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

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Seeking Chief Medical Director [CMD]

Magnolia Health Plan

By Missy Wohldmann

Dear Dr. Marcinko and ME-P Readers, 

Centene Corporation is seeking a Chief Medical Director (CMD) for Magnolia Health Plan (Magnolia), a wholly-owned subsidiary and HMO for the state of Mississippi. The regional headquarters for Magnolia is located in Jackson, Mississippi.

About Centene

A Fortune 500 company, Centene is a national leader in low-cost solutions for high quality healthcare services for uninsured and underinsured patients. Centene’s subsidiary health plans bring better health outcomes to their 1.5 million members. Centene’s core philosophy is that quality healthcare is best delivered locally. This local approach enables them to provide accessible, high quality and culturally sensitive healthcare services to their members in their own communities.

Visionary Needed

The Chief Medical Director will establish the strategic vision and attendant policies and procedures for Magnolia Health Plan. The CMD will provide leadership and direction to the medical management, quality improvement and credentialing functions for Magnolia Health Plan based on, and in support of, the company’s strategic plan. The CMD will review analyses of activities, costs, operations and forecast data to determine progress toward stated goals and objectives. Also within the purview of CMD will be oversight for compliance with National Committee on Quality Assurance (NCQA) and/or Joint Commission on Accreditation of Healthcare Organization (JACHO) standards as determined for accreditation of the health plan.

Candidates

Successful candidates will be physician leaders with thorough knowledge of quality improvement practices and familiarity with medical information systems, medical claims payment processing and coding. Knowledge of managed care, Medicaid, and case management programs are also essential. Board certification in a recognized medical specialty and an active medical license are required.

We welcome your interest, or nominations, for this highly visible role.

Assessment
Cejka Executive Search
4 CityPlace Dr., Ste. 300
St. Louis, MO 63141
314.236.4478 Office
mwohldmann@cejkasearch.com
http://www.cejkaexecutivesearch.com

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The “Whole Tooth” Blog Talk Radio to Interview Dr. Darrell Pruitt on eHRs

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Plugging my Interview and Otherwise Clogging Things

[By D. Kellus Pruitt DDS]

Where are the EDR cheerleaders when I need them? On Tuesday May 31st, I’ve got a show to put on!

http://www.blogtalkradio.com/thewholetooth

Where are the EDR Cheerleaders?

Every now and then I still come across EDR vendors on the internet who would mislead naïve dentists about their product to make a sale. Today, I held FirstEMR representative Robert Evans accountable for self-serving misinformation he posted on EMR and HIPAA forum. (My dad would be proud that I told him “Get that garbage out of here!”). Then, remembering my manners, I invited Mr. Evans to please call into The Whole Tooth Blogtalkradio program on May 31 to further discuss the future of EHRs in dentistry. Unfortunately, because of things like the reflexive “garbage” statement, I don’t think he’ll show.

I try my best to be “collegial,” but I simply cannot pretend unethical sales techniques are acceptable in my neighborhood, and I want to help my friends easily recognize them… so what if I have a little fun.

http://www.emrandhipaa.com/emr-and-hipaa/2010/11/18/emr-stimulus-q-and-a-emr-stimulus-money-and-dentists/comment-page-1/#comment-133132

Of Robert Evans

Thanks for your response, Robert Evans.

As I read your list of 6 rationalizations for electronic dental records here on the EMR and HIPAA forum , it occurred to me that you haven’t had a chance to read my detailed post on this thread from November 22 (Number 14) in which I de-bunked 28 similar myths – substantially including your 6. But since I never tire of doing this, let’s once again go through the details of a popular national blunder in dentistry you and other well-intentioned stakeholders in the HIT industry were sucked into.

“My personal background is medical administration and operations.” That would explain your misconceptions about EHRs in the unique field of dentistry.

For your first mistake, you say “Dentists can qualify as eligible providers for ARRA incentives” You really should have gone on to explain that for a dentist to qualify for the stimulus money, 30% of his or her practice has to be from Medicare/Medicaid. Since you surely should have known that, to fail to mention it could easily be interpreted as deceptive.

This is just a guess, but I’d say less than 10% of the dentists in the nation in private practice would make it on that qualification alone even if it made business sense to accept government money and the expensive demands that come with it. Since you are in the EHR business, you may have more accurate figures on that. What’s more, our grandchildren’s money will be gone long before the stimulus makes it to dentistry. You should already know that as well.

“All of our clients, including Dentists, Endodontists, Periodontists, Implant Surgeons and more are extremely pleased that they made the transition “ All of them, Robert? Really?

The ME-P Forum 

This ME-P forum right here is full of stories about disappointed providers – perhaps other than your clients – who are finding huge problems with the transition. De-installations are far too common. It seems like a while back it was close to 30%. Then again, since you are in the business, you probably have more accurate figures for that as well.

Even the stimulus money isn’t sufficient subsidy for physicians to realize a return on investment in EMRs. And virtually nobody is interoperable as planned. That means the office tools you sell raise the cost of healthcare rather than lower it. What’s more, physicians stand to benefit from interoperability much more than dentists regardless of stimulus money. And if a dentist can’t expect ROI from an office tool, it’s called a hobby.

By the way, have you looked at the Stage 2 Meaningful Use requirements that stand between dentists and disappearing ARRA money? Well-meaning outsiders with plans for the common good just don’t realize that someone has to enter every piece of irrelevant detail about dental patients that CMS requires in order to receive full payment.

It’s a trap, Robert. And it’s not very well hidden. Dentists don’t take candy from strangers.

The Benefits

“The benefits to your office are numerous and too many to mention here; but, please take into account the following”:

1. Never having to worry about compliance issues, as we are 100% compliant with all standards and formats that CMS is mandating.

– You are 100% scary. As long as a provider stores or transmits electronic PHI he or she clearly must be concerned about HIPAA compliance issues. What’s more, as a Business Entity for the dentists you serve, if your computer system is hacked or someone on your end otherwise fumbles or steals 500 or more of a dentists’ patients’ PHI, all of the dentist’s patients must be notified of the danger of identity theft. In addition, federal law stipulates that news of the data breach must be broadcast as a press release in the dentist’s local media. This can easily bankrupt a dentist… You just had to know about this before today.

Your compliancy claim is not only wrong, but it is irresponsible and unethical advertising. You are not 100% compliant. Since the Rule is intentionally vague, nobody is. Get that garbage out of here!

2. Greatly reduce or even eliminate human error. Some offices have brought back billing into their control and terminated the outsourcing.

– Are you kidding? Eliminate human error? Someone put you up to this didn’t they. And “outsourcing”? Once again, this is misleading and irresponsible information, Robert. What about keystroke errors? Only frustrated vendors wish computers would replace human intelligence.

3. Facilitate lab and prescription orders. Offices using e-scribe services are already on board into accepting the benefits of an EMR.

