Archive for the ‘Future’ category

Guest Post Dr Dan Handley

July 6th, 2022

I attended a video conference tumor board today as a guest observer.

If you don’t know what a tumor board is, it is an interdisciplinary team of professionals that can include oncologists, geneticists, and others such as pharmacists, nurses, genetic counselors, bioinformaticists, and anyone else who can help by providing their professional expertise.

Tumor boards systematically examine cancer patient histories, current clinical test results, and any other relevant information. As a team, they come together to propose the optimal treatment and support for patients based on the latest scientific information.

These are consummate professionals who are dedicated to understanding each patient’s unique situation and work together to provide the best care possible with the best outcomes combining their respective areas of expertise. It’s amazing to see such communication and cooperation. That’s not hyperbole, it’s the truth.

I understood all the underlying science since that is what I’ve been involved with for so many years in laboratory research, and it’s now what I teach, Not being an oncologist myself there were some learning opportunities for me on some of the clinical details. I am an information sponge, though, so I’m delving deeper into the clinical literature to make sure I understand anything that wasn’t completely clear to me.

Despite some people’s uninformed cynicism, we have thousands of dedicated professionals working together both on the scientific front and the clinical front in synergy to cure each person’s cancer if possible, prolong quality life, and at least minimize suffering. And along the way, gathering all of our understanding towards finding a way to cure as many cancers as possible.

It’s an honor to be involved in this continuing endeavor with so much promise and progress, and even more, to have students who want to participate in this amazing transformation of medicine into the 21st century.

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The Integrative Journey

March 28th, 2022

 

After having returned from the Ornish Coronary Artery Disease Reversal program in Sausalito, California, my life, my mental health, and my view of healthcare had been changed forever. Having previously been selected as the CEO of a traditional hospital that, like all hospitals, was all about sickness, I now realized I had new tools in my toolbox, new arrows in my quiver, and new eggs in my basket. . . you get the idea.

That workshop had taught me that there is no one right way to go through life, to achieve a better quality of life, to deal with health issues, and to survive this journey. I came home armed and informed that sickness could be stopped or reversed, and this concept did not just apply to heart disease. There was significant evidence that Type 2 diabetes, some autoimmune diseases, erectile dysfunction, some prostate cancers and other diseases could be positively impacted by diet, exercise, stress management and group support.

As Americans in one of only two developed countries that permits advertising of pharmaceutical products on our air waves, we had been carefully trained, pruned, mentally shaped and, if you will, brainwashed to believe in the “heal to the pill” method of care. We get sick, go to the doctor or hospital, are prescribed pills, and move on. Or we get a shot, or get the offending body part cut out, and life goes on, or not. Those were the options previously permitted on the proverbial healthcare menu.

It was only a few years later when the chief scientific officer of a major drug company explained his world to me like this, “You don’t understand the pharmaceutical industry. We’re like the movie business. We only want the blockbusters. We want to give you a pill that you’ll have to take from the time you’re five until you die at 75 or 80 that will never make you better. It will just help control the symptoms.”

In 1987, I was working toward another Masters Degree at Carnegie Mellon University, and our epidemiology professor challenged us to find something that would significantly alter the health, lives, or future of at risk people in our hospital’s catchment area. I decided to have our physicians give pneumococcal (pneumonia) vaccines to our at-risk senior population.

When I told my CEO of that plan, he suggested I present it to the primary care physicians at their monthly meeting. I boldly stood in front of a room full of internal medicine and family practice physicians and made my pitch. You would have thought I asked them to bring in their first born child to be assassinated. I was very nearly strung up. I heard cries like, “How are we supposed to pay or bills? How can we pay off our loans? What am I supposed to do, pull my kids out of college? Treating those patients is how we make our livings.”

Ironically, in 2017, I found myself in front of the leadership of a major health system with 125 cardiologists, and I informed them we were going to enter into the coronary artery disease reversal program. The spokesperson for the group put up his hand and said, “Let’s talk about the elephant in the room, do we really want these people to get better?”

Bottom line, we have created a medical industrial complex that is dependent upon sickness, and what I had learned in California was, “Yes, we’re all going to eventually die, but why not give your body a chance and live as healthy as you can for as long as you can?”

Interestingly, the Ornish program was not yet being offered in many places in the country, and when I asked if we could bring it to Western Pennsylvania, there was a long pause on the other end of the line, and Dr. Ornish asked,”What do you want?” He explained that he was working on a licensing project with our local Blue Cross, and I was not going to be able to bring it into my hospital, but that didn’t stop me.

