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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].

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    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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Stanford Health Care Will Test Digital Device Claims

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New Silicon Valley Startup – What the Doctor Ordered?

[By staff reporters]

A century ago, Sigmund Freud developed the radical idea that there is a lot more going on inside our heads that we know.

Today, many doctors (and patients) still stick by his groundbreaking theory.

But, it comes with a problem. As neuroscientist Eric Kandel notes in his book The Age of Insight, “psychoanalysis suffered from a serious weakness: it was not empirical and was therefore not amenable to experimental testing.”

***

rainbow http://www.gereports.com/post/112786788335/what-the-doctor-ordered-new-silicon-valley

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It is fitting that Dr. David Edward Marcinko, MBA, CMP™ and his fellow experts have laid out a plan of action in Financial Management Strategies for Hospital and Healthcare Organizations that physicians, nurse-executives, administrators, institutional CEOs, CFOs, MBAs, lawyers, and healthcare accountants can follow to help move healthcare financial fitness forward in these uncharted waters.
—Neil H. Baum, MD, Tulane Medical School

iMBA Inc – Supporting Doctors and their Consulting Advisors

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We are an emerging online and onground community that connects medical professionals with financial advisors and management consultants. We participate in a variety of insightful educational seminars, teaching conferences and national workshops. We produce journals, textbooks and handbooks, white-papers, CDs and award-winning dictionaries. And, our didactic heritage includes innovative R&D, litigation support, opinions for engaged private clients and media sourcing in the sectors we passionately serve.

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In the Health 2.0 era of political reform, our goal is to: “bridge the gap between practice mission and financial solidarity for all medical professionals.”  

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 BOOK REVIEW

Am I over-insured and thus wasting money? Am I under-insured and thus at risk for a liability or other disaster? I never really had the means of answering these questions; until now.

LLOYD M. KRIEGER; MD, MBA

[Rodeo Drive Plastic Surgery – Beverly Hills, CA]

More on Physician Suicide

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The Role of Hopelessness, Helplessness and Defeat

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Michael Lawrence Langan, M.D.

Boston, Massachusetts

Disrupted Physician

stewart_1

Although no reliable statistics yet exist, anecdotal reports suggest a marked rise inphysician suicide in recent years. From the reports I am receiving it is a lot more than the oft cited “medical school class” of 400 per year.

This necessitates an evaluation of predisposing risk factors such as substance abuse and depression, but also requires a critical examination of what external forces may be involved.  What acute and cumulative situational and psychosocial factors are involved in the descent from suicidal ideation to planning to completion?   What makes suicide a potential option for doctors and what acute events precipitate and trigger the final act?

Depression and Substance Abuse no Different from General Population

The prevalence of depression in physicians is close to that of the general population1,2 and, if one looks critically at the evidence based literature, substance abuse in medical professionals approximates that of the…

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Why I Love Amazon.com but Won’t Buy Its Stock

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By Vitaliy Katsenelson CFA

b385838e-683a-4798-b408-65d65d001799

You should look at your portfolio and want to throw up a little — this is how one value manager described what a true, die-hard value investor’s portfolio should look like. The two stocks I wrote about in my latest article — American Eagle and Aéropostale — have a tendency to elicit that unpleasant reflex in many investors today.I’m not writing this article as a pitch for those stocks (though, to be clear, my firm does own them) but to reinforce the lesson I have learned from past indecisions. If you want to buy a retailer selling clothes and shoes — items that are subject to fashion and weather risks — you want to buy them when they have missed their latest trend, when their financials look ugly and when the risks have already played out. One thing I like about these apparel retailers is that teens will shop there for just a few years. If a retailer screws up with one crop of kids, they get a second chance, because there is another crop coming right along. (The JCPenney crowd is not as forgiving. See “What I Learned from the JC Penney Fiasco .”)Also, unlike for the Best Buys and RadioShacks of the world, the Internet is not a significant threat to teen clothing retailers. Parents get sick of their kids driving them crazy at home on weekends — plus, let’s be honest, when your kids get to be teenagers, you are definitely not cool anymore. There is, however, an amicable solution: Drop the kids off at the shopping mall — a large, relatively secure enclosed space with video cameras and security personnel, with a movie theater, inexpensive fast food and a lot of retailers.

As I am writing this, I’m realizing that this is a quintessentially American phenomenon. The public transportation system is not really well developed in the U.S., and distances are large. Dropping off your kids at the mall pretty much ensures that they’ll still be there when you come back for them. And before the movie but after they have filled their bellies with French fries … you guessed it, the kids go to Aéropostale or American Eagle. Kids go there to kill time.

stock-exchange-

Growing up in Russia, which in many respects was a lot like Europe, we walked (there were wide sidewalks along the streets) and took public transportation. These were the times before the nightly news was allowed to talk about real local crime, and my parents were not really worried about safety on the streets, though if I was really, really late coming home, my mom still called the hospitals. I don’t know if Russian parents still feel the same way about letting their kids roam the streets today.

On a separate but related topic, for the past year, since we got Amazon Prime, I’ve been hooked on shopping on Amazon.com . I have bought things there that I never thought I would. We just bought a bunk bed for the kids. I read all the positive and, most important, the negative reviews. The bed was delivered to my door, and I did not have to pay for shipping. If I had bought it at Ikea, I would have had to either pay for delivery or load and unload boxes into and out of our minivan. But what is amazing about Amazon is how easy it is to deal with them and return things that don’t work out.

A few weeks ago we bought a foam mattress. It was vacuum-sealed, so when we opened it and removed the plastic it expanded to double the size of the original packaging. However, the mattress had an unpleasant smell that had not gone away after a week of airing. So I had a mattress that I couldn’t stuff back in the original box to return. I went on Amazon’s website — I didn’t even bother calling them but hit the “chat” button. Ten minutes later my problem was solved. A service truck (not UPS or FedEx) would pick up my mattress as is, without the original packaging, and it would not cost me a dime.

My wife was not very happy with me for buying this mattress and having to return it. But I reminded her to just imagine how much money and time we’d have wasted if we’d bought at a traditional retailer — we would have had to pay for delivery (a cost we wouldn’t recoup) and then pay again for delivery back to the store.

Amazon Prime is an ingenious idea. For a bit less than $100 a year, I receive free shipping on any item — no limits or constraints. This also buys my loyalty to Amazon. (Yes, my loyalty is that cheap!) I don’t even think about checking prices with other retailers — I know that with them I won’t get free shipping (both ways), incredible selection, the reviews of other buyers, absolutely pain-free customer service and competitive prices. Also, Amazon already has my work and home addresses and my credit card information. So Amazon Prime has done something that you wouldn’t think is possible: It has created online loyalty.

This new loyalty presents me, as an investor, with an interesting dilemma: What do I do about Amazon’s stock? Answer: absolutely nothing. It is incredibly difficult to value Amazon shares. Today they trade at 90 times next year’s earnings. I can definitely see how Amazon’s sales will grow over time, but because the company is not focused on making money, I have no idea whether that bright future is already priced in or not. Investors are forgiving Amazon for not making money today because at some point it will start to. It will stop investing in new product categories, it will raise its prices, and customers will be forgiving. So they may have a workable strategy.

But here is what I have learned over the years. You don’t have to own all the great companies. You can just enjoy their products and services until they stumble. They always do. Wall Street love affairs are like Hollywood marriages; they’re not forever. Look at Apple . I have always loved their products (I have owned every single iPhone), but I waited until I could buy the stock on my own terms, when I could value it and have a margin of safety. The same applies to electric car–maker Tesla Motors. My next car will probably come from them, but I’ll wait patiently for Tesla’s stock to become reacquainted with the concept of gravity.

ABOUT

Vitaliy N. Katsenelson, CFA, is Chief Investment Officer at Investment Management Associates in Denver, Colo.
 

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Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners(TM)

BOOK REVIEW

This is an excellent book. It is all inclusive yet easy to read with current citations, references and much frightening information. I highly recommend this text. It is a fine educational and risk management tool for all doctors and medical professionals.

