MEDICAL MALPRACTICE : Update on Physician Rates of Liability

By Staff Reporters

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About one in three physicians reported that they’ve been sued for medical malpractice during their career, a new study from the American Medical Association (AMA) found.

The study analyzed 14,000 responses from AMA Physician Practice Benchmark Surveys between 2016 and 2022. The longer a physician works in the industry, the higher their risk of getting a malpractice claim.

In summary, almost half of physicians over the age of 54 have been sued in their career, versus 9.5% of physicians younger than 40 years old. Specialty and gender influenced the likelihood of being sued. For example, general surgeons and ob-gyns, as well as men physicians, had the highest risk, per the AMA report.

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This is exactly why we produced a major 800 page textbook for all our medical colleagues: Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors Best Practices from Leading Consultants and Certified Medical Planners

ORDER HERE: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

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PHYSICIAN COMPENSATION: Rising but NOT with Inflation!

By Staff Reporters and MGMA Survey

Physician Compensation is Rising but Not Keeping Pace with Inflation

Despite physician and advanced practice provider productivity continuing its post-pandemic recovery, compensation gains are being outstripped by the most severe inflationary growth in decades, according to a new report. Provider compensation increased across the board, with primary care physicians (PCPs) receiving the biggest increase last year. Growth in median total compensation for primary care doctors doubled from 2021 to 2022—from pay growth of 2.13% to 4.41%. But these gains were eclipsed by the rate of inflation at 7% and 6.5%, respectively.

CITE: https://www.r2library.com/Resource

Surgical and non-surgical specialists saw their change in median total compensation cool slightly in 2022, dropping from 3.89% for surgical specialists in 2021 to 2.54% in 2022, and from 3.12% for non-surgical physicians in 2021 to 2.36% in 2022, according to the Medical Group Management Association’s 2023 provider compensation and production report.

Source: Heather Landi, Fierce Healthcare [6/6/23]

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CUSTOMIZABLE e-PODIATRY CONSENT FORMS

electronically CUSTOMIZABLE FOR EVERY SURGEON

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http://www.ePodiatryConsentForms.com

CUSTOMIZABLE CMS & AGENCY FOR HEALTHCARE RESEARCH AND QUALITY STYLED PROTOCOLS, CHECKLISTS AND TEMPLATES

.… Specifically for Podiatrists ….   

e-Podiatry Consent Forms™ is an innovative new suite of software programs from the Institute of Medical Business Advisors [iMBA, Inc]. Our products solve your informed consent problems and enhance the education, discussion and documentation of the informed consent process for all podiatrists performing foot, ankle and leg reconstructive surgical procedures.

THE PROBLEM

All podiatrists are being pressured by the Centers for Medicare and Medicaid Services [CMS], the Joint Commission on Accreditation of Healthcare Organizations [JCAHO], liability carriers and private insurance payers to make their consent process more patient-friendly, informed and easily understood. And, the pressure to standardize and comply is great.

Most recently, based on the need to make healthcare even safer, the Agency for Healthcare Research and Quality (AHRQ) undertook a major study to identify patient safety issues and develop recommendations for “best practices”.

The AHRQ Evidence Report

The AHRQ report identified the challenge of addressing shortcomings such as missed, incomplete or not fully comprehended informed consent, as a significant patient safety issue and opportunity for improvement.

The authors of the AHRQ report hypothesized that better informed patients:

“are less likely to experience errors by acting as another layer of protection.”

And, the AHRQ study ranked a “more interactive informed consent process” among the top 11 practices supporting more widespread implementation; especially for surgical consent forms.

THE SOLUTION

Why Us: https://epodiatryconsentforms.com/why-us/

One answer to the modern risk-management problem of “informed consent interactivity” may be e-Podiatry Consent Forms™  We license two core interactive surgical products, and a reference library, with related concepts and products in development:

  • Forefoot, Mid-Foot and Simple Rear-Foot Version
  • Complex Rear-Foot, Ankle and Lower Leg Version
  • Comprehensive content library for extreme customization.

Each e-Podiatry Consent Forms™ CD-ROM [secure email delivery is now available] is increasingly trusted as the simple solution to standardized communications across the entire office-enterprise; from managing-risk, informing-patients and complying with modern regulatory requirements through enhanced patient-centric informed consent encounters.

