August 16th, 2020 by Nick Jacobs 1 comment »
Western Pennsylvania Guide to Good Health

Getting to the Point of Acupuncture

June 5th, 2020 by Nick Jacobs 1 comment »
Western Pennsylvania Guide to Good Health

By Nick Jacobs
Let me get right to the, uh, point, on acupuncture: while this practice has been shown to be a safe, effective method to reduce pain, hasten healing and even kick some nasty habit for many people, it remains an under-used form of medical treatment.

Despite countless studies regarding its effectiveness, acupuncture remains shrouded in mystery for many Americans, who often view this key component of traditional Chinese medicine as too antiquated, too painful, too simple or too mysterious to offer any real or long-term positive health improvements.

Yet nothing could be further from the truth. While acupuncture might not prove effective for everyone, it is providing pain relief and other benefits for an increasing number of individuals. In fact, more than 19,000 papers have been written about the efficacy or effectiveness of acupuncture.

In a recent Time Magazine article titled “The Mystery of Acupuncture,” author Jeffrey Kluger said, “The World Health Organization has declared acupuncture a useful adjunct for more than 50 medical conditions, including chronic stress.”

Kluger also said that the National Institute of Health (NIH) agrees with this opinion and has endorsed acupuncture as a potential treatment for migraines, menstrual cramps, abdominal pain, tennis elbow, nausea from chemotherapy and more.

“The fact the Mayo and Cleveland Clinics have embraced acupuncture and groups like the AMA have gotten states to designate acupuncture as an essential health benefit is more than significant,” Kluger said. He added that more than 3.5 million adults and 80,000 children use acupuncture in the U.S. annually and that the military is using it for PTSD, pain disruption and an assortment of ailments, not the least of which is lower back pain.

As someone who once suffered regularly from bouts of lower back pain, I became alarmed when I saw statistics on lower back surgery that were less than encouraging, showing the procedure as sometimes as low as 30 percent effective. For me, osteopathic manipulation, exercise, weight loss and, yes, acupuncture, have all been medical gifts that have worked beautifully for me over the years.

Possibly the most powerful potential use for acupuncture is in the treatment of addiction. Considering that more than 50 million Americans suffer from chronic pain, acupuncture is one possible alternative to OxyContin and other addictive pain drugs.

So why wouldn’t someone suffering from debilitating or chronic pain give acupuncture a try?

For some, hesitation is caused by ignorance, exacerbated perhaps because someone—maybe even a medical professional—ridiculed the practice, perhaps even labeling it “woo-woo” medicine. Yet simply explained, traditional Chinese medicine describes acupuncture as a technique for balancing the flow of energy or life force thought to travel through the body’s pathways, also called meridians. Very thin needles are inserted along these pathways to “rebalance” energy flow. Western practitioners see these points as places to stimulate nerves, muscles and connective tissue, perhaps with the added benefit of boosting a body’s natural painkillers.

Or perhaps your hesitancy is more basic: the thought of little needles dotting your body like a pincushion sounds gross and painful. Yet this fear, while understandable to a degree, is overblown. The needles couldn’t be any smaller or less noticeable. Patients most often report very little to no discomfort, especially when balanced against the pain relief they gained.

But what of any risks associated with acupuncture?

Any risks are minimized if you have a competent, certified acupuncture practitioner who uses sterile needles. Since one-time-use, disposable needles are now common practice, risk of infection is minimal and most common side effects include soreness, very minor bleeding or bruising.

As is true with many treatments, acupuncture might not prove effective for everyone. But given the potential it offers, why not give it a try?

In many articles and speeches, I often quote the book Change or Die by Alan Deutschman, who suggests many of us would simply prefer the latter rather than change. Sound unbelievable? Just consider that every day we are inundated with advertising, political narratives and scientific positions that encourage us to remain loyal, to continue to behave in a certain way, even though we should question if doing so is in our best interest.

I recall a conversation I had with a scientist who told me that hydrogenated fats were the biggest medical experiment perpetrated on mankind without our knowledge. Yes, it prolonged the shelf life of food. It also created an inflammatory disease that was harmful to half a million American annually.