DR. DAVID B. LUMSDEN; MD, MS, MA

[Orthopedic Surgeon-Baltimore, Maryland]

Talking about End-of-Life Care

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The Importance of … EOL Care

[By Samantha Wanner]

***

It’s not easy, but the medical treatments you would want near the end of life need to be discussed with others. If you never bring up the topic and you were unexpectedly incapacitated and unable to speak for yourself, your medical wishes would never be known.

***

***

Important Topic

Despite the topic’s importance, only 27% of Americans report having talked with their families about end-of-life care. The best way to make your medical wishes known is to create an advance directive and share it with your family and your doctor.

An advance directive is actually two legal documents that enable you to plan and communicate your end-of-life wishes.  When you create your advance directive, you are being proactive about your medical care and sparing your loved ones from having to make difficult medical decisions in a time of crisis.

Don’t wait for a crisis. Create your advance directive, share copies with your loved ones and doctor and keep your copy in an accessible location others can find.

***

end_of_life_infographic

***

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Give your loved ones peace of mind.

Would they know what you want if you couldn’t talk? Do you know what you would want near the end of life? Find your own answers. Then open the conversation with the people you love. You are giving everyone a priceless gift.

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BOOK REVIEW

Physicians have more complex liability challenges to overcome in their lifetime, and less time to do it, than other professionals. Combined with a focus on practicing their discipline, many sadly fail to plan for their own future. They need trustworthy advice on how to effectively protect themselves, families and practice, from the many overt and covert risks that could potentially disrupt years of hard work.

 Fortunately, this advice is contained within RISK MANAGEMENT, LIABILITY INSURANCE, AND ASSET PROTECTION STRATEGIES FOR DOCTORS AND ADVISORS [BEST PRACTICES FROM LEADING CONSULTANTS AND CERTIFIED MEDICAL PLANNERS™]. Written by Dr. David Edward Marcinko, Nurse Hope Rachel Hetico and their team of risk managers, accountants, insurance agents, attorneys and physicians, it is uniquely positioned as an integration of applied, academic and peer-reviewed strategies and research, with case studies, from top consultants and Certified Medical Planners. It contains the latest principles of risk management and asset protection strategies for the specific challenges of modern physicians. My belief is that any doctor who reads and applies even just a portion of this collective wisdom will be fiscally rewarded. The Institute of Medical Business Advisors has produced another outstanding reference for physicians that provide peace of mind in this unique marketplace! In my opinion, it is a mandatory read for all medical professionals.

DAVID K. LUKE; MS-PFP, MIM, CMP™

[Net Worth Advisory Group, Inc – Sandy, Utah]

Podcast on Physician Employment Contracts

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Dennis-Hursh

By Dennis Hursh, PAHealthLaw.com

In this podcast episode, we are talking to Dennis Hursh, a physician focused attorney. In today’s interview, Dennis reveals why he tells his clients:

  • The standard physician employment agreement is a mythical creature
  • Don’t sign a letter of intent intending on changing the terms when you sign the employment contract
  • Don’t be afraid to negotiate – if they’ve made an offer to you, they are serious and usually will negotiate
  • The meek may inherit the earth, but they rarely obtain the best compensation packages.

***

Healthcare Gov Search

Click here to listen to this episode

***

More:

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

I read and use this book, and several others, from Dr. David Edward Marcinko and his team of advisors.

JOHN KELLEY; DO

The “White Coat Investor” PodCast

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By Dr. James Dahle MD – White Coat Investor

Jim Dahl md

Dr. James Dahle, editor of www.whitecoatinvestor.com and the rising star of physician financial advice and straight talk about success was kind enough to share his time and expertise with us and talked to us about:

  • What got him so interested in getting a financial education and why he shares that knowledge with other docs
  • How med students can minimize student loan debt and why that is so important
  • Insurance and why it is imperative that you have the right kind
  • The importance of creating profitable habits for your success

***

statistics

Click here to listen to this episode

***

Assessment

His new book is The White Coat Investor: A Doctor’s Guide to Personal Finance and Investing.

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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

Physicians who don’t understand modern risk management, insurance, business and asset protection principles are sitting ducks waiting to be taken advantage of by unscrupulous insurance agents and financial advisors; and even their own prospective employers or partners. This comprehensive volume from Dr. David Marcinko, and his co-authors, will go a long way toward educating physicians on these critical subjects that were never taught in medical school or residency training.

JAMES M. DAHLE; MD, FACEP

The Third Industrial Revolution Will Be Crowd-Sourced and Digitized

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Meet Your Maker

[Staff reporters]

Henry Ford was fond of saying that “nothing was particularly hard if you divided it into small jobs.” He followed his own advice, built world’s first assembly lines that cranked out 15 million Model Ts, and left his competitors in the dust. Engineers are now taking Ford’s advice to the extreme and breaking down the factory to bits and bytes.

“Software, data and analytics are changing what we can make in ways I couldn’t imagine when I left school,” says Christine Furstoss, global technology director at GE Global Research. “It’s more than 3-D printing jet engine parts from a digital file, which we already do. We can build a factory that can make itself better. We call it the Brilliant Factory.”

Furstoss spent a recent Tuesday afternoon at the White House, where President Obama announced that he would open two new innovation institutes to boost advanced manufacturing in the U.S. The first one, in Chicago, will focus on digital manufacturing and design innovation.

The other, in Detroit, will experiment with light-weight materials. “It’s all about growing a new generation of workforce,” Furstoss says. “The next manufacturing revolution can be an American revolution.”

***

Soldiers

http://www.gereports.com/post/77834521966/meet-your-maker

***

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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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Milliman Medical Index [CPI June 2015]

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By Javier Sanabria

The price of medical care boosts Consumer Price Index June 2015

A sharp rise in medical care prices contributed to a recent increase in the Consumer Price Index (CPI).

Although economists and healthcare experts have not clearly identified the reasons for the spike, the 2015 Milliman Medical Index (MMI) indicates that prescription drugs are driving medical costs upward.

MMI co-author Chris Girod offers some perspective in this CNBC article.

***

The so-called medical care index, maintained by the Bureau of Labor Statistics, rose 0.7 percent in April, “its largest increase since January 2007,” the BLS wrote in a report issued Friday. The BLS report comes three days after the large actuarial and consulting firm Milliman projected 6.3 percent growth in the costs of health care for a typical family of four on an employer-based plan in 2015. That compares to a low-water mark growth rate of 5.4 percent last year. Milliman’s report is the latest indication that health-care costs, which saw a historic slowdown in their rate of inflation in the years after the Great Recession of 2008, are headed back up toward the trends seen before the financial meltdown. Before the recession, double-digit inflation in health-care costs was common. “There’s a correlation between the CPI medical index and the MMI, but they’re very different measures,” said Chris Girod, a principal and consulting actuary at Milliman, who added that the MMI looks at a broader range of prices. “The annual increases [in the MMI] tend to be a lot higher than CPI.” Milliman’s report blamed resurgent inflation on price increases for prescription drugs, particularly specialty drugs. “The rest of the category, the increases were pretty ho-hum this year,” he said. Prescription drug prices overall are expected to increase by 13.6 percent in 2015, according to Milliman’s index. In the category of specialty drug prices alone, “the annual increases are around 20 percent right now,” Girod said. Those specialty drugs include Sovaldi, made by Gilead, which in a 12-week course of treatment can cost $84,000. “The drug trends have actually been coming down in the last four or five years until now,” Girod said.

***

stock market

See more at:

http://www.healthcaretownhall.com/#sthash.xgDF7hpd.dpuf

***

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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Information Overload & Healthcare’s Direction

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Iron Lung Ward Blog post by Joe Babaian

The difficulty lies not so much in developing new ideas as in escaping from old ones.
– John Maynard Keynes

Innovation distinguishes between a leader and a follower.
– Steve Jobs

We’ve all been embracing the shift in healthcare from information being contained to just the clinic visit, the surgery waiting room, the nurses’ office, and printed newspaper article. The good old days when the information we received was the information we believed. Well, we all know the good old days weren’t all that good and it’s the journey of developing new ideas and new innovations that takes hard work and matters the most.

