• Member Statistics

    • 842,673 Colleagues-to-Date [Sponsored by a generous R&D grant from iMBA, Inc.]
  • David E. Marcinko [Editor-in-Chief]

    As a former Dean and appointed University Professor and Endowed Department Chair, Dr. David Edward Marcinko MBA was a NYSE broker and investment banker for a decade who was respected for his unique perspectives, balanced contrarian thinking and measured judgment to influence key decision makers in strategic education, health economics, finance, investing and public policy management.

    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].

    Dr. David E. Marcinko is past Editor-in-Chief of the prestigious “Journal of Health Care Finance”, and a former Certified Financial Planner® who was named “Health Economist of the Year” in 2010. He is a Federal and State court approved expert witness featured in hundreds of peer reviewed medical, business, economics trade journals and publications [AMA, ADA, APMA, AAOS, Physicians Practice, Investment Advisor, Physician’s Money Digest and MD News] etc.

    Later, Dr. Marcinko was a vital and recruited BOD  member of several innovative companies like Physicians Nexus, First Global Financial Advisors and the Physician Services Group Inc; as well as mentor and coach for Deloitte-Touche and other start-up firms in Silicon Valley, CA.

    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.

    Dr. David E. Marcinko’s professional memberships included: ASHE, AHIMA, ACHE, ACME, ACPE, MGMA, FMMA, FPA and HIMSS. He was a MSFT Beta tester, Google Scholar, “H” Index favorite and one of LinkedIn’s “Top Cited Voices”.

    Marcinko is “ex-officio” and R&D Scholar-on-Sabbatical for iMBA, Inc. who was recently appointed to the MedBlob® [military encrypted medical data warehouse and health information exchange] Advisory Board.

    entrepreneur

    Frontal_lobe_animation

  • ME-P Information & Content Channels

  • ME-P Archives Silo [2006 – 2020]

  • Ann Miller RN MHA [Managing Editor]

    ME-P SYNDICATIONS:
    WSJ.com,
    CNN.com,
    Forbes.com,
    WashingtonPost.com,
    BusinessWeek.com,
    USNews.com, Reuters.com,
    TimeWarnerCable.com,
    e-How.com,
    News Alloy.com,
    and Congress.org

    Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners(TM)

    Product Details

    Product Details

    Product Details

  • CERTIFIED MEDICAL PLANNER® program

    New "Self-Directed" Study Option SinceJanuary 1st, 2020
  • Most Recent ME-Ps

  • PodiatryPrep.org


    BOARD CERTIFICATION EXAM STUDY GUIDES
    Lower Extremity Trauma
    [Click on Image to Enlarge]

  • ME-P Free Advertising Consultation

    The “Medical Executive-Post” is about connecting doctors, health care executives and modern consulting advisors. It’s about free-enterprise, business, practice, policy, personal financial planning and wealth building capitalism. We have an attitude that’s independent, outspoken, intelligent and so Next-Gen; often edgy, usually controversial. And, our consultants “got fly”, just like U. Read it! Write it! Post it! “Medical Executive-Post”. Call or email us for your FREE advertising and sales consultation TODAY [770.448.0769]

    Product Details

    Product Details

  • Medical & Surgical e-Consent Forms

    ePodiatryConsentForms.com
  • iMBA R&D Services

    Commission a Subject Matter Expert Report [$2500-$9999]January 1st, 2020
    Medical Clinic Valuations * Endowment Fund Management * Health Capital Formation * Investment Policy Statement Analysis * Provider Contracting & Negotiations * Marketplace Competition * Revenue Cycle Enhancements; and more! HEALTHCARE FINANCIAL INDUSTRIAL COMPLEX
  • iMBA Inc., OFFICES

    Suite #5901 Wilbanks Drive, Norcross, Georgia, 30092 USA [1.770.448.0769]. Our location is real and we are now virtually enabled to assist new long distance clients and out-of-town colleagues.

  • ME-P Publishing

  • SEEKING INDUSTRY INFO PARTNERS?

    If you want the opportunity to work with leading health care industry insiders, innovators and watchers, the “ME-P” may be right for you? We are unbiased and operate at the nexus of theoretical and applied R&D. Collaborate with us and you’ll put your brand in front of a smart & tightly focused demographic; one at the forefront of our emerging healthcare free marketplace of informed and professional “movers and shakers.” Our Ad Rate Card is available upon request [770-448-0769].

  • Reader Comments, Quips, Opinions, News & Updates

  • Start-Up Advice for Businesses, DRs and Entrepreneurs

    ImageProxy “Providing Management, Financial and Business Solutions for Modernity”
  • Up-Trending ME-Ps

  • Capitalism and Free Enterprise Advocacy

    Whether you’re a mature CXO, physician or start-up entrepreneur in need of management, financial, HR or business planning information on free markets and competition, the "Medical Executive-Post” is the online place to meet for Capitalism 2.0 collaboration. Support our online development, and advance our onground research initiatives in free market economics, as we seek to showcase the brightest Next-Gen minds. THE ME-P DISCLAIMER: Posts, comments and opinions do not necessarily represent iMBA, Inc., but become our property after submission. Copyright © 2006 to-date. iMBA, Inc allows colleges, universities, medical and financial professionals and related clinics, hospitals and non-profit healthcare organizations to distribute our proprietary essays, photos, videos, audios and other documents; etc. However, please review copyright and usage information for each individual asset before submission to us, and/or placement on your publication or web site. Attestation references, citations and/or back-links are required. All other assets are property of the individual copyright holder.
  • OIG Fraud Warnings

    Beware of health insurance marketplace scams OIG's Most Wanted Fugitives at oig.hhs.gov

Red Flags Delayed Again – A Poll

Take the Modern Physician Survey Poll
Staff Reporters

Join Our Mailing List

The Federal Trade Commission recently delayed the enforcement of its red flags rule until at least December 31st 2010.

So, do you think the “red flags” rule should apply to physician group practices that offer

creditor payment plans to patients?

Take the Poll Now

Assessment

 Product DetailsProduct DetailsProduct Details       

Conclusion

Feel free to comment and review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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

Get our Widget: Get this widget!

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 ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

On the Credibility of Financial Experts

ADVERTISEMENT

Keys to Protecting your Financial Expert’s Credibility in Court

By Trugman Valuation Associates

Join Our Mailing List

Dear Valued Friends and ME-P Colleagues

We hope this e-mail finds you happy and healthy! We have attached our most recent newsletter for your perusal and hope that you will find something of interest in it.

Link: Trugman Summer 2010

Assessment

All of us at Trugman Valuation Associates wish you and yours a happy and safe 4th of July and remainder of the summer.

www.trugmanvaluation.com  

Product DetailsProduct DetailsProduct Details    

Conclusion

Feel free to comment and review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

Get our Widget: Get this widget!

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 ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

On HIT Continuity Planning

Join Our Mailing List

Setting Up Your HIT Security System

Dr. MataBy Richard J. Mata, MD, CIS, CMP™ [Hon]

In order for a healthcare organization to thrive, it must be able to continue to function no matter what the circumstances are.

When disaster strikes, the organization must mobilize all the talent and resources needed to continue their operations and return to a normal state as soon as possible.

Time is money, and in today’s economy, an hour could be worth thousands of dollars.  Every department in an organization has responsibilities during a disaster.  Planning for a disaster and then dealing with it is a team effort by all parts of an organization.

Phases of Healthcare Business Continuity Planning

A system is required to realize this objective, and part of this system is healthcare entity business continuity planning (BCP).

Phase One: Set up a BCP Project

The first step is to set up a BCP project, which includes feedback from key members from all departments.  Appoint a project manager who has a solid background in the clinical and financial systems and functions that the organization deploys or services it provides.  The project manager can work with business and system analysts to document business flow and interactions with computerized systems that may go down, and how the organization will function on a manual system until service returns.

Phase Two: Review Emergencies and Assess Business Risk

The second phase involves reviewing the different types of emergencies that can arise and assessing the risks to the various business processes already documented.  This is accomplished following a system or service function.

Phase Three: Prepare for Emergencies

The third phase includes identifying of back-ups and recovery strategies to mitigate the effects of an emergency.  A storage area network (SAN) or redundant server could be used as back-ups.

Phase Four: Plan for Disaster Recovery

The fourth phase involves the development of procedures to be followed by a Disaster Recovery Team where human life may be at risk.  A disaster might be caused by weather, sabotage, or electrical power and be specific to the particular organization and its business and IT infrastructure.

Phase Five: Plan for Business Recovery

The fifth phase is critical, and involves developing detailed procedures for the recovery of the business.  Again, the BCP project manager could use each business or service procedure that was documented in phase two and detail which financial or clinical systems are involved, what would be done if the systems were down, and what the plan for recovering the system might be.

Phase Six: Test Business Recovery Procedures

The sixth phase involves simulating authentic emergencies and testing of the business recovery phase.  For example, how would business processes or services be affected by an electrical outage?  How fast can a power generator pick up the outage – and what might happen after a timely pause?  How would patients who were receiving mechanical support be affected?  What would happen to the clinical laboratory?

Phase Seven: Train the Staff

Phase seven covers the training of all employees in the procedures necessary to manage the business recovery process.  These are the procedures tested in phase six, which may require modification.

Phase Eight: Maintain the Currency of the Plan

Phase eight includes treating BCP as a dynamic project to be kept up to date to reflect all changes to business processes and employee structure.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Product DetailsProduct Details

Current Outlook for the Hospital Industry

Join Our Mailing List

Adaptation is Key in 2010 and Going Forward

By Robert James Cimasi; MHA, ASA, AVA, CBA, CMP™

cimasi

www.HealthCapital.com

Hospitals today must continually adjust to deal with pressures to contain reimbursement and utilization levels.  The continuing cost containment pressures manifest themselves in many patients being shifted not only to lower acuity treatments but also to other providers.

Reimbursement mechanisms are increasingly designed to control costs and access. Managed care insurance plans continue to be a strong influence as payers for acute care hospital services. Medicare’s HOPPS [hospital outpatient prospective payment system] has reduced many of the financial benefits of shifting more care to outpatient settings.

Personnel Shortages

Personnel shortages have plagued the industry, and with the pending retirement of baby-boomers, relief from these shortages seems remote. This population also heavily influences the consumer side of the industry, since healthcare plans are based heavily upon demographics.  Aging baby-boomers are the fastest-growing segment of the population; the portion of the population over 65 years old is expected to increase from 20 million in 1970 to 69.4 million in 2030. Following closely behind is the increase in other minority populations.  Both groups will influence how healthcare services are dispensed.

Additionally, despite pressure to limit ALOS [average length of stay] and the shift to outpatient and freestanding, off-campus care, there will continue to be demand for acute care hospitals and the demographic trends will support this demand for many years.

Technology

Technological advances always play a central role in changing the medical industry.  The issue will be how healthcare providers will adopt new technologies under their current capital constraints.

Currently, health care insurance coverage is a major unfolding issue in the US, and there remains uncertainty about the future level of both public and private insurance coverage.  Now, facing the recent economic instability, employers are looking at restraining healthcare benefits for their employees even more as a way to stay profitable.

Assessment

The decline in the healthcare workforce coinciding with the increase in labor costs and resource consumption poses an ongoing challenge.  And yet, in the midst of the economic turmoil, hospitals must continue to provide services while remaining aware of the economic threats that may still lie ahead.

More:

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Product DetailsProduct Details

On Military Brain Injury Treatment

Leader Steps Down Abruptly

By T. Christian Miller, ProPublica, and Daniel Zwerdling, NPR – June 23, 2010 6:33 pm EDT

Join Our Mailing List 

WASHINGTON, D.C.–The leader of the Pentagon’s premiere program for treatment and research into brain injury and post traumatic stress disorders has unexpectedly stepped down from her post, according to senior medical and congressional officials.

Brig. Gen. Loree Sutton told staff members at the Defense Centers of Excellence [1], or DCOE, on Monday that she was giving up her position as director. Sutton, who launched the center in November 2007, had been expected to retire next year, officials with knowledge of the situation said. The center has not publicly announced her leaving.

Tell Us Your Story [2]

Did you or a loved one suffer a traumatic brain injury while serving? ProPublica and NPR want to hear your story. Tell us about your experiences with TBI. [2]

Sudden Departure

Sutton’s departure follows criticism in Congress [3] over the performance of the center and in recent reports [4] by NPR and ProPublica that the military is failing to diagnose and treat soldiers suffering from so-called mild traumatic brain injuries, also called concussions.

It comes just as the Pentagon prepares to open a new, multimillion-dollar showcase treatment facility outside Washington, D.C., for troops with brain injuries [5] and post traumatic stress disorder, often referred to as the signature wounds of the wars in Iraq and Afghanistan.

Late Wednesday, in a sign of disarray within the program, Sutton cancelled a scheduled appearance at the opening of the National Intrepid Center of Excellence [6], a gleaming new facility of waving glass and futuristic virtual reality treatment rooms in Bethesda.

“The war in Iraq and Afghanistan could end tomorrow; our mission to restore health, hope and humanity will endure for decades,” Sutton wrote in her farewell message [7]. “We simply must uphold our commitment to all who have borne the burdens of war on our behalf.”

Sutton did not respond to requests for comment. Her replacement, U.S. Army Col. Bob Saum, also declined to comment.

Adult-Resources

DCOE

Cathy Haight, the acting spokeswoman for DCOE, said Sutton’s departure, though apparently well ahead of schedule, was part of a routine command rotation. Haight said Sutton decided to leave after turning down the Army’s offer to take a new position overseeing the military medical system in Europe.

“If a general officer declines (a new position)…they are in a transition to retire,” Haight said.

In recent months, legislators have questioned Sutton’s ability to carry out the mission of the centers, which is to catalyze research and treatment across the military for soldiers returning with brain injuries and psychological wounds.

Congress directed the military in 2008 to create the brain injury center and other facilities for wounded soldiers. At an April hearing [8] of a House Armed Services subcommittee, Rep. Susan Davis [9], D-Calif., said that the center had failed to carry out its role.

“The Defense Center of Excellence, while having achieved some notable small scale successes, has not inspired great confidence or enthusiasm thus far. The great hope that it would serve as an information clearinghouse has not yet materialized,” Davis said.

“The center has also made some serious management missteps that call into question its ability to properly administer such a large and important function,” Davis continued.

Sudden Scrutiny

Scrutiny of Sutton rose another notch earlier this month, when NPR and ProPublica reported on the military’s problems in handling soldiers with mild traumatic brain injuries. Such injuries leave no visible scars, but can cause lasting mental and physical difficulties.

