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

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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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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.

***

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

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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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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.

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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 Emotional and Financial Returns of Paying Off the Mortgage

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The ROI of Sudden Money

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

Suppose you’ve come into some extra cash, doctor. You decide to use it prudently in one of three ways: keeping it in cash, putting it into your retirement plan, or paying off your home mortgage. Which is the better option?

A Personal Decision

I usually find the answer, for most medical professioanls, isn’t just about the money. Paul Thorstenson, an accountant with Ketel Thorstenson, agrees. He calls paying off a home loan “as much a personal decision as an investment one.”

Factors for Doctors to Consider

The first factor to consider is investment return. Thorstenson suggests you think of paying off debt as a risk-free investment. “Because the interest is fully deductible if you itemize, your paydown of the debt is exactly equivalent to making a risk-free investment (like a CD) that pays you a taxable yield equivalent to your interest rate.”

If your interest rate is 4.5%, that’s the return you will earn on the money you invest in paying off your mortgage. If this is difficult to visualize, think of it this way. When you pay off your debt, you are actually buying your loan from your bank much like banks sell loans to one another. You continue to make payments, only now the payments go to you instead of the bank. The money you invested in “buying” (paying off) the mortgage is now earning 4.5% for you instead of your bank.

Paying down (investing) your own debt – for most medical professionals – is usually much better than keeping your funds in a money market, savings account, or certificate of deposit where they earn .5% to 2%.

Invest or Pay Off Debt?

A trickier decision is whether to invest the funds rather than pay debt. While investing always carries some risk, a diversified portfolio with 60% stocks and alternative investments (real estate, commodities, managed futures) and 40% bonds will typically return 6% to 8% over ten or more years.

If you can use your extra cash to maximize a contribution to a retirement account like an IRA or 401(k) or 403(b), you will earn 6% to 8% tax deferred (or tax free with a Roth IRA) which is better than paying off a debt yielding 4.5%. The younger you are, the more sense it makes to contribute the funds to a retirement account.

Non-Retirement Accounts

If the investments are not in a retirement account, then you must compare the after-tax return to get an equivalent comparison. For example, if you are in a 25% tax bracket and will earn 6% on your investment, your after-tax return is 4.5%, exactly equal to what you would earn in our example of paying down the debt. In this case, I would usually take the “guaranteed” investment of paying down the debt.

Mortgage Reduction Tax Benefits

In deciding whether to pay off a home mortgage, there are some additional tax and emotional considerations. Thorstenson notes that there are currently no limitations on the deductibility of loan interest, even by high income taxpayers. The “phaseouts” which expired two years ago will come back again in 2013 when (and if) the Bush tax cuts expire. “With the phaseout you will lose 3% of every dollar of deduction for every dollar of income that exceeds about $150,000.” For most taxpayers, this won’t be a major factor.

Emotional Benefits

Probably more important than the investment and tax considerations are the emotional benefits of paying off home mortgage debt. Thorstenson says, “It gives one a sense of freedom in that you are not handcuffed to a mortgage. I’ve never once seen a client  -or doctor- who had a paid off house leverage it back up and buy a mutual fund.”

Assessment

Like finishing medical school, paying off a home is a great emotional accomplishment. And, that sense of accomplishment may be the most important investment return you can have.

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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A Look at Some Famous IPOs [Including WebMD]

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Where Are They Now?

Assessment

With all the FB hoopla recently, we thought it would be fun to look at some other famous IPOs.

Link: http://marketday.msnbc.msn.com/_news/2012/05/23/11830823-facebooks-dream-ipo-is-starting-to-look-like-a-nightmare?lite

Channel Surfing the ME-P

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

Conclusion

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

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Introducing the ProPublica Patient Harm Community

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By Daniel Victor and Marshall Allen
ProPublica, May 21, 2012, 2:32 p.m.

On Facebook

You could fill a baseball stadium many times with the people who experts say die each year from an error [1], injury or infection [2] suffered while undergoing medical treatment. Many more are harmed.

Using Facebook, we’ve created a space to bring together those who have been harmed and others concerned about the problem. Join the community or follow the conversation here. [3]

Shared Stories

Group members have already shared stories of personal disability or the death of a loved one due to surgical mistakes, becoming infected with deadly drug-resistant bacteria and dental mishaps — including cases they claim were not properly addressed by health care providers.

