Amygdalae and World Peace

May 19th, 2017 by Nick Jacobs No comments »

My bucket list is virtually impossible and possibly somewhat delusional, but I believe you should either go big or go home. As long as I can remember, I wanted to do something significant to make the world better. After I left teaching and explored a few career cul-de-sacs, I did end up in healthcare administration and started a deeper search for my big impact opportunity. Then came research, and I realized there truly was potential to change the world. It was a few years after I left healthcare administration when I realized where those world changes could be found.

I started working with some brain scientists; neuroscientists and psychiatrists and they taught me about the amygdala. I’ve come to realize that the amygdala is the source of many of our world’s challenges. I’m not sure how I missed this fact, but today I also discovered we have two amygdala sections of the brain, one on either side. That’s like finding out that the bill you got for college is only half of the bill. Now, we’ll have twice as much to deal with on our quest to change the world through amygdalae.

Now, here’s where things get a little more complex but encouraging, the function of the frontal lobe’s prefrontal cortex helps control the amygdala. According to an article titled, “The Brain Made Simple,” You use your prefrontal cortex to think and make decisions. This part of the frontal lobe is also where our personality is formed and where we can carry out higher mental processes. In addition, the frontal lobe is necessary to be able to speak.” Controlling the amygdala via the prefrontal cortex could be the good news except for one very important thing. This part of our brain isn’t completely developed until our early and sometimes even mid-20s. This explains why most teenagers and young adults can be noncompliant regarding the rules of society. It’s this part of our brain that provides some reasoning skills to calm down the amygdala, but it doesn’t do it soon enough.

If you’re still with me, there are still more layers of influencers that contribute to how we act, and they can go back literally millions of years. There are genetic changes that have occurred over generations. Was your mom under stress while you were in the womb? Did your ancestors come from a society where war was always part of their lives? Do you have other specific genetic mutations, or have you been subjected to abuse? Do you have higher levels of testosterone? All these variables can contribute to how you act and react.

Back to my opening sentence. One of my bucket list items, like Miss Universe, is world peace, but now it’s clear that the only way to achieve that efficiently is to find the means to hijack the destructiveness and idiocy that sometimes emerges from the functioning of the amygdalae due to the lack of involvement from the prefrontal cortex.

That’s when I saw that Silicon Valley has employed some of the world’s greatest minds to make programs like Facebook, Instagram, Snap Chat, and LinkedIn addictive. This is great news. Everyone will be so hooked on their phones and computers all war will stop while we wait to see how many LIKES we get from that last cat picture we posted. I’m now on my way to bucket list item number two, Intergalactic travel.


More than you ever wanted to know about the repeal and replacement for the ACA

May 4th, 2017 by Nick Jacobs 1 comment »

We’re not going to know how the new repeal and replacement for the Affordable Care Act will impact us personally until it hits, but here are what the proposed changes look like. Thanks to the New York Times, Modern Healthcare, and half a dozen other publications that I receive, here are some highlights, or, depending upon your point of view and financial situation, lowlights from the proposed changes.

Before you read this let me give a quick summary.  If you’re wealthy, you’re going to be better off than before.  If you own a business, you should be better off financially. If you’re healthy, you’re good for now.  If you live in the right state, you might be fine, but, depending on your health situation, you may have to move from state to state to try to find coverage, and please, don’t be poor.

Pre-existing conditions – Under the ACA insurers are required to cover people regardless of any pre-existing conditions and they are not allowed to charge customers based on their health history. The new proposed House bill will allow price differences to be imposed by insurers on a state by state basis.  As long as states set up some type of high-risk program, insurers could charge higher prices to those sick customers if they’d experienced a lapse in coverage for more than 63 days.

Dependent coverage until 26 – The new bill keeps this provision.

Taxes – Under the ACA new taxes on medical devices, indoor tanning, prescription drugs and high-income individuals were imposed.  All of these taxes would be repealed.

Employer mandate-The ACA requires companies to provide affordable insurance to their employees.  This will no longer be a requirement.

Individual mandate- The ACA requires people who can afford health insurance to purchase it.  This provision will no longer be a requirement.

Subsidies for out-of-pocket expenses – Under the ACA tax credits currently are provided to help some people make co-payments and pay deductibles.  This provision would be repealed in 2020.