So maybe, when it comes to our individual health, we need to be more open minded and willing to try options that, while showing positive impacts, veer just a little from the usual path of suggested treatments.

The point is, acupuncture is a valid option to consider to relieve pain and encourage healing. Even if it’s done incorrectly, it releases endorphins. And that’s a good thing.

What have you got to lose by giving it a try?

Nick Jacobs is a partner with SMR, LLC, a senior leadership healthcare consulting firm. He is a founder of the Academy of Integrative Health and Medicine, former board member and officer of the American Board of Integrative Holistic Medicine and served on the Executive Committee of the Integrative Health Policy Consortium. A former hospital CEO and founder of two genetic research institutes, Jacobs maintains a website,


Deadly Political Game

May 13th, 2020 by Nick Jacobs No comments »

Washington is not focusing singularly on this virus as the enemy. COVID-19, SARS-2 Coronavirus should be a unifying factor for our country. Our political leadership is not seeing this tragic pandemic as a way to help us move our public health response more efficiently and quickly to accelerate our efforts to provide economic relief to all of those who need it.

Instead of working together for us, they are working overtime on tactics to divide Americans even more. Democrats are being portrayed as evil pessimists while Republicans are being identified as anti-virus militants, the liberators of our depressed economy.

Under the “Are you kidding me?” category: According to the AP, more than 70 people tested positive for coronavirus since the April 24 rally at the Wisconsin state capital. Michigan is working on legislation that may limit the carrying of AR-15s inside the State Capitol building.

Also in Michigan, a security guard was shot and killed by a family for attempting to enforce the “you must wear a mask policy” before entering an open establishment.

Several weeks ago, a lawsuit that may or may not go anywhere was filed against Fox News for violating the Washington State Consumer Protection Act because their national celebrity broadcasters falsely stated multiple times that the coronavirus is a hoax. At the same time, even though we all know the virus can be deadly 14,000 heroes have signed up to be voluntarily infected to assist in vaccine studies to help expedite the creation of a vaccine.

What do we know about this disease? Obviously, not as much as we don’t know.

Physicians in London, New York and elsewhere have reportedly seen an increase in children suffering from symptoms emulating Kawasaki disease with inflamed hearts. They have also identified numerous other unusual symptoms including the weakening of the heart muscles and disrupting its critical rhythm.

COVID-19 attacks kidneys so seriously that now, instead of a shortage of ventilators, we are seeing a need for more dialysis equipment. Besides the attacks to our nervous system that destroys taste and smell, the disease sometimes makes its way to the brain. If that’s not enough, 20 to 45-year-olds are suffering 50 percent higher than average numbers of strokes or are dying from blood clots due to inflamed blood vessels.

According to an article by Lenny Bernstein and Ariana Eunjung Cha, “It can begin with a few symptoms or none at all, then days later, squeeze the air out of the lungs without warning.

It picks on the elderly, people weakened by previous disease, and, disproportionately, the obese. It harms men more than women, but there are also signs it complicates pregnancies.”

We also have seen articles like this in the CDC where “the effects of COVID-19 suggests a disproportionate burden of illness and death among racial and ethnic minority groups.”

Throughout this, however, our president is continuing his battle against the Democratic governors by saying they are holding their citizens hostage while at the very same time due to an outbreak of COVID-19 in the West Wing of the White House, three of America’s top health professionals are quarantined in their homes.

So, we have to ask: What’s at stake here? Manufactured political divisions are now impacting aid for states as well. This is not a red or blue discussion. The opponent here is not us individually, not members of any party. The victims are members of the human race caused by the real enemy, COVID-19.

No one wants the economy to remain closed. Governors on both sides are attempting to balance the death-over-money equation, but the necessary arrows for the COVID quiver have been slow to arrive, and the needed instruction and supplies from the federal government have become an economic stand-off.

We all want freedom from our enemy. Stop the politicizing, and stop feeding these political war games, or we’ll die.


Things are gonna change

April 22nd, 2020 by Nick Jacobs 4 comments »

Things are gonna change after COVID

According to the medical examiners, the primary underlying conditions leading to death in the victims of this pandemic are hypertension and diabetes, chronic conditions brought on by environment and diet.

