Anxiety, Depression, Love and More!
[By staff reporters]
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[By staff reporters]
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By Staff Reporters
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Finally, telephonic, video or electronic advice for medical professionals that is:
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Second Opinions: https://medicalexecutivepost.com/schedule-a-consultation/
Coaching: https://medicalexecutivepost.com/coach/
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Altered and Poorly Written Rx for Vicodin
By Dr. David Edward Marcinko MBA
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Poorly-written Rx for vicodin
Drug: Rx Vicodin
Disp: # 10
Sig: Take I, as needed for pain.
Refills: 1 2 3 4 or 5
AM2685591
David Edward Marcinko, MBBS DPM MBA
The patient abuser may change drug quantity numbers, copy or remember the doctors’ DEA number, or take extra Rx pads. For this reason, a physician’s Rx pad should contain his/her name, address and telephone number. The doctor’s DEA number should not be pre-printed on the pad, for fear of mis-use.
Example:
Altered Rx for vicodin
Drug: Rx Vicodin
Disp: # 100
Sig: Take II, as needed for pain.
Refills: 1 2 3 4 or 5
AM2675591
David Edward Marcinko, MDBBS DPM MBA
The doctor drug addict, or a doc in need of funds, may write for more narcotic agent than needed, and receive the additional pills back from the patient-shill for personal consumption, sell them on the street himself for money, or receive a monetary kickback from the patient-shill.
A pharmacist may also indirectly alter a prescription using the above methods, or simply short-change the patient with fewer narcotic capsules than the prescription intends. This is more difficult to do with pills or tablets in the out patient setting, but easy to do in the in-patient setting when liquid IV drugs are used, by dilution and placing less than the full amount in IV bottles or bags. The harm to patients, of course, may be fatal.
Well-written Rx for vicodin
Drug: Rx Vicodin
Disp: # 10 (ten) capsules
Sig: Take one or two capsules, po, prn pain.
Refills: 1 2 3 4 or 5
AM2685591
David Edward Marcinko, MBBS DPM MBA
Example:
Doctor Rx prescription abuse foibles are legendary in the DEA and include a Maryland podiatrist who wrote prescriptions for more than 1,235 Mepergan Fortis capsules ostensibly for his wife following minor foot surgery. Or, the Florida physician who prescribed more than 2,150 Vicodin capsules for a patient with whom he was having an extra-marital affair in order that his consort not disclose the fling to his wife. Or, the osteopath from New Jersey who wrote more than 100 narcotic prescriptions every 8 hour day, for more than a year, to any patient standing in a line in front of his office. And, finally the California dentist whose excuse for writing more than 1,845 narcotic tablet prescriptions in a six month period for the same patient was that they would be needed in his next reincarnation. Yes, all of these incidents are laughable if not for their serious consequences to the involved individuals, and society, alike. The bastards!
Fortunately, unlike drug local domestic drug kingpins or international narco-traffickers who ply their trade virtually undetected, these naive white-collared nerds, always get caught by the Drug Enforcement Agency. Their Rx abuse tactics are so amateurish!
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A Nationwide Database Review
This “Guide to Travel Nursing Jobs” presents data obtained from a nationwide information database of travel nurses including motivational factors in choosing a travel nurse career, age demographics, benefits information, and social media usage.
In addition, the guide highlights the salary info for travel RNs as well as a timeline of the travel nursing process.
Source: onwardhealthcare.com
Channel Surfing the ME-P
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Conclusion
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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
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By Dr. David Edwarrd Marcinko MBA
Rx DRUG ABUSE
Traditional medicinal agents come in a variety of ways, known as dispensing vehicles. Drugs may be in liquid, pill or inject able form, they may be compounded in capsules, caplets, gelatin tablets, powders or suppositories, or they may come in creams or ointments for the eye, anus and vagina. They may be ingested into the stomach, placed and dissolved under the tongue, put into the eyes, popped, injected or smeared and transported through the human skin from patches.
A valid drug prescription is a written order, by a doctor, to a pharmacist. In this country, prescriptions are written by physicians, podiatrists, osteopaths, dentists. and some optometrists, physician assistants and nurse practitioners. In addition to the name of the patient and that of the medical prescriber, the prescription contains the name of the drug (not necessarily a narcotic), its quantity, instructions to the pharmacist, and directions to the patient. Narcotic prescriptions may not be prescribed to a drug addict to prevent withdrawal symptoms, as there must be some other therapeutic purpose for such an order.
The art of medicinal prescription writing, and pharmaceutical compounding, has declined in modern medicine for several reasons. Most drugs are made by pharmaceutical companies, and the role of the pharmacist, in most cases, consists only of compounding and error prevention. Many drugs are even automatically dispensed, and tracked, in the hospital setting with bar coding technology and modern inventory tracking mechanisms. Also, the practice of writing long and complicated prescriptions, containing many active ingredients, adjuvants, correctives, and elegant vehicles, has been abandoned in favor of using pure compounds.
Drugs may be prescribed by their official names, which were first given by the United States Pharmacopeia (USP), in 1920, or by the National Formulary (NF), since 1906. Unofficial or generic names may be used, known as New and Non-Official Drugs (NND) or by the United States Adopted Names (USAN), or by the manufactures trade name. For example, the generic narcotic meperidine or pithidine, is also known by the trade named, demerol. The designation USAN does not imply endorsement by the American Medical Association (AMA) Council on Drugs (CODs), or by the USP.
Of course, there is an advantage and disadvantages to prescribing drugs by their trade name, or generic names. Advantages of generics include economies of scale for both the patient and pharmacist, and although the active ingredient in generics are identical to trade drugs, they are often less expensive since research and development costs are absent, and various binders, colorizing agents, preservatives or dispersing agents are of an inferior quality, and hence cheaper for the patient. Appearance, size and taste issues are common. For the pharmacist, generics are cheaper since a multiplicity of very similar drugs need not be shelved.
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For example, the tablet or capsular form of many drugs contains inactive ingredients, such as: ammonio methacrylate copolymer, hydroxypropyl methylcellulose, lactose, magnesium stearate, povidone, red iron oxide, stearyl alcohol, talc, titanium dioxide, triacetin, yellow iron oxide, yellow iron oxide with FD&C blue No.2 (80 mg strength tablet only), FD&C blue No.2 and other ingredients. And yes, I’ve seen an addict do into shock, or die from acute anaphylaxis, after taking drugs containing ingredient he was highly allergic to.
Shock is a life-threatening condition where blood pressure falls too low to sustain life. It occurs when low blood volume (due to severe bleeding, excessive fluid loss or inadequate fluid uptake), inadequate pumping action of the heart or excessive dilation of the blood vessel walls (vasodilation) causes low blood pressure. This in turn results in inadequate blood supply to body cells, which can quickly die or be irreversibly damaged.
Anaphylactic shock is the severest form of allergy that is a medical emergency. It is a Type I reaction according to the Gell and Coombs medical classification, and is often severe and sometimes fatal systemic reaction in a susceptible individual upon exposure to a specific antigen (such as wasp venom or penicillin) following previous sensitization, or drug use. Characterized especially by respiratory symptoms, fainting, itching, itching and swelling of the throat or other mucous membranes and a sudden decline in blood pressure! The victim literally cannot breathe and drowns in its own congested and fluid filled lungs
So, patients in need of routine drugs for acute or chronic conditions like arthritis, high blood pressure, asthma, acne, hay fever, performance enhancing steroids or, so called life style drugs, like Viagra for a limp woody, or hair growth stimulator Rogaine, may get a good deal by going to Canada or Mexico for generics. But for important drugs, like nitroglycerine fro your heart, blood thinner coumadin, birth control pills or various anti-cancer agents, stick with brand names.
The main disadvantage of trade drugs is increased cost, due to R & D, patents, trademarks, marketing and company advertising expenses. Of course, trade drug are first to market, and hence may be beneficial as a new treatment modality, or injurious if significant side affects or other complications arise.
Today, the prime source for drug information is probably the well known, Physicians Desk Reference (PDR). Now, in its 58th edition, the PDR® provides the latest information on prescription, but not illegal street drugs. It is considered the standard reference that can be found in virtually every physician’s office, hospital and pharmacy in the United States. The current edition is over 3,000 pages long, and is where you can find data on more than 4,000 drugs, by brand and generic name, manufacturer and product categories. The PDR also provides usage information and warnings, drug interactions, plus full-size, full-color photos cross-referenced to specific drugs. For the layman, it also includes: phonetic spelling for each listing, a key to controlled substances, adverse reactions and contraindications, pregnancy ratings, dosages and all other FDA-required information. Of course, on the street, or in Mexico, none of this information matters.
Latin abbreviations, sometimes still used by doctors on prescription blanks include:
Rx = take thou (receipe)
po = by mouth (para orbis)
prn = as needed (pro re’nata)
hs = at bed time (hora somnae)
BID = twice daily
TID = three times daily
QID = four times daily
M = Mix
Traditionally, a medical prescription is written in a certain order, well known to drug abusers, and DEA agents, and consist of six basic parts:
Finally, in addition to the basic parts of a prescription, it should have the patient’s name, and physician signature written in ink, followed by degree designation, such as MD, DPM, DO or DDS, etc.
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Perhaps the most egregious narcotic prescribing habits recently encountered by DEA agents have been by doctors of all degrees and medical designations. Reasons are generally two-fold. First, the doctor may become a drug addict himself, either by accident or through initial legitimate therapeutic use, and over-prescribe the narcotics. Or, increasing office costs, and decreased reimbursement fee reductions of many managed medical care have so economically destabilized the medical community, that economically impoverished doctors desperately sell prescriptions to finance their personal lifestyles, automobiles, clothes, fancy vacations or own addictions.
For example, a staggering medical student loan debt burden of $100,000-$250,000 is not unusual for new practitioners. In fact, the federal Health Education Assistance Loan (HEAL) program reported that for the Year 2001, it squeezed significant repayment settlements from its Top 5 list of deadbeat doctor debtors. This included a $303,000 settlement from a New York dentist, $186,000 from a Florida osteopath, $158,000 from a New Jersey podiatrist, $128,000 from a Virginia podiatrist, and $120 from a Virginia dentist. The agency also excluded 303 practitioners from Medicare, Medicaid and other federal healthcare programs and had their cases referred for non-payment of debt.
These facts indicate that the current healthcare reimbursement climate has caused more pain and tumult to doctors than the pubic realizes. Older medical practitioners are retiring prematurely, mature providers are frustrated and in despair, and young physicians have no concept of the economic servitude to which they are about to be subjected. Frustration is high and physician suicides have been documented. Many doctors get divorced at the start of their careers. Even the U.S. Inspector General has declared healthcare providers to be public enemy #2,behind international narco-traffickers, for their federal drug, fraud and abuse initiatives. Still, the statistic above lends itself to narcotic drug prescription abuse, either on the part of the doctor or patient, since only these two parties that can directly alter a prescription for illicit drug use, as illustrated by this poorly written prescription for a narcotic pain killer, vicodin.
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Psychological Biases Affecting Financial Planning and Investing
By Dr. David Edward Marcinko MBA CMP®
[Editor-in-Chief]
Sponsored: http://www.CertifiedMedicalPlanner.org
The following are some of the most common psychological biases. Some are learned while others are genetically determined (and often socially reinforced). While this essay focuses on the financial implications of these biases, they are prevalent in most areas in life.
