Dr. David Edward Marcinko MBA MEd CMP™

Current Retirement Investment Options for Physicians

Posted on June 10, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Understanding Build America Bonds

By Somnath Basu PhD, MBA [www.clunet.edu/cif]

[Director California Institute of Finance]

There is heartening news for those of us in retirement or approaching it. There’s a new type of bond called the Build America Bond or BAB. The BAB, along with an older and often ignored retirement investment, is viewed as positive developments for those saving for retirement. But, before a doctor, or any investor, jumps into these investments, some background information is required.

The Accumulation Phase

When people in their early careers save, their primary objective should be that their money grows healthily. They generally should invest in stocks which provides for longer run growth. This phase of our financial life can be called the “Accumulation Phase.”

The Preservation Phase

However, people in their mid- to end-careers (roughly between the ages of 40 – 65) start switching their objectives towards a more conservative future growth in their current savings, especially those associated with emergencies and retirement. This phase is usually identified as the “Preservation Phase” where individuals should begin switching their investments towards more fixed-income securities, such as bonds and bond funds. This idea of how reasonable people “should” behave is commonly known as the life-cycle hypothesis of investments.

The Decumulation Phase

Finally, people in retirement, those who are in the phase termed as the “Decumulation Phase,” should have a healthy dose of bond-type investments in their retirement portfolios.

Strange as it may be to some, this opinion about the investment life-cycle actually contains a lot of truth. If most people followed this basic rule, we would be better off this way than by any other method and especially in times like the recent financial tsunami that hit us. Those hit especially hard were people between the ages of 55 and older who held unhealthy amounts of stocks in their portfolios. Following this simplified version of retirement investments is both easy and effective.

All we do as we age is reduce our stock investments and increase our bond investments. While such a strategy reduces the growth of our wealth it also protects us from large to calamitous losses.

Unfortunately, the last 10 years or so have not been good for bond investments because bond prices have been at or near all-time highs and their returns near all-time lows. The following picture shows the rates one would earn by investing in the government’s (highest safety) 10-Year Treasury Note. Many bonds and mortgages (and subsequently the respective funds) use the 10-Year rate as the benchmark rate.

Graph: 10 T Year Note

As can easily be seen, these rates have come down steadily. A result has been the difficulty, of late, to find (the safer type) bond funds because they have been so expensive. However, one recent development in this field is worth mentioning: that is the emergence of a class of (stimulus-related) bonds known as the “Build America Bonds” or BABs, which for the first time in many years offers investors a very suitable entry to convert stocks into bonds. BABs, which were introduced in April 2009, are an innovative new tool for municipal financing created by the American Reinvestment and Recovery Act of 2009. BABs are taxable bonds for which the U.S. Treasury Department pays a maximum of 35 percent direct subsidy to the issuer to offset borrowing costs.

The second issue of note is that at this point, it is quite expensive to hold cash in money market type funds because of the dismal rates offered on very short-term products. An alternative that physicians and all investors should contemplate purchasing instead of CDs, and money market deposits, is a class of bonds, issued by the Government and known as Treasury Inflation Protected Securities, or TIPS. These investments sold directly by the government to you (at http://www.TreasuryDirect.gov) are excellent vehicles for holding funds as they guarantee that your money will hold its buying power over time and a bit more. TIPS are a great way to hold the capital you will need in the short term. The following picture shows the stability of the TIPS rate; a much safer and more stable investment opportunity than short term Bank CDs, recent money market funds, etc.

Graph: TIPS Rate

Build America Bonds [BAB]

The Build America Bonds program, created by the American Recovery and Reinvestment Act, allows state and local governments to obtain much-needed financing at lower borrowing costs for new capital projects such as construction of schools and hospitals, development of transportation infrastructure, and water and sewer upgrades, according to a recent U.S. Treasury Department press release. Under the Build America Bonds program, the Treasury Department makes a direct payment to the state or local governmental issuer in an amount equal to 35 percent of the interest payment on the bonds.

Here’s how BABs work according to the Treasury Department:

“The bonds, which allow a new direct federal payment subsidy, are taxable bonds issued by state and local governments that will give them access to the conventional corporate debt markets. At the election of the state and local governments, the Treasury Department will make a direct payment to the state or local governmental issuer in an amount equal to 35 percent of the interest payment on the Build America Bonds. As a result of this federal subsidy payment, state and local governments will have lower net borrowing costs and be able to reach more sources of borrowing than with more traditional tax-exempt or tax credit bonds. For example, if a state or local government were to issue Build America Bonds at a 10 percent taxable interest rate, the Treasury Department would make a payment directly to the government of 3.5 percent of that interest, and the government’s net borrowing cost would thus be only 6.5 percent on a bond that actually pays 10 percent interest.”

Assessment

According to the Treasury Department, Build America Bonds have had a very strong reception from both issuers and investors. From the inception of the program in April 2009 to March 31, 2010, there have been 1,066 separate Build America Bonds issuances in 48 states for a total of more than $90 billion. Read more about BABs at this site

http://www.treas.gov/press/releases/docs/BuildAmericaandSchoolConstructionBondsFactsheetFinal.pdf

Now, until the general level of interest rates go back to their normal states, it will be difficult to find another opportunity such as this one. This is especially true of investments that are made to local governments through their taxable investments. Municipal bonds are typically considered less risky. Add to this the partial guarantee of the Govt. and you have the makings of a very safe Bond fund providing an average yield of nearly 6% for medium-term duration. There has been a dearth of such fixed income investments in the Bond markets for quite a while. Thus, for doctors and all of us at or nearing retirement age, an exploration and investigation of BABs is an absolute must.

Editor’s Note: Somnath Basu PhD is program director of the California Institute of Finance in the School of Business at California Lutheran University where he’s also a professor of finance. He can be reached at (805) 493 3980 or basu@callutheran.edu. See the agebander at work at www.agebander.com

Conclusion

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Filed under: Financial Planning, Investing, Retirement and Benefits | Tagged: American Reinvestment and Recovery Act, Build America Bond, California Institute of Finance, california lutheran university, Decumulation Phase, retirement planning, Somnath Basu, TIPS bonds, treasury bonds, Treasury Inflation Protected Securities, Treasury notes | 3 Comments »

Building a Meaningful Medical Practice Marketing Campaign

Posted on June 9, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

What it Is – How it Works

[By Dr. David Edward Marcinko MBA, CMP™]

[By DeeVee Devarakonda MBA]

The success of a knowledge driven healthcare organization depends on not only how data can be converted to information – and information into marketing insight – but also by acting upon and converting those insights into building meaningful patient acquisition campaigns.

Definition of Patient Recruitment

Patient recruitment or campaign managementis the process of designing, executing, and measuring marketing campaigns through the use of applications that help to:

Select and segment patients
Design campaigns and execute the campaigns to contact patients
Track the contacts made with patients
Measure the results of those contacts
Learn from these results to more efficiently target patients in the future.

Key Queries

Some key questions to ask while you build campaigns:

Do you have a Customer [Patient] Relations Management roadmap that fits in with your overall patient vision and strategies and outlines the course of action for campaign management?
What is your privacy policy and strategy? – It is imperative for healthcare organizations to be proactive and self-regulate with a coherent privacy policy and design their systems to comply with this strategy. This may affect the way you design and execute campaigns.
What tools should you use? – There are several campaign management tools available today but no one tool may solve all business problems. You need to decide: what works best for my technical/ business environment? Is any integration effort required, if yes, how much will it cost me? How user-friendly are the tools? How much should I invest in training?

Important Campaign Components

Critical components of campaign management include the following activities:

Patient Segmentation: Process of identifying groups of patients for better targeting marketing and communications efforts. Segmentation is critical for effective and intelligent one on one communications with your patient.

Ensure your data quality is excellent which can give you meaningful segmentation.
Consistency of treatments and processes are of paramount importance.
Buying a software tool is not enough for effective segmentation. You also need to understand what the software tool does in the backend. Watch out for anomalies and take steps to make reparations.
Make sure you administer the initiative to a small sample and the business rules are in place before you roll out your campaign to the larger group.

Personalization: Ability to customize your product/service to each patient:

Good personalization is possible especially when you have a good patient past history.
You also need to have all business rules in place for effective personalization.
Ensure your patient data is of high quality (e.g. addressing a female patient as a Mr. or sending mails to sign up for your service to a person who is already your patient can defeat the purpose of personalization)
If you model data before personalization, you can target more effectively and personalize.
It pays to have a clear privacy policy and ensure your personalization philosophies are in tune with that policy.

Execution – Actual implementation of your marketing programs and messages

Before you execute, ensure you are equipped to fulfill promises you are making in the campaigns (e.g. If you are printing a toll free phone number in your direct mail piece for your patients to use, that toll free telephone number should work)
Make sure your sales and service channels are aware of the campaigns and publish a general calendar for the whole company
Develop business rules and strategies for follow-up campaigns.

Learn more: http://www.CertifiedMedicalPlanner.org

The Mindset

Successful patient marketing campaigns begin with the proper mindset and practice culture. There is no technology silver bullet to any P[C]RM campaign. And today, patient privacy is the key element of loyalty with a commitment to build long lasting and profitable campaigns through mutual trust and engaging cross-functional teams that can pick and deploy the elements mentioned above, across the entire enterprise and IT network, as needed.

Assessment

Healthcare organizations should keep privacy and the above components as their laundry list of action items when considering a C(P)RM plan.

Conclusion

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Filed under: Career Development, CMP Program, Glossary Terms, Marketing & Advertising, Practice Management | Tagged: CRM, DeeVee Devarakonda, healthcare marketing campaigns, Medical CRM, medical marketing, www.certifiedmedicalplanner.com, www.HealthDictionaySeries.com, www.medicalbusinessadvisors.com | 2 Comments »

Will Fiscal Commission Consider a VAT to Reduce the Federal Deficit?

Posted on June 8, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Moro on the National Commission on Fiscal Responsibility and Reform

By Robert Giese
bob.giese@chsfl.org

The National Commission on Fiscal Responsibility and Reform [NCFRR] continues to develop a comprehensive proposal to address the federal deficit. It has invited comments from members of Congress, leaders of all types of American organizations and private individuals.

We invite ME-P contributions, as well.

A Four- Point Proposal

James Q. Riordan, Sr. sent a letter this week to co-chair Alan K. Simpson, the former Senator from Wyoming. Mr. Riordan made four basic points about the fiscal problems and suggested a Value Added Tax (VAT) as a solution.

[picapp align=”none” wrap=”false” link=”term=National+Commission+on+Fiscal+Responsibility+and+R&iid=8643885″ src=”8/6/7/2/Obama_Speaks_On_32c4.jpg?adImageId=13115540&imageId=8643885″ width=”380″ height=”536″ /]

First, he indicated that there is too much “unaffordable spending.” Even with limited spending growth, the income tax cannot be sufficiently increased to pay for current and future proposed spending without doing damage to the economy and increasing unemploymen.

Second, Riordan claims that the only potential solution is a VAT. However, because the VAT is a tax on consumption and would have great impact on middle and lower incomes, it needs to be accompanied by a progressive income tax.

His third point is that the new income tax would need to be very simple. In his view, there would be no deductions for home mortgage interest, charitable gifts or medical expenses.

Fourth, he would tax all income only once. There would presumably not be a corporate-level tax or an estate tax under this theory.

Inadequate Staff Resources

As the fiscal commission considers the options for reducing spending and increasing taxes, it has indicated that the current staff resources are inadequate. In response to a request by the commission, Senate Majority Reid sent a letter this week to the White House and requested additional staff support. The White House indicated that it will be pleased to “work with him” to provide additional assistance.

At a hearing on the financial challenges, Senator George Voinovich (R-OH) noted that the commission is under great pressure to develop an effective plan. He stated, “If we don’t get something out of that commission, we are over the cliff.”

Assessment

Senate Budget Committee Chair Kent Conrad (D-ND) was the prime supporter of the commission. He stated, “This is not a time to impose austerity in my judgment.” However, he indicated that austerity will be necessary in the future, and that budget cuts and tax increases “must be imposed in a way that is convincing.”

Editors Note: For now, we take no specific position on VAT or other tax and spending recommendations by the Fiscal Commission. This information is offered because potential Fiscal Commission plans may affect many of our ME-P physician readers, subscribers, consultants and advisors.

Conclusion

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Filed under: Accounting, Estate Planning, Taxation | Tagged: Alan K. Simpson, federal deficit, George Voinovich, James Q. Riordan, Kent Conrad, National Commission on Fiscal Responsibility and Reform, Robert Giese, Value Added Tax | 1 Comment »

Reporting Tips for Covering High Risk Health Insurance Pools

Posted on June 8, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

A Call to all ME-P Citizen and Investigative Journalists

By Hope Rachel Hetico RN, MHA

[Managing Editor]

According to our colleagues from the Association of Health Care Journalists [AHCJ], the federal government and states are scrambling now to create temporary high-risk pools for the medically uninsurable by July 1, 2010. As one of the first provisions of the Patient Protection and Affordable Care Act to go into effect, it will serve as a test case for implementation of the new law and it should be closely followed.

[picapp align=”none” wrap=”false” link=”term=medical+professionals&iid=5271528″ src=”e/4/2/f/portrait_of_medical_aedc.jpg?adImageId=12922304&imageId=5271528″ width=”380″ height=”380″ /]

Some states with existing high risk pools are passing laws to ensure their programs comply with the new federal rules and are eligible for some of the $5 billion in federal funding. Other states are refusing to alter their programs and ceding responsibility to the federal government.

But, apart from being a policy story, it’s of great interest to all our ME-P readers, viewers or listeners who have pre-existing conditions and are struggling to find coverage.

Avoid HI Scammers

Finally, don’t be scammed into buying fake health insurance. With unemployment high and complicated health care changes under way, scammers see big opportunities. Here’s how to avoid getting hurt.

http://articles.moneycentral.msn.com/Insurance/InsureYourHealth/scams-peddle-fake-health-coverage.aspx

Assessment

And so, we now ask our ME-P citizen journalists or investigative reporters to cover this topic for story tips, suggestions, comments and related posts. We hope to add your insights and resources as the story develops.

Conclusion

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Filed under: Experts Invited, Health Insurance, Industry Indignation Index | Tagged: AHCJ, Association of Health Care Journalists, health insurance pools, high risk health insurance pools, Patient Protection and Affordable Care Act | Leave a comment »

”Tremendous Upheaval” Over Estate Tax

Posted on June 7, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

An IRS Prediction by Senator Charles Grassley

By Robert Giese
bob.giese@chsfl.org

Senate Charles Grassley (R-IA) is the ranking Republican on the Senate Finance Committee. In a conference call with several reporters on June 2nd, 2010, he discussed the uncertain future of the estate tax.

The Proposal [Kyle-Lincoln Estate Tax Compromise]

Sen. Grassley noted that Sen. Jon Kyle (R-AZ) and Sen. Blanche Lincoln (D-AR) have proposed that the Senate Finance Committee pass an estate tax bill with a $5 million per person exemption and a 35% top estate tax rate.

However, Grassley expressed the opinion that “the Finance Committee would like to take up consideration of legislation, but we aren’t assured by the majority leader that the bill passed out of committee will be taken up on the floor.”

Senate Rules

Under the Senate rules, even if the Finance Committee were to pass the Kyle-Lincoln estate tax compromise, Majority Leader Harry Reid (D-NV) is not obligated to schedule a floor vote and could simply stall the legislation.

Assessment

In December of 2009, the House passed the Permanent Estate Tax Relief for Families, Farmers and Small Businesses Act of 2009. This makes permanent the 2009 estate exemption of $3.5 million and top estate tax rate of 45%. If the House and Senate are not able to take action on estate taxes by the end of 2010 then on January 1, 2011 the estate tax returns with a 55% top rate and an exemption of $1 million (plus indexed increases).

This would affect many medical professionals as well as hardworking Americans.

Conclusion

If this were to happen, Sen. Grassley stated that there will be a “tremendous upheaval at the grassroots of America.”