The fact that COVID is disproportionately impacting marginated communities should not be a surprise to anyone. A healthy public depends upon diet through fresh, healthy foods which are more expensive and in “Urban Food Deserts” almost impossible to find or afford. Plus, health is also related to the environment (think Flynt, Michigan), and sustainable employment.

We have produced so much vulnerability in the U.S. through our current circumstances that analyzing this disaster without properly taking into consideration our pre-existing health care crisis is, in itself, a crisis. Would we scrutinize this differently if we looked at our current system more holistically?

We have huge disparities in both our healthcare system and our public health system. We have been preparing for another pandemic since 1918, yet we were woefully unprepared for even the most basics of PPE, available ventilators, and ICU beds.

In an article titled “Disasters, Capitalism, and COVID-19” by Vincennes Adams, Naomi Klein describes disaster capitalism as a form of economics that responds to disasters in ways that promote “free-market, for-profit, corporate solutions.” She says, “It may succeed in creating company profits but ultimately fails in terms of democracy, fairness, and justice.”

She describes the Hurricane Katrina disaster as being caused, in part, by the privatization of the Army Corps of Engineers and the oil industry’s erosion of protective wetlands. The highest death tolls, financial, and material losses affected the most vulnerable social and economic groups. During the recovery, private sector contractors rewarded themselves richly while ordinary people were left to make it on their own.

I’m watching this same phenomenon unfold today with Community Health Centers across Pennsylvania as they try to get the needed Personal Protection Equipment. Wealthier health systems, States, and the Federal Government can buy the large quantities required to meet the corporate criteria for these purchases while the marginalized become further marginalized.

Why aren’t the flu, viral colds, heart disease, cancer and diabetes deaths considered disasters? It’s because of the immediacy of death with COVID. The author suggests: “Imagine how U.S. health care institutions and government responses might change if cancer, heart disease, and diabetes were framed in the same language and sense of urgency as COVID-19.”

According to the author, It’s because these diseases are “an outcome of allowing corporations to sell deadly, heart-disease producing foods and barely regulating cancer-causing chemicals at all.” This country has always had a very hard time determining the differences between the value of corporate profits vs.human life.

The article references a “pandemic industrial complex,” which, like the military industrial complex uses the disaster to form a framework in which government and financial resources are mobilized to leverage free market investing in the next big outbreak.

Global warming has contributed to fires, floods, hurricanes, and now unique viral mutations. The new prognosticators of these disasters are computational and zoonosis biologists, epidemiologists and geneticists.

What they have been able to point out to us is not necessarily the coming disasters as much as the pre-existing vulnerabilities, and they’ve been able to do it in ways that also predict capitalistic disaster as well.

If our population were more health conscious, had better access to health insurance, and was less influenced by the free capitalism that continuously promotes products that are detrimental to our health, a disaster already created by a capitalist free market, would this be a different set of analytics?

Is COVID-19 the disaster, or is our real United States disaster the lack of a functioning health care safety-net for our most vulnerable? The primary question we should be considering is: can we change that future for our kids and grandkids? Wuhan, China reopened today after 10 weeks, but nothing is the same.



March 25th, 2020 by Nick Jacobs 1 comment »

This is getting serious

When I was still running a hospital in 2008, the H1N1 virus was beginning to get a foothold internationally. We had numerous workshops and meetings regarding this potential plague, and the impact it could have on our region. It was a very sobering time, but nothing like what we’re experiencing now.

One of our research scientists had begun to dig into the history of the 1918 flu, and the results of his work were beyond eye-opening. My internal expert told me of the mass graves in the Central City area where roads are still not permitted to be built, and the outcries from undertakers because they had been prohibited from servicing the dead.

The 1918 influenza pandemic was also caused by an H1N1 virus, and that pandemic killed an estimated 50 million people worldwide, but its most chilling trait was the high death rate it caused in healthy adults.

Because I was informed by our Windber scientists, by expert epidemiologists from the academic universities, and by state health department officials, our preparation for a pandemic was very real, and I began loudly beating warning drums.

We jumped on preparation as if it were truly going to be life and death for many. As it turned out, this viral attack was contained in a very efficient manner, and although from April 2009 to November 2009, 3,900 people did die in the U.S. from H1N1, that was 1,000 less deaths than have occurred in the past few weeks in Italy which is more than five times smaller than the United States.

