Medical Office Fee Strategies for Disgruntled Patients

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Adroitly Handling a Tough but Common Office Situation

[By Dr. Gary L. Bode MSA CPA]

A common scenario, in medical practice, is patient disgruntlement over professional fees.

The Scenario

This scenario should not occur in front of other patients. Many receptionists find that genuine, cute little quips like, “I know it seems high, but (wink), I’m expensive to maintain,” defuse the situation by gentling pointing out the overhead factor.

The Balk

When a patient balks at fees, gently and politely imply that we could inquire if the local plumber was available to do the exam, procedure or surgery.

Assessment

This brings training and relative cost issues into play while making them smile.  Costs are high, but justifiable.

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Is Retirement Today a Game Changer for Mature Physicians?

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Understanding Succession and Exit Planning for Physicians

By Michael J. Searcy, ChFC, CFP®, AIFA®

www.SearcyFinancial.com

Doctors who once planned to rely on the sale of their practice to fund their retirement are now finding it more difficult to recruit younger physicians for their succession plan.  If you are a mature doctor today who owns a smaller medical / dental practice (one or two doctor groups), you may be finding that both the economy and desires of younger doctors are changing the game for developing an exit strategy.

The Plan

In preparing a succession plan, a major key to success is starting the process early.  Waiting until you near retirement to begin thinking about selling your practice may leave you with limited (often unfavorable) options.  While some doctors choose to fund a buy-out vehicle during the early stages of their practice with the end goal of selling and retiring in mind, the majority are not in a position where they have a longstanding plan in place.  For doctors who are more than 5-7 years out from retirement, making time to consult with professionals and come up with an enticing purchase proposition for a younger doctor can lead to receiving maximum value for the practice.

Understand the Obstacles

Several factors lead to younger doctors not purchasing existing practices.  These include the heavy competition from hospitals that are competing for more doctors, their desire to set up their own practice, or their aversion to the responsibilities of running a business.  By understanding the obstacles you may face in finding a successor, you can plan ahead to overcome them and get your practice in optimal operating order to increase its attractiveness to potential successors.

The Questions

Questions to consider during the process include:

  • Do I know my practice’s worth?  Getting an accurate valuation is important for you and your successor.  Valuation companies that specialize in medical and dental practice valuations will consider your tangible assets, accounts receivable and the goodwill/brand of your practice to give you an accurate picture of your worth.  By overvaluing your practice, you may repel potential buyers.
  • Are all operations running smoothly?  There may be areas of your practice that need strengthened before a sale.  This can make things smoother as you prepare for a sale, and also make the practice more attractive.
  • Can I/we sustain another doctor’s salary while they are being groomed to take over?
  • If not, is there a hospital affiliate who can hire the doctor to work in my practice until we build the financial base to sustain another salary?
  • Am I protecting my patients?  Aside from adhering to any patient notification laws of your state, you want your patients to understand any upcoming transitions.  Creating a plan to protect your clients may help retain them after the transition.

Build an Alternative Nest Egg

While the sale of your practice may be a wonderful addition to your retirement fund, it is important to build a nest egg as you work and not rely on that big chunk from a sale at the end of your career.  No sale or purchase price is guaranteed and economic changes or new regulations could make your practice unsellable.  By building a nest egg for retirement throughout the course of your career, you can have greater peace of mind that you can experience financial freedom in retirement.

Assessment

Developing your exit strategy will take time, organization and careful planning.  Avoid adding additional stress by viewing the sale of your practice as your financial freedom for retirement.  When it comes time to transfer your ownership out of your practice, make sure you are able to focus solely on a successful outcome!

The Author

Michael J. Searcy, ChFC, CFP, AIFA, is President of Searcy Financial Services, Inc., a registered investment advisory firm in Overland   Park, KS, offering integrated wealth management solutions to doctors.  Searcy has been listed by Medical Economics as one of the “Top 150 Financial Advisors for Doctors” in 2002-2006 and 2011.  For additional information, visit www.SearcyFinancial.com

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Death Takes a [Variable Annuity] Insurance Policy

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How a Lawyer Exploited the Fine Print and Found Himself Facing Federal Charges

By Jake Bernstein / @Jake_Bernstein / ProPublica

The Industry

The life insurance industry tried to make variable annuities irresistible to investors and was enraged when a Rhode Island lawyer exploited the fine print for his own profit.

The Story

This story was co-reported with This American Life from WBEZ Chicago and NPR’s Planet Money.

Video: Excerpts of Video Depositions in the Case Against Joseph Caramadre

Link: http://www.propublica.org/article/death-takes-a-policy-how-a-lawyer-exploited-the-fine-print

 skeleton

Conclusion

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On Hospital Tax-Exempt Debt

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An important means of external financing for hospitals

By Calvin W. Wiese CPA CMA

By Dr. David Edward Marcinko MBA

www.CertifiedMedicalPlanner.org

Tax-exempt debt has become an important means of external financing for hospitals, primarily because its cost is very attractive. Interest rates on tax-exempt financing are lower than interest rates on financing that is not tax-exempt because the interest income earned by the holders is exempt from federal income tax. In some states, it is also exempt from state income tax and in some cities; it is also exempt from city income tax. Thus, the holders of these debt instruments (usually bonds) are willing to accept lower rates of interest.

State and Local Governments Only

Hospitals themselves are not capable of issuing tax-exempt debt. Only state and local governments are. A state or local government issues tax-exempt debt for hospitals and then loans the proceeds to hospitals. This is called “conduit” financing: the state or local government acts as a conduit through which hospitals can access tax-exempt debt markets. State and local governments are authorized to loan proceeds of their bond issues to hospitals through state statutes, and each state statute is different. Some states authorize any state or local government to issue bonds to loan to hospitals. Other states restrict such power to special purpose governmental entities only. And some states restrict this power to a single governmental entity that is specially formed for the sole purpose of issuing tax-exempt bonds on behalf of hospitals.

The IRS

The Internal Revenue Service (IRS) regulates the issuance of tax-exempt financing. While the IRS code nominally provides that debt instruments issued by state and local governments are exempt from federal income tax, it imposes special rules on conduit issues. Thus, tax-exempt issues whose proceeds are loaned to hospitals must comply with special IRS rules. Although very complex, these rules primarily regulate the use of proceeds, restricting the use of tax-exempt proceeds to the acquisition of property, plant components and equipment.

Given state statutes, IRS code and applicable security laws (both state and federal), issuing tax-exempt bonds is legally complex. Many lawyers get paid handsome fees every time tax-exempt debt is issued. The quarterback of the legal team is the bond counsel who represents the interests of the bondholders; the bond counsel issues the critical tax opinion that investors rely upon to claim tax-exemption on the interest from these instruments. Everything revolves around getting this opinion.

The Underwriter’s

Given its critical nature, only highly qualified lawyers are accepted by the market to provide this opinion. Underwriter’s counsel represents the interests of the investment bankers; their primary concern is compliance with security laws. Issuer’s counsel represents the interests of the state or local government, and hospital counsel represents the interests of the hospital; both have relatively minor roles. In the event credit enhancement is involved, credit enhancement counsel represents their interests and has significant influence on the process.

The Trustees

Another unique party to most tax-exempt bond issues is the bond trustee. The bond trustee is usually a bank who performs a fiduciary duty on behalf of the bond holders throughout the life of the bonds. The face of the faceless bond holders, they act on their behalf. And they, too, are represented by counsel in the bond issuance process.

State or local government typically appoints bond counsel. In many cases, they work with only a single firm. Not unusually, these relationships are quite cozy, and often result in fees being paid that are well in excess of what otherwise would be paid.

The Documents

An excess of documents is involved in most tax-exempt financings. The heart of the documents is the indenture, which is the agreement between the bond trustee (on behalf of the bond holders) and the state or local government issuer. It contains the promises made to the bond holders, and it describes the work of the bond trustee. The bond trustee will only perform actions on behalf of bond holders that are explicitly set forth in the bond indenture. The bond indenture is the security given to the bond holders, describing all their recourses.

Assessment

The bond indenture is typically supported by the loan agreement between the state or local government that issues the bonds and the hospital to which the proceeds are loaned. Its terms complement the terms of the bond indenture, which together, form the conduit.

Conclusion

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IRS Tips for Charity Minded Medical Professionals

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IRS Help for Charitable Taxpayers

[By Children’s Home Society of Florida Foundation]

The IRS has published a series of six tips that are designed to help charitable taxpayers.  Both the Department of the Treasury and the IRS hope to enable donors to support various charities.  The six recommendations will help donors to be certain that their gifts are deductible.

1.  Tax Exempt Status

A charity must be qualified under the IRS guidelines for a gift to be deductible.  At www.irs.gov there is an “Exempt Organization Select Check” that allows donors to be certain the charity is qualified to receive deductible gifts.

2.  Itemizing

Your charitable gifts are deductible only if you itemize deductions on IRS Form 1040, Schedule A.

3.  Fair Market Value

Gifts of cash are deductible at face value.  Gifts of appreciated stock, land and many other types of property are often deductible at fair market value.  There are special rules for cars, boats, clothing and household items.  If the charity gives value in return, such as goods, services, admission to a charity banquet or sporting event, that amount will reduce the value of your charitable deduction.

4.  Good Records

You need to maintain records of all donations.  All cash gifts must be documented even if they are quite small.  You should keep cancelled checks, bank or credit card statements, payroll deductions or a statement from the charity with its name, contribution, date and amount for your gifts.

5.  Larger Gifts

If your gift is $250 and above, you must receive a receipt or written acknowledgement from the charity.  The acknowledgement should state the amount of the gift and may include a description and fair market value for property gifts.  It must state whether the charity provided goods or services for your gift.  Non-cash gifts over $500 require you to file IRS Form 8283, Non-Cash Charitable Contributions, with your Form 1040.  If the non-cash property is over $5,000 and is not a public stock, bond or mutual fund, you usually must obtain a property appraisal from a qualified appraiser who holds himself or herself out to the public for that purpose.  In some cases, the appraisal must be attached to the return with a signed Form 8283.

6.  Timing

If you make a pledge, the gift will be deductible only when it actually is made.  For example, a donor may make a pledge in November and then make the gift the following March.  The gift is deductible in the year it is made.  End-of-year donations by check or credit card are generally deductible in the year that they are made or placed in the U.S. mail.

Editor’s Note:  In nearly all cases, your charitable gifts will qualify for a substantial reduction in your taxes.  For specific information, go to www.irs.gov and search for IRS Publication 526, Charitable Contributions.  Valuation rules are available in IRS Publication 561, Determining the Value of Donated Property.

