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

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

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

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

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

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

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Hand Hygiene Goes High-Tech

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More on Hospital Acquired Infections with a Basic Review
As pressure to reduce infection rates builds, many hospitals are reevaulating their hand hygiene protocols. Of course, as a bone and joint surgeon, this was an important clinical concern to me and my patients. And, as a health economist, this is a vital issue of cost control and health insurance today.
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But, according to Jeff  Ferenc, “secret shoppers” and other self-reporting programs can lead  to inaccuracies, and many hospitals are turning to a slew of new electronic  surveillance products that give clinicians automatic hand-washing reminders that then verify compliance.

Link: http://www.hfmmagazine.com/hfmmagazine_app/jsp/articledisplay.jsp?dcrpath=HFMMAGAZINE/Article/data/04APR2012/0412HFM_FEA_Marketplace&domain=HFMMAGAZINE

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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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FINANCE: Financial Planning for Physicians and Advisors
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Seeking Nominations for Medical Hepatology Director

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Medical Hepatology

By Janice Perino
Associate Consultant

Dr. Marcinko and ME-P Readers,

Cejka Executive Search has been retained by Banner Health, one of the nation’s premier health care systems, to recruit an innovative physician leader as Medical Director, Medical Hepatology for Banner Good Samaritan Medical Center (BGSMC) in Phoenix, AZ.

The Medical Director will provide strategic leadership, program development and processes to improve patient safety, error reduction, and appropriateness and quality of patient care. The Medical Director will build partnerships with key stakeholders; participate in research; teach residents, fellows and medical students; and serve as mentor and coach to other physicians and employees.

Criteria

Candidates must be board-certified in Gastroenterology/Hepatology, be eligible for an Arizona medical license, and possess a minimum of eight years clinical experience plus prior leadership experience. Nominations for a role of this caliber are greatly appreciated.

Cejka Executive Search
4 CityPlace Dr., Ste. 300
St. Louis, MO 63141
314.236.4419 Office
jperino@cejkasearch.com

Thank you, in advance, for your consideration.

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

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

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Doctors and the “Buffett Rule”

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Once Earned – Twice Taxed

By Rick Kahler MS CFP® ChFC CCIM www.kahlerfinancial.com

The recent discussion of the “Buffett Rule” proposal to increase taxes on the wealthy [medical professionals and dividend seeking investors?] has focused attention on U. S. tax rates. It’s giving Americans a chance to better understand our tax policy and the economics of the free market system.

Mitt Romney, the probable Republican Presidential candidate, has come under attack from both Democrats and other Republican primary candidates for his high income and net worth and his low overall tax rate. The arguments are that Romney made his money by the wrong type of capitalism and that he pays too little in federal taxes.

A Tale of Two Tax Returns

The tax returns Romney has made public show most of his money comes from investment returns on his holdings rather than from wages or a salary. His overall tax rate in 2010 was 13.9% and his estimated rate for 2011 is 15.4%. This caused a predictable outcry that his tax rate is lower than the income tax bracket of many middle class Americans.

President Obama’s 2011 tax return shows a tax rate of just over 20%. Former Republican candidate Newt Gingrich paid 31% of his 2010 income in federal taxes.

Unfair Appearance

To the uninformed, these varying tax rates initially look unfair. What many people don’t understand is the big difference between “ordinary income” (from wages, a salary, short-term capital gains, and interest) and “passive income” (from stock dividends and long-term capital gains). The federal government taxes ordinary income at up to 35% and passive income at 15%.

Why the different rates?

First, let’s look at dividend income and long-term capital gains taxes on investments held over 12 months. Dividends come from corporations that must first pay income taxes on any profits. Long-term capital gains come from shares of a company purchased and held for more than 12 months.

Since the effective corporate rate is 39.2% (the top federal rate and the average state tax rate), the corporation has already paid taxes on all income, including what is paid out to investors as dividends. Prior to the Bush tax cuts in 2001, dividends were then additionally taxed at almost 40%. This meant every dollar of dividend income was taxed twice, once at the corporate level and again at the individual level. The result was that 60 cents out of every dollar of profit made by a company was paid to the federal government. The Bush tax cuts continued the practice of double taxation, but lowered the amount paid at the individual level to 15%.

The same double taxation applied to long-term capital gains, except that the tax rate was a flat 28% before the Bush tax cuts reduced it to 15%.

This double tax makes it seem that the wealthy pay less tax than they really do. An individual may pay 15% on passive income of, say, five million dollars. Yet corporations have already paid taxes of around 39.2% on that same income, for a total tax rate of 54.2%. Of the five million in profit, over two and a half million goes to Uncle Sam. That would seem to be more than a “fair share.”

Assessment

According to Congressional Budget Office figures from 2011, the top 1% of taxpayers pay an average of 29.5%, those in the percentiles from 81% to 99% pay 22.8%, those from 21% through 80% pay 15.1%, and the bottom 20% pay 4.7%. Those numbers, of course, don’t include the 49.5% of Americans who pay no federal income tax at all.

Even factoring in the different tax rates on ordinary and passive income, it’s clear that the more money Americans earn, the more tax they pay. What could be more fair than that?

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

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

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102 Personal Finance Tips Your Medical School Professor Never Taught You

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Ask the Advisor

If you’re anything like most doctors, you graduated from college and perhaps even took a finance class or accounting class here or there, but you didn’t learn anything about managing your personal finances.

In fact, there probably wasn’t even an opportunity to take any such class in high school, college or medical school, either.

But, if medical school is partly about training for a job, shouldn’t we learn what to do with the money we earn from medical practice? Especially in a country where 45% of college students are in credit card debt and 40% of all Americans say they live beyond their means, many think it’s time to wise up to some of the challenges of money management.

Assessment

So, here are a few (say, 102) simple tips that can help get your money life (back) on the right track.

Link: http://www.yourcreditadvisor.com/blog/2006/10/102_personal_fi.html

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Where Do Economies Of Scale Exist In US Hospitals?

NOTE: Click on image to enlarge.