[A] Incentives
It is broadly accepted that incenting someone to do something is effective, whether it be paying office staff a commissions to sell more healthcare products, or giving bonuses to office employees if they work efficiently to see more HMO patients. What is not well understood is that the incentives cause a sub-conscious distortion of decision-making ability in the incented person. This distortion causes the affected person – whether it is yourself or someone else – to truly believe in a certain decision, even if it is the wrong choice when viewed objectively. Service professionals, including financial advisors and lawyers, are affected by this bias, and it causes them to honestly offer recommendations that may be inappropriate, and that they would recognize as being inappropriate if they did not have this bias. The existence of this bias makes it important for each one of us to examine our incentive biases and take extra care when advising physician clients, or to make sure we are appropriately considering non-incented alternatives.
[B] Denial
Denial is a well known, but under-appreciated, psychological force. Physicians, clients and professionals (like everyone else) are prone to the mistake of ignoring a painful reality, like putting off an unpleasant call (thus prolonging a problematic situation and potentially making it worse) or not opening account statements because of the desire not to see quantitative proof of losses. Denial also manifests itself by causing human beings to ignore evidence that a mistake has been made. If you think of yourself as a smart person (and what professional doesn’t?), then evidence pointing to the conclusion that a mistake has been made will call into question that belief, causing cognitive dissonance. Our brains function to either avoid cognitive dissonance or to resolve it quickly, usually by discounting or rationalizing the disconfirming evidence. Not surprisingly, colleagues at Kansas State University and elsewhere, found that financial denial, including attempts to avoid thinking about or dealing with money, is associated with lower income, lower net worth, and higher levels of revolving credit.
[C] Consistency and Commitment Tendency
Human beings have evolved – probably both genetically and socially – to be consistent. It is easier and safer to deal with others if they honor their commitments and if they behave in a consistent and predictable manner over time. This allows people to work together and build trust that is needed for repeat dealings and to accomplish complex tasks. In the jungle, this trust was necessary to for humans to successfully work as a team to catch animals for dinner, or fight common threats. In business and life it is preferable to work with others who exhibit these tendencies. Unfortunately, the downside of these traits is that people make errors in judgment because of the strong desire not to change, or be different (“lemming effect” or “group-think”). So the result is that most people will seek out data that supports a prior stated belief or decision and ignore negative data, by not “thinking outside the box”. Additionally, future decisions will be unduly influenced by the desire to appear consistent with prior decisions, thus decreasing the ability to be rational and objective. The more people state their beliefs or decisions, the less likely they are to change even in the face of strong evidence that they should do so. This bias results in a strong force in most people causing them to avoid or quickly resolve the cognitive dissonance that occurs when a person who thinks of themselves as being consistent and committed to prior statements and actions encounters evidence that indicates that prior actions may have been a mistake. It is particularly important therefore for advisors to be aware that their communications with clients and the press clouds the advisor’s ability to seek out and process information that may prove current beliefs incorrect. Since this is obviously irrational, one must actively seek out negative information, and be very careful about what is said and written, being aware that the more you shout it out, the more you pound it in.
[D] Pattern Recognition
On a biological level, the human brain has evolved to seek out patterns and to work on stimuli-response patterns, both native and learned. What this means is that we all react to something based on our prior experiences that had shared characteristics with the current stimuli. Many situations have so many possible inputs that our brains need to take mental short cuts using pattern recognition we would not gain the benefit from having faced a certain type of problem in the past. This often-helpful mechanism of decision-making fails us when past correlations or patterns do not accurately represent the current reality, and thus the mental shortcuts impair our ability to analyze a new situation. This biologic and social need to seek out patterns that can be used to program stimuli-response mechanisms is especially harmful to rational decision-making when the pattern is not a good predictor of the desired outcome (like short term moves in the stock market not being predictive of long term equity portfolio performance), or when past correlations do not apply anymore.
[E] Social Proof
It is a subtle but powerful reality that having others agree with a decision one makes, gives that person more conviction in the decision, and having others disagree decreases one’s confidence in that decision. This bias is even more exaggerated when the other parties providing the validating/questioning opinions are perceived to be experts in a relevant field, or are authority figures, like people on television. In many ways, the short term moves in the stock market are the ultimate expression of social proof – the price of a stock one owns going up is proof that a lot of other people agree with the decision to buy, and a dropping stock price means a stock should be sold. When these stressors become extreme, it is of paramount importance that all participants in the financial planning process have a clear understanding of what the long-term goals are, and what processes are in place to monitor the progress towards these goals. Without these mechanisms it is very hard to resist the enormous pressure to follow the crowd; think social media.
[F] Contrast
Sensation, emotion and cognition work by contrast. Perception is not only on an absolute scale, it also functions relative to prior stimuli. This is why room temperature water feels hot when experienced after being exposed to the cold. It is also why the cessation of negative emotions “feels” so good. Cognitive functioning also works on this principle. So one’s ability to analyze information and draw conclusions is very much related to the context with in which the analysis takes place, and to what information was originally available. This is why it is so important to manage one’s own expectations as well as those of clients. A client is much more likely to be satisfied with a 10% portfolio return if they were expecting 7% than if they were hoping for 15%.
[G] Scarcity
Things that are scarce have more impact and perceived value than things present in abundance. Biologically, this bias is demonstrated by the decreasing response to constant stimuli (contrast bias) and socially it is widely believed that scarcity equals value. People who feel an opportunity may “pass them by” and thus be unavailable are much more likely to make a hasty, poorly reasoned decision than they otherwise would. Investment fads and rising security prices elicit this bias (along with social proof and others) and need to be resisted. Understanding that analysis in the face of perceived scarcity is often inadequate and biased may help professionals make more rational choices, and keep clients from chasing fads.
[H] Envy / Jealousy
This bias also relates to the contrast and social proof biases. Prudent financial and business planning and related decision-making are based on real needs followed by desires. People’s happiness and satisfaction is often based more on one’s position relative to perceived peers rather than an ability to meet absolute needs. The strong desire to “keep up with the Jones” can lead people to risk what they have and need for what they want. These actions can have a disastrous impact on important long-term financial goals. Clear communication and vivid examples of risks is often needed to keep people focused on important financial goals rather than spurious ones, or simply money alone, for its own sake.
[I] Fear
Financial fear is probably the most common emotion among physicians and all clients. The fear of being wrong – as well as the fear of being correct! It can be debilitating, as in the corollary expression on fear: the paralysis of analysis.
According to Paul Karasik, there are four common investor and physician fears, which can be addressed by financial advisors in the following manner:
Psychological Traps
Now, as human beings, our brains are booby-trapped with psychological barriers that stand between making smart financial decisions and making dumb ones. The good news is that once you realize your own mental weaknesses, it’s not impossible to overcome them.
In fact, Mandi Woodruff, a financial reporter whose work has appeared in Yahoo! Finance, Daily Finance, The Wall Street Journal, The Fiscal Times and the Financial Times among others; related the following mind-traps in a September 2013 essay for the finance vertical Business Insider; as these impediments are now entering the lay-public zeitgeist:
Textbook Order: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989
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ON “PRUDENCE” IN FINANCE AND INVESTMENT MANAGEMENT
Courtesy: http://www.CertifiedMedicalPlanner.org
TERMS & DEFINITIONS FOR PHYSICIANS AND ALL INVESTORS:
PRUDENT BUYER: The efficient purchaser of market balance between value and cost.
PRUDENT MAN RULE: An 1830 court case stating that a person in a fiduciary capacity (a trustee, executor, custodian, etc) must conduct him/herself faithfully and exercise sound judgment when investing monies under care. “He is to observe how men of prudence, discretion and intelligence manage their own affairs, not in regard to speculation, but in regard to the permanent distribution of their funds, considering the probable income as well as the probable safety of the capital to be invested.” Allows for mutual funds and variable annuities.
PRUDENT INVESTOR RULE: A fiduciary is required to conduct him/herself faithfully and exercise sound judgment when investing monies and take measured and reasonable investment risks in return for potential future rewards. Allows for mutual funds, stocks, bonds, variable annuities asset allocation & Modern Portfolio Theory.
CITATION: https://www.r2library.com/Resource/Title/0826102549
UNIFORM PRUDENT INVESTOR ACT: https://medicalexecutivepost.com/2011/02/18/the-uniform-prudent-investor-act-versus-fiduciary-accountability/
EDITOR’S NOTE: We interviewed noted authority Ben Aikin AIF® on this topic more than a decade ago. He was ahead of his time regarding fiduciary accountability and we appreciate his insights.
Dr. David Edward Marcinko MBA CMP®
[Editor-in-Chief]
INTERVIEW: https://medicalexecutivepost.com/2009/03/01/an-interview-with-bennett-aikin-aif/
FIDUCIARY OATH: http://www.thefiduciarystandard.org/wp-content/uploads/2015/02/fiduciaryoath_individual.pdf
SECOND OPINIONS: https://medicalexecutivepost.com/schedule-a-consultation/
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By Health Capital Consultants, LLC
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Biden Administration to Overhaul Vertical Merger Guidelines
The U.S. healthcare industry has seen a rise in vertical integration transactions since the passage of the ACA, especially among physician groups integrating with health systems or insurers, as providers seek to fill gaps in their continuum of care. In response to these trends and resulting market imbalances, the Biden Administration is aggressively pursuing antitrust enforcement by updating and revising U.S. antitrust law guidance.
This Health Capital Topics article will discuss the vertical integration movement and the proposed changes to antitrust laws that may affect the future of healthcare. (Read more…)
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CITE: https://www.r2library.com/Resource/Title/0826102549
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Filed under: Experts Invited, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc., Investing, Professional Liability, Research & Development | Tagged: ACA, Biden, Biden Administration to Overhaul Vertical Merger Guidelines, Health Capital Consultants LLC, Vertical Integration, Vertical Merger Guidelines | Leave a comment »
A HISTORICAL REVIEW WITH UPDATE
By Dr. David E. Marcinko MBA CMP®
SPONSOR: http://www.CertifiedMedicalPlanner.org
The Great Moderation is the name given to the period of decreased macroeconomic volatility experienced in the United States starting in the 1980s.
CITE: https://www.r2library.com/Resource/Title/0826102549
During this period, the standard deviation of quarterly real gross domestic product (GDP) declined by half and the standard deviation of inflation declined by two-thirds, according to figures reported by former U.S. Federal Reserve Chair Ben Bernanke. The Great Moderation can be summed up as a multi-decade period of low inflation and positive economic growth.
But, what about health economics, writ large? And, the actual practice of medicine by physicians in the trenches. Consider this historical review.