When I heard the “Don’t worry. Be happy,” spin that was initially coming from several news shows and the national press conferences downplaying this disease that was definitely coming our way, my blood ran cold. What if they were wrong? This was potentially a life and death scenario that was being pushed aside like a regular flu.

Then the numbers started coming in from places like China, South Korea and other Asian countries, and I knew it was beyond real. My scientific friends confirmed the potential lethality of this virus that was jumping into humans, and we had no known ability to stop it or fight it off and no chance for a vaccine for at least a year or 18 months.

This bat-based flu is a form of another disease; it is actually SARS-2. The Chinese shared RNA and DNA information as well as the general medical records of those infected with the world almost immediately. That information gave us a head start on vaccine discovery. Had we had the sophisticated infrastructure in place that existed pre-H1N1, this information might have already saved thousands of lives, but now is not a time for blame or finger pointing.

Consequently, today we have senators and representatives, celebrities, and loved ones suffering from COVID-19, all non-essential businesses are shut down, and our government still hasn’t made a decision that will help those suffering both physically and economically. Plus, we are still way behind the curve on NP-95 face masks, ventilators, gowns, COVID-19 tests or ICU beds to care for the sick, and we’re three months into this plague. Could we have been more aggressive?

Do I have the answers? No, but Russia has controlled it. Shanghai and South Korea have controlled it, and we have not. My advice? Believe in science, pray, keep a safe distance, and hope you don’t become a statistic.


Acupuncture why not

February 19th, 2020 by Nick Jacobs No comments »


Accupuncture, why not?


Published Tue Feb 18, 2020 8:15 PM EST

In a recent article in Time Magazine, Jeffrey Kluger wrote “The Mystery of Acupuncture.”

In the article he said the “World Health Organization has declared acupuncture a useful adjunct for more than 50 medical conditions, including chronic stress.” He went on to write that the NIH (National Institute of Health) also agrees and has endorsed acupuncture as a potential treatment for migraines, menstrual cramps, abdominal pain, tennis elbow, and nausea resulting from chemotherapy and more. “The fact the Mayo and Cleveland Clinics have embraced acupuncture and groups like the AMA have gotten states to designate acupuncture as an essential health benefit is more than significant.”

Kluger went on to say that more than 3.5 million adults and 80,000 children use acupuncture in the U.S annually. The military is using it for PTSD, pain disruption, and an assortment of ailments not the least of which is lower back pain. With all this information and these overwhelming statistics, why aren’t more of us using acupuncture?

If it’s fear of needles, you’re uninformed. These needles couldn’t be any smaller and less noticeable. As stated in the article, “The analgesic impact of a tiny needle is more than worth it.” The real beauty of this ancient Chinese practice is even if the practitioner doesn’t do it perfectly, it can’t hurt you.

Probably the most powerful potential use for acupuncture is in the treatment of addiction. Considering that more than 50 million Americans suffer from chronic pain, acupuncture as a treatment for chronic pain is one possible alternative to OxyContin and other addictive pain drugs. Of course, spinal manipulation by a physician trained in osteopathic medicine, a DO, or a chiropractor, plus yoga, and potentially non-addictive cannabinoids are also being used.

There have been more than 19,000 papers written about the efficacy of acupuncture, and recently I saw statistics on back surgery that were less than encouraging. According to recent studies, back surgeries are sometimes as low as 30% effective. Moreover, having been personally a regular sufferer from back pain, osteopathic manipulation, exercise, weight loss, and acupuncture have all been medical gifts that have worked beautifully for me over the years.

The question then becomes, why not? Why aren’t you trying acupuncture? Is it because you don’t understand how it works? Is it because some medical professional has indicated it is “woo-woo medicine?” Or is it because you’re afraid of the tiny little needles?

Maybe it is because you’re concerned it might be harmful in some manner? If you could be assured all these are really non-issues, what else would prevent you from trying this?

I’ve often quoted the book “Change or Die” which examines the thesis that many of us would rather die than change. I’m sure this idea sounds incomprehensible to many of you, but think about it. We are inundated every day with advertising, political narratives, and scientific treatises sponsored by organizations, businesses and associations that want us to remain loyal to their financial interests.