Thus, by improving the consistency, details, documentation and effectiveness of the informed consent process, e-Podiatry Consent Forms™ equips all podiatric surgeons with the tools needed to augment quality standards, reduce litigation potential and improve patient outcomes and safety.

http://www.ePodiatryConsentForms.com

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ORDER NOW: http://www.ePodiatryConsentForms.com

Phone: 770-448-0769

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DEFINITION: Medical [Health] Informaticist?

WHAT IT IS?

By Staff Reporters

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FORMAL DEFINITION:

According to Wikipedia, Health informatics is the field of science and engineering that aims at developing methods and technologies for the acquisition, processing, and study of patient data, which can come from different sources and modalities, such as electronic health records, diagnostic test results, medical scans. The health domain provides an extremely wide variety of problems that can be tackled using computational techniques.

Health informatics is a spectrum of multidisciplinary fields that includes study of the design, development and application of computational innovations to improve health care. The disciplines involved combines medicine fields with computing fields, in particular computer engineering, software engineering, information engineering, bioinformatics, bio-inspired computing, theoretical computer science, information systems, data science, information technology, autonomic computing, and behavior informatics. In academic institutions, medical informatics research focus on applications of artificial intelligence in healthcare and designing medical devices based on embedded systems. In some countries term informatics is also used in the context of applying library science to data management in hospitals.

‘Clinical informaticians’ are qualified health and social care professionals and ‘clinical informatics’ is a subspecialty within several medical specialties.

What does it mean to be a medical or healthcare informaticist practitioner?

A medical or healthcare informaticist works to improve how we use information to improve health and healthcare. You can have medical informaticists who are of various specialties, like a nurse informaticist, dentist informaticist. There is even a board certification level in clinical informatics. Improving healthcare also means improving the work of healthcare professionals—not just improving patients’ health, but making things easier for physicians, nurses, and all the various healthcare workers.

What kind of information do MI and HI clinicians deal with?

Patient information that’s stored in our electronic health record (EHR). A lot of the work we do is just making sure that information is showing up in the right places and that it’s flowing from other sources—whether through referrals or the lab system or radiology—then making sure it’s easy to find and easy to use by treating clinicians.

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PHYSICIANS: Executive Fiduciary Coaching, Mentoring & Second Investment Advisory Opinions; etc

ACT NOW!

By Ann Miller RN MHA

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Career and Financial Planning

Career, Business and Personal Financial Planning is a great opportunity to get your practice, finances and budgets in order before life gets too busy.

CALL US TODAY TO GET STARTED: https://medicalexecutivepost.com/coach/

SECOND OPINIONS: https://medicalexecutivepost.com/schedule-a-consultation/

DR. MARCINKO: https://davidedwardmarcinko.com/coach/

“From Chaos to Calm”

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DENTAL DATA BREACH: Paper is Safer – It Always has Been!

By Darrell K. Pruitt DDS

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PAPER IS SAFER – IT ALWAYS HAS BEEN!

“9M dental patient records published following LockBit ransomware attack”

By Duncan Riley for Silicone Angle, May 30th, 2023
READ: https://siliconangle.com/2023/05/30/9m-dental-patient-records-published-following-lockbit-ransomware-attack/

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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!

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FIDUCIARY: Obtain an Unbiased 2nd Financial Advisory -or- Economic Practice Management Opinion

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Dr. David Edward Marcinko MBA CMP®

Certified Medical Planner®

SPONSOR: http://www.CertifiedMedicalPlanner.org

CMP logo

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FINANCIAL PLANNING

CAREER DEVELOPMENT

MEDICAL PRACTICE BUY IN / OUT

INVESTMENT ANALYSIS

PORTFOLIO MANAGEMENT

MERGERS AND ACQUISITIONS

PRACTICE APPRAISALS AND VALUATIONS

RETIREMENT PLANNING

FEE-ONLY

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CONTACT: Ann Miller RN MHA

EMAIL: MarcinkoAdvisors@msn.com

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PODCAST: Hospital Out Patient Pricing Explained

By Eric Bricker MD

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PHYSICIANS: Mentoring & Second Opinions

By Ann Miller RN MHA

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Career and Financial Planning

Career, Business and Personal Financial Planning is a great opportunity to get your practice, finances and budgets in order before life gets too busy.