And so, we invite IRS head Douglas Shulman to respond. Your thoughts and comments on this ME-P are also appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

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Filed under: Estate Planning, Financial Planning, Taxation | Tagged: Charles Grassley, Douglas Shulman, estate tax, estate tax exemption, ITS, Kyle-Lincoln Estate Tax Compromise], Permanent Estate Tax Relief for Families, Robert Giese, Senate Finance Committee | 7 Comments »

Some Dental Consultants Say the Most Incredible Things

Posted on June 7, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Are Dentists like … Rodney Dangerfield?

By Darrell Kellus Pruitt; DDS

“Let’s face it — in our world dentists do not get the respect they deserve. They are not perceived to be ‘real’ doctors … Perhaps the lack of sex appeal in dentistry is part of why dental coverage for everyone is an afterthought in the national health care conversation.”

Gary Kadi DDS, DentistryiQ

http://www.dentaleconomics.com/index/display/article-display/4196579430/articles/dental-economics/volume-100/issue-5/features/the-cavity_in_the.html

Even if Dr. Kadi is correct, and the barrier between a 12 year old and his toothbrush is a world-wide lack of respect of dentistry, that hardly means that electronic dental records (eDR) are going to make the kid brush any better. Experience tells me that if mom’s nagging won’t motivate the stinker, the computer won’t either.

eDR Rationalization?

For those who read the article, did you notice how Dr. Kadi, a dental practice consultant, attempts to subtly insert a fat rationalization for adopting eDRs into the middle of a comment lamenting dentistry’s lack of respect? Tricks like Kadi’s make stakeholders look silly at times, and it bothers me that hardly anyone notices and appreciates the humor that these pros bring to marketplace conversation. That’s why I like to point out mistakes like Kadi’s when I come across them. It’s getting harder to find these kinds of articles about eDRs. My pleasure!

Working Both Sides of the Consulting Fence

As far as I can tell, all but a few dental consultants work both sides of the fence in order to please vendors who give them good deals, as well as dentists who pay for unbiased help. Sponsorship by vendors is the bottom level of a consultant career if one chooses to make a living at selling advice. In this way, the dental consultant business is a lot like the financial advice business. Some advisors push their favorite investments that serve them well no matter what happens to their clients’ money. If a client wants advice, but prefers not to pay full price, interested vendors can be counted on to quietly chip in on an advisor’s bill. And that is why the customer must always be cynical. What’s more, it is arguably one’s community obligation to publicly challenge such artists by luring them out into the open to explain further what they meant to say to naïve people. Dr. Kadi begins:

“The national health-care debate cannot be complete unless we include dental care as part of the discourse.”

He then presents oft-repeated, convincing findings which support the widely held conclusion that one’s overall health is dependent on one’s oral health. Even though this chunk of common sense has recently been supported with well-respected research, the news isn’t a revelation. Other stakeholders have proclaimed the findings as an example of ultra-modern “Evidence-Based Dentistry,” and proof of the need for thousands of their dental products. However, let’s not kid ourselves. A healthy mouth has less to do with computerization than the proper application of a low-tech toothbrush. 10,000 years ago, even buzzards recognized that bad breath from advanced gum disease smells like imminent death from a long way off if the wind is right. The results Dr. Kadi leans his reasons against only confirm traditional Evidence-Based Superstition.

eDR Lobbying

By half-way through the article Dr. Kadi turned “The cavity in the health-care debate” into a PR piece for eDRs. He’s in so deep that he cannot recognize that his misplaced concerns about image have nothing to do with dental patients’ oral health. Image is only cosmetic.

“A validation [of bringing “sex appeal” to the profession] is the inclusion of dentistry in the recently mandated National Healthcare Information Infrastructure (NHII). The purpose of the NHII is to create an information network to facilitate the creation of an electric health record [eHR] for all aspects of health care. The primary impetus is to achieve interoperability of health information technologies used in the mainstream delivery of health care.”

Note: Dr. Kadi admits that the goal is HIT, and sharing health information is the tool – not the other way around. As anyone can see, that kind of nonsense will never work out well in the US. Why that would be as foolish as stuffing a certifying commission for eHRs with industry, government and academic leaders rather than providers – and then tossing billions of dollars that could otherwise be used for treating disease out in the street for the biggest and fastest stakeholders who grab the most. That would be simply ridiculous.

Dr. Kadi bravely continues: “This will enable an individual’s health care information to be shared by all the necessary health care parties in a secure manner, including dentistry. It will improve patient care and reduce the number of patients, currently 100,000 plus, who die each year due to a lack of accurate, complete, or timely information. The federal government estimates a cost savings of $85 billion to $100 billion per year with electronic health records [eHR].”

Is HIT – Or any IT – Really Secure?

In a secure manner – really? There are so many other misleading statements in this paragraph as well. First of all, how can an eDR improve a dentist’s chance of successfully extracting a molar in one piece? It can’t. Secondly, how many of the alleged 100,000 victims died because of lack of electronic DENTAL records? Third, how many patients will die because of faulty information in interoperable records that would not have occurred if the records were paper? Fourth, to insinuate that patient information can only be shared over the Internet is plain silly. Telephone, fax and the US mail have been sufficient for dentistry for decades, and none involve HIPAA. Finally, the $85 to $100 billion in savings Dr. Kadi casually throws out is based on a five year old Rand study that’s been widely trashed for being biased in favor of the stakeholders who funded the research. That happens. It just amazes me that anyone in the healthcare industry who knows anything about HIT is foolish enough to still shop discarded garbage. And once again, regardless of the success of electronic medical records, how will eDRs save even $10 in dentistry? It’s impossible without re-defining “savings.”

Cost Savings

“Dentists and hygienists will play a vital role in this cost savings because people who go for regular cleanings will have their medical history updated in the shared system during each visit. In some cases, dental cleanings may be the only medical attention a person receives yearly.”

“Cost savings”? Where have I heard that term? And why didn’t Dr. Kadi simply say “savings”?

Now I remember. It was Dr. Robert Ahlstrom, the ADA’s eDR expert, who coined the handy buzzword in his testimony describing the benefits of paperless dental practices for the US Department of Health and Human Services in July of 2007. “Cost savings to providers and plans will translate in less costly health care for consumers. Premiums and charges will be lowered.” That would be the seventh of his 11 reasons that are each one so lame that other than Dr. Kadi, stakeholders never borrow them. Although it is undeniable that electronic records benefit insurers and the government more than the patient, if Ahlstrom hadn’t been coy, and had clearly stated that eDRs will save money in dentistry, his testimony would have been false. By calling it a “cost savings,” Ahlstrom technically concedes that using eDRs will indeed require an increase in cost of overhead – which dental patients will ultimately have to pay to obtain dental care. The saving part comes from “what could have been.” Whatever that could possibly mean, HHS Secretary Michael Leavitt bought it.

The PennWell Article

Because of a situation beyond my control, I am unable to provide a link, but to find more of my opinion of Ahlstrom’s testimony that is still used by lawmakers to establish national policy, simply google “Dr. Robert Ahlstrom.” My PennWell article from a year ago or so, “Dr. Robert H. Ahlstrom’s controversial HIPAA testimony,” is probably still his first hit. It could be on his first page the rest of his life.

Assessment

If necessary, I’ll make a few more examples of insensitive HIT stakeholders who know better than to offer such crap to the nation’s lawmakers as well as providers who are too busy to pay attention to the welfare of their profession. The ADA should reassure the nation that there are cheap, effective low-tech ways dental patients can stay healthy that don’t risk their identities and won’t bankrupt a dental practice because of a stolen computer. But; they won’t do it.

Conclusion

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Filed under: Op-Editorials, Practice Management, Pruitt's Platform, Quality Initiatives | Tagged: ADA, Darrell Pruitt, DDS, dental consultants, dental economics, dentistry, DentistryiQ, DMD, Dr. Robert Ahlstrom, eDRs, EHRs, EMRs, Gary Kadi DDS, HIPPA, HIT, NHII, PennWell | 37 Comments »

[Doctor’s] Guide to Roth IRAs

Posted on June 6, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Get Rich Slowly

By Ann Miller RN, MHA

[Executive Director]

From time to time, our readers send in e-books, files or e-chapters, pamphlets or other material they have created for client, educational or marketing use. Some of it may be worthwhile; some not so.

Nevertheless, these publications are often a good place to start the conversation, or thought-process on related topics. They will be occasionally offered as a complimentary membership feature of the Medical Executive-Post. We trust they are beneficial to you.

Guide to Roth IRAs [author]

JD Roth

Link: The GRS Guide to Roth IRAs

Disclaimer

No advice is offered. We make no copyright claim to these works. Veracity and information should be considered time sensitive. Consult a professional for your situation.

Assessment

Feel free to send in your own material for the benefit of all Medical Executive-Post readers and subscribers. All works will be considered; but not necessarily published.

More

Conclusion

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Our New Face – Same ME-P

Posted on June 6, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

We Got Visual “Fly”

By Ann Miller RN, MHA

[Executive Director]

As you may have noticed, we have a brand new look; very visual and very photographic. ME-P got fly.

But, underneath it all, we’re the same ME-P you’ve come to count on for daily essays, updates, investigative reportage, comments, gossips, breaking news, expert advice and op-ed pieces, the classifieds, and much more!

All features and functionality are the same; and our goals, objective, mission statement and topic channels remain the same. Most importantly, your subscriber account information remains secure and unchanged.

IOW: Your experience should be exactly the same as it has always been, just a lot better looking.

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Why the Change?

After 3 years we felt it was time to freshen things up a bit and create a visual experience that reflects the forward-thinking and innovative partner, we are. In the healthcare and financial services space, you can count on us on to inform, gather data and make important insights, that ultimately help you make better decisions to grow your practice, assist patients and clients, and professionally thrive in an ethical business fashion.

Your Opinion Matters

And so, we’d love to know what you think of the changes we’ve made. There is a feedback / comment link on the bottom of every page, and you can always reach us through our reader / subscriber email center.

MarcinkoAdvisors@msn.com

Conclusion

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Win a Free iMBA Inc Dictionary

Posted on June 5, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Dictionary of Health Insurance and Managed Care

ADVERTISEMENT

Health care and health insurance have become increasingly complicated for the average citizen. While we at the Benefits Group do our best to assist individuals and businesses with their insurance needs, we appreciate and understand the value of educating yourself on the subject.

With that in mind, we’re offering a no strings attached opportunity to win a book that will provide many answers to your health care questions.

From iMBA Inc: www.MedicalBusinessAdvisors.com

The book up for grabs is the Dictionary of Health Insurance and Managed Care by Dr. David E. Marcinko; FACFAS, MBA, CFP™, CMP™ [Editor-in-Chief] and Hope Rachel Hetico; RN, MHA, CPHQ, CMP™ [Managing Editor].

Click here to read the Amazon.com reviews for Dictionary of Health Insurance and Managed Care

Beyond that, all you need to do to win is provide your email below. We will not be using this email for any marketing purposes, nor do we participate with any lists. We just need your email to contact the winner so we know where to send the book.

The only rules are that participants be at least 18 years of age and live in the residential United States. Also, only one entry per person (our software knows how to sniff you out if you cheat, so please don’t bother). We will be announcing a winner on July 1st, 2010 and will be accepting entries until midnight EST on June 30th, 2010.

ENTER TO WIN

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Any how, thanks for subscribing to the ME-P and good luck!

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Microsoft’s Health Tech Today

Posted on June 5, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Newest Episode Just Released

By Staff Reporters

The latest episode of Health Tech Today is now available, featuring the following items.

Content

Text4baby, a service from Voxiva that is working to improve infant mortality rates in the United States with free text messages to underserved mothers.
Microsoft Unified Communications at one of Japan’s most technologically-advanced hospitals.
Bumrungrad International, a leader in medical tourism, using unique software to deliver the best in healthcare at a fraction of the price.
ZocDoc, an online service that helps people find a nearby physician, read reviews, check insurance, and schedule an appointment.

Assessment

Watch Microsoft Health Tech Today. Additionally, become a fan of Microsoft Health Tech Today on Facebook and enjoy updates directly to your news feed or follow Microsoft Health Tech Today on Twitter.

Conclusion

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FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: "Doctors Only", Alerts Sign-Up, Career Development, Information Technology, Research & Development | Tagged: Bumrungrad International, medical tourism, microsoft, Microsoft Health Tech Today, Microsoft Unified Communications, MS-HUG, Text4baby, Voxiva, ZocDoc | 1 Comment »

The Madoff Circle

Posted on June 4, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Who Knew What?

By Jake Bernstein, ProPublica – June 2, 2010 2:40 pm EDT

When Bernard Madoff pleaded guilty to running the biggest Ponzi scheme in history, he insisted he was the lone perpetrator, asserting that no one – not his family, not his colleagues, not his friends – knew of the fraud.

Alternative Narrative

But an alternate narrative is emerging from the pile of Madoff-related civil suits and court motions that have been filed in the last two years – one in which a small circle of men played knowing, integral roles in the scheme, in some cases benefiting more from it than even Madoff himself.

The evidence for this remains largely circumstantial. These relationships were forged in the days before e-mail, and none of the cases has yet produced anything for public consumption that delivers insights into what these men were thinking. In the one instance in which a judge has ruled on allegations against some of the men, he dismissed the charges for lack of evidence.

But the men’s actions, as described in the court cases, appear to have furthered the scheme. The Securities and Exchange Commission and the trustee charged with recovering money for Madoff’s victims have alleged that some of the men had expectations and influence far beyond what is typical for the usual investor. Most tellingly, the documents say that in at least one instance, and possibly more, these men helped keep the Madoff scam afloat, providing hundreds of millions of dollars of cash when it was on the verge of collapsing.

If this was a conspiracy – and the available information is by no means complete – it does not seem to have been one in which the perpetrators plotted together around a tavern table. Irving Picard, the trustee, has sued several of Madoff’s biggest beneficiaries, alleging they “knew or willfully ignored” that they were participating in a fraud. The suits are silent on the question of whether those involved coordinated or knew of one another’s activities, but they don’t need to demonstrate that to be successful.

A Commonality

What these men undeniably shared were similar backgrounds and interests. Based largely in New York and South Florida, they moved through parallel milieus of affluent Jewish country clubs and synagogues. They were active in similar philanthropies and served on the boards of foundations, universities and yeshivas.

The cast of characters, spelled out mostly in complaints filed by the trustee and the SEC, includes: Carl Shapiro, [1] 97, a Boston-based philanthropist who made one fortune in ladies dresses and a larger one with Madoff; Robert Jaffe [2], 66, Shapiro’s son-in-law; Maurice “Sonny” Cohn, 79, a one-time Madoff neighbor turned business partner; Robert Jaffe [3], 83, a close friend of Madoff’s for more than 50 years and one of his earliest investors; and Jeffry Picower [4], a lawyer and accountant, who recently died of a heart attack at 67.

None of these men has been charged criminally. Thus far, federal authorities have indicated in court filings that just one of them – Chais – is the subject of a criminal inquiry. A year ago, The Wall Street Journal, citing anonymous sources, reported that the U.S. Attorney’s Office in Manhattan was investigating at least eight investors, including Picower, Chais and Shapiro [5].

All have denied being anything but victims of Madoff’s [6].

Chais, Cohn and Jaffe have drawn considerable ire from investors for running so-called feeder funds that channeled huge sums into Madoff’s investment business. Jaffe alone funneled more than $1 billion of investor money to Madoff, according to the SEC. He worked with Cohn in a business called Cohmad – a contraction of Cohn and Madoff – that operated out of Madoff’s offices. Contrary to what some investors in the funds believed, it appears the men did little to manage the money beyond simply collecting it for delivery to Madoff.

Inner Circle Fared Well

Members of this circle not only did far better than other investors, who averaged 10 percent to 12 percent returns annually, they also had a highly unusual level of input into the nature of their returns.

According to the trustee’s complaint, there were several instances in which Picower or his associates contacted Madoff’s office, asking for specific monthly returns [7]. Over a five-year period in the late ’90s, two of Picower’s accounts [8] had annual returns ranging between 120 percent and 550 percent. A third had yearly returns as high as 950 percent.

