BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
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We knew digital dental records were never safe, even though our trusting patients had no idea. I started warning dentists about sudden public rejection of electronic dental records over a decade ago. In fact, that is why the Texas Dental Association suspended my membership.
It’s the start of the predictable end of digital records in most dental offices. The TDA and the ADA were repeatedly warned, but chose to say nothing about the comparative security of paper to dues-paying members. In fact, the American Dental Association marketed its own digital dental record system until a few years ago when over 500 dental practices using their system were hacked. Then the ADA quietly sold it.
“The records of nearly 9 million people have been published online following a LockBit ransomware attack on Managed Care of North America. The company, also known as MCNA Dental, is a leading provider of dental plans in the U.S., serving private employers, individuals and families through a range of Medicare, long-term and commercial plans. MCNA is also the largest dental insurer for government-sponsored Medicaid and Children’s Health Insurance Program, programs.”
The question is, what will this news do to huge, multi-location dental franchises such as Aspen Dental, Monarch, Medicare and other discount dentistry centers. Dentists have proven they can run successful, large practices using pegboards, ledger cards and bulky, loud metal filing cabinets without risking their patients’ privacy.
By the way, my practice is accepting new patients. Oh yea: TDA, you still owe me $200 in prorated dues for the remainder of the year you kicked me out. Idiots!
Envision, a $10 billion physician and ambulatory surgery firm owned by private equity giant Kohlberg Kravis Roberts, filed for Chapter 11 bankruptcy on May 15th 2023. It was the largest healthcare bankruptcy in US history.
Envision claimed to employ 25 thousand clinicians- emergency physicians, anesthesiologists, hospitalists, intensivists, and advanced practice nurses and contracted with 780 hospitals. Envision’s ER physicians delivered 12 million visits in 2021, not quite 10% of the US total hospital ED visits.
Have you been frustrated in your efforts to attract, engage and serve doctors? In this episode, colleague Dr. Vicki Rackner shares 5 common mistake financial advisors make; with more.
The study on ChatGPT “outperforming” doctors in answering patient questions quickly became the talk of the town. However, as is often the case, it was presented as a prime example of media sensationalism.
As we encounter more of these partially misinterpreted hypes – and rest assured, there will be many – we’ll need to navigate a sea of questions. Firstly, we must determine what AI can genuinely do better than healthcare professionals. Secondly, we need to consider how to identify unique areas where healthcare workers can assist patients, while AI automates repetitive and data-driven tasks.
May is mental health month in the USA. US Surgeon General Dr. Vivek H. Murthy issued a powerful public advisory yesterday warning of the considerable risks that social media poses to young people’s mental health. “Nearly every teenager in America uses social media, and yet we do not have enough evidence to conclude that it is sufficiently safe for them,” Murthy wrote. He argued that kids have “become unknowing participants in a decades-long experiment.”
The surgeon general’s report focuses on the impacts of social media on teens and kids—both positive and negative—and the attendant health risks. The report outlines two types of dangers associated with social networks: content-related problems, such as negative self-image or bullying, and use-related problems, such as poor sleep and addiction.
What we know about social media and kids’ mental health
By all accounts, America’s youth are currently experiencing a mental health crisis.
The number of teens and young adults with clinical depression doubled between 2011 and 2021, according to San Diego State University psychology professor Dr. Jean Twenge.
In 2021, the CDC found that nearly 25% of teenage girls had made a suicide plan.
Many experts have pointed to social media as a potential cause since the deterioration of kids’ mental health has coincided with the rise of social media platforms over the last decade.
Still, the effect of likes, retweets, and TikTok comments on kids’ brains remains more or less a mystery. We know that social media use affects adolescents and that teens show alarming rates of anxiety and depression. But studies that have attempted to determine whether social media is a direct cause of worsening mental health have been inconclusive. Plus, not all kids are impacted by social media similarly: Some—adolescent girls, for instance—appear to be more at risk than others.
Finally, and according to Morning Brew, while researchers search for answers, some lawmakers are pushing ahead with restrictions on teens’ use of social media. In March, for example, Utah became the first state to establish a curfew for teens on social media apps and mandate that parents have access to their children’s accounts.
Talks were “productive,” but no debt ceiling deal yet
As the US careens toward a June 1st deadline to avoid default, President Joe Biden and House Speaker Kevin McCarthy met last night and failed to reach an agreement to prevent economic chaos. Still, McCarthy called their discussion “productive” and “professional,” saying the tone was “better than any other time we’ve had discussions.”
Before the meeting, McCarthy acknowledged that a deal must be struck this week in order to get it through Congress prior to the deadline, but the two sides remain far apart on the Republican’s demands for spending cuts.
