Archive for the ‘Hospitals’ category

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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Acupuncture why not

February 19th, 2020

 

Accupuncture, why not?

NICK JACOBS

Published Tue Feb 18, 2020 8:15 PM EST

In a recent article in Time Magazine, Jeffrey Kluger wrote “The Mystery of Acupuncture.”

In the article he said the “World Health Organization has declared acupuncture a useful adjunct for more than 50 medical conditions, including chronic stress.” He went on to write that the NIH (National Institute of Health) also agrees and has endorsed acupuncture as a potential treatment for migraines, menstrual cramps, abdominal pain, tennis elbow, and nausea resulting from chemotherapy and more. “The fact the Mayo and Cleveland Clinics have embraced acupuncture and groups like the AMA have gotten states to designate acupuncture as an essential health benefit is more than significant.”

Kluger went on to say that more than 3.5 million adults and 80,000 children use acupuncture in the U.S annually. The military is using it for PTSD, pain disruption, and an assortment of ailments not the least of which is lower back pain. With all this information and these overwhelming statistics, why aren’t more of us using acupuncture?

If it’s fear of needles, you’re uninformed. These needles couldn’t be any smaller and less noticeable. As stated in the article, “The analgesic impact of a tiny needle is more than worth it.” The real beauty of this ancient Chinese practice is even if the practitioner doesn’t do it perfectly, it can’t hurt you.

Probably the most powerful potential use for acupuncture is in the treatment of addiction. Considering that more than 50 million Americans suffer from chronic pain, acupuncture as a treatment for chronic pain is one possible alternative to OxyContin and other addictive pain drugs. Of course, spinal manipulation by a physician trained in osteopathic medicine, a DO, or a chiropractor, plus yoga, and potentially non-addictive cannabinoids are also being used.

There have been more than 19,000 papers written about the efficacy of acupuncture, and recently I saw statistics on back surgery that were less than encouraging. According to recent studies, back surgeries are sometimes as low as 30% effective. Moreover, having been personally a regular sufferer from back pain, osteopathic manipulation, exercise, weight loss, and acupuncture have all been medical gifts that have worked beautifully for me over the years.

The question then becomes, why not? Why aren’t you trying acupuncture? Is it because you don’t understand how it works? Is it because some medical professional has indicated it is “woo-woo medicine?” Or is it because you’re afraid of the tiny little needles?

Maybe it is because you’re concerned it might be harmful in some manner? If you could be assured all these are really non-issues, what else would prevent you from trying this?

I’ve often quoted the book “Change or Die” which examines the thesis that many of us would rather die than change. I’m sure this idea sounds incomprehensible to many of you, but think about it. We are inundated every day with advertising, political narratives, and scientific treatises sponsored by organizations, businesses and associations that want us to remain loyal to their financial interests.

I’ll never forget the conversation I had with a scientist who once told me that hydrogenated fats were the biggest medical experiment perpetuated on mankind without our knowledge. It prolonged the life of food on the shelves while killing half a million Americans each year from inflammatory disease.

Industrial farms, Big Pharma, the soft drink and snack food industry all have their stakes firmly planted in the ground, or more specifically in our brains, with millions or billions of dollars of advertising to indoctrinate us over the years.

One of Jerry Seinfeld’s routines talked about food from his era, including boxes of chocolate chip-filled mini cookies that were sold as cereal.

We Boomers all remember hydrogenated margarine that sat on the table all day without refrigeration, those wonderful Twinkies, and, of course, physicians who were featured in ads endorsing the health benefits of cigarettes.

Try acupuncture. It really can’t hurt you.

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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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Memories of a new puppy and Pet Therapy

December 14th, 2016

It was a brisk, early, spring, weekend morning and Joanna, then a 16-year-old, now mother of four, said that we needed a transition dog. Tessie, our part-golden, part-black lab, part-border collie was getting long in the tooth, and it was our custom to always bring a replacement puppy into the house when the older dog was beginning to head toward the rainbow bridge.

