Archive for the ‘Integrative Health’ category

The Patient-Physician Connection

November 28th, 2011

With age, one sometimes begins to accumulate wisdom, and, although I am not one to focus on the woulda, shoulda, coulda opportunities that have passed me by, one regret that I surely have is that I had not met Dr. David Rakel  until about three years ago. Dr. Rakel is the Director of the University of Wisconsin Integrative Medicine program.  He attended medical school at Baylor in Houston, Texas, and completed a family practice residency in Greeley, Colorado.  He is a doctor, a father, an academician, but most importantly, he is a healer.  Of all of the physicians that I have ever known – and there have literally been hundreds of them, Dr. Rakel embraces all that is good in the medical profession.

David P. Rakel, MD - Healing Hospitals - Nick Jacobs, FACHE

David P. Rakel, MD

In his presentation, “Placebo or NoCebo,” David outlined the ingredients present in a healing environment:  1. A relationship with a helping person, 2. A healing setting, 3. An explanation that gives a sense of control of a symptom.  4. A ritual procedure or plan that involves active participation of both parties – patient and clinician – that results in belief towards action.  He spoke passionately about the importance of touch, the intrinsic value of healing, and the fact that something was done with the ritual.  One of my favorite, tongue- in- cheek quotes that David had was from Voltaire: “ It is the physician’s duty to amuse the patient while nature cures the disease.”

Dr. Rakel talked about the intelligence of being positive while giving the prognosis, showing empathy, empowering the patient, and demonstrating the importance of having a connection between the physician and patient.  I’m sure that I’m not capturing all of the salient points that David carefully made, but I am sure that I understood his commitment to connection with the patient and the significance of using as many positive words as possible to convey that connection.

Once again, a great quote from Dr. Rakel revolved around the fact that you get better faster if you have unconditional love from your pet than a bad connection with your doc.  He and his research on the common cold both suggested that, “It is better to stay home and be licked by your dog, than to spend time  at a clinic with a grumpy doc!”

His recommendations to his residents and to all of the physicians to whom he lectures is that the physician needs to display empathy, compassion, patience and the ability to listen.  His counsel to meditate revolved around the need for us to get out of our chaos and influence self-healing mechanisms.  He described this journey from awareness to awakening to authenticity and finally to awe where the closer that we get to authenticity, the more beautiful our lives become.

Dr. Rakel then launched into numerous studies that evolved around the placebo effect such as the study where arthroscopic knee surgeries were “faked,” but resulted in positive outcomes.  By referring to obesity as working toward optimal weight; chronic pain as myofascial health, depression (and this is my favorite) as potentially happy, the patients are not labeled with negative implications, and we accomplish a shift in our intentions.  Not unlike what Newton, Einstein and Stephen Hawkins have done in physics, perceptions have been shifted by changing the manner in which we observe things.  He said, “How about if we tell the patient that they are potentially happy rather than clinically depressed?” Our intention is reflective of our future.

Finally, Dr. Rakel suggested that physicians protect time in their schedules, create space, create positive patient expectations, be fully present and listen to the patient, that they offer support and collaboration and create a plan by using words that heal rather than words that harm.

Right on. Thanks, Dr. Rakel.

Temporary Immortality

November 8th, 2011

ABIHM Header 1 - Integrative holistic medicine

I’m speaking at the American Board of Integrative Holistic Medicine’s Educational Conference today at 2:00 PM, but have been listening intently to the various presenters — my fellow board members, throughout the event. All of these folks are MD’s who embrace holistic (body, mind and spirit) and integrative (the world’s greatest) treatment modalities for appropriate care in medicine.

I’ve learned about Abraham Flexner who wrote a white paper in 1910 that became the de facto guideline for what would be taught in medical schools; essentially, a reductionist approach to practicing medicine which has led to the modern formula of medical practice, where the physician asks, “What’s your chief complaint.” Then he or she treats that — many times as if it were a stand-alone, unconnected condition, unrelated to any other causal factors.