Assessment

The unrelenting pressure on hospitals to control costs will increase over the next few years as institutions look to be profitable at Medicare reimbursement levels.  One area that hospitals often look at to find cost savings is in economies of scale.  There are three main ways of approaching this: by growing a facility’s overall volume, specializing in particular service lines, or integrating with other health systems.

In this infographic, we see that growing overall facility volume doesn’t result in economies of scale.  But, one sees a different story when we look at a more micro level (service line specialization) and a more macro level (increased system size).

Conclusion

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

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

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How Smart Doctors Can Save Big at the Pump

Easing the Pain of High Gas Prices

By Dr. David Edward Marcinko MBA CMP®

[Editor-in-Chief]

We published a popular post on Easter Sunday 2012 about high gas prices. It was well received. So, since medical professionals often drive expensive, and inefficient cars [read expensive gas guzzlers], I thought it might be a good idea to relay my personal driving tips on how medical and all ME-P colleagues [MDs and FAs], can save big [or at least a bit] at the gas pump.

Link: https://medicalexecutivepost.com/2012/04/08/pain-at-the-2012-easter-sunday-pump/

Guilty – as Charged?

Look, I am a doctor and financial advisor, as well as journalist, editor, surgeon and expert legal witness. I wear many hats and my one indulgence is my pearl white Jaguar XJ-V8-LWB. This classic baby was a gift from my wife who bought it from a singular previous owner [software mogul] in pristine physical and engineering condition after years of meticulous and loving garaged care.

In other words, she let some someone else take the huge depreciation hit on a luxury European touring vehicle that originally sold for up to $100,000 direct from Coventry England. Fortunately, this is not a primary vehicle and I use it only on the weekends, weather permitting. What a joy to drive. Smooth and quiet; just like a hybrid vehicle. And, it is not unusual for nearby folks to stop, stare and even wave at me as I drive by.

 

Why?

So, if rising gas prices are making a huge dent in your wallet, I have a solution to save you money at the pump! Try these simple tips and you’ll find the savings quickly add up.

Tips and Quips

* At least once a month, make sure your tires are properly inflated according to the vehicle’s specifications. Over-inflating tires by even a pound or two might improve fuel mileage in the short run, but it causes tires to wear prematurely. The money you save in fuel is less than what you would pay to replace the tires. But, I am guilty of this tactic because I have Pirelli tires on my Jag.

* Buy the right octane. Look in your vehicle’s owner’s manual for the correct octane level for your car’s engine. Odds are that it will be regular unleaded. Your vehicle should run just fine on regular if that’s what the manual recommends; and it costs less. Again, I use and need 93 plus Octane.

* An annual full-vehicle inspection, including the air conditioning system, may help you avoid costly repairs. I detail and check out my automobile every quarter.

* Vehicles use less fuel the more slowly they travel. Try dropping your highway speed by 10 mph to see big savings at the pump. Here, I follow the rules.

* Extra weight in your vehicle makes it work harder, hence less fuel mileage. If you have a trunk full of junk, empty it out for better fuel economy and to save money. My Jag weighs 4,800 pounds.

* Nothing can put a damper on spring travel plans more than unpredictable gas prices. Search for the best price before you go to fill up. I use a smart-phone and auto navigation system for this chore.

Assessment

With such gorgeous weather, driving your car with sunroof open might be the first thing on your mind. So, just by taking a few small steps, you’ll save money on your vehicle, meaning more money stays in your wallet – while enjoying it more.

Conclusion

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

Our Other Print Books and Related Information Sources:

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

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

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More photos: DEM’s JAGUAR

When I Grow Up I Want to be a Doctor [Consultant, Financial Advisor, etc]. So I Can … ?

Finish the Sentence ……

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Help patients who can pay out of pocket.

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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

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

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EHRs – Still Not Ready For Prime Time

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At Least … Not Yet!

By David K. Luke MIM, Certified Medical Planner™ candidate

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www.CertifiedMedicalPlanner.org

Since Feb 17, 2009 when President Obama signed into legislation the Health Information Technology for Economic and Clinical Health Act (HITECH) as a part of the 2009 stimulus package, the incentives were promised for the adoption in health care practices of Electronic Health Records (EHRs).

The Carrot and the Stick

The incentives payments for “meaningful use” range from $63,750 over 6 years by Medicaid to maximum payments of $44,000 over 5 years for Medicare. The penalty for not adopting by Medicare will be 1% of Medicare payments in 2015, increasing to 3% over 3 years. Stimulus money is granted based on meaningful use of an EHR system.

The Reality

Stories are rolling in by early adopters now that give cause for a prudent physician to rethink implementation anytime soon of an EHR for his/her practice. Here is a sampling:

  • EHRs can be hacked and doctors will be held accountable. A total of 385 breaches of protected health information affecting over 19 million records have been reported since August 2009 (Redspin Breach Report 2011). Redspin also reports that industry estimates have put the value of a stolen health record on the black market at about $50 per record. For me, this is the biggest red flag for implementing an EHR now. Vendors are offering solutions in the form of data “masking”, but this could increase the cost of the systems.
  • EHRs have stringent audit requirements under the HITECH Act. Health care organizations are expected to monitor for breaches of PHI. Audit logs must be kept. Audit strategy, process, and implementation tools must be used to meet stage 1 meaningful use criteria. Sanctions to employees for not following protocol. Healthcare facilities leave themselves vulnerable to individual and class action lawsuits when they do not have a strong enforcement and audit program in place for their EHR.
  • EHRs are expensive to implement, both in terms of money and in terms of time. Dollar costs range from free (Practicefusion) to $50,000+ for such EHR vendors as Allscripts or eClinicalWorks + ongoing maintenance costs. But don’t’ forget the time investment. Even small EHR systems can take 2 years to implement. I have just witnessed a client’s large pediatric practice literally crippled with the initial time investment required for staff and physicians to learn the system. Half staffing the front desk and other areas so employees can go to training has caused a drain on both patient and employee morale.
  • Legal concerns are still unanswered regarding EHRs. Currently the debate is still on about who owns the electronic data. The EHR vendor will tell you that you do. HIPPA gives the patient the right to see their record or chart, and the right to have a physical copy of their record based on a reasonably cost for copying and postage. Typically doctors share medical records with other health care providers as a professional courtesy. Empowered patients think they own their records. According to a reference regarding an HIMSS white paper, a patient owns the data in a Continuity of Care Document and has the ability to input and access that information.
  • Obtaining meaningful use stimulus payments is not a given. I met with a physician owner client a few months ago in Arizona that has implemented an EHR for their pediatric practice and was hoping to receive the stimulus payment for stage one by completing the 20 criteria needed. After plowing through the 31-page “Arizona Medicaid EHR Incentive Program” guide provided by The Arizona Health Care Cost Containment System Administration or AHCCCS, which is the Arizona arm of Medicaid he turned in his application, which was denied. His initial reaction was that the program did not have the funding in Arizona, but that seems not to be the case as a number of large payments have been made now in the state. Banner Healthcare, which operates the largest hospital system in the state with thirteen inpatient facilities, reported a total of $12.4 million in Medicaid booty for implementation of its NextGen Healthcare EMR systems in 2011. It appears that there is a learning curve involved here and the smaller practices will catch up while the hospitals currently seem to have better systems in place to capture the stimulus money. An entire MU industry has emerged to help physicians such as my client perfect their stimulus applications.