For example, some of ProPublica’s past health-care reporting focused on gaps in nursing oversight [4], drug company payments to doctors [5] and abuses at psychiatric facilities [6]. With Facebook, we want to build a community of people — patients as well as doctors, nurses, regulators and health-care executives and others — who are interested in discussing patient harm, its causes and solutions. Among other things, we’ll post Q&As with experts and provide links to the latest reports, research and policy proposals. Your suggestions are welcome along the way.

Please Join Us

Share your story, ask questions and provide your perspective with other members. Your contribution may help shape our reporting.

The community is moderated by ProPublica reporters Marshall Allen [7] and Olga Pierce [8].

Marshall has covered patient harm since 2006. While at the Las Vegas Sun, Marshall’s series, “Do No Harm: Hospital Care in Las Vegas,” [9] won a Goldsmith Prize for Investigative Journalism and was a Pulitzer Prize finalist.

Assessment

Olga specializes in health policy, insurance issues and data journalism. She is a graduate of the Stabile Investigative Journalism Seminar at Columbia University and a finalist for the 2011 Livingston Awards.

Daniel Victor [10] and Blair Hickman [11], ProPublica’s social media team, try to also keep an eye on things.

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 on the Art of “Slow” Medicine

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And … Slow Dentistry, too!

By Ann Miller RN MHA

[ME-P Executive-Director]

BOOK REVIEW

We don’t know exactly when, but the practice of medicine has morphed into the delivery of health care.

Of course, if healthcare has become big business, we at the ME-P through our publication, text and handbooks, advertisers and sponsors, as well as speaking and consulting engagements may be partially to blame. But, hopefully not to the extreme it has become in some cases.

For example, did you know that Medicare has a CPT® medical payment code for a ten minute “treadmill” office visit?

God’s Hotel – The Book

So, if you aren’t sure – or are too young to know – of what’s happening today, the new book “God’s Hotel” is for you. It’s an engaging book by Dr. Victoria Sweet, a general internist from Laguna Honda Hospital that chronicles her perspectives from the last almshouse in the United States.

IOW: She is off the insurance grid and has discovered a way to benefit patients, not necessarily medical providers, by practicing something called “slow” medicine.

THINK: Marcus Welby MD

Slow Dentistry

Of course, our own ME-P investigative reporter Darrell K. Pruitt DDS, has been commenting and opining on this issue vis-a-vie the dental insurance industry treadmill of “fast” production line oral care.

For example, he often asks his colleagues: Are you fed up with successfully doing intricate handwork to exacting tolerances in mouths of anxious patients and then having to fight to get the patients’ insurance company to pay what they rightfully owe THEIR CLIENT.

IOW: Working faster and faster, for less and less compensation.

Assessment

“God’s Hotel”: A Doctor, a Hospital, and a Pilgrimage to the Heart of Medicine

Link: http://www.amazon.com/Gods-Hotel-Hospital-Pilgrimage-Medicine/dp/1594488436/ref=sr_1_1?ie=UTF8&qid=1337177871&sr=8-1

More from the ME-P: The Emerging Discipline of “Slow Medicine” and Professional Liability

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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Understanding Health Insurance Plan Coverage [A Video]

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Knowing Managed Care Terminology, too!

In this YouTube encore video presentation, Ricki Hasou from the MD Anderson Cancer Center talks about knowing your health insurance plan coverage and knowing the terminology behind managed care.

Link: http://www.youtube.com/watch?v=bDSm6vyHVVE&feature=related

Assessment

It is very important to understand how your health plan works when you sign up, before you begin making plans for cancer or any other type of medical treatment, and especially if you are leaving your designated healthcare service area.

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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The Anatomy of a DUI

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Do Not Drink and Drive

Drinking and driving has been one of America’s top issues in recent years. Just ask any emergency room doctor or nurse.

The current generation has been told over and over again about the dangers of drinking and driving. They’ve seen videos, brutal live-action plays, heart-wrenching self testimonies and even real life examples. Although, this infection of automobile alcoholism has managed to decrease fatalities by 5% in the last 3 years, the sheer amount of people who still drink and drive is astounding.

In fact, some universities have escort programs where students volunteer to be a ride home for those under the influence on Friday and Saturday nights.

Assessment

The battle against drunk drivers is one steep uphill treck. Alcohol has always been rooted in American tradition, but luckily taxies are too.

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:

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

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Why Physicians Should Double-Check Their 2012 Taxes

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A New AICPA Service

The American Institute of CPAs (AICPA) is offering a new service on the Total Tax Insights Website.