So, at Jo’s insistence, we drove to a dog pound about 23 miles away. When we got there, it was closed, but she kept pushing hard for a new puppy.

We then headed for another sanctuary for abandoned dogs, a no kill shelter. That shelter was about 31 miles in the other direction. We arrived right before closing time and were directed to a room that was filled with a half dozen beautiful, little, white puppies.

The puppy that jumped the highest and yipped the most was not our choice. It was instead it’s little brother, the most loving and cuddly of the brood. The volunteer said that he was probably part sheep dog and part poodle, but we really didn’t care what he was because he was adorable.

We paid our fee, packed him up, jumped into the car and headed home to our older dog Tessie for what would become months of mothering, teaching and unconditional love and patience. Jo named him Brody, and it fit him perfectly.

Tessie taught him how and when to go to he bathroom and, she taught him to be terrified of thunder, to bark at the meter readers, to play with the cats as if they were his very best friends, and to beg from me at the table. While Brody reminded Tessie how to play, he became her adopted puppy.

One evening, a newly roasted turkey was placed on the stove to cool. While working on my computer, I heard some noise in the kitchen. The next thing I heard was puppy feet on the steps and then a thump, puppy feet and a thump, puppy feet and a thump. Then Brody, the puppy appeared at my chair, his belly was completely distended, and he smelled of turkey breath. He and Tessie had eaten the entire thing. Kind of like the Butkus dogs on “A Christmas Story.”

Well, Brody grew to be the best dog and best friend ever. In fact, when my mother visited, she would hold complete conversations with him as if he was a human being.

In her obituary I wrote that “She often scolded her sons for not talking enough to their animals.” Somehow the Pittsburgh newspaper accidentally changed that line to “She often scalded her sons for not talking enough to their animals.” Only those who knew my mom could have ever appreciated the absurdity of that printed mistake. So, when people said they were sorry and scanned my body for burn scars, I knew why.

It was about six years after he joined us that I went on a heart healthy diet that excluded all meat, and, since I was the only sucker in the family who would sneak him table scraps, he had to follow my diet. He became a vegetarian dog. In fact, with some of the new fat free products and make believe meats, I always made it a rulethat if Brody wouldn’t eat it, I wouldn’t eat it either. That diet extended both of our lives.

After Brody died my life became doggy less, and I’ve never gotten over that disconnect, but with my schedule and all of the traveling that I do, it would not be fair to either the dog or to me.

So, I always spend considerable petting time with my daughter’s dog, Chipper, and believe me when I tell you that when I’m around, he is completely spoiled in every way because I’m just a dog kinda guy.

And in Tessie’s memory I added pet therapy at the hospital while I was a CEO, and I’m still convinced that those dogs provided as much healing as many of the drugs.

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People You Need (and People You Don’t)

October 31st, 2011

Tom Atchison - http://atchisontom.com/ - Nick Jacobs, FACHEA few weeks ago, I mentioned that I was in Santa Fe, NM for an ACHE educational training course. Since then, I’ve been thinking a lot about some of the things that were said there by Master Instructor, Dr. Tom Atchison, Ed.D. (a/k/a, Yoda), the President and founder of Atchison Consulting Group. In fact, a few of the tidbits that he offered have been wedged in my brain to the point of obsession. It took me 40+ years to learn some of this, and now I am dying to share it. If you are a boss, a manager, or an employee, it applies equally to everybody, and the information has been valid for as long as mankind has roamed this earth.  So, thanks to Dr. Tom, I can finally articulate it.

SSCS…yep, that’s it. SSCS. If you know what these letters stood for, you can stop reading now, but let me explain. In any group of workers, volunteers, employees, leaders, there are four very distinctive types of people:

Stars

There are the stars, and we all know the stars. No, not the “I’m going to get paid a million dollars to pose for a magazine” or for “selling the rights to my make-believe wedding” kind of stars. Rather, these are the bust your butt, be on the right seat in the bus, make it happen, hard working, cooperative, dedicated stars. They’re the people who lead the way and make things happen.