Risk vs. Reward

In the investment world I am always comparing risk vs. return when managing my client’s portfolios. At times in the marketplace, for various reasons, it just does not make economic sense to make certain investments as the possible risks far outweigh the potential return. An easy example now is the investment in “safe” longer-term treasury bonds. With a near 40-year low in interest rates, the 30-year treasury today yields 3.18 %. Yet if interest rates rise 1% in the marketplace, that 30-year treasury can drop 12%. A 2% rise can result in a fall of 22% in value. It would take 7 years accumulating 3.18% to offset the loss in value caused by a 2% rise in rates. I do not think rates are going up 2% tomorrow, but I just do not like the risk/reward spectrum here. Likewise, the biggest concern currently I have with EHRs is data breeches, as mentioned above, and the stiff penalties involved currently. Paper systems look a whole lot cheaper and safer when considering the ease at which a data breech can occur with electronic data. Fines, criminal sentencing, and disciplinary action by licensing boards are risks not worth taking considering current history on data breeches. Losing your license or your business or personal freedom because of an employee’s careless actions is not worth it. Lest you think I exaggerate, consider the following examples from the past few years enforced by the Office for Civil Rights (OCR), the enforcement side of the US Department of Health and Human Services that enforces HIPAA, and by employers and licensing boards:

Incident: A terminated researcher at UCLA School of Medicine retaliated by accessing UCLA patient records (many celebrities) 323 total times over the next four weeks.

Penalty: 4 years in prison for the terminated researcher for violating HIPAA Privacy Rules

Incident: Thirteen staff members at UCLA hospital accessed Britney Spears’ medical records without authorization.

Penalty: UCLA fired the 13 individuals, suspended another six.

Incident: A doctor and two hospital employees accessed the medical records of a slain Arkansas TV reporter. Details were leaked to the press of her attack.

Penalty: All pled guilty to misdemeanors for violating HIPAA privacy rules and were sentenced to one-year probation. The three all were curious about the case and “peeked” at the patient’s record as employees of the hospital, even though she was not their patient. The doctor’s privileges were suspended by the hospital for two weeks; he was fined $5,000 and ordered to perform 50 hours of community service by speaking to medical workers about the importance of patient privacy. The two other employees were terminated.

Incident: Cignet denied 41 patients, on separate occasions, access to their medical records when requested.

Penalty: Initial violation was $1.3 million. OCR concluded that Cignet committed willful neglect to comply with the Privacy Rule and fined an additional $3 million.

Incident: 57 unencrypted computer hard discs containing PHI of more than one million people was stolen from a storage locker leased by Blue Cross Blue Shield of Tennessee (BCBST).

Penalty: OCR fined BCBST $1.5 million in settlement. The fact that BCBST secured the information in a leased data closet that was secured by biometric and keycard scan in a building with additional security was not enough. BCBST also spent $17 million in investigation, notification and protection efforts and had increased future compliance costs.

Incident: Health Net discovered that nine portable hard drives that contained PHI and personal financial information of approximately 1.5 million people were missing. The hard drives in question went missing from an IBM-operated datacenter in Rancho Cordova, California.

Penalty: The complaint alleged violations of HIPAA. Connecticut Insurance Commissioner wins a $375,000 fine for failing to protect member information and not reporting in a timely manner just months after the Connecticut AG won a $250,000 settlement for the breach. Vermont’s AG jumps in and gets a settlement of $55,000 to the State because 525 Vermonters were on the lost drive.

Incident: WellPoint / Anthem Blue Cross became aware that its customers’ health applications and information website, which contained up to 470,000 applicant’s information, was potentially publicly accessible when an applicant alerted the company that altered URLS after an upgraded authentication code could allow access to other people’s information.

Penalty: WellPoint / Anthem agreed to the terms of a class action lawsuit filed in California that will provide $1.5 million in general settlement, with an additional donation of $250,000 to two non-profit organizations aimed at protecting consumer’s rights, $150,000 donated to Consumer Action and $100,000 donated to the Public Law Center in Orange County. WellPoint / Anthem also agree to pay $100,000 to the state of Indiana for the data breach that exposed 32,000 state residents. A 2009 Indiana law requires companies to notify the state of certain data breaches within a certain period that was not met.

An Investment?

I bring up these examples to make a point. The EHR vendor will talk about your EHR being an “investment”. You cannot have an ROI if you lose money. Notice that most cases were due to careless, innocent lapses of judgment. Also in many cases actual damages either did not occur or were hard to prove. The new HITECH act extends HIPAA to allow the states’ attorney general to also bring actions, which adds more salt to the wound. Some of these cases do not appear to be done yet either as far as the lawyers are concerned. Also, notice that even when the health care provider regarding storing the data exercised extreme care (BCBST with biometric, keyscan leased lockers and Health Net employing IBM’s “secure” datacenter), the health provider was sued and fined. Smaller medical practices I believe are even more susceptible to EHR data breaches, where bad password management practices and website maintenance problems are more common and often protocols and training are not firmly in place.

