Good Night H. Ed Roberts MD

Medical Inventor, Bio-Engineering Pioneer and Colleague

[September 13, 1941 – April 1, 2010]

By Dr. David Edward Marcinko; MBA

[Publisher-in-Chief]

According to Wikipedia, Henry Edward “Ed” Roberts MD was an American engineer, entrepreneur and medical doctor who designed the first commercially successful personal computer in 1975. He is most often known as the “father of the PC.” He founded Micro Instrumentation and Telemetry Systems [MITS]) in 1970 to sell electronics kits to model rocketry hobbyists, but the first successful product was an electronic calculator kit that was featured on the cover of the November 1971 issue of Popular Electronics magazine. The calculators were very successful and sales topped one million dollars in 1973. But, a brutal calculator price war left the company deeply in debt by 1974. Roberts then developed the Altair 8800 personal computer that used the new Intel 8080 microprocessor. This was featured on the cover of the January 1975 issue of Popular Electronics, and hobbyists flooded MITS with orders for this $397 computer kit. Bill Gates and Paul Allen joined MITS to develop software and Altair BASIC was Microsoft’s first product. Roberts sold MITS in 1977 and retired to Georgia where he farmed, studied medicine and eventually became a small-town doctor after commencing medical school at age 39.

Link: http://en.wikipedia.org/wiki/Ed_Roberts_(computer_engineer)

My Connection to Ed

Almost 20 years ago, I co-founded a small medical education software company, for a tiny niche market. My partner was a computer “whiz kid”. I was the chief executive, brain-child and enfant terrible. We are still in business today.

Nevertheless, I decided to contact Ed because I had just received my first PC [Intel® 286 microprocessor] from a publishing company who had contracted with me to write a medical textbook; remember DOS and WordPerfect? I was also very familiar with Microsoft lore, especially relative to business thought and competitive analysis. Regular readers of the ME-P may even recall my mention of attending lectures by Michael Porter PhD [father of competitive analysis] while dating a girl who was attending Wharton Business School while I was a medical student in Philadelphia, back-in-the-day.

Anyway, I took it upon myself to write Ed for some advice. Remember, this was before the commercial internet was widely available. I used medicine as a mutual point of interest. Anyway; after no response, the incident was quickly forgotten because of a busy lifestyle, new medical practice, book-project, etc. I follow-upped about a year later and this time received an encouraging written reply from Ed. I treasure the letter to this day, almost as much as the ones I have from Louis Rukeyser [TV fame-died in 2006] and his uber-investor guest, Sir John Marks Templeton [son is a surgeon] who died in 2008. In 2005, Templeton wrote a brief memorandum predicting that within five years there would be financial chaos in the world. It was eventually made public in 2010.

Assessment

Ed practiced as an internist until his death, in Cochran – a city near Macon, GA. The population was 4,455 at the 2000 census. It is a very poor county in South Georgia, and many, if not most of Ed’s patients were on Medicaid and/or Medicare. He loved them dearly, and they loved him, too!

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Although perhaps not as famous as Gates and Allen; we say with all due respect and admiration – good night Dr. Roberts – and thank you for the personal computer … your love of medicine and mankind … and for reaching out to me so very long ago!

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Queries for the ADA Member Service Center

Four Questions for Consideration

[By Darrell K. Pruitt; DDS]

Dear ME-P Readers

I’m considering these four questions for the ADA Member Service Center to break the ice. What do you think?

Question 1 – The FTC’s Red Flags Rule is due to be enforced on June 10. If the Rule is not delayed for a fifth time and a dentist has a contractual relationship with CareCredit/GE or similar healthcare financing service, will that mean he or she will become a covered entity obligated to additional paperwork, liability and expense?

Question 2 – According to the “ADA National Oral Health Agenda” found on the Advocacy page, it states that one of the ways the ADA intends to reduce the cost of dental care is to promote health information technology. This goal was first posted several years ago. Considering the ever increasing liability of data breaches in healthcare, can consumers still expect to save money in dental care by visiting a paperless practice?

Question 3 – Am I correct to assume that soon the ADA.org Website will include the capability for direct discussions between members and leadership?

Question 4 – If interactive functions are indeed to be included in the new ADA Website, will there be any topics concerning ADA policy that will be closed to questions from membership?

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Editors Note: The incredible power of the internet is illustrated with this post relative to the phenomenon of “crowd-sourcing.” In this context, the term means to harvest the reach of social networking, like this ME-P, to solve a problem, or ask for input or opinions.

IOW: A knowledge seeker asks a question and participants respond.  PeerClip.com is an example of how “wisdom of the crowds” allows you to follow the latest opinions on interesting topics. In the medical practice management arena, you can also participate at the: www.BusinessofMedicalPractice.com, our newest 850 page book available this Fall.

Channel Surfing the ME-P Have you visited our other topic channels? Established to facilitate idea exchange and link our community together, the value of these topics is dependent upon your input. Please take a minute to visit. And, to prevent that annoying spam, we ask that you register. It is fast, free and secure.

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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On Disruptive Healthcare Innovators and Financial Industry Change Agents

Calling all Young Doctors, FAs and Medical Executives with “FLY”

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

In my real-job travels as a medical management consultant, speaker and physician focused financial advisor, my clients and their healthcare practices / financial services business models run the gamut from the sublime to the ridiculous; from pegboards to eMRs and clinical groupware; from cash/bond holders to hedge fund devotees and IPO junkies.

And, from broker-sharks and commissioned sales agents, to fee-only financial advisors and fiduciary RIAs. Fortunately, we see much more of what’s in-between than the latter [www.MedicalBusinessAdvisors.com and www.CertifiedMedicalPlanner.org

Business Analogy

Nevertheless, I am always struck by the fact that change and disruptive innovation [both positive and negative] seems to be within the realm of the young, rather than the more “mature” [sic].

Why? Younger folks just don’t seem to have the mental baggage and fear of failure that older counterparts seem to harbor. THINK: Janis Joplin: Freedom is just another word for nothing left to loose.

For example, Microsoft, Dell, Google, Yahoo, Facebook, Apple and Twitter, etc. No one told these young founders that “it can’t be done” – or – “we don’t do it that way around here.” Or, they did not listen to such talk. Unfortunately, this hubris [confidence or elan] is often just lost with age in the guise of political correctness.

Nevertheless, although started by folks in their youth, the professional management that most successful companies in the public domain ultimately require is from “older” folks.

Healthcare / Financial Services Analogy

Still, it is not surprising to learn that even some hospitals that house the most accomplished authorities in the fields of IT and quality care do not always follow their own advice when it comes to making improvements in the delivery of healthcare, or in their operational and delivery activities. THINK: Robert Wachter, MD.

And, it is not unusual for industries like the financial services and banking sectors, facing deep structural change, to be slow moving. THINK: Harry Markopolis.

Also, consider the auto industry – public education and labor unions – before the fall. Why – because the leaders of such sectors are typically promoted within, and because of past success, and not any ability to change the current environment?

IOW: They were hired for their ability to maintain the status quo, rather than for their ability to make constructive changes.

Assessment

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Do we call this need for young blood, the “theory of business evolution?” The dinosaur is dead … long live the dinosaur!

Moral: We can’t help getting physiologically old – but we can help getting cognitively old to the extent possible. Be disruptive – champion change – don’t settle and raise a little hell in the dual industries we love and serve!

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Get fly! Review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Ease Up – Managing Editor Bob Mitchell

By Darrell K. Pruitt; DDS

[picapp align=”none” wrap=”false” link=”term=doctors+computers&iid=131173″ src=”0127/4caf5e52-a89a-4ddb-a0b2-bf4b6789c92b.jpg?adImageId=11344576&imageId=131173″ width=”414″ height=”413″ /]

Two days ago, ADVANCE for Health Information Executives’ managing editor Bob Mitchell publicly criticized the author of last week’s Parade Magazine article, “Electronic Health Records Face Critics.” Personally, I thought it was cowardly for the editor to accuse Drew Jubera of journalistic recklessness without mentioning his name.

http://community.advanceweb.com/blogs/hx_1/archive/2010/03/16/critics-ehrs-don-t-save-money.aspx

According to Jubera

Jubera wrote:

“A new Harvard Medical School study suggests that electronic health records do not save hospitals money—and in fact often end up increasing costs. The Obama Administration has allocated $19 billion in federal stimulus funds to facilitate the shift from paper to electronic records – a move the Rand Corporation has projected could save up to $80 billion a year. Yet the Harvard study found no evidence of savings so far and little evidence that electronic records improve care.”

http://www.parade.com/news/intelligence-report/archive/100314-electronic-health-records-face-critics.html

Dis-Respects Harvard

Incredibly, Bob Mitchell discounts the Harvard Medical School study as being dated research – even though it is less than 5 months old. “I did some research and found that this study was released back in November 2009, even before meaningful use of an eHR had been defined by [ONCHIT] – or the Office of National Coordinator of Health IT.” As if defining meaningful use was meaningful! That’s humor.

Dis-Respects Parade

Furthermore, editor Mitchell has taken on the responsibility to shield his readers from harm caused by Parade Magazine authors whose ethics fall short of acceptable.

He writes:

“I’m concerned that the public is not being served and they will get the wrong impression of computers in health care, especially if it’s being reported by Parade, which reports celebrity, entertainment and health news.”

Of Healthcare Providers

Not so fast with those tricky pronoun phrases, Bob. Rather than being merely a healthcare stakeholder like you, I’m actually the healthcare provider whom you would have fund your enthusiasm. I think your broad statement that “all of us in healthcare know that digital is much better than paper” is journalistically foolish. In addition, your creativity threatens society much more than alleged exaggerations in Parade Magazine. You not only write about HIT as a career, but people generously call you a managing editor.

eMRs in Dentistry 

The next time you feel important enough to quietly insult writers on behalf of providers like me, remember that eMRs in dentistry will not save money over paper records and will unnecessarily increase the risk of identity theft for my patients … unless you disagree.

It would thrill me if you want to publicly debate the value of electronic dental records (How much do you know about dentistry?)

Assessment

For example, do you realize that if a computer containing thousands of patients’ identifying data is stolen in a burglary, and the dentist, or physician, does the right thing and reports the data breach, he or she will likely be bankrupt even before the HIPAA inspections and lawsuits?

The Ponemon Institute estimates that it will cost about $50 per record just to notify affected patients. A few weeks ago, the HHS was obligated to release information that a burglar stole a computer containing more than 9,000 records from a Missouri dental practice. Just to notify the affected patients will cost the practice almost half a million dollars. But wait. That’s not all. Since the loss involves over 500 individuals, news of the breach must be provided as a press release to the local media. As goes the dentist’s reputation, so goes the dentist’s career – all because of a simple burglary.

Conclusion

So what were you saying about dangerous, biased articles in Parade Magazine? The author whose ethics you criticize has a name. It is Drew Jubera. He’s an award-winning staff member of the Atlanta Journal-Constitution, in Atlanta GA – home of this ME-P.  I’ll make sure he also gets this message.

And so, 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, be sure to subscribe to the ME-P. It is fast, free and secure.

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

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Congratulations Harry Markopolos

A Future SEC Chairman?

By Dr. David Edward Marcinko; MBA, CMP™

[Editor-in-Chief]

www.CertifiedMedicalPlanner.com

Harry Markopolos is finally taking his victory lap. He is out hustling a new book about his nearly decade-long pursuit of Bernie Madoff, and rightful criticism of the Securities Exchange Commission [SEC].

And, he’s been on a whirlwind media and PR tour of sorts: CNBC, MSNBC, “The Daily Show with Jon Stewart”, etc. Still, we’ve written about him before on this ME-P

No Schadenfreude

According to one trade magazine essay, Markopolos finally seems relaxed and at peace. Bernie Madoff is in jail. The Feds are closing in on his accomplices. Markopolos clearly is having some fun. After being ignored for so long, he’s finally the center of attention – on his terms.

But to be sure, schadenfreude was not a philosophy taught to Harry and I, while students back-in-the-day, at Loyola University Maryland.

http://www.fa-mag.com/fa-news/5322-harry-markopolos-sec-chairman.html

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. In my opinion, Harry would be a much better SEC chairman than Mary L. Schapiro, the 29th SEC Chairman [January 2009] -or- Christopher Cox, the 28th Chairman [June 2005].

Dare I say it … I’m just wild about Harry.

So, FAs, investors and doctor colleagues; what do you think about Harry? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

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Letter from the Editor-in-Chief

Help Support the ME-P

You were among of the first; the early adopters if you will. You saw the troubling state of healthcare, medical economics, private practice and the financial services community in our country.

And, you believed in the ME-P and our “new-wave” brand of informed and collaborative investigative journalism to do something about it.

Our History

For the last three years, the ME-P has played the role of educator, watchdog and advocate for medical practice management and financial planning transparency, scrutinizing powerful people, systems and institutions that would prefer to stay out of the spotlight, highlighting the fine print that might otherwise slip past cash-strapped physicians and their consulting advisors.