Surveys by the AICPA show that most Americans do not realize how much they are paying in federal, state and local taxes. AICPA President Barry C. Melancon noted, “Our recent national poll showed that taxpayers do not know the percentage of their income that goes to pay taxes or how many types of tax they pay annually. AICPA’s goal is to make federal, state and local taxes more transparent and the total tax insights calculator does that.”

In AICPA surveys, two-thirds of Americans did not understand the amount of tax that they were paying. Many did not realize that they were paying 10 to 20 different taxes over the course of a year.

The Total Tax Insights Website

AICPA’s website, www.totaltaxinsights.org is designed as a public service to help everyone understand taxes. AICPA believes that understanding taxes will be very helpful to Americans in their monthly financial planning.

The Total Tax Insights calculator enables taxpayers to enter their basic information. This includes their city, marital status, adjusted gross income and number of dependents. The optional entries include medical deductions, property taxes, charitable deductions and similar items.

After entering in your information, the calculator will show your federal income tax, state income tax and 10 to 15 other potential taxes. In addition to the list of potential taxes, there also is a pie-chart that shows the total amount and the percentage of each tax.

Assessment

Your identification is protected on the site. There is no name or identification required. The AICPA offers the educational website and calculator as a public service. So doctors, check it out and tell us what you think?

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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Tips from a Doctor for Optimizing Automobile Fuel Efficiency to Save Money

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Here’s How I Can Afford Gasoline for My Vintage Jaguar XJ-8-LWB

Dr. Dr. David Edward Marcinko MBA CMP

[Editor-in-Chief]

Dammit Spock! I’m a doctor – not an auto mechanic!

But, as the cost of fuel increases, more and more physician drivers are thinking about ways to maximize their gas mileage. As well as reducing the cost of fuel in the doctor’s pocket, optimizing fuel efficiency helps reduce the environmental impact of driving and conserves a resource that is only getting scarcer. This is especially true when you drive a luxury European touring sedan that has been said to be one of the finest in the world – like me!

There are a number of different ways drivers can increase their gas mileage. Advice and tips on fuel efficiency fall into a number of key categories.

My Tips and Pearls 

1. The car that you drive can make a big difference when it comes to fuel efficiency. Clearly, the larger and more powerful the vehicle is, the lower its gas mileage is likely to be. Car manufacturers are increasingly looking to new technology to help improve fuel efficiency, and if your car is quite old then it might be time to consider switching to a new model. Fuel efficiency statistics are now commonly published and compared on driving websites, and you should consider this before buying a new, or used, car.

2. Ensuring that your car is well-maintained is also a significant factor in the fuel efficiency that you will experience. Something as small and innocuous as spark plugs, for example, can reduce your gas mileage by as much as 12%. Over the course a year, the cost of the gas you waste is likely to be far more than the cost of replacing the part. If you are in doubt, talk to a trusted mechanic about maintenance, and alway have your car serviced at the recommended intervals.

3. Tire pressure can also have a significant impact on fuel efficiency. Low tire pressure can affect the vehicle’s performance, reducing gas mileage markedly. At the same time, it is also worth remembering that having the pressure too high can also have a negative effect. Ensure that you check your tire pressure on a regular basis. Talk to your mechanic if you are unsure about the optimum pressure value for your tires.

4. The way you drive your car also impacts your overall gas mileage. The official U.S. government website for fuel economy recommends that you always observe the speed limit, noting that for each 5 mph that you drive over a 60-mph speed limit, you are likely to paying an additional $0.29 per gallon of gas. Aggressive driving can reduce your gas mileage by as much as 33% on the highway. Carrying unnecessary weight in your car also uses more fuel, and you should always turn off your engine when the car is idle.

5. By changing the way in which you use your car, you can also save money. By combining multiple short trips into single, multi-purpose outings, you can prevent wasted mileage. Commuters can consider car sharing schemes, whereby drivers take it in turns to provide transport for fellow workers, reducing the number of cars on the road. You may even choose to switch to public transport on certain days of the week, to reduce the burden on your car.

6. You can even improve gas mileage by being careful about where and when you purchase fuel. Gas is at its densest during the coolest times of day. That means that by purchasing fuel early in the morning, or after dark, the volume of gas that the pump dispenses per unit will be moderately higher than at other, warmer times of day. Be savvy about prices in your local area too, keeping an eye out for the cheapest gas stations, but don’t go out of your way to purchase fuel. The money that you save at the pump is likely to be wasted on the additional mileage spent driving to the station.