Prohibitions on annual and lifetime limits – Under the ACA insurers are barred from setting a limit on how much they have to pay to cover any individual. The House bill allows states to waive the “essential health benefits” rules. Consequently, caps on coverage could become possible for certain types of care.

Restrictions for charging more for older Americans -The ACA prohibits insurance companies from charging older customers more than three times the prices charged to younger ones.  The new bill would allow insurers to charge five times more, but states could vote to charge even more.

Premium subsidies – The ACA gives tax credits to middle-income Americans to help offset the costs of the program, but the new bill would use age instead of income and location to calculate how much taxpayers can receive in subsidies. They also put a cap on this for higher earners.

Medicaid Expansion- Right now over 30 states expanded their coverage for Medicaid. The new act would allow those 30 states to continue receiving subsidies until 2020, but states that did not expand Medicaid would not be allowed to do so in the future. The bill also permits states to receive lump-sum block grants and suggests capping federal funding per enrollee, and it gives the states the right to impose work requirements for some Medicaid beneficiaries.

Essential health benefits – Basic benefits including for emergency care, maternity care,  and preventive services are currently part of the ACA.  The House bill allows states to decide if they want to provide basic benefits or not.

Health savings accounts -Under the ACA, individuals could put up to $3400 and a family $6750 into a tax-free health savings account, but the new bill would allow people to put much more into their HSA’s while also allowing spouses to make additional contributions.


My Youth Was All About Bikes

May 3rd, 2017 by Nick Jacobs No comments »

First, I had that used, blue, 14-inch girls bike that my dad bought for $6. Then a few years later, I finally saved enough money from my paper route, holiday and birthday presents to buy a J.C. Higgins, Pee-wee Herman-type bike with big white wall tires, handle bar streamers, a white headlight, and chrome fenders. As an adult, I began buying Treks and Cannondales when they came on the scene, and now I have stationary bikes.

Relative to biking, as a young adult, there was also a multi-year period where I was regularly forced to observe something that no person should ever have to see. One of my bosses, a very large man, often rode around in skin-tight biking gear. He looked like that guy from Monty Python where, if he ate that after dinner mint, he would explode. It was the skintight shorts that were the visual challenge. It’s been 17 years, but you just can’t unsee something like that.

 Fourteen years ago, I made a firm decision to do everything I could to help keep my grandkids on bikes because I believe bikes are better than couches and iPhones for their growing little bodies. Oh, and I also believe in helmets because one of my most terrifying life moments was when my son was hit by a pickup truck during those pre-helmet days. (When he sang Moooooon River in the emergency room during an internal exam, I knew he’d be OK.)

Now, I’m promoting a giant bike thing. Don’t get me wrong, I am still not riding in it, but it is with deep conviction that I’ve committed to promoting this thing. I’m excited about it because it could have a big impact on the area, and it’s for a good cause, Special Olympics Pennsylvania, Winter Games Nordic. We’ve all seen the incredible smiles on those kids faces as hundreds of athletes, coaches, families, and friends representing all corners of Pennsylvania compete in alpine and cross-country skiing, and speed skating, snowshoeing and individual skills events. More than 350 athletes and 130 coaches participate in three days of exciting winter sports.

So, here’s the lowdown on the bike ride. It’s called the Hidden Valley Mountain Metric PA Century Bicycle Challenge, and it starts at 9 a.m. on July 15. It offers several levels of rides through the scenic hills and countryside surrounding Hidden Valley, but the most challenging will be the Metric Century (62 miles) that features both the distance and climbs to challenge experienced cyclists. No, uh, uh . . . you won’t be seeing moi doing that 62-mile run. This Metric Century ride will, in part, follow the Cycle Southern Alleghenies Raging Rapids Adventure tour.

There will also be a less intense Half Metric Century (32-mile) ride for the recreational rider, but I’m won’t be on the ride either. Then there will be a fun ride for families of all ages over a lesser challenging route, and you won’t see me there either. But because all of the rides begin and end at Hidden Valley, include refreshment breaks along the route, and food and entertainment at the conclusion of the ride, you may see me there. Or I may be offering child care and babysitting because I’ve become very adept at offering those services.