As newsrooms across the country contract, in-depth investigations are viewed as a luxury that many print publications can’t afford. Journalists are getting kicked off their beats. And, when they do, we are there to help pick up the virtual baton.

The Pioneers

We’re pioneering a new, no-profit e-model, helping spearhead a movement to reinvigorate investigative and non-clinical healthcare administrative and business journalism in this country.

But, we need the support of our most loyal readers – concerned members of the healthcare industrial complex, like you – to spread the word about our mission. If you value our investigations and essays, you will tell five colleagues about the ME-P, today.

Participatory Power

You’ll see our stories in your inbox every day, so you know the types of issues we’re tackling. Our reporting speaks for itself – but we need your help to get the word out about where it’s coming from. We need your participation and collaboration to tell your colleagues.

Our Request

I’ll bet you believe in the power of investigative journalism just as much as I do. So, please tell five [5] of your colleagues that they can stay on the leading edge of the groundbreaking stories that shine a light on the unbiased nexus of medical practice and financial planning, in plain English.

Assessment

In the modern Health 2.0 era, our goal is to “bridge the gap between medical mission and profit margin.”     

Join the ME-P Nation today … and tell us what you think!   Thank you for standing up for investigative healthcare journalism. Thank you for supporting the Medical Executive-Post. Now go; please tell five [5 … or more] colleagues to subscribe. It’s fast, free and secure.

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Conclusion

NOTE: If you need a moderator or speaker for an upcoming event, we are available for seminar or speaking engagements.

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Why eMRs Won’t Improve Patient Care or Reduce Costs

Deus Ex Machina – NOT

By Staff Reporters

Question

Have electronic medical records made a difference in patient care?

Answer

According to a new study looking at the digital medical record adoption of 3,000 hospitals, electronic records have made little difference in healthcare costs or the quality of medical care.

Assessment

That’s discouraging, considering that the government is investing billions of dollars into the technology.  

Related posts from Kevin Pho MD:

Conclusion

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And so, 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, be sure to subscribe to the ME-P. It is fast, free and secure.

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Our Other Print Books and Related Information Sources:

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Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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Sponsors Welcomed

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New Regulations Needed For Financial Planners?

So Says New Coalition

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

The Financial Planning Coalition [FPC] is pushing for a law that would require anyone calling themselves a financial planner to meet certain ethical and educational standards and to register with the Securities and Exchange Commission [SEC].

About the FPC

According to its’ website, the Financial Planning Coalition is a collaboration of Certified Financial Planner Board of Standards (CFP Board), the Financial Planning Association® (FPA), and the National Association of Personal Financial Advisors (NAPFA) to advise legislators and regulators on how to best protect consumers by ensuring financial planning services are delivered with fiduciary accountability and transparency. Americans have grown leery of those who work in financial services.

Currently, financial planning (the process of advising individuals and families across a range of personal finance topics in addition to investment advice) is unregulated as a profession, resulting in major gaps in current laws. So, is it really a “profession” many ask – void of any significant barrier to entry?

The Financial Planning Coalition intends to work with Congress to produce legislation that puts the interests of clients first and enables consumers to identify a trusted financial adviser.

To learn more about the Financial Planning Coalition’s purpose and mission, click here to read, or download the Statement of Understanding [PDF].

SEC Wrong Oversight Agency?

According to this report in Financial Advisor magazine, an advertiser-driven trade journal:

the standards would be set by a public oversight board that would be funded by small registration fees paid by the financial planners, said Robert Glovsky, chair of the Certified Financial Planner Board of Standards during a conference call today. The CFP Board, as well as the Financial Planning Association and the National Association of Personal Financial Advisors makes up the coalition.

Exemptions

However, brokers and insurance agents would not be forced to register as financial planners, but those who held themselves out as financial planners would have to meet the required minimum competency and ethics standards or stop using the financial planner title.

Assessment

And so, as we have noted, written, preached and warned for more than a decade – anyone can call themselves a financial planner, or financial advisor; so beware medical colleagues.

More: http://www.fa-mag.com/fa-news/5314-new-regs-needed-for-financial-planners-coalition-says.html

NOTE: The fiduciary definitional standard conundrum was not even addressed in the article or by the committee, as far as I know. Moreover, note that SEC oversight was in place before, during and now after the Bernie Madoff scandal – so enough said about competency! www.HealthDictionarySeries.com

Conclusion

Your thoughts and comments on this ME-P are appreciated. What do you think FAs, and CFPs®? Should all become an RIA or ERISA styled fiduciary? Or, will this be another CFP® lite fiasco?

Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

Disclaimer: I am a former certified financial planner and CEO of the online www.CertifiedMedicalPlanner.com program for fiduciary advisors working in the healthcare space.

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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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Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

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I’m Not Economically Bashing JHU … But!

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In My Opinion … Hospital Charges Not 4 Me

Dr. David Edward Marcinko; MBA

[Editor-in-Chief]

On February 09, 2010, journalist Maggie Mahar posted an excellent op-ed piece on The Health Care Blog. In fact; I am now compelled to address one aspect of it. The essay was titled: “Massachusetts’ Problem and Maryland’s Solution”.

Assuredly, I’ve no beef with Maggie, her economic machinations or reporting. In fact, I am a fan and encourage all ME-P readers and subscribers to “read it and reap.’

Link: http://www.thehealthcareblog.com/the_health_care_blog/2010/02/massachusetts-problem-and-marylands-solution-we-dont-have-to-wait-for-washington-part-2.html#comments

Maggie Speaks

In her essay, Maggie says the following to which I agree. It is well known to me as a Balti-moron. For, I lived in the bowels of inner-city Baltimore when this legislation went down, back-in-the-day:

“While health care reformers argue about what it would take to “break the curve” of health care inflation, the state of Maryland has done it, at least when it comes to hospital spending. In 1977, Maryland decided that, rather than leaving prices to the vagaries of a marketplace where insurers and hospitals negotiate behind closed doors, it would delegate the task of setting reimbursement rates for acute-care hospitals to an independent agency, the Maryland Health Services Cost Review Commission. When setting rates, the Commission takes into account differences in labor markets and how much a hospital pays in wages; the amount of charity care the hospital does; and whether it treats a large number of severely ill patients.

For example, the Commission sets the price of an overnight stay at St. Joseph Medical Center in suburban Towson at $984, while letting Johns Hopkins, in Baltimore Maryland, charges $1,555. For a basic chest X-ray, St. Joseph’s asks $81 and Hopkins’ is allowed to charge $155. The differences reflect Hopkins’s higher costs as a teaching hospital and the fact that it cares for generally sicker patients.”  

Of Invoices, Charges and Cost Shifting – Oh My!

I do have a beef with the above charges, which are not necessarily costs, which are not necessarily what is ultimately paid by a third-party insurer, or patient. This cost shifting is not unique to JHU, of course, but mention of the “Johns” just caught my eye as I admit that I’ve been away from my hometown of Baltimore, Maryland for 35 years.

Oh my; don’t get me wrong. I loved the place and played stick-ball in JHU’s parking lot on Broadway in Upper Fells Point when I was a kid. I was seen in the ER, at a young age, for a forehead laceration. I even met two of the greatest physicians in the world there.

J. Alex Haller Jr. MD – the world famous Children’s-Surgeon-in-Charge of Johns Hopkins Hospital, and pectus excavatum surgical pioneer, from 1964 until 1997.  As well as pediatric heart surgeon Helen Brooke Taussig MD (1898 – 1986), developer of a famous operation to alleviate “blue baby” syndrome, and who first warned the public on the dangers of thalidomide.

Link: https://healthcarefinancials.wordpress.com/2009/09/01/off-road-touring-with-dr-marcinko-part-vii/

However, as a health insurance agent and advocate of HD-HCPs for more than a decade, who has direct economic “skin-in-the-insurance game”, I would rather go to suburban St. Joe’s medical center for non-traumatic, non-emergent care – if I had my druthers. The neighborhood is safer and the quality can’t be much different. After all, a basic chest x-ray … is a basic chest x-ray, and an uncomplicated overnight stay … is an overnight stay etc, ceteris paribus.

RememberParetto’s 80/20 economic principle of the “vital few and trivial many”? Most of us [trivial many] will not need JHU care [vital few]. And, that’s a good thing! 

The fact that JHU is a teaching hospital that generally cares for sicker patients has tremendous societal implications with positive “trickle-down” innovative benefits for the masses. But, not for me as one doctor-purchaser of healthcare services who knows better. I refuse to pay freight charges for the “full JHU monty”.

I just can’t afford it under my definition of medical / business school derived quality health care.

The correct diagnosis, necessary care and proper treatment with f/u and ancillaries; at the most convenient venue; by the appropriate level medical provider; in an appropriate time-frame, and at the right price.

Assessment

JHU is an outstanding healthcare entity in Baltimore, but perhaps even more so for the poor and/or rich; not us “tweeners”.

For the middle class, it is expensive care whose reputation for quality may actually be declining.

In fact, some JHU employee’s still living “back in the hood” tell me that it is “getting larger, but not better.” 

Link: https://healthcarefinancials.wordpress.com/2010/01/10/a-story-all-doctors-and-patients-should-re-read/

Quality guru, Bob Wachter MD, where are you?

http://community.the-hospitalist.org/blogs/wachters_world/about.aspx

PS: I am a former CPHQ myself [Certified Physician in Healthcare Quality].

Conclusion

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The ME-P as Provocateur

On Publishing Information and Entertainment

By Dr. David Edward Marcinko; MBA

[Publisher-in-Chief]

As avid blogger Darrell K. Pruitt DDS recently noted, this past quarter brought in a large number of monthly hits, readers and subscribers to the ME-P; and we are grateful. The traffic boost was mainly due to interest in eMRs and the financial essays of Somnath Basu PhD, especially during current political turmoil in Washington, DC involving both sectors simultaneously. The common element was the provocation of diverse opinions.

Audience Centric Philosophy

Through a focused attention on our target audience, we’ve come to understand that information and entertainment are inseparable in all but a theoretical sense.

For example, you’re reading this sentence because it entertains or interests you. That it is also informative may be a reason why it interests you, but entertainment and information are nevertheless inexorably linked.

A sure way to entertain is to be provocative.  Apparently some people really like to debate the value of eMRs, healthcare reform and the financial services industry. And, we appreciate multiple links from prominent bloggers, essays and journalists, too. Don’t misunderstand. We do not publish for the sake of provocation and we do lightly self-censor. But, we publish to advance our own thinking and understanding. That we also entertain and invite debate is an additional benefit.

Self Motivation Mission to Inform

Our posts and comments are motivated to correct the record and to infuse an unbiased debate over both healthcare and financial reform with the best evidence available. In the process, we learn much. Hence, though we may entertain, we are motivated by a desire to inform and “bridge the gap between medical mission and profit margin” in the Health 2.0 era.  

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Assessment

We’d even go so far as to say that anyone who does not agree is attempting to fool you with clever theory that belies the practical truth. According to Austin Frakt PhD, of the Incidental Economist, if you fall for it … that only proves our point!

Conclusion

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The FDA and eMR Regulation?

One HIT Futurist’s Opinion

By Staff Reporters

A few years ago, Shahid N. Shah wrote that the FDA should be paying closer attention to healthcare IT systems and consider regulating those systems; in other words – regulating them the same as any other drug, medical device or foodstuff.

After all, some healthcare IT systems can kill just as easily as inappropriate medical care.

Link: http://www.healthcareguy.com/2010/02/24/thank-goodness-the-fda-could-start-regulating-healthcare-it-systems/

Our View

We agree that hospital IT systems and eMRs can, do, and will kill when not used or implemented properly.

And, it’s a shame that we may need the government to improve quality; but perhaps the fear of regulation will do the trick. In fact, we’ve also warned of similar adverse unintended consequences of eMRs and related HIT systems, previously on this ME-P.

Link: https://healthcarefinancials.wordpress.com/2009/12/23/will-electronic-records-raise-the-legal-standard-of-care-and-increase-malpractice-risk/#comments

About Shahid Shah

Shahid is CEO of Netspective, a Java/.NET consultancy that specializes in healthcare IT with an emphasis on e-health, EMRs, data integration, and legacy modernization. He is also a valued thought-leader for the ME-P, who will be contributing the HIT chapter for the third edition of our best selling book: www.BusinessofMedicalPractice.com to be released later this Spring.

Conclusion

And so, your thoughts and comments on this ME-Pare appreciated. Should eMRs be regulated by the FDA? Does the FDA need to put even more on its plate and has it done a good job until now? Do we really need more governmental intervention in healthcare?

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About Disruptive Women in Healthcare™

Online Since September 2008

By Staff Reporters

According to their website, Disruptive Women in Healthcare™ seeks to serve as a platform for provocative ideas, thoughts, and solutions in the health sphere.

They recognize that to accomplish this, a call on experts outside of the health industry is required

Service Goals

The founding Disruptive Women have audacious hopes for their blog.  Furthermore, they say:

We’re not managing change;

We’re not thriving on chaos;

We’re not waiting for cures;

We’re driving change;

We’re creating chaos;

We’re finding cures;

IOW: They’re disrupting the health care status quo.

