PUBLIC HEALTH EMERGENCY: Ends May 11th, 2023

By Health Capital Consultants, LLC

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On January 30th, 2023, President Joseph Biden announced that the public health emergency (PHE) and national emergency declaration related to the COVID-19 pandemic will finally end on May 11, 2023, after being in place for over three years.

And so, this Health Capital Topics article will discuss the changes that will take place after both declarations cease, and the implications for stakeholders.  (Read more…)

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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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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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USA nears DEFAULT while Europe INFLATES!

By Staff Reporters

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Treasury Secretary Janet Yellen warned yesterday that the US could run out of money to pay all its bills as early as June 1st if Congress does not raise or suspend the debt limit before then. The US’ first-ever default would be disastrous for financial markets, economists say.

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Meanwhile, Europe’s painful inflation has inched higher, extending the squeeze on households and keeping pressure on the European Central Bank to unleash what could be another large interest rate increase. Consumer prices in the 20 countries using the euro currency jumped 7% in April from a year earlier, just up from the annual rate of 6.9% in March, the European Union statistics agency Eurostat said today. Food price inflation eased a little, falling to an annual rate of 13.6% from March’s 15.5%, while energy prices rose a more modest 2.5%. Core inflation, which excludes volatile food and fuel, slowed slightly but was still high at 5.6%, underlining the expectation that the ECB will press ahead with its campaign to beat inflation into submission with rate hikes.

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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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BANKS: New Federal Reserve Rules?

Detailing Oversight Lapses

By Staff Reporters

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The Fed says it’s time for new bank rules

Just in time for a new looming bank failure, the Federal Reserve issued a 102-page report dissecting the corpse of Silicon Valley Bank. Meanwhile, FRB [First Republic Bank] FRB was just sold to JPMorgan Chase.

LINK: https://medicalexecutivepost.com/2023/05/01/daily-update-frb-bidding-sold-to-jpmorgan-chase/

The Fed pointed the finger at both its own inadequate supervision and the bank’s management.

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

And in an accompanying letter, Michael Barr, the Fed’s vice chair for supervision, called for stricter rules to be applied to more financial institutions and for more tools to be given to regulators to bring firms with poor capital planning and risk management into line.

MORE: https://www.wsj.com/articles/jpmorgan-pnc-bid-to-buy-first-republic-as-part-of-fdic-takeover-aeb936a0?mod=RSSMSN

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

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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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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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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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SVB: Grew from the Business Start-Up Ecosystem

By Staff Reporters

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DEFINITION: Startups are young companies or ventures that are founded to develop a unique or innovative product, service, or platform, and bring it to market. They are typically in the early stages of their development and face high uncertainty and failure rates. They are usually self-funded by the founders or seek external funding from investors or loans. They aim to grow large beyond the solo founder and disrupt existing industries or create new one.

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

SVB rooted in the startup ecosystem

SVB was relatively small—it had 40,000 customers compared to JPMorgan Chase’s 66 million—but it claimed to bank nearly half of all US tech and life sciences startups last year, including household names like Etsy, Roblox, and Roku. The cultural cachet of having a relationship with SVB as a venture-backed startup was like sporting a New Yorker tote at Whole Foods.

But the reason its loss will leave such a gaping hole in the startup community isn’t that it was cool to name-drop at a networking event. Because the bank was created in 1983 specifically to cater to venture-backed startups, it helped them in ways that most banks can’t—or won’t.

SVB chill loans: According to the MorningBrew, SVB would offer loans to startups more readily than large banks, basing the loans on a company’s ability to raise venture capital funds, not to turn a profit. SVB was also known for being flexible—even if startups breached their loan terms. “They were the easiest money for an unprofitable, early stage to mid-stage tech company,” Irving Investors founder Jeremy Abelson told The Information. And, even small startups received hand-holding services, such as guidance on how to set up their financial infrastructure. Its bankers personally called startups when they secured their first rounds of funding, according to The Information.

Startups now have to deal with big banks

Several founders who previously banked with SVB told Bloomberg that they’re moving their money to Chase and Bank of America, banks considered “too big to fail.”

Startups’ experience at big banks won’t be like their time at SVB. Not only is Jamie Dimon unlikely to call a startup to congratulate them on their Series A, but big banks are also expected to be more tight-fisted with their loans. The Office of the Comptroller of the Currency, a regulator that oversees large US banks, disapproves of loans to companies that are further out than one year from profitability, according to Crunchbase.

The loss of SVB is therefore expected to have a chilling effect on loans to venture-backed startups, aka “venture debt,” which SVB handed out more of than any other bank.

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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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DAILY UPDATE: Business News Briefs Plus TESLA and the Markets

By Staff Reporters

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1. Regional banks’ plight was Morgan Stanley’s perk. The bank saw nearly $20 billion in new client assets in the wake of the banking crisis that rocked smaller banks like First Republic. Why the bank became a “destination of choice” amid the crisis.

