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By Dr. David Edward Marcinko; MBA, CMP™
[Editor-in-Chief]
To successfully complete a medical practice financial analysis and fair-market valuation [FMV] engagement, the following is a description of the documents that are typically required.
According to Robert James Cimasi MHA, AVA, CMP™ of Health Capital Consultants LLC, most of this information is analogous to that required for the valuation of other types of healthcare service sector entities.
A. Important Documents
Important for identifying key variables and trends for analysis. The consultant should obtain year-end financial statements for a sufficient, relevant period to allow reliable analysis, e.g., the most recent three-five years. If, however, significant changes such as technological upgrades, product shifts, or environmental changes have occurred or the five-year period is not long enough, or too short, to assess the entity’s performance during changes in its business cycle or economic conditions, a longer or shorter period may be needed.
Obtain tax returns to understand the entity’s tax position and to obtain additional accurate financial data. The returns provide a summary of tax policies and elections that affect tax expense and net income.
Prospective financial information (e.g., forecasts, proformas, and budgets) should be requested to provide an indication of the entity’s opinion of its earnings potential as well as its historical ability to meet projections. This data may be especially useful if the consultant must produce a proforma or valuation of future earnings or cash flows.
The consultant should review all significant legal documents to obtain an understanding of the ownership interests and relationships and to determine if contractual arrangements affect the entity’s operations and overall value. Some of the documents to be reviewed include:
– Articles of Incorporation, stockholder, or partnership agreements. These agreements indicate ownership interests and the owners’ rights and obligations. Also, any stock option agreements should be considered. This will help the consultant determine or verify the type of interests involved.
– Stock books. Review of these can help the consultant ascertain the relative size of various ownership interests and identify transactions in the entity’s stock.
– Existing buy-sell agreements. These may provide an indication of the value of the entity or an ownership interest in it. Such agreements, however, are often structured based on factors other than the entity’s fair market value.
– Purchase and sale agreements involving prior transactions of the entity’s stock. These provide indications of the entity’s value and any offers or letters of intent to sell or purchase stock should be carefully reviewed under IRS Revenue Ruling 59-60, which includes “Sales of the stock and the size of the block of stock to be valued” in a list of factors that, “although not all-inclusive are fundamental and require careful analysis in each case.” IRS Ruling 59-60 further requires:
Sales of stock of a closely held corporation should be carefully investigated to determine whether they represent transactions at arm’s length. Forced or distress sales do not ordinarily reflect fair market value nor do isolated sales in small amounts necessarily control as the measure of value. This is especially true in the valuation of a controlling interest in a corporation. Since, in the case of closely-held stocks, no prevailing market prices are available, there is no basis for making an adjustment for blockage. It follows, therefore, that such stocks should be valued upon a consideration of all the evidence affecting the fair market value. The size of the block of stock itself is a relevant factor to be considered. Although it is true that a minority interest in an unlisted corporation’s stock is more difficult to sell than a similar block of listed stock, it is equally true that control of a corporation, either actual or in effect, representing as it does an added element of value, may justify a higher value for a specific block of stock.
– Managed care and other service contracts. Types and numbers of managed care contracts should be reviewed, including whether they are with healthcare maintenance organizations (HMOs), preferred provider organizations (PPOs), or point-of-service (POS) contracts; whether they are on a discounted fee-for-service basis and if so, the size of the discount; whether they include a withhold percentage to only be paid based on quality criteria; or whether they are a flat fee per enrollee (“capitated”). Special terms such as the non-transferability of the contract to a new owner must be noted, e.g., managed care contracts often require that the provider be included on a panel of credentialed providers in order to contract to provide services.
– Key doctor and managers’ employment contracts. Such agreements can reveal excess compensation above fair market value or “golden parachute” provisions in the event the business is sold.
– Loan and lease agreements. These agreements may contain restrictive covenants, special demand clauses, or working capital requirements that affect the value of the entity. The length and terms of lease agreements is also important.
– Documents relating to current, pending, or threatened litigation. These may indicate major contingent liabilities that may affect an entity’s value.
– Patent/trademark documents. These documents may indicate the existence of valuable intangible assets. The absence of these documents could indicate the absence of a value consideration claimed by the client.
Consultants should also gain an understanding of the entity’s operations and key personnel. This can be accomplished by touring the facilities, interviewing key managers, and obtaining additional operational data. Obtaining enough information to thoroughly understand the entity, its operations, and its environment is the objective. The consultant becomes aware of operational data or contracts that may affect value by reviewing the following types of documents:
– Corporate documents, including stockholder and director lists, compensation schedules for officers and directors, schedule of key man life insurance policies and organizational charts.
– Operational documents, including practice business plans, brochures, price lists, catalogs and other product information, sales forecasts, data on customers and suppliers, and capital budgets.
– Reports of other professionals, including appraisals on specific assets and reports by other consultants.
– Other internal information, including documents or details relating to potential public offerings for debt or equity, venture capital prospectus or similar information, and tracking of incurred but not reported (IBNR) expenses.
The medical practice may have loaned or borrowed funds from affiliates. Such loan arrangements may require adjustments to be made to the economic value of the subject entity.
– Uncollectible loans receivable should have been written off.
– Collectible loans receivable may still be considered non-operating assets and evaluated separately.
– Loans payable to related parties may be structured as demand notes, but there may be little chance that such loans will be repaid. Such loans may be considered either long-term debt or a form of owners’ equity.
B. Site Visit / Interview Information
The following types of information specific to the medical practice should be gathered by the financial executive or healthcare consultant. This information may be obtained through an interview, questionnaire, or preferably a site visit.
Include such information as the number of years the entity has operated at its current location and in the community, as well as the office hours.
Include the location (urban/suburban), proximity to hospitals and other medical facilities, and its size, construction, electrical and computer wiring, age, access to parking, and so on.
Approximate acquisition details and price, as well as ownership or lease details should be included. The square footage and number of rooms, and a description of different office areas should be outlined, including, where applicable: medical equipment, including all diagnostic imaging and major medical equipment; pharmacy, laboratory, examination rooms, waiting rooms, and other areas.
Document types of hardware and software and the cost, age, and suitability of all components, including their management functions, reporting capabilities, and integration between programs.
Give the date founded and by whom, the number of full-time equivalent (FTE) physicians in practice by year, the physicians who have joined and left the entity, the dates they practiced at the entity, and their relationship and practice arrangement with the entity.
Include the number and types of non-physician positions as well as the tenure and salary of all current employees.
Include details of hospital programs impacting practice, growth or decline in the volume of business and the reasons, association with other physicians, competitive strengths and threats, the number and volume of procedures performed, any change in the number and volume, and the corresponding fees.
Encompass income distribution and percentages from different payors, the number of new patients and total patients seen per week, the age mix of patients, the number of hours spent in patient care per week, and the number of surgeries performed.
Detail the terms and conditions of all managed care contracts including discounts and withholds, the impact on referral patterns and revenues, willingness to participate in risk sharing contracts and capitation, and the entity’s managed care reporting capabilities.
List all hospital privileges held by physician members of the medical practice and the requirements for acquiring privileges at the different local hospitals.
Include practice policies for billing and payment, use of collection agencies, acceptance of assignments, other sources of revenues, and an aged breakdown of accounts receivable.
Include cash management procedures and protections, credit lines and interest, controls to improve payment of accounts payable, late payment frequency, formal or informal financial planning methods, and budgeting processes.
Assessment
Allow for discussion of overall relationships with physicians in the community, practice concerns, and needs.
Source: “Research and Financial Benchmarking in the Healthcare Industry”
By Robert James Cimasi; MHA, ASA, CBA. AVA, CM&AA, CMP™
By Todd A. Zigrang; MHA, MBA, CHE
By Anne P. Sharamitaro; Esq
Conclusion
And so, your thoughts and comments on this ME-P are appreciated. What did we forget and what is your experience? Why did you need a medical practice valuation?
Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
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FINANCE: Financial Planning for Physicians and Advisorsation?
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BY Ann Miller RN MHA CMP®
“EXPERTS INVITED”
SPONSOR: http://www.CertifiedMedicalPlanner.org
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The ME-P constantly publishes new and unique content for the medical business management, health economics, HIT and financial planning, advisory and services community, and is always interested in accepting submissions from guest authors.
Because this blog is intended specifically for all medical professionals, business consultants and financial advisors, guest post content should pertain directly to the issues and challenges faced by all constituents and/or provide advanced education on a technical topic pertinent to practitioners.
Accordingly, we typically accepts guest posts from fellow physicians, financial planning [CFP, CMP, RIA, etc] and/or medical management practitioners, or consultants [JD, CPA, MBA, PhD, DBA, etc] or vendors who work directly with doctors/nurses on a full-time basis and have the requisite specialized knowledge and expertise for medical professional [non-clinical] needs and concerns.
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Part Two: Medical Practice Valuation
By Dr. David Edward Marcinko, MBA, CMP
www.CertifiedMedicalPlanner.org
In Part 1, we discussed how to establish fair market value (FMV) for a medical practice in the article, “Establish Your Practice’s Fair Market Value.” This time, we’ll review important terms and conditions for the sale transaction.
LINK: https://medicalexecutivepost.com/2023/02/02/establish-your-practices-fair-market-value/
Valuation Types
Unfortunately, as a general rule, medical practice worth is presently deteriorating. A good medical practice is no longer a good business necessarily, and selling doctors can no longer automatically expect to extract a premium sale price. Nevertheless, appraising your medical practice on a periodic basis can play a key role in obtaining maximum value for it.
Competent practice valuation specialists typically charge a retainer to cover out-of-pocket expenses. Fees should not be based on a percentage of practice value, and may take 30-45 days to complete. Flat fees should be the norm because a sliding scale or percentage fee may be biased toward over-valuation in a declining marketplace. Fees range from $7,500-$50,000 for the small to large medical practice or clinic.
Expect to pay a retainer and sign a formal, professional engagement letter. Seek an unbiased and independent viewpoint. Buyer and sellers should each have their own independent appraisal done, using similar statistics, accounting measures, and economic assumptions.
At the Institute of Medical Business Advisors, Inc www.MedicalBusinessAdvisors.com we use three engagement levels that vary in intensity, purpose, and cost:
1. A comprehensive valuation provides an unambiguous value range. It is supported by most all procedures that valuators deem relevant, with mandatory onsite review. This gold standard is suitable for contentious situations. A written “opinion of value” is applicable for litigation support activities like depositions and trial. It is also useful for external reporting to bankers, investors, the public, Internal Revenue Service (IRS), etc.