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On Vacation Cruises for Doctors

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Something for Everyone

By Rick Kahler MS CFP® ChFC CCIM

www.KahlerFinancial.com

My family and I recently took our 20th cruise-ship vacation. Obviously, we’ve found that cruising offers something for each of us. Perhaps more medical professionals can too?

First Time

I was reluctant to go on my first cruise, both because I’m prone to motion sickness and because I couldn’t see why anyone would want to spend a vacation cooped up on a boat. I quickly learned two things that changed my mind. First, a number of drugs, patches, and shots are available to prevent or cure seasickness. Second, if you get bored on a cruise ship, it’s only because you choose to.

Benefits

A major asset of cruising is the 18 hours a day of tailor-made, supervised activities available for kids of various ages, even when the ship is in port. This allows parents plenty of time to tour ports of call unencumbered by cranky kids who couldn’t care less about museums or ancient ruins. Our kids are now old enough that they enjoy most of the shore excursions, but this still leaves them the option to opt out of any port that doesn’t call to them.

Bargains

Most people assume cruising with a family must be prohibitively expensive. We’ve found it to be a highly affordable way to vacation if you follow a few rules.

You can get some incredible cruising bargains, but it does take a little legwork. You will want to get on the email lists of the major cruise lines; my top picks are Cunard, Celebrity, Holland America, and Princess. They send out sales and last-minute offers continuously.

One of the best places to shop and compare deals is Cruise.com. However, when I’ve run into issues like an incorrect booking or an issue with the cruise company, Cruise.com wasn’t much help. I was left pretty much on my own to resolve the problems. I’ve found it’s better to shop the deals online with sites like Cruise.com or Cruisecritic.com, but to place the order with my local travel agent or directly with the cruise company.

Food

It will come as no surprise that one of the main features I look for in a ship is really good food. Many of the newer ships offer alternative dining rooms, where for an additional $25 to $40 per person, you can dine in true gourmet fashion. Some of the best specialty dining is found on Cunard and Celebrity.

Cost Balance

To balance the cost of my specialty dining habit, I select the least expensive stateroom, typically an inside cabin. It’s the same size as 80% of the cabins on the ship; it just doesn’t have a window. You can enjoy the same view—water and sky—from a lounge on deck while you relax with a cool drink. And the cheaper cabin leaves several hundred extra dollars to spend on food and shore excursions. For our latest 12-day cruise, our inside cabin cost $800 per person.

Rates

You typically get the best rates by booking the cruise as far in advance as possible. A small deposit is due upon booking but is totally refundable until about 60 days prior to the cruise date. Often, the prices rise the closer you get to that 60-day deadline, when the cruise must be paid in full and your deposit becomes non-refundable. If you are flexible, another great time to shop for cruises is about 30 to 60 days prior to sailing.

Assessment

A cruise isn’t what we typically think of as a middle-class family vacation. Yet when you figure in lodging, food, and admission fees for visiting major US vacation destinations, cruising can be just as affordable and just as much fun.

Conclusion

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Healthcare Job Expenses Can be Tax Deductible

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Appreciating the Medical Academic Calendar

By Andrew D. Schwartz, CPA

Many healthcare professionals work based on the Academic Calendar. That means that a lot of Doctors switch jobs over the summer. According to our friends at the IRS in their IRS Summertime Tax Tip 2012-06:

Summertime is the season that often leads to major life decisions, such as buying a home, moving or a job change. If you are looking for a new job that is in the same line of work, you may be able to deduct some of your job hunting expenses on your federal income tax return.

The Seven Tips

Here are seven things the IRS wants you to know about deducting costs related to your job search:

  1. To qualify for a deduction, your expenses must be spent on a job search in your current occupation. You may not deduct expenses you incur while looking for a job in a new occupation.
  2. You can deduct employment and outplacement agency fees you pay while looking for a job in your present occupation. If your employer pays you back in a later year for employment agency fees, you must include the amount you received in your gross income, up to the amount of your tax benefit in the earlier year.
  3. You can deduct amounts you spend for preparing and mailing copies of your résumé to prospective employers as long as you are looking for a new job in your present occupation.
  4. If you travel to look for a new job in your present occupation, you may be able to deduct travel expenses to and from the area to which you travelled. You can only deduct the travel expenses if the trip is primarily to look for a new job. The amount of time you spend on personal activity unrelated to your job search compared to the amount of time you spend looking for work is important in determining whether the trip is primarily personal or is primarily to look for a new job.
  5. You cannot deduct your job search expenses if there was a substantial break between the end of your last job and the time you begin looking for a new one.
  6. You cannot deduct job search expenses if you are looking for a job for the first time.
  7. In order to be deductible, the amount that you spend for job search expenses, combined with other miscellaneous expenses, must exceed a certain threshold. To determine your deduction, use Schedule A, Itemized Deductions. Job search expenses are claimed as a miscellaneous itemized deduction. The amount of your miscellaneous deduction that exceeds two percent of your adjusted gross income is deductible.

Assessment

  • For more information about job search expenses, see IRS Publication 529, Miscellaneous Deductions. This publication is available on www.IRS.gov or by calling 800-TAX-FORM (800-829-3676).

Links:

  • Schedule A, Itemized Deductions ( PDF)
  • Publication 529, Miscellaneous Deductions ( PDF)

Conclusion

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Wind Energy Alternate Investments

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Calm or Gusty?

By Children’s Home Society of Florida Foundation

The Energy Department released the “2011 Wind Technologies Market Report” this week. It noted that there was substantial growth for wind energy, but significant uncertainty about its future.

Federal Aviation Administration

In a parallel development this week, the Federal Aviation Administration issued tentative approval of Cape Wind, a planned wind farm off the shore of Cape Cod and Nantucket Island. The 130 wind turbines of Cape Wind will stand 440 feet tall. The wind farm is opposed by the Alliance to Protect Nantucket Sound.

However, the FAA approved the wind farm and noted that the towers would be required to include appropriate lights and be painted in colors that made them more visible to aircrafts. With the FAA approval, the Cape Wind developers may now seek final financing and could receive a 25 year lease from the federal government.

2011 Growth

The energy report on wind technology showed significant growth in 2011. Approximately 6.8 GW (gigawatts) of new wind energy capacity were added in the United States.

Of all the new energy facilities created, wind represented 32% of the total in 2011. However, total wind capacity is now just 3.3% of America’s electricity demand. Cape Wind will be the first major offshore U.S. wind project.

China Rising

The world leader in wind energy is China. The U.S. is now in second place with about 20% of global wind capacity. The states with major commitments to wind energy are Texas, California, Iowa, Minnesota, North Dakota and South Dakota.

Assessment

The major concern affecting wind energy in 2013 is the potential loss of federal and state wind tax benefits.

In addition, wind faces substantial competition from natural gas. With the development of “fracking,” natural gas production has substantially increased. With a large new supply of natural gas, there are now sufficient reserves to support the U.S. needs for 100 years. This increased supply reduces the cost of natural gas and makes it more attractive than wind energy.

Conclusion

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Selling into a House Poor Market

When the Local Real-Estate Market is Challenging

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

An exciting new medical practice opportunity in another state …. Health problems that make one-level living an urgent necessity …. The need to downsize quickly because of a hospitalist job loss ….

These are just a few of the reasons medical professionals might need to sell a home sooner rather than later. The real problem arises when the local real estate market is a challenging one. Here are a few suggestions for anyone looking to sell a house under difficult conditions.

1. Evaluate the urgency of your situation. If you can wait a few months without harming your career, your finances, or your health, that may be the wiser choice. If you can’t make payments, or you need to relocate right away and can’t buy a new house until you sell the current one, waiting to sell is usually a losing proposition.

2. Take a hard look at the costs of waiting. You often can cut your overall housing costs significantly by biting the bullet and selling, rather than paying for two homes until you get the price you want. In addition to mortgage payments, add up expenses like property taxes, maintenance, utilities, and commuting costs.

Example:

For example, suppose you paid $400,000 for a house that’s worth $300,000 in the current market. Selling it now would mean a loss of $100,000, but holding onto it costs $3000 a month. Suppose the market improves by 33% in three years, which of course is not something you can count on. You sell the house then for $400,000. In the meantime, keeping it has cost you $108,000. If you keep the house on the market for a year, then give up and sell at $300,000, you’ve added $10,800 to the original $100,000 loss. You’re often better off to cut your losses and sell.

3. Grit your teeth, hold your nose, and be realistic about the market value of the home you are selling. Your original purchase price has NOTHING to do with current reality. The market is the market, and buyers couldn’t care less about what you paid for the home. They only care about the competition and getting the most home for their money, just as you did when you bought the property.

You need to research the housing market in your area or hire competent help (like an appraiser) to help you determine the market value of your property. Real estate agents can help with pricing, but you must proceed carefully. Some agents practice a technique of “tell them what they want to hear, get the house listed, and then work on getting them to reduce the price.”

4. Think like a buyer as well as a seller. Many sellers forget that the pain of selling at a loss is eased if the replacement home they buy is also valued less than it was several years ago. The loss in the home being sold can often be offset by the bargain price of the home being purchased.

5. Do your best to negotiate with your lender. If your mortgage is more than the sale price of the house, you’ll owe money to the lender at closing. Depending on the circumstances, it may be possible to get the lender to accept a lower payoff. Before the closing date, find out exactly how much you’ll need to pay and know where you’re going to get it.

Assessment

Our reluctance to sell a property for less than the amount we’ve put into it is described as “sunk cost fallacy.” Holding on until we get our money back sometimes works. More often, though, all it does is sink us deeper into a financial hole.

Conclusion

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Medical Career Trends & Advancements

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100 Recognizable Jobs in Healthcare

By David Wallace [Search and social media marketer from Anthem, Arizona]

The medical career field has come a long way.

While medicine was once represented by a one-size-fits-all career, today there are over 100 recognizable jobs in the healthcare field. Just as the size of the medical field has increased, there have been medical advancements – and in equality. In fact, 2003 was the first time ever the number of women enrolling in medical school outnumbered men.

Assessment

All of these changes haven’t come cheap, however. The U.S. national health spending was just under $2 trillion in 2006. The above infographic delves into the historical medical advancement milestones, spells out every recognized medical career, provides compelling facts about former and current medical positions, and displays job and salary information for a select few.

Conclusion

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

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HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

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Do Foreclosures Promote Clandestine Pot Houses?

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About Indoor Marijuana Grow Farms and Labs

[By DEA Agent]

Marijuana growers are shifting to the suburbs from rural and commercial areas, helped by a housing crisis that created a glut of affordable home and basement farms like the images below.