Atlanta, GA – Governor Brian P. Kemp, joined by First Lady Marty Kemp and their three daughters, Lt. Governor Geoff Duncan, Speaker David Ralston, members of the House and Senate, and mental health advocates, to sign the Mental Health Parity Act (HB1013) into law.
You may view his remarks from the bill signing ceremony below, and you can watch the full ceremony here.
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Mental Health Rights
People living with mental health conditions are people. They have people they love, activities they enjoy, and dreams for their lives. As people, they deserve to be treated with dignity, and under the law they have rights and protections.
Unfortunately, it has long been the case that individuals with mental health conditions are among the most abused and discriminated against in our country. From leaving people to languish in overcrowded state hospitals to lobotomies and forced sterilization, the treatment of those with mental health conditions is a dark stain on our history as a nation.
While we have come a long way, abuse and discrimination continue to be serious problems today. The shackling or restraining of children, keeping people out of work, and denying access to services are just a few examples of the way we continue to fail the 1 in 5 Americans that has a diagnosable mental health disorder.
This is not just a small issue for a small group of people: half of all Americans will experience a diagnosable mental health condition in their lifetime. If it is not us being directly impacted, it is likely that it will be our family members, friends, or loved ones– whether we know it or not. Beyond struggles in education or employment, we see the loss of human dignity and even human life for the people we love and care about when we do not work to address abuses in the system.
For Mental Health America, the fight against abuse and discrimination is essential to our history and continues to guide our work. MHA’s symbol, which sits in our national office, is the Bell of Hope cast from the chains and shackles that were used to restrain individuals in old state hospitals. As an organization, MHA is committed to the principles of human and civil rights inherent to the concept of equal justice under the law.
By 2030, the WHO projects that 15 million healthcare workers will be missing globally.
Introducing Florence, the “world’s most extensive freely accessible AI health worker” is one way of tackling this issue. Florence is knowledgeable in key health topics, including mental health, nutrition and tobacco cessation, and provides information on COVID-19 vaccines. So, have a chat with her.
Today is World Family Doctor Day—and the US needs more family doctors. By 2026, 21% of family medicine and other primary care physicians will have reached retirement age, while demand for primary care is expected to grow 4%.
World Family Doctor Day is on May 19th every year. Founded by the World Organization of Family Doctors (W.O.N.C.A.) in 2010, World Family Doctor Day has now grown into a global celebration of the importance of family doctors in health care. Taking part in this event is a great way to show appreciation for the important role family medicine plays in providing patients with individualized, comprehensive, and long-term health care. Family doctors around the world have made significant contributions to medicine — now is the time to recognize that. It’s also a moment to recognize the advancements in family medicine and the unique efforts of primary care teams worldwide.
So we, at the ME-P, hope all the family doctors take time to relax from their busy schedules and enjoy the springtime blooms as we trust those April showers brought lots of May flowers.
Aspen Dental has been hit by a cyber attack. Aspen has over a thousand dental offices across the nation, and even though their official website says there are no signs of patient information being compromised, the American Dental Association is calling it a “breach,” since the attack involved ransomware.
If Aspen Practices each maintain dental records on 10,000 patients, and there are over a thousand Aspen locations, that would mean more than 10 million patients’ records were potentially breached. Texas has 58 Aspen locations – second only to Florida which has 124. (There are three Aspen locations near me in the Dallas-Fort Worth metroplex).
Last of all, history has shown that businesses which suffer one ransomware attack are likely to be targeted a second or even third time. It never ends. And then there are the HIPAA violations and remediation … This is bad for Aspen Dental.
President Joe Biden said Monday he intends to nominate a new director for the National Institutes of Health. Dr. Monica Bertagnolli, a surgical oncologist and cancer researcher, was picked by Biden as the successor to Francis Collins.
“Dr. Bertagnolli has spent her career pioneering scientific discovery and pushing the boundaries of what is possible to improve cancer prevention and treatment for patients, and ensuring that patients in every community have access to quality care,” Biden said in a statement. “As Director of the National Cancer Institute, Dr. Bertagnolli has advanced my Cancer Moonshot to end cancer as we know it.”
Happy 203rd birthday to Florence Nightingale, the founder of modern nursing. She rose to fame during the Crimean War, when her hygiene standards substantially reduced the mortality rate at army hospitals. The healthcare industry still relies on some of her ideas, such as using data as a tool to improve hospital care. The “lady with the lamp” is still lighting the path forward.