– So does this mean that when the lab delivery person comes to my office to pick up plaster models of a patient’s teeth, the prescription for the restoration must be sent separately by email instead of inserting a short hand-written note in the package… with the relevant patient’s models?

– I don’t sign enough prescriptions to make e-prescribing worth it. I really, really don’t. So how expensive would you make dental care?

4. Simple and efficient scheduling. The reception and schedulers are not tied to the telephone, fax and charting tasks as well as insurance verifications.

– That’s never before been a significant problem. Dental offices were run surprisingly efficient for decades before computers were around. Since dentistry is intricate handwork, the bottleneck in dental offices isn’t the front desk. It’s the dentist.

– What’s so wrong with telephone and fax, by the way? One doesn’t have to be a HIPAA-covered entity to use those tools.

– As for insurance verification, is the EDR intended to help the patient or the insurance company?

5. No fumbling for charts, paperwork, etc. (significant cost savings)

– Prove it.

6. Gain 15+ hours per week, back!

– Where did find this chunk of information? Please don’t insult us with wild, irresponsible statements to improve sales of your product. That would be unethical.

“Again, there are too many to list here, but contact me anytime for a quick on-site or online demonstration and let us prove to you that FirstEMR is the most appropriate solution to meet your required EMR needs.”

eDR Mandate? 

Did you intentionally say my “required” EMR needs? You wouldn’t be implying that EMRs are somehow “mandated” in dentistry are you, Robert? That would be called a rookie mistake and you would be about a year behind information published in the ADA News, which was wrong to mislead members on this point in 2008.

http://www.ada.org/5348.aspx

Rather than contacting you for a quick on-site or online demonstration, I’ll do you one better. I am to be interviewed on “The Whole Tooth” blogtalkradio on May 31 concerning the future of EHRs in dentistry. It promises to be an unprecedented discussion about the obscure topic, and is certain to be educational to thousands of dentists who have been misled for years about HIPAA and EDRs.

http://www.blogtalkradio.com/thewholetooth

Assessment

When the time comes, a telephone number will be provided for live questions. I invite you to call in, Robert, and we can discuss EHRs in dentistry before an audience of around 15,000.

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What Counts as a Good Doctor-Patient Relationship?

Nuances of Patient-Centricity

By Mario Moussa PhD MBA

By Jennifer Tomasik MS

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Researchers at the University of Pennsylvania are experimenting with an electronic nose that literally smells disease. In the not-too-distant future, it may be able to detect whether a patient has an infection in the lungs or somewhere else. There is no need to be radiated with an X-ray, or to wait anxiously for two days as bacteria sprouts from a biological sample. One simply lies in a hospital bed while the super-sensitive machine monitors the body’s exhalations.

Of Hippocrates

Hippocrates, the founding father of Western medicine, did it differently. He relied on smell, too. But, he used his actual nose. He sniffed and inspected his patients’ stool, as well as their earwax, pus, and phlegm. Then he went further, recording the details of his patients’ diets, the water they drank, the local weather, and even the positioning of their house. He spent a lot of time getting to know the highly personal facts of his patients’ lives. He was an early practitioner of individualized and holistic medicine.

Rise of the Historical Symptoms Review

But, doctors in the Hippocratic tradition have not always had this kind of intimate relationship with their patients. In 17th. and 18th. century Europe, the standards of human dignity imposed limits, especially on physical contact. Health providers were just as likely to scrutinize the story of an illness as its observable symptoms. Dr. John Symcotts, who had a successful practice that encompassed two English villages, captured his patients’ narratives in casebooks that contained vivid descriptions of intense subjective experiences. One patient, Miss Christian Tenum, complained of “a heavy burden or weight continually pressing down upon the top of her head,” a “pulsing of the arteries,” and “images passing before her eyes.” The diagnosis was unclear. Symcotts prescribed a fluid diet and a medicine that helped her expel stones with her urine. The outcome? Miss Tenum was cured.

Subjective Reporting

In Symcotts’ era, physicians treated subjective reporting as a valid source of information. Using an ancestral form of telemedicine, they even based diagnoses on letters. John Morgan, a founder of the University of Pennsylvania’s Medical School in the late 1700s, offered his expert opinion on patients who lived “ a distance from Philadelphia, whenever the history of the case is properly drawn up and transmitted to me for advice.” Why the emphasis on spoken and written first-hand accounts? In the words of one physician, there was a “repugnance” to physical examination that was “natural and proper.”

Link: www.BusinessofMedicalPractice.com

Assessment

Bottom line: intimacy can take strikingly different forms. This is especially important to remember in the world of Health 2.0, where you have so many choices for communicating.

In purely human terms, we think the relationship that Hippocrates had with his patients was neither better nor worse than the one Symcotts had with Miss Tenum or that Morgan had with his epistolary advice-seekers. Hippocrates paid meticulous attention to a patient’s circumstances: emotional outlook, diet, bodily secretions, family relationships and friends, climate, dwelling. Symcotts may not have known his patient in all of these ways, but he could hardly have been more committed to understanding Miss Tenum’s story in her own terms.

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. In different, but equally valid ways, can Hippocrates, Symcotts, and Morgan be considered patient-centered? 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.

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Cost Conflicts-of-Interest in Medicine

Clinical Care versus Finance

By Render S. Davis MHA CHE

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Conflicts of interest are not a new phenomenon in medicine. In the fee-for-service system, physicians controlled access to medical facilities and technology, and they benefited financially from nearly every order or prescription they wrote. Consequently, there was an inherent temptation to over-treat patients. Even marginal diagnostic or therapeutic procedures were justified on the grounds of both clinical necessity and legal protection against threats of negligence. 

Costs Rarely Considered

While it could be construed that this represented a direct conflict of interest, it could also be argued that most patients were well served in this system because the emphasis was on thorough, comprehensive treatment – where cost was rarely a consideration.  It was a well known adage that physicians “could do well, by doing good.” 

Managed Care

In managed care, the potential conflicts between patients and physicians took on a completely different dimension.  By design, in health plans where medical care was financed through prepayment arrangements, the physician’s income was enhanced not by doing more for his or her patients, but by doing less.  Patients, confronted with the realization that their doctor would be rewarded for the use of fewer resources, could no longer rely with certainty on the motives underlying a physician’s treatment plans.  One inevitable outcome was the continuing decline in patients’ trust in their physicians.  This has been exacerbated to some degree by revelations of significant financial remuneration to physicians by pharmaceutical and medical products firms for their services as researchers or active participants on corporate-funded advisory panels, calling into question the physician’s objectivity in promoting the use of company products to their peers or patients.

Conflicts of Interest

Conflicts of interest may also create concerns at a much higher level, as evidenced by the issues raised in 2008 litigation against Ingenix, a company that for more than a decade, provided information to the insurance industry on payments to out-of-network physicians for their “usual and customary rates (UCR).” As noted in court documents, Ingenix was a wholly-owned subsidiary of United Healthcare and the UCR information sold by the company to insurers may have been fundamentally biased in favor of the insurers, causing patients to pay larger out-of-pocket fees.