Military statistics show that about 115,000 troops have suffered such injuries since 2002, but in interviews, Army experts acknowledged the true toll may be far higher. Unpublished research we reviewed suggests that tens of thousands of soldiers may have gone undiagnosed. Our reporting also showed that even when soldiers were diagnosed, at one of America’s largest Army bases, they have had to fight to receive appropriate treatment [10].

Veterans’ Shocked

Still, some veterans’ advocates were shocked and saddened that Sutton was leaving. They said she had been a forceful, visible advocate for wounded troops and their families who had never received the full support of the military’s medical establishment.

Assessment

Critics of the military’s health system have noted a power vaccum at the top of the military medical structure. Four people in just over three years have rotated through the Pentagon’s top health policy position, the assistant secretary of defense for health affairs.

“She was always there for the troops,” said one veterans’ advocate, who did not want to be named for fear of criticizing the military. “She’s become the scapegoat.”

In an April interview with NPR and ProPublica, Sutton shrugged off the criticism. “Leading change,” she said, “is a journey not for the faint of heart.”

“We are very proud of the team that we have built, the concept in terms of the center of centers, the network of networks,” she said. “Are we anywhere close to where we want and need to be? No. Of course not.”

Link: http://www.propublica.org/feature/leader-of-militarys-program-to-treat-brain-injuries-steps-down-abruptly

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

LEXICONS: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com

Product DetailsProduct DetailsProduct Details

A New Model for Planing Physician Retirement Needs

Understanding Age Banding

By Ann Miller RN, MHA

[Executive Director]

Join Our Mailing List 

From time to time, our readers send in e-books, files or e-chapters, pamphlets or other material they have created for client, educational or marketing use. Some of it may be worthwhile; some not so. Nevertheless, these publications are often a good place to start the conversation, or thought-process on related topics.

They will be occasionally offered as a complimentary membership feature of the Medical Executive-Post.

  • Age Banding [author]
  • Somnath Basu PhD, MBA  [www.clunet.edu/cif]
  • [Director California Institute of Finance]

Link: AgeBander

 

 

Disclaimer

No advice offered. We make no copyright claim to these works. Veracity and information should be considered time sensitive. Always consult a professional for your situation.

Assessment

Feel free to send in your own material for the benefit of all Medical Executive-Post readers and subscribers.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

 

Product Details  Product Details

Where Are The Health Care Entrepreneurs?

The Failure of Organizational Innovation in Health Care

Submitted by Ann Miller RN, MHA

[Executive-Director]

Join Our Mailing List

The following quote is from a white paper by David M. Cutler

NBER Working Paper No. 16030
Issued in May 2010

Medical care is characterized by enormous inefficiency. Costs are higher and outcomes worse than almost all analyses of the industry suggest should occur. In other industries characterized by inefficiency, efficient firms expand to take over the market, or new firms enter to eliminate inefficiencies. This has not happened in medical care, however.

Therefore, this paper explores the reasons for this failure of innovation. I identify two factors as being particularly important in organizational stagnation: public insurance programs that are oriented to volume of care and not value, and inadequate information about quality of care.

Assessment

Recent reforms have aspects that bear on these problems.

Link: http://papers.nber.org/papers/w16030

Conclusion

The thoughts of all ME-P readers are appreciated. Then, be sure to subscribe. It is fast, free and secure.

Get our Widget: Get this widget!

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 ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Product Details

Implementation of the Healthcare Deficit Reduction Act

Signed by President Bush in 2006

By Gregory O. Ginn; PhD, MBA, CPA, MEd

By Hope Rachel Hetico; RN, MHA, CMP™

The Deficit Reduction Act (DRA), S. 1932, was signed by President Bush on February 8, 2006, and became Public Law No. 109-171.  Implementation of the act includes these provisions:

www.CertifiedMedicalPlanner.com

Subtitle A – Provisions Relating to Medicare Part A

  • hospital quality improvement (section 5001);
  • improvements to Medicare-dependent hospital (MDH) programs (section 5003);
  • reduction in payments to skilled nursing facilities (SNFs; section 5004);
  • phase-in of inpatient rehabilitation facility classification criteria (section 5005);
  • development of a strategic plan regarding investment in specialty hospitals (section 5006);
  • demonstration projects to permit gain-sharing arrangements (section 5007); and
  • post-acute care payment reform demonstration programs (section 5008).

Subtitle B  Provisions Relating to Medicare Part B

  • title transfer of certain durable medical equipment (DME) to patients after 13-month rental (section 5101);
  • adjustments in payment for imaging services (section 5102);
  • limitations on payments for procedures in ambulatory surgical centers (ASCs; section 5103);
  • minimum updates for physician services (section 5104);
  • three-year extension of hold-harmless provisions for small rural hospitals and sole community hospitals (section 5105);
  • updates on composite rate components of basic care-mix adjusted prospective payment systems (PPS) for dialysis services (section 5106);
  • accelerated implementation of income-related reductions in Part B premium subsidy (section 5111);
  • Medicare coverage of ultrasound screening for abdominal aortic aneurysms; National Educational And Information Campaign (section 5112);
  • improvements to patient access and utilization of colorectal cancer screening under Medicare (section 5113);
  • delivery of services at federally qualified health centers (FQHC) (section 5114); and
  • waiver of Part B Late Enrollment Penalty for certain international volunteers (section 5115).

Subtitle C – Provisions Relating To Parts A and B

  • home health payments (section 5201);
  • revision of period for providing payment for claims that are not submitted electronically (section 5202);
  • timeframe for Part A and B payments (section 5203); and
  • Medicare Integrity Program (MIP) funding (section 5204).

Subtitle D – Provisions Relating To Part C

  • phase-out of risk adjustment budget neutrality in determining payments to Medicare Advantage organizations (section 5301); and
  • Rural PACE Provider Grant Programs (section 5302).[1]

Join Our Mailing List

The goal of the act is to save nearly $40 billion over five years from mandatory spending programs through slowing the growth in spending for Medicare and Medicaid. Has it been successful to-date?

Assessment

We know from personal experience that the DRA can be implemented by all healthcare stakeholders to the benefits of the industry sector in the aggregate. But, has it been?

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

Editors Note: Gregory Ginn has been a professor in the Department of Health Care Administration at the University of Nevada, Las Vegas, since 2000. He received his doctorate, MBA, M.Ed., and undergraduate degree from the University of Texas at Austin, and is an inactive Certified Public Accountant registrant in the States of Nebraska and Texas. Before his current position at UNLV, he spent time teaching at Clarkson College, College of Saint Mary, University of Findlay, University of Central Texas, Stephen F. Austin State University, State University of New York at Buffalo, University of Houston at Victoria, University of Texas at Austin, and the Southwest Texas State University. Prior to his academic roles, he was an accountant for Touche Ross & Co., and an Internal Revenue Service Tax Auditor. Dr. Ginn has also been a reviewer for organizations such as: Health Care Management Review and the Health Care Administration Division of the Academy of Management. He is Treasurer for the Nevada Executive Health Care Forum and was a member of the Southern Nevada Wellness Council. His graduate teaching experience in healthcare administration is abundant, having taught courses in: Management of Health Services Organizations, Quantitative Methods, The U.S. Health Care System, Health Care Systems and Policy, Health Care Finance, Group Practice Management, Long-term Care, and Health Care Law.  He has been published in numerous journals, including Journal of Healthcare Management, Hospital Topics, Nursing Homes, Journal of Nursing Administration, International Electronic Journal of Health Education, and Hospital and Health Services Administration. His current and former professional memberships include: American College of Healthcare Executives, Nevada Executive Healthcare Forum, Academy of Management, Association of University Programs in Health Administration, Certified Medial Planner (Hon.) and Heartland Health Care Executives.

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:


Source: www.ncsl.org/statefed/health/ReconDocs0206.htm

Product DetailsProduct Details

Product Details

 

On Hospital Revenue Cycles Management

Operational Considerations for Improvement

By Dr. David Edward Marcinko, FACFAS, MBA, CMP™

By Hope Rachel Hetico; RN, MHA, CPHQ, CMP™

One of us has been an acute general care hospital administrator while the other vice-president of a clinical and medical staff.

Throughout our respective tenures, providing high quality care with improved health outcomes was our primary concern – and actually is that of most hospitals of any size, geography, or demographic. Conflicts of interest were inevitable of course, and occasionally the interest of stakeholders collided, or was ignored. And, continually we realized – and were reminded – that money matters and the maxim “no margin, no mission” applies.

www.CertifiedMedicalPlanner.com

Strong Management Required for Success

Nevertheless, the foundation of strong financial health ultimately lies in effective management of the hospital revenue cycle. And, strong internal management and leadership is the basis of an enhanced revenue cycle. In practical terms, effective management means understanding the process and targeting the core of the revenue cycle in order to fine-tune and support fiscal health and business growth.

www.MedicalBusinessAdvisors.com

A Triad of Processes Groupers

For us, the processes of hospital revenue cycles were grouped in three areas corresponding to the journey of a patient through the system: the front door, the middle, and the back door; to the extent possible.

1. Front-door processes are termed patient access functions and revolve around scheduling, registration, pre-admission, and admissions. When these processes are streamlined and swift; the value is most evident to a hospitals’ customers, the patients, but it is also vital to the revenue maintenance (and enhancement) of the facility. The most effective and efficient time to accomplish patient access activities is when patients and their caregivers are together. Patient access needs to be handled by highly skilled and motivated employees who can accomplish a hospital’s goals for information capture while carrying out customer service objectives. This is also the optimal stage for achieving denial management.

2. Middle processes include case management (CM) and health information management (HIM).  Those involved in the CM function act as gatekeepers to review the appropriateness of clinic referrals and ensure financial clearance is established.  CM also involves developing a plan for discharge and monitoring to ensure it is timely and appropriate to the level of care.  Another important focus of CM is the freeing up of acute care beds.

The HIM functions revolve around document management, coding, transcription, and charge capture. Financial performance can be significantly improved when case management and HIM activities are optimized by using information technologies that are integrated with process and workflow. The end result can be an increase in revenue and reduction in regulatory risk.

3. Finally, back-door processes are termed patient financial services (PFS) functions and revolve around billing, collections, follow-up, and resolution. These are the business office billing and administrative functions that support the front-line caregivers and that interface with external payers and patients to resolve outstanding accounts receivable. Back-door processes bring significant value to hospitals by reducing administrative costs, increasing collections levels, and dramatically lowering the percentage of aged accounts receivables [ARs].

Assessment

Modern hospitals today that are seeking to improve their bottom lines through better-managed and enhanced revenue cycle operations in these three areas front, middle, and back usually encounter challenges with people, processes, and technology. These challenges may be addressed by incorporating following:

  • optimizing organizational structure;
  • raising the bar through benchmarking; and
  • adopting appropriate technology.

Editors: We appreciate the ME-P input of Karen White PhD and Ross Fidler. 

www.HealthcareFinancials.com

Conclusion

Now, please tell us your hospital revenue cycles story and how these challenges were executed; successfully or not!  What benchmarks did you use for them, and were any others required. Do these operational activities conflict or compliment each other; how and why or why not?

Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

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

Get our Widget: Get this widget!

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 ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Product DetailsProduct DetailsProduct Details

Product Details  Product Details

Product Details

How eMR Vendors May Mislead You

Challenging Assertions

By Shahid N. Shah MS

As the physician executive of your medical practice, it’s your job to challenge any eMR vendors’ assertions about why you need an eMR, especially during the selection and production demonstration phase.

Information Availability [Anytime – Anywhere]

The most important reason for the digitization of medical records is to make patient information available when the physician needs that information to either care for the patient or supply information to another caregiver.

Electronic medical records are not about the technology but about whether or not information is more readily available at the point of need.

Reasons to Purchase?

In no particular order, the major reasons given for the business case of eMRs by vendors include:

• Increase in staff productivity
• Increase of practice revenue and profit
• Reduce costs outright or control cost increases
• Improve clinical decision making
• Enhance documentation
• Improve patient care
• Reduce medical errors

Assessment

So, doctors beware! Challenge vendor “authority.”

Join Our Mailing List

Editor’s Note

Shahid N. Shah is an ME-P thought leader who is writing Chapter 13: “Interoperable e-MRs for the Small-Medium Sized Medical Practice” [On Being the CIO of your Own Office] for the third edition of the best selling book: Business of Medical Practice [Transformational Health 2.0 Skills for Doctors] to be released this fall by Springer Publishers, NY. He is also the CEO of Netspective Communications, LLC.

www.BusinessofMedicalPractice.com

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Mr. Shah and Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – are available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

Get our Widget: Get this widget!

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 ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Product Details

GE Violated Danish Drug Reporting Law

In the Omniscan Case

By Jeff Gerth, ProPublica – June 17, 2010 5:59 pm EDT

Join Our Mailing List 

General Electric’s health care unit failed to promptly and completely inform regulators about a patient who died after experiencing adverse effects from the company’s MRI drug Omniscan, Danish drug regulators concluded in a ruling last month.

Danish Medicines Agency

The finding by the Danish Medicines Agency comes in the case of a Danish woman who had been injected with Omniscan for a magnetic resonance scan in 2002 and gradually became immobilized and died of a lung embolism the following year. The woman, Birthe Madsen, is believed to be among the first patients whose use of Omniscan and similar medical imaging drugs was associated with a rare and potentially crippling disease now known as nephrogenic systemic fibrosis [1], or NSF. Hundreds of patients became ill after Madsen’s death, before regulators and drug companies learned enough about the risks to begin issuing alerting doctors a few years later.

Government Insurance Agency

Reviewing the reasons Madsen died, a Danish government insurance agency determined in 2004 that Omniscan caused her immobility and in turn her death. Although this was relayed to GE Healthcare, the company did not immediately report it to the medicines agency as required, nor did a follow-up include the insurance agency’s conclusion that Madsen’s death could be attributed to the drug.

Although the reporting lapses violated Danish drug law, the medicines agency told GE Healthcare in a May 21 letter that the statute of limitations had expired and it would not pursue further action against the company. GE Healthcare maintains that its reporting about Omniscan’s side effects has been proper, and spokesman Jeff DeMarrais said in an e-mail that the woman’s death was not initially attributed to Omniscan because the fatal embolism occurred during a lengthy course of treatment “following the patient’s adverse reaction.”

The ruling by the Danish Medicine Agency, coming years after the reporting lapse, appears to have been prompted by an inquiry last October from a member of the Danish parliament about the agency’s response after cases of NSF first came to light in early 2006.