2. A limited valuation lacks additional suggested Uniform Standards of Professional Appraisal Practice (USPAP) procedures. It is considered to be an “agreed upon engagement,” when the client is the only user. For example, it may be used when updating a buy/sell agreement, or when putting together a practice buy-in for a valued associate. This limited valuation would not be for external purposes, so no onsite visit is necessary and a formal opinion of value is not rendered.
3. An ad-hoc valuation is a low level engagement that provides a gross non-specific approximation of value based on limited parameters or concerns involved parties. Neither a written report nor an opinion of value is rendered. It is often used periodically as an internal organic growth/decline gauge.
Structure Sales Transactions
When the practice price has been determined and agreed on, the actual sales deal can be structured in a couple of ways:
(1) Stock Purchase v. Asset Purchase
In an asset transaction, the buyer will receive a tax amortization benefit associated with the intangible value of the business. This tax amortization represents a non-cash expense benefiting the buyer. In this case, the present value of those future tax benefits is added to the business enterprise value.
(2) Corporate Transactions
Typical private deals in the past involved some multiple (ratio) of earning before income taxes (EBIT)—usually a combination of cash, restricted stock, notes receivable, and possibly assumption of liabilities. For some physician hospital organizations, and public deals, the receipt of common stock can increase the practice price by as much as 40-50 percent (to accept the corresponding business risk, in lieu of cash).
Complete the Deal
The deal structure will vary depending on whether the likely buyer is a private practitioner, health system or a corporate partner. Some key issues to consider in the “art of the deal” include:
Understand Private Deal Structure
Assuming a practice sale is a private transaction, deal negotiations are based on the following pricing methodologies:
Seller financing: Many transactions involve an earn-out arrangement where the buyer puts money down and pays the balance under a formula based on future revenues, or gives the seller a promissory note under similar terms. Seller financing decreases a buyer’s risks (the longer the terms, the lower the risk). Longer terms demand premiums, while shorter terms demand discounts. Premiums that buyers pay for a typical seller-financed practice are usually more than what you would expect from a simple time value of money calculation, as a result of buyer risk reduction from paying over time, rather than up front with a bank loan or all cash. Remember to obtain a life insurance policy on the buyer.
Down payment: The greater the down payment for acquisition of a medical practice, the greater the risk is to the buyer. Consequently, sellers who will take less money up front can command a higher than average price for their practice, while sellers who want more down usually receive less in the end.
Taxation: Tax consequences can have a major impact on the price of a medical practice. For instance, a seller who obtains the majority of the sales price as capital gains can often afford to sell for a much lower price and still pocket as much or more than if the sales price were paid as ordinary income. Value attributed to the seller’s patient list, medical records, name brand, good will, and files qualifies for capital gains treatment. Value paid for the selling doctor’s continuing assistance after the sale and value attributed to a non-compete agreement are taxed at ordinary income. A buyer willing to allocate more for items with capital gains treatment, or a seller willing to take more in ordinary income, can frequently negotiate a better price. This is the essence of economically prudent practice transition planning.
Sidestep Common Buyer Blunders
Here are 10 blunders to avoid, as a buyer:
1. Believing the selling doctor’s attestations. Always verify data through an independent appraisal.
2. Wanting to change the culture of the practice. Be careful: Patients may not adjust quickly to change.
3. Using all available cash without keeping a reserve for potential contingencies.
4. Creating a conflict with the seller by recognizing a weakness and continually focusing on it for a bargain price.
5. Failing to realize that managed care plan contracts can be lost quickly or may not be always transferable.
6. Suffering from analysis paralysis. Money cannot be made by continually checking out a medical practice, only by actually running one.
7. Not appreciating the uniqueness of each practice, and using inaccurate “rules of thumb” from the golden age of medicine.
8. Not realizing that practice worth and goodwill value have plummeted lately and continue to decline in most parts of the country.
9. Not understanding that practice brokers may play both sides of the buy/sell equation for profit. Brokers usually are not obligated to disclose conflicts of interest, are not fiduciaries, and do not provide testimony as a court-approved expert witness.
10. Not hiring an appraisal professional who will testify in court, if need be, using the IRS-approved USPAP methods of valuation. Always assume that the appraisal will be contested (many times, it is).
After pricing and contracting due diligence has been performed, the next step in the medical practice sale process—as Donald Trump might say—is just good, old-fashioned negotiation.
Electronic Downloads
Part I: Part I
Part II: Part II
Additional Reading:
Cimasi, R.J., A.P. Sharamitaro, T.A. Zigrang, L.A.Haynes. Valuation of Hospitals in a Changing Reimbursement and Regulatory Environment. Edited by David E. Marcinko. Healthcare Organizations: Financial Management Strategies. Specialty Technical Publishers, 2008.
Marcinko, D.E. “Getting it Right: How much is a plastic surgery practice really worth?” Plastic Surgery Practice, August 2006.
Marcinko, D.E., H.R. Hetico. The Business of Medical Practice (3rd ed). Springer Publishing,New York,N.Y., 2011.
Marcinko, D.E. and H.R. Hetico. Risk Management and Insurance Planning for Physicians and Advisors. Jones and Bartlett Publishers, Sudbury, Mass., 2007.
Marcinko, D.E. and H.R. Hetico. Financial Planning for Physicians and Advisors. Jones and Bartlett Publishers, Sudbury, Mass., 2007.
Marcinko, D.E. and H.R. Hetico. Dictionary of Health Insurance and Managed Care. Springer Publishers, New York, N.Y., 2007.
Marcinko, D.E. and H.R. Hetico. Dictionary of Health Economics and Finance. Springer Publishers,New York,N.Y., 2007.
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And … Their Insurance Agents and Financial Advisors
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[By Dr. David E. Marcinko MBA CMP™]
[By Ann Miller; RN, MHA]
Currently, there is a growing dilemma in the financial sales and services industry. It goes something like this:
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:
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:
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.
Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos
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:
LEXICONS: http://www.springerpub.com/Search/marcinko
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
8
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 | 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, RR | Leave a comment »
A MATH AND FINANCIAL-INVESTING TERM
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By Dr. David E. Marcinko MBA CMP®
SPONSOR: http://www.CertifiedMedicalPlanner.org
In mathematics, the absolute value or modulus of a real number x, denoted |x|, is the non-negative value of x without regard to its sign. Namely, |x| = x if x is positive, and |x| = −x if x is negative (in which case −x is positive), and |0| = 0. For example, the absolute value of 3 is 3, and the absolute value of −3 is also 3. The absolute value of a number may be thought of as its distance from zero.
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In finance, absolute value, also known as an intrinsic value, refers to a business valuation method that uses discounted cash flow (DCF) analysis to determine a company’s financial worth. The absolute value method differs from the relative value models that examine what a company is worth compared to its competitors. Absolute value models try to determine a company’s intrinsic worth based on its projected cash flows.
CITE: https://www.r2library.com/Resource/Title/0826102549
In investing, the key issues are as follows:
YOUR COMMENTS ARE APPRECIATED
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Thank You
******
Filed under: "Ask-an-Advisor", CMP Program, Glossary Terms, Healthcare Finance, Sponsors, Touring with Marcinko | Tagged: absolute value, certified medical planner, CMP™ Course, David Marcinko MBA | Leave a comment »
SOME GUIDELINES FOR COLLEAGUES
By Dr. David Edward Marcinko MBA CMP®
SPONSOR: http://www.CertifiedMedicalPlanner.org
According to Rick Kahler MS CFP® ChFC CCIM [www.KahlerFinancial.com] real estate is one of the largest asset classes in the world. The family home is the largest asset many middle-class Americans own. And, real estate makes up a significant portion of the net worth of many wealth accumulators. Directly owning real estate is not an investment for the faint of heart, the armchair investor, or the uneducated. Most wealth accumulators would do well to leave direct ownership of real estate to the pros and invest in real estate investment trusts (REITs) instead [personal communication].
Still, as we have seen, the lure of investing in a tangible asset like real estate is enticing for high risk tolerant physician-investors who need a sense of control and interaction with their investments. If you are among them, here are a few guidelines that may keep you on a profitable path.
1. Don’t attempt to purchase investment real estate without the help of a commercial real estate specialist who is a fiduciary bound to look out for your best interest. Engage a Certified Commercial Investment Member (CCIM) with years of training and experience in analyzing and acquiring investment real estate. To find a CCIM near you, go to http://www.ccim.com.
2. You will sign a disclosure agreement that will tell you who the Realtor represents. Be sure the Realtor you engage represents you and not the seller, both parties, or neither party.
3. Never trust the income and expense data provided by the seller’s Realtor. While a seller represented by a CCIM will have a greater chance of supplying you with accurate data, most will significantly understate expenses and overstate the capitalization rate. Selling Realtors often understate the average annual cost of repairs and maintenance. I estimate this annual expense at 10%.
4. Another often understated expense is management. Many owners manage their own properties, so the selling broker doesn’t include an estimate for management expenses. They should. Real estate doesn’t manage itself, ever. You will either need to hire professional management or do your own management (always a scary proposition). Even if you do it yourself, you have an opportunity cost of your time, so you must include a management fee in the expenses. Most small residential apartments and single-family homes will pay 10% of their rents to a manager.
5. You must verify all the costs presented to you by the seller’s Realtor. Demand copies of at least the last three and preferably five years of tax returns. Research items like utility bills, property taxes, legal fees, insurance costs and repairs, maintenance costs, replacement reserves, tax preparation and all management fees. As a rule of thumb, expenses will average 40% of rental income on average-aged properties where the tenants pay all utilities except water. Newer properties may have expenses as low as 35%, while older properties can be as high as 50%.
6. By subtracting the vacancy rate and stabilized expenses from the rent, you will find the net operating income. This is the income you will put in your pocket—assuming the property is paid for. By dividing the net operating income by the purchase price, you will find the return you will receive on your investment, called the capitalization or “cap” rate. In Rapid City SD, for example, the cap rate tends to be 4% for single-family homes, 5% to 8% for duplexes to eight-plexes, and 8% to 12% for larger residential and commercial properties.
Citation: https://www.r2library.com/Resource/Title/0826102549
ASSESSMENT: Yes, physician-investors and all of us can build wealth with real estate. You just need to educate yourself, work hard, start conservatively, think long-term, and be prepared for lean years. This is not a quick or easy path to riches.
Your comments are appreciated.
Thank You.
