Financial Advisory “F” Bomb

Placing Client Interest before Self-Interest

Staff Writers

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We are taking an informal poll, and are asking two key questions of financial intermediary modernity.

 

#1. As a financial advisor, regardless of designation, do you require a brokerage arbitration agreement; or not? Why or why not?

#2. Does this document place client interest first – as in a true fiduciary relationship – at all times? Please explain your rationale.

#3. Regardless of your philosophy – pro or con – regarding the use of arbitration agreements, do you give clients the option of selecting a fiduciary relationship; or not? Is it in writing?  

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Please respond; clients, doctors, laymen and FAs; etc. Is this query the ultimate “F” bomb?

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com  or Bio: www.stpub.com/pubs/authors/MARCINKO.htm

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest E-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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Market Driven Healthcare

Keep Practicing Medicine

By Dr. David Edward Marcinko; MBA, CMP™

By Hope Rachel Hetico; RN, MHA, CMP™biz-book2

In the second edition our book, the Business of Medical Practice, we cite Regina E. Herzlinger, PhD, the Nancy R. McPherson professor of business administration and chair at Harvard Business School, and mother of a physician-daughter. Regina was a guest lecturer at Piedmont Hospital, here in Atlanta, GA last year, as we were fortunate to heed her advice decades ago.

Herzlinger Speaks

In her musings, Regina opines that there is little wonder that some physicians become depressed and want to give up their careers entirely when pondering the future of medicine, managed care and related compensation issues?

Healthcare Update

In fact, the newest Medicare Trustees Report projects a 4.7% reduction in physician reimbursements in 2009 and 37% in cumulative cuts over the next nine years. It notes that each year for the next decade will feature a roughly 5% cut in doctors’ pay – unless Congress steps in – while the costs to physicians of providing care increase by more than 2%. Trustees also noted that spending on Medicare Part B continues to rise at alarming levels and puts growing strain on beneficiary and government pocketbooks.

In response, the Bush administration repeated its call for nearly $36 billion in Medicare reductions over five years to hospitals and non-physicians, and pushed again for a physician quality reporting program that would lead to reimbursements based on individual performance against predetermined standards. What path the new Obama Administration will pursue is still not known?

Market Driven Healthcare

Nevertheless, Herzlinger implores in her book, Market Driven Healthcare, “don’t give up practice, yet.” Pragmatically, the future is bright and offers great opportunity to early adaptors who have the foresight to change medicine for the better and be handsomely compensated, too! But, physicians’ inability to deal with competitive market forces is well known and many are loath to deal with them.

Assessmentcmp-logo4

And so, one way is to seek a strategic competitive advantage is with additional education through a traditional Master’s Degree in Business Administration (MBA); or a new-wave online distance-education resource like the Certified Medical Planner program in health economics and medical management for financial advisors and healthcare consultants (CMP™). Tuition, textbooks and fees may be tax deductible. In this way, doctors may maintain their place as salary and compensation leaders in the U.S. labor force www.CertifiedMedicalPlanner.com

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com  or Bio: www.stpub.com/pubs/authors/MARCINKO.htm

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest E-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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About Hyoumanity

The Persistent Non-Diagnosis Dilemma

By Dr. David Edward Marcinko; MBA, CMP™dr-david-marcinko4

It is well known that computerized information systems [CIS] are increasingly being used to analyze the cost-effectiveness and quality of care given by medical providers. And, providers are slowly receiving clarity in the methods used to track their practice patterns, whether the tracking includes the cost of the practice, quality of care (such as frequency of preventive services that a practice provides), and/or outcomes monitoring.

Using information systems for such purposes is part of the growing field of medical informatics, which can be defined as the applied science at the junction of the disciplines of medicine, business, and information technology, which supports the healthcare delivery process and promotes measurable improvements in both quality of care and cost-effectiveness [Source: Medical College of Wisconsin, and www.HealthDictionarySeries.com].

