“My team is not dirty.  All the issues were on their side of the field.  This is a football game, not  a Hallmark Moment.”   Quote from Scott Lago – a Pop Warner football coach in Southbridge,  Massachusetts after a game in which five opposing players all 12 or younger, suffered  concussions.  New York Times

My only grandson, a nine year old, announced that he was going to play football last year.  It made me nervous, but the teams that he played seemed pretty reasonable, and everyone appeared to be fostering a spirit of careful football where little kids were being taught and nurtured.   This year, his second year in the league, he blossomed into a high-speed runner and scored four touchdowns in the first game of the season.    Believe me when I tell you that there was no one cheering more loudly on the sidelines than I was that night.

Several weeks ago, however, my experience totally turned around.  Upon reaching the field, people began to tell me that the team that he was playing only played to win.  None of that made a lot of sense to me until I saw our little guy running with the ball to cross the goal line and a human missile, twenty or more pounds heavier  hit him straight on, helmet to helmet with the force of a predator drone.  It was like watching the NFL but without the $75,000 fine attached.

My heart stopped. I saw my grandson’s head snap back, watched him hit the ground and lay motionless.  Because I was standing only about five yards away from this hit, it left me in a state of complete shock.  Was it possible that someone would train a player to tackle eight and nine year olds like this?  Was it possible that the referee who was not near the incident wouldn’t call a penalty?  Most importantly, however, was it possible that my grandson would not get up or would have a concussion that would negatively impact him for the rest of his life?

Yes, it was all possible, and with the adults from the other side of the field screaming as if each play, each player and each hit would get them a huge raise, or make their lives complete, I had seen clearly before me both the best and the worst of the game.  These little kids, with weight differentials ranging from 20 to 30 or more pounds, are just that, little, and this particular game seemed to have become a blood sport for the adults on the opposite team.

Well, thankfully, he did get up, and he doesn’t appear to have a concussion, but, with four touchdowns from the previous game, he probably had a target on his back, and when I went to his next game, it was with my heart in my throat, and a prayer that saner heads would prevail, and these events will become what they were always intended to be, A GAME, and they did.

As a healthcare professional, I’ve seen too many former NFL stars take their own lives and ran the hospital that actually cared for a local football hero not to be aware of the fact that head injuries are a real potential problem at any age.  This issue is obviously very controversial to people like Coach Lago and those rabid fans that live their lives through the wins of those little kids, kids who just wanted to have some fun.

Interestingly, I’ve been told that coaches are having problems fielding teams in places like Seattle, Washington because the parents who work for Microsoft and Amazon are concerned that concussions could end their children’s’ chances for intellectual advancement.

Maybe we should all spend more time protecting the brains of the teams’ leadership . . . because, if they teach little kids to hit like missiles, they can’t be thinking straight.

Over the last twenty five years, I’ve often felt like a stranger in the heatlhcare world.  Each day I coped with rooms filled with individuals who had finely tuned left brains that were bathed at every opportunity in quantitative information.  This was such a phenomena to me that I became a student and then somewhat of an expert on this topic.  What made them tick?  Why did we see the world in such diametrically opposed ways?

Working in that environment often took me to the precipice of despair as my ideas were dismissed as frivolous, my thought patterns seen as radical and too progressive and my career opportunities stomped on by leaders who, for the most part, saw the world in a very similarly left brained manner.

At each  meeting, a history lesson revolving around previously memorialized numbers was the primary topic of discussion.  Most of the time, these numbers simply raised more and more questions, but, regardless, were seen as the most important part of these sessions.  When ideas were presented regarding impacting these numbers that were not quantitative and linear ideas, the rejections could not come fast enough from the lips of the various levels of leadership.  And when qualitative solutions were added that worked, they were still seen as the first thing to be cut in any budget crises.  (What ever happened to mission?)

Well, as with Karma, sooner or later life throws changes at us, and to many of my former peers, these changes have been incomprehensible, overwhelming and completely stiffling.   Why?  Well, for the first time in my adult life, quantitative is equally as important as qualitative in the world of healthcare.  Think of it.  Your patient goes home from the hospital and in the safety of their own house gets a survey from CMS (Centers for Medicare and Medicaid Services) that asks them, (Are you ready for this?) qualitative questions.   If that isn’t bad enough, depending upon how these questions are answered, your budget could be disrupted horribly, and it won’t be a matter of just lowering the quality of toilet paper to make up the difference.