BASEMENT POT HOUSE

CLOSE-UP VIEW

Assesment

Unlike traditional earthen farming methods in the photos above, hydroponic grow boxes may be large stealth cabinets that produce fresh marijuana, or other herbs and vegetables, in an indoor garden and grow on water, nutrients and grow-lights alone.

Conclusion

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Should Olympic Medal Winners Pay Tax?

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A Taxing Question

By Children’s Home Society of Florida Foundation

At press time this evening, the United States was embarked on a successful 2012 Olympics. The U.S. had received 90 medals — 39 gold, 25 silver and 26 bronze. Our Olympic team was on a path to receive well over 100 medals.

While each medal has very high personal value, there also is value to the tangible materials. The gold medals contain approximately $675 in materials, the silver $385 and the bronze medal value is $5. However, the U.S. Olympic Committee (USOC) also provides a cash gift for medal winners. The gift values are $25,000 for a gold medal, $15,000 for a silver medal and $10,000 for a bronze medal.

Should the Olympic winners pay tax?

The general income tax rule is that all prizes are taxable unless specifically excluded. Several Senators and Representatives have proposed that the value of the medal and USOC cash award should be excluded from taxable income.

Senator Marco Rubio (R-FL) introduced the Olympic Tax Elimination Act. It would exempt medal winners from paying tax. Rubio stated, “Athletes representing our nation overseas in the Olympics shouldn’t have to worry about an extra tax bill waiting for them back home.”

Similar bills were introduced in the House by Rep. Blake Farenthold (R-TX), Rep. Mary Bono Mack (R-CA) and Rep. Aaron Schock (R-IL).

 Expenses to Offset Income

All of the bills would exempt the medal and cash award from taxation. CPAs who have commented on the proposal note that the athletes would need to report the cash awards as income, but also could offset this income with “ordinary and necessary” expenses related to the awards. For example, the five women gymnasts who won the gold medal could take deductions for their classes, costs of coaches and their travel expenses.

Assessment

House Ways and Means Committee Chairman Dave Camp (R-MI) joined the group that favors excluding the Olympic medals from taxation. He stated, “These athletes deserve every bit of our support and appreciation for representing the United States on the world stage. Allowing our Olympians to receive and enjoy their medals and awards without having to worry about whether they can pay the taxes on their accomplishment is just one small way we can show that support.”

Conclusion

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Health Dictionary Series: http://www.springerpub.com/Search/marcinko

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

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

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

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

Physician Advisors: www.CertifiedMedicalPlanner.org

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As With Medical Decisions – Human Emotions Play a Role in Investment Advice

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Appreciating Transferrable Applications in Behavioral Finance

By Sidney A. Blum CFP® CPA/PFS ChFC

By Dr. David E. Marcinko MBA

Whether making medical decisions or financial decisions, both are influenced by emotions. The role of emotions, when making financial decisions, has transferable application in the world of medical decisions.

What Role Should Emotion Play in Financial Advice?

Financial advisors know that one of the most important components of providing financial advice is discussing client goals. Inherently your goals are tied to how you see yourself and in what ways you see your money and net worth as a reflection of yourself. This aspect of your financial life is usually tied to emotions based on perceived positive or negative experiences in your life.

Financial advisors find that they expend considerable time and energy addressing emotions and negative reactions to events in clients’ lives. The goal is to move the focus toward positive steps for reaching client goals. As with other aspects in your life, emotional reactions can distract you from well reasoned actions that benefit in the long run. This is the reason it is beneficial to engage a financial professional to guide you through your financial life circumstances with advice driven by goals rather than emotional negative reactions.

Emotional Intelligence

The use of Emotional Intelligence is a learned skill set. Financial Advisors who are skilled in understanding the four basic emotions that guide them and their clients will find they are more successful in their chosen work!

The Four Basic Emotions

The four emotions are: Glad, Sad, Mad and Scared. These four basic emotions are neither good nor bad – they just “are”!

It is one or more of these emotions that help determine just how “risk adverse” a client will be. It is absolutely necessary for a financial advisor to be aware of the client’s emotional state, whether the client is aware or not. People react emotionally to market downturns. They are probably scared first, but also mad and sad as the market changes. They may get caught up in the market’s emotional swings and lose sight of their own goals and strategy. They think it will always stay that way. Or in an upturn, they believe the market will always stay up. They get caught up in the euphoria of “glad” and again lose sight of their goals and strategy. Many people get caught up in the high market frenzy and end up buying shares that are overpriced; even doctors.

Examples:

Pulling out of the market to protect temporary downside losses in value also means not participating in the upside, which eventually occurs. From the major downturn in the spring of 2009 to the fall of 2009, the market recovered better than 35%. Those who pulled out of the market and stayed out missed out on that portion of their own portfolio’s recovery. Due to reacting emotionally, people buy in up market and sell in a down market – the opposite of what garners them a good return.

Another difficulty is that people lose sight of the fact that a fund investment is in actual companies – some of which survive and some don’t. The nature of the investment market is that there are no guarantees on return of investment. A certain amount of volatility is normal. It is the price you pay for the opportunity of garnering a higher return than with “safe” investments.

And, how safe are “safe” investments? If your “safe” investments are earning 1% while inflation is running at 3% as is the case in 2012, you are losing purchasing power. If the bucket is leaking slowly, it can still end up empty!

So when you feel “glad” about a safe investment, what may be a good feeling may turn out to be a bad investment.

How Advisors Help Clients

How does an advisor help to keep their clients’ focus on the positive steps that can be taken to meet goals instead of reacting solely to current market conditions? How does advisor keep from getting involved in the client’s negative and unproductive emotional reactions?

Financial advisors have seen these situations before, but clients may not be aware that financial markets tend to return to the norm and provide a positive return in the long run. By helping provide a perspective on how the market normally behaves; the focus can be shifted from how the market currently stands, a temporary fluid condition, to the longer range behavior of markets. This provides a sense of stable emotions that allows the client and the advisor to make better financial decisions.

Non-Monetary Goals?

A financial advisor can also help you realize that financial planning is more than investments and that some goals are not solely monetary. It is less stressful and far more productive for people to keep their eyes on their goals, not on the dollar value of their portfolio. In the end, your net worth is not the same as your self‐worth.

Assessment

Because emotions play a significant role in all decisions we make, a major part of an advisor’s job is to help the client keep their focus on the positive steps that can be taken to meet those goals instead of reacting based solely on emotions!

About the Author

Sid graduated from the University of Illinois with a degree in accounting and has been practicing as a CPA since 1975 and financial advisor since 1987. Sid received the CERTIFIED FINANCIAL PLANNER certification in 1987 and in 1988, received the AICPA Certificate of Education Achievement in Personal Financial Planning. In 1989, Sid received the designation of Chartered Financial Consultant (ChFC) and in 1991 the AICPA specialty designation of Personal Financial Specialist (CPA/PFS).

Channel Surfing the ME-P

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Conclusion

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About the RetireMark Planning System

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From HealthView Services (HVS)

By Staff Reporters

According to their website, HealthView Services (HVS) is one of the only firms in the country that builds solutions for the financial services industry to address out-of-pocket health care costs that individuals will face during retirement.

Founding

HVS was founded in 2008 by a team of experienced executives who identified a serious deficiency in financial planning in relation to retirement planning. In order to fill this void, HVS founders employed a group of expert physicians, experienced actuaries, and healthcare industry programmers to develop the HVS RetireMark Planning System.

Financial Planning and Health-Risk Assessment Tools

At its core, RetireMark is a combination of financial planning and health-risk assessment tools that provide financial institutions, independent advisors, and healthcare related firms with web-based reports. These customized reports project personalized out-of-pocket healthcare costs, life expectancy, and the Income Floor—a sophisticated and revolutionary approach to income distribution for retirement protection.

Customization

HVS’s product offerings can be customized to meet each institution`s exclusive needs and be seamlessly integrated into existing marketing and branding platforms. In addition to the software, HVS provides clients with training programs, seminars, and customized presentations in order to expand sales and grow revenues.

Assessmernt

In collaboration with industry leaders such as the Retirement Income Industry Association (RIIA), HVS has developed innovative solutions to address the growing needs of investors in transition. HVS is also a regular contributor to the HealthWatch segment of Retirement Weekly, a www.MarketWatch.com publication. By partnering with such prominent organizations, the firm hopes to become a pioneer in this emerging field.

Conclusion

So, give em’ a click and tell us what you think www.hvsfinancial.com

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

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Physician Advisors: www.CertifiedMedicalPlanner.org

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Succeed with the “Business of Medical Practice” Textbook

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[Transformational Health 2.0 Skills for Doctors]

By Ann Miller RN, MHA

www.BusinessofMedicalPractice.com

December 23rd, 2011 – The Institute of Medical Business Advisors [iMBA] Inc, in Atlanta, GA www.MedicalBusinessAdvisors.com and Springer Publishing Company of New York, just released the third edition of “The Business of Medical Practice” [Transformational Health 2.0 Skills for Doctors] edited by iMBA founder Dr. David Edward Marcinko MBA, CMP™ and President Hope Rachel Hetico RN, MHA, CPHQ, CMP™

Internal Contents

The 37 chapter, 750 page hard-cover textbook provides a comprehensive resource for those physicians, medical professionals, practice managers, nurse executives, health care administrators and graduate students seeking working knowledge on running a private facility or medical clinic.

Three Major Sections

The BoMP is comprised of three enterprise-wide sections: [1] Qualitative Office Operations, [2] Quantitative Aspects of Medical Practice and [3] Health Policies, Ethics and Leadership. Topics like ARRA, HITECH, ACA and the social networking aspects and ramifications of health 2.0 connectivity for all stakeholders are included for modernity.

Tools and Templates

Tools used throughout the book help readers reference and retain complex information. These tools include:

  • Sidebars. Key terms, key concepts, key sources, associations, and factoids all serve to enhance and reinforce the core takeaways from each chapter.
  • Tables. Tables are used to display and reference benchmark data, draw comparisons, and illustrate industry data trends.
  • Figures. Graphical depictions of concepts help you comprehend the material.
  • Charts. Charts allow easily referenced standard industry taxonomies alongside comparisons of related topics.

Assessment

For a further description of the Business of Medical Practice, with online “live’ community, please click: www.BusinessofMedicalPractice.com

To order directly: http://www.springerpub.com/product/9780826105752 

Conclusion

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

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Should Doctors Know the Top Black and White Hat Hackers?

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Attention Medical Professionals, HIT Specialists and EHR Devotees

[By Staff Writers]

Question: What is LulzSec?

LulzSec, short for “LulzSec Security”, is a hacker group that claims responsibility for several high profile attack.

LulzSec has gotten attention since May 2011 for targeting high profile website with poor security.