7. As the cost of gas fluctuates on such a frequent basis, learning to optimize your fuel efficiency is a great way to ensure that you get the most out of the money you spend on fuel. Ensure that your vehicle is as efficient as possible, moderate your driving behavior, and moderate the amount of driving that you do to see the biggest improvements in your gas mileage.

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

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Mobile Health Solutions Video from AT&T

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From HIMSS 2012 and Physician Nexus

 

Video Link :http://physiciannexus.com/video/mobile-health-solutions-from-at-t

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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A Five Minute Treatise on Healthcare Economics 101

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An Encore YouTube Video by Joe Flowers

[Staff Reporters]

Why it costs so much, yet we still don’t get what we want and need—better healthcare that is cheaper.

Video link: http://www.youtube.com/watch?v=4Ry1AkbxRQU

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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Anatomy of Health Insurance

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An Overview

Health insurance is a hotly debated topic in this year’s presidential elections. Obama-care has some doctors and citizens fuming over the possibility of universal healthcare. But, before preaching, one should get a full grasp of what health insurance entails for a typical buyer.

This infographic gives an overview of how the health insurance industry works. One thing for sure, the health insurance industry is a booming business, as the typical 22-year old will pay $400,000 for health care and insurance in his or her lifetime.

Assessment

So study up with our handbooks, textbooks, dictionaries and this ME-P so you can responsibly select an insurance plan that is right for you.

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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Financial Infidelity – Are Doctors Different?

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On Marriage and Money

Married people are happier by many measures, yet many marriages are unhappy or fail because couples bring to the partnership significant debt, including [medical and graduate] student loans and credit card balances, as well as self-deceptions and outright lies about money.

Assessment

Creditdonkey’s new research infographic urges couples to take a clear-eyed look at their prospects for happiness if they are not honest with themselves and their partners about money.

But, is this perspective also true for doctors and 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.

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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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Helping Physicians Find a Trustworthy Trustee

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Estate Planning Basics

By Rick Kahler MS CFP® ChFC CCIM

www.KahlerFinancial.com

Trusts are effective financial planning tools based on a structure that is simpler than it may seem. The creator of the trust [doctor-layman, etc] contributes something of value into the trust and creates instructions as to how it will be managed and eventually disbursed. The trustee [third party] is responsible for keeping the property safe and managing and distributing it according to the instructions. The beneficiary [spouse-children, etc ] is the person or entity that eventually will get the property in the trust.

Trusts may be useful in estate planning, asset protection, and providing for elderly parents or other family members who may be unable to manage their own affairs.

Establishing a trust isn’t especially difficult, but it’s not a do-it-yourself project. It’s important to work with an attorney to be sure the trust complies with legal requirements and will actually carry out its intended purpose.

Trustee Selection

What may be the hardest part of setting up a trust is choosing the trustee. Here are a few suggestions that may help. Some of them come from information provided by the Financial Planning Association [FPA]:

1. Be sure you as the creator of the trust understand the trustee’s role. Ideally, trustees will have some expertise in legal matters, taxes, and investments. The specific knowledge needed will vary, depending on the scope and purpose of the trust. It’s important to discuss that purpose in detail with any potential trustees to be sure they have the necessary skills and are comfortable taking on the responsibilities.

2. Consider the pros and cons of choosing a personal or a professional trustee. Generally your choice will come from one of three categories: A personal trustee who is a close friend or family member, a personal trustee who is a professional advisor, or a corporate trustee such as a bank’s trust department.

A family member or close friend may already have inside knowledge of your circumstances, as well as having personal relationships with the beneficiaries of the trust and a personal commitment to carrying out your wishes. The possible downside is that the trustee may have conflicts of interest or find it difficult to enforce some trust provisions.

Professional advisors such as attorneys or accountants will have specialized knowledge that may be important. Even advisors who have worked closely with you will have a level of professional detachment that may make it easier to carry out your wishes, especially any that involve saying “no.”

With a corporate trustee, the relationship is with the firm rather than an individual, which provides continuity and protects the trust even if the original trustee is unable to continue serving. The downside is the lack of detailed personal knowledge and involvement.

3. Evaluate costs. Professional or corporate trustees will, of course, charge for their services. Friends or family members may not charge fees but really should be compensated appropriately. State laws govern the maximum fees trustees can charge and the specific services provided.

4. A commitment to take on the responsibilities of the trust and to carry out your wishes with integrity may be the most important quality for a trustee. Someone without financial and legal knowledge can always get help from professional advisors.

