Posts Tagged ‘Nick Jacobs’

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The Smurfs and Culture

July 29th, 2011

The other day, I was imagining a conversation between our U.S. elected officials about the Smurfs.  On one side of the aisle, the rhetoric would go something like this: “I believe that Poppa Smurf  represents Karl Marx. He is not the leader of the Smurfs but an equal who is admired by the others for his age and wisdom.”  Then they might say, “And Brainy Smurf represents Trotsky, as he is the only one who comes close to matching Papa’s intellect.  He wears round glasses, is often isolated, ridiculed for being too professorial and is even ejected from the village for his ideas.”

Photo Credit: AP/Richard Drew

Furthermore they might add, “The smurfs don’t have private property, have adopted a collective-style economy and no individual Smurf is represented as either superior or inferior to others.” Someone would yell out, “They probably even have healthcare for everyone!” Consequently, the conclusion from one side of the aisle would be that the Smurfs are Socialists and are destroying the fabric of our society.

Then the other side might say something like: “Gargamel represents capitalism and embodies all the negative attributes associated with that economic system, such as greed, ruthlessness and the pursuit of personal gratification.”  “Gargamel is the quintessential symbol of Wall Street and will take his billions in tax cuts but never create even one job,” this side would say. At the same time, they might surmise that, “Azrael represents the worker in the ruthless, free-market state that is Gargamel’s house, and his union must be busted!”  Their final conclusion would be that, “The wealthy are taking all of our money and destroying the middle class.”

Is it any wonder we can’t get a debt ceiling bill?

One of my last professional trumpet playing jobs, “Smurfs on Ice,” was nearly 25 years ago. So, Brainy, Jokey, Grouchy, Greedy, and Stinky were all part of my early years, and now they are coming back, but the world is not the same!  So, be careful Smurfettes. Don’t invest in the market, real estate or dot.coms.  Try to avoid those outrageous credit card interest rates.  Don’t, whatever you do, don’t believe what the heads of the big banks and insurance companies are saying, and, for goodness sakes, buy gold, or maybe buy precious blue stuff.

When I was a kid, I was on journey to learn. So, when my dad bought me a box of vocabulary words and helped me learn ten new words every night, it wasn’t because he wanted us to grow up and be rich.  To him, the most important thing that he could do for his children was to make sure that they got an education.  He was all about the awareness that comes from exposure to information.

It started for me as a simple challenge to read the Bobbsey Twins books, and then the Hardy Boys, and from there, works by Mark Twain, Shakespeare, Dickens, Poe, Roth, Hemmingway and Tolstoy. Going through life without all of these friends would have been an empty and lonely journey. I’ll never forget when my brother, a young teacher at the time, introduced me to his classical record collection.  Yes, I was a trumpet player, but when I discovered Mahler, Beethoven, Mozart, Bach, Wagner, Brahms, Handel, Stravinsky, Chopin, Mendelssohn, Berlioz, Bartok and Sibelius, my life was changed forever.  Between the written word and the music, the mysteries, joys, challenges and humanness that is life became more apparent to me every day.

We have migrated away from anything but basic education and our favorite pastimes are video games, celebrity magazines and reality TV shows. Maybe that’s why we seem to have lost our way in this country.  We no longer embrace a culture of open mindedness, understanding and compromise.  Is it any wonder our U.S. Representatives can’t work together?  Maybe they are simply unenlightened…Maybe they all need to spend some time with the Smurfs and read a few blue books.

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Posted in Current Affairs, Leadership, Music

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The Budget Impasse and Death

July 16th, 2011

David Brooks wrote a very interesting column last week in the New York Times entitled  “Death and Budgets,” in which he explains the current Washington D.C. budget impasse and compares it to our collective inability to come to grips with our own mortality.

David Brooks - The New York Times - Nick Jacobs, F. Nicholas Jacobs, FACHE - healthcare - healing hospitals - SunStone Consulting

David Brooks | Josh Haner/New York Times

His treatise quotes S. Jay Olshansky, one of the leading experts on aging, who argues that life expectancy is now leveling off, and others who say that, we are marginally extending the lives of the very sick. Brooks goes on to articulate that, “A large share of our health care spending is devoted to ill patients in the last phases of life.”  Then enumerates upon the fact that, as a country, we will be spending $1 trillion dollars annually, double Medicare costs right now, on Alzheimer’s disease alone by 2050.