Assessment

The most prolific anti-EHR / anti-EDR contributor to this ME-P is investigative reporter Darrell K. Pruitt DDS; friend or foe of HIPAA and HIT data security?

Conclusion

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Doctors to Get a Smaller Piece of American Pie?

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And Contracting Lifestyles for Us All

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

“Any way you slice the pie, Americans better come to grips with the fact their lifestyles are going to contract.” That’s the bottom line I’ve gleaned from attending several conferences and listening to some of the nation’s top economists recently.

But, what about Doctors and Medical Professioanals?

New Medical Practice Entrepreneurial Business Rules for Young Physicians [circa 2012]

The Fundamentals

Basically, the US is spending far more than it takes in via tax revenues, creating an annual deficit. The shortfall is covered by borrowing the money, which adds to the national debt. The Treasury Department borrows the money from two sources: private investors (individuals, banks, companies, and other governments) and the Federal Reserve Bank.

The Federal Reserve Bank

Where does the Federal Reserve get money? I’ve written about this before and our Editor has commented on it. They create it with a keystroke, which is the digital-age equivalent of printing money.

The Modern US Monetary System

It’s important to understand that the US government has no intention of ever paying down the US debt. Neither politicians nor economists can agree on whether to stop borrowing (or creating) money to fund the annual deficit. To actually reduce the national debt, we must run surpluses, something we haven’t done in over 15 years and then it was only for one year. We actually have never paid off our debt from WWII.

Deficit Spending

Reducing our deficit spending requires us either to raise taxes, cut spending, or borrow (which includes creating) more money. If we raise taxes to cover the deficit, we will most likely force a recession or depression. We simply can’t take $1.3 trillion out of the private sector without imploding the economy. If we cut spending, we will most likely create a recession or depression, as we simply can’t cut $1.3 trillion of government spending overnight without imploding the economy. If we do both, we will most likely still have a recession or depression.

Print or Borrow

At the moment, Congress can’t agree what to do, so we continue to borrow and print money. An increasing national debt means higher borrowing costs (interest). This means we need more revenues (from taxes or creating more money) to continue to fund Social Security, Medicare, welfare programs, infrastructure, and national defense. Creating (printing) money can lead to rising inflation, though it doesn’t automatically do so, as Japan has demonstrated for 20 years. This results in the devaluation of our global purchasing power, meaning the cost of everything we buy from other countries increases. It’s clear that the most appealing option to politicians and most economists is to continue to borrow and inflate.

Why the Government is Not-Like Medical Professionals

The Message

No matter how you cut and paste these options, one result is the same. Americans’ lifestyles will contract. This will come either from less government support and services, less spendable income via higher taxes, or an erosion of purchasing power from a declining dollar. This is the last message most Americans want to hear. The attitude is like that of the overspender who recently asked me, “How can I cut my expenses but maintain my current lifestyle?” The most honest answer is, “Sorry, but it can’t be done.” True, it’s possible to find creative ways to keep the parts of your lifestyle that matter the most. However, reducing expenses almost always means a lifestyle reduction. This is one reason so many people resist budgeting.

Assessment

For most doctors, lawyers, CPAs, FAs, laborers and all Americans, budgeting means reducing spending, even though that isn’t inherently what budgeting is. In its purest form, it is becoming aware of our current spending patterns and redirecting income to the areas of spending that will best support our desired lifestyle. The more our income shrinks, the more crucial it becomes to redirect it carefully and consciously.

Personal Budgeting Guidelines for Doctors

Conclusion

In other words, if we have to settle for a smaller piece of pie, we’d better make sure we’re buying the kind of pie we really want.

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

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

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

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

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

Physician Advisors: www.CertifiedMedicalPlanner.org

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Opinion Poll on the Most Disruptive Health Issue Today?

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A Voting Opinion Poll

Today’s opinion poll for all modern hospital executives, financial advisors, health economists, patients and physician leaders is right on-point.

It was sent in by an astute ME-P subscriber and we are most pleased to oblige.

VOTE HERE

And so, what is the most singular disruptive development that you should be thinking about if you want your medical practice, clinic, hospital, state, local government or healthcare organization to thrive in the coming years?

Conclusion

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

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

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

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

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

Physician Advisors: www.CertifiedMedicalPlanner.org

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Appreciating the Financial Toll Drug Use Has on Us

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The Cost of Drug Abuse

What does it cost to send a drug addict to jail? Far more than it needs to as demonstrated by this infographic.

War on Drugs

Thanks in part to the War on Drugs, more than half of the inmates in the federal prisons are there because of drug-related offenses.

It’s a staggering statistic, one that helps explain the explosive growth of the prison system over the past thirty years, as officials struggle to keep up with the influx of inmates convicted of, in many cases, minor drug possession.

Source: www.clarityway.com via  www.fastcodesign.com

Conclusion

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Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

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

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

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

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

Physician Advisors: www.CertifiedMedicalPlanner.org

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What Health Care Fraud Costs Us

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Scrutiny Needed from the Patient Citizenry – Too?

As health care takes the center stage at the forefront of contemporary politics it is under scrutiny from several angles.

The Fraud Rate

One aspect of the health care system that has been garnering growing levels of interest is the rate at which medical fraud occurs. As the developed world steeps itself further and further into the digital age, things like medical history and billing records become more easily susceptible to fraud since they’re accessible from virtually anywhere.

Expensive Care

And, the fact of the matter is that trying to stay healthy is an expensive business. Each year, 300 million Americans spend about $2 trillion on health care, but the amount of that money that is lost to fraud seems to have grown a great deal in recent years.

Types

The government continues to crack down and identify fraudsters in all their forms—and they do come in many forms. Perhaps the most common type of health care fraud concerns how medical care providers bill. This type of fraud relies heavily on the fact that many patients don’t take the proper amount of time to really scrutinize their medical bills and invoices.

Source: InsuranceQuotes.org

Assessment

Fraud can cost a huge amount of money for victim, insurance companies and society. The best defense against fraud remains understanding EOBs forms and what’s on your medical bills.

Conclusion

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

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Doctors and Financial Advisors “Working 9 to 5”

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What an “Old” Way to Make a Living

[Challenging the Current Business Process Model and Scheduling Paradigm]

By Dr. David Edward Marcinko FACFAS MBA CMP™

[Editor-in-Chief]

First off – my apologies to Dolly Parton for bastardizing the title of her song

My dad worked for General Motors; the 11-PM to 7-AM shift to be precise. The company ran 3 shifts [8hr. X 3da. = 24 hrs / day / 7 days / week]. He was always home during the day for his children. In fact, it seemed as though he never slept. My mom worked the 9-AM to 5-PM  shift / 5 days / week as a banker. What a great arrangement; loving parental child care 24/7/365.

Then, after my own medical school, internship, residency training, fellowship, clinical practice and business school, I often wondered why corporate America and her white collar workers used the 9-5 work day paradigm and not the traditional blue collar 3 shift [24/7/375] manufacturing model – like  GM?

Working

With a 24/7/365 work day schedule [3 shifts/day], fixed office costs would remain the same, while variable costs would increase slightly but be compensated for by increased revenues, less HR stress, fewer utilities and reduced private and public infra-structure maintenance, etc [old styled B-school pedagogy]. This would increase operating capacity and output [patient/client output, CPT® codes, hourly fees, AUMs, etc]. You know – real top line revenue and bottom line profits. And, that’s a good thing for business and commerce.

But, is this 3 shift model applicable to the healthcare industrial complex and the financial services industry? If not – why not? And, I mean real work – examining and treating patients and interviewing clients – not automatic websites or interactive blogs, etc. Doctors, consultants and FAs actually interacting with real folks; not avatars!

An Old but Novel Idea?

As a medical business process consultant, my simple idea is more than two decades old. Yet, it remains largely untested and still considered novel … Perhaps until now! Offering extended hours is one way that physicians – can position themselves for the changes coming in the new healthcare era. How else will we accomodate 34 million new Medicaid insured patients.

In fact, so should financial advisors and medical management consultants. Shoot, why can’t most professionals use this model. Why be constrained to person, place and time [3-Dimensions]?

The Decision

This decision, however, should not be taken lightly and should be evaluated both from a provider, patient, civics, cultural and business standpoint. So, please read this essay for an elegant description of this model.

Then, our ME-P text books can be used to go granular into the nitty-gritty details; with real-life tools, templates, case models and checklists, etc.

Assessment

Link: Ready to offer extended patient hours?

Link: New Medical Practice Entrepreneurial Business Rules for Young Physicians [circa 2012]

Conclusion

Your thoughts and comments on this ME-P are appreciated. Colleagues – when not if – are you going 24/5 … or 6 … or 7?

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

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

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

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

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

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

Physician Advisors: www.CertifiedMedicalPlanner.org

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The Science and Some Medicine Behind Seat Belt Use

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It’s All About Saving Lives and Ankle Bones

By Muhammad Saleem, and

By Dr. David Edward Marcinko FACFAS MBA CMP™

[Editor-in-Chief]

Vintage 2000 Jaguar XJ-V8-LWB Touring Sedan

The Ankle Bone is Connected to the Foot [er –ah] Leg Bone

The talus is one of the important bones that makes up the ankle joint. Over one half of the talus is covered with cartilage–it serves as an important link between the leg and the foot. The talus moves not only at the ankle joint, but also below the ankle and in the midfoot. Therefore, injuries to the talus can affect motion of the ankle and foot joints.

‘Aviators Astragalus’

Talus [astragalus ankle bone] fractures were almost unheard of a hundred years ago. The first series of talus fractures was described, by Dr. WD Coltart, in men who were injured in the British Royal Air Force in the early 1900s. The term ‘aviators astragalus’ was used to describe these fractures that happened as old war planes made crash landings.

Original Historic Reference Link: AA

Today, talus fractures are seen in high speed car accidents when you don’t-buckle up that seat belt or shoulder harness. I’ve seen far too many during my days covering the local Emergency Room.

So, here is an infograhic on the science behind seat belts. It contains some interesting and some encouraging facts that we wanted to share with our ME-P readers and subscribers.

Mechanism of Injury: Hawkins classification Talar fractures (C) iMBA Inc

The Facts

  • National seat belt use has increased from 69% in 1998 to 84% in 2010.
  • Automotive fatalities rank third in terms of lives lost per year, behind cancer and heart disease.
  • Seat belts are responsible for saving between12,000 to 16,000 lives each year.
  • Most crash deaths occur within 25 miles of home and at speeds below 40 miles per hour.

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:

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Understanding The Federal Reserve Act

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[By Staff Reporters]

Uncovering The FED

In the early 20th century, a financial crisis led panicked citizens to withdraw all their money at once, damaging banks. By 1913, Congress responded with the Federal Reserve Act, creating 12 regional banks acting as a federal bank to deal in local and global affairs with both private banks and the federal government.