Assessment

The widespread use and integrated implementation of EHRs are going to happen, no doubt. Your practice will eventually have one. 2015 is still a few years off before the first 1% Medicare penalties hit. Tell the EHR vendor to call back in 2014 once the kinks are worked out. Waiting two more years may not prevent a costly incident due to the vengeful fired employee or due to a careless slip in protocol. Those landmines will always be there.

But, two more years will allow the EHR stakeholders more time to improve their product, namely the security and encryption of the data in case of a breach, and two more years will allow the OCR and the state AG’s to fill up on the low hanging fruit and make their point.

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Some Physicians are Tenants, Too!

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Tenant Improvements Can Be Good Investment

By Rick Kahler MS, CFP®, ChFC, CCIM

Recently I read a news story about a physician [small business owner] whose landlord was not renewing her lease. A chain restaurant was buying the building and intended to raze it. The doctor [business owner] was distraught, as she had recently spent $30,000 to remodel the property.

Dual Perspectives

One common reaction to stories like this is anger at a landlord for unfairly selling a building out from under a tenant.

Another is, “Why would tenants spend so much money remodeling a building they didn’t own?”

Neither response sees the whole story.

I empathized with this doctor’s loss as a result of a bad business decision. The bad decision wasn’t spending $30,000 to remodel a space she didn’t own. Business owners make such “tenant improvements” all the time. Every tenant or doctor’s office you see in a mall has poured thousands of dollars into fixing up and customizing their space. Tenant improvements can range from repainting a space to building a fast food restaurant on leased land.

Poor Decisions

The poor business decision this owner made was not being sure the lease term ran for long enough to recoup the cost of the tenant improvements. The cost of any tenant improvement is a pure expense that needs to be factored in as part of rent and amortized over the life of the lease. This is because when the lease expires, both parties have the right to not renegotiate a new lease. Any tenant improvements become the property of the owner. Landlords who choose to use property for something different when a lease expires aren’t abusing or taking advantage of tenants—they are simply exercising the contractual rights agreed to by both parties.

Mall Shells – Not Sea Shells

Most new strip centers or malls lease relatively unimproved spaces, sometimes called shells. Tenants get four walls, a cement floor, and bare girders above. It’s the tenants’ responsibility to finish the spaces in the manner they want. This makes a lot of sense, as usually each retailer is very specific about the floor plan, colors, and building materials they use in their spaces. At the end of the lease the relinquished tenant improvements, with years of wear and tear, are typically worth very little. New tenants will rip them out and finish the space according to their needs.

Example

Let’s take an example of a 5,000-square-foot shell that rents for $8 a square foot annually. Let’s say it will cost $100 a square foot for the retailer to finish the space. If the lease extends for 20 years, the annual cost of the tenant improvements is $5 a square foot ($100 divided by 20 years). This brings the total cost for the leased space to $13 a square foot ($8 shell rent plus $5 for improvements).

With a four-year lease, however, the amortized cost would be $27 a square foot. A one-year lease would cost $108 a square foot. Either one would make the space too expensive. A doctor business owner unable to get a longer term would either substantially reduce the cost of the tenant office improvements, or look elsewhere.

Sometimes a tenant needs to spend a lot to improve a space, but doesn’t want to commit to a long-term lease. In this case the tenant’s best strategy is to get the landlord to improve the space so the tenant isn’t left losing a substantial amount of money if either party doesn’t renew the lease.

Assessment

Medical provides who are business owners need to understand their rights and responsibilities as tenants. They also need to be sure the costs of rent and tenant improvements are reasonable over the life of the lease. It’s a good idea to consult both an attorney and an accountant before signing any lease.

Conclusion

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Celebrate Earth Day 2012

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Do Good – Relax

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A Survey to Shape the Definition of Physician-Focused Financial Planning

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Send us Your Thoughts

By Dr. David Edward Marcinko MBA CMP®

[Chairman, Founder and CEO]

www.CertifiedMedicalPlanner.org

The Institute of Medical Business Advisors, Inc is re-defining the role of “physician focused financial planning” and how the concept fits within the financial services industry.

Crowd-Sourcing Insights and Opinions

But, we can’t do it without your help. As a medical provider or seasoned financial professional, our readers can provide valuable input to determine exactly what constitutes a physician focused financial advisor in today’s complex healthcare industrial complex landscape.

For example, is it business as usual for FAs today; does it fall under the auspices of the Certified Medical Planner™ professional rubric, or is it something else?

Be a pioneer and help shape the industry’s definition of medically focused financial advice by sending us your thoughts on competency tasks and areas of subject matter expertise.

Results

The results will enhance iMBA’s Certified Medical Planner designation, which is designed to help financial advisors address the needs of physicians, medical professionals and all allied healthcare personnel; and help define the role of physician focused financial planning in the coming decade.

Learn More

To learn more about this growth specialty and designation, click here: www.CertifiedMedicalPlanner.org

Assessment

Please be assured that if you take the survey, your responses are confidential; we won’t share your contact information with third parties. Thank you for your participation!

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Recognizing DEA Badges

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A Review of U.S. Drug Enforcement Badges

By The DEA Agent

Assessment

As a doctor or financial advisor, you do not want to see one of these DEA badges show up in your professional office except as a patient or client.

Conclusion

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FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

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Pre-Reform Impact of Self-Pay Patients on US Hospitals

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Pre-healthcare reform, and full PP-ACA implementation, many hospitals experience significant uncompensated care costs from self-pay patients.  This infographic illustrates the variation in self-pay uncompensated care costs across US hospitals and regions.

Despite the uncompensated care risk, 1/6th of self-pay inpatients are scheduled admissions, though their procedures are much less elective than the procedures of the insured.

Conclusion

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Where Tax Dollars Go?