CALL US TODAY TO GET STARTED: https://medicalexecutivepost.com/coach/

CALL FOR A SECOND OPINION: https://medicalexecutivepost.com/schedule-a-consultation/

DR. MARCINKO: https://davidedwardmarcinko.com/coach/

“From Chaos to Calm”

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ENVISION HEALTHCARE : KKR Backed and Bankrupt!

A”Surprise Billing” Maven

By Staff Reporters

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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. 

CITE: https://www.r2library.com/Resource

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.

READ: https://www.advisory.com/daily-briefing/2023/05/19/envision-bankruptcy#:~:text=On%20Monday%2C%20Envision%20Healthcare%20filed%20for%20Chapter%2011,%E2%80%94%20will%20be%20cancelled%2C%20totaling%20around%20%245.6%20billion.

MORE: https://www.brookings.edu/wp-content/uploads/2021/10/Private-Equity-Investment-As-A-Divining-Rod-For-Market-Failure-14.pdf

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STUDY: ChatGPT Out Performs Doctors?

Answering Patient Messages

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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.

READ: https://medcitynews.com/2023/04/chatgpt-ai-healthcare-patient-messaging/?utm_source=The+Medical+Futurist+Newsletter&utm_campaign=98c09c20fb-EMAIL_CAMPAIGN_2022_02_01_COPY_01&utm_medium=email&utm_term=0_efd6a3cd08-98c09c20fb-399696053&mc_cid=98c09c20fb&mc_eid=40fee31c25

I hope you will find our newsletter useful!

Best regards,
Bertalan Meskó, MD, PhD
The Medical Futurist

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RE-PODCAST: Financial Implications of Ozempic, Wegovy and Mounjaro

By Eric Bricker MD

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CITE: https://www.r2library.com/Resource

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PODCAST: Venture Capital in Healthcare VS. Boot Strapping

By Eric Bricker MD

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PODCAST: Physician’s Mental Health

Doctor Burnout According to Specialty

By Eric Bricker MD

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SOCIAL MEDIA: Dr. Vivek Murthy Warns on Children’s Mental Health

U.S. SURGEON GENERAL ADVISORY REPORT

By Staff Reporters

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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.

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U.S. DEBT CEILING DISCUSSIONS: No So Fast!

By Staff Reporters

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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.”

MORE: https://abcnews.go.com/Politics/biden-negotiate-directly-mccarthy-debt-ceiling-republicans-move/story?id=99490207

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.

MORE: https://www.theguardian.com/us-news/2023/may/23/first-thing-biden-and-mccarthy-hold-productive-debt-talks-but-no-deal-reached

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RIGHTS: Mental Health in America [Georgia]

MENTAL HEATH AMERICA

By Staff Reporters

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MENTAL HEALTH PARITY ACT

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. 

GA MENTAL HEALTH PARITY LAW: https://gov.georgia.gov/press-releases/2022-04-04/gov-kemp-provides-remarks-and-signs-mental-health-parity-act

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.

CITE: https://www.r2library.com/Resource/Title/082610254

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.

PROVIDERS: https://medicalexecutivepost.com/2022/10/05/a-review-of-mental-healthcare-provider-types/

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ORDER: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

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CELEBRATE: World Family Doctor Day 2023

By Staff Reporters

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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.

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ASPEN DENTAL: Cyber Attack with Data Breach

By Darrell Pruitt DDS

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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.

Related: https://www.pact-one.com/2023/05/aspen-dental-cyber-attack-1000-dental-practices-affected-nationwide/

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NIH: Meet the New Director Dr. Monica Bertagnolli MD

By Staff Reporters

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.

CITE: https://www.r2library.com/Resource

“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.”

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PODCAST: Healthcare Entrepreneur Playbook

By Eric Bricker MD

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Happy Birthday Florence Nightingale [203rd]

By Staff Reporters

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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.

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Other Health Care Stories

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PODCAST: Hospital CEO Compensation

By Eric Bricker MD

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UnitedHealth Group’s Physician Acquisition Efforts Accelerate

By Health Capital Consultants, Inc

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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

. CITE: https://www.r2library.com/Resource

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…)

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PHYSICIANS: Fiduciary Coaching, Mentoring & Second Opinions

By Ann Miller RN MHA

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Career and Financial Planning

Career, Business and Personal Financial Planning is a great opportunity to get your practice, finances and budgets in order before life gets too busy.

