RE-BROADCAST: An Interview with Fiduciary Bennett Aikin AIF®

Posted on May 18, 2024 by Dr. David Edward Marcinko MBA

On Financial Fiduciary Accountability

[By Dr. David E. Marcinko MBA MEd CMP™]

[By Ann Miller; RN, MHA]

Currently, there is a growing dilemma in the financial sales and services industry. It goes something like this:

What is a financial fiduciary?
Who is a financial fiduciary?
How can I tell if my financial advisor is a fiduciary?

Now, in as much as this controversy affects laymen and physician-investors alike, we went right to the source for up-to-date information regarding this often contentious topic, for an email interview and Q-A session, with Ben Aikin.

About Bennett Aikin AIF® and fi360.com

Bennett [Ben] Aikin is the Communications Coordinator for fi360.com. He oversees all communications for fi360. His responsibilities include messaging, brand management, copyrights and trademarks, and publications. Mr. Aikin received his BA in English from Virginia Tech in 2003 and is currently an MS candidate in Journalism from Ohio University.

Q. Medical Executive Post

You have been very helpful and gracious to us. So, let’s get right to it, Ben. In the view of many; attorneys, doctors, CPAs and the clergy are fiduciaries; most all others who retain this title seem poseurs; sans documentation otherwise.

A. Mr. Aikin

You are correct. Attorneys, doctors and clergy are the prototype fiduciaries. They have a clear duty to put the best interests of their clients, patients, congregation, etc., above their own. [The duty of a CPA isn’t as clear to me, although I believe you are correct]. Furthermore, this is one of the first topics we address in our AIF training programs, and what we call the difference between a profession and an industry. The three professions you name have three common characteristics that elevate them from an industry to a profession:

Recognized body of knowledge
Society depends upon practitioners to provide trustworthy advice
Code of conduct that places the clients’ best interests first

Q. Medical Executive Post

It seems that Certified Financial Planner®, Chartered Financial Analysts, Registered Investment Advisors and their representatives, Registered Representative [stock-brokers] and AIF® holders, etc, are not really financial fiduciaries, either by legal statute or organizational charter. Are we correct, or not? Of course, we are not talking ethics or morality here. That’s for the theologians to discuss.

A. Mr. Aikin

One of the reasons for the “alphabet soup”, as you put it in one of your white papers [books, dictionaries and posts] on financial designations, is that while there is a large body of knowledge, there is no one recognized body of knowledge that one must acquire to enter the financial services industry. The different designations serve to provide a distinguisher for how much and what parts of that body of knowledge you do possess. However, being a fiduciary is exclusively a matter of function.

In other words, regardless of what designations are held, there are five things that will make one a fiduciary in a given relationship:

You are “named” in plan or trust documents; the appointment can be by “name” or by “title,” such as CFO or Head of Human Resources
You are serving as a trustee; often times this applies to directed trustees as well
Your function or role equates to a professional providing comprehensive and continuous investment advice
You have discretion to buy or sell investable assets
You are a corporate officer or director who has authority to appoint other fiduciaries

So, if you are a fiduciary according to one of these definitions, you can be held accountable for a breach in fiduciary duty, regardless of any expertise you do, or do not have. This underscores the critical nature of understanding the fiduciary standard and delegating certain duties to qualified “professionals” who can fulfill the parts of the process that a non-qualified fiduciary cannot.

Q. Medical Executive Post

How about some of the specific designations mentioned on our site, and elsewhere. I believe that you may be familiar with the well-known financial planner, Ed Morrow, who often opines that there are more than 98 of these “designations”? In fact, he is the founder of the Registered Financial Consultants [RFC] designation. And, he wrote a Foreword for one of our e-books; back-in-the-day. His son, an attorney, also wrote as a tax expert for us, as well. So, what gives?

A. Mr. Aikin

As for the specific designations you list above, and elsewhere, they each signify something different that may, or may not, lend itself to being a fiduciary: For example:

• CFP®: The act of financial planning does very much imply fiduciary responsibility. And, the recently updated CFP® rules of conduct does now include a fiduciary mandate:

• 1.4 A certificant shall at all times place the interest of the client ahead of his or her own. When the certificant provides financial planning or material elements of the financial planning process, the certificant owes to the client the duty of care of a fiduciary as defined by CFP Board. [from http://www.cfp.net/Downloads/2008Standards.pdf]

• CFA: Very dependent on what work the individual is doing. Their code of ethics does have a provision to place the interests of clients above their own and their Standards of Practice handbook makes clear that when they are working in a fiduciary capacity that they understand and abide by the legally mandated fiduciary standard.

• FA [Financial Advisor]: This is a generic term that you may find being used by a non-fiduciary, such as a broker, or a fiduciary, such as an RIA.

• RIA: Are fiduciaries. Registered Investment Advisors are registered with the SEC and have obligations under the Investment Advisers Act of 1940 to provide services that meet a fiduciary standard of care.

• RR: Registered Reps, or stock-brokers, are not fiduciaries if they are doing what they are supposed to be doing. If they give investment advice that crosses the line into “comprehensive and continuous investment advice” (see above), their function would make them a fiduciary and they would be subject to meeting a fiduciary standard in that advice (even though they may not be properly registered to give advice as an RIA).

• AIF designees: Have received training on a process that meets, and in some places exceeds, the fiduciary standard of care. We do not require an AIF® to always function as a fiduciary. For example, we allow registered reps to gain and use the AIF® designation. In many cases, AIF designees are acting as fiduciaries, and the designation is an indicator that they have the full understanding of what that really means in terms of the level of service they provide. We do expect our designees to clearly disclose whether they accept fiduciary responsibility for their services or not and advocate such disclosure for all financial service representatives.

Q. Medical Executive Post

Your website, http://www.fi360.com, seems to suggest, for example, that banks/bankers are fiduciaries. We have found this not to be the case, of course, as they work for the best interests of the bank and stockholders. What definitional understanding are we missing?

A. Mr. Aikin

Banks cannot generally be considered fiduciaries. Again, it is a matter of function. A bank may be a named trustee, in which case a fiduciary standard would generally apply. Banks that sell products are doing so according to their governing regulations and are “prudent experts” under ERISA, but not necessarily held to a fiduciary standard in any broader sense.

Q. Medical Executive Post

And so, how do we rectify the [seemingly intentional] industry obfuscation on this topic. We mean, our readers, subscribers, book and dictionary purchasers, clients and colleagues are all confused on this topic. The recent financial meltdown only stresses the importance of understanding same.

For example, everyone in the industry seems to say they are the “f” word. But, our outreach efforts to contact traditional “financial services” industry pundits, CFP® practitioners and other certification organizations are continually met with resounding silence; or worse yet; they offer an abundance of parsed words and obfuscation but no confirming paperwork, or deep subject-matter knowledge as you have kindly done. We get the impression that some FAs honesty do-not have a clue; while others are intentionally vague.

A. Mr. Aikin

All of the evidence you cite is correct. But that does not mean it is impossible to find an investment advisor who will manage to a fiduciary standard of care and acknowledge the same. The best way to rectify confusion as it pertains to choosing appropriate investment professionals is to get fiduciary status acknowledged in writing and go over with them all of the necessary steps in a fiduciary process to ensure they are being fulfilled. There also are great resources out there for understanding the fiduciary process and for choosing professionals, such as the Department of Labor, the SEC, FINRA, the AICPA’s Personal Financial Planning division, the Financial Planning Association, and, of course, Fiduciary360.

We realize the confusion this must cause to those coming from the health care arena, where MD/DO clearly defines the individual in question; as do other degrees [optometrist, clinical psychologist, podiatrist, etc] and medical designations [fellow, board certification, etc.]. But, unfortunately, it is the state of the financial services industry as it stands now.

Q. Medical Executive Post

It is as confusing for the medical community, as it is for the lay community. And, after some research, we believe retail financial services industry participants are also confused. So, what is the bottom line?

A. Mr. Aikin

The bottom line is that lay, physician and all clients have a right to expect and demand a fiduciary standard of care in the managing of investments. And, there are qualified professionals out there who are providing those services. Again, the best way to ensure you are getting it is to have fiduciary status acknowledged in writing, and go over the necessary steps in a fiduciary process with them to ensure it is being fulfilled.

Q. Medical Executive Post

The “parole-evidence” rule, of contract law, applies, right? In dealing with medical liability situations, the medics and malpractice attorneys have a rule: “if it wasn’t written down, it didn’t happen.”

A. Mr. Aikin

An engagement contract accepting fiduciary status should trump a subsequent attempt to claim the fiduciary standard didn’t apply. But, to reiterate an earlier point, if someone acts in one of the five functional fiduciary roles, they are a fiduciary whether they choose to acknowledge it or not. I have attached a sample acknowledgement of fiduciary status letter with copies of our handbook, which details the fiduciary process we instruct in our programs, and our SAFE, which is basically a checklist that a fiduciary should be able to answer “Yes” to every question to ensure the entire fiduciary process is being covered.

Q. Medical Executive Post

It is curious that you mention checklists. We have a post arguing that very theme for doctors and hospitals as they pursue their medial error reduction, and quality improvement, endeavors. And, we applaud your integrity, and wish only for clarification on this simple fiduciary query?

A. Mr. Aikin

Simple definition: A fiduciary is someone who is managing the assets of another person and stands in a special relationship of trust, confidence, and/or legal responsibility.

Q. Medical Executive Post

Who is a financial fiduciary and what, if any, financial designation indicates same?

A. Mr. Aikin

Functional definition: See above for the five items that make you a fiduciary.

Financial designations that unequivocally indicate fiduciary duty: Short answer is none, only function can determine who is a fiduciary.

Q. Medical Executive Post

Please repeat that?

A. Mr. Aikin

Financial designations that indicate fiduciary duty: none. It is the function that determines who is a fiduciary. Now, having said that, the CFP® certification comes close by demanding their certificants who are engaged in financial planning do so to a fiduciary standard. Similarly, other designations may certify the holder’s ability to perform a role that would be held to a fiduciary standard of care. The point is that you are owed a fiduciary standard of care when you engage a professional to fill that role or they functionally become one. And, if you engage a professional to fill a non-fiduciary role, they will not be held to a fiduciary standard simply because they have a particular designation. One of the purposes the designations serve is to inform you what roles the designation holder is capable of fulfilling.

It is also worth keeping in mind that just being a fiduciary doesn’t equate to a full knowledge of the fiduciary standard. The AIF® designation indicates having been fully trained on the standard.

Q. Medical Executive Post

Yes, your website mentions something about fiduciaries that are not aware of same! How can this be? Since our business model mimics a medical model, isn’t that like saying “the doctor doesn’t know he is doctor?” Very specious, with all due respect!

A. Mr. Aikin

I think it is first important to note that this statement is referring not just to investment professionals. Part of the audience fi360 serves is investment stewards, the non-professionals who, due to facts and circumstances, still owe a fiduciary duty to another. Examples of this include investment committee members, trustees to a foundation, small business owners who start 401k plans, etc. This is a group of non-sophisticated investors who may not be aware of the full array of responsibilities they have.

However, even on the professional side I believe the statement isn’t as absurd as it sounds. This is basically a protection from both ignorant and unscrupulous professionals. Imagine a registered representative who, either through ignorance or design, begins offering comprehensive and continuous investment advice. Though they may deny or be unaware of the fact, they have opened themselves up to fiduciary liability.

Q. Medical Executive Post

Please clarify the use of arbitration clauses in brokerage account contracts for us. Do these disclaim fiduciary responsibility? If so, does the client even know same?

A. Mr. Aikin

By definition, an engagement with a broker is a non-fiduciary relationship. So, unless other services beyond the scope of a typical brokerage account contract are specified, fiduciary responsibility is inherently not applicable. Unfortunately, I do imagine there are clients who don’t understand this. Furthermore, AIF® designees are not prohibited from signing such an agreement and there are some important points to understand the reasoning.

First, by definition, if you are entering into such an agreement, you are entering into a non-fiduciary relationship. So, any fiduciary requirement wouldn’t apply in this scenario.

Second, if this same question were applied into a scenario of a fiduciary relationship, such as with an RIA, this would be a method of dispute resolution, not a practice method. So, in the event of dispute, the advisor and investor would be free to agree to the method of resolution of their choosing. In this scenario, however, typically the method would not be discussed until the dispute itself arose.

Finally, it is important to know that AIF/AIFA designees are not required to be a fiduciary. It is symbolic of the individuals training, knowledge and ongoing development in fiduciary processes, but does not mean they will always be acting as a fiduciary.

Q. Medical Executive Post

Don’t the vast majority of arbitration hearings find in favor of the FA; as the arbitrators are insiders, often paid by the very same industry itself?

A. Mr. Aikin

Actual percentages are reported here: http://www.finra.org/ArbitrationMediation/AboutFINRADR/Statistics/index.htm However, brokerage arbitration agreements are a dispute resolution method for disputes that arise within the context of the securities brokerage industry and are not the only means of resolving differences for all types of financial advisors. Investment advisers, for example, are subject to respond to disputes in a variety of forums including state and federal courts. Clients should look at their brokerage or advisory agreement to see what they have agreed to. If you wanted to go into further depth on this question, we would recommend contacting Brian Hamburger, who is a lawyer with experience in this area and an AIFA designee. Bio page: http://www.hamburgerlaw.com/attorneys/BSH.htm.