I’ll never forget the conversation I had with a scientist who once told me that hydrogenated fats were the biggest medical experiment perpetuated on mankind without our knowledge. It prolonged the life of food on the shelves while killing half a million Americans each year from inflammatory disease.

Industrial farms, Big Pharma, the soft drink and snack food industry all have their stakes firmly planted in the ground, or more specifically in our brains, with millions or billions of dollars of advertising to indoctrinate us over the years.

One of Jerry Seinfeld’s routines talked about food from his era, including boxes of chocolate chip-filled mini cookies that were sold as cereal.

We Boomers all remember hydrogenated margarine that sat on the table all day without refrigeration, those wonderful Twinkies, and, of course, physicians who were featured in ads endorsing the health benefits of cigarettes.

Try acupuncture. It really can’t hurt you.


Mountain Goats Woodpeckers and Football Players

January 16th, 2020 by Nick Jacobs No comments »

What do mountain goats, woodpeckers, and football players all have in common? Head butts. Why is it that a woodpecker can pound his head millions of times and not suffer from debilitating brain injuries, and while, we’re at it, what about rams? Heck, even their name identifies what they do.

There have been numerous studies of woodpeckers to attempt to determine what the differentiator is relative to brain injuries and their natural assignment of beating holes in trees with their beaks. These beaks, if you haven’t noticed, are attached to their heads which is where their tiny little brains hang out.

Woodpeckers have to peck pretty hard to get the bugs and insects they’re after. It was originally believed they had a special bone-like, foam material between their brain and their skull, but after dissecting a few deceased woodpeckers, according to MIT professor, Lorna Gibson, it was clear they did not have any foam lining. She and several other scientists dug in and found woodpecker facts.

The woodpecker is absolutely the headbanger of the bird world. They also peck to profess their love and to layout their territory. Their pecking speed would absolutely produce a concussion for a human. They bang their beak at 15 mph between 700 and 12,000 times a day, at up to 20 times per second. That, my friends, is a lot of pecking.

They have thick, strong neck muscles which contract just before their bill hits the surface. This allows some of the force to dissipate down through the bird’s body which protects the bird’s skull from the full blow. They also have unequal upper and lower beaks which lowers the force of the peck from hitting the brain.

Another shock absorber is their tongue. Woodpeckers have tongue supports that wrap around their brains, and work as a safety harness. Plus their brain weighs only two grams and is tightly fit in the skull.

That configuration keeps the brain from banging around inside the skull. Because their tails help brace them against the tree and their toes also are built to brace them, you can say they’ve found the proper pecking posture.

In spite of all the protections Mother Nature provides for them, woodpeckers do get brain damage, but they also have an accumulation of a protein called tau which actually protects them from suffering from neurodegenerative diseases like the chronic traumatic encephalopathy that our football players get.

Because of these studies, all kinds of technological and safety advances have been implemented in sports equipment, but it is believed that the presence of tau in woodpeckers is a protective adaptation, because in moderation, it works to stabilize brains cells.

Tau is typically found in human patients with brain diseases ranging from Alzheimer’s to traumatic head injuries. Consequently, it is now up to scientists to discover why tau is good for woodpeckers and how that protein can be adapted to protect football players and others from brain injuries.

Rams, on the other hand, typically bash their heads together at a speed ranging from 20 to 40 mph without injury. How do they do it? Rams have strong, flexible horns that absorb much of the shock of the collisions, in addition to a physical anomaly that slows the blood flow from the head to the body.

Scientists studying football players in Colorado discovered that football players at higher altitudes had 30% fewer head injuries. Their hypothesis is that higher altitudes increase the volume of fluid in the cerebral venous system which provides another layer of protection.

So, maybe the solution is to equip football helmets with horns, to genetically modify the players’ toes, tongues, neck muscles and cerebral blood flows, to make sure only those players with smaller brains take or give the hits, and for goodness sake, to move all of the teams to the mountains.

Or maybe we should study the impact of tau?


Addressing fear and hatred In 2020

January 1st, 2020 by Nick Jacobs No comments »

Can we show more love, respect and kindness to each other in 2020?