Chais and his family consistently received yearly returns higher than 100 percent, far exceeding the gains realized by investors in his funds. Moreover, according to an SEC complaint [9], when Madoff told Chais he was switching to a new strategy that might show occasional short-term trading losses without interfering with net gains, Chais made a special demand to maintain the appearance of loss-free investments.

“Chais told Madoff that he did not want there to be any losses in any of [his] Fund’s trades,” the SEC complaint alleges [9]. “Madoff complied with Chais’ request. Between 1999 and 2008, despite purportedly executing thousands of trades on behalf of the Funds, Madoff did not report a loss on a single equities trade.”

Chais disputes the allegations [9], and his lawyer characterized the SEC’s complaint in a statement as “a distorted and false picture of Stanley Chais.”

“Like so many others, Mr. Chais was blindsided and victimized by Bernard Madoff’s unprecedented and pervasive fraud,” the statement said. “Mr. Chais and his family have lost virtually everything – an impossible result were he involved in the underlying fraud.”

Many of those in the circle took money from the scheme as fees rather than investment gains.

Cohmad officials reaped a total of $98.4 million in payments between 1996 and 2008, most of it labeled income from “account supervision,” according to the SEC [10].

Chais charged fees equal to 25 percent of each Chais fund’s net profit for calendar years in which profits exceeded 10 percent, according to the trustee. As profits exceeded 10 percent every year, Chais took in almost $270 million in fees from 1995 to 2008.

Though Madoff receives the lion’s share of the blame and/or credit for his scheme, it appears that several of his close associates profited more handsomely than he did. Shortly after he confessed, Madoff declared in court documents that his household net worth was about $825 million.

Picower, the biggest beneficiary of the scheme by far, took in $7.2 billion in profit, according to the trustee. Picower’s widow and the trustee are currently haggling over the exact amount of a multibillion-dollar settlement. Carl Shapiro and his family received more than $1 billion, the trustee charged in a court document filed last November in U. S. Bankruptcy Court.

Chais and his family members withdrew approximately $200 million more than they invested with Madoff, according to the SEC. This came on top of the hundreds of millions in fees Chais charged investors.

Chais’ lawyer denied that his client had any knowledge of the Ponzi scheme or that he had raked in the vast riches alleged. “Despite the astronomical numbers mentioned by the Trustee in his complaint, the bulk of the funds alleged to have been distributed to Mr. Chais were in fact distributed to his investors,” his statement said.

Keeping the Scheme Going

At key moments, Madoff’s investors came to the rescue to keep the scheme going. The first instance came in 1992, when the SEC shut down a feeder fund run by the accountants Frank Avellino and Michael Bienes, then Madoff’s largest, accusing the pair of operating a Ponzi scheme. Avellino and Bienes admitted they had acted as unregistered investment managers, but insisted the money had been invested with Madoff, who promptly returned more than $300 million.

Ironically, the SEC mistook Madoff’s ability to raise that amount so quickly as proof that his business was legitimate and “the money was where we [the agency] would expect it to be,” a staff attorney told the SEC’s inspector general last year. Almost two decades later, investigators suspect Madoff may have tapped his circle to collect the cash while scrambling, with the help of his right-hand man, Frank DiPascali, to fabricate trading records, a scene detailed in the agency’s case against DiPascali.

Identifying precisely who helped Madoff repay Avellino and Bienes’ investors is currently an area of inquiry for law enforcement, according to a person familiar with the investigation.

Despite his ever-growing network of feeder funds, Madoff had another liquidity crisis in November 2005. According to a federal complaint [11] filed against his employee Daniel Bonventre, Madoff’s investor account had an end-of-day balance of about $13 million to cover about $105 million in wires scheduled to go out over the next three days.

Two days later, one of Madoff’s investors, identified in the complaint [11] as “Client A,” sent about $100 million in bonds to Madoff, which he used as collateral to secure a $95 million bank loan to continue the Ponzi scheme. The following January, Client A gave Madoff $54 million more in bonds, which were used as collateral for a $50 million loan.

Investigators have not revealed the identity of Client A, but a person close to the investigation said he was among Madoff’s group of longtime close associates.

The final bailout came toward the end of 2008, when Madoff was hit with a tidal wave of redemption requests from investors caught up in the larger financial crisis. Toward the end of 2008, he looked to Shapiro, who pitched in $250 million.

Shapiro and his family have said repeatedly through spokesmen that they were unaware of the true nature of Madoff’s business. The spokesman declined to comment on the $250 million.

No civil or criminal complaints have been filed against Shapiro, but a court filing by the trustee raised questions about the nonagenarian’s “contentions that he is a victim of Madoff’s scheme,” alleging “inconsistencies between Mr. Shapiro’s counsel’s account of the family history with Madoff and the records available to the Trustee.” The trustee is negotiating with the family to recover profits made over the years.

The emergency cash infusion failed. Just 10 days later, Madoff says he confessed to his sons that “it’s all just one big lie,” finally ending the scheme.

The Case-To-Date

So far, efforts to hold Madoff associates accountable have met with mixed results.

Civil claims by the SEC [10] against Jaffe, Cohmad and Cohn were largely rejected by Federal District Judge Louis Stanton, who ruled in February that the agency had failed to prove they “knew of, or recklessly disregarded, Madoff’s fraud.” The judge left the door open for the SEC to refile its complaint by June 18, if it can strengthen its case.

Lawyers for Maurice Cohn and Cohmad released the following statement in response to the ruling: “As we have maintained all along and Judge Stanton agrees, the SEC’s complaint supports nothing other than “the reasonable inference that Madoff fooled the defendants as he did individual investors, financial institutions and regulators.”

Assessment

If there were others involved in the Ponzi scheme, building federal or state criminal cases against Madoff’s circle may prove difficult. Though their relationships go back decades, most of their dealings were done verbally, and there isn’t a lot of correspondence, according to a person with knowledge of the investigations. Federal investigators are working with DiPascali to get a clearer picture of the degree of complicity of others in the scheme.

Illness and age also may become factors. Though a grand jury could consider charges against Chais by mid-June, he suffers from a rare blood disorder and is in and out of the hospital. Shapiro, too, is said to be in ill health.

The trustee is expected to file more lawsuits in coming months as the date approaches when the statute of limitations runs out.

Criminal cases brought against several former Madoff employees have already eroded the notion, lodged so powerfully in the public imagination, that Madoff worked alone, said Daniel Richman, a professor at Columbia Law School and a former prosecutor. With each additional case, he said, it may well crumble further.

“I imagine the paradigmatic Ponzi scheme with the evil genius who keeps all the secrets to himself and engineers this massive crime, like most stick figures, will probably not hold true,” he said.

Link: http://www.propublica.org/feature/the-madoff-circle-who-knew-what

Conclusion

Industry Indignation Index: 99

Conclusion

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Filed under: Ethics, Financial Planning, Industry Indignation Index, Investing, Portfolio Management | Tagged: Bernard Madoff, Carl Shapiro, Frank Avellino, Frank DiPascali, Jeffry Picower, Maurice “Sonny” Cohn, Michael Bienes, Ponzi, Robert Jaffe, SEC, Securities and Exchange Commission, Securities fraud, Wall Sreet | 20 Comments »

Become an ME-P Personal Story Teller

Posted on June 4, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Seeking Positive or Negative Lay Experiences

By Staff Reporters

Recently, we sent out a call for healthcare, and financial service, whistle-blowers from those working as insiders in these sectors. Now, we seek input – not from doctors, nurses, accountants or financials advisors – but the patients and customers they treat and serve.

Tell us Your Story

And so, do you have a true story about the healthcare system, or financial services industry, that you’d like to share with us; good or bad? Or, some gossip, hearsay, innuendo or a question you’d like to put to our readers?

Conclusion

If so, email us at MarcinkoAdvisors@msn.com Please include the term “lay whistleblower” in the subject line; and a proposed title for your comment. You may remain anonymous, or be cited as an information source as you see fit.

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Preparing Physicians for Financial Emergencies

Posted on June 2, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Domestic Personal Savings Rate Increasing?

By Somnath Basu PhD, MBA [www.clunet.edu/cif]

[Director California Institute of Finance]

There is a heartening change that we are observing today, an event that is truly national in character. At the bottom of the financial abyss we single-handedly turned around our personal savings for the first time in 12 years. The chart (Department of Commerce publications data) below expresses this turnaround emphatically.

Graph: Personal Savings Rate

It is the timing of this turnaround that is so heartening. The realization that this crisis may truly be worse than any other enabled us as a nation to halt this decline. We have our emergency “nest eggs’ rebuilt again. Amazing still is that this feat was achieved with a determined effort to curtail our consumption levels to ensure that our emergency funds were rebuilt. Again, a similar chart expresses this aspect much better.

Graph: Change in Consumption

What next then? With our emergency nest eggs rebuilt, we must now ponder the question as to continue to increase our savings or not. For lay and senior physicians, the object would be to ensure they did not outlive their funds. For those medical professionals, and the rest of us, between the ages of 45-65 in general, retirement must loom somewhere, and retirement is sweet. Similarly, for those between ages 25 to 45, thoughts would turn towards families, home purchase and children’s education; all worthwhile savings objectives.

Assessment

Thus, the central question is whether we should increase our current consumption or postpone consumption to attain our future objectives. Only time will tell whether we continue the trend of increasing savings and moderating consumption or whether we go back to drawing down on our savings to increase current consumption.

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. What is your propensity to save or consume? Is it more or less for medical professionals? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

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Filed under: Financial Planning, Funding Basics, Investing, Op-Editorials | Tagged: California Institute of Finance, california lutheran university, consumption function, financial emergencies, Financial Planning, personal savings rate, propensity to consume, Somnath Basu | 3 Comments »

2010 Physician Sentiment Index™

Posted on June 2, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Taking the Pulse of the Physician Community

By Ann Miller RN, MHA

[Executive Director]

From time to time, our readers send in e-books, files or e-chapters, pamphlets or other material they have created for client, educational or marketing use. Some of it may be worthwhile; some not so. Nevertheless, these publications are often a good place to start the conversation, or thought-process on related topics.

They will be occasionally offered as a complimentary membership feature of the Medical Executive-Post.

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February 2010 Physician Sentiment Index™

By athenahealth

By Sermo

Link: Sermo

Disclaimer

No advice is offered. We make no copyright claim to these works. Veracity should be checked and information should be considered time sensitive. Please contact a professional for your situation.

Assessment

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The Economics of Stock Market Fear for Physicians

Posted on June 1, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Panic Control and the Possibility of Severe Financial Degradation

By Somnath Basu PhD, MBA [www.clunet.edu/cif]

[Director California Institute of Finance]

An experiential learning of mammoth proportions occurred several weeks ago in the financial markets. The absolute 10 minute freefall of the prices of stocks and bonds, without any pre-notification froze the hearts of many physicians and lay others both in, and outside, of the investment community. The possibility of a one trillion dollar loss had suddenly and unexpectedly turned real. It happened in a matter of minutes. This experience of panic, of the possibility of a severe economic degradation of life becoming immediately real, is like none other that most of us can ever remember experiencing. Even the 1987 crash happened over a large part of that Monday. Like then, this time too there is no known reason of why it happened, though attempts are being made to understand the cause(s). Whatever the reasons may be, it will not change the experience we had of the realization of the fear of a sudden and unexpectedly large loss.

Event Analogies

Before going deeper into the experienced fear, it is useful to provide some analogies to the event. If the meltdown in the financial markets of 2008 was like an earthquake, then this was like a severe aftershock. It is also similar to going down one of those severe roller coaster freefalls that some may consider very undesirable. Alternately, what makes a 30 year old physician be mostly unconcerned about his/her lack of retirement savings while a 60 year old doctor in the same poor condition is much more concerned. Obviously, the possibility of a lower quality of economic life is much more real for the elder than the younger. In such cases we would expect the fear of an economically degraded life to spur people to take preventive or remedial action.

Understanding Fear

To truly understand our responses to fear, we need to go deeper into our minds. According to behavioral psychologists and neurologists both, there are various segments within our mind. For example, one segments of our mind (the frontal lobe) is understood to process analytical tasks. Similarly, other parts of our brain (the older limbic system composed of mammalian and reptilian brains) react to and affect/control our emotions and fear. When we are faced with an immediate threat, this older system takes over control of our reactions and often drives us towards instinctive responses and will not, in general, make the analytically reasoned response. It is similar to learning about all the different ways we need to behave in the wild if we came across a bear. When people actually are faced by such a situation, they rarely remember all their learning and respond with their instincts. Those are the limbic responses. In other words, when threats are real, our emotional mechanisms will dominate our rational mind and we will react according to our older and longer existing nature.

Shocked Limbic System

Such was the effect of the financial freeform. In those 10 minutes the economic shock to our limbic system was the first of its kind, in terms of magnitude. While discussions are held about sudden unexpected losses, typically the impact of sudden huge losses in a very very short period of time is rarely thought of in very meaningful ways because the probability is so very low. This time, it did actually happen! We will bear some consequences which will begin playing themselves out slowly over this summer. For one, the investing nation will be much more circumspect about stocks and other volatile financial instruments. In a more technical way, our risk aversion as a nation will have suddenly increased. This will have an impact on both trading volume and security market prices and eventually on portfolio values. How younger physicians and other investors will react is less known.

www.CertifiedMedicalPlanner.com

Assessment

Finally, there is one important lesson in behavioral finance for us all – and that is for medical professionals to find competent financial advisors and planners who can safely herald all people in these times. It also is probably an important point to understand why the portfolios of older physicians should consider safety of principal first whilst the younger ones focus on growing their wealth.

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Would anyone like to discuss neurotransmitters or chime in on the flight or fight response? Are these very human reactions any different for doctors? How about feelings of “fear” or stock-market “panic attacks?”

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

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Health Administration Terms: www.HealthDictionarySeries.com

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Sponsors Welcomed

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Events Planner: June 2010

Posted on June 1, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

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Events-Planner: JUNE 2010

Staff Writers

“Keeping track of important health economics and financial industry meetings, conferences and summits”

Welcome to this issue of the Medical Executive-Post and our Events-Planner. It contains the latest information on conferences, news, and relevant resources in healthcare finance, economics, research and development, business management, pharmaceutical pricing, and physician/entity reimbursement! Watch for a new Events-Planner each month.

First, a little about us! The Medical Executive-Post is still a relative newcomer. But today, we have almost 175,000 visitors and readers each month from all over the country, in addition to our growing subscriber base. We have been a successful collaborative effort, thanks to your contributions. As a result, we are adding new resources daily. And, we hope the website continues to provide the best place to go for journals, books, conferences, educational resources, tools, and other things you need to establish the value your healthcare consulting and financial advisory intervention.

So, enjoy the Medical Executive-Post and this monthly Events-Planner with our compliments.

A Look Ahead this Month

Now, the important dates:

June 04: Healthcare Compliance Association Conference, Seattle, WA

June 09: AHIP Institute Conference, Las Vegas, NV

June 10: Pershing Institute 2010, Hollywood, FLA

June 13: Facilitating Innovation for Better Health Outcomes, Washington, DC

June 20: World Congress Medicare Leadership Summit, Washington, DC

June 23: Morningstar Investment Conference, Chicago, ILL

June 26: Health Compliance Association Meeting, Los Angeles, CA

Please send in your meetings and dates for listing in the next issue of our ME-P Events-Planner.

MarcinkoAdvisors@msn.com

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

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On American Health Care and Financial Services Competitiveness

Posted on May 31, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

A MEMORIAL DAY OPINION – EDITORIAL

[Innovation – Not Nationalization – Can Again Lead]

By Dr. David Edward Marcinko; FACFAS, MBA, CPHQ, CMP™

[Publisher-in-Chief]

By Hope Rachel Hetico; RN, MHA, CPHQ, CMP™

[Managing Editor]

Ann Miller; RN, MHA

[Executive-Director]

On this 2010 Memorial Day weekend, please allow us to directly reflect for a moment on the decline of the healthcare, banking and financial services industry in America. And; then somewhat indirectly comment on the hopeful emergence of the web 2.0 phenomena of which we all are a part. The competitive applicability to these sectors should be appreciated by the insightful ME-P reader.

