The new blog of F. Nicholas (Nick) Jacobs, FACHE, author of Taking the Hell Out of Healthcare
15 May
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.”
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):
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.
8 May
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?)
