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    As a former Dean and appointed Distinguished University Professor and Endowed Department Chair, Dr. David Edward Marcinko MBA was a NYSE broker and investment banker for a decade who was respected for his unique perspectives, balanced contrarian thinking and measured judgment to influence key decision makers in strategic education, health economics, finance, investing and public policy management.

    Dr. Marcinko is originally from Loyola University MD, Temple University in Philadelphia and the Milton S. Hershey Medical Center in PA; as well as Oglethorpe University and Emory University in Georgia, the Atlanta Hospital & Medical Center; Kellogg-Keller Graduate School of Business and Management in Chicago, and the Aachen City University Hospital, Koln-Germany. He became one of the most innovative global thought leaders in medical business entrepreneurship today by leveraging and adding value with strategies to grow revenues and EBITDA while reducing non-essential expenditures and improving dated operational in-efficiencies.

    Professor David Marcinko was a board certified surgical fellow, hospital medical staff President, public and population health advocate, and Chief Executive & Education Officer with more than 425 published papers; 5,150 op-ed pieces and over 135+ domestic / international presentations to his credit; including the top ten [10] biggest drug, DME and pharmaceutical companies and financial services firms in the nation. He is also a best-selling Amazon author with 30 published academic text books in four languages [National Institute of Health, Library of Congress and Library of Medicine].

    Dr. David E. Marcinko is past Editor-in-Chief of the prestigious “Journal of Health Care Finance”, and a former Certified Financial Planner® who was named “Health Economist of the Year” in 2010. He is a Federal and State court approved expert witness featured in hundreds of peer reviewed medical, business, economics trade journals and publications [AMA, ADA, APMA, AAOS, Physicians Practice, Investment Advisor, Physician’s Money Digest and MD News] etc.

    Later, Dr. Marcinko was a vital recruited BOD member of several innovative companies like Physicians Nexus, First Global Financial Advisors and the Physician Services Group Inc; as well as mentor and coach for Deloitte-Touche and other start-up firms in Silicon Valley, CA.

    As a state licensed life, P&C and health insurance agent; and dual SEC registered investment advisor and representative, Marcinko was Founding Dean of the fiduciary and niche focused CERTIFIED MEDICAL PLANNER® chartered professional designation education program; as well as Chief Editor of the three print format HEALTH DICTIONARY SERIES® and online Wiki Project.

    Dr. David E. Marcinko’s professional memberships included: ASHE, AHIMA, ACHE, ACME, ACPE, MGMA, FMMA, FPA and HIMSS. He was a MSFT Beta tester, Google Scholar, “H” Index favorite and one of LinkedIn’s “Top Cited Voices”.

    Marcinko is “ex-officio” and R&D Scholar-on-Sabbatical for iMBA, Inc. who was recently appointed to the MedBlob® [military encrypted medical data warehouse and health information exchange] Advisory Board.

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Few of Us Remove Gloves Properly

MORE Corona Virus Precautions

By Dr. David Edward Marcinko MBA

Courtesy: www.CertifiedMedicalPlanner.org

If you wear gloves because of Covid-19, and if you don’t take them off properly, you just get everything that was all over the gloves, all over yourself and everything else. As a surgeon for almost two decades, I can tell you that taking gloves off correctly isn’t a trivial thing.

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HOW TO REMOVE: Briefly, you want to pinch one glove near the wrist and pull it over your hand so it ends up inside out. Then hold that in your gloved hand and carefully slip the fingers of your bare hand into the top of the other glove, let it turn inside out and cover the balled-up other glove.

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CDC: Check out this step-by-step CDC infographic. And, if you’re not disposing of them properly, you’re just potentially contaminating more surfaces and putting yourself at a much higher risk. Finally, don’t skip hand washing after you take them off, even if you’ve removed them right.

PODCAST: https://www.bing.com/videos/search?q=how+to+removesurgicalgloves&&view=detail&mid=2607568A504FC540B18D2607568A504FC540B18D&&FORM=VRDGAR&ru=%2Fvideos%2Fsearch%3Fq%3Dhow%2Bto%2Bremovesurgicalgloves%26FORM%3DHDRSC3

Assessment: Your thoughts and comments are appreciated.