Collapse of Command and Control Monopolies and Oligarchies

Old monopolies everywhere are crumbling because of tougher new competitors and the transparency wrought by electronic connectedness. For example, our old newspaper has to compete with the internet, your electric utility company battles low-cost local start-ups, telephone companies must begin installing fiber optic lines to fend off cable companies; and RIAs and fiduciary focused financial advisors [FAs] will supplant BDs and stock brokers in the financial services sector.

www.CertifiedMedicalPlanner.com

The airline industry collapsed a few years ago, the banking industry has just collapsed, and the auto industry is recovering as we pen this post. [We have a particular affinity for the auto sector however, as the son of a UAW member and step-daughter of Michiganders]. Regardless, the rush to more intense competition cannot be stopped. As a doctor, FA or other business competitor; you either keep pace or get crushed by quasi-oligarchic organizations like the American Medical Association [AMA], American Podiatric Medical Association [FPMA], American Dental Association [ADA], American Osteopathic Medical Association AOMA], Financial Planning Association [FPA], Certified Financial Planner Board of Standards [CFP BoS], College for Financial Planning [CFP] or the National Association of Personal Financial Advisors [NAPFA], etc. What have they, and Wall Street, done for you … lately? Scandal, taint, doubt, lost-credibility, a business-as-usual ennui, lethargy and ruin! Enter www.Sermo.com

Link: https://healthcarefinancials.wordpress.com/2009/04/19/calling-for-cfp%c2%ae-fiduciary-status-real-education-and-higher-duty/#comment-4136

Health Insurance Companies

In the last-generation of health insurance companies and related fraternal medical organizations, patients exercised great control over physician selection, had quicker access to specialists and encountered fewer restrictions on care. The reverse was true with financial services. But, because of advancing technology, aging demographics, intense R&D, global manufacturing, and escalating domestic HR costs – competitive market forces against traditional and structured staff model managed care companies – many industry analysts [like us] predicted growth would decline [Yes, greed was also involved as healthcare was presumed a recession-proof sector; and didn’t we all own behemoth big-pharma and HMO stocks in our 401-K, and 403-B plans]? But now, many former stock-brokers and FAs are going rogue; er – independent!

“Although inefficiencies in any business often open up in the short term, and can be greatly exploited by creative and visionary entrepreneurs – as in most business structures – market forces will prevail in the long run”.

Leo F. Mullin, MBA

[Former CEO – Delta Airlines]

Next-Gen with “Fly”

Fortunately, a new generation of enlightened physician and FA entrepreneurs is coming “out-of-the-shadows” as new-wave web 2.0 corporations and RIAs are becoming more flexible, competitive and market responsive. Simultaneously, monolithic and collectivist political ideas keep trying to regulate the medical and financial services workplace with rules, regulations and contracts to control entire populations. Yet, in the new healthcare economy, this new generation of doctors and FAs with “fly,” is headed toward more competition; not less – with more collaboration with patients and clients – regaining self autonomy.

Physician and FA Advocates

Meanwhile, as medical professionals, FAs and patient advocates, we must all choose between staying flexible to ride out tough times – or – adopting a hard, brittle line that will crack under the pressure of competition. We know where we stand at the ME-P, do you?

Flexibility and Virtual Reality

In recent years, many large corporations and top-down business models were not market responsive and change was not inherent in their DNA. These traditional organizations represented a rigid or “used-to-be” mentality, not a flexible or “wanna-be” mindset; according to business columnist Alan Webber. Some financial advisory corporations, and today’s emerging health 2.0 initiatives, may possess the market nimbleness that cannot be recreated in a controlled or collectivist [nationalistic] environment. And so, going forward, it is not difficult to imagine the following new rules for the new financial and virtual medical ecosystem.

[A] Rule No. 1

Forget about “SEC suitability and FINRA rules”, large office suites, surgery centers, fancy equipment, larger hospitals and the bricks and mortar that comprised traditional medical practices or financial product delivery systems. One doctor or niche focused FA with a great idea, good bedside manners or competitive advantage, can outfox a slew of public servants, the AMA, SEC, ADA or FINRA “faux copy-cat examiners”, while still serving the public – and patients – and making money. It’s now a unit-of-one economy where “Me Inc.”, is the standard. Physicians and FAs must maneuver for advantages that boost their standing and credibility among patients, peers, payers, customers and clients. Examples include patient satisfaction surveys; outcomes research analysis, evidence-based-medicine, physician economics credentialing and true integrated fiduciary-focused financial planning.

However, we should also realize the power of networking, vertical integration and the establishment of virtual RIAs or medical practices, which come together to treat a patient, or help a client, and then disband when a successful outcome is achieved. Job security is earned with more successful outcomes; not necessarily a degree, automatic AUMs, certifications or onsite presence. In fact, some competition experts, like Shirley Svorny PhD, a professor of economics and chair of the Department of Economics at California State University, wonder if a medical degree is a barrier – rather than enabler – of affordable healthcare.

Link: https://healthcarefinancials.wordpress.com/2009/01/08/medical-licensing-obstacle-to-affordable-quality-care

Others even presume the establishment of virtual medical schools and hospitals, where students and doctors learn and practice their art on cyber-entities that look and feel like real patients, but are generated electronically through the wonders of virtual reality units. The same can be said for the financial services industry, although much farther down-line given its current slow rate of real education and quasi-professional acceptance.

[B] Rule No. 2

Challenge conventional wisdom, think outside the traditional box, recapture your dreams and ambitions, disregard conventional gurus and work harder than you have ever worked before. Remember the old saying, “if everyone is thinking alike, then nobody is thinking”. Do collective-nistas and nationalized healthcare advocates react rationally; or irrationally? [THINK: Wall Street, medical unions]

[C] Rule No 3

Differentiate yourself among your healthcare and financial advisory peers. Do or learn something new and unknown by your competitors. Market your accomplishments and let the world know. Be a non-conformist. Conformity is an operational standard and a straitjacket on creativity. Doctors and FAs should create and innovate, not blindly follow organization or political “union” leaders [shop stewards, BDs, etc] into oblivion.

[D] Rule No 4

Realize that the present situation is not necessarily the future. Attempt to see the future and discern your place in it. Master the art of the quick change with fast but informed decision making. Do what you love, disregard what you don’t, and let the fates have their way with you. Then, decide for yourself if you are of this ilk – and adhere to any of the above rules? Or, just become an employed [government, BD] doctor or FA shill. Just remember that the political party, or monopoly that can give you a job, can also take it away [THINK: LB, ML, Wachovia, national healthcare, etc].

Memorial Day Considerations

Finally, on this Memorial Day weekend, consider that life and career is a journey, and that in this country we have the choice to ponder or pursue any, and all of the above options, and more. We have the ability to think, cogitate and ruminate, as we have done here today. So – please – thank those who have helped turn this idealistic philosophy, into pragmatic daily reality.

For us personally, we thank Bonze Star Medal Winner Captain Cecelia T. Perez, RN. Now – ponder and consider – who do you thank? If no one has impacted you up-close on this Memorial Day weekend and national holiday, please visit our military channel to reflect, comment and opine.

Link: https://healthcarefinancials.wordpress.com/category/military-medicine

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to 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 Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com or Bio: www.stpub.com/pubs/authors/MARCINKO.htm

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Filed under: Career Development, CMP Program, Military Medicine, Op-Editorials, Sponsors | Tagged: ADA, alan webber, AMA, ann miller, AOA, APMA, BD, broker-dealers, bronze star award, business competition, cecelia perez, certified financial planner, certified medical planner, CFP, CFPBoS, CMP, College Financial Planning, david marcinko, dentists, doctors, FA, financial advisor, financial planning association, financial services, financial services sector, FPA, health 2.0, healthcare, hope hetico, labor unions, Managed Care, Memorial Day, NAPFA, national healthcare, osteopaths, physicians, podiatrists, RIA, RIAs, stock-brokers, UAW, Wall Street, web 2.0 | 10 Comments »

Doctors – Are You Using Health 2.0 Tools?

Posted on May 31, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

A New ME-P Survey

By Ann Miller RN, MHA

[Executive Director]

Web, or more specifically health 2.0, tools have made medical practice more interactive and collaborative for all stakeholders; doctors, patients, payers, hospitals, employers and third party insurance companies.

But, what actually is Health 2.0? Do you embrace or fear it?

A Definition

Link: https://medicalexecutivepost.com/2010/02/19/health-2-0-empowers-patients/

Link: www.HealthDictionarySeries.com

Survey:

Now, it’s your turn.

Doctors, do you use Health 2.0 tools in your own medical practice [all specialties and degree designations are invited to opine]; either in the cloud [SaaS] or thru on-site programs? Please tell us why or why not! What tools do you use, the risks, benefits, results, costs, etc?

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: "Doctors Only", Information Technology, Practice Management, Surveys and Voting | Tagged: health 2.0, managed care 2.0, www.HealthDictionaySeries.com | 3 Comments »

Two New eHR Reports from AHRQ

Posted on May 30, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Overview of Electronic Health Records Usability

By Staff Reporters

The Agency for Healthcare Research and Quality [AHRQ] recently funded a series of research activities focused on assessing and improving the state of usability in electronic Health Record (eHR) systems. Here are two of the most recent reports.

[picapp align=”none” wrap=”false” link=”term=computers+doctors&iid=194975″ src=”0191/b8c33be3-0cf2-4f5f-9134-184b5730e6b9.jpg?adImageId=13005008&imageId=194975″ width=”337″ height=”506″ /]

The Reports

1. eHR Usability [Interface Design Considerations]

Link: eHR Interface Design

2. eHR Usability [Vendor Practices and Perspectives]

Link: eHR Vendor Practices

Related Insights

A related essay on THCB, by Matt Quinn [Special Expert, Health IT, Agency for Healthcare Research and Quality], provides additional insight on the reports:

http://www.thehealthcareblog.com/the_health_care_blog/2010/05/new-ahrqfunded-report-provides-snapshot-of-electronic-health-record-ehr-vendor-usability-processes-a.html#comments

Assessment

And, in June, AHRQ plans to award a follow-on project for the development, testing and dissemination of an easy-to-use, objective and evidence-based toolkit to evaluate critical aspects of eHR systems’ usability, accessibility and information design.

In addition, the National Institute of Standards and Technology is currently seeking applications for development of an eHR usability evaluation framework, and the Office of the National Coordinator for Health Information Technology, AHRQ and other agencies are collaborating on a joint conference in July to promote collaboration in HIT usability.

https://www.fbo.gov/index?s=opportunity&mode=form&id=d4fbc540b23e02f239664042d6301ffe&tab=core&_cview=0

Conclusion

And so, your thoughts and comments on these two AHRQ reports are appreciated. What is your experience with eHRs? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Alerts Sign-Up, Information Technology, Quality Initiatives, Research & Development | Tagged: Agency for Healthcare Research and Quality, AHRQ, EHRs, EMRs, HIT, Matt Quinn, National Institute of Standards and Technology, Office of the National Coordinator for Health Information Technology | 3 Comments »

Advertise on the Medical Executive Post

Posted on May 29, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Promote Yourself, Your Firm or Site, Financial Products and/or Healthcare Support Services … with Us

By Ann Miller RN, MHA

[Executive-Director]

If you want the opportunity to reach a personalized weekly audience of the financial services sector, and health care industry insiders, innovators and watchers, the Medical Executive-Post and its educational forums may be right for you?

https://medicalexecutivepost.com/2007/11/11/advertise/

Widely Read and Discussed

We are discussed, read and viewed by financial advisors, accountants, medical students, physicians, dentists, podiatrists, optometrists and industry analysts; as well as healthcare administrators, office managers, CXOs, doctor-investors, insurance agents, Wall Street insiders and nurse-executives from many hospitals, clinics and health systems in the country.

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Our ME-P Brand

Advertise with us and you’ll put your brand, ad, classified or promo in front of a smart & tightly focused demographic; one at the forefront of our financial services and medical marketplace of collaboratively informed, growing and professional “movers and shakers of the Health 2.0 space.”

Why Advertise with Us?

https://healthcarefinancials.wordpress.com/2007/11/11/advertise/

Contact us for a rate card: MarcinkoAdvisors@msn.com

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: iMBA, Inc., Sponsors | Tagged: medical executive post, www.certifiedmedicalplanner.com, www.healthcarefinancials.com, www.healthdictionaryseries.com, www.medicalbusinessadvisors.com | Leave a comment »

Book Review of “Cyber War”

Posted on May 29, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

A Book Review

[By Darrell K. Pruitt; DDS]

I’m reading “Cyber War” by Richard A. Clark. He served the Pentagon, the State Department, and the National Security Council under Presidents Reagan, Bush, Clinton and Bush. It’s sobering to learn that North Korea has already successfully pulled cyber-war tricks against a vulnerable US. But; to learn that North Korea doesn’t have any Internet vulnerabilities is frightening.

China

And what about China – want to see sophistication? Clark says that within the last year, Canadians discovered a highly sophisticated program they named “GhostNet.” It had infected over an estimated 1300 computers at several countries’ embassies around the world. Get this: The program had the capability to remotely turn on a computer’s camera and microphone without alerting the user and to send the information back to China. So how could such capabilities affect you and me?

GhostNet

GhostNet had been working for almost 2 years before it was discovered. About the same time, US Intelligence leaked news that Chinese hackers had penetrated the US Power grid and left behind programs that can shut the grid down. Clark suggests that the Chinese intended us to find their program as a deterrent to our national will to intervene if China should find it necessary to annex Taiwan or even the Spratly Islands in the South China Sea – where the reefs shelter some of the largest remaining stocks of fish in the world, in addition to undeveloped oil and gas reserves that rival Kuwait’s.

Gates Speaks

Clark says that according to Defense Secretary Robert Gates, cyber attacks “could threaten the United States’ primary means to project its power and help its allies in the Pacific.” Clark adds, “The problem is, however, that deterrence only works if the other side is listening. U.S. leaders may not have heard, or fully understood, what Beijing was trying to say. The U.S. has done little or nothing to fix the vulnerabilities in its power grid or in other civilian networks.”

Assessment

If they shut down our power grids, it will be chaos. Are we as a nation flying far too fast into the cloud?

What does this say about eMRs and eHRs, regional health information exchanges, cloud computing, and related health 2.0 initiatives and/or information technology? Sobering thoughts for the weekend.

Conclusion

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
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Book Reviews, Information Technology, Pruitt's Platform | Tagged: computer hackers, cyber space, Cyber War, Darrell K. Pruitt, EHRs, EMRs, GhostNet, health 2.0, HIE's, Richard A. Clark, Robert Gates, www | 6 Comments »

Survey for Financial Advisors and Industry Leaders

Posted on May 28, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Tell Us What You Think!

By Staff Reporters

Your Subjective Impressions

The Medical Executive-Post would like to hear your insight on the most pressing issues facing financial advisors, accountants, stock-brokers, insurance agents and financial services industry leaders. Your insights and comments will aid us in our continued commitment to develop content and features that best fit your needs, and the needs of the organizations you lead.

www.CertifiedMedicalPlanner.com

Assessment

And so, as a member of the financial services sector, what keeps you up at night? Is it controlling costs? Obtaining and retaining quality advisor, brokers and agents? Implementing fiduciary accountability and/or quality initiatives and the flight to RIAs, etc? How about the recession or housing bust? Or, our favorite … difficult physician clients?

Plan

Just opine and tell us what you think!

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

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Filed under: "Advisors Only", Experts Invited, Surveys and Voting | Tagged: accountants, EAs, financial advisors, financial services industry | 2 Comments »

About ReachMD Media

Posted on May 28, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

The Center of New Media in Healthcare?

By Staff Reporters

ReachMD is an innovative communications company that provides thought-provoking medical news and information to healthcare practitioners. Established to help increasingly time-constrained medical providers stay abreast of new research, treatment protocols and continuing education requirements, ReachMD delivers innovative and informative radio programming via XM Satellite Radio Channel 160 and online streaming developed by doctors for doctors.