During a conversation with a good friend who has deep knowledge of the economy, he suggested that our putrid economic growth rate of 2 percent is because we’re in the midst of a revolution, an unnamed revolution that is not dissimilar to the agricultural or industrial revolution.

It’s an information revolution, and because we’ve been providing all of the raw material to those in charge for free through apps like Facebook, Google, Snapchat and Instagram, we collectively have not personally benefitted economically from it. The bottom line is millions of Americans are hurting economically, and that’s when things get stirred up.

The Unite the Right rally in Charlottesville was a symptom that comes from economic suppression or depression. One other thing about this movement appears to be clear; it seems to be based on fear, not scaredy-cat fear, but actual deep-seated fear of economic insecurity and loss of power. Hence the distressing chant, “They will not replace us.”

Every time this movement has pulsated, it’s been during economically challenging times. No matter how well the stock market and unemployment percentages are doing, people are still hurting.

Maybe a look back at the history of our country from the podcast “On the Media” will put some things in more perspective. University of Chicago professor, Kathleen Belew, explained that participants in the White Power movement see numerous issues as threats to their power, threats to white reproduction which, in their minds, will result in their loss of even more economic control.

Interestingly, none of this is new. The expansion of our country into the western frontier in the late 1800s was said to be part of a post-Civil War effort to deal with both new immigrants and freed slaves. It was thought to have been done to keep the non-white population from taking control of the former slave states. There was also fear that the less affluent immigrants would use their new voting rights to encourage more socialism.

When we ran out of the land in the West, Theodore Roosevelt began to build an un-acknowledged empire. The author of “How to Hide an Empire,” Daniel Limmerwahr, explained that in 1888-89, we engaged Spain in war and took over Puerto Rico, Guam, and later Hawaii and American Samoa. We also had a very bloody war for possession of the Philippines where over 1.5 million Filipinos were killed. The borders of the United States of America’s lower 48 States only lasted for three years before we expanded.

Our political leaders were very careful, however, in that the non-white residents of the majority of these conquered islands were given only limited rights by the United States government. We now had a country that was an empire, ruled by white people, but not a country ruled by representative government.

Our leaders didn’t want the new residents to have voting privileges. The acknowledgment of white supremacy was quietly brushed under the rug, and the people who lived in the territories were and still are relegated to the shadows.

The hopeful news about all of this is we are seeing what we had complacently over-looked in the past and are beginning to address some of the root causes of this fear and hatred. Some have described the current situation as similar to a supernova in that this approach to governing is shining brightly before it burns out.

Someday, we might finally become a country of, by, and for the people of all races, religions, creeds and countries of origin.

A personal note: I had one grandfather who, in his youth, was a member of the Ku Klux Klan and the Shrine and another who was a repressed Italian immigrant. Pick one. I’m just trying to figure out where all of this hatred and fear lives to try to make things better for my grandchildren.


Ron Vickroy

December 22nd, 2019 by Nick Jacobs 1 comment »


I’ve written several of these tributes over the past decade and a half, but this one has been one of my most emotionally challenging.

The first time I met Ron Vickroy, he was a board member of the Laurel Highlands Visitors Bureau, and I was a candidate for the position of President/CEO of that organization. He was working as the head of marketing for Crown American, and although he was a few years younger than me, I recognized immediately that his gifts were superior to not only his age but also to those of his peers.

I got that job, and Ron became my boss. I latched on to him as a mentor, a teacher, and quickly as a friend. Ron had one of the most fertile minds I had ever encountered. Yes, he had graduated first in his class from the Air Force Academy, and then went through the prestigious GSIA School at Carnegie Mellon University, but there was much more to Ron than IQ/EQ/QPA or any other intellectual marker. He was a compassionate, committed, community-minded leader with a nearly zero focus on materialism.

When you think about movies like “All The Right Stuff,” that’s what Ron had. After my Laurel Highlands experience, I was recruited to a VP position at the former Mercy Hospital in Johnstown and had an opportunity to recommend Ron as a member of the Foundation Board of Directors. By then Ron had made the decision to forgo his higher paying marketing job and begin work as a business professor at UPJ.
His talent was quickly recognized, and he was recruited onto the Hospital Board of Director where he served until he transitioned to the Conemaugh Board of Directors. This is where he literally found a home and served for pretty much the remainder of his life.