2. Taylor Swift was the only one asking the right question on FTX. The mega star didn’t sign a $100 million sponsorship deal with the crypto exchange because, unlike seemingly everyone in Silicon Valley, she did some form of due diligence.

3. The new-age pension plan. Fidelity and State Street are rolling out annuity options within their 401(k) products, The Wall Street Journal reports. But it comes with a hefty price tag, and not everyone is sold on it.

4. It’s starting to get scary in the housing market. Foreclosure filings were up 22% in Q1 compared to last year, and repossessions are headed in the wrong direction as well.

Finally, Fintel reports that on April 21, 2023, Goldman Sachs maintained coverage of Tesla (NASDAQ:TSLA) with a Buy recommendation. As of April 6th, 2023, the average one-year price target for Tesla is $203.14. The forecasts range from a low of $24.58 to a high of $315.00. The average price target represents an increase of 24.63% from its latest reported closing price of $162.99. The projected annual revenue for Tesla is $118,517MM, an increase of 37.75%. The projected annual non-GAAP EPS is $5.70.

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

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  • The S&P 500® Index was up 3.52 points (0.1%) at 4137.04; the Dow Jones industrial average was up 66.44 (0.2%) at 33,875.40; the NASDAQ Composite was down 35.25 (0.3%) at 12,037.20.
  • The 10-year Treasury yield was down about 7 basis points at 3.50%.
  • CBOEs Volatility Index was up 0.12 at 16.89.

Real estate and financials were among Monday’s weakest-performing sectors, while energy companies led gainers thanks to a jump of about 1% in crude oil futures. The U.S. dollar index fell to about 101.37, its weakest level since mid-April, while Treasury yields eased slightly.

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CITE: 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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Post MVA: GO FUND ME for Kirby “Sasha” Fenton

Post M.V.A.

Dr. Charles F. Fenton

My son, Kirby “Sasha” Fenton sustained a devastating medical injury in a motor vehicle accident on January 16, 2018 in Marietta, GA.

As of this writing, he had surgery last night and has additional surgery planned for this morning (due to blood loss during the first surgery). Additional surgeries are expected. He will be in Wellstar Kennestone Hospital for at least a week and then will be transferred to a rehabilitation facility for an extended period of time.

He is NOT expected to make a full recovery. He will have permanent, significant disability.

Sasha needs funds for (1) medical expenses, (2) legal expenses connected to the accident, (3) rehabilitation expenses, and (4) most especially expenses relating to his transitioning to his life as a disabled person – this is really where he needs the bulk of funds.

Marietta Daily Journal Article: http://www.mdjonline.com/news/police-marietta-teen-thrown-from-motorcycle-after-passing-cars/article_c6a53874-fb02-11e7-a34c-8325493600cf.html

Sasha will appreciate your generosity.

Thank You

https://www.gofundme.com/kirby-sasha-fenton-rehab-fund

EDITOR’S DISCLOSURE: Dr. Fenton is a friend, colleague and frequent contributor to this ME-P, as well as our textbooks and related white-papers.

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QUOTE: Sam Bankman-Fried’s Alleged Messages

By Staff Reporters

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FTX is a cryptocurrency exchange that was launched in 2018. It specializes in trading products such as derivatives, leveraged tokens, options, and volatility products. It supports most commonly traded cryptocurrencies and is powered by a top liquidity provider. FTX stands for Futures Exchange, a market where users can invest in commodities and foreign exchange.

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

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Quote: “We sometimes find $50m of assets lying around that we lost track of; such is life.”

The sudden collapse of FTX might have been a lot less surprising if you’d been privy to Sam Bankman-Fried’s messages to his fellow executives.

According to a report by the bankrupt crypto exchange’s new management, SBF allegedly found the company’s lack of proper accounting amusing. The report says he described the company’s related hedge fund Alameda Research as “hilariously beyond any threshold of any auditor being able to even get partially through an audit” and joked about misplacing millions.

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WOMEN: Gaining Economic Earnings Influence

Physician Salary Pay Gap Comparisons

By Staff Reporters

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Physician Salary Pay Gap Follow-Up: https://medicalexecutivepost.com/2023/04/14/physician-salary-pay-gap/

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Women earn as much as or more than their husbands in just under half of US opposite-sex marriages, a significant advancement for economic equality from past decades, according to a new Pew Research study.

  • Sixteen percent of wives in opposite-sex marriages are the sole or primary breadwinners in their home (“primary” meaning they make more than 60% of the household’s income). This share is triple the 5% of women breadwinners from 50 years ago.
  • In 29% of marriages, both spouses bring home about the same income.

But, according to MorningBrew, in marriages where both partners have the same income, women spend about four-and-a-half more hours per week on chores and care giving than men.