[picapp align=”none” wrap=”false” link=”term=denmark&iid=5207011″ src=”http://view2.picapp.com/pictures.photo/image/5207011/low-angle-view-amalienborg/low-angle-view-amalienborg.jpg?size=500&imageId=5207011″ width=”323″ height=”529″ /]

Contesting Lawsuits

GE currently is contesting more than 400 lawsuits [2] involving U.S. patients who say they contracted the disease after being injected with Omniscan. The company says it acted properly to protect patients and denies its drug causes NSF. Some manufacturers of competing products also have been sued, but in far fewer numbers than GE.

One of the major points of debate in the litigation concerns what GE Healthcare knew [2] and disclosed to regulators about Omniscan’s risks. The company contends it has been proactive and cooperative, while the plaintiffs claim the company failed to disclose damaging information about the drug and put patients in jeopardy.

Critics of GE Healthcare say more forthright disclosure might have helped doctors and regulators respond earlier and more effectively. Among them is Madsen’s son, Casper Schmidt, a Copenhagen lawyer who has carefully documented her case and the actions of various Danish authorities.

“If my mother’s case had been reported more accurately, and if the company had to explain why a patient died,” Schmidt said in an e-mail, “it would have helped enable doctors and regulators to better understand the disease earlier.”

US and European Drug Makers

Drug manufacturers in the United States and Europe are required to promptly report serious adverse reactions so that regulators and medical providers can monitor a product’s safety. They also must update the reports as new information about a case develops. In the U.S., the Food and Drug Administration logs the reports in a database [3].

At the time Madsen was exposed to Omniscan in 2004, tens of millions of patients who had undergone MRIs had been safely injected with such products, known as contrast agents, to enhance the images.

Omniscan [4], approved for use in the United States in 1993, is among a class of such agents that rely on gadolinium, a highly toxic metal. The body normally eliminates the drug quickly after treatment, except in some patients who have impaired kidney function.

Madsen was such a patient. According to Schmidt’s timeline of her treatment, she had at least one dialysis treatment before being injected with Omniscan in January 2002 to evaluate whether her veins were healthy enough for a kidney transplant. She experienced a cascade of crippling symptoms until her death in October 2003 at age 55.

Madsen’s adverse reactions prompted a medical review by a Danish government insurance agency, called Patientforsikringen, or Patient Insurance Agency, to see whether she had suffered drug side effects that might qualify her for state compensation.

The review determined that while Madsen died of a pulmonary embolism, her “immobilization was caused by the acknowledged pharmaceutical injury.”

That conclusion was reported to GE Healthcare on June 1, 2004, but the company failed to relay the information as required, the Danish Medicines Agency said in its May letter. In addition, the agency said a follow-up report from GE Healthcare, while noting several of Madsen’s adverse reactions, was insufficient because it did not repeat the state insurance agency’s finding that she died from an embolism due to being immobilized.

The GE Spokesman

DeMarrais, the GE spokesman, said that at the time, the company’s drug safety experts had a different understanding of Madsen’s death.

“Our filings regarding the case in question reflect that, as of 2004,” DeMarrais wrote, “our (drug safety) unit had not concluded, based on the information available at the time and in good faith, that the patient’s death had been caused by the adverse event that had been linked to the administration of Omniscan, but rather by a pulmonary embolism occurring during a protracted medical course following the patient’s adverse reaction.”

In its May letter, the Danish Medicines Agency said it had combed its files and could find no report from GE about Madsen in June 2004. DeMarrais, however, said the company believes a report was sent that month “at the same time as it was sent to other regulators, as confirmed by the FDA’s receipt of this filing.”

ProPublica Inquiry

At ProPublica’s request, Conor McKechnie, another company spokesman, provided a copy of the FDA filing [5] with Madsen’s name and some other information redacted. (The filing was on the letterhead of Amersham Health, the British maker of scanning drugs that GE acquired in late 2003 and early 2004.)

The filing references “new information” from the Danish insurance agency and states that the patient involved “suffered pulmonary embolism due to immobilization and died.” But it does not quote the insurance agency’s conclusion that “pharmaceutical injury” was to blame for Madsen’s immobility.

McKechnie said the FDA filing is accurate and mentioned immobilization, the embolism and death. DeMarrais said GE Healthcare also has submitted half a dozen more supplemental filings on the case over the last six years. “It would be a mistake,” he added, “to attach unwarranted significance to this particular case at this juncture.”

“It is our position that, consistent with the relevant health risk communication protocols, we provided complete and timely reports to the DMA and other global authorities regarding the adverse events associated with Omniscan that were reported to us,” DeMarrais said in his e-mail.

Dr. Sidney Wolfe, director of the health research group at the consumer watchdog organization Public Citizen, said GE should have been more forthcoming in 2004.

“Incomplete and misleading reports such as this undermine the ability of the government to make decisions more quickly to improve the public health,” said Wolfe, who is on an FDA advisory committee [6] that late last year reviewed Omniscan and other contrast agents.

In May 2006, following the disclosure of 20 NSF cases in Copenhagen, GE Healthcare issued a safety alert to the DMA and regulators around the world. It discussed the new cases and attached a brief description of each one. In the section involving Madsen, the company reported her death as “unrelated to Omniscan.”

By 2007, at the urging of regulators, the manufacturers of gadolinium-based agents put warnings about NSF on their labels. Three years later, much about the disease remains a mystery [7], including the exact cause. Patients experience a painful hardening or thickening of skin around the joints. The disease can be disfiguring and may attack internal organs.

Current Updates

As of last fall, the Patientforsikringen had reviewed 38 cases in which people exposed to Omniscan had suffered injury or death. In 26 cases, the insurance agency determined that GE Healthcare’s drug was the likely cause, according to a spokesman. In those cases, including Madsen’s, the agency made payments to the victims or their relatives.

[picapp align=”none” wrap=”false” link=”term=General+Electric&iid=8962953″ src=”http://view2.picapp.com/pictures.photo/image/8962953/general-electric-ceo-and/general-electric-ceo-and.jpg?size=500&imageId=8962953″ width=”380″ height=”537″ /]

Assessment

GE Healthcare has the opportunity to appeal the insurance agency’s decisions but has not done so, the Patientforsikringen spokesman said in an e-mail last fall. McKechnie said the company did not appeal because it was not a direct party to the agency’s decision.

DeMarrais said the company would respond to the Danish Medicines Agency’s finding of a reporting violation, which can be appealed.

Madsen’s name is redacted in the May 21 letter from the agency, but it was confirmed by her son and by matching the details in the letter with other public information.

Link: http://www.propublica.org/feature/ge-violated-danish-drug-reporting-law-in-omniscan-case

Conclusion

Your thoughts and comments on this ME-P reprint are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

Get our Widget: Get this widget!

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 ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

On this Blogging and Writing Lifestyle

About My Morning Routine

[By D. Kellus Pruitt; DDS]

For lack of anything else to write about at the moment, let me describe my morning routine on the weekends.

I like to get up early – 5:30 am yesterday morning. More often than not, Bo, our sheltie, is waiting to greet me because he knows we get to go after the newspaper. That’s exciting. Bo is a morning dog as well. I brew up some coffee, read the newspaper – headlines mostly – and then I sit down in an overstuffed chair with my laptop to check my Google alerts and email before I start writing on whatever strikes me as interesting.

Commencing this Lifestyle                                  

Many writers; like my friend Jill Kring Carter who writes professionally for DentalTown and other publications, do their best work late at night. My mom, who painted professionally, liked the hours between 10 pm and 2 or 3 am for her art when she didn’t have to teach school the next day.

My sons, Ryan and Kellus, like the late hours as well. Sometimes on the weekends, I’m getting up when they are going to bed after having played online video games with friends across the nation all night. That means that while they are sleeping, and before Marci gets up and turns on electrical appliances, I sit nice and cozy, hammering away – constructing sentences out of words and then rearranging it to say with surgical precision what I intend to say. I enjoy it.

Shutting off the Laptop 

About the time I run out of battery for my laptop is when dogs start whining and barking, the TV comes on and the day springs to life. After I turn off my computer, sometimes Ryan and I go out for breakfast and sometimes Marci fixes eggs and bacon, pancakes or French toast. Otherwise I heat up a bowl of oatmeal to eat, visit some, and then head to the office where it’s quiet all day long.

Assessment 

If you are a doctor, medical management consultant, or any sort of accountant, economist or financial advisor; please tell us how you spend your non-professional time /day. Is this post appropriate for a professional forum like the ME-P. Or, is it TMI and better suited for a social network site? Does anyone even care?

Conclusion

Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Product Details

***

Is the Texas Dental Association too Authoritarian?

Join Our Mailing List

About Employee Mary Kay Linn

[By Darrell Kellus Pruitt; DDS]

Texas Dental Association Executive-Director Mary Kay Linn seems to think that TDA members owe her respect for some reason. I don’t see it. You get what you give TDA employee Mary Kay Linn.

Link: TDA response to Pruitt

I’ve attached the partially answered, authoritarian response from the TDA. I think it speaks for itself. And, I posted the following Twitterpoem today.

Mary Kay Linn, the executive director of the TDA just doesn’t get it.

@theTDA, I received the responses to some of the 30+ questions that were invited by the TDA. Linn’s evasion is transparent and regrettable.

@theTDA, when a Judicial Committee member delivered the PDF, he said Linn told him to tell me that “This is it. No more questions.”

Assessment

He added that: “There will be no follow up responses and that the very busy TDA staff spent far too much time on my questions already.” 

TDA Executive Director Mary Kay Linn, this will not end well for you.

Assessment

How responsive was the TDA; just right, under or overwhelming when pushed? Or, was Dr. Pruitt over-the-top? Does he expect too much from his professional association? Does almost every DDS except him know that the “emperor has no clothes?” Or, is he one member with critical thinking skills instead of blind [misplaced] faith?

Finally, is there an analogy here for the AMA, ADA, APMA, ANA, AOA, etc? Are the aging command-control medical association monopolies crashing down in the era of internet connectivity and professional networking? Do we need new norms and etiquette models of communication? Please opine.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Product Details

Doctors Helping Seniors Avoid Financial Fraud?

The Elder Investment Fraud and Financial Exploitation Project

By Staff Reporters

A new program created in Houston and tested in Texas will teach medical professionals nationwide to identify and report signs of elder financial abuse.

The EIFFE

The Elder Investment Fraud and Financial Exploitation project includes a new survey and prevention campaign to help people 65 year, and older, avoid being fleeced. The program is designed to help geriatric health professionals and financial regulators work more closely to identify, and report and investigate elder financial abuse.

Assessment

And still, FINRA, the SEC and others are procrastinating on fiduciary responsibility for financial advisors.

http://blogs.chron.com/medblog/archives/2010/06/houston_program.html

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. FAs, and CSAs, are you embarrassed by this program? Are you a fiduciary – much like a physician or lawyer? Doctors, how do you feel – burdened, resentful, empowered, etc?

Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

Get our Widget: Get this widget!

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 ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

 

Product Details  Product Details

Understanding Patient-Focused Healthcare

Emerging Trend Focuses on the Patient

By Gregory O. Ginn; PhD, MBA, CPA, MEd

By Hope Rachel Hetico; RN, MHA, CMP™

One swelling competitive medical administration and clinical trend is patient-focused and holistic healthcare, which centers on patient needs and attempts to humanize patient care.

Definition

www.HealthDictionarySeries.com

Patient-focused healthcare therefore incorporates the following concepts, among others:

  • patient education;
  • active participation of the patient;
  • involvement of the family;
  • nutrition;
  • art; and
  • music.

These are thought to improve patient outcomes. Further, some think that patients will benefit from learning how to cope with healthcare processes before they enter into those processes and that this knowledge will result in better outcomes.

www.CertifiedMedicalPlanner.com

An example of this would be classes to prepare couples for childbirth. These classes teach prospective parents the different stages of labor and strategies for dealing with the challenges associated with each stage. They cover options for pain management such as breathing and relaxation techniques and/or analgesics. The classes also provide education about clinical options such as induced labor and caesarian sections, and they cover practical issues such as what to wear and what kind of car seat to buy to transport the newborn home.

Join Our Mailing List

Assessment

We know from personal experience that this type of education is enormously beneficial in reducing stress and improving the decision-making ability of patients who are involved in healthcare processes.

www.HealthcareFinancials.com

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

Editors Note: Gregory Ginn has been a professor in the Department of Health Care Administration at the University of Nevada, Las Vegas, since 2000. He received his doctorate, MBA, M.Ed., and undergraduate degree from the University of Texas at Austin, and is an inactive Certified Public Accountant registrant in the States of Nebraska and Texas. Before his current position at UNLV, he spent time teaching at Clarkson College, College of Saint Mary, University of Findlay, University of Central Texas, Stephen F. Austin State University, State University of New York at Buffalo, University of Houston at Victoria, University of Texas at Austin, and the Southwest Texas State University. Prior to his academic roles, he was an accountant for Touche Ross & Co., and an Internal Revenue Service Tax Auditor. Dr. Ginn has also been a reviewer for organizations such as: Health Care Management Review and the Health Care Administration Division of the Academy of Management. He is Treasurer for the Nevada Executive Health Care Forum and was a member of the Southern Nevada Wellness Council. His graduate teaching experience in healthcare administration is abundant, having taught courses in: Management of Health Services Organizations, Quantitative Methods, The U.S. Health Care System, Health Care Systems and Policy, Health Care Finance, Group Practice Management, Long-term Care, and Health Care Law.  He has been published in numerous journals, including Journal of Healthcare Management, Hospital Topics, Nursing Homes, Journal of Nursing Administration, International Electronic Journal of Health Education, and Hospital and Health Services Administration. His current and former professional memberships include: American College of Healthcare Executives, Nevada Executive Healthcare Forum, Academy of Management, Association of University Programs in Health Administration, Certified Medial Planner (Hon.) and Heartland Health Care Executives.

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

Get our Widget: Get this widget!

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 ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

What is M-Health for Physicians?

On “Smart Phones” and Mobiles Devices

By Shahid N. Shah MS

M-Health or “mobile health” is an industry term for collectively defining those tools and technologies that can be used on “smart phones” like iPhone, Blackberry, Android, or on traditional mobile phones from various vendors.