We have reached a point where the quantity of information in healthcare is so massive that it actually has become opaque to many – the very people who stand to benefit from new options, current research, and new ways of communicating…

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PERSONAL FINANCIAL ACCOUNTING AND INCOME TAXATION FOR DOCTORs

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[The Ethical Pursuit of Tax Reduction and Avoidance]

perry-dalessio-cpa

[By Perry D’Alessio CPA]

The objective of tax planning is to arrive at the lowest overall tax cost on the activities performed.  In as much as physicians constitute 14% of the so-called and maligned “one-percenters” [$388,905 earned-not passive income/year]; this essay will address some methods and strategies to reduce federal and state income taxes. It is applicable to all physicians and medical professionals; as independent practitioners or employees.

So, how much in income taxes do the wealthy pay? The top 10 percent of taxpayers paid over 70 percent of the total amount collected in federal income taxes in 2010, the latest year figures are available, according to the Tax Foundation, a think tank that advocates for lower taxes. That’s up from 55 percent in 1986. The remaining 90 percent bore just under 30 percent of the tax burden. And, 47 percent of all Americans pay hardly anything at all.

Realize, that’s just federal income tax and doesn’t include payroll tax for Social Security and Medicare (which the vast majority of people pay), plus state taxes and all of the other taxes we face. When you add them all together; using figures from the Tax Policy Center and the Institute on Taxation and Economic Policy. Earners in the top 1 percent pay about 43 percent of their incomes in tax. People in the middle quintile pay 25 percent while the poorest fifth pays 13 percent.

Finally, before you assume these one- and 10-percenters are living on luxury yachts and in million-dollar mansions, consider how little money it takes to be a top wage earner.

According to 2011 IRS data, the top 1 percent have adjusted gross incomes of $388,905 per year or more. To be in the top 10 percent, you need an adjusted gross income of just $120,136 or more. These are good incomes to be sure, but definitely not enough to be out work, or the medical office, for more than a few weeks each year.

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Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners(TM)

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Now consider the following more specifically:

  • 42 percent of all federal tax revenue came from individual income taxes in 2010 and it has been the largest single source of revenue since 1950.
  • Individuals paid more than $2.2 trillion in 2010.
  • Bush-era tax cuts have finally expired, giving us the 20th century tax rates with the top income tax rate of 39.6%, we have not seen rates this high in almost 15 years.
  • 39.6% tax rate kicks in at $400,000 for individual taxpayers and $450,000 for married couples filing jointly.
  • Taxpayers who make over $200,000 ($250,000 for married taxpayers) will be subject to the Medicare surtax. If that’s you, Medicare surtax will be tacked on to your wages, compensation, or self-employment income over that amount. The amount of the surcharge is .9%. 
  • Net Investment Income Tax (NIIT) new as of 2013; if you have both net investment income and modified adjusted gross income (MAGI) of at least $200,000 for an individual taxpayer and $250,000 for taxpayers filing as married an additional 3.8 percent of the net investment income is an added tax. 

ASSESMENT

So, where do you fall on this schematic, doctor?

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ABOUT

Perry D’Alessio has twenty years’ experience in public accounting. He specializes in the taxation of closely held businesses and their owners, as well as high wealth individuals. He has a broad range of experience that includes individual, corporate, partnership, fiduciary, estate, and gift taxation. Business development has also been a focus. Particularly in the Healthcare and Fitness Industry, he worked with successful entities whose emphasis was on growth through development of strategic relationships and unit building.  Mr.  D’Alessio received his Bachelor of Business Administration degree in Accounting from Baruch College. He is a Certified Public Accountant in New York. He is a member of the American Institute of Certified Public Accountants (AICPA), the New York State Society of Certified Public Accountants (NYSSCPA). He served on several New York State Society tax committees including: PCAOB and HealthCare. Mr. D’Alessio presents at financial and medical associations throughout the region, and authored a book chapter in the “Financial Management Strategies for Hospitals and Healthcare Organizations” for the Institute of Medical Business Advisors, Inc.

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On Health Plan Member Portals

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By http://www.MCOL.com

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Drug Companies and Doctors [A Story of Corruption]

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Disrupted Physician

Drug Companies and Doctors: A Story of Corruption.

What we need is a Marcia Angell to take on the multi-billion dollar drug and alcohol testing, assessment and treatment industry.

Screen Shot 2015-06-01 at 7.22.25 PMWhile all eyes were focused on the drug companies these multi-billion dollar industries erected a scaffold of immunity and profit by removing (and blocking) themselves from essentially all aspects of accountability; answerability, justification for actions and the ability to be punished by outside actors.    The 2009 quote in reference to “big pharma”  is just as applicable to the drug and alcohol testing industry,”  the inpatient assessment and treatment centers and the “authorities” pushing public policy and swaying public opinion to accept irrational and illegitimate authoritative opinion as truth.

And unlike the pharmaceutical industries carefully constructed “bent science” which requires a keen eye and critical analysis , the evidence-base supporting the testing, assessment and treatment industry rests on a foundation that can…

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Claude Monet‏

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Master Pieces of Impressionist

Monet’s ambition of documenting the French countryside led him to adopt a method of painting the same scene many times in order to capture the changing of light and the passing of the seasons.

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ImageProxy

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From 1883 Monet lived in Giverny, where he purchased a house and property, and began a vast landscaping project which included lily ponds that would become the subjects of his best-known works. In 1899 he began painting the water lilies, first in vertical views with a Japanese bridge as a central feature, and later in the series of large-scale paintings that was to occupy him continuously for the next 20 years of his life.

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Editors of World’s Most Prestigious Medical Journals…Speak?

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“Much of the Scientific Literature, Perhaps HALF, May Simply Be Untrue”

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About Inventionland‏

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Bring Your Idea to Life with Inventionland

[By staff reporters]

Inventionland, the world’ s largest invention factory, through their exclusive relationship with Davison, can help take your ideas for the new inventions and develop them into working prototypes!
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Find out how Inventionland can help you!

Medical: http://inventionland.com/?s=medical

Assessment

Have an invention or a product idea?  Inventionland can help take your Idea to the next level!

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Your Organs May Soon Report Their Status Over a New Generation of Wireless Medical Sensors

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Facebook for the Body?

[By staff reporters]

Mike Harsh, chief technology officer for GE Healthcare, tells the story of a doctor who had trouble placing a stethoscope to the chest of a cardiac patient and listen his heart because of a tangle of cables coming from monitoring devices attached to his torso.

“You sort of understand what the problem is,” Harsh says. “People wear so many wires. It just tethers them right to their beds.”

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image

http://www.gereports.com/post/74545052915/facebook-for-the-body-your-organs-may-soon-report

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UNDERSTANDING MEDICAL PRACTICE CYBER SECURITY RISKS

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

Mitigations for the Digital Health Era

Shahid N. Shah MS

[By Shahid N. Shah MS]

There has been a tremendous explosion of information technology (IT) in healthcare caused by billions of dollars of government incentives for usage of digital healthcare tools.

But, IT systems face threats with significant adverse impacts on institutional assets, patients, and partners if sensitive data is ever compromised. Every health enterprise is required to confidentiality, integrity and availability of its information assets (this is called “information assurance” or IA). Confidentiality means private or confidential information must not be disclosed to unauthorized persons. Integrity means that the information can be changed only in an authorized manner so as to maintain the correctness of the information. Availability defines the characteristic that information systems work as intended and all services are available to its users whenever necessary.

It is well known that healthcare organizations face and have been mitigating many risks such as investment risk, budgetary risk, program management risk, safety risk, and inventory risk for many years. What’s new in the last decade or so is that organizations must now manage information assurance risks related to operating its information systems because information systems. IT is now just as a critical an asset as most other infrastructure managed by health systems. It is important that information security risks are given the same or more importance and priority as given to other organizational risks.

As health records move from paper native to digital native, it’s vital that organizations have information risk management programs and security procedures that woven into the culture of the organization. For this to happen, basic requirements of information security must be defined and implemented as part of both the operational and management processes. A framework that provides guidance on how to perform these activities, and the co-ordination required between these activities is needed.

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hacker

[Black Hat Medical Hacker]

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INTRODUCTION

The Risk Management Framework (RMF), supported by the National Institute of Standards and Technology (NIST) provides this framework. The NIST 800 series publications provide a structured approach to achieve risk management. It provides broad guidance and not necessarily all the prescriptions, which means it can be tailored to meet the organization’s specific needs and providing the flexibility needed for the different organizations. Using the NIST RMF helps organizations with risk management not only in a repeatable manner, but also with greater efficiency and effectiveness. Healthcare information assurance is complex and without a framework that takes into account a broad risk management approach, it is difficult to consider all the intricacies involved.