***
INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/
THANK YOU
***
Filed under: CMP Program, Experts Invited, iMBA, Inc., Investing, Sponsors | Tagged: Certified Medical Planner™, CMP Program, Non-Publicly Traded REITS, real-estate, REITS, Rick Kahler CFP® | Leave a comment »
By Staff Reporters
SPONSOR: http://www.CertifiedMedicalPlanner.org
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Turnitin (stylized as turnitin) is an Internet-based plagiarism detection service run by the American company Turnitin, LLC, a subsidiary of Advance Publications.
LINK: http://www.TurnItIn.com
Founded in 1998, it sells its licenses to universities and high schools who then use the software as a service (SaaS) website to check submitted documents against its database and the content of other websites with the aim of identifying plagiarism. Results can identify similarities with existing sources and can also be used in formative assessment to help students learn to avoid plagiarism and improve their writing.
Students may be required to submit work to Turnitin as a requirement of taking a certain course or class. The software has been a source of controversy, with some students refusing to submit, arguing that requiring submission implies a presumption of guilt. Some critics have alleged that use of this proprietary software violates educational privacy as well as international intellectual-property laws, and exploits students’ works for commercial purposes by permanently storing them in Turnitin’s privately held database.
ChatGPT: https://medicalexecutivepost.com/2023/01/17/chatgpt-a-microsoft-start-up-venture/
Turnitin, LLC also runs the informational website plagiarism.org and offers a similar plagiarism-detection service for newspaper editors and book and magazine publishers called iThenticate. Other tools included with the Turnitin suite are GradeMark (online grading and corrective feedback) and PeerMark (student peer-review service).
NOTE: According to Wikipedia, in March 2019, Advance Publications acquired private Turnitin, LLC for US$1.75 billion.
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Thank You
***
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Filed under: Career Development, Ethics, Glossary Terms, Information Technology, LifeStyle, Op-Editorials, Sponsors | Tagged: ChatGPT, CMP, CMP Course, CMP Curriculum, CMP Program, Turn IT In, turnitin, turnitin.com | Leave a comment »
By Ann Miller RN MHA CMP®
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The Institute of Medical Business Advisors, Inc provides a team of experienced, senior level consultants led by iMBA Chief Executive Officer Dr. David Edward Marcinko MBA CMP™ MBBS [Hon] and Ann Miller RN MHA CMP™ to provide ongoing contact with our clients throughout all phases of each project, with most of the communications between iMBA and the key client participants flowing through this Senior Team. iMBA Inc., and its skilled staff of certified professionals have many years of significant experience, enjoy a national reputation in the healthcare consulting field, and are supported by an unsurpassed research and support staff of CPAs, MBAs, MPHs, PhDs, CMPs™, CFPs® and JDs to maintain a thorough and extensive knowledge of the healthcare environment. The iMBA team approach emphasizes providing superior service in a timely, cost-effective manner to our clients by working together to focus on identifying and presenting solutions for our clients’ unique, individual needs.
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The iMBA Inc project team’s exclusive focus on the healthcare industry provides a unique advantage for our clients. Over the years, our industry specialization has allowed iMBA to maintain instantaneous access to a comprehensive collection of healthcare industry-focused data comprised of both historically-significant resources as well as the most recent information available. iMBA Inc’s specific, in-depth knowledge and understanding of the “value drivers” in various healthcare markets, in addition to the transaction marketplace for healthcare entities, will provide you with a level of confidence unsurpassed in the public health, health economics, management, administration, and financial planning and consulting fields. iMBA Inc’s information resources and network of healthcare industry textbook resources enhanced by our professional consultants and research staff, ensure that the iMBA project team will maintain the highest level of knowledge regarding the current and future trends of the specific specialty market related to the project, as well as the healthcare industry overall, which serves as the “foundation” for each of our client engagements.
MORE HERE: https://medicalexecutivepost.com/sponsors/
www.MedicalBusinessAdvisors.com
[Executive Director]
Thank You
***
Filed under: Alerts Sign-Up, Breaking News, iMBA, Inc., Sponsors, Touring with Marcinko | Tagged: 2023, ann miller, consulting, iMBA, iMBA Inc, Marcinko, medical business advisors, Medical Executive-Post, sponsor ME-P | Leave a comment »
FOR PHYSICIANS AND THEIR FINANCIAL ADVISORS
SPONSOR: http://www.CertifiedMedicalPlanner.org
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REVIEWS:
“Physicians who don’t understand modern risk management, insurance, business, and asset protection principles are sitting ducks waiting to be taken advantage of by unscrupulous insurance agents and financial advisors; and even their own prospective employers or partners. This comprehensive volume from Dr. David Marcinko and his co-authors will go a long way toward educating physicians on these critical subjects that were never taught in medical school or residency training.”
—Dr. James M. Dahle, MD, FACEP, Editor of The White Coat Investor, Salt Lake City, Utah, USA
“With time at a premium, and so much vital information packed into one well organized resource, this comprehensive textbook should be on the desk of everyone serving in the healthcare ecosystem. The time you spend reading this frank and compelling book will be richly rewarded.”
—Dr. J. Wesley Boyd, MD, PhD, MA, Harvard Medical School, Boston, Massachusetts, USA
ASSESSMENT: Your thoughts are appreciated.
ORDER TEXTBOOK: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989
SECOND OPINIONS: https://medicalexecutivepost.com/schedule-a-consultation/
INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/
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THANK YOU
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Filed under: "Advisors Only", "Ask-an-Advisor", "Doctors Only", Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc., Managed Care, Recommended Books, Research & Development, Retirement and Benefits, Risk Management, Sponsors, Touring with Marcinko | Tagged: David Edward Marcinko, malpractice, medical risk management, physician risk management, Risk Management for Doctors, risk management for physicians and advisors | Leave a comment »
Call for Manuscripts, Articles, Essays, Comments or Opinions,
Dear Medical and Financial Services Colleagues, Health Economists, CPAs, JDs, Insurance Agents and Consultants
The Medical Executive-Post (ME-P), supported by iMBA Inc., with (ISSN 13: 978-1-4665-5873-1] is currently accepting manuscripts for publication.
The ME-P is an open access, multidisciplinary, international, blind peer-reviewed and non-peer-reviewed electronic forum which publishes high-quality solicited and unsolicited research, commentary, opinions, curated news and review articles in English, in all areas of Physician Focused Financial Planning, health economics, finance, accounting, medical practice management, health law, IT, policy and administration.
We have over 50 topic channels.
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LEARN MORE: https://medicalexecutivepost.com/2014/11/02/open-call-for-me-p-contributors/
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COMMENTS APPRECIATED
Thank You
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By Staff Reporters
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The ME-P is a reader-supported publication.
To receive new posts and support our work, consider becoming a free or paid subscriber.
SPONSORSHIPS: https://medicalexecutivepost.com/sponsors/
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CERTIFIED MEDICAL PLANNER: http://www.CertifiedMedicalPlanner.org
THANK YOU
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By Staff Reporters
***
We like to talk: MarcinkoAdvisors@msn.com
Yes. We’re looking for writers & cross-posts.
Send them to us: MarcinkoAdvisors@msn.com
WHAT WE’RE LOOKING FOR
Op-eds. Cross and Re-Posts, Links and Columns. Great ideas for improving physician focused financial planning, health insurance, economics and the financial ecosystem; etc. Pitches for healthcare-focused startups and business. Write-ups of original research. Reviews of new health care products, DME and AI. Data driven analysis of health care trends. Policy proposals; etc.
SPONSORS: https://medicalexecutivepost.com/sponsors/
ADVERTISE: https://medicalexecutivepost.com/2022/01/31/medical-executive-post-free-advertising-consultation/
ADULT LEARNERS: http://www.CertifiedMedicalPlanner.org
CONTACT US: Ann Miller RN MHA CMP
770.448.0769
THANK YOU
***
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Dear Pharmaceutical Company, Financial Services Firm or Corporate Medical Vendor
We often serve as Medical Science Liaison [MSL] for pharmaceutical companies, at medical seminars and/or financial services organization meetings. Based on our education, experience and skills, we are confident that we would be a great addition to your team.
My Record
For example, I have a proven record in collaborative leadership with functional healthcare executive management experience to develop and implement coordinated strategies designed to deliver top line growth; drive organizational change and enhance competitive positioning within multiple key markets; enhance relationships and influence physicians; analyze financial, economics, operational and quality measures and ensure health practices are operating within goals and standards.
In this role, I can identify external experts (KOLs), and engage, enhance, and build relationships by listening and understanding the views of these experts.
An Independent Conduit Link
More importantly, I can bring value to external experts through excellent communication of scientific dialogue. I see this position as a non-promotional conduit link between you and this community. It is one where I fuse scientific knowledge with business acumen to accelerate commercialization success. As a fully independent MSL, I can:
CV and Related Information
And, a formal CV with evidence of national notoriety and gravitas is available with related information online:
CV: Dr. David E. Marcinko CV 2017
Letterhead: Corporate Medical Science Liaison Opportunities
Informative Websites:
Travel is non-problematic from Atlanta. Teaching, speaking, writing and mentoring are areas of expertise. Thank you in advance for your time. Please do not hesitate to contact me if you have any questions.
Cordially,
Dave
Dr. David Edward Marcinko; FACFAS, MBA, CMP™
Filed under: Career Development, Financial Planning, Practice Management, Quality Initiatives, Sponsors, Touring with Marcinko | Tagged: Dr. David Edward Marcinko MBA CMP™, Medical Science Liaison, speaker's, Touring with Marcinko | Leave a comment »
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And, credible sponsors and like-minded advertisers are always welcomed.
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Filed under: Glossary Terms, Information Technology, Sponsors | Tagged: david marcinko, dictionary, dictionary health information technology, DNS, EHRs, EMRs, glossary, health information technology, HIT, HIT glossary, information technology dictionary, IT, NPI, ROM, RSS, USB, www.healthdictionaryseries.com | 2 Comments »
“$1 Million Mistake: Becoming a Doctor”
BY DR. DAVID E. MARCINKO MBA CMP®
SPONSOR: http://www.CertifiedMedicalPlanner.org
CBS Moneywatch published an article entitled “$1 Million Mistake: Becoming a Doctor” Aside from the possibility that devoting one’s life to helping others might be considered a mistake, medical student Dan Coleman was struck by the “$1 million” figure.