His closing thoughts revolve around the fact that “unless we confront death and our obligations to the living like his friend who was recently diagnosed with ALS, we will not be able to reduce health care inflation and balance our budgets. “ He then concludes that “we think the budget mess is a squabble between partisans in Washington. But in large measure it’s about our inability to face death and our willingness as a nation to spend whatever it takes to push it just slightly over the horizon.”

Since 2005 I have written  many times about this issue. In fact, one of my most quoted experts on this topic is a previous Pittsburgh resident, former Colorado Governor Richard Lamm, who spoke openly about the immorality of “inter-generational resource theft,” where the voting senior citizens have pulled the majority of the healthcare resources away from the children of our nation. According to Lamm, this generational robbery has contributed to produce one of the highest infant mortality rates in the civilized world  and has provided the resources allowing our seniors to squeak out another few months or days of life.

I also remember one of my Carnegie Mellon professors, Ian Rawson, PhD, describing the resource challenges presented in certain extremely conservative states where they have refused to fund organ transplants for children.  Obviously, those who voted most often and most passionately were the seniors themselves who could then use those resources for mechanical life support or surgeries on the frail elderly that neither extend nor improve the quality of their lives.

As a former hospital CEO, it seemed clear that the medical schools had taught the Northern European philosophy that “Death at any time is failure.”  It seemed that the very reality of our mortality was overlooked.  Having had responsibility for funding a palliative care unit in my last hospital, it struck me as sad that the vast majority of patients being admitted there arrived for the last week, day or few hours of life, and the “life extending measures that had be foisted upon the patient and their families” prior to that time neither reversed the disease nor improved the quality of their lives.  Unfortunately, some of this is about income for the provider, but most of it is about our inability to face the end of our time here on earth.

It was always disconcerting to see a priest or minister as a patient in critical care screaming out in fear of their own death.  It would seem that they, of all people, could find peace in the upcoming transition. So, what about the rest of us?

In closing, and this too is my “one note samba,” until or unless we begin to reimburse for wellness care, embrace death as part of life, and stop rewarding our scientists for “not sharing their ideas” with each other, we will continue to act pretty much like my daughter’s dog, Chipper. Tail-Chasing-R-Us, and Washington DC is currently engaged in chasing a tail that could easily wipe all of the china off the dining room table.

All we seem to see are blades of grass in our fields of dreams.

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People and Ponies

June 26th, 2011

I’ve been periodically volunteering my weekend time to help establish an equestrian healing center where the horses help to heal the people. Although I’m not particularly connected to horses, I appreciate them and like to watch them run freely through the fields. It’s the people in this particular volunteer leadership group, however, who “make me tick.”

Over the last twenty or more years, I’ve had several opportunities to meet healers. Now, don’t get all “New Age-y” here and run out of the room screaming. These people are “pure of spirit,” and have no ulterior motives, except to help other people navigate through this sometimes relentlessly unforgiving maze that we call life. There are two doctors, an RN, two equestrian specialists and a couple of administrative types like me who simply believe that mankind is somewhat intellectually challenged, and not always capable of grasping anything that is not black and white or concrete and factual.

Surely, with all of the things that we purport to believe in religiously, it seems incomprehensible to me that we, as a group, have problems giving it up to the fact that our brains, our spirits and our hearts don’t or can’t play a larger role than that assigned to us by our Primary Care Physicians or our big Pharma companies. For the most part, we believe in an after-life, we believe in miracles, we believe in goodness, but we have problems understanding how an Autistic kid on a loving, nurturing horse can be helped. It’s because there have not been enough control groups, double blind studies or scientific documentations to support the theory, and typically those scientific theories are only scientific law until they are proven wrong, and that has happened plenty of times.

The freedom of having been a nonmedical, nonclinical, nonscientific healthcare CEO was that “I really didn’t care what made people get better; just so they got better.” Consequently, if a golden retriever licking your hand or a clown bopping you with a sponge hammer, a violinist, a massage therapist, an acupuncturist, a flower essence or aroma therapy specialist, a reiki master or a visit from your grandchild helped you, it was all good to me. Pick your passion and start to heal.