Assessment

As a result, New York attorney general Andrew Cuomo filed suit against Ingenix.  This action was followed by suits brought against major insurers by the American Medical Association and several state medical groups for systematic underpayment to members, based on the biased data.  To date there have been monetary settlements, but the issue continues to raise growing concerns regarding conflicts of interest among the key payers for health care.

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Implementing the Global Strategic Health Plan

A Human Resources Issue for International Physician Entrepreneurs

By Henry H. Goldman PhD CPCM

 

Strategic planning is a fairly easy business managerial chore; not so for healthcare. Yet, physician executives and medical managers can usually determine the direction in which the company should move. They can generally determine, or make educated guesses about new services, products, expanded markets, changes in competition, innovations in technology, financing requirements, etc.

Gs and Os

Goals and objectives setting are staples of business management, worldwide. Most large organizations have accepted Russell Ackoff’s plea for them to create their own futures. It is not a difficult task to create a comprehensive set of alternative strategies at the corporate or divisional level. Making the strategies work for healthcare is the real issue.

Implementation

Implementing the strategic plan is an often-overlooked aspect of the planning process. Corporate and medical executives assume that the plan will be implemented. Generals always expect that their orders will be carried out, even if those orders are wrong. While strategy formulation is regarded as a staff function, strategic implementation is generally viewed as a key function of line management. If the strategic plan is to be put into place in a timely manner and the results of that plan, the anticipations and expectations that long-term goals and short-term objectives will be attained, then planners must examine the organizational issues involved in making the plan happen.

Full Link: goldman.strategic planning

Conclusion

The clear understanding of and the ability to deal with these issues during the strategy formulation process may make the difference between an international healthcare strategic plan that has become only an academic exercise – and a living, vital guideline to future profits and continued corporate success.

About the Author

Risk Management Associates International, LLP
5005 SW Raintree Circle
Lee’s Summit, MO 64082

Henry H. Goldman, Ph.D. is the Managing Director of the GOLDMAN-NELSON GROUP (USA), a global management consulting and executive training organization that he founded in 1981. Dr. Goldman’s areas of expertise include supervisory and management training, decision-making and problem solving, team building, international financial management, and strategic planning. He is frequently invited to facilitate programs and workshops on such diverse subjects as “Leading Organizational Change,” “Decision-Making for Managers,” “Budgeting in the Borderlands,” as well as issues dealing with global business and finance. Goldman recently served as Co-Editor of Taking Stock: A Survey on the Practice and Future of Change Management (Berlin, 2005). He has worked with executives and managers, worldwide, to develop an understanding of management and financial concerns in a global marketplace. He has conducted training programs along the Pacific Rim, Southern Africa, and the Middle East and among the Newly Independent States of the former Soviet Union. His clients include MGM Studios, Lucent Technologies–China, General Motors, Hughes Aircraft Company and Citizens’ Development Corps. He served as adjunct professor of management at the University of Macau, China, where he taught “Team Building” to MBA students. He is currently affiliated with the National Graduate School and Boston University’s Center for Executive Education. Dr. Goldman was recently appointed to the Mine Relief Global Business Council to assist in the remediation of land mines, world-wide, with a particular focus on the Turkey-Syria border.

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Is HI-TECH Dead?

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You Decide!

[By D. Kellus Pruitt DDS]

Yesterday, Don Fluckinger, Features Writer for SearchhealthIT, posted “Blumenthal: Building national health network could take decades”

“When Dr. David Blumenthal was national health IT coordinator, he focused on 2015, the HITECH Act’s original target date for meeting meaningful use criteria. Now that he’s back in civilian life, he’s taking a longer view of the initiative to create a national health network triggered by the HITECH Act’s cash incentives to physicians and hospitals using electronic health record (EHR) systems.”

http://searchhealthit.techtarget.com/news/2240035845/Blumenthal-Building-national-health-network-could-take-decades

Even though Fluckinger assures us that post-ONC, Blumenthal is still a “HITECH Act champion,” I’m not so sure. Perhaps in spirit only!

A Multi-Decade Project?

Last week, Dr. Blumenthal was the keynote speaker at the Massachusetts annual health IT conference. According to Fluckinger, he told the audience that building a secure, national, interoperable health information system “was always going to be a multi-year, maybe even multi-decade project.” That’s not what I remember. I remember being told that if I didn’t purchase a network-ready EHR for my dental practice by 2014, I wouldn’t be paid by insurance companies.

What Happened?

So, what happened to President Bush’s 2004 Executive Order of “interoperability (even with dentists) by 2014”? Is it too soon to say that he failed? So who is going to tell the thousands of HIT stakeholders who have been attracted by the smell of stimulus billions? Blumenthal?

Assessment 

I can only imagine that now that Dr. Blumenthal left his job as head of the ONC for a new job as a health policy professor at Harvard School of Public Health, the openness of life outside government makes him uncomfortable with the lame talking points he once pushed as part of his job, without cracking a smile.

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At a Time of Needed Financial Overhaul

A Leadership Vacuum

By Jesse Eisinger
ProPublica, May 18, 2011, 3:10 p.m.

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After the worst crisis since the Great Depression, President Obama has unleashed an unusual force to regulate the financial system: a bunch of empty seats [1].

With Sheila C. Bair soon to leave her post at the Federal Deposit Insurance Corporation, the Obama administration will have five major bank regulatory positions either unfilled or staffed with acting directors.

About The Trade

In this column, co-published with New York Times’ DealBook, I monitor the financial markets to hold companies, executives and government officials accountable for their actions. Tips? Praise? Contact me at jesse@propublica.org

The administration has inexplicably left open the vice chairman for banking supervision, a new position at the Federal Reserve created by the Dodd-Frank Act, despite having a candidate that many people think is an obvious choice: Daniel K. Tarullo [2]. The new Consumer Financial Products Board chairman is unnamed. There are some lower-level positions that don’t have candidates, including the head of the Treasury’s Office of Financial Research and the Financial Stability Oversight Council insurance post.

Perhaps most important, the Office of the Comptroller of the Currency, is being headed by an acting comptroller, John Walsh, who took over the agency last August. Nine months have passed without a leader who might better reflect the Obama administration’s views on banking regulation, a time lag made worse by the office’s coddling of the banks [3] even as they have acknowledged rampant abuse and negligence in the foreclosure process.

The vacancies come at a time that calls for stiffer regulatory examination. The financial regulatory system was remade under Dodd-Frank and requires strong leaders to put the changes into effect. Though the acting heads insist they feel empowered to make serious decisions, they have roughly the same authority as substitute high school teachers.

The Obama Administration

Supposedly, the Obama administration is getting close to naming people to head the comptroller’s office and the F.D.I.C. But we’ve been hearing that for a while. In April, Barbara A. Rehm of American Banker wrote that the administration was working on a big package of nominations to send to the Hill all at once. A month later, we’re still twiddling our thumbs in anticipation.

So what’s going on?