Before medical school, he worked in the pharmaceutical industry and even turned down a hefty promotion to his education as soon as possible, rather than defer for a year or two. But, his financial calculations made it fairly obvious that, including benefits, bonuses, and potential promotions, his medical decision was not a $1 million mistake, but was more like a $1.3 million dollar disaster. Still; he opined:
Yet, even today, as we stare down the barrel of the Affordable Care Act, being a doctor is a very desirable job. We may not be famous, but we will be well-respected. We may not be rich, but we will certainly live comfortably. We may work a lot, but we will never be out of work. To future doctors, the young and impecunious, the anti-millionaires, tuition is a mere afterthought. All that matters is the MD.
Source: http://in-training.org/medical-students-the-anti-millionaires-4361
OVER HEARD IN THE MEDICAL STUDENT’S LOUNGE
“We are medical students.
We are young, proud, and righteous.
We have made the hard choice (medicine), but we have cleared the high hurdle (getting into school).
We know healthcare is a difficult, imperfect art, but we are devoted.
We arm ourselves with the weapons of knowledge and compassion, prepared to defend against the onslaught of trauma, disease, and time.
We are here to the bitter end, for our patients and ourselves.
And above all, we know the cost of our choice.
And if we’re lucky, it will stay under 6% interest through graduation”.
Daniel Coleman
[Georgetown University School of Medicine]
First-year Student
Your thoughts are appreciated,
THANK YOU
***
ODER TEXTBOOK: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989
INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-
***
Filed under: "Doctors Only", Career Development, CMP Program, Ethics, Funding Basics, Health Economics, Healthcare Finance, Op-Editorials, Sponsors, Touring with Marcinko | Tagged: ACA, Anti-Millionaire Doctors, David Edward Marcinko, medical student debt | 2 Comments »
By Dr. David Edward Marcinko MBA CMP™
COURTESY: http://www.CertifiedMedicalPlanner.org
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FOREWORD
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ORDER: https://www.r2library.com/Resource/Title/0826102549
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Filed under: Book Reviews, CMP Program, Glossary Terms, Health Economics, Healthcare Finance, iMBA, Inc., Sponsors, Touring with Marcinko | Tagged: Dictionary of Health Economics and Finance, Health Economics, health finance, healthcare economics, Healthcare Finance | Leave a comment »
[By Dr. David E. Marcinko MBA CMP™]
[By Ann Miller; RN, MHA]
Currently, there is a growing dilemma in the financial sales and services industry. It goes something like this:
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:
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:
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.
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“NO MARGIN – NO MISSION”
Within Reason
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BY DR. DAVID E. MARCINKO MBA CMP®
SPONSOR: http://www.CertifiedMedicalPlanner.org
INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-
Your thoughts are appreciated.
THANK YOU
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BY DR. DAVID E. MARCINKO MBA CMP®
THE NEXT GENERATION OF FIDUCIARY FOCUSED FINANCIAL PLANNING AND MEDICAL MANAGEMENT ADVICE FOR DOCTORS
****
VISIT: http://www.CERTIFIEDMEDICALPLANNER.org
CURRICULUM: Enter the CMPs
BE AWARE ALL ADVISORS … NEXT GEN FINANCIAL ADVICE IS HERE?
Are you a financial planner, insurance agent or investment advisor seeking to assist your physician clients with medical practice enhancement solutions, along with healthcare targeted financial planning services, but don’t know where to turn for help?
OR, maybe you’ve already had a bad experience with a young physician or astute healthcare professional client that was actually more informed than you in these areas?
CITE: https://www.r2library.com/Resource/Title/0826102549
OR, a doctor/nurse client who demanded a true fiduciary advisor [not fee-based advice, with no dual licenses and no arbitration clauses] documented in writing].
Read this decade old Federal Government report to learn what can happen when your advisor is not an informed Certified Medical Planner© designated medical management practitioner.
Then, become a Certified Medical Planner© and thrive by helping others …. first!
GOV: https://oig.hhs.gov/fraud/docs/alertsandbulletins/consultants.pdf
True yesterday … more true today.
****
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CONTACT: Ann Miller RN MHA CMP®
Phone: 770-448-0769
EMAIL: MarcinkoAdvisors@msn.com
***
Filed under: "Advisors Only", "Ask-an-Advisor", Career Development, CMP Program, Financial Advisor Listings, Financial Planning, Glossary Terms, Health Economics, Health Insurance, Healthcare Finance, Investing, Risk Management, Sponsors | Tagged: Certified Medical Planner™, CMP, CMP Curriculum, fee-only, fiduciary financial advice, financial advisors, financial planners | Leave a comment »
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By Staff Reporters
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MARKETS: Stocks ticked lower as investors fretted over an upcoming interest rate hike from the Federal Reserve and a potential Russian invasion of Ukraine. With all the chatter of conflict in Europe, everyone’s watching whether oil prices will hit $100 a barrel—they didn’t budge yesterday.
CRYPTO: SEC Chair Gary Gensler said thr crypto firm BlockFi would pay $100 million to the SEC and 32 states over charges that it had violated securities law. The penalty is the agency’s largest ever against a cryptocurrency company. BlockFi, a banklike crypto company backed by Peter Thiel, didn’t admit or deny the SEC’s findings but did agree to stop opening new lending accounts to customers in the US.
METAVERSE: For doctors, nurses and healthcare professionals who’ve spent the last few years hunched over laptops smiling pleasantly into a Zoom meetings, burnout has been pervasive. Zoom fatigue is now a widely recognized work-induced malady studied by university researchers, and many remote workers say they have trouble balancing work and their personal lives. With images on screens surrounding remote healthcare workers like a labyrinthine maze of fun-house mirrors, it might seem like the last thing a burned out medical provider needs is to strap on a VR headset to detach from the rigors of the digital medical workplace.
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Filed under: "Doctors Only", Accounting, Book Reviews, Career Development, CMP Program, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc., Managed Care, Practice Management, Recommended Books, Sponsors, Touring with Marcinko | Tagged: Certified Medical Planner™, CMP™ Course, david marcinko, Dr. David Edward Marcinko MBA CMP™, Financial Management Healthcare, Financial Management Hospitals | 1 Comment »
Reach Industry Pros, Executives and Decision-Makers with Ease
By Ann Miller RN MHA
[Executive-Director]
Thank you for your interest in sponsoring the Medical Executive-Post, the web’s only site integrating medical practice management with personal financial planning for all health care and financial services professionals.
Why should your company sponsor an ad, text message or banner on the ME-P?
Contact me and I’ll e-mail you a rate card. Your support makes a difference!
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Speaker: David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
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| Dear Dr. David Marcinko, With warm wishes for a joyful holiday, we are please to announce that the layout of AJPH is almost back on schedule, following COVID-19 related impacts to our production team. To keep these monthly highlight emails synched, we are going to highlight articles in two issues of AJPH. |
| The December issue of AJPH features multiple articles focused on surveillance, surveys and COVID-19, along with articles discussing physical and mental health of home health care workers, racial and ethnic disparities in the impact of COVID-19 in the active U.S. military and firearm injury & gun violence. Here are a few of the many articles in the December 2021 issue: |
| Reaffirming the Foundations of Public Health in a Time of Pandemic Impact of the COVID-19 Pandemic on Public Health Surveillance and Survey Data Collections in the United StatesNational Health Interview Survey, COVID-19, and Online Data Collection Platforms: Adaptations, Tradeoffs, and New DirectionsPrevalence and Predictors of Home Health Care Workers’ General, Physical, and Mental Health: Findings From the 2014‒2018 Behavioral Risk Factor Surveillance SystemOral Histories of Civic Action to Address HIV/AIDS The mission of AJPH is to advance public health research, policy, practice and education. Toward that goal, the journal also produces monthly podcasts available in English and Chinese at ajph.org. The monthly podcasts are also on iTunes and Google Play. Be on the lookout for more timely research from AJPH, and consider subscribing or becoming an APHA member for full access. AJPH and the Centers for Disease Control and Prevention are seeking papers for an issue on “Ubiquitous Lead: Risks, Prevention-Mitigation Programs and Emerging Sources of Exposure.” Manuscripts must be submitted to AJPH by Jan. 30. For additional information about the supplement, contact T. LeBlanc. Happy Holidays!  Alfredo Morabia, MD, PhD Editor-in-Chief, AJPH @AlfredoMorabia @AMJPublicHealth  Join APHA and get full access to AJPH, the official journal of the American Public Health Association. |
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ME Inc = Going it Alone but with a Team
BY DR. DAVID EDWARD MARCINKO MBA CMP®
SPONSOR: http://www.CertifiedMedicalPlanner.org
The physician, nurse, or other medical professional should easily recognize that there are a vast array of opportunities, obstacles, and pitfalls when it comes to managing one’s finances. Still, with some modicum of effort, the basic aspects of insurance, investments, taxes, accounting, portfolio management, retirement and estate planning, debt reduction, asset protection and practice management can be largely self-taught. Yet, it is realized that nuances and subtleties can make a well-intentioned financial plan fall short. The devil truly is in the details. Moreover, none of these areas can be addressed in isolation. It is common for a solution in one area to cause a new set of problems in another.
Accordingly, most health care practitioners would be well served to hire [independent, hourly compensated and prn] financial help. Unlike some medical problems, financial issues may not cause any “pain” or other obvious symptoms. Medical professionals tend to have far more complex financial situations than most lay people. Despite the complexities of the new world of health reform, far too many either do nothing; or give up all control totally, to an external advisor. This either/or mistake can be costly in many ways, and should be avoided.
In reality, and at various time in their careers, the medical professional needs a team comprised of at least a financial analyst, lawyer, management consultant, risk manager [actuary, mathematician or insurance counselor] and accountant. At various points in time, each member of the team, or significant others, will properly assume a role of more or less importance, but the doctor must usually remain the “quarterback” or leader; in the absence of a truly informed other, or Certified Medical Planner™.
This is necessary because only the doctor has the personal self-mandate with skin in the game, to take a big picture view. And, rightly or wrongly, investments dominate the information available regarding personal finance and the attention of most physicians. One is much more likely to need or want to discuss the financial markets with their financial advisor than private letter rulings by the IRS, or with their estate planning attorney or tax accountant. While hiring for expertise is a good idea, there is sinister way advisors goad doctors into using all their retail services; all of the time. That artifice is – the value of time.
True integrated physician focused and financial planning is at its core a service business, not a product or sales endeavor. And, increasingly money is more likely to be at the top of the list for providers as the healthcare environment is contracting.
So, eschewing the quarterback model of advice, and choosing to self-educate thru this book and elsewhere, may be one of the best efforts a smart physician can make.