CALL US TODAY TO GET STARTED: https://medicalexecutivepost.com/coach/

CALL FOR A SECOND OPINION: https://medicalexecutivepost.com/schedule-a-consultation/

DR. MARCINKO: https://davidedwardmarcinko.com/coach/

“From Chaos to Calm”

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PODCAST: Financially Hospitals Must Survive

HOW TO SURVIVE?

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PODCAST: Health Insurance Prior Medical Authorization Rates Are Down

BUT MEANINGFUL?

By Eric Bricker MD

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CITE: https://www.r2library.com/Resource

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DEA Temporarily Extends Tele-Health Prescribing Flexibility

By Staff Reporters

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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.

Source: Heather Landi, Fierce Healthcare [5/3/23]

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e-BOOKS: For Doctors, Financial Advisors, CPAs, Insurance Agents, Medical Consultants and Health Law Attorneys

By Ann Miller RN MHA CMP

INTRODUCING OUR NEXT GENERATION e-BOOK LIBRARY FROM 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!

Payable thru PayPal [3% courtesy surcharge applies].

MORE HERE: https://medicalexecutivepost.com/me-pr-a-new-feature/

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Social Determinants of Health from Inside the Hospital System

SDOH

By Staff Reporters

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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.

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FORM ADV is a Must Read for Selecting a Financial “Advisor”

Form ADV – The Essential Document

Dr. David Edward Marcinko MBA - WEGO Health Awards Nominee

By Dr. David Edward Marcinko MBA CMP©

SPONSOR: http://www.CertifiedMedicalPlanner.org

CMP logo

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.

FIDUCIARY: https://medicalexecutivepost.com/2023/03/11/recast-an-interview-with-fiduciary-bennett-aikin-aif-2/

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.

CFP: https://medicalexecutivepost.com/2016/11/18/why-we-cannot-assume-cfp-equals-fiduciary/

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.

Form ADV | Moneygrow.com | Registered Investment Advisor ...

SEC Headquarters
100 F Street, NE
Washington, DC 20549
(202) 942-8088

TEXTBOOK ORDER: ORDER Textbook: https://www.amazon.com/Comprehensive-Financial-Planning-Strategies-Advisors/dp/1482240289/ref=sr_1_1?ie=UTF8&qid=1418580820&sr=8-1&keywords=david+marcinko

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

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Supreme Court Justices Hear False Claims Act Case

By Health Capital Consultants, LLC

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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.

Source: Sierra Sun Times [4/29/23]

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REQUEST A FIDUCIARY: Business, Financial or Management Second Opinion

By Ann Miller RN MHA

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Telephonic or electronic advice for medical professionals that is:

  • Objective, affordable, medically focused and personalized
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  • TOPICS: https://davidedwardmarcinko.com/coach/

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PODCAST: Confessions of a Hospital CFO

CHIEF FINANCIAL OFFICER

By Eric Bricker MD

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CITE: https://www.r2library.com/Resource/Title/0826102549

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USA: Cigarette Smoking is Down!

By Staff Reporters

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Cigarette smoking hits a record low in the USA

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.

Related: https://medicalexecutivepost.com/2020/09/04/the-economic-impact-of-lung-disease/

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.

CITE: https://www.r2library.com/Resource

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REQUEST A FIDUCIARY: Business, Financial or Management Second Opinion

By Ann Miller RN MHA

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Telephonic or electronic advice for medical professionals that is:

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  • Rendered by a pre-screened financial consultant or medical management advisor
  • Offered on a pay-as-you-go basis, by phone or secure e-mail transmission
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  • TOPICS: https://davidedwardmarcinko.com/coach/

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CELEBRATE: Medical Laboratory Professionals Week

APRIL 23-29, 2023

By Staff Reporters

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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.

READ: https://ascls.org/lab-week-mlpw/

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REQUEST A FIDUCIARY: Business, Financial or Management Second Opinion

By Ann Miller RN MHA

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Telephonic or electronic advice for medical professionals that is:

  • Objective, affordable, medically focused and personalized
  • Rendered by a pre-screened financial consultant or medical management advisor
  • Offered on a pay-as-you-go basis, by phone or secure e-mail transmission
  • Coaching and Mentoring
  • TOPICS: https://davidedwardmarcinko.com/coach/

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MORE HERE: https://medicalexecutivepost.com/schedule-a-consultation/

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ORDER: https://www.routledge.com/Comprehensive-Financial-Planning-Strategies-for-Doctors-and-Advisors-Best/Marcinko-Hetico/p/book/9781482240283

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VENTURE CAPITAL FUNDING: Slowing Down in Health Care!