Blog Goals

To become the “go to” health care blog that is recognized as a petri dish for fresh ideas and bold solutions.

Assessment

Open to all. Disruptive Women in Health Care™ is not intended to be positioned left, right or center. It will be what the authors — and those who comment — make it. Their goal is to generate as many wide-ranging posts as possible.

Link: http://www.disruptivewomen.net

Conclusion

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DrBicuspid.com is Biased against Dentists

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More on Delta Dental

By Darrell K. Pruitt; DDS

Kathy Kincade, Editor-in-Chief of DrBicuspid posted the article, “Studies urge adding adult dental benefits to Medicare” on January 29, 2010.

http://www.drbicuspid.com/index.aspx?sec=sup&sub=pmt&pag=dis&ItemID=303755

Ms. Kincade has always been generous to Delta Dental, making me suspect that she is less than unbiased.

Of Delta Dental

For example, at the end of the article, she devotes the last words about dental coverage for the elderly to an advertisement for Delta:

“Through a relationship with Delta Dental, the AARP offers the AARP Dental Insurance Plan, a dental PPO for AARP members that includes more than 100,000 dentist locations across the U.S. Delta also offers individual plans that are ‘particularly popular among retirees,’ according to Chris Pyle, director of public relations and community benefits at Delta Dental.”

Kincade closes her ad with a quote from Chris Pyle:

“Delta Dental has been a pioneer in developing affordable dental insurance options for those who do not have coverage through an employer. Retirees who take the time to do the math are finding individual and family dental insurance plans to be a wise option.”

How much does advertisement space on DrBicuspid go for these days?

Dr. Hamm                     

That is when Dr. Hamm got involved. He first requested that Chris Pyle document his claim:

”Prove it, Mr. Pyle. Let’s see your figures. Be sure to include comparison of the quality of care between PPO dentistry and fee-for-service dentistry. Do you think discounting fees – even for non-covered expenses – improves the quality of intricate care?”

When Dr. Hamm failed to get an immediate response, he went to the source. Here is what he had to say to the Editor in Chief of DrBicuspid:

——————————————————–

Kathy Kincade, pardon me for being straightforward, but at the risk of making it difficult for DrBicuspid reporters to obtain future interviews with Delta Dental PR professionals and ADA presidents, I proclaim that it is DrBicuspid readers’ rights – indeed Americans’ obligation – to challenge unsupported, self-serving statements that strategically discount facts in healthcare to protect stakeholders from principals (that would be dentists and patients).

DDPA Employee 

Chris Pyle, the on again – off again DDPA employee, isn’t the first Delta PR specialist who has told DrBicuspid outrageous statements before failing to answer the bell when challenged. A year ago, in an article by DrBicuspid Associate Editor Rabia Mughal, another shy and unaccountable Delta Dental PR professional poked his head up before diving for cover. Delta employee Ari Adler is reported to have said that “direct reimbursement to out-of-network dentists is a problem because it allows them to enjoy the benefits provided by the network without following cost guidelines and quality control measures of the network.”

http://www.drbicuspid.com/index.aspx?sec=sup&sub=pmt&pag=dis&ItemID=301436

“We put our dentists thorough a credentialing process and provide quality assurance. That means if a dentist does a filling that should last a certain amount of time and it doesn’t, they have to fix it without charging the network or the patients.” 

– Ari Adler, communications administrator at Delta Dental of Indiana

Even after repeated requests for an explanation of Delta’s unprecedented guarantee of dental work done by Delta’s preferred providers, Ari Adler, a very popular master of Twitter who also teaches PR as a part-time job, declined to answer (So much for popularity on Twitter). I assume the PR and social network expert thinks that since he’s the Communications Administrator for such a powerful company, he’s protected from accountability. Besides, American dentists love and respect Delta Dental, don’t they?

Dr. Ron Tankersley

And; what about Dr. Ron Tankersley who is President of the American Dental Association. Is he also simply too good to talk with us?

————————————————

I may or not know Dr. John Hamm. I know Editor in Chief Kathy Kincade, though. She kicked me off of DrBicuspid over a year ago – the day before DrBicuspid consummated a contractual relationship with the ADABEI to receive the ADA seal of approval.

An Invitation

I should warn readers that I could be wrong about what may have been just an odd coincidence, so I invite you, Kathy Kincade, to discuss journalism ethics with me on Pruitt’s Platform. I trust someone will warn you, Kathy, of this invitation before it comes up on your first page in a Google search. My article “DrBicuspid, the ADA and split allegiances” from 2/15/09 is the 8th hit already. Now do you remember me?

http://community.pennwelldentalgroup.com/forum/topics/drbicuspid-the-ada-and-split

Assessment 

Come on out, Kathy. I’ve been waiting for this a long time. Come on out where everyone can see you defend Delta Dental. Please invite Brian Casey as well. He was the Editorial Director of IMV Publishing a year ago. Is he still around – policing the Internet?

Conclusion

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About Medical Clinical IT Groupware

What it is – how it works

By Staff Reporters

According to Bill Crounse MD of Microsoft,

clinical medical groupware is a new and evolving model for the development and deployment of health IT platforms and applications, the characteristics of which include use of the Internet and the Web as a platform, explicit design for health data exchange and online communication among providers and patients/consumers, a modular or component architecture upon which applications can be aggregated to meet specific clinical and workflow tasks; while allowing interface standards and protocols for data exchange to emerge in a market-driven manner.  

Distribution Platforms

Clinical medical groupware applications can be distributed as software-as-as-service, and are intended to support today’s mobile health care environment by supplying the right information, at the right time and the right place.

Link: http://blogs.msdn.com/healthblog/archive/2009/09/14/learn-more-about-clinical-groupware.aspx

Assessments

Advocates of the clinical medical groupware approach are not limited to software developers and technologists, but also include practicing physicians, executives and managers from health care provider organizations and care management companies, patient advocates, and leaders in life sciences, home monitoring, and medical device manufacturing firms.

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. What is your experience with CMG? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Predicting the Economic Recovery

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How Would Life Change – Even if Prescience Possible?

By Somnath Basu PhD, MBA [www.clunet.edu/cif]

All medical professionals and ME-P readers should know that there’s about a 50% chance that someone will predict correctly when and how the domestic economy will recover. The chances of that person failing are the same, at 50%. There is very little chance (probability approaching zero) that nothing will change. Under these circumstances, it’s quite easy for the pundits to take a shot at being right. It is easy to be wrong because it’ll never be held against them, given the circumstances around the global financial crisis. There’s always a way out of being wrong.

Of Rumors, Guesses, Optimism and Pessimism

Of course being right has its rewards of reaping benefits without any downside. In the meantime, a whole nation is being held hostage as to what happens next. Rumors, guesses, optimism, pessimism abound as stock markets rise and fall, employment goes down by less or more than expected, price of oil suddenly becomes a leading economic indicator, China starts showing the way out, interest rates remain low, home (new, used, new construction, commercial vs. residential) sales increase and decrease in tandem, inflation is a problem but not deflation or vice versa and the economy grows as expected or not. The bewilderment at this state of things is taking a toll but the pundits keep going on. Politicians scream and bureaucrats moan. Obviously, this too is a crisis of sorts.

The Two Questions

There are two questions that fall out of this scenario. First, how does one predict the economy and how sound are the methodologies. Second, and more importantly, do we really need a prediction? I will explore these questions in the order presented above but the first one in more detail.

Let’s Begin the Evaluation

To begin with, it’s useful to evaluate the techniques used by our economic gurus who preach lofty sermons from their altars. These folks have a battalion of charts and graphs depicting why something is happening, ably backed up by rigorous mathematical models that have passed the test of their enlightened peers. These people consider economic indicators using complex models of GDP growth, change in unemployment, trade imbalances, flow of goods and services etc. etc. At the end of the day, they still have a 50% chance of being right. Of course they have a theory already explain this possibility (efficient market hypothesis, or EMH) which they use to explain why the market cannot be predicted with any certainty and the odds of predicting correctly are as good as repeatedly calling a coin toss right. However, it seems that this does not dampen their need in any way to keep on predicting.

 

 The Comparisons

Compared to previous recessions, there is a marked difference with the one we just experienced. This difference is that the great recession of 2008-09 can be considered as the first true global recession where even remote countries in Africa experienced mild recessionary conditions.

Hence, one of the first requirements for the predicting community is to truly incorporate global economic conditions in predicting the future. The current emphasis on domestic economic conditions precludes to an extent our ability to comprehend the changes underlying this “one world” which is necessary to get closer to a more realistic prediction. Further, we should include not only the developed economies along with some of the major emerging markets, but literally all economies, in extending our analysis. As we will ponder later, our model for prediction should be much more inclusive of all countries, no matter how small or economically less developed the countries are.  The understanding here is that given the fragile nature of the global economy at present, even a small non-economic ripple in a distant land can turn into something that encompasses the globe in some kind of economic turmoil.

Thus, hopefully, a globally inclusive model of understanding should definitely help us in the business of prediction.

Departure from the Traditional View

At this point I am going to depart from the traditional view that predicting the future of any economy should necessarily be an exclusive economic model. I shall argue that in this world we live in, such a model is inadequate if we realistically expect to beat the odds of a coin toss game. The point I seek to make is that in a world where we are so dependent of each other, how can we exclude factors like political or social conditions, geographic dispositions and historical interrelations, religion, world health, poverty or global climate change. I am going to elaborate upon some of these above contentions with some simple examples to support my view of an all inclusive understanding model before we go about the business of predicting the economy.

War- What is it Good For?

Consider the politics of wars in the world. Does it have an impact on our economy? It sure does. If we are directly involved, it has a huge cost in human suffering besides the direct dollar cost of war. The countries we are engaged in are similarly impacted by their casualties in human lives (and the subsequent economic effect of that) and the real time dollar costs of the real and financial economy being in shambles. If our country is not directly involved in some war overseas, then the whole defense and allied industries stands to gain – we are by far the largest suppliers of weapons in the world. Hence any war has economic consequences from tangible dollar costs to the associated costs of low morale, drops in consumer confidence, etc. An even simpler example would be to look at the wars we are engaged in (in Iraq and Afghanistan) and ask ourselves whether the economic consequences are not sufficient enough to be included in a predictive model.

Global Climate Change

What about global climate change? It is far too late to say it is not real. The main question is whether the economic consequences of global climate change are large enough to be included in any predictive model. What is the impact of climate change on our economy from the increased ravages of floods,   and famines? Costs in crop loss, insurance claims, higher food prices etc. etc. are surely not trivial. Are we willing to say that in the future these extremes of weather will dissipate and not increase so that we do not need to consider their economic impacts? If the climate changes problem is real then we do need to do something about carbon emissions and fossil fuels even as we find larger and larger oil deposits.

However, it is not enough for us to move strongly in this direction. China and India are already crying foul as the world tries to persuade these two countries to slow down carbon emissions. It is a difficult pitch to sell since the retort is that the economic development in the western world is what caused this condition and it is unfair to ask these two countries to slow down their growth ambitions especially since they have waited so long to wait their turn.

Moreover, less consumption of commodities (e.g. of oil, steel, building material) by China and India will trigger economic events of their own since lower production levels in these countries would mean higher costs to us since we are the main consumers of their economic production. The irony of this argument is that if these countries are not halted from their frenetic economic activity and stepped up consumption of commodities, then there is a good chance of inflation creeping through the commodity sector.

However, the point to make is that the effects of global climate change certainly do have serious economic consequences and excluding it would surely denigrate the prediction.

Other Issues

There are other associate issues. What is the impact of global poverty on future economic activities? Should this be an issue at all? What we don’t observe is the staggering scope of this problem. Let me clarify with a simple example. There are roughly 1.2 billion people in India. Another rough estimate would be to state that about 5% of this population are millionaires (in dollar terms), especially when you factor in that for each Indian Rupee that is accounted for (in the economic system) there is at least two Indian Rupees that are unaccounted (money on which tax has not been paid and has not been laundered either (black money) for but that which circulates in the economy.

Another way of expressing the 5% is to say that there are more millionaires (60 million) in India than there are people in France!! Another 400 million can be considered the middle class. No wonder India is an attractive market to developed nations whose internal markets have become tepid.  However, this also means that the rest of the Indians (about 750 million) live in abject poverty, on a dollar a day. Given that this is an average consumption value, there ought to be about 350 million Indians who live on a lot less than $1 a day. And, this entire population is growing.  In China as in Indonesia; in Bangladesh and in Nigeria. In Brazil and Russia. A growing number of people who are hungry and clamoring for food. People who are adding to the others in claiming land to live on, away from agricultural production. Is there a limit of how many people the world can support before it breaks apart. Does this have any significant (other than the usual Malthusian one) economic impact? It does for sure; much more surely than climate change and swine flu. Yet our models and predictions are oblivious to these possibilities.