Assessment

Finally, remember doctor, the word “trustee” isn’t used by accident or coincidence. The trustee’s role is to act in your stead when you are unable to, managing the assets of the trust with the same care you would use and making the decisions you would make in the best interests of the beneficiary of the trust. The most essential factor in choosing a trustee is finding someone you can rely on to act on your behalf.

Who is, in short, trustworthy?

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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About PAPERbecause.com

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Paper is Good … Pass it On

Domtar is committed to the responsible use of paper.

They are also committed to communicating paper’s place and value to the businesses and people that use their products every day. Paper is a sustainable, renewable, recyclable, plant-based product that connects us in so many ways to the important things in life.

  • Great ideas are started on paper.
  • The world is educated on paper.
  • Businesses are founded on paper.
  • Love is professed on paper.
  • Important news is spread on paper.

That’s why they love paper.

Assessment

But, does this include paper medical records?

Visit: http://www.paperbecause.com/

Conclusion

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

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

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

Our Other Print Books and Related Information Sources:

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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Will Retirement Be a Bust for [Doctor] Boomers?

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Are Doctors Different?

By Rick Kahler MS CFP® ChFC CCIM

www.KahlerFinancial.com

If you’re a lay or medical professional Baby Boomer, or your parents are, here’s a ray of sunshine to brighten your day: Boomers have so severely underfunded their retirements that Congress may turn to their children to bail them out.

Dr. Basu Speaks

This is the gist of an article in the April issue of Financial Advisor magazine, by ME-P “thought-leader” Dr. Somnath Basu PhD, professor of finance at California Lutheran University. He notes, “The problem could be as big, if not bigger, than the 2008 financial crisis.”

The Study

A new study by the Center For Retirement Research, Boston College, detailed on CNBC.com, finds the retirement years for Boomers will be much leaner than for their parents. An estimated 51% of them will be unable to maintain their current lifestyles in retirement.

Ironically, one major contributor to this bleak picture is the Boomer generation’s own optimism and positive thinking. Raised in a society of abundance with expectations of prosperity, Boomers have over-spent and under-saved for decades. Many of them assume they will receive ample inheritances. They see increased life expectancy as a wonderful thing, forgetting to factor in the higher medical costs that will come with it. They expect to work well into their 70′s, disregarding statistics that show many of them will be forced to retire sooner due to health problems or job layoffs.

The Numbers

Let’s look at some decidedly pessimistic numbers from the Center For Retirement Research study. The median 401(k) and IRA balance for Boomers nearing retirement is $78,000. Only around half can expect to inherit from their parents, with the median inheritance amount $40,000. That adds up to a total nest egg of $118,000, which at a 4% withdrawal rate provides less than $400 a month for life. Combining that with the average Social Security check of $1,077 means retiring on an income just above the poverty level.

What’s the Solution?

Many Boomers say they plan to never quit working. Unfortunately, this is delusional. According to a new survey by the Society of Actuaries, “The 2011 Risks and Process of Retirement Survey,” over one-third of Boomers think they will never retire and only 10% say they will retire by 60. Statistics show, however, that 50% have actually retired before age 60. The main reasons are health and downsizing, which boomers discount. Well over 90% of them maintain they have a healthy lifestyle and won’t get sick. Boomers are so out of touch with reality I wonder how many, if asked, “Will you ever die?” would answer, “No,” or “Maybe.”

Sadly, only one-third of Boomers have a plan for financing their retirement, other than planning to work until the day they die. What’s the solution for the remaining two-thirds who are unprepared?

Unfortunately, for many older Boomers it is already too late. Their lack of planning for their retirement years may mean forcing their children and grandchildren to decide whether taxpayers can afford to pick up the tab.

Assessment

Younger Boomers can take control of their retirement by radically downsizing their lifestyles and increasing their income. This means selling expensive homes, cars, and toys and living as frugally as possible. The resulting savings should first go to pay off high-interest debt, then to fund to the max every available retirement plan. Another possibility is to consider various employment options, including government jobs which offer pension plans unavailable in most private sector jobs.

Conclusion

Wise Boomers will also encourage their own children to emulate the frugality and money skills of their grandparents. The kids will need those skills for their own futures—especially if they have to help their Boomer parents pay the bills.

But, are doctors the same as the rest of us – or do they differ on this issue?

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On the Genetic Information Non-Discrimination Act

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A Review of GINA – 2008

[By Carol Miller RN MBA]

This Act prohibits the use of genetic information to make health insurance coverage determinations and in employment-related decisions.