We worked out a deal with some local churches to bring elements of the program that were available to the public just to test the water. Within weeks, we had heart disease participants in their 60’s, 70’s, and 80’s doing stretching exercises, meditation in whatever form they selected, nonjudgmental group support, and vegetarian covered dishes to church halls and basements.

The amazing thing about this program was that people who were suffering from angina pectoris (chest discomfort) found relief in sometimes less than a few weeks. They were no longer living in fear of dropping dead, and more importantly, they were taking control of their life without having to be afraid of the outcome. It was giving their bodies a chance to do what those bodies are so great a doing, healing.

Of course no good deed goes unpunished, and those non-believers, or those individuals who were potentially most negatively impacted by a health and wellness program began to identify me as a zealot, a fanatic, a vegetarian warrior. I was openly mocked at board and physician meetings when I ate my specially prepared vegetarian meals, and when I started holding meetings on the indoor track we had created with our new wellness center, those who would not benefit from my new found center for wellbeing went on a mission to discredit these ideas.

At one point the powerful head of a local Baptist Church began to take steps to have various conservative sects actually picket our hospital for teaching yoga and trying to take away the souls of our participants. (Their interpretation of yoga.) One of our powerful physicians sent emails on a regular basis to our staff with the intention of discrediting me and my programs for wellness and prevention. It was not unlike Salem, Massachusetts for a few years. Then something incredibly powerful occurred.

I was, for only the second time in my 30+ year career in hospital administration, invited to have dinner at a physician’s home. At that dinner, I was seated beside our local congressman, John P. (Jack) Murtha. The host’s wife did not know what to prepare for my meal so she gave me a large white plate with two egg whites on it. When the Congressman saw it, he asked, “What the heck is wrong with you?” I carefully explained my experiences in California with heart disease reversal, meeting patients who had successfully stopped and or reversed their disease, and how well they were living. He leaned back and said, “We’re spending a billion dollars a year on heart disease in the military. Maybe if you got to Bethesda or Walter Reed and find someone who would work with you, I might be able to help>”

We knew that his 25 plus years in Congress had given him some seniority, but what I didn’t realize was that he was in charge of the subcommittee on appropriations for the department of defense. His committee was responsible for well over $300B dollars of government spending. Well, my board chair was a former Navy airman and he flew me to Bethesda where we met with and were politely turned down by the Navy. A few months later when I was in D.C. for a meeting, I got in a cab and, without any knowledge of military life, command, or structure, I showed up at the front door of Walter Reed Army Military Hospital which became Walter Reed National Military Medical Center Bethesda several years later.

When I walked inside, I saw hundreds of soldiers, family members, and medical personnel, but I didn’t have an appointment. Consequently, I walked up to the first white coat I saw, explained who I was, where I was from, and who had suggested I come there. Serendipitously, he was the only physician who had ever received a federal earmark and it was about $75M from Senator Ted Stevens of Alaska to create a center for the study of prostate cancer. He looked at me, smiled, and said, “Follow me.”

After meeting with a Walter Reed cardiologist, I went home, wrote a white paper, and several months later we established two Ornish Centers, one at Walter Reed and one at Windber with a grant that was made possible through Congressman Murtha. The reason you need to understand this back story is that without these grants, there would have been no way a hospital our size could have supported a program featuring integrative medicine.

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COVID VACCINE CHALLENGE

September 23rd, 2020

COVID vaccine challenge
NICK JACOBS
Published Tue Sep 22, 2020 8:48 PM EDT

Besides wearing a mask, which we’ve known since 77AD protects us from the plague, the other best opportunity for stopping the progress of COVID-19 is through the discovery of an effective vaccine.

Rather than getting COVID via the natural infection pathway, a vaccine could produce herd immunity without harming or potentially killing people.

Thousands of Americans seem to have chosen the risk-it-all route as they go without masks, and attend large, unprotected social events and rallies.

Unfortunately, not unlike playing Russian Roulette with your loved ones and friends, this route is filled with potential suffering and an almost complete lack of predictability.

In an article in Time magazine, Alice Parks recounts how it was Edward Jenner who, in 1790, discovered that infecting people with small amounts of smallpox virus could produce immunity. Today, there are more than 100 vaccines being developed in an attempt to provide us with immunity from SARS COVID-19, and across the world, billions of dollars are being pumped into this effort.

There are numerous challenges to be faced in this effort including those of manufacturing and then distributing the vaccine in a humanitarian manner.

The good news is, regardless of political pressure, the major vaccine makers have already pledged to conduct complete safety studies before submitting their vaccines to international regulators. The not-so-good news is HIV/AIDS has been around for nearly 40 years and an effective vaccine is still not available.

