For the past several months, I have been searching for a new blog title. Nick’s Blog, NickJacobs.org, Ask a Hospital President, Taking the Hell out of Healthcare… none of them really told the story of my passion, my drive, my desire to change healthcare in a way that would be meaningful for every patient, every employee, and every physician. Finally, the idea of what exactly I believe in, try to strive for, and teach hit me: “Healing Hospitals.” Not only do I believe that we can make our hospitals healing places, I also believe that we can heal the hospitals themselves.
Nick Jacobs, FACHE – HealingHospitals.com
For too many years, the Socratic style of teaching our docs has basically made many of them as tough as professional football players. We have experienced “The Old Guard” in nursing, where, when new nurses come on board the older nurses are encouraged to “eat their young.” We also know that the over-utilization of overhead paging, blood tests in the middle of the night, loud staff members, et al lead to what can only be described as a tense environment.
For the past 20 plus years, we have advocated a kinder, gentler hospital environment. During that time we have introduced all types of non-traditional healing environments, integrative medicine, roving psychologists, drum circles, aroma, music, pet, and humor therapy as well as the elimination of bullies from the medical staff.
These are just a few of the very effective mechanism that can be introduced to create healing environments in hospitals. Healing gardens, labyrinyths, 24 hour visiting, double beds in the OB suites, and the beat goes on and on with decorative fountains, fireplaces, skylights, balconies, but most importantly dignity and respect amongst all staff and visitors toward patients. So, “Healing Hospital” has multiple meanings. Healing will take place more quickly, thoroughly, and meaningfully in these facilities, and the entire staff will be charged with the promotion of healing by creating an overall healing environment.
Well, I’m sure if you type in nickjacobs.org or even Ask a Hospital President.com you’ll still get to us, but remember that our overall goal, our direction, our mission, our passion, and our job is to help you to create healing environments where infection rates drop, as will lengths of stay, readmision, restraint and mortality rates. Call us at SunStone Consulting, LLC. 412-992-6197.
Those who have worked with me know that I have been unequivocally one of the most loyal supporters of the PlanetreePhilosophy of care in the world.
My former place of employment was the third Planetree hospital in the country, after Planetree’s headquarters moved to Griffin (Derby, CT.) We were the first Planetree hospital in Pennsylvania, and that hospital, Windber Medical Center, is now one of the top ten Planetree-designated sites internationally. After having served on the Board of Directors of Planetree for nearly eight years, having written literally dozens of blog posts and articles about Planetree, having taught numerous online seminars for them, contributed a chapter to their latest book, and served on the Planetree Speaker’s Bureau for half a dozen years, I’m back once again with a presentation this Tuesday at the Planetree 2009 conference. It’s called: Take Care of Your Employees and They Will Take Care of Your Patients.
Although I was encouraged to retire from the board in order to give newer members their opportunity to participate, and am no longer a part of the Speaker’s Bureau, with no formal ties to the organization anymore, I want to assure you that my experience, passion, and commitment to humanizing healthcare, transparency, creating a nurturing environment for patients and their families could not be stronger.
Since my transition from formally running hospitals full time, I have immersed myself deeply into the world of helping hospitals through my consulting practice to achieve the patient, employee, and family satisfaction ratings that ensure top scores in HCHAPS which, in turn, will result in increased business, increased revenue, and increased growth for any organization.
Nick Jacobs, FACHE
I am including one of my lastest articles on Integrative Health written for Hospital News. Remember, if I can help, just call, e-mail or or comment:
Integrative Medicine
Massage, Flower Essences, Spiritual Healing, Drumming, Reiki, Acupuncture, Music, Aroma, Humor, Pet, and Art Therapy; all of these healing practices were formerly referred to as Alternative or Complementary Medicine. They deserve, however, to be referred to as Integrative Medicine. Because, when we integrate these various disciplines with other contemporary healing methodologies, the results can be amazing.
As a hospital CEO, it brought me great satisfaction to introduce all of these treatments to the healing environment of the hospital. Many times they came amid intense resistance from both the medical staff, and some members of leadership. In fact, after nearly 10 years of offering comprehensive exposure to Integrative Medicine, we still had a smattering of nonbelievers. The only thing questionable about these therapies for a healthcare administrator is that the typical insurance companies don’t cover the costs of all of them and cash payments come into play.