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Tax Freedom Day is April 17th 2012

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Working 107 days for Uncle Sam

By Children’s Home Society of Florida Foundation

Each day the Tax Foundation publishes the “Tax Freedom Day.” For this year, Tax Freedom Day will be on April 17, 2012. Based on averages of incomes and taxes, Americans will work 107 days from January 1 to April 17 to pay the combined 29.2% tax bill for federal, state and local taxes. If the budget deficit amount were paid for through taxes, Tax Freedom Day would be extended to May 14, an additional 27 days.

Varying Dates

Tax Freedom Day has typically arrived earlier during the past five years. The latest Tax Freedom Day was May 1, 2000, when the total tax revenue was 33%. Generally, because of tax reductions in the stimulus bill enacted in 2008, Tax Freedom Day has come earlier during the past four years.

State Taxes

Several states collect lower taxes and have an earlier Tax Freedom Day. These states’ Tax Freedom Day include Tennessee on March 31, Louisiana and Mississippi on April 1 and South Carolina on April 3rd. The highest tax state is Connecticut, with Tax Freedom Day on May 5. However, New Jersey and New York both celebrate Tax Freedom Day on May 1st. The Tax Foundation also estimates the number of days that you may work to pay taxes in these separate categories.

 

Tax   Category Days
Federal   Income 32
State/Local   Income 8
Fed.   Social Insurance 23
State.   Social Insurance 1
Fed.   Sales 2
State   Sales 12
Property   Taxes 12
Fed.   Corporation 9
Other   Fed. 3
State   Corp 1
Other   State 4

Editor’s Note: The Tax Foundation publishes these calculations each year. They are based on overall tax payment averages. Other publications have observed that the dates would change if the numbers were calculated based upon taxpayer income tiers. However, no other publication calculates Tax Freedom Days for low-income, mid income and high-income taxpayers.

Conclusion

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Today’s Video for National Healthcare Decisions Day [NHDD]

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Goals and Objectives

By Staff Reporters

www.CertifiedMedicalPlanner.org

Today is the 5th Annual NHDD, April 16th, 2012. The purpose of this day is to inspire, educate & empower the public, estate attorneys, financial advisors & medical providers about the importance of advanced medical care planning. It is a rally for our loved ones and ourselves.

Video Link: http://www.nhdd.org

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Physician Advisors: www.CertifiedMedicalPlanner.org

Financial Planning Handbook for Physicians and Advisors

Financial Planning Handbook for Physicians and Advisors

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Enter the HIPAA Fear Mongers

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Fear of HIPAA Sells

[By Darrelkl K. Pruitt DDS]

“The HHS Office for Civil Rights (OCR) can show up at your door and ask to perform an audit on short notice, and your organization will need to be ready, or face fines of up to $50,000 per day for each regulatory provision violated.”

– Gene Kraemer [Customer Relationship Director at The Coding Institute]

http://www.audioeducator.com/hipaa-audits-and-enforcement-042412.html?utm_medium=email&utm_source=E99NAGAJ&utm_campaign=E99NAGAJ

The most successful of opportunistic HIPAA consultants are the scariest

As a dentist for almost 30 years, I’ve noticed that along with even rumors of mandate enforcement, ambitious compliance consultants’ fear-inspiring ads start interrupting happier thoughts. It happened with OSHA’s push into dentistry 20 years ago and we clearly see the aggressive sales pitches with HIPAA as well.

The scariest part of Gene Kraemer’s description of HIPAA’s tedious requirements and bankruptcy-level liabilities is that he is simply telling the truth. So if you are a HIPAA covered dentist, be scared.

On the other hand, if you don’t store or send your patients’ digital PHI – choosing instead to use the US Mail – you are increasingly fortunate in the dentistry market. For one thing, our patients are fed up with identity thefts, and paper dental records are the gold standard in security. In addition, nothing is holding down your competitors’ costs for HIPAA compliance and it is increasing much faster than the cost of postage.

De-identify now or lose computerization, Doc. If your patients’ PHI is not present it simply cannot be hacked by an identity thief. Guaranteed more secure than Cloud. Arguably more secure than even paper dental records.

Or … You can hire The Coding Institute.

You can bet Gene Kraemer isn’t someone who would hold down the cost of compliance.

 

From: Gene_Kraemer@mail.vresp.com

Subject: HIPAA Audits & Enforcement: New Penalties & Push for Compliance – Final Notice!

Good Morning,

The US Department of Health and Human Services (HHS) is currently implementing audits to meet requirements in the HITECH Act in the American Recovery and Reinvestment Act of 2009 (ARRA) for performing periodic audits of compliance with the HIPAA Privacy and Security Rules, and up to 150 random HIPAA compliance audits will be performed by the end of 2012.  While in the past, audits had been performed only at entities that had had a complaint filed against them, the new rule calls for audits whether or not there is a complaint.  This means, the HHS Office for Civil Rights (OCR) can show up at your door and ask to perform an audit on short notice, and your organization will need to be ready, or face fines of up to $50,000 per day for each regulatory provision violated.

Join us for this live audio conference on Tuesday, April 24, 2012 at 1 pm ET | 12 pm CT | 11 am MT | 10 am PT. This conference is being presented by Jim Sheldon-Dean, the founder and director of compliance services at Lewis Creek Systems, LLC, a Vermont-based consulting firm founded in 1982, providing information privacy and security regulatory compliance services to health care firms and businesses throughout the Northeast and nationally. He serves on the HIMSS Information Systems Security Workgroup, the Workgroup for Electronic Data Interchange Privacy and Security Workgroup, and co-chairs the WEDI HIPAA Updates sub-workgroup.  Sheldon-Dean is a participating member of the advisory board of Vermont Information Technology Leaders (VITL), and has participated in VITL’s Vermont Health Information Technology Plan working group, VITL’s Physician EMR adoption project, and the Security Workgroup of the New Hampshire/Vermont Strategic HIPAA Implementation Plan (NHVSHIP).

Highlights of the session :

• Fines and penalties for violations of the HIPAA regulations have been significantly increased and now include mandatory fines for willful negligence that begin at $10,000 minimum.