Approximately 132,000,000 people in the United States are living with pre-existing health conditions. Thus, the challenge becomes who gets a vaccine and when. These decisions may literally produce a life and death lottery game.

The Time article cited researchers from CUNY’s School of Public Health’s computer simulation that calculated if 75 percent of the world’s population were immunized, to control the ongoing pandemic, vaccines would need to be about 70 percent effective. Any of us who are regular recipients of the annual flu vaccine know that some years it’s effective and some years it’s not.

Consequently, we will be faced with arguments over the world’s current state of nationalism combined with America’s anti-vaccination movement. Plus we still have the challenges of discovery, manufacturing and actual implementation.

Oh, and there’s one more speed bump in that the United States has chosen not to join the other 172 countries of the world in the COVAX initiative on international unity for epidemic preparedness innovations originated by the World Health Organization.

If we prioritize our high-risk populations which include health care employees, first-responders, people with pre-existing conditions, and the elderly living in group environments, and then add critical workers such as teachers, food growers and service providers, people in group homes and the incarcerated, we finally end up getting the vaccines to our most precious hope for the future, young adults and children.

In short, none of this is going to be easy. One batch of improperly manufactured polio vaccine in the 1950s resulted in thousands of children being accidentally infected with polio. and because there are so many variations of vaccines being developed, there is also the risk of triggering excessive immune responses that could end up being more harmful than helpful.

Finally, and this is one more example of the broken public health system in this country, any plans for massive immunizations will be dependent upon public-health initiatives that are appropriately supported and resourced.

Keep in mind many of our states have been seeking leadership, supplies, direction, and funding from the federal government since March. At about $35 per dose and in most cases the vaccines require two doses, herd immunity is not likely to be achieved either quickly or in a cost-effective manner.

One thing is clear, however. An effective plan needs to be implemented to stop this out of control COVID transmission and to produce a clear pathway to normalcy. We need to get back to normal through a national strategy.

 

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Pittsburgh Post Gazette. Op-Ed

December 11th, 2017

Nick Jacobs, among his other affiliations, is an officer of the Integrative Health Policy Consortium, which represents more than 600,000 IHM practitioners; president of the Clinical and Translational Genome Research Institute, which he founded; and a consultant to the Department of Defense in breast cancer research.

Pennsylvanians received good news recently when the Pennsylvania Health Care Cost Containment Council reported that hospital readmissions and mortality rates continue falling locally and statewide.

The report shows these rates declining for a number of common types of treatments. It gives much of the credit to a “commitment of PA hospitals to provide quality care” and to the Affordable Care Act, which ties reimbursements to that quality care. This, in turn, encourages health care facilities to strive for improved mortality rates because doing so helps keep government funds flowing through their doors.

Regardless of the motivation, this is good news. But it’s not good enough.The mortality rate could be improved even more dramatically if more healthcare administrators and physicians would introduce integrative health and medicine practices into their services.

Integrative health and medicine (IHM), as defined by the American Board of Integrative Medicine and the Academic Consortium for Integrative Medicine & Health, recognizes the importance of the relationship between practitioner and patient. IHM focuses on the whole person, is evidenced-based and employs a wide range of appropriate therapies, healthcare professionals and disciplines to achieve optimal health and healing.

Integrative health practice includes treatments and therapies such as acupuncture; natural products; deep breathing; Tai chi and Qi Gong; meditation; massage; special anti-inflammatory diets; progressive relaxation; journaling; biofeedback; pet, music and dance therapies; hypnosis and guided imagery. When provided by a licensed or certified health care professional, IHM provides numerous benefits. It can decrease chronic pain, post-operative pain and the need for medications. It can improve patient satisfaction and shorten hospital stays. It can lower mortality rates. IHM methods also are relatively inexpensive.

Many places, including the Cleveland Clinic, have reported cost savings per patient, while also seeing reductions in patient anxiety, pain, and medications. During my tenure as CEO at Windber (Pa.) Medical Center, I worked with physicians, staff, and volunteers to create a healing environment by embracing all methods and therapies used in integrative medicine and combining them with the ambiance of a fine hotel and the amenities of a health spa. We carefully scrutinized and credentialed practitioners specializing in services such as aroma and massage therapy, integrative nutritional counseling, acupuncture, chiropractic manipulation, pet and music therapy, reiki and spirituality, to name a few.

In short, a healing environment permeated our facility.

Yes, we had our share of naysayers and opposition among physicians, allied health care professionals and others, but over time our infection rate dropped below 1 percent and stayed there for a decade. (The national average is 9 percent.) Of our peer hospitals, we had the lowest readmission rates, restraint rates and lengths of stay. Even with a palliative care unit to care for dying patients and their families, we had the lowest death rate among our peer hospitals.