And when women become the house’s primary income earner, little really changes about how much time either partner spends on chores, Pew found. But in this scenario, men report almost five more hours of leisure time per week than men in egalitarian households

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

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

By Eric BrickerMD

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ORDER: https://www.amazon.com/Financial-Management-Strategies-Healthcare-Organizations/dp/1466558733/ref=sr_1_3?ie=UTF8&qid=1380743521&sr=8-3&keywords=david+marcinko

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BEYOND: Advance Care Planning for Financial Advisors & Lawyers from Doctors on April 16-17th.

APRIL 17th. IS NATIONAL HEALTHCARE DECISION DAY 2023

By Dr. David Edward Marcinko MBA CMP

SPONSOR: http://www.CertifiedMedicalPlanner.org

Staff Reporters via National Institute of Health

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National Healthcare Decisions Day (NHDD) exists to inspire, educate and empower the public and providers about the importance of advance care planning. NHDD is an initiative to encourage patients to express their wishes regarding healthcare and for providers and facilities to respect those wishes, whatever they may be.

NHDD was founded in 2008 by Nathan Kottkamp, a Virginia-based health care lawyer, to provide clear, concise, and consistent information on healthcare decision-making to both the public and providers/facilities through the widespread availability and dissemination of simple, free, and uniform tools (not just forms) to guide the process.

NHDD is a series of independent events held across the country, supported by a national media and public education campaign. In all respects, NHDD is inclusive and brings a variety of players in the larger healthcare, legal, and religious community together to work on a common project, to the benefit of patients, families, and providers. A key goal of NHDD is to demystify healthcare decision-making and make the topic of advance care planning inescapable. Among other things, NHDD helps people understand that advance healthcare decision-making includes much more than living wills; it is a process that should focus first on conversation and choosing an agent.

As of June 2016, The Conversation Project has been responsible for the management, finances, and structure of NHDD.  NHDD’s founder, Nathan Kottkamp, continues to be involved in NHDD and provides leadership by ensuring the maintenance of NHDD’s high quality resources and support for the community.

Read more about NHDD’s founding: https://theconversationproject.org/nhdd/origins/

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DEFINITION: What is advance care planning for financial advisors and lawyers?

Advance care planning involves discussing and preparing for future decisions about your medical care if you become seriously ill or unable to communicate your wishes with your estate planning attorney or financial advisor. Having meaningful conversations with your loved ones is the most important part of advance care planning. Many people also choose to put their preferences in writing by completing legal documents called advance directives.

What are advance directives?

Advance directives are legal documents that provide instructions for medical care and only go into effect if you cannot communicate your own wishes.

The two most common advance directives for health care are the living will and the durable power of attorney for health care.

  • Living will: A living will is a legal document that tells doctors how you want to be treated if you cannot make your own decisions about emergency treatment. In a living will, you can say which common medical treatments or care you would want, which ones you would want to avoid, and under which conditions each of your choices applies. Learn more about preparing a living will.
  • Durable power of attorney for health care: A durable power of attorney for health care is a legal document that names your health care proxy, a person who can make health care decisions for you if you are unable to communicate these yourself. Your proxy, also known as a representative, surrogate, or agent, should be familiar with your values and wishes. A proxy can be chosen in addition to or instead of a living will. Having a health care proxy helps you plan for situations that cannot be foreseen, such as a serious car accident or stroke. Learn more about choosing a health care proxy.

Think of your advance directives as living documents that you review at least once each year and update if a major life event occurs such as retirement, moving out of state, or a significant change in your health.

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

Who needs an advance care plan?

Advance care planning is not just for people who are very old or ill. At any age, a medical crisis could leave you unable to communicate your own health care decisions. Planning now for your future health care can help ensure you get the medical care you want and that someone you trust will be there to make decisions for you.

  • Advance care planning for people with dementia. Many people do not realize that Alzheimer’s disease and related dementias are terminal conditions and ultimately result in death. People in the later stages of dementia often lose their ability to do the simplest tasks. If you have dementia, advance care planning can give you a sense of control over an uncertain future and enable you to participate directly in decision-making about your future care. If you are a loved one of someone with dementia, encourage these discussions as early as possible. In the later stages of dementia, you may wish to discuss decisions with other family members, your loved one’s health care provider, or a trusted friend to feel more supported when deciding the types of care and treatments the person would want.

What happens if you do not have an advance directive?

If you do not have an advance directive and you are unable to make decisions on your own, the state laws where you live will determine who may make medical decisions on your behalf. This is typically your spouse, your parents if they are available, or your children if they are adults. If you are unmarried and have not named your partner as your proxy, it’s possible they could be excluded from decision-making. If you have no family members, some states allow a close friend who is familiar with your values to help. Or they may assign a physician to represent your best interests. To find out the laws in your state, contact your state legal aid office or state bar association.