Unlike traditional computers, almost every patient that walks into your medical office, as well as all your own staff, have mobile devices already. If you can find mobile applications that can help your practice you can immediately put to use without large capital expenses, network configuration, and other technical tasks.

www.MedicalBusinessAdvisors.com

The M-Health Initiative

According to the mHealth Initiative, there are 12 major “application clusters” in mobile health: patient communication, access to web-based resources, point of care documentation, disease management, education programs, professional communication, administrative applications, financial applications, emergency care, public health, clinical trials, and body area networks.

www.CertifiedMedicalPlanner.com

The Applications

Almost all of these applications are focused around the patient but most of them will be directly useful to you and your staff as well. Here’s how:

  • Improving physician-patient communications. You can get your staff to send out text messages, e-mails, photos, and other information about your practice to the patient before their visit. You can remind them about appointments, tell them what to expect, ask them for their insurance and check-in information, or let them send you their personal health record link. During the visit you can send them patient education information directly to their phones instead of handing out paper. After the visit you can send medication reminders, additional educational resources, and update to their personal health record, or ask them to join a Health 2.0 social network. PumpOne, GenerationOne, Intouch Clinical, Life:Wire, and Jitterbug phones all have great patient user experiences and you should tell your patients about them.
  • Faster access to information for you and your patients. There are countless web-based resources that are now at your fingertips on a phone. Patients can lookup providers, labs, testing services, etc. that you can refer them to; you can help them join clinical trials, and manage their health records online. None of these require a computer either in your office or in their home, it can all be done on the phone. Check out companies like Healthagen and iSeek.
  • Real-time documentation of office or hospital visits. Most of the things you want to do in your EMR are possible on a smart phone today. You can get your patient profiles, document an encounter with basic order management and lab results review capabilities, and immediate storage into either your own EMR or your hospital’s information system.
  • Help those patients with the most time-consuming treatments. You already know that disease management is an important part of managing the health of chronic patients; diabetes and hypertension are two perfect examples. Help enroll your patients into Diabetes Connect, MediNet, HealthCentral, and similar applications that can help track compliance with your medical treatment guidance. If they use these applications they can simply give you printouts or login credentials so that you can track their progress without doing any data entry yourself. There are patient tools for most common diseases.

Join Our Mailing List

Editor’s Note

Shahid N. Shah is an ME-P thought leader who is writing Chapter 13: “Interoperable e-MRs for the Small-Medium Sized Medical Practice” [On Being the CIO of your Own Office] for the third edition of the best selling book: Business of Medical Practice [Transformational Health 2.0 Skills for Doctors] to be released this fall by Springer Publishing, NY. He is also the CEO of Netspective Communications, LLC.

www.BusinessofMedicalPractice.com

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Mr. Shah and Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – are available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

Get our Widget: Get this widget!

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 ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Personalizing the Doctor or Client’s Living Will

Helping Financial Advisors Plan Future Medical Decisions

By Ann Miller RN, MHA

[Executive Director]

From time to time, our readers send in e-books, files or e-chapters, pamphlets or other material they have created for client, educational or marketing use. Some of it may be worthwhile; some not so.

Nevertheless, these publications are often a good place to start the conversation, or thought-process on related topics. They will be occasionally offered as a complimentary membership feature of the Medical Executive-Post. We trust they are beneficial to you.

Your Life – Your Choices [authors]

  • Robert Perlman MD
  • Helen Starks MPH
  • Kevin Cain PhD
  • William Cole PhD
  • David Rosengren PhD
  • Donald Patrick PhD

Link: Your life – your choices

Disclaimer

No advice is offered. We make no authorship nor copyright claim to these works. Veracity and information should be considered time sensitive. Consult a professional for your situation.

Assessment

Feel free to send in your own material for the benefit of all Medical Executive-Post readers and subscribers. All works will be considered; but not necessarily published.

Conclusion

And so, your thoughts and comments on this ME-P feature appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

Get our Widget: Get this widget!

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 ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Product DetailsProduct DetailsProduct Details

Product Details  Product Details

Product Details

On Hospital CPOE Systems [Part Two]

Join Our Mailing List

Computerized Physician Order Entry Systems

By Brent Metfessel; MD, MIS

A significant initial cost outlay for an organization-wide CPOE system is necessary, which for a large hospital may run into the tens of millions of dollars.  Understandably, the majority of the hospitals that have installed a CPOE system are large urban hospitals.  The up-front cost outlay may be prohibitive for smaller or rural hospitals unless there is an increase in outside revenue or third-party subsidies.

However, although it may take a few years before a positive ROI becomes manifest, there can be a significant financial return from such systems.

www.CPOE.org

Potential Benefits

The potential benefits of a CPOE system go beyond quality. Significant decreases in resource utilization can occur. In one study, inpatient costs were 12% lower and average Length of Stay (LOS) was 0.89 day shorter for patients residing on general medicine wards that used a CPOE system with decision support. Rather simple decision support tools can reap cost benefits as well. When a computerized antibiotic advisor was integrated with the ordering process, one institution realized a reduction in costs per patient ($26,325 vs. $35,283) and average LOS (10.0 days vs. 12.9 days), with all differences statistically significant.

Studies have shown that CPOE systems can significantly reduce medication error rates, including rates of serious errors.

For example, one large east coast hospital saw a 55% reduction in serious adverse medication errors after the system was installed. However, on occasion errors can actually be introduced due to the computing process; in particular, errors can be introduced if the provider accidentally selects the wrong medication from the list or drop-down menu.

Accordingly, a CPOE system should not be viewed as a replacement for the pharmacist in terms of checking for medication errors. In addition, proper user interface design such as highlighting every other line on the medication screen for better visibility and having the provider give a final check to the orders before sending are some ways of reducing this kind of error. Overall, error rates from incorrect order entry on the computer are much smaller than other medication errors prior to introduction of the system.

Appropriate use of a CPOE system helps prevent errors and quality of care deficiencies due to problems with the initiation of orders.  However, errors can also occur in the execution of orders, particularly with the administration of medications to patients.  Bar coding of medications, discussed previously, is a simple way to close the loop in medication error prevention as well as further increase the efficiency of workflow.

Despite its advantages, a CPOE system has been implemented on an organization-wide basis in only about 45% of all US hospitals and growth in implementations has been relatively slow, although about 67% plan to add a CPOE system in the next few years.  Implementing a CPOE system is not an easy task, and there is a significant risk of failure.  Most hospitals utilize vendors for implementation rather than attempting to develop the system in-house given the difficulty of hiring full-time IT talent that specializes in CPOE systems.

One critical feature of any CPOE system is to obtain physician buy-in to the technology, since they will be doing most of the ordering.  Actually, unless the system is of the highest sophistication, physicians may claim it takes more time to write orders using a CPOE system than using the paper chart, as there may be a number of drop-down menus to negotiate prior to arriving at the appropriate drug.  Real-time retrieval of information and electronic documentation, provision of on-line alerts, and the ability to use standard order sets (prepackaged sets of orders pertaining to a particular clinical condition or time period in an episode of care), when relevant, can make the net time spent on writing orders similar to using paper charts.

Doctor Acceptance

It is also important, for physician acceptance, to not overwhelm them with on-line alerts.  Clearly, the system needs to point out the more serious errors, but if the physician’s process is frequently interrupted by alerts, they may increasingly resist the system.

For example, medication allergy alerts may warn physicians not only of potential problems with medications that have an exact match to the allergen, but also, as a defensive maneuver (“better safe than sorry”), to other medications that have a related molecular structure,, even though the patient may already be taking such medication and tolerating it well.  Furthermore, allergies to medications that may result in life-threatening anaphylactic shock may not be distinguished from “sensitivities” that consist of side effects that are not true allergies and are usually much less serious.

Thus, the potential exists for frequent alert generation that would interrupt the work flow and require time spent to override the alerts, making the system difficult to use and leading to user resistance.  One suggested solution is to have a hierarchy of importance, with alerts for potentially life-threatening situations being allowed to interrupt the work flow and requiring specific override or acknowledgment, and alerts for less serious problems being “noninterruptive,” allowing easy visibility of the alert without requiring stoppage of the work flow.

Product DetailsProduct DetailsProduct Details

CPOE Pitfalls

Other pitfalls with respect to CPOE systems include the following:

  • crowded menus making it easy to select the wrong patient or wrong drug with the mouse;
  • fragmented information necessitating navigation through numerous screens to find the relevant information;
  • computer downtime (scheduled or unscheduled); and
  • location of terminals in busy places, which can lead to distractions and resulting incomplete or incorrect entries.

Intelligent, well-thought-out system designs can serve to mitigate many of these problems.  It is important that such difficulties appear on the systems designers’ “radar screen” and are explicitly considered in the implementation.

Pharmacists

As for pharmacists, a CPOE system will not take them out of the process. Although a CPOE system has the capability to capture many drug errors and remove the need for manual order entry, there will always be a need for pharmacists to not only give a second look at possible errors, but to take a more active role in patient care, including going on ward rounds for complex cases, defining optimal treatment, and giving consultative advice.

www.MedicalBusinessAdvisors.com

Assessment

A CPOE system has the potential to give physicians ready access to patient data anywhere in the hospital as well as at home or on the road, especially with Internet-based connections. This is significant given the difficulty in obtaining patient charts for mobile providers.

In today’s environment of high expectations for care quality and pay-for-performance initiatives, enhanced quality of care can translate into financial gain. Although there is a significant up-front allocation of funds for CPOE systems, given present trends the time may arrive where there is no longer a choice but to implement such a system.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Product Details

Coordination, Switching Costs and the Division of Labor in General Medicine

An Economic Explanation for the Emergence of Hospitalists in the United States

Submitted by Hope Rachel Hetico RN, MHA

[Managing Editor]

Join Our Mailing List

From a white paper by David O. Meltzer, Jeanette W. Chung

NBER Working Paper No. 16040
Issued in May 2010

General medical care in the United States has historically been provided by physicians who care for their patients in both ambulatory and hospital settings.  Care is now increasingly divided between physicians specializing in hospital care (hospitalists) and ambulatory-based care primary care physicians.  We develop and find strong empirical support for a theoretical model of the division of labor in general medicine that views the use of hospitalists as balancing the costs of coordinating care across physicians in the hospitalist model against physicians costs switching between ambulatory and hospital settings in the traditional model.

Assessment

These findings suggest opportunities to improve care.

Link: http://papers.nber.org/papers/w16040

Conclusion

All ME-P readers are invited to opine.

Get our Widget: Get this widget!

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 ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Sponsorship Opportunities

Advertise on the ME-P

By Ann Miller RN, MHA

[Executive Director]

Become a sponsor on the #1 resource for medical management consultants and financial advisors in the healthcare space.

[picapp align=”none” wrap=”false” link=”term=economics&iid=254766″ src=”0251/ee927eb2-7cea-467f-8a10-21ba2c3c6504.jpg?adImageId=13102461&imageId=254766″ width=”380″ height=”257″ /]

About Us: https://medicalexecutivepost.com/2007/10/08/hello-world/

The “Deal”

The Medical Executive-Post is offering sponsorship opportunities to market leaders in the fields of practice management, financial planning, health economics, business, HIT and pharma.

Advertise with Us:  https://medicalexecutivepost.com/2007/11/11/advertise/

Sponsors will gain visibility for their companies, products and services – demonstrate their support for our 50 related field topics in the healthcare industrial complex – and be afforded unique opportunities to interact with medical professionals, doctors, nurses, CXOs, each other and healthcare executives of all types.

Assessment

We reach more than 5,000 dedicated medical executives each week, and thousands more visitors.

But, the ME-P has limited sponsorship and advertising opportunities available. Reserve your space today.

MarcinkoAdvisors@msn.com

Conclusion

Be sure to subscribe, too. It is fast, free and secure.

Join Our Mailing List

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

Get our Widget: Get this widget!

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

On Hospital CPOE Systems [Part One]

Join Our Mailing List

Computerized Physician Order Entry Systems

[By Brent Metfessel MD, MIS]

Since the late 1990s, there has been increasing pressure for hospitals to develop processes to ensure quality of care. The Institute of Medicine (IOM) has estimated the number of annual deaths from medical error to be 44,000 to 98,000.  Manual entry of orders, use of non-standard abbreviations, and poor legibility of orders and chart notes contribute to medical errors.  They also concluded that most errors are the result of system failures, not people failures.

www.CPOE.org

Other studies suggest that between 6.5% and 20% of hospitalized patients will experience an adverse drug event (ADE) during their stay. Both quality and cost of care suffer.  The cost for each ADE is estimated to be about $2,000 to $2,500, mainly resulting from longer lengths of stay. The National Committee on Vital and Health Statistics reported that about 23,000 hospital patients die annually from injuries linked specifically to the use of medications.

Join Our Mailing List

The Joint Commission and the Leapfrog Group

In addition, the Joint Commission and the Leapfrog Group, a consortium of large employers, have pushed patient safety as a high priority and hospitals are following suit. The Leapfrog Group in particular highlighted CPOE systems as one of the changes that would most improve patient safety.  These patient safety initiatives have further advanced CPOE systems, since these systems have the reduction of medical errors as a prime function.  State and federal legislatures have also stepped up activity in this regard.

For example, back in July 2004, the federal government strongly advocated for electronic medical records, including the creation of the Office of the National Coordinator for Health Information Technology to develop a National Health Information Network. Consequently, regional health information organizations have been established in many states, and these are used for the purpose of expediting the sharing and exchange of healthcare data and information, although there still remain issues in terms of providing adequate funding to these programs.

In addition, consideration was given to the allocation of grants and low-interest loans to aid hospitals in implementing healthcare technology solutions.  In 2000, California first enacted legislation (Senate Bill 1875) stating that as a condition of licensure, acute care hospitals, with the exception of small and rural hospitals, submit plans to implement technological solutions (such as CPOE systems) to substantially reduce medication-related errors by January 1, 2002. Hospitals in California had until January 1, 2005, to actually implement their medication error-reduction plans and make them operational. Unfortunately, many are still not in compliance today.

Health plans also entered the patient safety stage. In 2002, one large health plan in the northeast provided a 4% bonus to hospitals implementing a CPOE system and staffing intensive care units (ICUs) with “intensivists.” Today, this goal is almost the norm, but not yet reality for all.

More than Data Retrieval 

Many hospitals have “data retrieval” systems where a provider on the wards can obtain lab results and other information. A CPOE system, however, allows entry of data from the wards and is usually coupled with a “decision support” module that does just that — supports the provider in making decisions that maximize care quality and/or cost effectiveness.

In this application of HIT, physicians and possibly other providers enter hospital orders directly into the computer. Many vendors of such systems make special efforts to create an intuitive and user-friendly interface, with a variable range of customization possibilities. The physicians can enter orders either on a workstation on the ward or in some cases at the bedside.

