Archive for the ‘Public Health’ category

Integrative Medicine

July 20th, 2018
Having served in healthcare senior leadership for over two decades, my tolerance level for various “healthcare norms,” that revolved around the sometimes-insensitive treatment and care of patients and their families had reached the breaking point.  Consequently, at the end of my 40th decade when I became a hospital CEO, I arrived in the position with a quiver full of change arrows that were sure to shake up the status quo, and it did.Because I had entered the healthcare field some twenty years after most of my senior leadership peers, my life experiences were much more varied and non-traditional. For ten years, I had been a band and orchestra director in both City and Urban school districts.  After that, I ran what became a successful arts organization in a rural area, and finally, served as the CEO of a convention and visitors bureau.  It was during those years that I went back to school for another Masters degree in public management/health systems management.

When this CEO opportunity presented itself, I realized how each and every one of my life experiences could help me run a hospital, but not just any hospital. It was my vision to create a hospital that embraced all modalities used in integrative medicine with the ambiance of a fine hotel and the amenities of a health spa.  We carefully scrutinized and then credentialed practitioners specializing in massage therapy, integrative nutritional counseling, acupuncture, osteopathic manipulation, pet and music therapy, reiki, and spirituality to name a few. These practices intermixed with traditional Western medicine became our new norm.

As the traditionalists who are reading this article begin to shake and scream about a lack of medical evidence, I can only point to the 19,000 papers written supporting the efficacy of acupuncture and the thousands of other medical papers written about the healing powers of music, massage, and such. In that same spirit, there is also the fact that the head is connected to the body and provides a mind-body connection that doesn’t fit neatly into the scientific “heal to the pill” mentality of our current system.As a non-clinician, non-scientist, it was easy for me to believe in things like “the Placebo effect” as well.  It really didn’t matter to me why people got better. It was our goal to create a healing environment where people would not be immersed in fear and trepidation, where their loved ones could comfortably stay with them, and where unnecessary paging, and middle of the night prodding, and wake-ups were avoided as much as humanly possible.

It seemed to me that by training our employees at Disney University, allowing them to learn from the Ritz Carlton, and exposing them to sensitivity and emotional quotient training, we could create a healing environment. Because my philosophy was that you could not change the human condition, but you could change the condition under which humans worked, we also embraced an anti-bullying environment where employees were cherished and recognized for their contributions to the welfare of our patients.

How did implementing all of these ideas change healthcare in our little slice of Camelot?  Our infection rate dropped to below 1% and stayed there for eleven years. (The national average is nine percent.) And I know we weren’t washing our hands more than they were at other hospitals. Of our peer hospitals, we had the lowest readmission rates, restraint rates, and lengths of stay, and when the naysayers saw these numbers, they said it was because we were not a large hospital. My belief was that we successfully had created a healing environment where our patient’s white blood cells were actually able to function to fight off infection.  We were transparent, nurturing, and caring. We were not a “Healthcare FACTORY” where the patients became widgets in an Industrial Revolution model of care.

Music was always used in healing ceremonies by an indigenous man. Acupuncture has been deemed effective for over 5000 years. Massage makes you feel better, and sometimes your spine gets out of alignment and needs to be corrected. This is neither rocket science nor brain surgery. It’s about love, kindness, and caring, wrapped up in good Western medicine. Oh, and one more thing.  Even with a palliative care unit, a hospice, we had the lowest death rate of our peer hospitals. I had always wanted to put up a billboard that said, “Come to our hospital . . . you’ll die less often.”
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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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Random Thoughts About Things That Confuse ME

October 12th, 2015
 People have often asked me, “Where were you when Kennedy was shot?” In fact, I was in gym class. Six years after that, on April 4, 1968, I was in Pittsburgh when Martin Luther King was shot. I was back again in Pittsburgh on June 5, 1968 when Bobby Kennedy was killed. Finally, as a young teacher in Johnstown, on May 4, 1970, four students were killed and nine more were wounded by the Ohio National Guard at Kent State University. Between the riots and civil unrest that followed these events, I was pretty sure that our world was spinning out of control, and I had just graduated from college.

It was during that time of the Vietnam War, the escalation of the Cold War, the race riots and political rallies, that a chasm began to appear between those men who still had crew cuts and white socks, and conservative hippie kids like me with my wire-frame glasses, sideburns, and mustache.