• HIPAA Audits have been few and far between in the past, but that’s now changing – the HHS will be auditing HIPAA covered entities and business associates even if there have been no complaints or problems reported.

• What HHS OCR is likely to ask you if you are selected for an audit, and what you’ll have to have prepared already when they do.

• The rules are that you need to comply with will be explained. Learn about the policies you can adopt that can help you come into compliance and be prepared for an audit.

• How the HIPAA rules have changed and how you may need to change. How you work to keep up with them.

• How having a good compliance process can help you stay compliant and respond to audits more easily.

• The documentation needed to survive an audit and avoid fines will be described.

• A discussion on what you’ll need to think about to deal with current and future threats to the security of patient information.

If interested, please click the following link to register and get your early bird discount : –

http://www.audioeducator.com/hipaa-audits-and-enforcement-042412.html?utm_medium=email&utm_source=E99NAGAJ&utm_campaign=E99NAGAJ

Please apply discount code “GENE20” at checkout to get your $20 discount on early registration.

Looking forward to having you onboard here.

Thanks,

Gene Kraemer

Customer Relationship Director

The Coding Institute LLC

2222 Sedwick Drive,

Durham, NC 27713

************************************************************************************8*************************

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Tax Facts for Taxpayers and Young Physicians

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The Tax Foundation

By Children’s Home Society of Florida Foundation

The Tax Foundation, a nonpartisan research organization, monitors the taxes paid by Americans each year.  On April 11, 2012, they released their report for the past year.  As Americans prepare to file before the April 17 deadline this year, many may be interested in the impact of taxes on their daily lives.

In tax year 2010, the total federal income taxes paid were $945 billion.  143 million families filed tax returns.  85 million paid taxes and 58 million were not required to make tax payments.  The taxpayers with more modest incomes received refundable credits of $105 billion.

The following table shows the income, effective tax rates and percent of the total tax paid by three groups of taxpayers.

Effective Tax Rates and Payments

Income Effective Tax Rate Percent of Taxes Paid
$0 – $50,000 3.5% 6.7%
$50,000 – $250,000 14.1% 47.6%
$250,000+ 23.4% 45.7%

About one-third of taxpayers chose to itemize deductions.  Twenty-five percent of taxpayers deducted mortgage interest and saved approximately $381 billion.  Charitable gifts were reported by 27% of taxpayers.  These gifts produced a tax savings of $158 billion.

The tax code continues to grow in size and complexity.  It now has expanded to 3.8 million words.  For the past decade, there has been an average of one change to the tax code every day.  What is the time required to complete taxes this year?  Over seven billion hours will be devoted to complying with the tax code.

Editor’s Note:  There is great debate on many aspects of tax law.  However, there is a general agreement by Americans from all walks of life that a tax code with 3.8 million words is too long and too complicated.  When Congress turns its efforts toward major tax reform in 2013, it hopefully will be able to reduce the size and complexity.  By working diligently, perhaps Congress might be able to reduce the Internal Revenue Code to only 3.7 million words.

Conclusion

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How Our Brain Ages

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A Reminder for Doctors, Management Consultants and FAs

By Muhammad Saleem

It’s no surprise that our brains change as we age.  In fact, some new studies show that mental decline may start as early as age 45

Source: www.TermLifeInsurance.org

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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

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

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The Hospital Room of Tomorrow?

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[By Staff Reporters]

[Click on image to enlarge]

Have you ever wondered what’s just around the corner in terms of the technology we can expect to see in hospitals. You might be surprised by some of the gizmos, gadgetry and other medical advancements that will soon become regular fixtures. This infographic offers a fascinating glimpse into how hospital rooms might look in the very near future.

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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IRS Help for Last-Minute Tax Filing Doctors

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2011 Tax Tips for 2012 [Are You Ready to File?]

By Children’s Home Society of Florida Foundation

The IRS published information letters last week to assist taxpayers who are filing their taxes before the April 17, 2012 deadline. Doctors, dentists and some other medical professionals may especially need some help.

And, the IRS YouTube channel is the fourth most popular government channel.

The IRS receives about 1 million views per year. Taxpayers may find several YouTube programs helpful. They are available in English, Spanish and American’s Sign Language.

IRS YouTube Programs

* Need more time to file your tax return?
* Last-Minute Tax Tips
* IRS Tax Payment Options
* Owe Taxes but can’t pay?
* When will I get my refund?

Smart Phone Accessible

The IRS YouTube videos are also available on iPhone or Android through the IRS2Go application that may be downloaded through the App Store or Android Marketplace. This is a nice feature for doctors interested in m-health.

For individual physicians who need extra time to file, it is possible to request an extension with Form 4868 (either electronically or by paper). This extension filing requires that you estimate and pay the correct tax, but your time to file is extended to October 15th. If you do not pay the correct tax, there is interest of 3% per year and a late penalty of 0.5% per month on the balance.

The Exceptions

There are three exceptions to the filing date. If you live and work abroad or are on military duty outside the U.S., you may pay on April 17 and file by June 15. Military members serving in Iraq or Afghanistan may file 180 days after departing the combat zone. Finally, several federal disaster areas in the Midwest are permitted to file and pay on May 31.

Need More Time?

Some taxpayers will need more time to pay. If your tax, penalties and interest are $50,000 or less, you may request a payment agreement from the IRS with Form 9465-FS. If you are unemployed or self-employed with a 25% reduction in income for 2011, you may file Form 1127-A to request permission to pay by October 15, 2012. You still must to pay the tax plus interest at that time.

Assessment

Finally, if you have a substantial overdue tax obligation, you may be able to negotiate an “offer-in-compromise” with the IRS. This will require the IRS to review all of your income and assets to make a determination as to the correct tax payment.

Conclusion

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

Our Other Print Books and Related Information Sources:

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

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

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The Best, Most Revealing Reporting on Our Healthcare System

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Reading and Reviewing

By Blair Hickman and Cora Currier

ProPublica,  March 30, 2012, 1:44 pm

As we wait for the Supreme Court to issue its verdict on the health-care reform law  we rounded up some of the most revealing reporting on the issues.

