BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
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Posted on October 17, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Dr. David Edward Marcinko MBA MEd
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A paradox is a logically self-contradictory statement or a statement that runs contrary to one’s expectation. It is a statement that, despite apparently valid reasoning from true or apparently true premises, leads to a seemingly self-contradictory or a logically unacceptable conclusion. A paradox usually involves contradictory-yet-interrelated elements that exist simultaneously and persist over time. They result in “persistent contradiction between interdependent elements” leading to a lasting “unity of opposites”.
THE TELE-MEDICINE PARADOX
Classic Definition: Refers specifically to the treatment of various medical conditions without seeing the patient in person. Healthcare providers may use electronic and internet platforms like live video, audio, PCs, tablets, or instant messaging to address a patient’s concerns and diagnose their condition remotely.
Modern Circumstance: This may include giving medical advice, walking them through at-home exercises, or recommending them to a local provider or facility. Even more exciting is the emergence of telemedicine apps which give patients access to care right from their phones or computer screens.
Paradox Examples: Treating certain conditions remotely can be challenging. Tele-medicine is often used to treat common illnesses, manage chronic conditions, or provide specialist services. If a patient is dealing with an emergent or serious condition, the remote provider suggests they seek in-person medical care.
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com -OR-http://www.MarcinkoAssociates.com
Posted on October 17, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Dr. David Edward Marcinko MBA MEd
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Can a physician medical provider charge an office cancellation fee?
According to the American Medical Association’s Code of Medical Ethics, physicians can charge fees for “missed appointments or appointments not cancelled in advance in keeping with the published policy of the practice”, and they should “clearly notify patients in advance of fees charge” (Opinion 11.3. 2) [28].
And so, if you miss a doctor’s appointment these days, you could get hit with a “no-show” fee of up to $150 — or more for some specialties.
Is it legal for an insurance company to charge a cancellation fee?
These practices are typically legal. They help businesses ensure they can recoup the lost revenue due to no-shows or last-minute cancellations.
Cancellation fees are permitted, but seldom collected absent unusual circumstances, such as a great deal of work having been provided.
QUESTION: As a doctor [MD, DO, DPM or DDS], do you charge an office cancellation fee? If so, how much is it?
Why It Is Difficult to Practice Medicine Part-Time Today?
In the past, part-time medical practice offered physicians a flexible way to balance professional responsibilities with personal or family commitments. Today, however, the healthcare environment has evolved in ways that make part-time medicine increasingly challenging. From administrative burdens to economic pressures and patient expectations, the obstacles are both systemic and personal.
One of the most significant barriers is the rise in administrative complexity. Physicians are now required to navigate electronic health records (EHRs), comply with insurance documentation, and meet regulatory standards such as HIPAA and MACRA. These tasks consume hours of non-clinical time, which is difficult to compress into a part-time schedule. Even seeing fewer patients doesn’t exempt part-time doctors from the same documentation and compliance requirements as their full-time counterparts.
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Another challenge is financial viability. Many physicians are paid based on productivity metrics, such as Relative Value Units (RVUs), which reward volume over quality. Part-time practitioners often struggle to meet these benchmarks, resulting in lower compensation and reduced benefits. Additionally, malpractice insurance premiums and licensing fees remain fixed regardless of hours worked, further eroding the financial appeal of part-time practice.
Continuity of care is also a concern. Patients increasingly expect immediate access to their providers, especially in primary care and specialties like psychiatry or pediatrics. Part-time physicians may not be available for urgent issues, leading to fragmented care and dissatisfaction. This can strain relationships with patients and colleagues who must cover gaps in availability.
From a professional standpoint, part-time physicians may face limited career advancement. Leadership roles, academic appointments, and research opportunities often favor full-time commitment. There’s also a perception—sometimes unfair—that part-time doctors are less dedicated or less competent, which can affect peer respect and influence within medical institutions.
Technology, while beneficial, adds another layer of complexity. Telemedicine, remote monitoring, and digital communication tools have expanded access but also increased the expectation for constant availability. Part-time physicians may find it difficult to manage asynchronous messages, follow-ups, and virtual visits without extending their work hours beyond what they intended.
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Lastly, burnout and work-life balance—ironically one of the reasons doctors seek part-time roles—can still be elusive. The pressure to maintain clinical excellence, stay updated with medical advancements, and meet patient needs doesn’t diminish with reduced hours. In fact, squeezing these responsibilities into fewer days can intensify stress rather than alleviate it.
In conclusion, while part-time medical practice may seem like a solution to modern work-life challenges, the reality is far more complex. The structure of today’s healthcare system, combined with economic, technological, and cultural pressures, makes it difficult for physicians to thrive in part-time roles. Addressing these challenges will require systemic reform, flexible compensation models, and a cultural shift in how we value and support diverse medical careers.
SPEAKING: ME-P Editor Dr. David Edward Marcinko MBA MEd will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com -OR-http://www.MarcinkoAssociates.com