GOLDEN AGE OF MEDICINE
The ‘golden age of medicine’ – the first half of the 20th century, reaching its zenith with Jonas Salk’s 1955 polio vaccine – was a time of profound advances in surgical techniques, immunization, drug discovery, and the control of infectious disease; however, when the burden of disease shifted to lifestyle-driven, chronic, non-communicable diseases, the golden era slipped away. Although modifiable lifestyle practices now account for some 80% of premature mortality, medicine remains loathe to embrace lifestyle interventions as medicine Here, we argue that a 21st century golden age of medicine can be realized; the path to this era requires a transformation of medical school recruitment and training in ways that prioritize a broad view of lifestyle medicine. Moving beyond the basic principles of modifiable lifestyle practices as therapeutic interventions, each person/community should be viewed as a biological manifestation of accumulated experiences (and choices) made within the dynamic social, political, economic and cultural ecosystems that comprise their total life history. This requires an understanding that powerful forces operate within these ecosystems; marketing and neoliberal forces push an exclusive ‘personal responsibility’ view of health – blaming the individual, and deflecting from the large-scale influences that maintain health inequalities and threaten planetary health. The latter term denotes the interconnections between the sustainable vitality of person and place at all scales. We emphasize that barriers to planetary health and the clinical application of lifestyle medicine – including authoritarianism and social dominance orientation – are maintaining an unhealthy status quo.
NOTE: https://pubmed.ncbi.nlm.nih.gov/31828026/
GOLDEN AGE OF MEDICAL PRACTICE
To listen to all those desperate to reform health care, you get the impression that physicians are pretty horrible people. We are all sexist, greedy, money grubbing tyrants who will perform unnecessary tests and procedures just to make money. We don’t care about quality or cost. We are killing off 250,000 patients every year with our ignored “errors.”
We purposely keep our patients in pain, or we addict them to narcotics just to shut them up. We are constantly told by lawyers that lawsuits are necessary to protect patients from doctors. We provide unsafe drugs just because the drug reps give us free pens and coffee cups. The government must step in to clean up the mess.
PODCAST: https://www.kevinmd.com/blog/2017/08/9-reasons-golden-age-medicine-golden.html
GOLDEN AGE OF PATIENT TRUST
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THE GREAT PHYSICIAN RETIREMENT AND RESIGNATION: https://medicalexecutivepost.com/2021/11/09/healthcare-industry-hit-with-the-great-resignation-retirement/
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RETIREMENT PLANNING: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989
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By Health Capital Consultants, LLC
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Biden Announces Fix to ACA’s “Family Glitch”
On April 5, 2022, the Internal Revenue Service (IRS) proposed a rule change to its eligibility requirements for families to receive premium tax credits toward purchasing high-quality health coverage on the insurance marketplaces established by the Patient Protection and Affordable Care Act (ACA). This proposed change comes on the heels of two Biden Administration executive orders calling for improvements to the ACA and Medicaid. This Health Capital Topics article will discuss the proposed solution to a decade-long problem and how it will affect millions of Americans. (Read more…)
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By Staff Reporters
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According to Wikipedia, May Day is a European festival of ancient origins marking the beginning of summer, usually celebrated on 1 May, around halfway between the spring equinox and summer solstice. Festivities may also be held the night before, known as May Eve. Traditions often include gathering wildflowers and green branches, weaving floral garlands, crowning a May Queen (sometimes with a male companion), and setting up a Maypole, May Tree or May Bush, around which people dance. Bonfires are also part of the festival in some regions. Regional varieties and related traditions include Walpurgis Night in central and northern Europe, the Gaelic festival Beltane, the Welsh festival Calan Mai, and May devotions to the Blessed Virgin Mary. It has also been associated with the ancient Roman festival Floralia.
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But in 1889, it was chosen as the date for International Workers’ Day by the Second International, to commemorate the Haymarket affair in Chicago and the struggle for an eight-hour working day. As a result, International Workers’ Day is also called “May Day”, but the two are unrelated.
CITE: https://www.r2library.com/Resource/Title/082610254
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By Staff Reporters
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Markets: The NASDAQ stayed flat at its lowest level this year. Spotify shares sank to a record low. Facebook is having a rough go, but it’s not the only one. Netflix stock plunged nearly 70% this year after hitting a ceiling on subscriber growth. At one point, it was worth more than Disney; now, it’s not even half as valuable. Even Google is googling “ways to make more money.” Its parent company, Alphabet, reported a slowdown in growth last quarter because, like Facebook, YouTube’s also being been dinged by TikTok and Apple’s privacy changes: The video platform’s revenue came in more than $500 million below expectations.
Energy: Russia’s halted oil shipments to Poland and Bulgaria yesterday.
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April 22nd, 2022
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By Dr. David Edward Marcinko MBA
Founding Editor-in-Chief
Go Green!
At this Medical Executive-Post, we are trying to go GREEN! Our green mindset permeates brightly whenever we conduct business. However, green is more than just a color, it’s a way of working and living that honors our environment and helps preserve it for future generations. And so, below is a list of our environment-friendly green initiatives.
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THE ENTREPRENEURIAL M.D.
In this episode we are joined by Dr. Brent Jackson, Chief Medical Officer for Mercy General in Sacramento, CA to discuss the physician life-cycle, burnout, and transitioning into leadership within healthcare.
Play EpisodeDownload (40.4 MB)
Summary: Dr Brent Jackson discusses the flow of revenue throughout the medical industry.
CITE: https://www.r2library.com/Resource/Title/0826102549
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By Staff Reporters
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Russia: Shut its stock market all week in a bid to curb panic-selling after the invasion of Ukraine. The ruble cratered to trade below 1 cent as Western sanctions effectively weaponized the financial system.
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CITE: https://www.r2library.com/Resource/Title/082610254
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By Staff Reporters
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DEFINITION: A rate of return (RoR) is the net gain or loss of an investment over a specified time period, expressed as a percentage of the investment’s initial cost. When calculating the rate of return, you are determining the percentage change from the beginning of the period until the end.
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And so, according to Greg McBride CFA, before you invest your money, you’re likely wondering how much you’re going to earn. This is known as the rate of return. The rate of return is expressed as a percentage of the total amount you invested. If you invest $1,000 and get back your original investment plus an additional $100 in interest, you’ve earned a 10 percent return.
CITE: https://www.r2library.com/Resource/Title/082610254
However, numbers don’t always tell the full story. You’ll also need to think about how long you plan to keep the money invested, how your investment options have performed historically and how inflation will impact your bottom line.
When you’re trying to get the best return on your investment, you’ll likely start combing through loads of data. A good place to start is looking at the past decade of returns on some of the most common investments:
CD rate data is from internal Bankrate averages.
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How have you done so far in 2022?
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A Graphic Presentation [1861-1935] with Commentary from the Publisher
By Dr. David Edward Marcinko FACFAS MBA CPHQ CMP™
http://www.CertifiedMedicalPlanner.org
As our private iMBA Inc clients, ME-P subscribers, textbook and dictionary purchasers, seminar attendees and most ME-P readers know, Ken Arrow is my favorite economist. Why?
About Kenneth J. Arrow, PhD
Well, in 1972, Nobel Laureate Kenneth J. Arrow, PhD shocked Academe’ by identifying health economics as a separate and distinct field. Yet, the seemingly disparate insurance, asset allocation, econometric, statistical and portfolio management principles that he studied have been transparent to most financial professionals and wealth management advisors for years; at least until now.
Nevertheless, to informed cognoscenti, they served as predecessors to the modern healthcare advisory era. In 2004, Arrow was selected as one of eight recipients of the National Medal of Science for his innovative views. And, we envisioned the ME-P at that time to present these increasingly integrated topics to our audience.
Healthcare Economics Today
Today – as 2022 passes – savvy medical professionals, management consultants and financial advisors are realizing that the healthcare industrial complex is in flux; along with the Russian war, domestic inflation and this dynamic may be reflected in the overall flagging economy.
Like many laymen seeking employment, for example, physicians are frantically searching for new ways to improve office revenues and grow personal assets, because of the economic dislocation that is Managed Care, Medi Care and Obama Care [ACA], the depressed business cycle, etc.
Moreover, the largest transfer of wealth in US history is – or was – taking place as our lay elders and mature doctors sell their practices or inherit parents’ estates. Increasingly, the artificial academic boundary between the traditional domestic economy, financial planning and contemporaneous medical practice management is blurring.
I’m Not a Cassandra
Yet, I am no gloom and doom Cassandra like I have been accused, of late. I am not cut from the same cloth as a Jason Zweig, Jeremy Grantham or Nouriel Roubini PhD, for example.
However, I do subscribe to the philosophy of Hope for the Best – Plan for the Worst.
And so dear colleagues, I ask you, “Are the latest swings in the economic, healthcare and financial headlines making you wonder when it will ever stop?”
The short answer is: “It will never stop” because what’s been happening isn’t any “new normal”; it’s just the old normal playing out before a new audience; sans the war.
What audience?
The next-generation of investors, FAs, management consultants and the medical professionals of Health 2.0.
How do I know all this?
History tells me so! Just read this work, and opine otherwise, or reach a different conclusion.
Evidence from the American Financial Scene, circa 1861-1935
The work was created by L. Merle Hostetler in 1936, while he was at Cleveland College of Western Reserve University (now known as Case Western Reserve University). I learned of him while in B-School, back in the day.
At some point after it was printed, he added the years 1936-1938. Mr. Hostetler became a Financial Economist at the Federal Reserve Bank of Cleveland in 1943. In 1953 he was made Director of Research. He resigned from the Bank in 1962 to work for Union Commerce Bank in Cleveland. He died in 1990.
The volume appears to be self published and consists of a chart, approximately 85′ long, fan-folded into 40 pages with additional years attached to the last page. It also includes a “topical index” to the chart and some questions of technical interest which can be answered by the chart.
Link: http://fraser.stlouisfed.org/75years
Assessment
And so, as with Sir John Templeton’s [whose son is an MD] four most dangerous words in investing (It’s different this time), Hostetler effectively illustrates that it wasn’t so different in his era, and maybe—just maybe—it isn’t so different today for all these conjoined fields.
Conclusion
Your thoughts and comments on this ME-P are appreciated. While not exactly a “sacred cow,” there is a current theory that investors will experience higher volatility and lower global returns for the foreseeable future.
In fact, it has gained widespread acceptance, from the above noted Cassandra’s and others, as problems in Europe persist and threats of a double-dip recession loom. But, how true is this notion; really?
Is Hostetler correct, or not; and why?
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:
DOCTORS:
“Insurance & Risk Management Strategies for Doctors” https://tinyurl.com/ydx9kd93
“Fiduciary Financial Planning for Physicians” https://tinyurl.com/y7f5pnox
“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8
HOSPITALS:
“Financial Management Strategies for Hospitals” https://tinyurl.com/yagu567d
“Operational Strategies for Clinics and Hospitals” https://tinyurl.com/y9avbrq5
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Filed under: Health Economics, iMBA, Inc., Investing, Op-Editorials, Portfolio Management | Tagged: ACA, CMP, david marcinko, double-dip recession, Jason Zweig, Jeremy Grantham, Ken Arrow, L. Merle Hostetler, National Medal of Science, Nouriel Roubini PhD, physician investors, Sir John Templeton’s, Why 75 Years of American Finance Matters, www.BusinessofMedicalPractice.com, www.certifiedmedicalplanner.com, www.healthcarefinancials.com, www.medicalbusinessadvisors.com | 12 Comments »
SPONSOR:
http://www.CertifiedMedicalPlanner.org
By Dr. David Edward Marcinko MBA CMP™
We have been involved in the highly competitive private, and/or “for-profit”, education sector for two decades. Yet, are also familiar with the larger public university and sustainable ecosystem.
Solo Medical Practice NOT Dead!