This type of practice has virtually eliminated the holistic approach and pushed medicine into ICD9/10 codes, (currently going from about 14,000 codes to nearly 68,000…in fact, there’s even one, specific code for “injury caused by riding on the back of pig.)  It all becomes a matter of diagnosis of disorders leading to the prescription of drugs. The U.S. is spending $308 billion a year on pharmaceuticals, which is one half of the expenditures of the rest of the entire world in drug purchases. We’re spending about $14.6 billion on anti-psychotic drugs and $10 billion on antidepressants, alone.

The $2.5 trillion that we are spending on healthcare in the United States is NOT allowing us to live longer than other countries, and the really sad news is that most of these expenditures are for preventable diseases. About 90 percent of our expenditures are because of stress related issues, and when we take such amazing statistics into consideration as the fact that the United States consumes two times more fat than Asia, three times less fiber, and 90 percent more animal protein, it has to make us think a little bit about this course that we are currently pursuing.

If you study the statistics, you’ll see that China consumes less red wine than us…but their population lives longer. Japan consumes less fat than we do, and their population lives longer. Italians consume much more red wine than we do, and they live longer. Germans do everything wrong, i.e., eat high fat, drink lots of beer, eat sausages and fats and even they live longer than Americans. What must our conclusion be? Maybe living in the United States is the problem? (Just kidding . . . but maybe it is the fact that we are so intensely committed to a more-is-better philosophy.)

As a population we eat about 50 tons of food in our lifetime. In fact, it’s probably been closer to 51 tons for some of us, and, for the most part, we’re eating lots of chemicals, insecticides and antibiotics in our unnatural and subsidized corn fed animals, and farm raised fish.

Where am I going with all of this? Have you ever been around a really cocky kid who acts like he or she is invincible? That’s why our highest death rates in the teenage years are primarily related to automobile accidents with Caucasian teens and guns with many of the ethnic teens. They truly believe that they are invincible.

It’s always been interesting to me that those people who have been fortunate enough to have lived charmed lives with no sickness and no close relatives or friends who have died have a certain air of immortality that surrounds them. They are lulled into the belief that they will beat the odds and live forever. We are, in fact, on a finite journey that requires us to provide some self-nurturing, lots of personal lifestyle education and a willingness to try to do what is best for our long term quality of life issues the majority of the time.

The bottom line? as my blogger friend, Paul Levy says in his most recent blog post, we are dealing with “temporary immortality.” So, live every day as if it is your last and take better care of yourself.

Steve, Dean and Nick: Be “Insanely Great.”

October 25th, 2011

Steve Jobs - HealingHospitals.com - Nick Jacobs, FACHE
During this time of economic uncertainty, the recent loss of creative, innovative leaders like Steve Jobs and Dr. Lee Lipsenthal adds to a collective national and personal concern over what seems like a serious lack of truly inventive and ethical leadership. Who will represent the next wave of 50-something leaders, and how will their personal characters influence upcoming generations?

One hope that I have for the future is Dr. Dean Ornish, a man who has been a personal friend, mentor and physician to both Mr. Jobs and Dr. Lipsenthal. To describe Dr. Ornish as a man of character, knowledge and creative medical vision would be akin to calling Winston Churchill a “good dinner speaker.”

Dr. Ornish and I have a long history of friendship, respect and support for each other’s work. Years ago, wanting to avoid being a heart surgery patient, I began to explore alternatives to legacy procedures and regimens. And, not unlike Steve Jobs, whose initial interest was also to avoid having his body violated by surgery, my research led me to the work of a young Dr. Dean Ornish. As soon as I learned more about his extraordinary program for coronary artery disease reversal, it was a simple decision to invest my own personal funds in one of his intensive workshops, held near his home in California.