The Founder

Founded by Dr. David Preskill, a well-known OB/GYN, ReachMD is a communication and education platform that even the busiest clinician can use.

For example, ReachMD’s first innovation was to allow healthcare providers a method to receive education in 15-minute segments on demand by cell phone. Clinicians can call in anytime from any phone to listen to relevant content, answer a few short voice-activated questions and receive CME credit in a completely paperless transaction.

Launch

In April 2007 ReachMD launched the first-ever national radio channel for medical professionals: a platform for clinical discussion, news and education. This content is broadcast 24/7 on XM Satellite Radio channel 160.

In October 2007, ReachMD launched new online streaming access to all programming and CME content and continues to expand the listening audience and deliver on its’ mission of providing the best communication, education and information to America’s medical professionals.

Assessment

ReachMD strives to provide compelling information to the healthcare community in the most convenient formats. So, give em’ a click, and tell us what you think?

http://www.reachmd.com

Conclusion

And so, 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, be sure to subscribe. It is fast, free and secure.

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

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Health Administration Terms: www.HealthDictionarySeries.com

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Sponsors Welcomed

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Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: "Doctors Only", Practice Management, Research & Development | Tagged: Dr. David Preskill, new medical media, ReachMD, XM Satellite Radio Channel 160 | Leave a comment »

Sevocity® Announces Free Electronic Health Records (EHR) System

Posted on May 27, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

For Educators and Regional Extension Centers (REC)

ADVERTISEMENT

By Catherine G. Huddle

VP, Market Development

www.Sevocity.com

Ph: (210) 412-5653

True Internet / Cloud EHR System Ideal for Educating Providers, Clinical Staff, and REC Support Staff

San Antonio, TX –Sevocity, a division of Conceptual MindWorks, Inc. (CMI), today announced Sevocity U, its Internet-based Ambulatory Electronic Health Records (EHR) program for Regional Extension Centers (RECs), Local Extension Centers (LECs), Management Service Organizations (MSOs), Technical Colleges, Universities, Medical Schools, and other organizations needing a turn-key EHR for training.

The Program

Under the program, educational organizations will receive free use of the fully functional Sevocity EHR for up to 20 users (teachers and students) through a demonstration clinic specifically for the educational organization. Because Sevocity is a true Internet-based EHR, these organizations will not need to purchase, install, or maintain any servers or special software. All that is required to access the system is a standard personal computer and an Internet connection, making student access for training and practice easy for the educator. Sevocity U demonstration clinics will use the fully functional production version of Sevocity EHR.

CCHIT Certified

Sevocity 08 is CCHIT Certified® by the Certification Commission for Healthcare Information Technology (CCHIT®) and meets the Commission’s ambulatory electronic health record (EHR) criteria for 2008. Sevocity will release its next version of Sevocity EHR this summer, at which time the company will apply for CCHIT 2011. Sevocity is also committed to “meaningful use” certification and plans to apply as soon as certification is available. Sevocity’s customer agreement includes a commitment to certification and any other requirements for providers to receive EHR incentives under the American Reinvestment and Recovery Act of 2009 (ARRA).

“We developed this program because we recognize the tremendous challenge Regional Extension Centers and other educators have teaching clinicians and others about Electronic Health Records in a very short period of time and with limited funding,” stated Catherine Huddle, VP of Market Development with Sevocity. “While more standardization of EHRs is coming, today most systems have the same basic functionality. Because Sevocity is a true Internet-based EHR and is very easy to use, it provides the ideal platform for educators providing EHR training.”

Assessment

Sevocity is rolling out this program in phases. Phase I begins today with the availability of Sevocity to the first ten (10) educational organizations that apply. Interested organizations should contact Sevocity at 877-777-2298 or EHReducation@Sevocity.com.

About Sevocity

Based in San Antonio, Texas, Sevocity empowers physician practices and health centers to embrace electronic health record (EHRs) by providing an easy-to-use, Internet-based electronic health record system. Because Sevocity EHR is an Internet-based (or cloud computing) product that provides secure access to clinical information via the Internet, practices and health centers avoid the expensive upfront capital expenditure and ongoing maintenance costs associated with client/server offerings. For more information about Sevocity, visit www.sevocity.com or call (877) 777-2298.

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Use the product, or give them a click and tell us what you think.

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Sponsors Welcomed

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Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Breaking News, Information Technology, Research & Development | Tagged: American Reinvestment and Recovery Act, ARRA, Catherine G. Huddle, CCHIT, Certification Commission for Healthcare Information Technology, Conceptual MindWorks, LECs, Local Extension Centers, Management Service Organizations, MSO, RECs, Regional Extension Centers, Sevocity | 2 Comments »

Marketing of Physicians by Hospitals

Posted on May 27, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

National Survey Results

ADVERTISEMENT

By Michele von Dambrowski

Dear ME-P Readers and Colleagues,

Thank you for your participation in the National Survey on Marketing of Physicians by Hospitals. With your valuable input, we have been able to greatly enhance the understanding of how hospitals and health systems are promoting both employed and community physicians.

The Results

Over 300 people participated, far exceeding our expectations. As promised, survey results can be downloaded from Strategic Health Care Marketing, right here:

Link: SurveyReport-MarketingPhysicians

Audio Conference Invitation

Because of the significance of the survey findings and other acquired information, we have decided to hold a special audio conference on Thursday, June 24 at 1:30 p.m. Eastern Time. Titled “Marketing Physicians and Driving Hospital Revenue,” the 90-minute audio conference will cover survey implications and information gathered from follow-up phone calls with participants. Three marketing professionals will also discuss their successful marketing programs.

Assessment

To learn more about the special audio conference, go to: www.strategichealthcare.com/audioconfs/marketingphysicians.php.

As a survey participant, you are entitled to a $25 discount. After you register, just send me an e-mail indicating you participated in the survey and we’ll apply the discount.

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: "Doctors Only", Career Development, Media Mentions and PR, Surveys and Voting | Tagged: hospital marketing, Marketing Physicians and Driving Hospital Revenue, medical marketing, Michele von Dambrowski, National Survey on Marketing of Physicians by Hospitals, PHOs, Strategic Health Care Marketing | 7 Comments »

Of Wants, Needs, Economic Sustainability and Even Healthcare Reform

Posted on May 26, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

A Social Domestic Healthcare Initiative?

By Somnath Basu PhD, MBA [www.clunet.edu/cif]

[Director California Institute of Finance]

Necessities, conveniences and luxuries are an articulation of the hierarchy within wants and needs. The scale and scope of this hierarchy seems quite seamless at the surface. Food, micro waved dinners to gourmet meals. Transportation needs become personal transportation needs and then into Ferraris. Family picnics are replaced by TVs and then by exotic vacations. Home rentals needs change to the wanting of mansions.

As we move up each of the needs totem poles, our monetary requirements stretch endlessly; otherwise if we were all able to bask in everlasting luxury, the end of capitalism and free markets would be in sight. The ideal of everlasting luxury forever too is therefore necessarily unachievable but something that is pursuable, forever. In this vein of reasoning, all of society’s resources and endeavors must go towards attaining this ideal. What then are the limitations of such pursuits?

The above concept of needs and wants also defines layers of society by their consumption abilities. It also defines the pressures imposed upon the growth of GDP from large sections of society to increase their consumption. It is a single-minded pursuit by the upper middle-class of society to strive towards the entering the class of the wealthy, followed by the middle class seeking upper-middle class status, etc. The wealthy comprise a group who are small in number (10% or less) but who account for more than 67% of the ownership and consumption of resources and production, respectively. As large numbers of people start striving to break into the next higher classes of citizenry, pressures increase for GDP to grow. Over time, the wealthy get wealthier, some new entrants appear in each socio-economic group while the general population at large become poorer and more frustrated from this sum-zero game. At some point, the sustainability of the economic system is tested and then broken; societies develop, peak and then wither through strife.

GDP Pressures

For the event of the entire upper-middle class citizenry of joining the class of the wealthy to happen, the GDP would probably need to grow at about a rate of 10 – 12% per year, for each of the next 10 to 20 years! We can easily deduce that for the remaining 80% of the population, the ideal is mostly unachievable. Thus, it may be useful to ask ourselves what is a desirable benchmark for our way of life? “How much money do we need to be happy?” may be another variable approach. Clearly, there are social costs arising from our relentless pursuits of wealth.

To properly assess the cost-benefits of our economic system we need to explore two issues at the heart of the situation. One is the production of wealth. The second is its distribution. Clearly, distributing some wealth inequally is preferred to distributing nothing equally. The question then becomes one of society’s tolerances of inequality. Thought another way, how is enough provided at each level of society such that there is strive and not strife, such that the entire society is better off.

The Elderly

One victim to the current economic system is the elderly. In relentlessly pursuing growth and consumption of luxuries over anything else, we often forget to save for the years where we are no more productive, in a GDP sense. The retirement woes of the generation of unprepared baby boomers can be seen in articles and papers in many depressing data forms. The main reason we fall victim to being unprepared for retirement is the need to spend every penny we earn on consumption so as not to forget that we are striving to attain the ranks of the upper echelons of society and which demands that our consumption and lifestyles mimic those we aspire to emulate. Using this example, we can take a closer look at some of our spending patterns and understand the pressures we impose upon our savings, GDP growth and the limitations inherent in such growth.

What is Enough?

We spend about 17% on transportation, another 15% on food, and about 35% on housing. This is the national average. If collectively we wished to move into the class of the wealthy, we would impose immense pressure on GDP, one that would clearly not be sustainable. That begs the question as to what’s enough. There is somewhere along these lines of reasoning a place of social well being, where the pressures of producing wealth do not dominate our lifestyles.

Global Considerations

On another plane an argument can be made for the prolongation of our imperial life cycle. As with any cycle, micro or macro, our rein at the top of the global economic cycle is waning; the question then becomes as to what course of action can slow down our descent. It is the respite we need where we can also plan for our grandchildren and beyond, rather than be engrossed in current mindless consumption and the bequest of their repercussions for generations to come. Slowing down consumption is one way of prolonging our place near the top; our “apparent” successor, China, depends mostly on us to buy the goods that they produce on our behalf. Developing fully China’s own middle markets for consumption and reducing its dependency on our consumption will take more than one lifetime for the Chinese. On the same note, let us not give away our technological supremacy to India either. In pursuit of the bottom line and exporting many technical and business jobs to India in the name of bottom line economics will also eventually impoverish our own citizens.

American Economics Nobel laureates

A recent study conducted by two American Economics Nobel laureates (Joseph Stiglitz and Amartya Kumar Sen) examined the very issue of GDP focus on behalf of the Government of France. Their findings were of a similar vein where they questioned the government’s fixation with GDP and society’s need for a balanced, sustainable and comfortable lifestyle. They found that using only GDP as the benchmark lead to myopia of sorts amongst government officials that people are happy and satisfied or that their relentless pursuit of GDP growth does not matter to them. The scientists also found that a need exists among people to also have an achievable benchmark of happiness and satisfaction with life without the mires of just GDP alone.

In a sense, if people can be liberated from the necessary requirements of basic living (food, shelter, basic healthcare and retirement), the self-induced pressures to outperform economically, along with the accompanying social malaises, would not be necessary; our lifestyles would also possibly change in very meaningful and simplifying ways as we seek more sustainable allocations of our land, labor and capital.

While the idea above may sound utopian at first, it may be useful to note that there are some societies in the world (primarily Scandinavia) where a much smaller version of such a system exists. First, a visit to any of those countries will persuade any American that their style of life is no less than ours. This is in spite of lesser wages and a staggering (income and sales) tax burden. However, ironically, it is the latter reason (high tax rate) that allows the citizens in Scandinavia to enjoy free education (up to any academic level and including boarding, lodging and international studies!), adequate and free healthcare, subsidized and efficient transportation and a basic pension for all upon retirement. However, this magic is mainly because of a small and highly efficient government giving back probably 90 cents for every dollar worth of taxes collected. Now, that is public good.

The First Issue

What are the issues for us to scale to such a system? Obviously, the first is not having such a big and unwieldy government. Unfortunately, a lean, mean and highly efficient government is not foreseeable for us either in the near future and neither are higher tax rates. Higher tax rates just drives high income individuals and businesses underground and is not a market solution. Can our society at large demanding such a welfare state, be willing participants in such a system and demand such a government? If it did, we certainly could sail smoother through our busy impersonal lives. Having the GDP monkey off our backs will certainly calm us; consider the intense polarization in political thought around the globe arising from inequities of both consumption and thought. A sustainable solution that creates a safety net for all citizens would indeed be desirable for any society.

The Second Issue

This brings back the second issue, the issue of wealth distribution among society. Even when a non-market system (such as taxes) does not work in making society more egalitarian, a reallocation of wealth is somewhat desirable but no tools exist to make this happen. Possibly, the only market solution is philanthropy where suppliers provide capital for fulfilling social needs.

In the true sense of a long run, the ethical decision of philanthropy is also utilitarian; the value of the family name pays back handsomely to the family over the years. It is well known that where moderately large inheritances are left purely to the children and family inheritors, the family descends into decadence and the wealth is squandered in about three generations.

Of Relentless Pursuits

In a society where economic demarcation lines cannot be drawn but exist, the population at large will go towards a state of constant strife for higher status and eventually self-destruct. In other words, a mass population fed on this idea of relentless pursuit of income or wealth will eventually not be able to sustain itself and disintegrate and decay in its social fabric. In the long run, keeping people distracted by wars, economic woes or other narrow global or domestic events will not keep people placated forever; people have a way of collectively being heard.

Our Global Role

While the above may seem like a commentary on our own social system, it is not. The recent financial disasters have taught us that going into the future, no solution can remain purely domestic in nature. This world, through the unifying effect of the financial disaster, has learnt like never before, that any sustainable solution has to be global in nature. Now, more than at any time before, we must shed any feeling of ethnocentrism and nationalism and prepare to enter and lead the world through global solutions. After all, in relation to the about 5.5 other billion people, our way of life is still grand and we remain the Mecca of all aspiring global citizens.

Politics

As a political nation, we have shown that we are more enlightened than any other nation when we elected the Mr. Barack H. Obama as the President of the country. Ask this simple question: which Caucasian majority country will next vote a non-Caucasian to its highest seat? Nowhere, not in our lifetimes, I think.

Yet by electing President Obama, we sent a clear signal to the rest of the world about our system of meritocracy which very few societies can show and also not brag about. Through this action we have also shown that we have the political will and dedication to bring around changes in shape to global economic systems as well.

A social domestic healthcare initiative, even if it be a non-market solution, is one in the right vein, though only time will tell if we executed the policy correctly or not.

Assessment

As for myself, I would be willing to pay the costs for a social safety net. If I was assured of some basic amenities by way of food, lodging, healthcare and retirement, I would be quite willing to do the requisite work to pay the appropriate cost and spend the rest of my time in a warm sunny beach and eventually experience the liberating feeling of retirement and enjoy each day as the holiday it is.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

***

Filed under: Financial Planning, Health Economics, Op-Editorials, Research & Development, Taxation | Tagged: California Institute of Finance, california lutheran university, GDP, healthcare reform, obama, Sen, Somnath Basu, Stiglitz, wealth distribution | 4 Comments »

The DDS / Doctor [Salesman] will See [Up-Sell] you Now

Posted on May 25, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Blurring the Line between Medical Professionalism … and Mercantilism

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

Concerns and complaints about pushy dentists are apparently becoming more numerous among consumers, as elective cosmetic treatments and marginally effective tests and modalities are increasingly available from the same providers that patients formerly turned to for unbiased dental advice and oral healthcare. All for a price!

http://www.msnbc.msn.com/id/37198272/ns/health-oral_health

So, enter the cosmetic [rank-and-file] dentists and the elective renaissance of the profession – at least economically. An entire industry has even sprung up teaching dentists how to sell various products, and up-sell related services and procedures.

[picapp align=”none” wrap=”false” link=”term=dentists&iid=166771″ src=”0163/1731b859-b744-4a0e-b055-a9e985ad8673.jpg?adImageId=12959860&imageId=166771″ width=”372″ height=”459″ /]

Root-Cause [pun intended]

Why is this happening? Economics of course! Dental profession success in eradicating cavities, caries and other common mouth disorders – which used to comprise 80% of dental procedures and income – is now a two-edge sword working against their financial self interests … damn!