Features of a True CPOE System

Basic features of CPOE should include the following:

  • Medication analysis system — A medication analysis program usually accompanies the order entry system. In such cases, either after order entry or interactively, the system checks for potential problems such as drug-drug interactions, duplicate orders, drug allergies and hypersensitivities, and dosage miscalculations. More sophisticated systems may also check for drug interactions with co-morbidities (e.g., psychiatric drugs that may increase blood pressure in a depressed patient with hypertension), drug-lab interactions (e.g., labs pointing to renal impairment that may adversely affect drug levels), and suggestions to use drugs with the same therapeutic effect but lower cost. Naturally, physicians have the option to decline the alerts and continue with the order. In fact, if there are alerts that providers are frequently overriding, providers will often provide feedback that can lead to modification of the alert paradigms. Encouraging feedback increases the robustness of the CPOE system and facilitates continuous quality improvement.
  • Order clarity — Reading the handwriting of providers is a legendary problem. Although many providers do perfectly well with legibility, other providers have difficulty due to being rushed, stressed, or due to trait factors. Since the orders are accessible directly on the workstation screen or from the printer, time is saved on callbacks to decipher illegible orders as well as preventing possible errors in order translation. A study in 1986 by Georgetown University Hospital (Washington, D.C.) noted that 16% of all manual medical records are illegible. Clarifying these orders takes professional time, and resources are spent duplicating the data; thus, real cost savings can be realized through the elimination of these processes.
  • Increased work efficiency — Instantaneous electronic transmittal of orders to radiology, laboratory, pharmacy, consulting services, or other departments replaces corresponding manual tasks. This increase in efficiency from a CPOE system has significant returns. In one hospital in the southeast, the time taken between drug order submission and receipt by the pharmacy was shortened from 96 minutes (using paper) to 3 minutes. Such an increase in efficiency can save labor costs and lead to earlier discharge of patients. The same hospital noted a 72% reduction in medication error rates during a three-month period after the system was implemented. Alerting providers to duplicate lab orders further saves costs from more efficient work processes. And, in another instance, the time from writing admission orders to execution of the orders decreased from about six hours to 30 minutes, underscoring CPOE system utility in making work processes more efficient; thus positively affecting the bottom line.

Assessment

In today’s environment of high expectations for care quality and pay-for-performance initiatives, enhanced quality of care can translate into financial gain. Although there is a significant up-front allocation of funds for CPOE systems, given present trends the time may arrive where there is no longer a choice but to implement such a system.

Conclusion

Although a Computerized Physician Order Entry system alone will reap significant benefits if intelligently implemented, in order to realize the greatest benefit a CPOE system should be rolled up into a fully functioning EMR system where feasible.

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Product DetailsProduct Details

 

Why Hospital IT is Almost like a Retail Mall

Hospital Bar-Coding Systems

By Brent A. Metfessel; MD, MIS

www.HealthcareFinancials.com

Given anticipated benefits in patient safety, the FDA required in April 2006, that bar codes be installed on all medications used in hospitals and dispensed based on a physician’s order.  The bar code must contain at least the National Drug Code (NDC) number, which specifically identifies the drug. 

Unfortunately, by 2008 only about 18% of hospitals used bedside bar coding systems. Nevertheless, this ruling heightened the priority of implementing hospital-wide systems for patient/drug matching using bar codes and implementation that is still growing rapidly today.

Procedures

Conceptually, the procedure for bar coding is as follows:

  • The drug is given to the nurse or other provider for administration to the patient.
  • Once in the patient’s room, the provider scans the bar code on the patient’s identification badge, which positively identifies the patient.
  • The medication container is then passed through the scanner, which then identifies the drug.
  • The computer matches the patient to the drug order.  If there is not a match, including drug, dosage, and time of administration, an alert is displayed in real-time, enabling correction of the error prior to drug administration.

Enter the FDA

The FDA estimates that over 500,000 fewer adverse events will occur over the next 20 years, a result of an expected 50% decrease in drug dispensing and administration errors. The decrease in pain, suffering, and lengths of stay from drug errors is estimated to result in $93 billion in savings over the next 20 years. 

Avoidance of litigation, decreased malpractice premiums, reduction in inventory carrying costs, and increase in revenue from more accurate billing result from the improvement in quality and efficiency of care.

This makes implementation of bar coding technology relatively low-risk, although there needs to be sufficient informatics capability to capture and store drug orders.

Estimated Cost Savings

For a bar coding system, a 300-bed hospital may expect up-front costs of $700,000 to $1.5 million with about $150,000 in maintenance fees annually.  The returns, however, in terms of improved patient safety and cost of care make an investment in bar coding technology one of the more cost-effective information systems investments.

Assessment

Also, given the increasing consumerism in healthcare, prospective patients will be more assured of care quality from a hospital investing in state-of-the-art technology in this area, giving the medical center a competitive advantage.

Conclusion

Thus, hospitals are becoming more like retail businesses every day … finally!

And so, your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

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

Get our Widget: Get this widget!

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 ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Product DetailsProduct DetailsProduct Details     

Ending Employer Sponsored Health Insurance

Or … at Least as We Currently Know It

By Staff Reporters

Join Our Mailing List

The latest Kaiser Health News column bids farewell to employer-sponsored health insurance. It will supposedly erode. And that’s a good thing, according to some experts.

Of Criticisms

The KHN news begins by saying that one of the latest criticisms of the new health overhaul law is that it will encourage employers to stop offering health insurance. And, in fact, it may.

http://www.kaiserhealthnews.org/Columns/2010/May/052710Frakt.aspx

Alternatives Must Exist

According to economist Austin Frakt PhD, we should welcome this, provided the decline in employer coverage is gradual and good alternatives like HSAs, exist. So, there are several advantages to the way in which the new law promotes severing the connection between employment and health insurance.

http://theincidentaleconomist.com/the-end-of-employer-sponsored-health-insurance-as-we-know-it/?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+TheIncidentalEconomist+%28The+Incidental+Economist+%28Posts%29%29

[picapp align=”none” wrap=”false” link=”term=health+insurance&iid=102664″ src=”0099/8461586d-cbd6-48d8-b6bc-0620b4303fad.jpg?adImageId=13084712&imageId=102664″ width=”380″ height=”253″ /]

Assessment

One of them is that it will make more visible the biggest looming health care problem: costs.

https://medicalexecutivepost.com/2010/01/25/why-health-savings-accounts-are-no-longer-a-pariah-in-the-banking-industry/

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Is there a difference of opinion between employers and employees; recall doctors and financial advisors [FAs] often are both at some career inflection point?

And, feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

Get our Widget: Get this widget!

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 ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Contact us for a rate card: MarcinkoAdvisors@msn.com

Current Retirement Investment Options for Physicians

Understanding Build America Bonds

By Somnath Basu PhD, MBA [www.clunet.edu/cif]

[Director California Institute of Finance]

There is heartening news for those of us in retirement or approaching it. There’s a new type of bond called the Build America Bond or BAB. The BAB, along with an older and often ignored retirement investment, is viewed as positive developments for those saving for retirement. But, before a doctor, or any investor, jumps into these investments, some background information is required.

The Accumulation Phase

When people in their early careers save, their primary objective should be that their money grows healthily. They generally should invest in stocks which provides for longer run growth. This phase of our financial life can be called the “Accumulation Phase.”

The Preservation Phase

However, people in their mid- to end-careers (roughly between the ages of 40 – 65) start switching their objectives towards a more conservative future growth in their current savings, especially those associated with emergencies and retirement. This phase is usually identified as the “Preservation Phase” where individuals should begin switching their investments towards more fixed-income securities, such as bonds and bond funds. This idea of how reasonable people “should” behave is commonly known as the life-cycle hypothesis of investments.

The Decumulation Phase

Finally, people in retirement, those who are in the phase termed as the “Decumulation Phase,” should have a healthy dose of bond-type investments in their retirement portfolios.

Strange as it may be to some, this opinion about the investment life-cycle actually contains a lot of truth. If most people followed this basic rule, we would be better off this way than by any other method and especially in times like the recent financial tsunami that hit us. Those hit especially hard were people between the ages of 55 and older who held unhealthy amounts of stocks in their portfolios. Following this simplified version of retirement investments is both easy and effective.

All we do as we age is reduce our stock investments and increase our bond investments. While such a strategy reduces the growth of our wealth it also protects us from large to calamitous losses.

Unfortunately, the last 10 years or so have not been good for bond investments because bond prices have been at or near all-time highs and their returns near all-time lows. The following picture shows the rates one would earn by investing in the government’s (highest safety) 10-Year Treasury Note. Many bonds and mortgages (and subsequently the respective funds) use the 10-Year rate as the benchmark rate.

Graph: 10 T Year Note

As can easily be seen, these rates have come down steadily. A result has been the difficulty, of late, to find (the safer type) bond funds because they have been so expensive. However, one recent development in this field is worth mentioning: that is the emergence of a class of (stimulus-related) bonds known as the “Build America Bonds” or BABs, which for the first time in many years offers investors a very suitable entry to convert stocks into bonds. BABs, which were introduced in April 2009, are an innovative new tool for municipal financing created by the American Reinvestment and Recovery Act of 2009. BABs are taxable bonds for which the U.S. Treasury Department pays a maximum of 35 percent direct subsidy to the issuer to offset borrowing costs.

The second issue of note is that at this point, it is quite expensive to hold cash in money market type funds because of the dismal rates offered on very short-term products. An alternative that physicians and all investors should contemplate purchasing instead of CDs, and money market deposits, is a class of bonds, issued by the Government and known as Treasury Inflation Protected Securities, or TIPS. These investments sold directly by the government to you (at http://www.TreasuryDirect.gov) are excellent vehicles for holding funds as they guarantee that your money will hold its buying power over time and a bit more. TIPS are a great way to hold the capital you will need in the short term. The following picture shows the stability of the TIPS rate; a much safer and more stable investment opportunity than short term Bank CDs, recent money market funds, etc.

Graph: TIPS Rate

Build America Bonds [BAB]

The Build America Bonds program, created by the American Recovery and Reinvestment Act, allows state and local governments to obtain much-needed financing at lower borrowing costs for new capital projects such as construction of schools and hospitals, development of transportation infrastructure, and water and sewer upgrades, according to a recent U.S. Treasury Department press release. Under the Build America Bonds program, the Treasury Department makes a direct payment to the state or local governmental issuer in an amount equal to 35 percent of the interest payment on the bonds.

Here’s how BABs work according to the Treasury Department:

“The bonds, which allow a new direct federal payment subsidy, are taxable bonds issued by state and local governments that will give them access to the conventional corporate debt markets. At the election of the state and local governments, the Treasury Department will make a direct payment to the state or local governmental issuer in an amount equal to 35 percent of the interest payment on the Build America Bonds. As a result of this federal subsidy payment, state and local governments will have lower net borrowing costs and be able to reach more sources of borrowing than with more traditional tax-exempt or tax credit bonds. For example, if a state or local government were to issue Build America Bonds at a 10 percent taxable interest rate, the Treasury Department would make a payment directly to the government of 3.5 percent of that interest, and the government’s net borrowing cost would thus be only 6.5 percent on a bond that actually pays 10 percent interest.”

Join Our Mailing List

Assessment

According to the Treasury Department, Build America Bonds have had a very strong reception from both issuers and investors.  From the inception of the program in April 2009 to March 31, 2010, there have been 1,066 separate Build America Bonds issuances in 48 states for a total of more than $90 billion. Read more about BABs at this site

http://www.treas.gov/press/releases/docs/BuildAmericaandSchoolConstructionBondsFactsheetFinal.pdf

Now, until the general level of interest rates go back to their normal states, it will be difficult to find another opportunity such as this one. This is especially true of investments that are made to local governments through their taxable investments. Municipal bonds are typically considered less risky. Add to this the partial guarantee of the Govt. and you have the makings of a very safe Bond fund providing an average yield of nearly 6% for medium-term duration. There has been a dearth of such fixed income investments in the Bond markets for quite a while. Thus, for doctors and all of us at or nearing retirement age, an exploration and investigation of BABs is an absolute must.

 

Editor’s Note: Somnath Basu PhD is program director of the California Institute of Finance in the School of Business at California Lutheran University where he’s also a professor of finance. He can be reached at (805) 493 3980 or basu@callutheran.edu. See the agebander at work at www.agebander.com

 

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Product Details  Product Details

Building a Meaningful Medical Practice Marketing Campaign

Join Our Mailing List

What it Is – How it Works

[By Dr. David Edward Marcinko MBA, CMP™]

[By DeeVee Devarakonda MBA]

The success of a knowledge driven healthcare organization depends on not only how data can be converted to information – and information into marketing insight – but also by acting upon and converting those insights into building meaningful patient acquisition campaigns.

Definition of Patient Recruitment

Patient recruitment or campaign managementis the process of designing, executing, and measuring marketing campaigns through the use of applications that help to:

  • Select and segment patients
  • Design campaigns and execute the campaigns to contact patients
  • Track the contacts made with patients
  • Measure the results of those contacts
  • Learn from these results to more efficiently target patients in the future.

Key Queries

Some key questions to ask while you build campaigns:

  • Do you have a Customer [Patient] Relations Management roadmap that fits in with your overall patient vision and strategies and outlines the course of action for campaign management?
  • What is your privacy policy and strategy? – It is imperative for healthcare organizations to be proactive and self-regulate with a coherent privacy policy and design their systems to comply with this strategy. This may affect the way you design and execute campaigns.
  • What tools should you use? – There are several campaign management tools available today but no one tool may solve all business problems. You need to decide: what works best for my technical/ business environment? Is any integration effort required, if yes, how much will it cost me? How user-friendly are the tools? How much should I invest in training?

Important Campaign Components

Critical components of campaign management include the following activities:

  • Patient Segmentation: Process of identifying groups of patients for better targeting marketing and communications efforts. Segmentation is critical for effective and intelligent one on one communications with your patient.
  1. Ensure your data quality is excellent which can give you meaningful segmentation.
  2. Consistency of treatments and processes are of paramount importance.
  3. Buying a software tool is not enough for effective segmentation. You also need to understand what the software tool does in the backend. Watch out for anomalies and take steps to make reparations.
  4. Make sure you administer the initiative to a small sample and the business rules are in place before you roll out your campaign to the larger group.
  • Personalization: Ability to customize your product/service to each patient:
  1. Good personalization is possible especially when you have a good patient past history.
  2. You also need to have all business rules in place for effective personalization.
  3. Ensure your patient data is of high quality (e.g. addressing a female patient as a Mr. or sending mails to sign up for your service to a person who is already your patient can defeat the purpose of personalization)
  4. If you model data before personalization, you can target more effectively and personalize.
  5. It pays to have a clear privacy policy and ensure your personalization philosophies are in tune with that policy.
  • Execution – Actual implementation of your marketing programs and messages
  1. Before you execute, ensure you are equipped to fulfill promises you are making in the campaigns (e.g. If you are printing a toll free phone number in your direct mail piece for your patients to use, that toll free telephone number should work)
  2. Make sure your sales and service channels are aware of the campaigns and publish a general calendar for the whole company
  3. Develop business rules and strategies for follow-up campaigns.