Balancing v. Manipulation

Some say the Fed was meant to create a balanced economy, while others argue its purpose was to inorganically manipulate free enterprise, rescuing banks that we’d be better off without.

Assessment

Is the Fed still doing its job today? What secrets are being kept from us and how are the Fed’s actions impacting our economy?

Channel Surfing the ME-P

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

Conclusion

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:

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The Financial Impact of Reducing Avoidable Hospital Admissions

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Population Health Models

By Staff Reporters

Most readers are aware that colleague David B. Nash MD, MBA is the population health guru for the ME-P. In fact, he is an ME-P “thought-leader.” And, to use a modern colloquialism, he was into population health before PH was cool.

Link: http://nashhealthpolicy.blogspot.com

Preventing Avoidable Hospitalizations

And so, as hospitals and health systems accelerate towards population health models, there is an increasing focus for physicians and health systems to work together to prevent avoidable hospitalizations.

The Infographic

This infographic shows that an average 300-bed hospital is at risk of losing $9.5 million in annual contribution when inpatient admissions for 11 potentially avoidable conditions are completely reduced. These 11 conditions, identified by AHRQ, represent diagnoses for which coordinated outpatient care and early intervention can potentially prevent the need for hospitalization.

Source: Objective Health [McKinsey & Company]

Assessment

A colloquialism is a word or phrase that is employed in conversational or informal language but not in formal speech or formal writing.

Conclusion

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

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

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

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

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

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

Physician Advisors: www.CertifiedMedicalPlanner.org

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How Do We Improve Collaboration between Physicians and Hospital Administrators?

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An Opinion Poll for Doctors, FAs and Patients

By Jennifer Tomasik MS [Principal: www.CFAR.com]

“It is the long history of humankind (and animal kind, too) those who learned to collaborate and improvise most effectively have prevailed.”

– Charles Darwin

Beyond institutional mergers and joint ventures, collaboration in healthcare is being driven by other factors; there is a need to move from a healthcare system driven by volume and characterized by fragmentation, waste, high cost, and inconsistent quality to a system where care is coordinated, costs are lower, and quality is higher.

Merger Mania

Merger mania in the 1990’s was driven by similar concerns, including the fear of for-profit competition and the rise of managed care. The results of this earlier round of mergers were unexpected. The 1990s ‘consolidation fever’ raised hospital prices by at least 5%, and did not measurably improve quality.[i] Hospitals purchased physician practices without a great deal of thought about expectations and mutual accountability, and many of those relationships failed—usually with significant financial implications.

Of Savvy Healthcare Leaders

Fearful of history repeating itself, savvy healthcare leaders are thinking differently about how to develop the collaborative relationships they need to succeed today. They see Accountable Care Organizations [ACOs] and Global Payments—where institutions will take on greater risk for the cost and quality of the services a patient requires—as an opportunity to get clear about how they can best position themselves across the full continuum of care. They believe potentials gains are not likely to show up simply as a result of mergers and acquisitions or consolidation per se. Rather than just integrating the bottom lines of their institutions, they are focused on ensuring that those individuals and teams who actually care for patients can productively collaborate with each other, and that they understand the clear and compelling rationale for why that collaboration is necessary.

Nowhere is this relationship more important than between hospital administrators and the medical staff.

What is “Collaboration” Anyway?

Merriam-Webster defines collaboration as “to work jointly with others or together especially in an intellectual endeavor.” While true, we find this definition insufficient for our purposes. Our colleagues at The Rhythm of Business, a consulting firm focused exclusively on collaboration, provide a more productive way to think about collaboration:

“Collaboration is a purposeful, strategic way of working that leverages the resources of each party for the benefit of all by coordinating activities and communicating information within an environment of trust and transparency.”

We add to this definition one additional, yet critical dimension. Collaboration also means working with, and through, differences. Any highly functioning team will, by its very nature, have differences – team members are ideally bringing innovative ideas that compete for “idea space” at the table.

Effective collaboration requires that teams not only value differences, but in fact encourage them to be surfaced. Viewed in this way, collaboration is not an event or an idea. It’s not “agreeing to get along.” Effective collaboration is an ongoing, systematic, strategic process. It is also, we believe, a business imperative – and nowhere more so than in healthcare.

Assessment

Given the often difficult nature of relationships between hospital administrators and medical staff, how do you improve collaboration to increase productivity and performance?


NOTE: [i] Vogt, William B and Robert Town. “How has hospital consolidation affected the price and quality of hospital care?” Robert Wood Johnson Foundation: Policy Brief No. 9. 2006.

Conclusion

And so, how do we improve collaboration between Physicians and Hospital Administrators?

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

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

About the Author

Jennifer Tomasik, Principal,  leads CFAR’s Health and Hospital Systems practice. She works with her clients to solve complex strategic and organizational challenges. Her approach to consulting emphasizes communication and collaboration, supported by a blend of quantitative and qualitative analytics. Jennifer has worked in the health care sector for nearly 15 years, with expertise in public health, clinical quality measurement, strategic management, and organizational change. Her clients include some of the most prestigious hospitals, health systems and academic medical centers in the country. She has a Master’s in Health Policy and Management from the Harvard School of Public Health.

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

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

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

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

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

Physician Advisors: www.CertifiedMedicalPlanner.org

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Update on Health Insurance Claims Processing Costs

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Paper versus Electronic

[By Matias Klein]

[Senior VP Technology Portico Systems Integrated Provider Management Solutions]

The average cost of processing a single, clean, paper-based or electronic claim can range from 85 cents to $1.58.

However, according to AHIP, nearly half of all claims (48 percent) were pended due to the submission of duplicate claims (35 percent), lack of complete information or other information needed to justify the claim (12 percent), or invalid codes (1 percent).

The manual adjudication of these duplicate or incorrect claim submissions increases the cost of administration to $2.05. The $2.05 scenario is a best case calculation. In our actual field experience the cost can be as high as $10.00 per claim.

Payment Delays

In addition to the increased administrative cost, one must not forget about the delayed payment to the provider. As stated by AHIP, a duplicate claim can take 9 days to remediate and missing information on a claim can take up to 11 days. This kind of delay damages the relationship between the provider and the health plan, which in terms of costs is priceless.

Enter ID Management

To solve this problem, some healthcare organizations are implementing Master Identity Management (IDM)—a valuable approach to creating an enterprise “source of truth” for provider identity information. But when it comes to payment integrity and claims processing, IDM without a Provider Information Management (PIM) system doesn’t work. Provider relationship and contract data are far too complex, and both types of data are needed to supplement provider identity data in support of claims administration.

Provider Information Management

When IDM is fully integrated with PIM, payers can successfully establish a single, accurate and effective source of truth. An integrated approach also:

  • Ensures quality – by standardizing, cleansing, cross-referencing and consolidating relevant data, while removing duplicate entries.
  • Mitigates risk – reducing the downstream impact of inaccurate data on all claims processing, contracting, credentialing, provider directory and connected systems.
  • Saves millions of dollars – by reducing duplicate entries by even a fraction of a percent, thus ensuring that claims are being processed in an efficient and effective manner.

Assessment

IDM plays a pivotal role in the future of healthcare. As new, collaborative and accountable care delivery models evolve, reliable provider identity management is absolutely critical. Combining IDM with PIM gives payers the most powerful solution for assuring payment integrity while improving provider identity and duplication management.

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.

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:

Our Newest Textbook Release

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Learn How to Profit and Thrive in the PP-ACA Era

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A Barclay Bank Ad Campaign Photo

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“For the best fixed rates”

Source: Paul Higgins and Sandy Teagle – Futurists from Melbourne and Brisbane in Australia.

Assessment

Truth in advertising.

Barclay campaign says pic.twitter.com/0XOmyQjg

Conclusion

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

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

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Vital iMBA Inc Links for Savvy Doctors and their Financial Advisors

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An Educational Resource Supporting Doctors and their Consulting Advisors 

Healthcare OrganizationsMedical Business AdvisorsCertified Medical PlannerHDS

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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We are sponsored by the Institute of Medical Business Advisors, Inc

www.MedicalBusinessAdvisors.com

INSTITUTE OF MEDICAL BUSINESS ADVISORS, INC.
Suite #5901 Wilbanks Drive
Norcross, Georgia, 30092-1141 USA
Phone: 770.448.0769

ADMINISTRATORS: http://www.springerpub.com/Search/marcinko
PHYSICIANS:www.MedicalBusinessAdvisors.com
PRACTICE: www.BusinessofMedicalPractice.com
PODIATRISTS: www.PodiatryPrep.com
HOSPITALS:http://www.crcpress.com/product/isbn/9781439879900
ADVISORS:www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com

Assessment

Link: Letterhead.iMBA_Inc.

Link: Letterhead CMP

Conclusion

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

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

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

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

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

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

Physician Advisors: www.CertifiedMedicalPlanner.org

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Product Details

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The Tax Man Cometh to Police You on Health Care

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About the New Health Care Tax and IRS Job Creation

WASHINGTON (AP)

The Supreme Court’s decision to uphold most of President Barack Obama’s health care law will come home to roost for most taxpayers in about 2 1/2 years, when they’ll have to start providing proof on their tax returns that they have health insurance.

LINK: New Jobs: IRS to hire thousands more agents to collect new health care taxes

Conclusion

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

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

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

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

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

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

Physician Advisors: www.CertifiedMedicalPlanner.org

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Transitioning and Appraising a Podiatry [Medical] Practice

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A Round Table Fair Market Valuation Discussion of One

By Dr. David Edward Marcinko MBA CMP™

[Former – American Society of Health Economists (ASHE) member]

[Editor-in-Chief]

www.CertifiedMedicalPlanner.org

Recently, I was asked to participate in a roundtable of expert’s discussion on the worth or fair market value [FMV] of a typical podiatric [medical] practice on an “ongoing concern” basis.

Of course, this is the type of engagement we often perform at the www.MedicalBusinessAdvisors.com And, I have written about this topic informally on this blog, and more formally in our white-papers and books: www.BusinessofMedicalPractice.com

So, I was pleased to add my experienced opinion to the discussion sponsored by a trade industry magazine upon the invitation of Editor Dr. Barry H. Block JD.

LINK: Podiatry Mgmt Round Table

Assessment

Due to copyright issues, I posted only my comments to the questions posed to all participants. Nevertheless, they are very representative of most medical practices with the exception of the noted podiatric-specific differences.

Invitation: Letterhead.iMBA_Inc.

