Archive for the ‘Nutrition’ category

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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The Food Crisis

May 24th, 2011

Each year American farmers must feed an additional 80 million people internationally.

Food is The New Oil (c) ForeignPolicy.com - Nick Jacobs, FACHE - Healing Hospitals

Image credit: ForeignPolicy.com

During the first two decades of my adult life, it was commonplace to see story after story about the starving people in places like Biafra. Some three decades later, I now understand more deeply the geopolitical ramifications of these tragedies. A friend of mine sent me an article from the May/June Foreign Policy magazine. It detailed the food supply challenges facing this planet’s  growing population. The intensity of concern that this essay raises is palpable.

The article, The New Geopolitics of Food, by Lester R. Brown, opens with an example of what a 75% increase in wheat prices might mean to the average American who spends less than 1/10th of their income at the supermarket.  The answer is…probably a ten cent increase in a loaf of bread. As a result, a $2.00 loaf of bread will become a $2.10 loaf of bread. He then contrasts that difference with the impact it would have in a place like New Delhi where that same wheat is carried home to be ground into flour. The cost of the wheat there is actually double what it was. Consequently, Brown states, the world’s poorest two billion people — who spend 50 to 70% of their income on food — will go from two to one meal a day. His evaluation of this situation is that it can, will, and has already resulted in revolutions and political upheaval.

When the reasons for these shortages are explored, it quickly becomes apparent that changes in our climate represent a major contributing factor.  Be it too much hot dry weather, too many storms contributing to excessive rainfall, or soil that is simply exhausted from a lack of nutrients caused by depleted aquifers, the result leads to food becoming the hidden driver of world politics. As land and water become more limited, as temperatures go up and world food security deteriorates, scarcity is emerging as the norm, rather than than the exception.

Infographic: The Food Price RollercoasterUntil recently, the food supply was primarily in the hands of the world markets which were primarily monitored and sometimes driven by the United Nations’ World Food Program, but because of recent shortages and population growth, several countries have taken it upon themselves to secure their food supply in nontraditional ways. We are seeing unprecedented land grabs in developing countries, and water grabs from geographies where the end result creates shortages and where grain is being directly purchased from U.S. farmers.  All of this is contributing to a global power struggle for food security.

According to Brown, “With grain stocks low and climate volatility increasing, the risks are also increasing.  We are now so close to the edge that a breakdown in the food system could come at any time.”  For example, a 40% drop in grain production in the U.S. would be equivalent to a loss of 160 million tons of grain as opposed to a 40 million ton drop in Russia from the same percentage loss.  This would be devastating to the world food supply. As long as oil is expensive, ethanol production will remain high and corn will be pulled from the food chain to the fuel chain. “Oil exporting countries that import grain would…barter oil for grain, and low income grain importers would [lose] out.”

Brown concludes:

“If we cannot produce higher crop yields with less water and conserve fertile soils, many agricultural areas will cease to be viable. Each year, 1,400 square miles of land in Northern China turn to desert. If we cannot move at wartime speed to stabilize the climate, we may not be able to avoid runaway food prices. If we cannot accelerate the shift to smaller families and stabilize the world population sooner rather than later, the ranks of the hungry will almost certainly continue to expand.”

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Healthcare Reform? Blow it up, and Start from Scratch!

June 20th, 2009

Healthcare Reform? The premise and the incentives are wrong.  We treat sickness (which can be a good thing), however, we do it to the almost total exclusion of encouraging and incenting wellness. While in the Netherlands a few years ago, I asked a very comfortably-situated business person why she and her entire family all rode bikes. She smiled and explained that the millions of bikes in the Netherlands are a way of life because they keep people healthy.  Of course, we don’t have to ride bikes, but why not?  “It is much less costly.  It gets us where we want to go, and it is so much better for our bodies,” she said.

Photo credit: Amsterdamize
Photo credit: Amsterdamize

After going to doctor after doctor in my early thirties and then again in my early forties for a recurring and seriously painful back problem, someone suggested a Chicago-trained chiropractor.  After a very quick, one time manipulation, he said, “Follow me, please.”  When we descended the stars of his office, in front of me was literally an entire homemade work out facility.  This particular center seemed to emphasize strength training.   The Doc walked me over to a row of three machines and said, “If you use these three machine or their equivalent, just the way I show you, you will never have to come back here again.”  Then he said, “Oh, and if you drop fifteen pounds, you may be able to get off those blood pressure pills, stop taking that stomach medicine, and feel better about yourself in the process.”