The NIST Risk Management Framework consists of a six step process designed to guide organizations in managing the risks in their information systems.

The various steps as defined in the NIST specifications are the following:

  • Categorize the information system and the information processed, stored, and transmitted by that system based on an impact analysis.
  • Select an initial set of baseline security controls for the information system based on the security categorization; tailoring and supplementing the security control baseline as needed based on an organizational assessment of risk and local conditions
  • Implement the security controls and describe how the controls are employed within the information system and its environment of operation.
  • Assess the security controls using appropriate assessment procedures to determine the extent to which the controls are implemented correctly, operating as intended, and producing the desired outcome with respect to meeting the security requirements for the system.
  • Authorize information system operation based on a determination of the risk to organizational operations and assets, individuals, other organizations, and the Nation resulting from the operation of the information system and the decision that this risk is acceptable.
  • Monitor the security controls in the information system on an ongoing basis including assessing control effectiveness, documenting changes to the system or its environment of operation, conducting security impact analyses of the associated changes, and reporting the security state of the system to designated organizational officials.

All information systems process, store and transmit information. What is the possible impact if a worst case scenario occurs that causes endangers this information? A structured way to find out the potential impact on the confidentiality, integrity and availability of information can be done through the first step of NIST RMP, the categorization of information systems.

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keyboard

[Triple Redundant Passwords and Encryption]

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The NIST SP 800-60 [1, 2, 3 4] provides such guidance. The potential impact is assigned qualitative values – low, moderate, or high. Based on these impact levels for each of the information type contained in the system, the high water mark level is calculated, that helps in selecting the appropriate controls in the subsequent steps.

Organizations need to mitigate risks adequately by selecting an appropriate set of controls that would work effectively. In the selection of security controls step, the set of controls are chosen based on the categorization of the information system, the high water mark and the goals of the organizations.

These baseline controls are selected from NIST SP 800-53 [5] specification, one of three sets of baseline controls, corresponding to low, moderate, high impact rating of the information system. These baseline controls can be modified to meet specific business needs and organization goals. These tailored controls can be supplemented with additional controls, if needed, to meet unique organizational policies and environment factors and its security requirements and its risk appetite. The minimum assurance requirements need to be specified here.

All the activities necessary for having the selected controls in place, is done in the implementation of security controls step. The implementation of the selected security controls will have an impact on the organization risks and its effects. NIST SP 800-70 [6, 7] can be used as guidance for the implementation. An implementation strategy has to be planned and the actions have to be defined and the implementation plan needs to be reviewed and approved, before the implementation is done.

Once the controls are implemented, then the assessment of security controls is done to find out whether the controls have been correctly implemented, working as intended, and giving the desired output with respect to the security requirements. In short, whether the applied security controls are indeed the right ones, done in the right way, giving the right outcome. NIST SP 800-53 [5], NIST 800-53A [6], NIST 800-115 [8-11] can provide the necessary guidance, here. 

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md-defeated-

[Frustrated Physician]

***

The authorization of information systems is an official management decision, authorizing that the information system can be made operational, with the identified risks mitigated and the residual risks accepted, and is accountable for any adverse impacts on the confidentiality, integrity and availability of information systems. If the authorizing personnel find that the risks are not mitigated and hence can compromise the sensitive information, they can deny authorizing the information system. NIST SP 800-37 [2] provides guidance on authorization. The authorizing personnel are to be involved actively throughout the risk management process.

Risk management is not one-time process, that once it is done, it is forgotten. It is a continuous process, to be integrated with day-to-day activities. One of the key aspects of any risk management is the monitoring of security controls to check whether the controls are performing as intended. The main focus of monitoring security controls is to know whether the controls are still effective over a period time, given the changes that occur in the information systems — the changes in hardware, software and firmware, the changes in environment factors, operating conditions etc. NIST SP 800-37 [2] provides guidance about this. And, if the security controls are found to be ineffective, the cycle starts again, with either re-categorization or selecting another set of baseline controls, or assessing the effectiveness of the controls once more etc.

Regardless, in all the steps in risk management framework, one of the important aspects is communication. Appropriate documents needed to be generated in all the steps, reviewed and kept up-to-date.

Organizational risk management provides great benefits to the organization because it helps to prioritize the resources, increase interoperability, and reduce costs incurred due to the adverse effects. It helps to prevent unauthorized access to personally identifiable information which will lead to security breaches. 

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ABOUT 

Mr. Shahid N. Shah is an internationally recognized healthcare thought-leader across the Internet. He is a consultant to various federal agencies on technology matters and winner of Federal Computer Week’s coveted “Fed 100″ Award, in 2009. Over a twenty year career, he built multiple clinical solutions and helped design-deploy an electronic health record solution for the American Red Cross and two web-based eMRs used by hundreds of physicians with many large groupware and collaboration sites. As ex-CTO for a billion dollar division of CardinalHealth, he helped design advanced clinical interfaces for medical devices and hospitals. Mr. Shah is senior technology strategy advisor to NIH’s SBIR/STTR program helping small businesses commercialize healthcare applications. He runs four successful blogs: At http://shahid.shah.org he writes about architecture issues; at http://www.healthcareguy.com he provides valuable insights on applying technology in health care; at http://www.federalarchitect.com he advises senior federal technologists; and at http://www.hitsphere.com he gives a glimpse of HIT as an aggregator. Mr. Shah is a Microsoft MVP (Solutions Architect) Award Winner for 2007, and a Microsoft MVP (Solutions Architect) Award Winner for 2006. He also served as a HIMSS Enterprise IT Committee Member. Mr. Shah received a BS in computer science from the Pennsylvania State University and MS in Technology Management from the University of Maryland. 

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***

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

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READINGS

[1] National Institute of Standards and Technology Special Publication 800-30 Revision 1, Guide for Conducting Risk Assessments, http://csrc.nist.gov/publications/nistpubs/800-30-rev1/sp800_30_r1.pdf

[2] National Institute of Standards and Technology Special Publication 800-37 Revision 1, Guide for Applying the Risk Management Framework to Federal Information Systems, http://csrc.nist.gov/publications/nistpubs/800-37-rev1/sp800-37-rev1-final.pdf

[3] National Institute of Standards and Technology Special Publication 800-60 Volume I Revision 1, Guide for Mapping Types of Information and Information Systems to Security Categories, http://csrc.nist.gov/publications/nistpubs/800-60-rev1/SP800-60_Vol1-Rev1.pdf

[4] National Institute of Standards and Technology Special Publication 800-60 Volume II Revision 1,  Appendices to Guide for Mapping Types of Information and Information Systems to Security Categories, http://csrc.nist.gov/publications/nistpubs/800-60-rev1/SP800-60_Vol2-Rev1.pdf

[5] National Institute of Standards and Technology Special Publication 800-53 Revision 4, Security and Privacy Controls for Federal Information Systems and Organizations, http://nvlpubs.nist.gov/nistpubs/SpecialPublications/NIST.SP.800-53r4.pdf

[6] National Institute of Standards and Technology Special Publication 800-53A Revision 4, Assessing Security and Privacy Controls in Federal Information Systems and Organizations, http://nvlpubs.nist.gov/nistpubs/SpecialPublications/NIST.SP.800-53Ar4.pdf

[7] National Institute of Standards and Technology Special Publication 800-70 Revision 2, National Checklist Program – Guidelines for Checklist Users and Developers Recommendations of the National Institute of Standards and Technology for IT Products, http://csrc.nist.gov/publications/nistpubs/800-70-rev2/SP800-70-rev2.pdf

[8] National Institute of Standards and Technology Special Publication 800-115, Technical Guide to Information Security Testing and Assessment, http://csrc.nist.gov/publications/nistpubs/800-115/SP800-115.pdf

[9] National Institute of Standards and Technology Special Publication 800-137, Information Security, http://csrc.nist.gov/publications/nistpubs/800-137/SP800-137-Final.pdf

[10] U.S. Department of Health and Human Services, HIPAA Security Series, Security Standards: Technical Safeguards, http://www.hhs.gov/ocr/privacy/hipaa/administrative/securityrule/techsafeguards.pdf

[11] U.S. Department of Health and Human Services, HIPAA Security Series, Security Standards: Physical Safeguards, http://www.hhs.gov/ocr/privacy/hipaa/administrative/securityrule/physsafeguards.pdf

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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About Moritz Moszkowski

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And …. the Black Swans

[By Vitaliy Katsenelson  CFA] write-us@imausa.com 

Today I wanted to share with you undeservedly underrated and underrecorded composer that in my not so humble opinion deserve to be over-rated and over-recorded.

