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US Government Glossed Over Cancer Concerns As It Rolled Out Airport X-Ray Scanners

Radiation Safety Concerns

By Michael Grabell
ProPublica, November 1st, 2011, 1:06 pm

On Sept. 23rd, 1998, a panel of radiation safety experts gathered at a Hilton hotel in Maryland to evaluate a new device that could detect hidden weapons and contraband. The machine, known as the Secure 1000, beamed X-rays at people to see underneath their clothing.

One after another, the experts convened by the Food and Drug Administration raised questions about the machine because it violated a longstanding principle in radiation safety — that humans shouldn’t be X-rayed unless there is a medical benefit.

“I think this is really a slippery slope,” said Jill Lipoti, who was the director of New Jersey’s radiation protection program. The device was already deployed in prisons; what was next, she and others asked — courthouses, schools, airports? “I am concerned … with expanding this type of product for the traveling public,” said another panelist, Stanley Savic, the vice president for safety at a large electronics company. “I think that would take this thing to an entirely different level of public health risk.”

The machine’s inventor, Steven W. Smith, assured the panelists that it was highly unlikely that the device would see widespread use in the near future. At the time, only 20 machines were in operation in the entire country.

“The places I think you are not going to see these in the next five years is lower-security facilities, particularly power plants, embassies, courthouses, airports and governments,” Smith said. “I would be extremely surprised in the next five to 10 years if the Secure 1000 is sold to any of these.”

US Marching Millions thru Body Scanners

Today, the United States has begun marching millions of airline passengers through the X-ray body scanners, parting ways with countries in Europe and elsewhere that have concluded that such widespread use of even low-level radiation poses an unacceptable health risk. The government is rolling out the X-ray scanners despite having a safer alternative that the Transportation Security Administration says is also highly effective.

ProPublica Investigates

A ProPublica/PBS NewsHour investigation of how this decision was made shows that in post-9/11America, security issues can trump even long-established medical conventions. The final call to deploy the X-ray machines was made not by the FDA, which regulates drugs and medical devices, but by the TSA, an agency whose primary mission is to prevent terrorist attacks.

Research suggests that anywhere from six to 100 U.S.airline passengers each year could get cancer from the machines. Still, the TSA has repeatedly defined the scanners as “safe,” glossing over the accepted scientific view that even low doses of ionizing radiation — the kind beamed directly at the body by the X-ray scanners — increase the risk of cancer.

“Even though it’s a very small risk, when you expose that number of people, there’s a potential for some of them to get cancer,” said Kathleen Kaufman, the former radiation management director in Los AngelesCounty, who brought the prison X-rays to the FDA panel’s attention.

About 250 X-ray scanners are currently in U.S.airports, along with 264 body scanners that use a different technology, a form of low-energy radio waves known as millimeter waves.

Robin Kane, the TSA’s assistant administrator for security technology, said that no one would get cancer because the amount of radiation the X-ray scanners emit is minute. Having both technologies is important to create competition, he added.

“It’s a really, really small amount relative to the security benefit you’re going to get,” Kane said. “Keeping multiple technologies in play is very worthwhile for the U.S.in getting that cost-effective solution — and being able to increase the capabilities of technology because you keep everyone trying to get the better mousetrap.”

Determined to fill a critical hole in its ability to detect explosives, the TSA plans to have one or the other operating at nearly every security lane in America by 2014. The TSA has designated the scanners for “primary” screening: Officers will direct every passenger, including children, to go through either a metal detector or a body scanner, and the passenger’s only alternative will be to request a physical pat-down.

How did the United States swing from considering such X-rays taboo to deeming them safe enough to scan millions of people a year?

A new wave of terrorist attacks using explosives concealed on the body, coupled with the scanners’ low dose of radiation, certainly convinced many radiation experts that the risk was justified.

But other factors helped the machines gain acceptance.

Gaining Acceptance

Because of a regulatory Catch-22, the airport X-ray scanners have escaped the oversight required for X-ray machines used in doctors’ offices and hospitals. The reason is that the scanners do not have a medical purpose, so the FDA cannot subject them to the rigorous evaluation it applies to medical devices.

Still, the FDA has limited authority to oversee some non-medical products and can set mandatory safety regulations. But the agency let the scanners fall under voluntary standards set by a nonprofit group heavily influenced by industry.

As for the TSA, it skipped a public comment period required before deploying the scanners. Then, in defending them, it relied on a small body of unpublished research to insist the machines were safe, and ignored contrary opinions from U.S. and European authorities that recommended precautions, especially for pregnant women. Finally, the manufacturer, Rapiscan Systems, unleashed an intense and sophisticated lobbying campaign, ultimately winning large contracts.

Both the FDA and TSA say due diligence has been done to assure the scanners’ safety. Rapiscan says it won the contract because its technology is superior at detecting threats. While the TSA says X-ray and millimeter-wave scanners are both effective, Germanydecided earlier this year not to roll out millimeter-wave machines after finding they produced too many false positives.

Most of the news coverage on body scanners has focused on privacy, because the machines can produce images showing breasts and buttocks. But the TSA has since installed software to make the images less graphic. While some accounts have raised the specter of radiation, this is the first report to trace the history of the scanners and document the gaps in regulation that allowed them to avoid rigorous safety evaluation.

Little research on Cancer Risk

Humans are constantly exposed to ionizing radiation, a form of energy that has been shown to strip electrons from atoms, damage DNA and mutate genes, potentially leading to cancer. Most radiation comes from radon, a gas produced from naturally decaying elements in the ground. Another major source is cosmic radiation from outer space. Many common items, such as smoke detectors, contain tiny amounts of radioactive material, as do exit signs in schools and office buildings.

As a result, the cancer risk from any one source of radiation is often small. Outside of nuclear accidents, such as that at Japan’s Fukushima plant, and medical errors, the health risk comes from cumulative exposure.

In Rapiscan’s Secure 1000 scanner, which uses ionizing radiation, a passenger stands between two large blue boxes and is scanned with a pencil X-ray beam that rapidly moves left to right and up and down the body. In the other machine, ProVision, made by defense contractor L-3 Communications, a passenger enters a chamber that looks like a round phone booth and is scanned with millimeter waves, a form of low-energy radio waves, which have not been shown to strip electrons from atoms or cause cancer.

Only a decade ago, many states prohibited X-raying a person for anything other than a medical exam. Even after 9/11, such non-medical X-raying remains taboo in most of the industrialized world. In July, the European Parliament passed a resolution that security “scanners using ionizing radiation should be prohibited” because of health risks. Although the United Kingdom uses the X-ray machine for limited purposes, such as when passengers trigger the metal detector, most developed countries have decided to forgo body scanners altogether or use only the millimeter-wave machines.

While the research on medical X-rays could fill many bookcases, the studies that have been done on the airport X-ray scanners, known as backscatters, fill a file no more than a few inches thick. None of the main studies cited by the TSA has been published in a peer-reviewed journal, the gold standard for scientific research.

Those tests show that the Secure 1000 delivers an extremely low dose of radiation, less than 10 microrems. The dose is roughly one-thousandth of a chest X-ray and equivalent to the cosmic radiation received in a few minutes of flying at typical cruising altitude. The TSA has used those measurements to say the machines are “safe.”

Most of what researchers know about the long-term health effects of low levels of radiation comes from studies of atomic bomb survivors in Hiroshima and Nagasaki. By charting exposure levels and cancer cases, researchers established a linear link that shows the higher the exposure, the greater risk of cancer.

Some scientists argue the danger is exaggerated. They claim low levels stimulate the repair mechanism in cells, meaning that a little radiation might actually be good for the body.

National Academy of Sciences

But, in the authoritative report on low doses of ionizing radiation, published in 2006, the National Academy of Sciences reviewed the research and concluded that the preponderance of research supported the linear link. It found “no compelling evidence” that there is any level of radiation at which the risk of cancer is zero.

Radiation experts say the dose from the backscatter is negligible when compared to naturally occurring background radiation. Speaking to the 1998 FDA panel, Smith, the inventor, compared the increased risk to choosing to visit Denver instead of San Diegoor the decision to wear a sweater versus a sport coat.

Using the linear model, even such trivial amounts increase the number of cancer cases. Rebecca Smith-Bindman, a radiologist at the University of California, San Francisco, estimated 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. David Brenner, director of Columbia University’s Center for Radiological Research, reached a higher number — potentially 100 additional cancers every year.

“Why would we want to put ourselves in this uncertain situation where potentially we’re going to have some cancer cases?” Brenner asked. “It makes me think, really, why don’t we use millimeter waves when we don’t have so much uncertainty?”

But even without the machines, Smith-Bindman said, the same 100 million people would develop 40 million cancers over the course of their lifetimes. In this sea of cancer cases, it would be impossible to identify the patients whose cancer is linked to the backscatter machines.

How the scanners avoided strict oversight

Although they deliberately expose humans to radiation, the airport X-ray scanners are not medical devices, so they are not subject to the stringent regulations required for diagnostic X-ray machines.

If they were, the manufacturer would have to submit clinical data showing safety and effectiveness and be approved through a rigorous process by the FDA. If the machines contained radioactive material, they would have to report to the Nuclear Regulatory Commission.

But because it didn’t fit into either category, the Secure 1000 was classified as an electronic product. The FDA does not review or approve the safety of such products. However, manufacturers must provide a brief radiation safety report explaining the dose and notify the agency if any overexposure is discovered. According to the FDA, no such incidents have been reported.

Under its limited oversight of electronic products, the FDA could issue mandatory safety regulations. But it didn’t do so, a decision that flows from its history of supervising electronics.

Regulation of electronic products in the United States began after a series of scandals. From the 1930s to the 1950s, it was common for a child to go to a shoe store and stand underneath an X-ray machine known as a fluoroscope to check whether a shoe was the right fit. But after cases arose of a shoe model’s leg being amputated and store clerks developing dermatitis from putting their hands in the beam to adjust the shoe, the practice ended.

In 1967, General Electric recalled 90,000 color televisions that had been sold without the proper shielding, potentially exposing viewers to dangerous levels of radiation. The scandal prompted the creation of the federal Bureau of Radiological Health.

“That ultimately led to a lot more aggressive program,” said John Villforth, who was the director of the bureau. Over the next decade, the bureau created federal safety standards for televisions, medical X-rays, microwaves, tanning beds, even laser light shows.

But in 1982, the FDA merged the radiological health bureau into its medical-device unit.

“I was concerned that if they were to combine the two centers into one, it would probably mean the ending of the radiation program because the demands for medical-device regulation were becoming increasingly great,” said Villforth, who was put in charge of the new Center for Devices and Radiological Health. “As I sort of guessed, the radiation program took a big hit.”

The new unit became stretched for scarce resources as it tried to deal with everything from tongue depressors to industrial lasers. The government used to have 500 people examining the safety of electronic products emitting radiation. It now has about 20 people. In fact, the FDA has not set a mandatory safety standard for an electronic product since 1985.

As a result, there is an FDA safety regulation for X-rays scanning baggage — but none for X-rays scanning people at airports.

Meanwhile, scientists began developing backscatter X-rays, in which the waves are reflected off an object to a detector, for the security industry.

The Secure 1000 people scanner was invented by Smith in 1991 and later sold to Rapiscan, then a small security firm based in southern California. The first major customer was the California prison system, which began scanning visitors to prevent drugs and weapons from getting in. But the state pulled the devices in 2001 after a group of inmates’ wives filed a class-action lawsuit accusing the prisons of violating their civil liberties.

***

***

US Customs Service

The U.S. Customs Service deployed backscatter machines for several years but in limited fashion and with strict supervision. Travelers suspected of carrying contraband had to sign a consent form, and Customs policy prohibited the scanning of pregnant women. The agency abandoned them in 2006, not for safety reasons but because smugglers had learned where the machines were installed and adapted their methods to avoid them, said Rick Whitman, the radiation safety officer for Customs until 2008.

Yet, even this limited application of X-ray scanning for security dismayed radiation safety experts. In 1999, the Conference of Radiation Control Program Directors, a nongovernmental organization, passed a resolution recommending that such screening be stopped immediately.

The backscatter machines had also caught the attention of the 1998 FDA advisory panel, which recommended that the FDA establish government safety regulations for people scanners. Instead, the FDA decided to go with a voluntary standard set by a trade group largely comprising manufacturers and government agencies that wanted to use the machines.

“Establishing a mandatory standard takes an enormous amount of resources and could take a decade to publish,” said Dan Kassiday, a longtime radiation safety engineer at the FDA.