Will an advance directive guarantee your wishes are followed?

An advance directive is legally recognized but not legally binding. This means that your health care provider and proxy will do their best to respect your advance directives, but there may be circumstances in which they cannot follow your wishes exactly. For example, you may be in a complex medical situation where it is unclear what you would want. This is another key reason why having conversations about your preferences is so important. Talking with your loved ones ahead of time may help them better navigate unanticipated issues.

There is the possibility that a health care provider refuses to follow your advance directives. This might happen if the decision goes against:

  • The health care provider’s conscience
  • The health care institution’s policy
  • Accepted health care standards

In these situations, the health care provider must inform your health care proxy immediately and consider transferring your care to another provider.

Other advance care planning forms and orders from doctors

You might want to prepare documents to express your wishes about a single medical issue or something else not already covered in your advance directives, such as an emergency. For these types of situations, you can talk with a doctor about establishing the following orders:

  • Do not resuscitate (DNR) order: A DNR becomes part of your medical chart to inform medical staff in a hospital or nursing facility that you do not want CPR or other life-support measures to be attempted if your heartbeat and breathing stop. Sometimes this document is referred to as a do not attempt resuscitation (DNR) order or an allow natural death (AND) order. Even though a living will might state that CPR is not wanted, it is helpful to have a DNR order as part of your medical file if you go to a hospital. Posting a DNR next to your hospital bed might avoid confusion in an emergency. Without a DNR order, medical staff will attempt every effort to restore your breathing and the normal rhythm of your heart.
  • Do not intubate (DNI) order: A similar document, a DNI informs medical staff in a hospital or nursing facility that you do not want to be on a ventilator.
  • Do not hospitalize (DNH) order: A DNH indicates to long-term care providers, such as nursing home staff, that you prefer not to be sent to a hospital for treatment at the end of life.
  • Out-of-hospital DNR order: An out-of-hospital DNR alerts emergency medical personnel to your wishes regarding measures to restore your heartbeat or breathing if you are not in a hospital.
  • Physician orders for life-sustaining treatment (POLST) and medical orders for life-sustaining treatment (MOLST) forms:These forms provide guidance about your medical care that health care professionals can act on immediately in an emergency. They serve as a medical order in addition to your advance directive. Typically, you create a POLST or MOLST when you are near the end of life or critically ill and understand the specific decisions that might need to be made on your behalf. These forms may also be called portable medical orders or physician orders for scope of treatment (POST). Check with your state department of health to find out if these forms are available where you live.
  • MORE: https://www.kevinmd.com/2023/04/april-16th-is-national-healthcare-decisions-day-plan-for-your-end-of-life-care-now.html

Medicare Enrollment at CMS?

At enrollment, Medicare in the future could offer three advance directives with goals of care: Directive A: CONSENT to treat — inpatient medical treatment Directive B: CONSENT to comfort — home bound holistic care Directive C: CHOOSE against medical advice — outpatient palliative resources.

CITE: https://www.kevinmd.com/2023/04/the-heartbreaking-story-of-jimmy-carter-a-call-for-medicare-reform-in-end-of-life-care.html

You may also want to document your wishes about organ and tissue donation and brain donation. As well, learning about care options such as palliative care and hospice care can help you plan ahead.

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Healthcare Leadership V.S. Management

Understanding the Difference

[By Dr. David Edward Marcinko MBA]

DEM blueMany times, individuals will use the terms management and leadership synonymously. In actuality the terms have significantly different meanings.

For example, Warren Bennis describes the difference between managers and leaders as “Managers do things right, Leaders the right thing.”

Managers are those individuals who have as their primary function managing a team of people and their activities. In effect, managers are those who have been given their authority by the nature of their role and ensure that the work gets done by focusing on day to day tasks and their activities.

On other hand, a leader’s approach is generally innate in its approach. Good leadership skills are difficult to learn because they are far more behavioral in nature than those skills needed for management. Leaders are also very focused on change recognizing that continual improvement can be achieved in their people and their activities can be a great step towards continued success.

Training Camps

Perhaps some of the best training grounds for the development of leaders are the military. The Marine Corps slogan is “A Few Good Men” and the military academies at Annapolis (Navy), New London, Connecticut (Coast Guard), Colorado Springs (Air Force), and West Point (Army) all have as their main mission, the development of leaders.

This is done by a number of different techniques. At graduation, the new officers, regardless of the branch of service, have been taught, and more importantly, have internalized the following: communicate the missions, sensitivity matters, real respect is earned, trust and challenge your soldiers. It is due to these lessons that many graduates of the military academies go on to positions of leadership in the private sector as well as in government.  Communicating the mission refers to conveying to those who work with us what are practice is hoping to accomplish and the role of each employee in achieving that goal. Given an understanding and awareness of the mission, when confronted with a barrier, employees are able to face hard problems when there is no well-defined approach by which to deal with them.