SAARS

Physicians and ME-P readers may recalls that about 5-6 years ago, we saw the advent of SAARS, a lethal infection in China and Taiwan, beginning to spread in other parts of the world. There was an immediate and sharp economic impact on many of the industrialized nations. Fortunately for us, the spread of the infection was arrested and the global economy quickly got back in track. Surely, we were lucky. A few years ago, the world witnessed bird flu, an even more lethal viral infection. This too was quickly contained. At some point during the financial meltdown of 2008-09 we witnessed the advent of swine flu, a close relative of the bird flu. This time too we were lucky.

Of course, it is important to note that these infections are one step away from being an epidemic of immense proportions where 100s of millions may perish. If the swine flu was not contained when it appeared in late 2008 – early 2009, the financial meltdown we experienced would seem like a tame event. What happens if the next time and next viral mutation around) we are not that lucky? Should we consider the economic consequence of such an event, albeit within a probability framework?

Non-Economic Issues

As we can see, there are many other noteworthy non-economic issues that can have serious economic impacts.  As a matter of fact, we can all conjure up other examples of non-economic issues at will and make a case for their inclusion because we can so easily rationalize their economic impact. But I have made the point to wrap up the answer to my first question – how good are the economic models? Not much, really.

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Educated ME-P Readers

Since my readers possess financial knowledge and acumen, it is worthwhile for me to allude to the various predictions that are flying about in the economy without having to explain them in great detail. This time around, predictions of economic recovery are in the form of shapes. So now the big question is whether the recovery will look like the shape of a V (a sharp recovery) as compared to a U (a prolonged recession followed by a fairly sharp recovery) or a W (a second round of recession followed by another sharp recovery or like a pair of conjoint Vs (V V). The latest one I had the misfortune to hear about was a square root (√, a V-shaped recovery till a point after which the economy changes very little for a considerable period of time). What is also quite obvious that we can make up many other shapes like the above, using economic (and non-economic) arguments as mentioned earlier but at the end of the day, any one of them has a 50% chance of being right. Because our theories say (yes, the very ones we constructed) that markets are efficient and predictions are futile.

Which brings us to the second question: knowing all this, how important are predictions in the way we live. How much better would our lives be, knowing that one or two of these predictions are right and all others are not? Can we identify the ones that are right?  Most likely not, and definitely much harder than finding good or bad stocks.

Assessment

How would our lives change if we could find that handful of people who predicted correctly and consistently more often than not, if there were such people? Surely, armed with this knowledge, we would be able to exploit the predictions for gain. But, given the odds, it is also quite plain and obvious that finding such people is as difficult as winning the lottery. We know the odds. We continue to admonish our clients who stray in these extreme speculative peripheries. Yet, when it comes to reading about predictions, we continue to play the lottery, in hopes of a windfall. The windfall wills make us richer, but will it make us better or happier?

Note: Dr. Somnath Basu is a professor of Finance at California Lutheran University and the President of Financial Health Technology (www.financialhealthtechnology.com), a personal financial software company.

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Conclusion

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A Skeptical View of the ‘National Summit on Health Care Fraud’

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Seeking Real Results; not Empty Rhetoric

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

All our ME-P readers and subscribers are aware of the ‘National Summit on Health Care Fraud’, at the National Institutes of Health (NIH), held on January 28, 2010 in Bethesda, Maryland. The much publicized summit discussed ways to eliminate fraud, waste and abuse in the US health care system.

A major speaker, of course, was US Secretary of Health and Human Services [DHSS] Kathleen Sebelius.

In My Opinion

IMHO, the summit was more political posturing and “nibbling at the margins”, than innovative thought leadership. Much like a hawkish politician with a platform against crime; who can argue with the proposition?

But, how do we actually reduce fraud and abuse? In other words, how can we achieve real results, and not just more anti-fraud rhetoric?

Here are two considerations, currently on the books, that need hard enforcement:

1. Medicare Integrity Program

The MP-P allows the DHHS to contract with non-governmental organizations, known as Medicare Program Safeguard Contractors, to carry out fraud and abuse detection, cost report audits, utilization review, provider payment determinations, and provider education, and to create a list of durable medical equipment subject to prior authorization for reimbursement.

Under this program, the Centers for Medicare and Medicaid Services (CMS) must implement regulations for contracting procedures.

2. Beneficiary Incentive Program

Under the BIP, Medicare beneficiaries are encouraged to report any suspicious billing activities. When a claim results in collection of funds of at least $100, the beneficiary may be paid a portion of the collections, up to $1,000 for each occurrence. Since this process does not require the same amount of time and resources associated with whistleblowing actions, there has been activity generated by senior groups leading to various enforcement actions.

This program has allowed the Medicare carriers to send notices to patients, which encourages them to call, report, and possibly be rewarded if the report results in action.

Assessment

The first step in fighting healthcare fraud and abuse is to know which laws apply in specific cases.

The next step is formulating policies and procedures to ensure that all workforce members understand how to comply and what their individual responsibilities are in maintaining a sound healthcare business organization.

The third step is enforcement and punishment; less talk and more action!

Assessment

The most effective way to accomplish all of this is through the implementation of a medical practice compliance program, and more specifically, the augmentation of the above two programs currently in existence.

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Questioning [Physician’s] Upward Social Mobility and the State of the Union Address

Broad Consensus Seems Impossible for Medical Professionals – and Everyman

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

While an undergraduate student at Loyola University in Maryland, I learned from my Jesuit teachers and philosophers that a couple of centuries ago, the decider of all matters of importance in Jerusalem was the Great Sanhedrin, or a council of 71 judges. The council met most every day except on festivals and the Sabbath. It functioned as sort of a combination of the Supreme Court, Congress and a political debate boiler room.

Incorrect Unanimity

As one might imagine, the Sanhedrin’s members normally disagreed as they hammered out their daily opinions; much like today’s political debates over healthcare reform. But occasionally they came to a unanimous decision, and they had an amazing and very wise rule when that occurred: The decision was immediately overturned because the sages believed that a unanimous conclusion among so many individuals just had to be wrong.

THINK: The US Senate and Congress

Rules for Upward Mobility

Anyway, I was thinking about the Sanhedrin’s rule after last night’s 2010 State of the Union address by President Barrack H. Obama while I was considering the current state of the economic union for doctors – specifically. The translation is easy for non-physicians [everyman] as well; so bear with me.

Anyway, I was struck by the fact that if there was one grand unified theory which gets at least 90-100% agreement from current generations of America’s medical and lay punditocracy – it is the rules for upward [medical professional] mobility.

These rules, especially for second generation Americans like me, were:

  • A medical degree [college education] leads to a lucrative profession [job] and a satisfying lifestyle.
  • [Working hard], or practicing long hours, means your income will grow.
  • Devotion to medicine, or your job, will produce a comfortable retirement.
  • Your children will follow your career path [job] and create a lasting legacy

The Paradigm Shift

Today, with a national unemployment rate hovering around 10%, doctors and everyman may need to reconsider the above unwritten rules that have governed our upward mobility since the end of World War II. As the son of a GM auto worker – I did decades ago – and still do.

For example, from 1945 to 2000, various private and public health insurance mechanisms were developed, along with the idea that health insurance was a fringe benefit in lieu of the wage and price controls instituted after the war. Today it is even considered a “right” by some.

Nevertheless, the doctor-class was a surrogate for the affluent American upper middle class lifestyle, and a type of perpetual prosperity machine that created wealth.

There were periodic general economic dislocations of course, like the recessions of the mid-1970s and early 1980s, and the rise of managed care in the early 1990s. But, wealth seemed to compound for physicians, and progress always resumed its upward trajectory. This was especially true for all medical professional during the “golden age of medicine” [circa 1965-1990, approx].

After all, wasn’t [isn’t] healthcare considered a recession proof business? Perhaps no more!

The Physician Net-Worth Numbers

Then: I was involved in study a few years ago [September 16, 2008] which determined that the average 47 year-old physician, earning $180,000 annually, needed to amass a net-worth of about $5.5-M in order to maintain the same lifestyle throughout retirement at age 65.

Link: http://www.hcplive.com/finance/publications/pmd/2005/92/3951

Link: www.CertifiedMedicalPlanner.com

Now: Today, with the DJIA down about 30% from its’ October 2008 high, is this retirement / employment scenario still possible? Are our opinions Sanhedrin-like?

And remember, the estate tax laws sunset back to their original rates in 2011. Moreover, many financial advisors, like me, believe income tax rates and brackets will increase going forward; along with increasingly onerous regulations for small businessmen and women like physicians and private medical practitioners. New business innovations of all stripes will also be adversely affected.

Full Disclosure: I am founder of the Certified Medical Planner™ online education program for financial advisors and medical management consultants.

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Assessment

And so, I ask, do the rules of upward mobility for physicians or everyman still apply; or have they changed?  Why or why not? If so, is the change permanent or temporary, and is it for the positive or negative. Please consider financial, societal and/or generational implications.

IOW: Is President Barack H. Obama correct?

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Is the HITECH Act Unconstitutional?

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Parts 1 and 2

[By Alberto Borges; MD]

Is the HITECH Act Unconstitutional? – PART 2

Is the HITECH Act Unconstitutional? – PART 1

Dr. Borges is a ME-P thought-leader in private practice. He is an associate clinical professor of medicine at the George Washington University in Washington, DC.

Assessment

Check out his website at http://msofficeemrproject.com

Conclusion

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I Want Obama Transparency for the ADA

No More Hiding Places

By D. Kellus Pruitt; DDS

Today, Ed O’Keefe of the Washington Post posted “New Obama Orders on Transparency, FOIA Requests.”

http://voices.washingtonpost.com/federal-eye/2009/01/_in_a_move_that.html

O’Keefe writes:

“In a move that pleased good government groups and some journalists, President Obama issued new orders today designed to improve the federal government’s openness and transparency. The first memo instructs all agencies and departments to ‘adopt a presumption in favor’ of Freedom of Information Act requests, while the second memo orders the director of the Office of Management and Budget to issue recommendations on making the federal government more transparent.”

Soon, other ADA members are going to bluntly ask Pres Dr. Ron Tankersley:

“If the President of the United States has the courage to face those whom his actions affect, why oh why doesn’t the President of the American Dental Association support transparency in the non-profit organization that belongs to dues-paying members?” After all, ADA members pay more than $1000 per year for ADA services.”

“If you are an ADA leader, pay close attention. This is the future I warned you about that far too many of you avoided out of convenience. As you can read below in his memos, Obama promises, “The Government should not keep information confidential merely because public officials might be embarrassed by disclosure, because errors and failures might be revealed, or because of speculative or abstract fears.”

Who will be held accountable for the ADA/IDM blunder… among other bone-head ideas?

Obama promises that his administration:

“Will work together to ensure the public trust and establish a system of transparency, public participation, and collaboration. Openness will strengthen our democracy and promote efficiency and effectiveness in Government.”

I think openness will do the same in healthcare if we can move a handful of entrenched ADA leaders on down the road. They are weighing us down with their selfish special interests.

Assessment 

Did you hear that, Dr. Ron Tankersley, President of the American Dental Association? There are simply no more hiding places for the anonymous ADA hobbyists who elected you. I’m sure the long run of irrelevant ADA Presidents was fun before electricity and social networks, though.

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Healthcare Reform and the US Constitution

Consider this Proposed 28th Amendment

Submitted by Cecelia T. Perez; RN

Author Unknown

For too long we have been too complacent about the workings of Congress. Many citizens have no idea that Congress members can retire with the same pay after only one term, that they didn’t pay into Social Security, and that they specifically exempted themselves from many of the laws they have passed (such as being exempt from any fear of prosecution for sexual harassment); while ordinary citizens must live under those laws. 

The Healthcare Reform Exemption

The latest is to exempt themselves from the Healthcare Reform that is being considered … in all of its forms.  Somehow, that doesn’t seem logical.  We do not have an elite class that is above the law.  I truly don’t care if they are Democrat, Republican, Independent or whatever. The self-serving must stop. This is a good way to do that.  It is an idea whose time has come.

Proposed 28th Amendment to the United States Constitution:

“Congress shall make no law that applies to the citizens of the United States that does not apply equally to the Senators and Representatives; and, Congress shall make no law that applies  to the Senators and Representatives that does not apply equally to the citizens of the United States.”

Assessment

Each person contact a minimum of twenty people on their address list, in turn ask each of those to do  likewise. Then in three days, all people in The United States of America will have the Message. We ask you to pass this idea to your friends for their consideration.

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Desperately Seeking Medical Professionals in Haiti

The Catastrophe in Port-au-Prince

By Dr. David Edward Marcinko; MBA

[Publisher-in-Chief]

The ME-P is attempting to assist those in need in Haiti. So, if you are a healthcare professional interested in volunteering, please send an email to volunteer@pih.org with information on your credentials, language capabilities (Haitian Creole or French desired), availability and contact information; etc.

Acute Medical Needs

Orthopedic and trauma surgeons and related specialists are especially desired. In particular, ER doctors and nurses – and full surgical teams (including anesthesiologists, scrub and post-op nurses, and nurse anesthetists) – are in short supply.

Chronic Medical Needs

Down line, primary care doctors, infectious disease specialists, nurses, dentists and internists will be needed once the acute situation has been controlled.