In a vacuum of leadership, conspiracy theories arise. One is that Treasury Secretary Timothy F. Geithner is making a power grab and doesn’t mind that these roles aren’t filled. The idea is that he is asserting his influence over the Dodd-Frank rule-making process. A former adviser to Mr. Geithner dismissed that notion as ridiculous, and that’s persuasive to me. It seems too Machiavellian by half.

If it’s not Mr. Geithner, then who or what is responsible for the vacancies? Not surprisingly, people close to the administration blame Republicans. The nomination process has become hopelessly broken in Washington. Even low-level appointments are now deeply partisan affairs, the playthings of score-settling senators with memories like elephants and the social responsibility of hyenas (which probably insults hyenas).

The Obama administration put up Peter A. Diamond for a position on the Federal Reserve board. Winning a little something called the Nobel Prize [4] hasn’t helped him with confirmation, however Sen. Richard Shelby, the powerful Alabama Republican and ranking member of the banking committee, is standing in his way. The senator also quashed the nomination [5] of Joseph A. Smith Jr. to head the Federal Housing Finance Agency.

Blame Game

But much of the blame for this situation lies with the Obama administration. It’s almost as if the president and his staff have thrown up their hands. The administration has had trouble finding good candidates who are willing to go through the vetting process and has shied away from fights. It also hasn’t seeded the ground or supported the nominations it has made, people complain.

A Democratic Senate staff member confided worry to me about the fate of Mark Wetjen, whom the administration nominated last week as a candidate for a seat on the Commodity Futures Trading Commission. “They didn’t shop it and they didn’t get buy-in,” the staff member said. “The administration doesn’t seem to be putting any sort of effort into it.”

Making these appointments will help answer a question: Where does Mr. Obama stand on financial regulation?

With the Geithner appointment, the president chose early on the path of continuity over muscular regulation. Immediately, the Treasury secretary became the personification of every Obama financial policy. Mr. Geithner remains the most politically costly appointment Mr. Obama has made, saddling him with all the Bush presidency’s financial crisis decisions. After all, Mr. Geithner, as head of the Federal Reserve Bank of New York, was intimately involved in the emergency actions of September 2008. Republicans made great hay tying Democrats to the Wall Street bailouts in the 2010 midterm elections. Now, of course, Republicans are leading Democrats in Wall Street campaign donations [6].

With these positions unfilled, Mr. Obama is losing out on a political opportunity to draw a line between himself and his opposition.

Assessment

But it’s more important than that. Allowing these vacancies to linger drains leadership from the financial overhaul at the exact moment when it is needed most.

Link: http://www.propublica.org/thetrade/item/at-a-time-of-/0763745790

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Some Data on Cosmetic Surgery

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Here are some fun facts about the many people undergo some sort of cosmetic surgery in the world

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Scientists Cast Doubt on TSA Tests of Full Body Scanners

Safe or Not – A Controversy

By Michael Grabell

ProPublica, May 16, 2011, 2:11 p.m.

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The Transportation Security Administration says its full-body X-ray scanners are safe and that radiation from a scan is equivalent to what’s received in about two minutes of flying. The company that makes them says it’s safer than eating a banana [1].

But some scientists with expertise in imaging and cancer say the evidence made public to support those claims is unreliable. And in a new letter [2] sent to White House science adviser John Holdren, they question why the TSA won’t make the scanners available for independent testing by outside scientists.

The machines, which are designed to reveal objects hidden under clothing, have the potential to close a significant security gap for the TSA because metal detectors can’t find explosives or ceramic knives, which can be just as sharp as the box cutters that hijackers used on 9/11.

Enhanced Pat-Downs

They are also important for TSA’s public relations battle over the alternative, the “enhanced pat-down,” which has bred an epidemic of viral videos: A 6-year-old girl [3] is touched from head to toe. A former Miss USA [4] says she was violated. A software programmer warns a screener, “If you touch my junk [5], I’m going to have you arrested.”

After the underwear bomber tried to blow up a Northwest Airlines plane on Christmas Day 2009, the TSA ramped up deployment of full-body scanners and plans to have them at nearly every security line by 2014.

Scanner Types

There are two types of body scanners [6]. Millimeter wave machines emit a radio frequency similar to cellphones. Backscatters work like a fast-moving X-ray. In the latter, the rays bounce off the skin and create a fuzzy white image [7] of the passenger’s body. Because the beam doesn’t go through the body, most of its radiation is received by the skin

The FDA

The TSA says the backscatter technology has been evaluated by the Food and Drug Administration [8], the National Institute for Standards and Technology [9] and the Johns Hopkins University Applied Physics Laboratory [10]. Survey teams are using radiation-detecting dosimeters to check the machines at airports. The TSA says the results have all confirmed that the scanners don’t pose a significant risk to public health.

According to the agency and many radiation experts, the dose is so low, even for children or cancer patients; that someone would have to pass through the machines more than a thousand times before approaching the annual limit set by radiation safety organizations.

Test Flaws

But the letter to the White House science adviser, signed by five professors at University of California, San Francisco, and one at Arizona State University, points out several flaws in the tests. Studies published in scientific journals in the last few months have also cast doubt on the radiation dose and the machines’ ability to find explosives.

A number of scientists, including some who believe the radiation is trivial, say more testing should be done given the government’s plans to put millions of passengers through the machines. And they have been disturbed by the TSA’s reluctance to do so.

“There’s no real data on these machines, and in fact, the best guess of the dose is much, much higher than certainly what the public thinks,” said John Sedat, a professor emeritus in biochemistry and biophysics at UCSF and the primary author of the letter.

The same group stirred controversy last year when it sent a letter to Holdren [11] arguing that while the overall dose to the body may be low, the TSA hadn’t quantified the dose to the skin. Last fall, FDA and TSA officials released a study [12] that estimated the dose to the skin to be twice the dose to the body, though still extremely low.

In the most recent letter sent to Holdren on April 28th, the professors note that the Johns Hopkins lab didn’t test an actual airport machine. Instead, the tests were done on a model built by the manufacturer, Rapiscan [13], and configured to resemble a system previously tested by the TSA.

The researchers’ names have been kept secret, and the report on the tests is so “heavily redacted” that “there is no way to repeat any of these measurements,” they wrote.

The physics and medical professors also took issue with the device used to measure the radiation. Although the device, known as an ion chamber, is commonly used to test medical equipment, they argue that the detector gets overwhelmed by the amount of radiation the backscatter deposits in a short time and might not provide accurate readings.

Helen Worth, a spokeswoman for the Johns Hopkins lab, referred questions to the TSA.

Part of the trouble is that there is no ideal device for measuring the radiation dose given by backscatter X-rays, said David Brenner, director of theColumbia University Centerf or Radiological Research. The machines emit a pencil beam that rapidly moves across and up and down the body, he said.

“We are one of the oldest and biggest radiological research centers in the country, and we find this to be a very hard technical problem,” said Brenner, who was not involved with the letter.