In fact, at my very first job interview, the department head, a man who was still firmly planted in the 50’s, asked me if because I was my college class president, I’d ever been involved in a campus riot. Meanwhile, there had only ever been one small demonstration at my university, and I wasn’t even on campus when it happened. But his question offended me so much that I replied, “Only the one.” Needless to say that job went to someone with a crew cut and white socks.

Throughout my life I held profound optimism that because we were a country that embraced education, espoused Judeo-Christian love, and incorporated tolerance and diversity in our stated beliefs, our philosophies would prevail and the world would become a better place. Wrong.

Because I spend much of my time on the road, Facebook is often the way I keep in touch with my virtual and real families. It keeps me apprised of changes, challenges, and the daily activities of those I both care about and want to be connected to through this last quarter of my life.

Of course, Facebook is filled with puppies, kittens, babies, and opinions, and many of those opinions remind me of the Archie Bunker character who so famously dominated the airwaves in the All in the Family sitcom of the 1970’s. That series, along with MASH and The Jefferson’s attempted to challenge the way Americans dealt with race, war, and general closed-minded prejudices.

It makes me sad when my friends, people that I love and most often respect, write posts that are passionately in support of social beliefs that embrace continued gun violence, racial prejudice, twisted religious beliefs, intolerance, greed and hatred. It would be easy to unfriend them, to write them off, and forget about them, but the teacher in me wants to try to educate them and to help them find their way. That never works because most of them are Archie Bunker’s age and older. All I’m asking is for tolerance, the embracing of diversity, and a non-violent philosophy of loving others. It’s the Golden Rule. Unfortunately, it’s often the Rule of Gold that seems to prevail.

I can tell you where I was on April 20, 1999, April 6, 2007, December 14, 2012: Columbine, Virginia Tech, and Sandyhook. Unfortunately, I can’t even tell you the name of the school or how many kids were killed on January 4, September 14, September 30 of this year. October 1, 2015, however, became more tangible because the hospital that cared for the wounded in Oregon is run by a friend, and Troy Polamalu’s cousin Brandon, a teacher at Umpqua Community College, was on campus at the time of the shooting.

Minimally, as a country, can’t we invest in behavioral health initiatives and enforce background checks.

Meathead really was the voice of reason on so many levels

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On Cancer Research, Incentives and Cures

September 18th, 2011

From a blog entitled TTAG, The Truth About Genetics, comes a scathing indictment of the American Cancer Society. Truthfully, some of the contents are infuriating, but especially so, because as a co-founder of a research institute, I’ve lived them. First hand. When I saw that  the American Cancer Society’s two CEOs make a combined $1.6 million dollars in salary, I wasn’t shocked. Heck, the president of a 120 bed hospital who retired recently made almost that much. ACS is a big organization with lots of moving parts. It takes talented people to run big organizations, and they typically don’t work just for food.

From the TTAG  blog:

Today, ACS’s revenue is $1 billion, and the amount that goes to research is a measly 16%. Research is not the primary goal of ACS, and one of the great things they do is help patients undergoing chemotherapy by buying them plane tickets and paying for their costs. But, even when you consider other program costs like cancer treatment for patients, ACS has the lowest score for charities in terms of efficiency: 1-2 stars out of 4. (24.78%, according to CharityNavigator.org)

See also:

Once again, no surprise. The main issue that I had with the ACS was that their research funding, as meager as it is, goes to the “Good Ole Boys,” the group that is already part of the NIH/NCI club. Okay, you say, they have to have some standards. The Komen people don’t follow that same “Good Ole Boy” path, and thank goodness. They look for good science wherever they can find it.

So, what’s the real reason that I get upset? I sometimes think I’ve written too many posts about this already, but let me say it one more time: Unless and until we realign the system that currently is used to fund basic science in this country, we will never find true cures for cancer. There is very little to no incentive to cooperate, to work together, to encourage scientists to share and to reward them with grants for cooperating.  In fact, the entire system actively discourages it. It is a “Diva”-based system, that encourages silos of power around individuals.

Bottom line? We have a healthcare system that does not support wellness and prevention, but  instead financially rewards sickness and continuous testing and care for what may have been preventable ailments, and we have a research system that discourages cooperation and collaboration. We have a pharmaceutical industry that is interested in financial blockbusters…just like the movie industry.  We have a political system that caused our country’s credit rating to be downgraded and the price of money to escalate, and finally, we have an infastructure that is crumbling.

The good news, however, is that we still are the United States of America, and if we work together T-O-G-E-T-H-E-R  this can all be fixed.  It’s time for those of us who understand this to be heard.