In addition, since the mid-1990s, Congress has directed federal safety agencies to use industry standards wherever possible instead of creating their own.

The FDA delegated the task of establishing the voluntary standards to the American National Standards Institute. A private nonprofit that sets standards for many industries, ANSI convened a committee of the Health Physics Society, a trade group of radiation safety specialists. It was made up of 15 people, including six representatives of manufacturers of X-ray body scanners and five from U.S. Customs and the California prison system. There were few government regulators and no independent scientists.

In contrast, the FDA advisory panel was also made up of 15 people — five representatives from government regulatory agencies, four outside medical experts, one labor representative and five experts from the electronic products industry, but none from the scanner manufacturers themselves.

“I am more comfortable with having a regulatory agency — either federal or the states — develop the standards and enforce them,” Kaufman said. Such regulators, she added, “have only one priority, and that’s public health.”

A representative of the Health Physics Society committee said that was its main priority as well. Most of the committee’s evaluation was completed before 9/11. The standard was published in 2002 and updated with minor changes in 2009.

Ed Bailey, chief of California’s radiological health branch at the time, said he was the lone voice opposing the use of the machines. But after 9/11, his views changed about what was acceptable in pursuit of security.

“The whole climate of their use has changed,” Bailey said. “The consequence of something being smuggled on an airplane is far more serious than somebody getting drugs into a prison.”

Are Inspections Independent?

While the TSA doesn’t regulate the machines, it must seek public input before making major changes to security procedures. In July, a federal appeals court ruled that the agency failed to follow rule-making procedures and solicit public comment before installing body scanners at airports across the country. TSA spokesman Michael McCarthy said the agency couldn’t comment on ongoing litigation.

The TSA asserts there is no need to take additional precautions for sensitive populations, even pregnant women, following the guidance of the congressionally chartered National Council on Radiation Protection & Measurements.

But other authorities have come to the opposite conclusion. A report by France’s radiation safety agency specifically warned against screening pregnant women with the X-ray devices. In addition, the Federal Aviation Administration’s medical institute has advised pregnant pilots and flight attendants that the machine, coupled with their time in the air, could put them over their occupational limit for radiation exposure and that they might want to adjust their work schedules accordingly.

No similar warning has been issued for pregnant frequent fliers.

Even as people scanners became more widespread, government oversight actually weakened in some cases.

Inspections of X-ray equipment in hospitals and industry are the responsibility of state regulators — and before 9/11, many states also had the authority to randomly inspect machines in airports. But that ended when the TSA took over security checkpoints from the airlines.

Instead, annual inspections are done by Rapiscan, the scanners’ manufacturer.

“As a regulator, I think there’s a conflict of interest in having the manufacturer and the facility inspect themselves,” Kaufman said.

Last year, in reaction to public anger from members of Congress, passengers and advocates, the TSA contracted with the Army Public Health Command to do independent radiation surveys. But email messages obtained in a lawsuit brought by the Electronic Privacy Information Center, a civil liberties group, raise questions about the independence of the Army surveys.

One email sent by TSA health and safety director Jill Segraves shows that local TSA officials were given advance notice and allowed to “pick and choose” which systems the Army could check.

That email also suggests that Segraves considered the Army inspectors a valuable public-relations asset: “They are our radiation myth busters,” she wrote to a local security director.

Some TSA screeners are concerned about their own radiation exposure from the backscatters, but the TSA has not allowed them to wear badges that could measure it, said Milly Rodriguez, health and safety specialist for the American Federation of Government Employees, which represents TSA officers.

“We have heard from members that sometimes the technicians tell them that the machines are emitting more radiation than is allowed,” she said.

McCarthy, the TSA spokesman, said the machines are physically incapable of producing radiation above the industry standard. In the email, he said, the inspections allow screeners to ask questions about radiation and address concerns about specific machines.

TSA Video: http://en.wikipedia.org/wiki/File:TSA-_How_It_Works.ogv

The company’s lobbying campaign

While the TSA maintains that the body scanners are essential to preventing attacks on airplanes, it only began rolling them out nine years after 9/11.

After the attempted shoe-bombing in December 2001, the federal government conducted a trial of a Rapiscan backscatter at the Orlando International Airport. But the revealing images drew protests that the machines amounted to a virtual strip search.

The TSA considered the scanners again after two Chechen women blew up Russian airliners in 2004. Facing a continued outcry over privacy, the TSA instead moved forward with a machine known as a “puffer” because it released several bursts of air on the passengers’ clothes and analyzed the dislodged particles for explosives. But after discovering the machines were ineffective in the field and difficult to maintain, the TSA canceled the program in 2006.

Around that time, Rapiscan began to beef up its lobbying on Capitol Hill. It opened a Washington,D.C., office and, according to required disclosures, more than tripled its lobbying expenditures in two years, from less than $130,000 in 2006 to nearly $420,000 in 2008. It hired former legislative aides to Rep. David Price, D-N.C., then chairman of the homeland security appropriations subcommittee, and to Sen. Trent Lott, R-Miss.

It started a political action committee and began contributing heavily to Price; Rep. Bennie Thompson, D-Miss., then head of the homeland security committee; Rep. Jane Harman, D-Calif., also on that committee; and Sen. Thad Cochran, R-Miss., the top Republican on the Senate appropriations committee.

In addition, it opened a new North Carolina plant in Price’s district and expanded its operations in Ocean Springs, Miss., and at its headquarters in Torrance, Calif., in Harman’s district.

“Less than a month after U.S. Senator Trent Lott and other local leaders helped officially open Rapiscan Systems’ new Ocean Springs factory,” Lott’s office announced in a news release in late 2006, “the company has won a $9.1 million Department of Defense contract.”

But Rapiscan still hadn’t landed a major contract to roll out its X-ray body scanners in commercial airports. Indeed, in 2007, with new privacy filters in place, the TSA began a trial of millimeter-wave and backscatter machines at several major airports, after which the agency opted to go with the millimeter-wave machines. The agency said health concerns weren’t a factor.

But with the 2009 federal stimulus package, which provided $300 million for checkpoint security machines, the TSA began deploying backscatters as well. Rapiscan won a $173 million, multiyear contract for the backscatters, with an initial $25 million order for 150 systems to be made inMississippi.

Three other companies — American Science & Engineering, Tek84 Engineering Group and Valley Forge Composite Technologies — make X-ray scanners, but none are used by the TSA. Peter Kant, executive vice president for Rapiscan, said the company expanded its lobbying because its business was increasingly affected by the government.

“There’s a lot of misinformation about the technology; there’s a lot of questions about how various inspection technologies work,” he said. “And we needed a way to be able to provide that information and explain the technology and how it works, and that’s what lobbying is.”

The lawmakers either declined to comment or said the lobbying, campaign contributions and local connections had nothing to do with the TSA’s decision to purchase Rapiscan machines. The TSA said the contract was bid competitively and that the winning machines had to undergo comprehensive research and testing phases before being deployed.

While the scanners were appearing in more and more airports, few passengers went through them, because they were used mostly for random screening or to resolve alarms from the metal detector.

That changed on Christmas Day 2009, when a Nigerian man flying toDetroittried to ignite a pouch of explosives hidden in his underwear.

Following the foiled “Great Balls of Fire” suicide bombing, as the New York Post dubbed it, Homeland Security Secretary Janet Napolitano ramped up plans to roll out body scanners nationwide. Members of Congress and aviation security experts also pushed heavily for the TSA to install more machines that could detect explosives on passengers.

Harman sent a letter to Napolitano, noting that Rapiscan was in her district.

“I urge you to expedite installation of scanning machines in key airports,” Harman wrote in the letter, which was first reported by the website CounterPunch. “If you need additional funds, I am ready to help.”

Michael Chertoff, who had supported body scanners while secretary of Homeland Security, appeared frequently on TV advocating their use. In one interview, he disclosed that his consulting firm, Chertoff Group, had done work for Rapiscan, sparking accusations that he was trying to profit from his time as a government servant.

Despite the criticism, little has been revealed about the relationship. Rapiscan dismissed it, asserting that the consulting work had to do with international cargo and port security issues — not aviation.

“There was nothing that was not above board,” Kant said. “His comments about passenger screening and these machines were simply his own and was nothing that we had engaged the Chertoff Group for.”

In a statement, the Chertoff Group said it “played no role in the sale of whole body imaging technology to TSA” and that Chertoff “was in no way compensated for his public statements.”

A public records request by ProPublica turned up empty: The Department of Homeland Security said it could not find any correspondence to or from Chertoff related to body scanners. DHS also said Chertoff did not use email.

Assessment

The TSA plans to deploy 1,275 backscatter and millimeter-wave scanners covering more than half its security lanes by the end of 2012 and 1,800 covering nearly all the lanes by 2014.

According to annual reports filed with the Securities and Exchange Commission, OSI Systems, the parent company of Rapiscan, has seen revenue from its security division more than double since 2006 to nearly $300 million in fiscal year 2011.

Link: http://www.propublica.org/article/u.s.-government-glossed-over-cancer-concerns-as-it-rolled-out-airport-x-ray.

Miles O’Brien and Kate Tobin of PBS News Hour contributed to this report.

Related Stories:

New Army Study Says Radiation From Airport Body Scanners Is Minor

by Michael Grabell, ProPublica, July 14

TSA Airport Scanners Wouldn’t Catch an Implant Bomber

by Michael Grabell, ProPublica, July 6

Scientists Cast Doubt on TSA Tests of Full-Body Scanners

by Michael Grabell, ProPublica, May 16

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By Dr. David Edward Marcinko MBA CMP™

[Publisher-in-Chief]

As regular ME-P readers know, I held a property and casualty insurance license for more than 15 years; this included homeowners and automobile insurance.

It also included malpractice [doctors and medical professionals] and E&O insurance [accountants, financial advisors, attorneys, etc]. Yep! Med-mal is classified under the property-casualty moniker. I even edited a handbook on the topic.

So, it is no surprise that car insurance companies number well over 100 in many states. But, who are the top 10 car insurance companies? Most doctors and lay drivers would not be surprised to see Allstate, State Farm or GEICO on the list of top 10 car insurance companies by market share; but how about USAA, Farmers or Liberty Mutual?

Source: Carinsurancecompanies.net

After an Accident

Following a collision, the insurance company will assign a claims adjuster to determine the extent of damage and the cost of repairs.  If these repairs exceed the estimated value of the vehicle, it may be “totaled.”  Experience tells me that the value of the vehicle to the owner nearly always exceeds that estimated by the insurance company. This is true in my case, as well.

Assessment

The medical professional is therefore strongly urged to consider purchasing replacement cost coverage rather than accepting actual cash value, which is the depreciated value of the vehicle. The cost may be higher for this coverage, but accepting a larger deductible will often make up the difference. Paying a little more towards the deductible could easily be worth it, if the damage is extensive.

Or, if you have a special vehicle [pristine pearl white 2001 Jaguar, XJ-V8-LWB] like I do.

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

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Beware Cyber Monday Hacks and Scams

Doctor Shoppers and Consumers Beware!

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The holiday season signals the time of year when consumers are often at the highest risk of falling victim to hackers and scammers whose schemes can fool even the most experienced online shoppers.

This infographic advises both web merchants and consumers on how to avoid Black Friday and Cyber Monday attacks.

Source: veracode.com

Assessment

This essay is a surrogate case example applicable to medical professionals considering the plethora of eMR, eHR and PHR security issues of modern healthcare delivery.

Conclusion

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Plastic Surgery in the USA

 On the Business, Gender, Reasons and Procedures

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According to Wikipedia, plastic surgery is the medical specialty concerned with the correction or restoration of form and function.

Though cosmetic or aesthetic surgery is the best-known kind of plastic surgery, most plastic surgery is not cosmetic – as plastic surgery includes many types of  reconstructive surgery.

 

Source: http://www.surgicaltechschools.net

Assessment

In the term plastic surgery, the adjective plastic denotes sculpting, and derives from the Greek πλαστική (τέχνη), plastikē (tekhnē), “the art of modelling” of malleable flesh.

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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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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Marketing Basics for Financial Advisors and Physicians

On Differences and Similarities

By David K. Luke; MIM

[Investment Advisor]

www.NetWorthAdvice.com

The difference between internal marketing and external marketing for physicians is that internal marketing is the management strategy of improving satisfaction by making patients aware of the positive differences in the physician’s practice –versus- other modern or traditional alternatives that the doctor might externally use [yellow pages, coupons, TV, radio, internet, blogs, etc].