Skeptics

The next group of employees is the skeptics. Skeptics are generally really good people, sometimes slightly below the star category because they question everything in a meaningful, truth-seeking manner. The only problem with the skeptics is that they take a lot more energy than the stars. You must keep them informed, up to speed and appeased. Once they do get it, they are on board and make things happen in a big and important way. It’s just a little harder to get them there.

Cynics

Next we have the cynics. These people are insincere, and they are motivated by self-interest. They question everything, but more importantly, they dis everything, don’t cooperate and try to block every idea, action or activity. They are the ones who work behind the scenes to make sure that things don‘t get done, that people don’t cooperate and then openly criticize each and every idea no matter how sound the concept may be.

Slugs

Finally, there are the slugs. Usually they are nice enough people, but on a scale from one to ten with the stars being a ten, the slugs are exactly what they sound like. In fact, in reference to printing, the word slug came from traditional hot-metal printing where a strip of type metal is used for spacing that is less than type-high, hence a slug to fill in SPACE! They are space-fillers.

So, here’s what leaders who were present at this workshop were told. The cynics suck your life out of you by continuously challenging and undermining everything, and the slugs add no value to the organization. The problem with stars is that they are often taken for granted, or passed over because they are consistently amazing, and because we spend so much time dealing with the cynics and redoing everything the slugs don’t do.

His solution? Fire ‘em. (The slugs and cynics, that is.) Now if that seems a little harsh, maybe it’s because we all know and love both slugs and cynics. Unless you’re a tenured professor or the boss’s kid, it’s really tough to stay in a job where you do these sluggish and cynical things over and over again. Of course, if you fall into either of those categories, you could change!

Final advice? Be kind and nice and wonderful to the stars and the skeptics, and spend time explaining everything to the skeptics so that they embrace the concepts and dreams and vision and move forward with the rest of the team. Oh, yeah, and help the slugs and cynics find work, especially if you can find them work with a competitor because they will be the gift that keeps on giving cause they’ll probably be cynics and slugs for the next place, too, and all of those disgruntled patients and customers will come to you!

The new Brad Pitt film, Moneyball offers some object lessons here…

“We’re building a baseball team, here. We’re not looking for Fabio. We’ve got to think differently!”

“Who’s ‘Fabio?'”

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Sometimes it’s Better to Punch a Bear in the Face

March 27th, 2011

I’ve tried to avoid controversy, but since my reading audience has dropped by a few thousand readers after departing my previous CEO position a few years back, I doubt that this will cause me any more problems as a consultant than I’ve already caused by expressing my opinions in previous posts. So, for those of you who are still dependent upon me for financial support, I apologize.

This morning, I read an article in the Pittsburgh Post Gazette by John Hayes entitled “Meet Your Neighbors: The Bears,” about black bears living in Pennsylvania. The essence of the piece is that there are about 18,000 bears living among the 12,000,000 citizens of Pennsylvania, yet there are only about 1,200 bear-related complaints to authorities a year. The bigger issue, however, is that there have been no reported deaths caused by black bears. They don’t eat people.

During this same period of time, I read a post by my friend and fellow patient advocate, Dale Ann Micalizzi, referencing an article about the former president of Beth Israel Deaconess Medical Center (BIDMC) in Boston, Paul Levy,  another nontraditional hospital CEO who espouses transparency. “Admiting Harm Protects Patients” is the article appearing in today’s Las Vegas Sun. In my book, Taking the Hell out of Healthcare, which Paul graciously endorsed on the cover page, we talk about patient rights, patient advocacy, and the need to have someone with you during your hospital stay to ensure that you are not going to become a statistic. In today’s article, Paul is recognized for the work that he did with his blog — a blog which I encouraged him to write and to keep writing — in which he challenged the hospitals of Boston to reveal their mistakes, to stop keeping the infection rates and other problem statistics secret.