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Conclusion

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

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

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

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

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

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

Physician Advisors: www.CertifiedMedicalPlanner.org

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An Rx for Physician’s Financial Health

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Fundamental Principles for all Medical Professionals

Donald M. Roy CFP® CFS www.newealthadvisors.com

SPONSOR: www.PhysicianNexus.com

The demands on medical practitioners today can seem overwhelming. It’s no secret that health-care delivery is changing, and those changes are reflected in the financial issues that health-care professionals face every day. You must continually educate yourself about new research in your chosen specialty, stay current on the latest technology that is transforming health care, and pay attention to business considerations, including ever-changing state and federal insurance regulations.

Like many, you may have transitioned from medical school and residency to being on your own with little formal preparation for the substantial financial issues you now face. Even the day-to-day concerns that affect most people–paying college tuition bills or student loans, planning for retirement, buying a home, insuring yourself and your business–may be complicated by the challenges and rewards of a medical practice. It’s no wonder that many medical practitioners look forward to the day when they can relax and enjoy the fruits of their labors.

Unfortunately, substantial demands on your time can make it difficult for you to accurately evaluate your financial plan, or monitor changes that can affect it. That’s especially true given ongoing health care reform efforts that will affect the future of the industry as a whole. Just as patients need periodic checkups, you may need to work with a financial professional to make sure your finances receive the proper care.

Maximizing your personal assets

Much like medicine, the field of finance has been the subject of much scientific research and data, and should be approached with the same level of discipline and thoughtfulness. Making the most of your earning years requires a plan for addressing the following issues.

Retirement

Your years of advanced training and perhaps the additional costs of launching and building a practice may have put you behind your peers outside the health-care field by a decade or more in starting to save and invest for retirement. You may have found yourself struggling with debt from years of college, internship, and residency; later, there’s the ongoing juggling act between making mortgage payments, caring for your parents, paying for weddings and tuition for your children, and maybe trying to squeeze in a vacation here and there. Because starting to save early is such a powerful ally when it comes to building a nest egg, you may face a real challenge in assuring your own retirement. A solid financial plan can help.

Investments

Getting a late start on saving for retirement can create other problems.

For example, you might be tempted to try to make up for lost time by making investment choices that carry an inappropriate level or type of risk for you. Speculating with money you will need in the next year or two could leave you short when you need that money. And once your earnings improve, you may be tempted to overspend on luxuries you were denied during the lean years. One of the benefits of a long-range financial plan is that it can help you protect your assets–and your future–from inappropriate choices.

Tuition

Many medical professionals not only must pay off student loans, but also have a strong desire to help their children with college costs, precisely because they began their own careers saddled with large debts.

Tax considerations

Once the lean years are behind you, your success means you probably need to pay more attention to tax-aware investing strategies that help you keep more of what you earn.

Using preventive care

The nature of your profession requires that you pay special attention to making sure you are protected both personally and professionally from the financial consequences of legal action, a medical emergency of your own, and business difficulties. Having a well-defined protection plan can give you confidence that you can practice your chosen profession without putting your family or future in jeopardy.

Liability insurance

Medical professionals are caught financially between rising premiums for malpractice insurance and fixed reimbursements from managed-care programs and you may find yourself evaluating a variety of approaches to providing that protection. Some physicians also carry insurance that protects them against unintentional billing errors or omissions.

Remember that in addition to potential malpractice claims, you also face the same potential liabilities as other business owners. You might consider an umbrella policy as well as coverage that protects against business-related exposures such as fire, theft, employee dishonesty, or business interruption.

Disability insurance

Your income depends on your ability to function, especially if you’re a solo practitioner, and you may have fixed overhead costs that would need to be covered if your ability to work were impaired. One choice you’ll face is how early in your career to purchase disability insurance. Age plays a role in determining premiums, and you may qualify for lower premiums if you are relatively young. When evaluating disability income policies, medical professionals should pay special attention to how the policy defines disability. Look for a liberal definition such as “own occupation,” which can help ensure that you’re covered in case you can’t practice in your chosen specialty.

To protect your business if you become disabled, consider business overhead expense insurance that will cover routine expenses such as payroll, utilities, and equipment rental. An insurance professional can help evaluate your needs.

Practice management and business planning

Is a group practice more advantageous than operating solo, taking in a junior colleague, or working for a managed-care network? If you have an independent practice, should you own or rent your office space? What are the pros and cons of taking over an existing practice compared to starting one from scratch? If you’re part of a group practice, is the practice structured financially to accommodate the needs of all partners? Does running a “concierge” or retainer practice appeal to you? If you’re considering expansion, how should you finance it?

Questions like these are rarely simple and should be done in the context of an overall financial plan that takes into account both your personal and professional goals.

Many physicians have created processes and products for their own practices, and have then licensed their creations to a corporation. If you are among them, you may need help with legal and financial concerns related to patents, royalties, and the like. And if you have your own practice, you may find that cash flow management, maximizing return on working capital, hiring and managing employees, and financing equipment purchases and maintenance become increasingly complex issues as your practice develops.

Practice valuation

You may have to make tradeoffs between maximizing current income from your practice and maximizing its value as an asset for eventual sale. Also, timing the sale of a practice and minimizing taxes on its proceeds can be complex. If you’re planning a business succession, or considering changing practices or even careers, you might benefit from help with evaluating the financial consequences of those decisions.

Estate planning

Estate planning, which can both minimize taxes and further your personal and philanthropic goals, probably will become important to you at some point. Options you might consider include:

  • Life insurance
  • Buy-sell agreements for your practice
  • Charitable trusts

You’ve spent a long time acquiring and maintaining expertise in your field, and your patients rely on your specialized knowledge. Doesn’t it make sense to treat your finances with the same level of care?

Channel Surfing the ME-P

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Conclusion

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

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How to Get Started in Healthcare IT [Video Presentation]

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An Encore Presentation from a ME-P Thought-Leader

By Ann Miller RN MHA [Executive-Director]

In this ME-P, Shahid N. Shah MS shares his best advice for information technology workers looking to get started in the healthcare industry.

Mr. Shah is also known as the Healthcare IT Guy [http://www.healthcareguy.com] informing us about technology issues in the healthcare field.

Link: http://www.physbiztech.com/video/shahid-shah-how-get-started-healthcare-it

###

More Expert Advice from Leaders in Healthcare Management

And, sourced below are related interviews with these experts:

  • Todd Linden, President and CEO of Grinnell Regional Medical Center (about rural healthcare management);
  • Paul Levy, former CEO of Beth Israel Deaconess Medical Center; and
  • Dr. Robert Wachter, Professor of Medicine, University of California, San Francisco (author of “Understanding Patient Safety” and the blog “Wachter’s World”).

Link: Health Administration Degrees http://www.healthadministrationdegrees.com

Assessment

Shahid also authored Chapter 13 on eMRs, HIT and Clinical GroupWare [INTEROPERABLE e-MRs FOR THE SMALL-MEDIUM SIZED MEDICAL PRACTICE] in our best-selling book, the “Business of Medical Practice” http://businessofmedicalpractice.com/chapter-13-2/

So, the text and videos are worth a look www.BusinessofMedicalPractice.com Our colleague, and uber hospitalist Robert Wachter MD, is also mentioned in the book.

Conclusion

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

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

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

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

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

Physician Advisors: www.CertifiedMedicalPlanner.org

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IRA Strategies for Physicians in 2012

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Money Flows-In Even as Volatility Continues in Mid-Year

By Martha J. Schilling AAMS CRP ETSC CSA

http://www.schillinggroupadvisors.com

The amount of money in IRAs is climbing even as the volatility continues.

Most of us have at least one IRA and eventually many people roll over their main retirement assets, 403(b) and 401(k) accounts to IRAs.

Unfortunately, a lot of the value in IRAs isn’t being maximized.

By focusing on a few key strategies you can make an IRA more valuable in your lifetime and beyond.

Now, doctors and all medical professionals should consider the following:

OWN THE RIGHT ASSETS

An IRA has the advantage of tax deferral. Gains and income compound free of taxes until they are distributed. They have the disadvantage of converting long-term capital gains into ordinary income. All taxable distributions from an IRA are taxed as ordinary income. Research reveals that assets that pay high ordinary income are best held in IRAs. High-Yield bonds, Real Estate Investment Trusts and investment grade bonds as well as stocks, mutual funds and other investments that tend to be owned for less than a year generate short-term capital gains. Nontraditional, or alternative investments can be utilized, however know which are prohibited in retirement accounts.

PRACTICE TAX DIVERSIFICATION

No one can forecast how the tax code will alter. Different scenarios are in the works, perhaps one will be put into place late this fall. Different types of accounts have different tax treatments now, and that could change. Instead of forecasting one tax outcome and arranging your finances accordingly, it’s safer to have different types of accounts so you won’t be burned in any scenario. Try to own investments in taxable accounts, traditional IRAs, and Roth IRAs

CONVERT TO A ROTH

Every year, consider whether it makes sense to convert all or part of your traditional IRA into a Roth IRA. Discuss with your Tax advisor factors such as your expected rate of return, the difference between your current tax rate and future tax rates, the source of the cash to pay the taxes and whether future required minimum distributions would exceed your spending needs.

Your CPA/advisor will add other questions as he would know your personal situation and needs.

CONSOLIDATE or SPLIT?

Simplifying your finances often means consolidating all your accounts at one financial institution. Many people have multiple IRAs and simplifying means rolling them over into one IRA when practical. But suppose you have multiple heirs and expect IRAs to be a significant legacy. You could name all heirs as joint beneficiaries and let them decide what to do with the account. On the other hand, you could split the IRA now and name one person as the primary beneficiary for each.

SPEND ACCOUNTS in the RIGHT Order

As a general rule, it’s best to spend taxable accounts first, traditional IRA’s next and ROTH IRAs last. Not in all cases. When you visit your advisor and review what you need in cash flow at retirement, you may find that taking your RMD at 70 ½ puts you into a higher tax bracket. It may be less taxing to take normal distributions on a regular basis after 591/2.

REVIEW your BENEFICIARIES. There are horror stories of people who haven’t changed beneficiaries for decades and find a sibling or a parent is the beneficiary rather than your spouse.

CONSIDER CHARITY. Should you decide to leave part of your estate to charity, the most tax efficient way to do that might be to name the charity as beneficiary of your IRA? Individuals pay tax on distributions, Charities do not.

CATCH-UP CONTRIBUTIONS

When you’re still working and making contributions to IRAs, you can make higher contributions when age 50 or older. In 2012, the maximum for those over 50 is $6000 rather than $5000.

CONSIDER SPOUSE Generally IRA contributions can be made only to the extent you have earned income from a job or business. When filing a joint return, contributions can be made for both spouses up to the maximum of $6000.