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IRA advice and leadership

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Sensitivity Does Matter

This is my area to improve; as I can be glib on occasion.

A leader treats each employee with respect and dignity, regardless of race, gender, cultural background or particular role they actually perform in the practice. Consider how many legal suits are filed against any type of organization, whether it is a medical practice or a large manufacturing facility due to perceived disparate treatment towards the employee based on race, religion, gender sexual preference or other non-work related issues.

Real respect is earned – Having initials after one’s name and the wearing of a lab coat does not automatically entitle an individual to respect. Formal authority has been found to be one of the least effective forms of influence. Only by earning the respect of your staff as well as your patients can you be sure that your intent will be carried out when you are not present. Setting the example in performance and conduct, rather than ‘do as I say, not as I do,” level of activity enables one to exert influence far greater than titles.

Trust and challenge your employees – How many times have practices sought to hire the best and brightest only to second guess the employee. Eric Schmidt, the CEO of Google, describes his management philosophy as having “… an employee base in which everybody is doing exactly what they want every day.” Obviously there are certain policies and procedures, but at the same time, the leader enables decision making to the lowest possible level. This also enables employees to question why certain policies and procedures are still being followed when more effective and efficient methods are available.  (How the Army Prepared Me to Work at Google, Doug Raymond, Harvard Business)

The phrase “Physician, heal thyself” (Luke 4:23, King James Version) means that we have to attend to our own faults, in preference to pointing out the faults of others. The phrase alludes to the readiness of physicians to heal sickness in others while sometimes not being able or will to heal themselves.

By the same token, it now is necessary for us to learn how to manage ourselves. It suggests that physicians, while often being able to help the sick, cannot always do so, and when sick themselves are no better placed than anyone else (Gary Martin, phrases.org.uk/meanings/281850.html, 2010).

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Feet

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Self-Development

“We will have to learn how to develop ourselves. We will have to place ourselves outside the boundaries where we can make the greatest contribution. And we will have to stay mentally alert and engaged during a 50-year working life, which means knowing how and when to change the work we do” (Managing Oneself, Harvard Business Review – Jan. 2005 – pp 100-109, by Peter Drucker).

Although one’s IQ and certain personality characteristics are more or less innate and appear to remain stable over time there are individual capabilities that enable leadership and can be developed. Enhancement of these capabilities can lead to the individual being able to carry out the leadership tasks of setting direction, gaining commitment, and creating alignment. These capabilities include self-management capabilities, social capabilities and work facilitation capabilities.

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Assessment

Without question, while it is possible to cram for at test and graduate at the top of one’s class, that does not assure   leadership ability. We all know at least one person who scores at the highest levels on cognitive measures but would be incapable of pouring liquid out of a boot if the instructions were written on the heel.

So, here is my philosophy:

  • Leadership: By example and thru transparency with collaboration [Do the right thing]
  • Management: By walking-around thru tangible / intangible metrics [Doing things right].

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HEALTH INSURANCE: Impact of Insurance on Lower ExtremityAmputations

By Staff Reporters

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A significant study recently published in the Annals of Vascular Surgery has uncovered a troubling correlation between loss of health insurance coverage and increased risk of amputation. Led by Dr. Tze Woei Tan, a vascular surgeon and associate professor, the research team from the University of Arizona and Keck School of Medicine of USC, which includes co-senior author Dr. David G. Armstrong, a podiatric surgeon and professor of surgery, brings attention to this important issue. Titled “The Impact of Health Insurance Loss on Amputation Rates in the United States,” the study highlights the consequences of losing insurance coverage. 

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

Researchers examined a large cohort of patients at risk of peripheral artery disease (PAD) and diabetic foot complications, noting that those without insurance were more likely to experience amputation. The study found that individuals who lost their insurance coverage were 2.5 times more likely to undergo a major amputation compared to those with continuous coverage. This striking difference emphasizes the importance of consistent access to healthcare and the potential consequences of gaps in insurance.

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OPINIONS: Stock Markets VERSUS Economic Vision?

What is Your Opinion?

By Staff Reporters

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  • Markets: Stocks ran on a treadmill yesterday as investors waited for the high-stakes inflation report to drop this morning. Major cryptocurrencies have emerged as the biggest winners of 2023 so far, and Bitcoin topped $30,000 for the first time in 10 months.
  • Dueling economic visions: Depending on who you ask, the economy is doing just fine…or it’s about to slow down dramatically. Treasury Secretary Janet Yellen said yesterday that “the US economy is obviously performing exceptionally well.” But that’s not obvious at all to the IMF, which predicted weak global growth this year and gave its gloomiest five-year economic forecast since 1990.
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Corporate Moves in Healthcare Continue to Disrupt the Industry

By Health Capital Consultants LLC

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Instead of waiting on regulatory reform, corporate America has sought to disrupt the healthcare industry over the last few years, by streamlining the delivery of healthcare (and associated costs) and taking advantage of technological advancements.