Assessment

We at the ME-P would be very grateful if you are able to contact them, or the Red Cross, and provide medical assistance. As patients flood from Port-au-Prince, they are also finding themselves in need of both personnel and medical supplies, as well.

In other words, any help is much appreciated [time, talent and money].

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. If confirmed, we will laud your humanitarian efforts in an upcoming edition of the ME-P.

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Stuff that Still Floats to the Top on the ME-P

Interesting Articles of Yore

By Darrell K. Pruitt: DDS

I’ve posted hundreds of articles on the Medical Executive-Post over the last year, and it always surprises me when something I long ago forgot rises to the top of their popularity scale.

The Run-Down

Earlier today, a comment I posted on March 30 titled “Usual and Customary UnitedHealthcare” was the most popular article out of thousands (?).

https://healthcarefinancials.wordpress.com/2009/03/30/usual-and-customary-unitedhealthcare/

Why the sudden interest in UnitedHealth? Where is it coming from? 

At the same time, an article I posted on June 17 titled, “GM Bankruptcy Hits Delta Dental Hard,” had just showed up at 11th of the top dozen most popular articles. Why?  

https://healthcarefinancials.wordpress.com/2009/06/17/gm-bankruptcy-hits-delta-dental-hard/

Now, the UnitedHealthcare has dropped off the top dozen, and GM Bankruptcy has moved up to number 6.

Assessment 

Do you find that interesting? What do you think happened in the dental insurance market that has ME-P juggling my articles?

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How a Few Private Health Insurers Are on the Way to Controlling Health Care

A Re-Post from Robert Reich; PhD

Staff Reporters

The healthcare public option is dead, killed by a handful of senators from small states who are mostly bought off by Big Insurance and Big Pharma -or- intimidated by these industries’ deep pockets and power to run political ads against them.

Assessment

Some might say it’s no great loss at this point because the Senate bill Harry Reid came up with contained a public option available only to 4 million people, which would have been far too small to exert any competitive pressure on private insurers anyway.

Link: http://robertreich.blogspot.com/2009/12/how-few-private-health-insurers-are-on.html

Conclusion

What do you think? Is Reich correct? Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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***

Prominent Politician Views on Health Information Technology

A Guest Thought-Leader Op-Ed Piece

Ann Miller; RN, MHA [Executive-Director]  

By Alberto Borges; MD

In this review, ME-P thought-leader and colleague, Al Borges MD dissects and presents the political views of HIT by several prominent politicians.  WHY?

He believes that only a handful of politicians are questioning whether the cost of HIT will actually improve healthcare as promised, which can end up in wasted taxpayer money, and worse, become a slow-moving HIT blunder which puts patient lives at risk. Even President Obama’s staff quietly admits that these statements are unproven.

Assessment

For example, Dr. Ezekiel Emanuel, the brother of White House Chief of Staff Rahm Emanuel and the current health-policy adviser at the Office of Management and Budget and a member of Federal Council on Comparative Effectiveness Research stated last year that:

“Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality are merely ‘lipstick’ cost control, more for show and public relations than for true change.”

Link: Politician Views of HIT [updated November 2009]

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Should Specialists Staff Medical Homes, etc?

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Are they Even Needed?

[By Staff Reporters]

In an op-ed piece originally published in HCPLive.com, by Alan Berkenwald MD, the approaching fire storm over the “patient-centered medical home” model reminds us of the destructive powers seen with some early restrictive HMO models.

Enter – Exit – ReEnter the Gatekeepers

Once seemingly destined to revolutionize organized medicine, and empower patients and primary care physicians, the HMO model of “gatekeepers” nearly destroyed it.

Assessment

And so, can we learn from past failures with this new medical home model? Or, are they even needed?

Related posts from Kevin Pho MD:

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Barriers to Free Market Competition in Healthcare Delivery

Why Supply and Demand Doesn’t Work in Medicine

By Dr. David Edward Marcinko; MBA

[Publisher-in-Chief]

Much has been written here, and elsewhere, about free market competition in healthcare; especially in light of the current national political debates. Yet, these markets are not free.

Like Evolution – Healthcare Competition is Only a Theory

Perfectly competitive healthcare markets are not free; they exist only in economic theory as a useful comparative artifice. In reality, industries and markets have varying constraints on competition. The healthcare industry has often been characterized as unique with its many significant barriers to free market competition, such as market controls on price and quality.

According to colleague Robert James Cimasi, of Health Capital Consultants LLC, in St. Louis MO; there are three main reasons for these barriers in healthcare:

Competitive Healthcare Barriers 

  1. The nature of healthcare creates an unpredictable, urgent, and “infinite” level of demand.
  2. The ubiquitous involvement of insurance companies, private and governmental, as intermediary organizations in the purchase of healthcare interferes with consumer motivations and consequently their choice of providers and services.
  3. The difficulties in measuring healthcare quality and beneficial outcomes (both of quantifying and qualifying them) and the lack of information on the relative costs of healthcare providers and services also inhibit consumer selection, further removing incentives to providers to increase quality and lower costs. 


Barriers to Healthcare Competition               

Included among the many other barriers to competition in healthcare delivery are the following:

  • Patients don’t purchase services directly from providers;
  • Patients don’t compare prices between providers;
  • The government is the largest purchaser of healthcare;
  • Private purchasers often lack market power;
  • Patients, purchasers and providers lack information;
  • Occupational licensing;
  • Many providers have monopoly or near-monopoly power (yet antitrust laws prevent some potentially beneficial integration);
  • Providers are rewarded for increasing costs;
  • Capital investments are overly subsidized (It should be noted that Stigler argues that an industry will not use its power to collect money from the government unless the list of beneficiaries can be limited, due to the fact the amount of subsidies will be divided among a growing number of rivals.*
  • Certificate of Need (CON), regulation, and licensing laws are an entry barrier to competing and substitute providers and services; and
  • Exit barriers protect low-quality providers.

Assessment

Of course, the supply side is also flagrantly encouraged by excessive medical testing, procedural interventions and surgery; mostly excused by malpractice phobia as a well as the personal financial interests of involved stakeholders.

References

Stigler, George J. “The Theory of Economic Regulation.” The Bell Journal of Economics and Management Science. Vol. 2, No. 1 (Spring 1971): 5.

Conclusion

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BEWARE: Top Ten Mistakes Financial Advisors Make

Understanding the “Cobbler’s Children are Barefoot” – Syndrome

Staff Reporters

Here is an article by Philip Palaveev recently published in a financial services trade industry magazine.

“Before helping others, put your own oxygen mask first.”

That’s what they say on airplanes when instructing passengers on what to do in an emergency. It makes a lot of sense: If you can’t breathe, you can’t help others.

Personal Issues

Unfortunately, an alarming number of financial advisors suffer from personal financial “issues” that can interfere with their ability to help their clients. Personal financial problems can indeed cloud advisors’ judgment and can prevent FAs from making much needed investments in the practice.

http://registeredrep.com/advisorland/marketing_selling/top_ten_financial_mistakes_financial_advisors_1124/index.html

Assessment

According to ME-P Publisher-in-Chief Dr. David E. Marcinko, MBA, a former certified financial planner and financial advisor himself;

“Far too many so-called “Financial Advisors” have no formal business management education and precious little real financial training from sources other than their Broker-Dealers or wire-houses; so this report comes as no surprise. The vast majority of stock-brokers are product sales men and women, period.  So – always beware – dear medical colleagues and all readers.”

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 Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com 

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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The “Real Facts” about eMRs with .ppt Presentation

A Guest Thought-Leader Presentation

Ann Miller; RN, MHA [Executive Director]

By Alberto Borges; MD

In this colorful MSFT PowerPoint presentation, ME-P thought-leader and colleague, Al Borges MD dispels a plethora of eMR myths. He discusses the true cost of eMR implementation, and presents his views on the dark side of the eMR certification process.

Assessment

He concludes with an opinion on insider C-eMR politics in the USA.

Link: The Real Facts about eMRs [last updated April 2009].

Conclusion

And so, 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.

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Product DetailsProduct Details

 

ME-P Holiday Publishing Schedule

“Bridging the Gap between Medical Mission and Profit Margin”

By Ann Miller; RN, MHA

[Executive Director]

The ME-P does not usually close for the Holidays. So, if you are in need of some informative reading material during your down-time, try our archives of past articles.

If that isn’t enough, on the middle left sidebar of our home page you’ll see a list of popular posts, and reader comments, ranked from the past.

Finally, scroll down and look at the lower left sidebar for another topic grid. Click on a tag-of-choice and start reading. Oh! Don’t forget to subscribe for fee and secure delivery direct to your e-mail box.

Have a happy and safe holiday season.

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The ME-P Publisher, Editors and Staff

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Thanksgiving “Food-for-Thought” on “Money Driven Medicine”

View the “Money-Driven Medicine” Video [A Free Streaming Download]

By Staff Reporters

During the month of November, Money-Driven Medicine will stream for free as part of the Watch-In! for America’s Health.

Based on Maggie Mahar’s Book

“Money-Driven Medicine” provides the essential analysis Americans need if they are to become knowledgeable participants in healthcare reform during these crucial days and in the years to come.

Assessment

Link: http://moneydrivenmedicine.org/watch-in

If you find this film to be a valuable tool, consider screening the DVD at your conference or professional event or in your community, association, school, workplace or place of worship.

Channel Surfing

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Strategic Modern Portfolio Theory Considerations in Hospital Capital Formation

Understanding Risk for Doctors and Financial Advisors

By Calvin W. Wiese; MBA, CPA

www.HealthcareFinancials.com

Hospital capital investments financial create risk. Risk is the uncertainty of future events. When hospitals make capital investments, they commit to costs that affect future periods. Those costs are known and relatively fixed. What are unknown are the benefits to be realized by those capital investments. For capital investments, risk is the certainty of future costs coupled with the uncertainty of future benefits. In some cases, while the future benefits are uncertain, there is a high degree of certainty that the benefits will exceed the costs. In these cases, risk can be very low.

Risk Re-Defined

Risk may be better defined as the degree to which the uncertainty of unknown benefits will exceed the known and committed costs. For example, when capital assets are purchased, both the burdens and the benefits of ownership are transferred to the owner. The burdens are primarily the costs associated with acquisition and installation. The benefits are primarily the revenues generated by operating the capital assets. Risk of ownership is created to the degree that the benefits are uncertain.

Managing Risk

Hospital managers and physician executives need to be skilled at putting hospital assets at risk. Without clear knowledge and understanding of the benefits and the burdens, hospitals can quickly find themselves at unacceptably high levels of risk. Risk must be continually assessed and evaluated in order to successfully put hospital assets at risk. Hospitals require many varied capital investments; their capital investments represent a risk portfolio. An effective combination of risky assets can often create risk that is less than the sum of the risk of each asset.

About MPT

Of course, financial managers have know this for years as a basic principle of Modern Portfolio Theory (MPT), first introduced by Harry Markowitz, PhD, with the paper “Portfolio Selection,” which appeared in the 1952 Journal of Finance. Thirty-eight years later, he shared a Nobel Prize with Merton Miller, PhD, and William Sharpe, PhD, for what has become a broad theory for securities asset selection; and hospital assets may be viewed as little different. Prior to Markowitz’s work, investors focused on assessing the rewards and risks of individual securities in constructing a portfolio. Standard advice was to identify those that offered the best opportunities for gain with the least risk and then construct a portfolio from them.

Following this advice, a hospital administrator might conclude that a positron emission tomography (PET) scanning machine offered good risk-reward characteristics, and pursue a strategy to compile a network of them in a given geographic area. Intuitively, this would be foolish. Markowitz formalized this intuition. Detailing the mathematics of diversity, he proposed that investors focus on selecting portfolios based on their overall risk-reward characteristics instead of merely compiling portfolios of securities, or capital assets that each individually has attractive risk-reward characteristics. In a nutshell, just as investors should select portfolios not individual securities, so hospital administrators should select a wide spectrum of radiology services, not merely machines.

Assessment

Savvy hospital managers will mitigate ownership risk by constructing their portfolio of risky assets in a manner that lowers overall risk.

Conclusion

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And so, your thoughts and comments on this ME-P post are appreciated. How do you define financial risk in your healthcare organization? How do you manage and mitigate it? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Top Ten Signs the ADA is Hunkering Down

About the American Dental Association

By Darrell K. Pruitt; DDS

Today, I especially cherish my right as a dues-paying member of the ADA – and as an American – to share my blunt, un-requested opinion as if you were a colleague, a patient or disinterested lawmaker.

For by early 2011, such liberty could warrant official sanction by the yet to be revealed national enforcer of the 2010 ADA Code of Conduct … if by then they find someone in the ADA capable of publicly announcing my crimes with a straight face, just before I receive a good talking-to about professionalism. If the future Ethics Enforcer would like me to help burnish his or her brand new gunslinger reputation quickly and deeply, I will gladly link any ADA official’s name to mine, and we’ll be companions for as long as I feel our union helps bring even more transparency to my profession. I’ve been an SEO assist for several ADA leaders for a couple of years already. Just ask ADA President Dr. Ron Tankersley – or – just Google his name.