Now, compare marketing with advertising, which attempts to draw patients to the medical practice or clinic using more expensive channel distribution means and/or media messaging.

The “X” Factor

Internal marketing gives the patient “something extra” during the visit that tends to make them pleased, satisfied – or better yet – delighted!

In show business, Simon Cowell calls this something extra the “X” factor.

Whether it is a “Patient Bill of Rights” or just making sure that patients are treated fairly, and with respect throughout the process, turns the patient into a practice advocate instead of a patient from hell.

Improved listening/communication can come in the form of an attentive and caring human ear, enhanced bedside manner, or technology like P[C]RM (Patient {Client} Relationship Management) tools and/or eMRs, for example.

Sloppy Medical Office Procedures

Having office staff involved, by noticing improvements, can also help with the implementation of a successful internal marketing strategy. Sloppy office procedures can be cleaned up, scheduling access management can be revamped, and any administrative mix-ups can be avoided.

Negative practices such as “we enforce a minimum $50 office visit fee” should be stopped, as this casts a negative attitude on all patients, not just future deadbeats.

An effective P[C] RM strategy can increase patient satisfaction and be inexpensive to implement and maintain, especially in light of modern advertising tools for medical practices.

Financial Advisor Comparisons 

A physician’s internal marketing program is comparative to an FA’s internal marketing program, in that both methods are much more cost effective and yield better results than traditional external marketing or advertising.

For an FA, the practice of encouraging referrals can be done discreetly without making the existing clients uncomfortable.

An FA practice that is “referable” is one in which there are consistent standards and procedures in place. This creates a comfort factor with existing clients and assures them that when they refer their friends and family they will also receive consistent quality treatment.

Assessment

An FA can implement procedures similar to a medical practice by training staff to point out and recognize office procedures that might be improved. Letting clients know they are appreciated and that referrals are accepted sounds like obvious advice, but is often ignored by too many Financial Advisors, and even doctors.

Editor’s Note: David K. Luke is currently enrolled in the online www.CertifiedMedicalPlanner.org chartered professional designation program.

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

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[Ancient] Thoughts on Japanese Bloodletting

Therapeutically Withdrawing Blood

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According to Wikipedia, Bloodletting (or blood-letting) is the withdrawal of often little quantities of blood from a patient to cure or prevent illness and disease. Bloodletting was based on an ancient system of medicine in which blood and other bodily fluid were considered to be “humors” the proper balance of which maintained health. It was the most common medical practice performed by doctors from antiquity up to the late 19th century, a time span of almost 2,000 years.

The practice has now been abandoned for all except a few very specific conditions. It is conceivable that historically, in the absence of other treatments for hypertension, bloodletting could sometimes have had a beneficial effect in temporarily reducing blood pressure by a reduction in blood volume. However, since hypertension is very often asymptomatic and thus undiagnosable without modern methods, this effect was unintentional. In the overwhelming majority of cases, the historical use of bloodletting was harmful to patients.

Today, the term phlebotomy refers to the drawing of blood for laboratory analysis or transfusion. Therapeutic phlebotomy refers to the drawing of a unit of blood in specific cases like hemochromatosis or porphyria cutanea tarda, etc., to reduce the amount of red blood cells.

 

Source: http://www.nursingschoolsinchicago.org  [Nursing Schools in Chicago for More Info]

Assessment

In the medical condition known as polycythemia vera or other primary polycythemia syndromes, a major treatment options is phlebotomy.

A recommended hematocrit of less than 45 in men, and less than 42 in women, is the goal of phlebotomy therapy.

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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Saying “Thanks” to Patients and Clients

On Doctors and Financial Advisors Saying “Thank You”

By ME-P Staff and Reporters [A family of communication and educational companies]

In 1621, our settlers acknowledged a large autumn harvest feast as one of the first Thanksgiving celebrations in the colonies. But, it wasn’t until 1863, in the midst of the Civil War, that President Abraham Lincoln proclaimed a national Thanksgiving Day to be held each November. Ever since, Americans have used this gathering time to be with family and friends and reflect on those things we are most thankful for in our lives.

Note: click  the image

So here we are, ramping up to celebrate the anniversary of that first Thanksgiving some 148 years ago. This year, let’s take the same reflective approach and apply it to our ME-P work worlds.

For example, whether a doctor, nurse, CXO or financial advisor, when was the last time:

  • You expressed gratitude to your key patients, hospitals, employees or clients?
  • You recognized a newer prospect referral for sending a patient or client your way?
  • You were truly grateful for those patients and clients who keep your medical practice, financial advisory or medical management business viable – and you showed it?
  • You said “thank you” to one of your referring physicians, attorneys or accountants?

Assessment

This time of year is a good reminder to show your appreciation to patients, customers, vendors and clients—not from only a monetary perspective, but for all they contribute to your relationships.

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Our Question

As so, what are some of the helpful and creative ways that you say “thank you” this season for all your loyal fans?

Of course, we also extend our gratitude and say “thanks” to all clients, readers, providers, sponsors, advertisers and subscribers to this Medical Executive-Post

Happy Thanksgiving Weekend 2011, and thank you for your continued support!

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

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Promoting “National Family [Medical] History Day” 2011

AKA Thanksgiving Day

By Staff Reporters

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Did you know that each year since 2004, the Surgeon General has declared Thanksgiving to be National Family History Day?

Over the holiday season or at other times when families gather, the Surgeon General encourages Americans to talk about, and to write down, the health problems that seem to run in their family.  PHRs are a perfect tool in this regard.

Moreover, doctors speak about the FH with patients every day, and as they commence office work on this Black Friday. Of course, learning about a family’s health history may help ensure a longer, healthier future together too!

Assessment

For information from the Office of the Surgeon General, please visit http://www.hhs.gov/familyhistory/

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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Celebrating our National Holiday

Thanksgiving Day 2011

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As Americans enjoy Thanksgiving and its turkey, stuffing, cranberries, potatoes and pumpkin pies, we’ve compiled the facts and figures about our national holiday, just in time for the beginning of the holiday shopping season.

Source: Creditdonkey.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, 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

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On Healthcare Collaboration Trends

A Lay Perspective

By David K. Luke MIM CMP

[Investment Advisor]

http://www.CertifiedMedicalPlanner.org

Collaboration within healthcare has sprung from the general body of health communication research; ie., crowd-sourcing, etc..

And, there are a number of other emerging trends, visible to the lay man or woman, in the patient collaboration arena today.

1. Cross-Discipline Communication Teams

One trend is the formation of cross-discipline communication teams among health care professionals.  Different disciplines in pairs, small groups and teams now collaborate directly with each other. This is an important development in improving the healthcare delivery process to the patient.

Typically health care providers tend to identify strongly with their own discipline and likewise cross collaboration may be very difficult. But this trend is developing so that Nurses, Social workers, pharmacists and others work with physicians with a full realm of issues. Likewise we see now the Nurse/Physician collaborative, Nurse Practitioner/Physician Collaborative, Social Worker/Physician, Pharmacist/Physician and even Physician/Physician collaborative groups.

2. Clinical Health Care Teams

A second trend in patient collaboration is Clinical Health Care Teams.  A team approach to care and measurable patient outcomes has shown in studies (Cooke, 1997; Cooley, 1994: Fagin, 1992, et al.) as improving overall care for patients. These multidisciplinary teams facilitate and improve training of students in medicine and nursing and other related fields as well.

3. Informal Backstage Communication

Finally, a third emerging patient collaborative trend is the increase is informal backstage communication.

Typically communication in the healthcare setting regarding the patient has been done among the team members in a team meeting setting for a one to two hour collaboration session.

Now we see the emergence of the backstage regions such as the break rooms, hallways, clinic computer desk, work tables, photocopy rooms, and offices. While these encounters between team members are often fleeting and “messy”, the environment within a practice setting can be consciously created to allow for this increased interaction among team members that will certainly improve the care of the patient.

Of course social media and e-communication facilitates this trend.

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

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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A New Plan for [Medical] Student Loans?

The Debt Crisis

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Recently, President Barack H. Obama announced a new plan for student loans and the severe debt it has placed on students. Obviously, more needs to be done, but it’s a start.

As you can tell, this infographic illustrates the strategies that President Obama has implemented or improved along with thoughts that go beyond the new deal, especially about students.

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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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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How Good Looks Lead to Higher [MD] Paychecks

Even for Medical Professionals?

DEM 2

By Dr. David Edward Marcinko MBA CMP™

www.CertifiedMedicalPlanner.org

[Editor-in-Chief]

Beauty seems like enough of a reward in and of itself, but a wealth of research reveals that it comes with extra perks too.

Prettier people earn more money, find higher-earning and more attractive spouses, and even get better mortgage deals!

And, now that more than 40% of young new physicians are seeking employment, do looks really matter?

Assessment

Source: www.onlinembaprograms.net

Conclusion                

Is this controversial thought true for doctors and learned medical professionals? How about publishers and editors? Do you have any real-life examples to share with the ME-P? Your thoughts and comments 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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Our Other Print Books and Related Information Sources:

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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Doctors and Gift Annuities

On the ACGA Support for Tax Initiatives

By Children’s Home Society of Florida Foundation

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A Senate Finance Committee hearing was held on October 18th, 2011 to discuss potential changes in the tax law relating to charitable deductions. Conrad Teitell, volunteer counsel to the American Council on Gift Annuities, prepared a statement for the record that was submitted to the Senate Finance Committee.

Teitell outlined five principles for considering changes to charitable deductions; including the following:

1. Tax Incentives – A reduction in tax incentives would harm a broad spectrum of Americans served by charities.

2. Current IRA Rollovers – The option for an IRA rollover up to $100,000 per IRA owner over age 70½ will expire on December 31, 2011. This should be made permanent.

3. IRA Nonitemizer Deduction – For IRA owners over age 70½ who do not itemize (about 70% of taxpayers), the IRA rollover functions in a manner similar to a nonitemizer deduction. While the IRA transfer is not deductible, an IRA owner’s taxable required minimum distribution is reduced by the amount of the qualified charitable distribution (QCD). This reduces taxable income by the amount of the IRA rollover.

4. Expanded IRA Rollover – The IRA rollover should permit the transfer from an IRA trustee to a charitable organization for a charitable gift annuity or to a trustee of a charitable remainder trust.

5. Decreased Federal and State Support – Budget cuts at both the Federal and the state level are frequently targeting social services and the most vulnerable citizens of our nation.

Teitell also outlined a proposed “All-American Charitable IRA Rollover Act of 2012.” His proposed bill permits the current tax-free distributions to charities of $100,000 per year for IRA owners over age 70½.

Expanded Rollover

However, he advocates an expanded rollover that would enable IRA owners over age 59½ to make QCDs up to $500,000 for a charitable gift annuity or to a charitable remainder trust. The QCD would be available for a one life gift annuity or CRT, or two lives for an IRA owner and spouse.

Assessment

QCDs would not be deductible charitable gifts, but they are also not included in taxable income. A QCD is permitted for a public charity gift, but not for transfers to a donor advised fund or supporting organization. All payments from a life income agreement will be ordinary income.

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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Understanding the Power of Consumer and Patient Sentiment

About New-Wave Social Media and Medical Marketing

By Staff Reporters

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With social media and healthcare data becoming a focus for many healthcare businesses, hospitals and even medical practices, how are doctors taking advantage of consumer and new-wave patient sentiment?

Businesses like clinics and medical practices have more power than ever to start gleaning insights from online patient conversations to measure sentiment, and ultimately put power back into the hands of patient-consumers.

Source: IBM.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, 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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About Drug Use and Abuse in America

The United States of Drug Addicts?

By Muhammad Saleem with ME-P Staff Reporters
http://muhammadsaleem.com
msaleem@gmail.com

Example 1:

Georgia meth seizure near US record
[Augusta Chronicle 12/01/2010]

Gwinnett County police seized nearly half a ton of methamphetamine with an estimated street value of $44.6 million from a home in Norcross, one of the biggest meth seizures ever made in the United States.

Police raided a house off  Beaver Ruin Road between Interstate 85 and Buford Highway late Monday after authorities got a report that a large amount of meth was being produced there.

Officers found 150 pounds of crystal methamphetamine ready for sale and 200 gallons of liquid methamphetamine oil in a large drug lab.