GINA supports a patient’s privacy. Forty states have enacted legislation related to genetic discrimination in health insurance and thirty-one states have adopted laws regarding genetic discrimination in the workplace according to the National Human Genome Research Institute.

Assessment

For more info: www.genome.gov

***

UPDATE 2020

Channel Surfing the ME-P

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Conclusion

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Evaluating ACOs at Mid-Launch

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Moving Forward but Challenges Ahead

[By ME-P Staff]

Accountable Care Organizations [ACOs] are generating considerable attention for their potential to improve the value of our health care spending through better coordination of care and new payment incentives that focus on quality and efficiency of care.

The Challenges

Yet, even as ACOs develop at a fairly rapid clip across the nation, they face substantial challenges.

For example, In this essay, Steven Lieberman reviews the ACO landscape in both the public and private sectors and examines the major obstacles confronting these emerging organizations, including limited tools for influencing patient choice, the need for immediate and sustained cost savings, and system-wide concerns about rising costs due to enhanced market power.

Assessment

Link: http://nihcm.org/images/stories/EV_Lieberman_FINAL.pdf

Conclusion

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FINANCE: Financial Planning for Physicians and Advisors
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The Trouble with Stock Marketing Timing

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Visual Statistics for ME-P Readers

Here are some statistics on the perils of market timing presented in an infographic format, including the facts that:

  • Over 20 years, ending in 2008, the annual return of the S&P 500 in the U.S. was 8.4% compared to the Average Investor who received 1.9%;
  • This cost market timers around $127,000 over that period; and
  • 85% of sell decisions are wrong and are manly based on emotion.

Conclusion

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The 20 Largest Private Companies in the US

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A look at the 20 largest private companies in the US

Interesting how many of them (8 of the 20) are in some way highly involved in food — Cargill, MARS, Publix, C&S Wholesale Grocers, US Foods, H-E-B, Meijer and Reyes Holdings.

And, although not grouped as such below, you could arguably add Love’s Travel Stops, Pilot Travel Centers and Aramark to that group – bringing it to 11 of the 20.

Assessment

Think any of these will go pubic; besides Facebook?

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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Actual DEA “Meth Lab” Drug Raid [POV Photo Essay]

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Just say No to “Illegal” Drugs

By Anonymous DEA Agent

Preparing for a clandestine night-time lab raid – inner city row-house; Baltimore, MD

Spot lights and infrared beams cast a luminescent hue.

Note the armed agent silhouetted in the attic window.

Assessment

Danger – these guys mean business.

Conclusion

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INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

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New-Age Physician Risks Courtesy of Health Information Technology

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Issues You May Not Have Considered

By David K. Luke MIM, Certified Medical Planner™

www.CertifiedMedicalPlanner.org

The entire nation continues to experience a medical malpractice liability crisis.

Facing physicians is the concern of frequency and severity of claims that either continues to rise or remains steady. And, much has been written about the impact of the liability crisis on physicians, the medical community, patients and access to care.

But, with health 2.0 connectivity, there are even more risks for doctors, and most all medical professionals, to consider.

So, here are a few fresh liability risks to your medical practice, to you, and to your patients courtesy of the health information age:

  1. Data breech risk. While not a new risk, the higher prevalence is new. The risks of a being fined by OCR due to the privacy rules of HIPAA because a practice had a data-breech with their EHR is becoming more common and very expensive
  2. Risks of telemedicine. As physicians become more technologically enabled in their practice of medicine, some are turning to real-time videoconferencing and other technologies. Some specialties such as psychiatry have been early adopters, but have to make sure they are still employing the same standards of care required by an in office visit (Cash 26). Also, the telephone can facilitate medical care but also result in adverse outcomes leading to telephone-related malpractice suits (Mondor, et al 517).
  3. Risks of new age medicine practices and their regulation. Case in point: Dry needling, which is like acupuncture, is a growing practice in places like Australia but is unregulated. Physicians should understand all regulatory and other risks when implementing new unregulated practices pushed by our new age society (Janz). Home births are on the rise in North America (even in Canada with government provided hospital delivery) but physicians end up dealing with the disasters and associated risks when they occur (Bochove 68).
  4. Reputation Risk. Reputation is a doctor’s most valuable asset. With the new age of internet and instant information, physicians must take great care in managing their reputation on such media sources as they are under increasing public and press scrutiny (Boyd 221).
  5. Communication risks to immigrants with limited non-native language proficiency. With today’s higher immigrant population in the United States, more medical practices are treating patients with limited English language proficiency. Clinicians now run the risk of not properly communicating medical risk information to these populations. A recent study shows that materials that include visual aids are being used by medical practices to effectively communicate with the patient (Garcia-Retamero, Rocio, and Mandeep, K. Dhami 47).
  6. The rise of the informed distrusting patient and related risks. With the ubiquity of medical information on the internet, the risks incurred by a medical practice in properly dealing with the newly informed patients with medical degrees from the University of Google Medical School are on the rise. Physicians must refine their “bed side manner” and improve their communication skills in order to deal with a more questioning patient population. Clinicians should actively discuss what patients have read on the internet when patients refer to their internet diagnoses (Lam-Po-Tang, John, and Diana McKay 130).