By Staff Reporters

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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.

READ: https://www.healthcare-brew.com/stories/2023/02/21/digital-health-hesitancy?cid=30649741.22835&mid=349b552221c994e2540a304649746d7c&utm_campaign=hcb&utm_medium=newsletter&utm_source=morning_brew

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PODCAST: Physicians Need to Be Trained as Entrepreneurs and Encouraged to Innovate!

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By Kevin Pho MD

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“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.”

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PODCAST: https://kevinmd.libsyn.com/physicians-need-to-be-trained-as-entrepreneurs-and-encouraged-to-innovate

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BUSINESS MEDICINE: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?s=books&ie=UTF8&qid=1287563112&sr=1-9

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PODCAST: Future of Healthcare Profit Opportunities

By Eric Bricker MD

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Physician Assets, Liabilities and Personal Net Worth

How are Assets and Liabilities Related to Doctor Net Worth?

cropped-dem

Dr. David E. Marcinko MBA  

Before the relationship among financial assets, liabilities and net worth can be examined, some based definitions must be understood. 

LINK: http://www.CertifiedMedicalPlanner.org

[A] Short-Term Assets

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. 

CITE: https://www.r2library.com/Resource/Title/082610254

Conclusion

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Gifts that Violate the FCA Anti-kickback Statute

THE EIGHT [8] GIFTS

By Staff Reporters

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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.

FCA: https://medicalexecutivepost.com/2022/03/28/doj-recoveries-for-false-claims-act-cases-doubled-in-2021/

CITE: https://www.r2library.com/Resource

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

STARK LAWS: https://medicalexecutivepost.com/2023/04/18/podcast-the-anti-kickback-and-stark-laws-for-doctors-and-hospitals-explained/

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MEDICARE / MEDICAID: Physician Acceptance Down

By Staff Reporters

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Physicians Who Accept Medicare, Medicaid at All-time Low of 65%

Reduced Medicare and Medicaid payments are having more physicians considering reducing those patient bases, according to Medscape’s “Physician Compensation Report” for 2023. Sixty-five percent of physicians surveyed said they would continue treating current Medicare or Medicaid patients and take on new ones, according to the report. Medscape said it is the lowest percentage it has seen in its annual compensation reports. Five years ago, 71 percent of physicians said they would continue treating current Medicare or Medicaid patients and take on new ones. 

CITE: https://www.r2library.com/Resource

For the report, Medscape collected responses from 10,011 physicians across more than 29 specialties. The data was collected between Oct. 7, 2022, and Jan. 17, 2023. Eight percent of physicians surveyed said they would not take on new Medicare patients, and 5 percent said they would not take new Medicaid patients. Four percent said they will stop treating some or all of their current Medicare patients and will not take on new ones, and 3 percent said the same about Medicaid patients. Twenty-two percent said they have not yet decided how they will move forward regarding Medicare and Medicaid patients, according to the report. 

Source: Andrew Cass, Becker’s Payer Issues [4/18/23]

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PODCAST: Accounting Deception in Health Care

Examples of Exploitation and Deception?

BY ERIC BRICKER MD

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TERMS: https://medicalexecutivepost.com/2021/11/02/financial-terms-and-definitions-all-physician-should-know/

Triple Entry Accounting: https://medicalexecutivepost.com/2020/12/28/triple-entry-accounting/

HEALTH ECONOMICS CITE: https://www.r2library.com/Resource/Title/0826102549

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https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?s=books&ie=UTF8&qid=1287563112&sr=1-9

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https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

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PODCAST: Medical Practice Managers Stealing from Doctors!

By Eric Bricker MD

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MORE: https://medicalexecutivepost.com/2022/07/21/some-common-medical-practice-accounting-embezzlement-schemes/

CITE: https://www.r2library.com/Resource/Title/0826102549

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PODCAST: Investing in Digital Health Sales and Marketing

By Eric Bricker MD

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DHITS: https://www.amazon.com/Dictionary-Health-Information-Technology-Security/dp/0826149952/ref=sr_1_5?ie=UTF8&s=books&qid=1254413315&sr=1-5

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PODCAST: The Anti-Kickback and Stark Laws for Doctors and Hospitals Explained

By Eric BrickerMD

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