Gwinnett County police called in the U.S. Drug Enforcement Administration and a fire department hazmats team because of the size of the drug lab.

“This would feed hundreds and hundreds of addicts and destroy who knows how many lives, countless lives,” said Rodney Benson of the DEA field office in Atlanta. No one was in the home at the time of the raid, police said.

Authorities said they suspect a Mexican-based drug trafficking organization in the drug-making operation, but added investigators have not determined what group was responsible.

Police arrested 33-year-old Jose Galvez-Vela of Weslaco, Texas, and charged him with trafficking in meth. Police didn’t say exactly where he was arrested and didn’t know if he had a lawyer. Authorities said they are seeking others following the raid in Norcross, in the Northern Atlanta suburb of Gwinnett County.

The discovery underscored a growing trend of Mexican drug trafficking organizations smuggling liquid meth into the United States to be converted into a crystal form for sale, Benson said. The liquid can be converted to crystal form within 48 hours, he said.

Investigators in hazmats suits cautiously removed the meth and flammable drug-making chemicals from the house Monday. It didn’t appear that anyone was living in the house and that it was used strictly for manufacturing meth, police said. The house was “really a powder keg, ready to blow at any time,” Benson said. “Clearly removing that threat from that house is clearly making that neighborhood much safer today.”

The house is set in a quiet, low-to middle-income subdivision, Gwinnett police Cpl. Edwin Ritter said.

Example 2:

Georgia police seize meth worth $44.6M from house
[Los Angeles Times 12/01/2010]

NORCROSS, Ga. (AP) — Investigators have seized hundreds of pounds of methamphetamine with an estimated street value of $44.6 million in suburban Atlanta, one of the biggest meth seizures in the country, authorities said Tuesday. Investigators said the raid was conducted late Monday at a house in Norcross, just north of Atlanta, after authorities were told a large amount of meth was being produced there. They reported finding 150 pounds of crystal methamphetamine ready for sale and 200 gallons of liquid methamphetamine oil in a large drug lab.

“This would feed hundreds and hundreds of addicts and destroy who knows how many lives, countless lives,” said Rodney Benson with the federal Drug Enforcement Administration’s field office in Atlanta.

No one was in the home at the time of the raid, police said. Authorities said they suspect a Mexican-based drug trafficking organization in the drug making operation, but added investigators have not determined what group was responsible.

Investigators said they arrested 33-year-old Jose Galvez-Vela of Weslaco, Texas, and charged him with trafficking in meth. Police didn’t say exactly where he was arrested and didn’t know if he had a lawyer. Authorities said they are seeking others following the raid in Norcross, in the northern Atlanta suburb of Gwinnett County.

The discovery underscored a growing trend of Mexican drug trafficking organizations smuggling methamphetamine in liquid form across the border with the United States to be converted into a crystal form for sale, Benson said. The liquid can be converted to crystal form within 48 hours, he added. Investigators in hazmat suits used extreme caution as they removed the meth and highly flammable drugmaking chemicals from the house. It didn’t appear that anyone was living in the house and that it was used strictly for manufacturing meth, police said.

The house was “really a powder keg, ready to blow at any time,” Benson said. “Clearly removing that threat from that house is clearly making that neighborhood much safer today.”

The house is set in a quiet, low-to middle-income subdivision, Gwinnett police Cpl. Edwin Ritter said. Benson said the lab’s location was typical of Mexican drug organizations known to operate sophisticated networks from nondescript houses in suburban Atlanta for distribution along the East Coast.

Investigators said they were following several leads to others allegedly involved but declined further comment, citing an ongoing investigation.

Citing the size of the drug lab and the hazardous chemicals involved, police said they requested help from the DEA and a hazardous materials team with a local fire department.

Editor’s Note

Although Georgia is the home of the ME-P, these Georgia State examples were purely coincidental.

Source: http://www.criminaljusticeusa.com

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Newt Gingrich has his Way with the ADA

Dentists should be furious with Gingrich for commandeering the ADA

By D. Kellus Pruitt DDS

On This Week roundtable discussion this morning [Sunday], George Will began his comments about Newt Gingrich, now a frontrunner, by saying that he “embodies everything disagreeable about modern Washington.”

Dentists should be furious with not only Gingrich, but with our inattentive dental leaders as well.

Why? 

A couple of days ago, Steve Chapman posted “Gingrich’s corruption” on the ChicagoTribune.com.

http://www.chicagotribune.com/news/opinion/chapman/chi-gingrichs-corruption-20111118,0,4581968.story

Chapman writes:

“Conservatives may be able to forgive Newt Gingrich for being an adulterer and for his flip-flops on climate change and mandatory health insurance. They are willing to put those aside because they think he’s shown a fierce attachment to their cause. But, the latest revelations will be harder to digest, because they suggest that his allegiance is for sale.”

He punctuates the condemnation with a quote from USA Today:

http://www.usatoday.com/news/politics/story/2011-11-16/newt-gingrich-think-tank-opeds/51246512/1  

“In a series of op-eds stretching over several years, Gingrich repeatedly advocated for various health-care related issues, including electronic health care records, ways to improve the health care sector, and medical malpractice reform without acknowledging the issues were directly connected to members of the Center for Health Transformation, a for-profit think tank he founded in 2003.”

Newt, for a Freddie Mac historian, you’re pretty sly!

According to information that Center for Health Transformation [CHT] spokeswoman Susan Meyers provided USA Today, healthcare stakeholders participating in Gingrich’s “think tank” can expect to pay Gingrich between $5,000 and $200,000, “depending on how many employees attend the center’s meetings and use other services.”

Wouldn’t you just love to ask Ms. Meyers if Gingrich’s think tank members are more likely to realize a return on their investment than their software offers dentists?

I suggested to the editor of the Chicago Tribune to specifically ask ADA President-elect Dr. Robert Faiella questions about the cost and safety of EHRs in dentistry. Then I followed the comment with,

 “And, be sure to tell Dr. Faiella that D. Kellus Pruitt DDS referred you to him. Though we’ve never met, he knows who I am. If you get around to it, you might ask him how much HIPAA compliance raises the cost of dentistry. There are thousands of dentists who would find the President-elect’s answer to that question truly enlightening.”

I Do Find this Fun

Psst…! Chicago Tribune Editor; want a hot tip? I know of a local but far-reaching lead concerning the malignant, corporate corruption described by Steve Chapman in his article. A reporter wouldn’t have to travel far to aggravate employees of a secretive, command and control organization. The ADA National Headquarters is just down the street at 211 East Chicago Avenue. In 2004, the widely-overlooked, not-for-profit’s lack of transparency made it especially vulnerable to Gingrich’s deceptive selling points!

ADA Officials

I think everyone agrees that asking ADA officials reasonable questions about the cost and safety of any high-tech dental product they recommend – including electronic dental record systems – is not unreasonable.

In fact, now that Steve Chapman has shown Newt Gingrich’s profit motives for misleading our dental leaders, caution seems prudent.

This could be ornery-fun if, like me, someone on your staff gets a kick out of asking shy good ol’ boys questions they are hardly ready to answer. I wish the Tribune luck getting past anonymous, unaccountable gatekeepers who shield ADA officials from accountability. I suggest sending your questions to Dr. Robert Faiella. He is not only the unresponsive Chair of the ADA Electronic Health Record Workgroup, but he is the ADA’s latest insensitive President-elect.

Dentists should be furious with Newt Gingrich for commandeering the ADA

Psst…! Chicago Tribune Editor! You interested in another hot tip? I know of a local but potentially far-reaching lead concerning the malignant, corporate corruption described by Steve Chapman in his article exposing Newt Gingrich’s poor manners.

Should you choose to do so, you won’t have to travel far to aggravate employees of a stoic, command and control organization. The national headquarters for the American Dental Association is just down the street at 211 East Chicago Avenue. The widely-forgotten, not-for-profit’s traditional lack of transparency made it especially vulnerable to Gingrich’s deception back in 2004.

I think everyone agrees that asking ADA leaders reasonable questions about the cost and safety of any high-tech dental product they recommend – including electronic dental record systems – is not unreasonable.

In fact, now that Steve Chapman has shown us Newt Gingrich’s motives for misleading our dental leaders, caution seems prudent.

This could be ornery-fun if someone on your staff gets a kick out of asking shy good ol’ boys questions they are not yet ready to answer.

Nevertheless, the ADA will refuse to respond to questions, Editor. Even while I was still a member of the professional organization up until a year ago, it clearly aggravated dental leaders when I repeatedly questioned the cost and safety of EDRs on local, state and national levels of the organization.

I always find evasion intriguing. Maybe you will have better luck getting past anonymous, unaccountable gatekeepers who shield the good ol’ boys from transparency.

Assessment 

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Here’s the official to whom I suggest you futileyly address your questions: Dr. Robert Faiella. He is not only the unresponsive Chair of the ADA Electronic Health Record Workgroup, but he is theADA’s latest insensitive President-elect.

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OWS versus Tea Party Movement

Understanding Two Poplar Political Movements

By Staff Reporters

This infographic compares the two most popular political movements in the United States: Occupy Wall Street and the Tea Party Movement.

It debunks several misconceptions surrounding both movements, including the stereotype that OWS protesters are largely lazy, liberal, and jobless -OR- does it?

Assessment

Is this a matter of conservative [republican] medical professionals versus liberal [democratic] laymen – or something else?

More:

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Selecting Practice Management Consultants Wisely

Business Education Needed for Physicians and all Medical Colleagues

By Dr. David Edward Marcinko MBA CMP™

[Publisher-in-Chief]

While the doctors consult, the patient dies

-English Proverb

There are many self-help publications, online resources and management guru’s purporting to impart business information to their physician clients. Within the current managed care climate, economic malaise, and specter of nationalized healthcare following the 2010 health insurance reform legislation, medical business consultants are all the rage.

However, in the same vein, physician bankruptcies are mounting, medical student loan delinquencies are increasing, physician finances are friable and medical and ancillary practices are closing at record numbers. What gives?

Do Doctors Lack Business Knowledge?

Perhaps the answer lies in the lack of real business, accounting, financial and managerial acumen by the average practitioner? This growing concern is prompting more and more doctors to seek the help of a healthcare consultant or financial advisor. But, just what does a practice management consultant do, what credentials are needed to be in the business, and how can a healthcare advisor help you coordinate all aspects of your practice’s life? 

Here are two examples of major practice management fiascos.

Corporate Medicine and Doctor Super-Groups

As the managed and healthcare care crisis exacerbates, and Obama Care [Patient Protection and Affordable Care Act] unfolds over the next eight years, there will be many examples of irrational practice management behavior on the part of physicians, and no specialty is immune.

Just collectively reflect a moment on colleagues willing to securitize their practices a decade ago – and currently with so the so called medical super groups – and cash out to Wall Street for riches that were not rightly deserved. Where are firms such as MedPartners, Phycor, FPA and Coastal Healthcare now? A survey of the Cain Brothers Physician Practice Management Corporation Index of publicly traded PPMCs revealed a market capital loss of more than 99%, since inception; despite their various heath 2.0 re-incarnations. And, how will modern financial regulatory reform, Dodd-Frank, the SEC, insurance company and banking controls resulting from Wall Street’s 2008-09 economic debacles, impact physicians?

A Southern Gentleman and Solo Physician

Or, consider the personal situation of a solo Southern primary care physician who learned an accounting lesson the hard way when he asked his CPA to appraise his business. Upon sale, his attorney brother-in-law drew up the contract, as he was pleased the practice quickly sold for its full asking price. What he didn’t know, but would soon discover, is that accounting value or “book” value — the figure his accountant gave him — is far different than the fair-market value that he could have received for his long years of toil. Was the CPA wrong? Not really. Was the gentleman doctor incorrect? No. Both were merely operating under a different set of practice management terms, and accounting definitions, without communication or knowledge of each other’s perspectives. 

Assessment

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Link: www.BusinessofMedicalPractice.com

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More Evidence of the Association between Hospital Market Concentration and Higher Prices and Profits

NIHCM Expert Voices in Health Care Policy

By James C. Robinson, PhD

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In this essay, Dr. James Robinson presents results from his latest work showing that the prices hospitals charge to private insurers for 6 common procedures are 30 to 50 percent higher when the hospital is located in a market where it faces less competition from other hospitals.

These findings add to the already substantial body of research showing that consolidation in hospital markets confers market power that enables hospitals to secure higher prices.