For example, we’ve participated in start-up business competitions, and refereed PhD / MBA Capstone presentations at Georgia State University, Emory University and the Georgia Institute of Technology; including at Triangle Technology Park, NC; and the Whitman School of Business in Syracuse, NY.
Funding was achieved for emerging initiatives deemed most efficient and profitable; like solo and small group medical practices and clinics.
Executive Service Line [ESL] education
Also known as Executive Service Line [ESL] education, this business model refers to academic programs for business leaders and adults that are generally non-credit and non-degree-granting, but may lead to professional certifications.
Estimates by Business Week magazine suggest that executive education in the United States is a $900 million annual business with approximately 80 percent provided by university schools. Beside the educational benefits, monetary dividends are reaped as open enrollment eases matriculation access. Similar programs at the Wharton School, Darden, Harvard and the Goizueta Business School at Emory University charge premium rates for the implied institutional moniker.
Assessment
And, an imperative is that electronic technology be used to expand the universe of targeted adult-learners. This is for aspiring professionals and executives, or those already in the workforce. The tuition gathering universe is thus expanded beyond the School. We have developed and launched several such successful programs that were merged or sold to private investors, colleges and hedge funds
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More:
FREE WHITE PAPER [Is Medical Practice a New Asset Class?] from iMBA, Inc.
FREE Sample BP Here:
Feel free to request your free medical office start-up BP, right here.
MarcinkoAdvisors@msn.com
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ANN
ANN MILLER RN MHA
[Executive-Director]
http://www.MedicalExecutivePost.com
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THE PHYSIOLOGIC v. PSYCHOLOGICAL FINANCIAL PLANNING DIVIDE
Holistic Life Planning, Behavioral Economics & Trading Addiction
READ:
Psychology Behavioral Economics Finance
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On Ricardian Derived Demand – Does it Even Exist?
Courtesy: www.CertifiedMedicalPlanner.org
What it is – How it works
In economics, derived demand is demand for a factor of production or intermediate good that occurs as a result of the demand for another intermediate or final good. In essence, the demand for one is dependent on that whose demand its’ demand is derived from another: www.HealthDictionarySeries.org
For example, if the demand for a good such as cars increases, then this leads to an increase in the demand for iron ore.
OR
For example, if the demand for a good such as wheat increases, then this leads to an increase in the demand for labor.
Medicine
So, what about medicine? Saurabh Jha gives us some insight right here!
ESSAY: http://thehealthcareblog.com/blog/2018/08/30/is-medical-imaging-a-ricardian-derived-demand/
RELATED: big data
Your thoughts are appreciated.
MORE INVESTING FOR DOCTORS:
“Insurance & Risk Management Strategies for Doctors” https://tinyurl.com/ydx9kd93
“Fiduciary Financial Planning for Physicians” https://tinyurl.com/y7f5pnox
“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8
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By Staff Reporters
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BY DR. DAVID EDWARD MARCINKO MBA CMP®
One of the greatest things about the virtual economy is the expanded opportunity for people to branch out on their own and create something using their own expertise. Related to this is the growing societal desire to have more free time and a more balanced, efficient life overall.
In fact, years ago when I was in business school, I learned that during a recession when jobs were sparse – folks would either go back to school to re-engineer and re-educate OR start their own business.
Today – If the pandemic taught us anything, it’s that we need to be able to pivot when circumstances call for it. In the years ahead, there will be a premium on flexibility, portability, and improvisation; knowing how to earn income outside the traditional employer-employee relationship will continue to be an especially valuable skill.
ASSESSMENT: So, if you are a physician, nurse, medical professional or financial advisor in the healthcare space, think about what you’re naturally good at (or at least interested in), and determine if there’s an opportunity to monetize it in some way on your own. Your career might thank you for it!
Your thoughts and comments are appreciated.
http://www.CERTIFIEDMEDICALPLANNER.org
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A Detailed Plan for Medical Professionals
By Dr. David Edward Marcinko MBA CMP
http://www.CertifiedMedicalPlanner.org
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PODCAST Transcript: Podcast
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:
[Foreword Dr. Hashem MD PhD] *** [Foreword Dr. Silva MD MBA]
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BY DR. DAVID E. MARCINKO MBA CMP®
SPONSOR: http://www.CertifiedMedicalPlanner.org
REVIEWS:
Written by doctors and healthcare professionals, this textbook should be mandatory reading for all medical school students—highly recommended for both young and veteran physicians—and an eliminating factor for any financial advisor who has not read it. The book uses jargon like ‘innovative,’ ‘transformational,’ and ‘disruptive’—all rightly so! It is the type of definitive financial lifestyle planning book we often seek, but seldom find.
—LeRoy Howard MA CMPTM,Candidate and Financial Advisor, Fayetteville, North Carolina
I taught diagnostic radiology for over a decade. The physician-focused niche information, balanced perspectives, and insider industry transparency in this book may help save your financial life.
—Dr. William P. Scherer MS, Barry University, Ft. Lauderdale, Florida
This book was crafted in response to the frustration felt by doctors who dealt with top financial, brokerage, and accounting firms. These non-fiduciary behemoths often prescribed costly wholesale solutions that were applicable to all, but customized for few, despite ever-changing needs. It is a must-read to learn why brokerage sales pitches or Internet resources will never replace the knowledge and deep advice of a physician-focused financial advisor, medical consultant, or collegial Certified Medical Planner™ financial professional.
—Parin Khotari MBA,Whitman School of Management, Syracuse University, New York
In today’s healthcare environment, in order for providers to survive, they need to understand their current and future market trends, finances, operations, and impact of federal and state regulations. As a healthcare consulting professional for over 30 years supporting both the private and public sector, I recommend that providers understand and utilize the wealth of knowledge that is being conveyed in these chapters. Without this guidance providers will have a hard time navigating the supporting system which may impact their future revenue stream. I strongly endorse the contents of this book.—Carol S. Miller BSN MBA PMP,President, Miller Consulting Group, ACT IAC Executive Committee Vice-Chair at-Large, HIMSS NCA Board Member
This is an excellent book on financial planning for physicians and health professionals. It is all inclusive yet very easy to read with much valuable information. And, I have been expanding my business knowledge with all of Dr. Marcinko’s prior books. I highly recommend this one, too. It is a fine educational tool for all doctors.—Dr. David B. Lumsden MD MS MA,Orthopedic Surgeon, Baltimore, Maryland
There is no other comprehensive book like it to help doctors, nurses, and other medical providers accumulate and preserve the wealth that their years of education and hard work have earned them.
—Dr. Jason Dyken MD MBA,Dyken Wealth Strategies, Gulf Shores, Alabama
I plan to give a copy of this book written ‘by doctors and for doctors’ to all my prospects, physician, and nurse clients. It may be the definitive text on this important topic.
—Alexander Naruska CPA,Orlando, Florida
Health professionals are small business owners who need to apply their self-discipline tactics in establishing and operating successful practices. Talented trainees are leaving the medical profession because they fail to balance the cost of attendance against a realistic business and financial plan. Principles like budgeting, saving, and living below one’s means, in order to make future investments for future growth, asset protection, and retirement possible are often lacking. This textbook guides the medical professional in his/her financial planning life journey from start to finish. It ranks a place in all medical school libraries and on each of our bookshelves.
—Dr. Thomas M. DeLauro DPM,Professor and Chairman – Division of Medical Sciences, New York College of Podiatric Medicine
Physicians are notoriously excellent at diagnosing and treating medical conditions. However, they are also notoriously deficient in managing the business aspects of their medical practices. Most will earn $20-30 million in their medical lifetime, but few know how to create wealth for themselves and their families. This book will help fill the void in physicians’ financial education. I have two recommendations: 1) every physician, young and old, should read this book; and 2) read it a second time!
—Dr. Neil Baum MD,Clinical Associate Professor of Urology, Tulane Medical School, New Orleans, Louisiana
I worked with a Certified Medical Planner™ on several occasions in the past, and will do so again in the future. This book codified the vast body of knowledge that helped in all facets of my financial life and professional medical practice.
—Dr. James E. Williams DABPS, Foot and Ankle Surgeon, Conyers, Georgia
This is a constantly changing field for rules, regulations, taxes, insurance, compliance, and investments. This book assists readers, and their financial advisors, in keeping up with what’s going on in the healthcare field that all doctors need to know.
—Patricia Raskob CFP® EA ATA, Raskob Kambourian Financial Advisors, Tucson, Arizona
I particularly enjoyed reading the specific examples in this book which pointed out the perils of risk … something with which I am too familiar and have learned (the hard way) to avoid like the Black Death. It is a pleasure to come across this kind of wisdom, in print, that other colleagues may learn before it’s too late— many, many years down the road.
—Dr. Robert S. Park MD, Robert Park and Associates Insurance, Seattle, Washington
Although this book targets physicians, I was pleased to see that it also addressed the financial planning and employment benefit needs of nurses; physical, respiratory, and occupational therapists; CRNAs, hospitalists, and other members of the health care team….highly readable, practical, and understandable.
—Nurse Cecelia T. Perez RN, Hospital Operating Room Manager, Ellicott City, Maryland
Personal financial success in the PP-ACA era will be more difficult to achieve than ever before. It requires the next generation of doctors to rethink frugality, delay gratification, and redefine the very definition of success and work–life balance. And, they will surely need the subject matter medical specificity and new-wave professional guidance offered in this book. This book is a ‘must-read’ for all health care professionals, and their financial advisors, who wish to take an active role in creating a new subset of informed and pioneering professionals known as Certified Medical Planners™.
—Dr. Mark D. Dollard FACFAS, Private Practice, Tyson Corner, Virginia
As healthcare professionals, it is our Hippocratic duty to avoid preventable harm by paying attention. On the other hand, some of us are guilty of being reckless with our own financial health—delaying serious consideration of investments, taxation, retirement income, estate planning, and inheritances until the worry keeps one awake at night. So, if you have avoided planning for the future for far too long, perhaps it is time to take that first step toward preparedness. This in-depth textbook is an excellent starting point—not only because of its readability, but because of his team’s expertise and thoroughness in addressing the intricacies of modern investments—and from the point of view of not only gifted financial experts, but as healthcare providers, as well … a rare combination.
—Dr. Darrell K. Pruitt DDS, Private Practice Dentist, Fort Worth, Texas
This text should be on the bookshelf of all contemporary physicians. The book is physician-focused with unique topics applicable to all medical professionals. But, it also offers helpful insights into the new tax and estate laws, fiduciary accountability for advisors and insurance agents, with investing, asset protection and risk management, and retirement planning strategies with updates for the brave new world of global payments of the Patient Protection and Affordable Care Act. Starting out by encouraging readers to examine their personal ‘money blueprint’ beliefs and habits, the book is divided into four sections offering holistic life cycle financial information and economic education directed to new, mid-career, and mature physicians.
This structure permits one to dip into the book based on personal need to find relief, rather than to overwhelm. Given the complexity of modern domestic healthcare, and the daunting challenges faced by physicians who try to stay abreast of clinical medicine and the ever-evolving laws of personal finance, this textbook could not have come at a better time.
—Dr. Philippa Kennealy MD MPH, The Entrepreneurial MD, Los Angeles, California
Physicians have economic concerns unmatched by any other profession, arriving ten years late to the start of their earning years. This textbook goes to the core of how to level the playing field quickly, and efficaciously, by a new breed of dedicated Certified Medical Planners™. With physician-focused financial advice, each chapter is a building block to your financial fortress.
