What is a MEME Stock?

MEME ME!

BY PROFESSOR DR. DAVID EDWARD MARCINKO MBA Certified Medical Planner®
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SPONSOR: http://www.CertifiedMedicalPlanner.org

A “MEME” stock isn’t as easily defined as a growth or value stock, so to give it a definitive categorization would be inappropriate. Nor would actually categorizing it alongside growth and value stocks. They won’t be found in textbooks anytime soon, but to overlook their impact could potentially be an expensive oversight.

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

Stonks Meme, Explained: What Can It Teach You About Actual ...

READ: https://blog.mywallst.com/what-is-a-meme-stock/#:~:text=A%20meme%20stock%20isn%E2%80%99t%20as%20easily%20defined%20as,their%20impact%20could%20potentially%20be%20an%20expensive%20oversight.

DIY Textbooks: https://medicalexecutivepost.com/2021/04/29/why-are-certified-medical-planner-textbooks-so-darn-popular/

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

CONTACT: Ann Miller RN MH

[Executive Director]

MarcinkoAdvisors@msn.com

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SIMPLE: The “50-30-20” Budget Rule of Thumb

Try the 50/30/20 rule OF WANTS, NEEDS AND SAVINGS

By Dr. David Edward Marcinko MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

There are varying opinions on how much of your total income should go toward savings and retirement goals each month. Moreover, the answer is likely to vary, depending on your full financial profile.

But if you’re looking for some basic KISS guidelines, consider applying the 50-30-20 rule, a budgeting method that allocates 50% of your income to essentials, like rent and bills, 30% to discretionary spending and 20% to savings.

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

Image shows a pie chart broken up into 50%, 30%, and 20%. Title reads: "The 50/30/20 Budgeting Rule." Under 50% says "Needs: groceries, housing, utilities, health insurance, car payment." Under 30% reads: "Wants: shopping dining out, hobbies." Under 20% says "Savings"

Your thoughts are appreciated.

THE RULE: https://www.thebalance.com/the-50-30-20-rule-of-thumb-453922

THANK YOU

ZERO BASED BUDGET: https://medicalexecutivepost.com/2021/05/24/the-zero-based-budget-for-physicians/https://medicalexecutivepost.com/2015/07/02/can-doctors-achieve-financial-independence-without-budgeting/

EPI BUDGET FACTS: https://www.epi.org/resources/budget/budget-factsheets/

NO BUDGETS: https://medicalexecutivepost.com/2015/07/02/can-doctors-achieve-financial-independence-without-budgeting/

HOUSEHOLD BUDGET: https://medicalexecutivepost.com/2013/10/07/on-setting-your-household-budget-ugh/

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Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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

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TAX DEDUCTIONS: Home Ownership Simplified

Take Full Advantage Of These Tax Deductions

DR. DAVID EWARD MARCINKO MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

The housing market is HOT right now. Lumbar and wood is expensive. Inflation is emerging. So, owning a home can be very lucrative. Seriously, owning a home can not only give you a cheaper monthly payment than renting but in many cases, the tax benefits make the decision a no-brainer.

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

Home ownership falls for first time in a century - Telegraph

Here are a few of the larger deductions that you need to be sure to take:

Interest you pay on your mortgage: If you own a home and don’t have a mortgage greater than $750,000, you can deduct the interest you pay on the loan. This is one of the biggest benefits to owning a home versus renting–as you could get massive deductions at tax time. The limit used to be $1 million, but the Tax Cuts and Jobs Act of 2017 (TCJA) reduced the limit and made some clarifications on deducting interest from a home equity line of credit.

Property taxes: Another awesome benefit to owning a home is the ability to deduct your property taxes. Before TCJA, the rules were a little more flexible and you were able to deduct the entirety of your property taxes. Now things have a changed a bit. Under the new law, you can deduct up to $10,000. The deduction for state and local income taxes was combined with the deduction for state and local property taxes, too.

Tax incentives for energy-efficient upgrades: While most of the tax incentives for making energy-efficient upgrades to your home have gone away, there are still a couple worth noting. You can still claim tax deductions on solar energy–both for electric and water heating equipment, through 2021. The longer you wait, though, the less money you’ll get back. Here’s the percentage of equipment you can deduct, based on time of installation:

Between January 1, 2017, and December 31, 2019 – 30% of the expenditures are eligible for the credit
Between January 1, 2020, and December 31, 2020 – 26%
Between January 1, 2021, and December 31, 2021 – 22%

ASSESSMENT: But, is now the best time to buy a home? Your thoughts are appreciated.