The only real way to describe this philosophy was “Open” because that’s what it was and is. One of the amazing aspects of the collection of healers that have gathered to lay the groundwork to make this amazing dream operational is that they also believe that there is much more to healing than a pill or seven pills, and they are more than willing to be open to the spirit of healing.

Of course, one of the problems with this type of work is that you have to “let go” to allow things to happen, and if you are too into the discipline of concrete and only proven science, you will not let enough of your guard down to see what can happen. The problem is that we’ve all heard about the quacks who almost religiously rip off naïve people with magic elixirs or spiritual interventions like Whoopi Goldberg called forth in the beginning of the movie “Ghosts,” but our collection of healers is filled with people who are sincere, well-trained, highly-credentialed and, believe it or not, open to understanding what may otherwise be ignored by the scientists or the traditional establishment.

So, on we roll in search of others who believe that there may be ways to help people that have not been used for several decades or centuries where the brain leads itself into healing or where the switch that turned the gene on inappropriately can be coerced into reversing that physically destructive non-decision. Life is a journey, and when I look back at all of the people who were helped because of things that sometimes make no sense to anyone else, my only response is “Yeah, that’s right.” It can happen, and with the help of other believers it will happen.

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Posted in Healthcare, Integrative Health

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Treating People With Dignity

June 9th, 2011

As part of my continuing series of anti-bullying blog posts, this week’s post was inspired by a WDUQ/NPR interview of the authors of a book entitled: Unleashing the Power of Unconditional Respect: Transforming Law Enforcement and Police Training. It was written by Jack Colwell, a police veteran and trainer, and Chip Huth, who heads a SWAT team for the Kansas City, Missouri Police Department. The interview was inspired by the Pittsburgh police beating of CAPA (Creative and Performing Arts) student Jordan Miles, a who hadn’t done anything wrong. The interviewer stated that this beating, and the subsequent ruling regarding its legality, has seriously eroded the support of law-abiding citizens in the African American community and beyond toward the Pittsburgh Police.

CAPA student Jordan Miles and his mother, Terez

CAPA student Jordan Miles and his mother, Terez | Photo credit: Justin Merriman, Pittsburgh Tribune-Review

Why, in a healthcare blog, would I select this topic? It is my firm belief that treating people with respect and dignity, regardless of the situation, leads to a more harmonious environment. Chip Huth, one of the two authors interviewed by WDUQ,  commented that the he believes that the Kansas City police force’s policy of holding meetings that allow community members to express their points of view and to feel understood may open them up to understanding the police point of view. He went on to say that “after a SWAT raid…when the situation is secure, his teams sit down with the suspects and explain the terms of the search warrant, answer questions, advise of rights, etc.” Convicted felons heading off to jail have told him how much they respect the way his team treated their families.

So, read between the lines. It’s not any different from healthcare work when it comes to “Treating People With Respect and Dignity.” It is what it is, and that care and treatment must transcend all races, colors and creeds. More importantly, it crosses all professions. By analogy, think of us as the SWAT (caregiving) team. We break into your life and scare you. It’s a well known fact that those individuals who are most often sued in healthcare are those with the weakest interpersonal skills  and worst “bedside manner.” They are often mean, curt or simply uncaring in their attitude and responses. Or else they make sure that they just don’t communicate at all with the family or patient.

Not so many years ago, I was taken to task by a group of physicians who were upset because I had written an article about those docs “who make rounds before the families are present and the patient is awake.” The good docs were indignant — and in some cases rightfully so — because they were communicators, but the “bullies” that I targeted, who were not patient centered, came at me from all directions: letters, phone calls, and attempts to have me censured by my hospital’s board. It really reminded me of the often-paraphrased Shakespearean line, “methinks he doth  protest too much.” If they were truly “caregivers,” and not technical health scientists, they would want to communicate with the patients and their families, to answer their questions, to help them understand what is happening (or about to happen) to them, and they would be sensitive so as to ensure that the fears being expressed by those involved were ameliorated about as well as could be expected under the circumstances.