The Dr. Dean Ornish Coronary Artery Disease Reversal Program is completely about health and prevention.  It is about wellness; treating yourself with the love and respect that you deserve, being kind to yourself, yet being disciplined enough to get you where you need to be in order to enjoy a healthy, pain free life.

We spend only 4% of our health care dollars on prevention.  That may sound like a lot to some of you, but do the math.  Take 4% and multiple it times $2.2 trillion …or possibly soon $3 or $4.0 trillion.  Every physician should endorse a workout facility and work to send you there, and every physician should receive bonuses for having you use it.  A primary care physician in Britain can make about $320K a year, which includes incentives directed toward encouraging healthy living for their patients.  Our primary care docs make, what, $130,000, $150,000, $180,00 in comparison?   Would you really care if your physician could make almost twice as much if you were living a wonderful, healthful, reduced stress life?

There is absolutely NO DOUBT in my mind that the reason I’m typing this here today and not deceased at age 58, like my father, is because of the work of people like Drs. Ornish, Benson, Jonas, and Weil.   It is not because of my old donut shop, the nachos and cheese, the automobiles, my Lazy Boy, or the grueling work habits that we Americans think of as normal.

And what about death?  I have to tell you that death happens to all of us.  (Sorry.)  When it happens may depend a great deal upon our recognition of that fact, but it is not avoidable.  So, why is it that we, as a society, reject death as evil, and ignore its possible existence?  How could we cut billions and billions of wasted healthcare dollars?  Hospice is the answer.  Don’t commission oncologists for drug use when there is absolutely no hope that the patient will live.  Don’t pay radiologists for radiation treatments that will not work in preventing death.  Don’t reward hospitals financially for readmission after readmission for people who should have been told to mark  their DNR’s months earlier.  Face death as part of life.

healthy_food

Finally, look at the food and restaurant industry.   For every restaurant or food company that pulls a killer food and replaces it with the reasonable alternatives, reward them through the $3 or $4 trillion health budget.  You can buy veggie hot dogs on the streets of Toronto.  (Try Morning Star Farms brand veggie hot dogs.  They rock.)

In closing; diet, exercise, stress management, balanced lives, less capitalistic rewarding of killer diets, higher reimbursements in healthcare for the “right stuff,” and acknowledgement that this will eventually end, can make it all work so much better, so much cheaper, so much easier.  Did you have your pneumonia shot yet?  Well, actually, you may not need one if you start taking care of yourself.  I’m going downstairs to workout now.

Next time?  Tort reform.

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NickJacobs.org???

April 2nd, 2009

Let me open this blog with a little housekeeping chore. Because I’ve retired from being a hospital president (Yes, they replaced me with two great people, count ’em, two.) , I’d like to change the name of this thing. It’s not that I’ve established a P-Diddy-type Twitter following where 100,000 human beings are waiting with baited breath to see what my next move will be, it just doesn’t seem right to keep calling myself a hospital president. We know who reads this thing, and we are grateful to our loyal, talented, and brilliant followers. We also know that we can link the old blog names to get you here. So, regardless of what you typed, or what gets Googled, our genius social media maven & webmaster, Michael Russell, can help to bring you home to this site.

Okay, so as a transformational advisor, a broker of sorts, most people with whom we have consulted have described me as a person who can fix things that are broken before they actually break. Maybe we should call it the “Break it if it’s not already fixed” blog. I’d love it if it was a name that would generate millions of hits and companies would fight to advertise on it.

My first thought was to use nickjacobs in the title because there is a Nick Jacobs on Facebook who teaches Aboriginal people in Australia, and he seems popular. There is another Nick Jacobs who is a professional organist, and one who is an athlete. There’s a Nick Jacobs who is a consultant and another a paramedic in London, one who had a blog who is a yachtsman, there’s my son, the commercial real estate broker, and finally, there’s a Nick Jacobs who does pornographic movies who is not my son. Actually, that Nick Jacobs’ followers would probably be the most disappointed by this blog.

Since the .com version of nick jacobs was already taken by some guy in England, we captured nickjacobs.org, and that will work for right now.

If you have any ideas, however, that you think would really rock the blogspere, let us know and we’ll check with our domain registrar to see if it is available. In fact, if you are the winner of a Name Nick’s Blog Contest, I’d be happy to consult for free BY PHONE for at least one hour of brainstorming with you about the topic of your choice: music, healthcare, proteomics, teaching, PR/Marketing, the travel business, or even physician recruitment.