On February 22, 2023, UnitedHealth Group’s (UHG’s) Optum division, the health insurance giant’s care delivery arm, acquired Crystal Run Healthcare, a New York based physician group of almost 400 physicians, nurse practitioners, and other providers
This significant move is just the latest in UHG’s concerted effort over the past few years to acquire outpatient providers, surgery centers, and physician groups. This Health Capital Topics article will briefly survey some of the insurer’s recent acquisitions and initiatives to expand their physician services network. (Read more…)
It’s National Nurses Week and National Student Nurses Day. We at the ME-P salute all the nurses (and future nurses) who read and inform our stories, and all of those who’ve been on the front-lines of the pandemic. We hope you take some time to kick back or at least slip into some comfortable shoes.
The S&P 500® Index was up 1.87 points at 4138.12; the Dow Jones industrial average was down 55.69 (0.2%) at 33,618.69; the NASDAQ Composite was up 21.50 (0.2%) at 12,256.92.
The 10-year Treasury yield was up about 7 basis points at 3.515%.
CBOEs Volatility Index was down 0.2 at 16.99.
Among S&P 500 sectors, financial and energy companies were top gainers, with the latter getting some help from a more than 2% rally in WTI crude oil futures.
Transportation, utility and industrial stocks were among the weakest performers, and the Russell 2000 was down about 0.3%, reflecting continued weakness in small-caps.
INTRODUCING OUR NEXT GENERATION e-BOOK LIBRARYFROM iMBA, Inc.
An e-book is an electronic or digital book that can be read on a computer or a handheld device.
Our new e-books consists of text, images, and are fixed to a specific spot on the page.
And, our e-books are a data files similar in content and structure to a word-processing document that comes in a PDF format. To use our e-books, you need to purchase and download it to a device that has a .pdf file reader app, such as ADOBE® or similar on a smartphone, tablet or computer. A PDF, also known as a portable document format, is the format most people are familiar with and used in our e-books. PDFs are known for their ease of use and ability to hold custom layouts. They are the most commonly used e-Book formats, especially by professionals and adult-learners.
You can then access the e-book and read it, or highlight pages and even take side notes.
e-Books Save Money
With no manufacturing, printing, binding or shipping costs, e-Books are cheaper than traditional hard or paper back books.The price of each specialized and highly niche focused e-Book [50-100 pages] is only $25, whereas similar paperback printed books of this type generally cost $145, or more!
Tele-Health medical providers are cheering the Drug Enforcement Agency (DEA) move to temporarily extend virtual prescribing flexibility.
The DEA is looking to buy some time to consider whether it should require patients to see doctors face-to-face to get prescriptions for controlled drugs or continue to allow Tele-Health prescriptions. The agency received a record 38,000 public comments on its proposed rule.
INTRODUCING OUR NEXT GENERATION e-BOOK LIBRARYFROM iMBA, Inc.
An e-book is an electronic or digital book that can be read on a computer or a handheld device.
Our new e-books consists of text, images, and are fixed to a specific spot on the page.
And, our e-books are a data files similar in content and structure to a word-processing document that comes in a PDF format. To use our e-books, you need to purchase and download it to a device that has a .pdf file reader app, such as ADOBE® or similar on a smartphone, tablet or computer. A PDF, also known as a portable document format, is the format most people are familiar with and used in our e-books. PDFs are known for their ease of use and ability to hold custom layouts. They are the most commonly used e-Book formats, especially by professionals and adult-learners.
You can then access the e-book and read it, or highlight pages and even take side notes.
e-Books Save Money
With no manufacturing, printing, binding or shipping costs, e-Books are cheaper than traditional hard or paper back books.The price of each specialized and highly niche focused e-Book [50-100 pages] is only $25, whereas similar paperback printed books of this type generally cost $145, or more!
READ: Social determinants of health aren’t just for patients. Health systems looking to promote health equity within their communities can start internally, by looking at their own workforce; according to HealthcareBrew.
Under law, financial advisors and planners must provide you with a form ADV Part II or a brochure that covers the same information. Even if a brochure is provided, ask for the ADV. While it is acceptable, even desirable, for the brochure to be easier to read than the ADV, the ADV is what is filed with the appropriate state or SEC. If the brochure reads more like a slick sales brochure or the information in the brochure glosses over the items on the ADV to a high degree, one should consider eliminating the advisor from consideration.
Registering with a state or SEC gives an advisor a fiduciary duty to the client. This is a high standard under the law.
There are several types of advisors who are exempt from registering and filing an ADV.
First, there are registered representatives (brokers). Brokers have a fiduciary responsibility to their firms regardless of whether they are statutory employees or independent contractors. Not the client.