Because he was trained as an economist and a city planner, Paul Levy was considered an outsider by his peers when he took over the troubled Deaconess hospital, but as he quickly turned it around, he did so through the eyes of an outsider. In December 2006, he published his hospital’s monthly rates of infection associated with central-line catheters, which are inserted deep into the body to rapidly administer drugs or withdraw blood. These central line infections, which can be caused by nonsterile insertion of the catheter or not removing it soon enough, are preventable. The Centers for Disease Control and Prevention estimate 250,000 central-line infections occur annually, costing $25,000 each and claiming the lives of one in four infected patients.

Dale Ann Micalizzi (L) and Paul F. Levy (R)  - Healing Hospitals - F. Nicholas Jacobs, FACHEHe then challenged the other Boston hospitals to do the same. He was accused of self-aggrandizement, egomania, and numerous other witchcraft-like things, but the bottom line was that the number of infections went down, and they went down because the staff and employees wanted to do better and wanted them to go down.

What else happened at Beth Israel Deaconess?

• Hospital mortality of 2.5 percent, which translates to one fewer death per 40 intensive-care patients.

• Cases of ventilator-associated pneumonia, from 10-24  per month in early 2006, to zero in as many months by mid-2006.

• Total days patients spent on ventilators from 350-475 per month in early 2006 to approx. 300 by mid-2007.

• The length of an average intensive care stay from 2005 through 2009, the average stay was reduced by a day to about 3 1/2 days.

(See my previous post on outrageous claims at my prior place of employment.)

Well, in today’s article about the bears, I read that “when bear attacks occur they are generally very brief, and injuries can include scratches and bites.”  Here’s the part I had not anticipated from the bear conservation officer: “Fight back, don’t play dead.  Unlike other North American Bears, black bears don’t consider people to be food.  When it realizes what you are, or gets a painful punch in the face, it is likely to go away.” I believe it’s a useful metaphor.

If you or your organization would like to hear a CEO or two speak about patient advocacy (and way better healthcare), I’m sure I know a former teacher/musician and a former city planner who would welcome the invitation.

Patient advocacy is in your hands!

Health 2.0 Leadership (1 of 2) from Nick Jacobs, FACHE on Vimeo.

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Veratherm

February 3rd, 2011

For the past 25-plus years, my personal commitments, both intellectually and emotionally, have been directed toward helping to make positive changes in the healthcare system worldwide. It’s been my great pleasure to have had the opportunity to connect with such organizations as Planetree, and to work with them to enhance and promote their philosophy of integrative medicine and human touch. We have watched them grow from three to more than 600 affiliated hospitals. It has also been exciting to have had the chance to work with organizations like the American Board of Integrative Holistic Medicine (ABIHM), a truly transformational healing organization. Their laser-focused goal is to reach more and more physicians worldwide to assist them in becoming certified in the techniques of holistic and integrative healing arts.

Along with these high-touch organizations, I’ve also been privy to advancements and discoveries made within the research field. As a former hospital CEO, and Founder of a medical research institute, I have been exposed to both the peaks of promise created by medical technology and the valleys of disappointment that have evolved from those unfilled expectations generated by the promises of that same technology.

Veratherm - ThermalTherapeutic Systems, Inc. - Nick Jacobs, FACHE

The subject matter to be addressed in this next blog segment is not a false promise. This particular medical device, the VERATHERM™ system was designed, patented and FDA-cleared as a portable hyperthermic perfusion system. There are two other FDA-cleared devices that have been used for this procedure – one which has been retrofitted and the other is somewhat outdated. There are also experimental-type devices that have been pieced together for use in some research facilities and academic medical centers, but they are not FDA-cleared and cannot be marketed.

What VERATHERM™ does provide is a very real opportunity for surgeons and perfusionists to not only standardize hyperthermic perfusion in the treatment of cancer but, potentially, to help to significantly extend the lives of those patients touched by these surgeons and the use of this technology. Most recently, I have had an opportunity to not only see this medical device but also to work with the extremely passionate individual who is in charge, Raymond Vennare, CEO of Thermal Therapeutic Systems, Inc. Raymond has helped to develop and bring to market this compact and mobile perfusion system that, I believe, will contribute to helping literally hundreds of thousands of people worldwide. In my exploration of hyperthermic perfusion, however, I have discovered that only a tiny fraction of those patients who could be helped by the technique that is enabled through the use of this device have any idea that it even exists. Hence, the reason for this blog. VERATHERM™ not only does exist, but the procedure performed by these surgeons and perfusionists can also have a dramatic impact on certain types of cancers.