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

Sandpaper sheets, green jello and patients who leave with infections they didn’t have when they were admitted. Hospitals DON’T have to be this way. Nick Jacobs FACHE reveals how, as CEO, he transformed a rural, critical care hospital from near bankruptcy to a consistently profitable, internationally-recognized model of patient-centered care and innovation. By creating a hospital environment that embodies healing in every aspect of its operations, Nick’s hospital also achieved one of the lowest acquired (nosocomial) infection rates in the U.S. for five years running.

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Barcelona, VAT and Ambiance

August 18th, 2011

Last weekend, I traveled to Barcelona. How does one afford to spend a weekend in Barcelona in this economy with the dollar at $1.40 to one Euro, one might ask?  Points, my friends, points. When you travel enough, it’s possible to build up quite a few of these delightfully-useful but quickly-diminishing-in-value “perks,” and that’s how I got there.

Because it’s “Vacation time in Europe,” numerous hotels, restaurants, and tourist attractions offer nice packages for a reasonable number of points, and because I’d never been to Barcelona or anywhere in Spain for that matter, it seemed like a good plan. Albeit brief, my 4 day journey into yet another culture was almost worth the pain of traveling. Of course, if you remember my Serbia, Nigeria, Bosnia, Netherlands and Italy blog posts, you know that I’m all about “experiences.”

Barcelona - juice seller - Flickr Photo

Barcelona: juice seller at the Mercat de la Bouqueria - Flickr photo credit: Halvorson Photo

The longer I live, the more interested I am in how other people live. Many years ago, probably 20 or so, we had an exchange student, Monica, from Barcelona who used to stand in my family room, look out the window into the rolling fields and proclaim, “Nick, Nick, I am sooo bored.”  Truthfully, I was, too.

So, why Barcelona, VAT and the “A” word? I fell in love with the city. I loved the ambiance, the food, the wines, the architecture, and the people. Maybe it was the fact that there are two million souls living there, and I never felt uneasy even once. Unlike my last trip to Chicago, where I couldn’t sleep all night because of the continuing chorus of sirens from emergency vehicles, Barcelona’s street in front of our hotel erupted in the wail of those distinctive, European sirens only
about four times, from Friday until the following Monday.

Interior of La Sagrada Familia basilicaSome of the little things that captured my attention included the walk/don’t walk sign on the streets that actually allowed you enough time to cross at your leisure without being hit by an oncoming car. The people and cab drivers were polite and, most importantly, there was a feeling of helpfulness and respect in the shops, restaurants and architectural wonders.

Of course, by Sunday evening, we had visited nearly every architectural work of Antoni Gaudí, and toured and listened to a great concert at the inspiring Palau Música Catalana. Barcelona is today one of the world’s leading tourist, economic and cultural and sports centres, and this all contributes to its status as one of the world’s leading cities.

But what about the rest of the title of this blog post? Every time we purchased something material there, the VAT tax was applied, and when I asked someone to explain it, the answer was simple, “It’s how we pay for healthcare.” Consequently, when we walked the streets over that entire weekend, we saw a total of five beggars, and three of them had a Starbucks Cup to catch the falling Euros.

The other things that we saw everywhere were dumpster-style recycling binsBarcelona: color-coded recyclying bins. And not just any bins, either. Very fancy, clean, able-to-be-picked-up-mechanically bins, that were specifically color coded for every imaginable kind of recyclables. Not rocket science, but a comment on community pride, sustainability or climate change, perhaps.

So, we’ve taken care of the creation of a pleasant ambiance on numerous levels with extraordinary architecture, beautiful tree-lined streets, recycling, healthcare, low crime and compassion for fellow human beings. We didn’t see many Mercedes, but we also didn’t see much evidence of poverty, either. The beaches in town were public, and not controlled by exclusive beachfront hotels. Barcelona’s public transportation was a pleasure — clean, comfortable and efficient, with a train to Paris that delivers you there in about three hours…and the Tapas, wine and customer service were all simply amazing.

Nationally, Spain’s unemployment rate hit 21.3%, and they are listed as one of the PIIGS:  Portugal, Ireland, Italy, Greece and Spain…i.e., economically-unsound EU countries. In spite of these huge challenges,  Barcelona was a great city, a great experience, and a great setting with world class arts. So, should we charter an Airbus 380, load up our U.S. Congress, and fly them to Barcelona?

Nah, it wouldn’t help.

Hmm. Maybe we should fly them to Somalia?

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Geographic Variances in Medicaid Spending – And the Winner Is?