Don’t worry, there will be a Support and Gear wagon along the major routes, and if you play your cards right, you may get your hands on some simple carbs and sports drinks. For your $30 advanced registration, you’ll get all of those things plus a food coupon and a performance fabric event shirt. Come on, think about it. Why not pedal your buns off for a few hours, burn off some calories, and then eat and drink afterward? You can register online at Start elevation, 2,923-feet., max elevation 2,934-feet, and gain is 5,655 feet. Do ya feel the burn?


Healthcare is the Third Leading Cause of DEATH in the United States

April 24th, 2017 by Nick Jacobs No comments »

That was a headline in an E-mail that I received today from Michelle, and the premise of the content of that E-mail was that one cause of the medical errors which contribute to a significant number of deaths in America’s hospital is the continuous use or overuse of safety alerts in Information Technology programs.  Their hypothesis was that these alert are programmed to happen so often that the healthcare professionals begin to ignore them altogether and thus miss the significant ones. They referred to this as ALERT FATIGUE.  Interesting premise and there most probably is some truth to this.

Michelle’s E-mail was promoting Wolters Kluwer Clinical Drug Information’s (CDI) Technology, and they wanted me to call them to write a blog about their technology.  Obviously, I didn’t, but they did get a free plug here so that I’d have some reason to start this entry with that attention-getting headline.  I’m sure alert fatigue plays some part in some medical errors.

But the number one cause of medical errors that can lead to death is humanness. One of my scientists would become infuriated if someone compared going to the moon to curing cancer because, according to him, the moon shot was primarily controlled through engineering and cancer cures require deep science.  Of course, he was referring only to those portions of the trip that were not science related which were, hmmm? None?  It was the combination of science and engineering that made it work, but the humans sure as heck played a major part in its success. Just like in healthcare, the medical errors can come from science and engineering, but most of all, those errors come from humans.

In my book, “Taking the Hell Out of Healthcare,”I stressed patient advocacy. At the tender age of 13, I observed my grandfather die needlessly because there was construction dust in an operating room that kept him unnecessarily bedridden for a week.   The inactivity resulted in a DVT (deep vein thrombosis) that killed him.  From that day forward, it was clear to me that the patient better have an advocate for as many hours a day as possible because it could save their life.  More importantly, it had better be someone who knows a little something about healthcare because it only takes one mistake to begin a cascade of unhappiness.

I’ve always believed there is a potential profession in patient advocacy. Physician Assistants or Nurse Practitioners could work to ensure the patient is treated, medicated, and nurtured appropriately, and they would make a small fortune from those who could afford them.

What about the rest of us? Just having someone who cares a little bit about your well-being standing nearby to ask prudent person questions when you’re sleeping, confused, or befuddled by the medical speak that’s going on around you could save your life.

I’m not a doctor, not a scientist, and surely not a genius, but I do know that humanness is what leads to errors which lead to death. Those errors are human errors. They may be because someone didn’t learn about something in school or because they forgot, or they were tired, or sleepy, or angry, or fearful, but they do happen, and if someone simply says, “What’s that pill for, and why does my friend need that pill?” It could lead to appropriate answers.

I’ve seen hundreds, no thousands of documents detailing medical errors that could have resulted in liabilities for the hospitals where I worked, and those documents always told the story of how one professional forgot to communicate something to the next professional or how someone misunderstood a written order or they didn’t check a wristband, and the story goes on and on.

Get someone. Pay someone if you must in order to stand by you. The wonderful people who work in hospitals are there because they care, but long hours, traumatic situations, labor pressures, and more contribute to accidents.  Make sure you’re not one of them.


Planes, no trains, and Uber

April 5th, 2017 by Nick Jacobs No comments »

 As I had hinted at a few weeks ago, I’ve officially transitioned now from being Han Solo to being Yoda. OK, I’m not green. Yes, I’m not as smart as Yoda, and I have no secret, magical powers, but in many ways, my transition into my eighth decade has become a personal challenge to keep getting it done. I’m just not always sure what it is.