Second are attorneys and accountants whose advice is “incidental” to their legal or accounting practices. But, why would one hire someone whose advice is “incidental” to his primary profession? A top-notch advisor is a full-time professional and should be registered. One should insist that their advisor be registered.
The ADV will describe the advisor’s background and employment history, including any prior disciplinary issues. It will describe the ownership of the firm and outline how the firm and advisor are compensated. Any referral arrangements will be described. If an advisor has an interest in any of the investments to be recommended, it must be listed as well as the fee schedule. There is also a description of the types of investments recommended and the types of research information that is used.
ASSESSMENT: A review of the ADV should result in an alignment of what the advisor said during the interview and what is filed with the regulators. If there is a clear discrepancy, choose another advisor. If it is unclear, discuss the issue with the advisor.
Your thoughts and comments are appreciated.
SEC Headquarters 100 F Street, NE Washington, DC 20549 (202) 942-8088
DSOs are companies that take on all the business-related tasks necessary to run a dental practice, like IT support, accounting and billing, marketing, and facility maintenance, Lisa Ward, VP of communications at industry trade group the Association of Dental Support Organizations, told Healthcare Brew.
A DSO can own the dental practice it operates, or a private practice can contract with a DSO. Some DSOs are owned by a group of dentists, but private equity firms own many large DSOs, according to the Academy of General Dentistry.
The idea behind a DSO is that the “dentist can focus on patient care and not have to worry so much about the business side,” Ward said.
The DSO business model was created in 1975 but didn’t become popular until the 1990s, as dentists graduated with piles of student debt and found it hard to open their own practice, according to Huron Consulting Group.
Today, 10.3% of dentists are affiliated with a DSO, per investment bank Harris Williams. In 2020, 30% of dental school seniors said they planned to join a DSO-affiliated practice, compared to 12% in 2015, a survey from the American Dental Education Association found.
The rise in popularity of DSOs has brought about the decline of private practice ownership. In 2021, the number of dentists who owned their practices fell to 73%, according to research from the ADA.
On April 18th, 2023, the U.S. Supreme Court heard oral arguments in two False Claims Act (FCA) cases, which cases center on the necessary state of mind needed to violate the FCA.
This Health Capital Topics article will review the oral arguments in the combined cases and how the justices seem posed to rule based on their questions and comments during the session. (Read more…)
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JUST IN: CA Doctor Settles FCA Allegations for $23.9 Million
A plastic surgeon in Beverly Hills, along with his son, and medical practices and billing company, have agreed to pay $23.9 million to resolve allegations that they violated the False Claims Act by submitting or causing the submission of false claims to both Medicare and Medicaid.
The civil settlement includes the resolution of claims brought under the qui tam, or whistleblower, provisions of the False Claims Act by parties who worked for the plastic surgeon (Dr. Aronowitz) and his associated medical practices and businesses. Whistleblowers include TDP, a billing company; Dr. Jason Morris, a podiatrist; and Harold Bautista, a billing department employee. Under the qui tam provisions, a private party can file an action on behalf of the government and receive a portion of any recovery.
Written by doctors and healthcare professionals, this textbook should be mandatory reading for all medical school students—highly recommended for both young and veteran physicians—and an eliminating factor for any financial advisor who has not read it. The book uses jargon like ‘innovative,’ ‘transformational,’ and ‘disruptive’—all rightly so! It is the type of definitive financial lifestyle planning book we often seek, but seldom find. —LeRoy Howard MA CMPTM,Candidate and Financial Advisor, Fayetteville, North Carolina I taught diagnostic radiology for over a decade. The physician-focused niche information, balanced perspectives, and insider industry transparency in this book may help save your financial life. —Dr. William P. Scherer MS, Barry University, Ft. Lauderdale, Florida This book was crafted in response to the frustration felt by doctors who dealt with top financial, brokerage, and accounting firms. These non-fiduciary behemoths often prescribed costly wholesale solutions that were applicable to all, but customized for few, despite ever-changing needs. It is a must-read to learn why brokerage sales pitches or Internet resources will never replace the knowledge and deep advice of a physician-focused financial advisor, medical consultant, or collegial Certified Medical Planner™ financial professional. —Parin Khotari MBA,Whitman School of Management, Syracuse University, New York In today’s healthcare environment, in order for providers to survive, they need to understand their current and future market trends, finances, operations, and impact of federal and state regulations. As a healthcare consulting professional for over 30 years supporting both the private and public sector, I recommend that providers understand and utilize the wealth of knowledge that is being conveyed in these chapters. Without this guidance providers will have a hard time navigating the supporting system which may impact their future revenue stream. I strongly endorse the contents of this book.—Carol S. Miller BSN MBA PMP,President, Miller Consulting Group, ACT IAC Executive Committee Vice-Chair at-Large, HIMSS NCA Board Member This is an excellent book on financial planning for physicians and health professionals. It is all inclusive yet very easy to read with much valuable information. And, I have been expanding my business knowledge with all of Dr. Marcinko’s prior books. I highly recommend this one, too. It is a fine educational tool for all doctors.—Dr. David B. Lumsden MD MS MA,Orthopedic Surgeon, Baltimore, Maryland There is no other comprehensive book like it to help doctors, nurses, and other medical providers accumulate and preserve the wealth that their years of education and hard work have earned them. —Dr. Jason Dyken MD MBA,Dyken Wealth Strategies, Gulf Shores, Alabama I plan to give a copy of this book written ‘by doctors and for doctors’ to all my prospects, physician, and nurse clients. It may be the definitive text on this important topic. —Alexander Naruska CPA,Orlando, Florida