They’re grouped roughly into articles on high costs and those on insurance.

Assesment

Link: http://www.propublica.org/article/top-muckreads-the-best-most-revealing-reporting-on-our-healthcare-system

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

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

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Variations in Medical Practice Patterns for Financial Advisors

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Lessons Learned for both Physicians and Financial Advisors

By David K Luke MIM, Certified Medical Planner® candidate

[Physician Financial Advisor – Fee-Only]

http://www.NetWorthAdvice.com

http://www.DocFP.com

www.CertifiedMedicalPlanner.org

Physicians are constantly being trained in new techniques and methodologies, learning about new treatments and new drugs as they become available. For example, Elaine Zablocki (Zalocki, Elaine, Changing Physician Practice Patterns: Strategies for Success in a Capitated Health Care System, New York: Aspen Publishers, 1995 Print) gives examples from a physician profiling study done by Blue Cross Blue Shield of Nebraska (p 13-14).

BCBSN circa 1993

In 1993 BCBSN began to analyze data on Nebraska patients and discovered striking variations in practice patterns in different parts of the state.  One observation was that in two small rural areas there was a particularly high hospital surgical admission rates for nonmalignant gynecological conditions. Another observation was of wide variations in physician practice patterns for ENT surgical procedures such as tympanostomy tubes and surgery for nose and sinus problems. Some ENT physicians were performing three times as many procedures per patient as the average. According to medical director David Bouda, MD “our overall approach has been to take this information to the local physician group or area that seems to be different compared to others, present the data, and then have some kind of dialogue with the physicians. We say, ‘Here’s a group of physicians who seem to be exceptional in these ways – – what do you think about this?’”. The effort seems to pay off.  In the case of the high admission rates for hysterectomy cases, BDBSN saw a steady decline over 3 years. In the ENT example, questionable claims dropped markedly. The general approach to changing physician practices patterns was to take an educational approach getting physicians to pay attention to established parameters modified or created by his or her peers which would have a greater impact on health care costs than harassing the physicians over the phone regarding hospital length of stay or procedure questioning.

Defensive Doctors?

Not surprisingly, physicians often became defensive the first time they see this type of data. There is no point challenging an individual at this point. What I found interesting about the study, in spite of it being dated, was the comment that “…after all, educating physicians about practice patterns to promote better health care is a long-term process”. Are you a better doctor today then you were X years ago? Of course! Change is good even though it can be painful. Are you disingenuous because you practice medicine in a better fashion than you did years ago? Of course not! The concern would be if a practitioner doesn’t change (or worse refuses to change) in spite of being enlightened by a different method or approach.

Of the Financial Advisory Business

Enlightenment occurs in the financial advisory business as well. I started in the financial world in May of 1986  as a new recruit with my new graduate business degree working for GM of Canada in the Treasury Department. I spent time managing the foreign currency exposure, assisting the chief investment officer in the daily cash management (taking over for him while he was on vacation) and supervising the Borrowings Department at GMAC of Canada. All of these responsibilities involved making daily multiple transactions with brokers in the million dollars plus territory. In 1989 we moved our small family to Arizona so I could ply my trade as a stockbroker and help people retire successfully. Over the years the business has evolved greatly. When I got started in the trade, pretty much everything was sales commission driven. While “fee-only” existed, it was still very much in the pioneering phase with very fee practitioners. Over the years, especially beginning around 5 years ago, like the physician that observes the data in the above examples, I began to perceive that perhaps there was a better way to give advice to my clients. In the beginning I was defensive and even suspicious that these “fee-only” folks were just a little too bit self-righteous. Changing a few words from the observation of physicians above we could say:

“after all, educating financial advisors about practice patterns to promote better financial advice is a long-term process”

My Own Journey as a Financial Advisor

In 2010 I joined Net Worth Advisory Group as a fee-only advisor and have not looked back.  Am I a hypocrite because now I espouse a view and business model that is in some respects totally different then the views and business model I used 5, 10 or 20 years ago? I don’t think so.  In fact, to NOT have changed would have been the easier thing to do. I believe that following my conscience (yes, I used that self-righteous word “conscience” in this discussion) and changing to a much more client centric model, dropping thousands of dollars in retainer fees, dropping licenses that I had worked so hard to obtain, and really learning how to be a better financial planner was certainly initially a big sacrifice.

The point is … I knew I had to do it … and that was that. I believe the business model I have now is absolutely in the best interest of our clients. I wish I had this model available 23 years ago.

And today, in the medical industry, a better model is patient centered care. What an exciting opportunity, for all physicians, to reduce practice variation and pursue the grail of evidence based medicine [EBM].

NOTES: It should be noted that the “father” of medical variations may be Jack Wennberg MD, who studied prostatectomy, hysterectomy and appendectomy rates in the 1970’s and continues his work today at http://www.dartmouthatlas.org/

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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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

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

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Social Media in Medicine

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A New Policy Resource For Hospitals and Doctors

Social media is becoming increasingly more prevalent within the healthcare industry. With more hospitals and doctors joining social-media platforms on a consistent basis, it begs the question of “helpful or harmful”? One thing is certain: clear parameters must be established, so professional and personal lines don’t become blurred.

It’s vital to have a well-diversified and comprehensive social-media policy in place, outlining the dos and don’ts for everyone within your facility.

So, start reducing risk and liability associated with social media, stat—access renowned medical facilities’ social media policies for their guidelines on getting social.

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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A Physician Practice Demographics Slide-Show

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By SK & A Research

Link: http://www.physbiztech.com/slideshow/physician-practice-demographics-ska-research?s=0

Conclusion

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

Our Other Print Books and Related Information Sources:

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

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

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On the Control of Birth Control

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The cost of FDA-approved contraceptive drugs

When President Obama signed the Patient Protection and Affordable Care Act in 2012, the bill included a requirement that companies cover the cost of FDA-approved contraceptive drugs and services with no charge to employees.

