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

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

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

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

    Later, Dr. Marcinko was a vital 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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How Doctors and Advisors are Defending Themselves Online

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About www.Reputation.com

Medical professionals, financial advisors and management consultants can now get instant results and find out about their reputation on the Internet.

Why?

Patients, people and clients are posting new content on the Internet every day. Keeping tabs on a personal or professional reputation, with this Internet monitoring service, may be vital to your reputation and practice success.

Why you may need Internet Monitoring

  • Finds existing posts about YOU online
  • Sends alerts whenever new posts appear
  • Finds exposed personal info in databases
  • Identifies and alerts you to damaging posts

Assessment

No one asks for job references, patient or client referrals, or background information anymore; they ask Google. And so, if your name turns up negatively in news or CRD reports, patient complaints, messy divorces, bankruptcies, legal filings, embarrassing photos or other questionable material, you’re likely to get passed over.

Check out www.Reputation.com and tell us what you think?

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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Increasing Operating Room Efficiency and Flow-Thru Logistics

Achieving Better Prep, Execution, and Discharge in the OR

By Denice Soyring Higman

By Adam Higman

By Dragana Gough

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Pre-Operative Phase

The OR should run like a well-oiled machine with patients moving through each stage seamlessly as the slightest factor can have lasting negative effects.  As with most things, the process of improvement must start at the beginning with Pre-admission Preparation.  Ensuring that patient files have an up-to-date History and Physical (H&P) and Laboratory and Radiology reports, as well as financial clearance will aid in the improvement process.

Some Vital Queries

One of the keys to improving preoperative performance is involving physicians. Assess where things stand by asking these questions:

  • Is Anesthesia involved in team decision making?
  • Are Medical Staff taking an active role in throughput?
  • Is your Anesthesia staff reviewing patient charts for the next day?
  • Anesthesia staff should assess a scheduled patient when the health history suggests potential problems

Holding Area or Not?

It depends.  Most hospitals do not use holding areas for all patients, even though the areas may exist.  Typical uses for holding areas include inpatient surgery patients and anesthesia services for line insertions, etc.  For smoother transitions in the OR, you should consider elimination of multiple stops for outpatients.

Operative Phase

Operative throughput should start with an assessment of your instrument and supplies. This begins with a review of your case cart readiness, including the number of trays and instruments, used and unused.  The goal of this review is to eliminate any additional unneeded instrument counting/processing.  To avoid case delays, ensure that all materials and supplies pulled for the case are correct and your preference cards are updated.  As with any procedure, make sure that the equipment is functioning correctly and that all personnel are fully trained for the job.  Perform proper maintenance checks ahead of time and review storage and organization procedures to ensure that the equipment is readily available for the next case start time.  Unreliable items that frequently break/malfunction can have a huge effect on turnover.

Team Approach to Operating Room Turnover

It is imperative that the OR staff be ready to start on time and every person in surgery should have a part of the turnover process.  Surgeons can set the stage for expectations, especially if they are present during turnover/set-up.  Do not let them perform a disappearing act.  Work with surgeon’s office staff on scheduling issues if there continues to be a problem.  For Anesthesia, Scrub, and Circulator staff, create buy-in for quick turnover time, utilize specialty teams, if possible, publicize turnover results (monthly), and celebrate improvements.  Anesthesia can help transport patients from Holding/Day Surgery to OR and housekeeping needs to be readily available to assist with cleanup.  Nursing staff can assist with cleanup of rooms and patient transport.  The bottom line, everyone needs to pitch in whether it is in their “job description” or not.

Post-Operative Phase

To continue the momentum, make strides in post-op procedures starting with discharging from the post-anesthesia care unit (PACU).  Acute care facilities should consider discharging select, low acuity patients directly from PACU.

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We are now preparing the next edition of our book: “Healthcare Organizations” [Management Strategies, Tools, Techniques and Case Studies]. In-Process from: (c) Productivity Press 2012
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The High Cost of College Loans

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Slowing Down the Speeding Train of Educational Debt

By Rick Kahler MS CFP® ChFC CCIM

www.KahlerFinancial.com

Trying to improve on the free market system almost always ends badly. Take medical school or college tuition as an example. It’s an important segment of our economy, since for most a college education is a door to higher wages and a better lifestyle.