Please understand that my interest in hyperthermic perfusion in the treatment of cancer revolves around a commitment to those individuals – people like my father, and Raymond’s father, mother and brother who, because products like this were not available, were all lost prematurely due to different types of devastating cancers.

How does this work? After complex surgery for the removal of the tumors in specific body cavities, such cancers as the colon, appendix, stomach, lung and even some types of metastatic breast cancer, the appropriate fluids can be heated in order to perform an intraperitoneal or intrathoractic lavage. These heated fluids then are circulated through the impacted body cavity as needed to help eradicate any remaining cancer cells. Sensors and probes built directly into the VERATHERM™ Console and Disposable Kit efficiently monitor temperature, pressure and flow of heated and unheated sterile solutions while protecting the patient, physician and profusionist.

Let me close by saying one more time that, due to the procedure enabled by this medical device, the lives of many patients have been extended by as much as three-to- five years. It’s not technically impossible to do, but, as a patient, you have to know about it to request it, and only a handful of cancer centers in the entire country have begun to even look at the creative re-use of profusion equipment for non-traditional surgical lavages such as this.

You read it here first!

The Parable of the Starfish

One morning an elderly man was walking on a nearly deserted beach. He came upon a boy surrounded by thousands and thousands of starfish. As eagerly as he could, the youngster was picking them up and throwing them back into the ocean. Puzzled, the older man looked at the young boy and asked, “Little boy, what are you doing?” The youth responded without looking up, “I’m trying to save these starfish, sir.” The old man chuckled aloud, and queried, “Son, there are thousands of starfish and only one of you. What difference can you make? Holding a starfish in his hand, the boy turned to the man and, gently tossing the starfish into the water, said, “It will make a difference to that one!”

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Finding the Cure…for Bullying

January 21st, 2011

No workplace bullying - Nick Jacobs - healinghospitals.comThis week, NBC’s Today Show featured another story about bullying. As I have have mentioned in previous posts here and elsewhere, I believe that bullying is the quintessential cancer on our lives in places of business, in the military, politics, and relationships of all types.  The good news – actually the very good news –  is that there has been some incredible work being performed on this topic through the efforts of Dr. Matt Masiello at my former place of employment, the Windber Research Institute in Windber, PA.  Grants through the Highmark Blue Cross Foundation of Pittsburgh have fueled this initial effort and the academic and quantitative analysis being done by Clemson University has documented this work.  I believe that this joint effort is a magnificent  example of what can be done to change the future course of events currently being controlled by bullies.

The Today Show story that I saw featured the Massachusetts school where, due to cyber-bullying, a young girl committed suicide last year.  Apparently, another girl is now having the same experience at the same school. With the help of programs like this comprehensive anti-bullying program, the former Secretary of Education from PA, Jerry Zahorchak, (now Superintendent of the Allentown PA school system), embraced the effort to quell and discourage this type of destructive behavior.  And the program, under the direction of Dr. Matt Masiello has successfully been introduced across the  entire State of PA. (Matt had started the Allegheny County’s Goods for Guns program in 1994, when he was the head of pediatric intensive care at Allegheny General Hospital. To date, this program is responsible for collecting more than 11,000 illegal guns from the streets of Pittsburgh.) Matt has had the same success with this anti-bullying program. Now, both Massachusetts and Maryland are looking into embracing this effort.

This anti-bullying program is based on a European program with which Dr. Masiello had become familiar.  This is a school system-wide effort that is very well documented and results in tremendous awareness and reduction of bullying at all grade levels.

The trainers bring a group of teachers and administrators together in the school system, and then “train the trainers” as to how this effort can become part of the philosophy of the school.  They start the training in the spring, typically launch the school wide effort in the fall and run it for at least a year. During that time, detailed records are kept measuring outcomes.