In fact, I recall about three decades ago when the situation first became acute, as more than a few of our nation’s dental schools closed for lack of interest in matriculation. Right here in Atlanta, the prestigious Emory University School of Dentistry closed its doors while I myself was a patient there; and employed as a surgical resident at a nearby acute care hospital. Contemporaneous cocktail party talk and medical gossip centered on the “death of dentistry” as I exhaled a sigh of relief at my career choice.

Going forward, years later, far too many managed care contracts reimbursed so poorly that they became a loss-leader [access portal to a patient population] for dental practitioners. In other worlds, lose money or break-even on the covered services contract, but profit handsomely by offering [pushing] non-covered services to cohort contract members … and their sphere of influence.

One Word from Mrs. Robinson – Plastics

Plastic surgeons, of course, are still the doctors most commonly associated with non-covered and purely cosmetic and elective treatments such as Botox injections, facelifts and tummy tucks. But, similar elective procedures — which generally aren’t covered by insurance — are being offered by a wide variety of medical specialists.

For example, many dermatologists, who treat patients for skin cancer and other diseases, also promote treatments to smooth wrinkles, lighten age spots and remove hair. Otolarnygologists, who care for patients with conditions of the ear, nose and throat, commonly perform nose jobs, brow lifts and eyelid surgery. And, podiatrists, who are often experts at foot reconstructive, diabetic and ankle surgery, sell shoes, shoe-inserts, laser beam treatments for fungus toenails and various cosmetic and prosthetic devices for deformed toenails and crooked digits.

Medicare Limits – Privates Don’t

At least Medicare requires an ABN [advanced beneficiary notice] for non-covered medical services, and limits non-participating doctors to 115% of the Medicare fee schedule for all providers. Increasingly, some private health plans are doing and proposing, same.

Practice Management Guru

Now, I have no issue with efficient medical practice management operations, for any specialty. In this era of managed care and health 2.0, governmental intervention is onerous, competition is fierce and patient empowerment is reversing the aging command-control medical establishment. Nor, do I have a problem with offering the entire range of therapeutic and/or elective options to any patient. This is a “good – better – best” elective marketing concept.

In fact, the third edition of our best-selling book, the Business of Medical Practice [Transformational Health 2.0 Skills for Doctors] will soon be released this autumn www.BusinessofMedicalPractice.com. In it, we seek to educate doctors about modern business, management and economics practices; as well as the emerging participatory health 2.0 philosophy and information technology skills. Our goal is enhancing the survival potential of the independent practicing medical professional.

But, the ever expanding menu of treatment options – promoted by a trusted medical professional – should include procedural risks and complications, period of recovery and alternatives, including benign neglect [watchful waiting], marginal benefit and marginal utility, as well as price transparency.

Call this new-wave litany, a type of “informed patient business consent”.

[picapp align=”none” wrap=”false” link=”term=doctor+money&iid=182012″ src=”0178/66353b45-9776-48b9-9bdd-2993a48f32bf.jpg?adImageId=12959922&imageId=182012″ width=”372″ height=”459″ /]

Aphorisms of the Past

Over the years, we have heard phrases like the following from all sorts of independent specialists. I know I have, and so have you. Many are the butt of “insider” jokes:

MD: I’m sure that appendix is hot – I have a car payment to make

DPM: Even the normal foot can be surgically improved

DO: Now, I can bill like a real MD

DDS: We can straighten out – the straightest teeth

DC: I’ll crack your back in only forty sessions … and I finance

But, these are aphorisms of the last-generation. Today we are responsible adults. Let’s grow up and become medical professionals and “DOCTORS” again … not healthcare merchants, sales sharks or equipment shills that offer strategic competitive advantages; but not real patient benefits.

Assessment

The old practice management business adage of yesteryear – to work longer hours, see more patients quicker, up-sell marginally effective procedures, or do more treatments in order to realize more income – will not necessarily hold true in the modern era.

http://www.washingtonpost.com/wp-dyn/content/article/2010/05/17/AR2010051703034.html

According to colleague, financial advisor and ME-P thought leader Brian J. Knabe MD – a primary care physician and current www.CertifiedMedicalPlanner.com matriculant – and textbook chapter 27 co-author on physician compensation and salary:

In the environment of Healthcare 2.0, those doctors who embrace efficiency, innovation and appropriate business models will be better positioned to optimize their incomes.

http://businessofmedicalpractice.com/chapter-27-salary-compensation-2/

Conclusion

Comments from our dental – and other – physician readers are requested. And, so are your general or specific thoughts on this ME-P. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

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Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: "Doctors Only", CMP Program, Ethics, Op-Editorials, Quality Initiatives | Tagged: ABN, DDS, DMD, DO, DPM, MD, medicare, osteopaths, Otolarnygologists, podiatrists, Practice Management, www.BusinessofMedicalPractice.com, www.certifiedmedicalplanner.com, www.healthcarefinancials.com, www.healthdictionaryseries.com, www.medicalbussinessadvisors.com | 2 Comments »

Survey for Physicians and Health Industry Leaders

Posted on May 24, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Tell Us What You Think!

By Staff Reporters

Your Subjective Impressions

The Medical Executive-Post would like to hear your insights on the most pressing issues facing doctors, physician and nurse-executives, CXOs and healthcare administrators. Your insight and comments will aid us in our continued commitment to develop content and features that best fit your needs, and the needs of the organizations you lead.

Assessment

And so; as a member of the healthcare industrial complex, what keeps you up at night? Is it controlling costs? Obtaining and retaining quality physicians, nurses and medical providers? Implementing clinical quality initiatives, etc?

Plan

Tell us what you think.

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: "Doctors Only", Experts Invited, Surveys and Voting | Tagged: health administration survey, healthcare administrators, healthcare industrial complex, nurse executives, physician-executives | Leave a comment »

New Agreement on IRA Charitable Rollovers

Posted on May 24, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Includes Tax Extenders
By Robert Giese
bob.giese@chsfl.org

After months of negotiation, Senate Finance Committee Chair Max Baucus (D-MT) and House Ways and Means Committee Chair Sander Levin (D-MI) have announced an agreement.

Passed House and Senate

The House and Senate both previously passed bills that would extend over 40 tax provisions, including the IRA Charitable Rollover. Because there were different tax offsets in the House and Senate bills, extended negotiations were required to find tax increases acceptable to both.

The House bill paid for the tax extenders by increasing the tax rate on hedge fund managers. Currently, the “carried interest” or income of hedge fund managers is taxed at capital gain rates. The House proposed to tax this income at the higher ordinary income rates.

American Jobs and Closing Tax Loopholes Act of 2010

Under the compromise published in the American Jobs and Closing Tax Loopholes Act of 2010 (H.R. 4213), the “carried interest” amounts will be subject to increased tax. For hedge fund managers, 75% of income is taxed at ordinary rates and 25% is taxed as long-term capital gain.

Vote this Week

The House plans to vote on the bill the week of May 24. Former Chair of the House Ways and Means Committee Charles Rangel (D-NY) stated, “For a lot of members, it’s a very difficult vote and they don’t want to take a vote unless they have assurance that the Senate is going to pass it.”

Assessment

Sen. Max Baucus indicated that he expected to find the 60 votes required for passage in the Senate. As is true in the House, a number of Senators who represent regions with financial service firms are concerned about the change in the tax on hedge fund managers. However, Sen. Baucus indicates that the votes are likely to be sufficient to pass the bill.

Editor’s Note: Because the tax extenders portion of the bill includes the educational deduction for teachers, a research and development credit for business and many other popular provisions, similar bills normally pass by large margins. Even with the tax offsets, it is probable that the bill will pass in the next few weeks. Charities should begin planning their fall IRA Charitable Rollover marketing campaigns. Because most individuals with larger IRAs take their required minimum distributions in the fall, there is still time to have a successful IRA Rollover Campaign in 2010.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Breaking News, Financial Planning, Retirement and Benefits, Taxation | Tagged: American Jobs and Closing Tax Loopholes Act of 2010, H.R. 4213, House Ways and Means Committee, IRA Charitable Rollover, Senate Finance Committee, tax extenders | 3 Comments »

The Wellstone-Domenici Mental Health Parity and Addiction Act‏

Posted on May 22, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

ADVERTISEMENT

An Invitation to ME-P Readers on the Implications of Implementation

By Karen D. Matthias RN, MBA

The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act was enacted into law on October 8, 2008. This act will end health insurance benefits inequity between mental health/substance use disorders and medical/surgical benefits for group health plans with more than 50 employees. The regulations that guide implementation of this law will be effective for health plan years beginning on or after July 1, 2010. These regulations have significant implications for providers of mental health services, payers, employers, and consumers.

Hayes, Inc

On June 23rd and 24th, Hayes, Inc. and URAC are hosting a 2-day symposium in Baltimore featuring an expert faculty of nationally known legal experts, researchers and leaders brought together to provide detailed information about this law and its expected impact on all stakeholder groups www.urac.org/2010MHPConference

David Wellstone (Dave) will be giving the keynote address. Mr. Wellstone is the son of the late Senator Paul Wellstone (D-MN, 1990-2002). Along with his brother Mark, Dave is the Co-Founder of Wellstone Action, a national center for training and leadership development for the progressive movement. Dave is the Co-Chair of the Wellstone Action Advisory Board and contributes to advocacy efforts on behalf of mental health and domestic violence.

Speaking

Also speaking is Carol McDaid, co-founder and Principal of Capitol Decisions Inc. Ms. McDaid led the Parity NOW Coalition behind passage of the 2008 “Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act.” Ms. McDaid has nearly 25 years of federal legislative experience in Washington, providing her clients with legislative and public affairs consulting on issues that span the breadth of health care, including Medicare, Medicaid, private sector reimbursement issues, and comparative effectiveness research.

Assessment

Both Dave Wellstone and Carol McDaid are available to answer your questions about the implications of implementing this legislation. If you, or any of your ME-P colleagues or readers are interested in interviewing either Dave or Carol (or both), please contact me at 215-855-0615 or via email at kmatthias@hayesinc.com

Thanks for your consideration.

Hayes, Inc
157 S. Broad Street
Lansdale, PA 19446
T: 215-855-0615 x7918
Email: kmatthias@hayesinc.com
Website: www.hayesinc.com

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Alerts Sign-Up, Career Development, Health Law & Policy | Tagged: Capitol Decisions Inc, Carol McDaid, David Wellstone, domestic violence., Hayes Inc, mental health, mental health policy, Pete Domenici, Senator Paul Wellstone, URAC, Wellstone Action Advisory Board, Wellstone-Domenici Mental Health Parity and Addiction Act‏ | 6 Comments »

What is the Medical Executive-Post?

Posted on May 22, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

What is our Blog – How does it Work?

By Ann Miller; RN, MHA

[Executive-Director]

The Medical Executive-Post is an independent information sharing portal for the integrated healthcare industrial complex, medical practice management and financial planning and advisory communities. We have a search engine to help find essays and follow the breaking news that interests you for this space.

Our articles, gossip, videos, books, journals, dictionaries, alerts and related essays and information are continuously updated and ranked by users thru more than 50 topical channels. And, we are sponsored by the www.MedicalBusinessAdvisors.com

[picapp align=”none” wrap=”false” link=”term=blog&iid=306845″ src=”0303/0000303556.jpg?adImageId=12802899&imageId=306845″ width=”337″ height=”506″ /]

Assessment

Of course, this means he ME-P is a participatory service: you can publish an article directly on the site or comment on an existing item. Or, we can edit, re-write and proof-read for you. You can also vote for an article or a group that captures your interest in order to increase its visibility on the site. And, you may virtually matriculate online at www.CertifiedMedicalPlanner.com

Each ME-P page also offers an RSS feed that allows you to subscribe to receive the information that appears there in the reader of your choice. But, you must subscribe for full functionality.

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. How can we make the ME-P better and more useful to you? What new features would you like to see?

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

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Filed under: Alerts Sign-Up, Career Development, CMP Program, Financial Planning, Health Economics, iMBA, Inc., Investing, Managed Care, Marketing & Advertising, Practice Management, Sponsors | Tagged: ann miller, david marcinko, healthcare blogs, hope hetico, medical executive post, www.CertifiedMedicalPlanner, www.healthcarefinancials.com, www.HealthDictionaySeries.com, www.medicalbusinessadvisors.com | Leave a comment »

CRM Considerations for a Health 2.0 Medical Practice

Posted on May 21, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

The Build vs. Buy vs. Outsource Conundrum

By DeeVee Devarakonda MBA

There are several options to build, buy or outsource a medical practice Customer Resource Management infrastructure. And, there are advantages and disadvantages to all three options. I will review all three for our ME-P readers.

Build:

Rapid technology advances are transforming the business landscape. This makes it very challenging for healthcare organizations to keep abreast of the technologies, to train and manage resources on tools, to grapple with cross-functional, cross-departmental dynamics and build the CRM application. In addition mergers/ acquisitions and other market realities can make CRM operations complex and distract healthcare organizations from delivering excellent patient experience.

It is very tempting for small healthcare organizations to think they can develop what they need in-house themselves. May be May be not. It is very essential to stay focused on your main business and see if the solution is available elsewhere. Figure out if you are in the business of whatever you are doing or let us say in the business to develop patient survey tool or a low-end database. It is best to get outside help wherever you are dealing with an initiative/ task that is not your core competence or where it is to your strategic advantage- be it time-to-value or cost savings.

Buy:

Depending on your business needs you can either buy CRM package solution and implement or build best of breed solutions that are suited to your business needs. You need to pay very close attention to what the software vendors are promising. Naturally they will be more interested in making the sale, than advising on whether it integrates well with your existing technologies, so the onus is on you as a buyer to ask the right questions and make appropriate purchases.

Outsource:

Especially for very young healthcare organizations today, outsourcing can be an option worth exploring to de-risk technology decisions. Outsourcing de-risks marketing program – avoids unnecessary, upfront, massive capital investment and will also equip the marketers with the flexibility to ramp up or down as situation demands. Outsourcing does not mean healthcare organizations can wash their hands off the CRM function. Still it is the business that will have to provide the strategic direction and control the CRM process and outcome. There are also Application Service Provider (ASP) solutions which de-risk technology decisions.

Assessment

One of the attractions of going the hosted route becomes very clear when you have a two doctor practice marketing medical services that require 24×7 availability of information, transaction and service. They have attractive pricing that encourage “pay as you go” paradigm which is of enormous help to young businesses. However, the disadvantages of an ASP [SaaS] are: 1) you can’t integrate with your other enterprise systems for patient 360-degree view 2) you can’t customize to reflect your exact needs 3) you can’t work offline, which can be a disadvantage if you are a mobile “new-wave” medical practice.

MORE: CRM Marketing

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Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

***

Filed under: "Doctors Only", Career Development, Experts Invited, Information Technology, Practice Management | Tagged: CRM, CRM applications, Customer Resource Management, DeeVee Devarakonda | 4 Comments »

About HAI Watch News.com

Posted on May 20, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

On Preventable Hospital Infections – wth Videos

By Barbara Dunn

Hello Dr. David E. Marcinko and all ME-P Readers and Subscribers

You may have seen that the government recently released its annual report on the quality of health care Americans receive. While there have been some improvements, the news was not positive: hospitals still have work to do to put an end to the ongoing, but very solvable, problem of patients acquiring life-threatening infections in hospitals.

[picapp align=”none” wrap=”false” link=”term=surgeons&iid=220391″ src=”0216/46368189-e70f-4a8c-bdf7-a53bef1948a7.jpg?adImageId=12906391&imageId=220391″ width=”337″ height=”506″ /]

A Dangerous Education

Patients, their caregivers, and health care professionals need to educate themselves on the dangers and what can be done to protect people from getting sick while in the very place they went in order to get well.