Health Risk Assessment Data

Although HRA data are not generally used to profile care processes per se, such measures help to determine which members are at highest risk for chronic illness in the future, such as heart disease. And, according to our Business of Medical Practice print-book colleague – Brent A. Metfessel MD, MIS – patients usually fill out such surveys directly, as many Internet sites have sprung up which include free HRAs and calculation of risk scores. Included in HRA surveys are smoking history, dietary habits, general health questions, energy levels, emotional health, driving habits, and other parameters. Providers may use these results as guides to ascertain which members need the most intensive intervention and thus help prevent poor future outcomes http://www.springerpub.com/prod.aspx?prod_id=23759

None address the emerging problem of persistent non-diagnosis, however.

The Problem

Therefore, Bradley Kittredge of Hyoumanity suggests that a significant dilemma is emerging when addressing – or not addressing – HRA data relative to persistent non-diagnosis. In other words, the persistent non-diagnosis dilemma may represent a significant under-recognized and under-addressed emerging problem in our healthcare system today.

Not Iatric

This situation is unlike iatrogenic conditions which may be defined as those conditions that are physician induced [complications, “never-events”, allergic reactions, un-necessary treatments, interventions and/or surgery, etc]. More formally; iatros means physician in Greek, and-genic, meaning induced-by, is derived from the International Scientific Vocabulary [ISV]. Combined, of course, they become iatrogenic, meaning physician-induced. Iatrogenic disease is obviously, then, disease which is caused by a physician [www.iatrogenic.org].

The Definition

Blogger Kittredge – an MBA/MPH candidate for 2009 at the Haas School of Business at UC Berkeley and a Brian Maxwell Fellow – defines persistent non-diagnosis as:

“any patient who experiences clinical symptoms that five or more doctors are unable to diagnose.”

And, he opines that every day, thousands of Americans are desperately seeking answers to complex medical conditions that doctors are unable to diagnose.

Quality Improvement Initiatives

Findings ways to improve the process of diagnosis and the handling of these tough cases for both patients and doctors will reduce costs, improve health outcomes, and dramatically impact lives. It is the stuff of such medical quality improvement icons like Robert M. Wachter MD, Professor and Associate Chairman of the Department of Medicine at UCSF and my colleague and print-journal Foreword contributor David B. Nash; MD, MBA of the Jefferson Medical College in Philadelphia, PA www.HealthcareFinancials.com

Assessment

Currently, Brad is working to build an online tool to assist with complex and difficult diagnoses, which he considers among the biggest problems in medical care. His technical off-spring, Hyoumanity, is committed to improving awareness and understanding of the prevalence, causes, and implications of persistent non-diagnosis – and misdiagnosis – and to the development of tools to assist and empower patients and doctors to resolve complex cases [http://hyoumanity.blogspot.com]. We wish him well.

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com  or Bio: www.stpub.com/pubs/authors/MARCINKO.htm

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest E-Ps delivered to your email box each morning? Just subscribe using the link below. It’s free. You can unsubscribe at any time. Security is assured.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Non-Profit Hospital Accountability

Raising the Ethical Bar

Staff Reportersred-cross3

According to the Wall Street Journal, December 18 2008, Senator Charles Grassley – ranking Republican on the Senate Finance Committee – is weighing proposing legislation in early 2009 that would hold nonprofit hospitals more accountable for the billions of dollars in annual tax exemptions they enjoy.

Minimal Levels of Care Sought

The legislation would require non-profit hospitals to spend a minimum amount on charity care, and set curbs on executive compensation and conflicts of interest. Disclosure requirements would also be increased.

Assessment

Under the new legislation, penalties would be imposed on nonprofit hospitals that fail to meet the new requirements, while penalties could escalate from taxes and fines to stripping a hospital of its federal-tax exemption if it continues to misbehave.

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com  or Bio: www.stpub.com/pubs/authors/MARCINKO.htm

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest E-Ps delivered to your email box each morning? Just subscribe using the link below. It’s free. You can unsubscribe at any time. Security is assured.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

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