Works Cited

  • Bochove, Danielle. “Don’t Try This At Home.” Maclean’s 124.33/34 (2011): 68. MasterFILE Premier. Web. 27 Apr. 2012.
  • Boyd, M. “Managing Risk To Reputation.” Clinical Risk 15.6 (2009): 221-223. CINAHL Plus with Full Text. Web. 27 Apr. 2012.
  • Cash, Charles, D. “Telepsychiatry And Risk Management.” Innovations In Clinical Neuroscience 8.9 (2011): 26-30. CINAHL Plus with Full Text. Web. 27 Apr. 2012.
  • Garcia-Retamero, Rocio, and Mandeep, K. Dhami. “Pictures Speak Louder Than Numbers: On Communicating Medical Risks To Immigrants With Limited Non-Native Language Proficiency.” Health Expectations 14.(2011): 46-57. CINAHL Plus with Full Text. Web. 27 Apr. 2012.
  • Janz, StephenAdams “Acupuncture by Another Name: Dry Needling in Australia.” Australian Journal Of Acupuncture & Chinese Medicine 6, no. 2: 3-11. Alt HealthWatch, EBSCOhost. Web. 27 Apr. 2012
    • Lam-Po-Tang, John, and Diana McKay. “Dr Google, MD: A Survey Of Mental Health-Related Internet Use In A Private Practice Sample.” Australasian Psychiatry 18.2 (2010): 130-133. Academic Search Complete. Web. 27 Apr. 2012.
    • Maureen Mondor, et al. “Patient Safety And Telephone Medicine.” JGIM: Journal Of General Internal Medicine 23.5 (2008): 517-522. Academic Search Complete. Web. 27 Apr. 2012

Conclusion

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May Patients Privately Contract with their Doctors?

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Ask-An-Advisor

QUESTION: A question to ME-P readers and subscribers.

Medicare may disallow private contracting by federal law. But, can private insurances, whether PPO or managed care, legally prevent a patient from privately contracting with their doctor for services or goods above the contracted rates, as long as informed consent and appropriate waivers are executed in advance of the service?

IOWs: Do private managed care insurance companies have the legal  right to limit a person’s liberty to seek care above the constraints of the health insurers contract, if the patient so desires?  I understand that an insurer by contract with provider and patient is obligated to pay only a negotiated fee for a specific service or good, but if the patient desires a more accommodating service or extra features to a durable good, do they have the right to privately contract for such services beyond the contract payment or benefit restraints. I believe that this goes into state law safeguards for patient welfare in as much as most non-federal or non-ERISA health insurances are guided by state law.

Assessment

This is not a naïve question for I have posed it to various plan medical directors in our area and have had surprisingly varied responses.

I welcome your crowd-sourced comments with thanks in advance.

Dr. Mark D. Dollard

Loudoun Foot and Ankle Center

46440 Benedict Drive

Suite #111  – Sterling, VA 20164

703 444-9555 [ph] 703 444-1190 [fax]

mdollard@erols.com

Conclusion

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

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Physician Advisors: www.CertifiedMedicalPlanner.org

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On Pharma Marketing, Oysters and Testosterone Replacement Therapy

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Men flock to testosterone meds from Abbott, Lilly

Are testosterone drugs another hormone-replacement ordeal in the making?

Medical Opinions

Some doctors think so, Bloomberg reports. The testosterone products, including AndroGel from Abbott Laboratories ($ABT) and Axiron from Eli Lilly ($LLY), are selling like ice cream on a hot day, and they’re expected to keep growing at that pace.

Assessment

But. testosterone therapy has its risks, especially in men whose hormone levels aren’t pathologically low.