When seen in the context of current policies encouraging additional provider consolidation through accountable care organizations [ACOs], this work serves as an important reminder that ongoing vigilance of the potential anti-competitive effects of these new delivery systems is needed along with other measures to counteract growing market power of providers.

About the Author:

James C. Robinson, PhD is the Leonard D. Schaeffer Professor of Health Economics and Director, Berkeley Centerfor Health Technology, University of California, at Berkeley.

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A Guide to Travel Nursing Jobs

A Nationwide Database Review

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This “Guide to Travel Nursing Jobs” presents data obtained from a nationwide information database of travel nurses including motivational factors in choosing a travel nurse career, age demographics, benefits information, and social media usage.

In addition, the guide highlights the salary info for travel RNs as well as a timeline of the travel nursing process.

Source: onwardhealthcare.com

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.

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Inbound Healthcare Marketing vs. Outbound Marketing

A New Paradigm for Physician Executives

By Staff Reporters

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Thanks to the Internet, medical marketing has evolved over the years. Consumers and patients no longer rely solely on billboards and TV spots — a.k.a. first-generation outbound marketing — to learn about physicians, new products or medical services, because the web has empowered them. This is especially true for payment services like HD-HCPs, direct care business models, private pay and concierge medicine, etc.

In fact, the internet gives patients next-generation alternative methods for finding, buying and researching brands, products and yes – even doctors and providers. The new marketing communication — inbound marketing and health 2.0 — has become a two-way dialogue, much of which is facilitated by social media.

Assessment

Source: voltierdigital.com via mashable.com

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Where Does our National Debt Originate?

Letting the White House … Tell Us!

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By Staff Reporters

One of the fundamental things to understand about reducing our national debt is how we accumulated so much in the first place.

Assessment

To explain the impact various policies have had over the past decade, shifting us from projected surpluses to actual deficits and, as a result, running up the national debt, the White House has developed a graphic for us.

Source: Whitehouse.gov

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Pfizer’s Latest Twist on ‘Pay for Delay’

Protecting Brand-Named Drugs

By Marian Wang
ProPublica, November, 14th, 2011, 2:41 pm

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Pharmaceutical companies have sought for years to protect their expensive brand-name drugs by paying generic rivals [1] handsome sums of money to put off efforts to introduce cheaper, generic alternatives that could steal market share.

Pay for Delay

The controversial practice, known as “pay for delay,” occurs as part of patent litigation settlements and typically buys a brand-name drug company more time to sell its blockbuster drug exclusively until its patent on the drug expires. Federal Trade Commission regulators have said the practice costs consumers an estimated $3.5 billion each year [2], and have pushed for a ban.

But now it appears the drug company Pfizer is adding yet another twist to its efforts to delay generic competitors. As The New York Times reports, the company seems to have struck a deal with certain pharmacy benefit managers — the middlemen in the pharmaceutical industry — to block generic versions [3] of Lipitor.

The Block Buster

Lipitor, Pfizer’s blockbuster cholesterol-lowering drug, is among the world’s best-selling pharmaceuticals, and this isn’t Pfizer’s first attempt to protect it.

In 2008, the company settled patent litigation [4] with Ranbaxy, an Indian generic manufacturer, striking a deal that guaranteed that Pfizer would not have to face challenges [5] from Ranbaxy’s generic version of Lipitor until the end of November 2011. Pfizer granted Ranbaxy some incentives [6] as part of the bargain but said it made no payments. Nonetheless, a group of pharmacies filed suit [7] against Pfizer and Ranbaxy last week over the deal, calling it “an extraordinary ripoff” and alleging price-fixing between the two companies.

Big Discounts

Now that it’s November 2011, Ranbaxy and other drugmakers are gearing up to offer cheaper versions of Lipitor. As The Times reports [3], Pfizer has tried to counter this competition by offering big discounts on Lipitor to the middlemen that process prescriptions [8] for pharmacies and other buyers, giving them discounts in exchange for having them block generic versions of Lipitor for another six months. Here’s The Times:

Many drugstores are being asked to block prescriptions for a generic version of Pfizer’s Lipitor starting Dec. 1, when the company loses its patent for the blockbuster cholesterol drug and generic competition begins.

Medco Health Solutions, among the nation’s largest pharmacy benefit managers, is one of the companies issuing instructions, seeking to have pharmacists keep filling prescriptions with the more expensive Lipitor for six months.

See some of those instructions [9] sent to pharmacies by the pharma middlemen. The documents were released by Pharmacists United for Truth and Transparency, a group of independent pharmacists. (We first noticed them posted at the blog Pharmalot [10].)

According to the group, Pfizer’s plan would mean that customers at the pharmacies serviced by these middlemen would receive Lipitor even when they’ve been prescribed a generic version. Because Lipitor co-pays would also be reduced to the level of generic co-pays, customers might not notice, but employers and Medicare Part D would pay the same amount as before, despite the availability of a cheaper alternative.

Assessment

A Pfizer spokesman gave The Times a statement saying that the company was committed to ensuring that customers had access to Lipitor but declined to answer additional questions. We’ve also asked Pfizer for comment and will update when we hear back.

Conclusion

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Financial Independence Guidelines for Medical Professionals

A Common Sense Approach

By Rick Kahler; MS ChFC CCIM CFP®

Someday, the time will come to retire from medical practice and actively earning a living.

But, for many newbie physicians, it’s way out there in the future, something to plan for – “someday.” You’re often too busy with your lives, families and professional careers to pay much attention to it.

Late Starters

In some cases, that in-attention lasts until the 50’s or even 60’s. All of a sudden it hits you that “someday” is getting closer faster, and you aren’t ready. You don’t have anywhere near enough in savings and investments to provide a sufficient income when no longer practicing medicine, dentistry, podiatry, osteopathy, or optometry etc. Or, working as a nurse, medical technician, hospital or clinic administrator; or office manager, etc.

General Guidelines

If you’re in this situation, it’s time to get serious about planning for financial independence. But, don’t panic. Before you start pricing cat food at the grocery store, and hinting to your kids about moving in with them, try these strategies first:

1. Cut back now so you can be more comfortable later. Make saving and investing to become financially independent your primary goal. This means no new cars, no new toys, no expensive vacations, and no funding college educations for kids or grandkids. Take an inventory of your spending, then go over it together with your spouse to find all the places you can cut expenses. Create a spending plan focused on freeing up funds to invest for your future.

2. Consider downsizing now instead of later, but only if you can live more cheaply by doing so. If you can sell your house for, say, $550,000, buying something smaller for maybe $250,000, and investing the difference might be a smart move. This works best if you have substantial equity in your house, meaning it is paid for or your mortgage is small.

3. Get rid of debt. Stop using credit cards unless you pay the bill in full every month. Pay off credit card balances and any other personal debt.

4. If you and your spouse are both working, pretend one of you loses your job and you have to live on one income; then put the second income toward saving and investing to become financially independent. A spouse who isn’t employed might consider getting a job solely for saving and investing.

5. Accept the reality that you’re probably going to need to postpone retiring from practice. If you enjoy your work, you might be happy to stay employed for a few more years. If you don’t, look into possibilities for changing careers now. This blog will help. Or, you might make plans for a second non-clinical career after you retire from your current one.

6. Take an inventory of your assets. Include your savings accounts, investments, and retirement plans. Don’t forget to include your Social Security income (yes, it will be there if you are over 55) and assets like a paid-for house or valuable personal property. Add in hobbies, skills, or interests that might bring in some part-time income. Also, include intangible assets like health, family, and friends. These may not affect your finances directly, but they have a great deal to do with your well-being.

7. Remember to enjoy the present. You may be cutting back on your spending, but don’t discourage yourself by cutting back so much that life – in the here and now – is bleak. Find creative and inexpensive ways to stay involved in activities that are important to you and enjoy time with friends and family.

Assessment

Don’t waste time and energy beating yourself up because you didn’t start saving earlier. Instead, give yourself credit for what you are doing now. Remember, you aren’t depriving or punishing yourself. You’re investing in yourself in order to build a more comfortable future.

The Author

Rick Kahler, Certified Financial Planner®, MS, ChFC, CCIM, is the founder and president of Kahler Financial Group in Rapid City, South Dakota. In 2009 his firm was named by Wealth Manager as the largest financial planning firm in a seven-state area. A pioneer in the evolution of integrating financial psychology with traditional financial planning profession, Rick is a co-founder of the five-day intensive Healing Money Issues Workshop offered by Onsite Workshops of Nashville, Tennessee. He is one of only a handful of planners nationwide who partner with professional coaches and financial therapists to deliver financial coaching and therapy to his clients. Learn more at KahlerFinancial.com

Conclusion                

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Healthcare Organizations: www.HealthcareFinancials.com

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On the Leadership Shake-Up at the “Clinician’s Report” Foundation

Paul Child is now the Former CEO of the CR Foundation

[An Exclusive ME-P “Breaking” News Event]

By D. Kellus Pruitt DDS

If you work hard on a righteous pursuit long enough, in spite of what shy people might think of your motives, sometimes you win one for the community.

I wish Dr. Paul Child, former CEO of the Clinician’s Report [CR] Foundation, the best of luck in his new pursuits.

The Exiting CEO [Dr. Paul Child]

In my latest comment on CR Foundation Facebook, I demanded to speak with an anonymous employee’s supervisor because of her unexplained censorship of my three comments – including important questions about EDRs and HIPAA. A few hours ago, that comment was also censored without warning or explanation.

However, in its place I found an announcement that Dr. Child is no longer CEO, and that co-founder Dr. Gordon Christensen himself is taking over the position.

https://www.facebook.com/pages/CR-Foundation/160588080492

The CR Foundation Announcement

“Dr. Paul L. Child Jr., the CEO of Clinicians Report for the last 3-1/2 years, will be leaving CR at the end of 2011 to pursue other interests as he continues his contributions to the dental profession. We wish Paul the best in his new endeavors and are pleased that he will continue to serve CR Foundation as a member of the CR Board of Directors.”

The New CEO [Dr. Gordon J. Christensen]

“Dr. Gordon J. Christensen, the Co-Founder of CR, has been appointed to the position of CEO. He will lead the experienced team of over 400 clinicians in 19 countries and 40 son-site scientists, engineers, and support staff. Additionally, Gordon continues to practice, speak internationally, and provide leadership for needed research in CR.”

Link: http://www.cliniciansreport.org/

That looks to me like a heartfelt apology. I accept.

If any dental leader can be honest with dentists about important, time-sensitive issues nobody else will address it’s Dr. Christensen. He’s a good man with high ideals that don’t include hiding the truth about dental products from dentists in order to shield stakeholders from accountability. 

Assessment 

Now that you’ve witnessed in real time how even one dentist’s voice can improve our community on a national level, why in the hell aren’t you speaking up, Doc?

If your assertiveness is inhibited by traditional notions of “professional conduct,” let me remind you that in Alaska, high school grads are legally extracting large portions of teeth for US citizens who can-least afford complications.

Good luck with silence in a networked marketplace.

Conclusion                

And so, your thoughts and comments on this ME-P are appreciated. Is this new development related to the ME-P titled: In Defense of the eDR Industry?

Link:  https://medicalexecutivepost.com/2011/11/03/in-defense-of-the-edr-industry/

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Drs. Beware the Rise of Home Owner Associations?

Important Information for Medical Professionals

By Staff Reporters

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With 62 million Americans governed by HOA’s and $35 billion dollars in operating revenues and growing, HOATown.com thought is was time to bring clarity to the homeowner association with this one-of-a-kind infographic.

Assessment

In Atlanta, for example, the affluent developments are Country Club of the South, and the St. Marlo gated communities. Both are governed by HOAs and house doctors and medical professionals of all types.

Source: hoatown.com

Conclusion     

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Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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How Do Health Plans Measure Patient Satisfaction?

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With … Data of Course

[By Dr. Brent A. Metfessel MS]

Patient satisfaction is a subjective measure of what the patient perceives in terms of the level of service quality and care provided by the clinician. Many health plans consider patient satisfaction an important measure of physician quality.

Now, although not a direct measure of clinical quality, many researchers link patient satisfaction to clinical outcomes. This data, however, is also resource-intensive to collect and requires commitment on the part of the patient to fill out the forms and return them in the mail or on-line.

Selection Bias

However, selection bias may occur in terms of patient satisfaction data, in that patients who choose to fill out and return the forms may in some cases not be representative of the overall patient population for a physician.