For those who would say it was all coincidence because Windber is a small hospital, I would direct them to the 19,000 papers written supporting the efficacy of acupuncture alone, and then to the thousands of papers written about the healing power of music, massage and so many other treatments dismissed all too readily by traditional practitioners.

IHM practices are not at odds with traditional medical practices; rather, they enhance them. Yet in many hospitals and physicians’ offices, they are ignored, discouraged, even ridiculed. Such negative reactions result from ignorance, misinformation, prejudice and even greed — pharmaceutical companies, for instance, see no profit in promoting most IHM treatments, and some medical practices might earn less if, instead of scheduling patients for costly treatments or surgeries, they instead treated patients with acupuncture, spinal manipulation, massage therapy or even mindfulness.

Resistance to IHM is breaking down, but this shift in attitude needs to be accelerated. If you travel to Europe or Asia, you will see integrative medicine practices thriving because their value is acknowledged and embraced. In America, IHM beachheads are being established in health care systems and universities, thanks to such groups as the Family Medicine Education Consortium, Integrative Health Policy Consortium and the Academy of Integrative Health and Medicine, of which I am a co-founder. The academy includes among its member’s hundreds of licensed physicians who have successfully merged IHM with traditional medical practices.

Much remains to be done to more broadly spread the healing benefits of IHM, which will happen only when more patients take more responsibility for their health and demand IHM treatments, more physicians research and adopt them, and more insurance companies pay for them. When that day comes, there will be a lot more good news about mortality rates and other measures of medical care for Pennsylvanians and people all over the country to celebrate.

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Four ways to improve access to Integrative Medicine Practices

November 13th, 2017

Licensure, regulation, medical evidence, and funding are four sure ways to speed up the process needed to allow integrative medicine practices to be embraced. If we begin with the assumption that money has a lot to do with everything medical in the United States, then we must look at the winners and losers and the WIFM’s?  (What’s in it for me?)  If you’re a practicing surgeon, and acupuncture or chiropractic care results in the patient not needing a surgery, that can be a financial threat to you. Let’s be fair, that probably doesn’t happen that often, but sometimes it does, and when it does, that’s money lost to your practice.

 

If you’ve spent four years in undergraduate school, four years in medical school, four or five years in a residency, and your educational debts amount to hundreds of thousands of dollars, the last thing you need is a clinical study demonstrating through medical evidence that thousands of patients won’t need your services, and your skills will become exponentially less in the demand.

 

On the other hand, if, like ophthalmologists who surround their practices with optometrists, orthopods did the same with chiropractors and acupuncturists, could that not create a steady stream of referrals for their practices?

 

Let’s face it, there is a role for all three of those professions, and there are skill levels in every profession and duties relegated to each that both overlap and potentially conflict. So, wouldn’t it be better to have the three practice as a team of professionals working together to help you?

 

“There’s not enough medical evidence”  has been the hue and cry of the uninformed for years. Ironically, once traditional medical evidence is thoroughly interrogated, it’s not unusual to find numerous flaws in even the most accepted medical practices. We’ve seen slanted reporting in even the furthermost prestigious journals where various drugs, procedures, and devices have been proven to be ineffective years later.

 

There are over 19,000 papers that have been written and submitted to medical journals in which acupuncture has been endorsed and proven to be effective, but there never seems to be enough medical evidence for the naysayers.

 

Credentialing is a very challenging area as well.  Not unlike the highly skilled surgeon with her medical degrees from the Sorbonne in Paris that is not permitted to practice medicine in the United States, there are sometimes economic and political reasons to limit the number of practitioners allowed in the United States. In my experience, by creating a hospital-based credentials committee that specializes in integrative medicine, the nay-sayers ability to discredit highly trained practitioners with different skills will become more limited.

 

Regulation may be the most difficult challenge in this discussion because, as we have come to know very well, political power can come from political contributions, and when it comes to regulations, those with the gold have more clout than those without. That is not to say that our politicians can be encouraged to be more flexible because they can.  All it takes is for hundreds of constituents to stand in front of a Congressional office to encourage change to occur.

 

So, what are we really dealing with here?  In 1910, the AMA put out a request for proposal to determine what should be taught in the medical schools of Canada and the United States and no physician would accept that assignment.  Consequently, a Ph.D., Abraham Flexner, did, and his approach was to eliminate everything that wasn’t already proven science.  From there we have evolved to a “heal to the pill” mentality where words like root cause and placebo have been dropped from the vernacular.

