F. Nicholas Jacobs, FACHE
F. Nicholas (Nick) Jacobs, FACHE along with Dr. Craig Shriver was a co-founder of the Windber Research Institute, now The Chan Soon-Shiong Windber Institute for Molecular Medicine, and is the founder of the Clinical and Translational Genome Research Institute. He has also been the President and founder of several other organizations including: The Conemaugh Health Foundation, Mercy Healthcare Foundation, the Laurel Highlands Educational Foundation, and a co-founder and officer of the Academy of Integrative Health and Medicine. Nick was the CEO of Windber Medical Center, Laurel Highlands Tourism, and Laurel Arts. He served in senior leadership roles for Mercy Medical Center and the Conemaugh Health System, now Duke-Lifepoint and is currently an officer on the board of the Integrative Health Policy Consortium.
Last year, he completed Integrative Medical Centers at the Atlantic Health System and Hackensack University Medical Center. Nick’s currently working in Integrative Medicine at Cedars Sinai in Los Angeles, in Pharmacogenomics with health systems in Southwest Florida, and is consulting for the Department of Defense’s Clinical Breast Care Project in pharmacogenomics and breast cancer research.
He holds Masters Degrees in both Education and Public Management Administration/Health Systems Management from Indiana University of Pennsylvania and Carnegie Mellon University, has completed his certification in Health Systems Management from Harvard University, and is a fellow in the American College of Healthcare Executives. Nick has written two books and is a regular contributor to several blogs and newspapers. He is a partner-owner in SunStone Management Resources and is a speaker both nationally and internationally.
Tell us about your career path. How did you get to where you are currently?
When I was 8 years old, my aunt gave me a pair of drum sticks. I fell in love with drumming, and I thought I was destined to become a professional drummer—that is until my eighth grade band director decided I should play the trumpet. From that time on, I became accustomed to playing catch-up, because, at that point, every peer I was going to face had been playing the trumpet for years, and I was taking it up in eighth grade. I found that I could overcome that time gap through practicing, but that required extreme self-discipline, and I literally began to live on a schedule. I practiced when I was supposed to practice, and I studied when I was supposed to study. It was scheduled discipline, because I was dedicated to progressing. When I became the first chair trumpet player, it taught me; I could do it. My ability to pivot and lead a life of discipline at an early age set the tone for my future career aspirations.
Throughout my career, I have had the opportunity to take on various roles within different employment sectors, and I’ve used that discipline to make those transitions. What I’m most known for is transforming troubled organizations. For instance, I was offered an opportunity to run an arts organization. A few months after taking the job I learned the organization was bankrupt. I rolled up my sleeves, and within three years it was the largest rural arts organization east of the Mississippi.
Following that path, my next job was a failing convention bureau which we turned around in the first year. From there I was recruited to a position that was leading to the West Wing of the White House. My family didn’t want to move to Washington DC, and we didn’t move, but at that point in my career, I was ready to take on new challenges. I enrolled at the Heinz School at Carnegie Mellon University to pursue my second master’s degree. While working 60 hours a week and commuting two hours each way, to Pittsburgh, I received a master’s degree in Public Management/Hospital Administration. Then I got a certification from Harvard and a Fellowship in the American College of Healthcare Executives. From there, my career in healthcare began to blossom. Soon after receiving my degree, I became a Chief Communications Officer for a $1B health system.
During my time at the health system, I became the CEO of a small, failing hospital which we then converted to a fully-Integrative facility. Our local congressman loved this unique hospital environment and challenged me to write a grant around integrative healthcare services. I wrote that grant and a year later an MD, a Lieutenant Colonel showed up on my doorstep and said, “What do you want to do with this $7.5 million grant that you just received?” MY reply was, “We are not an academic medical center, and except for our integrative medicine, no one has ever heard of us, I want to be your partner.” He said, “What do you want to do?”
