Archive for August, 2015

Speaking on this at AIHM Conference San Diego on October 24th

August 28th, 2015


We’ve all heard the expression that we are products of our environment, but that doesn’t really explain our decisions in life. For example, the first decade of my youth was spent in poverty. It was not Appalachian, dirt floor, poverty because we lived in my grandmother’s house, but it was powdered milk, government cheese, patches on my clothes poverty.   Then my dad got a job that literally thrust us into the middle class overnight. Some kids who were raised poor want to help their fellow man. Others want to show everyone that they are superior.   Who does which and why?

After teaching for nearly a decade in City Schools where children from low socio-economic backgrounds, were the rule, I became sensitized to their problems and lack of privilege. My last two years of teaching, however, were spent in a school where the average family income was much higher. The problems were still there, but in different packages. Some of those kids, both rich and poor, have made it big and have dedicated their lives to helping others. Which ones were they and why?

When I went to Europe for the first time, I experienced a different philosophy that fascinated me. It was a form of humanism. As a population they were taking care of each other.

That opinion was reinforced during my first trip to Toronto. There were no people living on the streets in Toronto. The both the ill and the mentally ill were being cared for, and, most importantly, there seemed to be much less violence, a type of peace in the form of mutual respect.

In the mid-2000’s, I made a trip to Africa. In one of the largest oil producing countries in the world, I saw poverty that was incomprehensible. It was clear that the only thing that was trickling down to the masses there was sadness, sorrow, and early death.

When I began working in the Netherlands a few years later, the vast majority of the people were middle class. Beggars were not visible on the streets, and a few years later, at the height of the world economic collapse, a trip to Spain reinforced this. With a 26% unemployment rate, I saw only three beggars in a major city.

It was at that time that the Affordable Care Act was being discussed, and my hopes began to rise.   Finally, we would prioritize wellness and prevention and behavioral health with parity for all other forms of health. We would take care of our fellow man in some way other than imprisonment. We would not have one of the highest infant mortality rates in the world, and we would begin to care for each other in a way that would be three times less expensive than our last two wars.

We would find the money that would allow us to take care of our fellow man and things would begin to get better; less obesity, less diabetes, less domestic terrorism from mentally ill, young white men. We would help those people who needed help the most.

The Accountable Care Organization, a result of the Affordable Care Act, seemed to be one way to finally shift the resources from a Sickness to a Wellness and Prevention based venue. We would be reimbursed for quality not quantity.   We would convert from a case by case sickness to a root-cause humane oriented, wellness based system.

Then it struck me that our medical profession has not been trained to function in this system, and as long as the rewards for sickness were greater than those for wellness, making that change would be incredibly difficult. So, I’ve spent the last seven years investing my energy in a philosophy that embraces evidence based, world medicine. It’s my dream that we can integrate world health modalities for wellness and prevention, and save our country from economic ruin while protecting our future generations from premature death.



The Windber Journey

August 16th, 2015

As a Vice President at Mercy Hospital, the Chief Communications Officer at Conemaugh (now Duke Lifepoint) and finally a CEO at Windber Medical Center, I became a frontline recipient of the knowledge needed to help change our system from sick care to wellness and prevention care.  The problem was that we had directed all of our country’s resources to sickness.   It became increasingly apparent that if we didn’t create massive changes in the system, the Baby Boomers would bankrupt the country and create a generation of children that would not live as long or be even as healthy as their parents.

Four critical stepping stones that appeared along my journey.

  1. As a 27 year old band director, I had personally experienced integrative medicine as a patient and saw the incredible value that those modalities could provide to patients.
  2. Another fortuitous event that occurred along my journey was that I was interviewed for a CEO position at Boys Town National Research Hospital. I was shocked and amazed when the former president of Boys Town, Father Val Peters, a Jesuit priest, introduced me to the concept of having a genome center as part of the hospital. This was in 1992, about a decade before the mapping of the genome.
  3. When I arrived as CEO of Windber Medical Center, I was informed by a former employee that because they had mastered a surgical technique that was unique, Windber surgeons had performed thyroid surgeries on several luminaries back in the 50s and 60s. It showed me that anyone would travel for the appropriate care.
  4. This last step came when Congressman John Murtha took an interest in our work, and he gave us an opportunity to become involved with the healthcare within the Department of Defense.

It was the confluence of those opportunities and ideas that merged in my mind, and when we received financial support for breast cancer research though the Congressman, Dr. Craig Shriver appeared on our campus and said to me, “What do you want to do here?”

The next stream of words flowed freely out of my mouth, “I want to create the genome center for the Department of Defense for Breast Cancer.”  His response was, “If you’re going to do genetics, we might as well do proteomics as well.”  To which I said, “We might as well because I’m not sure what either one of them are.  I’ll be the administrator you can be physician and principal investigator.”  And our partnership began.

When I asked him how we would get PhD’s to come to Windber, Pennsylvania, he smiled and said, “Let me help you work on that.”  When the first PhDs arrived I asked them why they had not won the Nobel Prize. Interestingly enough, they had a list of reasons that identified some of the dysfunctionality of basic science.

It was Dr. Richard Somiari who understood and embraced our vision for the Windber Research Institute.   As a musician I told him that I wanted to have ensembles of scientists, not divas and he and his wife, Dr. Stella Somiari, had told me that we also wanted tissue collected in a manner that would produce the finest results.

They also said that we needed to collect patient demographic information in a way that would give the scientist the needed information to do their work.  This resulted in Col. Shriver creating a 40 page protocol on how to collect tissue, and then he, Richard, and Dr. Hai Hu created a 500 question survey of demographic information to be collected from each donor.

This tissue repository, managed by Dr. Stella Somiari and managed by Jim Bombatch with over 60,000 donated breast tissue ended up being used as one of the resource centers for mapping the human breast cancer genome, and with an 84% acceptance rate, nearly triple the acceptance rate of the other major medical organizations that were involved, Windber was rated by the National Cancer Institute as the only platinum quality tissue repository in the United States.

Finally, we decided to create one central data repository to hold all of the collected information.

Fifteen years later, Tom Kurtz, CEO of both the Research Institute and Medical Center made one phone call which captured the imagination of Dr. Patrick Soon Shiong that has led to a remarkable partnership, the first of many that will launch Windber and the Johnstown area into one of the top ranking centers of excellence and cancer care in United States and the world.

Congratulations, Tom and the Board members who embraced this opportunity and to Dr. Soon Shiong for your amazing vision.  I love it when a plan comes together, and I couldn’t be more proud of my friends and former colleagues.