Enter the CAHPS® Consortium

More recently, the field has been moving from measuring “satisfaction” to elucidating a more validated and specific “patient experience of care”.  The Consumer Assessment of Healthcare Providers and Systems (CAHPS®), funded and administered by the Agency for Healthcare Quality (AHRQ), is a part of a national initiative to measure, report on, and improve health care quality from the viewpoint of patients and other consumers. Separate surveys are used for evaluating ambulatory care and facility or hospital care.

In addition, the National CAHPS Benchmarking Database contains over 10 years of CAHPS survey data from commercial and Medicaid plans and is designed to facilitate comparative analysis of individual CAHPS survey results with benchmarks, including national or regional averages. The CAHPS program works closely with other public and private research agencies, known collectively as the CAHPS Consortium, for continued review and enhancement of the survey tools.

Pre-Order Book Now [more from this author]

We are now preparing the next edition of our book:
“Hospitals and Healthcare Organizations”  [Operational Management Strategies, Tools, Techniques and Case Studies].

In-Process from: (c) Productivity Press 2012
http://www.crcpress.com/product/isbn/9781439879900 

About the Author

Brent A. Metfessel, MD MS is currently Senior Medical Informaticist in Clinical Analytics at UnitedHealthcare, where he designs physician measurement algorithms and statistical methods and leads the application of risk adjustment methodologies to various health care quality and cost-efficiency measurement initiatives. He also has a decade of experience in general computer science, statistical analysis, artificial intelligence, and computational biology. Dr. Metfessel received his Masters of Science Degree in health informatics from the Universityof Minnesota and his Medical Doctorate from the Universityof California, San Diego. 

Conclusion

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Financial Services Career Evaluation [An Opinion and Voting Poll]

Would You Continue to Work if Financially Independent?

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By staff reporters

Studs Turkel, in his outstanding book Working, made the comment that work is the mechanism by which many of us get our daily bread and our daily purpose.

If this is to be the case, then the modern financial services sector may need a lift to offer something more than a paycheck. This may especially be true when one considers the recent shenanigans on Wall Street, the slow decline of the broker-dealer business and product model – and considering that RIA, fiduciary and/or niche marketing models are slowly rising http://www.CertifiedMedicalPlanner.org

A General Survey

The Wilson Learning Corporation surveyed 1,500 laypeople, asking “If you had enough money to live comfortably for the rest of your life, would you continue to work?

Seventy percent said that they would continue to work, but 60 percent of those said they would change jobs and seek “more satisfying” work.

But more specifically, regardless of whether you are called a Financial Advisor, Stock-Broker, Wealth Manager or Financial Planner – how about you?

Assessment

If financially independent, would you continue to be a financial consultant [regardless of nomenclature]?

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.

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Do You Have a Healthcare Related Patent or Business Idea?

Crowd-Source Your Concept for Grassroots Industry Feedback

By Staff Reporters

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The Medical Executive-Post is proud that our readership is at the very cutting edge of modern innovation. And, we know that many of you have great ideas but don’t always have the time or resources to move them toward realization.

Our Community Advantage

Through our online community for healthcare and financial professionals, you are now able to engage relevant market populations directly and progress your business ideas forward.

And, we have already worked with a select nucleus of organizations to drive conversations around several innovative healthcare related business ideas.

Assessment

Concept, start-up or ready to launch; let us help you find the insights you need … and feedback  you’re desperately looking for. 

Who knows, the next Steve Jobs of healthcare may be out-there!

Conclusion                

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Healthcare Organizations: www.HealthcareFinancials.com

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Understanding the Debt Settlement Process for Doctors

Not just for Laymen

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The Debt Consolidation Care Community [DCCC] has developed a financial infographic on the debt settlement process.

For the DIYers

This interactive infographic helps understand what happens in a DIY debt settlement when the debtor successfully negotiates a reduced payoff amount with a creditor.

Reviewing the graphical representation will also help know how a debt settlement company can help a debtor when he/she cannot settle debts on his/her own. The settlement company can negotiate with creditors to reduce the payoff amount and decide upon a single monthly payment that has to be paid to the settlement company every month. When enough accumulates, the settlement company pays the creditor the payoff amount as per agreement, and the debt thus gets settled.

Assessment

Debtors often ask questions in DCCC forums regarding what actually happens in debt settlement.

So, the primary reason behind this finance infographic is to clear misconceptions regarding the debt settlement process. This graphical representation can make it easily understandable for the many debtors who are looking for suitable solutions to solve their debt problems; not just medical professionals.

Source: www.debtconsolidationcare.com

Conclusion                

And so, your thoughts and comments on this ME-P are appreciated. Is this simplified essay applicable to medical professionals who may have complex business holdings? 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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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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How the Economy is Hurting Americans

Doctors and Medical Professionals, Included

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The stock market was down 389 points yesterday! With the current state of the economy, depressed housing and jobs market, Americans are cutting back on basic necessities; clothing, healthy nutrition habits and food. Even doctor visits and medical practices are declining; and stress and anxiety are on the rise for all.

See how the economy is really affecting our quality of life with this somber look at our mental, physical and financial health in this infographic.

 

Assessment

Source: www.creditloan.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, 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

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Content Life Cycle and Branding Management for Physicians

Freshness Also Required

By Dr. David Edward Marcinko MBA CMP™

By Eugene Schmuckler PhD, MBA

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Self-Branding in the Modern Era

In 1987 the magazine Fast Company published an article authored by Tom Peters entitled “The Brand Called You.” Although some individuals may shy away from the concept of self-branding in actuality, many of the online social network sites such as Facebook become media by which we in fact brand ourselves.

Peter’s Speaks

In his article, Peter’s stated. “Regardless of position, regardless of the business we happen to be in, all of us need to understand the importance of branding. We are CEOs of their own companies, Me Inc.”

To be in business today, our most important job is to be head marketer for the brand called you. As a medical practitioner how do you differentiate yourself from others in your specialty and why should a new patient choose your practice above those of the others in the field? Branding is about finding your big idea and building your identity and game plan around it. The bottom line: if you can’t explain who you are, and the value you bring to your practice in a short sentence or two, you have work to do.

According to Catherine Kaputa, a personal coach she suggests that there are the objective things: your credentials, the schools you went to, your years of experience, and your skill set, which represent what she refers to as hard power. Then there’s soft power: your image and reputation, your visibility in the community, your network of contacts, supporters and mentors. In today’s competitive marketplace, soft power plays a vital role in attracting people to you and your practice.

Standing Out

Peters suggests that everyone has a chance to stand out. Everyone has a chance to learn, improve, and build up their skills. Everyone has a chance to be a brand worthy of remark. Corporations spend millions of dollars creating and maintaining their distinct brand. The Olympic Rings are representative of a brand which the International Olympic Committee guards zealously. Professional services firms such as McKinsey, foster self-branding among their employees. Major corporations have as employees those individuals who are smart, motivated and talented. Self-branding allows the employees to differentiate themselves from their peers.

For one to engage in self-branding is first necessary to ask the question, “What is it that my practice does that makes it different?” You can begin by identifying the qualities or characteristics that make you distinctive from your competitors-or your colleagues. What have you done lately-this week-to make yourself stand out? What would your healthcare colleagues say is your greatest and clearest strength? What would they say is your most noteworthy personal trait? As a medical practitioner does your customer get dependable, reliable service that meets his or her strategic needs?

In addition, ask yourself: “what do I do that adds remarkable, measurable, distinguished distinctive value.” How do you manage your name brand, and content?

Assessment

Content for online brand visibility needs to be well written, fluid, dynamic, and shared. Source: www.digitalc4.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, subscribe to the ME-P. It is fast, free and secure.

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Caffeine, Health and Health Insurance Premiums

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Physically Harmful, Risk Premium Rated — or Not?

[By Dr. David Edward Marcinko MBA CMP™]

[Editor-in-Chief]

Q: As both a doctor and health insurance agent, back in the day, many patients asked me about the health effects of caffeine consumption; especially malpractice attorneys during my expert witness depositions.

Other clients often wondered about how consumption affected their health insurance premium quotes.

A-1: Here are some reported effects of caffeine. The following effects are commonly attributed to over-use of caffeine. While reading them, bear in mind that what is true for one person may not be true for someone else:

1. Stimulates your heart, respiratory system, and central nervous system

2. Makes your blood more `sludgy’ by raising the level of fatty acids in the blood

3. Causes messages to be passed along your nervous system more quickly

4. Stimulates blood circulation

5. Raises blood pressure

6. Causes your stomach to produce more acid

7. Irritates the stomach lining

8. Makes digestion less effective by relaxing the muscles of your intestinal system

9. Its diuretic effect caused increased urination – although you’d have to drink about 8 coups of coffee in one sitting for this to occur

And so, here is an additional sampling of information about the health effects of caffeine.

A-2: And, caffeine has no affects on health insurance premium rates; smoking does!

Assessment

Source: www.freeinsurancequotes.net

Conclusion

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Understanding the Modern Challenges of Student Doctors

An Evolving Educational Model

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By Cyndi Laurenti

laurenticy@gmail.com

Medical education could be driving potential doctors away and damaging those who do go on to practice with long hours, high debt, inconsistent training, and lack of emotional support. Research indicates the current structure of residency programs produces resident physicians who are stressed, sleep-deprived, and prone to medical errors.

Medical Residents

Medical school graduates who’ve begun their on-the-job training are called residents varying in length from three to seven years, depending on the specializations doctors pursue. Most programs utilize experienced physicians called preceptors to teach the new doctors how to practice their particular branches of medicine. Another common practice is to pair second- or third-year residents with one or more first-year residents, so the senior students take on some of the teaching and supervision roles.

Duties

Residents admit patients to the hospital, obtain medical histories, perform examinations, and administer treatments or do procedures under the guidance of the senior resident or preceptor.

The hours in a residency program are long. Despite recommendations from the Institutes of Medicine intended to decrease long shifts and work hours, 80-hour weeks are common in residency programs and 30-hour shifts with five-hour sleep periods are the norm. Moreover, those 80-hour work weeks represent the average over a four-week period, so a resident might actually work considerably longer in a single week.

Work Shifts

Rotating shifts, in which residents work at different times of the day or night, are also common. Sleep deprivation is the norm: a 2004 survey of over 3,000 residents reported 66 percent slept less than six hours a night, and 20 percent slept less than five. Of even more concern, those who slept less than five hours a night reported they had used alcohol, resorted to stimulants to stay awake, had serious accidents or injuries, had conflicts with other professional staff, or made serious medical errors.

Financial Stress

Many residents also face financial or family stressors as well. Debt is common in medical school: the New England Journal of Medicine reports one fourth of graduating residents have debt exceeding $200,000. Some residents use their limited free time to moonlight for additional income as the average medical resident salary is about $45,000 per year.

Age

Medical residents are often in their late twenties or early thirties, a time when many people look to starting families. The lack of income may drive them to work extra hours in an already crowded schedule, which prevents them from spending time with children or a spouse, if indeed they manage to have either. Research from as far back as 1986 indicated over 40 percent of medical residents experience problems with their spouses during residency. Respondents often feel the working conditions of residency contribute to family problems, which in turn affect their hospital work as a result. On a positive note, researchers have found stress can be moderated by family relationships and social contact, and recommended social support systems be fostered in residency programs.

Stress

Emotional stress related to patient care is another aspect of the issues with residency. Over 70 percent of residents in one study reported hospital activities such as cardiopulmonary resuscitation were extremely stressful and the lack of a debriefing session afterward increased the impact of that stress, particularly when the resident felt the resuscitation was inappropriate.

Recipe for Disaster?

The combination of stress and sleep deprivation is a recipe for disaster. A study at HarvardUniversityfound residents who worked extended shifts or long hours were involved in 300 percent more fatal errors than when they did not work excessive hours. These same physicians reported they were likely to fall asleep during surgery, patient examinations, hospital rounds or lectures, and that their medical errors induced guilt, anger, humiliation, and decreased compassion for the patients they treated.

To add to these stresses, as recently as October 2011 almost half of graduate physicians in one survey reported they had been harassed, intimidated or discriminated against while residents. These behaviors took the form of verbal abuse and being assigned extra work as punishment. The sources of inappropriate behavior were primarily specialty physicians, but specialty residents, hospital nurses, and patients also participated in the harassment.

The Changing Paradigm

Some residency programs have made changes to improve the quality of life for residents. These include strategies such as decreasing patient load, senior residents supervising a single resident instead of two or more, and decreasing hand-offs, the transfer of patients from one group of residents to another. Other recommendations include debriefing sessions for stressful situations such as cardiopulmonary resuscitation, ethics committees to which residents can take complicated problems, and increased emotional support.