Matt Masiello, MD - Windber Research Institute - Nick Jacobs - Taking the Hell OUt of Healthcare

Matt Masiello, MD

Matt is a wonderful physician, a truly giving person and a saint of a man who is the only U.S. representative on the board of the World Health Organization’s Health Promoting Hospitals program. I hired him before I left Windber Research Institute, and he has worked tirelessly to address both this problem and the problems of childhood obesity.

The Olweus Bullying Prevention Program (Olweus.org on the web, @Olweus on Twitter) has impacted more than 400 school districts and 20% of all school-aged children in Pennsylvania. It has also had up to a 50% reduction in student reports of bullying …and bullying others.

For more information, please contact me or Dr. Matthew Masiello at the Windber Research Institute.

Michael & Marisa’s anti-bullying song – “The Same”

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Engage With Grace

November 26th, 2010

Excerpts from: Chapter 18 of  Taking the Hell out of Healthcare

by Nick Jacobs

When Dying is Finally Enough


The Dichotomy of Death

On Thursday evenings from 1970 until 1975 there was a standing invitation to play pool at Jim’s Dad’s house.  Now, the truth of the matter was that, as young school teachers, most of us barely owned houses, let alone a pool table, so one of my colleagues parents’ opened their home to allow us to have some safe recreation. During those innocent days of my mid twenties, many of the world’s problems were solved. Jim’s father was a wise old philosopher in his early sixties,  a retired coal miner who loved to be around the kids.

One night, we began discussing religion, faith, and death as we mechanically yelled out lines like “16 in the side pocket.”  The discussion became particularly heated when it came to hypocrisy of our healthcare system. We kids or at least this kid listened in amazement as old Carl explained how life was in the old days. His relatives from the old country had salves and ointments, herbs and mustard plasters that took care of virtually every ailment known to man, and when they failed and death was inevitable, death was accepted. He used to laugh and say, “But now, everyone wants to go to heaven, but nobody wants to die.”

It was then that the subject changed to today where there was truly a cure for nearly everything, or so it seemed at age 23.  Get sick? Take a pill or get a shot. But then, a few weeks earlier, my father had been diagnosed with lung cancer and was given less than a three percent chance of survival. As Carl and I discussed this situation, he put his arm on my shoulder, and wished me luck. At 58, my dad was still a young man, and neither my education, my prayers, nor my love would be able to save him.

The American way of death seems to be that death is not acceptable at any age, at any time or for any reason. Death is rarely seen as the inevitable future that we all face. Our American system of death is that it should not  happen. Death is no longer accepted as part of life. Oh, yes, we hear those words, but when it is our loved one, they are very difficult to embrace or articulate.

Our medical schools, our nursing schools, our technology schools train  our students in most cases that death is failure. This is why we have a system of health care that is crumbling under our very eyes. Through drugs, machines, and other advances, we have the ability to allow individuals to live longer than ever in the history of mankind. It is absolute reality that more people will have an opportunity to live longer than 100 years of age than ever in history, but at what cost, and with what degree of quality?

Engage With Grace - The One Slide - Nick Jacobs, FACHE - Healing Hospitals - Taking the Hell Out of Healthcare

Because of our culture, we fight death until we are shocked by it, and the result is that we, as families miss the wonderful opportunity to allow our loved one a peaceful, beautiful, comforting transition.

Palliative care, a.k.a., hospice care, provides that transition.  In a hospice program, we experience love in all forms until death. Hospice provides a womb-like environment where love can replace fear, where family can be the center of that love, and where the transition can be a beautiful, healing journey for everyone involved so that it becomes a peaceful transition.

What Can You Do?

Do your personal homework. Begin to talk to your loved ones early on about their wishes.  Make those wishes as clear as you can. Do not be fearful that anyone will let you die before your time. Trust that your family or friends can support you in your intentions, and be sure that you put everything in writing that you possibly can. Most importantly, however, try to find peace with yourself.

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