July 7th, 2011

Health Affairs cover - Nick Jacobs, FACHE - Medicare - MedicaidWhen Health Affairs released a first-ever study of geographic variances in Medicaid spending on July 7th, it was a new twist on transparency that is just the beginning of what will become a detail-by-detail exposé of care and treatment of patients in the United States.  Just imagine a few years from now, when every record is electronic and every detail will be instantly available to the government.  Like this variance report, we will begin to see the good, the bad and the ugly of how medicine is practiced in this country.  So… how do you spell transparency?

A few weeks ago, the New York Times ran an article in which the “overuse of Medicare-funded CT scans” was explored. Featured in the digital version of this article was an interactive map showing virtually every hospital in the United States, and as the mouse was passed over each hospital, the percentage of inappropriate CT scans appeared above the facility’s name. If yours was one of the hospitals that was 80+ percent over using this device in multiple single-day scans, you were, as they say, “busted.”

Well, this release exposed at least one entire section of the country that is overusing Medicaid on numerous levels.  Although the study revealed a wide variance in per-beneficiary spending, one geographic region outshined them all.  The findings showed that after adjusting for the case-mix of patients, variations are driven mostly by volume of services provided and, to a lesser degree, by price.  Per-beneficiary spending in the ten highest states was $1,650 above the national average, mostly caused by the greater number of services provided.

Image credit: New York Times

One of the most significant findings revealed by this study was that the supply of primary care physicians in specific areas was associated with reduced rates of admissions for diabetes, lung disease, and adult asthma.  The authors suggest that this finding might point to the fact that increased access to primary care providers may result in improved management of common chronic diseases for people on Medicaid.

So, by now you’re asking, “Who won?  Who used more money per capita to treat Medicaid patients?”  It was The Mid-Atlantic States : New Jersey, New York and Pennsylvania used more Medicaid funds per capita than any of the regions in the United States. For example, the per beneficiary cost in New York was twice that of California; $21,195 for New York vs. $11,200 for California.

As a region, New England used the least amount of Medicaid resources and as a state, Washington provided the best example of “how things should be.”  How did they do it?  They increased access to primary care and reduced hospital care.

Todd P. Gilmer, Ph.D.

Todd P. Gilmer, Ph.D. - UCSD

Finally, places that had higher numbers of hospital beds and specialists were associated with higher numbers of hospital admissions while higher numbers of primary care physicians were associated with reduced rates of hospital admissions… Todd P. Gilmer, PhD, professor of health economics in the Department of Family and Preventive Medicine at the University of California – San Diego said, “By looking at service mix, access and price, states can find ways to make their programs work better.”

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Coffee and Cancer

May 19th, 2011

Several years ago, at the Clinical Breast Care Project’s (CBCP) offsite retreat with the physicians from Walter Reed Army Medical Center, our biomedical informatics group had prepared a demonstration for the CBCP’s Scientific Advisory Board, a group of distinguished scientists, breast cancer consultants and physicians.

Colonel Craig D. Shriver, MC Director, Clinical Breast Care Project Program Director and Chief, General Surgery Walter Reed Army Medical Center

COL Craig D. Shriver, MC Director, Clinical Breast Care Project (CBCP), Program Director & Chief of General Surgery, Walter Reed Army Medical Center

As the 7:00 PM meeting time approached, it was obvious that there was not going to be a quorum present to start the formal meeting.  The two additional members had called in and we sat waiting patiently for the remainder of this august body to join us; fifteen minutes passed, then twenty and finally at about 7:25 PM, the group burst apologetically into the conference room to begin the call.

In case you’re wondering what would have caused such a delayed response from an otherwise very prompt group of individuals, it was the introduction provided by the biomedical informatics group of how this data repository’s capabilities could be explored.  The advisory group was so captivated by the power of this tool that they literally became lost in the excitement of the demonstration.

This form of science was fascinating to me, because having trillions of pieces of data available from thousands of women allowed the queries to be guided by the data itself.  When this power was coupled with the normal questioning generated by the intellectual curiosity of the individual scientists, the outcomes were beyond fascinating.

For example, you could ask the question, “How many of you drink coffee?” The thousands of participants whose biopsies – both malignant and benign – were being stored in the tissue repository at our research institute had agreed to answer over 500 demographic questions relating to their very personal and now anonymous lives. A graph appeared showing the proportion of women who were coffee drinkers. When I then asked, “How many cups a day do you drink?”a new graph appeared with that information as well. My final question was, “How many of you were diagnosed with breast cancer?” This resulted in an interesting fusion of information. The women who consumed the most coffee had the least amount of breast cancer. Of course, that general assumption needed to be researched, confirmed and proven in numerous ways, but there it was, way back in about 2005.