I.O.M

Other possible strategies include a decreased shift length, or simply adherence to the Institutes of Medicine’s guidelines for residency training programs. Social networks for residents’ spouses and families would provide a forum to air concerns and obtain emotional support from those in similar circumstances.

Additional efforts to relieve medical student debt would also make a considerable positive impact. A program currently exists in theUnited Statesfor physicians to obtain loan forgiveness: the National Health Service Corps pays off medical student debt if the physician practices full-time at a NHSC-approved site, usually a federally-qualified health center, rural or Indian Health service clinics, or prison. If a physician serves full-time for six or more years, the entire debt may be repaid by the NHSC.

Assessment

Most residency programs in other parts of the world are similar to those in theUnited States, although there may be different laws that affect work hours or salaries. There is clear evidence that overstressed and sleep-deprived residents are more likely to make serious or even fatal medical errors and lose their sense of compassion for patients. The current residency system is expensive, emotionally stressful, and puts the lives of patients at risk. America (and likely other nations as well) would benefit from making even more changes in residency programs to provide adequate time for sleep, family or social interaction, and emotional support for fledgling doctors.

About the Author

While she figures out her next career move, Cyndi Laurenti works as an online writer and editor. Her primary interests are education, technology, and how to combine them. She enjoys the trees and beaches of thePacific Northwest, and looking things up on other people’s iPhones.

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

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Some Inexpensive – but worthwhile – Retirement Planning Tools for Medical Professionals

About Henry K. “Bud” Hebeler: http://www.analyzenow.com/author.html

By Staff Reporters

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Analyze Now

According to their website, the mission of Analyze Now is to disseminate inexpensive retirement planning tools to educate the user about the realities of retirement planning.

No Securities Sales 

Analyze Now does not sell or promote any securities. It produces and distributes planning papers, booklets, books and software. 

In fact, you will find numerous Helpful Articles about various aspects of retirement planning and crucial retirement decisions.  Or, you can review answers to questions people Ask Bud About most often.

Free Programs, too!

Be sure to try the Free Retirement Programs if you have an Excel spreadsheet on your computer. These are not dumbed-down programs designed to sell products. They address key current issues, particularly those on social security and the decision whether to take a lump-sum or a pension or buy an annuity.

If you don’t want to download the free programs, you can get them all on one CD [Link to Order Information].

Assessment

If you are a doctor, or layman, who is thinking about how much you should save for retirement, or if you are already retired, this site can help you determine how much to spend this year, or next, etc? 

Download the Comprehensive Retirement Planning program, too. It does not have the many misleading elements of overly simplified financial advisors and financial planners that you often find on many web sites.  These provide other important retirement decisions that people must make, not ignore, as well. 

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Give em’ a click, and try, to tell us what you think. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites. 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

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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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How Financial Advisors Can Earn Exposure on the ME-P

Using Our Free -or- Fee Based Methods

Ann Miller RN MHA

[Executive-Director]

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Dear Financial or Investment Advisor, Consultant or Financial Planner

Are you looking for added marketing exposure for yourself, your website, or your financial advisory business or financial planning firm? Do you have some area of expertise in the financial planning niche for doctors and medical professionals?

If so – the Medical Executive Post is here to help make your brand, website presence and your original articles and comments available to the more than 175,000 visitors that read us every month.

How for Free?

The first step is to join us:

  1. Then submit an original essay, or comment on an existing ME-P [no store bought or ghost written material]. Include an author bio with photo.
  2. Get feedback and back-links to your email address or website with the added marketing exposure to our community.
  3. Serve your clients well.

How for Fee?

The first step is to join us.

  1. Submit videos, with audio, to give yourself or firm, additional time and exposure for a small fee.
  2. Help us create an Expert Page – a dedicated page on our website that provides additional information exclusively on you, your services and products. Use this page to network and communicate with doctors, nurses and other medical professionals in need of your services, products or advice.
  3. Serve your clients well.

Assessment

We look forward to helping you gain exposure to ME-P readers and subscribers – a win-win proposition for all concerned.

Thank you.

ME-P Editorial Department

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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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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Accountable Care Organizations are Here

The Final Federal Guidelines

By Garfunkel Wild PC

http://www.garfunkelwild.com

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The much anticipated final federal regulations on accountable care organizations (ACOs) were published on October 20th, 2011. The Affordable Care Act created ACOs to deliver seamless, high quality care to traditional fee-for-service Medicare beneficiaries while reducing the cost of care to those beneficiaries. If successful, ACOs will receive a portion of the shared savings they achieve for the Medicare program.

ACO Workgroup 

The Garfunkel Wild ACO Workgroup is in the process of analyzing these final regulations, and we will be hosting a webinar in the near future to discuss ACO participation and other ways providers can move towards collaborative care.

Final Regulations

In reviewing the final regulations, it is clear CMS took public comments to their proposed regulations seriously and made significant changes that should strengthen the ACO program. Some of these changes include:

  • Allowing ACOs to participate in an upside shared savings track (without being subject to downside losses) for the first three years of participation
  • Expanding the definition of participants eligible to form ACOs to include federally qualified health centers (“FQHCs”)
  • Reducing by about half the number of quality measures ACOs have to report
  • Permitting ACOs to share in first dollar saved once a minimum savings rate is achieved
  • Creating more flexibility for start dates for ACOs beginning in 2012
  • Removing EHR readiness as a condition of participation
  • Revising the process of assigning beneficiaries to ACOs from a pure retrospective process to a prospective process that includes retroactive adjustments

Assessment

Also published with the CMS final regulations were interim final regulations published by the Office of Inspector General addressing the waiver of the application of federal fraud and abuse laws; a final policy statement issued by the Federal Trade Commission and Department of Justice outlining the agencies’ antitrust enforcement policies for ACOs, and an IRS Fact Sheet regarding tax exempt organizations participating in the Medicare Shared Savings program.

Conclusion                

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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 Social Security Owner’s Manual [Book Review]

A New Book by Jim Blankenship

By Staff Reporters

Who he is

Jim Blankenship is a Certified Financial Planner [CFP®], Enrolled Agent [EA] and the owner of Blankenship Financial Planning in Illinois.

Link: http://www.bfponline.com/

What he’s done

We’ve been following his blog Getting Your Financial Ducks In A Row for some time now. We also have referred to his online publication The IRA Owner’s Manual from time to time, with questions about inherited IRAs, etc. Jim knows his stuff.

Our Omission

Now, we admit that we’ve not paid much attention to Social Security because we are all still far from being eligible for it, and at the ME-P, we assume it won’t be here for us.

The Book

Nevertheless, when Jim published a new book A Social Security Owner’s Manual, we took the opportunity to learn more about Social Security.

And, we think, so should all medical professionals and their financial advisors.

Assessment

Jim provides expert guidance for retirement, education funding, and income tax issues, too. In addition to this all this, you’ll find Jim’s writings all around the internet, as he is a regular contributor to Forbes.com, TheStreet.com, and FiGuide. Several other sites also republish his work.

Conclusion                

Your thoughts and comments on social security and 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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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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Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

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Sexual Harassment in the [Healthcare] Workplace

And … How to Prevent It

By Staff Reporter Ashley

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We’ve written about medical workplace violence and sexual harassment before on the ME-P and in our handbooks and texts. It is an increasingly important issue around the blog-o-sphere and in the real world.

Link: https://medicalexecutivepost.com/2008/08/02/risk-management%e2%80%94it%e2%80%99s-not-all-about-medical-malpractice/

This harassment in the workplace Infographic explains through images what sexual harassment is and how to prevent sexual harassment from happening at your small business or [medical practice, clinic or healthcare entity].

The authors’ research shows that your business [practice] is more at risk than you think and that you need to act now in proactively protecting that business.

Romance Sex Harassment

Assessment

Source: boltinsurance.com

Conclusion

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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

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The ME-P Consulting Proposition

[WHY CHOOSE US?]

The MEDICAL EXECUTIVE-POST provides a team of experienced senior level executive physicians, accountants, lawyers, economists, and management consultants led by CEO Dr. David Edward Marcinko MBA, CMP™ to provide ongoing contact with our clients throughout all phases of each project, with most of the communications between us and the key client participants flowing through this senior ME-P Team. The ME-P and its’ skilled staff of certified professionals have many years of significant experience, enjoy a national reputation in the healthcare consulting field, and are supported by an unsurpassed research to maintain a thorough and extensive knowledge of the healthcare environment. The ME-P team approach emphasizes providing superior service in a timely, cost-effective manner to our clients by working together to focus on identifying and presenting solutions for our clients’ unique, individual needs.

The ME-P project team’s exclusive focus on the healthcare industry provides a unique advantage for our clients. Over the years, our industry specialization has allowed us to maintain instantaneous access to a comprehensive collection of healthcare industry-focused data comprised of both historically-significant resources as well as the most recent information available. Our specific, in-depth knowledge and understanding of the “value drivers” in various healthcare markets, in addition to the transaction marketplace for healthcare entities, will provide you with a level of confidence unsurpassed in the consulting field.

The ME-P’s information resources and network of healthcare industry sources (related to the financial, legal, economic, demographic and administrative areas of healthcare) enhanced by our [in-house produced] professional library and research staff, ensure that the ME-P project team will maintain the highest level of knowledge regarding the current and future trends of the specific specialty market related to the project, as well as the healthcare industry overall, which serves as the “foundation” for each of our client engagements.

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Ann Miller RN, MHA
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Eight [8] Myths about College Financial Aid

Despite the Credit Bubble

By Staff Reporter Ashley

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As most all MDs and Financial Advisors are aware, financial aid is one of the determining factors in where students attend college. It could either make or break their dreams. And, we are aware of some students who’ve been blessed with a sufficient amount of financial aid to attend a college they never imagined themselves going to, rich or poor, affluent parents or not.

The College Credit Bubble

And, believe it or not, those who are financially capable to pay for college – like the offspring of some medical professional and FA parents – are often still eligible for financial help. But beware – if this sounds too good to be true?

We’ve written about this topic before at the ME-P, and in our handbooks and print texts, as a cautionary tale.

Link: https://medicalexecutivepost.com/2011/10/18/examining-the-college-credit-bubble

The Myths

Nevertheless, here are the 8 other myths about college financial aid:

Source: onlinegraduateprograms.com

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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DICTIONARIES: http://www.springerpub.com/Search/marcinko
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PRACTICES: www.BusinessofMedicalPractice.com
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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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Things to Consider when Buying a Home

Not Just for Medical Professionals!

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Today’s mortgage industry continues to evolve despite the constant market turmoil.

But, with President Barack H. Obama’s recent debt ceiling agreement, mortgage rates have significantly declined and the conditions for buying a home have become extremely favorable.

So, is now the right [best] time to buy a home?

Assessment

Source: www.askshah.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, subscribe to the ME-P. It is fast, free and secure.

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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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In Defense of the eDR Industry

One Dentist Consultant’s Opinion

By Paul L. Child Jr, DMD, CDT
CR Foundation
3707 North Canyon Road, Building 7
Provo, UT 84604

Three days ago, I shared the email I sent to Dr. Paul Child and Kathleen Noll concerning their claims that electronic dental records offer dentists a return on investment (ROI). Dr. Child responded yesterday.

Darrell K. Pruitt DDS

———————————————

Dear Dr. Pruitt,

Thank you for your recent communication and questions regarding my recent article in Dental Economics, specifically your question: Does the ROI for Practice Management systems include the cost of HIPPA compliancy?

In regards to your communications with QSI, I cannot comment as I do not represent them. Unfortunately, I too am not able to give you the “proof” you are seeking, as I do not have a specific chart nor do I plan on fabricating one to “prove” the efficacy of computers in the dental office (although a controlled study would be interesting, I’m not sure it would be an effective use of funds to prove something that is already proven in every other industry).

However, I will provide you with information from thousands of our readers at CR as well as many more in our lectures worldwide.

The section of the article to which you are referring is under the title of: Practice and patient records management and patient education. Specifically, the paragraph states:

“Implementation of computers into each operatory and throughout the practice is the first and most frequent adoption of digital dentistry. In North America and most developed countries, this has reached the “early majority” stage as all of the criteria for being an advantage have been met. Dentists who have not yet adopted this prerequisite for digital dentistry should do so now! Daily advances and improved software adapted from other industries allow this technology to be affordable, attain the fastest adop¬tion rate, and offer a high return on investment. Current and highly effective systems include Eaglesoft (Patterson), Dentrix (Schein), PracticeWorks (Carestream Dental), and Web-based software such as Curve Dental” (underlines added for emphasis).