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BUSINESS, FINANCE AND INSURANCE TEXTS FOR DOCTORS

1 – https://lnkd.in/ebWtzGg

2 – https://lnkd.in/ezkQMfR

3 – https://lnkd.in/ewJPTJs

THANK YOU

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Medical Laboratory Test SENSITIVITY “versus” SPECIFICITY

Obvious Covid-19 Implications

By Dr. David Edward Marcinko; MBA, CPHQ, CMP

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We’ve discussed biologic false positives and false negatives before on this ME-P.

LINK: https://medicalexecutivepost.com/2019/09/14/what-are-false-positive-and-false-negative-tests/

Courtesy: www.CertifiedMedicalPlanner.org

So, now is the time to discuss and conquer the medical laboratory concepts of Sensitivity and Specificity.

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Sensitivity and specificity are statistical measures of the performance of a binary classification test, also known in statistics as a classification function, that are widely used in medicine.

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

  • Sensitivity (also called the true positive rate, the recall, or probability of detection in some fields) measures the proportion of actual positives that are correctly identified as such (e.g., the percentage of sick people who are correctly identified as having the condition).
  • Specificity (also called the true negative rate) measures the proportion of actual negatives that are correctly identified as such (e.g., the percentage of healthy people who are correctly identified as not having the condition).

LINK: https://www.differencebetween.com/difference-between-sensitivity-and-vs-specificity/

NOTE: The terms “positive” and “negative” don’t refer to the value of the condition of interest, but to its presence or absence; the condition itself could be a disease, so that “positive” might mean “diseased”, while “negative” might mean “healthy”.

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And so, colleague Michael Lawrence Langan MD opines on a much deeper level.

ESSAY: https://disruptedphysician.blog/2016/11/19/diagnostic-testing-101-1-the-importance-of-sensitivity-specificity-and-diagnostic-test-accuracy-5/

Assessment: Your thoughts and comments are appreciated.

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Product DetailsProduct DetailsProduct Details

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BUSINESS, FINANCE AND INSURANCE TEXTS FOR DOCTORS

1 – https://lnkd.in/ebWtzGg

2 – https://lnkd.in/ezkQMfR

3 – https://lnkd.in/ewJPTJs

THANK YOU

***

On Marketing, Advertising and Sales; etc.

Including Public Relations, Risk, Change and Crisis Management

By Dr. David Edward Marcinko MBA

Marketing is the business process of identifying, anticipating and satisfying customers’ needs and wants. It is your unique value proposition or strategic competitive advantage. Marketers can direct product to other businesses or directly to consumers.

Advertising is a marketing communication that employs an openly sponsored, non-personal message to promote or sell a product, service or idea. Sponsors of advertising are typically businesses wishing to promote their products or services. Advertising is communicated through various mass media, including traditional media such as newspapers, magazines, television, radio, outdoor advertising or direct mail; and new media such as search results, blogs, social media, websites or text messages. The actual presentation of the message in a medium is referred to as an advertisement, or “ad” or advert for short.

Advertising is differentiated from public relations in that an advertiser pays for and has control over the message. It differs from personal selling in that the message is non-personal, i.e., not directed to a particular individual. We pay for advertising but pray for public relations.

Sales are activities related to selling or the number of goods or services sold in a given targeted time period. The seller, or the provider of the goods or services, completes a sale in response to an acquisition, appropriation, requisition, or a direct interaction with the buyer at the point of sale. There is a passing of title (property or ownership) of the item, and the settlement of a price, in which agreement is reached on a price for which transfer of ownership of the item will occur. The seller, not the purchaser, typically executes the sale and it may be completed prior to the obligation of payment. In the case of indirect interaction, a person who sells goods or service on behalf of the owner is known as a salesman or saleswoman or salesperson, but this often refers to someone selling goods in a store/shop, in which case other terms are also common, including salesclerk, shop assistant, and retail clerk.

Change management is the discipline that guides how we prepare, equip and support individuals to successfully adopt change in order to drive organizational success and outcomes.

Crisis management is the identification of threats to an organization and its stakeholders, and the methods used by the organization to deal with these threats.

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Risk management is the identification, evaluation, and prioritization of risks (defined in ISO 31000 as the effect of uncertainty on objectives) followed by coordinated and economical application of resources to minimize, monitor, and control the probability or impact of unfortunate events or to maximize the realization of opportunities.

Assessment: Your thoughts are appreciated from a healthcare perspective.

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An Interest Rate Review for Physician-Executives

Managerial Accounting

By Dr. David E. Marcinko MBA

Recently, several major banking institutions have addressed the problem of escalating debt upon graduating physicians, mid-life practitioners and even seasoned healthcare providers; despite historically low rates for prime customers.