—Thomas McKeon, MBA, Pharmaceutical Representative, Philadelphia, Pennsylvania
An excellent resource … this textbook is written in a manner that provides physician practice owners with a comprehensive guide to financial planning and related topics for their professional practice in a way that is easily comprehended. The style in which it breaks down the intricacies of the current physician practice landscape makes it a ‘must-read’ for those physicians (and their advisors) practicing in the volatile era of healthcare reform.
—Robert James Cimasi, MHA ASA FRICS MCBA CVA CM&AA CMP™, CEO-Health Capital Consultants, LLC, St. Louis, Missouri
Rarely can one find a full compendium of information within a single source or text, but this book communicates the new financial realities we are forced to confront; it is full of opportunities for minimizing tax liability and maximizing income potential. We’re recommending it to all our medical practice management clients across the entire healthcare spectrum.
—Alan Guinn, The Guinn Consultancy Group, Inc., Cookeville, Tennessee
Dr. David Edward Marcinko MBA CMP™ and his team take a seemingly endless stream of disparate concepts and integrate them into a simple, straightforward, and understandable path to success. And, he codifies them all into a step-by-step algorithm to more efficient investing, risk management, taxation, and enhanced retirement planning for doctors and nurses. His text is a vital read—and must execute—book for all healthcare professionals and physician-focused financial advisors.
—Dr. O. Kent Mercado, JD, Private Practitioner and Attorney, Naperville, Illinois
Kudos. The editors and contributing authors have compiled the most comprehensive reference book for the medical community that has ever been attempted. As you review the chapters of interest and hone in on the most important concerns you may have, realize that the best minds have been harvested for you to plan well… Live well.
—Martha J. Schilling; AAMS® CRPC® ETSC CSA, Shilling Group Advisors, LLC, Philadelphia, Pennsylvania
I recommend this book to any physician or medical professional that desires an honest no-sales approach to understanding the financial planning and investing world. It is worthwhile to any financial advisor interested in this space, as well.
—David K. Luke, MIM MS-PFP CMP™, Net Worth Advisory Group, Sandy, Utah
Although not a substitute for a formal business education, this book will help physicians navigate effectively through the hurdles of day-to-day financial decisions with the help of an accountant, financial and legal advisor. I highly recommend it and commend Dr. Marcinko and the Institute of Medical Business Advisors, Inc. on a job well done.
—Ken Yeung MBA CMP™, Tseung Kwan O Hospital, Hong Kong
I’ve seen many ghost-written handbooks, paperbacks, and vanity-published manuals on this topic throughout my career in mental healthcare. Most were poorly written, opinionated, and cheaply produced self-aggrandizing marketing drivel for those agents selling commission-based financial products and expensive advisory services. So, I was pleasantly surprised with this comprehensive peer-reviewed academic textbook, complete with citations, case examples, and real-life integrated strategies by and for medical professionals. Although a bit late for my career, I recommend it highly to all my younger colleagues … It’s credibility and specificity stand alone.
—Dr. Clarice Montgomery PhD MA,Retired Clinical Psychologist
In an industry known for one-size-fits-all templates and massively customized books, products, advice, and services, the extreme healthcare specificity of this text is both refreshing and comprehensive.
—Dr. James Joseph Bartley, Columbus, Georgia
My brother was my office administrator and accountant. We both feel this is the most comprehensive textbook available on financial planning for healthcare providers.
—Dr. Anthony Robert Naruska DC,Winter Park, Florida
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Filed under: "Advisors Only", "Doctors Only", Book Reviews, CMP Program, Financial Planning, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc., Insurance Matters, Investing, Portfolio Management, Practice Management, Risk Management, Touring with Marcinko | Tagged: david marcinko, Financial Planning, financial planning physicians, Investing, Physician Finances, physician investing | Leave a comment »
SOME GUIDELINES FOR COLLEAGUES
By Dr. David Edward Marcinko MBA CMP®
SPONSOR: http://www.CertifiedMedicalPlanner.org
According to Rick Kahler MS CFP® ChFC CCIM [www.KahlerFinancial.com] real estate is one of the largest asset classes in the world. The family home is the largest asset many middle-class Americans own. And, real estate makes up a significant portion of the net worth of many wealth accumulators. Directly owning real estate is not an investment for the faint of heart, the armchair investor, or the uneducated. Most wealth accumulators would do well to leave direct ownership of real estate to the pros and invest in real estate investment trusts (REITs) instead [personal communication].
Still, as we have seen, the lure of investing in a tangible asset like real estate is enticing for high risk tolerant physician-investors who need a sense of control and interaction with their investments. If you are among them, here are a few guidelines that may keep you on a profitable path.
1. Don’t attempt to purchase investment real estate without the help of a commercial real estate specialist who is a fiduciary bound to look out for your best interest. Engage a Certified Commercial Investment Member (CCIM) with years of training and experience in analyzing and acquiring investment real estate. To find a CCIM near you, go to http://www.ccim.com.
2. You will sign a disclosure agreement that will tell you who the Realtor represents. Be sure the Realtor you engage represents you and not the seller, both parties, or neither party.
3. Never trust the income and expense data provided by the seller’s Realtor. While a seller represented by a CCIM will have a greater chance of supplying you with accurate data, most will significantly understate expenses and overstate the capitalization rate. Selling Realtors often understate the average annual cost of repairs and maintenance. I estimate this annual expense at 10%.
4. Another often understated expense is management. Many owners manage their own properties, so the selling broker doesn’t include an estimate for management expenses. They should. Real estate doesn’t manage itself, ever. You will either need to hire professional management or do your own management (always a scary proposition). Even if you do it yourself, you have an opportunity cost of your time, so you must include a management fee in the expenses. Most small residential apartments and single-family homes will pay 10% of their rents to a manager.
5. You must verify all the costs presented to you by the seller’s Realtor. Demand copies of at least the last three and preferably five years of tax returns. Research items like utility bills, property taxes, legal fees, insurance costs and repairs, maintenance costs, replacement reserves, tax preparation and all management fees. As a rule of thumb, expenses will average 40% of rental income on average-aged properties where the tenants pay all utilities except water. Newer properties may have expenses as low as 35%, while older properties can be as high as 50%.
6. By subtracting the vacancy rate and stabilized expenses from the rent, you will find the net operating income. This is the income you will put in your pocket—assuming the property is paid for. By dividing the net operating income by the purchase price, you will find the return you will receive on your investment, called the capitalization or “cap” rate. In Rapid City SD, for example, the cap rate tends to be 4% for single-family homes, 5% to 8% for duplexes to eight-plexes, and 8% to 12% for larger residential and commercial properties.
Citation: https://www.r2library.com/Resource/Title/0826102549
ASSESSMENT: Yes, physician-investors and all of us can build wealth with real estate. You just need to educate yourself, work hard, start conservatively, think long-term, and be prepared for lean years. This is not a quick or easy path to riches.
Your comments are appreciated.
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Filed under: CMP Program, Experts Invited, iMBA, Inc., Investing, Sponsors | Tagged: Certified Medical Planner™, CMP Program, Non-Publicly Traded REITS, real-estate, REITS, Rick Kahler CFP® | Leave a comment »
By Ann Miller RN MHA CMP®
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The Institute of Medical Business Advisors, Inc provides a team of experienced, senior level consultants led by iMBA Chief Executive Officer Dr. David Edward Marcinko MBA CMP™ MBBS [Hon] and Ann Miller RN MHA CMP™ to provide ongoing contact with our clients throughout all phases of each project, with most of the communications between iMBA and the key client participants flowing through this Senior Team. iMBA Inc., and its skilled staff of certified professionals have many years of significant experience, enjoy a national reputation in the healthcare consulting field, and are supported by an unsurpassed research and support staff of CPAs, MBAs, MPHs, PhDs, CMPs™, CFPs® and JDs to maintain a thorough and extensive knowledge of the healthcare environment. The iMBA team approach emphasizes providing superior service in a timely, cost-effective manner to our clients by working together to focus on identifying and presenting solutions for our clients’ unique, individual needs.
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The iMBA Inc project team’s exclusive focus on the healthcare industry provides a unique advantage for our clients. Over the years, our industry specialization has allowed iMBA to maintain instantaneous access to a comprehensive collection of healthcare industry-focused data comprised of both historically-significant resources as well as the most recent information available. iMBA Inc’s specific, in-depth knowledge and understanding of the “value drivers” in various healthcare markets, in addition to the transaction marketplace for healthcare entities, will provide you with a level of confidence unsurpassed in the public health, health economics, management, administration, and financial planning and consulting fields. iMBA Inc’s information resources and network of healthcare industry textbook resources enhanced by our professional consultants and research staff, ensure that the iMBA project team will maintain the highest level of knowledge regarding the current and future trends of the specific specialty market related to the project, as well as the healthcare industry overall, which serves as the “foundation” for each of our client engagements.
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[Executive Director]
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Demanding High Moral Standards of Self … and Economic HEALTHCARE Organizations
Dr. David Edward Marcinko MBA CMP®
SPONSOR: http://www.CertifiedMedicalPlanner.org
It has been argued that physicians have abdicated the “moral high ground” in health care by their interest in seeking protection for their high incomes, their highly publicized self-referral arrangements, and their historical opposition toward reform efforts that jeopardized their clinical autonomy.
Experts Speak
In his book Medicine at the Crossroads, colleague and Emory University professor Melvin Konnor, MD noted that “throughout its history, organized medicine has represented, first and foremost, the pecuniary interests of doctors.” He lays significant blame for the present problems in health care at the doorstep of both insurers and doctors, stating that “the system’s ills are pervasive and all its participants are responsible.”
In order to reclaim their once esteemed moral position, physicians must actively reaffirm their commitment to the highest standards of the medical profession and call on other participants in the health care delivery system also to elevate their values and standards to the highest level.
Evolution
In the evolutionary shifts in models for care, physicians have been asked to embrace business values of efficiency and cost effectiveness, sometimes at the expense of their professional judgment and personal values. While some of these changes have been inevitable as our society sought to rein in out-of-control costs, it is not unreasonable for physicians to call on payers, regulators and other parties to the health care delivery system to raise their ethical bar.
Harvard University physician-ethicist Linda Emmanuel noted that “health professionals are now accountable to business values (such as efficiency and cost effectiveness), so business persons should be accountable to professional values including kindness and compassion.”
Within the framework of ethical principles, John La Puma, M.D., wrote in Managed Care Ethics, that “business’s ethical obligations are integrity and honesty. Medicine’s are those plus altruism, beneficence, non-maleficence, respect, and fairness.”
Incumbent in these activities is the expectation that the forces that control our health care delivery system, the payers, the regulators, and the providers will reach out to the larger community, working to eliminate the inequities that have left so many Americans with limited access to even basic health care.
Charles Dougherty clarified this obligation in Back to Reform, when he noted that “behind the daunting social reality stands a simple moral value that motivates the entire enterprise”.
ASSESSMENT
Health care is indeed grounded in caring. And, managing risk is a component of caring. It arises from a sympathetic response to the suffering of others.