The provision became controversial among religious conservatives, forcing Obama to shift responsibility for contraceptive costs to insurance providers when employers object on moral grounds.

Assessment

This infographic created with GOOD looks to answer the question: what is the state of birth-control coverage in America, and where do people stand on the issue?

Conclusion

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

Our Other Print Books and Related Information Sources:

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

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

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Seven Ways to Stretch Retirement Income

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Back to Basics

Assessment

Read more: 7 ways to stretch your retirement income http://www.bankrate.com/finance/retirement/7-ways-to-stretch-your-retirement-income-infographic.aspx#ixzz1qLZ0z5Ua

Conclusion

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

Our Other Print Books and Related Information Sources:

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

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

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NBER Bulletin on Aging and Health

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Year 2012 – Number One [Selected ME-P Reading Suggestions]

View a printable PDF copy of the 2012 No. 1 NBER Bulletin on Aging and Health at http://www.nber.org/aginghealth/2012no1/2012no1.pdf

The 2012 No. 1 Bulletin includes the articles below:

1)  Why Are Recessions Good for Your Health? by Ann Huff Stevens, Douglas Miller, Marianne Page, and Mateusz Filipski http://www.nber.org/aginghealth/2012no1/w17657.html

2)  How Did the Great Recession Affect Near Retirement-Age Households? by Alan Gustman, Thomas Steinmeier, and Nahid Tabatabai http://www.nber.org/aginghealth/2012no1/w17547.html

3)  The Draw-Down of Retirement Savings by James Poterba, Steven Venti, and David Wise http://www.nber.org/aginghealth/2012no1/w17536.html

4)  Abstracts of Selected Recent NBER Working Papers: http://www.nber.org/aginghealth/2012no1/WorkingPaperSummaries.html

Assessment

NBER Profile: David Neumark http://www.nber.org/aginghealth/2012no1/Neumark.html
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

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

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On the Society of Physician Entrepreneurs

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About SoPE

The Society of Physician Entrepreneurs (SoPE) was established as a community of interest in 2008 by several members of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS), including Dr. Arlen Meyers, the President & CEO. SoPE became a separate and independent legal entity; incorporating in Washington, D.C. in January 2011.

It is a 501 (c) 6 member organization with the stated purpose of providing support; idea stage through funding, for physician entrepreneurs with ideas on how to improve healthcare. Currently there are over 1,000 members included in their LinkedIn site.

Vision

SoPE’s vision is to accelerate physician originated biomedical innovation.

Mission

The mission of SoPE is to foster scholarship in biomedical entrepreneurship and provide education, training and support; idea stage through funding, to primarily community-based physician entrepreneurs in the interest of better healthcare.

Membership

SoPE membership is open to all physicians and also accepts individuals as associate members; representatives of medical device, legal, venture capital, and other firms with an interest in serving and/or supporting physician entrepreneurs.

Assessment

www.sopenet.org

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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Dire Emails About New Medicare Surtax Have It Wrong

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Enter the Obama Care Fear Mongers

By Rick Kahler MS, CFP®, ChFC, CCIM

www.KahlerFinancial.com

Ronald Reagan was noted for saying, “Trust but verify.” And, that was before Al Gore invented the Internet. When it comes to believing forwarded emails with dire warnings, it’s a good idea to go even further and “Verify before trusting.”

My e-mail

Here are a few lines from an email I’ve received numerous times over the past two years: “Did you know that if you sell your house after 2012 you will pay a 3.8% sales tax on it? That’s $3,800 on a $100,000 home . . . It’s in the health care bill and goes into effect in 2013. . . . Under the new health care bill all real estate transactions will be subject to a 3.8% Sales Tax. If you sell a $400,000 home, there will be a $15,200 tax.”

Before trusting this, I verified it with Paul Thorstenson, an accountant with Ketel Thorstenson in Rapid City, South Dakota. He said, “The information in this email is nearly entirely false.”

As with a lot of what you read on the Internet and hear from politicians, if you sift through the rubbish in this statement you will find a few grains of truth.

The True, and Not So True, Grains

First the truth

There is a 3.8% Medicare surtax contained in the health care act passed by Congress and signed into law by President Obama in 2009. It does take effect in 2013.

Now the falsehoods

This is not a sales tax. Sales taxes apply to the gross sale price of an item. Thorstenson explained this is a surtax that only applies to a gain (not the sales price) on sale of an investment asset. This not only includes real estate, but other investments like stocks, bonds, mutual funds, commodities, precious metals, and collectables. The surtax will also apply to other passive and investment income, such as interest, dividends, and net rental income.

The act only applies the surtax to investment gains when the total adjusted gross income on a return exceeds $250,000 for couples and $200,000 for single taxpayers. If your adjusted gross income is less than those amounts, the surtax will not apply.

If you sell a primary residence, the surtax will not apply to the first $500,000 of gain for couples or the first $250,000 of gain for individuals (IRS Code Section 121). “The surtax will only apply if the gain is above $500,000,” explained Thorstenson, who added, “And who even has a gain in a home these days, let alone over $500,000?”

Section 121

What is important to note is there is no Section 121 exclusion on the gains of vacation homes, second homes, or rental property. So if your adjusted gross income tips over $200,000 for individuals and $250,000 for couples in the year you sell an investment like a mutual fund, rental property, second home, or small business, you will be hit with a 3.8% tax on the portion that exceeds the $200/$250 threshold.

Assessment

Now consider what happens if President Obama gets his way and raises the capital gains tax to 28% on taxpayers earning over the $200/$250 limits. You could easily see the capital gains rate more than double from 15% to 31.8%. On every $100,000 of gain, that means a tax increase from $15,000 to $31,800.

Thorstenson told me, “This law is an atrocity in my opinion. It is an attack on successful investors, and the tax revenues aren’t even earmarked for Medicare. The proceeds just go into the general fund.”

The truth about this surtax is bad enough without believing exaggerations about it. The next time this particular email shows up in your inbox, just delete it. Trust me; I verified.

Conclusion             

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

Our Other Print Books and Related Information Sources:

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

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

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