Rent V. Buy: https://medicalexecutivepost.com/2017/03/14/the-apartment-rent-vs-home-buy-decision/

MDs: https://medicalexecutivepost.com/2012/02/15/is-home-renting-for-chumps/

DIY Textbooks: https://medicalexecutivepost.com/2021/04/29/why-are-certified-medical-planner-textbooks-so-darn-popular/

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THANK YOU

***

HOSPITALS and Health Care Organizations

Management Strategies, Operational Techniques, Tools, Templates and Case Studies

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Drawing on the expertise of decision-making professionals, leaders, and managers in health care organizations, Hospitals & Health Care Organizations: Management Strategies, Operational Techniques, Tools, Templates, and Case Studies addresses decreasing revenues, increasing costs, and growing consumer expectations in today’s increasingly competitive health care market.

Offering practical experience and applied operating vision, the authors integrate Lean managerial applications, and regulatory perspectives with real-world case studies, models, reports, charts, tables, diagrams, and sample contracts. The result is an integration of post PP-ACA market competition insight with Lean management and operational strategies vital to all health care administrators, comptrollers, and physician executives. The text is divided into three sections:

  1. Managerial Fundamentals
  2. Policy and Procedures
  3. Strategies and Execution

Using an engaging style, the book is filled with authoritative guidance, practical health care–centered discussions, templates, checklists, and clinical examples to provide you with the tools to build a clinically efficient system. Its wide-ranging coverage includes hard-to-find topics such as hospital inventory management, capital formation, and revenue cycle enhancement. Health care leadership, governance, and compliance practices like OSHA, HIPAA, Sarbanes–Oxley, and emerging ACO model policies are included. Health 2.0 information technologies, EMRs, CPOEs, and social media collaboration are also covered, as are 5S, Six Sigma, and other logistical enhancing flow-through principles. The result is a must-have, “how-to” book for all industry participants.

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

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MEDICARE: Safe Harbor Regulations

Medicare “Safe Harbor” Regulations

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The Medicare Safe Harbor rules were passed in an effort to identify areas of practice that would not lead to a conviction under the anti-fraud statute.  The Safe Harbor regulations provide for eleven areas where providers may practice without violating the anti-fraud statute. 

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

Areas of safe practice under these regulations are briefly highlighted below:

  • Large Entity Investments – Investment in entities with assets over $50 million. The entity must be registered and traded on national exchanges.
  • Small Entity Investments – Small entity investment entities must abide by the 40-40 rule.  No more than 40% of the investment interests may be held by investors in a position to make referrals. Additionally, no more than 40% of revenues can come through referrals by these investors.
  • Space and Equipment Rentals – Such lease agreements must be in writing and must be for at least a one year term. Furthermore, the terms must be at fair market value.
  • Personal Services and Management Contracts – These contracts are allowable as long as certain rules are followed. Like lease agreements, these personal service and management contracts must be in writing for at least a one-year term, and the services must be valued at fair market value.
  • Sale of a medical practice – There are restrictions if the selling practitioner is in a position to refer patients to the purchasing practitioner.
  • Referral services– Referral services (such as hospital referral services) are allowed. However, such referral services may not discriminate between practitioners who do or do not refer patients.
  • Warranties – There is certain requirements if any item of value is received under a warranty.
  • Discounts – Certain requirements must be met if a buyer receives a discount on the purchase of goods or services that are to be paid for by Medicare or Medicaid.
  • Payments to Bona Fide Employees – Payments made to bona fide employees do not constitute fraud under the Safe Harbor Regulations.
  • Group Purchasing Organizations – Organizations that purchase goods and services for a group of entities or individuals are allowed; provided certain requirements are met.
  • Waiver of Beneficiary Co-Insurance and Deductible – Routine waiver would not come under the safe harbor.

A physician’s actions that come under the Safe Harbor Regulations will not violate the Medicare Fraud and Abuse Statutes.  However, the provider must still abide by the Stark amendments and must also abide by applicable state law.

STARK UPDATE: https://medicalexecutivepost.com/2018/08/03/cms-to-review-stark-law-relevance-once-again/

Your thoughts are appreciated.

THANK YOU

***

ORDER TEXTBOOK [3rd]: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko

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ME-P Speaking Invitations

Dr. David E. Marcinko is at your Service

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Dr. David Edward Marcinko MBA CMP® enjoys personal coaching and public speaking and gives as many talks each year as possible, at a variety of medical society and financial services conferences around the country and world.

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

His talks tend to be engaging, iconoclastic, and humorous. His most popular presentations include a diverse variety of topics and typically include those in all iMBA, Inc’s textbooks, handbooks, white-papers and most topics covered on this blog.