The number of patients coming to our facility had tripled through the emergency room alone as did the overall budget of the entire organization during that time period. Those “Forest for the Trees” practical leaders still could not bring themselves to give credit to one of the major contributing factors involved in that surge of the hospital’s popularity. Yes, of course, we also encouraged 24 hour, seven day a week visiting, had guest beds in many patient’s rooms, and served meals to the families on the medical floor where their loved one was a patient. Did all of this combine to the create a healing environment? Of course it did, but Integrative Medicine was the heart and soul of the difference.
Their skepticism seems to fit into the cycle of questioning the validity of wellness and prevention, two comprehensively established methodologies for improving general health and well-being, proven over centuries of unofficial clinical trials. Wellness and Prevention works, but because the insurance companies have not yet fully embraced these philosophies, then some still say that they are not valid. Treating sickness can be as comprehensive as ensuring wellness. For whatever reason, some of our medical and administrative leaders often confuse reimbursements with healing, and forget to add new patients and additional income from related disciplines like PT and OT to the equation.
As a nonmedical, nonscientist, it was easy for me to understand why the various integrative arts worked so well for our patients and their families. From the old song, “All You Need is Love,” you could easily enjoy the looks on the faces of those patients and family members who used these treatments to receive sorely needed relief from whatever pain or loneliness they were experiencing. It doesn’t matter if you’re eighty minutes or eighty years old; touch, nurturing, and love all remain critical in our lives. Have you seen the statistics on how much better people do with pets than without, or how many babies died in orphanages due to the “failure to thrive?”
None of these ancient arts were created because the scientific method produced FDA approved results in trials of 200,000 or more. They evolved into centuries old healing arts because they provided relief and help in a time when leeches, bleedings, and a lack of hand washing were the accepted medical treatments. The tribal shaman, medicine man, healers, and other spiritual leaders all knew what the subtle and not so subtle impact of their work meant to their fellow human beings.
We have casually observed the use of these healing modalities on patients who have experienced restored feelings to otherwise numb feet.
We have seen them relieved from debilitating back pain, healed from hopeless wounds, saved from surgeries due to the opening of blocked intestines through acupuncture. We have observed psychological breakthroughs from drumming that had never been reached by traditional therapy. Truthfully, I didn’t care exactly what made our patients better, just that they were better, and the results were dramatic, with an infection rate of 1% or less, a 3.4 day length of stay, a low readmission rate, and the lowest mortality rate for adjusted morbidity in the region.
The time has come to realize that the old habits, the old arguments, are irrelevant to the challenges faced by our people. They lead nations to act in opposition to the very goals that they claim to pursue — and to vote, often in this body, against the interests of their own people. They build up walls between us and the future that our people seek, and the time has come for those walls to come down. Together, we must build new coalitions that bridge old divides — coalitions of different faiths and creeds; of north and south, east, west, black, white, and brown.
The choice is ours. We can be remembered as a generation that chose to drag the arguments of the 20th century into the 21st; that put off hard choices, refused to look ahead, failed to keep pace because we defined ourselves by what we were against instead of what we were for. Or we can be a generation that chooses to see the shoreline beyond the rough waters ahead; that comes together to serve the common interests of human beings, and finally gives meaning to the promise embedded in the name given to this institution: the United Nations. (President Barack Obama’s Speech to the United Nations)
Interestingly enough, there were 22 years in a row when I could have made the same speech (Okay, it would not have been rendered as eloquently as the President’s, but the content would have been similar.) The most disconcerting thing about this statement is that I was referring to the internal stakeholders of many hospitals. One of my favorite statements during those years because of all of the infighting was that ”We are not the enemy.”
An enormous amount of energy is expended in almost every healthcare organization on internal power struggles. In many cases these struggles revolve around issues relating to money. Questions like “Should the radiologist or the cardiologist be permitted to perform one particular test?” Turf battles over procedures always seem to be part of the equation. Other struggles revolve around perceived power relating to whatever positions are held because someone wants more control of larger pieces of the budget.