 

Finally, funding is the key. It has been proven time and again that integrative medicine practices can reduce health care costs exponentially. With that in mind, every bill that comes out of Washington ignores that fact, and funding for many of these well-documented practices is not present. There were over 5000 codes in the Affordable Care Act that were intended to fund such practices as acupuncture, but when the FAQ initially was released, it said, in essence, “Don’t worry about paying these codes.”

 

If you go almost anywhere in Europe and Asia and you will see integrative practitioners thriving because their value is acknowledged and embraced. Of course, we’re not professing that a massage therapist performs open heart surgery, but we do know that Integrative medicine can help to reduce costs across the board.

 

There are many good things that can come from Integrative medicine. You just need to be open-minded.

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BMW . . . ing

August 20th, 2014

 

If you don’t know what that abbreviation stands for, Google it!  I’m not referring to: BMW: Born Moderately Wealthy, BMW: Brought My Wife, or BMW, Bring More Worries.  In fact, I’m not thinking about anything that is directly related to a thing, okay, well, maybe I am.     

What I’m referring to is the phrase, Bi*ch, Moan, and Whine!   For whatever reason, I’ve recently been inundated with individuals who are not happy about various things impacting their lives.  I’ve been hearing about money, jobs, marriages, fees for cable TV, healthcare and college costs, the government, animal cruelty, gasoline prices, racism, city manager selections, and a dozen or so other issues.  In fact, even though Heinz just had to pull their tainted baby food off the shelves in China (Now, that’s a reversal of fortune, Mr. Buffet).  The only thing that I haven’t heard people complaining about (euphemism for bi*ching) is the “price of rice in China.”   

Ha, bet that rang a bell for you ole folks.  What ever happened to that phrase?  We used to say that all the time in the 50’s and 60’s?  When someone was babbling on about something that we thought was meaningless in our lives, we used to say, “Now what’s that have to do with the price of rice in China?” 

Guess it’s not so meaningless anymore? (If you’re interested, you can look up the “Live Rice Index” for the price of rice in China), but I digress. My philosophy has always been, if you can do something about it, then do it.  If you can’t . . . then move on, my friend.   Truthfully, in this country, we hold the power to change nearly everything, but we choose instead to join the BMW Club.  

Think about it.  We have in our hands the amazing ability to influence and to change almost anything that exists.  It’s a simple formula.  We ban together and say that famous line from the movie, Network, “I’m mad as hell, and I’m not going to take it anymore.”  

Could you imagine showing up en masse anywhere and yelling that?  It would be international news.  If we could get enough people to come together to offer alternative solutions to almost any problem that we face, the offenders, enforcers, and especially the elected law makers would be forced to pay attention, and public pressure could change everything.  

The key to this tactic is to find enough people who care about ANYTHING.  

We’ve all seen what Rosa Parks, The First Lady of Civil Rights, The Tianamen Square tank man, Gandhi, Mother Teresa, Martin Luther King, and now Pope Francis, the former night club bouncer, have done to contribute to CHANGE in our world, but we . . . you, me and tens of thousands of our closest friends, can really make a difference. 

Heck, thousands of us just threw cold water on our heads to make a statement about ALS, and before that . . . ?  Probably a lot of the participants thought ALS stood for Advanced Life Support or Apply for Disability! 

What’s the quote from Margaret Mead? “Never doubt that a small group of thoughtful, committed, citizens can change the world. Indeed, it is the only thing that ever has.”  (She also said, “Children must be taught how to think, not what to think,” but that’s a different column for a different day.)  

The whole idea here is to get us together, to unit, to make change!  What would you change if you could?  Want lower gas prices?  We could do that.  Want to stop dangerous, unmarked oil trains from driving through our towns and cities.  We could do that. How about big corporations not paying taxes? 

The key is to stop the BMW-ing, and get your friends together and present positive ideas to the folks who can make the changes.  It’s an American right.  

Oh, and you might want vote this year, too! 

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What is Real and What is NOT? The Truth, or Maybe NOT . . .

April 30th, 2012

Sixty two years ago, George Orwell wrote the novel, 1984.   He described a society controlled by government where the individual had no privacy, no real freedom, and was literally put into the equivalent of a drug induced state by the pabulum of mass media television.  It was an intimidating forecast.   But now the question; how much dumber can television get with shows like:  “My Big Fat, Obnoxious Boyfriend,” “Real Housewives of  Wherever,” and “Temptation Island?” 