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

This entrepreneurial approach to problem-solving may provide meaningful competition to traditional healthcare organizations, which may result in higher quality, more affordable healthcare. Some of the biggest companies in the U.S. – CVS Health, Walgreens, Amazon, Walmart, and Best Buy – are expanding their healthcare empires through acquisitions and other strategic moves. (Read more…) 

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Coordinated Actions Indicate Growing Scrutiny of Tele-Medicine

By Health Capital Consultants, LLC

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GROWING SCRUTINY OF TELE-MEDICINE

On July 20, 2022, the Office of Inspector General (OIG) of the U.S. Department of Health & Human Services (HHS) released a Special Fraud Alert on telemedicine. On the same day, the U.S. Department of Justice (DOJ) announced a “nationwide coordinated law enforcement action” against 36 defendants, and the Centers for Medicare & Medicaid Services (CMS) Center for Program Integrity announced administrative actions against 52 providers, related to alleged telemedicine arrangements. These coordinated actions indicate a growing scrutiny of telemedicine arrangements by federal government regulators. (Read more...) 

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PODCAST: Healthcare Brokers in Cars

By Eric Bricker MD

Price and Quality Transparency Data

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CMS: “Open Payments” Pre-Publication Review & Dispute

NOW AVAILABLE

By Staff Reporters via CMS

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Open Payments is a national disclosure program that promotes a transparent and accountable healthcare system. Open Payments houses a publicly accessible database of payments that reporting entities, including drug and medical device companies, make to certain healthcare providers, which are referred to as covered recipients.

Pre-publication review and dispute for the Program Year 2022 Open Payments data opened on April 1st and is available through May 15th, 2023. Disputes must be initiated by May 15th, 2023 in order to be reflected in the June 2023 data publication. 

CITE: https://www.r2library.com

For more information on review and dispute timing and publication, refer to the Review and Dispute Timing and Data Publication Quick Reference Guide.

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WORLD HEALTH ORGANIZATION: World Health Day

Happy 75th Birthday

By Staff Reporters

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It’s World Health Day and the 75th birthday of the World Health Organization (WHO). Thanks to the WHO, we have almost eradicated diseases like polio and smallpox, and the organization led the largest-ever response to a global health crisis against the Covid-19 pandemic.

So, why not Celebrate this World Health Day by taking care of yourself? It doesn’t have to be tough or uninteresting to eat a well-balanced, nutrient-dense diet, reduce alcohol intake or go for a walk or other exercise. And, stick around for next year!

READ: https://www.who.int/westernpacific/news-room/events/detail/2023/04/07/western-pacific-events/world-health-day-2023

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FDIC: Lifting the Insurance Deposit Cap?

By Staff Reporters

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Understanding FDIC insurance limits

The FDIC wants to make sure it can cover everyone with a bank account, so to make that happen, it caps how much money it insures. The FDIC says its standard is to cover up to “$250,000 per depositor, per insured bank, for each account ownership category.

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

Here’s an example: Let’s say you have $100,000 in your checking account and $150,000 in your savings, all at the same bank. The FDIC classifies those under the same category: single accounts. So you would have hit your FDIC deposit limit. Every additional cent deposited into either account would be uninsured. But if you have money in other banks or other deposit categories, you may have additional coverage.

Could the insured deposit cap get a lift?

At least four US lawmakers—two from each side of the aisle—said they would support raising the cap on FDIC-insured deposits in order to reassure frazzled bank customers that their deposits are safe. The current cap is $250,000 (up from $100k pre-financial crisis), but Democratic Sen. Elizabeth Warren said bumping it up “is a good move.” Opponents of raising the cap say it would only increase risk-taking and bad behavior by banks. Some even argue we should lower it.

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PODCAST: The CXO “Rapid Resolutions Team” in Health Insurance

CLAIMS DENIED

By Eric Bricker MD

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Libertarian’s (Unexpected) View on the Bailout of the Banking System

By Vitaliy Katsenelson CFA

CLICK PHOTO FOR FULL REPORT

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HOW: The ME-P Helps Your Financial Advisory Business or Medical Practice Grow?

All about the Medical Executive-Post Business Model

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One of the questions we receive most often from readers of the Medical Executive-Post is how can we “afford” to give away so much content for free. Or stated another way, “how do we get paid for all of this?”

The simple answer is that we know many (or even most) of you will simply take the ideas that we share and implement them yourself. Do-It-YourSelfers can always simply purchase our texts, books and peer reviewed handbooks redacted in more than a thousand, medical, law, business and graduate schools, as well as the Library of Congress, Institute of Health and Library of Congress.