Q. Medical Executive Post

What about our related Certified Medical Planner® designation, and online educational program for financial advisors and medical management consultants? Is it a good idea – reasonable – for the sponsor to demand fiduciary accountability of these charter-holders? Cleary, this would not only be a strategic competitive advantage, but advance the CMP™ mission to put medical colleagues first and champion their cause www.CertifiedMedicalPlanner.org above all else.

A. Mr. Aikin

I think it is a good idea for any plan sponsor to demand fiduciary status be acknowledged from anyone engaged to provide comprehensive and continuous investment advice. I also think it is a good idea to be proactive in verifying that the fiduciary process is being followed.

Q. Medical Executive Post

Is there anything else that we should know about this topic?

A. Mr. Aikin

Yes, a further note about fi360’s standards. I wrote generically about the fiduciary standard, because there is one that is defined by multiple sources of regulation, legislation and case law. The process defined in our handbooks, we call a Fiduciary Standard of Excellence, because it covers that minimum standard and also best practice standards that go above and beyond. All of our Practices, which comprise that standard, are legally substantiated in our Legal Memoranda handbook, which was written by Fred Reish’s law firm, who is considered a leading ERISA attorney.

Additional resources:

Q. Medical Executive Post

Thank you so much for your knowledge and willingness to frankly share it with the Medical-Executive-Post.

Assessment

All are invited to continue the conversation with Mr. Aikin, asynchronously online, or thru this contact information:

fi360.com
438 Division Street
Sewickley, PA 15143
412-741-8140 Phone
866-390-5080 Toll-free phone
412-741-8142 Fax

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com

Filed under: "Advisors Only", "Doctors Only", Book Reviews, Career Development, Ethics, Financial Planning, Insurance Matters, Interviews, Investing, Media Mentions and PR, Monthly Reports, Op-Editorials, Portfolio Management, Professional Liability, Quality Initiatives, Research & Development, Sponsors, Touring with Marcinko | Tagged: AIF, ann miller, bennett aikin, Bob Veres, certified medical planner, CFA, CFP, CMP, CPA, david marcinko, Fi360, fiduciary, financial fiduciary, Fred Reish, hope hetico, iMBA, Inc., insurance agents, Marcinko, RR | Leave a comment »

HISTORY: Medical Education and Practice in the USA

Posted on May 7, 2024 by Dr. David Edward Marcinko MBA

Domestic Medical SCHOOL Education

Robert James Cimasi

Todd A. Zigrang

U.S. medical education began in the late eighteenth century as an apprenticeship program in which physicians taught their trade to a few pupils, a pedagogical learning style which relied heavily upon the capacity, skills, and knowledge of the individual physician.[1] However, as learning newly discovered information and utilizing new technologies became more necessary to the industry’s practice, many physicians found the apprenticeship system no longer adequate as a manner of educating the next generation of physicians.[2] As a result, the conventional concept of medical education that originated in the U.S. in the 1750s was manifested through informal courses and demonstrations by private individuals or for-profit institutions. Those individuals who were not satisfied with a typical U.S. medical education, consisting of two identical 16-week lecture terms, might venture to Europe for a more formalized and detailed manner of learning.[3]

One of these students who studied in Europe was William Shippen, who began teaching an informal course on midwifery when he returned to the American colonies in 1762.[4] He later addressed the limitations of what might be taught in one informal course when he began teaching a lecture series on anatomy to help educate those who wished to be a physician, but could not travel abroad. John Morgan, a classmate of Shippen, noticed the potential of his friend’s endeavor and proposed the idea to create a professorship for the practice of medicine to the board of trustees of the College of Philadelphia.[5] Just across town, Thomas Bond, who conceived the idea of, and successfully established, the Pennsylvania Hospital with Benjamin Franklin, recognized the value to allowing medical students to participate in bedside training.[6] When Bond agreed to a partnership with the College of Philadelphia, the University of Pennsylvania became home to America’s first medical school.[7]

In 1893, Johns Hopkins University also made history by housing the first medical school that was able to operate out of a university-owned hospital.[8] The medical school not only encouraged clinical research to be performed by every member of their faculty, but the program also included a clinical research clerkship for every student during their rotation.[9] This program quickly became the model to which schools aspired and set the foundation for national medical education by connecting science and medical research with clinical medicine.[10]

With these early examples of medical schools, America’s field of medical education and clinical medicine made monumental strides. However, the societal pressures, caused by the U.S.’s population growth and demand for educated physicians,[11] did not allow many other universities to build on Johns Hopkins’ or the University of Pennsylvania’s foundation model, and led to the development of medical schools that had their own unique set of entrance and graduation requirements. While some focused entirely on medicine, other schools (termed Studia Generalia) also incorporated law, theology, and philosophy in their curricula.[12] In an attempt to both understand and make uniform the field of medical education, the American Medical Association (AMA) founded the Council on Medical Education (CME) in 1904.[13] The CME created minimum national educational standards for training physicians, and subsequently found that many schools did not meet these established standards.[14] However, the CME did not share the ratings of any of these medical schools “outside the medical fraternity.”[15]

In 1910, the AMA commissioned the Carnegie Foundation for Advancement of Teaching to conduct a study of medical education and schools.[16] Abraham Flexner conducted the inquiry and detailed his findings in what became known as The Flexner Report.[17] In his review of the U.S. medical education system, Flexner found that many of the proprietary medical schools met the AMA’s educational goals, but an imbalance existed between the pursuit of science and medical education.[18] Professors were focused solely on student throughput, and did not ensure a high level of medical training that reflected the developments in the medical industry.[19] As aptly noted by Dr. John Roberts in his book entitled The Doctor’s Duty to the State, “[m]any of you remember the struggle to wrest from medical teachers the power to create medical practitioners with almost no real knowledge of medicine. The medical schools of that day were, in many instances, conducted merely as money-makers for the professors.”[20] As the AMA gained more influence over the provision of healthcare in the U.S., the value and power of medical education also gained recognition. Notably, teaching hospitals had the power to influence the development of their disciplines through their research initiatives, the quality of care they provided, and their ability to operate as an economy of scale, allowing them to dictate the evolution of medical education.[21]

Since the establishment of the first medical school in the U.S., medical education has been the foundation for shaping standards of care in the practice of medicine and defining medical errors as deviations from the norms of clinical care.[22] When Thomas Bond helped establish the University of Pennsylvania medical school, he envisioned a normal day where the physician:

“…meets his pupils at stated times in the Hospital, and when a case presents adapted to his purpose, he asks all those Questions which lead to a certain knowledge of the Disease and parts affected; and if the Disease baffles the power of Art and the Patient falls a Sacrifice to it, he then brings his Knowledge to the Test, and fixes Honour [sic] or discredit on his Reputation by exposing all the Morbid parts to View, and Demonstrates by what means it produced Death, and if perchance he finds something unexpected, which Betrays an Error in Judgement [sic], he like a great and good man immediately acknowledges the mistake, and, for the benefit of survivors, points out other methods by which it might have been more happily treated.”[23]

Originally, students were to study and learn from medical errors and adverse events through medical education as a means of improving the quality of care. However, it is difficult to effectively implement any significant advancement learned through the research and investigation of prior errors in a timely and cost-effective manner. Additionally, physician supply shortages have only increased the amount of patients that a physician must see daily, while simultaneously decreasing the amount of time they can spend with each patient. Although medical education continues to be one of the central underpinnings to the development of the medical industry, outside pressures that shape the clinical practice of physicians continue to limit physician effectiveness in providing quality care to patients.[24]

While improving the quality and rigor of medical education has been a constant focus throughout the history of U.S. medical education, the challenges of replicating it on a scale that produces enough qualified physicians to meet the growing demands of the U.S. population, with constantly changing technologies, has consistently been a central issue. Notably, in the 13 years preceding 1980, the ratio of actively practicing physicians to patients increased by 50%.^[25] This increased physician-to-patient ratio led to concerns over quality of care and cost-effectiveness, which in turn caused the creation of a government committee to evaluate physician manpower allocation and distribution. The Graduate Medical Education National Advisory Committee (GMENAC) was first chartered in April 1976, and later extended through September 1980.^[26] Its purpose was to “analyze the distribution among specialties of physicians and medical students and to evaluate alternative approaches to ensure an appropriate balance,”as well as to“encourage bodies controlling the number, types, and geographic location of graduate training positions to provide leadership in achieving the recommended balance.”^[27] GMENAC produced seven volumes of recommendations regarding physician manpower supply,^[28] through the development of several models by which to determine the projected number of physicians that would be needed in the future by different subspecialties to achieve “a better balance of physicians.”^[29] Ignoring critics of the report, U.S. medical schools adjusted their enrollment numbers in response to the GMENAC’s recommendations, causing a significant decrease in the supply of new physicians going into the 21^st century.

***

History of Conventional Medicine - 24 Hour Translation ...

[1] “Healthcare Valuation: The Four Pillars of Healthcare Value,” Volume 1, Robert James Cimasi, MHA, ASA, FRRICS, MCBA, CVA, CM&AA, John Wiley & Sons, Hoboken, NJ: 2014, p. 22-23.RR

[2] “Before There Was Flexner,” American Medical Student Association, 2014,

http://www.amsa.org/AMSA/Homepage/MemberCenter/Premeds/edRx/Before.aspx (Accessed 1/7/15).

[3] “Time to Heal: American Medical Education from the Turn of the Century to the Era of Managed Care,” By Kenneth M. Ludmerer, New York, NY:

Oxford University Press, 1999, p. 4.

[4] “The Flexner Report on Medical Education in the United States and Canada in 1910,” By Abraham Flexner, Bethesda, MD: Science and Health

Publications, Inc., p. 3-5.

[5] “The Flexner Report on Medical Education in the United States and Canada in 1910,” By Abraham Flexner, Bethesda, MD: Science and Health

Publications, Inc., p. 3-5.

[6] “The Flexner Report on Medical Education in the United States and Canada in 1910,” By Abraham Flexner, Bethesda, MD: Science and Health

Publications, Inc., p. 3-5.

[7] “Before There Was Flexner,” American Medical Student Association, 2014,

http://www.amsa.org/AMSA/Homepage/MemberCenter/Premeds/edRx/Before.aspx (Accessed 1/7/15).

[8] “Time to Heal: American Medical Education from the Turn of the Century to the Era of Managed Care,” By Kenneth M. Ludmerer, New York, NY:

Oxford University Press, 1999, p. 18-19.

[9] “Time to Heal: American Medical Education from the Turn of the Century to the Era of Managed Care,” By Kenneth M. Ludmerer, New York, NY:

Oxford University Press, 1999, p. 18-19.

[10] “Science and Social Work: A Critical Appraisal,” By Stuart A. Kirk, and William James Reid, New York, NY: Columbia University Press, 2002, Chapter 1, p. 2-3.

[11] “The Flexner Report on Medical Education in the United States and Canada in 1910,” By Abraham Flexner, Bethesda, MD: Science and Health

Publications, Inc., p. 6-7.

[12] “Western Medicine: An Illustrated History,” By Irvine Loudon, New York, NY: Oxford University Press, 1997, p. 58.

[13] “Western Medicine: An Illustrated History,” By Irvine Loudon, New York, NY: Oxford University Press, 1997, p. 58.

[14] “Western Medicine: An Illustrated History,” By Irvine Loudon, New York, NY: Oxford University Press, 1997, p. 58.

[15] “Western Medicine: An Illustrated History,” By Irvine Loudon, New York, NY: Oxford University Press, 1997, p. 58.

[16] “U.S. Health Policy and Politics: A Documentary History,” By Kevin Hillstrom, Thousand Oaks, CA: CQ Press, 2012, p. 141.

[17] “The Flexner Report on Medical Education in the United States and Canada in 1910,” By Abraham Flexner, Bethesda, MD: Science and Health

Publications, Inc., p. 3-19.

[18] “The Flexner Report on Medical Education in the United States and Canada in 1910,” By Abraham Flexner, Bethesda, MD: Science and Health

Publications, Inc., p. 3-19.

[19] “The Flexner Report on Medical Education in the United States and Canada in 1910,” By Abraham Flexner, Bethesda, MD: Science and Health

Publications, Inc., p. 3-19.

[20] “The Doctor’s Duty to the State: Essays on The Public Relations of Physicians,” By John B. Roberts, AM, MD, Chicago, IL: American Medical Association Press, 1908, p. 23.

[21] “Time to Heal: American Medical Education from the Turn of the Century to the Era of Managed Care,” By Kenneth M. Ludmerer, New York, NY:

Oxford University Press, 1999, p. 19.

[22] “Science and Social Work: A Critical Appraisal,” By Stuart A. Kirk, and William James Reid, New York: Columbia University Press, 2002, Chapter 1, p. 2-3.

[23] “Dr. Thomas Bond’s Essay on the Utility of Clinical Lectures,” By Carl Bridenbaugh, Journal of the History of Medicine (Winter 1947), p. 14; “The Flexner Report on Medical Education in the United States and Canada in 1910,” By Abraham Flexner, Bethesda, MD: Science and Health

Publications, Inc., p. 4.

[24] “Time to Heal: American Medical Education from the Turn of the Century to the Era of Managed Care,” By Kenneth M. Ludmerer, New York, NY:

Oxford University Press, 1999, p. xxi.

[25] “How many doctors are enough?” By J.E. Harris, Health Affairs, Vol. 5, No. 4 (1986), p.74.

[26] “Report of the Graduate Medical Education National Advisory Committee to the Secretary, Department of Health and Human Services – Volume VII,” Graduate Medical Education National Advisory Committee, Washington, DC: U.S. Government Printing Office, 1981, p. 5, 16.