A report that touched on this topic was released during the second week of May, and it was fascinating. It was a Harvard study that followed almost 50,000 male health professionals for more than two decades.  Over 5,000 of the participants got prostate cancer – 642 of them the most lethal form. “For the men who drank the most coffee, their risk of getting this bad form of prostate cancer was about 60 percent lower compared to the men who drank almost no coffee at all,” says Lorelei Mucci, an epidemiologist at the Harvard School of Public Health and an author of the study. The same group reported about a 50 percent reduced risk of dying from prostate cancer among men who took two or three brisk walks a week. As a part of our funding, similar studies performed by the Preventative Medicine Research Institute under the direction of Dr. Dean Ornish also confirmed this exercise theory of risk reduction for prostate cancer.

The new study shows that a 60 percent reduction in risk of aggressive prostate cancer requires at least six cups a day. However, men who drank only three cups a day still had a 30 percent lower chance of getting a lethal prostate cancer, and that’s not bad. Earlier research also suggests coffee reduces the risk of diabetes, liver disease and Parkinson’s.

But here is best part of this story. Just last week, Swedish researchers reported that women who drink at least five cups of coffee a day have nearly a 60 percent lower risk of a particularly aggressive breast cancer that doesn’t respond to estrogen.

Epidemiologist Mucci says more research is needed before officially urging people to drink coffee for its health benefits. Meanwhile, she says, “there’s no reason not to start drinking coffee.

So, all of these years later, the National Cancer Institute is using about 200 of these CBCP biopsies from that same tissue repository to map the Human Breast Cancer Genome, and everyday new reports are emerging that confirm the value of this research. All of this from a little coal mining town in Western Pennsylvania – the location of the research institute and hospital where I served as President and CEO – just three seconds in air miles from where Flight 93 went down.

Now that’s a story.

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Things People Are Thinking About

October 14th, 2010

Every few weeks or so, I take the time to read articles produced by The Pew Research Center, a non-partisan fact tank. Pew does not take sides in policy disputes, but they do provide a valuable information resource for political leaders, journalists, scholars and citizens. I believe that I come under that last category, citizen. The only requirement that Pew has relative to their findings is that their sources are cited accurately and in context.

Recently, they provided some fun statistics:

For example, among the public, one-in-four (25%) believe in astrology (including 23% of Christians); 24% believe in reincarnation, nearly three-in-ten (29%) say they have been in touch with the dead; almost one-in-five (18%) say they have seen or been in the presence of ghosts. If none of those statistics surprise you, then you clearly are not me.

Here was another great poll finding: 87% of scientists say that humans and other living things have evolved over time and that evolution is the result of natural processes such as natural selection, but only 32% of the public accepts this as true. (From the work of Jodie T. Allen and Richard Auxier, Pew Research Center)

Conference on Climate Change, Poznan, Poland

Well, this next poll was even more interesting to me. As both a business person and a humanist, it has been difficult for me to hear large numbers of my friends and acquaintances literally “going off” about how ridiculous global warming is. They say things like, “Global warming and global cooling happen all the time; it’s just a natural course of events.” Others say, “Al Gore filled us with lies about global warming for his own financial gain.” Finally, I have heard over and over, “Well, we can’t do anything about it anyway, so why worry.”

Then there’s the opposite side where experts say things like, “If we stopped using all fossil fuels right now, the earth will continue to heat for another 60 years, and all of the devastating floods and fires that we’ve seen this year were the result of only a 1 degree increase in the world’s temperatures, and in 60 years we will heat up by 5 degrees.”

What did Pew find about the current global attitudes about climate change?

Pew - global attitudes about global climate change - Nick Jacobs, FACHETheir international polling shows that publics around the world are concerned about climate change. In the recent spring 2010 Pew Global Attitudes survey, majorities in all 22 nations polled rate global climate change a serious problem, and majorities in ten countries say it is a very serious problem. There are some interesting differences among the countries included in the survey. Brazilians are the most concerned about this issue: 85% consider it a very serious problem. Worries are less intense, however, in the two countries that emit the most carbon dioxide — only 41% of Chinese and 37% of American respondents characterize climate change as a very serious challenge.