If the SWAT team can kick in your door, throw in flash grenades, tie your hands behind your back, and arrest you, but take the time to heat the baby’s milk and explain to everyone involved what exactly is going on and what to expect, there will be a marked difference in response from those who are being impacted by their work. A hospital does not attain 98 or 99% patient satisfaction scores by ignoring patients and their families, treating the employees and administrators like they are minions and ignoring the kindness and respect that should be part of their jobs.

Respect - Nick Jacobs, FACHE - healthcare - anti-bullying - Healing Hospitals

Okay, I’m done. Like Aretha Franklin sang, “R-E-S-P-E-C-T / Find out what it means to me.” Look up the Jordan Miles story online, or better still, buy the Unleashing the Power of Unconditional Respect book and see what can happen when you treat people with dignity.

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Posted in Communication, Current Affairs, patient-centered care, workplace

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Sometimes it’s Better to Punch a Bear in the Face

March 27th, 2011

I’ve tried to avoid controversy, but since my reading audience has dropped by a few thousand readers after departing my previous CEO position a few years back, I doubt that this will cause me any more problems as a consultant than I’ve already caused by expressing my opinions in previous posts. So, for those of you who are still dependent upon me for financial support, I apologize.

This morning, I read an article in the Pittsburgh Post Gazette by John Hayes entitled “Meet Your Neighbors: The Bears,” about black bears living in Pennsylvania. The essence of the piece is that there are about 18,000 bears living among the 12,000,000 citizens of Pennsylvania, yet there are only about 1,200 bear-related complaints to authorities a year. The bigger issue, however, is that there have been no reported deaths caused by black bears. They don’t eat people.

During this same period of time, I read a post by my friend and fellow patient advocate, Dale Ann Micalizzi, referencing an article about the former president of Beth Israel Deaconess Medical Center (BIDMC) in Boston, Paul Levy,  another nontraditional hospital CEO who espouses transparency. “Admiting Harm Protects Patients” is the article appearing in today’s Las Vegas Sun. In my book, Taking the Hell out of Healthcare, which Paul graciously endorsed on the cover page, we talk about patient rights, patient advocacy, and the need to have someone with you during your hospital stay to ensure that you are not going to become a statistic. In today’s article, Paul is recognized for the work that he did with his blog — a blog which I encouraged him to write and to keep writing — in which he challenged the hospitals of Boston to reveal their mistakes, to stop keeping the infection rates and other problem statistics secret.

Because he was trained as an economist and a city planner, Paul Levy was considered an outsider by his peers when he took over the troubled Deaconess hospital, but as he quickly turned it around, he did so through the eyes of an outsider. In December 2006, he published his hospital’s monthly rates of infection associated with central-line catheters, which are inserted deep into the body to rapidly administer drugs or withdraw blood. These central line infections, which can be caused by nonsterile insertion of the catheter or not removing it soon enough, are preventable. The Centers for Disease Control and Prevention estimate 250,000 central-line infections occur annually, costing $25,000 each and claiming the lives of one in four infected patients.

Dale Ann Micalizzi (L) and Paul F. Levy (R) - Healing Hospitals - F. Nicholas Jacobs, FACHEHe then challenged the other Boston hospitals to do the same. He was accused of self-aggrandizement, egomania, and numerous other witchcraft-like things, but the bottom line was that the number of infections went down, and they went down because the staff and employees wanted to do better and wanted them to go down.

What else happened at Beth Israel Deaconess?

• Hospital mortality of 2.5 percent, which translates to one fewer death per 40 intensive-care patients.

• Cases of ventilator-associated pneumonia, from 10-24  per month in early 2006, to zero in as many months by mid-2006.

• Total days patients spent on ventilators from 350-475 per month in early 2006 to approx. 300 by mid-2007.

• The length of an average intensive care stay from 2005 through 2009, the average stay was reduced by a day to about 3 1/2 days.

(See my previous post on outrageous claims at my prior place of employment.)

Well, in today’s article about the bears, I read that “when bear attacks occur they are generally very brief, and injuries can include scratches and bites.”  Here’s the part I had not anticipated from the bear conservation officer: “Fight back, don’t play dead.  Unlike other North American Bears, black bears don’t consider people to be food.  When it realizes what you are, or gets a painful punch in the face, it is likely to go away.” I believe it’s a useful metaphor.