He lived in the golden age of the late romantic, early modern period of classical music, that is, the late 19th to early 20th century.

Lifestyle

I want to share with you the Piano Concerto in E minor by Moritz Moszkowski (part 1part 2 and part 3), German-Jewish composer born in Breslau, Prussia (now Poland).

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mm

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According to that most trusted source, Wikipedia, he was very popular in his day but died in poverty, “sold all his copyrights and invested the whole lot in German, Polish and Russian bonds and securities, which were rendered worthless on the outbreak of the war.”

Assessment

Now, I am not trying to draw parallels between the early 20th century and today, but when he poured his life savings into German government bonds, he probably could not imagine that they would be wiped out – there is a black swan for you!

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Ex-Cathedra black swan

*** 

Conclusion

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BENEFITS OF A HEALTHCARE COMPLIANCE PROGRAM

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Reality versus Perception

By Carol Miller RN MHA

Carol S. MillerThere are many associated benefits of a healthcare or medical practice compliance program, some of which are only perceived whereas others are very definitive.  Most providers try to comply with the rules and regulations and what is or is not covered by different insurance programs.

Risk Management and Quality Initiatives

Regardless of their ethical and quality processes in their office practice, the decision to develop and implement a compliance program still is an important and needed business decision.  The processes involved in a compliance program can help improve the organization’s performance by providing basic principles in quality improvement which can help improve the provider’s bottom line.

The Benefits

Several benefits of a compliance program are:

  • Improving the quality of patient care
  • Servicing as a resource for information about compliance-related issues
  • Saving time, money, and associated apprehensions during audits or reviews
  • Preventing or identifying improper conduct with systems for evaluation and correction
  • Providing training for employees and contracted services to recognize fraud and abuse
  • Providing a way for employees to report potential problems
  • Demonstrating to staff and community that the practice is committed to honesty and appropriate conduct
  • Minimizing loss associated with false claims through early recognition and reporting, and decreasing the provider’s exposure to civil penalties, sanctions and other administrative actions, such as exclusion

The OIG

The OIG has developed a series of voluntary compliance program guidance documents directed at various segments of the healthcare industry, such as hospitals, nursing homes, third-party billers, durable medical equipment suppliers, clinical laboratories, home health agencies, hospices, nursing facilities, ambulance suppliers, pharmaceutical manufacturers, physician practices, and others, to encourage the development and use of internal controls to monitor adherence to statutes, regulations and program requirements.

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Safe

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Fraud and Abuse, Too!

The OIG documents also identify fraud and abuse risks to watch out for when creating a programs

ABOUT

Ms. Carol S. Miller has an extensive healthcare background in operations, business development and capture in both the public and private sector. Over the last 10 years she has provided management support to projects in the Department of Health and Human Services, Veterans Affairs, and Department of Defense medical programs. In most recent years, Carol has served as Vice President and Senior Account Executive for NCI Information Systems, Inc., Assistant Vice President at SAIC, and Program Manager at MITRE. She has led the successful capture of large IDIQ/GWAC programs, managed the operations of multiple government contracts, interacted with many government key executives, and increased the new account portfolios for each firm she supported. She earned her MBA from Marymount University; BS in Business from Saint Joseph’s College, and BS in Nursing from the University of Pittsburgh. She is a Certified PMI Project Management Professional (PMP) (PMI PMP) and a Certified HIPAA Professional (CHP), with Top Secret Security clearance issued by the DoD in 2006. Ms. Miller is also a HIMSS Fellow.

CASE MODEL: Compliance

Assessment

The documents provide principles to follow when developing a compliance program that best suits the organization’s needs.

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On Hiring Home Contractors

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By Rick Kahler MS CFP http://www.KahlerFinancial.com

Rick Kahler MS CFP

Doctors Beware!

This time of year, half the homeowners in town are trying to hire landscapers. All of us check our phones even in the middle of meetings or medical appointments, because we desperately hope it might be the yard guy calling back.

As my wife and I work on our yard, however, I’m proceeding with caution. Several years ago I hired a landscaper and paid him $2,000 up-front as a down payment on the work. We never saw a single bush, tree, or shrub. We never saw him or the money again, either.

In response to my recent column about filing consumer complaints, I heard from a reader who is struggling to get recourse from an unethical building contractor. It’s a horror story about bullying, failed inspections, outrageous costs to fix shoddy work, and an expensive lawsuit.

Both this homeowner and I made the same mistake: we trusted someone who turned out not to be trustworthy, and we paid in advance.

Whether you’re hiring someone to redesign your yard, build or remodel a house, create a website for your business, or provide any other kind of service, you can’t afford to just assume that person is trustworthy. It’s your responsibility as the customer to protect your interests in the transaction.

The Hiring List

Here are some ways to increase your chances of finding ethical and competent contractors before you hire anyone:

  1. Be wary of anyone who seems to lack experience or qualifications. Even someone just starting a business should be able to show you related experience or training.
  2. Look for someone who is professional and businesslike. That includes putting estimates and quotes in writing, providing references, and focusing on helping you create what you want rather than telling you what you should want.
  3. Say “no, thanks,” immediately to any contractor who shows a cavalier attitude about requirements like licensing, permits, and inspections.
  4. Use caution with contractors who don’t apply in their own businesses the skills they are trying to sell to you. If you need a website, for example, don’t hire a developer whose own site is a mess.
  5. Get references, and contact them. Ask specific questions about the kind of work the contractor did for them and what the experience was like.
  6. Don’t hire out of desperation, as I did with my so-called landscaper. If you have trouble finding someone to do the work you want done, it’s all too easy to skip essentials like checking references when a candidate does show up. That oversight could cost you dearly.

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 home

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The Project List

Once you do hire a contractor, continue to protect yourself as the project proceeds:

  1. Never pay in advance. Reputable building contractors, for example, should have the resources to buy materials up front. For any services, don’t pay in full until the work is done to your satisfaction. If there is a problem, withholding payment is often your best leverage for getting it resolved.
  2. Pay attention throughout the work. Make sure you get copies of all permits and inspection reports. Insist on fixes for small problems, and follow up to make sure they’re taken care of. As the customer, you should never feel like a trespasser on your own project.
  3. Address serious problems promptly, in a serious way. If issues are not being resolved, don’t hesitate to file complaints with consumer protection agencies, contact professional associations, or involve an attorney.

Finally, when you do receive quality work or service, acknowledge it. Express your satisfaction, write references or positive reviews, and recommend the business to others.

Assessment

One way to discourage predatory or incompetent contractors is to support ethical, trustworthy professionals.

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Do you Know these ICD 10 Codes?

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Funny … if NOT so Serious!

[By Staff Reporters]

Greater Coverage with ICD 10 Codes

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bill

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Injury, Venue, Situation

Assessment:

You’ve got yourself covered.

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Malignant Melanoma Trends

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USA Trends – It is Summer-time

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Heart Disease Prevention for Caregivers

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[By Samantha Wanner]

Heart disease is the number one killer of women, killing more than all forms of cancer combined. That’s why VITAS Healthcare has partnered with the American Heart Association to raise awareness of heart disease so caregivers can live healthier, longer lives.

As a physician or caregiver, you spend much of your time caring for those around you, and it’s easy to ignore your heart health. When you compromise your health, you compromise the care that you provide to those around you.

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image

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Start by Taking Control

Knowledge is power and understanding your family history of heart disease is the first step in understanding your risk.

Lifestyle choices play a major role in heart disease prevention. Make sure you manage your stress levels, develop better eating habits and exercise 20 minutes per day.

You are not alone in your journey to heart health. The American Heart Association is your resource for heart health.

***

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Learn More About Caregiving:

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Holistic Prevention for Alzheimer’s Disease?