Health professionals are small business owners who need to apply their self-discipline tactics in establishing and operating successful practices. Talented trainees are leaving the medical profession because they fail to balance the cost of attendance against a realistic business and financial plan. Principles like budgeting, saving, and living below one’s means, in order to make future investments for future growth, asset protection, and retirement possible are often lacking. This textbook guides the medical professional in his/her financial planning life journey from start to finish. It ranks a place in all medical school libraries and on each of our bookshelves. —Dr. Thomas M. DeLauro DPM,Professor and Chairman – Division of Medical Sciences, New York College of Podiatric Medicine
Physicians are notoriously excellent at diagnosing and treating medical conditions. However, they are also notoriously deficient in managing the business aspects of their medical practices. Most will earn $20-30 million in their medical lifetime, but few know how to create wealth for themselves and their families. This book will help fill the void in physicians’ financial education. I have two recommendations: 1) every physician, young and old, should read this book; and 2) read it a second time! —Dr. Neil Baum MD,Clinical Associate Professor of Urology, Tulane Medical School, New Orleans, Louisiana
I worked with a Certified Medical Planner™ on several occasions in the past, and will do so again in the future. This book codified the vast body of knowledge that helped in all facets of my financial life and professional medical practice. —Dr. James E. Williams DABPS, Foot and Ankle Surgeon, Conyers, Georgia
This is a constantly changing field for rules, regulations, taxes, insurance, compliance, and investments. This book assists readers, and their financial advisors, in keeping up with what’s going on in the healthcare field that all doctors need to know. —Patricia Raskob CFP® EA ATA, Raskob Kambourian Financial Advisors, Tucson, Arizona I particularly enjoyed reading the specific examples in this book which pointed out the perils of risk … something with which I am too familiar and have learned (the hard way) to avoid like the Black Death. It is a pleasure to come across this kind of wisdom, in print, that other colleagues may learn before it’s too late— many, many years down the road. —Dr. Robert S. Park MD, Robert Park and Associates Insurance, Seattle, Washington
Although this book targets physicians, I was pleased to see that it also addressed the financial planning and employment benefit needs of nurses; physical, respiratory, and occupational therapists; CRNAs, hospitalists, and other members of the health care team….highly readable, practical, and understandable. —Nurse Cecelia T. Perez RN, Hospital Operating Room Manager, Ellicott City, Maryland
Personal financial success in the PP-ACA era will be more difficult to achieve than ever before. It requires the next generation of doctors to rethink frugality, delay gratification, and redefine the very definition of success and work–life balance. And, they will surely need the subject matter medical specificity and new-wave professional guidance offered in this book. This book is a ‘must-read’ for all health care professionals, and their financial advisors, who wish to take an active role in creating a new subset of informed and pioneering professionals known as Certified Medical Planners™. —Dr. Mark D. Dollard FACFAS, Private Practice, Tyson Corner, Virginia As healthcare professionals, it is our Hippocratic duty to avoid preventable harm by paying attention. On the other hand, some of us are guilty of being reckless with our own financial health—delaying serious consideration of investments, taxation, retirement income, estate planning, and inheritances until the worry keeps one awake at night. So, if you have avoided planning for the future for far too long, perhaps it is time to take that first step toward preparedness. This in-depth textbook is an excellent starting point—not only because of its readability, but because of his team’s expertise and thoroughness in addressing the intricacies of modern investments—and from the point of view of not only gifted financial experts, but as healthcare providers, as well … a rare combination. —Dr. Darrell K. Pruitt DDS, Private Practice Dentist, Fort Worth, Texas This text should be on the bookshelf of all contemporary physicians. The book is physician-focused with unique topics applicable to all medical professionals. But, it also offers helpful insights into the new tax and estate laws, fiduciary accountability for advisors and insurance agents, with investing, asset protection and risk management, and retirement planning strategies with updates for the brave new world of global payments of the Patient Protection and Affordable Care Act. Starting out by encouraging readers to examine their personal ‘money blueprint’ beliefs and habits, the book is divided into four sections offering holistic life cycle financial information and economic education directed to new, mid-career, and mature physicians.