If you or your organization would like to hear a CEO or two speak about patient advocacy (and way better healthcare), I’m sure I know a former teacher/musician and a former city planner who would welcome the invitation.

Patient advocacy is in your hands!

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

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Posted in Healthcare, Hospitals, patient-centered care

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Excerpts and Opinions on “What Makes a Hospital Great?”

March 17th, 2011

Dr. Pauline W. Chen’s March 17th New York Times article answers the question, “What Makes a Hospital Great?” In this article, Dr. Chen finds:

Dr. Pauline W. Chen - surgeon & New York Times contributor - Nick Jacobs, FACHE

Pauline W. Chen, MD | Blog: paulinechen.typepad.com

“Hospitals have long vied for the greatest clinical reputation. Recent efforts to increase public accountability by publishing hospital results have added a statistical dimension to this battle of the health care titans. Information from most hospitals on mortality rates, readmissions and patient satisfaction is readily available on the Internet. A quick click of the green ‘compare’ button on the ‘Hospital Compare’ Web site operated by the Department of Health and Human Services gives any potential patient, or competitor, side-by-side lists of statistics from rival institutions that leaves little to the imagination. The upside of such transparency is that hospitals all over the country are eager to improve their patient outcomes. The downside is that no one really knows how.”

I’ve written often about the failed promise of technology alone, and this is reaffirmed in Dr. Chen’s findings:

“…hospitals have made huge investments in the latest and greatest in clinical care — efficient electronic medical records systems, ‘superstar’ physicians and world-class rehabilitation services. Nonetheless, large discrepancies persist between the highest and lowest-performing institutions, even with one of the starkest of the available statistics: patient deaths from heart attacks.”

As she asks why this is,  the answers have become relatively clear from a study that was released in the Annals of Internal Medicine this very week. This research indicated that it was not the expensive equipment, the evidence-based protocols, or the beautiful Ritz Carlton-like buildings. It was, instead, the culture of the organization.

Hosptials in both the top and bottom five  percent in heart attack mortality rates were queried by the study team. One hundred fifty interviews with administrators, doctors and other health care workers found that the key to good (or bad) care was “a cohesive organizational vision that focused on communication and support of all efforts to improve care.”

Elizabeth H. Bradley, Phd, Yale School of Public Health

Elizabeth H. Bradley, Phd, Yale Global Health Leadership Institute

“It’s how people communicate, the level of support and the organizational culture that trump any single intervention or any single strategy that hospitals frequently adopt,” said Elizabeth H. Bradley, Senior Author and Faculty Director of Yale University’s Global Health Leadership Institute.

So, it wasn’t the affiliation with an academic medical center, whether patients were wealthy or indigent, bed size, or rural vs. urban settings that mattered in hospital mortality rates. Rather, it was the way that patient care issues were challenged that made the difference. The physicians and leaders at top-performing hospitals aggressively go after errors. They acknowledge them, and do not criticize each other. Instead, they work together to identify the sources of problems, and to fix them.

One of the most telling findings in this study was that relationships inside the hospital are primary, and the physicians and staff must be committed to making things work. Dr. Bradley said. “It isn’t expensive and it isn’t rocket science, but it requires a real commitment from everyone.”

So, the next time that you select a hospital, look up its statistics, and I guarantee you that you will be surprised. When it comes to outcomes, to nurturing or even competent care, the biggest is not always the best.

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Medical Homes – Defining What Patients Want

February 13th, 2011

The definition of a medical home can be confusing to those who have not been dedicated students of this terminology. As the medical home concept has been added to the healthcare landscape of  the U.S., many uninformed healthcare professionals look at each other and shrug as if they seem to expect to see villages being built with work-out facilities and critical care equipment as part of the accoutrements. Instead, the concept of the medical home (also known as the Patient Centered Medical Home – PCMH) refers to patient-centered care, a phrase that we and Planetree have been using for over thirty years.