Power, control, greed? All of these traits are part of the human experience, but when an organization expends much of its energy on these issues, the result is wasted time, wasted resources, wasted anguish, and, in many cases, lower quality outcomes.
Watching old movies of workers in factories during World War II have always fascinated me because we, as a country, had found a common enemy toward which we could focus our angst. The fact that health care never seemed to be able to embrace illness as the common enemy always created intrigue for me. Yes, we would rally and work together when emergencies hit, but the other daily activities became somewhat mundane and boring, and our instinct seemed to be to revert to power, control, and greed.
Maybe, just maybe, we could find a way to marshal the medical staff, employees, and administration, the volunteers, and patient families to work together every day in every way to create an actual healing environment where patients can be surrounded with the energy of love, kindness, respect, dignity, and healing. Maybe this environment could be the goal of every hospital executive, and they could begin and end each day by focusing on setting the example for the creation of a healing environment.
Over the years it has been my aspiration to try very hard to help you laugh, and, regardless of the depth of the topic, I’ve always looked to find humor somewhere in the message. For example, potty training, Smokey the Bear, flying DVD’s, even old dogs with no tricks.
Today, however, I am writing about an issue that may inflame some of you and prove to be very troubling to others. It’s not my goal to do either. I’d just like to bring into focus the crazy stuff that seems to be taking us over, a kind of Bird Brain Flu that doesn’t have a vaccine and that appears to be enveloping our nation.
You see, it is my humble opinion that we as a country have reached a new low point in dumbness. The wild, inflammatory rhetoric, a/k/a crazy talk that’s being spouted every day, appears to be pushing the fringe players out from under their rocks and their basement fortresses. This political flu is taking us to levels of foolishness that are so low that even a Limbo expert couldn’t fit under the broom stick.
Have you noticed how open public hatred and outright prejudice has become? It’s like we’re living a rap song from Gran Torino. Each and every day we hear the ranting of media talking heads leading the charge to endorse this movement. For those of you who have read my work over the past few years, you know that I personally am repulsed by bullies, by racists, and by those who believe they are superior to other human beings.
The new accusations and sick suggestions that are the current craze are veiled as protests regarding big government, health insurance reform, and a lack of confidence in the ship of state. What they really seem to be, however, is fear and lack of tolerance for our President. So what if you don’t like him? There still have to be some limits and boundaries. Are there any more lines?
I’m telling you, the crazies are coming out from their caves. Seriously, watch out for them. Many of these radicals are great examples of why some animals eat their young.
Just last week on a trip to Washington D.C., I had to be evacuated from the Pittsburgh airport because a passenger was carrying a defused hand grenade in his suitcase. What is the single thought that must be in the mind of any individual who believes that a weapon, even, as it turned out, an inert one, such as that grenade, would be okay to pack for your plane ride? Let me guess. That thought was “Duh?”
It seems that every time some poor innocent gets shot in this country, there was some fringe individual who believed that he was not only given permission to take their life, but that there was an overwhelming endorsement of his actions that would somehow vilify him from any prosecution, and reward him with glory. Does that sound like the Jihadi 72 virgins thing to you?
Yes, we have freedom of speech. Yes, we have the right to bear arms, but do we have the right to just be nuts in public? Maybe instead of statins in the water system to control cholesterol, or fluoride to prevent tooth decay, we should start putting Zoloft or some other selective serotonin reuptake inhibitors (SSRIs) in that keep the brain from becoming unbalanced.
What’s wrong with love, kindness, and the golden rule, of doing to your neighbor as you would have them do unto you? Can’t we look for compromise without demonizing those with opposite views?
Can’t we stop endorsing or even worse stop inflaming those with extreme views? When is enough enough? When will we return to civility, to compromise, and to brotherhood? Would you rather have peace, love, and rock ‘n roll, or “Go ahead. Make my day, @#%&+^@#”?
President Obama’s eloquent address to Congress on his proposed changes to the U.S. healthcare system was fraught with ambiguous issues that will certainly provide a feeding frenzy for opponents. When the President stated that “This country’s failure to meet this challenge year after year, decade after decade has lead us to a breaking point,” he was exactly correct. We are the only industrialized nation in the world that has not addressed this challenge.