Unfortunately, one may still wonder how many clinicians truly appreciate the risks associated with usurious interest rates for homes, cars, medical equipment and other consumer items; as we offer the following review to reduce this peril.

WHITE-PAPER: IRs

Assessment: Your thoughts are appreciated.

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Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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Medical Practice Scheduling Issues

FOR DOCTORS AND PATIENTS, ALIKE

By Dr. David E. Marcinko MBA

Doctor Scheduling Issues

Nothing creates more distress for a new medical practice administrator than “holes”, or empty slots, in a physician’s appointment schedule. While doctors may complain about too much work and not enough time with patients, a corollary is the lack of production that accompanies such downtime.

This scenario is common in January-February [patient insurance deductibles not paid] and August-September [new doctors join existing practices]. An increase in new doctor days, and marginal native practice growth, usually mean space in the daily schedule.

Now, the natural tendency is to try and fill the day. And, it is best if the day is filled by increasing patient services acuity levels. However, a common, but ill-advised approach is to add time to existing patient appointments. So, when a practice accepts a new medical provider, creation of a checklist similar to the one below may be helpful.

LIST:

  1. List appointment types and expected length.
    2. Use booking or scheduling secretarial templates.
    3. Review the templates with booking secretary then make sure they’re followed.
    4. Allow for walk-in or ‘urgent’ visits.
  2. Rather than having a policy of scheduling days or weeks ahead, ask patients if they’d like to come in the same day.
  3. Some physicians have moved to open-access appointments that eliminate traditional time slots altogether. This should be tested short-term before instituting since it is not effective in all markets.
  4. Know your area and know your patient base. If you have a high “no show” rate, you may want to pad in additional access by double-booking on the hour. Certain payers also have members with historically high “no show” rates that should be taken into consideration.
  5. Give yourself at least 60 days to credential the new provider (if they will be billing under your TIN). Otherwise, they may be seeing patients free of charge for some payers where credentialing is not yet completed. Limiting them to self-pay, work comp, non-covered services or patients whose payers have issued a provider number may pose some scheduling obstacles.

The danger of open appointment slots is adding inefficiencies to a schedule by the pressure to fill time. Instead, look at organic practice growth [5-8% annually for a mature practice], the change in provider time and have realistic expectations for open time-slots in the first few years of new practitioner availability [see http://waittimes.blogspot.com, Wait Time & Delayed Care; a blog devoted to helping healthcare providers shorten wait times and improve patient flow].

Patuient Scheduling Issues

Most mature doctors follow a linear (series-singular) time allocation strategy for scheduling patients (i.e., every 15 or 20 minutes).  This can create bottlenecks because of emergencies, late patients, traffic jams, absent office personal, paperwork delays, etc.  Therefore, as proposed by Dr. Neal Baum, a practicing urologist in New Orleans, one of these three newer scheduling approaches might prove more useful. 

 1. Customized Scheduling

The bottleneck problem may be reduced by trying to customize, estimate or project the time needed for the patient’s next office visit. For example:  CPT #99211 (5 minutes), #99212 (10 minutes), #99213 (15 minutes), #99214 (25 minutes), or #99215 (40 minutes). Occasionally, extra time is need, and can be accommodated, if the allocated times are not too tightly scheduled.   

2. Wave Scheduling

Some patient populations do not mind a brief 20-30 minute wait prior to seeing the doctor.  Wave scheduling assumes that no patient will wait longer than this time period, and that for every three patients; two will be on time and one will be late. This model begins by scheduling the three patients on the hour; and works like this. The first patient is seen on schedule, while the second and third wait for a few minutes.  The later two patients are booked at 20 minutes past the hour and one or both may wait a brief time. One patient is scheduled for 40 minutes past the hour. The doctor then has 20 minutes to finish with the last three patients and may then get back on schedule before the end of the hour. 

 3. Bundle Scheduling

Bundling involves scheduling like-patient activities in blocks of time to increase efficiency.  For example, schedule minor surgical checkups on Monday morning, immunizations on Tuesday afternoon, and routine physical examinations on Wednesday evening, or make Thursday kid’s day and Friday senior citizens day. Do not be too rigid, but by scheduling similar activities together, assembly-line efficiency is achieved without assembly line mentality, and allows you to develop the most economically profitable operational flow process possible for the office. 