[27] “Report of the Graduate Medical Education National Advisory Committee to the Secretary, Department of Health and Human Services – Volume VII,” Graduate Medical Education National Advisory Committee, Washington, DC: U.S. Government Printing Office, 1981, p. 73.

[28] “Report of the Graduate Medical Education National Advisory Committee to the Secretary, Department of Health and Human Services – Volume VII,” Graduate Medical Education National Advisory Committee, Washington, DC: U.S. Government Printing Office, 1981, p. 5-6.

[29] “GMENAC: Its Manpower Forecasting Framework,” By D.R. McNutt, American Journal of Public Health, Vol. 71, No. 10 (October 1981), p. 1119.

[30] “Crossing the Quality Chasm: A New Health System for the 21st Century,” Institute of Medicine, National Academy of Sciences, 2001, front matter.

[31] “Overview of Medical Errors and Adverse Events,” By Maité Garrouste-Orgeas, et al., Annals of Intensive Care, Vol. 2, No. 2 (2012), p. 6.

Your thoughts are appreciated.

Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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

THANK YOU

***

Filed under: Experts Invited, Glossary Terms, Health Law & Policy, Managed Care, Professional Liability, Risk Management | Tagged: AMA, Flexner Report, HCC, Health Capital Consultants LLC, JHU, medical education, modern medicine, Robert Cimasi, TODD A. ZIGRANG, william osler, William Shippen | 1 Comment »

Medical [Dental] Anti-Defamation Contracts and Doctor Accountability

Posted on April 27, 2024 by Dr. David Edward Marcinko MBA

Was the ADA Complicit?

By D. Kellus Pruitt DDS

If you were to walk into my dental office with a toothache, and I told you that before I relieve your pain, you have to agree not to say bad things about me on the internet, how badly would the tooth have to be hurting to keep you from walking out the door?

The article, “Toothache lawsuit may stifle medical gag orders against online rants”, by JoNel Aleccia, was posted on MSN.com years ago.

[Robert Lee, 42] who had a bad toothache has filed a class-action lawsuit against his New York dentist after she required him to sign a contract promising not to trash-talk her online — and then fined him thousands of dollars trying to enforce it.”

Aleccia adds: “[Dr. Stacy Makhnevich] was among hundreds of medical professionals nationwide in recent years who refused to care for patients unless they signed anti-defamation contracts. In the contracts, the doctors and dentists promised not to evade federal patient privacy protections in exchange for patients’ agreeing not to post public comments about them.”

The Dentist

Other than its obvious ineffectiveness for this particular Manhattan dentist, whose practice is on the 69 th. floor of the Chrysler Building, Lexington Avenue at East 42St., (212) 697-4400, what’s wrong with this business plan?

First of all, aside from the insult, if a dentist required you to sign a contract forfeiting your right to express your opinion about the quality of care even before being seen, how confident would it make you feel about the doctor’s abilities?

The HIPAA Question

Then there’s HIPAA. It’s sad that healthcare providers on the 69th. floor of the Chrysler Building would take advantage of vulnerable Americans who don’t understand that their right to privacy isn’t something that can be withheld – even as part of a twisted “copyright” deal intended to enable a dentist to dodge accountability. It seems to me like the Office of Civil Rights as well as the Attorney General should be alerted. How is threatening a patient’s privacy in return for direly-needed treatment different than extortion?

The Gotcha!

Mr. Lee had forgotten the contract until months later when he allegedly discovered that Dr. Makhnevich had overcharged him by about $4,000, improperly filed the insurance and then refused to provide him with the documents he needed to file the claim himself. That’s when he started posting rants on sites like Yelp and DoctorBase, such as, “Avoid at all cost! Scamming their customers!” and “Honestly, how do you live with yourself? Just try being a decent human being.”

“Within days, Makhnevich demanded that the sites remove the comments and threatened to sue Lee. She also said he was infringing on her copyright provisions and started sending invoices for fines of $100 a day. By October, the total topped $4,600, he said.”

The Service

Since the dentist purchased the right to use Medical Justice Inc. anti-defamation contracts to prevent complaints from dis-satisfied customers from being discussed on the internet, I say she is due a refund. What’s more, if she’s given any trouble about it, she should get on the internet and complain – if she didn’t forfeit that right as part of the agreement.

The ADA

So where did Dr. Stacy Makhnevich learn about Medical Justice Inc.’s ineffective, unethical and probably illegal anti-defamation contract service? Of all places, it may well have been in ADA Headquarters, 211 E. Chicago Ave., Chicago, (312) 440-2500

Dr. Jeffrey Segal [MD, JD], the neurosurgeon and founder of Medical Justice Services Inc. which sold providers like Dr. Makhnevich the right to use his company’s contracts, was a featured speaker at the American Dental Association’s [ADA] annual Benefits Conference last year.

The ADA leadership’s decision to invite Dr. Segal to advertise his product at a benefits conference (?) reveals the old timers’ underlying paranoia that makes them prefer silence from members as well as their own dental patients.

Assessment

Since the ADA effectively put its stamp of approval on Medical Justice’s anti-defamation contracts, don’t you think the ADA News should at least post a warning about the liability to members who attended Dr. Segal’s presentation in ADA Headquarters? Let’s watch dentistry’s leaders ignore the abysmal results of yet another half-baked blunder caused by people too proud to listen.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Ethics, Op-Editorials, Practice Management, Professional Liability, Pruitt's Platform, Risk Management | Tagged: ADA, anti-defamation contracts, D. Kellus Pruitt DDS, Dr. Jeffrey Segal, Dr. Stacy Makhnevich], HIPAA, Medical Justice Inc, OCR | 11 Comments »

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

Posted on April 22, 2024 by Dr. David Edward Marcinko MBA

By Ann Miller RN MHA CMP™

INTRODUCING OUR NEXT GENERATION e-BOOK LIBRARY FROM iMBA, Inc.

An e-book is an electronic or digital book that can be read on a computer or a handheld device.

Our new e-books consists of text, images, and are fixed to a specific spot on the page.

And, our e-books are a data files similar in content and structure to a word-processing document that comes in a PDF format. To use our e-books, you need to purchase and download it to a device that has a .pdf file reader app, such as ADOBE® or similar on a smartphone, tablet or computer. A PDF, also known as a portable document format, is the format most people are familiar with and used in our e-books. PDFs are known for their ease of use and ability to hold custom layouts. They are the most commonly used e-Book formats, especially by professionals and adult-learners.

You can then access the e-book and read it, or highlight pages and even take side notes.

e-Books Save Money

With no manufacturing, printing, binding or shipping costs, e-Books are cheaper than traditional hard or paper back books.The price of each specialized and highly niche focused e-Book [50-100 pages] is only $25, whereas similar paperback printed books of this type generally cost $145, or more!

Payable thru PayPal [3% courtesy surcharge applies].

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

COMMENTS APPRECIATED

Thank You

***

Filed under: "Advisors Only", "Doctors Only", Accounting, Book Reviews, Career Development, Experts Invited, Financial Planning, Funding Basics, Health Economics, Health Insurance, Health Law & Policy, iMBA, Inc., Information Technology, Investing, Managed Care, Portfolio Management, Practice Management, Practice Worth, Professional Liability, Recommended Books, Research & Development, Retirement and Benefits, Risk Management, Touring with Marcinko | Tagged: .pdf files, e-books, electronic books, Marcinko | Leave a comment »

EXPERT WITNESSES: What Exactly Are They?

Posted on March 21, 2024 by Dr. David Edward Marcinko MBA

SPONSOR: http://www.MARCINKOASSOCIATES.com

***

***

At DE Marcinko & Associates an “expert witness” possesses specialized knowledge in a particular field and is qualified to provide deposition or testimony in court and under oath. This testimony can be based on their personal experience, education, training or research. The role of an expert witness is to provide objective and unbiased opinions, analysis, and insights to help a lawyer, judge and/or jury understand technical or complex issues related to the case.

An expert witness can be called by either the prosecution or the defense in a legal case. The expert witness may be required to provide a written report or affidavit detailing their opinions, analyses and conclusions, and they may be asked to testify in court to provide oral testimony and answer questions from the judge and lawyers.

READ HERE: https://marcinkoassociates.com/expert-witness/

MORE: https://medicalexecutivepost.com/2023/09/02/the-medical-expert-trial-witness/

COMMENTS APPRECIATED

Thank You

***

Filed under: "Doctors Only", Experts Invited, Professional Liability, Risk Management, Touring with Marcinko | Tagged: Charles Fenton, expert, expert legal witness, expert witness, grife, Marcinko, witness | Leave a comment »

PEP: What is a Pooled Employer “Defined Contribution” Plan?

Posted on March 2, 2024 by Dr. David Edward Marcinko MBA

RETIREMENT PLANNING

By Staff Reporters

***

***

A PEP is a defined contribution plan, such as a 401(k), in which multiple employers can participate. When employers join a PEP, they delegate their named fiduciary role to a third-party pooled plan provider (PPP). PEP fiduciary oversight falls on the PPP rather than the employer. And although each PPP may set its own eligibility requirements, businesses joining a PEP benefit plan needn’t operate in the same industry or geographical area.

PEP plans provide viable 401(k) alternatives for small business owners who may otherwise struggle to compete for talent against large organizations with comprehensive benefits packages.

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

Other advantages include: Less in-house administration: The PPP assumes responsibility for much of the plan administration, handling all plan documentation, governmental filings and ongoing compliance. Employee payroll deductions are left to the employer, but these can be efficiently managed with the help of a payroll service provider that integrates payroll and benefits.

Tax credits can help offset PEP start-up costs. For the first three years of participation, employers may be eligible for a tax credit of $5,000 annually, with an additional $500 available to those who set up automatic enrollment. Under Secure Act 2.0, an additional credit of up to $1,000 per employee for eligible employer contributions may apply to employers with up to 50 employees for the preceding taxable year. This credit phases out from 51 to 100 employees.

Businesses participating in single-employer retirement plans (SEP) must independently communicate and coordinate with their record-keeper, custodian, investment advisor, trustee and auditor. With PEP, all these tasks and services are bundled into one, saving employers time and money.

Despite its advantages, a PEP does have some drawbacks, particularly when compared to an SEP. Unlike a PEP, an SEP gives employers more of the following:

Flexibility: Employers can customize the design of their plan to meet their retirement goals and the needs of their employees.
Control: Employers are not dependent on the actions or decisions of others and can access information and resolve problems directly without the need of a third party.
Choice: Employers have the unilateral freedom to choose a different service provider, move their plan or negotiate better pricing if they are unsatisfied with the cost or quality of service.

COMMENTS APPRECIATED

Thank You

***

Filed under: "Ask-an-Advisor", Accounting, Experts Invited, Financial Planning, Funding Basics, Investing, Practice Management, Professional Liability, Retirement and Benefits, Risk Management, Taxation | Tagged: 401(k), DCP, defined contribution plan, fiduciary, payroll, payroll benefits, PEP, pooled employer plan, pooled plan provider, PPP, retirement planning, SEP | Leave a comment »

PRACTICE RISKS IN CORRECTIONAL CARE MEDICINE

Posted on March 1, 2024 by Dr. David Edward Marcinko MBA

Some Thoughts and Some Statistics

[By Dr. David Edward Marcinko MBA]

Most primary care doctors, psychologists and psychiatrists who work in corrections long enough will end up being named in a lawsuit or having a complaint filed against them with their licensing board.

And, it is a fact that physicians who treat inmates are at greater risk of litigation.

Bureau of Justice Statistics

According to the 2011-12 National Inmate Survey conducted by the Bureau of Justice Statistics:

Half of state and federal prisoners and jail inmates reported a history of a chronic medical condition.
About 2/3 of females in prisons (63%) and jails (67%) reported ever having a chronic condition
An estimated 40% of prisoners and inmates reported having a current chronic medical condition.
About 1 in 5 (21%) of prisoners and 14% of jail inmates reported ever having an infectious disease.
Approximately 1% of prisoners and jail inmates reported being HIV positive.
High blood pressure was the most common condition reported by prisoners (30%) and inmates (26%).
Nearly a quarter (24%) of prisoners and jail inmates reported ever having at least 2 chronic conditions.
66% of prisoners and 40% of jail inmates with a chronic condition reported taking prescription medication.And, although specific figures are not available, malpractice carriers are quite aware of this risk.

***

Risks Not a Work Deterrent

Yet, according to colleague Eric A. Dover MD and Jeffrey Knuppel MD, a psychiatrist who blogs at The Positive Medical Blog, the risk of litigation should not be a deterrent to working as a health care professional in correction facilities if:

1. You truly like working in the correctional setting. This work is not for everyone. If you don’t really like it anyway, then the thought of getting sued is just likely to decrease your career satisfaction further.

2. You have ability to be assertive yet get along well with most people. If you frequently find yourself in power struggles with people or cannot politely set limits, then do not work in corrections. If you let your ego get involved in you interpersonal interactions very often, then you’re likely to irritate many inmates, and you probably will become a target for lawsuits and complaints [personal communication].

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

“With time at a premium, and so much vital information packed into one well organized resource, this comprehensive textbook should be on the desk of everyone serving in the healthcare ecosystem. The time you spend reading this frank and compelling book will be richly rewarded.”