Another issue is that there is a lot of uncertainty with the model used to estimate cancer risk from radiation exposure to the skin, said Rebecca Smith-Bindman, a UCSF radiologist who also was not involved in the letter.

Smith-Bindman, who has testified before Congress about excessive radiation from medical scans, studied the TSA reports and said she wasn’t concerned about the airport X-rays.

The risks are “truly trivial,” she wrote in an article [14] for the Archives of Internal Medicine. A passenger would have to undergo 50 airport scans to reach the level of a dental X-ray, 1,000 for a chest X-ray, and 4,000 for a mammogram.

Though imperfect, the available models predict that the backscatters would lead to only six cancers over the course of a lifetime among the approximately 100 million people who fly every year, Smith-Bindman concluded.

“There’s really unnecessary fear related to these scans,” she said. “What I’m not as comfortable with is that there has not been access to these machines. They are not being tested on the same regulatory basis that we see on medical equipment.”

After her article was published, Smith-Bindman was contacted by a TSA public affairs officer. During the conversation, she suggested that she or other outside scientists be allowed to test the machine. The official was shocked by the suggestion and said such access could tip off people who want to avoid detection, Smith-Bindman said.

“It was not appreciating that there’s legitimate scientific questions that have to be balanced against the security questions,” she said.

ProPublica

The TSA did not respond to ProPublica’s questions about why it wouldn’t allow outside testing. But at a congressional hearing [15] in March, Robin Kane, assistant administrator for security technology, said doing so would expose a lot of sensitive information the agency wouldn’t normally share publicly. The machines had already been tested several times, he said, and if set up securely, the agency would allow more testing.

The available information leaves scientists with little to work with. Peter Rez, theArizonaStatephysics professor who signed the letter to Holdren, has tried to calculate the radiation by examining the handful of backscatter images that have been released publicly.

The Electronic Privacy Information Center [16], a civil liberties group, sued the Department of Homeland Security, TSA’s parent agency, in federal court seeking release of 2,000 backscatter images used in testing. But, it has not been successful.

The few images that have been made public do not reveal faces or detailed private features. The TSA says the images Rez used are out of date, but Rez says the current image on TSA’s website is unusable.

Using the earlier images, Rez concluded [17] in the Radiation Protection Dosimetry journal that it was highly unlikely the machines could have produced such high-quality images with doses of radiation as low as those described by TSA. He estimated the dose, while still very small, is 45 times higher than the results measured by Johns Hopkins.

Applying Rez’s numbers, Brenner wrote a paper [18] for the journal Radiology, estimating that 100 additional cancers would develop for every 1 billion scans.

For Rez, the real danger occurs if the machine stops in the middle of a scan, allowing the beam to focus on a tiny area for several seconds. Given that the backscatter works with a wheel rotating at a high speed, and that the agency plans to use the scanners continuously 365 days a year, mechanical failures are likely, he said.

Assessment

The TSA says that the scanners have safety systems, such as automatic shutoffs and emergency stop buttons, that will kill the beam in the event of any problem that could result in abnormal radiation. How those fail-safe systems work isn’t entirely clear.

When Johns Hopkins researchers visited the Rapiscan facility, the automatic termination appeared to work. But, the full results of the shutoff tests are redacted.

What’s more, the test system didn’t have an emergency stop button.

Link: http://www.propublica.org/article/scientists-cast-doubt-on-tsa-tests-of-full-body-scanners

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US Reaches Debt Limit

May 16th 2011 Deadline

By Children’s Home Society of Florida Foundation

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In February of 2010, the federal debt limit was set by Congress at $14.294 trillion. Treasury Secretary Timothy Geithner indicates that the United States will reach that debt limit on May 16th, 2011. Through various internal borrowing strategies, Secretary Geithner believes that there will not be an actual default on U.S. bonds until August 2nd, 2011. However, the Federal Government may face funding problems by late July if there is no expansion of the debt limit.

Three Sets of Negotiations

Facing a serious economic problem if the debt limit is not expanded, there are at least three sets of negotiations underway in Washington.

  • First, the “Gang of Six” Senators from both parties are still attempting to move forward with a bill that implements the recommended solution by the 2010 Presidential Fiscal Commission.
  • Second, at the request of President Obama, Vice President Joseph Biden is meeting with House and Senate leaders of both parties.
  • Finally, Senate Majority Leader Harry Reid (D-NV) disclosed this week that Senate Budget Chair Kent Conrad (D-ND) has prepared a new proposed compromise plan. The proposal by Sen. Conrad is to increase taxes in an amount equal to the budget cuts. In effect, the proposal is 50% tax increases and 50% budget reductions.

The Skeptics

Minority Leader Mitch McConnell (R-KY) was skeptical that the “Gang of Six” plan would succeed. He stated, “With all due respect to the Gang of Six or any other bipartisan discussion going on in this issue, the discussions that can lead to a result between now and August are the talks being led by Vice President Biden.”

House Speaker John Boehner (R-OH) spoke May 9th to the Economic Club of New York. He indicated that tax increases were not acceptable and that the deficit plan should instead focus on spending reductions.

In response to the comments by Boehner, White House Press Secretary Jay Carney suggested that the Speaker is “holding the US economy hostage.” Press Secretary Carney indicated that there needs to be flexibility in order to produce compromise.

Assessment

Majority Leader Reid continued the discussion later in the week and noted that it would be essential to have some tax increases. He stated that it “can’t all be done with spending cuts.

“House Majority Leader Eric Cantor (R-VA) is part of the discussion group with Vice President Biden. He indicated that he cannot disclose the specifics of the negotiations. However, in his view, House Republicans continue to support the spending reduction plan introduced by Rep. Paul Ryan (R-WI).

Editors Note: Your editor and this organization take no specific position on these comments. It is widely expected that the discussions on increasing the federal debt limit will lead to a compromise before the August deadline. The Republican negotiators continue to seek a solution that involves spending cuts. It now appears that Democratic negotiators are moving to a proposal with 50% tax increases and 50% budget reductions. Final negotiations are likely to produce a result that reduces federal spending and may include tax increases.

Conclusion

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Dr. Marcinko and Prof. Hetico Feted for Literary Works

Top Ten “Must-Have” Reference Books for Doctors;  by BingMed

By Ann Miller RN MHA

[ME-P Executive-Director]

Ever wonder where your most successful colleagues get such great ideas for running an efficient medical office or maximizing profits? Discover tried-and-true business methods from these collaborative works by MDs.

Whether you are opening your first medical practice or just want to stay up to date on your business and passion, BingMed recommends the following books.