LINK: https://medicalexecutivepost.com/2021/10/22/why-are-certified-medical-planner-textbooks-so-darn-popular/

On the other hand, some of you will realize you need some additional help.

For example:

Maybe as a financial advisor you’re “stuck” in your financial planning business and recognize that some outside assistance is necessary to help you get to the next level of niche specificity thru our Certified Medical Planner™ chartered certification program designation. Helping physicians of all specialty types in a fiduciary focused manner is the proverbial Win-Win for all concerned.

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OR, perhaps you are seeking a glossary of terms and definitions in heath economics, finance, accounting, insurance, managed care, health information technology and security; found in our Health Dictionary Series Wiki Project? Free and print versions are available.

LINK: http://www.HealthDictionarySeries.org

LINK: https://medicalexecutivepost.com/2011/09/17/order-our-three-newest-best-selling-dictionaries/

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OR, as a doctor maybe your medical practice is growing so much you just hit a wall where you don’t have time to do it all for your patients. After all, with only “so much” time available every day and week, it’s vital to delegate or outsource anything that isn’t really core to your practice and management skill set.

LINK: http://www.MedicalBusinessAdvisors.com

OR, maybe you are even starting, buying or selling your medical practice and need our financial and valuation services. Part (1) – Part (2) – Part (3) Financial, estate, investing and retirement planning services are also available.

OR, you may just need a second informed opinion about a topic not listed; there are a myriad of issues to consider in the competitive ecosystem today.

LINK: https://medicalexecutivepost.com/schedule-a-consultation/

Regardless, we may have solutions to help!


So, in the meantime, I hope that the ME-P content continues to be helpful food for thought, and perhaps we’ll have an opportunity to cross paths soon at a future conferences or podcasts. Feel free to invite us to speak at your own seminar/podcast online V-log, as well.

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email: MarcinkoAdvisors@msn.com

Phone: 770-448-0769

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WORKPLACE SAFETY: 10 Rules and Guidelines

WORKPLACE MEDICAL VIOLENCE

By Staff Reporters

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Workplace safety is no joke. Slips and trips can lead to a hospital visit—though at least it’s a quick commute for healthcare workers in states with high rates of workplace injuries. In fact, Maine, Oregon, and Vermont had the highest rates of nonfatal workplace accidents and injuries, according to an analysis shared with Healthcare Brew via email of 2021 US Bureau of Labor Statistics data compiled by High Rise Financial, a pre-settlement legal funding company.

What do these states also have in common? According to HealthcareBrew, nursing, ranked within the top 10 most popular professions in each state.

Maine had the highest rate of workplace accidents: 4.7 out of every 100 full-time workers in the state were involved in a nonfatal workplace accident in 2021, High Rise Financial found. That is 67.9% higher than the country’s yearly average. In 2021, 30,270 of the 592,000 registered employees in Maine were home healthcare workers or registered nurses. MaineHealth was the state’s largest private employer in 2021 with approximately 20,500 employees, per the Maine Center for Workforce Research and Information. But the state’s high accident rate isn’t a failure—it suggests that Maine workers are reporting accidents and injuries before they become more serious and require workers’ compensation, Maine Public Radio reported. The most recent data from 2011 shows that workers’ compensation losses cost hospitals nationwide $2 billion, the Occupational Safety and Health Administration found.

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

If tedious workplace safety rules sound like a pain, try having an accident. “Slips, trips, and falls,” especially without a wet floor warning sign, are the top causes of workplace accidents that are eligible for pre-settlement funding, according to the High Rise Financial analysis. Even a small slip could lead to a back injury, a broken bone, or a concussion—no banana peel needed.

It’s not all doom and gloom: The CDC has generously curated a list of songs with workplace safety and health themes to liven up your nine-to-five. Just be sure to wear nonslip shoes if you feel like dancing.

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Workplace Violence: https://medicalexecutivepost.com/2022/12/08/medical-workplace-violence-prevention-guidelines/

Related: https://medicalexecutivepost.com/2022/09/23/assessment-of-workplace-violence-in-healthcare/

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Valuation of Medicare Advantage Plans and the Competitive Environment

By Health Capital Consultants, LLC

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Medicare Advantage (MA) plans, also known as Part C plans, serve as a supplement or an alternative to Original (also called Traditional) fee-for-service (FFS) Medicare Part A and Part B coverage, but they are still part of the Medicare program.

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

Most of these plans also include Part D (drug) coverage. MA was created by Congress to offer seniors an alternative to Original Medicare – with an emphasis on treating and managing the health of the whole patient. MA plans are offered to Medicare beneficiaries by Medicare-approved private companies, known as MA Organizations (MAOs), that must follow rules set by Medicare. (Read more…) 

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DAILY UPDATE: Charles Schwab and the Major Market Indices

By Staff Reporters

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Analysts at Morgan Stanley downgraded Charles Schwab Corp (NYSE: SCHW) on Tuesday, citing concerns over cash sorting and regulatory changes. But, Schwab CEO Walt Bettinger recently said that the company’s banking unit had enough liquidity to cover if 100% of its bank deposits ran off without having to sell a single security — Morgan Stanley says otherwise. Schwab’s recent performance has not been up to Morgan Stanley’s expectations, with customers moving cash out of sweep accounts into money market funds at a rate twice that which the bank had been modeling.