Dr. J. Wesley Boyd MD PhD MA [Harvard Medical School, Boston, Massachusetts]

Filed under: Professional Liability | Tagged: Bureau of Justice Statistics, CORRECTIONAL CARE MEDICINE, Eric A. Dover MD, Jeffrey Knuppel MD, National Inmate Survey | 4 Comments »

Medical Malpractice Trial Types

Posted on February 16, 2024 by Dr. David Edward Marcinko MBA

Understanding the Litigation Process

By Dr. Jay S. Grife; Esq, MA

There are two types of trials, trial by jury and trial by judge. It is the task of the judge to determine the law, while the jury determines the facts. In a trial by judge—called a “bench” trial—the judge determines both the law and the facts. The U.S. Constitution guarantees a trial by jury. If a party does not request a jury trial, however, the right to a jury trial can be waived.

The Statistics

Most civil cases in the United States are tried by jury. Of the 3 percent of all cases that go to trial, the Department of Justice reports about two-thirds are jury trials, and one-third are bench trials. Whether to try a case to the judge or to a jury is strictly a matter of choice by the litigants. If either party timely requests a jury trial, however, the case must be tried to a jury. Because of the constitutional implications, in most cases both parties must waive their right to a jury trial in order for the case to be tried to a judge. In a few instances, such as trials for injunctions and family law matters, a jury trial is not an option and a judge must hear the case. However, the majority of civil issues offer the litigants a choice between bench or jury trials.

Notions and Perceptions

So why would anyone choose to have a case heard by a judge as opposed to a jury, or vice versa? The reasons are mainly based on preconceived notions about judge and juror biases. Generally, most litigants favor a jury over a judge because the decision is put into the hands of many rather than in the hands of one. Plaintiffs usually like juries because lay individuals are believed to be more sympathetic, and a plaintiff can appeal to the emotions of a jury. Conversely, defendants usually prefer bench trials because a judge is thought to be more objective in deciding a case. Requesting a bench trial can also result in a much quicker trial date. Since court dockets in most large cities are becoming increasingly congested, the time difference between a jury trial date and a bench trial date can be literally years.

Assessment

None of the perceptions about the benefits of a jury trial or a bench trial apply to all situations—every case is different. There is at least some empirical evidence that some of the commonly held conceptions about bench and jury trials are actually misconceptions. For example, while it is almost universally believed that juries tend to favor plaintiffs and award much higher monetary amounts, a recent study by the Department of Justice suggests that judges favor plaintiffs and return higher verdicts. Still, jury trials outnumber bench trials by about two to one [1].

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PHYSICIANS: www.MedicalBusinessAdvisors.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

[1] See Civil Jury Cases and Verdicts in Large Counties, Civil Justice Survey of State Courts at: http://www.usdoj.gov/bjs/abstract/cjcavilc.htm.

Filed under: "Doctors Only", Book Reviews, Ethics, Professional Liability, Recommended Books, Risk Management | Tagged: bench trial, david marcinko, jay grife, jury trial, malpractice, malpractice trials, medical malpractice, medical negligence | 4 Comments »

Malpractice Trial Jury Selection

Posted on February 16, 2024 by Dr. David Edward Marcinko MBA

Understanding the Trial Process

[By Dr. Jay S. Grife; Esq, MA]

The selection process for a jury begins with what is called the jury pool. A number of citizens are selected as potential jurors, usually several times the number of jurors needed for a trial. From this pool of potential jurors, the jury panel is selected.

Jury Size and Constituency

The size of the jury panel varies by state and locale. Most juries consist of about six to twelve individuals on a panel. In addition, one or more alternate jurors may also be selected. Alternate jurors sit with the jury and hear evidence just as all the other jurors. In some states, they also sit in on jury deliberations, though they are not allowed to participate. If for some reason a member of the panel is unable to continue with the trial or other deliberations, the alternate juror fills in. The number of alternate jurors varies, and determining the number is usually left to the discretion of the judge. Generally; longer trials require more alternate jurors.

Pre-Trial Questionnaires

Before any potential juror appears at the courthouse for a trial, usually a questionnaire form is mailed for the individual to complete and return to the court. Such forms request information such as name, age, occupation, educational background, participation as a party or witness in previous litigation, previous jury service, etc. Attorneys for the parties are able to obtain and review these questionnaires in advance of the trial date.

More Questions

On the day of trial, when the potential jurors arrive at the courthouse, the judge typically asks some generic questions about their ability to serve. The judge may ask whether any potential juror has a problem staying for the duration of the trial, or whether the potential jurors know any of the parties or their attorneys. The purpose of these questions is for the judge to determine which, if any, of the potential jurors will be excused immediately from service.

Assessment

Many juries tend to be comprised of citizens with little or no college education. One of the possible reasons for this result is that many professionals, especially medical professionals, request to be excused from jury service, citing their professional commitments as justification. Ironically, professionals are usually the first to complain when juries who lack any representatives with advanced education hear their own cases. Once the judge is finished with the preliminary screening of the jury pool; attorney questioning of the jurors and voir dire begins.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PHYSICIANS: www.MedicalBusinessAdvisors.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: "Doctors Only", Book Reviews, Ethics, Experts Invited, Professional Liability, Recommended Books, Risk Management | Tagged: footlaw, gtife, jury, malpractice, Malpractice Trial Jury Selection, malpractice trials, trial, trials | 5 Comments »

VALUE BASED CARE: Guidelines and Best Practices?

Posted on February 11, 2024 by Dr. David Edward Marcinko MBA

http://www.MarcinkoAssociates.com

***

***

Three healthcare industry groups—America’s Health Insurance Plans (AHIP), the American Medical Association (AMA), and the National Association of Accountable Care Organizations (NAACOS)—released the 36-page playbook on July 25th, 2023. Adoption of the best practices in the playbook is voluntary; the playbook is intended to encourage the adoption of value-based care arrangements in the private sector, according to a news release from the three groups.

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

Under a value-based care model, providers are reimbursed based on patient outcomes rather than the quantity of services provided like in the traditional fee-for-service model. The value-based care model has been around since the late 1960s. But, widespread adoption has been slow—less than half of the primary care physicians said in a 2022 survey from the Commonwealth Fund that they had received any value-based payments.

***

COMMENTS APPRECIATED

Thank You

***

Filed under: "Doctors Only", Drugs and Pharma, Ethics, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Managed Care, Marcinko Associates, Professional Liability, Research & Development, Touring with Marcinko | Tagged: Accountable Care Organization, ACO, AHIP, AMA, American Medical Associaion, Commonwealth Fund, David E. Marcinko, david marcinko, marcinkoassociates.com, NAACOS, value based care, VBC | Leave a comment »

Disruptive Behavior and Bullies in Medicine

Posted on January 18, 2024 by Dr. David Edward Marcinko MBA

“Micro-Aggressors” in Healthcare

[By staff reporters] http://www.CertifiedMedicalPlanner.org

Every workplace has “micro-aggressors” or/or bullies that exhibit disruptive behavior.

But, when the workplace is a hospital, it’s not just an employee problem.

Definition

Microaggression is a term coined by psychiatrist and Harvard University professor Chester M. Pierce in 1970 to describe insults and dismissals he said he had regularly witnessed non-black Americans inflict on African Americans.

In 1973, MIT economist Mary Rowe extended the term to include similar aggression directed at women; eventually, the term came to encompass the casual degradation of any socially marginalized group, such as the poor and the disabled.

***

Case Report

In one reported case, the worker, felt threatened: His superior came at him “with clenched fists, piercing eyes, beet-red face, popping veins, and screaming and swearing.” He thought he was about to be hit. Instead, his angry co-worker stormed out of the room.

But, it wasn’t just any room: It was in a hospital, adjacent to a surgical area. The screamer was a cardiac surgeon, and the threatened employee was a perfusionist, a person who operates a heart/lung machine during open heart surgery. In 2008, the Indiana Supreme Court ruling in Raess v. Doescherupheld a $325,000 settlement for the perfusionist, who said he was traumatized.

PHYSICIAN COACH: https://marcinkoassociates.com/process-what-we-do/

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Foreword by: J. WESLEY BOYD MD PhD MA

Harvard Medical School

Boston Children’s Hospital – Psychiatrist

Yale University

Filed under: "Doctors Only", Ethics, Experts Invited, Marcinko Associates, mental health, Professional Liability, Risk Management | Tagged: advisor, Chester M. Pierce, CMP™ Course, coach, Disruptive Behavior, Marcinko, Mary Rowe, mentor, Microaggression, physician bullies, physician coach | Leave a comment »

VALUATION OF MSOs: Introduction and Competitive Environment

Posted on December 6, 2023 by Dr. David Edward Marcinko MBA

MANAGEMENT SERVICE ORGANIZATION

By Health Capital Consultants, LLC

***

Valuation of MSOs: Introduction & Competitive Environment

DEFINITION: A management services organization is an outside entity that can help with the non-medical parts of running a medical practice, out-patient facility or clinic; etc.

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

Management service organizations (MSOs) can be defined as “a healthcare specific administrative and management engine that provides a host of administrative and management functions necessary to be successful in the ever changing healthcare environment.” MSOs are primarily utilized by non-physicians as a vehicle to legally owning an entity that provides administrative support to a medical practice’s operations.

Most states only allow medical practices to be owned by physicians, which can limit the number of investors in a medical practice, as well as the financial value of the practice. (Read more…)

COMMENTS APPRECIATED

Thank You

***

Filed under: Career Development, Experts Invited, Health Economics, Healthcare Finance, Managed Care, Professional Liability, Research & Development | Tagged: Health Capital Consultants, management service organization, MSO, MSOs | Leave a comment »

PHYSICIANS: Books, Texts & Dictionaries

Posted on November 26, 2023 by Dr. David Edward Marcinko MBA

BUSINESS, FINANCE AND NON-CLINICAL ECONOMICS EDUCATION

By Dr. David Edward Marcinko MBA CMP™

SPONSOR: http://www.MARCINKOASSOCIATES.com

Academic Team of Internationally Known Contributors

D. E. Marcinko & Associates is one of the most academically published authorities on the topic of financial planning and private wealth management for physicians, nurses and medical professionals. We have published 33 major peer reviewed textbooks redacted in the Library of Medicine, Institute of Health and the Library of Congress, in four languages, with over 5,025 online white papers, web-posts and related publications. These cover a range of financial planning topics from medical malpractice, risk management and insurance, to investment policy statement analysis and endowment funding management, and to taxation, retirement, estate and legacy planning.

Financial planning, business and strategic management, FMV for practice and clinics and related “hard” topics are included.

***

We also include “soft” subjects from investor psychology, ethics and lost fortunes to luxury spending, from understanding the middle-class millionaire to the political philosophies of physicians and the affluent. Our corpus of work is regularly consulted by doctors, medical, business, graduate and nursing schools, to elite advisors, private and investment bankers, wealth managers, venture capitalists, academics and the press.

MORE HERE: https://marcinkoassociates.com/textbooks-academic-catalog/

Leading Resources, Books, Texts, Dictionaries and References for Medical Professionals

E-BOOKS: https://wordpress.com/post/medicalexecutivepost.com/426370

THANK YOU

***

Filed under: "Advisors Only", "Doctors Only", Accounting, Alerts Sign-Up, Book Reviews, Estate Planning, Ethics, Financial Planning, Funding Basics, Health Insurance, Health Law & Policy, Healthcare Finance, Information Technology, Insurance Matters, Investing, Marcinko Associates, Portfolio Management, Practice Management, Practice Worth, Professional Liability, Retirement and Benefits, Risk Management, Taxation, Touring with Marcinko | Tagged: Accounting, cost management, estate, Financial Planning, Investing, managerial accounting, Marcinko, medical management, practice management medical FMV, retirement, tax planning | Leave a comment »

M&As: In Healthcare

Posted on October 29, 2023 by Dr. David Edward Marcinko MBA

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

***

***

Hospital and health system deal activity is finally starting to rebound following a pandemic-era plunge, according to consulting firm Kaufman Hall, but hospitals are increasingly citing “financial distress” as the reason behind the deals.

In more than a third of the 18 hospitals and health systems deals made in Q3 2023—including mergers and acquisitions (M&A) and partnerships—at least one party cited financial distress as the impetus for the transaction. That figure is “well above historical benchmarks,” according to the firm.

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

“Hospitals and health systems have been under extreme financial pressure since 2022, when median operating margins remained in negative territory for the full year,” Kaufmann Hall analysts wrote in an October 12 report. “These challenges are reflected in the 39% percent of announced transactions in Q3 in which a party has cited, or publicly available information has enabled Kaufman Hall to infer, an element of financial distress as a transaction driver.”

***

COMMENTS APPRECIATED

Thank You

***

Filed under: "Advisors Only", "Doctors Only", Accounting, Investing, Practice Management, Practice Worth, Professional Liability, Taxation | Tagged: acquisitions, healthcare acquisitions, Kaufman-Hall, M&A, M&As, medical mergers, medical mergers acquisitions, mergers | Leave a comment »

LAWSUITS: Amazon, Facebook and Google

Posted on September 28, 2023 by Dr. David Edward Marcinko MBA

By Staff Reporters

***

***

Stocks are diving recently, giving the Dow its worst day since March as new data on declining home sales and consumer confidence gave investors the recession-could-be-coming jitters again.

And, Amazon dipped after the FTC filed its long-awaited anti-monopoly suit against the company. The FTC and 17 states delivered a sweeping lawsuit accusing the trillion-dollar e-commerce company of being an illegal monopoly. It’s the fourth lawsuit levied by the FTC against Amazon this year and easily the one with the most profound consequences for US antitrust legislation. The FTC and state attorneys general allege that Amazon abused its power by punishing sellers if they offered lower prices on other platforms, a practice that led to higher prices for consumers. Sellers on the marketplace were also allegedly coerced to use Amazon’s logistics and advertising services or face penalties like reduced visibility.