HCHAPS are making hundreds of my former peers ask questions like, “How much are we going to be cut this year due to poor patient responses?”  More importantly, many of them are finally asking, “How can we change our scores?”

Like I said, it’s Karma.

My formula was relatively easy, but it took a balance of right and left brain to implement it.  You see, no matter what you think, life is emotional, and when we base decisions on emotions, entirely new challenges appear?  “Did your nurses treat you nice?”  “Did you get any sleep?”  “Did your doctor explain things appropriately?”  These types of qualitative questions require a different approach to life and to care . . . it’s “Not just the facts!”

In order to be successful in this new healthcare environment, there is a tremendous need for you and your staff to stop and act like human beings on all levels, to reach out to people, to build relationships, to nurture relationships, to mingle, to care, to be transparent, to pay attention to the root causes of numbers that may evolve from something other than algorithms and more numbers.

It’s time to consider balancing right with left brain; to do exercises that challenge your  creative and humanistic deficiencies; to realize that it is not your full time job to simply react analytically.  We are now in an era of qualitative and quantitative like never before, and if you want to thrive and survive, it is not good enough to have HCHAP scores lower than the average prison hospital.

It is time to look at how you treat your employees . . . do they have HOPE?  Do you ever embrace their ideas and dreams?   It is time to embrace the families with transparency, honesty, openness, and, when appropriate, sympathy.   It is time to wake up and pass out the roses.

I’m currently working in the hospital where I was born, on both coasts of Florida and both coasts of New Jersey.  Okay, New Jersey doesn’t have a west coast, but I’m working both sides of that state as well.  Don’t get me wrong,, it’s not the New York City/Philadelphia sides of New Jersey, it’s the Jersey Shore/Mountain sides of Jersey.   Here’s what’s happening:   In Florida, we’re working on establishing a tissue repository that will provide tissue to the Department of Defense project that we helped birth back in 2001.  We’re also looking to establish a research capability on the East Coast that will focus on, among other things, Single Nucleotide Polymorphisms.

Back in PA we’re working on the Breast Cancer Program and behavioral health.  Its been four years since I was a hospital CEO, and, interestingly enough, it seems that many of the changes that we watched in the late 80’s are the topics of conversation again due to the legislation now being implemented in the U.S. Healthcare system.  The major difference between the decades is that the Baby Boomers are “hitting the proverbial wall” and with their furious entry into the health system, they are demanding changes that will help everyone.

You see, qualitative is finally meeting quantitative in a very big way.  HCAHPS are changing the way hospitals do business as Medicare patients fill out their evaluation forms in the safeness and confidientality of their own homes.  Did your doctor communicate appropriately with you?  Did you get any rest? Were you happy with nursing? These are the types of questions that are literally changing the face of health care.

How does this equate with the way hospitals treat you?  Well, their reimbursements are based upon the scores that they receive.  Consequently, as one of my friends often says, “If your HCAHP evaluations are lower than a typical prison hospital, your reimbursement will reflect that as well.”  In other words, if you don’t take exceptional care of your patients, you will get less money from Medicare which eventually means that you will get less money from ALL insurance companies because, as Medicare goes, the business world soon follows.

Let’s recap, no money for wrongful site surgeries, no reimbursements for hospital acquired infections, less money if your evaluations from the patients do not come in with high scores, oh, and finally, quality.  By forcing all hospitals to go to Electronic Medical Records, CMS (Centers for Medicare and Medicaid Services) will have almost instant access to numerous important data points that will become transparent to the public.  Follow this scenario:  You want to know which hospital has the best outcomes in Cancer treatment or Heart Disease, no problem, you’ll find it on the websites.  If you want to know infection rates, that will be available, too.  TRANSPARENCY!

So, everything changes, and it changes pretty dramatically.  If you wonder where the $715B or so that was cut from the Health Insurance Providers and Hospitals is going, this should give you a little insight.   Now, let’s take a look at what a new genetic test called Single Nucleotide Polymorphism will potentially do for medical care.  By testing about 300 genes, not 30,000, these tests will analyze the ability of your individual body to metabolize various medications.  The important news is that is ALL this test will do.  There will be no exposure of your future medical challenges or genetic weaknesses.   That improvement alone will change the way medicine is prescribed and utilized, and it will also cut out millions of dollars in drugs that would otherwise be given unnecessarily or, in some cases, inappropriately.