YOUR THOUGHTS ARE APPRECIATED
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Filed under: CMP Program, Ethics, iMBA, Inc., Op-Editorials, Practice Management, Touring with Marcinko | Tagged: certified medical planner, Charles Dougherty c, CMP, David Edward Marcinko, Ethics, John La Puma, medical ethics, Melvin Konnor | 1 Comment »
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A defined benefit (DB) pension plan is a type of pension plan in which an employer/sponsor promises a specified pension payment, lump-sum or combination thereof on retirement that is predetermined by a formula based on the employee’s earnings history, tenure of service and age, rather than depending directly on individual investment returns. Traditionally, many governmental and public entities, as well as a large number of corporations, provide defined benefit plans, sometimes as a means of compensating workers in lieu of increased pay.
A defined contribution (DC) plan is a type of retirement plan in which the employer, employee or both make contributions on a regular basis. Individual accounts are set up for participants and benefits are based on the amounts credited to these accounts (through employee contributions and, if applicable, employer contributions) plus any investment earnings on the money in the account. In defined contribution plans, future benefits fluctuate on the basis of investment earnings. The most common type of defined contribution plan is a savings and thrift plan. Under this type of plan, the employee contributes a predetermined portion of his or her earnings (usually pretax) to an individual account, all or part of which is matched by the employer.
CITE: Wilipedia
CITE: https://www.r2library.com/Resource/Title/0826102549
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THANK YOU
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What’s Up?
[By staff reporters]
According to Wikipedia, the hemline index is a theory presented by economist George Taylor in 1926. The theory suggests that hemlines on women’s dresses rise along with stock prices.
In good economies, we get such results as miniskirts (as seen in the 1920s and the 1960s), or in poor economic times, as shown by the 1929 Wall Street Crash, hems can drop almost overnight.
Non-peer-reviewed research in 2010 supported the correlation, suggesting that “the economic cycle leads the hemline with about three years”.
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Conclusion
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About NFTs
[By staff reporters]
Sponsored: http://www.CertifiedMedicalPlanner.org
According to Wikipedia, a non-fungible token (NFT) (previously referred to as Bitcoin 2.0) is a unit of data stored on a digital ledger, called a blockchain, that certifies a digital asset to be unique and therefore not interchangeable. NFTs can be used to represent items such as photos, videos, audio, and other types of digital files. Access to any copy of the original file, however, is not restricted to the buyer of the NFT. While copies of these digital items are available for anyone to obtain, NFTs are tracked on blockchains to provide the owner with a proof of ownership that is separate from copyright.
In 2021, there has been increased interest in using NFTs. Blockchains like Ethereum, Flow, and Tezos have their own standards when it comes to supporting NFTs, but each works to ensure that the digital item represented is authentically one-of-a-kind. NFTs are now being used to commodify digital assets in art, music, sports, and other popular entertainment. Most NFTs are part of the Ethereum blockchain; however, other blockchains can implement their own versions of NFTs.
Crypto Currency Basics: https://medicalexecutivepost.com/2014/01/23/understanding-currencies-bitcoins/
The Crypto-future through Bitcoin, Ethereum, Ripple XRP and IOTA
Carbon Footprint!
CARBON
The NFT market value tripled in 2020, reaching more than $250 million. The rise of NFT transactions has also led to increased environmental criticism. The computation-heavy processes associated with proof-of-work blockchains, the type primarily used for NFTs, require high energy inputs that are contributing to global warming. The carbon emissions produced by the energy needed to maintain these blockchains has forced some in the NFT market to rethink their carbon footprint.
Your thoughts are appreciated.
BITCOIN: https://medicalexecutivepost.com/2014/01/23/understanding-currencies-bitcoins/
Comments Appreciated
THANK YOU
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Filed under: Financial Planning, iMBA, Inc., Investing | Tagged: Bitcoin, blockchain, cryptocurrency, NFT, Non-Fungible Token, NTFs | 5 Comments »
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Filed under: Book Reviews, Career Development, Estate Planning, Financial Planning, Health Economics, Health Insurance, Health Law & Policy, iMBA, Inc., Practice Management, Recommended Books, Retirement and Benefits, Risk Management | Tagged: cyber monday, Hospitals and Healthcare Organizations, Hosptals | 6 Comments »
http://www.CertifiedMedicalPlanner.org
A Chief Strategy Officer [CSO], or chief strategist, is the senior executive responsible for assisting the Chief Executive Officer [CEO] with developing, communicating, executing, and sustaining corporate strategic initiatives. Some companies give the title Chief Business Officer [CBO] to its’ senior executives who are holding the top strategy role.
My opinion in academia
A few decades ago, the role of university Chief Strategy Officer [CSO] did not exist or marginally existed as a mid-level project manager in the communications department. It may have consisted of a formal background in teaching and education exhibited by the BA and/or B.Ed degrees or HR certification.
A first generation didactic CSO 1.0; if you will.
Then, as academic competition and granularity increased along with new technology information exchange, the need for deeper subject matter expertise arose. Next – generation business, under/graduate LAs, HUMANITIES, modern culture, psychology / sociology and STEM expertise arose to create and explore new – real or perceived – strategic advantages for university public relations in the form of the M.Ed, MA or MBA degrees in marketing, advertising, sales or competitive analysis.
THINK: Michal Porter PhD, known for his theories on economics, business strategy, and social causes. He is the Bishop William Lawrence University Professor at Harvard Business School, and a social impact consultant. He is credited for creating Porter’s five forces analysis, which is instrumental in business strategy development today.
Also, consider traditional S.W.O.T analysis, as well. SWOT analysis (alternatively SWOT matrix) is an initialism for strengths, weaknesses, opportunities, and threats—and is a structured planning method that evaluates those four elements of a project or business venture. A SWOT analysis can be carried out for a product, place, industry, university or person.
So, let’s call this a second generation expert CSO 2.0
However, as the complex business of running any college or university is ever changing, the ideal profile of CSO is still morphing to face modern business and management challenges like: physical and cyber security; culture and organizational behavior; gender differences, racial disparities and workplace violence issues; enrollment and international expansion; corporatization and competition; online and e-learning initiatives; with accounting, financial and economic pressures, etc.
Consequently, BODs are now seeking and embracing a new kind of CSO with advanced PhD or DBA degrees; and college and university experience. In fact, the role of contemporary CSO is emerging and becoming closer to that of an experienced corporate Chief Executive Officer, than the mere educator, academician or manager of the past.
Universities and colleges today
Insightful academic search committees are now seeking a new type of modern CSO who can build university and college rankings, maintain relationships with stakeholders, and project a positive image as a “celebrity university”.
This means shepherding students and attracting qualified youth, and faculty, for matriculation as areas of particular importance. This new entrepreneurial CSO must focus on business management, economics and finance – operational, marketing, advertising and consultative sales strategies to attract a qualified, protean and diverse student / professional staff that sets it apart from the competition; as well as more meaningfully interacting within [research and development], and without the university [outreach].
Accordingly, this modern CSO must be a combination and protean surrogate for the university CEO / CFO / CMO / COO / CAO and leader – NOT just a teacher or manager – who will help run it like a matrix business unit that makes a profit to generate needed capital and ROI.
Multiple lines of business – tuition; certifications; worker-placement; grants and endowments; CEUs and non-degree program fees; as well as for-profit R&D, publications, patents, copyrights and trade-marks; and applied business incubators – must ALL be created and managed as a diversified portfolio. S/he must lead in the implementation, planning and operations of systemic community responsive programs, as well as policy interventions requiring advocacy, political action and public analysis.
I prefer the moniker – CSO 3.0
Assessment
This academic CSO 3.0 must be a change-agent, crisis manager, corporate strategist, Machiavellian devotee and/or seasoned C-suite executive with the required inter – disciplinary skills outlined for this important position.
Above all – the modern CSO 3.0 must be pro-active, flexible and market responsive. This is not the place for tenure tracking.
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[Foreword Dr. Phillips MD JD MBA LLM] *** [Foreword Dr. Nash MD MBA FACP] [Foreword Dr. Hashem MD PhD] *** [Foreword Dr. Silva MD MBA]
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.
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Filed under: iMBA, Inc., Op-Editorials, Touring with Marcinko | Tagged: chief strategy officer, CSO, education | 7 Comments »
The teacher of entrepreneurship as a role model
[Students’ and teachers’ perceptions]
By Staff Reporters
LINK: iencedirect.com/science/article/abs/pii/S1472811719301375
Your thoughts are appreciated.
THANK YOU
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Filed under: Career Development, iMBA, Inc. | Tagged: entrepreneur, entrepreneur-in-residence, Entrepreneurs | 1 Comment »
Happy “Pi” Day
Dr. David E. Marcinko MBA
MORE: https://en.wikipedia.org/wiki/Pi_Day
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CITE: https://www.r2library.com/Resource/Title/082610254
COMMENTS APPRECIATED
Thank You
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Filed under: iMBA, Inc., LifeStyle | Tagged: 3.14, march 14, Pi, pi day | 1 Comment »
Including Public Relations, Risk, Change and Crisis Management
By Dr. David Edward Marcinko MBA
Marketing is the business process of identifying, anticipating and satisfying customers’ needs and wants. It is your unique value proposition or strategic competitive advantage. Marketers can direct product to other businesses or directly to consumers.
Advertising is a marketing communication that employs an openly sponsored, non-personal message to promote or sell a product, service or idea. Sponsors of advertising are typically businesses wishing to promote their products or services. Advertising is communicated through various mass media, including traditional media such as newspapers, magazines, television, radio, outdoor advertising or direct mail; and new media such as search results, blogs, social media, websites or text messages. The actual presentation of the message in a medium is referred to as an advertisement, or “ad” or advert for short.
Advertising is differentiated from public relations in that an advertiser pays for and has control over the message. It differs from personal selling in that the message is non-personal, i.e., not directed to a particular individual. We pay for advertising but pray for public relations.
Sales are activities related to selling or the number of goods or services sold in a given targeted time period. The seller, or the provider of the goods or services, completes a sale in response to an acquisition, appropriation, requisition, or a direct interaction with the buyer at the point of sale. There is a passing of title (property or ownership) of the item, and the settlement of a price, in which agreement is reached on a price for which transfer of ownership of the item will occur. The seller, not the purchaser, typically executes the sale and it may be completed prior to the obligation of payment. In the case of indirect interaction, a person who sells goods or service on behalf of the owner is known as a salesman or saleswoman or salesperson, but this often refers to someone selling goods in a store/shop, in which case other terms are also common, including salesclerk, shop assistant, and retail clerk.
Change management is the discipline that guides how we prepare, equip and support individuals to successfully adopt change in order to drive organizational success and outcomes.
Crisis management is the identification of threats to an organization and its stakeholders, and the methods used by the organization to deal with these threats.
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Risk management is the identification, evaluation, and prioritization of risks (defined in ISO 31000 as the effect of uncertainty on objectives) followed by coordinated and economical application of resources to minimize, monitor, and control the probability or impact of unfortunate events or to maximize the realization of opportunities.
Assessment: Your thoughts are appreciated from a healthcare perspective.