Even though majorities around the globe express at least some concern about this issue, publics are divided on the question of whether individuals should pay more to address climate change. In 11 nations, a majority or plurality agree that people should pay higher prices to cope with this problem, while in 11 other nations a majority or plurality say people should not be asked to pay more.

These findings remind me of numerous other examples of confusion created by the short term winners and losers in what are serious economic discussions. There are 1.5 B Chinese, and over the next several years, many of them are going to want a car. Regardless of your own personal stand on this issue, that’s some serious potential pollution.

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Congressman John P. Murtha

February 9th, 2010

Yesterday’s phone call from the Somerset Daily American caught me off guard.  “Hi, Nick, have you heard?  Congressman Murtha passed away this afternoon.  Could you give us a quote?”  the reporter said.   Truthfully, I was not ready for this call.  Having talked to friends who had been with him only a week earlier, everything seemed like it was going to be okay, but obviously, okay was not what it was.  He had one of the 500,000 or so laparoscopic cholesystectomies performed each year to remove a gallbladder.  This surgery has a .05% complication rate, but the call proved that, regardless of the percentages, there is always risk from human involvement.

The Late Rep. John Murtha I’ve decided to dedicate this as a very personal look back at my journey with Jack Murtha.  Ironically, we had grown up practically as Pennsylvania neighbors in Westmoreland/Fayette Counties.  My first real meeting with Mr. Murtha was during the 1977 Johnstown Flood.  I was a young teacher and volunteer who was mopping the floors of the relief centers,  getting things ready for survivors who had lost their homes when I heard a helicopter come flying in and saw a tall, impressive, 44 year old Congressman deplane.  He had only been in Congress for a few years, but had clearly learned enough about the  System to keep then-President Carter on his toes and get legislation passed to help his home district.

My very next encounter with Mr. Murtha wasn’t until about three years later, when his Washington office called me to see if they could help my employer at that time, Laurel Arts of Somerset, with a bill that was going through the House before Ronald Reagan took office.  Nothing came out of that call except for the fact that I realized that his employees were parents of former students and people who liked and respected my work from those days.

Then the big encounter hit.  Mr. Murtha was looking into bringing the National Park Service into Cambria County to start what became the America’s Industrial Heritage (Tourism Development) Project.  He and several other Congressmen came to the University of Pittsburgh in Johnstown to hold a Congressional hearing on the project, and, as the newly-elected President of the Laurel Highlands Convention and Visitors Bureau, I testified against the plan and explained that if they didn’t include Westmoreland, Somerset, and Fayette Counties, we would not display any literature promoting it at all of the tourist sites that we controlled.  They agreed, and not many months later, he ended up representing Fayette County as part of his district.   It worked out for both of us.

A few years later, I had transitioned into healthcare senior leadership and  invited Mr. Murtha to introduce Bob Hope at a fund raising event for the Mercy Hospital of Johnstown.  Approximately 6,000 people were in attendance and Mr. Murtha got as much applause as Mr. Hope.  The following year he helped us bring in Henry Mancini and his orchestra for a similar event and our respect for each other began to grow.

Rep. Murtha speaking at Biotechnology expo (2004)

Rep. John P. Murtha speaking at Biotechnology Expo (2004)

In 1997, when I became the President of Windber Medical Center, Mr. Murtha and I were seated near each other at a dinner party.  It was there that we  began to discuss healthcare, and his vision for the future.  Anything that would help the soldiers stay well, prevent illness, or stop it before it became an issue was his goal.  I heard him speak at the opening of one of his many health center initiatives at Walter Reed Army Medical Center, and he said, “I have 13 honorary degrees, hundreds of awards, and am well known as for my work in defense, but I want my legacy to be healthcare, prevention, and wellness.

His contributions to healthcare, however  small they may seem compared to what he has done for the world and for mankind, through his tireless and dedicated work were where his heart was.  His strength and vision made him the most impressive human being that I have ever known, and my love and respect for both him and his wife, Joyce, cannot be calculated in mere human measurements.  I am proud of him, his work, and his commitment, and I know that the seeds that he has planted in Breast Cancer Research will go on to save thousands of lives someday.

Ironically, it was healthcare that took his life.  No one can ever replace Jack Mutha; his knowledge of the system, his guts and determination, his singular efforts to help a district that had been devastated by natural disaster, his kindness and great personality.  No one.  So, today, I write with great sadness that our great friend is gone, but at the same time, I vow that his name, his contributions to humanity, and his memory will never be gone.

Look at wriwindber.org or windbercare.com, and see what Jack Murtha built.  We loved you, Jack.

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