Meanwhile the FTC is also looking to break up both Google and Facebook but it is unclear if that’s the real goal here. The FTC asked for a permanent injunction to stop alleged misconduct. Bad news for Google which celebrates its’ 25th birthday today.

COMMENTS APPRECIATED

Thank You

***

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

***

Filed under: "Advisors Only", Ethics, Experts Invited, Investing, Professional Liability, Risk Management | Tagged: Amazon, DJIA, DOW, Facebook, FTC, google, Lawsuits, Meta, stocks | Leave a comment »

RSV VACCINE: CDC OK’s Pfizer Maternal Shots

Posted on September 25, 2023 by Dr. David Edward Marcinko MBA

By Staff Reporters

***

***

Respiratory syncytial virus (RSV), also called human respiratory syncytial virus (hRSV) and human orthopneumovirus, is a common, contagious virus that causes infections of the respiratory tract. It is a negative-sense, single-stranded RNA virus. Its name is derived from the large cells known as syncytia that form when infected cells fuse.

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

CDC panel backs Pfizer’s maternal RSV vaccine

A Centers for Disease Control and Prevention advisory committee yesterday recommended administering the vaccine to pregnant people during the third trimester to prevent infants from contracting the virus.

The vaccine is already available, and another RSV vaccine made by AstraZeneca and Sanofi, which is given directly to babies, also won approval recently. RSV sends ~80,000 children under five to US hospitals annually, according to the CDC, and it’s the second leading cause of death for under-one-year-olds globally.

***

COMMENTS APPRECIATED

JOIN US

***

Filed under: "Doctors Only", Accounting, Breaking News, Drugs and Pharma, Health Economics, Health Insurance, Healthcare Finance, Professional Liability, Quality Initiatives | Tagged: AstraZeneca, CDC, Pfizer, Respiratory syncytial virus, RSV, Sanofi | Leave a comment »

FTC & DOJ Announce Revised Merger Guideline

Posted on September 17, 2023 by Dr. David Edward Marcinko MBA

By Health Capital Consultants, LLC

***

FTC & DOJ Announce Revised Merger Guidelines

On July 19, 2023, the Federal Trade Commission (FTC) and the Department of Justice (DOJ) released a draft update of its Merger Guidelines, which guides the regulatory agencies in their review of both mergers and acquisitions in evaluating compliance with federal antitrust laws.

The new Guidelines replace, amend, and consolidate the Vertical Merger Guidelines and Horizontal Merger Guidelines, which were published in 2020 and 2010, respectively.

This Health Capital Topics article will discuss the new Guidelines and the proposed changes to antitrust laws that may affect the future of healthcare. (Read more…)

***

COMMENTS APPRECIATED

Thank You

***

Filed under: "Ask-an-Advisor", Funding Basics, Investing, Op-Editorials, Professional Liability, Recommended Books | Tagged: Department Justice, DOJ, Federal Trade Commission, FTC, Health Capital Consultants, Horizontal Merger, M&As, MAs, Revised Merger Guidelines, Vertical Merger | Leave a comment »

The Medical Expert [Trial Witness]

Posted on September 2, 2023 by Dr. David Edward Marcinko MBA

An Important Determinant of Success or Failure

By Dr. Jay S. Grife; JD, MA

In every civil medical malpractice trial, besides counsel for the respective parties, there is a Plaintiff (patient) and a Defendant (doctor).

In addition to the parties and their respective counsel, witnesses, both lay and expert, form the main body of testimony that will be elicited and heard by the Judge and jury.

Overview of Witness Types

Both lay and expert witnesses serve to tell the story of the parties to the court. In a medical malpractice case, a lay witness generally explains the facts of specific events which they have witnessed, or more likely, how the Plaintiff has been affected by the alleged negligence. The parties may also call a special kind of witness, called a “medical expert”, to testify on their behalf.

Definition of Medical Expert

An expert witness is simply a witness with experience in a particular field, whose testimony will aide the lay jury in understanding the medical aspects of the case. In most medical malpractice cases, the Plaintiff must present expert testimony from a health care practitioner that the Defendant fell below the standard of care required and caused injury to the patient.

These are the two essential prongs which when conjoined equate to negligence in legal terminology; (1) liability being a breach in the standard of care and (2) causation being that the negligence caused the Plaintiff damages.

The “Two-Pronged” Test

It is essential to understand that a Plaintiff cannot prevail in litigation if only one of these two prongs has been left unsatisfied.

For example, if a physician failed to diagnose cancer in a terminally ill patient, the fact that the diagnosis was not made can be deemed negligent, but the negligence in the failure to diagnose did not damage the patient, in that she was terminal when she initially presented.

It is this two pronged test which delineates legal negligence from commonly expressed negligence or a bad result from the care and treatment provided.

Experts Not Always Required

In rare instances, and in ever diminishing jurisdictions, expert testimony is not required in medical negligence matters.

In those instances, the legal doctrine of Res Ipsa Loquitur or “the thing speaks for itself” often will attach to obviate the expert’s place.

Normally, in a medical malpractice case, a Plaintiff is required to establish: (1) a breach in the standard of care or that an act or omission by the Defendant that was not in keeping with the degree of skill and learning ordinarily used under the same or similar circumstances by members of defendant’s profession; and (2) causation or that such negligence or omission caused the plaintiff’s injury.

The Res Ipsa Loquitur Doctrine

However, the doctrine of Res Ipsa Loquitur exists to preclude the need for direct proof of negligence through medical testimony, and allows cases submitted under the doctrine to proceed to the jury even in the absence of testimony as to negligence because a jury is permitted to draw an inference of negligence from the specific act itself.

The classic example of such an incident would be the leaving of a surgical instrument inside a patient’s body, or operating upon the wrong body part [“Never-Event”].

Never-Events: https://medicalexecutivepost.com/2007/12/20/new-never-events-policy/

Conclusion:

What has been your experience with medical expert witnesses – help or hindrance – hired gun or balanced interpreter?

***

Filed under: Career Development, Ethics, Experts Invited, Professional Liability, Risk Management | Tagged: expert witness, Health Law & Policy, jay grife, medical expert witness, medical malpractice | 2 Comments »

PODCAST: CVS Replaces it’s PBM

Posted on August 26, 2023 by Dr. David Edward Marcinko MBA

Existential Threat to Pharmacy Benefits Managers?

By Staff Reporters

***

***

DEFINITION

PODCAST: PBM Money Flow Explained

***

Just now, CVS got a taste of its own medicine after Blue Shield of California said it will replace CVS’s pharmacy benefit manager system [PBMs] with other companies, including Amazon Pharmacy and Mark Cuban’s Cost Plugs Drugs business, to supply cheaper drugs to its members.

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

The move poses an existential threat to the entire pharmacy-benefit manager model.

***

COMMENTS APPRECIATED

Thank You

***

Filed under: "Doctors Only", Accounting, Career Development, Drugs and Pharma, Ethics, Experts Invited, Health Economics, Health Insurance, Healthcare Finance, Professional Liability, Risk Management, Videos | Tagged: Amazon, Amazon Pharmacy, Blue Shield California, Cost plus Drugs, CVs, drug formulary, Eric Bricker, Mark Cuban, Mark Cuban's Cost Plus Drugs, PBM, PBM Money Flow, pharmacy benefits manager | Leave a comment »

National Report Up-Coding Fraud Day

Posted on August 21, 2023 by Dr. David Edward Marcinko MBA

AUGUST 21st

By Dr. David Edward Marcinko MBA CMP

***

It’s National Report Upcoding Fraud Day, an initiative started in 2017 to support whistleblowers of Medicare fraud, which costs the US billions of dollars each year. If you need any encouragement to report suspected healthcare fraud (like upcoding or inflated Medicare reimbursement claims), here’s your chance.

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

What Is Upcoding?

Upcoding is defined as having a doctor or billing person assign an inaccurate billing code to a medical procedure or treatment. It’s done to increase the reimbursement to that physician.

Beyond that, CPT codes are 5-digit codes that tell billing and insurance companies what was done to you while in that physician’s care. It may sound straightforward, but with around 7,800 codes in use, it isn’t hard to get things mixed up or to miss the fact that they overcharged you for a service.

Sometimes the mistake is made in error. In other situations, the office or hospital may mix it up intentionally. Most often, intentional miscoding happens when the facility is billing Medicaid or Medicare. Again, this may not seem like a big deal for you since the government covers it, but it may still affect your ability to get the healthcare that you need.

MORE: https://medicalexecutivepost.com/2022/11/05/medical-billing-down-and-up-coding/

And so, National Report Upcoding Fraud Day is on August 21st. An initiative by Joel Hesch, a former attorney with the Department of Justice. Hesch and a passionate advocate for whistleblowers, created the day for anyone looking to report healthcare fraud. He wanted to make it easier, so everyone could get the process right. The day generates awareness and detailed steps on how the general public can report unethical healthcare providers. Fraudsters siphon off $65 billion each year in Medicare fraud through inflated reimbursement claims. Upcoding is one of the most rampant types of healthcare fraud that must end.Hesch draws on his 15 years as an attorney in the D.O.J. to support and encourage whistleblowers to come forward. The most successful claims have two things in common – facts and the use of proper reporting channels. National Report Upcoding Fraud Day aims to empower anyone with a legitimate case for claims.

MORE: https://medicalexecutivepost.com/2023/06/29/daily-update-healthcare-fraud-schemes-up-as-the-dow-dips-down/

COMMENTS APPRECIATED

Thank You

***

Filed under: "Doctors Only", Accounting, Career Development, Ethics, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Information Technology, Professional Liability, Quality Initiatives, Taxation, Touring with Marcinko | Tagged: david marcinko, Joel Hesch, MGN, national fraud upcode day, National Report Up-Coding Fraud Day, national upcoding report day, upcode, upcoding | Leave a comment »

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

Posted on July 7, 2023 by Dr. David Edward Marcinko MBA

By Ann Miller RN MHA CMP™

INTRODUCING OUR NEXT GENERATION e-BOOK LIBRARY FROM iMBA, Inc.

An e-book is an electronic or digital book that can be read on a computer or a handheld device.

Our new e-books consists of text, images, and are fixed to a specific spot on the page.

You can then access the e-book and read it, or highlight pages and even take side notes.

e-Books Save Money

Payable thru PayPal [3% courtesy surcharge applies].

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

COMMENTS APPRECIATED

Thank You

***

Filed under: "Advisors Only", "Doctors Only", Accounting, Career Development, Experts Invited, Financial Planning, Funding Basics, Health Economics, Health Insurance, Health Law & Policy, iMBA, Inc., Information Technology, Investing, Managed Care, Portfolio Management, Practice Management, Practice Worth, Professional Liability, Recommended Books, Research & Development, Retirement and Benefits, Risk Management | Tagged: .pdf files, e-books, electronic books | Leave a comment »

VALUATION: Medicare Advantage [Part C] Plans

Posted on June 15, 2023 by Dr. David Edward Marcinko MBA

By Health Capital Consultants, LLC

***

***

Valuation of MA Plans: Regulatory Environment

Healthcare provider organizations, including Medicare Advantage organizations (MAOs), face a range of federal and state legal and regulatory constraints, which affect their formation, operation, procedural coding and billing, and transactions.

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

This final installment of the three-part series on the valuation of Medicare Advantage (MA) plans will review the regulatory environment in which these plans operate. (Read more…)

***

COMMENTS APPRECIATED

Thank You

***

Filed under: "Doctors Only", Accounting, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Investing, Practice Management, Professional Liability | Tagged: Health Capital Consultants LLC, medicare, Medicare Advantage, Medicare C, Medicare Part C, Part C, Valuation Medicare Advantage Plans, Valuation Part C | Leave a comment »

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

Posted on May 6, 2023 by Dr. David Edward Marcinko MBA

By Ann Miller RN MHA CMP™

INTRODUCING OUR NEXT GENERATION e-BOOK LIBRARY FROM iMBA, Inc.

An e-book is an electronic or digital book that can be read on a computer or a handheld device.

Our new e-books consists of text, images, and are fixed to a specific spot on the page.

You can then access the e-book and read it, or highlight pages and even take side notes.

e-Books Save Money

Payable thru PayPal [3% courtesy surcharge applies].

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

COMMENTS APPRECIATED

Thank You

***

Physician Medical Risk Management and Insurance Planning Practices of Leading CERTIFIED MEDICAL PLANNERS®

Posted on April 1, 2023 by Dr. David Edward Marcinko MBA

SPONSOR: http://www.CertifiedMedicalPlanner.org

Our New Texts – “Take a Peek Inside“ – Now Available

“BY DOCTORS – FOR DOCTORS – PEER REVIEWED – FIDUCIARY FOCUSED”

SAMPLE: 21. Practice Risks

MORE: Risk Mgmt Leadership

***

Filed under: Book Reviews, CMP Program, Funding Basics, Health Insurance, Healthcare Finance, iMBA, Insurance Matters, Professional Liability, Recommended Books, Research & Development, Risk Management, Touring with Marcinko | Tagged: certified medical planner, CMPs, Dr. Marcinko, Insurance Plannng for Doctors, medical risk management | 1 Comment »

INVITE: Professor Marcinko to Your Next Seminar or Event

Posted on March 31, 2023 by Dr. David Edward Marcinko MBA

See You Soon

SPONSOR: http://www.CertifiedMedicalPlanner.org

Colleagues know that I enjoy personal coaching and public speaking and give as many talks each year as possible, at a variety of medical society and financial services conferences around the country and world. All in a Corona safe environment.