Filed under: iMBA, Inc., Touring with Marcinko | Tagged: advertising, change risk crisis management, marketing, public relations, sales | 2 Comments »
Jonathan Mase | Jonathan A. Mase's WordPress Blog
Operating as a startup company will present many challenges, but you should take heart in knowing that many of today’s biggest companies were once in your position. If you wish for your startup company to succeed, then employee engagement will be a crucial factor. Keep reading to learn more about the importance of employee engagement for startups. It should allow you to figure out the right path forward to find the success you desire.
It Makes Employees Loyal
When employees are engaged in the work they are doing, they will be more likely to be loyal to your company. Having loyal employees will benefit you in several different ways, but one of the most important ones is that they will work harder. When employees are engaged in the work that they’re doing, then that means that they truly care about it. They’re going to take things seriously, and you will…
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IS PRIVATE EQUITY BUYING DOCTORS ILLEGAL?
By Eric Bricker MD
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YOUR COMMENTS APPRECIATED
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Filed under: Accounting, Career Development, Ethics, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc., Investing, Videos | Tagged: Blackstone, corporate practice medicine, KKR, PPMC, Private Equity, Private Equity Medicare, VCs, Venture Capital | Leave a comment »
AVOID COLLATERAL ECONOMIC DAMAGE OF HEALTH CARE REFORM – AS A CERTIFIED MEDICAL PLANNER™ PROFESSIONAL
By Eugene Schnmuckler PhD MBA MEd CTS
[Academic Provost and Dean]
http://www.CertifiedMedicalPlanner.org
The healthcare industrial complex represents a large and diverse collateral support industry, and the livelihood of synergistic professionals who advise doctors depend on it. So, if you want to be an outstanding financial advisor in the healthcare space, you better read this book and learn something about physician specific financial planning.
Better yet! Combine financial planning and practice management and become a Certified Medical Planner ™. Then, integrate this knowledge, and CMP™mark of distinction, into your current financial advisory or healthcare consulting practice.
Or, as some of the following financial services professionals are learning, you might just become more collateral economic damage in the current managed healthcare debacle, if you don’t.
Certified Public Accountants
The nation’s 330,000 or so CPAs know little about the new healthcare dynamics and financial planning. Many often feel as though they are laboring away in obscurity and that their doctor clients do not appreciate what they do or how hard they work.
If you are a CPA, your workweek is ridiculously long, especially January through April; and you often deliver bad news to your doctor clients. You do not earn a generous salary, but you do receive their ire for your efforts. Even ex-SEC chief Arthur Levitt said, “Accounting is clearly a profession in crisis”, after reviewing Arthur Andersen, LLP’s role in Enron Corporation’s collapse, in 2002; not to mention the Global Crossing Ltd, Vivendi Universal, Warnaco, Martha Stewart and WorldCom fiascos.
So, you begin to scratch your head and ponder, quietly at first, and then out loud. Perhaps advising and managing the medical practice of a physician, or providing consulting services to other medical professionals is an opportunity that won’t require a new client base? You can keep your accounting practice during the first four months of the year, and supplement your income with something that may actually earn more than you are making now.
A light then goes off in your head. Epiphany! Enter iMBA’s Certified Medical Planner™(CMP™) professional certification program, exhorting accountants to “integrate personal financial planning with medical practice management”, through an additional 500 hours of online managerial and planning experience.
However, terms such as capitated medicine; per member-per month fixed fees; payment withholds’; activity based costing with CPT codes; utilization and acuity rates; and more investment and financial nomenclature is likely quite unfamiliar to you.
Furthermore, you may not have the temperament to be responsible for the financial affairs of others. Then you realize that CMPs along with MBAs and CFPs may actually be the new denizens of the healthcare bean counting and practice management scene. Rather than present numbers of the historic past, they make logical and mathematical inferences about the future.
Slowly, you realize that this has occurred because these professionals are proactive, not reactive, as the accounting profession is loosing its premier advisory position within the medical profession. Since doctors are paid a fixed fee amount, regardless of the number of services performed, these futuristic projections are the most important accounting numbers in healthcare today.
In fact, your research suggests that as a result, nearly every major accounting firm has created a financial advisory unit, or acquired one. Moss-Adams acquired Financial Securities in Seattle. Plante and Moran’s advisory unit is one of the largest and most successful in Michigan. And, 1st Global now offers a turnkey program that allows nearly every accounting firm to create its own advisory unit overnight.Even, the AICPA is providing encouragement to CPAs who wish to provide more professional client services by uniting with Fidelity to serve as a professional vendor. And, the PFS designation is about to be abandoned by the AICPA.
Tax Attorneys and Lawyers
As a tax planning, health-law or estate attorney, you already know that almost every legal magazine around has articles or advertisements proposing that you become a financial planning professional or business consultant to your physician clients. Moreover, lawyers of all stripes are being pushed toward interdisciplinary alliances by encroachment on their turf by the Big Four consulting firms. With audits of publicly held companies now a commodity, the giant law firms are getting more of their revenues from consulting fees; and that puts them into direct competition with you and other legal professionals.
Of all careers, you know how absolutely onerous it is to practice medicine today, and are finally thankful that you did not take that career route many years ago. So, like your neighbor the accountant, you begin to explore that potential of developing a service line extension to your legal practice, in order to assist your medical colleagues who have been hit on hard economic times.
In fact, you soon realize that more than 90,000 trust, probate and estate planning attorneys like yourself are interested in pursuing financial planning in the next decade. Sure, you know its difficult to get a CLU or variable annuity license, or become a Certified Financial Planner (CFP), but earning your law degree was no cinch either. And, you reckon, advising physicians has got to be easier than law, or less stressful than the corporate lifestyle of your CMP trained brother-in-law, right?
So, you set out to stretch your legal horizons with an online Certified Medical Planner™ certification program and explore the basic legal nuances of those topics not available in law school when you were a student. Things like medical fraud and abuse; managed care compliance audits and Medicare recoupments; PP-ACA, RACS, OSHA, DEA, HIPAA and EPA standards; anti-trust issues; and managed care contract dilemmas or de-selection appeals.
What a brave new world the legal profession has become! Even the American Bar Association’s commission on multi-disciplinary practice has recommended that lawyers be permitted to share fees and become partners with financial planners, money managers and other similar professionals.
As a real life example, the venerated Baltimore brokerage firm of Legg Mason, Inc, has recently teamed up with the Boston law firm of Bingham Danna, LLC, to create one of the first marriages between a law and securities firm. If you want in on the challenge, and bucks, you’d better acquire at least a working knowledge of health care administration, or perhaps help craft some new case law, or assist your doctor-clients in some other fashion; otherwise, you will remain a legal document producer.
Financial Planners and Investment Advisors
As a CFP, CFA, investment advisor or general securities representative, you realize that the financial service sector is going to become the next great growth opportunity of the 21st Century, despite the fact that the stagnant stock market in 2003-2004 set profits for the securities industry back by seven years.
Even H & R Block, and the Charles Schwab Corporation are trying to build medical professional interest in their respective firms and compete with your independent practice. They are fervently wooing away one group or another to interface with their embryonic financial advisory programs. Meanwhile, more than 260,000 of the nation’s brokers are moving into the investment advisory and financial planning business, as transactions have become commoditized.
A recent survey conducted for the Financial Planning Association clearly demonstrated the dominance of registered investment advisors, over stockbrokers, among clients 35-49 years old. With the average Merrill Lynch private client well over 60, it’s easy to spot the future vulnerability of this business model.
When asked to determine the added value of key industry players, baby boomers in a recent Dalbar study ranked financial planners first, followed by stockbrokers, CPAs, mutual fund companies, insurance agents, and commercial bankers, respectively. Even if you are a CFP, and despite the proliferation of investment advisors, evidence suggests that your individual impact is still narrow.
Furthermore, another Prince & Associates study of 778 affluent individuals including physicians, each with more than 5 million dollars to invest, examined the relationship between clients and their providers of five key financial services; retirement planning, estate planning, investment management, executive benefits and health-disability insurance. Prince found that 59 percent of the clients had been serviced in only one area by a particular advisor. Despite the significant assets of each client, the advisers have been unsuccessful at broadening these relationships– a key indicator that many affluent clients do not have a primary financial adviser.
Among the challenges you face to broaden your influence is to offer your clients value added services, perhaps by establishing your expertise in the medical niche and capitalize on being different (your unique knowledge-based value proposition). You must not remain just another of the more than 250,000, or so individuals who claim to be financial planners, with a collective universe of an additional 700,000, who purport to be financial advisors, in some fashion or another. You must begin to develop the strategic competitive advantage of practice management knowledge to synergize with your existing financial services product line.
Like the physicians you advise, you must consider becoming a specialist. In the highly coveted healthcare space, this specialist to high net worth doctors, is known as a Certified Medical Planner™ practitioner.
Integrated practice management and financial planning will also become much more competitive among physicians because they are aware of the above fusion. No one is suggesting therefore, that you abandon your core financial advisory business for medical practice management. It is merely a fact that healthcare has drastically changed during the past decade, and the knowledge you used yesterday will no longer be enough for you to get by on in the future.
Medical practice management is the natural outgrowth of traditional financial planning services, and investment advice in turn, is central to the implementation of a unified medical office and personal financial plan. The most successful financial planners therefore, may be CMPs and CFPs who incorporate medical management services into their practices.
Insurance Agents and Counselors
As a traditional life insurance agent, it seems that almost all your colleagues are acquiring a general securities license, or CFP designation in addition to the CLU or ChFC after their name. Currently, there are more than 3 million insurance agents, half of which are independent. They are being pressured to move toward financial planning, as distribution of insurance products over the Internet spreads like wildfire.
Meanwhile, the same insurance and investment companies that are knocking on your door are also courting the medical professionals with their practice enhancement programs. Even if you are not interested in going into the financial planning business, you have seen the status of the American College erode of late, even as your own insurance business has declined because of the World Wide Web and various discounted insurance companies.
And, in the eyes of your former golden goose doctor-clients, you may have become a charlatan and everyone is clamoring for a piece of your insurance business and cloaking it in the guise of the contemporary topic of the day; medical practice management and financial planning. Think this is an exaggerated statement? An October 1997 survey conducted by Deloitte & Touche Consulting Group of New York, found insurance agents ranked last in having the trust of a wide selection of the public! Erosion has continued, ever since.
So, how do you regain this lost trust, and what about this new entity known as managed care? How do you learn about it at this stage in your career? What ever happened to the traditional indemnity health insurance, with its deductible and 80/20payment scheme? It was so easy to sell, provided good coverage, and the agent made a nice profit.
As an insurance agent, all you want to know is, can I still sell insurance and make a living? Like the struggling doctors you seek to advise, and the collateral advisors above, you find yourself asking, how do I talk the talk, and walk the walk, in this new era of medical insurance turmoil?
Slowly, as you read, study and learn about the Certified Medical Planner™ certification program, you become empowered with the knowledge and ideas for new insurance product derivatives, that actually provide value to your physician clients. You are no longer just an insurance salesman, but a trusted medical risk management advisor.
Congratulations!
You can avoid the managed care economic ripple effect. Act now!
Office: Dean of Admissions
Certified Medical Planner™ Designation Program
Institute of Medical Business Advisors, Inc
Peachtree Plantation – West
Suite # 5901 Wilbanks Drive
Norcross, Georgia 30092-1141
770.448.0769 (voice)
770.361.8831 (fax)
http://www.MedicalBusinessAdvisors.com
http://www.CertifiedMedicalPlanner.org
MarcinkoAdvisors@msn.com
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:
Filed under: Career Development, Financial Planning, iMBA, Inc., Practice Management | Tagged: certified medical planner, CMP Program | 1 Comment »
BY JONATHAN MASE R.N.
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Being an entrepreneur is not necessarily easy, and many people that try to become entrepreneurs wind up failing. It’s important to recognize the risk of failure before you decide to walk down this path. Being an entrepreneur is very rewarding, and you can find success if you can do things right.
Keep reading to learn about common entrepreneurial mistakes that you can avoid to give yourself a better chance of realizing your entrepreneurial goals.
READ: https://jonathanmase.wordpress.com/2021/08/06/common-entrepreneurial-mistakes/
Your comments are appreciated.
THANK YOU
MD Entrepreneurs: https://medicalexecutivepost.com/2021/07/29/minnovation-for-physician-entrepreneurs/
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Filed under: Career Development, Events-Planner, Funding Basics, Health Economics, Healthcare Finance, iMBA, Inc., Interviews | Tagged: entrepreneur mistakes, entrepreneurial MDs, Entrepreneurs, Jonathan Mase, Physician Entrepreneurs | Leave a comment »
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Hospitals Are Paid More for SAME SERVICE in Outpatient Department Than Doctors Are Paid in Office.
For Example, the SAME Echocardiogram Costs $600 in a Hospital Outpatient Department and $250 in a Doctor’s Office.
By Dr. Eric Bricker MD
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Filed under: "Doctors Only", Career Development, Ethics, Experts Invited, Glossary Terms, Health Economics, Health Insurance, iMBA, Inc., Videos | Tagged: AHA, AMA, cite neutral payments, CMS, Dr. Eric Bricker MD, HOPD, hospital out-patient, Hospital Out-Patient Pricing, medicare, out-patient, Rick Kahler CFP® | 1 Comment »
FOR PHYSICIANS AND THEIR FINANCIAL ADVISORS
SPONSOR: http://www.CertifiedMedicalPlanner.org
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REVIEWS:
“Physicians who don’t understand modern risk management, insurance, business, and asset protection principles are sitting ducks waiting to be taken advantage of by unscrupulous insurance agents and financial advisors; and even their own prospective employers or partners. This comprehensive volume from Dr. David Marcinko and his co-authors will go a long way toward educating physicians on these critical subjects that were never taught in medical school or residency training.”
—Dr. James M. Dahle, MD, FACEP, Editor of The White Coat Investor, Salt Lake City, Utah, USA
“With time at a premium, and so much vital information packed into one well organized resource, this comprehensive textbook should be on the desk of everyone serving in the healthcare ecosystem. The time you spend reading this frank and compelling book will be richly rewarded.”
—Dr. J. Wesley Boyd, MD, PhD, MA, Harvard Medical School, Boston, Massachusetts, USA
ASSESSMENT: Your thoughts are appreciated.
ORDER TEXTBOOK: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989
SECOND OPINIONS: https://medicalexecutivepost.com/schedule-a-consultation/
INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/
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THANK YOU
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Filed under: "Advisors Only", "Ask-an-Advisor", "Doctors Only", Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc., Managed Care, Recommended Books, Research & Development, Retirement and Benefits, Risk Management, Sponsors, Touring with Marcinko | Tagged: David Edward Marcinko, malpractice, medical risk management, physician risk management, Risk Management for Doctors, risk management for physicians and advisors | Leave a comment »
Some Financial Thoughts and/or Rules?
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By Dr. David Edward Marcinko MBA CMP®
SPONSOR: http://www.CertifiedMedicalPlanner.org
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The 10-year rule for buying a new vehicle
When trying to decide whether to buy a used car or a new one, it’s typically financially wiser to buy used. But if you want to buy new, you should plan to drive the car for 10 years or more.
Better yet – do not buy a new vehicle.
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If you have to borrow when buying a car, to avoid spending more than you can afford you should put down at least 20%, keep the loan limited to no more than four years (to avoid interest), and spend no more than 10% of your gross income on transportation costs (which includes the car payment, parking, gas, and insurance).
Better yet – do not buy a new vehicle.
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Pre-Owned Used Cars!
MORE: https://medicalexecutivepost.com/2012/11/28/how-doctors-might-buy-a-pre-owned-car/
MORE: https://medicalexecutivepost.com/2014/11/09/doctors-and-rental-cars/
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Filed under: "Ask-an-Advisor", "Doctors Only", Accounting, iMBA, Inc., Insurance Matters, LifeStyle | Tagged: auto purchases, auto rentals, new automobiles, new cars, older cars, pre-purchased cars, used cars | Leave a comment »
Book Dr. David E. Marcinko MBA MBBS for your Next Medical, Pharma or Financial Services Seminar or Personal and Corporate Coaching Sessions
Dr. Marcinko enjoys personal coaching and public speaking and gives as many talks each year as possible, at a variety of medical society and financial services conferences around the country and world.
These include lectures and visiting professorships at major academic centers, keynote lectures for hospitals, economic seminars and health systems, endnote lectures at city and statewide financial coalitions, and annual engagements for a variety of internal and external yearly meetings.
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[Dr. Cappiello PhD MBA] *** [Foreword Dr. Krieger MD MBA]
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[Foreword Dr. Hashem MD PhD] *** [Foreword Dr. Silva MD MBA]
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Filed under: iMBA, Inc. | Leave a comment »
Indications for 2022
BY HEALTH CAPITAL CONSULTANTS, LLC
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2021 M&A in Review: Indications for 2022
After an understandable slowdown in 2020, due to the onset of the COVID-19 pandemic, merger & acquisition (M&A) activity in the healthcare industry accelerated in 2021, and the industry is expected to continue the high number of deals and high deal volume in 2022.
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This Health Capital Topics article will review the U.S. healthcare industry’s M&A activity in 2021, and discuss what these trends may mean for 2022. (Read more…)
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CITE: https://www.r2library.com/Resource/Title/0826102549
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Filed under: "Ask-an-Advisor", Accounting, Ethics, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc., Managed Care | Tagged: Covid-19, Health Capital Consultants LLC, healthcare mergers acquisitions, HEALTHCARE: 2021 M&A in Review, M&As | Leave a comment »
The “Real Deal”
A co-payment is a fixed amount ($20, for example) you pay for a covered health care service after you’ve paid your deductible.
Let’s say your health insurance plan’s allowable cost for a doctor’s office visit is $100. Your copayment for a doctor visit is $20.
Copayments (sometimes called “copays”) can vary for different services within the same plan, like drugs, lab tests, and visits to specialists. Generally plans with lower monthly premiums have higher copayments. Plans with higher monthly premiums usually have lower copayments.
CITE: https://www.r2library.com/Resource/Title/0826102549
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BY DR. DAVID E. MARCINKO MBA CMP®
SPONSOR: http://www.CertifiedMedicalPlanner.org
Co-Pay Cards May Be Creating More Controversy Instead of Solutions
Instead of reducing the actual price of their excessively priced medications, many companies have opted to provide co-pay cards / coupons as an affordable solution. However, co-pay cards may only lower the cost for some consumers and patients.
Novartis: https://www.copay.novartispharma.com/nvscopay/#
Pfizer: https://www.pfizerpro.com/co-pay-cards-patient-savings-offers
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But – The insurer is still left to pay the high price, which will eventually be passed back on to the patient / consumers in the form of higher health insurance deductibles. So – It doesn’t really seem like much of a solution when we all end up paying for these co-pay cards / coupons; does it?
Find out more here. (Source: Rebecca Mayer Knutsen, MM&M, 8/26/16)
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MEDICAL OFFICE CREDIT CARDS:
We stopped taking credit cards altogether. The only credit cards we take are for call-in payments of balances. We have placed ATM machines in our lobbies and we educate patients in advance of their visits that we only take cash or check. Our cash income has increased, our credit card fees have decreased, and we make $1.50 from each transaction through our ATM. Our patients have taken to the idea so much that they use the ATM for personal cash for other transactions because our fee is the lowest of any ATM. It has been a win-win-win.
–Dr. Farshid Nejad, Beverly Hills, CA [PM Magazine]
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For anyone contemplating taking credit cards for payments or copayments in your office, please be aware that some of the credit card companies require you to sign a contract. Don’t do that! If you do and you either have a problem with the company or find out that they are overcharging you, they will hold you responsible for the contract and may take you to court. There are enough credit card companies out that that do not require contracts and are highly competitive.
-Dr. Elliot Udell, DPM, Hicksville, NY [PM Magazine]
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YOUR COMMENTS ARE APPRECIATED.
Thank You
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Filed under: CMP Program, Drugs and Pharma, Ethics, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, iMBA, Inc., Touring with Marcinko | Tagged: Certified Medical Planner™, CMP, co-pay cards, co-pay coupons, drug cards, drug copays, drug coupons | Leave a comment »
The Top 10 [Ten] Disruptive Digital Business Models For Health Insurers
By Zhang Jie
Digital technologies will transform the health insurance business. Early adopters have started to implement new digital business models with initial success. A new report describes ten digital business models for health insurers that will disrupt the industry.
Dear Dr. David Marcinko and all ME-P Readers,
We are excited to announce the release of Research2Guidance’s new “The 10 Disruptive Digital Business Models for Health Insurers” report.
Please find below the special report story.
Advances in higher-quality digital technology—especially apps, sensors, and artificial intelligence (AI)—along with their proliferation among members have spurred the emergence of new business models.
The new report “The 10 Disruptive Digital Business Models for Health Insurers” published by Research2Guidance describes how start-ups, health insurance and general payer organizations have started using these technologies to venture into new forms of health insurance offerings and increasingly step into the healthcare provider role.
New digital models change the way the insurers interact with patients. For example, digital insurers have reworked the trust equation with the patient, outsourced much of their value chain to their members, and now know much more about them. Digital business models tend to also blur the lines between payer and care giver organizations. Some of the first-movers already crossed the line and started to offer services which have previously been provided exclusively by doctors and nurses. The ten digital business models are defined as follows:
First implementations of these models indicate the positive impact that they have on the company evaluation, the ability to attract new members, the cost structure, and new revenue streams. Currently, the main impact of digital business models is on company evaluation, which reflects the hype that some companies have created in the investor community. Companies like Oscar, Clover Health, and Bright Health are valued at over $1 billion USD each after only a few years of operation.
Health insurers and start-ups from the USA and China are the most aggressive in adopting new digital business models. Companies from other regions tend to choose a follower approach or implement copycats.
ASSESSMENT
The report also profiles first-mover digital implementations. Profiles include their target groups, operating models, service offerings, and early evidence for success where available.
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.
Book Marcinko: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/
Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.
DOCTORS:
“Insurance & Risk Management Strategies for Doctors” https://tinyurl.com/ydx9kd93
“Fiduciary Financial Planning for Physicians” https://tinyurl.com/y7f5pnox
“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8
HOSPITALS:
“Financial Management Strategies for Hospitals” https://tinyurl.com/yagu567d
“Operational Strategies for Clinics and Hospitals” https://tinyurl.com/y9avbrq5
Filed under: Experts Invited, Health Insurance, iMBA, Inc., Information Technology | Tagged: Disruptive Digital Business Models For Health Insurers, Zhang Jie | 3 Comments »