Imagine a physician’s office or clinic where the patient’s records are reviewed prior to each visit to ensure that the necessary immunizations, tests and wellness milestones are in place and accounted for on a consistent basis. If that stretched your imagination, consider a medical support staff that communicates by secure e-mail and phone to organize the patient’s care. Add to that an electronic medical record system that tracks the patients, their tests and prescriptions. That is just the beginning of what a medical home could be and do.

One of the companies with which SunStone Management Resources is working goes so far as to add nurse- patient advocates to the mix and then assigns them to help sort through the morass of decisions every person faces with significant co-morbidity risk factors. This system not only helps the patient, it holds down costs by giving people a stable, well-coordinated patient centered medical experience. As an advocate, I believe that it will be key to stopping the loss of billions of dollars in unnecessary treatment costs that conversely leaves millions of our citizens without appropriate medical care.

These outcomes can only be achieved by developing years-long, longitudinal relationship with the primary care provider and their team, and with patient advocate nurses who are assigned to work with those teams to help sort out the redundant tests and medications that often evolve from interacting with as many as nine different specialists each year. This number of hands usually results in at least 15 office or clinic visits and countless unnecessary tests. Imagine how great it would be to have someone who can lead the patients more efficiently through this journey.

In a recent edition of Modern Healthcare, Andis Robeznieks wrote an article entitled “In Search of Medical Homes.” Interestingly, it described the evolving requirements from the National Committee for Quality Assurance for medical home standards. Some of you may remember that this journey began officially in 2008. Of course, the Joint Commission and the Accreditation Association for Ambulatory Health Care were also in on the act as they began that same journey. The question posed by these organizations centers around the unique qualities of a patient-centered medical home.

Somava Stout, MD - Cambridge Medical Associates - Nick Jacobs, FACHE

Somava Stout, MD

Even though, as the article pointed out, the NCQA was experiencing success from their medical home practices business line, patients weren’t experiencing that same feeling of success, attention or comfort. According to Mr. Robeznieks this fact was eagerly confirmed by the patients as they filled out their patient satisfaction scores. The piece went on to outline the latest and greatest revisions to the NCQA standards which included, heaven forbid, a stronger voice from the patients. My favorite quote from the article was from Dr. Somava Stout, Vice President of Patient–Centered Medical Home Development for the Cambridge Health Alliance: “One of the things we do over and over again in healthcare is we don’t remember to include the patient as a partner in designing the (personal ) healthcare system.”

In summary, medical homes would provide patient-centered care that results in reduced visits to specialists and allows less expensive primary care doctors to care for the majority of people’s health care needs. This in turn would result in higher quality outcomes with greater patient satisfaction and more funds to take care of the under insured.

Sounds like a plan.

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Veratherm

February 3rd, 2011

For the past 25-plus years, my personal commitments, both intellectually and emotionally, have been directed toward helping to make positive changes in the healthcare system worldwide. It’s been my great pleasure to have had the opportunity to connect with such organizations as Planetree, and to work with them to enhance and promote their philosophy of integrative medicine and human touch. We have watched them grow from three to more than 600 affiliated hospitals. It has also been exciting to have had the chance to work with organizations like the American Board of Integrative Holistic Medicine (ABIHM), a truly transformational healing organization. Their laser-focused goal is to reach more and more physicians worldwide to assist them in becoming certified in the techniques of holistic and integrative healing arts.

Along with these high-touch organizations, I’ve also been privy to advancements and discoveries made within the research field. As a former hospital CEO, and Founder of a medical research institute, I have been exposed to both the peaks of promise created by medical technology and the valleys of disappointment that have evolved from those unfilled expectations generated by the promises of that same technology.

Veratherm - ThermalTherapeutic Systems, Inc. - Nick Jacobs, FACHE

The subject matter to be addressed in this next blog segment is not a false promise. This particular medical device, the VERATHERM™ system was designed, patented and FDA-cleared as a portable hyperthermic perfusion system. There are two other FDA-cleared devices that have been used for this procedure – one which has been retrofitted and the other is somewhat outdated. There are also experimental-type devices that have been pieced together for use in some research facilities and academic medical centers, but they are not FDA-cleared and cannot be marketed.