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

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Here’s how the major indexes performed Thursday.

  • The S&P 500® Index rose 23 points (0.57%) to 4050.84; the Dow Jones industrial average was up 141 points (0.43%) at 32859.03; the NASDAQ Composite was up 87 points (0.73%) at 12013.47.
  • The 10-year Treasury yield slipped 2 basis points to 3.555%.
  • CBOE’s Volatility Index was little changed at 19.14.

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Understanding Financial Broker and Advisor Licenses

Image result for sec

Series #65 VS Series #7

By Dr. David Edward Marcinko MBA

When I am approached by a prospective client, the question they always ask without fail is “Are you properly licensed?” This is actually the wrong question to ask. The right question should be, “Which license do you have?”

The Types of Licenses

Generally, there are two types of licenses for people who call themselves a “financial advisor.” People who passed the series #65 test and people who passed the series #7 test. The nature of these two licenses is as far apart as heaven and earth.

The Securities License

Series #7 is a securities license. People who have passed this test can legally be a stock-broker. They are actually prohibited by law to give financial advice, except incidental to the financial products they are selling.

A financial advisor with a series #7 license can receive third party payments like kickbacks, commissions etc in conjunction with the products they sell you. They are not required to put your interest first as they are not your fiduciary. Legally they abide by a much lenient “suitability standard.” That is, if they think the product is suitable for you, irrespective of the cost, they are legally off the hook.

All of Morgan Stanley, Merrill Lynch and other Wall Street firms’ financial advisors are required to pass the series 7# license.

The Advisor License

Series #65 is an advisor license. People who have passed this test are legally called registered investment advisors or RIA representative. An RIA representative’s compensation is in the form of fees paid directly by the client. He or She is prohibited to receive any third party payment unless disclosed to and approved by the client first.

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Wall Street

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Assessment

When searching for a financial advisor, it’s crucial to find out what licensure he or she has. Do not use a stock-broker as your financial advisor – unless you’re in the habit of letting you friendly neighborhood used car salesman hand pick your vehicle purchases.

More:

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

PODCAST: Hospitals Co-Ordinate Care for Medicare Patients

USUALLY NOT PRIVATE INSURERS!

By Eric Bricker MD

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The DENTA-VERSE [A Dental Web 3.0 & Virtual Reality Community

Connecting the future of dentistry in 3D

By Staff Reporters

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Dentaverse was born in the heart of Europe between young professionals. A combination of Dental, Finance, 3D and web professionals coming together to connect dental dots. In doing so Dentaverse has grown in to a deep integration of dental know-how and innovative technologies like: Metaverse (VR), blockchain, web3 tech and education.

Accelerating personal and professional growth by connecting dental students, universities, professionals and suppliers in virtual reality.

WEBSITE: https://www.dentaverse.io/

Related: Google Health rolls out new tech offerings to improve access to care, health outcomes

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CELEBRATE: National Physician’s Week 2023

By Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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This National Physicians Week, from March 25–31, we can show doctors we appreciate them as much as they deserve with creative gifts, simple notes, and appreciation posts online.

Doctors deal with years of school, grueling shifts, and emotionally difficult decisions, and still manage to care for us with focus and kindness. Physicians drastically improve the duration and quality of life for everyone, and throughout history have done their best to use cutting-edge science to care for others.

Physician appreciation is also symbolized by a red carnation, so be sure to bring one to your favorite doc this week!

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Here Are the Top Ten Ways To Celebrate National Physicians Week in 2023:

  1. Send a doctor red carnation and/or gift of your choice to show appreciation.
  2. Host a Zoom or virtual celebration.
  3. Doctors can take the day off (If the schedule permits)
  4. Record and post a video to show gratitude for your doctor and physicians nationwide.
  5. Encourage others and spread the word about National Physicians Week on and offline.
  6. Write or share an article about National Physicians Week.
  7. Offer product or service discounts to doctors.
  8. Host an office party to celebrate staff physicians.
  9. Plan a happy hour or networking event for physicians and the community.
  10. Send red carnations and or/greeting cards.

READ: https://www.physiciansworkingtogether.org/national-physicians-week

LOCUM: https://www.locumjobsonline.com/blog/week-remember-showing-appreciation-doctors-physicians-week/

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PODCAST: Doctor MEDICAL Specialty Rankings

The R.O.A.D. to Happiness?

By Eric Bricker MD

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