Ron also found his love in teaching, and no matter when you met his students, the description of his talent, dedication, knowledge, but most importantly his inspiration was their focus. Ron was not only an amazing person, a brilliant and creative individual, he was also the best of the best as an instructor, a mentor, and a leader for his students.

Besides a vacation with he and his wife, Donna, to Aruba, my fondest memories of Ron were brain-storming meetings in his family room. He filled me with hope, excitement, and commitment to progress.

There was only one exception to this. I had attempted to take up golfing in my 40’s. Ron was a scratch golfer and sometimes tolerated my presence on the golf course.

Once after a particularly awful round, I turned to him in complete frustration and asked, “Ron, do you think I’ll ever be a great golfer.”  Knowing full-well that my passion and expertise had been in music, he said, “Let me ask you, Nick, if I took up trumpet right now, would I ever be any good?”  I gave my clubs away after that game and never regretted that decision one time!

Let me close by saying there was no better board member, teacher, mentor, friend, or human being than Ron Vickroy.


Love ya, man.


Perfection is worth the effort

December 4th, 2019 by Nick Jacobs 1 comment »


At age 21, I learned a significant lesson in both humility and reality. As a musician in a pit orchestra for a very complicated musical, my job was to play an extremely difficult trumpet part perfectly. This show required every ounce of musical training, knowledge, skill, coordination and endurance I had.

After a nearly 100% flawless performance, and an above-average performance from the actors, the show ended, and the audience applauded generously in appreciation. When we gathered together after the show, all of the praise and acknowledgement of skill and talent was directed toward the actors. At first I was confused and then a little angry that not one attendee congratulated the pit musicians for their almost flawless performance, not even my own parents.

That’s when it hit me. Similar to my orchestra playing friends, but completely different from my jazz and pop musician friends, my job involved one thing only that day: perfection. Those 10,000 hours I spent practicing in my room, in practice rooms and in orchestras, bands and ensembles, were all directed toward a perfect performance. Not unlike the job of an airline pilot or a racing pit crew, it’s only when things are not perfect that you’re noticed.

Of course, that same thing was not the case when I played in lounges and clubs, but when I was hired to perform symphonic work, ice shows and shows for Disney or for other performing groups and stars, it was also about perfection. In fact, if you missed even a few important notes or  entrances in a virtual sea of notes and music, you could be fired on the spot for those minor misses.

Let’s turn our attention to health care. I’ve written about medical errors. They are a major cause of death and suffering in the United States, and I have personally experienced several incidents over the years.

It hit me today that the same rules that are applied to musicians, racing pit crews and pilots might also be directed toward the staff and teams of performers employed in our health centers and hospitals. The phrase “Close enough for jazz” definitely should not apply to medical care.

I’m not sure which personality profiles should be married to which job descriptions, but if you’ve ever spent significant time with a pharmacist, it’s pretty clear they have been inculcated with the perfection gene, and collateral damage is not in their vernacular.

On the other side of that coin, Monday mornings were eye-opening times for me in the health care CEO seat as I’d review and sign off on the recorded medical errors that could lead to eventual lawsuits or malpractice claims, even though our hospital had the lowest rate of these types of incidents of any of our peer hospitals and one of the lowest rates of error in the United States.

Let’s be clear, perfection is not always something we should strive for in every aspect of life. It can make us crazy. In fact, I love life’s imperfections, but not when it comes to someone who is cutting me open or medicating me.

What can we do to ignite our perfection gene, and how do we instill that propensity to be perfect in the right people for the right jobs? How do we create more Top Guns?

Practice works, and not unlike those musicians or pilots who sit in rehearsals and simulation labs for hours at a time, every health system should require the same.

Fifteen years ago, I performed brain surgery on a human simulation dummy, and it felt very real when I applied that scalpel to the skin and hit the skull bone beneath. It certainly got my attention.

It’s my belief we can reduce deaths from unnecessary medical accidents by building in more simulation practice to the process, by requiring periodic testing to determine skill levels, and then reassigning personnel appropriately.

Let’s stop burying our mistakes.