This structure permits one to dip into the book based on personal need to find relief, rather than to overwhelm. Given the complexity of modern domestic healthcare, and the daunting challenges faced by physicians who try to stay abreast of clinical medicine and the ever-evolving laws of personal finance, this textbook could not have come at a better time. —Dr. Philippa Kennealy MD MPH, The Entrepreneurial MD, Los Angeles, California Physicians have economic concerns unmatched by any other profession, arriving ten years late to the start of their earning years. This textbook goes to the core of how to level the playing field quickly, and efficaciously, by a new breed of dedicated Certified Medical Planners™. With physician-focused financial advice, each chapter is a building block to your financial fortress. —Thomas McKeon, MBA, Pharmaceutical Representative, Philadelphia, Pennsylvania An excellent resource … this textbook is written in a manner that provides physician practice owners with a comprehensive guide to financial planning and related topics for their professional practice in a way that is easily comprehended. The style in which it breaks down the intricacies of the current physician practice landscape makes it a ‘must-read’ for those physicians (and their advisors) practicing in the volatile era of healthcare reform. —Robert James Cimasi, MHA ASA FRICS MCBA CVA CM&AA CMP™, CEO-Health Capital Consultants, LLC, St. Louis, Missouri Rarely can one find a full compendium of information within a single source or text, but this book communicates the new financial realities we are forced to confront; it is full of opportunities for minimizing tax liability and maximizing income potential. We’re recommending it to all our medical practice management clients across the entire healthcare spectrum. —Alan Guinn, The Guinn Consultancy Group, Inc., Cookeville, Tennessee Dr. David Edward Marcinko MBA CMP™ and his team take a seemingly endless stream of disparate concepts and integrate them into a simple, straightforward, and understandable path to success. And, he codifies them all into a step-by-step algorithm to more efficient investing, risk management, taxation, and enhanced retirement planning for doctors and nurses. His text is a vital read—and must execute—book for all healthcare professionals and physician-focused financial advisors. —Dr. O. Kent Mercado, JD, Private Practitioner and Attorney, Naperville, Illinois
Kudos. The editors and contributing authors have compiled the most comprehensive reference book for the medical community that has ever been attempted. As you review the chapters of interest and hone in on the most important concerns you may have, realize that the best minds have been harvested for you to plan well… Live well. —Martha J. Schilling; AAMS® CRPC® ETSC CSA, Shilling Group Advisors, LLC, Philadelphia, Pennsylvania I recommend this book to any physician or medical professional that desires an honest no-sales approach to understanding the financial planning and investing world. It is worthwhile to any financial advisor interested in this space, as well. —David K. Luke, MIM MS-PFP CMP™, Net Worth Advisory Group, Sandy, Utah Although not a substitute for a formal business education, this book will help physicians navigate effectively through the hurdles of day-to-day financial decisions with the help of an accountant, financial and legal advisor. I highly recommend it and commend Dr. Marcinko and the Institute of Medical Business Advisors, Inc. on a job well done. —Ken Yeung MBA CMP™, Tseung Kwan O Hospital, Hong Kong I’ve seen many ghost-written handbooks, paperbacks, and vanity-published manuals on this topic throughout my career in mental healthcare. Most were poorly written, opinionated, and cheaply produced self-aggrandizing marketing drivel for those agents selling commission-based financial products and expensive advisory services. So, I was pleasantly surprised with this comprehensive peer-reviewed academic textbook, complete with citations, case examples, and real-life integrated strategies by and for medical professionals. Although a bit late for my career, I recommend it highly to all my younger colleagues … It’s credibility and specificity stand alone. —Dr. Clarice Montgomery PhD MA,Retired Clinical Psychologist In an industry known for one-size-fits-all templates and massively customized books, products, advice, and services, the extreme healthcare specificity of this text is both refreshing and comprehensive. —Dr. James Joseph Bartley, Columbus, Georgia
My brother was my office administrator and accountant. We both feel this is the most comprehensive textbook available on financial planning for healthcare providers. —Dr. Anthony Robert Naruska DC,Winter Park, Florida
Just 1 in 9 Americans smoked cigarettes last year, a record low, according to the CDC. Compared to the 1960s, when 42% of US adults smoked cigarettes, it’s a dramatic drop that reflects greater awareness of the health risks of smoking, and economic hurdles like cigarette taxes.