Getting Spanked? 

I’m not too worried about getting spanked. What can the ADA possibly do to me? Besides, officially, nobody will utter as much as a peep because of the transparency thing. Unofficially, ADA officials will privately send more attaboys because they trust me. They know by now that I never betray friends. I’m selectively transparent – which is my right but not yours, non-profit ADA. I think we both know, Dr. Tankersley, that I’m not the only one who thinks a minority of ADA leaders are playing naïve, childish and costly games.

Then again, it could just be my persistent, egocentric stage of emotional development that causes me to imagine that Resolution 82 is pointed directly at the nose of D. Kellus Pruitt; DDS.

“Patient rights, ethics considered” was posted on Nov 16 on the ADA News Online, and was written by Jennifer Garvin 

http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=3843

Garvin writes, “Res. 82 asks that the following principles be considered for an ADA member Code of Conduct:”

1. Members will maintain high standards of integrity and conduct their dealings as members of the Association in a professional manner.

2. Members will treat other members and Association officers, trustees and staff with courtesy and respect, and shall refrain from conduct that is unreasonably disruptive or is harassing.

3. Members will respect the decisions and polices of the Association and will not engage in conduct that is disruptive to Association staff or causes the Association to expend an unreasonable amount of time or effort to address.

4. Members are encouraged to use proper Association channels of communication to address differences.

5. Members will comply with all applicable laws and regulations, including but not limited to antitrust laws and regulations.

6. Members will respect and protect the intellectual property rights of the Association, including any trademarks, logos and copyrights.

7. Members will not use Association membership lists for personal solicitation purposes.

8. Members will not use all or part of Association lists, including membership directory, online member listings, conference attendees and education course participants for selling, prospecting or creating a directory or database.

9. Members will treat all information furnished by the Association as confidential and will not reproduce materials without the Association’s written approval.

10. Members will avoid conflicts of interest.

Assessment

Garvin concludes: “The resolution also states that a proposed member code of conduct, together with proposed sanction and enforcement procedures, be presented for consideration by the 2010 House of Delegates.”  It is probably earthly unprofessional to make light of authoritarian bluster, but this really reminds me of the John Landis film “Animal House” when Dean Wormer put John Belushi and other ΔΤΧ Fraternity misfits on double secret probation. ADA Trustees shouldn’t take themselves so seriously. It looks silly to those watching. Or then again, keep it up. After all, it looks silly to those watching.

Toga Party! Dentures 2 for 1! Just ask for Dr. Ron.

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Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. But, feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Joe Flowers New Healthcare Reform Strategy

Selling Patients like Baseball Players – Seriously

By Staff ReportersFuture Physicians

Here is a health care reform strategy that we have not heard of before. It was formulated by healthcare futurist Joe Flowers, and is reposted below for your review.

It first posits this question, and then gives a plausible answer, with unique new operational strategy.

Question

Why aren’t health plans more aggressive in promoting the long-term health of their members, like getting them to eat better, stop smoking, get a little exercise, and all that?

Answer

Because of health insurance industry “churn”

Strategy

Give Joe’s idea a read and tell us what you think?

http://www.thehealthcareblog.com/the_health_care_blog/2009/11/sell-patients-like-baseball-players-seriously-.html

More: www.imaginewhatif.com

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About the New Video-Launch of InvestorGov.com

Do You Trust Mary?

By Dr. David Edward Marcinko; MBA

[Publisher-in-Chief]Dr. David E. Marcinko MBA

Did you know that according to this new website, the mission of the US Securities and Exchange Commission [SEC] is to protect investors, maintain fair, orderly and efficient markets, and facilitate capital formation?

Well, I did, but during the last two years you might surmise that the SEC didn’t.

So – What’s an Inept Government to Do?

Launch a new website, of course, with these tab menus:

1. Invest Wisely

2. Avoid Fraud

3. Plan for Your Future

4. How the SEC Helps

A FINRA Re-Deux

Much information on the site is from the Financial Industry Regulatory Authority [FINRA/NASD]. Of course, SEC Chairwoman Mary Schapiro is the former chief executive of that organization, and we all know how they protected us from Bernie Madoff and his ilk, don’t we.

Assessment

Nevertheless, take a look at this video from Mary Schapiro. She sure looks serious, doesn’t she?

Video Link: http://investor.gov/welcome-message-from-chairman-schapiro/

Conclusion

Click to play :

And so, your thoughts and comments on this Medical Executive-Post are appreciated. What do you think about the new site? Oh, by the way, my answer to the posed question is No! But, feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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How Much Do “Financial Advisors” Pay for Doctor [Any Client] Prospect Leads?

More Than you Think in this Murky Advertising World – but – Are Matching Services Effective? 

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]Dr. David E. Marcinko MBA

Recently, I received the sixth telephone cold call from one Mr. Tim Smith [866 952 4065], in as many months, regarding a service called Prospect Match of Concord California. It purports to match financial advisors with pre-screened clients [like affluent doctors] in my area.

Of course, because of their high quality selection process, only three advisors are “needed” in my locale. I also received this email sales-service pitch.

The Introductory e-mail Sales Pitch

We are hosting a live presentation with Ilene Hirsch of ProspectMatch, and new agent Wayne Dunlap will show you a service that will prospect for you—even in a terrible economy. See How Wayne Dunlap invested $1,094 in his business to earn $39,560 and does it again and again. Join us for 30 minutes and learn how Wayne:

  • Outsources his prospecting, and was
  • Introduced to 73 new prospects; resulting in 23 appointments and in 9 sales. 

Thank you
Eric Palmer (800) 290-7226
www.Brokersalliance.com 

About Prospect Match

“ProspectMatch helps financial professionals who are wasting time and earning too little. If you are earning less than $100,000 a year, you’re either not serious, or doing the wrong things and we can show you what to do. If you are earning $100,000-$300,000 annually, you’ve figured some things out. But those who use our systems see their income top $500,000 annually because they spend their days doing marketing the right way, talking to motivated affluent prospects and they sell the right way.”

Link: www.ProspectMatch.com

Costs

The blog states that there is a one time non-refundable registration [fixed-cost] fee of $149; so that prospects meeting their selection criteria are assigned to me exclusively. For each prospect match, the charge is an additional $20 [variable-cost] fee. This is known as a hybrid business cost model.   

Assessment

Here are a few interesting thoughts and co-incidences for further ME-P subscriber consideration and commentary:

  • The site is a pre or post-retiree sales lead generator for the 45 +age market for annuities; typically the most commission loaded and profitable financial product in the industry today. The fear of Obama-care may be self-promoting for annuities. 
  • It appears to be geared more for insurance sales agents; not RIAs or fiduciaries.
  • The service appears to help mitigate the so-called national “do-not-call” prohibitions. 
  • Explanatory sales booklets and other customized self-promotional literature are available for an additional surcharge, along with other premium upgrade services.
  • We have been getting more than the usual number of contacts recently, either to buy our ME-P mailing list [not for sale-confidentially assured], or to purchase an AMA. APMA or ADA mailing list for doctors, podiatrists and dentists. These folks are apparently unaware of our medical affiliations.
  • How do you feel about being called a “prospect” or book-of-business?
  • I am not – and have never been – a member of the Financial Planning Association [FPA], and I haven’t been a certified financial planner for the last three years; having quit that organization in abject disgust after more than a decade [read related posts – why?]. So, how and why did they target me? Big mistake, too.

Disclosure

I am not a member of the AMA; 82% of eligible [cogent and modern] physicians are not. But, I am founder of the www.CertifiedMedicalPlanner.com for fiduciary advisors and medical management consultants.

ConclusionProspecting Advisors  

And so, your thoughts and comments on this Medical Executive-Post are appreciated. What are the good and bad points of this service? Has any FA used it and what is your experience with it? As a doctor, how do you feel about being targeted as a “prospect” by a third-party head-hunter? Be sure to give the website a click and tell us what you think? 

We will try to contact Tim, or other representative of this advertising/marketing program, for an email interview. Let’s be objective.

Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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ADA Opens a Facebook

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Perhaps too Early?

[By Darrell K. Pruitt; DDS]pruitt

Something strange has happened to www.DentalBlogs.com I think they have partially shut down their Facebook account. They no longer feature original articles such as those by Dr. Rhonda Savage and Ms. Linda Miles, and in the last couple of weeks, they eliminated their collection of photos. Now the site only features ads and press releases. Does anyone else wonder what happened? Sure you do! This is exciting.

Perhaps Re-Tooling 

Unless they are just re-tooling this weekend, I suspect that since their previous format was biased heavily in favor of advertising dollars in a tough economy, their funding simply dried up. Like so many other advertising-related careers, the dinosaur found it couldn’t compete in a 2.0 market.  Nevertheless, today I did learn something important from the DentalBlogs Wall: The ADA has opened a Facebook account.

http://www.facebook.com/home.php#/pages/American-Dental-Association/32252997166?ref=mf

Such transparency is inspirational

When I announced this news on Twitter a few hours ago (“Proots”), neither the ADA nor the TDA had yet told membership. Yea, I scooped them on their in-house news. It happens all the time.  Naturally, I became a fan of the ADA Facebook. When I joined, there were already 1205 fans, even though the site is yet operational. I found that intriguing because it usually takes a long time for most FBs to attain 1200 fans – especially when all one can gather is the mission statement of the ADA’s newest Internet site.

My View 

Here’s what I see: About the time DentalBlogs laid off employees from their fully active Facebook, the ADA opened theirs (Gasp)! The ADA was well known to DentalBlogs because the ADA once advertised with them regularly. That is where I found an article about the ADA-approved CareCredit/GE that ended up causing problems for some people and entertainment for others. Let’s face it, friends. I just know that I’m not the only dentist in the nation with at least two burning questions. I bet at least 4 others are wondering who were the first seven fans to sign up for the ADA Facebook and Has Kim Volk, CEO of DDPA signed up yet?

Because the number of fans is rapidly piling up, such information from a few weeks (?) ago could soon be just too difficult to uncover from the fans list on the ADA site. It took a long time for me to scroll down through 1200 names – looking for those I recognize (Gasp)!

Scrolling Quickly, but Carelessly

I could have easily missed several easily recognizable names in contemporary dentistry, but as far as I can tell, not only was Delta Dental Plans Association CEO Kim E. Volk’s name not present in the list of 1200 fans, but there were very few names I recognized … and I’m sorry if I insulted anyone. I also did not see “Ron Tankersley” and other ADA officials’ names on the fans list. Didn’t the ADA try partial transparency like this once before? I may be wrong, but I think I played a role in shutting it down a few years ago with my persistent and still unanswered questions about the NPI number.

More Semi-Reliable Information

Here’s another bolus of semi-reliable information: I also quickly scrolled through DentalBlog’s list of 400 fans and did not notice an unusual amount of matches with the ADA Facebook fans list.

Those who dare to do so, might just ask, “So if the ADA fans didn’t come from dentalblogs, where did they come from?” I think one possibility is that the ADA effort has been in Beta and limited to a select group of people up until now. Doesn’t it seem strange that nobody is able to post anything? Did someone open the doors a few hours early? So who were the first 7 fans? No, you don’t have to scroll down to find out for yourself. I’ll tell you.

Who is John Hergert?

The first person to become a fan of the ADA Facebook account is named John Hergert from Chicago, Illinois.

2nd – Laurie Rich

3rd – Amy Lund

4th – Kelsey Majors

5th – Jessica Stevens

6th – Samantha Campbell

7th – Lina Kulkormi

I don’t recognize any of the seven, and I have not searched anyone’s name other than John Hergert’s – the first person to become a fan of the ADA Facebook. I found someone named John Hergert in Chicago, Illinois who is Associate Vice President at Lipman Hearne Inc. – an advertising agency.

http://www.spoke.com/info/p6JVgPy/JohnHERGERT.

Here is the bio of the person I only suspect is the first to become a fan of the ADA Facebook.

John Hergert’s Biography

John Hergert Associate Vice President John Hergert has a keen understanding of what it takes to capture and hold the attention of marketing audiences via innovative marketing techniques. Formerly Associate Director of Marketing Communications at DePaul University in Chicago, John works with both traditional and interactive media to design and implement marketing strategies that build a client’s image, increase support, and grow enrollment or attendance. John’s experience includes developing ROI-based marketing strategies for a variety of nonprofit and for-profit clients. Prior to DePaul, John was an account executive overseeing marketing and advertising strategy, web development, direct mail, print production, and promotional development for clients including Disney, Marconi, Owens Corning, and Reynolds. John began his marketing career while at the University of Wisconsin, where he was hired by a Los Angeles firm to implement cutting-edge marketing programs for Saturn and Trek Bicycle Corporation. John received his B.A. in Journalism from the University of Wisconsin and his Master of Science in Information Systems from DePaul University.”

Assessment 

What do you want to bet that the ADA Facebook is Mr. Hergert’s baby?