Dean Ornish at PopTech (2009) - Camden, Maine - Nick Jacobs, FACHE - HealingHospitals.com

Dean Ornish at PopTech, Camden, Maine (2009)

 

As providence would have it, my own work resulted in what became a steady stream of research grants, and my subsequent personal decision to include Dr. Ornish in our appropriations for the next half-dozen years at the hospital and research institute where I previously served as President and CEO. Each year, I fought to have at least one million dollars invested in the Preventative Medicine Research Institute in California so that Drs. Ornish and Lipsenthal could continue to move forward in their research, as well.

Once, Dr. Ornish asked me, “Nick, what do you really want from our work together?” Without a moment’s hesitation, I replied, “Dean, I want to lose the question mark after the name of the town, ‘Windber.’  Whenever I tell people where we’re based,  they usually respond, ‘Windber?’…’You mean Windber, PA… the old coal mining town?’” Some history here: I had been hired by the board of rural 102-bed, acute care hospital in that historic, rural community to either radically turn it around, or shut it down. For me, the latter option was never a consideration.

Among the many transformational changes we made as part of the turnaround was to be among the first hospitals — and most probably the first rural hospital — in America to implement Dr. Ornish’s evidence-based program that arrests (and can even reverse) the effects of coronary artery disease. The results — with patients of broadly diverse ethnic backgrounds — were so successful, that we were asked to present to the World Congress on Cardiology in Belgrade, Serbia in 2007 on our outcomes and research discoveries, garnered from our experience implementing the Ornish program.

We were also instrumental in introducing the program at other sites for Highmark Blue Cross, as well as a host of other innovations and reforms at our own hospital; from live music playing, to fountains, delicious, nutritious food, cooked by classically-trained chefs, 24-hour family visitation and… wait for it… pajama bottoms for the comfort, dignity and modesty of our patients.

The goal: an environment entirely dedicated to the healing of body, mind and spirit.

The result: among other verified successes, one of the lowest hospital acquired (i.e., nosocomial) infection rates – less than 1%) in the U.S., where the national average is around 9%.

And, yes, we were profitable. Consistently profitable, quarter over quarter.

On one flight in a private plane with my board chairman and me from Cincinnati, Dr. Ornish and I had mutually planned to spend some “quality time” together – collaborating, planning and just trading stories about our experiences. Instead, he wound up honoring an emergent commitment as a personal health advisor and consultant to the leader of an Asian nation, and spent the majority of our flight in direct, one-on-one communication with this person. Awesome? That’s just the kind of guy he is.

My personal hope is that Dean Ornish will take up the mantle for both Jobs and Lipsenthal, as he takes his wellness programs to new levels through mobile apps and enterprise solutions using  iPhones and other mobile devices, and iPads and other tablets, making innovative use of social media technology. (Talk to my friend Mike Russell about that.) My further hope is that  Dr. Ornish’s success as an agent of influence and change will continue to be used in a powerful way, to not only help improve the health of the world, but to continue to positively influence public policy in the United States, as well.

Newsweek cover - Dr. Dean Ornish - Healing Hospitals - Nick Jacobs, FACHEDean Ornish has long been recognized as a leader, a man of character and a visionary, but with the loss of two of his closest friends, the pressure to perform grows exponentially greater. So, my best to you Dr. Ornish. Thanks for your confidence in my work. Keep the faith, and keep up the good fight to make a phenomenal difference in this world, thinking in insightful new ways and never resting on your laurels. As your friend  Steve Jobs famously said at his Stanford commencement address, “Stay hungry. Stay foolish”…but especially the phrase he immortalized early in his career: be “insanely great.”

Going “Rogue” – An Open Letter to Healthcare CEOs

October 17th, 2011

For the past three years, I have had a chance to dig heavily into the future, and I’m pretty convinced that the old saying, “Necessity is the mother of invention,” has never been more true than in today’s healthcare environment.  What was a given before in healthcare management may no longer be so in the future, and since most hospitals only Chief Innovation Officer is the President him or herself, their tasks of visualizing, understanding, deciding and directing the future of the organization will be shifting even more heavily from quantitative deciding-and-directing to the more qualitative visualizing-and-understanding side of this leadership equation.