But Americans haven’t given up their nicotine addiction entirely. Vaping rose to almost 6% last year, and 14% of teens reported using e-cigarettes in another CDC study.
This celebration is to honor and appreciate the important role laboratory professionals play in improving diagnostic innovation and accuracy, particularly in light of the rapidly evolving global public health climate. Join us in acknowledging and appreciating their contributions and commitment!
Medical Laboratory Professionals Week, an annual celebration of medical laboratory professionals and pathologists who play a vital role in health care and patient advocacy, takes place between April 23-29, 2023. CLSI is one of 17 laboratory medicine organizations responsible for coordinating this annual celebration of this profession.
Venture capital funding in the digital health space cooled significantly in 2022 following a red-hot 2021; according to Healthcare Brew. Overall, digital health companies raised $15.3 billion last year, down substantially from the $29.1 billion raised in 2021—but still above the $14.1 billion raised in 2020, according to research from Rock Health, a seed fund that supports digital health startups.
Analysts predict investors will still put a good amount of money into digital health in 2023, particularly in alternative care, drug development technology, and software that reduces physician workload. But investors will likely pull dollars away from a few specific sectors this year.
“There is definitely more diligence, a little bit more skepticism in the investments that are made. So you tend to see investments go slower because diligence is taking longer or investors are being a little bit more conservative,” Adriana Krasniansky, head of research at Rock Health, told Healthcare Brew.
Direct-to-consumer products. The first sector in which Krasniansky expects to see funding slow this year is direct-to-consumer (DTC) products. One reason is that with recession fears, “Consumer spend is not as readily available,” Krasniansky said.
But Apple’s new data privacy rules are also partially to blame. As of April 2021, apps sold through Apple’s App Store must ask users for permission to track activity, and users can opt out. That tracking data is crucial for advertisers to create personalized ads.
“Apple’s privacy measures have impacted customer acquisition costs, making the DTC channel more challenging for a lot of startups—and not just digital health startups,” said Krasniansky.
The two tech giants posted earnings that showed they’re both on solid footing, despite investors’ concerns that growth would slow to a trickle. For Alphabet, Google search advertising revenue grew again after a quarter in the red. And Microsoft’s all-important cloud division posted better-than-expected sales. Both companies stated AI could impact their businesses, but they differed in their predictions: Microsoft characterized AI as a much more disruptive force than Google did.
Get ready for earnings calls from pharmaceutical companies: Eli Lilly, AstraZeneca, AbbVie, and more quarterly calls this week. Investors will watch AbbVie’s sales numbers, as Amgen introduced the first biosimilar version of AbbVie’s blockbuster arthritis drug, Humira, in January. In its last call, AbbVie executives said they expected to lose $7.9 billion in Humira sales in 2023
The S&P 500 Index was down 15.64 points (0.4%) at 4055.99; the Dow Jones industrial average was down 228.96 (0.7%) at 33,301.87; the NASDAQ Composite was up 55.19 (0.5%) at 11,854.35.
The 10-year Treasury yield was up about 4 basis points at 3.439%.
Colleague Peter R. Quinones and Per Bylund return to the show to talk about the role of the entrepreneur not only in society, but according to the Austrian School of Economics. Medical perspectives are implied.
In this episode we are joined by Dr. Brent Jackson, Chief Medical Officer for Mercy General in Sacramento, CA to discuss the physician life-cycle, burnout, and transitioning into leadership within healthcare.
“Teaching medical students entrepreneurial and business skills is invaluable as the need for leadership in medicine grows in every single sector. Many physicians already engage in managerial and entrepreneurial-like practices without labeling these skills. By formalizing these skills into medical education, physicians will be able to take their ambitions and ideas about how to best run existing health care institutions and translate them into innovations for the future of the field.”
Sofia Yunez is a medical student.
She shares her story and discusses her KevinMD article, “To be effective leaders, physicians need to be trained as entrepreneurs and encouraged to innovate.”
Short-term goals (less than 12 months) require liquidity or short-term assets. These assets include cash, checking and saving accounts, certificates of deposit, and money market accounts. These accounts have two things in common. The principal is guaranteed from risk of loss, and pay a very low interest rate. As an investment, they are considered substandard and one would only keep what is actually needed for liquidity purposes in these accounts.
[B] Long-Term Assets
Longer-term assets (more than 12 months) include real estate, mutual funds, retirement plans, stocks, and life insurance cash value policies. Bonds may also be an appropriate long-term investment asset for a number of reasons, for example, if you are seeking a regular and reliable stream of income or if you have no immediate need for the amount of the principal invested. Bonds also can be used to diversify your portfolio and reducing the overall risk that is inherent in stock investments.