ASSESSMENT: Your thoughts are appreciated.
ORDER TEXTBOOK: https://www.routledge.com/Comprehensive-Financial-Planning-Strategies-for-Doctors-and-Advisors-Best/Marcinko-Hetico/p/book/9781482240283
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*****
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By Calvin Wiese MBA CPA CMP ®
Dr. David Edward Marcinko MBA CMP®
SPONSOR: http://www.CertifiedMedicalPlanner.org
A Distance Definition
A rural hospital is defined as a hospital serving a geographic area ten or more miles from the nexus of a population center of 30,000 or more
More specifically, a rural hospital means an entity characterized by one of the following:
·Type A Rural Hospital — small and remote, has fewer than 50 beds, and is more than 30 miles from the nearest hospital.
·Type B Rural Hospital — small and rural, has fewer than 50 beds, and is 30 miles or less from the nearest hospital.
·Type C Rural Hospital — considered rural and has 50 or more beds.
Citation: https://www.r2library.com/Resource/Title/0826102549
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SELF-BRANDING IN THE MODERN ERA
By Dr. David Edward Marcinko MBA CMP©
SPONSOR: http://www.CertifiedMedicalPlanner.org
In 1987 the magazine Fast Company published an article authored by Tom Peters entitled “The Brand Called You.” Although some individuals may shy away from the concept of self-branding in actuality, many of the online social network sites such as Facebook become media by which we in fact brand ourselves.
In his article, Peter’s stated. “Regardless of position, regardless of the business we happen to be in, all of us need to understand the importance of branding. We are CEOs of their own companies: Me Inc. to be in business today, our most important job is to be head marketer for the brand called you.”
As a medical practitioner how do you differentiate yourself from others in your specialty and why should a new patient choose your practice above those of the others in the field?
Branding is about finding your big idea and building your identity and game plan around it. The bottom line: if you can’t explain who you are, and the value you bring to your practice in a short sentence or two, you have work to do.
According to Catherine Kaputa, a personal coach she suggests that there are the objective things: your credentials, the schools you went to, your years of experience, and your skill set, which represent what she refers to as hard power. Then there’s soft power: your image and reputation, your visibility in the community, your network of contacts, supporters and mentors. In today’s competitive marketplace, soft power plays a vital role in attracting people to you and your practice.
Standing Out
Peters suggests that everyone has a chance to stand out. Everyone has a chance to learn, improve, and build up their skills. Everyone has a chance to be a brand worthy of remark. Corporations spend millions of dollars creating and maintaining their distinct brand.
The Olympic Rings are representative of a brand which the International Olympic Committee guards zealously. Professional services firms such as McKinsey, foster self-branding among their employees. Major corporations have as employees those individuals who are smart, motivated and talented. Self-branding allows the employees to differentiate themselves from their peers. For one to engage in self-branding is first necessary to ask the question,
“What is it that my practice does that makes it different?”
You can begin by identifying the qualities or characteristics that make you distinctive from your competitors-or your colleagues.
What have you done lately-this week-to make yourself stand out? What would your colleagues say is your greatest and clearest strength?
What would they say is your most noteworthy personal trait? As a practitioner does your customer get dependable, reliable service that meets his or her strategic needs?
In addition, ask yourself: “what do I do that adds remarkable, measurable, distinguished distinctive value.”
Business Cards
While we are on the topic of mass media look at your business card and check to see if it has a distinctive logo on it. Keep in mind that packaging counts.
Getting and using power, intelligently, responsibly, and powerfully are essential skills for growing your brand. One of the things that attract us to certain brands is the power they project. Power, is largely a matter of perception. If you want people to see you as a powerful brand, act like a credible leader.
Another technique advocated by Peters is developing loyalty among your patients. In addition, you yourself need to be loyal to your colleagues, your staff, patients and to yourself.
Another way in which you can begin to promote yourself is, with a personal visibility campaign; getting yourself on a panel discussion with signing up to make a presentation at a workshop. If you are a medical writer, try writing about the corona pandemic, or contributing a column on a regular basis to your local newspaper. Community newspapers and professional newsletters are always seeking articles to fill the space. Not only does it give you the opportunity to express yourself it also is an excellent means to expose your practice and your capabilities to a mass audience.
ASSESSMENT: Your thoughts are comments are appreciated.
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INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/
THANK YOU
Filed under: Book Reviews, Career Development, CMP Program, iMBA, Inc., Marketing & Advertising, Recommended Books, Sponsors, Touring with Marcinko | Tagged: brands, Certified Medical Planner™, CMP Program, David Edward Marcinko, doctor marketing, medical advertising, medical branding, physician advertising, physician branding | 1 Comment »
By Dr. David Edward Marcinko MBA CMP®
SPONSOR: http://www.CertifiedMedicalPlanner.org
CORPORATE PRACTICE OF MEDICINE (CPM) LAWS
OK – I admit that I am not an attorney. But, approximately half of states in the U.S. have made it unlawful for practicing physicians to be employees of corporations. This ban on the corporate practice of medicine (CPM) is intended to keep medical professionals independent and free from financial pressures and influence.
Most states have made exceptions allowing physicians to become employees of not-for-profit organizations and sometimes hospitals. States such as California, Iowa, and Texas, have declined to allow hospitals to employ physicians, although even those states have special exceptions. Iowa hospitals may employ pathologists and radiologists, and Texas public hospitals and California teaching hospitals may employ physicians. Ohio has no ban on the corporate practice of medicine.
ASSESSMENT: Anyone can own a physician practice in Ohio.
QUERY: So, who does the aggrieved patient sue?
YOUR THOUGHTS ARE APPRECIATED
ORDER TEXTBOOK: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989
INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/
THANK YOU
***
Filed under: "Doctors Only", Career Development, CMP Program, Ethics, Health Law & Policy, Professional Liability, Risk Management, Sponsors | Tagged: certified medical planner, CMP, corporate practice medicine, CORPORATE PRACTICE OF MEDICINE LAWS, David Edward Marcinko, medical risk management | Leave a comment »
SPONSOR: http://www.CertifiedMedicalPlanner.org
SECOND OPINIONS: https://medicalexecutivepost.com/schedule-a-consultation/
INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/
THANK YOU
***
Filed under: "Advisors Only", "Doctors Only", Accounting, Book Reviews, Career Development, CMP Program, Ethics, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc., Information Technology, Insurance Matters, Managed Care, Marketing & Advertising, Media Mentions and PR, Practice Management, Practice Worth, Professional Liability, Quality Initiatives, Recommended Books, Research & Development, Risk Management, Sponsors, Touring with Marcinko | Tagged: Business of Medical Practice, Certified Medical Planner™, CMP, David Edward Marcinko | Leave a comment »
[By Staff Reporters]
The concept of a self-taught and student motivated, but automated outcomes driven classroom may seem like a nightmare scenario for those who are not comfortable with computers.
Now everyone can breathe a sigh of relief, because the Institute of Medical Business Advisors just launched an “automated” final examination review protocol that requires no programming skill whatsoever.
In fact, everything is designed to be very simple and easy to use. Once a student’s examination “blue-book” is received, computerized “robotic reviewers” correct student assignments and quarterly test answers. This automated examination model lets the robots correct tests and exams, while the students concentrate on guided self-learning.
Assessment
According to Eugene Schmuckler PhD MBA MEd, Dean of the CERTIFIED MEDICAL PLANNER® professional designation and certification program,
“This option allows the modern adult-learner save both time and money as s/he progresses toward the ultimate goal of board certification as a CMP® mark holder.”
The trend is growing and iMBA, Inc., is leading the way.
THANK YOU
***
Filed under: Breaking News, Career Development, CMP Program, iMBA, Inc., Op-Editorials, Research & Development, Sponsors | Tagged: Certified Medical Planner™, CMP Program, CMP www.CertifiedMedicalPlanner.com, CMP™ Class, robo advisors, robo planners | Leave a comment »
By Dr. David Edward Marcinko MBA CMP™
Sponsored: http://www.CertifiedMedicalPlanner.org
According to colleague David K. Luke MIM, MS-PFP, CMP™ the current structure of the life insurance industry regarding cash-value life insurance policies with most major insurance companies is to reward the selling agent with the entire commission upfront on a newly issued policy. The criticism to this practice is that this of course reduces the needed client-agent reviews and interaction and generates more “churning” and “flipping”. Unscrupulous agents are tempted to sell physician-clients another policy for another commission rather than encourage them to maintain and keep their existing policy, which most likely would have lower costs than any new policy considering the client was younger and most likely in better health with the existing contract. A model in which the insurance agent would have a financial incentive for their client’s continued patronage could create a win-win for both parties. We see this “pay as you” model currently operating successfully with wealth advisors and property/casualty agents, why not life insurance agents [personal communication]?
There are some flaws to this argument. The reality is that the captive life insurance industry and their agents prefer this form of lump compensation. The claim is that selling an individual a life insurance policy (the ultimate intangible product) is hard work, and likewise the 70% – 110% of the first year premium is fair compensation for the efforts. For existing agents to reduce their current income to a fraction of this commission upfront, but convert it into a trail over a multiyear period is actually quite distasteful. Therefore, this change will likewise not be initiated from the Insurance agent or insurance industry side unless other forces prevail.
The drive by the consumer to change this up front lump form of compensation has not yet presented itself in full force. After all, why does the consumer care about how the agent is paid if the consumer is satisfied with the end result? One must acknowledge that the drive to reduce commissions and up front loads in the investment advisory business was driven by the consumer that insisted on lower fees and costs.
However, the relevant costs of a life insurance policy are not quite as obvious. Only by comparing a quote from different companies can a consumer compare costs, and even then it is unknown and not understood how the pricing mechanisms used by the insurance company work. The advent of non-agent sold policies however is decreasing the cost of life insurance (there is no big commission check written to the selling agent) and is hitting the radar of consumers. The consumer can notice this difference if the consumer compares the proposed agent sold policy premium with one sold directly by a financial institution such as USAA or AARP. These companies have a work force of sales people that are compensated primarily on salary. Likewise the company can structure more competitive pricing, and in effect offers a levelized cost (in place of commission) insurance product.
Textbook Order: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989
For example, Mark Maurer CFP® of Low Load Insurance Services believes that a levelized compensation basis will not occur unless all the insurance companies were to go to such a plan all at once. If an agent can “pick and choose” he/she may use a “levelized compensation” policy when in a competitive situation, as such a policy should in theory make a policy more inexpensive. An agent would then use the higher “front-end” policy when there is a large up-front premium or in a scenario with limited competition. Mark believes the answer to the whole argument is full disclosure. Both agents and home offices would not want the purchaser to know that 100% or more of their premium is going to sales costs and then products would then get better [personal communication].