Although I understand the reluctance of most CEO’s to be on the bleeding edge of creativity, my experiences at my former positions can significantly reduce or mitigate the majority of risk from any decision regarding innovation.

Our new competitive environment has an insatiable appetite for information, access and connectivity and it’s a well known fact that a periodic injection of chaos fosters creativity and forces your co-workers to leverage technology.   Because most organizations already have an environment that is built on trust and collaboration, injecting a little creativity can put their CEOs in more of a position to be the orchestrator and the inspirer.

That Used to be Us That Used to be Us is the new book by Thomas Friedman and Michael Mandelbaum in which they analyze four specific challenges Americans face as a nation—globalization, the revolution in information technology, the nation’s chronic deficits, and our pattern of excessive energy consumption—and spell out what they believe needs to be done to sustain the American dream, and achieve true supremacy based on innovation and excellence.

As an innovator and futurist,  several sections of this book captured my imagination and brought closure to a myriad of beliefs that I have instinctively embraced over the past few decades.  When my responsibilities revolved around the CEO position, I always saw my job as being a contributor to an environment where creative decisions were embraced allowed to happen and then those innovators were rewarded and inspired to keep going.

As the co-founder of a Research Institute, one issue that continually resonates with me is that  “We don’t have enough ‘rogue’ CEO’s in healthcare administration to take risks so that the rest can benefit from both their successes and knowledge.”

Well, fortunately, I’m your guy.

For the last several years I have been out there implementing unusual things, and many of these disruptive ideas are coming to pass in a big way.  I was the first hospital CEO to blog, starting in 2005 (HealingHospitals.com), was an early Planetree board member, created the first breast cancer research center dedicated to the Department of Defense, and filled my hospital with Integrative Medicine, hotel amenities, and music.

Below, I’ve listed thirteen new examples of areas of innovation, in which we’ve been working for the past three years, as well as numerous ways to pay for these initiatives.

 Thirteen Examples of Disruptive Technologies and Practices That Hospitals Need to Understand 

  1. Robotic algorithmic software that improves emergency room flow by 37 to 50 percent.
  2. Financial transaction software that reduces electronic transfer fees exponentially (25% of health care income is from electronic transfers.)
  3. Utilization of nurses and actuaries as patient advocates to significantly reduce your employee health costs.
  4. Preventative medicine reimbursements that can double a physician’s income and add bottom line profits to hospitals.
  5. Treble growth potential of your organization through adding Integrative Medicine
  6. Diabetic retinopathy telemedicine for Family and Internal Medicine docs.
  7. Proteomic and genomic testing creating new “hospital income.”
  8. Peritoneal lavage that extends Stage 4 cancer patients from three months to five years or more.
  9. Bone scaffolding that supports bone growth and virtually eliminates bone infection.
  10. Special bandages that protect and stem cell cocktail sprays that heal burn wounds
  11.  Access to a cancer consortium that allows small and medium hospitals to become Certified Cancer Centers
  12. Hospitals paid “not to play” during an energy crisis as a back-up to the power grid.
  13. Green hazardous waste disposal costing 25% less than traditional methods

If you’d like to learn more about any adopting any of the concepts above, or receive a leadership presentation that will enable your staff to see the opportunities (rather than just the threats) in our current, uncertain environment, here’s where to find me.

Why Are Hospitals The Way They Are? from Nick Jacobs, FACHE on Vimeo.

In Memoriam, Dr. Lee Lipsenthal

September 22nd, 2011

We have not even to risk the adventure alone; for the heroes of all time have gone before us. The labyrinth is thoroughly known. We have only to follow the thread of the hero path. And where we had thought to find an abomination, we shall find…God.
—Joseph Campbell

Such has been my experience with Dr. Lee Lipsenthal. Lee was the co-founder of Finding Balance in a Medical Life, a recognized leader, teacher and pioneer in the field of provider wellness. He was internationally known for his research work with my friend Dr. Dean Ornish in preventive cardiology. He was also well known in the field of Integrative Health, and past president of the American Board of Integrative Holistic Medicine.