Top Ten List

1. The Medical Entrepreneur: Pearls, Pitfalls and Practical Business Advice for Doctors by Steven M. Hacker MD, MS, Daniel Mark Siegel MD, Joseph C. Kvedar MD and Franklin P. Flowers MD

2. Financial Management for the Medical Practice by Max Reiboldt and the American Medical Association

3. Tools for an Efficient Medical Practice: Forms, Templates and Checklists by Kathryn I. Moghadas

4. Starting a Medical Practice by Jeffrey P. Daigrepont, Lauretta Mink and American Medical Association

5. Medical Practice Management in the 21st Century: the Handbook by Marjorie A. Satinsky and Randall T. Curnow Jr.

6. Business of Medical Practice [Advanced Profit Maximization Techniques for Savvy Doctors] by David E. Marcinko

7. Medical Practice Policies and Procedures by Kathryn I. Moghadas

8. Practice Management: a Practical Guide to Starting and Running a Medical Office by Christian Ranier

9. Marketing Your Clinical Practice: Ethically, Effectively, Economically by Neil Baum and Gretchen Henkel

10. Business of Medical Practice [Transformational Health 2.0 Skills for Doctors] Third Edition by David Marcinko and Hope Rachel Hetico

Assessment

Congrats to our ME-P Editor, and Managing Editor, for this accomplishment.

Link: http://bingmed.com/resources/practice-management/top-10-must-have-reference-books-doctors

Book Link: www.BusinessofMedicalPractice.com

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Interesting Facts About Sex

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Infographics

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Sex: it is everywhere, from the news to TV shows and Internet ads.  Here are some interesting facts about sex

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Meet Mackson Consulting LLC

Our Newest Sponsor

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By Ann Miller RN MHA

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Who They Are

Mackson Consulting is a premier IT services firm headquartered in Reston, Virginia with a focus on straightforward approaches to optimizing business results. Mackson develops and integrates complete systems of all sizes.

For every engagement they bring to bear our unique combination of technical expertise, broad experience to quickly understand our customer environments, and strong systems engineering and program management skills. Their focus is on optimizing the business results of our clients and resolving problems of crucial importance to our nation.

Capabilities

  • Full range of Software Development Lifecycle capabilities (SDLC)
  • Enterprise Architecture design and delivery
  • Business Process reengineering
  • Operations and Maintenance support
  • Database design and optimization
  • Oracle application, middleware and database experts
  • Project Management Leadership
  • Subject Matter Expertise in Health IT

Assessment

Mackson is a professional services and technology solutions provider specializing in application development, enterprise architecture and project management services. They provide a wide variety of IT services to both public sector and commercial clients.

Contact:

Carol S. Miller BSN, MBA

Mackson Consulting LLC
1818 Library Street
Suite 500
Reston, Virginia 20190

www.MacksonConsulting.com

info@macksonconsulting.com

Why Your Stitches Cost $1,500 [Part II]

InfoGraphics – Part 2

Courtesy Medical Billing and Coding

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The United States has fallen behind other nations, failing to provide affordable health care to its citizens. Americans spend $477 billion a year MORE on health care than other advanced countries.

So why do we pay so much compared to other wealthy nations?

Part 2 of 2 in a Series

This Infographic is part two in a two part series which dissects the state of our health care system and presents some alarming numbers.

Assessment

Link: http://www.medicalbillingandcoding.org/medicals-costs-2/

Part 1: https://medicalexecutivepost.com/2011/04/25/why-your-stitches-cost-1500/

Conclusion

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Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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On Physician Relations Management [PRM] Technology

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Criteria for Selection

By Dr. Gary L. Bode MSA, CPA, LLC

Both research and experience reveals an often confusing, complicated world of claims, features, and upgrades, a wide array of technical architectures, and an even wider array of pricing structures when it comes to choosing Physician [Customer] Relations Management [PRM] software.

For me – as a medical practice management consultant – critical criteria for selection includes the following features.

Scalability:

In a young medical practice, a scalable marketing program and PRM infrastructure should be flexible enough to accommodate specialty trends effortlessly and seamlessly without crushing your marketing infrastructure or its’ people, patients or processes. A scalable PRM infrastructure should allow a new channel, a new patient segment, a medical product or service-line seamlessly and with minimum incremental effort or cost.

Interoperability:

You may need an authoring tool today to develop your collateral data, and so select a simple MSFT Word® program. Later, you may want to conduct campaigns to re-introduce your practice or gauge satisfaction among current patients through an online survey. The software you build or purchase for individual activities should be able to co-exist and talk to each other. The software you purchase does not have to be monolithic, but it needs to be modular and work together incrementally.

For example, your e-mail campaign software, CPOESs [computerized physician order entry systems] and e-prescribing functions should work with your authoring tools and eMR.

In today’s complex and fast paced evolution of PRM products, newer technologies need to co-exist with older legacy technologies, and futuristic eMR systems; so interoperability is one of the critical criteria for PRM technology selection.

Ease of Use:

As a young medical practice, pulled in different directions, it is important to have a PRM solution that is easy to use and does not necessitate extensive user training.

Cost structure:

Remember, all PRM software comes with obvious costs as well as hidden costs. Ask the right questions and find out the hidden costs for systems implementation, integration and user training.

Assessment

Channel Surfing the ME-P

Have you visited our other topic channels? Established to facilitate idea exchange and link our community together, the value of these topics is dependent upon your input. Please take a minute to visit. And, to prevent that annoying spam, we ask that you register. It is fast, free and secure.

Conclusion

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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:

 

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Bitching about Dental Insurance

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Both Hippocratic and Patriotic

By D. Kellus Pruitt DDS

For the benefit of our trusting patients, let’s start openly discussing the unethical practices of dental insurance companies’ right here. Marketplace conversation about deceit in healthcare is not only the Hippocratic thing to do, but once the awkwardness wears off, it’s really, really fun sport. We simply must lower the cost of dental care in the nation, and I say we start with dental insurance executives’ salaries and bonuses. Are you with me; Doctor? And let’s not forget all the non-productive busywork insurance companies never reimburse us for.

Are you Fed Up?

Are you fed up with successfully doing intricate handwork to exacting tolerances in mouths of anxious patients and then having to fight to get the patients’ insurance company to pay what they rightfully owe THEIR CLIENT? Are you tired of the way anonymous and unaccountable insurance employees treat you and your staff when their company’s contractual relationship is not with anyone in your office?

In my opinion, Delta Dental, United Concordia, UnitedHealth, BCBSTX and most other secretive dental insurance companies have been cheating Americans for decades under the cover of the McCarran-Ferguson Act of 1945 – which protects them from prosecution by the FTC and cries out to be repealed (tell your Congressperson).

The Age of Transparency

Even in the age of transparency, old habits die hard, especially when there is a profit and campaign funds involved. Dental “insurance” has always harbored fraudulent business activities and has never made sense as a wise purchase – even if one doesn’t brush their teeth. It’s a business built on complicated rules, client deceit and intrusion into their relationship with their dentist.

Dental insurance crime as policy has long avoided market correction because up until now, dentists had no control over the media (and dentistry is boring). Not unexpectedly, when business entities are shielded from accountability in an otherwise free market, it is always the clueless consumer who wastes money on lousy dental insurance policies.