It was Marshall McLuhan, the Canadian educator, philosopher and academician who came up with terms like, “the global village, “medium is the message,” and the concept of the “World Wide Web” almost thirty years before Al Gore said he invented it.  Marshall described the fact that the mass media was quickly taking over our ability to think independently as we rushed into the realities of Orwell’s  Big Brother.  He explained that we would be once again living in a world of tribal drums, total interdependence and superimposed terror as opposed to thought and feelings from rational analysis.  Can you say, “Weapons of Mass Destruction?” 

The World Wide Web has placed us in a type of tribal unity for which none of us were prepared.  Why do you think tattoos are more in now than any time before 1500 B.C.?  Piercings and tattoos make you “part of the tribe.”  Hey, the majority of presidential candidate debate issues revolved around turning the clock back to the 1950’s, no web. 

It appears that, because of this tribal unity, many very obvious changes have become accepted by our current culture.  For example, according to columnist Rex Huppke, the fact that someone of any political party can say something that is completely false and stand by it makes facts meaningless and thus, dead. He goes on to theorize that, rumor and innuendo along with emphatic assertion are also part of this new communications standard. 

Dartmouth political scientist, Brendan Nyhan professes that, “In journalism, in health and education, we tend to take the attitude that more information is better, and so there’s been an assumption that if we put the correct information out there, the facts will prevail.”Nyhan says that, “Unfortunately, that’s not always true.”   Facts don’t seem to matter, and those who expose bogus facts are often more highly criticized than the person who misrepresented the truth in the first place.

We all know that the spin can change the view on any subject matter.  In many cases, it’s the quality and persuasiveness of the argument, not the facts which becomes the issue.   If you are on the right side of the spin, or if enough information can be put out there, the mass audience will be distracted from the facts, and confusion will reign supreme. 

Fact:  The United States has one of the highest infant mortality rates in the industrialized

Fact: Legislation has recently been proposed to take away additional funding for prenatal care. 

Fact:  The United States has fallen to “average” in international education scores and our State austerity measures include the laying off of teachers. 

Fact:  The incarceration rate in the United States of America is the highest in the world with only five percent of the world’s population, one-quarter of the world’s inmates are incarcerated in the United States. 

Fact:  Average annual cost per student for a public school education $8500; average annual cost per prisoner, $23,000. 

See, many of you will not know if you should believe these facts.  Some of you will fact check them.  Others will say, so what?   Some of you will look for my prejudices regarding this list, or you may be overwhelmed and say, “I can’t change any of this anyway.”  Most, however, will not bother to read this far. 

Twitter has become the new novelette and everything is a sound bite.   As Jimmy Kimmel said, “What’s back and white and read all over? Nothing anymore.”

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Living the Dream – Southwest Florida Global Research Institute

January 30th, 2012

Greetings From Florida - Southwest Florida Research Institute - Nick Jacobs, FACHEI’ve been on a blog hiatus — the longest since I began writing this back in 2005, but for good reason. Another former trumpet player, Kevin Taylor and I have been working on the creation of a research institute in Southwest Florida.  It will embrace an ambitious research mission, academic excellence and become the biotech engine of what could become the future of Southwest Florida’s clinical research, environmental, aging research, behavioral health and translational medicine efforts for the region.

The structure of the not-for-profit arm of this project and the strategic direction of this new 501(c)3 corporation will be the Southwest Florida Global Research Institute.

The initial primary services outlined in this plan are to outfit and set up a tissue repository. From this hub, numerous spokes will emanate that will include opportunities for faculty-student involvement from the Florida Gulf Coast University and other Florida universities, as well as research opportunities for organizations that will eventually feed other related organizations such as an incubator and an accelerator.

It is our intent to focus on the various ideas, concepts, and programs that have been embraced by the leadership of all of the local organizations with whom we have interacted during this effort to include health systems, universities, the private and public pharmaceutical and research communities, environmental science, public health officials and political leaders.

In the financial summary of a business plan, it is evident that the revenue from programs, grants contributions, sponsorships and subsidies must initially be the fiscal drivers behind all of the suggested work at SFGRI with a clear goal of having financial streams in place by year four of the operation to allow the organization to not only survive but also to thrive. With all relevant guidelines, requirements, restrictions, and recommendations in mind, let us begin with an analysis of each suggested area of concentration.

Southwest Florida Regional map - Nick Jacobs FACHE - HealingHospitals.comThe Southwest Florida Global Research Institute tissue repository is a key to growth for both research and biotech efforts in the region. Physician, faculty, staff and community involvement will all determine the degree of success that will ultimately emanate from this key research component, but the ultimate determinant for the success of this repository will come from professional guidance and initial oversight provided through the Clinical Breast Care Project’s Windber Research Institute Tissue Repository.