Lee Lipsenthal, MD - Enjoy Every Sandwich - Nick Jacobs, FACHE - HealingHospitals.comAlthough Lee’s entrance into medicine was traditional, (a BS from George Washington University, his MD from Howard and an internship and residency at the Medical College of Pennsylvania), he started on his truth path of healing as a resident, where he developed the first multi-disciplinary cardiac rehabilitation program in Philadelphia, a plan that addressed stress reduction, exercise and nutrition teaching.

He then went on to become the Director of Cardiovascular Services for the Benjamin Franklin Clinic in Philadelphia, as well as a staff physician at The Pennsylvania Hospital. In this role, he developed treatment programs for patients with heart disease or risk of heart disease; he developed corporate wellness programs for national companies, and consulted on patients with cholesterol disorders at the hospital.

But who was the real Lee Lipsenthal? Lee was a hero who embraced the adventure and led the way for us all. In an incredibly selfless and positive way, like all heroes, Lee “lost himself and then gave himself to all of us.” He mastered the transformation of consciousness, and taught us all to look deeply inside ourselves. Lee’s life and teaching was always about the powers of life and their modulations through the action of man, and Lee’s actions led us all to a better place; a place of healing, love and understanding. He did this through his words, his music, his soul and his heart.

Lee Lipsenthal, MDLee captured the imaginations of many of us and gently drew us into his circle of positive influence where he provided a psychological center for our lives, he fed our individual and collective souls and he helped us to experience life at its fullest. He often took us to the edge of self-discovery, but he always took us to a place of peace and love. He could literally show us the “belly of the whale,” and then bring us back to a deeper understanding of our lives, our abilities and our spirits.

In many ways he helped us transcend our humanities so that we all could emerge into a deeper reality of serving our fellow man. He taught us that, as a person, if we don’t listen to the demands of our own spiritual and interior life, we will drift dangerously off-center.

Lee was our center. Lee was our friend, our mentor, our spiritual guide and our hero.

Lee passed this week, surrounded by his wonderful, loving family, and our hearts are breaking from the loss, but also reveling in the joy of having known him, having shared him and always loving him.

Learn more about Lee’s extraordinary journey, and his wonderful book, Enjoy Every Sandwich below.

You will be inspired and moved.

E-Patient Dave: Let Patients Help!

August 7th, 2011

After a life-changing experience, Boston area businessman Dave deBronkart has re-named himself E-patient Dave.  My introduction to Dave took place on January 26th, 2010.  We were both invited to make presentations in Washington D.C. at the Health 2.0 STAT event. This was my first rapid-fire Ignite or Pecha Kucha-style presentation, and, frankly, I was at first a little overwhelmed by the brevity. Having been a teacher for the first decade of my career, the experience was similar to following the Assembly Day bell schedule in any school. We had strictly limited time to “tell our story,” and as the first hospital CEO in the country to have had my own blog (beginning in 2005), it was a story that I had told before in cities like Chicago, Las Vegas, Washington D.C., Charleston. What I hadn’t expected to hear that evening was my fellow presenter Dave’s powerful and inspiring story.

Interestingly enough, after retiring from my hospital CEO position in 2008, my passion had been redirected toward the one thing that touched me the most during my 22 years of hospital administration, patient advocacy. It was simple to me. The United States of my youth was changing, but healthcare, not unlike many other professions, has always been filled with terms, attitudes and activities that are mysterious, confusing, sometimes inhuman and usually concealed from the very patients who are receiving the services and benefits. Consequently, it was my desire to reach out to every person to let them in on the “inside track” to healthcare, to share with them the insights gained by my two-plus decades in the business, and to help them get the excellence they truly deserve regarding treatment, respect and care. The result was my first book, Taking the Hell out of Healthcare.