There are too many people without coverage of any kind who use emergency rooms as their primary care physician. Unfortunately, the difference in cost between a visit to your emergency room vs. a visit to a physician’s office is exponentially different.
If we, as a country, do not believe that we are paying for these patients in some real way, then we are not cognizant of how the system is being contorted in order to allow hospitals to remain solvent. When you hear individuals complain about the high cost of Q-tips in a hospital, it’s because they are being priced to help cover the losses being incurred from the millions of uninsured.
So, what is it that we must address? When the President said, “Under the present system, due to job loss or illness, many could lose their coverage,” he was totally accurate. Unfortunately, millions of Americans have come to experience this phenomena first hand, and could lose their homes, investments, and their possessions because they have no insurance. So, as President Obama appropriately questioned, “What is the best solution that is both moral and practical and best reflects the ideals and freedoms upon which our country is based?” He was clear to explain that implementation of either a Canadian-style system or an individual based system would both be a radical shift, and each represents extreme positions that would completely change the way healthcare is delivered in this country.
So, if we eliminate the extremes and concentrate on compromise, we begin to see signs of conciliation that might be embraced. For example, there appear to be very few people who would argue against providing “more security and stability to those who have health insurance.” The majority of Americans also seem to embrace the concept of providing some type of coverage for those who currently have none.
What the President and most of our elected representatives are avoiding in the conversation is talk about quality, safety, end of life care, wellness, prevention and outcome data.
David B. Nash, MD
I had the fortuitous opportunity to hear David B. Nash, MD, MBA and Dean of the Jefferson School of Population Health’s presentation on Population Health. At the risk of misquoting Dr. Nash, I will carefully attempt to touch on only a few of the facts, figures, and points that he made in his analysis of what it would take to fix the system.
One of the most profound points that Dr. Nash made was in seeking the answer to the following question:
What percent of adult Americans do all the following?
Exercise 20 minutes 3x a week
Don’t smoke
Eat fruits and vegetables regularly
Wear seatbelts regularly
Are at appropriate BMI (Body Mass Index)
The answer surprised even this writer. Only 3% of American adults are following all five of these wellness and prevention guidelines, and 40% of deaths are the result of smoking, unhealthy diet, physical inactivity and alcohol use. In an interesting analysis of the President’s healthcare speech, finance author J. André Weisbrod writes: “I see it as a Darwin Awards kind of issue. You are free to be stupid and I am free to not have to pay for your stupidity…”
Bundled payments, end-of-life counseling, evidence-based medicine, an emphasis on quality and systemic approaches to ensuring safety are only a few of the myriad suggestions recommended in Dr. Nash’s presentation. Bottom line? The third rail of politics is limiting honest, open dialogue regarding reform, and time is running out.
About two years ago, I had a call from my local bank asking if I had purchased a washer and dryer… in Barcelona, Spain. Somewhere, someone had gained access to my credit card number, and used it illegally for that purchase overseas.
It was not too long after that that another bank informed me that my card had to be canceled because of a data breach at a national chain store where I had purchased some clothing. (I have since come to learn that this data breach has already cost their parent company over $220M.) Then, a few weeks later, another card had to be canceled and re-registered. Finally, about three months after that, restrictions were placed on still another set of cards due to similar, but entirely unrelated breaches. Three cards, three banks, multiple breaches …and my wallet was still firmly tucked in my back pocket.
In a recent article in Forbes Magazine, the facts and figures of this new, growing phenomena were outlined statistically so as to begin to bring some sense to the table regarding what we are facing. The authors, Joe Carberry and David J. Chamberlin state that “Only 36% of C-level executives are confident their organizations will not suffer data breaches in the next 12 months.”
As healthcare gears up to go completely electronic, we must remember that there are, for all practical purposes, entire countries dedicating serious efforts to breach the United States data banks. Hackers are no longer identified as stereotypical, 98 pound computer savants. Many of them are professional criminals and terrorists. As a former CEO, I always had to be cognizant of the risk, then do whatever we felt we could afford to do to help mitigate that risk. Rarely, however, have I seen any type of comprehensive commitment to a comprehensive, multi-faceted approach to this effort.
