Archive for February, 2014


February 16th, 2014

One definition of a monopoly is “the exclusive control of a commodity or service in a particular market, or a control that makes possible the manipulation of prices.”  Don’t get me wrong, if I had total control of a geography or industry, I’d love to own it.  Think about it, having the only lemonade stand in the middle of a desert would be a great business.  Even better would be to own the lemonade grove where the lemons are grown, and the sugar plantations where the sugar comes from, and finally, the water supply.  Now, that’s a monopoly. 

Someone told me years ago that the reason that Johnstown, Pennsylvania was never able to survive the loss of Bethlehem Steel was that Bethlehem controlled all of the water in that area.  Not having access to water for manufacturers is not any different than owning all of the lemon groves and sugar.

Recently, I read an article that a banker friend of mine gave me comparing hospitals and health systems to the banking industry.  This article, compared everything that is happening in the healthcare world in this country to what has been happening to banks.   It predicted that small and medium sized hospitals and health systems will continue to be forced into mergers and acquisitions in order to survive at any level.  The Affordable Care Act has set financial and information technology requirements and rules that make it almost impossible to maintain independent hospitals and health systems over the long-haul.

Back in 1987 when managed care was penetrating our area, the prediction was that Pennsylvania would end up with three health systems representing the entire State.  That prediction seems to be coming true.  The banking article continued to put things in perspective as the “Too Big to FAIL” model grows in healthcare. 

Pittsburgh is going through an interesting “monopoly or no monopoly decision making time” where two nonprofit Titans are clashing, and the money being used to wage this war, not unlike the wars in Iraq and Afghanistan is coming from us, the citizens.   It’s interesting to calculate the costs of monopolies that, even in the nonprofit world, demonstrate a sort of capitalism run amuck.   How can anyone mess with organizations that employ tens of thousands of people?  Too big to fail. 

So, the Affordable Care Act will change this country forever.  Yes, there will be millions of people with insurance who lived before in fear of losing their homes, savings, and lives.  Yes, there will be hope where before there was nothing but fear.  The question becomes, however, will the health systems select the same model of mergers as the Defense, Airline, and the Banking Industries?  Will physicians be commoditized?  Will employees be placed on a long list where human beings can be moved and replaced like widgets and their value will be dictated by one source of power?  Last week 800 nurses walked off the job at a regional health system, the following day, 200 replacement nurses were brought in to take care of the patients.  This move represented the beginning of the end of an era.  Too big to fail or to negotiate?

I’ve been in leadership positions in large health systems and small hospitals.  I’ve started corporations, and run non-profits, but one thing I know for sure is that “Too Big to Fail” becomes a very dangerous place to live.  When an organization can place an economic strangle-hold on the everyday people who need that service the most, customer care and service always suffers.  I’m paying nearly a thousand dollars at 5:30AM tomorrow morning to fly one hour because of an airline monopoly.  Customer service doesn’t matter when you own the market.  Too big to fail allows corrupt investment bankers to walk free while for profit prisons continue to fill with people about which our system was too big to care.   It’s a jungle out there!


Heal with the PILL!

February 9th, 2014


A friend of mine showed me a paper that had been written by a brilliant, young physician.  In the paper she explained that, in her research, she had discovered that a fundamental piece of knowledge regarding the manner in which physicians in her specialty are expected to practice was seriously flawed.  She went on to prove that the science based on these two incredibly small original studies was also significantly outdated by new technologies.  In fact, it was clear that the knowledge garnered in the last decade alone through the use of new techniques and scientific advancements has proven this lack of accuracy in an unquestionable manner.

Here’s the worst part of this story; this flawed information has been printed in every textbook pertaining to this topic since about 1970, and change is slow.  Furthermore, every student of this specialty is expected to practice incorrectly in order to comply with the standards of their profession.

Okay, you say, what’s the big deal?  Well, the big deal is that the alternative practices that these flaws have resulted in suggest that the physicians prescribe certain types of drugs that, long term, may even be related to specific types of cancers in both men and women.  In other words, these mistakes which apply mostly to teenagers, could eventually lead to their premature death.  So, later in life when you say, “Why me?” there may indeed be an answer.

Far be it from me to reveal much more about this than to say that I’m NOT a doctor and I’m NOT a scientist, but I am a passionate individual who reads and learns a lot from the people with whom I am associated.  For example, we know that the chance that five prescription drugs will interact with each other in an unknown manner in our bodies is one hundred percent. Yet, many of us take more than that every day.

We know that nearly three quarters of the antibiotics used in this country are not used for human medicine. They are used on healthy livestock to prevent overwhelming infection.  Why?  To compensate for poor husbandry practices (severe overcrowding, filthy, excrement ridden environment, high degree of psychological stress, diet mismatched to their physiology and because antibiotics can act as growth promoters. They get sick, and when they get sick, Big Pharma is standing nearby to make their fortune by encouraging our farm factories to continue pumping antibiotics into our chickens, cattle and even farm raised fish.  The major health organizations in this country have called for a phase out to this practice.  We’re not really getting exposed to antibiotics in our food, but rather the antibiotic resistant strains of bacteria.

Research is currently being pursued in regard to certain antibiotics which, taken long term are suspected to be contributing to at least two types of cancer.  What are the risks long term for entire generations that are being exposed to the ramifications caused by these antibiotics in our food supply?

When we were doing breast cancer research, we saw that about 75 percent of the cancers presented were caused by our environment.  So, when it comes time to side against the environment, against naturally produced food products, and to walk away from obvious flaws in the literature that is the basis for the education  of certain physician specialties, just know that it may be your kids or grandkids that are going to pay the price.

Let me end this rendition of “Nick-a-pedia” by suggesting that Integrative Medicine considers food as your medicine. Seriously, diet, exercise, stress management, and socialization are the fundamental principles of functional medicine.  How can these things hurt anyone?

I’ll never forget when one of my research scientists told me years ago that hydrogenated fats were the worst human experiment ever perpetrated on man-kind without his knowledge, and here we are decades later, after tens of thousands of unnecessary heart attack deaths, finally banning them.  This is NOT BRAIN SURGERY!