HAI = Healthcare Associated Infection

New Site Launch

To help achieve that, Kimblery-Clark Healthcare has put together a website called “Not on My Watch” at www.haiwatch.com to educate patients and health care professionals. Their goal is to eliminate these preventable illnesses and their often tragic consequences.

Editor’s Note: Related link: https://medicalexecutivepost.com/2009/07/31/hand-washing-for-healthcare-facilities/

Assessment

I hope you will help in this effort, too, by informing the readers of Medical Executive Post about how they can learn more about protecting patients from preventable hospital infections. I’ve created a useful site that you’re welcome to check out and grab resources from: http://haiwatchnews.com

Conclusion

Please let me know if you have any questions or need more information.
Barbara Dunn
barbara@haiwatchnews.com
www.haiwatch.com

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Filed under: Alerts Sign-Up, Quality Initiatives, Risk Management, Videos | Tagged: hospital acquired infections, hospital quality, infectious diseases, Kimblery-Clark Healthcare, medical quality, nosocomial infections, www.haiwatch.com | 7 Comments »

Our Unsustainable Budget Situation

Posted on May 20, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

National Institute for Health Care Management Foundation

By Nancy Chockley, PhD
President & CEO
NIHCM Foundation

The U.S. Federal debt is exploding to levels not seen since World War II, and some say this threatens our living standards, compromises our independence in domestic and foreign policy, and leaves future generations with a staggering financial burden. One needs to look no further than the situation in Greece to witness the crippling effects of excessive debt.

The Fiscal Essay

In her essay, Maya MacGuineas, President of the Committee for a Responsible Federal Budget and Director of the Fiscal Policy Program at the New America Foundation, reviews the budget projections and comments on Administration proposals for addressing the fiscal crisis.

EV-MacGuineas

Assessment

She also describes a new set of recommendations from the Peterson-Pew Commission on Budget Reform calling for immediate and bold steps designed to stabilize our federal debt at 60 percent of GDP by 2018.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: Accounting, Alerts Sign-Up, Health Economics, Op-Editorials, Taxation | Tagged: Budget Reform, Committee for a Responsible Federal Budget, fiscal crisis, Maya MacGuineas, Nancy Chockley, National Institute for Health Care Management Foundation, New America Foundation, NIHCM Foundation, Peterson-Pew Commission, U.S. Federal debt | 3 Comments »

Slow, Steady Progress on Estate Tax and Extenders

Posted on May 19, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Increased Exemption Possible?
By Robert Giese
bob.giese@chsfl.org

Senate Finance Chair Max Baucus (D-MT) has been in intensive negotiations with Sen. Jon Kyl (R-AZ) and Sen. Blanche Lincoln (D-AR) over the estate tax. Sen. Kyl and Sen. Lincoln have proposed increasing the $3.5 million exemption that was applicable in 2009 to $5 million per person. In addition, the previous estate tax rate of 45% would be reduced to 35%.

Ongoing Negotiations

Negotiations have been ongoing for several weeks. On May 11, 2010, Sen. Kyl reported, “We have an agreement about how we would like to move forward and an agreement on many of the offsets.” He continued by observing that the offsets are still subject to discussion. It is estimated that the offsets will be from $60 billion to $80 billion.

An Option

While the details of the proposed compromise have not been released, several aides suggested that it may include an estate tax option in 2010. If the option is enacted, lawyers, financial and estate planners could choose either the repeal of estate tax and lose part of the step-up in basis under the 2010 rules or select the new compromise estate exemption and estate tax rate.

Assessment

It may occur that the tax extenders and the estate tax are combined in one legislative bill. Senate Budget Chair Kent Conrad (D-ND) observed this week, “You have got 13 legislative weeks. It seems to me it would be wise to put all the tax measures together.”

Conclusion

The House proposal for the offsets for the tax extenders (including the IRA charitable rollover) is to change the “carried interests” of hedge fund managers from being taxed at capital gain rates to ordinary rates. It now is possible that the change in the law will occur, but it may be phased in over a number of years.

Editor’s Note: The Senate continues to attempt to complete work on the estate tax and the tax extenders by early June. The estate planning community and the charitable community are both hopeful that the Senate will resolve the current great uncertainty in planning by passing compromise legislation in both areas.

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Filed under: Breaking News, Estate Planning, Taxation | Tagged: Blanche Lincoln, estate tax, estate tax exemption, Jon Kyl, Kent Conrad, Max Baucus, Robert Giese | 4 Comments »

Be a Financial Services Whistle-Blower!

Posted on May 19, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Have You Ever Worked in the Financial Services Industry?

By Ann Miller; RN, MHA

[Executive-Director]

Do you have experience in the financial services sector? Have you ever worked for a broker-dealer, or on Wall Street, or for a wire-house, financial advisory or planning firm, or even an insurance company, retail, commercial or investment bank?

If so – the Medical Executive Post is interested in your gossip, insider information, knowledge, personal opinion, insight or related hearsay – both positive and negative. Remain anonymous or be named outright.

Please contact us today: MarcinkoAdvisors@msn.com

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Filed under: "Advisors Only", "Ask-an-Advisor", Ethics, Experts Invited, Op-Editorials, Risk Management | 4 Comments »

On the New Freedom of the Press Act

Posted on May 18, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

The Daniel Pearl Freedom of the Press Act

By Staff Reporters

At the Medical Executive-Post, we take freedom of the press very seriously.

H.R. 3714

The Bill, now known as H.R. 3714 – The Daniel Pearl Freedom of the Press Act – was originally introduced to Congress by Senator Chris Dodd on October 1, 2009. Almost 7 months later, on April 30th 2010, HR 3714 passed in Congress. And, on March 17, 2020, President Obama signed into law, The Daniel Pearl Freedom of the Press Act.

The new law requires the State Department, in its annual Human Rights Reports, to recognize global threats to journalists, listing the countries and the governments that partake in heinous crimes against them.

[picapp align=”none” wrap=”false” link=”term=politics+obama&iid=8827073″ src=”1/3/0/0/President_Obama_Signs_c5e8.JPG?adImageId=12902043&imageId=8827073″ width=”380″ height=”401″ /]

Assessment

We agree with the new law and could not be more pleased … better late than never.

http://content.usatoday.com/communities/theoval/post/2010/05/obama-signs-press-freedom-act-declines-to-take-questions/1

Conclusion

And so, your thoughts are appreciated.

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Filed under: Breaking News, Health Law & Policy | Tagged: Daniel Pearl, Daniel Pearl Freedom of the Press Act, Freedom of the Press Act, HR 3714 | Leave a comment »

Why Healthcare Variations are Expensive

Posted on May 18, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

The Cost of Medical Quality

By Daniel L. Gee; MD MBA

The cost of medical quality actually goes up when the variation and error rate of a process goes up. For example, the costs of pharmaceutical errors alone, in terms of lives and money, are huge. Consider the legal implications of incorrect procedures to an institution. Coding errors that lead to variability in reimbursements costs physicians and other providers, lost revenue.

Think also of the cost of additional safeguards, such as inspectors, that must be put into place to oversee defective processes. When a process is improved, the cost of quality goes down. There are fewer costs due to redundancy, lost time and lost labor.

A Variations Analogue

The concept of looking at medical variations in a process is analogous to the process of teaching a child to ride a bicycle for the first time. The child will be wobbly when he or she gets on the bicycle, at first and, may even fall, several times. As long as you are watching closely, to help the child back on the bicycle, help steer a little and provide encouragement, the child soon learns to ride smoothly and it appears all so natural. The child soon learns to balance from the feedback gained from you and the internal feedback from the brain. After studying the learning process closer, you may find the child to be more successful learning on a set of training wheels or on a bicycle a little smaller in size.

Regardless, the closed loop feedback, analysis, and monitoring by a teacher or process “champion,” keeps the child from wobbling too much and to stay on a straight and narrow course.

A Closed Feedback Loop

Businesses and medical practices wobble too in their processes and, in Six Sigma terminology, this wobbling is the variation that needs continual feedback to help correct and stabilize. Unlike riding a bike, where when once learned it becomes natural and smooth, businesses continue to wobble in their processes and may fall without ever being able to get back up. The institution of Six Sigma methodology is a closed feedback loop to prevent instability in processes.

More: http://businessofmedicalpractice.com/bonus-e-material/

Assessment

Virtual perfection may not be as easily attainable in an industry – like medicine – as computer chips coming off an assembly line; and the healthcare industry certainly has its share of “wobbliness;”

It is, nonetheless, the desire to constantly improve operations, perfect the way healthcare business is done – and tune in to what the patient needs – that separates the Six Sigma Sx improvement method from those QI techniques that have come before.

Moreover, the benefits of setting high performance goals, is a strategic decision to accelerate improvement, promote continual learning and sustaining efforts to succeed. It is a cultural change in medical mind-set to attain quality at its highest level.

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. What is your SS experience with medical variations? How should we define cost; in economic or human terms? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

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Filed under: Quality Initiatives | Tagged: CPHQ, Daniel Gee, healthcare quality improvement, medical quality, medical variations, Six Sigma | 4 Comments »

Financial Reform Amendment Would Address Loan Modification Problems

Posted on May 16, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Proposed New ‘Office of the Homeowner Advocate’

By Paul Kiel, ProPublica – May 7, 2010 11:37 am EDT

An amendment to the financial reform bill filed recently by Sen. Al Franken, D-Minn., and Sen. Olympia Snowe, R-Maine, would create a special office to assist homeowners who are facing problems with the administration’s mortgage modification program. The measure has White House support [1], but is opposed by the financial services industry.

Mortgage Servicers

As we’ve reported, homeowners and housing counselors frequently complain that mortgage servicers frequently lose financial documents [2] and make mistakes [3]—mistakes that can result in foreclosure [4]. Homeowners regularly wait several months [5] for an answer on their application.

About $75 billion has been earmarked for the program from the TARP [6], but very little of that has so far been spent owing to the small number of permanent modifications so far: about 228,000 as of March [7].

The amendment proposes a new “Office of the Homeowner Advocate” that would be devoted to solving homeowner problems with the program. Right now, homeowners with complaints are told to call the HOPE Hotline, which has a staff of counselors to handle escalations—a process that’s been criticized as ineffective [8].

[picapp align=”none” wrap=”false” link=”term=mortgage+reform&iid=1896936″ src=”a/3/e/7/Jesse_Jackson_Rallies_e4dd.jpg?adImageId=12804308&imageId=1896936″ width=”380″ height=”246″ /]

Office of Homeowner Advocate

Under the amendment, all homeowner complaints about servicers would go to this new “Office of the Homeowner Advocate” within the Treasury Department. That would effectively create an appeals process for homeowners who think they’ve been wrongly denied a modification—something that housing counselors and other consumer advocates have long said is desperately needed [9].

“A mandated homeowner’s advocate, built into the process and reportable to Congress, would counteract the servicer unresponsiveness we’ve heard so much about and be able to serve as a recourse for homeowners,” said Richard H. Neiman, superintendent of banks for New York State and a member of the Congressional Oversight Panel for the TARP. Neiman has been pushing for the creation of the office.

The office would have the power to penalize servicers for noncompliance with the program‘s guidelines, but would need the sign-off from Herb Allison, the Treasury official in charge of the TARP, to do so. The Treasury currently has the power to penalize services, but so far has not done so [10].

Financial Services Industry Opposition

The idea has already garnered opposition from the financial services industry. Scott Talbott, a lobbyist with the Financial Services Roundtable, which counts the largest mortgage servicers among its many members [11], said the group opposed the amendment because it would just create “another layer of bureaucracy that could actually slow” the program’s process. He also said there is already adequate oversight of the program.

One of the watchdogs that over-sees the TARP, the Government Accountability Office, reported in March (PDF) that servicers have widely varying ways of dealing with homeowner complaints and some were not systematically tracking them. Several tracked only written ones, the GAO said. Another servicer had closely tracked only those complaints that were addressed to a company executive.

“The unnecessary problems with HAMP are found mostly with servicers who have provided inadequate, inconsistent service to homeowners and delayed or denied homeowner assistance on a mass basis,” said Alys Cohen of the National Consumer Law Center.

Assessment

The amendment has support from Americans for Financial Reform [12] and a host of consumer advocate groups, including the Center for Responsible Lending, the Service Employees International Union and the United Auto Workers.

The amendment also specifies that any candidate for the homeowner advocate position would have to come from an advocacy background and cannot have worked for a servicer or the Treasury in the previous four years. The advocate’s office would be funded out of the TARP and close down after the federal program ends. The idea is modeled after the Internal Revenue Service’s “taxpayer advocate.” [13] It’s not clear when the amendment might come up for a vote.

Link: http://www.propublica.org/ion/loan-mods/item/financial-reform-amendment-would-address-loan-mod-problems-with-homeowner-a

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Do you agree with this new proposal? How might medical professionals and/or financial advisors be affected?

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Filed under: Breaking News, Ethics, Financial Planning, Investing | Tagged: Al Franken, Alys Cohen, Americans for Financial Reform, banking reform, Center for Responsible Lending, Financial Services Roundtable, GAO, HAMP, Herb Allison, home mortgage defaults, National Consumer Law Center, Office of the Homeowner Advocate, Paul Kiel, ProPublica, Richard H. Neiman, Scott Talbott, Service Employees International Union, TARP, United Auto Workers | 3 Comments »

About the Institute for Interactive Patient Care [IIPC]

Posted on May 16, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Advancing the role and prevalence of patient and family engagement in the healthcare 2.0 era

By Staff Reporters

The Institute for Interactive Patient Care (IIPC) is a healthcare organization dedicated to empowering patients and improving health outcomes through direct patient engagement. Their mission is to foster widespread adoption of patient and family/caregiver engagement strategies, which are proven to optimize patient care outcomes.

[picapp align=”none” wrap=”false” link=”term=medical+care&iid=299749″ src=”0296/b744a919-026d-4cb2-8a9a-5edd2a9ce15d.jpg?adImageId=12868513&imageId=299749″ width=”317″ height=”480″ /]

Vision

The vision of IIPC and its’ national board of advisors is to create a forum through which healthcare leaders worldwide learn about and adopt best practices in patient engagement as a principle means of improving healthcare outcomes. To achieve its mission, the IIPC engages in high quality research and advocates for advances in policy, standards and payment reform, all consistent with the mission of IIPC. The IIPC is governed by an independent National Advisory Board comprised of prominent leaders in healthcare.

Responsibilities

Among its primary responsibilities, advisory members help oversee and validate research projects, as well as to guide the use and dissemination of information and findings from the research in order to promote establishment of patient engagement standards for all care providers. IIPC fills a unique role in healthcare by serving as a reliable source of information and evidence-based data on the impact and efficacy of patient and family/caregiver engagement.

Assessment

IIPC is a not for profit 501(3)(c) organization.

Link: http://www.instituteipc.org/research/

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Give the IIPC a click, and tell us what you think? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

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Seeking ME-P Readership Opinions on eMRs

Posted on May 15, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

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An Exercise in Crowd-Sourcing

By Chris Thorman

Senior Marketing Manager
www.SoftwareAdvice.com

I just finished an essay about market share in the EMR industry and I wanted to give ME-P readers a heads up about it.

Here is the link: http://www.softwareadvice.com/articles/medical/ehr-software-market-share-analysis-1051410/

Essay Content

In the article, I break down:

The size of the outpatient EMR market;
What EMR vendors have the most physicians using their system; and,
What EMR vendors have the most practices using their systems?

Assessment

As I’m sure you can imagine; it was a tough project to get accurate numbers on. And, I’d like to get more eyes on it so we can clear up any discrepancies. Sort of a ME-P reader “crowd sourcing” project if you will. So, all thoughts on our findings are appreciated. I can be contacted directly here by email, or below: chris@softwareadvice.com

(512) 364-0118
(800) 918-2764 (toll free)
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Contact: MarcinkoAdvisors@msn.com

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Filed under: Experts Invited, Information Technology, Op-Editorials | Tagged: ARRA, chris thorman, EHRs, EMRs, health information technology, HITECH, SoftwareAdvice.com | 2 Comments »

Celebrating our 1,500th Medical Executive-Post

Posted on May 15, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Even More to Come in the Years Ahead

By Ann Miller; RN, MHA

[Executive-Director]

This ME-P is an information sharing portal for the integrated healthcare industrial complex, medical practice management and financial planning and advisory communities.