It is imperative that this program carries the most immediate gain for the overall success and future of the institute. The very essence of this initiative revolves around not only equipment and space, but also quality tissue derived through comprehensive protocols. In time, this effort could lead to an ongoing stream of funding that will help to meet the myriad fiscal needs of the other aspects of this project.

Equipment for setting up this program is relatively inexpensive, but expertise and recommendations for the actual business model are not and it is our recommendation that these efforts should be led through a consulting assignment with the Clinical Breast Care Project’s Windber Research Institute. In order to activate a comprehensive program such as this, highly skilled PhD’s and techs will be needed. Having contributed to the design of the numerous other programs and centers, we would recommend the researchers and employees at the Windber Research Institute as consultants to assist in this effort.  Under their direction, they have successfully put together and managed a similar program that has been identified by the National Cancer Institute as the only platinum quality tissue repository in the United States. They also have world-class experience in data management for the control of the tissue, as well as expertise in accounting, staffing, billing, and management systems that allow for the comprehensive management of the collected tissue.

Windber Research Institute - Image by PlanetRussell.netThe timeline for this program can be relatively immediate, but the overall effort must be seen as neutral and independent from all of the participating organizations. This tissue repository will contribute to biotech research which will enrich physician recruitment opportunities, for profit biotech spin-offs and training experiences for students in the schools of arts and science, business and public health at the local universities.`

In summary, the Southwest Florida Global Research Institute will be the centerpiece for what will become the vision of this region; care for aging, preventative medicine, auto-immune and diseases of the brain while spinning off companies to address all of these maladies and meeting these challenges. It will become part of a world-wide effort based in Southwest Florida with a singular goal —  to improve the health of humanity on many different levels.  That will be the mission of the Southwest Florida Global Research Institute.

Learn more:

Chico's in Lee County, near Ft. Myers, FL

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Bhutan’s Philosophy of “Gross National Happiness”

October 3rd, 2010

Not everything that can be counted counts, and not everything that counts can be counted.
—Albert Einstein

At a recent conference I had the opportunity to learn about the Himalayan nation of Bhutan. Most of us had not heard of this country, but we should have, because they have done something that is reminiscent of the Broadway Musical “Camelot,” or possibly “Brigadoon.” Their King introduced a philosophy of living that is intended to shape all of the government’s activities. According to Mr. Kuenga Tshering, Director of the National Statistics Bureau of Bhutan, Gross National Happiness (GNH) was promulgated as Bhutan’s philosophy of economic and social development by the Fourth King of Bhutan as soon as he came to the throne in 1972.

The reason I’m writing about this is because I believe it is an amazing idea, a wonderful goal, and a step toward embracing  idealism.  Many of you have heard my thoughts on change, and know that I do not believe that there is only one route to follow on this journey through life.

Takstan Monastery, Bhutan (image credit: johnehrenfeld.com)

Takstan Monastery, Bhutan (image credit: johnehrenfeld.com)

The Bhutanese philosophy of “living” refers to a set of social and economic interventions that evaluate societal change in terms of the collective happiness of people.  Further, these measures are also applied to the creation of policies that are aimed at that objective. Premised on the belief that all human beings aspire to happiness in one way or another, the concept promotes collective happiness of the society as the ultimate goal of development.  Now that would be a political platform!

The philosophy of Gross National Happiness considers economic growth as one of the means towards achieving happiness, but it also offers a holistic paradigm within which the mind receives equal attention. While GNH recognizes the importance of individual happiness, it emphasizes that happiness must be realized as a collective or societal goal and not be defined as an individualized or competitive good.

The philosophy should also not cause misery to future generations, other societies, or to other  beings, and it is important to the government of Bhutan that the efforts of this philosophy be distributed evenly across all sections of  the society.

They work at strengthening the institutions of family and community; the spirit of voluntarism, tolerance and cooperation; the virtues of compassion, altruism, honor and dignity, all of whose active promotion may be a contributing factor to Bhutan’s low crime rate.

Culture also provides a framework where an individual’s or society’s psychological and emotional needs are addressed. By preserving local, regional, and national festivals, the government attends to these needs and provides a forum for maintaining social networks and promoting the conviviality of public culture.

His Majesty, King Jigme Singye Wangchuck of Bhutan

His Majesty, King Jigme Singye Wangchuck of Bhutan

Bhutan treasures the extended family network as the most sustainable form of social safety net. Aware of the possibilities of family disintegration or nuclearization, the government makes conscious efforts to revive and nourish the traditions and practices that bond families and keep communities resilient and thriving.

Their environmental policy is predicated on the perspective that human beings and nature not only live symbiotically but are inseparable from each other. According to this perspective, nature is a partner in existence; a provider of sustenance, comfort and beauty.