What VERATHERM™ does provide is a very real opportunity for surgeons and perfusionists to not only standardize hyperthermic perfusion in the treatment of cancer but, potentially, to help to significantly extend the lives of those patients touched by these surgeons and the use of this technology. Most recently, I have had an opportunity to not only see this medical device but also to work with the extremely passionate individual who is in charge, Raymond Vennare, CEO of Thermal Therapeutic Systems, Inc. Raymond has helped to develop and bring to market this compact and mobile perfusion system that, I believe, will contribute to helping literally hundreds of thousands of people worldwide. In my exploration of hyperthermic perfusion, however, I have discovered that only a tiny fraction of those patients who could be helped by the technique that is enabled through the use of this device have any idea that it even exists. Hence, the reason for this blog. VERATHERM™ not only does exist, but the procedure performed by these surgeons and perfusionists can also have a dramatic impact on certain types of cancers.

Please understand that my interest in hyperthermic perfusion in the treatment of cancer revolves around a commitment to those individuals – people like my father, and Raymond’s father, mother and brother who, because products like this were not available, were all lost prematurely due to different types of devastating cancers.

How does this work? After complex surgery for the removal of the tumors in specific body cavities, such cancers as the colon, appendix, stomach, lung and even some types of metastatic breast cancer, the appropriate fluids can be heated in order to perform an intraperitoneal or intrathoractic lavage. These heated fluids then are circulated through the impacted body cavity as needed to help eradicate any remaining cancer cells. Sensors and probes built directly into the VERATHERM™ Console and Disposable Kit efficiently monitor temperature, pressure and flow of heated and unheated sterile solutions while protecting the patient, physician and profusionist.

Let me close by saying one more time that, due to the procedure enabled by this medical device, the lives of many patients have been extended by as much as three-to- five years. It’s not technically impossible to do, but, as a patient, you have to know about it to request it, and only a handful of cancer centers in the entire country have begun to even look at the creative re-use of profusion equipment for non-traditional surgical lavages such as this.

You read it here first!

The Parable of the Starfish

One morning an elderly man was walking on a nearly deserted beach. He came upon a boy surrounded by thousands and thousands of starfish. As eagerly as he could, the youngster was picking them up and throwing them back into the ocean. Puzzled, the older man looked at the young boy and asked, “Little boy, what are you doing?” The youth responded without looking up, “I’m trying to save these starfish, sir.” The old man chuckled aloud, and queried, “Son, there are thousands of starfish and only one of you. What difference can you make? Holding a starfish in his hand, the boy turned to the man and, gently tossing the starfish into the water, said, “It will make a difference to that one!”

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Posted in Healthcare, Hospitals, Integrative Health

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Finding the Cure…for Bullying

January 21st, 2011

No workplace bullying - Nick Jacobs - healinghospitals.comThis week, NBC’s Today Show featured another story about bullying. As I have have mentioned in previous posts here and elsewhere, I believe that bullying is the quintessential cancer on our lives in places of business, in the military, politics, and relationships of all types.  The good news – actually the very good news –  is that there has been some incredible work being performed on this topic through the efforts of Dr. Matt Masiello at my former place of employment, the Windber Research Institute in Windber, PA.  Grants through the Highmark Blue Cross Foundation of Pittsburgh have fueled this initial effort and the academic and quantitative analysis being done by Clemson University has documented this work.  I believe that this joint effort is a magnificent  example of what can be done to change the future course of events currently being controlled by bullies.

The Today Show story that I saw featured the Massachusetts school where, due to cyber-bullying, a young girl committed suicide last year.  Apparently, another girl is now having the same experience at the same school. With the help of programs like this comprehensive anti-bullying program, the former Secretary of Education from PA, Jerry Zahorchak, (now Superintendent of the Allentown PA school system), embraced the effort to quell and discourage this type of destructive behavior.  And the program, under the direction of Dr. Matt Masiello has successfully been introduced across the  entire State of PA. (Matt had started the Allegheny County’s Goods for Guns program in 1994, when he was the head of pediatric intensive care at Allegheny General Hospital. To date, this program is responsible for collecting more than 11,000 illegal guns from the streets of Pittsburgh.) Matt has had the same success with this anti-bullying program. Now, both Massachusetts and Maryland are looking into embracing this effort.