This week I flew to Los Angeles to serve as a new trustee on a board of directors at the Southern California University of the Health Sciences. The huge challenge that my daughter presented to me was to attend that board meeting on Thursday and still make it back to celebrate my birthday. All my plans were made. I would Uber to the airport, jump on the earliest red-eye flight home, spend one hour at the Newark Airport, fly to Pittsburgh, get a cab to my place, and drive to Johnstown for the beginning of a birthday bash.

At exactly 8:15 p.m., the gate agent said, “We’ll board in about 10 minutes.” Then in 15 minutes, another gate agent said, “They have discovered a malfunctioning joint on one of the airplane’s tires. We will let you know in 20 minutes if we can find another plane.” This was the dreaded reality of trying to get from one coast to the other. Remarkably, in 20 minutes they said, “We found another plane for the Newark trip. Go to Gate 71B.”

We stood in line at Gate 71B for about 45 more minutes. It was now well after midnight Eastern time, and we were all tired. Because I had no status with this airline, my seat was just a few rows in front of the back lavatory, and it was a tiny space. The boarding process was incredible with least 40 people not able to put their luggage in the overhead compartments.

We took off 84 minutes late, flew at 551 miles per hour across the United States, and landed 10 minutes after my flight to Pittsburgh left. I went to the service desk to find that the next flight was late.

Then it was canceled. Then the next flight had 20 people on the waiting list, and they anticipated that the next three flights would be canceled. But either way, my trip home would not take place that day.

It was then that I made an impulsive decision. I left the airport, went outside, and hit my Uber app. It was impossible to imagine that anyone would drive me five-and-a-half hours to Johnstown from the Newark airport without charging me at least $1,200, but then Ali pulled up in his 2016 Toyota Camry, looked at the distance of the trip, smiled and said, “No, it’s OK. Let’s go.”

Ali was from Yemen. He was a kind, a 32-year-old father of three who now lives in Brooklyn. Ali drove me through the fog, heavy rain, the wind, some ice, past lots of trucks, and he did it with skill.

We arrived in Johnstown at 3:30 p.m. I paid and then tipped him generously, but I wanted to high five him and thank him for helping me celebrate my big birthday. It was an incredible gift for me and my family.


The chicken coop 

April 2nd, 2017 by Nick Jacobs No comments »

It started out as a family project and evolved into a full-blown farming experience. My daughter and her husband bought six chickens. OK, they were baby chickens, you know, – chicks, peeps. Of course, it was fun at first as each one of their kids played with them and took responsibility for feeding them, changing their bedding and providing them with water.

Throughout the spring, summer, and fall, there were plenty of frustrating days with the kids as they attempted to herd their free-range chickens into their pen for the night, and there were plenty of times when parents and kids argued over whose turn it was to collect eggs, catch chickens, and change bedding after cleaning out the pen.

Watching the coop evolution itself was fascinating as they moved their chicken family from a little coop, added fencing, and then put them in a bigger coop that was insulated-light heated.

Miraculously, those six birds made it through an entire summer without incident. Then, in the early fall, the first attack hit. Initially, they thought it was a four-legged critter, but then they found the remnants of the bird and figured it was eaten by a chicken hawk.

As the winter went on, the attacks did as well. Each call to me came with sadness and compassion as they described the latest horrific occurrence and eaten chicken. It was like they had created “Pickin’ Chicken” for the local predators. They’d tell me how the other chickens had stopped laying eggs due to PTSD, and how sad it was that their birds were becoming animal food.

As of last week, there were only two hens and a rooster left. The carnage had taken its toll on the kids, but in a discussion with my daughter this morning when she was describing how ruthless those chicken hawks are, it suddenly hit me that this experience was textbook because it was undeniably representative of real life.

Back when I was a chicken or a sitting duck, my primary boss walked into my board meeting one night and, out of the clear blue sky said, “There’s only one thing wrong with this place, and it’s Nick Jacobs. I’m making a motion that you take a vote right now to fire him, tonight.” Boom! Chickenhawk attack! Apparently, I’d upset him, and this was his response.

Just then one of my board members looked at him and said, “My father told me that there would only be afew people in my life who I would care about as a truly good friend, and I’ve felt that about Nick since the first time I met him.” Following that endorsement, the motion fell short of getting even one vote. That boss got up and stormed out of the boardroom in frustrated anger.