The laws that address data breaches involve not only civil but also criminal penalties, and the individual laws of various states are most times very different. It doesn’t matter if your business is located in only one state. What matters is where your customers are from, and if they are a diverse group, you must comply with each
state law regulating breach notification.
SunStone Consulting, LLC, and Immersion Ltd., through their InfoLaunch suite of products, are positioned to assist you to prepare for any type of breach. As Carberry and Chamberlin state, preparation must involve not only legal, but also communications, the C -suite, and risk management. They further recommend the following steps:
1. Be prepared
2. Move quickly
3. Take action, and
4. Be responsible.
The professional reputation damage that could be encountered by the hospital or physician practice that is not responsible, not prepared, slow moving, and not action-oriented can be devastating.
As a hospital CEO, one of the greatest challenges that I faced was that of resource allocation. Because my personal goals included making our organization:
A facility that became recognized for its very high quality physicians
A Planetree facility where you never had to “leave your dignity at the door”
State of the art in every technological area
The employer of choice in the area
…our financial challenges were sometimes overwhelming. This hospital was located in an area where the average salary was only $22,000 a year, the population continued to decrease, and there were three other hospitals within about eight miles of this facility.
Due to these very real financial challenges, many of my nights during the eleven years of my presidency were sleepless ones. Consequently, it has become my personal mission in my consulting efforts to help remove the barriers for my former CEO peers so that they can meet their personal goals through a “Get, Find, or Save” philosophy.
Under the “Get new sources of funding” category, one of my successes was that of creating alternative solutions to very challenging problems. Many times we found new financial resources by following the “Road Less Traveled.” Although not all of these journeys were fruitful, the ones that were deserve to be replicated, so that other CEO’s might generate funds for their organizations using knowledge learned and perfected through these personal trials and errors. Included in this list were efforts in areas such as sophisticated diagnostics, the use of new high technology modalities, high-touch integrative medicine, special packages for wellness and prevention, a community workout facility, the use of molecular testing, and many more.
The “Find” portion of this equation comes from my associates at SunStone Consulting. Their particular skills and talents learned through years of work with the largest accounting firms have resulted in unique, proprietary software and knowledge that allows them to uncover monies already generated by your organization that otherwise might never be collected: Worker’s Comp, Transfer DRG’s, Pharmacy Charge master analysis, and a half dozen more areas bring these funds straight to your bottom line.
Finally, the “Save” piece of this puzzle is coming from a dozen new ideas, products, opportunities, and technologies that until very recently were generally unknown. Everything from software that provides your physicians with Continuing Medical Education Credits for researching their own patients to new Hazardous Medical Waste Recovery to FDA-approved technologies to identify wounds that have not yet manifested themselves. All of these are on the pallet for potential use in a hospital or clinical setting.
As the Executive Director of a 501(c) 3, nonprofit organization back in the early 1980’s, I remember hearing for the first time a hard core description of the personal qualities that should be considered by the executive when looking for a board member. While the original board member recruitment philosophy had been to seek out people who would either Work for or would bring Wealth or Wisdom to the organization, this particular advisor said, “We are looking for people who will Give Money, Get Money, or Get off the Board.”
Well, if you are looking to find already-earned yet not collected resources, to create new resources, or to work with companies that bring you extensive savings and value, or if you are just looking for a little more sleep, look to those who have successfully navigated the white waters and thrived.
Let me be the first to admit that I was and am all about change. Change has been the only consistent thing in my life. Today, however, when the deficit projection was revealed to be nine trillion dollarsover the next ten years, my non-economist mind began to wonder where this is all going?
My son-in-law is coming home in the next several days from a one year deployment that saw him in harms way in Iraq for the last eight months, and now we all sit with our fingers crossed that we will not be facing a similar deployment not too many months from now to Afghanistan.
How does one maintain two wars, keep soldiers stationed post-World War II in Italy, Germany, and Turkey, to name a few, and in South Korea plus continuing to remain in Iraq, and now push more and more into Afghanistan without bankrupting this country? Is it possible that very very smart people are not capable of figuring out that in a down economy, the finances will continue to go south until we are, like the USSR in the Cold War, going broke?