We have a search engine to help find essays and follow the breaking news that interests you for this space. Our articles, gossip, videos, books, journals, dictionaries, alerts and related information are continuously updated and ranked by users.

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Publish on the ME-P

And, just recently we’ve celebrated our 1,500^th post. Of course, as a participative service, you can publish an article directly on the site or comment on an existing item. You can also vote for an article or a group that captures your interest in order to increase its visibility on the site.

Join Us

But, you must be a member to post; so join us today. We’ve come a long way in less than 3 years, with a lot farther to go!

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25 or so – Unintended Consequences of Healthcare Reform

Posted on May 14, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Protean, Pervasive, Prolonged and Painful

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

Definition of the Term

Much like the physical laws of nature, action begets consequences, which are usually known, unknown or disregarded by human foibles.

According to Robert Norton, the law of unintended consequences, often cited but rarely defined, is that actions of people—and especially of government—always have effects that are unanticipated or unintended. Economists and other social scientists have heeded its power for centuries; for just as long, politicians and popular opinion have largely ignored it.

My List

And so, regardless of your political affiliation or opinion on healthcare reform in America, passed on March 21 2010 [Patient Protection and Affordable Care Act], there is a plethora of unintended consequences with the [any] new law. So, please indulge me in a bit of healthcare administration prescience:

Healthcare costs will be shifted to doctors in the form of lower reimbursement with higher practice overhead costs for private physicians, and with fewer office employees and more ancillary business and service line extensions.
Hospital based physicians like pathologists, radiologists, anesthesiologists, emergency department doctors and hospitalists will demand, and receive, higher salaries.
Fewer [under populated] primary care physicians with more [over populated] PAs, nurse practitioners and DNPs; with a blunted medical establishment oligopoly.
Higher health insurance costs for employers and most patients, especially young adults without a commensurate increase in aggregate risk.
Medical care access impediments for most Americans, but improvements for those previously uninsured.
Health 2.0 electronic connectivity for the masses with medical data “internet-neutrality”.
Continued rise of evidence based medicine and crowd-sourced healthcare information.
Higher costs for DME, instruments and drugs; particularly in the filed of human genomics and personalized pharmaceuticals.
Increased acceptance of MSAs, HSAs, concierge medicine, private-pay and other direct cash payment methods for medical care.
Realization that eMRs do not improve patient care or reduce costs as “meaningful use” is diluted.
An enterprise wide health data breach of epic proportions, with in-numerable smaller security breaches despite the HIPAA laws.
Long term macro-economically induced national inflation with weakness in the US dollar
Poor quality digital manipulation of medical information with eMR specific inflation due to ARRA and HI-TECH.
Increased national unemployment with widespread underemployment for some Americans.
Modified value added taxation in addition to increased federal tax brackets, rates and related others.
Promotion of outcomes reimbursement models, values based healthcare [episodes of care] and various micro-capitation derivatives.
Many more community hospitals, which lost 12 cents/dollar spent on Medicare and 35 cents/dollar on Medicaid patients last year, will close.
Medicare will become the defacto health insurance, much like public housing, food stamps, the USPS and public transportation.
There will be fewer viable alternatives to commercial health insurance, other than Medicare and Medicaid, since the antitrust exemption for health insurers was not repealed.
The impact of changing to ICD-10 for medical records coding and billing, will be as significant across the industry, as was Y2K and will push many other HIT projects to lower priority.
New HIPAA 5010 requirements will present substantial changes in the content of the data submitted with claims as well as the data available in response to electronic inquiries.
The Obama health insurance “police” program will be a policy failure, but a job creator.
Medical practices, often a doctor’s largest financial asset, will go down in value jeopardizing personal retirement plans.
Medicine’s lost professional status will become complete as healthcare becomes commoditized and future grass-roots caregivers are neutered.
Your 2 cents here.

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Assessment

In order to be politically correct – not a known trait for me – I will adopt a scientist’s perspective and omit any value judgment regarding the above [positive or negative] unintended consequences.

www.BusinessofMedicalPractice.com

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. 25 consequences not listed? Add your 2 cents. What else can you think of? Am I correct, or not, and how do you feel about the above?

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Filed under: Career Development, Health Economics, Health Insurance, Healthcare Finance, Op-Editorials, Practice Management, Research & Development | 7 Comments »

Should Banks Pay a TARP Tax?

Posted on May 13, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Born form the Emergency Economic Stabilization Act

By Robert Giese
bob.giese@chsfl.org

During the financial crisis, of October of 2008, Congress passed the Emergency Economic Stabilization Act. Part of that Act created the Troubled Asset Relief Program (TARP) with a $700 billion fund for loans to banks. As part of TARP, the banks borrowed $248 billion. Approximately $199 billion of that amount has been repaid.

Auto and Insurance Companies

However, TARP was also extended to auto companies and auto-financing entities. In addition, because of the fear of collapse of the entire system if securities insurance funds went under, the government funded a loan/guarantee of over $100 billion to financial giant AIG. The total distribution to General Motors, AIG, CIT and related entities was $244 billion. Most of this amount is still unpaid.

Treasury Requirement

Part of the Emergency Economic Stabilization Act was a requirement that Treasury eventually determined the best means for the government to be repaid the TARP funds. As a result, Treasury Secretary Timothy Geithner has proposed a 0.15% tax on the covered liabilities of banks with over $50 billion in assets. Secretary Geithner appeared on May 4, 2010 before the Senate Finance Committee to explain the administration proposal. He noted that it is appropriate for the banks to pay for TARP. The TARP Program put out “a financial fire” and the banks benefited from it. Sec. Geithner stated that the purpose of “the Financial Crisis Responsibility Fee proposed by President Obama in January is to make sure that the direct costs of TARP are paid for by the major financial institutions, not by the taxpayer.”

Small Business Unharmed

In response to concerns by senators that a TARP tax may cause lending to small businesses to be reduced, Sec. Geithner responded, “Small businesses would not be harmed by the tax for the simple reason that it leaves untouched 99% of American financial institutions.” The tax on large banks is estimated to raise approximately $90 billion over 10 years. The cost of TARP is currently estimated by the Congressional Budget Office to be approximately $110 billion.

Assessment

Sen. Max Baucus (D-MT) indicated that a TARP tax is “inevitable.” He stated, “We need to understand the best way to design the tax so that it’s fair and achieves its purpose. We need to understand who should pay the tax. And we need to understand what effect the tax would have on small businesses and the economy.”

Predictably, the American Bankers Association opposed the tax. Their representative James Chessen responded, “Had the TARP been limited to the banking industry, there would be no losses on that program.” The ABA maintained that it was not fair to tax the banks because government losses on TARP will be primarily related to the auto companies and other non-bank recipients of TARP loans.

And so, Is this topic applicable to the healthcare industry? Why or why not? Does it impact SAR-BOX or the “red flag rules?” Should we care at all?

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Conclusion

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FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Alerts Sign-Up, Financial Planning, Funding Basics, Taxation | Tagged: ABA, AIG, American Bankers Association, CBO, CIT, Emergency Economic Stabilization Act, General Motors, James Chessen, Robert Giese, Sar-Box, Sen. Max Baucus, TARP, Timothy Geithner, Troubled Asset Relief Program | 3 Comments »

“The Vanishing Oath”

Posted on May 12, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

A Documentary Film

By Ryan Flesher, MD

Reaching for a patient chart in the ER one night, a young physician is suddenly overwhelmed by a strange mixture of panic, anger and fear. But, such emotions are unacceptable for a doctor.

A Self-Loathing Doctor -OR- Modern Realist?

Tearing down a hallway, he slips into a room and as the door clicks shut, he slumps to the floor. The truth is wrenching: he hates being a doctor. In the burial ground of his emotions he unearths the regret, guilt, confusion that he feels. Like a sudden rainstorm, years of anguish and disillusionment come pelting downward. Emotions are a dangerous mix of chemicals when buried. Forcing himself to a standing position he returns to his patients, his priority. There is no going back from a defining moment; one cannot un-ring a bell.

“Is there something wrong with me?” he wonders. It is a burning, compelling question that takes him across the globe and back to answer.

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An Insider’s View

This first-ever glimpse takes us into the raw emotions that doctors hold beneath the white coats. Ultimately, he realizes that the untrained hands of corporate executives are health care’s decision makers and a doctor’s suffering is considered intangible. With no heart or vision, the mission is to profit off the backs of doctors and patients.

Physicians are quietly leaving clinical medicine and the momentum is growing. If the attack upon those who heal us does not end … the foundation will collapse. But, from which floor does one fall?

Assessment

This unique film, from an inside view rarely seen, examines the reality of modern medical practice and the obstacles to care that complicate the path to great care.

http://drwes.blogspot.com/2010/05/vanishing-oath-review.html

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. If you view the video, please tell us what you think?

Link: http://www.amazon.com/Vanishing-Oath-Feature-Film-DVD/dp/B003KVMULI/ref=sr_1_1?ie=UTF8&s=dvd&qid=1273494090&sr=8-1

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Filed under: Book Reviews, Career Development, Ethics, Videos | Tagged: “The Vanishing Oath”, physician career change, Ryan Flesher | 4 Comments »

Become a Whistle Blower in the Healthcare Industrial Complex

Posted on May 11, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Have You Ever Worked in the Medical Profession?

By Ann Miller; RN, MHA

[Executive-Director]

If you ever worked for a private medical practice, health insurance company, third party administrator or payer, hospital, public health clinic, VA or anywhere else in the healthcare space, we’d like to hear from you.

Tell the Medical Executive-Post about your work conditions, doctors or nurses, management shenanigans, or the politics and your observations of what is happening at your healthcare organization. Gossip, insider information, knowledge, personal opinion, insight or related hearsay – both positive and negative – is sought.

The clinical, financial, legal, insurance, pharma or administrative scenes are all fertile grounds for exposure and transparency. You may remain an anonymous tipster, or we will publish your identity upon request for additional credibility.

Please email MarcinkoAdvisors@msn.com or call us at: 770.448.0769

Please contact us today: MarcinkoAdvisors@msn.com

Conclusion

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Filed under: "Doctors Only", Career Development, Experts Invited, Insurance Matters, Professional Liability, Quality Initiatives, Risk Management | Tagged: CPT codes, medical billing, medical errors, medical fraud, medical upcoding, medical whistleblower, never-events, wrong site surgery | 34 Comments »

Video on HealthCampRDU

Posted on May 10, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

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About Participatory HealthCare

By Staff Reporters

HealthCampRDU is a highly-collaborative, day-long conference with a focus on issues and opportunities related to the changing face of healthcare. Health industry experts and thought leaders, practitioners, health systems, consumers, developers, disease charities, insurers, technologists, journalists, entrepreneurs, bloggers, government and academic institutions will converge to openly exchange views and ideas in a think-tank atmosphere on a variety of topics including, mobile health, telemedicine and social health.

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A HealthCamp Conference

HealthCampRDU is the latest in the series of HealthCamp participant organized conferences.

HealthCamp is about Participatory Health Care. HealthCampRDU will be examining Mobile Health, Telemedicine and Social Health. HealthCampRDU happens on May 14th in Durham, NC. 150 people will be taking part in the day long event where they define the agenda.

Assessment

North Carolina Blue Cross/Shield is appreciated for their Foundation Sponsorship of this event.

http://www.healthcampRDU.org

Conclusion

And so, your thoughts and comments on this conference are appreciated. If you attend, please tell us what you think.

More: http://www.youtube.com/user/ekivemark

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Filed under: Alerts Sign-Up, Sponsors, Videos | Tagged: Blue Cross/Shield, health 2.0, healthcamp, HealthCampRDU, Mobile Health, Participatory Health Care, participatory medicine, Social Health, telemedicine | Leave a comment »

Should the Government Mandate 401(k) Annuities?

Posted on May 10, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

About the Guaranteed Retirement Accounts Proposal
By Robert Giese
bob.giese@chsfl.org

Recent hearings in the House and Senate have focused on the need for 401(k) and IRA accounts to provide better retirement income. Vice President Joe Biden referred to these discussions in the White House Task Force on the Middle Class. He suggested creating “Guaranteed Retirement Accounts [GRAs].”

The guaranteed retirement accounts may replace conventional 401(k)s and could eventually provide annuity income to individuals.

Response to GAO Report

In response to a White House request, the General Accounting Office (GAO) released a report on April 28, 2010 that discussed some of these retirement issues. The GAO noted that a couple age 62 has at least a 47% probability that one of the two spouses will live to age 90. While life expectancy is in the mid-to-late 70s when one is born, the age at maturity increases as we grow older. Therefore, the average retirement age couple in America has a reasonable prospect that the survivor will live to be age 90.

GAO reports that Social Security is the primary support for lower income retired Americans. For the median retired person, Social Security is expected to provide approximately 47% of retirement income. The balance will come from savings or investments, a qualified plan such as a 401(k) or IRA and retirement earnings from employment.

Better than Conservative Investments?

The GAO report notes that an annuity may provide more income than a conservative investment, such as a bond or CD.

Assessment

Republican lawmakers this week wrote a letter to Treasury Secretary Timothy Geithner and expressed concern about the guaranteed retirement accounts. They noted that a number of the witnesses before the various committees would “dismantle the present private-sector 401(k) system” and replace it with the GRA.
Their letter expressed concern and opposition to any effort to “nationalize” the 401(k) system. The Republican lawmakers continued by noting that over 90% of households have a favorable opinion of 401(k) or IRA accounts.

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Is this new vehicle really better than a bond or CD? Is it the correct vehicle for a long-term retirement strategy? Is it even appropriate for physicians and medical professionals?

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

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Filed under: Breaking News, Insurance Matters, Investing, Op-Editorials, Portfolio Management, Retirement and Benefits | Tagged: 401-k, 403-b, annuities, GAO, Guaranteed Retirement Accounts, IRA, Joe Biden, Robert Giese, social security, Timothy Geithner, White House Task Force on the Middle Class | 3 Comments »

Exploring Career Change for Physicians

Posted on May 9, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

ADVERTISEMENT

About the Medical Fusion Conference

By Staff Reporters

Physician career change is the focus of the Medical Fusion conference. Non-clinical jobs, medical journalism, medical informatics, physician entrepreneurs, medical device development, and venture capital are all topics that will be covered at this exciting new event.

For all Specialties and Physicians

Whether you are a medical resident who wants to learn about all of the possibilities available to you or a retired physician looking for entrepreneurial side ventures, this is the conference for you. Medical Fusion reports to supply the tools necessary to take your career to the next level.

Non-Clinical Careers

Medical Fusion is for physicians interested in exploring non-clinical career opportunities. Designed to teach physicians how to leverage their medical training and expand their careers, participants receive training from experts with practical knowledge on a variety of non-clinical subjects.

A Tool Box 4 a Black Bag

Medical Fusion is designed as a “tool box” for the modern physician. Clinical physicians today need to know how to leverage their clinical training in new and unique ways. Medical Fusion provides broad exposure to a variety of niche areas, leaving participants with practical steps to begin crafting the career they’ve always wanted. Come learn from physicians who’ve already developed their own unique careers.

Assessment

Medical Fusion is a new medical event for physicians, by physicians.

Link: http://medfusionconf.com/home/tabid/122/Default.aspx

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Are you a physician seeking a career change away from clinical medicine? Tell us your experiences to-date. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

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Filed under: "Doctors Only", Career Development, iMBA, Inc., Sponsors | Tagged: careers for doctors, david marcinko, entrepreneurial MDs, medical career change, Medical Fusion, non clinical medicine, physician jobs | 1 Comment »

Advertise on the ME-P

Posted on May 8, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Consider Advertising on the Medical Executive Post

If you want the opportunity to reach a personalized weekly audience of health care industry insiders, innovators and watchers, the Medical Executive-Post and its educational forums may be right for you?

Conclusion

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Sponsors Welcomed

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Filed under: iMBA, Inc., Sponsors | Leave a comment »

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