After this, in our own symbolic way we put fencing over the top of our figurative coop, hung shiny CDs, and got a fake owl. OK, not really, but we did take steps to protect ourselves from this human predator who was after me.

As time went on, I watched him try to take out several other hypothetical chickens inappropriately. As soon as I’d see him swooping in on someone who was competent but did not acquiesce to his bullying, I’d offer them a job. (He finally self-destructed.)

Remember, no matter how hard you try, there will always be predators lurking to bring turmoil into your life.

By the way, my daughter and family bought 10 peeps and a new coop today, and they found out it was a Fox!


Less information, more education

March 15th, 2017 by Nick Jacobs 2 comments »

Less information, more education

Nick Jacobs

I watched the movie, “Hacksaw Ridge” and was overwhelmed by the bravery of the soldier, Desmond Doss, who was portrayed in this true story. At the same time, I was disturbed by the graphic depiction of the total insanity of war. The United States has only had 21 years of peace since 1776.

Maybe because of these continuous conflicts, many of us seem to have burrowed once again into a deep hole of fear. We fear those people who we perceive to be dissimilar to us. More importantly, however, we fear losing control. It’s that fear, perceived or real, that seems to be consuming societies across the world.

Think of it. All of the knowledge ever accumulated by mankind is virtually available to us at our fingertips, and our inability to either absorb or control that information can be the source of some of this fear and discontent. Add to that our inability to deal with the daily run of information that is intensified and modified by the 24-hour news cycle. We are inundated with the explainers, and the bloggers, the opinion columnists, talk show radio and podcast hosts who benefit from producing views that represent these extremes.

She went on to say that the other relatively new twist in all of this was our ability to directly communicate with each other in a way that has not existed since the very beginning of humankind. She explained that a young Massai boy from Tanzania could be in instant contact with his 13-year-old cousin in an apartment in Jersey City through his smartphone.

This ability to communicate so broadly can be extremely problematic for authoritarians’ governments. Someone who is trying to rule a country could have previously told unchecked lies to their people, but today those autocrats are called out by world connectivity so that only those supporters who choose to or are forced to be blinded by their lies will continue to endorse their leadership.

My son just returned from his third trip to China, and he said that, besides the totally intimidating presence of the military, there was a complete lack of access to the Internet. The outside world is virtually shut out. You are only permitted to access what the government wishes for you to access.

With all of this in mind, let’s take a few steps back and try to be objective about our personal journey and potential. What is it that we could achieve if we could just stop focusing on fear, embrace the vastness of opportunity and direct our lives accordingly.

Two weeks ago I heard a presentation by Deepak Chopra that revolved around his new book, “You Are the Universe.“ What follows is an excerpt from my notes. Ninety-six percent of the universe is unknown and unknowable. Seventy percent is dark energy and expanding. Of the 30 percent that’s left, 26 percent is dark matter that is invisible, and 4 percent is atomic. Of that four percent, 99.99 percent is dust. Consequently, only about .01 percent is the visible universe.

He went on to say that atoms are made of particles, and atoms disappear into waves. It is those WAVES which represent possibilities. So, with that in mind, your body’s atoms represent a localized adventure of the entire universe.

We are the universe, and we have the ability to lead ourselves, our country, and our world out of this funk that we currently seem to be entering. Let’s will us to personally embrace the light and stop being so very well informed and yet so incredibly unwise.



February 1st, 2017 by Nick Jacobs No comments »

When I was a little boy, I remember hearing a loud explosion, looking out my window and seeing a cross burning in front of the Catholic church. My mom, a daughter of the American Revolution whose relatives had been senators and military officers, and my dad, a first generation Italian born to immigrant parents, both told me not to be afraid. They told me it was just people who liked to party on Friday nights. (By setting off dynamite and burning crosses?)

By the time I was a teenager, the terrorism toward Catholics had reached a new peak as the first Catholic was elected president and the United States traditionalists said that the Pope would literally take over running Washington. Obviously, that didn’t happen, and, in fact, John F. Kennedy became one of the most beloved presidents to serve our country. (Of course, he was also assassinated.)

As an adult, I once asked my mother if she ever knew anyone who was in the Ku Klux Klan, and she very casually said, “Only my dad when he was young.”