IMHO

In my opinion, employers should be offering their employees the choice of cash or dental insurance. Then let Adam Smith’s invisible hand of competition spank the butts of the greedy and deceitful.

Dentists

Dentists, if you were given the opportunity to effectively voice your opinion directly to employers who carelessly purchase bad dental plans they know nothing about according to the appearance of an ad, what would you say? So why aren’t you saying it right here, right now? If not now, when, Doc?

Assessment

If you don’t make your complaints known, do you think MBA benevolence will eventually improve the dental insurance industry in the nation? I say we do what feels natural and bitch. Let’s live on the wild side and take our chances on someone calling us “unprofessional.” We owe it to our patients to promote honesty in our community. Otherwise, how can your silence possibly help your patients?

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:

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On Oil and Gas Tax Breaks

Reducing Tax Incentives?

By Children’s Home Society of Florida Foundation

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In his address to the nation last week, President Obama indicated that he favors a reduction in the tax incentives for oil and gas companies. He noted that gas in some communities is now over $4.00 a gallon and oil companies had $25 billion in profits during the early months of 2011.

While he does not have “a problem with any company or industry being rewarded for their success,” the President suggests that it would be appropriate to reduce tax incentives for the oil and gas industry.

The Response

House Ways and Means Committee Democrats responded with a letter to Chairman Dave Camp (R-MI). They noted that a specific Sec. 199 Domestic Manufacturing Deduction saved the oil companies approximately $1 billion last year in taxes. Democratic Members of the House Ways and Means Committee recommend that this benefit be eliminated for the oil companies.

Assessment

The energy industry responded to the proposals. American Petroleum Institute (API) President Jack Gerard suggested, “We need to stay focused on energy policy, not demonizing industries.” The energy industry notes that there are 9.2 million Americans who are engaged in the domestic oil and gas industry. Oil and gas represents 7.7% of GDP. If the incentives were reduced, there could be lower employment and higher costs due to greater imports of foreign oil.

Editor’s Note: Sen. Max Baucus has indicated that he will introduce legislation to reduce the oil and gas tax incentives within the next two weeks. He plans to spend the revenue gained through changes in oil and gas tax rules on new incentives for clean energy.

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, 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:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Healthcare Organizations: www.HealthcareFinancials.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.

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

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Pod-Casts from the Institute of Health Economics [IHE]

Seeking an International Flavour for the ME-P

By Staff Reporters

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About The Institute

The Institute of Health Economics (IHE) is a Canadian non-profit organization committed to producing, gathering, and disseminating health research findings from health economics, health policy, health technology assessment and comparative effectiveness to improve the delivery of health care and support a sustainable future.

Vision 

The IHE vision is to be an international center for excellence for health economics, health outcomes, and health policy research, and be recognized nationally and internationally for our contributions towards the efficient and effective use of health care resources.

Mission

The IHE mission is to deliver outstanding health economics, health outcomes, health policy research, and related services to governments, health care providers, the health industry, and universities, for the betterment of society. 

Objectives 

  • Facilitate partnerships among government, academia, industry and health care providers  to address important issues in health care
  • Assess the clinical, economic, social, and ethical implications of both established and new health technologies and practices
  • Support health service delivery with evidence from research in health economics and health technology assessment.
  • Provide relevant economic research to guide policy makers in ensuring high quality care and cost-effective care.

Values
IHE’s values are: Partnership, Creativity, Independence, Quality, Relevance, Accountability, Transparency and Trust

Assessment

Visit Website: www.IHE.ca

Three podcasts released within the last 48 hours:

View PodCasts: http://vimeo.com/ihe

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, 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:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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A Video Vision of Healthcare’s Future from Microsoft

By Staff Reporters

Medical Tourism and Health Information Technology in Malaysia

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According to Dan Dunlop, over at The Healthcare Marketer, the following video promotes Malaysia as a preferred healthcare destination. It positions the country as a one stop destination for all medical and tourism related needs, bringing together related service providers on a single platform. Malaysia would like to be seen as being on the leading edge of technology.

Malaysia Healthcare

In fact, here’s what the Malaysia Healthcare website had to say about the video:

“With state of the art hospitals being built in Malaysia; it’s just a matter of time before we experience seamless healthcare delivery. Malaysia Healthcare patients use a portable Personal Health Record (PHR) called the iPHER that carries all their PHI which includes, medications, lab tests, diagnosis, immunizations, alternative procedures, digital images, dental records, ophthalmic care (lens and contact prescriptions) and DNA any where in the world with no need to access the Internet to view the information. Malaysia Healthcare currently uses this PHR to reduce medical errors and create continuity of care for all their patients and to provide seamless healthcare delivery.”

Assessment

This is an incredible video that demonstrates how Microsoft sees the future of healthcare and shows one vision for how technology will potentially improve our way of life!

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ME-P medical malpractice education

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More:

Link: http://www.youtube.com/watch?v=6aKNK7OTHKs&feature=player_embedded#at=235

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

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Seeking Director of Quality Improvement

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Clear Lake Regional Medical Center

By Shawn Harding
National Management Recruiter
USr Healthcare
(615) 445-3035 Office
(800)826-8127 Toll Free
http://www.usrhealthcare.com

The Director of Quality Improvement will direct the hospital wide organizational performance improvement program reporting to the Service Line Director of Quality. The Director of Quality Improvement will be responsible, either personally or through delegation, for coordinating those systems necessary for the identification and resolution of known or suspected problems and opportunities to improve the dimensions of performance in health care. He/she will be responsible for ensuring hospital wide compliance with all accreditation and licensure standards, and will provide guidance and education to facility leadership, clinical personnel, Board of Trustees and Medical Staff members related to performance improvement.

POSITION REQUIREMENTS:

Education:
• At a minimum: Graduate of an accredited school of nursing with a Baccalaureate degree in nursing.
• Masters Degree in a healthcare discipline highly preferred.

Experience:
• Minimum of 5 years of current clinical experience in an acute care facility required as a Director of Quality Management.
• Supervisory and/or management experience required.

Special Qualifications:
• Comfortable and skilled at working with physicians, healthcare providers and other stakeholders in the organization.
• Capable of gaining immediate credibility with individuals through experience, presentation, communication skills, empathy, and compassion.
• Analytical skills including working knowledge of basic statistics and statistical analysis methodologies.
• Knowledge of PC based computer software (i.e., Word, Excel, Access and/or similar systems preferred).
• Ability to work independently and interdependently.
• Knowledge of healthcare-related regulatory and accreditation requirements.

To apply, please go to http://www.usrhealthcare.com and click on the CAREERS tab, or contact Shawn Harding @ 1.800.826.8127, or email your resume to sharding@usrhealthcare.com

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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John Maynard Keynes v.s. FA Hayek

A Rapping Video

By Staff Reporters

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Is the Great Recession over?

***

***

How is prosperity best created? By government spending or free, unencumbered markets!

***

ext

***

John Maynard Keynes and FA Hayek rap it out on this YouTube video, released last week by collaborators John Papola and Russ Roberts.