REQUIRED DISTRIBUTIONS It appears people continue to make mistakes when taking and computing their RMD after 70 ½. The IRS has been lax on this in the past but is stepping up its tracking and enforcement.

Assesment

Can you think of any others?

Conclusion

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

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

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

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

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

Physician Advisors: www.CertifiedMedicalPlanner.org

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Why the Government is Not-Like Medical Professionals

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An Endless Supply of US Dollars

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

Is the United States in danger of bankruptcy? Contrary to what you may read in the media or hear from many politicians, no, it isn’t. The US Treasury will never run out of dollars. Unlike doctors and medical professionals, it’s impossible.

Reasons Why?

The reason is relatively simple. The US government owns a printing press. As long as goods, services, or obligations are priced in US dollars, the supply of dollars to our government to buy those goods and services is unlimited. This is not true of individual physicians, corporations, cities, states, and countries that don’t issue their own currency.

For most people, this is a hard concept to grasp, with good reason. The capacity of our government to create an unconstrained supply of dollars is a relatively new phenomenon.

The Gold Standard

Until 1971, all US currency was theoretically redeemable in gold. This was known as the gold standard. In the early decades of the 20th century, you could actually go to a bank and change your dollars for gold. That ability was terminated in 1933, but the dollar’s value was still tied to gold. This basically meant the only way the US government could create new dollars was by obtaining more gold, the supply of which only increases by the new amount of gold mined.

Nixon

In 1971 we had a paradigm change in monetary policy that many still don’t understand. President Nixon decoupled the dollar from the gold standard [Nixon also wanted to flood the country with MDs, and drive down physician income, by opening up medical school admissions]. It became a fiat currency, which is used as a medium of exchange but has no intrinsic value. Suddenly, the US government was no longer constrained by solvency issues and could never run out of money. It could create as many dollars as it wished ie; inflation].

Constraints

This didn’t mean it had no constraints. The major constraint to an issuer of fiat currency is inflation. However, creating money does not guarantee inflation if the newly created money is not spent. Japan, for example, is still fighting deflation even though they’ve been pumping money into reserves like crazy for 20 years.

What should have caused a massive rethinking and reeducating of the financial sector went relatively unnoticed. Text books, professors, economists, and politicians largely continued to follow many pre-1971 monetary principles that became irrelevant overnight.

Unlike the federal government, US states, cities, and other government entities cannot print money. They have to get it the old-fashioned way—from taxes, fees, or borrowing. It’s entirely possible for these entities to go bankrupt, just like individuals and corporations, if their outflow exceeds their inflow.

Europe

Interestingly, the same is true for member countries of the European Union. When in 1999 they adopted the Euro and gave up their sovereign right to print their own money, they took on the same status as states. Therefore, a country like Greece, which is a user of currency as a member of the European Union, can involuntarily default on its obligations.

This is a significant difference between the United States and Greece. While Greece can (and most likely will) go bankrupt because it doesn’t have an unlimited supply of Euros, the US can’t go bankrupt because it does have an unlimited supply of dollars.

The major threat that sovereign countries face is not running out of money, but devaluing their currency through inflation. A devalued currency is one that loses its purchasing power and often results in a lower standard of living.

Assessment

Just because the US can’t involuntarily default on its obligations doesn’t mean we can keep on over spending and pretend we don’t have any money worries. As a nation, we still need to acknowledge and deal with our serious financial problems. So should our doctors, financial planners and financial advisors.

Conclusion

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

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

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

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

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

Physician Advisors: www.CertifiedMedicalPlanner.org

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About Next-Gen Bath Salts

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By The DEA Agent

Innocent Name – The Dangerous Consequences of MDPV

The recent media explosion over bath salts is not unwarranted. Over the past two years, the public eye has zoomed in on dangerous drug, still legally sold in some states. And, there’ve been many bizarre cases of violence and psychotic outbursts from users.

About MDPV

But, what exactly are bath salts?

Assessment

Keep reading the above to learn about the history and effects of bath salts.

Source: rehab-international.org

More info: http://en.wikipedia.org/wiki/Methylenedioxypyrovalerone

Conclusion

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

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Promoting the ME-P Holistic Physician Lifestyle

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Enter the Certified Medical Planners™

By Ann Miller RN MHA

[Executive-Director]

Life planning and behavioral finance, as proposed by physicians and financial advisors, and as integrated by the Institute of Medical Business Advisors (iMBA), emanates from a holistic union of personal financial planning and medical practice management solely for the healthcare space.

Source: https://www.mapsforthat.com/map.php?m=587

The CMP™ Difference

Unlike pure life planning, pure financial planning, or pure management theory, it is both a quantitative and qualitative “hard and soft” science. It has an ambitious economic, psychological and managerial niche value proposition never before proposed and codified, while still representing an evolving philosophy. Its’ zealous practitioners are called Certified Medical Planners (CMPs).

Assessment

Health 2.0 focused physician baby boomers & modern Gen-X financial advisors can help transition you successfully through medical practice and life changing financial events by exchanging knowledge, experiences and inspiration with industry professionals and peers in the casual and friendly atmosphere of the ME-P. Join us today.

More: https://medicalexecutivepost.com/2009/10/20/understanding-behavioral-finance/

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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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Doctors Shouldn’t Wait Till Retirement To Act On Travel Dreams

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

What’s at the top of your retirement bucket list? If you are like most folks that I help prepare for retirement, travel is high on that list.  As I’ve grown older, my views on retirement travel have changed. I used to buy into the dream of retirement as the “Golden Years.” I thought of it as the time in life when people are free to do what they want, when they want, with whom they want.

Working with older clients has taught me that my younger views of the glory of retirement were a bit naïve. While certainly some people do experience years of unlimited and unfettered travel, many more don’t find it so easy. Doing “what you want, when you want, with whom you want,” assumes three things we often take for granted: good health, adequate finances, and meaningful relationships.

This seems especially true for command-control type medical professionals.

The Three Legs of Retirement Lifesyle

1. Health. When it comes to travel, good health may not be essential, but it will make your experience more fulfilling and enjoyable. Of course, we aren’t typically in either “good” or “poor” health, but fall somewhere on a continuum. With limited mobility, you may be able to shop at the bazaar in Istanbul, but chances are you won’t hike the Grand Canyon or explore the Acropolis.

Like most things, good health typically requires a conscious intention to create and maintain it. Someone who has a money script of, “When I retire I’ll have the time and money to take better care of myself” may be in for a surprise. Most people who chose not to take care of their health before retirement won’t do so in retirement. As one retired friend said, “If you didn’t have the energy to work out when you were young, you sure won’t have it when you retire!”

What’s even more uncontrollable is the health of those with whom you wish to share your travel adventures. Even if you’ve taken care of yourself, your significant other may be unable to travel. Instead of strolling a beach in the Bahamas, you could end up at home being a caretaker.

2. Money. On average, baby boomers have saved less than $100,000 for retirement. That won’t pay for many around-the-world cruises. If you want to travel after you retire, you need a serious commitment during your working years to live frugally and invest as much as you can. Otherwise, you may end up with just barely enough to cover your basic living expenses.

3. Relationships. If you spend your career working 80-hour weeks, you may accumulate enough assets to fund plenty of retirement travel—but by then you may be traveling alone. Saving for the future is out of balance if it’s done at the expense of enjoying life and close relationships today.

Assessment

By now you may think I’m suggesting you have no better choice than to spend your retirement years at home. Not at all. Here’s one possibility: If travel is one of your dreams, what would happen if you did some of it now? Use your vacation time while you can enjoy yourself. Take that motorcycle trip through Europe or go scuba diving in Belize while you’re in top shape. Do the international travel now when you can better negotiate airports, handle travel delays, and power through jet lag. To save on expenses, plan ahead, use a credit card that awards frequent flyer miles (which you pay off monthly), and use cost-saving options like home swaps and off-season travel.

Then, after you retire, when you need more access to medical care and less demanding travel, you can stay closer to home and enjoy the opportunities in your own back yard.

More: http://www.mississippimedicalnews.com/retirement-and-succession-planning-cms-1524

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

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

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

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

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

Physician Advisors: www.CertifiedMedicalPlanner.org

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On Smart Phones, Texting and Doctors Driving‏

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Doctors Beware – A Bad Idea

By Muhammad Saleem

Did you know that almost 60% of drivers use their phones on the road? What about doctors?

The numbers from our piece today could not be clearer on the consequences of using your smartphone while driving. For example:

  • You are 23 times more likely to get into an accident while texting.
  • 18% of distraction-related crashes are from cell phone usage.
  • Distracted driving is the number one killer of American teens.

Assessment

Doctors – Have you ever texted medical orders, or patient instructions etc., while driving? Be honest!

In addition to the above, our infographic discusses statistics on smarthpones and driving, illustrate the dangers, discuss the law, and provide tips to make you and your passengers safer.

Conclusion

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

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New IRS Guidance on Health FSAs for Doctors

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On Section 125 Cafeteria Plans

By Children’s Home Society of Florida Foundation

In Notice 2012-40; 2012-25 IRB 1 (29 May 2012), the IRS issued guidance on the changes required in 2013 for Sec. 125 Cafeteria Plans.

Section 125 Plans

Many companies have created healthcare flexible spending accounts under Section 125.  For 2013, the salary reduction contributions are limited to $2,500.  The notice indicates that this limit will be adjusted for inflation in 2014 and later years. If contributions greater than $2,500 are made to the account, the excess funds will not subject the employee to penalties if the funds are distributed as taxable income in the taxable year in which the cafeteria plan year ends.  The $2,500 limit does not apply to non-elective plans.  Many of these plans are described as “flex limit” or similar plans.

New Limits

Written cafeteria plans must be modified to reflect the new $2,500 limit and other provisions.  If the plan follows the proposed regulations issued in 2007, the participants may rely on the plan to be qualified.

Assessment

And so, as more and more medical professionals become employees, FSA rules should be monitored closely by doctors and their FAs.

Conclusion

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

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The Marcinko Method of Improving Quality while Reducing Medical Errors and Healthcare Costs

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Dr. David Edward Marcinko FACFAS MBA CMP

[Former – Certified Physician in Healthcare Quality]

[Former – Certified Financial Planner]

www.CertifiedMedicalPlanner.org

[Publisher-in-Chief]

THINK TWICE!

Doctor’s Orders

Life Corollaries:

Marcinko’s Rx for Obesity: Eat less – Exercise more – Avoid noxious lifestyles.

Marcinko’s Rx for Practice Success: Treat sick patients – Be humble – Keep faith.