Please note that the sentence in which “high return on investment” is mentioned is referring to “advances and improved software adapted from other industries”. As such, other industries (too many to count) have proved without a doubt, the massive improvement in return on investment in the following areas: improved efficiency (eg. Legible records vs. scribbles, or worse off, incomplete records), improved accuracy of records, use of computers for rapid recollection of stored data, rapid recording of data, time savings, standardization, and many more. A brief look at the medical industry and literature (our closest industry – of which we are a part of) can demonstrate the above. In addition, the observations I made are directed to the use of computers in a practice.

Finally, proper implementation of practice and patient management systems can easily improve ROI, via better record taking, accurate financial statements that can be easily generated daily for better practice management, treatment planning with all options, benefits, and risks recorded – then printed for the patient, and most of all – time savings. What is a dentists time worth? My time is priceless (as is most dentists I know). Yes, there are clearly unknown aspects of this digital transformation from paper to digital. Government and controlling organizations may make new rules and regulations that can positively or negatively affect this process.

But, from our observations of thousands of other dentists that have made this transition, very few – if any, would even think about reverting back to paper.

To your question regarding HIPPA compliance, YES, the overall ROI would include even this. HIPPA compliance is still relatively new to many dentists, even though it has existed for years. This compliance in important for all the reasons you already know. As dentistry evolves and new technologies are introduced (and ruling bodies continue to make new rules and regulations), this digital evolution will continue to prove itself an EXCELLENT ROI for today’s and tomorrow’s dentists.

Best regards,

Paul L. Child Jr., DMD, CDT

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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A Look at Level Life Insurance Commissions!

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Will It Ever Happen?

[By David K. Luke; MIM]

Investment Advisor

www.NetWorthAdvice.com

The current structure of the life insurance industry regarding cash-value life insurance policies with most major insurance companies is to reward the selling agent with the entire commission upfront on a newly issued policy.

The criticism to this practice is that this of course reduces the needed client-agent reviews and interaction and generates more “churning” and “flipping”.

Unscrupulous agents are tempted to sell clients another policy for another commission rather than encourage them to maintain and keep their existing policy, which most likely would have lower costs than any new policy considering the client was younger and most likely in better health with the existing contract. A model in which the insurance agent would have a financial incentive for their client’s continued patronage could create a win-win for both parties. We see this “pay as you” model currently operating successfully with wealth advisors and property/casualty agents, why not life insurance agents?

A Flawed Argument

There are some flaws to this argument. The reality is that the captive life insurance industry and their agents prefer this form of lump compensation. The claim is that selling an individual a life insurance policy (the ultimate intangible product) is hard work, and likewise the 70% – 105% of the first year premium is fair compensation for the efforts.

For existing agents to reduce their current income to a fraction of this commission upfront, but convert it into a trail over a multiyear period is actually quite distasteful. Therefore, this change will likewise not be initiated from the Insurance agent or insurance industry side unless other forces prevail.

Consumers [Even some Doctors] are Un-Aware

The drive by the consumer to change this up front lump form of compensation has not yet presented itself in full force. After all, why does the consumer care about how the agent is paid if the consumer is satisfied with the end result? One must acknowledge that the drive to reduce commissions and up front loads in the investment advisory business was driven by the consumer that insisted on lower fees and costs.

However, the relevant costs of a life insurance policy are not quite as obvious. Only by comparing a quote from different companies can a consumer compare costs, and even then it is unknown and not understood how the pricing mechanisms used by the insurance company work. The advent of non-agent sold policies however is decreasing the cost of life insurance (there is no big commission check written to the selling agent) and is hitting the radar of consumers. The consumer can notice this difference if the consumer compares the proposed agent sold policy premium with one sold directly by a financial institution such as USAA or AARP. These companies have a work force of sales people that are compensated primarily on salary. Likewise the company can structure more competitive pricing, and in effect offers a levelized cost (in place of commission) insurance product.

A Personal Opinion 

Mark Maurer CFP® of Low Load Insurance Services believes that a levelized compensation basis will not occur unless all the insurance companies were to go to such a plan all at once. If an agent can “pick and choose” he/she may use a “levelized compensation” policy when in a competitive situation, as such a policy should in theory make a policy more inexpensive. An agent would then use the higher “front-end” policy when there is a large up-front premium or in a scenario with limited competition.

Mark believes the answer to the whole argument is full disclosure. Both agents and home offices would not want the purchaser to know that 100% or more of their premium is going to sales costs and that products would then get better.

Assessment

The insurance industry has a powerful lobby in Washington. I believe that only market pressure will cause a change in this decades old insurance industry practice that has made many life insurance policies expensive and inefficient. Pricing from non-agent sold life insurance companies will be the impetus that drives the old-line Insurance companies to restructure their commissions to agents.

I remember the days of 8% load mutual fund commissions and minimum $60 dollar commissions on stock trades in the late 1980’s when I first became a stockbroker! That is an inflation equivalent of more than $130 a trade minimum commission. The current investing world would laugh at these costs [charges] today. When the consumer realizes, through full disclosure and outside competitive market pressures, that life insurance protection can be more affordable from other non-traditional channels, then the consumer will insist on a better, more affordable product. Then the big agent driven life insurance companies will have to change their commission structure. The transition is currently in process. Only time will tell now.

Editor’s Note: David K. Luke is currently enrolled in the online http://www.certifiedmedicalplanner.org chartered professional designation program.

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White House Rejects Petition To Legalize Marijuana

Initiative to Stop State Interference Fails

[By Staff Reporters]

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The White House has rejected several marijuana legalization petitions, one of which called on the federal government to stop interfering with state marijuana legalization efforts.

The ONDCP

“As a former police chief, I recognize we are not going to arrest our way out of the problem,” wrote Gil Kerlikowske, director of the Office of National Drug Control Policy, in a statement released late last Friday. “We also recognize that legalizing marijuana would not provide the answer to any of the health, social, youth education, criminal justice, and community quality of life challenges associated with drug use.”

The statement came in response to a petition submitted by retiredBaltimore narcotics officer Neill Franklin as part of the White House’s “We The People” project, an effort to allow ordinary Americans to gain the attention of policymakers through an online portal at the White House website. Any petition garnering 5,000 signatures within 30 days of submission is guaranteed a response from the White House;Franklin’s petition received more than 17,000.

Failed Prohibition Policies

“It’s maddening that the administration wants to continue failed prohibition polices that do nothing to reduce drug use and succeed only in funneling billions of dollars into the pockets of the cartels and gangs that control the illegal market,” said Franklin, who serves as executive director of advocacy group Law Enforcement Against Prohibition, in a statement released last Saturday.

Franklin’s petition comes as federal prosecutors have escalated enforcement actions against medical marijuana dispensary owners inCalifornia, vowing to shutter state-licensed businesses and threatening landlords with property seizures for violating federal drug laws.Franklinhas also called on the president to remember his campaign promise not to waste government resources interfering with state-regulated marijuana dispensaries.

Rejected by the White House

The White House’s rejection statement was directed at seven other marijuana-related petitions, which together garnered more than 150,000 signatures. One such petition, which called for marijuana to be regulated in a manner similar to alcohol, received almost 75,000 signatures.

“Like many, we are interested in the potential marijuana may have in providing relief to individuals diagnosed with certain serious illnesses,” the White House wrote in its official response. “That is why we ardently support ongoing research into determining what components of the marijuana plant can be used as medicine. To date, however, neither the FDA nor theInstituteofMedicinefound smoked marijuana to meet the modern standard for safe or effective medicine for any condition.”

Read the full response from the White House below:

When the President took office, he directed all of his policymakers to develop policies based on science and research, not ideology or politics. So our concern about marijuana is based on what the science tells us about the drug’s effects.

The National Institute of Health

According to scientists at the National Institutes of Health — the world’s largest source of drug abuse research — marijuana use is associated with addiction, respiratory disease, and cognitive impairment. We know from an array of treatment admission information and Federal data that marijuana use is a significant source for voluntary drug treatment admissions and visits to emergency rooms. Studies also reveal that marijuana potency has almost tripled over the past 20 years, raising serious concerns about what this means for public health -– especially among young people who use the drug because research shows their brains continue to develop well into their 20’s. Simply put, it is not a benign drug.

Like many, we are interested in the potential marijuana may have in providing relief to individuals diagnosed with certain serious illnesses. That is why we ardently support ongoing research into determining what components of the marijuana plant can be used as medicine. To date, however, neither the FDA nor the Institute of Medicine have found smoked marijuana to meet the modern standard for safe or effective medicine for any condition.

A Balanced National Drug Control Strategy

We recognize that legalizing marijuana would not provide the answer to any of the health, social, youth education, criminal justice, and community quality of life challenges associated with drug use.

That is why the President’s National Drug Control Strategy is balanced and comprehensive, emphasizing prevention and treatment while at the same time supporting innovative law enforcement efforts that protect public safety and disrupt the supply of drugs entering our communities. Preventing drug use is the most cost-effective way to reduce drug use and its consequences inAmerica. And, as we’ve seen in our work through community coalitions across the country, this approach works in making communities healthier and safer. We’re also focused on expanding access to drug treatment for addicts. Treatment works. In fact, millions of Americans are in successful recovery for drug and alcoholism today. And through our work with innovative drug courts across the Nation, we are improving our criminal justice system to divert non-violent offenders into treatment.

Assessment

Our commitment to a balanced approach to drug control is real. This last fiscal year alone, the Federal Government spent over $10 billion on drug education and treatment programs compared to just over $9 billion on drug related law enforcement in theU.S.

Thank you for making your voice heard. I encourage you to take a moment to read about the President’s approach to drug control to learn more.

Source: Dawn Dearden

More Info:

Drug Enforcement Administration

Section Chief, Public Affairs

Phone 202 307-2402

Fax 202 353-1628

dawn.n.dearden@usdoj.gov

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David Camp Proposes Corporate Tax Reform

The House Ways and Means Committee Chairman Speaks

By Children’s Home Society of Florida Foundation

On October 26th 2011, House Ways and Means Committee Chairman Dave Camp (R-MI) proposed a comprehensive tax reform of corporate taxes. He stated that the present “outdated” tax system discourages employers from hiring in America and transfers jobs overseas.

Camp noted, “If we are serious about creating a climate for job creation, now is the time to adopt tax policies that empower American companies to become more competitive and make theUnited States a more attractive place to invest and create the jobs this country needs.”

The Specifics

The discussion proposal specified the changes that Camp would make in the corporate tax system:

1. Corporate Tax Rate – The top rate would be reduced from 35% to 25%. The rate reductions would be accomplished through major changes in corporate tax deductions for depreciation, depletion and other items.
2. Territorial Tax System – The “worldwide” system of taxation was created five decades ago and the U.S. should move to a territorial tax system similar to that used by most other industrial nations.
3. Repatriation – There would be a 95% exclusion for overseas earnings brought back to America. At present, many large American companies have billions of dollars in cash and investments that are held overseas to avoid U.S. corporate taxes.
4. Anti-Abuse Rules – There would be multiple rules and guidelines to preclude companies avoiding a payment of their fair share of tax.
5. Global Competition – An updated tax system for corporations would encourage American companies to hire U.S. citizens and make them more competitive on a global basis.

The prime concern that Camp expressed is that all of the industrial nations in Europe and Asia (except Japan) have reduced their corporate tax rates during the past decade. The comparatively higher U.S. corporate tax rates place our companies at a disadvantage and encourage movement of jobs overseas.

Assessment

One major concern with the reduction in rates is that manufacturing corporations will pay higher taxes because of the loss of their various deductions.

Ways and Means Committee ranking member Sander Levin (D-MI) noted, “Lowering the top corporate tax rate to 25% without adding to the deficit would require repealing key provisions that strengthen domestic manufacturing and encourage American innovation and investment.”

He also expressed concern that lowering the corporate rates could cause a shift in the tax burden to individuals.

Editor’s Note: It is a very long path to major tax reform. The main debate between the parties is whether or not tax reform should be revenue-neutral or produce higher revenue. Comprehensive tax reform will await a resolution of this debate in Congress.

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Events Planner: November 2011

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Events-Planner: NOVEMBER 2011

By 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.

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

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

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