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Why America Spends More on Healthcare

A McKinsey Global Institute Review

By Nancy Chockley; PhD
President & CEO
NIHCM FoundationRed Cross

Path breaking work by the McKinsey Global Institute (MGI) shows that, relative to other peer countries from the Organization for Economic Cooperation and Development, the U.S. spends nearly $650 billion more on health care than would be expected after adjusting for cross-country differences in wealth.  Fully two-thirds of this added spending occurs in the outpatient sector. 

Out-Patient Services

The highly profitable nature of many outpatient services coupled with the incentives of a fee-for-service payment system are contributing to greater intensity of outpatient care and helping to fuel this spending.  In this essay, “Why America Spends More on Health Care,” Eric Jensen and Lenny Mendonca describe MGI’s work to examine all sectors of the American health care system and identify factors responsible for the higher-than-expected spending.  

More Examples

Other recent Expert Voices essays on health reform include:

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When Investing or Stock Trading Is No Longer Fun

Understanding Obsessive-Compulsive Behavior

By: Dr. David Edward Marcinko; FACFAS, MBA, CMP™

By: Dr. Eugene Schmuckler; MBA, CTS

By: Dr. Kenneth H. Shubin-Stein, CFA

By: Richard B. Wagner; JD, CFP®fp-book1

An obsession is a persistent, recurring preoccupation with an idea or thought. A compulsion is an impulse that is experienced as irresistible. Obsessive-compulsive individuals feel compelled to think thoughts that they say they do not want to think or to carry out actions that they say are against their will. These individuals usually realize that their behavior is irrational, but it is beyond their control. In general, these individuals are preoccupied with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency.

Specifically, behaviors such as the following may be seen:

  • Preoccupation with details.
  • Perfectionism that interferes with task completion.
  • Excessive devotion to work and office productivity.
  • Scrupulous and inflexible about morality (not accounted for by cultural or religious identification).
  • Inability to discard worn-out or worthless objects without sentimental value.
  • Reluctance to delegate tasks or to work with others.
  • Adopts a miserly spending style toward both self and others.
  • Demonstrates a rigid, inflexible and stubborn nature.

Most people resort to some minor obsessive-compulsive patterns under severe pressure or when trying to achieve goals that they consider critically important. In fact, many individuals refer to this as superstitious behavior. The study habits required for medical students entail a good deal of compulsive behavior.

Related Addictions

As the above examples suggest, there are a variety of addictions possible. Recent news accounts have pointed out that even high-level governmental officials can experience sex addiction. The advent of the Internet has led to what is referred to as Internet addiction where an individual is transfixed to the computer working for hours on end without a specific project in mind. The simple act of “surfing” offers the person afflicted with the addiction some degree of satisfaction.

The Gambler

Still another form of addictive behavior is that of the compulsive gambler. This is the behavior of an individual who is unable to resist the impulse to gamble. Many reasons have been posited for this type of behavior including the death instinct; a need to lose; a wish to repeat a big win; identification with adults the “gambler” knew as an adolescent; and a desire for action and excitement. There are other explanations offered for this form of compulsive behavior. The act of betting allows the individual to express an immature bravery, courage, manliness, and persistence against unfavorable odds. By actually using money and challenging reality, he puts himself into “action” and intense emotion. By means of gambling, the addicted individual is able to pretend that he is favored by “lady luck,” specially chosen, successful, able to beat the system and escape from feelings of discontent.

Just Plain Greed

Greed is another reason. In fact, a 1987 poll conducted by the Chicago Tribune revealed that people who earned less than $30,000 a year, said that $50,000 would fulfill their dreams, whereas those with yearly incomes of over $100,000 said they would need $250,000 to be satisfied. More recent studies confirm that goals keep getting pushed upward as soon as a lower level is reached. Now, consider Bernie Madoff, and the recent sub-prime mortgage debt fiasco in this light?

Compulsive Doctors

Edward Looney, executive director of the Trenton, New Jersey based Council on Compulsive Gambling (CCG) reports that the number of individuals calling with trading-associated problems is doubling annually. In the mid 1980s, when the council was formed, the number of people calling the council’s hotline (1 – 800 Gambler) with stock-market gambling problems was approximately 1.5 percent of all calls received. In 1998 that number grew to 3 percent and it is projected to rise to 7-8 percent by 2005. Dr. Robert Custer, an expert on compulsive gambling reported, that stock market gamblers represent over 20 percent of the gamblers that he has diagnosed. It is evident that on-line trading presents a tremendous risk to the speculator. The CCG describes some of the consequences:

  • Dr. Fred B. is a 43-year-old Caucasian male physician with a salary above $100,000 and in debt for more than $100,000. He is married with two children. He was a day trader.
  • Michael Q. is a 28-year-old Caucasian male registered nurse. He is married and the father of one (7 month old) child. He earns $65,000 and lost $40,000 savings in day trading and is in debt for $25,000. He has suicidal ideation.

Assessment

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Question: So how much money is enough?

Answer: Just a little bit more.

Conclusion

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Our Recent Experience with CFP® Mark Utility

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Certification Falling from Grace – Deserved or Not?

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief] dem21 

The Premise

In the summer [2008], we sent a random email blast to the first 200 Certified Financial Planners® on our list-serve. These were folks who had previously contacted us, and/or purchased our textbooks, handbooks, tools and/or dictionaries that assist accountants, financial advisors, attorneys, medical management consultants and all those working to assist physicians and medical professionals on business and economics matters.

The “Straw-Poll” Query

Our email blast asked the simple question:

“Did you ever voluntarily resign your license to use the CFP® mark?”

First Round Results

We received four positive responses [2%]. We then followed up to learn that 2 of the 4 were CPAs, one was a CFA and another was an MBA. Now, what do these results signify – probably nothing – or maybe an emerging trend?

Repeat

So, last summer [2009], after the continuing Wall Street collapse, and the Somnath Basu PhD article on “CFP Trust” in Financial Advisor magazine and this blog, we sent out a follow-up email to the exact same 200 Certified Financial Planners® as before; but carved-out and replaced the 4 CFPs who had resigned the mark, with 4 others.

Link: I Jealously “Shake my Fist” at Somnath Basu PhD

This time we asked the question:

“Have you recently considered allowing your CFP mark to lapse; or resigning it?”

Second Round Results

This time we received exactly eight positive replies [4%] or double the number from the first round. One CFP® said:

“I am rethinking my entire business and marketing philosophy. This includes separation from any taint left over from recent industry scandals – and yes – even including my CFP® mark”

 CMP logo

http://www.CertifiedMedicalPlanner.org

Assessment

This little experiment was not statistically significant by any means. And, again it probably is indicative of nothing. Yet, these types of questions must be boldly asked today; even if they were not even timidly asked yesterday.

Nevertheless, cited plausible reasons for the increased negative CFP® mark response may be:

 

  • CFP BoS lacks modernity and membership alliance. 
  • SEC mismanagement.
  • NASD/FINRA impotence.
  • Wall Street greed.
  • Lack of true fiduciary accountability.
  • Client anger and public distrust.
  • Advisor frustration at lost income.
  • College for Financial Planning and American College credibility.  
  • ME-P operations in the medical niche advisory space.
  • CFP® mark and related industry certification taint.
  • Alternative degrees and available designations.
  • Rise of RIAs and the fiduciary CMPmark for healthcare specificity.
  • Resigning [doing] and considering [thinking] are not equivalent;
  • etc, etc. 

It is interesting to note that no CFP® resigned their mark who did not hold either another graduate degree [MBA, MSFS, MA, MS, PhD], or more rigorous industry [CFA and CPA] certification.

Assessment 

So, is CFP mark allegiance just a union-like mentality of “united we stand – divided we fall”, by those with little to no gravitation pull of their own – or something else; ie., industry group think? You decide; and do tell us what you think.

Note: I am the founder of the CMP online education and certification program for financial advisors and consultants interested in the health economics, finance and medical practice management space, and a former [resigned] certified financial planner www.CertifiedMedicalPlanner.org 

Update 2013:

Conclusion

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Healthcare Reform Articles from Kevin Pho MD

Aggregating Content – Disseminating Knowledge

By Ann Miller; RN, MHA

[Executive Director] Books

Here are five interesting new articles on the healthcare reform debates from colleauge Kevin Pho, MD. 

Kevin practices at the Nashua Medical Group near the Massachusetts border. He is board certified in internal medicine and provides both comprehensive adult and primary care services.

Related posts:

Give them a click, read em’ and comment now.

Assessment

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Healthcare Organizations: www.HealthcareFinancials.com

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Popular Healthcare Reform Articles

Aggregating Content – Disseminating Knowledge

By Ann Miller; RN, MHA

[Executive Director]Text Books 

Here are three interesting and related articles from The Incidental Economist:

 

 

Give them a click, read em’ and comment now.

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Why ADA / Intelligent Dental Marketing Failed?

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The ADA is an Incredible Dinosaur

By Darrell K. Pruitt; DDSpruitt

As a member of the ADA, I am also a part owner in any business venture the leaders of the organization enter into. I’ve observed the loss of my investment in a business deal because my employees made mistakes. As a business owner, it would be simply irresponsible for me to ignore something like this.

The Embarrassing Story  

Do you know what part is missing from this embarrassing story? The ADA has not uttered a word about the ADA/IDM failure… Or, as the ADA Business Enterprise Inc. leaders call it – the ”ADA/idm” failure.

The fact that the two business entities never came to an agreement on what to even call their doomed joint venture reveals a lot about the egos that gummed up the machinery. It’s possible that pride undermined our non-profit/for-profit partnership from the very start. We just don’t know what happened because there are so many possible reasons for this business model to fail. Will loss of ADA members’ investment happen again if the cause is not recognized and eliminated? I think the chances are pretty good that even more embarrassment is on the way. Given the soft environment, it’s only natural.

Over my 27 year career as a dentist, I have met many ADA officials, both employed and elected, on all three levels of the tripartite system of governance – local, state and national. From the topmost quality of character I have witnessed in all but a few politically-empowered and proudly insensitive exceptions, I can assure you that like all major projects of the ADA, the failed ADA/IDM adventure into dental marketing was assembled with nothing but noble intentions and benevolent wishes for ADA members and dental patients – at least from the ADA side. Whether the leaders of the ADA’s new business partner, Intelligent Dental Marketing out of Utah, were dedicated to serving ADA members in a captive market is unlikely. The ADA/IDM business model is sort of like managed care dentistry. When dentists sign contracts that provide them with clients regardless of how they are treated, there is a natural tendency for dentists to become unappreciative of those who pay their bills.

Little Consumer Competition  

The ADA allows Americans to experience what socialism is like in markets where there is no competition for consumers: Professionals such as dentists stop trying to please their patients, and IDM stops trying to please dentists. If IDM was a decent company before the business venture with ADA membership, the ADA ruined them with a sweetheart deal that included protecting them from competition, as well as shielding them from complaints by angry ADA members. And like dental patients with preferred provider lists, ADA members noticed the bad treatment. However, complaints were never made transparent even as more ADA members where signing contracts with ADA/IDM. That is unfair and unethical.

Just Google for Complaints  

Want to see what an embarrassment in situ looks like? Just Google “CareCredit complaints.” ADA-approved CareCredit/GE has a long history of sweetheart deals like the one they made with ADA leaders. Their trail is always marked by complaints. The ADABEI is selling ADA members’ reputations. I just read ADA reporter James Berry’s article highlighting outgoing ADA President Dr. John S. Findley’s address to the House of Delegates that he gave on Friday. The article is titled, “We built our home on a foundation of science and values: Dr. Findley”

http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=3771

One free-standing paragraph in the article caught my attention that perhaps exposes a symptom of the pride and secrecy that surrounds the ADA/IDM disaster. In the middle of the article, James Berry offers this cryptic message that was obviously not meant for all members to understand:

“On the Association itself, the president noted that the ADA has undergone significant change in the past year and a half. As problems were discovered and defined, he said, the leadership acted to resolve them.” 

Was the ADA/IDM fiasco one of the problems that was resolved? Did they resolve the problem with CareCredit/GE causing ADA members to be covered by the Red Flags Rule – and not letting members know about it? Did they resolve the problem of data breaches and how they can mean certain bankruptcy for ADA members, even if the members do the right thing?

Possibly  

We just don’t know which problems were resolved, but somehow we should feel much better, now that President Findley got the message out to mid-level ADA leaders who probably know exactly what he is referring to. And, by protecting lower caste members from knowing things they don’t need to know, problems are quietly resolved and the profession’s image is preserved. “Image is everything” – ADA/IDM business slogan.

“Findley for the future”- Dr. John S. Findley’s campaign slogan.

Bingo! We have a match.

We should not forget that before IDM leaders got in way over their heads and started doing foolish things like marketing Search Engine Optimization (SEO) talents they lacked, there has not been a dues increase for a couple of years – in part because of the profits that were churned from ADA/IDM purchases ADA members made. I am certain that the ADA Business Enterprise Inc’s failure breaks the hearts of sincere and devoted leaders in the ADA who would have never recommended going outside the ADA’s Mission Statement had ADA employees been transparent with them. The officials of IDM couldn’t care less. Their part of the venture is much easier to dissolve for the Utah businessmen. They just picked up and walked away. However, the ADA officials have a fiduciary responsibility to members who trusted them. Once again, virtually all of the ADA leaders are just like you and me. Some just got in too deep on our behalf and couldn’t shut the mistake down before members got needlessly hurt.