Environmental preservation, therefore, is a way of life in Bhutan. Currently, 72% of the country’s area is under forest cover, 26% of the area is declared as protected areas, and the state has decreed to maintain 60% of its area under forest cover for all times to come. Environmental cost is an essential ingredient of evaluating new development projects in  Bhutan.

Finally, Bhutan launched parliamentary democracy 2008, becoming the youngest democratic country in the world. All this was initiated by the country’s leader – His Majesty, King Jigme Singye Wangchuck, thus fostering people’s capacity to make choices.

Well, we have generally been making choices as a country for some time now that generally do not embrace nature, family, our fellow man, or the environment.  On a recent boat trip up the Caloosahatchee River, I expressed a dream, namely that mankind would embrace a philosophy of “National Happiness.”

Now wouldn’t that ROCK?

Not everything that can be counted counts, and not everything that counts can be counted. — Albert Einstein

Read more: http://blog.rypple.com/2010/06/chip-conleys-ted-talk-on-gross-national-happiness-gnh/#ixzz11MQ5ZTm6

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Overexposure to Radiation

July 12th, 2010

When I saw this…

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Ever since a surge in cases of patient exposure to excess amounts of radiation during diagnostic procedures, pressure has been mounting for healthcare providers and equipment manufacturers. The FDA has already taken action, including a call for stepped-up training for practitioners and a more stringent approval process for radiation-emitting equipment.

Antique X-Ray machine used to determine shoe size

Antique x-ray machine used to determine children's shoe sizes. Photo credit: desertsurvivor.blogspot.com

…I couldn’t stop thinking about it.  Overexposure to radiation is something I’ve thought about for many years.  In fact, I’m pretty sure that, short of cancer victims, I’d be the poster child for this for Boomers.  Let me count the ways.  Every time I went to my family doc as a kid for anything except a strain or a splinter, he’d zap me with the fluoroscope,  just for good measure.  Then, when we went shopping at Buster Brown’s, in order to determine my foot length and width,  I’d get my feet x-rayed.  After that, I played too much trumpet and had to have my lip radiated because of a blemish that wouldn’t go away.  There were at least seven radiation sessions with Dr. Jacob, a dermatologist who reminded me of Dr. Jekyll.  He zapped me because that’s what they did in “those days” for blemishes.  He would lay me on the table, cover me in lead, and zap my lip with radiation.  Thank goodness for the lead.

As a young adult, my Internal Medicine doctor had his own x-ray equipment and used to say, “Okay, time for your chest x-ray.”  Problem was, he did it every single time I went to him.   Once, however, when I went there, there was no x-ray.  I asked the nurse why and she laughed and said, “Oh, that old piece of junk…it was zapping all of us with radiation.”   Later that week I heard on the radio that he had donated his unit to a small hospital.

As a teacher, chest x-rays were a requirement.  We would be invited to go onto an old x-ray bus every two years and they would light us up on a piece of x-ray equipment that probably put out more radiation than the bombs dropped at Nagasaki and Hiroshima. All in the name of TB checks.

Bronchitis visited me regularly over the past several decades, and chest x-rays were always part of those visits. So were dental x-rays, over and over and over again. The MRIs do things a little differently, but I’m sure there’s still some type of telltale exposure there, and I’ve had three or four of those. Annual physicals now include chest x-rays, thallium stress tests, et al, and visits to the bone docs required x-rays, too.  Oh yeah, and the heart caths?  They fill you with dye and then they light you up with the ol’ fluoroscope… did that three times.

And don’t forget the “new fangled invention that’s perfectly safe,” the heart screening on the 2, 16, 64 and then 128 slice PET/CTs. Did that three times, too.

BUT let’s get to the real exposure — playing in the sunshine, sans any type of sun tan lotion or sun screen.  Okay, I guess that’s an exaggeration.  We used to mix Merthiolate with baby oil, or sometimes just use baby oil to ensure a nice brown cooked look.  Every year I looked like a half Italian coffee bean.  It was more than a tan.  It was a deep fried, make your teeth look whiter than snow, fun in the sun, ain’t wearin’ no shirt, nature is good for you, sun tan with burns that preceded the tans every year.

HealingHospitals.com - Overexposure to Radiation - Nick Jacobs, FACHE

So, when people tell me to eat organic, I smile and think, “Yep, that will erase all of those rads that filled me up like a Rocky Mountain boulder,” but I do what they say and just wait and pray that the radiation devil will not come my way.  If the sickness won’t kill you, the cure will, and that’s the truth.  At least you won’t ever need a night light.

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