Remember, Hospital Impact is already taken, and, because my last three consulting jobs have been with a newspaper, a nonprofit arts oragnization, and a chain of hotels, we don’t want to think too restrictively. Gotta earn a little money, too.

When we ran the breast center, we found that the website got more hits than anyone could imagine. The problem was that the readers were mostly thirteen-year-old boys who probably weren’t too interested in running a hospital. After Miss America had visited us, the hits went up exponentially when those two searches were combined. Somehow, I don’t think that Nick Jacobs’ Breast Center for Miss America would probably get me the type of following I’m currently hoping to attract. On the other hand?

A very good friend recently asked me to write a brief bio about what my new life is like, and it struck me that it is very much like my old life but without any restrictions. This is what I wrote:

While teaching junior high school instrumental music in the early 1970’s, Nick Jacobs made an extraordinary discovery. He learned that, by empowering his students and surrounding them with positive influences, he no longer was providing a service or even an experience for them.

What this entirely unique teaching style resulted in was a method for helping to transform students. By providing with both passion and commitment the tools needed by them to undertake their journey, his involvement with the students became a means of dramatically helping them to make whatever positive life changes they were seeking.

It was during that early period in his career that he also discovered that this formula could work to positively change lives in almost any aspect of living as he ran an arts organization, a convention bureau, and finally a hospital and research institute.

Since that time he has dedicated his personal work to helping others make their lives better, and that is exactly what he is doing in his position as an international executive consultant with SunStone Consulting, LLC.

Maybe that will give you something to chew on? Okay, something on which to chew.

SunStone Consulting. With more than 20 years experience in executive hospital leadership, Nick has an acknowledged reputation for innovation and patient-centered care approaches to health and healing.

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Dr. Atkins and Me…

December 23rd, 2008

Some of you know my history . . . for a decade I was a totally dedicated follower of the Dr. Dean Ornish coronary artery disease reversal program.

For example, for the past ten years, the only thing that would typically pass between my lips at a holiday party would be party garnishes. No kidding; decorations, twigs, sticks… and the occasional veggie. No dips, no chocolates, no meats or shell fish, no cookies, no pie, no fat.

One interesting factor that evolved from embracing that philosophy is that, in spite of all of my efforts to enlongate my life, my personal challenges never really decreased. It hit me one day when I was looking in the mirror that I was actually peering at the enemy, and it was me. It has been pointed out to me that, for all intents and purposes, I am a crisis magnet.

During those years of complete passion for the Ornish program, there were many days where my adrenaline flowed freely. It usually happened when Dr. Ornish and Dr. Atkins had debates on television about their very different diets. Truthfully, the diet was such a small part of the Ornish program that it angered me when so much emphasis was placed on the complete disparity between these two very different programs.

Well, tonight I felt closer to Dr. Atkins than I had ever felt. In 1976, my buddy Jim and I went on the Atkins diet and lost about 30 pounds. That diet ended because the pork rinds, hard boiled eggs, and thousands of chicken wings, rashers of bacon, sides of beef, and pounds of cheese just became too much for me, and they probably resulted in my needing the Ornish diet.

What made me feel close to Dr. Atkins this time? Ice. He had slipped and fallen on the ice, hit his head, and eventually died from the injury. Well, tonight provided me with a bonding opportunity with Dr. A. It was the beginning of the holiday season. The kids had gathered for dinner with the four and a half grandkids, the soon to be deployed son-in-law, Moosie the dog, and Kiki the cat. It was a nice gathering and, as I walked off the porch and onto the walk, my feet went out from under me, my body went air borne, and I fell directly on my back with the force of a meteor hitting a dry lake. The wind left my body. Stars were flying around my head like a Road Runner cartoon, and pain began sweeping through my limbs in waves.

The difference between Dr. Atkins and me was that my head did not hit the ground. Was it a conscious decision to hold it up, or was it just pure luck? Don’t know, but, at least for now, it seems like I might live. The last time this happened to me was on a cold winter afternoon in 1978. After teaching for eight hours, I was leaving school with a baritone saxophone case in one hand and a euphonium case in the other, both destined to go to the repair shop. It was then that my feet left the ground. Once again, the air completely evacuated my lungs. It was that very day that I vowed to always wear rubber-soled shoes in the winter. Didn’t help tonight. Oh, well, at least my fall didn’t include a head injury. Dr. Atkins and I both needed more salt in our diets.

No fear. I’m still here.

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