In New Jersey we are implementing Integrative Medicine in various health systems.  Why is this important?  It’s important because it is not only what individual patients are demanding, it is also a means of treating people that leads to prevention and wellness opportunities.  It’s proven to raise HCAHP scores, and it will lower the overall costs of medicine in the U.S.

Florida  equals discovery.  PA and New Jersey equal implementation.  The new world order is here and it’s starting now.

Barry Estabrook wrote a book called Tomatoland.  It is not necessarily the type of book that I would normally read, but I heard the author on a radio talk show, and he captured my imagination.  Not because of my great love for tomatoes, but because he explained some things about the working conditions of the tomato pickers.

He explained that he was visiting his father in Naples, Florida when hard green missiles began falling off the truck in front of him and bouncing across the road.  He had first assumed that they were green apples, but because his passion is food and his curiosity was aroused, he pulled over, picked up one of these foreign objects and discovered that it was, in fact, a tomato.

Although this fruit/vegetable had fallen out of a truck going the speed limit on a Florida four lane, and although it had bounced across the highway, when he began looking at the fallen tomatoes, he saw no nicks, no dents, no cracks and no significant scratches.  Obviously, they were bred to be transported.

I’m not going to continue writing about the tomato itself or the extremely detailed account of the Florida Tomato Growers except for one particular section that deals with those people who live every day in those tomato fields.  People who are exposed to “Pesticides, so toxic to humans and so bad for the environment that they are banned outright for most crops, are routinely sprayed on virtually every Florida tomato field, and in too many cases, sprayed directly on workers, despite federally mandated periods when fields are supposed to remain empty after chemical applications.   All of this is happening in plain view, but out of sight, only a half-hour’s drive from one of the wealthiest areas in the United States with its estate homes, beachfront condominiums, and gated golf communities.”

Estabrook goes on to describe the horrific birth defects of the children being born from those pregnant female workers who have worked in the fields during the insecticide spraying, and the sheer abuse that these workers suffer from at the hands of the tomato growers.  The most devastating examples of this abuse, however, come in the sections describing the fact that over the past decade and a half, numerous mid-management picker bosses have been arrested and prosecuted for actually holding immigrants as slaves, in chains, within high fenced areas and then buying and selling them to other mid-management picker bosses.

So, let’s recap, we are growing rock hard green tomatoes that can roll off of a truck at 65 mph, not bruise or break, are gassed to turn them red, are submitted to seven or eight times more chemicals than in California and that are picked, in the most extreme cases by SLAVES.  Oh, yeah, and they taste like cardboard . . . or worse.

It simply puts this whole IPad manufacturing issue into perspective when we cry out about working conditions in other countries.  Do we really want to know how old the little girls are who weave our Persian carpets, make our tennis shoes, or sew our suits?  Do we really want to know what it costs to hire someone to pick something by hand in a field?  Do we really care if the million and billionaires who run this country are paying taxes at the same level that we are?  It’s always been very interesting to me as to what we ignore.  In healthcare for example:

What is the infection rate at the hospital where you are going for surgery?

How about the patient or employee satisfaction rate is?

Or the re-admission rate for patients?

Do you know if your doc has a file with the National Physician Data Bank?

Or what his or her success ratio is for the type of surgery you’re having?

Probably not . . . but now, at least you know a little more about those rock hard tomatoes you’re eating in the winter!

Maybe, little by little, we’ll know where to look to protect ourselves and our fellow human beings.

Marvin Hamlisch died last week at the age of 68.  When I first heard the news, it was strangely surreal to me, not because he died, that is, afterall, the ultimate journey for all of us, but because he represented so much of the music that had been and will be part of us forever.  As I mentioned his passing to friends, the reaction was mixed, usually sympathetic, not very nostalgic and, for the most part, clueless.  “Who was Marvin Hamlisch?” “What did he do?”  “Hmmmm, okay, I knew that song,  that’s too bad he died.”  This struck me as a sad testament to at least the focus of my generation’s knowledge of greatness in the arts and it pointed out to me that, I’m still an honest to goodness music geek at heart.

What did Hamlisch do during his lifetime?  Well, for one thing, he won Emmys, Oscars, Tonys, Grammys, Golden Globes and even a Pulitzer Prize for his work.   In fact, he was recognized as the only composer who won all of these awards from every different arena of entertainment.  He created the music from everything from the “Sting,” to “Ice Castles,” “A Chorus Line,” “The Way We Were,” “Sunshine, Lollipops and Roses,” and the themes for “Late Night with David Letterman” and “Good Morning America.”  Oh, and don’t forget “Three Men and a Baby,” “The Informant,” “Sophie’s Choice,”  and literally dozens of others.