[C] Short-Term Liabilities
Short-term liabilities (less than 12 months) include credit card debt, utility bills, and auto loans or leasing. When a young doctor leaves residency and starts practice, the foremost concern is student debt. This is an unsecured debt that is not backed by any collateral, except a promise to pay. There are recourses that an unsecured creditor can take to recoup the bad debt. Usually, if the unsecured creditor is successful obtaining a judgment, it can force wages to be garnished, and the Department of Education can withhold up to ten percent of a wages without first initiating a lawsuit, if in default. It is also probable that young medical professionals have been holding at least one credit card since their sophomore year in college. Credit card companies consider college student the most lucrative target market and medical students hold their first card for an average of fifteen years. There are several other types of other unsecured debt, including department store cards, professional fees, medical and dental bills, alimony, child support, rent; utility bills, personal loans from relatives, and health club dues, to name a few.
[D] Long-Term Liabilities
A secured debt, on the other hand, is debt that is pledged by a specific property. This is a collateralized loan. Generally, the purchased item is pledged with the proceeds of the loan. This would include long-term liabilities (more than 12 months) such as a mortgage, home equity loan, or a car loan. Although the creditor has the ability to take possession of your property in order to recover a bad debt, it is done very rarely. A creditor is more interested in recovering money. Sometimes, when borrowing money, there may be a requirement to pledge assets that are owned prior to the loan.
For example, a personal loan from a finance company requires that you pledge all personal property such as your car, furniture, and equipment. The same property may become subject to a judicial lien if you are sued and a judgment is made against you. In this case, you would not be able to sell or pledge these assets until the judgment is satisfied.
A common example of a lien would be from unpaid federal, state or local taxes. Doctors can be found personally liable for unpaid payroll taxes of employees in their professional corporations. Be aware that some assets and liabilities defy short or long-term definition. When this happens, simply be consistent in your comparison of financial statements, over time.
[E] Personal Physician Net Worth
Once the value of all personal assets and liabilities is known, net worth can be determined with the following formula: Net worth = assets minus liabilities. Obviously, higher is better. In The Millionaire Next Door, Thomas H. Stanley, PhD, and William H. Danko give the following benchmark for net worth accumulation. Although conservative for physicians of a past generation, it may be more applicable in the future because of current managed care environment.
Here is the guide: Multiple your age by your annual pre-tax income from all sources – except inheritances – and divide by ten.
Real-Life Medical Example:As an HMO pediatrician, Dr. Curtis earned $ 60,000 last year. So, if she is 35, her net worth should be at least $ 210,000.
How do you get to that point? In a word, consume less, save more and watch the student loans. Stanley and Danko found that the typical millionaire set aside 15 percent of earned income annually and has enough invested to survive 10 years, at current income levels if he stopped working. Now, if Dr. Curtis lost her job tomorrow, how long could she pay herself the same salary?
[F] Common Liability Management Mistakes
A common liability management mistake is not recognizing when you are heading for trouble. If doctors are paying only the minimum payments on credit card debt, while continuing to charge purchases at a rate faster than the pay-down, trouble is brewing. If you don’t categorize your debt, you could find yourself paying down non-priority debt while ignoring priority debt.
A priority debt is one that is essential or subject to serious consequences, if not paid. Examples include rent, mortgage payments, utility bills, child support, car payments, unpaid taxes, and other secured debt. If in one month, a doctor had to choose between paying his accounting bill or his rent, it would be essential to pay the rent.
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Much like the False Claims Act, the Anti-Kickback Statute (AKS) remains a frequent tool used by the Department of Justice to investigate the healthcare industry. Unlike the False Claims Act, the AKS imposes criminal penalties on violators.
The leaders of a physicians’ practice may be held liable for what others in the practice do, even if the leader did not know precisely what was going on. It has been called the “crime of doing nothing.”
1. Providing free dinners or lunches to physicians
2. Travel expenses paid to physicians
3. Entering into consulting or research agreements with physicians under which payments are made but minimal (or zero) work is done in return
4. Other gifts, such as electronics or tickets to sporting events
5. Laboratory pays a specimen processing fee to physicians above the fair value for those fees
6. Physician retention or recruitment agreements, when those agreements provide for payments above fair market value or are made with the intent to induce Medicare referrals
7. Agreements for speaking or teaching where the payments are above fair market value or made with the intent to induce referrals
8. Discount schemes that do not meet the safe harbor requirements
Source: Sara Kropf and Logan Lutton, Physicans Practice
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