Officials in other businesses the size of the ADA are held accountable for their mistakes and are not afforded the opportunity to filter communications with the owners because of image concerns. This kind of sweetheart deal for business executives, most of who come from Delta Dental, UnitedHealthcare or both, as in the case of the new executive director, Dr. Kathleen T. O’Loughlan, occurs only in the ADA and to a lesser extent in the US government and dental insurance industry.

Assessment

The state of the ADA is not nearly as rosy as Dr. Findley would have us believe. I think we have all seen authoritarian leaders re-write history. The ADA is an incredible dinosaur.Business can be ugly in the highly competitive land of the free. If businesses don’t take risks, we cannot move forward. For that reason, mistakes are expected. But never forget. Owners expect to be told about them.

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Encrypt or De-identify PHI

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Which One Just Might Work?

[By Darrell K. Pruitt; DDS]pruitt

The United States’ advancement in Healthcare Information Technology, which has the potential to lead to wonderful money-saving cures through research using trustworthy interoperable health records, is currently stopped cold by patient security problems that are only getting worse. Our lawmakers cannot get around the security obstacle without resorting to authoritarian means using CMS’s power to withhold providers’ discounted payments and threats of obscene fines from the HHS and the FTC. History shows that tyranny is not tolerated well in this part of the world. Lawmakers can get their butts voted smooth out of office in my neighborhood.

HITECH  

Here is something nobody mentions: Despite the current hope in a thick, political fantasy called HITECH, encryption of patients’ Protected Health Information [PHI] is a non-starter in the land of the free. Everyone knows that resourceful, cynical Americans will simply never trust encryption to protect their secrets, and will reliably withhold important information from their eMRs – one way or another. Doctors as well as patients can be expected to go out of their way to sabotage technology they fear. We all intuitively know this is true, don’t we? We aren’t so naïve to think all the players will happily play by the rules, are we? And I think we can all agree that an untrustworthy digital health record in an emergency room is worse than no patient information at all. Security is a grand problem with eMRs that started with HIPAA changes in 2003 that made eHRs so slippery. And the problem is clearly not being resolved. Not yet.

Public Lacks Trust 

Regardless of the campaign donations which follow him, there is nothing Newt Gingrich and his entrepreneurial friends in high places can do about the public’s lack of trust in encryption. It gets worse: Encryption hasn’t a chance of isolating PHI from dishonest employees in doctors’ offices, and slippery digital patient data can be moved soo easily. Everyone knows that as well, don’t they? It is estimated that two-thirds of the identities stolen in the nation are lifted from doctors’ offices. That’s us, Doc. HIPAA is not only irrelevant, it is an expensive distraction – it gives future ID theft victims a false sense of security.

HIPAA Approved 

De-identifying digital records is not mentioned in HITECH as a HIPAA-approved method of security. Yet it is the ONLY solution that promises to be even more secure than paper records. Because of heavy stakeholder stakes in hospital care, it will take longer for CEO-types to embrace patient-friendly de-identification. Other than identifiers such as names, social security numbers, birthdates, addresses and other items that have street value, NOBODY cares what is in a dental record. I actually think this opens a tremendous opportunity for someone courageous in the Texas Dental Association to discuss the feasibility of de-identification of dental records. Otherwise, instead of leading the nation in solving security problems, the TDA will look just as stupid as the ADA.

Encryption would also provide a dangerous false sense of security in eMRs – that is if it had a chance in the marketplace. But encryption will never go far because consumers simply won’t buy it. That is a marketplace fact that stoically optimistic HIT stakeholders are trying hard to avoid. They also know they are running out of time. Deadlines are quickly approaching for both HIPAA and the Red Flags Rule that providers are far from prepared for.

Former Attorney Speaks 

Bill Lappen, a former attorney and author of the ad I copied below, as well as a partner with his brother David in the de-identified health record venture says: “Since no identifying information is ever entered, a hacker can’t determine whose information is shown.”

So in addition to protecting one’s practice against dishonest or vindictive employees, de-identification of dental records would make hacking a dentist’s computer a complete waste of time, and hackers wouldn’t endanger dental patients and bankrupt dentists.

My Confidence 

I confidently tell you that soon, someone smart will come upon the unprecedented idea that the ultimate answer to our security problem in healthcare will be de-identification of medical records, not encryption. De-identification allows a compromise of privacy for only a miniscule percentage of physicians’ patients. We cannot allow that to stand in the way of better health for everyone else. Those special cases are so few that I am confident that they can be dealt with individually. We simply must move forward. I’ll have to retire some day. I may need help from Medicare.

Encryption gives us only danger and protects nobody but a thief with a key.

Assessment 

We’ve wasted enough time on HITECH and HIPAA, as well as CCHIT. It’s time to say no to stakeholders and pay attention to patients’ needs instead of those who would needlessly increase the cost of their care. Stimulus money attracts cockroaches.

In the name of Hippocrates, disregard the tainted HIPAA mandate. It is dangerous, and especially absurd in dentistry.

Link: http://www.theopenpress.com/index.php?a=press&id=58568

Life-Saving Patient Information can be Online, Anonymous and Usable

Published on: September 26th, 2009 12:19am

By: blappen

Los Angeles, CA (OPENPRESS) September 26, 2009 — Hospital Emergency Rooms need instant access to patient medical information. Allergic reactions and dangerous drug interactions can be deadly. Time is critical. Until now, privacy was a large concern. Two brothers, who have developed medical software over the past 15 years, think they have a simple first step towards moving patient information on to the internet.

“The ER doesn’t need to look up the information by patient name” said Bill Lappen, a former attorney. “We have implemented secure systems in the past, but no matter how secure we make the site, we have to assume that it will be hacked” added David Lappen, a computer design engineer from Stanford. “But providing instant access to life-saving information is too important to ignore”, he added. To protect patient privacy, their system does not know to whom the medical information belongs. Since the person’s identifying information is never on the system, it can’t be stolen. “By enabling anonymous entry, we have protected people’s privacy while allowing them to put their life-saving information in a place where it can be instantly accessed when needed”, added Bill Lappen.

www.AMCC.me is the public service website they created. It allows anyone to enter medical information anonymously. The site provides a random ID which the user carries in his/her wallet. For someone to see that user’s medical information, they merely enter the ID into the site. Unless the user has given them their ID, the information shown is meaningless. That same information, when associated with a patient, can save their life.

Since no identifying information is ever entered, a hacker can’t determine whose information is shown. “Secure patient-controlled Electronic Medical Records are now available on the internet” said David Lappen. A sample ID has been set up on the site to allow users to evaluate the concept before setting up their own free ID.

Contact:

Bill Lappen

Bill@AMCC.me

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Stockholder Suit Targets Troubled Mental Health Chain

Psychiatric Solutions, Inc

By Robin Fields, ProPublica – September 22, 2009 5:01 pm EDTCaduceus

Psychiatric Solutions Inc. the nation’s leading provider of inpatient mental health care is being sued by stockholders who claim the company issued “false and misleading statements” about troubles at one of its hospitals.

The Lawsuit

The lawsuit, filed Monday in U.S. District Court in Tennessee, alleges that PSI violated securities laws by downplaying problems at Riveredge Hospital near Chicago and waiting too long to tell shareholders how they had affected the company’s bottom line.

The Investigations

Investigations last year by the Chicago Tribune and ProPublica detailed violence, sexual abuse and neglect at PSI facilities from coast to coast, including Riveredge. In several instances, PSI facilities were cited for not reporting patient deaths and injuries as required, federal and state records showed. In response to the reports, the Justice Department opened an investigation and the Illinois Department of Children and Family Services froze admissions of foster children to Riveredge.

The Allegations

The lawsuit alleges that PSI’s statements – particularly those indicating the admissions hold would end soon and that other regulatory deficiencies had been fixed – inflated the company’s stock price, helping company leaders reap millions from insider sales. In early 2009, PSI announced that its 2008 results had fallen short of estimates. Its share price dropped about 35 percent on the news.

Assessment

Through a spokesman, PSI called the lawsuit “wholly without merit.” “We have at all times operated, and will continue to operate in full compliance with the rules and regulations of the Securities and Exchange Commission,” John Van Mol said in a written statement.

Note: Robin Fields is a reporter for the ProPublica news service, which first published this article.

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Ask an Advisor – Must an Insurance Claim CramDown be Accepted?

Calling on Insurance Professionals to Expose the “Wizard” Behind the Curtain

By ME-P Staff ReportersOp-Ed

We received the following request recently. Apparently, this ME-P reader-nurse sustained a covered loss with valid home insurance property-casuality claim. It resulted in disagreement with her insurance adjuster [a common occurrence]. The adjuster cited his/her supervisor’s insistence on claim settlement and closure.  The nurse’s general contractor thinks the monetary amount is significant [$50,000 range after three independent estimates]. The insurance company wants to settle for about half that amount. 

What say you about this scenario?   

INSURED

Dear Big Insurance Company Adjuster

”Many thanks for reaching out to us by phone yesterday. Please be aware that we did not agree to partial payment or supplements and are sorry for any confusion. 

We would however, be pleased to assist by informing your management of our declination of same. Thus, there is no need to issue any payments at this time.

It seems to make far more sense to get all the numbers together with our general contractor and then arrive at a consensus before moving forward. As you know, this was our original plan. We appreciate your deeper understanding of these very complex issues.”

Your Small Client 

INSURANCE ADJUSTER

Dear Client

“This email will serve as a follow up to our telephone call yesterday. I am sorry we were disconnected but I attempted to call you several times and I was unable to leave a message. I am attaching a copy of the updated Big Insurance Company estimate which reflects those changes made due to additional information gathered during my second inspection of your property on September 8th.  Also you will find an updated Replacement Cost Letter.

As discussed, due to the fact we know we owe you the value of the attached estimate, I am processing the actual cash value payment in the amount of $ XYZ. Any additional payments will be handled as supplements. Please feel free to contact me with any questions.

Your Big Insurance Company Adjuster

MANAGEMENT

Dear Client

Also, my management told me I need to proceed with issuing payment based on the amount I know I owe you [insured] as of now, and that I should handle any further negotiations as supplements. I have already discussed this with your husband.

Your Big Insurance Company Adjuster

Assessment

After some internet research, our RN reader discovered that abut 85% of all folks accept inadequate PC insurance payments after being strong-armed by their insurance company in various ways. She is determined to be made whole and indemnified. She also understands that future negotiations and “supplements” after acceptance are typically not favorable to her, and she wishes to maintain her leverage by not accepting them. Can she refuse to cash the check, if sent to her, until satisfied? She is not feeling in good hands, at the moment!

Industry Indignation Index: 85%

Audio Razz: Click to play :

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Must our reader “accept assignment” in the form of this under payment cram-down? How can she expose the Wizard of Oz manager behind the curtain? Will she be the “squeaky wheel” of informed insureds who “get the economic grease” they deserve. Should our Industry Indignation Index percentage be higher, or lower? Is the audio razz deserved, or not. What can she do? Insurance agent and attorney input is appreciated.

Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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den window

The Largest Purchaser of Domestic Healthcare?

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It’s the Government – Silly

By Ann Miller; RN, MHA

[Executive Director]ERT Prison Healthcare

By far, our federal government is the largest purchaser of healthcare services, according to Robert James Cimasi MHA, AVA, CMP™ of Health Capital Consultants, in St. Louis, MO; and many others.

Obama Care

Although the government faces immense pressure to control healthcare costs, especially during the current HR 3200-3400 debates, it also faces pressure to expend additional funds in order to achieve its ostensible primary mission in its involvement in healthcare, i.e., to expand and improve public health.

Federal Payment Schemes

In many ways the government has led the way for cost control through its development of resource-based reimbursement, prospective payment systems, budget limitations and other payment schemes. However, its conflicting goals have led it to approach these controls in a hesitant and piecemeal manner rather than effecting bold, comprehensive reforms.

Consider, for example, the lack of government intervention in the face of mounting pressure to remove some of the barriers preventing a reduction in US pharmaceutical costs.

Assessment

Today, most experts agree that Uncle Sam pays for at least 51% of domestic healthcare when Medicare, Medicaid, SHIPS, the VA, Indian and Prison Healthcare Systems are considered. In fact, according to our Publisher-in-Chief, Dr. David Edward Marcinko; MBA:

‘We already have a single payer health system in this country, but most folks just don’t realize it.”

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.

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Guest ME-P Bloggers Welcome

Join Us!

By Ann Miller; RN, MHA

[Executive Director]Lighthouse

Perhaps you have a great idea for a short article to promote the integration of personal financial planning and medical practice management, including expert posts, humorous stories or interesting news; but don’t want to maintain a blog? We have more than 50 topic channels to consider.

 

Contact me at MarcinkoAdvisors@msn.com and be a guest blogger! 

Conclusion

Be sure to subscribe to the ME-P. It is fast, free and secure.

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