Learn more: http://www.CertifiedMedicalPlanner.org

The Mindset

Successful patient marketing campaigns begin with the proper mindset and practice culture. There is no technology silver bullet to any P[C]RM campaign. And today, patient privacy is the key element of loyalty with a commitment to build long lasting and profitable campaigns through mutual trust and engaging cross-functional teams that can pick and deploy the elements mentioned above, across the entire enterprise and IT network, as needed.

Assessment

Healthcare organizations should keep privacy and the above components as their laundry list of action items when considering a C(P)RM plan.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Product Details 

Product DetailsProduct Details

Will Fiscal Commission Consider a VAT to Reduce the Federal Deficit?

Moro on the National Commission on Fiscal Responsibility and Reform

By Robert Giese
bob.giese@chsfl.org

The National Commission on Fiscal Responsibility and Reform [NCFRR] continues to develop a comprehensive proposal to address the federal deficit. It has invited comments from members of Congress, leaders of all types of American organizations and private individuals.

We invite ME-P contributions, as well.

A Four- Point Proposal

James Q. Riordan, Sr. sent a letter this week to co-chair Alan K. Simpson, the former Senator from Wyoming. Mr. Riordan made four basic points about the fiscal problems and suggested a Value Added Tax (VAT) as a solution.

[picapp align=”none” wrap=”false” link=”term=National+Commission+on+Fiscal+Responsibility+and+R&iid=8643885″ src=”8/6/7/2/Obama_Speaks_On_32c4.jpg?adImageId=13115540&imageId=8643885″ width=”380″ height=”536″ /]

First, he indicated that there is too much “unaffordable spending.” Even with limited spending growth, the income tax cannot be sufficiently increased to pay for current and future proposed spending without doing damage to the economy and increasing unemploymen.

Second, Riordan claims that the only potential solution is a VAT. However, because the VAT is a tax on consumption and would have great impact on middle and lower incomes, it needs to be accompanied by a progressive income tax.

His third point is that the new income tax would need to be very simple. In his view, there would be no deductions for home mortgage interest, charitable gifts or medical expenses.

Fourth, he would tax all income only once. There would presumably not be a corporate-level tax or an estate tax under this theory.

Inadequate Staff Resources

As the fiscal commission considers the options for reducing spending and increasing taxes, it has indicated that the current staff resources are inadequate. In response to a request by the commission, Senate Majority Reid sent a letter this week to the White House and requested additional staff support. The White House indicated that it will be pleased to “work with him” to provide additional assistance.

At a hearing on the financial challenges, Senator George Voinovich (R-OH) noted that the commission is under great pressure to develop an effective plan. He stated, “If we don’t get something out of that commission, we are over the cliff.”

Assessment

Senate Budget Committee Chair Kent Conrad (D-ND) was the prime supporter of the commission. He stated, “This is not a time to impose austerity in my judgment.” However, he indicated that austerity will be necessary in the future, and that budget cuts and tax increases “must be imposed in a way that is convincing.”

Editors Note: For now, we take no specific position on VAT or other tax and spending recommendations by the Fiscal Commission. This information is offered because potential Fiscal Commission plans may affect many of our ME-P physician readers, subscribers, consultants and advisors.

Join Our Mailing List

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

Get our Widget: Get this widget!

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 ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Reporting Tips for Covering High Risk Health Insurance Pools

A Call to all ME-P Citizen and Investigative Journalists

By Hope Rachel Hetico RN, MHA

[Managing Editor]

According to our colleagues from the Association of Health Care Journalists [AHCJ], the federal government and states are scrambling now to create temporary high-risk pools for the medically uninsurable by July 1, 2010. As one of the first provisions of the Patient Protection and Affordable Care Act to go into effect, it will serve as a test case for implementation of the new law and it should be closely followed.

[picapp align=”none” wrap=”false” link=”term=medical+professionals&iid=5271528″ src=”e/4/2/f/portrait_of_medical_aedc.jpg?adImageId=12922304&imageId=5271528″ width=”380″ height=”380″ /]

Some states with existing high risk pools are passing laws to ensure their programs comply with the new federal rules and are eligible for some of the $5 billion in federal funding. Other states are refusing to alter their programs and ceding responsibility to the federal government.

But, apart from being a policy story, it’s of great interest to all our ME-P readers, viewers or listeners who have pre-existing conditions and are struggling to find coverage. 

Avoid HI Scammers

Finally, don’t be scammed into buying fake health insurance. With unemployment high and complicated health care changes under way, scammers see big opportunities. Here’s how to avoid getting hurt. 

http://articles.moneycentral.msn.com/Insurance/InsureYourHealth/scams-peddle-fake-health-coverage.aspx

Assessment

And so, we now ask our ME-P citizen journalists or investigative reporters to cover this topic for story tips, suggestions, comments and related posts. We hope to add your insights and resources as the story develops. 

Conclusion

Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

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

Get our Widget: Get this widget!

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 ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

”Tremendous Upheaval” Over Estate Tax

An IRS Prediction by Senator Charles Grassley

By Robert Giese
bob.giese@chsfl.org

Senate Charles Grassley (R-IA) is the ranking Republican on the Senate Finance Committee. In a conference call with several reporters on June 2nd, 2010, he discussed the uncertain future of the estate tax.

The Proposal [Kyle-Lincoln Estate Tax Compromise]

Sen. Grassley noted that Sen. Jon Kyle (R-AZ) and Sen. Blanche Lincoln (D-AR) have proposed that the Senate Finance Committee pass an estate tax bill with a $5 million per person exemption and a 35% top estate tax rate.

However, Grassley expressed the opinion that “the Finance Committee would like to take up consideration of legislation, but we aren’t assured by the majority leader that the bill passed out of committee will be taken up on the floor.”

Senate Rules

Under the Senate rules, even if the Finance Committee were to pass the Kyle-Lincoln estate tax compromise, Majority Leader Harry Reid (D-NV) is not obligated to schedule a floor vote and could simply stall the legislation.

Assessment

In December of 2009, the House passed the Permanent Estate Tax Relief for Families, Farmers and Small Businesses Act of 2009. This makes permanent the 2009 estate exemption of $3.5 million and top estate tax rate of 45%. If the House and Senate are not able to take action on estate taxes by the end of 2010 then on January 1, 2011 the estate tax returns with a 55% top rate and an exemption of $1 million (plus indexed increases).

This would affect many medical professionals as well as hardworking Americans.

Conclusion

If this were to happen, Sen. Grassley stated that there will be a “tremendous upheaval at the grassroots of America.”

And so, we invite IRS head Douglas Shulman to respond. Your thoughts and comments on this ME-P are also appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

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

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

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Some Dental Consultants Say the Most Incredible Things

Are Dentists like … Rodney Dangerfield? 

By Darrell Kellus Pruitt; DDS

“Let’s face it — in our world dentists do not get the respect they deserve. They are not perceived to be ‘real’ doctors … Perhaps the lack of sex appeal in dentistry is part of why dental coverage for everyone is an afterthought in the national health care conversation.”

Gary Kadi DDS, DentistryiQ

http://www.dentaleconomics.com/index/display/article-display/4196579430/articles/dental-economics/volume-100/issue-5/features/the-cavity_in_the.html

Even if Dr. Kadi is correct, and the barrier between a 12 year old and his toothbrush is a world-wide lack of respect of dentistry, that hardly means that electronic dental records (eDR) are going to make the kid brush any better. Experience tells me that if mom’s nagging won’t motivate the stinker, the computer won’t either.

eDR Rationalization?

For those who read the article, did you notice how Dr. Kadi, a dental practice consultant, attempts to subtly insert a fat rationalization for adopting eDRs into the middle of a comment lamenting dentistry’s lack of respect? Tricks like Kadi’s make stakeholders look silly at times, and it bothers me that hardly anyone notices and appreciates the humor that these pros bring to marketplace conversation. That’s why I like to point out mistakes like Kadi’s when I come across them. It’s getting harder to find these kinds of articles about eDRs. My pleasure!

Working Both Sides of the Consulting Fence

As far as I can tell, all but a few dental consultants work both sides of the fence in order to please vendors who give them good deals, as well as dentists who pay for unbiased help. Sponsorship by vendors is the bottom level of a consultant career if one chooses to make a living at selling advice. In this way, the dental consultant business is a lot like the financial advice business. Some advisors push their favorite investments that serve them well no matter what happens to their clients’ money. If a client wants advice, but prefers not to pay full price, interested vendors can be counted on to quietly chip in on an advisor’s bill. And that is why the customer must always be cynical. What’s more, it is arguably one’s community obligation to publicly challenge such artists by luring them out into the open to explain further what they meant to say to naïve people. Dr. Kadi begins:

“The national health-care debate cannot be complete unless we include dental care as part of the discourse.”

He then presents oft-repeated, convincing findings which support the widely held conclusion that one’s overall health is dependent on one’s oral health. Even though this chunk of common sense has recently been supported with well-respected research, the news isn’t a revelation. Other stakeholders have proclaimed the findings as an example of ultra-modern “Evidence-Based Dentistry,” and proof of the need for thousands of their dental products. However, let’s not kid ourselves. A healthy mouth has less to do with computerization than the proper application of a low-tech toothbrush. 10,000 years ago, even buzzards recognized that bad breath from advanced gum disease smells like imminent death from a long way off if the wind is right. The results Dr. Kadi leans his reasons against only confirm traditional Evidence-Based Superstition.

eDR Lobbying 

By half-way through the article Dr. Kadi turned “The cavity in the health-care debate” into a PR piece for eDRs. He’s in so deep that he cannot recognize that his misplaced concerns about image have nothing to do with dental patients’ oral health. Image is only cosmetic.

“A validation [of bringing “sex appeal” to the profession] is the inclusion of dentistry in the recently mandated National Healthcare Information Infrastructure (NHII). The purpose of the NHII is to create an information network to facilitate the creation of an electric health record [eHR] for all aspects of health care. The primary impetus is to achieve interoperability of health information technologies used in the mainstream delivery of health care.”

Note: Dr. Kadi admits that the goal is HIT, and sharing health information is the tool – not the other way around. As anyone can see, that kind of nonsense will never work out well in the US. Why that would be as foolish as stuffing a certifying commission for eHRs with industry, government and academic leaders rather than providers – and then tossing billions of dollars that could otherwise be used for treating disease out in the street for the biggest and fastest stakeholders who grab the most. That would be simply ridiculous.

Dr. Kadi bravely continues: “This will enable an individual’s health care information to be shared by all the necessary health care parties in a secure manner, including dentistry. It will improve patient care and reduce the number of patients, currently 100,000 plus, who die each year due to a lack of accurate, complete, or timely information. The federal government estimates a cost savings of $85 billion to $100 billion per year with electronic health records [eHR].”

Is HIT – Or any IT – Really Secure? 

In a secure manner – really? There are so many other misleading statements in this paragraph as well. First of all, how can an eDR improve a dentist’s chance of successfully extracting a molar in one piece? It can’t. Secondly, how many of the alleged 100,000 victims died because of lack of electronic DENTAL records? Third, how many patients will die because of faulty information in interoperable records that would not have occurred if the records were paper? Fourth, to insinuate that patient information can only be shared over the Internet is plain silly. Telephone, fax and the US mail have been sufficient for dentistry for decades, and none involve HIPAA. Finally, the $85 to $100 billion in savings Dr. Kadi casually throws out is based on a five year old Rand study that’s been widely trashed for being biased in favor of the stakeholders who funded the research. That happens. It just amazes me that anyone in the healthcare industry who knows anything about HIT is foolish enough to still shop discarded garbage. And once again, regardless of the success of electronic medical records, how will eDRs save even $10 in dentistry? It’s impossible without re-defining “savings.”

Cost Savings

“Dentists and hygienists will play a vital role in this cost savings because people who go for regular cleanings will have their medical history updated in the shared system during each visit. In some cases, dental cleanings may be the only medical attention a person receives yearly.”

“Cost savings”? Where have I heard that term? And why didn’t Dr. Kadi simply say “savings”?

Now I remember. It was Dr. Robert Ahlstrom, the ADA’s eDR expert, who coined the handy buzzword in his testimony describing the benefits of paperless dental practices for the US Department of Health and Human Services in July of 2007. “Cost savings to providers and plans will translate in less costly health care for consumers. Premiums and charges will be lowered.” That would be the seventh of his 11 reasons that are each one so lame that other than Dr. Kadi, stakeholders never borrow them. Although it is undeniable that electronic records benefit insurers and the government more than the patient, if Ahlstrom hadn’t been coy, and had clearly stated that eDRs will save money in dentistry, his testimony would have been false. By calling it a “cost savings,” Ahlstrom technically concedes that using eDRs will indeed require an increase in cost of overhead – which dental patients will ultimately have to pay to obtain dental care. The saving part comes from “what could have been.” Whatever that could possibly mean, HHS Secretary Michael Leavitt bought it.

The PennWell Article

Because of a situation beyond my control, I am unable to provide a link, but to find more of my opinion of Ahlstrom’s testimony that is still used by lawmakers to establish national policy, simply google “Dr. Robert Ahlstrom.” My PennWell article from a year ago or so, “Dr. Robert H. Ahlstrom’s controversial HIPAA testimony,” is probably still his first hit. It could be on his first page the rest of his life.

Join Our Mailing List

Assessment

If necessary, I’ll make a few more examples of insensitive HIT stakeholders who know better than to offer such crap to the nation’s lawmakers as well as providers who are too busy to pay attention to the welfare of their profession. The ADA should reassure the nation that there are cheap, effective low-tech ways dental patients can stay healthy that don’t risk their identities and won’t bankrupt a dental practice because of a stolen computer. But; they won’t do it.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
PODIATRISTS: www.PodiatryPrep.com
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Product DetailsProduct DetailsProduct Details

[Doctor’s] Guide to Roth IRAs

Get Rich Slowly

By Ann Miller RN, MHA

[Executive Director]

Join Our Mailing List

From time to time, our readers send in e-books, files or e-chapters, pamphlets or other material they have created for client, educational or marketing use. Some of it may be worthwhile; some not so.