Growing up It was not unusual to hear derogatory remarks about the Italians, Irish, Jews, and African Americans. Interestingly, however, that bigotry had not been a major part of my high school experience. I honestly believe that was because most of the African Americans, Irish, Slovaks, and Italians were working in the coal mines, and if you were a bigot in a coal mine, the only thing your working partner had to do to get you killed was to walk away from impending danger without letting you know.

It was not until I began teaching that I saw total and complete, blatant prejudice. It was devastating and disgusting. In fact, it was not only among the students but also from some of the teachers toward the students. Consequently, I began to treat my non-white students from the Philippines, China, African American, or LGBT very special.

I was their guy, and it was easy for me because, as a musician, I didn’t see differentiators and didn’t care. All I wanted to know was how they played their instrument.

My liberal approach to these minority kids became so obvious to them that one of my gifted African American students came into my office one day and said, “Mr. Jacobs, I need to tell you something.” To which I responded, “Sure, Alicia.” She went on to say that her friends designated her to tell me to stop treating the minority kids so differently. She said, “Mr. Jacobs, we just want to be treated the same as everyone else.” That girl was 13 years old, but she taught me a lesson that has lasted for my entire life.

As the president of a research institute with brilliant scientists from all over the world, and as a student at one of the most diverse schools in America, Carnegie Mellon, I saw first-hand that intelligence, ability, and more importantly work ethic, drive, and ambition was not limited to only one race.

The only thing one has to do is watch some of the reality TV shows to see messed up people, and that’s not race based. There are gifted, kind, and not so kind people of all races.

That statement “of all races” is really where the problem begins. There truly is only one race, the human race, and liking people because of skin pigmentation, hair texture, eye shapes, or any other differentiator is a nonstarter for any of us, but hatred is definitely taught.

Some of the absolutely most beautiful people in this world are amalgams of all races, colors, and creeds. So, if you’re a hater, look in the mirror and try to determine what it is you hate. It may be looking back at you.

As Albert Einstein that famous Jewish scientist said, “What a sad era when it’s easier to smash an atom than a prejudice.”


It’s Okay. I’m over it now.

January 24th, 2017 by Nick Jacobs 2 comments »

In the last three years, I’ve had a flu shot every year, two types of pneumonia shots, a shot for Hepatitis C, one for shingles, and another one for Tetanus and whooping cough, but none of them stop me from becoming disease-ridden with the dreaded flu at least once a season. For the past eight years, I’ve been blaming it on flying in airplanes filled with recirculated coughs and sneezes, but all of my work in the past three weeks has not been in the sky.

OK, I do work in hospitals, those capricious breeding grounds for hundreds of unusual infections, but I’m pretty careful when I’m in those places.

It is always intense. In fact, the intensity of this condition hasn’t changed much in 30 years. The only thing I can figure out is that my childhood allergic asthma attacks, or playing professional trumpet in smoke-filled clubs for 20 years have resulted in some type of permanent damage to my lungs. When even the littlest cold attacks my immune system, it takes every white blood cell that I can muster from my entire body to keep those sniffles from blossoming into full-blown pneumonia. (I’ve had pneumonia about six or seven times, too.)

It was about 10 years ago when a radiologist friend said to me, “Hey, Nick, do you remember breaking your ribs because they’ve definitely been broken.” Did I remember breaking my ribs? The answer to that had to have been, no, but do I remember coughing so much, so hard, so loudly, and so forcefully that the chandelier started to swing? Do I remember the dog hiding in the other room? Do I remember being banned to a Lazy Boy recliner in the basement as my sit-up bed? Yes. I do remember those things very well.

It always starts out the same. There’s a little tickle in my throat that makes me sound like Barry White or some ripped guy with washboard abs at the other end of 1-900 phone number. (Not that I would know how someone like that sounds.) But I do know how Barry White sounds, and he drives the ladies crazy. Then, by the next morning the sneezes, continuous nose dripping, and mild coughing begin. By about 7:30 p.m. that night, I’m fully immersed in humidifiers, neti pots, flannel jammy pants, gallons of fluid, Tylenol, cough drops and cough medicine, tissues, and soft animal pillows to hold against my chest to ease the pain caused as I try not to crack more ribs.