I quickly thought back to 1992—which was seven years before I received that grant. I was interviewing for the CEO position as the head of Boys Town National Research Hospital in Omaha, Nebraska. I distinctly remember the priest who was the head of Boys Town, Father Val Peters. I’d asked him why the hospital was called a research center. He explained, “I started with three Ph.D.’s, and now I have 38 Ph.D.’s, and we are a genome center.” I was impressed because the genome was not mapped until 2002, so this guy was way ahead of his time? That stuck with me so, when the Colonel asked what I wanted to do with the $7.5M, I looked him right in the eye, and I said: “I want to be the genome center for breast cancer for the Department of Defense.” He said, “Since we are going to do genetics then we should do proteomics, too.”
Over an 11-year period, we recruited M.D.’s and Ph.D. ’s from all over the world, and we collected 100,000 donated breast tissue. The Institute was deemed to have the only platinum quality bio-repository in the United States, and the tissue that we collected with 800 fields of demographics on each woman was partially used to map the human breast cancer genome by the National Cancer Institute.
It forced me into a scientific world that was totally foreign to me. I became articulate at translating genetics and proteomics. Things moved quickly from there. We were working internationally; we were making quite a reputation for ourselves. But in 2007 the congressman who assisted us with receiving our initial grants spoke out against the Iraq War, and the Department of Defense money came very, very slowly. If we were supposed to get a contract for September, it would come the following May, and the stress and pressure finally got to me, so at the age of 62, I decided to retire. That lasted for about one month. I hated retirement, so I became a contractor for the Department of Defense and continued to work with them on this breast cancer project. I have setup a research institute in Fort Meyers, Florida that specializes in pharmacogenomics. Additionally, we have been creating integrative centers at places like Cedars Sinai, Atlantic Health, Hackensack Meridian and Parkview Health Systems. I have been consulting all over the country.
But I’m just a trumpet player.
Describe a typical day for you?
A typical day for me is not so typical. For example, Tuesday morning, I was up at 4:30 a.m., and at the airport by 5:30 a.m. I landed in Toronto 8:30 a.m., and I had meetings from 8:30 a.m. to 3:30 p.m. I took a train back to the airport and was in my home by 9 p.m. that night. Yesterday I was at West Virginia University; today I am in my office, so this is a good day. I was working in Florida last week, and it’s not uncommon for me to be working in New York, New Jersey, and Chicago in any given two week period. It’s not about the money; I don’t own my company; it’s not anything like that. It’s about spreading Integrative and genomics medicine; I believe it’s the future of medicine. I think that anyone who is armed with the knowledge of both will have a huge advantage.
Throughout the years, you’ve played vital roles in the integrative medicine movement. What led you to your passion for integrative medicine?
When I was a high school band director, my neighbor asked for help refinishing his driveway. We ended up picking up a piece of concrete that was way too heavy for the two of us. He let go, and I didn’t, and I couldn’t straighten up. I was 27 years old at the time. I was bent over in an “L” shape. They put me in the car and took me to the hospital where I was given muscle relaxants. Nothing helped. I left there, and it was like I had a hot knife in my back. I could hardly walk, and it was football season. I should have been running up and down the bleachers; I should have been running beside the band. Instead, I couldn’t walk. After seeing me in pain, a friend of mine, another teacher, pulled up beside me at the end of practice and said, “Get in my car.” I got into the car, and he drove me to this beautiful old house. I rang the doorbell, and a physician in a white coat opened the door. He took me back to his examining room, took my blood pressure and said, “Yeah, you should probably be drinking a Manhattan every night when you get home.” He laid me on the table, and said, “This is simple, you’re out of alignment.” He reached down, pulled on my ankle, and I was fine. I said to him, “how did you know that?” he said, “I am an Osteopath.”
I wondered why they didn’t know how to treat me at the hospital. The doctor explained to me that he wasn’t even allowed to practice in hospitals at that time. They are now, but that was in the 70’s. That struck me. What else don’t we know about in our hospitals? Then I read the story of Abraham Flexner, a German Ph.D. who was hired in the year 1910 by the American Medical Association because no Medical doctor would take the job. His was to decide what was supposed to be taught in the medical schools of the United States and Canada. He looked at all of the integrative modalities and said, “I don’t understand any of these; they’re all gone.” We are only doing pure science. He introduced a reductionist approach to medical education starting in 1911. This has led to a “heal to the pill” medical system where our physicians rarely have time to get to the root cause of the illness that the patient is suffering from. Even though there have been 1,900 papers written on the efficacy of acupuncture, it was not part of the curriculum. So when I saw how people responded to integrative medicine, and I learned that it is a $10 billion industry and none of that money was going into the hospitals, I thought, “This is not rocket science,” and I embraced it.
It’s funny I live in the city of Pittsburgh, but you can’t live in Pittsburgh unless you support the teams. People identify or want to identify with winners. If you’re not part of that fever, then you don’t fit in.
I see myself creating that fever—not for Pittsburgh or teams, but for healthcare organizations in Integrative Medicine. For example, we opened a center in New Jersey where they are doing 44,000 integrative treatments a year. It just changes everything. My fully integrative hospital started to see statistics that were unbelievable. When the Department of Health and the Joint Commission did their deep dive, of our 13 peer hospitals, we had the lowest readmission rate, the lowest lengths of stay, and the lowest infection rates. Our infection rate dropped below 1 percent. The National average is 9 percent, and I know we were not washing our hands more than anybody else. We had a palliative care unit, a hospice where people came to die, and of our peer hospitals, we had the lowest mortality rate. I wanted to put up a billboard that said “Come to our hospital. You will die less often.” I attribute all of this to integrative medicine. We created a healing environment. We created an environment where people had a chance to get better, where they were not living in total fear. Patients were being embraced, and they were being nurtured and cared for in a way that they could never experience in the other factory model hospitals that exist. It was a pretty exciting time.
In your current roles in integrative medicine, you must have the opportunity to be on the pulse of trends in integrative medicine and integrative healthcare. Can you please tell us some of the trends you’re seeing?
Graduates today need to be change agents. I often use the old adage about a washing machine: When it’s still, it’s difficult to move, but as soon as it starts shaking and jumping around, almost anybody can move it. The best time to change something is when there is an uproar. So now is the perfect time for bright, young graduates to be involved in the change and transform healthcare into what they want it to be.
People want it; we are in a county where there are 5,000 codes to reimburse integrative specialist in the Affordable Care Act, but they aren’t being paid, and still, patients want it badly enough they are paying for it out of pocket. The problem is that it’s not reimbursed. So that’s why I serve as an officer of the Integrative Health Policy Consortium. We are working to get these codes reimbursed so that the practitioners can be paid.
Tell us about your Hall of Fame Award.
This award was a hometown award. The reason that it is a sweet award is that I was the next to the last class to ever graduate from my high school. A merger then consumed my school, and, to date, only 3 or 4 graduates from my high school have every gotten this recognition. Our little high school went away in 1966. I received other awards from my university, the Boy Scouts, the Girl Scouts, and numerous other organizations, but this was fun because my grandkids were there to see me receive it.
Where do you see integrative healthcare going in the near future?
The future of healthcare lies in the combining of integrative and genetic medicine. Let me describe what I am talking about. The pharmacogenomics Research Institute that I founded in Florida can look at 300 of your 21,000 genes via your saliva and tell you for your entire life from birth until death which medicines you can take. It will tell you what will work, which ones won’t work and which ones will hurt you. We have had that capability for several years, but it’s not being taught in medical schools. It’s not quackery its hardcore, real science. To put that into prospective for you, when I got my test back it said if I took a certain statin, based on my genetic profile, it would cause me to have a myocardial infarction. That was the statin I was on when I got my first stents. So I think within the next three to five years, genetics will be a part of every exam. The equipment we used in 2001 cost $3-$5 million dollars and took weeks to run, now it’s the size of a microwave and costs $120,000 and can get results over night. They have made the technology very viable, but there are not enough genomic counselors and no genomic certifications for laboratory technologists to work this equipment. I see schools like Southern California University of Health Sciences training and teaching physicians, genomic counselors, nurse practitioners, PA’s, chiropractors, pharmacists, and lab techs the basics of what this is and how to utilize it with their patients. When you marry that with traditional integrative medicine techniques you begin to find ways to cure and heal that are not tied to just prescribing pills— that’s the future of healthcare.