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 Patient Self Scheduling (Internet Based Access Management) 

The traditional linear patient scheduling system is slowly being abandoned by modern medical practitioners; an all venues (medical practices, clinics, hospitals and various other healthcare entireties). New software programs, and internet cloud applications, allow patients to schedule their own appointments over the internet. The software allows solo or individual group physicians with a practice to set their own parameters of time, availability and even insurance plans. Through a series of interrogatories, the program confirms each appointment. When the patient arrives, a software tracker communicates with office staff and follows the patients from check-in, to procedures, to checkout. Today, many hospitals have even abandoned the check-in or admissions, department. It has been replaced by access management systems.

Automated Medical Office Access Management Systems [Patient Check-In Kiosks]

According to a McLean report published in InfoTech,

“Today’s patients demand the same level of self-service convenience in healthcare that they do in other industries. Medical kiosks save money, reduce wait times, and significantly enhance the patient experience. The payback period for medical kiosks is often as short as 180 days”

Automated medical office access management [AM] or patient self check-in solutions provide a wide range of functionality including patient registration, insurance verification, and demographic-validation, electronically consent form completion, back-end scheduling, financial systems integration, real-time appointment re-scheduling, direction text mapping and way finding; and more.  Often, solutions can be individualized and integrated with HIT systems using HL7, XML, web and other standard data exchange protocols.

Open Access Patient Scheduling

A sub variant of the above is open-access patient self-scheduling, either in full or part. Benefits include reduced patient appointment wait times, matching and scheduling patients with physician, improved continuity of care, increased productivity per patient visits, higher physician compensation and higher net gains for medical offices and clinics.

Real Time Claim Adjudication

Real Time Claim Adjudication [RTCA] or expecting payment at the time of service is becoming the rule, not the exception, in the modern AM era. RTCA makes a medical practice more like other businesses.

Benefit of Automated Medical Office Access Management

  • Streamlines patient flow with focus on improved patient care
  • Real-time insurance verification
  • Capture credit/debit card information with funds verification
  • Improves office cash flow and collections
  • Provides patient payment receipts
  • Decrease accounts receivable [ARs]
  • Save time and office staff resources
  • Increases office return on investment [ROI]
  • Demographic capture and validation improve marketing
  • Continually improve office operations.

Vendors for the above AM processes include: Phreesia.com, KioHealth.com, MediSolve.Ca; VecnaMedical.com; MeridianKiosks.com; AppointmentDesk.com; and KioskMarketPlace.com; etc.

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Five people are sitting in the waiting room of a doctor’s office. Some of the people look tense or upset, and others look completely relaxed.

More: Simple Steps to a Patient Registry: Ticket to Care Coordination, Quality Reporting and Pay for Performance

LINK: http://store.hin.com/Simple-Steps-to-a-Patient-Registry-Ticket-to-Care-Coordination-Quality-Reporting-and-Pay-for-Performance_p_0-3855.html#

Assessment: Your thoughts are appreciated.

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WANT TO JOIN A PRIVATE MICRO-NETWORK?

THE FUTURE VALUE IS IN “WHO” WE CONNECT !

By Dr. David E. Marcinko MBA

Forget amassing “likes”, “smiles”, “winks” or cultivating your online persona. Micro-Networks are all about being your true authentic self with just a select and carefully curated few people; and that’s it! No social influencers, marketers or viral posts. Just micro-segmentation!

THINK: Family members, professional colleagues, neighbors and close friends; sport or class-mates, and co-workers or faculty members in small distinct groups. There is no “network” as you occupy the space with just these people. The total number of participants is pre-determined; 25, 50, 100, 175, 250; etc. And, when reached, the only way to add new members is for existing members to drop out.

“The Vital Few … Not the Trivial Many.”

QUERY: Would you join a micro-network? What cohort of members?

Please comment.

QUERY: Would you pay a small membership surcharge? How much?

Please comment.

ASSESSMENT: Your thoughts and comments are appreciated.

THANK YOU

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The “Chinee Room” Argument of A.I.

On John Searle and his Paper

By Dr David E. Marcinko MBA

The Chinese room argument holds that a digital computer executing a program cannot be shown to have a “mind”, “understanding” or “consciousness”, regardless of how intelligently or human-like the program may make the computer behave.

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The argument was first presented by philosopher John Searle in his paper, “Minds, Brains, and Programs“, published in Behavioral and Brain Sciences in 1980. It has been widely discussed in the years since. The centerpiece of the argument is a thought experiment known as the Chinese room.
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Conclusion: Your thoughts are appreciated.
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