The insurance industry has a powerful lobby in Washington. Only market pressure will cause a change in this decades old insurance industry practice that has made many life insurance policies expensive and inefficient. Pricing from non-agent sold life insurance companies will be the impetus that drives the old-line Insurance companies to restructure their commissions to agents.
Insurance agents also remember the days of 8% load mutual fund commissions and minimum $60 dollar commissions on stock trades in the late 1980’s! That is an inflation equivalent of more than $130 per trade, minimum commission, today. The current investing world would laugh at these costs [charges] today. When the physician-consumer realizes, through full disclosure and outside competitive market pressures, that life insurance protection can be more affordable from other non-traditional channels, then s/he will insist on a better, more affordable product.
Ultimately, the big agent driven life insurance companies will have to change their commission structure. The transition is currently in process. Only time will tell now [personal communication].
Your thoughts are appreciated.
THANK YOU
***
Filed under: Experts Invited, iMBA, Inc., Insurance Matters, Sponsors | Tagged: david luke, insurance agents, insurance sales commissions, Level Life Insurance | 1 Comment »
Readers, Visitors, Clients and Friends
[By Sean G. Todd; Esq. M. Tax, CFP©, CPA]
Greetings … This ME-P will have nothing to do with finances / money / taxes / healthcare / the economy … or all the other things you are hearing about 24/7 – don’t stop reading though. It’s merely about the most exciting 2 minutes in sports; always held on the 1st Saturday in May … a tradition lasting 145 years … can you think of what it is?
Kentucky Derby
You’re right! — 146th running of the Kentucky Derby. The “Run for the Roses” is set for [today] Sept 5th, 2020. Here are several reasons why the Kentucky Derby is such a tradition.
Twin Spires
Throughout the world, the Twin Spires are a recognized landmark that has become symbolic to Churchill Downs. Constructed in 1895, the Spires were the creation of a twenty-four-year-old draftsman, Joseph Dominic Baldez. Surpassing a century after being built, the Twin Spires continue to greet the winner of the Kentucky Derby and stand as a familiar beacon to horse racing enthusiasts everywhere.
The Trophy
Since the 50th running of the Kentucky Derby in 1924, Churchill Downs has annually presented a gold trophy to the winning owner of the famed “Run for the Roses.” History is unclear if a trophy was presented in 1875 to the winner of the first Kentucky Derby, and trophy presentations were sporadically made in following years. Finally, in 1924, legendary Churchill Downs President Matt Winn commissioned that a standard design be developed for the “Golden Anniversary” of the Derby.
To commemorate Derby 125 a change was made and the horseshoe was turned 180 degrees so that its ends pointed up. The trophy now annually incorporates the horseshoe with the ends pointing up. Racing superstition decrees that if the horseshoe is turned down all the luck will run out.
Since 1975, the trophy has been created by New England Serling located in North Attleboro, MA. The trophy, which is topped by an 18-karat gold horse and rider, includes horseshoe shaped handles, is 22 inches tall and weighs 56 ounces, excluding its jade base. The entire trophy is handcrafted with the exception of the horse and rider that are both cast from a mold.
To complete the trophy by April, craftsmen begin the process during the fall of the previous year and literally work hundreds of hours. The trophy is believed to be the only solid gold trophy that is annually awarded the winner of a major American sporting event.
***
***
Mint Julep
The Mint Julep has been the traditional beverage of Churchill Downs and the Kentucky Derby for nearly a century. Each year; almost 120,000 Early Times Mint Juleps are served over the two-day period of the Kentucky Oaks and Kentucky Derby.
Hit Parade
The second most entertaining parade next to the Kentucky Derby post parade is the parade of hats on display at Churchill Downs. From the fantastic to the sublime, there are no rules or limits. Does a Derby hat improve one’s luck at picking winners? Some say; “yes, it certainly helps.”
Assessment
Be sure to take a moment out of your day and participate in the running of 145th Kentucky Derby. As always, make the most of each day!
MORE: https://www.nytimes.com/2018/05/01/sports/kentucky-derby-draw-odds.html
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.
Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
Filed under: Op-Editorials, Sponsors | Tagged: Joseph Dominic Baldez, Kentucky Derby, Kentucky Oaks, Matt Winn, Mint Julep, New England Serling, run for the roses, Twin Spires | 15 Comments »
SPONSORED
HOSPITAL AND HEALTH CARE OPERATIONS, ORGANIZATIONAL BEHAVIOR AND FINANCIAL MANAGEMENT COMPANION TEXT BOOK SET
***
[Foreword Dr. Phillips MD JD MBA LLM]
[Foreword Dr. Nash MD MBA FACP]
***
PURCHASE TODAY – FLOURISH TOMORROW!
Filed under: Health Insurance, Health Law & Policy, Healthcare Finance, Practice Management, Practice Worth, Recommended Books, Sponsors | Tagged: Financial Management Strategies for Hospitals, HOSPITAL AND HEALTH CARE OPERATIONS | 2 Comments »
Sponsored Advertisement
MentorHealth, the sponsor of these ME-P webinars, is a comprehensive training source for healthcare professionals that is high on value, but not on cost. MentorHealth is the right training solution for physicians and healthcare professionals. With MentorHealth webinars, doctors can make the best use of time, talent and treasure to benefit their continuing professional education needs.
So, it is no wonder why they partnered up with the ME-P to produce these three exciting and timely Webinars, delivered by our own Publisher-in-Chief and Distinguished Professor David Edward Marcinko.
***
A Medical Malpractice Trial From The Doctor’s POV
Even among the sciences, medicine occupies a special position. Its practitioners come into direct and intimate contact with people in their daily lives they are present at the critical transitional moments of existence.
For many people, they are the only contact with a world that otherwise stands at a forbidding distance. Often in pain, fearful of death, the sick have a special thirst for reassurance and vulnerability to belief. When this trust is violated, whether rooted in factual substance or merely a conclusion lacking in reality, American jurisprudence offers several remedies with the core being civil litigation.
We have personally witnessed a spectrum of reasons that prompts a patient to seek the counsel of an attorney.
Monday, February 6, 2017
10:00 AM PST | 01:00 PM EST
60 Minutes
$139.00
Medical Workplace Violence Issues
Violence in hospitals usually results from patients, and occasionally family members, who feel frustrated, vulnerable, and out of control.
Transporting patients,long waits for service,inadequate security, poor environmental design, and unrestricted movement of the public are associated with increased risk of assault in hospitals and may be significant factors in social services workplaces as well. A lack of staff training and the absence of violence prevention programming are also associated with the elevated risk of assault in hospitals.
Although anyone working in a hospital may become a victim of violence, nurses and aides who have the most direct contact with patients are at higher risk.
Wednesday, February 22, 2017
10:00 AM PST | 01:00 PM EST
60 Minutes
$139.00
Within the medical practice, clinic, hospital or university setting, faculty and supervisors exercise significant power and authority over others. Therefore, primary responsibility for maintaining high standards of conduct resides especially with those in faculty and supervisor positions. Members of the medical faculty and staff, including graduate assistants, are prohibited from having “Amorous Relationships”with students over whom they have “Supervisory Responsibilities.”
“Supervisory Responsibilities”are defined as teaching, evaluating, tutoring, advocating, counseling and/or advising duties performed currently and directly, whether within or outside the office, clinic or hospital setting by a faculty, staff member or graduate assistant, with respect to a medical, nursing or healthcare professional student.
Such responsibilities include the administration, provision or supervision of all academic, co-curricular or extra- curricular services and activities, opportunities, awards or benefits offered by or through the health entity or its personnel in their official capacity.
Monday, March 13, 2017
10:00 AM PST | 01:00 PM EST
60 Minutes
$139.00
***
WEBINAR NOTE: These are online interactive training courses using which, professionals from any part of the world have the opportunity to listen to and converse with some of the best-known experts in the HR Industry. These are offered in live & recorded format for single & multiple users (corporate plans). Under recorded format each user gets unlimited access for six months. Corporate plans give you the best return on your investment as we do not have upper limit on the number of participants who can take part in webinar.
***
Filed under: iMBA, Inc., Op-Editorials, Professional Liability, Risk Management, Sponsors, Touring with Marcinko, Videos | Tagged: david marcinko, Malpractice Liability, malpractice trials, medical workplace violence, MentorHealth, Sexual Harassment Issues | 1 Comment »
Sponsored Advertisement
MentorHealth, the sponsor of these ME-P webinars, is a comprehensive training source for healthcare professionals that is high on value, but not on cost. MentorHealth is the right training solution for physicians and healthcare professionals. With MentorHealth webinars, doctors can make the best use of time, talent and treasure to benefit their continuing professional education needs.
So, it is no wonder why they partnered up with the ME-P to produce these three exciting and timely Webinars, delivered by our own Publisher-in-Chief and Distinguished Professor David Edward Marcinko.
***
A Medical Malpractice Trial From The Doctor’s POV
Even among the sciences, medicine occupies a special position. Its practitioners come into direct and intimate contact with people in their daily lives they are present at the critical transitional moments of existence.
For many people, they are the only contact with a world that otherwise stands at a forbidding distance. Often in pain, fearful of death, the sick have a special thirst for reassurance and vulnerability to belief.
When this trust is violated, whether rooted in factual substance or merely a conclusion lacking in reality, American jurisprudence offers several remedies with the core being civil litigation. We have personally witnessed a spectrum of reasons that prompts a patient to seek the counsel of an attorney.
Monday, February 6, 2017
10:00 AM PST | 01:00 PM EST
60 Minutes
$139.00
Medical Workplace Violence Issues
Violence in hospitals usually results from patients, and occasionally family members, who feel frustrated, vulnerable, and out of control. Transporting patients,long waits for service,inadequate security, poor environmental design, and unrestricted movement of the public are associated with increased risk of assault in hospitals and may be significant factors in social services workplaces as well.
A lack of staff training and the absence of violence prevention programming are also associated with the elevated risk of assault in hospitals.
Although anyone working in a hospital may become a victim of violence, nurses and aides who have the most direct contact with patients are at higher risk.
Wednesday, February 22, 2017
10:00 AM PST | 01:00 PM EST
60 Minutes
$139.00
Within the medical practice, clinic, hospital or university setting, faculty and supervisors exercise significant power and authority over others. Therefore, primary responsibility for maintaining high standards of conduct resides especially with those in faculty and supervisor positions.