Dave, on the other hand, told the story of his own very personal journey through his near-death experiences as a patient at one of the Harvard Hospitals. His very moving and special story was one that not only touched everyone’s heart; it also demonstrated the very deep and real need for transparency, communication and access to our own health records.  Interestingly, the happy ending to Dave’s story was a twist on what had been a very moving and very different ending for one of my closest personal friends about two decades earlier. So, the good news for Dave was that they had refined, improved and eventually perfected that treatment that saved his life.

The most important aspect of his story, however, was that his physician encouraged him to seek input via the Internet from other people who had lived through similar experiences. It’s where Dave found the recommendation that later proved to be the secret to his survival.

Because of his compelling story, his amazing recovery and the beauty of having lived to participate in his daughter’s wedding, there was not a dry eye in the house. As a patient advocate, I freely admit that included my own eyes. Dave is exactly what this country needs right now. He is a man who is utilizing all of the tools available to all of us via Internet connectivity, and he is pushing hard for positive change that is sorely needed in our field.  So, you go, E-patient Dave… don’t stop now.  In fact, don’t ever stop.

e-Patient Dave de Bronkart, Nick Jacobs, FACHE, Health 2.0 DC STAT meetup #health2stat

People and Ponies

June 26th, 2011

I’ve been periodically volunteering my weekend time to help establish an equestrian healing center where the horses help to heal the people. Although I’m not particularly connected to horses, I appreciate them and like to watch them run freely through the fields. It’s the people in this particular volunteer leadership group, however, who “make me tick.”

Over the last twenty or more years, I’ve had several opportunities to meet healers. Now, don’t get all “New Age-y” here and run out of the room screaming. These people are “pure of spirit,” and have no ulterior motives, except to help other people navigate through this sometimes relentlessly unforgiving maze that we call life. There are two doctors, an RN, two equestrian specialists and a couple of administrative types like me who simply believe that mankind is somewhat intellectually challenged, and not always capable of grasping anything that is not black and white or concrete and factual.

Surely, with all of the things that we purport to believe in religiously, it seems incomprehensible to me that we, as a group, have problems giving it up to the fact that our brains, our spirits and our hearts don’t or can’t play a larger role than that assigned to us by our Primary Care Physicians or our big Pharma companies. For the most part, we believe in an after-life, we believe in miracles, we believe in goodness, but we have problems understanding how an Autistic kid on a loving, nurturing horse can be helped. It’s because there have not been enough control groups, double blind studies or scientific documentations to support the theory, and typically those scientific theories are only scientific law until they are proven wrong, and that has happened plenty of times.

The freedom of having been a nonmedical, nonclinical, nonscientific healthcare CEO was that “I really didn’t care what made people get better; just so they got better.” Consequently, if a golden retriever licking your hand or a clown bopping you with a sponge hammer, a violinist, a massage therapist, an acupuncturist, a flower essence or aroma therapy specialist, a reiki master or a visit from your grandchild helped you, it was all good to me. Pick your passion and start to heal.

The only real way to describe this philosophy was “Open” because that’s what it was and is. One of the amazing aspects of the collection of healers that have gathered to lay the groundwork to make this amazing dream operational is that they also believe that there is much more to healing than a pill or seven pills, and they are more than willing to be open to the spirit of healing.

Of course, one of the problems with this type of work is that you have to “let go” to allow things to happen, and if you are too into the discipline of concrete and only proven science, you will not let enough of your guard down to see what can happen. The problem is that we’ve all heard about the quacks who almost religiously rip off naïve people with magic elixirs or spiritual interventions like Whoopi Goldberg called forth in the beginning of the movie “Ghosts,” but our collection of healers is filled with people who are sincere, well-trained, highly-credentialed and, believe it or not, open to understanding what may otherwise be ignored by the scientists or the traditional establishment.

So, on we roll in search of others who believe that there may be ways to help people that have not been used for several decades or centuries where the brain leads itself into healing or where the switch that turned the gene on inappropriately can be coerced into reversing that physically destructive non-decision. Life is a journey, and when I look back at all of the people who were helped because of things that sometimes make no sense to anyone else, my only response is “Yeah, that’s right.” It can happen, and with the help of other believers it will happen.