Link: http://www.bloomberg.com/news/2012-05-02/testosterone-chases-viagra-in-libido-race-as-doctors-fret.html

Conclusion

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How to Avoid Whitney Houston’s Estate Planning Mistakes

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Look at Money Scripts

By Rick Kahler MS CFP® ChFC CCIM

Since the death of singer Whitney Houston, I’ve seen several articles from attorneys and financial advisors about the errors in her estate planning. They have summarized three areas where it was badly flawed:

1. Lack of privacy. Ms. Houston had a simple will that was subject to public probate, rather than a living trust that would have kept her affairs private. Anyone with thumbs and access to the Internet can see a copy of her will.

2. Lack of protection from claims, con artists, and circumstances. The estate, estimated to be worth over 20 million dollars, was left to Ms. Houston’s daughter, Bobbi Kristina Brown. A vulnerable young woman just barely of legal age will receive three huge payouts over the next decade and become a multi-millionaire by the time she’s 30. A trust could have given her some limits and structure, as well as providing for advisors to help her learn how to manage her wealth and protect herself from predators.

3. Lack of tax planning. The federal estate tax of 35% on anything over $5,120,000 will apply to the estate, so Uncle Sam will take around a third of it off the top.

Estate Planning – How Time Flys By

Unfortunately, this lack of skilled estate planning isn’t all that rare among wealthy people; or even some medical professionals. So, here are a few of the money beliefs that may be behind inadequate estate planning:

  1. “Complicated estate planning is for rich people, and I’m not rich.” This may especially apply to owners of small businesses – like some doctors – who don’t have a particularly high income or lifestyle but whose land or businesses may be worth several million dollars. Yet good estate planning advice is especially important for them, because their heirs aren’t necessarily aware of or prepared for a substantial inheritance.
  2. “The financial advice that was good enough when I was just starting out is good enough now that I’m successful.” A tax preparer, accountant, or financial advisor who is highly competent with small individual or business matters may not have the knowledge necessary for more complex estate planning. Seeking out different financial advisors as your income and net worth grow is no different from consulting a specialist rather than a general practitioner if you have specific medical needs.
  3. “When you can afford the best, you’ll get the best.” Trying to save money by hiring bargain-basement financial advisors is almost always a mistake. It can also be a mistake to assume that someone who charges top-tier fees will always have top-tier skills and integrity. Even if a financial planner or other professional has a reputation as an advisor to the wealthy, it’s still essential to verify that the person or firm is right for you. Ask for references and be willing to ask hard questions about compensation, investment philosophy, and services. Make sure you are a client, not a customer. Work only with financial advisors who, like accountants or attorneys, have a fiduciary duty to put your interests first.
  4. “I know how to make money, so of course I know how to manage money.” Many highly educated and skilled professionals are high earners but don’t necessarily have the knowledge to manage their earnings well. In order to know whether the advisors you hire are competent, it’s important to learn the basics of investing and money management. Look for advisors who don’t set themselves up as “gurus” but are willing to teach and to work in partnership with you.

Assessment

When it comes to financial advice, it isn’t enough to find someone who will “make you feel like a million dollar bill.” It’s more important to find advisors who will help you take good care of all your dollars.

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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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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Which Hospitals Are Cutting Costs?

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And … Where Are They Doing It?

This infographic shows that about only 10% of US hospitals have aggressively cut costs during the recession.  Most hospitals have kept costs close to inflation with 1-5% annual increases.

Of those who aggressively cut costs, many service lines contributed, though general surgery was the largest, followed by neonatal, obstetrics, and infectious diseases.

Conclusion

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Ten Ways to Prevent Consumer Financial Fraud Transactions

By Dr. David Edward Marcinko MBA CMP™

[Publisher-in-Chief]

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Avoid Being Ripped-Off in the Modern Era

OK, I grew up on the “mean streets” of Baltimore City and took public transportation to high school through the crack addled neighborhoods, and drug-induced “zombies”, of West Baltimore.

I played stick ball in the parking lot of Johns Hopkins Medical School and Hospital, and watched the gang bangers “groan in – and bail out” of the ER.

Later, I attended Loyola University, daily also via public bus, and then came of age on the streets of South Philadelphia long before attending Temple University. And, I walked to work in the emergency room of Pennsylvania Hospital through it all.

So, as a journalist, doctor and financial advisor today, I guess I’ve got some street credibility or some sort of rep [good or bad]!

Accordingly, it is not unusual for me to be asked to speak or write about modern financial fraud prevention. Simple really … Street smarts!

Assessment

Link: Ten Ways to Prevent Fraud

What else can you add in sanitized form.

Conclusion

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