Members of the medical faculty and staff, including graduate assistants, are prohibited from having “Amorous Relationships”with students over whom they have “Supervisory Responsibilities.” “Supervisory Responsibilities”are defined as teaching, evaluating, tutoring, advocating, counseling and/or advising duties performed currently and directly, whether within or outside the office, clinic or hospital setting by a faculty, staff member or graduate assistant, with respect to a medical, nursing or healthcare professional student.
Such responsibilities include the administration, provision or supervision of all academic, co-curricular or extra- curricular services and activities, opportunities, awards or benefits offered by or through the health entity or its personnel in their official capacity.
Monday, March 13, 2017
10:00 AM PST | 01:00 PM EST
60 Minutes
$139.00
***
MORE:
http://www.mentorhealth.com/control/webinarsearch?speaker_id=41224
***
WEBINAR NOTE: These are online interactive training courses using which, professionals from any part of the world have the opportunity to listen to and converse with some of the best-known experts in the HR Industry. These are offered in live & recorded format for single & multiple users (corporate plans ). Under recorded format each user gets unlimited access for six months. Corporate plans give you the best return on your investment as we do not have upper limit on the number of participants who can take part in webinar.
***
Filed under: iMBA, Inc., Insurance Matters, Interviews, Practice Management, Professional Liability, Risk Management, Sponsors, Videos | Tagged: A Medical Malpractice Trial From The Doctor's POV, david marcinko, Medical Workplace Violence Issues, MentorHealth, Romantic Patient Advances | 1 Comment »
By Ann Miller RN MHA
[Executive Director]
***
NOTEWORTHY LINKS
***
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Handwashing Revisited for Laymen and Physicians
[By Staff Reporters]
Some laymen in the office were recently wondering about hand washing. Why do we wash our hands after using the restroom? Why do we not wash our hands prior to “doing our business”? And is it really necessary to wash every single time?
So, after some research, the short answer to that last question seems to be a resounding yes. Want to know why?
Source: tradewindsimports.com
Publisher’s Note:
As most ME-P readers are aware, I am a HAI fanatic and even edited and wrote a medical textbook on bone and soft tissue extremity infections, back in the day. And so, for our medical professional readers, this encore report by www.PodiatryPrep.com will review surgical sterilization and disinfection procedures for doctors and surgeons.
Link: Surgical Sterilization and Disinfection
Dr. David Edward Marcinko MBA
Channel Surfing the ME-P
Have you visited our other topic channels? Established to facilitate idea exchange and link our community together, the value of these topics is dependent upon your input. Please take a minute to visit. And, to prevent that annoying spam, we ask that you register. It is fast, free and secure.
Conclusion
Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
Filed under: Career Development, Professional Liability, Sponsors | Tagged: Dr. David Marcinko, HAIs, hand washing, hospital acquired infections, nosocomial infections, The Joy of Healthy Hands, www.PodiatryPrep.com | 6 Comments »
What it is – How it Works
ADVERTISEMENT
This graphic is the first in a potential series, looking at the use of visualization in medicine. As a medical service company, we are passionate about advances in technology, and the impact they have on people’s lives.
Assessment
This image is provided as a free resource from Acclarent UK (under a Creative Commons License) for anyone who wishes to use it.
Conclusion
And so, your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos
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:
Health Dictionary Series: http://www.springerpub.com/Search/marcinko
Practice Management: http://www.springerpub.com/product/9780826105752
Physician Financial Planning: http://www.jbpub.com/catalog/0763745790
Medical Risk Management: http://www.jbpub.com/catalog/9780763733421
Healthcare Organizations: www.HealthcareFinancials.com
Physician Advisors: www.CertifiedMedicalPlanner.com
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Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise
Filed under: iMBA, Inc., Professional Liability, Sponsors | Tagged: Acclarent UK, MRI, NMRI | 1 Comment »
Our Newest ME-P “Thought-Leader”
By Ann Miller RN MHA
[Executive-Director]
Mr. John Deutsch has been a vital component in the exponential growth of numerous healthcare IT and internet companies over the last ten years. He has benefited immensely from a unique mix of professional experiences, boasting a strong background in both marketing and technology.
HIT and EMRs
John deems the emerging field of healthcare technology a significant opportunity to advance today’s healthcare. He is dedicated to delivering solutions to physicians that translate into a greater overall efficiency and a higher level of care. John has worked in the development of four Electronic Medical Record / Patient Portal software solutions and is the founder of Medical Web Experts – a web consulting firm which has helped hundreds of healthcare practices convert to an EMR solution.
CEO of Medical Web Experts (New Wave Enterprises LLC)
John is also the founder and CEO of Medical Web Experts, a web development agency specializing in patient portal technology, EMR, practice marketing and web design. He oversees the development of their flagship patient portal solution (The Medical Web Experts Enterprise Patient Portal) and directs their internet marketing channel. John founded New Wave in 2003, and he oversees the rapid growth of the company by directing upper management and by developing strategic partnerships with other vendors. He was the co-founder of EMR Experts LLC – a EMR consulting firm. His extensive experience in helping physicians to grow and streamline their businesses has resulted in hundreds of physicians utilizing his solutions.
Link: http://www.medicalwebexperts.com
John Deutsch
President/CEO
Medical Web Experts
Tel: 619-819-8610
Fax: 619-923-2155
www.medicalwebexperts.com
Assessment
Please give Mr. John Deutsch a warm ME-P welcome. Be sure to visits his websites, read his upcoming posts and comments, and tell us what you think?
Conclusion
And so, your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos
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:
Health Dictionary Series: http://www.springerpub.com/Search/marcinko
Practice Management: http://www.springerpub.com/product/9780826105752
Physician Financial Planning: http://www.jbpub.com/catalog/0763745790
Medical Risk Management: http://www.jbpub.com/catalog/9780763733421
Healthcare Organizations: www.HealthcareFinancials.com
Physician Advisors: www.CertifiedMedicalPlanner.com
Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.
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Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.
Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise
Filed under: Breaking News, Information Technology, Sponsors | Tagged: EliteHealth MD, EMR Experts, EMRs, HIT, Inc., John Deutsch, New Wave Enterprises | Leave a comment »
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By Ann Miller RN MHA
Who They Are
Mackson Consulting is a premier IT services firm headquartered in Reston, Virginia with a focus on straightforward approaches to optimizing business results. Mackson develops and integrates complete systems of all sizes.
For every engagement they bring to bear our unique combination of technical expertise, broad experience to quickly understand our customer environments, and strong systems engineering and program management skills. Their focus is on optimizing the business results of our clients and resolving problems of crucial importance to our nation.
Capabilities
Assessment
Mackson is a professional services and technology solutions provider specializing in application development, enterprise architecture and project management services. They provide a wide variety of IT services to both public sector and commercial clients.
Contact:
Carol S. Miller BSN, MBA
Mackson Consulting LLC
1818 Library Street
Suite 500
Reston, Virginia 20190
Filed under: Information Technology, Practice Management, Sponsors | Leave a comment »
Invitation to Respond
By Prof. Hope Rachel Hetico; RN MHA CPHQ CMP™
[Managing Editor]
Dear ME-P Readers and Subscribers,
On behalf of the Medical Executive-Post, I would like to invite you to become a member of the ME-P Partner Research Panel (MPRP) for 2011. This panel presents a chance for a limited number of M-E-P participants to have their voices heard through ongoing research studies with the www.MedicalBusinessAdvisors.com [iMBA, Inc].
The insights and suggestions of this vital partner community help shape products and programs which are critical to our mutual success.
The MPRP Panel
The MPRP panel is composed of ME-P readers and subscribers who have agreed to participate in a research program which asks their opinions via surveys typically once or twice a month. Most of your feedback would be submitted online, although there may be opportunities to participate in more in-depth types of research throughout the year. In all cases, it is up to you whether you choose to participate in the research request. All responses remain confidential and are reported only in aggregate.
Building Out the Process
As we continue to build out this process we are seeing greater internal iMBA Inc management participation and interest. External ME-P product development groups and business teams are asking for MPRP insights, as well. Complete studies have been developed around some topics, while at other times MPRP members have been asked to help with focus group activities and in-depth interviews. The help provided by the MPRP is not only appreciated by iMBA Inc, but has become vital to our work here at the ME-P.
Registration Required
I hope you will become a part of this new, vital component of the MPRP network. The registration process requires only a click on the “Join Us” tab, or confirmation-reply email to: MarcinkoAdvisors@msn.com Your membership will be a powerful way to present your thoughts and opinions to the management and staff of the ME-P. Please call us [770-448-0769] with queries, and/or “click” or email register now.
Assessment
You’ve probably already noticed that we have asked two of our valued research partners and sponsors www.CertifiedMedicalPlanner.com to assist us in managing and maintaining the many details of the panel. The CMP™ program has been involved with partner research on an ongoing basis for more than five years. Over time, you will become familiar with both www.MedicalBusinessAdvisors.com and www.CertifiedMedicalPlanner.com as two of the primary contacts for the ME-P Partner Research Panel.
Conclusion
Thanks for your participation in the ME-P Partner Network. I look forward to hearing more from you in the future. And so, your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, 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 and http://www.springerpub.com/Search/marcinko
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Health Dictionary Series: http://www.springerpub.com/Search/marcinko
Practice Management: http://www.springerpub.com/product/9780826105752
Physician Financial Planning: http://www.jbpub.com/catalog/0763745790
Medical Risk Management: http://www.jbpub.com/catalog/9780763733421
Healthcare Organizations: www.HealthcareFinancials.com
Physician Advisors: www.CertifiedMedicalPlanner.com
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Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.
Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise
Filed under: CMP Program, Research & Development, Sponsors | Tagged: CMP, hope hetico, institute of medical business advisors, medical executive post, research and development, www.certifiedmedicalplanner.com, www.medicalbusinessadvisors.com | Leave a comment »
By Ann Miller RN, MHA
[Executive-Director]
A Unique Advertising Model
We’ve taken a unique approach with our advertising model. We don’t necessarily sell rotation banner ads. We sell article sponsorship and content. What this means is that we will pair your product or company with an article we [or you] have written covering a topic that logically connects to your company or product. Your ad is then embedded into the article for all time. The article, outfitted with your witty ad, will continue to exist indefinitely in our searchable archives.