Nevertheless, these publications are often a good place to start the conversation, or thought-process on related topics. They will be occasionally offered as a complimentary membership feature of the Medical Executive-Post. We trust they are beneficial to you.

Guide to Roth IRAs [author]

  • JD Roth

Link: The GRS Guide to Roth IRAs

Disclaimer

No advice is offered. We make no copyright claim to these works. Veracity and information should be considered time sensitive. Consult a professional for your situation.

Assessment

Feel free to send in your own material for the benefit of all Medical Executive-Post readers and subscribers. All works will be considered; but not necessarily published.

More

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Product Details  Product Details

Our New Face – Same ME-P

We Got Visual “Fly”

By Ann Miller RN, MHA

[Executive Director]

Join Our Mailing List

As you may have noticed, we have a brand new look; very visual and very photographic. ME-P got fly.

But, underneath it all, we’re the same ME-P you’ve come to count on for daily essays, updates, investigative reportage, comments, gossips, breaking news, expert advice and op-ed pieces, the classifieds, and much more!

All features and functionality are the same; and our goals, objective, mission statement and topic channels remain the same. Most importantly, your subscriber account information remains secure and unchanged.

IOW: Your experience should be exactly the same as it has always been, just a lot better looking.

[picapp align=”none” wrap=”false” link=”term=financial+advisors&iid=106036″ src=”0102/6fbf34d8-8ea8-42e5-a352-647f54125824.jpg?adImageId=13102507&imageId=106036″ width=”337″ height=”506″ /]

Why the Change?

After 3 years we felt it was time to freshen things up a bit and create a visual experience that reflects the forward-thinking and innovative partner, we are. In the healthcare and financial services space, you can count on us on to inform, gather data and make important insights, that ultimately help you make better decisions to grow your practice, assist patients and clients, and professionally thrive in an ethical business fashion.

Your Opinion Matters

And so, we’d love to know what you think of the changes we’ve made. There is a feedback / comment link on the bottom of every page, and you can always reach us through our reader / subscriber email center.

MarcinkoAdvisors@msn.com

Conclusion

As always, thank you for reading the ME-P, and purchasing our products and/or related consulting services. We appreciate the opportunity to serve you. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

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

Get our Widget: Get this widget!

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 ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

The Madoff Circle

Who Knew What?

By Jake Bernstein, ProPublica – June 2, 2010 2:40 pm EDT

Join Our Mailing List

When Bernard Madoff pleaded guilty to running the biggest Ponzi scheme in history, he insisted he was the lone perpetrator, asserting that no one – not his family, not his colleagues, not his friends – knew of the fraud.

Alternative Narrative

But an alternate narrative is emerging from the pile of Madoff-related civil suits and court motions that have been filed in the last two years – one in which a small circle of men played knowing, integral roles in the scheme, in some cases benefiting more from it than even Madoff himself.

The evidence for this remains largely circumstantial. These relationships were forged in the days before e-mail, and none of the cases has yet produced anything for public consumption that delivers insights into what these men were thinking. In the one instance in which a judge has ruled on allegations against some of the men, he dismissed the charges for lack of evidence.

But the men’s actions, as described in the court cases, appear to have furthered the scheme. The Securities and Exchange Commission and the trustee charged with recovering money for Madoff’s victims have alleged that some of the men had expectations and influence far beyond what is typical for the usual investor. Most tellingly, the documents say that in at least one instance, and possibly more, these men helped keep the Madoff scam afloat, providing hundreds of millions of dollars of cash when it was on the verge of collapsing.

If this was a conspiracy – and the available information is by no means complete – it does not seem to have been one in which the perpetrators plotted together around a tavern table. Irving Picard, the trustee, has sued several of Madoff’s biggest beneficiaries, alleging they “knew or willfully ignored” that they were participating in a fraud.  The suits are silent on the question of whether those involved coordinated or knew of one another’s activities, but they don’t need to demonstrate that to be successful.

A Commonality

What these men undeniably shared were similar backgrounds and interests. Based largely in New York and South Florida, they moved through parallel milieus of affluent Jewish country clubs and synagogues. They were active in similar philanthropies and served on the boards of foundations, universities and yeshivas.

The cast of characters, spelled out mostly in complaints filed by the trustee and the SEC, includes: Carl Shapiro, [1] 97, a Boston-based philanthropist who made one fortune in ladies dresses and a larger one with Madoff; Robert Jaffe [2], 66, Shapiro’s son-in-law; Maurice “Sonny” Cohn, 79, a one-time Madoff neighbor turned business partner; Robert Jaffe [3], 83, a close friend of Madoff’s for more than 50 years and one of his earliest investors; and Jeffry Picower [4], a lawyer and accountant, who recently died of a heart attack at 67.

None of these men has been charged criminally. Thus far, federal authorities have indicated in court filings that just one of them – Chais – is the subject of a criminal inquiry. A year ago, The Wall Street Journal, citing anonymous sources, reported that the U.S. Attorney’s Office in Manhattan was investigating at least eight investors, including Picower, Chais and Shapiro [5].

All have denied being anything but victims of Madoff’s [6].

Chais, Cohn and Jaffe have drawn considerable ire from investors for running so-called feeder funds that channeled huge sums into Madoff’s investment business. Jaffe alone funneled more than $1 billion of investor money to Madoff, according to the SEC. He worked with Cohn in a business called Cohmad – a contraction of Cohn and Madoff – that operated out of Madoff’s offices. Contrary to what some investors in the funds believed, it appears the men did little to manage the money beyond simply collecting it for delivery to Madoff.

Inner Circle Fared Well

Members of this circle not only did far better than other investors, who averaged 10 percent to 12 percent returns annually, they also had a highly unusual level of input into the nature of their returns.

According to the trustee’s complaint, there were several instances in which Picower or his associates contacted Madoff’s office, asking for specific monthly returns [7]. Over a five-year period in the late ’90s, two of Picower’s accounts [8] had annual returns ranging between 120 percent and 550 percent. A third had yearly returns as high as 950 percent.

Chais and his family consistently received yearly returns higher than 100 percent, far exceeding the gains realized by investors in his funds. Moreover, according to an SEC complaint [9], when Madoff told Chais he was switching to a new strategy that might show occasional short-term trading losses without interfering with net gains, Chais made a special demand to maintain the appearance of loss-free investments.

“Chais told Madoff that he did not want there to be any losses in any of [his] Fund’s trades,” the SEC complaint alleges [9]. “Madoff complied with Chais’ request. Between 1999 and 2008, despite purportedly executing thousands of trades on behalf of the Funds, Madoff did not report a loss on a single equities trade.”

Chais disputes the allegations [9], and his lawyer characterized the SEC’s complaint in a statement as “a distorted and false picture of Stanley Chais.”

“Like so many others, Mr. Chais was blindsided and victimized by Bernard Madoff’s unprecedented and pervasive fraud,” the statement said. “Mr. Chais and his family have lost virtually everything – an impossible result were he involved in the underlying fraud.”

Many of those in the circle took money from the scheme as fees rather than investment gains.

Cohmad officials reaped a total of $98.4 million in payments between 1996 and 2008, most of it labeled income from “account supervision,” according to the SEC [10].

Chais charged fees equal to 25 percent of each Chais fund’s net profit for calendar years in which profits exceeded 10 percent, according to the trustee. As profits exceeded 10 percent every year, Chais took in almost $270 million in fees from 1995 to 2008.

Though Madoff receives the lion’s share of the blame and/or credit for his scheme, it appears that several of his close associates profited more handsomely than he did. Shortly after he confessed, Madoff declared in court documents that his household net worth was about $825 million.

Picower, the biggest beneficiary of the scheme by far, took in $7.2 billion in profit, according to the trustee. Picower’s widow and the trustee are currently haggling over the exact amount of a multibillion-dollar settlement. Carl Shapiro and his family received more than $1 billion, the trustee charged in a court document filed last November in U. S. Bankruptcy Court.

Chais and his family members withdrew approximately $200 million more than they invested with Madoff, according to the SEC. This came on top of the hundreds of millions in fees Chais charged investors.

Chais’ lawyer denied that his client had any knowledge of the Ponzi scheme or that he had raked in the vast riches alleged. “Despite the astronomical numbers mentioned by the Trustee in his complaint, the bulk of the funds alleged to have been distributed to Mr. Chais were in fact distributed to his investors,” his statement said.

Keeping the Scheme Going

At key moments, Madoff’s investors came to the rescue to keep the scheme going. The first instance came in 1992, when the SEC shut down a feeder fund run by the accountants Frank Avellino and Michael Bienes, then Madoff’s largest, accusing the pair of operating a Ponzi scheme. Avellino and Bienes admitted they had acted as unregistered investment managers, but insisted the money had been invested with Madoff, who promptly returned more than $300 million.

Ironically, the SEC mistook Madoff’s ability to raise that amount so quickly as proof that his business was legitimate and “the money was where we [the agency] would expect it to be,” a staff attorney told the SEC’s inspector general last year. Almost two decades later, investigators suspect Madoff may have tapped his circle to collect the cash while scrambling, with the help of his right-hand man, Frank DiPascali, to fabricate trading records, a scene detailed in the agency’s case against DiPascali.

Identifying precisely who helped Madoff repay Avellino and Bienes’ investors is currently an area of inquiry for law enforcement, according to a person familiar with the investigation.

Despite his ever-growing network of feeder funds, Madoff had another liquidity crisis in November 2005. According to a federal complaint [11] filed against his employee Daniel Bonventre, Madoff’s investor account had an end-of-day balance of about $13 million to cover about $105 million in wires scheduled to go out over the next three days.

Two days later, one of Madoff’s investors, identified in the complaint [11] as “Client A,” sent about $100 million in bonds to Madoff, which he used as collateral to secure a $95 million bank loan to continue the Ponzi scheme. The following January, Client A gave Madoff $54 million more in bonds, which were used as collateral for a $50 million loan.

Investigators have not revealed the identity of Client A, but a person close to the investigation said he was among Madoff’s group of longtime close associates.

The final bailout came toward the end of 2008, when Madoff was hit with a tidal wave of redemption requests from investors caught up in the larger financial crisis. Toward the end of 2008, he looked to Shapiro, who pitched in $250 million.

Shapiro and his family have said repeatedly through spokesmen that they were unaware of the true nature of Madoff’s business. The spokesman declined to comment on the $250 million.

No civil or criminal complaints have been filed against Shapiro, but a court filing by the trustee raised questions about the nonagenarian’s “contentions that he is a victim of Madoff’s scheme,” alleging “inconsistencies between Mr. Shapiro’s counsel’s account of the family history with Madoff and the records available to the Trustee.” The trustee is negotiating with the family to recover profits made over the years.

The emergency cash infusion failed. Just 10 days later, Madoff says he confessed to his sons that “it’s all just one big lie,” finally ending the scheme.

The Case-To-Date

So far, efforts to hold Madoff associates accountable have met with mixed results.

Civil claims by the SEC [10] against Jaffe, Cohmad and Cohn were largely rejected by Federal District Judge Louis Stanton, who ruled in February that the agency had failed to prove they “knew of, or recklessly disregarded, Madoff’s fraud.” The judge left the door open for the SEC to refile its complaint by June 18, if it can strengthen its case.

Lawyers for Maurice Cohn and Cohmad released the following statement in response to the ruling: “As we have maintained all along and Judge Stanton agrees, the SEC’s complaint supports nothing other than “the reasonable inference that Madoff fooled the defendants as he did individual investors, financial institutions and regulators.”

Assessment

If there were others involved in the Ponzi scheme, building federal or state criminal cases against Madoff’s circle may prove difficult. Though their relationships go back decades, most of their dealings were done verbally, and there isn’t a lot of correspondence, according to a person with knowledge of the investigations. Federal investigators are working with DiPascali to get a clearer picture of the degree of complicity of others in the scheme.

Illness and age also may become factors. Though a grand jury could consider charges against Chais by mid-June, he suffers from a rare blood disorder and is in and out of the hospital. Shapiro, too, is said to be in ill health.

The trustee is expected to file more lawsuits in coming months as the date approaches when the statute of limitations runs out.

Criminal cases brought against several former Madoff employees have already eroded the notion, lodged so powerfully in the public imagination, that Madoff worked alone, said Daniel Richman, a professor at Columbia Law School and a former prosecutor. With each additional case, he said, it may well crumble further.

“I imagine the paradigmatic Ponzi scheme with the evil genius who keeps all the secrets to himself and engineers this massive crime, like most stick figures, will probably not hold true,” he said.

Link: http://www.propublica.org/feature/the-madoff-circle-who-knew-what

Conclusion

Industry Indignation Index: 99

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Product DetailsProduct DetailsProduct Details

Product Details  Product Details

   Product Details

Become an ME-P Personal Story Teller

Seeking Positive or Negative Lay Experiences

By Staff Reporters

Recently, we sent out a call for healthcare, and financial service, whistle-blowers from those working as insiders in these sectors. Now, we seek input – not from doctors, nurses, accountants or financials advisors – but the patients and customers they treat and serve.

Tell us Your Story

And so, do you have a true story about the healthcare system, or financial services industry, that you’d like to share with us; good or bad?  Or, some gossip, hearsay, innuendo or a question you’d like to put to our readers?

Product Details  Product Details

Conclusion

If so, email us at MarcinkoAdvisors@msn.com Please include the term “lay whistleblower” in the subject line; and a proposed title for your comment. You may remain anonymous, or be cited as an information source as you see fit.

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

Get our Widget: Get this widget!

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 ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Product Details

Why [Some] Doctors Won’t Ever Work for Uncle Sam

Understanding the Medical Career Path

[circa 2019]

cropped-dem 

By Dr. David E. Marcinko MBA

By Eugene Schmuckler PhD, MBA

www.MedicalBusinessAdvisors.com

MEDICARE FOR ALL?

Who seaks for, or writes about, physician careers under a M-4-Uber scenario?

When you think about careers, how many adults are truly aware of their own interests, values, strengths and weaknesses during their teen years? As with much of human behavior, career choices actually go through a series of stages.

Psychologists have for years identified stages of human development.  Kohlberg discussed stages of moral development. In the 1970’s, Daniel Levinson published The Season’s of a Man’s Life, a project he undertook when he began to look inward and tried to understand his behaviors, values and attitudes to work. Discussions with his university colleagues indicated that what he was experiencing was not unique to him.