MARCINKO in the METAVERSE

These include lectures and visiting professorships at major academic centers, keynote lectures for hospitals, economic seminars and health systems, end-note lectures at city and statewide financial coalitions, and annual lectures for a variety of internal yearly meetings.

LIVE or PODCAST enabled, as well.

Topics Link: imba-inc-firm-services

Teleconference: https://medicalexecutivepost.com/2020/10/14/me-marcinko-and-my-avatar/

My Fond Farewell to Tuskegee University

And so, we appreciate your consideration.

Invite Dr. Marcinko

CONTACT: ANN MILLER RN MHA CMP®

[ME-P Executive-Director]

PH: 770-448-0769

EM: MarcinkoAdvisors@msn.com

THANK YOU

***

Filed under: Experts Invited, Financial Planning, Health Economics, Health Insurance, Healthcare Finance, iMBA, Inc., Information Technology, Insurance Matters, Interviews, Investing, LifeStyle, Practice Management, Practice Worth, Professional Liability, Touring with Marcinko | Tagged: David Edward Marcinko, medical seminars, metaverse, podcasts | Leave a comment »

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

Posted on March 30, 2023 by Dr. David Edward Marcinko MBA

Connecting the future of dentistry in 3D

By Staff Reporters

***

***

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

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

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

***

COMMENTS APPRECIATED

Thank You

***

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

***

Filed under: Alternative Investments, Ethics, Information Technology, Investing, Professional Liability, Pruitt's Platform | Tagged: 3D dentistry, DDS, Denta-Verse, dental work, Dentaverse, dentistry, DMD, future dentistry, google, Google Health, metaverse | Leave a comment »

RISK MANAGEMENT & LIABILITY PROTECTION FOR PHYSICIANS

Posted on March 18, 2023 by Dr. David Edward Marcinko MBA

And … Their Insurance Agents and Financial Advisors

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-

By DR. DAVID EDWARD MARCINKO MBA CMP®

SPONSOR: http://www.CertifiedMedicalPlanner.org

***

https://images.routledge.com/common/jackets/amazon/978149872/9781498725989.jpg

***

BOOK REVIEW

It is not uncommon for practicing physicians to have more than a dozen separate insurance policies to protect their medical practice and personal assets. Yet, most doctors understand very little about their policies.BOOK REVIR

Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™explains to physicians and insurance professionals the background, theory, and practicalities of medical risk management, asset protection methods, and insurance planning.

The book presents information in a manner that is convenient and highly useful for busy medical practitioners. It discusses the medical records revolution and addresses concerns regarding cloud computing, data security, and technological threats.

The book covers modern health law and policy, including fraud and abuse, workplace-violence, Medicare compliance, HIPAA regulations, AR protection strategies with internal controls, P4P and value based care, insurance and reputation management, and how the ARA legislation is impacting physician practices. It also includes case models and examples that provide you with a real-world understanding of how to recognize and reduce personal and medical practice risks.

With time at a premium for all, and so much information packed into one well-organized resource, this book is a must-read for every physician and financial advisor that serves the health care sector. The book will help physicians make better decisions about the risks they face and will help financial advisors improve the value they provide to their clients who are doctors.

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

THANK YOU

***

Filed under: "Advisors Only", "Doctors Only", Book Reviews, Career Development, CMP Program, Financial Planning, Glossary Terms, Health Insurance, Insurance Matters, Professional Liability, Recommended Books, Risk Management, Sponsors, Touring with Marcinko | Tagged: asset protection, David Marcinko MBA, Estate Planning, insurance planning and risk management for physicians, Malpractice Liability, Risk Management for Doctors | Leave a comment »

Sample Medical Practice Sales Non-Disclosure Agreement

Posted on March 10, 2023 by Dr. David Edward Marcinko MBA

Customizable Medical Practice Example

[By Staff Reporters]

The undersigned acknowledges that Hamilton Family Clinic (HFC) has furnished to the undersigned potential Investor (“Investor”) certain proprietary data (“Confidential Information”) relating to the business affairs and operations of Hamilton Family Clinic (HFC) for study and evaluation by Investor for possibly investing in Hamilton Family Clinic (HFC).

It is acknowledged by Investor that the information provided by Hamilton Family Clinic (HFC) is confidential; therefore, Investor agrees not to disclose it and not to disclose that any discussions or contracts with Hamilton Family Clinic (HFC) have occurred or are intended, other than as provided for in the following paragraph.

It is acknowledged by Investor that information to be furnished is in all respects confidential in nature, other than information which is in the public domain through other means and that any disclosure or use of same by Investor, except as provided in this agreement, may cause serious harm or damage to Hamilton Family Clinic (HFC), and its owners and officers.

Therefore, Investor agrees that Investor will not use the information furnished for any purpose other than as stated above, and agrees that Investor will not either directly or indirectly by agent, employee, or representative, disclose this information, either in whole or in part, to any third party; provided, however that (a) information furnished may be disclosed only to those directors, officers and employees of Investor and to Investor’s advisors or their representatives who need such information for the purpose of evaluating any possible transaction (it being understood that those directors, officers, employees, advisors and representatives shall be informed by Investor of the confidential nature of such information and shall be directed by Investor to treat such information confidentially), and (b) any disclosure of information may be made to which Hamilton Family Clinic (HFC) consents in writing. At the close of negotiations, Investor will return to Hamilton Family Clinic (HFC) all records, reports, documents, and memoranda furnished and will not make or retain any copy thereof.

__________________

Signature – and – Date

LINK: Sample

Assessment

No intent to practice law; sample customizable template only. Always consult an attorney or competent consultant familiar with your individual circumstances before use.

Conclusion

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Book Reviews, Career Development, Practice Management, Professional Liability, Recommended Books, Risk Management | Leave a comment »

SECOND OPINIONS: Physician Financial Planning, Investing, Medical Practice Management and Business Valuations; etc!

Posted on February 21, 2023 by Dr. David Edward Marcinko MBA

BY DR. DAVID EDWARD MARCINKO MBA CMP

***

Financial Planning for Medical Professionals

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

CONTACT: Ann Miller RN MHA

770-448-0769

***

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

THANK YOU

***

Filed under: "Doctors Only", Career Development, Estate Planning, Experts Invited, Financial Planning, Investing, Managed Care, Media Mentions and PR, Portfolio Management, Practice Management, Practice Worth, Professional Liability, Recommended Books, Risk Management | Tagged: clinic valuations, clinical appraisals, david marcinko, medical practice worth, physician financial planning, physician investing | Leave a comment »

SECOND OPINIONS: Physician Financial Planning, Investing, Medical Practice Management and Business Valuations; etc!

Posted on February 12, 2023 by Dr. David Edward Marcinko MBA

BY DR. DAVID EDWARD MARCINKO MBA CMP

***

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

CONTACT: Ann Miller RN MHA

770-448-0769

***

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

THANK YOU

***

PODCAST: JP Morgan Healthcare Conference 2023

Posted on February 10, 2023 by Dr. David Edward Marcinko MBA

EXPLAINED

By Eric Bricker MD

***

It is a healthcare investor conference where investors meet with digital health companies, not-for-profit hospital systems, insurance carriers, biotech and med device companies.

The J.P. Morgan Healthcare Conference is invite-only. There is no large exhibition hall. The agenda is not published.

Most of the ‘action’ happens outside the conference with private meetings across the city.

Most people who attend are not invited and they just go for the private meeting opportunities.

Hear a summary of the 2023 J.P. Morgan Healthcare Conference from This Week Health‘s Bill Russell and his guest Rob, DeMichiei–the former CFO of UPMC.

Hospital systems actually have a plan to cut costs for the first time in AGES.

Insurance carriers are going to become healthcare providers themselves.

Will insurance carriers eat hospitals’ lunch? etc.

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

***

ORDER: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko

***

COMMENTS APPRECIATED

Thank You

***

Filed under: "Advisors Only", "Doctors Only", Accounting, Experts Invited, Health Economics, Health Insurance, Healthcare Finance, Practice Management, Professional Liability, Taxation, Videos | Tagged: Eric Bricker MD, Healthcare Conference, JP Morgan, PODCAST: JP Morgan Healthcare Conference 2023 | Leave a comment »

PODCAST: Financial Planning and Medical Business Management Mistakes of Independent Doctors

Posted on February 9, 2023 by Dr. David Edward Marcinko MBA

By Entrepreneurial MD

***

***

In this episode, host Christopher Hughey talks to Steven Huskey about the financial, management and planning mistakes many independent doctors make when setting up their own medical practice.

PODCAST: https://www.theentrepreneurmd.com/search?query=mistakes

***

COMMENTS APPRECIATED

Thank You

***

ORDER: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko

***:

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

***

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

***

Filed under: "Doctors Only", Career Development, Experts Invited, Health Economics, Healthcare Finance, Insurance Matters, Investing, Marketing & Advertising, Practice Management, Professional Liability, Risk Management | Tagged: Christopher Hughey, Entrepreneurial MD, Financial Planning, financial planning mistakes, independent doctors, medical business management, Practice Management, practice management mistakes, Steven Huskey | Leave a comment »

ADVISORY OPINION: Allows Nurse Practitioner Support in Hospitals

Posted on February 7, 2023 by Dr. David Edward Marcinko MBA

NURSE PRACTITIONERS [NPs]

By Health Capital Consultants, LLC

***

***

Advisory Opinion Allows Nurse Practitioner Support in Hospitals

On December 19, 2022, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) published Advisory Opinion (AO) No. 22-20, analyzing the utilization of nurse practitioners (NPs) in lieu of attending physicians within medical units. The OIG concluded that the arrangement utilizing NPs in certain medical units, subject to several safeguards, presented a low risk for fraud or abuse.

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

As noted by legal experts, this AO deviates from OIG’s typical approach to limiting arrangements involving potential remuneration from a hospital to its referring physicians. (Read more…)

***

ORDER: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko

***

COMMENTS APPRECIATED

Thank You

***

Filed under: "Advisors Only", "Doctors Only", Career Development, Ethics, Experts Invited, Health Economics, Health Insurance, Healthcare Finance, iMBA, Inc., LifeStyle, Professional Liability, Risk Management | Tagged: advisory opinion, ADVISORY OPINION: Allows NP Support in Hospitals, Health Capital Consultants LLC, Health Human Services, HHS, NP Support in Hospitals, NPs, nurse practitioners, Office Inspector General, OIG, PAs | Leave a comment »

PODCAST: Financial Deception in Healthcare

Posted on December 15, 2022 by Dr. David Edward Marcinko MBA

THIRTY EXAMPLES

By Eric Bricker MD

***

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

***

***

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

***

COMMENTS APPRECIATED

Thank You

****

Filed under: "Doctors Only", Accounting, Career Development, Glossary Terms, Health Insurance, Health Law & Policy, Healthcare Finance, Investing, Professional Liability, Videos | Tagged: Eric Bricker MD, financial deception, financial deception in healthcare, healthcare | Leave a comment »

PODCAST: Doctor’s Don’t Disclose Conflicts of Interest

Posted on December 13, 2022 by Dr. David Edward Marcinko MBA

C.O.I.

By Eric Bricker MD

***

MORE: https://medicalexecutivepost.com/2022/10/05/video-on-doctors-money-and-conflicts-of-interest/

***

COMMENTS APPRECIATED

Thank You

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

***

Product Details

ORDER: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko

***

Filed under: "Doctors Only", Drugs and Pharma, Ethics, Health Economics, Health Insurance, Professional Liability | Tagged: COI, Conflicts of Interest, Don't Disclose Conflicts of Interest, Drugs, Eric Bricker MD, pharma, pharmaceuticals | Leave a comment »

How to THRIVE in Private Independent Medical Practice, Today?

Posted on December 5, 2022 by Dr. David Edward Marcinko MBA

Click to access foreword-hashem-md-phd.pdf

Click to access foreword-silva.pdf

ORDER TEXTBOOK: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-

THANK YOU

***

Filed under: "Doctors Only", Book Reviews, Career Development, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Managed Care, Practice Management, Practice Worth, Professional Liability, Risk Management, Touring with Marcinko | Tagged: Business of Medical Practice, David Edward Marcinko, Hashem MD, private medicine, private practice, Silva MD | 1 Comment »

Should Doctors Protect their Turf?

Posted on November 21, 2022 by Dr. David Edward Marcinko MBA

Testing Free-Market Principles and Medical Licensing

By Mike Accad MD

It’s been a little over a 100 years since medical licensing laws were introduced in the US. If people doubt that slippery slopes are real, they should reflect on that history.

In our latest video, Anish Koka and I discuss a “white paper” jointly written by Jeffrey Flier, former dean at Harvard Medical School, and Jared Rhoads from the Dartmouth Institute, calling for some deregulation of the apparatus that rules the supply of physicians and their scope of work. The paper gives an exhaustive account of the bureaucratic mess and offers some possible remedies.

LINK: http://alertandoriented.com/should-doctors-protect-their-turf/

Your thoughts are appreciated.

THANK YOU

***

Filed under: Practice Management, Professional Liability, Videos | Leave a comment »

PUBLIC HEALTH: RSV versus COVID?