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The Time is Now!

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By Mark MD MPH

A newly released study demonstrates that approximately one third of Alzheimer’s cases worldwide are attributable to seven modifiable risk factors: depression, physical inactivity, diabetes, midlife hypertension, midlife obesity, smoking, and low educational attainment.

The largest proportion of cases was attributed to physical inactivity, which affects more than half of all Americans. Depression, which affects approximately 14.8 million Americans, accounted for approximately one in ten cases of Alzheimer’s disease globally.

***

sad

 Holistic Prevention for Alzheimer’s: The Time is Now

***

ABOUT

Mark J. Harris received his MD/MPH from Columbia University in May 2015. He will be starting Anesthesiology residency in June at Brigham and Women’s Hospital in Boston, MA. Mark is interested in the intersection between medicine and public policy, especially as it relates to chronic disease prevention (such as for diabetes, heart disease, and obesity), and he wishes to merge medicine, outcomes research, and public policy to address issues of perioperative risk factors, pain management, and end-of-life care.

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The Opportunity Cost of Healthy Behavior

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On Health Economics

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By Mark MD MPH

Living a “healthy” lifestyle – however defined – takes work and energy. It means extra time to make it to the grocery store (instead of ordering in), saying no to that extra drink, and being conscientious when eating out. It can have the added social side effect of making you seem uptight, judgmental, or boring.

So, what exactly is the Opportunity Cost of Healthy Behavior?

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health

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The Opportunity Cost of Healthy Behavior

ABOUT

Mark J. Harris received his MD/MPH from Columbia University in May 2015. He will be starting Anesthesiology residency in June at Brigham and Women’s Hospital in Boston, MA. Mark is interested in the intersection between medicine and public policy, especially as it relates to chronic disease prevention (such as for diabetes, heart disease, and obesity), and he wishes to merge medicine, outcomes research, and public policy to address issues of perioperative risk factors, pain management, and end-of-life care.

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Ten Steps for Starting a [Medical] Software Business

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A ten-point plan for aspiring software entrepreneurs

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SplitShire-8881-1280x854-970x500

Ten Steps for Starting a Software Business

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About IBM Watson “Doctor Evidence”

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What it is … How it works

Doctor Evidence is a leader in technological solutions for Evidence-Based Medicine (EBM) with a mission to support efforts of healthcare providers and patients to gain access to important evidence-based knowledge, based on the most timely and relevant medical evidence and related analytics, to inform clinical decisions and improve the health and wellbeing of patients worldwide.

This specialty software and services company’s methodology uses a Digital Outcome Conversion (DOC™) approach for transforming data from published clinical studies, epidemiological databases, and other sources, into reusable and updatable databases.

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Doctor Evidence brings valuable health data to IBM Watson Ecosystem

***

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Investing and Economics is an Imprecise Science

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BUT … It’s still all about CONSUMERISM!

[By Dr. David Edward Marcinko MBA MBBS [Hon] CMP]

http://www.CertifiedMedicalPlanner.org

DEM 2013There is a major variable, dominant in any marketplace that pushes an economy in a forward direction. It is called consumerism.

This became apparent while I was waiting in a doctor colleague’s office one recent afternoon.

Scenario:

The front office receptionist, who appeared to be about 21 years old, was breaking for lunch and her replacement, and appeared not much older, came over to assist.

Realizing the propensity for a long wait, one was taken by the size of waiting room and the number of patients coming in and out of the office. [Americans consume healthcare and a lot of it].

There was another notable peculiarity. The sample prescription bags being carried out the door were no match for the bags under everyone’s eyes, including the doctor’s. The office staff was probably working overtime, if not two jobs, and the doctor was working harder and faster in a managed care / ACA system.

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stock-exchange-

[Consumerism driving the Stock Market]

***

Why?

So they all could afford to buy and voraciously consume for their children and themselves. Americans indeed work longer hours than any other industrialized nation.

Assessment

Additionally, as women female medical professionals entered the workforce in unprecedented numbers, the stock markets reached an all time high in 2015, even as money was spent at a feverish pace as the Federal Reserve pumped out money in inflammatory fashion.

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Laugh Loudly!

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A discussion on the medical benefits of laughter

By Jeffrey Niezgoda MD

Laugh Loud, Live Long

Publisher’s Note:

Here is what I think about this ME-P.

-Dr. David Edward Marcinko MBA

Click to play :

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The Pill Mill Epidemic

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What it is – How it works?

michelle

[By Michelle Peterman]

miche.peterman@gmail.com

People who are getting access to prescription medication illegally are on the rise, thanks to what the government and drug addiction specialists call “Pill Mills.”

The United States has a significant enough problem with people addicted to illegal substances, such as heroin, cocaine, and methamphetamines.

What Is A Pill Mill?

You may be asking yourself, “What’s A Pill Mill?” All over the US there are legitimate doctors and pain management centers that are in place to assist patients with managing pain. These centers take great care to make sure patients do not become addicted to their medications and will provide assistance if they do.

Unfortunately, there are pain management centers that operate as these “Pill Mills” and are glorified drug dealers. These people are as bad as the drug suppliers and traffickers who sell Heroin or Ice on the streets. Pill Mills will often have a walk in appointment policy, minimum record keeping methods, and armed guards. Other signs include accepting cash-only, no physical exams, and supplying patients with doses of narcotics that are over the authorized limits.

Many people who are legally prescribed medication may start self-medicating and become addicted, needing more and more drugs. These same individuals often turn to pill mills to gain access to prescriptions that more ethical doctors would not give them.

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pill mill

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Pill Mill Issues in Florida

It has been said that Florida is the epicenter of the pill mill industry. In 2010, as many as seven people were dying every day as a result of a prescription medication overdose in the State of Florida, and countless other deaths were occurring throughout The States. Authorities believed that Florida had become a haven for drug abusers and distributors to make huge profits in dispensing narcotics illegally.

In 2011, government took action and many pain management centers, medical practices, and clinics were raided. This happened in South Florida with the intention to crack down on the many “pill mills” that the authorities strongly suspected were prescribing Oxycodone in extremely high doses outside of controlled substance authority guidelines.

The authorities also found during their investigation that patients were recruited via the Internet. Six clinic owners and various other staff were indicted on charges that they conspired together to illegally supply patients with over 660,000 high and illegal doses of Oxycodone and collected over $22 million in profits.

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pill mill

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The DEA Wages War Against Pill Mills in the South

In 2010, Florida had over nine hundred registered pain management centers. As of January 2014, that number dropped to around three hundred and fifty clinics.

However, it seems that Georgia is now dealing with many of those businesses that fled Florida after stricter measures were implemented. Huffington Post reports that “The DEA is prosecuting pain clinic operators who used to do business in Florida and picked up and moved to Georgia immediately after Florida passed tougher restrictions in 2011.”

Moreover, just recently, Drug Enforcement Administration Raids ‘Pill Mills’ in Four Southern States, including Arkansas, Alabama, Louisiana, and Mississippi.

Assessment

Prescription drug abuse has been declared a massive epidemic in the United States and yet another fight the authorities are trying to win. Tougher regulations and crackdowns from the DEA seem to be making a dent in this major issue.

More:

Sources:

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ABOUT

Michelle is a former communications associate who transitioned into building her own freelance business. She enjoys health and staying on top of the latest news.  Sitting by the beach is one of her favorite activities in her free time.

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On National Obesity Rates?

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By State for 2014

By http://www.MCOL.com

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On Depressing Investments?

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OR … Boring is Good!

By Rick Kahler MS CFP® http://www.KahlerFinancial.com

Rick Kahler MS CFP“We are in both a depressing and boring investment environment.”

That not-so-cheery statement came from Cliff Asness, Ph.D., managing and founding principal of AQR Capital Management, LLC, in a recent address to investment advisors gathered at the University of Chicago’s Gleacher Center.

Personally, I can handle “boring” investment environments just fine. Actually, when it comes to my investments I much prefer boring to exciting. I had all the investing excitement I need for a lifetime in 2008-2009. It’s the “depressing” portion of Asness’s remarks that caught my attention.

He maintains that both bonds and stocks are expensive when judged by their historical means—bonds in the 97th and stocks in the 92nd percentile.