Generating Targeted Traffic
Your purchase of a single ad will continue to generate traffic every time a ME-P reader seeks out information on the topic we’ve tied to your product or company. Check out the example below of a massage company ad strategically paired and embedded within a heart article.
Sample Heart: https://medicalexecutivepost.com/2010/08/14/about-theheart-org/
Contact: www.MarcinkoAdvisors@msn.com
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
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Our Other Print Books and Related Information Sources:
Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759
Physician Financial Planning: http://www.jbpub.com/catalog/0763745790
Medical Risk Management: http://www.jbpub.com/catalog/9780763733421
Healthcare Organizations: www.HealthcareFinancials.com
Health Administration Terms: www.HealthDictionarySeries.com
Physician Advisors: www.CertifiedMedicalPlanner.com
Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.
Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos
Sponsors Welcomed
And, credible sponsors and like-minded advertisers are always welcomed.
Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise
Filed under: Marketing & Advertising, Sponsors | Tagged: ME-P, www.MedicalExecutivePost.com | 1 Comment »
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Events-Planner: NOVEMBER 2010
By Staff Writers
“Keeping track of important health economics and financial industry meetings, conferences and summits”
Welcome to this issue of the Medical Executive-Post and our Events-Planner. It contains the latest information on conferences, news, and relevant resources in healthcare finance, economics, research and development, business management, pharmaceutical pricing, and physician/entity reimbursement! Watch for a new Events-Planner each month.
First, a little about us! The Medical Executive-Post is still a relative newcomer. But today, we have almost 175,000 visitors and readers each month from all over the country, in addition to our growing subscriber base. We have been a successful collaborative effort, thanks to your contributions. As a result, we are adding new resources daily. And, we hope the website continues to provide the best place to go for journals, books, conferences, educational resources, tools, and other things you need to establish the value your healthcare consulting and financial advisory intervention.
So, enjoy the Medical Executive-Post and this monthly Events-Planner with our compliments.
A Look Ahead this Month: Now, the important dates:
November 07: World Congress Health Innovation Meeting. Alexandra, VA
November 08: Patient Centered Medical Homes and ACOs, Hartford, CT
November 08: Medical Compliance Meeting in a Post Reform World, Baltimore, MD
November 11: Conducting Effective internal Medical Investigations, HCCA, Orlando, FL
Please send in your meetings and dates for listing in the next issue of our Events-Planner.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest E-Ps delivered to your email box each morning? Just subscribe using the link below. It’s free. You can unsubscribe at any time. Security is assured.
Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos
Filed under: Events-Planner, Recommended Books, Sponsors | Tagged: certified financial planner, david marcinko, financial advisors, healthcare administrators, nurse executives, physician-executives, practice managers, www.certifiedmedicalplanner.com | Leave a comment »
The ME-P is at your Service
By Ann Miller RN MHA [Executive Director]
Do you need to engage physicians and/or their related financial advisors and management consultants? Learn how to use the ME-P’s social media tools to conduct research and create product and brand awareness.
Our ME-P Platform
Accordingly, use the ME-P platform, surveys, polls, publishing, posting and commenting platform, and other advanced online tools like web-casts and pod-casts to reach this highly active advisory and /or physician community:
Assessment
For more info: MarcinkoAdvisors@msn.com
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
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Our Other Print Books and Related Information Sources:
Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759
Physician Financial Planning: http://www.jbpub.com/catalog/0763745790
Medical Risk Management: http://www.jbpub.com/catalog/9780763733421
Healthcare Organizations: www.HealthcareFinancials.com
Physician Advisors: www.CertifiedMedicalPlanner.com
Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.
Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos
Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.
Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise
Filed under: Alerts Sign-Up, iMBA, Inc., Marketing & Advertising, Research & Development, Sponsors | Tagged: david marcinko, ME-P, medical executive post | 3 Comments »
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Early October 2010 Edition
By Douglas B. Sherlock, CFA
In this edition of Plan Management Navigator, we summarize the cost benchmarks of health plans focused on Medicaid.
Administrative Expenses
Core administrative expenses for selected Medicaid focused health plans was 8.4% of premiums in 2009, both overall and in the Medicaid HMO product itself. Comprehensive products had total PMPM costs of $24.90 and the Medicaid HMO product had total PMPM costs of $22.77.
The median values for core administrative expenses for the Medicaid HMO products offered by these health plans were 7.5% of premium and $21.30 PMPM.
Core Costs
Core costs declined by 5.2% PMPM on an as-reported basis compared with a decline of 1.4% last year. Holding product mixes constant, costs declined by 5.8% PMPM compared with a PMPM decline of 1.4% PMPM. Central to the decline was a 13% PMPM decline in Account and Membership Administration costs.
The peer group in this analysis consisted of ten Medicaid plans, which together served 3.9 million members. Of these members, 2.8 million were Medicaid HMO, and this product comprised on average 70.8% of the total.
HealthCare Reform
Health care reform is expected to have a dramatic effect on plans serving Medicaid-eligible members as Medicaid eligibility is expected to increase by 16 million members. But, this takes place in a weak economy which contributes to membership growth while federal and state tax revenues are under pressure. Medicaid health plans are heavily committed to the management of administrative expenses.
Web Conference
We will host a web conference on Tuesday, October 12th from 2:00 PM to 3:00 PM East Coast Time to discuss the summary results. I will offer a brief presentation, followed by questions and answers.
To participate register here: https://www2.gotomeeting.com/register/995011459.
Once registered, dial-in information and a link to connect to the web will be provided in a confirmation email.
Assessment
Link: Navigator Early October 2010
I hope that you find this month’s Navigator of interest and we look forward to your participation on Tuesday.
Sherlock Company
sherlock@sherlockco.com
Ph: 215-628-2289
Fax: 215-542-0690
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Our Other Print Books and Related Information Sources:
Health Dictionary Series: http://www.springerpub.com/Search/marcinko
Practice Management: http://www.springerpub.com/product/9780826105752
Physician Financial Planning: http://www.jbpub.com/catalog/0763745790
Medical Risk Management: http://www.jbpub.com/catalog/9780763733421
Healthcare Organizations: www.HealthcareFinancials.com
Physician Advisors: www.CertifiedMedicalPlanner.com
Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.
Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos
Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.
Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise
Filed under: Alerts Sign-Up, Career Development, Health Economics, Health Insurance, Healthcare Finance, Sponsors | Tagged: CFA, Douglas B. Sherlock, healthcare reform, Medicaid, Medicaid HMO, Plan Management Navigator | 2 Comments »
Tell Us What You Think?
By Ann Miller RN MHA
[Executive-Director]
We believe we have the most intelligent readers and subscribers online today!
And so, please take a few minutes and kindly let us know how and why you like or dislike this blog. Your opinions and feedback are very important to us. Please use the comment space far below.
Masthead: https://medicalexecutivepost.com/2007/11/28/publication-mast-head/
ME-P Advertising
Advertisements are vetted and accepted on this blog; but not approved. Interested advertisers – please contact us. But remember, advertisements on this blog are just advertisements. They are not recommendations or endorsements.
Ads: https://medicalexecutivepost.com/2007/11/11/advertise/
ME-P Note to Publicists
Publicists; please don’t add us to your e-mail distribution lists without asking first. Unsolicited commercial e-mails violate the federal CAN-SPAM Act. Each violation can subject your to a personal fine up to $11,000. We will send one gentle reminder on first violation. A second offense will be reported to the FTC without exception.
However, you may contact us at 770.448.0769 for PR and related promotional activities.
Our Medical Business Textbooks:
Link: http://www.springerpub.com/Search/marcinko
Our Office Business Management CD ROMs:
Link: https://medicalexecutivepost.com/office-checklists-on-cd-rom/
Link: www.HealthcareFinancials.com
Link: www.CertifiedMedicalPlanner.com
Our Financial Planning Handbooks for Doctors
Link: http://www.jblearning.com/catalog/searchresults.aspx [Search: “Marcinko”]
ME-P Disclaimer
We are not all doctors, financial advisors or medical management consultants. But, we do have informed, experienced and personal opinions; sometimes strong, ignorant, or biased. Everything you read here on this blog is the author’s personal opinion, not specific managerial or financial advice. And, we are by no means an expert on anything. We don’t intend to mislead, but our facts, figures, and calculations can be incomplete, inaccurate or plain wrong. The word “you” in a post doesn’t mean literally you, the reader. In most cases it means the author. Please be sure to double check everything if you decide to act on anything we wrote about. The bottom line is this: please don’t blame the ME-P for anything you do.
About: https://medicalexecutivepost.com/2007/10/08/hello-world/
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 and http://www.springerpub.com/Search/marcinko
Get our Widget: Get this widget!
Our Other Print Books and Related Information Sources:
Health Dictionary Series: http://www.springerpub.com/Search/marcinko
Practice Management: http://www.springerpub.com/product/9780826105752
Physician Financial Planning: http://www.jbpub.com/catalog/0763745790
Medical Risk Management: http://www.jbpub.com/catalog/9780763733421
Healthcare Organizations: www.HealthcareFinancials.com
Physician Advisors: www.CertifiedMedicalPlanner.com
Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.
Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos
Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.
Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise
NOW: TELL US WHAT YOU THINK – IN THE COMMENT BOX BELOW
Filed under: CMP Program, Financial Planning, Glossary Terms, iMBA, Inc., Marketing & Advertising, MAST-HEAD, Practice Management, Recommended Books, Sponsors, Surveys and Voting | Tagged: certified medical planner, david marcinko, financial advisors, medical executive post, Practice Management, www.CertifiedMedicalPlanners.com | Leave a comment »
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New Partner Onboard
By Staff Reporters
Dear ME-P Readers and Subscribers,
It is with great pleasure that the firm of D’Alessio & Tocci, LLP [Certified Public Accountants],
welcomes its newest partner M. Howard Pell, CPA.
About M. Howard Pell CPA
Mr. Pell has over 30 years experience in public accounting. He was formally Director of Tax for PKF New York, NY. The company will now be called D’Alessio Tocci & Pell, LLP Certified Public Accountants, and will continue to operate out of its current address:
245 Fifth Ave
Suite 602
New York, NY 10016
with a second address at:
923 Warren Parkway
Teaneck, NJ 07666
Assessment
Visit: http://dalecpa.com/
Conclusion
Feel free to welcome Mr. Pell. Then, subscribe to the ME-P. It is fast, free and secure.
Filed under: Accounting, Sponsors | Tagged: CPA, D'Alessio & Tocci, D'Alessio Tocci & Pell, LLP Certified Public Accountants, M. Howard Pell | Leave a comment »
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