Posted on November 19, 2022 by Dr. David Edward Marcinko MBA

[Emergency Request]

By Staff Reporters

***

***

Children’s hospitals are asking the federal government to declare a public health emergency to help them deal with the surge of RSV cases. Infants are being hospitalized at seven times the rate of 2018.

DEFINITION: Respiratory syncytial virus, also called human respiratory syncytial virus and human orthopneumovirus, is a common, contagious airborne virus that causes infections of the respiratory tract. It is a negative-sense, single-stranded RNA virus.

***

COMMENTS APPRECIATED

Thank You

***

Filed under: Breaking News, Ethics, Health Insurance, iMBA, Inc., Managed Care, Professional Liability | Tagged: covid, public health, Respiratory syncytial virus, RSV | Leave a comment »

PODCAST[s]: Medicare Re-Admission Penalties

Posted on November 16, 2022 by Dr. David Edward Marcinko MBA

UPDATE 83% Penalized!

By Eric Bricker MD

***

HRRP PODCAST: https://www.youtube.com/watch?v=mwRrKM83CVQ

COMMENTS APPRECIATED

Thank You

***

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

****

Filed under: "Doctors Only", Career Development, Ethics, Experts Invited, Health Insurance, Health Law & Policy, Healthcare Finance, Professional Liability, Quality Initiatives, Research & Development, Videos | Tagged: Eric Bricker MD, hospital readmission penalties, hospital readmissions, HRRP, medicare, Medicare Re-Admission Penalties, PodCast | Leave a comment »

COLONOSCOPIES: Statistical Update

Posted on October 18, 2022 by Dr. David Edward Marcinko MBA

By Dr. David Edward Marcinko MBA

***

DEFINITION: A Colonoscopy and/or sigmoidoscopy are procedures that let your doctor look inside your large intestine. They use instruments called scopes. Scopes have a tiny camera attached to a long, thin tube. The procedures let your doctor see things such as inflamed tissue, abnormal growths, and ulcers.

EDITOR’S NOTE: The ME-P does not normally discuss medical or clinical matters. But, this report is noteworthy to all.

***

***

About 15 million colonoscopies are performed in the US yearly as part of standard preventive care for adults over 45, but a new study has called into question whether all the footage from those tiny cameras is really necessary.

Over a 10-year period, people who had the screenings were 18% less likely to develop colon cancer than people who didn’t, according to the study in the New England Journal of Medicine. However, the risk of death from the cancer for both the screened and un-screened was about the same, hovering around 0.3%.

***

COMMENTS APPRECIATED

Thank You

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

***

Filed under: "Doctors Only", Breaking News, Drugs and Pharma, Ethics, Health Economics, Health Insurance, Healthcare Finance, iMBA, Inc., Insurance Matters, LifeStyle, Professional Liability, Quality Initiatives, Touring with Marcinko | Tagged: colon, COLONOSCOPIES: Statistical Update, colonoscopy, sigmoidoscopy | Leave a comment »

A Review of Mental Healthcare Provider Types

Posted on October 5, 2022 by Dr. David Edward Marcinko MBA

Implications for Staffing Modern Mental Health Facilities

[By Carol Miller RN MBA]

Community Mental Health Centers are also referred to as County Mental Health Centers and treat patients usually with no or limited insurance in a domiciliary setting versus an inpatient state or community facility.

And, both children and adults are eligible to receive such assistance.

These programs provide a wide range of psychiatric and counseling services to the residents in their community as well
as other types of assistance. But, what type of mental healthcare staff, and providers, are involved with these facilities?

Staffing

Staffing levels at community mental health facilities depend on the size and funding of each clinic, and vary in number, qualifications, and mix. Many personnel hold or are working on Master’s degrees and various professional certifications.

Typical staffing would include:

Administrative or Mental Health Director ¾ This individual, working under general policy directives, is responsible for planning, organizing, coordinating, and directing delivery of a community’s comprehensive mental health programs and services. This would include the development and implementation of goals, objectives, policies, procedures, budget, standard compliance, and work standards for mental health services. The Director is responsible not only for the services offered under the program, but also for extensive coordination with other county departments, public and private organizations, citizen groups, and the Board of Supervisors.
Case management staff ¾ These personnel are responsible for compiling all the services related to the treatment program.
Psychiatrists ¾ These individuals may work for a mental health center full or part time, and be Board-eligible or Board-certified in Psychiatry.
Psychologists ¾ These individuals will hold Ph.D., Psy.D. or Ed.D. qualifications and be licensed as clinical psychologists in the state.
Licensed Independent Social Worker (LISW) ¾ These individuals will have expertise in such services as family counseling, child psychology, geriatric dementia, psychological testing, and so on.
Licensed Marriage and Family Therapist (LMFT) — These individuals are specialized in various fields and provide an array of counseling services to patients, dependent on the nature of their problem.
Clinical Nurse Specialists ¾ These personnel are certified in psychiatric nursing by a national nursing organization such as the American Nurses Association to practice within the scope of these services and are licensed in the state.
Support staff ¾ These staff members would include an administrative assistant to the Director, medical billers, transcriptionist, and possibly a receptionist.
Substance Abuse Counselor or Licensed Professional Clinical Mental Health Counselor (LPC or LPCC) — An individual who takes a holistic approach where they exam a person’s external environmental and societal influences while also monitoring inner emotion, physical and behavioral health.

###

Counselor Qualifications

A licensed mental health counselor has met or exceeded the following professional qualifications:

earned a Master’s degree in counseling or a closely related mental health discipline;
completed a minimum of two years post-Master’s clinical work under the supervision of a licensed or certified mental health professional; and
passed a state-developed or national licensure or certification examination.

Assessment

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Career Development, Ethics, Experts Invited, mental health, Professional Liability, Quality Initiatives | Tagged: Clinical Nurse Specialists, Licensed Independent Social Worker, Licensed Marriage and Family Therapist, Licensed Professional Clinical Mental Health Counselor, LISW, LMFT, LPC, LPCC, Mental Healthcare Provider Types, Psychiatrists, Psychologist, Substance Abuse Counselor | 7 Comments »

MSSP: Performance Results Indicate Another Successful Year

Posted on October 3, 2022 by Dr. David Edward Marcinko MBA

By Health Capital Consultants, LLC

***

***

MSSP Performance Results Indicate Another Successful Year

On August 30, 2022, the Centers for Medicare & Medicaid Services (CMS) released the financial and quality performance results for the Medicare Shared Savings Program (MSSP) Performance Year (PY) 2021.

The results revealed net savings of $1.66 billion for Medicare, marking the fifth consecutive year of savings. In total, 58% of MSSP accountable care organizations (ACOs) achieved savings as a result of their performance. This Health Capital Topics article will discuss the 2021 performance results, which are being released on the eve of seismic changes to the MSSP. (Read more…)

***

COMMENTS APPRECIATED

Thank You

***

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

****

Filed under: "Doctors Only", Alerts Sign-Up, Career Development, Drugs and Pharma, Ethics, Experts Invited, Practice Management, Professional Liability, Quality Initiatives | Tagged: Health Capital Consultants LLC, Medicare Shared Savings program, MSSP | Leave a comment »

Appeals Court Strikes Down Bid to Reinstate OSHA COVID-19 Protection Standard

Posted on September 5, 2022 by Dr. David Edward Marcinko MBA

By Robert King

***

***

The U.S. Court of Appeals for the District of Columbia just ruled that it did not have the power to overturn the Occupational Safety and Health Administration’s (OSHA’s) decision to scrap a temporary protection standard that outlined requirements for hospitals to keep front-line health workers safe from contracting COVID-19. The union National Nurses United decried the decision.

OSHA issued a temporary protection standard for COVID-19 back in June 2021. However, OSHA did not move to make a permanent standard before the temporary one expired last year, as the agency shifted resources toward a vaccine mandate, the appellate opinion said. OSHA had called for health systems to still impose the standard’s requirements voluntarily.

Source: Robert King, Fierce Healthcare [8/30/22]

***

COMMENTS APPRECIATED
Thank You

DICTIONARY: Health Economics and Finance

***

Filed under: Breaking News, Experts Invited, Managed Care, Professional Liability | Tagged: Covid-19, OSHA, Reinstate OSHA COVID-19 Protection Standard, rOBERT kING | Leave a comment »

On Wall Street’s Suitability, Prudence and Fiduciary Accountability

Posted on August 24, 2022 by Dr. David Edward Marcinko MBA

Financial Advisor’s are Not Doctors!

Dr. David E. Marcinko FACFAS MBA CMP™ MBBS

THRIVE-BECOME A CMP™ Physician Focused Fiduciary

http://www.CertifiedMedicalPlanner.org

Financial advisors don’t ascribe to the Hippocratic Oath. People don’t go to work on “Wall Street” for the same reasons other people become firemen and teachers. There are no essays where they attempt to come up with a new way to say, “I just want to help people.”

Financial Advisor’s are Not Doctors

Some financial advisors and insurance agents like to compare themselves to CPAs, attorneys and physicians who spend years in training and pass difficult tests to get advanced degrees and certifications. We call these steps: barriers-to-entry. Most agents, financial product representatives and advisors, if they took a test at all, take one that requires little training and even less experience. There are few BTEs in the financial services industry.

For example, most insurance agent licensing tests are thirty minutes in length. The Series #7 exam for stock brokers is about 2 hours; and the formerly exalted CFP® test is about only about six [and now recently abbreviated]. All are multiple-choice [guess] and computerized. An aptitude for psychometric savvy is often as important as real knowledge; and the most rigorous of these examinations can best be compared to a college freshman biology or chemistry test in difficulty.

Yet, financial product salesman, advisors and stock-brokers still use lines such as; “You wouldn’t let just anyone operate on you, would you?” or “I’m like your family physician for your finances. I might send you to a specialist for a few things, but I’m the one coordinating it all.” These lines are designed to make us feel good about trusting them with our hard-earned dollars and, more importantly, to think of personal finance and investing as something that “only a professional can do.”

Unfortunately, believing those lines can cost you hundreds of thousands of dollars and years of retirement.

More: Video on Hedge Fund Manager Michael Burry MD

***

Suitability Rule

A National Association of Securities Dealers [NASD] / Financial Industry Regulatory Authority [FINRA] guideline that require stock-brokers, financial product salesman and brokerages to have reasonable grounds for believing a recommendation fits the investment needs of a client. This is a low standard of care for commissioned transactions without relationships; and for those “financial advisors” not interested in engaging clients with advice on a continuous and ongoing basis. It is governed by rules in as much as a Series #7 licensee is a Registered Representative [RR] of a broker-dealer. S/he represents best-interests of the firm; not the client.

And, a year or so ago there we two pieces of legislation for independent broker-dealers-Rule 2111 on suitability guidelines and Rule 408(b)2 on ERISA. These required a change in processes and procedures, as well as mindset change.

Note: ERISA = The Employee Retirement Income Security Act of 1974 (ERISA) codified in part a federal law that established minimum standards for pension plans in private industry and provides for extensive rules on the federal income tax effects of transactions associated with employee benefit plans. ERISA was enacted to protect the interests of employee benefit plan participants and their beneficiaries by:

Requiring the disclosure of financial and other information concerning the plan to beneficiaries;
Establishing standards of conduct for plan fiduciaries ;
Providing for appropriate remedies and access to the federal courts.

ERISA is sometimes used to refer to the full body of laws regulating employee benefit plans, which are found mainly in the Internal Revenue Code and ERISA itself. Responsibility for the interpretation and enforcement of ERISA is divided among the Department Labor, Treasury, IRS and the Pension Benefit Guarantee Corporation.

Yet, there is still room for commissioned based FAs. For example, some smaller physician clients might have limited funds [say under $100,000-$250,000], but still need some counsel, insight or advice.

Or, they may need some investing start up service from time to time; rather than ongoing advice on an annual basis. Thus, for new doctors, a commission based financial advisor may make some sense.

Prudent Man Rule

This is a federal and state regulation requiring trustees, financial advisors and portfolio managers to make decisions in the manner of a prudent man – that is – with intelligence and discretion. The prudent man rule requires care in the selection of investments but does not limit investment alternatives. This standard of care is a bit higher than mere suitability for one who wants to broaden and deepen client relationships.

***

Prudent Investor Rule

The Uniform Prudent Investor Act (UPIA), adopted in 1992 by the American Law Institute’s Third Restatement of the Law of Trusts, reflects a modern portfolio theory [MPT] and total investment return approach to the exercise of fiduciary investment discretion. This approach allows fiduciary advisors to utilize modern portfolio theory to guide investment decisions and requires risk versus return analysis. Therefore, a fiduciary’s performance is measured on the performance of the entire portfolio, rather than individual investments

Fiduciary Rule

The legal duty of a fiduciary is to act in the best interests of the client or beneficiary. A fiduciary is governed by regulations and is expected to judge wisely and objectively. This is true for Investment Advisors [IAs] and RIAs; but not necessarily stock-brokers, commission salesmen, agents or even most financial advisors. Doctors, lawyers, CPAs and the clergy are prototypical fiduciaries.

***

More formally, a financial advisor who is a fiduciary is legally bound and authorized to put the client’s interests above his or her own at all times. The Investment Advisors Act of 1940 and the laws of most states contain anti-fraud provisions that require financial advisors to act as fiduciaries in working with their clients. However, following the 2008 financial crisis, there has been substantial debate regarding the fiduciary standard and to which advisors it should apply. In July of 2010, The Dodd-Frank Wall Street Reform and Consumer Protection Act mandated increased consumer protection measures (including enhanced disclosures) and authorized the SEC to extend the fiduciary duty to include brokers rather than only advisors, as prescribed in the 1940 Act. However, as of 2014, the SEC has yet to extend a meaningful fiduciary duty to all brokers and advisors, regardless of their designation.

