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[Chief Executive and Education Officer]
David E. Marcinko MBBS DPM FACFAS MBA MEd BSc
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Filed under: Breaking News, Career Development, iMBA, Inc. | Tagged: David Edward Marcinko, Dr. David Marcinko, Linked-In | Leave a comment »
NON-NATIVE LANGUAGE PERILS
[Staff reporters]
Communication risk to immigrants with limited non-native language proficiency is a growing concern.
With today’s higher immigrant population in the United States, more medical practices are treating patients with limited English language proficiency.
All medical professionals and clinicians now run the risk of not properly communicating medical risk information to these populations.
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Assessment
In fact, a recent study shows that materials that include visual aids are being used by medical practices to effectively communicate with the patient.
Source: Garcia-Retamero, Rocio, and Mandeep, K. Dhami. “Pictures Speak Louder Than Numbers: On Communicating Medical Risks To Immigrants With Limited Non-Native Language Proficiency.” Health Expectations 14.(2011): 46-57. CINAHL Plus with Full Text Web 27 Apr. 2012
Conclusion
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Filed under: iMBA, Inc., Risk Management | Tagged: Garcia-Retamero, Mandeep K. Dhami, Non-Native Language Perils in Health Care | Leave a comment »
By Rick Kahler MSFS CFP®
Is investing fun? Certainly—for some of us who think number-crunching is more exciting than, say, gardening or watching “Game of Thrones.” Yet, as crucial as investing is for creating financial independence, most people don’t enjoy it.
Fortunately, understanding the investment process in detail isn’t a requirement to successful investing, any more than being a physician is a requirement for good health.
The Research
Research suggests a correlation between good health and investing in one’s health by getting regular physicals. Similarly, research shows people who engage professional money management have a significantly higher chance of investment success than those who do it themselves or rely on financial salespeople for guidance.
Unfortunately, it’s easier to find a competent doctor than a competent investment adviser. You know those with M.D. after their names must have passed stringent education and licensing requirements. Yet almost anyone can put “investment adviser” on a business card.
Few Regulations
Despite the lack of legal requirements, there are many competent investment professionals with wide education and strong skills. You just need to look beyond the designations after their names to find them.
Some things to look for:
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Assessment
When you find a professional investment adviser who meets these qualifications, you have one thing left to do. Your biggest challenge may be to let go of any fears or need to control and trust the adviser to work for you.
Conclusion
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8 
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Filed under: iMBA, Inc. | Tagged: Rick Kahler CFP® | 1 Comment »
Welcome Original Thinkers
By Nina Martin – Dreamer nina@wotquiz.com
Hi Dr. David E. Marcinko,
I’m reaching out to you because I thought you and the readers of Medical Executive-Post News [Trends, Info & Insights for Savvy Doctors and Their Advisors] might like to take and share a short fun personality quiz we call Welcome Original Thinkers or the WOT Quiz.
Kimberly-Clark thrives on original thinking and we are currently recruiting original thinkers to add to our teams. We’ve launched a new recruitment campaign, “Welcome Original Thinkers,” to find great talent that can help us solve problems and create solutions before consumers even know they need them. I’ve put all the info including videos, images and more on this microsite:
Be sure to let me know what kind of Original Thinker you are (I’m a Dreamer) and if you post, tweet or share, please use the hashtags #wot, #wotquiz and #welcomeoriginalthinkers
Assessment
Also, please send me the link as I’d love to share it with my team. I’m here if you have any questions. Thanks so much!
Conclusion
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[Dr. Cappiello PhD MBA] [Foreword Dr. Krieger MD MBA]
Front Matter with Foreword by Jason Dyken MD MBA
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Filed under: iMBA, Inc. | Tagged: Kimberly-Clark, Nina Martin, Welcome Original Thinkers | 1 Comment »
By Dr. Eowyn
Another VA scandal for Obama’s record. From Fox News: A Houston VA hospital altered records to hide lengthy patient waiting lists even as a national scandal regarding treatment of veterans was unfolding, a federal watchdog charged in a scathing report released this week. Officials at the Michael E. DeBakey VA Medical Center in Houston and […]
Conclusion
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Filed under: iMBA, Inc. | 4 Comments »
By Michael Langan MD
“I’m only here for a four day evaluation”– T-shirt sold at Talbott Recovery Center The New York Times article below written by Robert Dupont advocates coercion to facilitat…
Conclusion
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Filed under: iMBA, Inc. | Leave a comment »
[By Michael Lawrence Langan MD]
I can think of nothing more institutionally unjust than an unregulated zero-tolerance monitoring program with no oversight using unregulated drug and alcohol testing of unknown validity. But that…
Conclusion
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Filed under: Ethics, iMBA, Inc., Risk Management | Tagged: Elizabeth Warren, Michael Lawrence Langan MD, physician health programs | Leave a comment »
By ACR and AAN
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Conclusion
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Filed under: iMBA, Inc. | 4 Comments »
[By Darrell K. Pruitt DDS]
Expect malware entrepreneurs to charge what the market will bear, again and again.
“OCR Releases Guidance on Ransomware: ‘Your Money or Your PHI’”. By Dianne J. Bourque for The National Law Review,” July 12, 2016
http://www.natlawreview.com/article/ocr-releases-guidance-ransomware-your-money-or-your-phi
Bourque: “A key component of the guidance provides a ransomware attack that encrypts a Covered Entity’s ePHI is presumed to be a breach. As ransomware can infect a Covered Entity’s entire system, this presumption may lead to enormous breach notification obligations.”
Bourque adds: “OCR indicates that when ePHI is encrypted as a result of a ransomware attack, a breach has occurred because the ePHI encrypted by the ransomware was acquired (i.e., unauthorized individuals took possession of the information) and is thus a ‘disclosure’ not permitted under the HIPAA Privacy Rule has occurred.”
When patients are notified of data breaches – for any reason – many will quietly change providers. According to The Ponemon Institute, loss of future income is the most costly result of lawfully reporting data breaches…. and ransomware attacks are at “epidemic” levels. I have heard dentists are paying the ransom quickly.
The disincentives to do the right thing were overwhelming providers even before the OCR’s recent ruling. Such is the ugly nature of extortion.
Assessment
Cha-ching!
Conclusion
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Filed under: iMBA, Inc., Information Technology, Pruitt's Platform | Tagged: D. Kellus Pruitt DDS, Dianne J. Bourque, HIPAA, malware entrepreneurs, OCR, PHI, RansomWare | Leave a comment »
[By Jaan Sidorov MD]
An Interesting Book
Reputation Economics by Joshua Klein builds on the observation that humans ultimately prefer to trade goods with persons they genuinely trust. The invention of money as a medium of exchange may have solved a lot of inconveniences, but it also distanced the seller and the buyer.
He suggests that our Information Age is ironically ushering in a return of barter, where many goods and services can be directly exchanged between parties who create a track record of their trustworthiness online.
Interestingly, your personal identity doesn’t need to be part of that reputation. And if barter isn’t available, enter cryptocurrency like Bitcoin, which preserves anonymity but commands trust.
Conclusion
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Filed under: Book Reviews, iMBA, Inc. | Tagged: Bitcoin, Jaan Sidorov MD, Joshua Klein, Reputation Economics | Leave a comment »
A New Era of Medicine
[By Staff Reporters]
When The White House announced their Precision Medicine Initiative last year, they referred to precision medicine as “a new era of medicine,” signaling a shift in focus from a “one-size-fits-all-approach” to individualized care based on the specific characteristics that distinguish one patient from another.
While there continues to be immense excitement about its game-changing impact in terms of early diagnoses and targeting specific treatment options, the advancements in technology, which underlie this approach, may not always yield the best medical results.
Assessment
But, in some cases, low cost approaches, based on sound clinical judgment, are still the better option.
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Conclusion
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Filed under: iMBA, Inc. | Leave a comment »
[By staff reporters]
HCC CEO Bob Cimasi Recognized as a “Pioneer of the Profession” under NACVA’s “Industry Titans” Awards |
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Health Capital Consultants CEO Robert James Cimasi MHA ASA FRICS MCBA CVA CM&AA, CMP® has been named a “Pioneer of the Profession” by the National Association of Certified Valuators and Analysts (NACVA) and Consultants Training Institute as part of their Silver Anniversary recognition luncheon of valuation “Industry Titans,” held on June 10th. 2016, during the 25th Annual Conference in San Diego.
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Mr. Cimasi joins valuation profession luminaries, including: Dr. Shannon P. Pratt, Chris Mercer, James R. Hitchner, Roger J. Grabowski, Richard Wise, Jay E. Fishman, Nancy Fannon, Honorable Judge David Laro, Howard Lewis, and Mel H. Abraham, along with fourteen others, in receiving this honor.
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Congratulations to Bob Cimasi and his fellow “Pioneer of the Profession” honorees from the HCC Team and ME-P Topics Staff.
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 Well Done!CONGRATULATIONS – BOB***
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Filed under: iMBA, Inc. | Leave a comment »
NEW ASA OFFICERS
[By Jennifer M. Aguilar]
Marketing and Communications Assistant
American Society of Appraisers
11107 Sunset Hills, Suite 310, Reston, VA 20190
Direct (703) 733-2120 | Fax (703) 742-8471 | jaguilar@appraisers.org
Hello ME-P Readers and Subscribers,
The ASA is pleased to announce the results of ASA’s 2016-17 elections for the new International Officers, Board of Governors and Discipline Committee Officers and Members At-Large. Those elected will officially take office on July 1, 2016.
To learn more please see this PR attachment: ASA Election Results
Thank you in advance for sharing this information.
Conclusion
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Filed under: Health Insurance, iMBA, Inc., Uncategorized | Tagged: American Society of Appraisers, ASA, Jennifer M. Aguilar | 1 Comment »
We are excited to announce that we are now accepting applications for the 2017 Hearst Health Prize for Excellence in Population Health. The winner will receive a $100,000 cash prize in recognition of outstanding achievement in managing or improving population health.
The Hearst Health Prize, in partnership with the Jefferson College of Population Health (JCPH), was created to help identify and promote promising new ideas in the field that will help to improve health outcomes. The goal is to discover, support and showcase the work of an individual, group, or institution that has successfully implemented a population health program or intervention that has made a measurable difference.
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The deadline to apply is August 26, 2016. To apply or learn more about the Hearst Health Prize, click here.
Conclusion
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Filed under: iMBA, Inc., Research & Development | Tagged: David B. Nash MD MBA, Hearst Health Prize, Hearst Health Prize Call for Submissions | Leave a comment »
A Reprint by Andrew Foy MD
A Hayekian Defense of Evidence-Based Medicine
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http://thehealthcareblog.com/blog/2016/05/11/a-hayekian-defense-of-evidence-based-medicine/
ABOUT
Andrew Foy is an academic cardiologist who is taking up blogging, again, for the instant gratification it brings while his real research is under peer-review. His Twitter account is @AndrewFoy82.
Conclusion
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Filed under: iMBA, Inc. | Tagged: evidence based medicine, FA Hayek | 1 Comment »
OVER HEARD IN THE DOCTOR’S LOUNGE
By Dr. David E. Marcinko MBA CMP™
In an OpenNotes study, researchers examined the impact on patients and doctors when patients were allowed access to their doctors’ notes via a secure Internet portal.
Through the use of surveys, patients’ benefits, concerns, and behaviors, as well as physicians workload, were measured.
The Study
Beth Israel Deaconess Medical Center (BIDMC) in Boston, Geisinger Health System (GHS) in Pennsylvania, and Harborview Medical Center (HMC) in Seattle were selected for this quasi-experimental year-long study.
The study included 105 physicians and 13,564 of their patients. Patients were notified when their notes were available, but whether or not to open the note was at their own discretion. The authors analyzed both pre- and post-intervention surveys from the physicians who completed the study; 99 physicians submitted both pre- and post-intervention surveys. Of the patients who viewed at least one note, 41 percent completed post-intervention surveys.
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Almost 99 percent of patients at BIDMC, GHS, and HMC wanted to have continued access to their visit notes at the completion of the study; no physician elected to end this practice.
Assessment
Although a limited geographic area was represented, the positive feedback and clinically relevant benefits demonstrate the potential for a widespread adoption of OpenNotes.
Moreover, it may be a powerful tool in helping improve the lives of patients.
Citation: Inviting Patients to Read Their Doctors’ Notes: Author(s): Delbanco, T; Walker, J; Bell, SK and Darrer, JD et al: American College of Physicians, Annals of Internal Medicine, October 2012
Open Notes, a grantee of the Robert Wood Johnson Foundation, was developed to demonstrate and evaluate the impact on both patients and clinicians of fully sharing (through an electronic patient portal) all encounter notes between patients and their primary care providers.
Conclusion
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Filed under: iMBA, Inc., Practice Management | Tagged: Altered Medical Records, Bell, Darrer, Delbanco, JD, medical records, OpenNotes, Patients to Read Doctors' Notes, SK | 1 Comment »
Via Megan McArdle:
Conclusion
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Filed under: iMBA, Inc., Jokes and Puns | Tagged: citizen journalist, journalist | Leave a comment »
Including Supplements for 2005-2011
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Conclusion
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Filed under: iMBA, Inc., Research & Development | Tagged: Elderly drugs, Medication Use in Older Adults, Supplement Use in Older Adults | Leave a comment »
By Don Hoppert
[APHA Government Relations Director]
Dear Dr. David E. Marcinko,
Sen. Tom Udall, D-N.M., and Rep. Lucille Roybal-Allard, D-Calif., are joining the audacious goal of creating the healthiest nation in one generation by introducing resolutions recognizing National Public Health Week and the importance of public health in our daily lives in supporting a strong, healthy nation.
While resolutions, such as the NPHW resolution, do not become laws, they function as statements of intent for Congress. This is an excellent opportunity to encourage your members of Congress to acknowledge the importance of public health, and potentially pave the way for additional support on other public health issues.
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Send a message to your senators and representative urging them to support public health and co-sponsor the NPHW resolution!
Assessment
Note that the following representatives have already committed to joining the resolution as original co-sponsors:
• Rep. Rob Wittman, R-Va.
• Rep. Gene Green, D-Texas
• Rep. Jim McGovern, D-Mass.
Conclusion
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[Mike Stahl PhD MBA] * [Foreword Dr.Mata MD] * [Dr. Getzen PhD]
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Filed under: iMBA, Inc. | Tagged: APHA, Don Hoppert, National Public Health Week, NPHW resolution | Leave a comment »
By Dr. David Edward Marcinko MBA CMP®
http://www.CertifiedMedicalPlanner.org
The health care provider should not alter the medical record under any circumstances.
The office, clinic or hospital must zealously guard its medical records from alterations by physicians or members of the nursing staff.
Even an inconsequential alteration will throw the validity of the entire record into question. If an entry must be changed, a single line should be drawn through the entry, taking particular care to make sure that the original entry is clearly legible. The new entry should be written above or next to the old entry, and the date of the new entry, as well as the name of the person making the entry, should be recorded. The entry must also be signed by that person.
Juries are very intolerant of altered medical records; and even innocent mistakes, such as the loss of a few pages of a record, will be construed as an intentional cover-up. Under no circumstances should materials such as liquid paper or other opaque liquids be applied to the record in order to correct any entry.
Assessment
The health care provider should not alter the medical record under any circumstances.
Conclusion
Is there an emerging migration back to paper medical records?
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Harvard Medical School
Boston Children’s Hospital – Psychiatrist
Yale University
Filed under: Career Development, iMBA, Inc., Practice Management, Risk Management | Tagged: Altered Medical Records, Dr. David Marcinko, medical records | 1 Comment »
Plan Management Navigator
By Douglas B. Sherlock CFA
This issue of Plan Management Navigator contains a summary of our analysis comparing “Best-in-Class” Blue Cross Blue Shield Plans and the other Plans that we refer to as “Peer” Plans.
Best-in-Class Plans operated with costs, excluding Sales and Marketing and Medical Management that were 32% lower than their Peers.
Low Staffing Ratios was the primary driver in the Best-in-Class cost advantage, while Staffing Costs per FTE and Non-Labor Costs per FTE were also lower.
The functional area of Information Systems was key in superior Best-in-Class performance. Economies of scale played no role in the ranking.
Our highly valid, well-populated Benchmarks provide an unbiased ranking and helps prioritize activities that will have the greatest impact on improving your health plan’s overall operating performance.
The overwhelming proportion of health plans participating last year are participating this year, and we have added several plans. Please follow this link to see what last year’s participation looked like.
We will meet to finalize the content of the survey in February, distribute the survey forms in March, collect the completed surveys in May and publish beginning in late June or early July. Participation entails efforts on your part since useful outputs require relatively granular inputs. The cost is relatively modest.
Because of the calendar, if you are considering participation, please contact me as soon as convenient. We can answer questions and help get the paperwork out of the way.
Assessment
Thank you again for your continuing interest in the Sherlock Benchmarks. Please visit this link to find the January 2016 Plan Management Navigator.
Conclusion
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Filed under: Health Insurance, iMBA, Inc. | Tagged: Blue Cross Blue Shield Health Plans, Douglas B. Sherlock CFA, Health Insurance | 2 Comments »
http://www.BusinessofMedicalPractice.com
Conclusion
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Filed under: iMBA, Inc., Research & Development | Tagged: new cancer types, www.MCOL.com | 1 Comment »
Title X of the USA PATRIOT Act contains several calls for strengthening the public health system. Section 1013(a)(4) calls for “enhanced resources for public health officials to respond to potential bioterrorism attacks.” Section 1013(a)(6) calls for “greater resources to increase the capacity of hospitals and local healthcare workers to respond to public health threats.”
PRE 9/11
Prior to September 11, 2001, the capacity of healthcare entities to respond to biological and chemical attacks by terrorists was quite limited. Strictly speaking, however, healthcare organizational preparedness plans are not as directly encumbered by the USA PATRIOT ACT, or by the Department of Homeland Security’s (DHS’s) Chemicals of Concern [COC] List, or the various steps of its Section 550 Program as some other industries. Nevertheless, healthcare organizations may have their sources of contaminants, such as: Mercury, Dioxin: DEHP (2-ethylhexyl), Volatile Organic Compounds and Glutaraldehyde, etc.
For some time now, the Joint Commission (formerly the Joint Commission on Accreditation of Healthcare Organizations) has also required hospitals to have a disaster preparedness plan mimicking the USA PATRIOT Act [personal communication, Kenneth A. Powers, Media Relations Manager, TJC].
Post 9/11
After September 11, 2001, “disaster preparedness” evolved into something that could more accurately be described as “emergency preparedness.” Experience in New York and Virginia has shown that there will be spillover outside the immediate geographic areas affected by a terrorist attack, which will affect suburban and rural hospitals.
Thus, the emphasis in emergency preparedness is on the coordination and integration of organizations throughout the local system. Hospitals and healthcare entities therefore need to revise existing plans for disaster preparedness to reflect the realities of potential terrorist threats. Mitigation against risk is essential to safeguard the financial position of an entity. Medical practices and healthcare entities can mitigate risks by developing an emergency preparedness plan.
The entity should start by identifying possible disaster situations, such as earthquakes and biological or chemical attacks that could affect the facility. Next, the entity should identify the potential damages that could occur to structures, utilities, computer technology, and supplies. After that, the entity should use resources currently available to safeguard assets, and then budget to acquire any additional materials or alterations required to secure the facility.
Practices can take several steps to mitigate even in the absence of significant funding:
In addition to preparedness for an attack within its catchment area, a healthcare organization must be prepared for an attack on its own facility or office. They should assess the vulnerability of the heating, ventilation, and air conditioning (HVAC) systems to biological or chemical attack. The positioning of the air intake vents is especially important because intakes on roofs are fairly secure as compared to intakes on ground level.
One way to increase security is to restrict access to the facility. Some facilities are using biometric screening to restrict access to their facilities. Biometric screening identifies people based on measurements of some body part such as a fingerprint, handprint, or retina. The advantage of this approach is that there are no problems with forgotten badges, and biometric features cannot be shared or lost like cards with personal identification numbers (PINs).
Assessment
In preparing for a possible attack, healthcare entities should also examine the federal, state, and local laws that might affect their response to a biological or chemical attack.
And so, is there really a roll; at all?
Unfortunately, there is no central source of legislation, and an extensive search of many sources might be required to determine the legal constraints.
Conclusion
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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
[Best Practices from Leading Consultants and Certified Medical Planners™]
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Redundancy occurs when more than one person (or committee) has the responsibility to make a decision or assume a task. Redundancy in a team based care model becomes a problem when it allows tasks to be overlooked or decisions to be avoided. This happens when a person or committee assumes that someone else with responsibility for the same task will make the necessary decisions. This can be due to a misunderstanding, or it can be due to an intentional dodging of the task or decision.
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Redundancy is best avoided by having only one person, lead physician or committee responsible for each task or decision. Since this is almost impossible in a hospital or large organization, there must be an unambiguous protocol for allocating tasks and decisions among the responsible personnel. The protocol must also establish a system for handling problems that the assigned personnel cannot solve.
Assessment
It is important that such problems be brought to the attention of a supervisor for reassignment to new personnel. Reassignment should not be done by first level personnel; reassignment at that level will make it impossible to prevent the dodging of unpleasant tasks.
More: Why I Rue the Hospital “Team-Based Medicine” Approach to In-Patient Care
Conclusion
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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
[Best Practices from Leading Consultants and Certified Medical Planners™]
Harvard Medical School
Boston Children’s Hospital – Psychiatrist
Yale University
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By Samantha Wanner [VITAS Healthcare]
Watch this short animation to learn why advance directives are so important.
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What Do You Want?
It’s not easy, but the medical treatments you would want near the end of life need to be discussed with others. If you never bring up the topic and you were unexpectedly incapacitated and unable to speak for yourself, your medical wishes would never be known.
Despite the topic’s importance, only 27% of Americans report having talked with their families about end-of-life care. The best way to make your medical wishes known is to create an advance directive and share it with your family and your doctor.
Advance Directives
An advance directive is actually two legal documents that enable you to plan and communicate your end-of-life wishes. When you create your advance directive, you are being proactive about your medical care and sparing your loved ones from having to make difficult medical decisions in a time of crisis.
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Assessment
Don’t wait for a crisis. Create your advance directive, share copies with your loved ones and doctor and keep your copy in an accessible location others can find.
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:
Harvard Medical School
Yale University
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Filed under: Health Insurance, iMBA, Inc., Insurance Matters, Risk Management, Videos | Tagged: End of Life Care | 2 Comments »
[By Dr. David E. Marcinko MBA]
Be careful out there!
A GMAC survey revealed that 1 in 5 drivers would not pass the written driver’s test if they took it today. And, getting a ticket will raise your car insurance rate, but by how much?
The Survey
The survey found that reckless driving triggers the highest hike — an average increase of 22 percent — yet many drivers aren’t even sure what constitute reckless driving?
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Reckless Driving
Depending on state laws, reckless driving can be defined as: driving over 80 mph, driving too fast for weather conditions, knowingly driving in a way that endangers others.
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
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***
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http://www.CertifiedMedicalPlanner.org
OK; I admit it. I held life insurance license for almost a decade. But, don’t hold that against me.
With any universal life insurance policy (and certainly all variable life policies), fluctuating rates of return, the actual timing of the premium payments, and potential internal policy changes by the insurance company, all contribute to results that will probably differ substantially from the original illustration. So, be sure to monitor them periodically.
The Rule
As a professor of health economics, I know the 5 – 100 Rule states that as a result of accounting for these elements, all initial projections of cash value beyond 5 years, will necessarily be 100 percent incorrect when compared to actuality.
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[Don’t Fall Asleep on Variable Life Insurance Policies]
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Assessment
A prudent physician policy owner should therefore keep on top of any changes and react accordingly. If a policy owner ignores his/her policy for even 5 years, any adverse changes could be so drastic as to make rectifying them very costly.
Conclusion
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8
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Among Adults 18-65
Conclusion
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Human Nature, Medical Ethics and Modern Principles
In any textbook of gravitas on medical risk management, asset protection and insurance planning, a chapter on human nature is usually placed at the end of the book, or as an appendix, or an afterthought if included at all.
However, we elected to prominently place this material as the premier chapter of our textbook.
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Why?
In the end, the success of any risk management endeavor ultimately comes down to changing human behavior – helping a doctor/nurse/technician alter whatever s/he was doing toward something that will better allow them to avoid errors and pursue quality care and practice management goals.
Yet, there is still remarkably little education or training for medical professionals focused directly on motivation or change theory, in any related area except psychiatry/psychology or perhaps professional liability.
Instead, doctors are increasingly turning to professional consultants to learn best practices on how to help them actually make the behavioral changes necessary to achieve their quality improvement and risk reduction goals; as we attempt to answer these questions.
The Queries:
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Leadership Shortcomings
In addition, medical practitioners need to strive to avoid what Zenger and Folkman describe as the 10 most common leadership shortcomings based on a survey of 11,000 leaders. They include:
Source: Zenger and Folkman: The Daily Stat: The 10 Most Common Failures of Business Leaders, Harvard Business Publishing, June 4, 2009.
More:
Assessment
Want to lean even more about hundreds of medical risk management topics? Order our newest text book, today!
Conclusion
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Filed under: Book Reviews, Ethics, iMBA, Inc., Practice Management, Risk Management | Tagged: David E. Marcinko, medical ethics, medical leadership, medical risk management, Zenger and Folkman | 2 Comments »
[By Dr. David Edward Marcinko CMP® MBA MBBS]
http://www.CertifiedMedicalPlanner.org
The Real Notion of Teams
I HATE teams. There I said it. Now; I repeat. I hate team sports, teams in medicine and especially teams in financial planning. I am NOT a team player; most doctors are independent minded and not team players.
On the other hand, my wife says that I am most assuredly a team player. But, that I just select my teams very carefully. She is much smarter than I; so perhaps she is correct!
Why I Rue the Hospital “Team-Based Medicine” Approach to In-Patient Care
Financial Planning
In financial planning, there seems to be a fixation … that a team is a financial planner [certified; or not] and an attorney; nice-but a couple and not really a team in the true sense of group development as first proposed by Bruce Tuckman PhD, in 1965.
In his model, Tucker maintained that four phases are all necessary and inevitable in order for the team to grow, to face challenges, to tackle problems, to find solutions, to plan work, and to deliver results [Forming – Storming – Norming – Performing].
Later, he added Adjourning to successfully complete the task and break up the team. Timothy Biggs PhD further added the Re-Norming stage to reflect a period where the team re-assembles, as needed. This put the emphasis back on the ME Inc or physician team leader – as too many ‘diplomats’ in a leadership role may prevent the team from reaching full potential.
Source: http://infed.org/mobi/bruce-w-tuckman-forming-storming-norming-and-performing-in-groups/
A Metaphor
This is why “team” must be more than a metaphor. It deserves more than lip service. Delivering client-centered, coordinated financial planning services and products demands true collaboration–a fully integrated team engaged in practices that involve each member at the top, highest and best use of their licensure and education; optimizing their contributions and maximizing their impact on the well being of the client [Boyer Model of Education].
In this context, board Certified Medical Planners™ may play a lead role going forward; along with other like-minded and educated professionals.
Unfortunately, the ranks of CMPs™ while growing; are still painfully small. But, in addition to true expertise, they link physician clients with appropriate providers and resources throughout the holistic professional life/practice planning continuum. They focus on the doctor-client’s totality — emotional, financial, risk and business management and psyche. As fiduciaries at all times; They advocate for the doctor client to connect him/her to the necessary resources, professional advisors and consultants who need to have their voices heard. Such successful, high-functioning financial planning teams give each member a voice.
The medical professional must be an active participant; not a passive bystander. This is not the norm in financial planning today where doctors are urged to hire a team quarterback. But, the NFL-QB is not a generalist at all; his arm is special and unlike all other teams players. He/she is unique, skilled and exceptional. A franchise player!
Past not Prologue
Fortunately, past is not prologue in the era of transparency, information at your fingertips, tablet PCs, Skype® and smart phones. To succeed in the hyper competitive new era of health reform requires education, involvement and active participation.
In short, a new model of physician focused advisor. No longer is there a free lunch of passivity for medical professionals; either as doctors or advisory clients themselves.
For financial planning in the new era of healthcare reform, and robo-advisors, successful doctors will assume the mantle of self-quarterback themselves.
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[Go Team Go]
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ME Inc., or Going it Alone – but with a Team
The physician, nurse, or other medical professional should easily recognize that there are a vast array of opportunities, obstacles, and pitfalls when it comes to managing one’s finances.
Still, with some modicum of effort, the basic aspects of insurance, investments, taxes, accounting, portfolio management, retirement and estate planning, debt reduction, asset protection and practice management can be largely self-taught. After all, it is NOT rocker science.
After all, anyone can purchase the exact same financial planning software that legions of FAs use, and there are many iterations on the market, as well. This concept is not unlike patients, using Dr. Google. No license required.
And TAMPs, relegate FAs to the role of “asset gather”; or should I say salesman/woman.
Why Physician-Investors Must Understand TAMPs
Informed Patient [Client]
So, an informed patient or client is ideal; is it not?
Yet, it is realized that nuances and subtleties can make a well-intentioned plan fall short. The devil truly is in the details. Moreover, none of these areas can be addressed in isolation. It is common for a solution in one area to cause a new set of problems in another.
Hourly Model
Accordingly, most health care practitioners would be well served to hire [independent, hourly compensated and prn] financial help.
Unlike some medical problems, financial issues may not cause any “pain” or other obvious symptoms. Medical professionals tend to have far more complex financial situations than most lay people. Despite the complexities of the new world of health reform, far too many either do nothing; or give up all control totally, to an external advisor. This either/or mistake can be costly in many ways, and should be avoided.
In reality, and at various time in their careers, the medical professional needs a team comprised of at least a financial analyst [CFA], lawyer, management consultant, risk manager [PhD actuary or insurance counselor] and accountant. At various points in time, each member of the team, or significant others, will properly assume a role of more or less importance, but the doctor must usually remain the “quarterback” or leader; in the absence of a truly informed other, or Certified Medical Planner™.
This is necessary because only the doctor [client] has the personal self-mandate with skin in the game, to take a big picture view. And, rightly or wrongly, investments dominate the information available regarding personal finance and the attention of most physicians. One is much more likely to need or want to discuss the financial markets with their financial advisor than private letter rulings by the IRS, or with their estate planning attorney or tax accountant.
So, while hiring for expertise is a good idea, there is sinister way advisors goad doctors into using all their retail services; all of the time. That artifice is – the value of time. Don’t fall for this out sourcing gambit!
How Doctors Pay for Wealth Management Services
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[Not Going it Alone]
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Assessment
True integrated physician focused and financial planning is at its core a service business, not a product or sales endeavor. And, increasingly money is more likely to be at the top of the list for providers as the healthcare environment is contracting.
So, eschewing the quarterback model of advice, and choosing to self-educate thru these new book and elsewhere, may be one of the best efforts a smart physician can make.
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:
[Dr. Cappiello PhD MBA] *** [Foreword Dr. Krieger MD MBA]
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Filed under: CMP Program, Ethics, Financial Planning, iMBA, Inc., Practice Management | Tagged: Dr. Marcinko, financial planning team, physician focused financial planning, team healthcare | 1 Comment »
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[By Dr. David Edward Marcinko CMP® MBA]
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As little as a hundred years ago, detailed medical records were likely to have been compiled by medical researchers such as Charcot and Hughlings-Jackson. The medical record was an aide memoire for detecting changes in patients’ conditions over time, solely for the benefit of the physician in treating the patient.
As health care became more institutionalized, medical records became a communications device among health care providers. Doctors made progress notes and gave orders. Nurses carried them out and kept a record of patient responses. A centralized record, theoretically, allowed all to know what each was doing. The ideal was that if the doctor were unable to care for the patient, another physician could stand in his or her shoes and assume the patient’s care.
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Enter Third Parties
Then pressures from third party payers occurred. As insurance and then government programs became larger players in the compensation game, they wanted to know if the care they were paying for was being delivered efficiently.
Though the real push behind these questions was the desire to save money, utilization review also directly contributed to better patient care. A patient who was being given inefficient care was getting substandard care as well. Utilization review was mainly retrospective; denial of compensation was rarely imposed, and suasion by peers was the main effector of change. Though “economic credentialing” was shouted about, it rarely showed itself in public.
PP-ACA
Even health reform which openly admitted economic incentives as one of its motivators preferred to find some other reason for deciding not to reimburse, or admit Dr. Jones to its narrow panel of ACA, or other “skinny” network providers, or not renewing Dr. Smith’s contract an HMO. The medical record remained essentially a record of patient care which was good or not, efficient or not. If the record wasn’t complete, the doctor could always supplement it with an affidavit, use information from somewhere else, or provide explanations.
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Socio Economic Status
Today, the concept known as Socio Economic Status [S.E.S.] is conceptualized as the social standing, or class of an individual or group. It is often measured as a combination of education, income and occupation. Examinations of socioeconomic status often reveal inequities in access to medical resources, plus issues related to privilege, power and control. SES is increasingly being considered as another payment component [CPT® codes] to medical providers, as reflected in the paper medical record, EMR and elsewhere.
Assessment
Have you encountered any Socio Economic Status initiative in your clinic, hospital or other medical institution?
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:
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[Dr. Cappiello PhD MBA] *** [Foreword Dr. Krieger MD MBA]
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Filed under: iMBA, Inc., Practice Worth, Risk Management | Tagged: EMRs, Marcinko, medical records, Socio Economic Status | 2 Comments »
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[Dr. David Edward Marcinko CMP™ MBA MBBS]
http://www.CertifiedMedicalPlanner.org
EDITOR-IN-CHIEF
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In SECTION ONE, of our newest textbook, on medical practitioner personal risk management issues, let us all recall the Canadian physician Sir William Osler MD, one of the founders of Johns Hopkins Hospital in my hometown of Baltimore Maryland, and where I played stickball in the parking lot as a kid. He left a sizeable body of wisdom that has guided many physicians in the practice of medicine. So, allow me to share with you some of that accumulated wisdom and the quotes that have served me well over the years.
From Dr. Osler, I learned the art of putting myself in the patient’s shoes. “The motto of each of you as you undertake the examination and treatment of a case should be ‘put yourself in his place.’ Realize, so far as you can, the mental state of the patient, enter into his feelings.” Osler further stresses that we should “scan gently (the patient’s) faults” and offer the “kindly word, the cheerful greeting, the sympathetic look.”1
“In some of us, the ceaseless panorama of suffering tends to dull that fine edge of sympathy with which we started,” writes Osler in his famous essay “Aequanimitas.”2 “Against this benumbing influence, we physicians and nurses, the immediate agents of the Trust, have but one enduring corrective — the practice towards patients of the Golden Rule of Humanity as announced by Confucius: ‘What you do not like when done to yourself, do not do to others.’”
Medicine can be both art and science as many physicians have discovered. As Osler tells us, “Errors in judgment must occur in the practice of an art which consists largely of balancing probabilities.”2 Osler notes that “Medicine is a science of uncertainty and an art of probability” and also weighs in with the idea that “The practice of medicine is an art, based on science.”3,4
Osler emphasized that excellence in medicine is not an inheritance and is more fully realized with the seasoning of experience. “The art of the practice of medicine is to be learned only by experience,” says Osler. “Learn to see, learn to hear, learn to feel, learn to smell, and know that by practice alone can you become expert.”5
Finally, some timeless wisdom on patient care came from Osler in an address to St. Mary’s Hospital Medical School in London in 1907: “Gain the confidence of a patient and inspire him with hope, and the battle is half won.”6
Osler has also imparted plenty of advice on the business of medicine. In “Aequanimitas,” Osler says there are only two types of doctors: “those who practice with their brains, and those who practice with their tongues.”7
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In a valedictory address to medical school graduates at McGill University, Osler suggested treating money as a side consideration in a medical career.8 “You have of course entered the profession of medicine with a view of obtaining a livelihood; but in dealing with your patients let this always be a secondary consideration.”
“You are in this profession as a calling, not as a business: as a calling which exacts from you at every turn self-sacrifice, devotion, love and tenderness to your fellow man,” explains Osler in the address to St. Mary’s Hospital Medical School.6 “Once you get down to a purely business level, your influence is gone and the true light of your life is dimmed. You must work in the missionary spirit, with a breadth of charity that raises you far above the petty jealousies of life.”
It is not easy for doctors to combine a passion for patient care, a knowledge of science and the maintenance of business, according to Osler in the British Medical Journal.9 “In the three great professions, the lawyer has to consider only his head and pocket, the parson the head and heart, while with us the head, heart, and pocket are all engaged.”
While some aspects of practice may fall short or be devoid of appropriate financial remuneration, the giving of one’s time, expertise and experience in improving patient outcomes and the quality of their lives may be the greatest gift. “The ‘good debts’ of practice, as I prefer to call them … amount to a generous sum by the end of each year,” says Osler.9
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http://www.BusinessofMedicalPractice.com
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By Render S. Davis MHA
By David Edward Marcinko
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And so, as you read and reflect on the chapter of SECTION ONE, always remember the words and wisdom of Dr. William Osler, and keep patient welfare as your first priority.
Dr. David Edward Marcinko; CMP™ MBA MBBS [Hon]
[Chief Executive Officer]
iMBA Inc., Norcross, GA
References
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[Dr. Cappiello PhD MBA] *** [Foreword Dr. Krieger MD MBA]
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Filed under: "Doctors Only", CMP Program, Ethics, Financial Planning, iMBA, Inc., Risk Management | Tagged: CMP, CMP Program, David E. Marcinko, Financial planning MDs, medical risk management, Render Davis | Leave a comment »
For 2015
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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:
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[Foreword Dr. Phillips MD JD MBA LLM] *** [Foreword Dr. Nash MD MBA FACP]
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Filed under: Health Insurance, iMBA, Inc., Quality Initiatives | Tagged: State Health Rankings | 2 Comments »
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It is with a heavy heart that we inform you that Lon Jefferies passed away unexpectedly this weekend due to complications inherent with a seizure disorder. We are extremely saddened by Lon’s all-too-soon departure. He was a vital contributor to this Medical Executive-Post and Financial Planning industry writ large; and he will be greatly missed.
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As you know, Lon was an excellent financial planner and prolific blogger. To his credit – one of the variables he planned for – was the possibility of a life altering event such as this. With this foresight, Lon chose to align his financial planning services with his team at Net Worth Advisory Group. Lon’s plan ensures that each client can continue to receive the same high level of financial planning and assistance going forward, while allowing his beneficiaries to receive some residual income.
Our most sincere sympathies go out to Lon’s new bride Jen, his parents, and their families.
With best regards and sincere sympathy.
Dr. David Edward Marcinko MBA CMP® MBBS
[Publisher and Editor-in-Chief]
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Filed under: Ethics, iMBA, Inc. | Tagged: Lon Jefferies MBA CFP® | 2 Comments »
http://www.CertifiedMedicalPlanner.org
Now, is the perfect time of year to consider one, or all, of these texts as the perfect holiday gift for your favorite doctor, or allied health care professional.
Also, may be used as a client-prospecting tool for Financial Advisors, Wealth and Practice Managers, and CPAs, etc.
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Filed under: Book Reviews, Financial Planning, iMBA, Inc., Insurance Matters, Practice Management, Recommended Books, Retirement and Benefits | Tagged: Financial Planning, Holiday gifts, Investing, medical practice management, wealth management | Leave a comment »
By Dr. David Edward Marcinko MBA CMP™
To be sure, physicians and Financial Advisors are aware that there is a sometime need to recommend a LTCI policy to clients. Of course, in such cases, it is a good idea to work with a low load provider (or the physician or client’s agent).
The Need?
Yet, most LTCI policies are sold by insurance agents for big commissions; not bought, and that most statistics used to sell LTCI policies are fear-based and half-truths. I know, as I was a licensed insurance agent for more than a decade.
Even the Department of Health and Human Services [DHHS] gets into the fear mongering on their website quoting that “about 70 percent of people over age 65 require some type of long-term care services during their lifetime”
Source: http://www.longtermcare.gov/LTC/Main_Site/Planning/Index.aspx
Department of Health and Human Services
This may be a deceptive statistic as it omits the length of long-term care needed in these 70% of cases. And, it is not 3+ years in all these cases [our estimate is closer to 2.5]. With the stamp of approval by the Supreme Court of the United States SCOTUS on the PP-ACA, we may be looking at social LTCI in the US like other social medicine countries and give up on private LTCI insurance altogether.
Other Countries
Germany introduced mandatory long-term care insurance in 1995. Japan and France also have a LTCI tax funded insurance plan. And, the poor utilization and growing risks associated with long-term care insurance, are leading a growing number of insurance agents, financial advisors and Certified Medical Planners™ to recommend alternatives to their clients.
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Assessment
To be a thought-leader ahead of the curve, the newest aging trend is away from LTCI and toward sheltering at home – living at home and dying at home. Perhaps, this is the way it should be.
Dying should not be a for-profit industry.
http://www.CertifiedMedicalPlanner.org
More:
Conclusion
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[Dr. Cappiello PhD MBA] *** [Foreword Dr. Krieger MD MBA]
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Filed under: CMP Program, Ethics, Health Insurance, iMBA, Inc., Research & Development, Retirement and Benefits, Touring with Marcinko | Tagged: David E. Marcinko, long term care insurance, LTCI | 2 Comments »
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Filed under: Health Economics, iMBA, Inc., Investing, Practice Management, Recommended Books | Tagged: FOMC, interest rates, IRS, Michael A. Gayed CFA | 5 Comments »
[By Edward Bukstel]
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Conclusion
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Filed under: iMBA, Inc. | 14 Comments »
| New Changes on the [CMS Payment Reform] Horizon |
| [By Dreama Sloan-Kelly MD CCS]
CMS released their final 2015 Medicare Physician Fee Schedule (MPFS) ruling late last year. Embedded in this document was a proposal by CMS to get rid of both the 10 day and 90 day global periods! In fact, they want to do away with global period billing all together and have all procedures paid based on the work required to do the procedure itself — thereby billing for all post-surgical visits separately using E/M codes. According to the final ruling, CMS proposes to transform all 10 day global services to ZERO global days starting in 2017. They will do the same in regards to 90 day global services starting in 2018. And, according to the U.S. Department of Health and Human Services (HHS) and the Office of Inspector General (OIG) they have “identified a number of surgical procedures that include more visits in the global period than are being furnished”. They go on to say that they are “also concerned that post-surgical visits are valued higher than visits that were furnished and billed separately by other physicians such as general internists or family physicians”. Based on the final ruling, they plan to begin the transition as previously stated in 2017 after they have considered all comments. The ruling goes on to state, “as the agency begins revaluation of services as 0-day global periods, we will actively assess whether there is a better construction of a bundled payment for surgical services that incentivizes care coordination and care redesign across an episode of care”. So let’s talk reality and my take on this change. Over the past few weeks I have read a lot of articles on this subject from various pundits in the industry — they are actually arguing that this change will mean increased reimbursement when you combine the separate payment for the procedure itself along with the visit by visit billing for the post-surgical follow up care when compared to the current reimbursement rate. ***
*** Personally, I think they are all wrong for the following reasons: Procedure Reimbursement Amount: This is the wild card. They are going to use the same RVU system that has always been used to calculate payment — but I guarantee you the payment for the procedure will not be anywhere near the reimbursement for the global package. I think the closest we could get to estimating the reimbursement rate of the procedure is to figure out what the current surgical care only rate would be (ie. as if you appended Modifier 54 to the procedure code). Beware that this rate would still encompass the pre-surgical evaluation — which I am assuming would be carved out since that is a part of the current global package they are trying to phase out. Post Op Visits: Getting a patient to comply with medical visits is hard enough — now adding in the fact they would have to pay a copay each time — most often a specialty co-pay is going to make it even harder. Patient’s understand their follow up visits are currently covered in the cost for the surgery, and hence they tend to show up to these visits knowing they do not have any out of pocket expenses. If the proposed change comes to fruition many of the post-surgical visits may become cost prohibitive for a lot of patients and actually lead to a decrease in the number of follow up visits the patient actually schedules. Once the patient starts to feel better their motivation to return dwindles. Lower Reimbursement Rate for Post-Surgical Visits: It is clearly stated in the CMS ruling that it is felt the post-surgical follow up care visits are paid at a higher rate than what a regular E/M visit would be paid for had the patient been seen by a primary care provider or an internist. That simple statement confirms to me that when the new procedure rate is combined with the individual visit payment rate, the overall reimbursement rate will be less than what is currently being paid. So, how do you prepare? First, stay on top of all bulletins coming from CMS in regards to this issue. Most of your medical societies and/or specialty societies have taken clear positions in regards to this matter — so be sure to stay in the loop and become a part of the process. Run a report that allows you to pinpoint the average number of post-surgical follow up visits for your most billed procedures. This will give you an idea of the average number of follow up visits for particular procedures you know you will bill for if this transition does occur. Does this mean this number will be exact — NO — I would factor in a decrease of 15-20% for visits across the board based on the dynamics I previously described. Lastly, begin creating a policy in regards to post-surgical follow up care that can act as an education tool for the patient, teaching them the important benefits of being compliant with their post-surgical care schedule and also warning them about the possible increase in out of pocket cost. Being transparent can go a long way into easing patient’s fear and encouraging their follow through. As always I have included documentation for your library of information — you can find the CMS 2015 MPFS final ruling fact sheet HERE! I also created a brief video presentation on this hot topic HERE. |
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Conclusion
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Filed under: Healthcare Finance, iMBA, Inc., Practice Management | Tagged: CMS global periods, CPT codes, Dreama Sloan-Kelly MD | Leave a comment »
Update on the Medicare prescription drug benefit program
[By Staff Reporters]
Medicare Part D, also called the Medicare prescription drug benefit, is a United States federal-government program to subsidize the costs of prescription drugs and prescription drug insurance premiums for Medicare beneficiaries. It was enacted as part of the Medicare Modernization Act of 2003 (which also made changes to the public Part C Medicare health plan program) and went into effect on January 1, 2006.
Medicare Part D Premiums
The monthly Medicare Part D base premium is set to pay 25.5 percent of the cost of standard coverage, established by bids submitted annually by Part D plans. CMS releases the Medicare Part D base premium in early August each year. Actual premiums are based on this set premium, but can vary greatly. The premium for 2014 was $32.42.
As of 2011, beneficiaries with higher incomes must pay a premium adjustment based on their income. This premium adjustment is called the Income-Related Monthly Adjustment Amount (IRMAA), and is paid directly to the Federal government (deducted from Social Security, Railroad Retirement Board, or Office of Personnel Management benefits).
Medicare Part D Deductible
The annual deductible for the standard Medicare Part D benefit was $310 in 2014, which is a decrease of $10 from the 2013 deductible. No Medicare drug plan may have a deductible more than $310 in 2014, although some plans may have a lower deductible or no deductible at all.
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*** CMS Part D 2015 Standard Benefit Model Plan Details Here are the highlights for the CMS defined Standard Benefit Plan changes from 2014 to 2015. The chart below shows the Standard Benefit design changes for plan years 2011, 2012, 2013, 2014 and 2015. This “Standard Benefit Plan” is the minimum allowable plan to be offered.
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Conclusion
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* 8
Filed under: Health Insurance, iMBA, Inc. | Tagged: Medicare Part D, Medicare prescription drug benefits | 7 Comments »
The Book and the Body
[By Dr. David Edward Marcinko MBA]
“Vesalius on the Verge: The Book and the Body” explores the groundbreaking work of 16th century professor and physician Andreas Vesalius, who changed the way that human anatomy was taught forever with “De humani corporis fabrica (On the fabric of the human body)”.
The book did two things not seen before: it corrected errors in the conception of the human body that existed for over a millennia, and it combined text with artistic illustration, which enabled interactive learning.
Where else can you see a first edition of the 1543 published text, a desiccated body juxtaposed with a full skeleton, and a contemporary recreation of Vesalius’ dissection table?
Plan your visit today! #muttermuseum #vesalius #anatomy #medicine #rarebooks” By muttermuseum on Instagram
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Source: tumblr_inline_nhs0feL7wW1qzgziy
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Assessment:
I went to medical school in Philadelphia PA, and visited the Mutter Museum many times. If you’ve never been there – I urge you to check it out!
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Conclusion
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Filed under: Book Reviews, Ethics, iMBA, Inc. | Tagged: Anatomy Dissection, David Edward Marcinko, Mutter Museum, Vesalius, Vesalius on the Verge | 1 Comment »
Who needs it … What for?
[By Ann Miller RN MHA]
What’s the point of publishing your essays, thoughts, comments and articles on this ME-P?
Today, many physicians, FAs and health economic experts still don’t have the potential to express themselves to a large audience. By adding articles to their own blogs, with poor attendance, they deprive a wide audience of the opportunity to familiarize themselves with their works.
That’s why material from our ME-P website is available to all English-speaking inhabitants of the world. Some website owners even visit our web portal to pick up or re-post the best articles to place on their own websites.
Why publish with the ME-P?
All this is interesting, but what is the use of the website to an author? So, here is what you get by publishing with us:
• A unique method of promoting your website, self, financial advisory or medical practice; or ideas. If your essay is really interesting – many others will want to read our related books, white-papers and texts; so you will become well-known among our readers.
• The content of our website is automatically placed on other main web sources via RSS feeds. By this you can attract a wide range of readers – and with little effort. The readers will get acquainted with your thoughts, articles and the personal data you share in your included profile.
• Our website is a great launching pad for new doctors, starting academics, medical practitioners, FAs, CPAs, health economists and fledgling writers. By publishing your articles here, you will be able to raise your prestige among colleagues and ME-P readers.
• You may use any free articles from our website to fulfill your own web project (you must add a link to our original material) via RSS feeds. The probability that someone will be interested in you is increased many times.
• Everyday our website is visited by many people, and their numbers are growing constantly. By adding articles the number of your readers will grow in geometric sequence.
• Once placed on the ME-P, your essay will stay on our website [almost] forever. All published materials [probably] will not be deleted with the lapse of time. This means that many years later – your articles will be still available to everyone.
Assessment
The number of ME-P subscribers and regular visitors is growing rapidly. And, the traffic to our authors’ web sources are growing too. Join us – we welcome all authors who are willing to cooperate with our vision and mission!
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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
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* 8
Filed under: Experts Invited, iMBA, Inc. | Tagged: ME-P, medical executive post | 1 Comment »
On Configurations and Varieties
[By Brent Metfessel MD MIS]
Hospitals can use a variety of configurations for HIS implementation depending on business needs and budgetary constraints.
Staffing needed for these systems can range from a few full-time equivalents (FTEs) per 100 beds for very basic off-site processing systems to 15 or more FTEs per 100 beds for sophisticated systems that attempt to combine several architectures into one system (e.g., combination of client-server systems with mainframe processing). Resource use and customizability tend to vary in tandem; the greater the flexibility of the system to meet unique user needs, the greater the cost outlay for capital and/or additional FTEs.
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Relationship of Resource Use and Customizability Based on System Architecture Selected
| Values range from one (low) to four (high) stars | ||
| Architecture | Hospital resource use | Customizability |
| Off-site processing | * | * |
| Turnkey systems | ** | ** |
| Mainframe systems | *** | *** |
| Client-server | *** | **** |
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The Possibilities
The basic system architecture possibilities are as follows:
Off-site (remote) processing: In this case the hospital contracts with a vendor external to the hospital. The hospital sends data over to the vendor site where the actual processing takes place. When processing is complete, the vendor sends the data back to the hospital, usually in electronic form.
Turnkey systems: A vendor provides the hospital with systems that are “pre-packaged” so that hospital-based system development is minimal. Limited customization of the system is possible using systems analysts or programmers.
Mainframe systems: Most applicable to large hospitals, this configuration is highly centralized. A large and powerful computer performs basically all the information processing for the institution and connects to multiple terminals that communicate with the mainframe to display the information at the user sites. Hospital IT departments usually use in-house programmers to modify the core operating systems or applications programs such as billing and scheduling programs.
Client-server systems: In this configuration one or more “repository” computers exist, known as “servers,” that store large amounts of data and perform limited processing. Communicating with the server(s) are client workstations that perform much of the data processing and often have graphical user interfaces (GUIs) for ease of use. Both customizability and resource use is high, depending on the desired sophistication.
Many clinical information systems that process data directly related to patient care use this configuration. For instance, the Veterans Health Administration, which has implemented what is likely the largest integrated healthcare information system in the United States, uses client-server architecture. Known as the Veterans Health Information Systems and Technology Architecture (VistA), this system provides technology infrastructure to about 1,300 care facilities, including hospitals and medical centers, outpatient facilities, and long-term care centers. VistA utilizes a client-server architecture that links together workstations and personal computers using software that is accessed via a graphical user interface.
Overall, for hospitals that have the financial and manpower resources for a significant investment in IT, client-server architectures are the fastest-growing and typically the most preferred of the system architectures, due in large part to their local adaptability and flexibility to meet changing hospital and medical center needs.
Broad Categories
The above architectures are broad categories. Modifications and combinations of the above also exist, such as the use of client-server technology with mainframe systems and the addition of wireless technology, smart phones, laptop PCs and tablets, and various personal digital assistants (PDAs) to supplement the core computing functionality.
In considering the optimal architecture for a hospital, management needs to take into account factors such as size of the institution, desired sophistication of the application, IT budget, and anticipated level of user community involvement.
Assessment
Another important aspect of HIS is the need for integration. Often, different hospital departments have their own stand-alone systems — such as a Laboratory Information System (LIS) and pharmacy systems — that do not communicate with each other. Duplicate data may be kept in separate systems, creating additional work to enter the data multiple times.
In an integrated system, each departmental system communicates with the other systems through either a centralized or decentralized. A computerized physician order entry (CPOE) system, for example, would be much less effective if it did not communicate electronically with the pharmacy system that would process the medication orders.
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Conclusion
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NOTES: Resource use refers to the need for FTEs and hospital capital expenditure. Customizability refers to the ability for users to alter the system structure or function to meet the unique needs of the institution.
Filed under: iMBA, Inc., Information Technology | Tagged: graphical user interfaces, GUI, health information technolgy, HIT, hospital information systems, Mainframe systems, Veterans Health Information Systems and Technology Architecture, VistA | 4 Comments »
By Eugene Schmuckler PhD MBA MEd CTS [Academic Provost]
About the Medical Executive-Post
We are an emerging online and onground community that connects medical professionals with financial advisors and management consultants.
We participate in a variety of insightful educational seminars, teaching conferences and national workshops. We produce journals, textbooks and handbooks, white-papers, CDs and award-winning dictionaries. And, our didactic heritage includes innovative R&D, litigation support, opinions for engaged private clients and media sourcing in the sectors we passionately serve.
Through the balanced collaboration of this rich-media sharing and ranking forum, we have become a leading network at the intersection of healthcare administration, practice management, medical economics, business strategy and financial planning for doctors and their consulting advisors. Even if not seeking our products or services, we hope this knowledge silo is useful to you.
In the Health 2.0 era of political reform, our goal is to: “bridge the gap between practice mission and financial solidarity for all medical professionals.”
More: Letterhead.iMBA_Inc.
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Enter the Certified Medical Planners™
There is no certification program, course of study or professional designation for FAs who wish to enter the lucrative financial planning space serving physicians and healthcare professionals.
That’s why the R&D efforts of our governing board of physician-directors, accountants, financial advisors, academics and health economists identified the need for integrated personal financial planning and medical practice management as an effective first step in the survival and wealth building life-cycle for physicians, nurses, healthcare executives, administrators and all medical professionals.
Now – more than ever – desperate doctors of all ages are turning to knowledge able financial advisors and medical management consultants for help. Symbiotically too, generalist advisors are finding that the mutual need for extreme niche synergy is obvious.
But, there was no established curriculum or educational program; no corpus of knowledge or codifying terms-of-art; no academic gravitas or fiduciary accountability; and certainly no identifying professional designation that demonstrated integrated subject matter expertise for the increasingly unique healthcare focused financial advisory niche … Until Now!
Enter the Certified Medical Planner™ charter professional designation. And, CMPs™ are FIDUCIARIES, 24/7.
Video: http://vimeo.com/84247360
An Interview with Bennett Aikin AIF®
Physician-Investors and the “F” Word
More:
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Conclusion
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Filed under: "Doctors Only", Career Development, CMP Program, Experts Invited, Health Economics, iMBA, Inc., Investing, Portfolio Management, Practice Management | Tagged: certified medical planner, fiduciary, Financial Planning, Institute Medical Business Advisors, medical practice management | 1 Comment »
A Case Model Example
[By Dr. David Edward Marcinko MBA]
http://www.CertifiedMedicalPlanner.org
Just as the field of medicine continuously changes, so too does the field of endowment management.
Endowment managers continue to increase their knowledge of the science and expand their skill in the art.
However, successful endowment managers will continue to focus on the areas that they can control in order to minimize the risk of the areas they cannot.
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So, here is a case model to show you how it is done.
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Conclusion
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Filed under: CMP Program, iMBA, Inc., Investing, Portfolio Management | Tagged: Dr. David Edward Marcinko MBA CMP™, hospital endowments, Investing, Portfolio Management | 2 Comments »
CrowdMed Company Background
CrowdMed purports to harnesses the wisdom of crowds to collaboratively solve even the world’s most difficult medical cases quickly and accurately online.
The company offers individuals, insurance providers, and self-insured corporate customers the ability to more quickly diagnose medical conditions and reduce healthcare costs without compromising care.
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The results speak for themselves?
Since launching publicly in April 2013, CrowdMed has helped solve hundreds of medical cases for patients around the world, and this number is quickly growing as word spreads of the new service. On average, these patients had been sick for 8 years, seen 8 doctors, and incurred more than $50,000 in medical expenses. Despite the difficulty of their cases, more than half of these patients tell us that the crowd successfully brought them closer to a correct diagnosis or cure.
Anyone can submit a case on the CrowdMed website for free (with a $50 refundable deposit), or along with a cash compensation offer to draw more attention to their case. They use incentives to increase participation, and the overall quality and confidence levels of suggested diagnoses. Thousands of people with diverse backgrounds in medicine, health care, education and research have already joined the crowd, and they are continually recruiting new medical and disease experts to help solve cases.
During early testing of the CrowdMed platform, the founder [Jared] submitted his own sister’s [Carly] anonymous case information to the crowd to test the system. More than 300 people participated, evaluating the same symptoms that had been provided to Carly’s original doctors. In just three days, the crowd gave Jared their answer: Fragile X-associated primary ovarian insufficiency
Founded by veteran technology entrepreneur Jared Heyman and based in San Francisco, CA, CrowdMed has received more than $2.4 million in funding from some of Silicon Valley’s top venture capital firms including NEA, Andreessen Horowitz, Greylock Partners, SV Angel, Khosla Ventures and Y Combinator. The company’s advisors have founded and run some the world’s most successful online healthcare companies including WebMD. CrowdMed graduated from Y Combinator’s Winter 2013 class, and was officially launched during the TEDMED 2013 conference in Washington DC.
You can read more about CrowdMed’s leadership team click here.
More:
Assessment
Check em’ out today: http://blog.crowdmed.com
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Filed under: "Doctors Only", Ethics, Experts Invited, iMBA, Inc., Research & Development, Touring with Marcinko | Tagged: crowd-med, david marcinko, Wisdom of Crowds | 3 Comments »
About the iMBA Inc, Health Glossary and Administration Dictionary Series … with Book Reviews
[By Staff Reporters]
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According to James Somers, the way we use an ordinary [medical] dictionary is to look up words, acronyms or initialisms we’ve never heard of; or whose sense we’re unsure of, or need more clarification or spelling direction. Makes sense!
http://jsomers.net/blog/dictionary
But, you would never look up health administration industry specific words or terms in an ordinary medical dictionary — words like HL7, “meaningful-use”, “skinny networks”, managed care organization, hospital cloud computing, patient portal, stop-loss ratio, economic externality, PHO, MPT, SAR-BOX, Fama-French, US Patriot Act, the Treynor index, Asset Pricing Theory, PP-ACA, or ACOs — because all you’ll learn is nothing about what they mean.
Extreme Utility – Not just tchotchkes!
You would need an industry specific dictionary of health administration terms and definitions, right? And, preferably designated as a Doody’s Core Title for credibility, and written by leading experts.
So; try these 3 dictionaries for 10,000 health 2.0 administration terms and definitions, EACH.
Dictionary Forewords
More:
Forget the Paper Weights
According to Wikipedia, a tchotchke (/ˈtʃɒtʃkə/ CHOCH-ka) is a small bauble or miscellaneous item. The word has long been used by Jewish-Americans and in the regional speech of New York City and elsewhere. Tchotchkes are often given at Chanukkah as part of a game.
The word may also refer to free promotional items dispensed at financial services trade shows, medical conventions, and similar large events. They can also be sold as cheap souvenirs which are sometimes called “tchotchke shops”.
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Not a Throw-Away
But, if you want to give your hospital, medical clinic or physician clients an advertising item that’s both useful and handy at the same time, try using these dictionaries. Make an IMPACT, and forget those paper-weights.
As a Financial Advisor [FA], or drug rep, you can represent your eagerness to be there for clients and prospects anytime they need your service by having the dictionaries engraved or placing your business card, inside. Plus, they serve as a great addition to a wonderfully decorated medical office or home library. It is an item they will refer to again and again; not just throw-away.
Give one … or all three … they are so reasonably priced.
Conclusion
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Filed under: Book Reviews, Glossary Terms, iMBA, Inc. | Tagged: Dr. David Marcinko, health administration dictionaries, Health economics and finance; health insurance and managed care, health IT and security, tchotchke | Leave a comment »
About
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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 President Hope Rachel Hetico RN MHA CMP™ to provide going 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.
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.
Ann Miller RN MHA
www.MedicalBusinessAdvisors.com
Financial Advisor Education Letterhead CMP™
Solicitation Letterhead.iMBA, Inc
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