Sometimes I cough so hard it seems like losing consciousness would be a blessing, but it’s only a cold.

In my work in healthcare, it always amazes me that we can do proteomic analytics to determine what proteins are spreading cancer or heart disease. We can look at individual microbes to ascertain what’s happening with our microbiome and digestion. We can look at the 300 genes that control the metabolism of our medications so that we take the right drugs, but we can’t figure out the common cold or flu.

How many times have we heard, “The Centers for Disease Control did not guess correctly on the strain of flu this year for your flu shots?” Good luck with that. I heard this morning that 400 stray cats have been quarantined in a warehouse in New York City because they have a new version of the swine flu. I’m sure I do as well. Too bad I’m allergic to cats, or I’d go hang out there, too. Here kitty kitty kitty.


Integrative Medicine is Becoming More Popular

January 10th, 2017 by Nick Jacobs 4 comments »

According to a recent article published by the American Hospital Association, Integrative Medicine is becoming more popular in the healthcare industry, and the major force behind this movement is primarily coming from the patients themselves.

Integrative care programs, such as acupuncture, energy medicine, and tai chi, have garnered increased acceptance among the general public, and an increasing number of hospitals and health systems are adding these integrative therapies to their menu of options.  The AHA confirms that the primary reason for this increase is actually due to individual patient demand.

Massage, music, humor, and pet therapy along with mindfulness, yoga, and acupuncture are all being more widely accepted because clinicians are incorporating these therapies into their traditional Western Medicine practices in a coordinated way.

According to the AHA, comprehensive outpatient centers specializing in Integrative Medicine operate at a high cost, and, for the most part, do not have adequate reimbursements.  Consequently, many of these centers are still dependent upon donations.

It’s been my experience that, depending on the health system’s size, location, and other factors such as economic well-being, they offer either comprehensive outpatient integrative centers or integrative services in inpatient settings. Either way, the providers have to deal with reimbursement challenges for these programs.

It is customary for many Insurers to cover acupuncture and in many states, they also provide reimbursements for massage therapy. But the primary source of payment in Integrative Medicine is still from the patients who are asked to pay for them out of pocket. In some cases, like at Highlands Hospital, in the inpatient setting, the services are offered to the patients without any charges.

Because the various treatment modalities offered in integrative medicine are still not taught in traditional medical schools, there are physicians who continue to be skeptical about their use, but the amazing results that can emanate from these programs are becoming more and more widely accepted and acknowledged.

One reason for the acceptance of these programs is the increasing number of evidence-based scientific papers that are being submitted to and accepted by traditional medical journals each year. There have been over 19,000 papers submitted on the effectiveness of acupuncture alone.

The other reason for more widespread acceptance is the now recognized positive patient outcomes. In my experience as a hospital CEO, we have seen integrative therapies shorten the patient’s length of stay and reduce the need for pain medication while improving the patient’s overall care experience.

Dr. Angela LaSalle, director of integrative services at Parkview Health System in Fort Wayne, Indiana, Dr. Kelly Warshel, director of palliative care services at the Chan Soon Shiong Medical Center at Windber, Dr. Leonard Wisneski, Chairman of the Integrative Health Policy Consortium, and Dr. Mimi Guarneri, President of the Academy of Integrative Health and Medicine are just a few of the physicians with whom I have worked to create “healing environments,” for patients.

This type of total care is integral to the overall quality of the patient experience. We have seen time and time again where Reiki, music, and mindfulness practices can decrease patient’s anxiety, and with less anxiety, the immune system has a greater opportunity to work properly.

In my experience, when we compared such benchmarks as lengths of stay, pain medication use, or patient satisfaction for patients who received integrative therapies as compared to those who did not the patients almost unanimously reported a decrease in both, pain and anxiety.

As we look for ways to decrease the use of drugs and become more active in our own health and wellness efforts, it is apparent that integrative care practitioners who combine traditional medicine with the integrative therapies are providing extremely meaningful care to their patients.

I remember hearing a prominent integrative physician state the following, “Acupuncture may not work for every patient in every situation, but the great news is it can’t hurt you.  Even if it’s done incorrectly, it releases endorphins.”