It’s Not Just About the Passion

February 20th, 2011

Get up at 3:00 AM, get to the airport at four, fly out at five, arrive in Austin, Texas at 10:20 AM, wait until 1:30 PM to meet three other board members, rent a car and drive to the retreat center. Check–in, have a quick dinner and go to the first evening board meeting; in bed by 11:30 PM, up at 6:30AM and meetings on Saturday until 11:00 PM. Next day: Up at 6:30 AM, meet until 10:30 AM, drive to the airport and fly home through multiple cities; arrive at around 8:00 PM. That was my weekend. Why? Because I am the only non-physician member of the American Board of Integrative Holistic Medicine. More specifically, I am the not-so-token former hospital administrator, and that’s how much ABIHM cares about spreading the word.

This is my third year as a board member, and during that time, it has been my genuine pleasure to watch this amazing group of caring, integrative/holistic physicians build what is fast becoming the most important element in the U.S. healthcare reform movement. Most of them may not be seeing this the same way that I am (i.e., as not only life but also economic saviors), but it is absolutely a fact that their way of providing care is the only hope that we have in this country to contain health care costs and improve the quality of life in America.

As physicians, this group of humble yet brilliant men and women are true giants in their respective fields of endeavor, be it Family Practice, Internal Medicine, OB/GYN, or Psychiatry. They are “top docs” in combining traditional practice with integrative and holistic medicine. They come from prominent medical schools, and some eve teach residents at these schools. Some are in private practice and still others are working for large, prestigious health systems. They have literally written many of the books on integrative and holistic medicine, but the most important thing that I can tell you is that they are all unbelievably positive people; kind, caring, nurturing, thoughtful human beings who are “in it for all the right reasons.” No kidding. All of them.

Why am I so enthusiastic about these folks? They truly practice what they preach. Spending even 50 hours with them revives the soul and confirms my beliefs that every one of these holistic modalities can contribute to our well-being. I’ve heard their stories about the power of meditation, of vigor restored by appropriate diet and things like simple yoga stretching and walking. They casually discuss case after case of people who have been cured or healed of what would otherwise be considered debilitating maladies simply by altering a diet; cutting out the processed foods and sugars, walking a little every day and finding anywhere from 20 to 40 minutes a day to just step back and focus on themselves, their hopes, dreams and positive outcomes through internal journeys of self-exploration and meditation.

So, where do we go from here?

If you’re a doctor, look them up on the web at integrativeholisticdoctors.org, attend their seminars and workshops, meet them, learn about their peer mentoring program, embrace them and their 1200 Diplomates, and, most importantly, get on board. Each and every one of these gifted, inspired physicians has one thing in common: they love their work; they love to go to work, and their patients and staff love to work with them. If for no other reason, look them up for yourself.

If you’re a patient, don’t settle for less. Search their website at and find physicians near you who are certified in Integrative Holistic medicine. Get off those medicine cabinets full of pills, start taking care of yourself, and begin to live the life that you and your loved ones deserve. It’s the only way. The promise of technology has not cured us. The skill of steel from our gifted surgeons has not prevented the malady from impacting us in the first place, and, finally, the pain and suffering keeps going on and on in our lives.

The solution? Find an ABIHM doctor and start the change today.

The American Board of Integrative Holistic Medicine (ABIHM) is pleased to announce an additional opportunity to take the 11th Annual Board Certification Examination, on-site at the conclusion of the iMOSAIC Conference in Minneapolis, MN.  Please take a moment to review the iMOSAIC conference schedule at www.imosaicconference.com, where you will see an impressive program of faculty and topics!

Date: Sunday, April 10th, 2011 at 1:30 PM. Sign in between 1:00-1:30 (preregistration required).

Location: Minneapolis Convention Center, Room 208 AB

Duration: 5 hours allotted; at least 50% of candidates finish by 2.5-3 hours

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!”

Is Saint Vincent’s Just the Beginning?