Marcinko’s Rx for Financial Success: Spend less – Earn more – Be a fiduciary. 

Marcinko’s Rx for Wealth & Happiness: Don’t divorce – Love kids – Practice philanthropy.

Professional Medical Corollary:

The Choosing Wisely® list, which is aimed at cutting down on unnecessary testing by doctors and patients.

Assessment  

I am not an oracle. What else can you ad to the list?

Conclusion

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

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Certified Medical Planner

Physicians as “Dr. Money Waster”

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Paging … Doctor Money Waster?

By Rick Kahler MS CFP® ChFC CCIM

www.KahlerFinancial.com

Be frugal. Live on less than you make. Save for the future. It’s my message, and I’m sticking to it.

Just in case you’re getting tired of that message, though, let’s take a look at thrift from a slightly different perspective.

And so, for any medical professional who wants to throw cash around, here are some effective ways to waste your money:

How to Waste Money on Travel:

  • Buy package vacation deals.
  • Buy a vacation home.
  • Get an RV and only use it one or two weeks a year.
  • Buy a timeshare unit.
  • Pay for hotel Internet packages.
  • Eat at hotel restaurants.
  • Use room service.
  • Over-pack and pay checked airline baggage fees.
  • Don’t bother to use a travel credit card that gives you frequent flyer credits.
  • Stay at full-service hotels with amenities you don’t use.

How to Waste Money on Big-Ticket Items:

  • Buy a new car every three years.
  • Buy hybrid cars.
  • Pay for extended warranties.
  • Fail to compare prices and check product reviews.
  • Pay full price for furniture.

How to Waste Money on Insurance:

  • Get a cancer or accidental death policy.
  • Buy credit life insurance.
  • Buy variable universal life insurance.
  • Have life insurance if you don’t need it.
  • Keep your deductibles low.
  • Purchase the cruise line’s trip insurance.
  • Purchase car rental insurance.

How to Waste Money on Investing:

  • Don’t take advantage of a retirement plan with employer matching that doubles your money.
  • Invest outside of a retirement plan instead of fully funding the plan first.
  • Buy variable and fixed annuities that charge you big commissions and high fees.
  • Buy load mutual funds and trade them often.
  • Cash in your 401(k) or 403(b) plan when you leave your job instead of rolling it to an IRA.
  • Cash in your IRA when money gets tight.

How to Waste Money on Health and Fitness:

  • Buy home fitness equipment and use it to hang clothes on.
  • Pay for a fitness center membership but rarely or never use it.
  • Be a sucker for the latest “cure-all de jour” supplement or multi-level marketing product.
  • Pay more for specialized brand-name vitamins even though store brands are just as good.
  • Buy junk food instead of stuff that’s good for you.
  • Skip those regular visits to the doctor and the dentist.

How to Waste Money with Your Everyday Habits:

  • Drive across town to save two or three cents on gas.
  • Buy grocery name brands instead of cheaper store brands.
  • Pay full retail price for clothes, furnishings, or other items instead of waiting for sales.
  • Buy bottled water.
  • Disregard ATM fees.
  • Pay hefty overdraft fees because you don’t bother to keep track of your bank balance.
  • Forget to change your furnace filter.
  • Don’t bother to maintain your car or house.
  • Be disorganized about taking care of bills on time, so you pay late fees.
  • Pay for premium cable TV packages with channels you rarely watch.
  • If you can’t afford something now, pull out the plastic. When you don’t pay a credit card bill in full at the end of the month, high interest rates can quickly double or triple the price of anything you buy.
  • Gamble. Online gambling, slot machines, gaming  tables, and lottery tickets are all good ways to get rid of extra cash.
  • Speed. This is a three-for-one deal. You’ll use extra gas, pay $100 or more for a speeding ticket, and end up with higher car  insurance premiums.

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Don’t subscribe or read the Medical Executive-Post.

Assessment

Even practicing a few of these overspending habits will give you more financial stress and less financial security. Just observing half of them will give you an interesting life full of financial chaos.

Follow more than half and you, too, can qualify as a first-class Dr. Money Waster.

Conclusion

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

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

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

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

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

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

Physician Advisors: www.CertifiedMedicalPlanner.org

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How a Medical Answering Service Really Works

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The Traditional System

Ever wonder that happens when you call your doctor’s office after hours and someone picks up the phone? The office is not open at midnight if that’s what you were wondering. Most physicians / doctors / medical professionals have their phones forwarded to an answering service after hours!

What does that mean?

Well, it means that no matter what time it is you can always reach your doctor.

Check out the above infographic to learn out how the call routes from your cell phone to the service to the doctor.

Assessment

Now, with all these steps, it is no wonder modern doctors are using cell phones, iPads, direct or open access online patient scheduling systems.

Conclusion

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Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

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

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

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

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

Physician Advisors: www.CertifiedMedicalPlanner.org

Product Details

How to Calculate your Financial APGAR Score

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Using a Well-Known Medical Model for Personal Financial Planning

By Andrew D. Schwartz CPA

The term “APGAR Score” should already be familiar to people who’ve experienced the birth of a child and to people in the medical community. Immediately after birth, every baby is evaluated by a doctor to determine its medical condition. The evaluation consists of the following five signs: appearance, pulse, grimace, activity, and respiration. The the eponymous Dr. Virginia APGAR score, developed in 1952, ranges from 0 to 10 and serves as an initial indication of the baby’s overall health.

The Financial Affairs Paradigm Shift

Anyone looking to gain control of their financial affairs must first get a sense of where they stand. And so, we’ve developed a variation of the APGAR test to help people make an initial self-evaluation of their financial condition. The five financial attributes of our APGAR test are as follows:

  1. Accumulated Wealth
  2. Payment of Credit Card and Consumer Debt
  3. Got Life and Disability Insurance
  4. Automobile Habits
  5. Residential Equity
Accumulated Wealth

In this first step, you compare your net investments, your age, and your income. You first need to calculate the total fair market value of all of your investments assets, excluding your principal residence and your cars. Make sure to include non-retirement savings, retirement savings, and any other investments that you may own. You should then calculate the total of all of your debts, excluding any loans on your principal residence and your cars. Don’t forget to include your student loans and your credit card debts.

You should then subtract your total debts (excluding loans on your principal residence and your cars) from your total assets (excluding your principal residence and your cars) and:

  • Give yourself 2 points if your net assets divided by your annual household income exceeds
    {[(your age – 30) * .2] +1}. Married couples should use the average of their two ages.
  • Give yourself 1 point if your net assets are greater than $0 but not enough to qualify you for 2 points.
  • Give yourself 0 points if your net assets are less than $0.
Payment of Credit Card and Consumer Debt

In this step, you’ll take a look at your credit card habits. Always maintaining a balance on your credit cards can really cause your financial position to erode significantly.

  • Give yourself 2 points if you generally pay off your credit cards each month.
  • Give yourself 1 point if you owe money on your credit cards, but will have them all paid off within 6 months.
  • Give yourself 0 points if there is no way that you’ll be out of credit card debt within 6 months.
Got Life and Disability Insurance

Life insurance and disability insurance are two key ingredients to a successful financial plan. Generally, a person will obtain life insurance and disability insurance either as part of their benefits package provided by their employer or on their own through an insurance salesperson or financial advisor.

  • Give yourself 2 points if you have purchased life insurance or disability insurance on your own.
  • Give yourself 1 point if you have life and/or disability insurance through the benefits package offered by your employer.
  • Give yourself 0 points if you have no life or disability insurance at all.
Automobile Habits

Besides one’s home, automobiles are generally a person’s largest purchase. The car you drive is also perceived as a status symbol and can be an area where even the most frugal person would consider being extravagant. How long do you generally hold onto your cars for?

  • Give yourself 2 points if you hold onto your cars for more than 5 years, are provided with a company car from your employer, or don’t own a car and spend less than $300 per month on rentals and cabs.
  • Give yourself 1 point if you generally hold onto your cars for less than 5 years, but more than 3 1/2 years or, if you don’t own a car, you spend more than $300 per month but less than $500 per month on car rentals and taxis.
  • Give yourself 0 points if you generally hold onto your cars for less than 3 1/2 years or, if you don’t own a car, spend more than $500 per month on car rentals and taxis.
Residential Equity

Owning a home is an essential component to most financial plans. Home ownership provides a hedge against inflation and a tax-free means of accumulating wealth. For this step, you’ll need to know the fair market value of your home and the current balance of any mortgages and equity loans on that property.

If you own a home, you must calculate the value of your home’s equity by subtracting the current balance of your mortgages and equity loans from the current fair market value of the home.

  • Give yourself 2 points if the equity in your home divided by the home’s fair market value exceeds {[(your age – 30) * 2.5%] +25%}.
  • Give yourself 1 point if the home’s value exceeds the current balance of the mortgage and equity loans but you don’t have enough equity to qualify for 2 points.
  • Give yourself 0 points if you do not own a home, or if the amount that is owed on your home exceeds its fair market value.

Your APGAR Score Card

A: _____________

P: _____________

G: _____________

A: _____________

R: _____________

TOTAL: ______________

 Assessment and Score Interpretation
  • If your score is 8 or higher, you appear to be on the right track with your finances. Take a look at any attribute that didn’t score a 2, and see if you should make any changes.
  • If your score is between 5 and 7, you have a pretty big job ahead of you. You should try to determine which of the financial attributes need work and put together a plan to make improvements in those areas.
  • If your score is 4 or less, you have lots of work to do. Take a deep breath, and make a commitment to get your finances on track. Keep in mind that the challenge you face may be daunting, but it is not insurmountable.

About the Author

Andrew D. Schwartz, CPA is founder and managing partner of Schwartz & Schwartz, PC, in Woburn, MA. Since 1993, Andrew has provided tax, practice management, payroll, and basic financial planning services to healthcare professionals and their practices. Andrew is also the founder of The MDTAXES Network, a national association of CPAs that specialize in the healthcare profession. Andrew is a frequent speaker at national and area conferences (including the Yankee Dental Congress and the 2012 National Audiology Conference), medical and dental schools, and community events.  Andrew is the author of many tax and basic financial planning articles on a variety of issues that impact healthcare professionals. He is frequently interviewed as a tax advisor on current topics in national media, such as ABCNews.com, Washington Post and Wall Street Journal, and local media, such as Greater Boston Radio 92.9 and Boston.com.  Andrew graduated from the Wharton School at the University of Pennsylvania. He is a member of the Massachusetts Society of CPAs (MSCPA) and the American Institute of CPAs (AICPA). Andrew was selected as a 2011 and a 2010 winner of Boston Magazine’s “Five-Star Wealth Manager – Best in Client Satisfaction” award.

Conclusion

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

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

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

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Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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