Tuition Due in Cash

In the days before college loans were as ubiquitous as mountain pine beetles in the Black Hills of SD, college costs were like any other service. They were due in cash. Students and their parents had to save money or pay tuition out of their earnings. Many students worked their way through college. Those whose parents didn’t save, who couldn’t or didn’t want to work, or who didn’t have high enough grades to get scholarships didn’t go to college.

Supply and Demand Basics

Since colleges competed for students, of course, schools had to keep a close watch on their tuition rates. Raising tuition too much resulted in fewer students. Fewer students meant falling revenues. The two forces of supply (college capacity) and demand (the ability to pay the tuition) kept college costs in check.

Political Fiat

Understandably, getting a loan to pay for college tuition was difficult. What sane bank or investor would make a loan to an unemployed teenager with no collateral to speak of? If you could find someone willing to make such a risky loan, the interest rate was more like the high rates charged by credit card companies.

Well-intended politicians decided it wasn’t fair that those who didn’t have the means to pay the tuition were denied college educations. They decided the solution would be to require the taxpayers to loan unemployed teenagers the money they needed to pay their tuition, sometimes at interest rates lower than what the most creditworthy could obtain.

Easy Money

With tuition money easy to obtain through loans, demand for a college education increased. With the increased demand came higher tuition costs. This easy money is the primary reason that college tuition costs have far outpaced inflation and gone up twice as fast as medical costs since 1985.

Unfortunately, one consequence of loaning money to someone the private sector deems a poor risk is that many of those borrowers will be unable to repay the debt. That’s why the private sector took a pass on making the loans in the first place. It should come as no surprise that 60% of all student loans are currently in default. According to The Kiplinger Letter, December 2, 2011, that default rate will only get worse, as the unemployment rate of those aged 20 to 24 is around 14%. Today, taxpayers are on the hook for over 70% of the $1 trillion in outstanding student loans.

Rising Appetites

And the appetite for loans continues to rise. This year we will add another $100 billion in college debt to the books. Today, the average student graduates with over $27,000 of debt owed to institutions or the government and another $7,000 owed to parents. It isn’t uncommon for a medical student to amass over $200,000 of student loan debt.

College Loan Debt

The more college loan debt that graduates take into the workplace, the less they have to spend for vehicles, rent, and consumer goods. The 60% who are in default on their debt will also mar their credit ratings, so their purchasing power will suffer for years to come.

Assessment

If taxpayers ever decide to quit footing the bill, many colleges’ tuition rates will fall. They may crash as hard as housing prices did in Florida, Arizona, and California. It will be a buyer’s market. But, that day could be years away. In the meantime, savvy students will do whatever they can to minimize their college tuition and graduate debt-free. 

Conclusion

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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

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

Physician Advisors: www.CertifiedMedicalPlanner.org

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Emergency Room Doctor Pet Peeves [A Humorous Video]

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An Insider’s Look Around

[By Staff Reporters]

Are you tired of those long Emergency Room wait times and the overcrowding once inside? The ERs are usually jammed on weekends, and holidays, right?

***

***

Assessment

Well – This video is an example of the many issues an emergency department will unlikely be able to help you with this Memorial day weekend. But, those medical personnel, and ME-P readers, who work in the EMS or ER setting can hopefully relate to this encounter. A word to the …wise!

Video Link: http://www.youtube.com/watch?v=1KYmcwVGo9w&feature=related

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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Reasons Why Doctors Should Get New Automobile Tires

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My Diatribe on Saving Lives

By Dr. David Edward Marcinko MBA

[Editor-in-Chief]

Even though the price of crude oil, and hence gasoline is down of late, we’ve had an excellent response from doctor readers regarding our recent ME-Ps on automobiles, car insurance, driving costs, and fuel efficiency, etc. So, while not a forum for auto enthusiasts –  it is Memorial Day weekend after all – I’ll try to give our readers what they want with this personal essay.