His musical, “A Chorus Line” was the first reality musical, a musical that “swept audiences off their feet and created a demand for tickets so huge that the show ran seemingly forever.”  As a musical, it ran longer than anything had ever run on Broadway.   Oh, yeah, and in his spare time, he had been the director of the Pittsburgh Symphony’s Pops Orchestra for the past 17 years.  That’s right, Pittsburgh.  Well, he did direct a few other pops orchestras: Milwaukee, San Diego, Seattle, Dallas, Buffalo, the National Symphony and the Pasadena Symphony and Pops.

“So, who cares,” some of you might ask, and there-in is the problem.  Who cares, indeed?  If you’re over 40, and none of these songs ever moved you in any way, then I’d suggest that you’re probably right to feel detached from the loss of this unbelievable talent, but if, like me, all of his music is tucked somewhere deep in your memories, your spirit, and your heart, then you have to realize that, unlike the untimely demise of a retired athlete, Marvin Hamlisch was a creative genius who never stopped creating, composing and delivering his own rare form of beauty to this planet, and he is gone.

In our efforts to understand and deal with Mother Nature, we have invented, engineered, and manipulated her in ways that often produce unexpected results. There is currently a drought in the Midwest that is devastating small farmers all across the Plains. In fact, the experts are saying that it is the worst drought since the Dust Bowl of the 1930’s. The difference this time, however, is that genetically engineered crops are still squeaking through. You see, by altering the gene make-up of our food, companies like Monsanto have been able to engineer corn that can resist insects and continue to thrive on much smaller amounts of water.

The skeptics might be asking, “What happens when you mess with Mother Nature,” and, not unlike my daily diet of unrelated pharmaceuticals, we know that there may be ramifications, but we don’t know exactly what those effects might be. For example, we know for sure that if you take five pills a day for different ailments, there is a 100% chance that they will interact with each other. What we don’t know, because they were made by different manufacturers to address different ailments is what that interaction may be.

Recently, a friend of mine posted a photo of the vascularization of the heart, and it was placed beside another photo of the Amazon River water basin. To the untrained eye, the complex network of the blood vessels of the heart looked exactly like the map of the river’s connecting creeks and streams. In fact, a few years ago I saw a presentation by a radiologist who had read over 1,000,000 mammograms. He was also an amateur botanist, and for every image that he showed depicting a malignancy, he had a corresponding image of flower and plant formations in nature that was almost indiscernible from the cancers, an ironic contrast of the beauty and cruelty of Nature.

A further exploration of this inner connectedness was the recent story on NPR about an Italian wine maker, a microbiologist, Duccio Cavalieri, who had clarified the connecting by which insects ( in this case a wasp) transfer yeast from their guts onto wine grapes. This wasp yeast then shares in the fermenting of the wine. This interconnectedness explains some of the centuries old complexities in taste in the wines from Chianti. In fact, since the Roman era, vineyard owners knew that their wines would be impacted by planting flowers around the vineyards.

The story elaborated on the concerns of Ann Pringle, an Evolutionary Biologist at Harvard, related to the unintended penalties of a smaller amount of species diversity once that diversity is lost. In other words, the yeast from the wasps digestive juices makes the wine taste amazing. If a wasp biting into a grape can change the taste of your wine, what happens when you change Mother Nature’s corn by genetic engineering?

Ironically, one of the things that happens is that the corn stalks on this altered corn become bigger, stronger and tougher than regular corn. In fact, the corn stalks are so strong that, once they are cut down at the end of the growing season, they literally rip into the tractor tires as they drive over them. Consequently, the tractors with eight tires that average about $1000 each are taking a real beating when they drive through these Super Corn fields. This has resulted in tire manufacturers and post- manufacturers hardeng the rubber and, in fact, adding Kevlar to them, the stuff from which they make bullet proof vests.

So, we feed our cows, pigs and chickens genetic corn, kill the wasps by spraying them, and place bullet proof vest materials inside our tires. It seemed so much simpler when all we had to do as kids was to hang out with farmers where we could eat, drink and enjoy Mother Nature’s best any day of the week. Little did we know.