Traditional Career Routes

For many years the prevailing thought was that the correct way to function in the labor market was to gain employment with a company progressing through the years until such time as you were eligible to receive the “gold watch”, the symbol of retirement. If you entered a professional discipline such as medicine or law, you did that for the rest of your life.

Alternate Career Paths

Today there are still individuals who follow these traditional patterns but there are other career paths that may be taken.

The most traditional career route follows a linear path, one that most of you have rejected. This entails gaining employment in a large, bureaucratic organization with a tall pyramidal structure [command-control]. It involves a series of upward (hopefully) moves in the organization until the career limit is reached. As the individual progresses upward in the organization he or she may work in different functional departments such as marketing, finance, and production. Organizations having these paths seek employees who tend to be highly oriented toward success defined in organizational terms and exhibit “leadership” skills. In general, these people demonstrate a strong commitment to the workplace. A person with this type of orientation (Organizationalist) exhibits the following tendencies:

  1. A strong identification with the organization; seeking organization rewards and advancement that are important measures of success and organizational status.
  2. High morale and job satisfaction.
  3. A low tolerance for ambiguity about work goals and assignments.
  4. Identification with superiors, showing deference toward them, conforming and complying out of a desire to advance; maintains the chain of command and compliance, and views respect for authority as the way to succeed.
  5. Emphasis on organizational goals of efficiency and effectiveness, avoiding controversy and showing concern for threats to organizational success.

As many readers of the Medical Executive-Post are aware, you have followed the expert medical career path, building a career on the basis of personal competence, or the development of a profession (legal or accounting professionals). As you are so painfully aware, you invest heavily, personally and financially in acquiring a particular skill and then you spend the major portion of your life following that skill. Unlike the pyramidal structure of the linear path, career paths are found in organizations that tend to be relatively flat, have departments in which there is a functional emphasis, emphasize quality and reliability, and have reward systems containing a strong recognition component.

md

Medical Professionals are Different

Medical professionals are folks who are job-centered – not organization centered – viewing the demands of the organization as a nuisance that they seek to avoid [THINK: Gregory House MD].

However, that avoidance is impossible since the healthcare professional must have an organization in which to work. This is even more prevalent in today’s era of managed health care and e-Health 2.0, than ever before. At work, professionals experience more role conflict and are more alienated. Medical professionals exhibit these four tendencies:

  1. An experience of occupational socialization that instills high standards of performance in the chosen field; highly ideological about work values.
  2. Sees organizational authority as non-rational when there is pressure to act in ways that are not professionally acceptable.
  3. Tends to feel that their skills are not fully utilized in organizations; self-esteem may be threatened when they do not have the opportunity to do those things for which they have been trained;
  4. Seeks recognition from other professionals outside the organization, and refuses to play the organizational status game except as it reflects their worth relative to others in the organization. Professionals are very concerned with personal achievement and doing well in their chosen field. Organizational rewards serve to reflect the professional’s importance relative to others in the system. This recognition may be extremely fulfilling, especially when he or she is accorded higher status and pay than others. In the absence of organizational rewards the professional may use material objects (large homes, expensive cars) as a way of reflecting status and accomplishment.

Performance not Authority

Medical professionals are of the opinion that successful performance, not compliance with authority, is more reinforcing. With this mindset it is not surprising why many medical practitioners balk at working in the managed health care, state-run or governmental lead healthcare environment. Many professionally oriented people come from the middle class and have become successful through a higher level of education or by other efforts to acquire competence.

The Spiral Career Path

Those on the spiral career path make periodic moves from one occupation to another. Individuals who follow this career path tend to have high personal growth motives and are relatively creative. Usually these changes come after you have developed competence in the occupation you are working in and you think it is time to change what you do. The ideal spiral career path is to move from one occupation to an area related to it. This enables you to use some of the basic knowledge that you developed in your past work and to transfer it to your new occupation. The difference between this path and the linear path discussed above is that in this case the mobility pattern is lateral, not upward.

The Transitory Career Path

People who take the transitory career path cannot seem to, and perhaps do not want to settle down. The pattern is one of consistent inconsistency in their work. These are individuals who may find a great deal of satisfaction working as healthcare consultants. The work style is marked by an ability to do many things reasonably well. They value independence and variety, and they work best in relatively loose and unstructured organizations that tolerate the type of freedom they demand in their work.

Sam (1)

The Indifferents          

We have so far discussed the four types of career paths and two career orientations. A final form of career orientation is that of the indifferents, those who simply work for a paycheck. Will this be the result of Obama care? These are individuals who do their work well, but they are not highly committed to their job or the organization. Some characteristics of indifferents are:

  1. More oriented toward leisure, not the work ethic (is it Friday yet?); separates work from more meaningful aspects of life, and seeks higher-order need satisfaction outside the work organization.
  2. Tends to be alienated from work and not committed to the organization.
  3. Rejects status symbols in organizations.
  4. Withdraws psychologically from work and organizations when possible.

Join Our Mailing List

Assessment

Indifferents are not necessarily born that way; some are actually a product of their work experiences. People who once had an organizational orientation and were highly loyal may no longer follow orders without question.

For example, you may have had a medical officer manager who very early in his or her career was extremely committed to you and your medical practice, hospital or healthcare organization. He or she may seek rewards and want to advance. However, in later career life, after having been passed over several times for promotion, the person seeks rewards elsewhere. Thus, it is possible that through office practices, your healthcare organization may turn highly committed organizationalists (or medical professionals) into relative indifferents; HMO patsies or grunts for Uncle Sam.

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

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

Note: Dr. Gene Schmuckler is director of behavior economics for www.MedicalBusinessAdvisors.com. He is an expert on physician career re-engineering, and a retired Professor of Organizational Behavior who taught Dr. Marcinko [our Publisher-in-Chief] in business school, almost two decades ago.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko and Dr. Schmuckler are available for seminar or speaking engagements .Contact: MarcinkoAdvisors@msn.com

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

Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise


Brousseau, K.R., Driver, M.J., Eneroth, K. and Larson, R.: Career Pandemonium: Realigning organizations and individuals. Academy of Management Executive 10 (4), 52-66. 1996

Presthus, R. The Organizational Society. New York, NY: St. Martin’s Press.

Product DetailsProduct DetailsProduct Details

   Product Details

Product DetailsProduct Details

Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

Invite Dr. Marcinko

***

Preparing Physicians for Financial Emergencies

Join Our Mailing List

Domestic Personal Savings Rate Increasing?

By Somnath Basu PhD, MBA [www.clunet.edu/cif]

[Director California Institute of Finance]

There is a heartening change that we are observing today, an event that is truly national in character. At the bottom of the financial abyss we single-handedly turned around our personal savings for the first time in 12 years.  The chart (Department of Commerce publications data) below expresses this turnaround emphatically.

Graph: Personal Savings Rate

It is the timing of this turnaround that is so heartening. The realization that this crisis may truly be worse than any other enabled us as a nation to halt this decline. We have our emergency “nest eggs’ rebuilt again. Amazing still is that this feat was achieved with a determined effort to curtail our consumption levels to ensure that our emergency funds were rebuilt. Again, a similar chart expresses this aspect much better.

Graph: Change in Consumption

What next then?  With our emergency nest eggs rebuilt, we must now ponder the question as to continue to increase our savings or not. For lay and senior physicians, the object would be to ensure they did not outlive their funds. For those medical professionals, and the rest of us, between the ages of 45-65 in general, retirement must loom somewhere, and retirement is sweet. Similarly, for those between ages 25 to 45, thoughts would turn towards families, home purchase and children’s education; all worthwhile savings objectives.

Assessment

Thus, the central question is whether we should increase our current consumption or postpone consumption to attain our future objectives. Only time will tell whether we continue the trend of increasing savings and moderating consumption or whether we go back to drawing down on our savings to increase current consumption.

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. What is your propensity to save or consume? Is it more or less for medical professionals? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

 

Editor’s Note: Somnath Basu PhD is program director of the California Institute of Finance in the School of Business at California Lutheran University where he’s also a professor of finance. He can be reached at (805) 493 3980 or basu@callutheran.edu. See the agebander at work at www.agebander.com

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Product Details  Product Details

2010 Physician Sentiment Index™

Taking the Pulse of the Physician Community

By Ann Miller RN, MHA

[Executive Director]

From time to time, our readers send in e-books, files or e-chapters, pamphlets or other material they have created for client, educational or marketing use. Some of it may be worthwhile; some not so. Nevertheless, these publications are often a good place to start the conversation, or thought-process on related topics.

They will be occasionally offered as a complimentary membership feature of the Medical Executive-Post.

[picapp align=”none” wrap=”false” link=”term=doctors&iid=279612″ src=”0276/0e9a3c11-109e-45f7-8862-39f6ee6676a3.jpg?adImageId=13062844&imageId=279612″ width=”319″ height=”480″ /]

February 2010 Physician Sentiment Index

By athenahealth

By Sermo

Link: Sermo

Disclaimer

No advice is offered. We make no copyright claim to these works. Veracity should be checked and information should be considered time sensitive. Please contact a professional for your situation.

Assessment

Feel free to send in your own material for the benefit of all Medical Executive-Post readers and subscribers.

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

Get our Widget: Get this widget!

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 ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

The Economics of Stock Market Fear for Physicians

Panic Control and the Possibility of Severe Financial Degradation 

By Somnath Basu PhD, MBA [www.clunet.edu/cif]

[Director California Institute of Finance]

An experiential learning of mammoth proportions occurred several weeks ago in the financial markets. The absolute 10 minute freefall of the prices of stocks and bonds, without any pre-notification froze the hearts of many physicians and lay others both in, and outside, of the investment community. The possibility of a one trillion dollar loss had suddenly and unexpectedly turned real. It happened in a matter of minutes. This experience of panic, of the possibility of a severe economic degradation of life becoming immediately real, is like none other that most of us can ever remember experiencing. Even the 1987 crash happened over a large part of that Monday. Like then, this time too there is no known reason of why it happened, though attempts are being made to understand the cause(s). Whatever the reasons may be, it will not change the experience we had of the realization of the fear of a sudden and unexpectedly large loss.

Event Analogies

Before going deeper into the experienced fear, it is useful to provide some analogies to the event. If the meltdown in the financial markets of 2008 was like an earthquake, then this was like a severe aftershock. It is also similar to going down one of those severe roller coaster freefalls that some may consider very undesirable. Alternately, what makes a 30 year old physician be mostly unconcerned about his/her lack of retirement savings while a 60 year old doctor in the same poor condition is much more concerned. Obviously, the possibility of a lower quality of economic life is much more real for the elder than the younger. In such cases we would expect the fear of an economically degraded life to spur people to take preventive or remedial action.

Understanding Fear

To truly understand our responses to fear, we need to go deeper into our minds. According to behavioral psychologists and neurologists both, there are various segments within our mind. For example, one segments of our mind (the frontal lobe) is understood to process analytical tasks. Similarly, other parts of our brain (the older limbic system composed of mammalian and reptilian brains) react to and affect/control our emotions and fear. When we are faced with an immediate threat, this older system takes over control of our reactions and often drives us towards instinctive responses and will not, in general, make the analytically reasoned response. It is similar to learning about all the different ways we need to behave in the wild if we came across a bear. When people actually are faced by such a situation, they rarely remember all their learning and respond with their instincts. Those are the limbic responses. In other words, when threats are real, our emotional mechanisms will dominate our rational mind and we will react according to our older and longer existing nature.

Shocked Limbic System

Such was the effect of the financial freeform. In those 10 minutes the economic shock to our limbic system was the first of its kind, in terms of magnitude. While discussions are held about sudden unexpected losses, typically the impact of sudden huge losses in a very very short period of time is rarely thought of in very meaningful ways because the probability is so very low. This time, it did actually happen! We will bear some consequences which will begin playing themselves out slowly over this summer. For one, the investing nation will be much more circumspect about stocks and other volatile financial instruments. In a more technical way, our risk aversion as a nation will have suddenly increased. This will have an impact on both trading volume and security market prices and eventually on portfolio values. How younger physicians and other investors will react is less known.

www.CertifiedMedicalPlanner.com

Assessment

Finally, there is one important lesson in behavioral finance for us all – and that is for medical professionals to find competent financial advisors and planners who can safely herald all people in these times. It also is probably an important point to understand why the portfolios of older physicians should consider safety of principal first whilst the younger ones focus on growing their wealth.

Editor’s Note: Somnath Basu PhD is program director of the California Institute of Finance in the School of Business at California Lutheran University where he’s also a professor of finance. He can be reached at (805) 493 3980 or basu@callutheran.edu. See the agebander at work at www.agebander.com

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Would anyone like to discuss neurotransmitters or chime in on the flight or fight response? Are these very human reactions any different for doctors? How about feelings of “fear” or stock-market “panic attacks?”

Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

Get our Widget: Get this widget!

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 ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed. 

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Events Planner: June 2010

ADVERTISEMENT

Events-Planner: JUNE 2010

Staff Writers

“Keeping track of important health economics and financial industry meetings, conferences and summits”

Welcome to this issue of the Medical Executive-Post and our Events-Planner. It contains the latest information on conferences, news, and relevant resources in healthcare finance, economics, research and development, business management, pharmaceutical pricing, and physician/entity reimbursement!  Watch for a new Events-Planner each month.

First, a little about us! The Medical Executive-Post is still a relative newcomer. But today, we have almost 175,000 visitors and readers each month from all over the country, in addition to our growing subscriber base. We have been a successful collaborative effort, thanks to your contributions.  As a result, we are adding new resources daily. And, we hope the website continues to provide the best place to go for journals, books, conferences, educational resources, tools, and other things you need to establish the value your healthcare consulting and financial advisory intervention.

So, enjoy the Medical Executive-Post and this monthly Events-Planner with our compliments. 

A Look Ahead this Month 

Now, the important dates:

June 04: Healthcare Compliance Association Conference, Seattle, WA

June 09: AHIP Institute Conference, Las Vegas, NV

June 10: Pershing Institute 2010, Hollywood, FLA

June 13: Facilitating Innovation for Better Health Outcomes, Washington, DC

June 20: World Congress Medicare Leadership Summit, Washington, DC

June 23: Morningstar Investment Conference, Chicago, ILL

June 26: Health Compliance Association Meeting, Los Angeles, CA

Please send in your meetings and dates for listing in the next issue of our ME-P Events-Planner.

MarcinkoAdvisors@msn.com

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 

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

%d bloggers like this: