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    Dr. Marcinko is originally from Loyola University MD, Temple University in Philadelphia and the Milton S. Hershey Medical Center in PA; as well as Oglethorpe University and Emory University in Georgia, the Atlanta Hospital & Medical Center; Kellogg-Keller Graduate School of Business and Management in Chicago, and the Aachen City University Hospital, Koln-Germany. He became one of the most innovative global thought leaders in medical business entrepreneurship today by leveraging and adding value with strategies to grow revenues and EBITDA while reducing non-essential expenditures and improving dated operational in-efficiencies.

    Professor David Marcinko was a board certified surgical fellow, hospital medical staff President, public and population health advocate, and Chief Executive & Education Officer with more than 425 published papers; 5,150 op-ed pieces and over 135+ domestic / international presentations to his credit; including the top ten [10] biggest drug, DME and pharmaceutical companies and financial services firms in the nation. He is also a best-selling Amazon author with 30 published academic text books in four languages [National Institute of Health, Library of Congress and Library of Medicine].

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    As a state licensed life, P&C and health insurance agent; and dual SEC registered investment advisor and representative, Marcinko was Founding Dean of the fiduciary and niche focused CERTIFIED MEDICAL PLANNER® chartered professional designation education program; as well as Chief Editor of the three print format HEALTH DICTIONARY SERIES® and online Wiki Project.

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Dentists, HIPAA, IT and Reform

Healthcare Reform and Presidential Candidates 

[Surprising Obama and McCain]

By Darrell K. Pruitt; DDS

pruitt

Some readers of the Medical Executive-Post may wonder why a dentist’s opinions on healthcare reform should be given space on a website that is about the personal business, management, finance and economics of healthcare. 

Like Lab Animals

Even though dentistry is only around 5% of the healthcare market; when it comes to government/insurance regulation using the one-size-fits-all micromanagement model of MBAs and politicians – dentists are your lab animals. So, hear me squeal! 

HIPAA Hurts

Our nation’s leaders could learn sobering lessons about how their rules affect healthcare by observing how they affect dentists.  As businesses, dental practices are naturally much less complicated than medical practices. 

For one thing, dentists maintain only a few thousand active patient charts, whereas family physicians may have three to ten-thousand.  This is because physicians see forty or more patients a day.  Dentists, whose work involves intricate, but routine hands-on procedures in unpredictable mouths, may see ten patients in a busy day – eighteen if one counts checking hygiene patients. 

Sans Bottlenecks 

In dentistry, patient bottlenecks have never occurred in the clinical setting, even when burdened by modern, strategically complicated insurance hoops.  It takes just as long today to pull a tooth as it did in 1960. 

Actually, considering the OSHA mandate of the late ‘80s, defensive medicine and non-productive paperwork such as the meaningless HIPAA privacy release that patients have signed without reading since 2003, dentistry takes a lot more time than it used to. 

Thank goodness patients never take the time to read what they sign or dentistry would take even longer.

Pulling teeth will never be faster than it was a hundred years ago when x-rays, as well as surgical-grade alloys became available. Back then dentists were never delayed by the wait for onset of anesthesia. For a closely related reason, experienced patients didn’t want dentists piddling around indecisively using cold steel. 

Of Peg-Boards and Ledgers 

For decades, the busiest of medical and dental practices ran efficiently using only pegboards, ledger cards and lots of carbon paper, yet the staff still seemed to have time to ask patients about their families. The business of dentistry is so simple that even today some dentists choose to run their practices without the aid of a computer at all – thereby eliminating the unproductive expense of being a covered entity. 

Always remember this: there is nothing holding down the cost of being HIPAA compliant, and doctors with small, three-and-a-half employee businesses will be held to the same standards as hospitals with large staffs and a fondness for busywork – busywork that demands department budgets that include overtime pay.  HIPAA fits a sole-proprietor dental practice like socks on a rooster. 

The Economics of Choice 

Here is another important difference.  For a considerable amount of dental care, one might delay the purchase of a home entertainment center to chew comfortably.  For serious medical care, one might forgo a home to stay alive.  Almost all acute, health-threatening dental emergencies can be quickly solved in an outpatient manner with a simple extraction that costs less than $200, and available in almost any neighborhood.

HIPAA

From a dentist’s perspective, the Health Insurance Portability and Accountability Act [HIPAA] was never about portability.  Oh, I could tell you stories; couldn’t we all.  And, considering how many electronic health records have been fumbled under HIPAA, accountability is a cruel joke as well.  That leaves the original 1996 HIPAA Rule stripped down to HIA – the Health Insurance Act; transparency at last.

The Four Cornerstones

A year ago, President George Bush signed an Executive Order that centered on four “cornerstone” goals to help bring about a systematic approach for measuring quality and value in health care, and for making that information publicly available. They are:

  • Connecting the system through the adoption of interoperable health information technology;
  • Measuring and making available results and outcomes on the quality of health care delivery;
  • Measuring-Transparency and making available information on the price of health care items and services; and,
  • Aligning incentives so payers, providers and patients benefit when all are focused on achieving the best care-value at the lowest unit-cost

The last three cornerstones, Measuring, Measuring-Transparency and Aligning are dependent on providers volunteering for the first – Connecting.  Even though dentists were intended to be included in Bush’s plans for healthcare reform, connecting with dentists never happened – especially for dentists who did not volunteer for an NPI number – which gives stakeholders a legal right to Measure, Measure-Transparency and Align. 

Or, as my dad, a furniture maker, used to say, “Measure twice, cut once (and for your own sake do not get personally involved in the machinery).”

Assessment

As a dentist who has observed physicians methodically lose control of doctor-patient relationships to stakeholders who hold payments for ransom, I say that if this is interoperability, I hope it never connects to my sheet metal file cabinets full of paper.  HIPAA has nothing to offer but expense and liability.

Mark my words. History will show that HIPAA was exposed as a national failure in dentistry first, and that the presidential candidates still don’t know. 

Won’t presidential candidates Barack H. Obama and John S. McCain be surprised! 

Conclusion

Politicians never consider dentistry. Though it is unfortunate and very expensive, it is nothing new. Stick around. I have other issues, as well, and am not bashful. Of course, your thoughts, opinions and comments are appreciated.

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Investment Policy Statements

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In Physician’s Money Digest

By Dr. David Edward Marcinko; MBA, CMP™

By Hope Rachel Hetico; RN, MHA, CMP™

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It is well known that some physicians have a reputation for being poor investors—buying as the market peaks, selling as the market bottoms, and easily trusting brokers, agents, or other commission-driven salespeople.

A portfolio strategy or reasoned wealth building discipline often seems absent. While those physicians are heading in the right direction by creating a portfolio, it is important for them to also develop a strategy for that portfolio to ensure it stays on track with their investment goals.

This document is known as an Investment Policy Statement [IPS], and our take on it was recently published in Physician’s Money Digest.

We now extend the concept to our ME-P readers for their review and consideration. 

Read more: http://www.pmdlive.com/Article.cfm?ID=4473 Search term: Marcinko

November 2006 Physician’s Money Digest

9780763733421

Conclusion

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