When do we begin to see that the previous several administrations lead us into a mindset of borrowing against our future to the extent that we may not have a future, and when will we say, “Okay, enough, let’s stop feeding trillions into wars, and start trying to figure out the rest of this economic equation?” It clearly is no longer a war on terror, but what is it? If it is an economic war intended to create jobs a.k.a., the argument for or against the F-22 cuts, can’t we find a better way?
The people who seem the most upset about the health care debate are clearly the people who have healthcare, and the people who are least likely to speak out are the young women and children who have no coverage. Not only will they not speak out, they also don’t, for the most part, vote. If anyone believes that we are not in some way paying for the 46 or 47 million uninsured now, they are clearly delusional. Ask a hospital CEO how much the facility charges for an aspirin or a Q-tip. It’s not because these items cost so much more in a hospital setting, it’s because there is not enough money to go around when patient after patient presents at their doors without healthcare coverage.
Far be it from me to take a political stand on such complex economic matters, but it does seem very certain that our futures are tied inextricably together and, unless we slow down our expenditures, find ways to be more fiacally responsible, and, take care of our fellow man, we seem to be heading down a very destructive path. Alan Greenspan’s admission of missing the economic targets of not too many years ago rings in my ears as he said, “I underestimated the greed.“ Maybe we have all underestimated the greed for too long.
As a professional giver of advice, let me conclude by saying that we can make this work. We can pull back the reins, slow the spending, and still move the economy. It’s no different than managing our own personal economics; live below your means, save, take care of the necessities, and realize that not all belts can wrap around a 44″ waist. But all of this takes some serious discipline, something that our leaders seem to have been missing for a very long time. We can’t continue to talk our way out of trouble; serious, positive action is the key.
In January, my journey to create a new division for SunStone Consulting, LLC, began, and, with the economy in a deep slump, it appeared to be a journey fraught with almost insurmountable challenges. How does one begin a new division during a time when most organizations were digging deeply into self-preservation mode?
Outer Banks, NC | Photo credit: Generation Y Travel
The first concept that we explored was to help organizations, groups, councils, and associations assist their members while providing either a stream of income or discounts for these organizations. Several companies responded positively to this idea: Chambers of Commerce, Hospital organizations, and others signed on for involvement in these relationships.
By March, nearly 20 companies had come on board and 12 more have followed since then. We brought on two additional marketing specialists to assist us with these contacts. The areas of interest ranged from Environmental to Government; software to construction projects, from hazardous waste to fund raising, building quality initiatives into employee job descriptions; and economic development to educational training for management.
Once it was clear that this component of the new division was going to be functional and effective, we placed our focus and emphasis on direct consulting, which, due to the economy, was a much greater challenge. This effort started very slowly as organization after organization expressed sincere interest but most also faced serious budgetary challenges. Of course, for SunStone Consulting’s other financial divisions, because they specialize in finding the money that typically was already earned by the hospital or assisting with compliance and billing issues, business remained strong.
During this time some very interesting assignments appeared including: a university wellness program, multiple brain-oriented companies, as well as two PTSD, and two combat wound injury-related programs. This part of the new division is now beginning to flourish with assignments ranging from the military to a hospital-based disaster recovery center, from telemedicine in rural hospitals to development efforts in Indiana, New Jersey and Pennsylvania, and California.
As we move forward into this next quarter, it is clear that the new division will produce results through rewarding relationships for all companies involved.
Some of you have asked me how this effort relates to having been a hospital CEO, and that answer is clear. As a CEO, my days were filled with challenges, with literally dozens of special efforts emanating from numerous areas. For example, here is a typical list of topics dealt with on a CEO’s agenda: meetings regarding the following:
Community Fitness Center
Tissue Repository
Breast Center
Hospice
OB department expansion
Pharmacy
Operating Rooms scheduling
Emergency Department
a construction project
marketing efforts for a new initiative
finance
If you can’t multi-task, the position of CEO is not a place to be, and keeping up with these consulting clients is just as stimulating.
By March, nearly 20 companies had come on board and 12 more have followed since then. We brought on two additional marketing specialists to assist us with these contacts.
Since stepping back from my CEO role, I have had time to reflect upon the toll that a position like that can take on any individual regardless of the thickness of their epidermis. I have come to realize that anyone who is completely in charge of an organization faces many of the same challenges.
As a young man, I had serious delusions about what it would be like to be in the role of President. It was kind of a Superman fantasy: Yes, I would be kind, understanding, and fair. It would be my further commitment to be honest, forthright, and ethical in every way. My obligation would be to the people and the patients at all levels. My motto would be “Truth, justice, and the American way.”
Then the big day came, and my tenure began. It took about an hour to realize that it was now my personal responsibility to do everything necessary to generate all of the money needed to make payroll for the employees. In an area with a disappearing population base, that was an extremely challenging task, and as the Sisters of Mercy used to say, “No money; no mission.”
During the money quest, the issues of loyalty and fairness were always rearing their ugly heads. Could you, in this very self-centered culture, ever really expect people to be loyal no matter what your commitment had been to them? I would minimally try to play the role of a benevolent, servant-leader.
I was the guy who would reach out to people who needed a break and then provide them with that break; sometimes against the conventional wisdom. What did I expect in return from them? Simple loyalty. Time and time again, however, those same people who might never have had the opportunity that they were given would turn on me. It became almost predictable.
It took them a long time to believe that they were capable of doing the job that I had personally selected them to take, but usually as soon as they reached their comfort zone they would begin to turn away. Maybe it is just human nature, but even Mighty Mouse would have been disillusioned by this recurring situation.
The other CEO reality is that fairness is situational and so subject to interpretation that it becomes impossible to please or satisfy everyone. The nature of our new collective employee psyches seems to be one of “If it’s not done directly for me, then it’s not fair.” The list of individuals who were brought to the leadership stage over my 22 years in healthcare was voluminous. Dozens of people were given consideration for their education, salaries, promotions, and advancements, yet if one other person was recognized in a similar way, the hue and cry was often, “It’s not fair.”
So, looking back over two decades of running hospitals, foundations, a research institute, and several other spin-off companies, an appropriate summary for any future leader is to “go with your gut.” With that in mind:
You are not now and will never be a superhero.
You are a human being with human frailties.
You cannot right the world or repair dysfunctional childhoods, marriages, or lifestyles through your benevolence.
However:
You can do what you believe will result in the most good for the most people.
You can respect the fact that your efforts could help to continue payrolls for hundreds or even thousands of families.
You can embrace the fact that the vast majority of your mistakes will not be fatal to anyone, but you also need to learn to cut your losses and deal with the disloyal.
One of my mentors used to pull me aside periodically and say, “Nick, you’re doing a great job, but you need to lighten up. We only pass through here once. So, try to enjoy yourself, my friend.”
F. Nicholas “Nick” Jacobs, FACHE, is the international director for SunStone Consulting, LLC. In that capacity he provides transformative, strategic solutions to companies, organizations and individuals. He has more than 20 years experience in hospital management, with an acknowledged reputation for innovation and consumer-centered leadership.
Throughout his career, Mr. Jacobs has developed a reputation for innovative leadership that focuses on effective delivery of service that puts the patient’s needs and concerns first. He speaks extensively on this topic and has spoken for the American College of Healthcare Executives, American Hospital Association, and the World Health Organization numerous times.
These are just a few of the very effective mechanism that can be introduced to create healing environments in hospitals. Healing gardens, labyrinyths, 24 hour visiting, double beds in the OB suites, and the beat goes on and on with decorative fountains, fireplaces, skylights, balconies, but most importantly dignity and respect amongst all staff and visitors toward patients. So, “Healing Hospital” has multiple meanings. Healing will take place more quickly, thoroughly, and meaningfully in these facilities, and the entire staff will be charged with the promotion of healing by creating an overall healing environment.
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If we, as a country, do not believe that we are paying for these patients in some real way, then we are not cognizant of how the system is being contorted in order to allow hospitals to remain solvent. When you hear individuals complain about the 
The laws that address data breaches involve not only civil but also criminal penalties, and the individual laws of various states are most times very different. It doesn’t matter if your business is located in only one state. What matters is where your customers are from, and if they are a diverse group, you must comply with each