Tires

Regardless of how well you care for your tires, the time will come when you must replace them. Safety as well as convenience is at stake. You don’t want a flat tire, but driving with worn tires also makes your car more difficult to control, especially in bad weather. Although many doctors get so busy they forget to check their tires, others do not know how to tell when they need to replace their tires. The following pointers will help you learn how:

Tread Depth

As tires roll over highways, the friction between them and the road wear down their treads. When tires have inadequate tread depth, they will not grip the road well and can lead to unsafe driving conditions, especially in the rain. The National Highway Transportation Safety Administration says the minimum safe depth of a tread is 1/32 of an inch. You may not have a ruler handy to measure your tread, but a simple technique makes checking your treads easy.

Take a penny and insert it into the tread groove with Lincoln’s head pointed downward toward the center of the wheel, facing outward. If you can see Lincoln’s forehead, the tire still has useful life. If you can see Lincoln’s hair on top of his head, you will soon need a replacement. Finally, if you can see the top of Lincoln’s head or the empty space above it, you should replace the tire as soon as possible.

Tire Inflation

tires

Wear Indicators

In the United States, tires have wear bars that provide a visual signal when they need replacement. Wear bars are shorter than healthy treads, so they are not noticeable to most drivers. When treads wear, the wear bars become visible and look like bridges across the tread grooves. When this happens, you need to buy new tires. Some doctors have trouble identifying wear bars at first, so if you can’t see them on your tires, ask a service technician or your local mechanic to show you.

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tires

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Age

Tires lose their integrity with age. Heat, sunlight, chemicals from the road, and gases from the air cause tires to corrode and oxidize, making them unsafe for use. This problem can especially affect spare tires which often sit in trunks unnoticed and unused for prolonged periods. Develop a replacement plan for any cars you own that get little use and for your spare tires. Tires wear at different rates depending on how often the car is driven and how many miles are put on it each year, so there is no exact time frame for tire replacement.

Other Signs of Wear

Not all tires wear evenly, so all medical professionals should periodically inspect every part of their tires. Look for uneven wear and flat spots on the edge of the tread. Replace tires that bulge on the sides. Visible wires signal that a tire has gone too far. The wires you see come from the metal belts that strengthen tires; manufacturers do not intend for this part of a tire to contact the road.

To avoid problems with your tires, inspect them regularly or have your mechanic or dealership inspect them anytime you go in for service or an appointment. Try adding a reminder to your task list, calendar, or schedule to make sure your tires never leave you stranded or put you or your car in danger.

My Tires

My own luxury weekend “fun” vehicle is a vintage European, pearl white, touring Jaguar XJ -V8- LWB. I love the control, precision and feel of my high-performance Pirelli P6 tires. It’s how I roll.

GOMER [Get Out of My Emergency Room]

I covered the emergency room for more than a decade; auto accidents due to poor tire tread are endemic especially at night and in the rain. So, please check your tires, and replace them if needed; today. We want our ME-P readership to grow. The life you save may be your own.

Assessment

This ME-P is a follow-up, by reader request, of a prior popular essay of mine. How Smart Doctors Can Save Big at the Pump I appreciate your interest.

More photos: https://healthcarefinancials.files.wordpress.com/2012/04/dems-jaguar.pdf

Conclusion

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

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

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

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How Much Money Do Americans [Doctors] Really Save?

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Not Nealry Enough – Much More Needed

This infographic from BillShrink.com displays the average savings accounts of typical Americans.

The Averages

It begins by showng the median household income, minus taxes, plus tax returns, which equals about $40,500 per year. The average American spends 94% of their disposable income, leading only $2,400 to be saved each year by this “average American,” but only 41% actually put that money into savings. That said, 43% of Americans spend more than they earn, leaving them in debt. When compared to the rest of the world, Americans save far less, with China saving 30% of their income on average.

Reasons for Not Saving

After displaying this staggering data, the infographic goes into a list of reasons by Americans can’t save money. These reasons include the following:

  • Lifestyle maintenace
  • Instant gratification
  • Credit cards don’t feel like real money
  • Avoiding the truth about their bank account
  • Egotism
  • Keeping up with the Jones’, other doctors’, etc.

Assessment

For anyone who has a problem saving, this infographic could be eye opening. If we as Americans could come to terms with the 5 reasons it’s hard to save, we could likely overcome these and start saving more. But, what about medical professionals?

Conclusion

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

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

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

Our Other Print Books and Related Information Sources:

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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