  • Does that mean stock and bond markets are in a bubble? Asness says not.
  • Is a stock or bond market crash likely?

According to Asness, it’s anybody’s guess, because, “We really don’t know what causes crashes. It’s folly to try and predict a crash.”

While Asness doesn’t believe markets are in a bubble or that a crash is impending, what he had to say about expectations for future portfolio returns was certainly depressing.

Historical Review

Over the past 115 years, according to Asness’s data, the real return on a 60/40 portfolio (one holding 60% stocks and 40% bonds) has ranged from as high as 11% to as low as 2.2%. A real return is net of inflation. So, for example, if the total return is 8% and inflation is 3%, the real return is 5%. If inflation is only 1% and the total return is 6%, then the real return is 5%.

Now; for the depressing part. The real return of bonds is currently 0% while that of stocks is 3.7%. Do the math and that’s a 2.2% real return for a 60/40 portfolio. That puts the current real returns from stocks in a historical 8th percentile and bonds in the 3rd percentile.

The bottom line is that if you want high odds that in retirement you will never run out of money, you will need to limit your withdrawals to the real return of 2.2%. This leaves the return that equals the inflation rate in the portfolio to preserve the purchasing power of the portfolio. That means for every $1 million you have in investments you can withdraw $22,000 a year in income on which to live.

That is depressing, especially when you consider the professional norm for withdrawal rates is around 4%. For many years I’ve conservatively advocated for 3% withdrawal rates, which if Asness is right could turn out to be aggressive.

So What’s a Physician or other Investor to Do?

Asness’s advice is a bit self-serving, as his company, AQR, is one of the leading mutual fund managers of alternative investment strategies. That said, what he recommends agrees largely with what I’ve written for 24 years: that investors diversify their portfolios among more asset classes than just stocks and bonds.

Additional asset classes that can bolster portfolio returns and lower volatility are commodities, real estate, TIPS bonds, and alternative investment strategies such as long/short, arbitrage, and managed futures mutual funds.

Another option is to increase what you are saving for retirement and reduce your withdrawal rate expectations to something less than the traditional 4%.

***

Photo of hands of businesspeople during discussing

Stock Market

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Marketing Timing?

Whatever you do, there is one thing Asness and I agree you should not consider. Don’t try to time the market. Selling out stocks and bonds, going to cash, and buying back into the market when the time is “right” almost guarantees a depressing future.

Assessment

Instead, rely on the boring strategy of investing for the long term with asset class diversification. It’s an effective investing anti-depressant.

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About the Institute of Medical Business Advisors, Inc

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Who we are – What we do!

[By Ann Miller RN MHA]

www.MedicalBusinessAdvisors.com

The Institute of Medical Business Advisors, Inc provides a team of experienced, senior level consultants led by iMBA Chief Executive Officer Dr. David Edward Marcinko MBA CMPMBBS [Hon] and President Hope Rachel Hetico RN MHA CMP™ to provide going contact with our clients throughout all phases of each project, with most of the communications between iMBA and the key client participants flowing through this Senior Team.

iMBA Inc., and its skilled staff of certified professionals have many years of significant experience, enjoy a national reputation in the healthcare consulting field, and are supported by an unsurpassed research and support staff of CPAs, MBAs, MPHs, PhDs, CMPs™, CFPs® and JDs to maintain a thorough and extensive knowledge of the healthcare environment.

The iMBA team approach emphasizes providing superior service in a timely, cost-effective manner to our clients by working together to focus on identifying and presenting solutions for our clients’ unique, individual needs.

***

Risk Management and Insurance Foreword for Doctors by Lloyd Krieger MD MBA article-2270211-173CD250000005DC-373_634x447

Financial Planning for Physicians Foreword by Jason Dyken MD MBA

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Our Team 

The iMBA Inc project team’s exclusive focus on the healthcare industry provides a unique advantage for our clients.  Over the years, our industry specialization has allowed iMBA to maintain instantaneous access to a comprehensive collection of healthcare industry-focused data comprised of both historically-significant resources as well as the most recent information available.

iMBA Inc’s specific, in-depth knowledge and understanding of the “value drivers” in various healthcare markets, in addition to the transaction marketplace for healthcare entities, will provide you with a level of confidence unsurpassed in the public health, health economics, management, administration, and financial planning and consulting fields.

iMBA Inc’s information resources and network of healthcare industry textbook resources enhanced by our professional consultants and research staff, ensure that the iMBA project team will maintain the highest level of knowledge regarding the current and future trends of the specific specialty market related to the project, as well as the healthcare industry overall, which serves as the “foundation” for each of our client engagements.

Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners(TM) 

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And, through the balanced collaboration of this rich-media sharing and ranking ME-P forum, we have become a leading network at the intersection of health administration, practice management, medical economics, business strategy and financial planning for doctors and their consulting advisors. Even if not seeking our products or services, we hope this knowledge silo is useful to you.

In the Health 2.0 era of political reform, our goal is to: “bridge the gap between practice mission and financial solidarity for all medical professionals.”

Join the ME-P Nation today … and tell us what you think! 

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On Medical Debt

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In the USA

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Electronic Medical Data Exchange in Denmark

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Used by 91% of doctors according to research2guidance

By Ralf Jahns

ralf

Denmark emerges as the number one country to start an mHealth business according to a survey conducted by research2guidance in partnership with HIMSS Europe. Over 5000 app developers, healthcare professionals and mHealth practitioners took part in the “European mHealth App Market Ranking” survey, where participants were asked to rank the mHealth App market readiness of the 28 EU member states. The results were recently revealed by Ralf Jahns, Managing Director at research2guidance, during the HIMSS Europe event in Riga, the mHealth Summit, on 12th May 2015.

The results, which establish Denmark as having the best market pre-requisites needed for an mHealth business, are based on the average of the scores in five categories: eHealth adoption, level of digitalisation, market potential, ease of starting an mHealth business and mHealth regulatory framework. Hans Erik Henriksen, CEO of Healthcare Denmark commented on the survey findings: “Denmark has a very digitalised society and is familiar with using technology in healthcare, supported by a regulatory framework. The research2gudiance and HIMSS Europe survey confirms the progress we are making. I sincerely hope that this will inspire the European countries and mHealth community in their efforts to progress mobile solutions, which will make a big difference for our citizens”. Denmark ranked top country for eHealth adoption being the only country where exchanging patients’ medical data electronically is used amongst 91% of doctors, whereas the average of other covered countries is only 34%

In terms of market attractiveness and healthcare investments, Denmark is at the top in the mHealth market potential category, together with Austria which also has one of the highest expenditures for health. The ease of starting mHealth business category describes how easy it is to start and maintain a new business based on the number of days needed to start business, the number of necessary start-up procedures to register a business and the level of tax and, in this case, Denmark also ranked extremely high, as the smaller countries – Ireland was also top in this category – tend to support new businesses better compared to larger countries. Rainer Herzog, General Manager at HIMSS Europe, added: “This year’s survey has revealed that the market conditions for mHealth which Denmark offers are truly remarkable. This has been the largest global mHealth research study to date and there are different learnings that could be drawn from the EU countries’ mHealth App Market Ranking. Ultimately though, although mHealth is still it is an emerging market, and a number of countries in Europe are currently in the process of defining their mHealth roadmaps, Denmark leads the way in all aspects”.

eHRs

Download the full mHealth study report here.

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On the Wisdom of the Crowd

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A Belated Edison’s Birthday Marks National Inventors’ Day

[By Staff Reporters]

Steve Wozniak, who built the first Apple computer, has this advice for inventors: “You are going to be best able to design revolutionary products if you are working on your own,” he writes in his memoir iWoz. “Not on a committee. Not on a team.”

GE engineer Peter de Bock begs to differ. “Innovation is about talking to people, connecting with people,” de Bock says. “It’s about knowing what’s out there, what’s needed.”

Recently, De Bock applied his method to build an ingenious cooling device that could launch a new generation of thinner, quieter, and more powerful laptops and tablets like Apple’s iPad.

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crowds

LINK

http://www.gereports.com/post/74545117561/the-wisdom-of-the-crowd-edisons-birthday-marks

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The Stock Market Has Been Flat For Six Months

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This is Great News!