The Fiduciary Oath: fiduciaryoath_individual

Assessment

Ultimately, physician focused and holistic “financial lifestyle planning” is about helping some very smart people change their behavior for the better. But, one can’t help doctors choose which opportunities to take advantage of along the way unless there is a sound base of technical knowledge to apply the best skills, tools, and techniques to achieve goals in the first place.

Most of the harms inflicted on consumers by “financial advisors” or “financial planners” occur not due to malice or greed but ignorance; as a result, better consumer protections require not only a fiduciary standard for advice, but a higher standard for competency.

The CFP® practitioner fiduciary should be the minimum standard for financial planning for retail consumers, but there is room for post CFP® studies, certifications and designations; especially those that support real medical niches and deep healthcare specialization like the Certified Medical Planner™ course of study [Michael E. Kitces; MSFS, MTax, CLU, CFP®, personal communication].

Being a financial planner entails Life-Long-Learning [LLL]. One should not be allowed to hold themselves out as an advisor, consultant, or planner unless they are held to a fiduciary standard, period. Corollary – there’s nothing wrong with a suitability standard, but those in sales should be required to hold themselves out as a salesperson, not an advisor.

The real distinction is between advisors and salespeople. And, fiduciary standards can accommodate both fee and commission compensation mechanisms. However; there must be clear standards and a process to which advisors can be held accountable to affirm that a recommendation met the fiduciary obligation despite the compensation involved.

Ultimately, being a fiduciary is about process, not compensation.

More: Deception in the Financial Service Industry

Full Disclosure:

As a medical practitioner, Dr. Marcinko is a fiduciary at all times. He earned Series #7 (general securities), Series #63 (uniform securities state law), and Series #65 (investment advisory) licenses from the National Association of Securities Dealers (NASD-FINRA), and the Securities Exchange Commission [SEC] with a life, health, disability, variable annuity, and property-casualty license from the State of Georgia.

Dr.Marcinko was a licensee of the CERTIFIED FINANCIAL PLANNER™ Board of Standards (Denver) for a decade; now reformed, and holds the Certified Medical Planner™ designation (CMP™). He is CEO of iMBA Inc and the Founding President of: http://www.CertifiedMedicalPlanner.org

More: Enter the CMPs

***

[PHYSICIAN FOCUSED FINANCIAL PLANNING AND RISK MANAGEMENT COMPANION TEXTBOOK SET]

[Dr. Cappiello PhD MBA] *** [Foreword Dr. Krieger MD MBA]

[Two Newest Books by Marcinko annd the iMBA, Inc Team]

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

***

[PRIVATE MEDICAL PRACTICE BUSINESS MANAGEMENT TEXTBOOK – 3rd. Edition]

[Foreword Dr. Hashem MD PhD] *** [Foreword Dr. Silva MD MBA]

***

Filed under: Book Reviews, Career Development, CMP Program, Financial Planning, Health Economics, Health Insurance, Healthcare Finance, iMBA, Inc., Op-Editorials, Portfolio Management, Practice Management, Professional Liability, Recommended Books, Research & Development, Risk Management, Touring with Marcinko | Tagged: Dr. David E. Marcinko, fiduciary accountability, financial planing MDs, Prudent Investor Act, prudent man rule, suitability rule, Uniform Prudent Investors Act, Wall Street | 3 Comments »

UPDATE: Recession, Goldman Sachs, and Tesla

Posted on August 5, 2022 by Dr. David Edward Marcinko MBA

By Staff Reporters

***

***

The director of the nonpartisan Congressional Budget Office [CBO] added his voice Thursday to those economists who say it’s unclear if the economy has hit a downturn, despite posting two straight quarterly drops in growth. “The U.S. economy shows signs of slowing, but whether the economy is currently in a recession is difficult to say,” wrote CBO Director Phillip Swagel in a letter to Sen. Lindsey Graham (R-S.C.). “It is possible that, in retrospect, it will become apparent that the economy moved into recession sometime this year. However, that is not clear from data that were available at the beginning of August,” Swagel added.

Goldman Sachs said its credit card unit is under investigation by the Consumer Financial Protection Bureau, a federal agency tasked with protecting Americans from financial abuse. In a securities filing, Goldman said the CFPB is examining a number of the company’s credit card account management practices, including refunds, resolving billing errors, advertisements and reporting to credit bureaus. And, in a statement to CBS MoneyWatch, Goldman said the bank “is cooperating with the CFPB on this matter.”

Finally, shares of electric vehicle maker Tesla rallied in after-hours trading as the company won shareholder approval for a 3:1 stock split, the second such move in two years, as the world’s most valuable automaker looks to make its stock more affordable.

***

COMMENTS APPRECIATED

Thank You

***

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

****

Filed under: Ethics, Experts Invited, Industry Indignation Index, Investing, Op-Editorials, Professional Liability | Tagged: CFPB, Goldman Sachs, Phillip Swagel, recession, Tesla | Leave a comment »

Biden Administration to Overhaul Vertical [Health Systems] Merger Guidelines

Posted on July 20, 2022 by Dr. David Edward Marcinko MBA

***

By Health Capital Consultants, LLC

***

***

Biden Administration to Overhaul Vertical Merger Guidelines

The U.S. healthcare industry has seen a rise in vertical integration transactions since the passage of the ACA, especially among physician groups integrating with health systems or insurers, as providers seek to fill gaps in their continuum of care. In response to these trends and resulting market imbalances, the Biden Administration is aggressively pursuing antitrust enforcement by updating and revising U.S. antitrust law guidance.

This Health Capital Topics article will discuss the vertical integration movement and the proposed changes to antitrust laws that may affect the future of healthcare. (Read more…)

***

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

***

COMMENTS APPRECIATED

Thank You

HOSPITALS: https://www.amazon.com/Hospitals-Healthcare-Organizations-Management-Operational/dp/1439879907/ref=sr_1_4?s=books&ie=UTF8&qid=1334193619&sr=1-4

***

Filed under: Experts Invited, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc., Investing, Professional Liability, Research & Development | Tagged: ACA, Biden, Biden Administration to Overhaul Vertical Merger Guidelines, Health Capital Consultants LLC, Vertical Integration, Vertical Merger Guidelines | Leave a comment »

When Routine Medical Tests Trigger a Cascade of Costly, Unnecessary Care

Posted on July 1, 2022 by Dr. David Edward Marcinko MBA

By N.P.R

***

***

READ: https://www.npr.org/sections/health-shots/2022/06/13/1104141886/cascade-of-care?utm_source=pocket-newtab

***

COMMENTS APPRECIATED

Thank You

***

Filed under: "Doctors Only", Ethics, Experts Invited, Health Insurance, Practice Management, Professional Liability, Quality Initiatives | Tagged: costly unnecessary medical care, NPR, routine medical tests, unnecessary medical care, unneeded medical tests | Leave a comment »

Transformational Business Skills for Doctor Entrepreneurs

Posted on June 2, 2022 by Dr. David Edward Marcinko MBA

THE BUSINESS OF MEDICAL PRACTICE [Health 2.0]

Textbook Review

***

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

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

SPONSOR: http://www.CertifiedMedicalPlanner.org

***

Filed under: Book Reviews, Health Economics, iMBA, Inc., Managed Care, Marketing & Advertising, Practice Management, Professional Liability, Touring with Marcinko | Tagged: Business of Medical Practice, David Edward Marcinko, HMO, Managed Care, Practice Management | Leave a comment »

About Medical Workplace Violence

Posted on June 2, 2022 by Dr. David Edward Marcinko MBA

UPDATE

At least three people are dead and multiple people are injured following a shooting at the Natalie Building at St. Francis Hospital in Tulsa, Oklahoma.

Link: https://www.msn.com/en-us/news/crime/at-least-3-dead-multiple-people-injured-in-shooting-at-oklahoma-medical-office/ar-AAXYITO?li=BBnb7Kz

More than Physical Assault

[By Staff Reporters and Dr. David E. Marcinko MBA]

Workplace violence is more than physical assault.

According to trauma specialist Eugene Schmuckler; PhD, MBA, CTS opining and writing in www.BusinessofMedicalPractice.com; workplace violence is any act in which a person is abused, threatened, intimidated, harassed, or assaulted in his or her employment. Swearing, verbal abuse, playing “pranks,” spreading rumors, arguments, property damage, vandalism, sabotage, pushing, theft, physical assaults, psychological trauma, anger-related incidents, rape, arson, and murder are all examples of workplace violence.

The RNANS

The Registered Nurses Association of Nova Scotia [RNANS], a leading study group, defines violence as “any behavior that results in injury whether real or perceived by an individual, including, but not limited to, verbal abuse, threats of physical harm, and sexual harassment.” As such, medical workplace violence includes:

· threatening behavior — such as shaking fists, destroying property, or throwing objects;

· verbal or written threats — any expression of intent to inflict harm;

· harassment — any behavior that demeans, embarrasses, humiliates, annoys, alarms, or verbally abuses a person and that is known or would be expected to be unwelcome. This includes words, gestures, intimidation, bullying, or other inappropriate activities;

· verbal abuse — swearing, insults, or condescending language;

· muggings — aggravated assaults, usually conducted by surprise and with intent to rob; or

· physical attacks — hitting, shoving, pushing, or kicking.

Cause and Affect

Workplace violence can be brought about by a number of different actions in the workplace. It may also be the result of non-work related situations such as domestic violence or “road rage.” Workplace violence can be inflicted by an abusive employee, a manager, supervisor, co-worker, customer, family member, patient, physician, nurse, or even a stranger.

The UI-IPRC

The University of Iowa – Injury Prevention Research Center [UI-IPRC] classifies most workplace violence into one of four categories.

· Type I Criminal Intent — Results while a criminal activity (e.g., robbery) is being committed and the perpetrator had no legitimate relationship to the workplace.

· Type II Customer/Client — The perpetrator is a customer or client at the workplace (e.g., healthcare patient) and becomes violent while being assisted by the worker.

· Type III Worker on Worker — Employees or past employees of the workplace are the perpetrators.

· Type IV Personal Relationship — The perpetrator usually has a personal relationship with an employee (e.g., domestic violence in the workplace).

Conclusion

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
PODIATRISTS: www.PodiatryPrep.com
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Career Development, Ethics, Practice Management, Professional Liability, Research & Development, Risk Management | Tagged: assault, battery, healthcare violence, nurse abuse, physician abuse, workplace violence | 19 Comments »

FRUSTRATED Physicians!

Posted on May 22, 2022 by Dr. David Edward Marcinko MBA

By Staff Reporters

***

65% of Physicians Report Feeling Frustrated in Past 3 Months

A recent study by Survey Healthcare Global on the mental health of healthcare professionals found:

• 65% of physicians report feeling frustrated.
• 54% of physicians report feeling burned out.
• 52% of physicians report feeling unappreciated.
• Respondents rank constant stress (34%) and staff shortages (30%) as the leading factors for stress.
• 18% report that they are more likely to drink, smoke, or use/abuse substances as a result.
• 75% say their organizations do not offer any wellness resources and programs to HCP employees.

Source: Survey Healthcare Global Via Business Wire, March 21, 2022

***

COACH

***

COMMENTS APPRECIATED

Thank You

***

***

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

****

Filed under: "Doctors Only", Career Development, Industry Indignation Index, Professional Liability | Tagged: frustrated doctors, frustrated physicians, mad doctors, mad physicians, MCOL, Survey Healthcare Global | 1 Comment »

Subscribe MEDICAL EXECUTIVE-POST?

Member Statistics

ME-P Information & Content Channels

Ann Miller RN MHA [Managing Editor]

CERTIFIED MEDICAL PLANNER® program

Most Recent ME-Ps

PodiatryPrep.org

ME-P Free Advertising Consultation

Medical & Surgical e-Consent Forms

iMBA Inc., OFFICES

ME-P Publishing

SEEKING INDUSTRY INFO PARTNERS?

Reader Comments, Quips, Opinions, News & Updates

Start-Up Advice for Businesses, DRs and Entrepreneurs

Up-Trending ME-Ps

Capitalism and Free Enterprise Advocacy

OIG Fraud Warnings

On Financial Fiduciary Accountability

Share this:

Share this:

Was the ADA Complicit?

Share this:

e-Books Save Money

Share this:

Share this:

Share this:

Some Thoughts and Some Statistics

Share this:

Understanding the Litigation Process

Share this:

Understanding the Trial Process

Share this:

Share this:

“Micro-Aggressors” in Healthcare

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

An Important Determinant of Success or Failure

Share this:

Share this:

Share this:

e-Books Save Money

Share this:

Share this:

e-Books Save Money

Share this:

Our New Texts – “Take a Peek Inside“ – Now Available

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Financial Advisor’s are Not Doctors!

Dr. David E. Marcinko FACFAS MBA CMP™ MBBS

[PHYSICIAN FOCUSED FINANCIAL PLANNING AND RISK MANAGEMENT COMPANION TEXTBOOK SET]

[PRIVATE MEDICAL PRACTICE BUSINESS MANAGEMENT TEXTBOOK – 3rd. Edition]

Share this:

Share this:

Share this:

Share this:

Share this: