might throw some of you for a loop, but for many of us, it’s that not so common, “common sense” that our grandparents, parents, and friends have shared with us throughout our lives.

            Buettner worked with Google, Gallup, and the University of Pennsylvania and found some fun examples from about 50 billion Google searches regarding happiness. Generally, people who own dogs are happier than cat owners. (Sorry, Taylor) People who liked action movies or comedies seemed to be happier than those looking for romance movies.  

From his world observations, he found that gender equality is important. It makes men happier when women are treated equally. Education for both men and women was an important key to happiness because educated girls become educated mothers and produce better everything. Plus, countries where there is complete equality are where the happiest people live.  

They found that healthcare . . . not America’s sick care, but genuine health care which includes prevention and wellness is a great predictor of happiness. 

Mike Norton, a professor of business administration from Harvard asked these two questions on three continents: Do you think life is short and hard or long and easy? The people who selected long and easy were always happier, but they were also more civic-minded and generous. They were 40% happier, 30% more likely to vote, and 60% more likely to donate money. That’s a good psychographic profile to seek out for your next fundraising event. It will save you time if you ask those two questions and then only invite the generous, civic-minded, happy people.  

Happy people place their values on family, some type of belief system, face-to-face conversations, walking to the church, market, and friend’s homes, laughter, and seven hours of sleep a day. They also take all their vacation days and try new things.  

So, own a dog, socialize, stay married if you can, pick a job you love over money, give something back, and most importantly, choose where you live because that is the single most important happiness indicator. If you live in an unhappy place and move, you will be exponentially happier within a year. 

They also recommend meditation, financial security over consumption, big windows for lots of light, a front porch, and having a best friend at work. 

Dr. Carl Jung said, “Eat without gluttony, drink without drunkenness, love without jealousy, argue but don’t go to bed mad, and occasionally, with great discretion, misbehave.” 

Check off your happiness boxes and make some changes because it’s never too late, and they can make a tremendous difference. You can choose to be happy every day.  



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.


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.


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.




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.


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:

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)


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.”


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.