 

Video Links:

  • Check out the very hilarious and brilliant video here.
  • Round 1 here.
  • And here’s a podcast about Papola and Hayek’s collaboration.

MORE:

Conclusion

In any case, early planning is the key to supporting both your kids’ futures and your retirement. Making logical college funding decisions, rather than emotional ones, creates a win/win for everyone.

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.

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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

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Should Health Insurance Pay for Patient Exercise Programs?

Or – Enough with the “Benefits” Already!

By Dr. David Edward Marcinko MBA, CMP™

[Former Licensed Insurance Agent]

[ME-P Editor-in-Chief]

An editorial just published in the Journal of the American Medical Association says research supports consideration of a wider policy of reimbursing for structured exercise programs, particularly in high-risk groups, such as diabetics.

Link: http://jama.ama-assn.org/content/305/17/1808.full

Present Status

Currently, health-insurance plans don’t treat exercise as medicine; only some plans offer a fitness benefit, usually a partial reimbursement for gym membership.

Link: http://blogs.wsj.com/health/2011/05/04/reader-consult-should-insurance-reimburse-for-exercise-programs/

Yet, the push for this benefit does seem to be growing.

My Opinion

And yes, as a doctor and surgeon who treated diabetic bone and soft tissue infections, ulcers and related necrotic gangrene for two decades, there’s something to this philosophy in-theory. But, this “theory” is not grounded in risk-management principles or economic sense; and it does seem counter-intuitive to most insurance models that I know.

Note: Most adult diabetics are Type II, maturity onset and controllable.

Examples

For example, auto insurance does not pay for routine car maintenance, nor does home owner’s insurance or most other standard insurance policy types.

Question: Why should health insurance be any different?

Answer: Because it is a public good.

Oh, come on now!  Obeying moral codes and legal boundaries is also a public good for civility; but we don’t mitigate the risk of breaking them with insurance policies; do we?

Why? They would be too expensive. Believe me, if insurance companies thought they could make a buck this way, they surely would!

Assessment

Aren’t these types of benefits already in place in some Flexible Spending Accounts, High Deductible Medical [Health] Savings Accounts , and employee cafeteria plans, etc.

Moreover, don’t we all know that we aren’t supposed to smoke, use street drugs, drink excessively, pig-out, or have promiscuous sex? Yet – we still do – like the diabetic who excessively indulges.

If you want to get-or-stay healthy[ier]; exercise more and eat less. A simple – understandable – and free healthcare Rx; but no best selling book, “breaking news” or JAMA report, here.

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Should health insurance pay for exercise programs? 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.

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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:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Healthcare Organizations: www.HealthcareFinancials.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.

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Thoughts On Financial Advisors and Planners [Videos]

Candid YouTube Videos

By Staff Reporters

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A Conversation with My Financial Planner:

http://www.youtube.com/watch?v=dFf6ibuAl5w&feature=related

The Wrong Financial Advisor:

http://www.youtube.com/watch?v=Vv4HQG2Hz0I&feature=related

Become an Investment Advisor:

http://www.youtube.com/watch?v=N1xpd4Z2p-g&feature=related

Assessment

“Many a true word is spoken in jest” and “Some truths, too painful or too likely to provoke, can be spoken only when the listener has been disarmed by laughter.”

-Geoffrey Chaucer

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. How true are these videos? Are they more tongue-in-cheek or thoughtful and sobering?

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.

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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:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Healthcare Organizations: www.HealthcareFinancials.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.

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What is the Impact of Osama bin Laden’s Death on Investing? [An Opinion Poll]

A Bullish or Bearish Outlook?

By Staff Reporters

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After enduring Europe’s credit crisis and Japan’s nuclear disaster, investors are unlikely to view the death of Osama bin Laden as anything but bullish; or are they?

Link: http://www.fa-mag.com/fa-news/7325-bin-laden-death-boosts-bull-clout-after-europe-asia-crises.html

VOTE HERE:

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, subscribe to the ME-P. It is fast, free and secure.

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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:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Healthcare Organizations: www.HealthcareFinancials.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.

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Dr. Marcinko Interviewed by PedSource.com

On … Medical Practice Mission Statements [“Use Them or Lose Them”]

By Jill Fahy

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You won’t find a formal mission statement posted on the website or framed on the wall at East Bay Pediatrics, in Berkeley, California.

Dr. Marcinko Speaks

But, you will find a few words on medical practice Mission Statements, from our ME-P Editor-in-Chief Dr. David E. Marcinko MBA CMP™, right here.

Assessment

http://www.pedsource.com/library/mission-statements-use-them-or-lose-them

About

PCC created PedSource, an online community for pediatricians, to share insights they’ve gained through their extensive experiences improving revenue and implementing technology in pediatric practices. Their vision is to share resources and build a community to improve the health of pediatric practices nationwide.

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, 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:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Healthcare Organizations: www.HealthcareFinancials.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

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Nominate the “100 Most Influential People in Health Care”

Consider our ME-P Thought-Leaders in Your Deliberations

[By Staff Reporters]

Join Our Mailing List

Between now and this Friday, May 6th 2011, you can nominate the individuals you believe have been the most influential in changing the face of health care for Modern Healthcare magazine’s annual list of “100 Most Influential People in Healthcare.

The ME-P Blog’s “Thought-Leaders”

Why not nominate the experts who regularly post to our ME-P blog? These include the “thought-leaders” listed on our right side bar.

VOTE HERE:

http://www.modernhealthcare.com/section/100-Most-Influential

Assessment

Please help us recognize our friends’ hard work and commitment to improving health care.

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:

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What is the Point of Financial Planning [Pod Cast]?

A Video and Audio Survey

By Staff Reporters

Join Our Mailing List

Question

What’s the point of financial planning?

One Answer

Read WSJ’s post from Richard Reyes and comment below to share what you think the point is.

Assessment

PodCast link: http://www.vimeo.com/22892025?ab

Conclusion

And so, your thoughts and comments on this ME-P are appreciated.

Is financial planning different for doctors, as we contend here at the ME-P? Do we need a separate educational track and designation for healthcare, like: www.CertifiedMedicalPlanner.com ?

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:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Healthcare Organizations: www.HealthcareFinancials.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

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Survey on the Prescription Drug Abuse Prevention Plan

Doctors – How do you feel about the Obama Administration’s New Plan?

Join Our Mailing List

Background Review:

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Healthcare Organizations: www.HealthcareFinancials.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

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Events Planner: May 2011

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Events-Planner: MAY 2011

“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 of your healthcare consulting and/or financial advisory intervention.

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

A Look Ahead this Month – And now, the important dates:

  • May 16-18: Healthcare Quality Institute Conference, Pittsburgh, PA
  • May 16-20: IMCA Conference, Las Vegas, NEV.
  • May 18-20: NAPFA Conference, Salt Lake City, UT.

Please send in your meetings and dates for listing in the next issue of our 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

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