This anti-bullying program is based on a European program with which Dr. Masiello had become familiar.  This is a school system-wide effort that is very well documented and results in tremendous awareness and reduction of bullying at all grade levels.

The trainers bring a group of teachers and administrators together in the school system, and then “train the trainers” as to how this effort can become part of the philosophy of the school.  They start the training in the spring, typically launch the school wide effort in the fall and run it for at least a year. During that time, detailed records are kept measuring outcomes.

Matt Masiello, MD - Windber Research Institute - Nick Jacobs - Taking the Hell OUt of Healthcare

Matt Masiello, MD

Matt is a wonderful physician, a truly giving person and a saint of a man who is the only U.S. representative on the board of the World Health Organization’s Health Promoting Hospitals program. I hired him before I left Windber Research Institute, and he has worked tirelessly to address both this problem and the problems of childhood obesity.

The Olweus Bullying Prevention Program (Olweus.org on the web, @Olweus on Twitter) has impacted more than 400 school districts and 20% of all school-aged children in Pennsylvania. It has also had up to a 50% reduction in student reports of bullying …and bullying others.

For more information, please contact me or Dr. Matthew Masiello at the Windber Research Institute.

Michael & Marisa’s anti-bullying song – “The Same”

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Making Sense of Tucson

January 11th, 2011

It was 1991 when one of  my professors at Carnegie Mellon University began discussing health policy in the United States.  He told us about Arizona, where the state government had decided to stop paying for transplants.  Then he went on to explain that desperate families were moving from Arizona to Pittsburgh, just so they could establish residency in Pennsylvania, and their loved one could receive a transplant.

At around that same time, an outspoken politician from Colorado, former Governor Richard Lamm, who ran for President of the United States on the Reform Party, described the travesty of Medicare vs. Medicaid.   He described the older generation as committing “generational murder” because, even though many times there was no hope  for their survival, for extending their life or for having any quality to their life, we, as a nation, spend 60% of our Medicare dollars on the last  30 or so days of life.  He advocated being honest and allowing people to decide if they wanted palliative care.

What he also pointed out was that, as a country, we continue to have one of the highest infant mortality rates in the industrial world. The reason, he theorized, was because the seniors voted and the young mothers didn’t and no politician would dare vote against that senior coalition.  (This is not about death panels, it is about honesty in healthcare. It is about transparency and explaining the facts to the families so that they could make rational decisions.) None of his words were well received, but nevertheless, they were filled with candor and embraced very difficult ethical views.

Giffords Tucson tragedy - Nick Jacobs, FACHE - Healing Hospitals

The bottom line?  It is a very sad situation when we have to, in effect, sentence people to death at any age because resources are not available to save them, but this is emphatically not about rationing of care, because rationing infers giving everyone a little less.  This is about making a government decision to take away everything. So, this is about making rational  resource allocation, not based upon the number of votes needed to get re-elected, but based on the value of a life at any and all ages.

Finally, the elephant in the room?  Those people killed and wounded in Arizona were killed and wounded because of a man who is most likely mentally ill.  We, as a country, must begin to address this mental health issue with parity, with commitment and without judgment.  No family is without some member who is suffering from some mental health issue, but  this discussion is still ignored, hidden or buried.

So, when the pundits ask if it is about the rhetoric? We don’t know. When they ask if it is about the availability of weapons and ammunition?  The answer seems to fall under that same category. BUT, when the question is properly directed toward mental health?  The answer seems to be absolutely, yes without a doubt.

During this time of reflection, let’s get serious about the very real and very big challenges that this nation faces. We must, as a nation, take these challenges head-on and deal with “problem solving,” and if this Congress does not begin to take action and begin to solve problems, then we must vote again in May and November to continue to make our voices heard.

Unless we can begin to talk with each other with dignity and respect, we will not make progress.  Until we begin to respect the other person’s point of view and understand that debates are healthy again, we will not make progress. Our leaders need to debate, but at the end of that debate, it is essential that they walk out of the room together and agree that they are all here to do a job, and that job is to solve problems.

My heart goes out to all of those families who were impacted by this awful tragedy.

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