By Lon Jefferies MBA CFP® http://www.NetWorthAdvice.com

Lon JefferiesInvestors have experienced a very uneventful 2015.

In fact, for seven months the Dow Jones Industrial Average was at essentially the same value.* This lack of fluctuation has been even more pronounced over the last two months. As of the market close on May 14th, 2015, the S&P 500 has closed between 2,040 and 2,120 for 71 days in a row.

Further, for nearly a full month, the DOW hasn’t experienced a 1-month high OR low and traded within a 2% range the entire time (always between -1% and 1%).** This was the longest streak in over 100 years!

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one-month-return

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Believe it or not, this may be the best pattern possible for the U.S. stock market.

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Trendline Image

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History tells us that the market is likely to increase in value over time. If we were to plot the market’s value from the time the market first opened to the current day, a chart of those two points would illustrate a return as such:

Trendline Image

However, we all know that the market doesn’t provide a consistent return. On individual trading days, the market can either increase or decrease in value, and the range of potential gains or losses is wide. Over extended periods of time, the market’s actual value may be above or below the expected trend line. In fact, the market’s actual historical return may look more like:

Historical vs Trendline

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Historical vs Trendline

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Anyone who is familiar with Net Worth Advisory Group is likely aware that we are not the type to make market predictions. We have no idea whether the market is near a temporary top or is still experiencing the upward trend after hitting the bottom of an S curve in 2008. However, let’s assume the market has reached the top of an S curve and is currently above the trend line that would represent consistent growth (similar to the illustration above).

If that is the case, there are two ways the market could get back in line with the trend line representing consistent long-term growth. The first and most obvious way this could happen is for actual market performance to curve downwards towards the trend line. This would represent a market correction or even crash.

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crash

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The second, and perhaps less obvious way that actual returns could become aligned with the long-term trend line is for time to allow the trend line to catch up to the actual returns we have experienced since 2008.

In this scenario, the market doesn’t slump but remains stable while time enables price-to-earnings ratios, valuations, and the economy a chance to catch up.

Time Catch Up

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Time Catch Up

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Very few investors enjoy or take advantage of a market correction. In fact, most investors lose control of their emotions when the market experiences a drastic downturn, and do exactly the opposite of what they should do: they sell at market lows – hardly a profitable investment strategy.

Consequently, if we are to avoid an over-heated market, it is likely better for most investors if the market realigns itself with the long-term growth rate by remaining flat for awhile and allowing the trend line time to catch up.

Allow me to reemphasize that I am not predicting that the market is in fact at a temporary high and above where it should be. I have no idea what the market will do tomorrow, over the next month, or over the next year. That is why I’m a believer in having a well diversified portfolio that represents your risk tolerance and you stick to it through thick and thin.

However, let’s look at the other side of the coin and assume the market is still at the bottom of an S curve, below the long-term trend line, and needs to experience further growth in order to catch up. Even in this scenario, an extended period of flat market performance is hardly a bad thing – it would simply make the potential upside needed to get back to market norms all the larger.

Market Under Valued

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Market Under Valued

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Assessment

It turns out that an extended period of flat market performance may very well be a positive for investors in any environment, regardless of whether the market is currently over or under-valued.

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On Medicare Advantage Plan[s] Enrollment

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Medicare Pre-Paid Enrollee Composition

By http://www.MCOL.com

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medicare advantage

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NOTE: CMS Releases 2013 Hospital, Physician Data

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The opening of this week’s Health Datapalooza conference in Washington was the setting for a new Medicare data dump on physician and hospital inpatient/outpatient payment and utilization rates. This is the third annual release of data as part of the Obama administration’s information transparency initiative to promote increased quality of care and more informed healthcare spending by consumers. A link to the inpatient dataset is here, the outpatient dataset is here, and the physician / supplier dataset is here.

Source: Joseph Goedert, Health Data Management [6/2/15]

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On Non-Financial Conflicts of Interest

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Devastating?

Austin Frakt PhD[By Austin Frakt PhD]

Noam Schieber’s NYT piece today is devastating.

About selecting papers to be most prominently featured at a top economics conference, David Card is quoted,

“‘I choose papers that are going to be written up’ in the mainstream press. […] ‘It’s what the people want.’”

via Non-financial conflicts of interest.

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Censure

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Assessment

Has this philosophy seeped into medicine, the financial services industry and health economics; etc?

Dr. David Edward Marcinko MBA

More: Another report casts skeptical eye on patient satisfaction surveys

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UPDATE

Conflicts of interest, the NEJM, and where we go next

Posted: 04 Jun 2015 03:20 PM PDT

If you haven’t yet, take a look at Lisa Rosenbaum’s NEJM essays (here, here, and here) calling for new thinking about researchers and financial conflicts of interest. The essays are nuanced and go against the grain of much recent writing on research ethics.

Rosenbaum’s essays have generated many responses (the Lown Institute has collected some of them here). I examine Rosenbaum’s views in an essay in the New Republic. I’m sympathetic to many of her arguments, but I think we need more transparency in science, not less (see also here). Austin explores her views herehere, and here. Rosenbaum has elicited some exceptionally harsh rejoinders, including one from two former editors-in-chief of the NEJM.

This discussion has been intense because the stakes are very high. If manipulated research data allow bad drugs to enter the market, people can die. Conversely, if unjustified prejudice against industry slows the progress of research, that could kill people too.

@Bill_Gardner

What If the Stock Market Falls 30%?

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Are YOU ready, Doctor?

By Michael Zhuang,

[Principal of MZ Capital Management – Contributor to Morningstar and Physicians Practice]

Ever since it touched bottom on March 9th, 2009, the market has been going up and up and up with barely any hiccup. That’s dangerous! Because our minds could get complacent. That’s why I want to do a mental exercise with all of you: What would you do if the market falls 30%?

First of all, recognize these two important facts:

1.    Market fall of 30% and above happened every ten years or so.

If we use history as a guide, we should expect a 10% odds of that happening over the next 12 months. (So don’t be surprised.)

2.    All market tumbles of that magnitude were recovered within 18 months in the US. (So don’t despair.)

So instead of seeing a 30% fall a bad thing: a horrible hit to your wealth, how about seeing that as a good thing: a deep discount of productive assets on sale that happens only once every decade.

Here is what you should do before, during and after a 30% fall of the market.

1.    Start with having an appropriate asset allocation. Depending on your age and risk tolerance, maybe it’s a 70/30 portfolio, or a 60/40 one, or a 50/50 one.

2.    Stick to it through good market and bad.

3.    Rebalance periodically or opportunistically

Let’s take a 50/50 portfolio for example. After the (stock) market tumble of 30%, the portfolio becomes 35/65. To rebalance back to 50/50, you must sell appreciated bonds and buy discounted stocks.

When you do the above over and over, you create a system of buying low and selling high.

An additional note on rebalance, to keep it simple, you can rebalance every year. The optimal rebalance however, is opportunistic not periodic. The research on that was published in Journal of Financial Analyst and it suggests a rebalance when an asset class has deviated from its target allocation by 20%. When this is done right, you can add about 40 basis points in excess return.

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stock market

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2015 Harvard Medical School Class

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Congratulations to the 160 HMS and 37 HSDM

[By staff reporters]

#HarvardMed15

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[By figure1 on Instagram]

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Great Book Gifts for Medical School and Health Care Graduates

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[By Staff reporters]

An Educational Resource Supporting Doctors, Universities and Consulting Advisors  

We are an emerging online and onground community that connects medical professionals with financial advisors and management consultants. We participate in a variety of insightful educational seminars, teaching conferences and national workshops. We produce journals, textbooks and handbooks, white-papers, CDs and award-winning dictionaries. And, our didactic heritage includes innovative R&D, litigation support, opinions for engaged private clients and media sourcing in the sectors we passionately serve.

Through the balanced collaboration of this rich-media sharing and ranking forum, we have become a leading network at the intersection of healthcare administration, practice management, medical economics, business strategy and financial planning for doctors and their consulting advisors. Even if not seeking our products or services, we hope this knowledge silo is useful to you.

In the Health 2.0 era of political reform, our goal is to: “bridge the gap between practice mission and financial solidarity for all medical professionals.”

Join the ME-P Nation today … and tell us what you think! 

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