As my dad lay dying in the bed on the right side of the semi-private room, the pain that I felt in my heart was inexpressible.   You see, for all intents and purposes, my life had been pretty much perfect up to that point, and when the call came from the hospital that “I should come as quickly as possible because my father was most probably not going to be with us much longer,” I could not have driven faster, not have run at a quick enough pace and not felt more pain than those words produced.  It was a given that eventually my dad might die from his disease, lung cancer, but it was never clear to us that his passing at 58 years of age would occur so quickly.

Dad was the son of Italian immigrants who, like many of the people who came to this country in hopes of creating a better life for themselves and their families, ended up living in what was in essence a company owned home where they paid rent to their employer from their minimum wage salaries until my grandfather passed and his widow, my grandmother, was evicted.  It was the immigrant life that had caused my father to be somewhat of a pessimist and yet to embrace every one of our successes as if it was a Super Bowl win.

My dad had not been able to afford college, even with the offer of scholarship assistance, and he had worked his entire life in jobs that sometimes provided barely a middle class income to his family.   His endlessly stated goal for his children was that we get a college education.     He did not care about the field of concentration or what we decided we wanted to be, just that we were officially educated.  Imagine his pride when both my brother and I completed our Master’s Degrees and then continued to seek education beyond that level.  He was a very effective cheerleader and, at the same time, a strong and determined father who provided us with the roots that we needed to move forward and the freedom that was required for us to grow, thrive and survive on our own volition.

But  on July 5, 1975, 7-5-75, he was consuming the last hours of time that he had been allocated on this planet, and my heart was breaking.  As tears streamed down my face, he leaned over, gasping for breath, and said, “Kid, you’ve got to toughen up.”

I’m happy to report that I never have.

The death of my father in a traditional U.S. hospital in 1975 has steered many of my career and personal decisions.  You see, from my perspective, my father’s death was a very real example of how people were and unfortunately are, in many cases, still being treated.   It is what eventually took me into healthcare administration, the Planetree philosophy of care, and, most importantly, the American Board of Integrative Holistic Medicine.   It also allowed me to appreciate the amazing good and healing that takes place in Palliative Care and Hospice as well.

Bottom line, these organizations introduced us to the power of unconditional love.  When Father’s Day comes around, I can still see the smile on my Dad’s face, and then I recreate the unbelievable moment when he whispered to his nurse during one of his very last minutes of consciousness, “What did Dick Tracey do today?”    He embraced humor, honor, dignity and love to the end.   So, too do the physicians of ABIHM and the believers of Planetree.    ABIHM is completely about providing unconditional love to their patients, their families and the people who actually provide the care.

This is all about human dignity.  It is about nurturing, caring and carefully selecting the appropriate words to give hope and support even in times of transition.  This  should be the future of healthcare in this country.

First I would like to reinforce what drives me as a person and consultant along with my purpose and passion.   My training and background is in Education, the Arts, and Healthcare Administration, but I was mentored and guided by people who added intuitive management capabilities to my skill base.  In simple terms, despite what the financial analysis and traditional business people may say, those mentors helped me understand that two plus two can equal 5 or 55; not always from a logical or traditional standpoint but from a creative and passionate one.

In July of 1975 one of my mentors was hospitalized and while I was sitting with him he turned to me and uttered his last words, “What happened to Dick Tracy today?”  He embraced humor to the very end and passed away minutes later at the age of 58.   He was my father, and the experience that our family had in that health care institution made me want to avoid hospitals at all costs forever.  Instead, I later decided that I would not only enter hospitals but would also work to lead them and change the philosophy of how patients are treated.   As a CEO, we offered integrative medicine, aroma, massage, pet, music and humor therapy as well as all other certified modalities in integrative holistic medicine, but most importantly, our patients were never asked to leave their dignity at the door.

From that day forward I dedicated much of what I do to those people who help other people with their own health by using my ability and knowledge from both my creative and innovative education to the more concrete business and reality skills that I’ve developed as a CEO and Founder of a Research Institute.    During the last 25 years I have met incredible people both nationally and internationally and have done my best to share what I believe is a tremendous failing in the health care industry; providing patient centered care with compassion by creating a truly healing environment through entrepreneurship.

My vision is simple.  Strategically help you to reach your goals in an exciting and creative manner.  This is not about a business plan, this is about a deliberate strategic plan centered in Integrative Medicine and the new techologies and with evidence based outcomes, we will demonstrate how you can fit into this ever evolving new world order as the current system continues to shift dramatically.

With innovation, compassion and creativity, the future can most assuredly be incredibly exciting.