November 9th, 2010

In an article in New York magazine by Mark Levine entitled, “St. Vincent’s Is the Lehman Brothers of Hospitals,” we are taken on an extremely in-depth and comprehensive review of the sickness and death of one of New York City’s oldest hospitals. It is not my intent to re-create or completely paraphrase this incredible article, but only to select a few of the most poignant facts that literally jumped off the pages and painted a reality for me that was not restricted to the hospitals of New York City.

Photo Credit: Associated Press via WSJ.com

A worker removes signage from now-closed St. Vincent's Hospital.



Mr. Levine’s research revealed that “In 2008, local hospitals spent $3 billion more delivering care than they took in.” He also found that New York hospitals carried twice as much debt in relation to net assets as hospitals around the country, and that, — this is no surprise, as various New York City hospitals close, “the health of low-income and minority residents will be most affected.”

In this commentary, he listed a myriad reasons why these facts represent reality. Included is the $600 per square foot construction costs, outrageous malpractice premiums that are double the national average, 15% higher staffing levels than in other areas, CEO salaries that in some cases have reached nearly $10M per year, daunting demographic challenges, a lack of private physicians living in most communities, lengths of stay that, once again, are at least a day longer than other U.S. hospitals, the 1.4 million New Yorkers who have no health insurance, decreasing Medicaid rates, and a private insurance network that makes considerably more on its New York hospitals than is the case in other geographic areas.

Interestingly enough, as we forged our way through this comprehensive history of how the City system has devolved over the past thirty or so years, we were taken on a journey that is not unfamiliar to many of us in hospital administration. As government swung from socialized (as Mr. Levine states…with a small “s”) medicine to shock-therapy free market, to increased costs in competition, physician recruitment, technology build-up (a build-up that he referred appropriately to as the “medical arms race“), and more movement toward outpatient care, it is very clear that New York City’s hospitals crisis is just one view of a dysfunctional healthcare system that is clearly on a path that could eventually lead to collapse for not only the system, but also for the economy of the country as well.

New York City’s hospitals crisis is just one view of a dysfunctional healthcare system that is clearly on a path that could eventually lead to collapse for not only the system, but also for the economy of the country as well.

This paragraph is one of the most telling paragraphs in the article, “The way forward seems perfectly, if brutally, clear. With private insurers under pressure to cover more patients yet not hike premiums, with federal and state governments facing record deficits, and in a local industry climate with free-market survivalism, many New York (substitute U.S.) hospitals won’t be able to generate sufficient revenue to restore themselves to financial health.”

Image Credit: gothamgazette.com - Nick Jacobs, FACHE - HealingHospitals.com

Interestingly enough, the conclusions reached regarding survival embrace numerous ways of doing business that were not entirely foreign to many hospitals. Included were such concepts as: moving more toward outpatient care in less expensive locations, more follow-up care to keep patients from returning, reduction of unnecessary testing, employment of and profit sharing with physicians, and additional methods of dealing with “the tyranny of insurance companies.

Steps such as measuring nursing hours, housekeepers per square foot, food service people per meals delivered, and embracing the entire model of industrial efficiency were all suggested contributors to the bottom line.

Mr. Levine also granted partial sainthood to a profoundly bullying management style of one CEO who cut services that didn’t make profits, eliminated catering to the poor and “told doctors where to go.”

All of this plays perfectly into the story that I had lived and am currently telling across these United States and beyond; that dignity, prevention and wellness, attention to human and humane detail, the removal of autocratic leadership, and patient and employee-centered care — all enveloped in a spirit of entrepreneurship — can prevail.

That integrative and holistic medicine practices will contribute to taking us out of the current crisis and into a health care delivery system that will be the design for this century and beyond. Of course, we need malpractice reform; we need more control over big pharma and most importantly, we need to provide some type of safety net for those without coverage, but the path to survival is not simply one of a “business model.” It is a path to a humane model, a creative model that embraces people, embraces wellness, embraces humanness in creative, meaningful ways.

Perhaps hospitals are not being killed, but rather are committing slow suicide by following their “Calf Paths” from the past.