CONTACT: Ann Miller RN MHA

MarcinkoAdvisors@msn.com

Ph: 770-448-0769

Abbreviated Topic List: https://medicalexecutivepost.com/wp-content/uploads/2009/02/imba-inc-firm-services.pdf

Second Opinions: https://medicalexecutivepost.com/schedule-a-consultation/

DIY Textbooks: https://medicalexecutivepost.com/2021/04/29/why-are-certified-medical-planner-textbooks-so-darn-popular/

THANK YOU

***

PODCAST: Physician WEDDING Costs

 The Economics of Weddings for Medical Professionals

The average wedding costs about $ 25,525 and medical professionals often spend much more.

Destination Weddings - Dynamic Roadshow

QUERY: Do you want a big wedding party for your family and friends, or an earlier retirement for yourself?

PODCAST: https://www.youtube.com/watch?v=XQBRHJ7aGbM

Your thoughts are appreciated.

THANK YOU

***

Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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

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

***

HOSPITAL EMPLOYER PROVIDED TRANSPORTATION BENEFITS

By Dr. David Edward Marcinko MBA CMP©

SPONSOR: http://www.CertifiedMedicalPlanner.org

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COST COMPARISONS

Example 1: Dr. Kurt purchases an automobile for $15,000.

His hospital business use is 80% and he drives 20,000 total miles per year.  Operating costs for the year, including gasoline, oil, insurance, maintenance, repairs, and license fees, are $4,000. If Kurt owns the car for five years, ownership will cost $35,000 ($4,000 x 5 = $20,000, $20,000 + $15,000 = $35,000), or $7,000 per year. For, each personal use mile costs $1.75 (100% -80% = 20%, 20% x 20,000 miles = 4,000 miles, $7,000/4,000 miles = $1.75). Kurt’s employer reimburses him 34.5 cents per mile for the business-related miles. As a result, the business use of the car is only partially reimbursed (16,000 business miles x 34.5 cents = $5,520).  

However, the business usage costs Kurt $5,600(80% of $7,000). Kurt subsidizes the employer 9.25 cents per mile ($7,000 – $5,520 = $1,480, $1,480 /16,000 = 9.25 cents). Kurt’s total cost of ownership is $1.84 per mile, or $36,850 ($1.88 x 20,000 personal miles over the five-year life).

1

Example 2: Dr. Ben uses a hospital employer-provided vehicle 4,000 miles per year in 2003.

He reimburses the employer 34.5 cents per mile. His cost for five years is $6,900 (5y x 4,000 = 20,000 miles, 20,000 miles x 34.5 = $6,900).

Beginning on January 1st 2013, the standard mileage rates for the use of a car (also vans, pickups or panel trucks) were:

  • 56.5 cents per mile for business miles driven
  • 24 cents per mile driven for medical or moving purposes
  • 14 cents per mile driven in service of charitable organizations

Note the dramatic contrast, from the employee’s perspective, between the above two examples, of the company reimbursing the employee for business use of his personal car, versus the employee reimbursing the company for personal use of the vehicle.

The business, medical, and moving expense rates decrease one-half cent from the 2013 rates.  The charitable rate is based on statute.

Source: http://www.irs.gov

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ASSESSMENT: Your updated thoughts in modernity are appreciated.

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

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THANK YOU

***

New “MEDICAL SPECIALTIES” 2.0

BY DR. DAVID E. MARCINKO MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

GLOSSARY OF PRACTITIONER TERMS?

Each generation of doctors and medical professionals is extraordinarily complex, bringing various skills, expertise and expectations to the modern medical work environment. Determining the best method to unite such diverse thinking is one of the many challenges faced by physician executives and healthcare leaders today.

And, as linguistic evolution occurs, the nomenclature of hospitalist was followed by that of intensivist, proceduralist and nocturnalist, etc [www.MedInnovationBlog.com and Personal communication Richard L. Reece MD].

Is it any wonder that many medical leaders and executive in the Baby Boomer generation find themselves at a loss? The days of functional leadership are gone and suddenly, no one cares about the expertise of the Baby Boomers or how they climbed the corporate ladder, in medicine or elsewhere. Leadership in the new era is no longer about command-control or dictating with intense focus on the bottom line; it is about collaboration, empowerment and communication. And, it is not about titles and nomenclature; it is about lifestyle choice.

What else drives these new-wave specialists?

The answer, of course, is the next-generation of physicians and their emerging new medical business and practice models, which include:

  • “Ambulists” are doctors that travel locally, have no, or only a sparse physical office presence of their own. They sporadically provide services that are additive to traditional practice models [i.e., endocrinologist in a large family medical office with many diabetics]. 
  • “In-Situ” physicians regularly provide services that are complimentary to existing traditional practice models [i.e., dentists or podiatrists in a medical practice].
  • “Laborists” are obstetricians that do not wish to be on-call. First begun in Cape Cod and other Massachusetts hospitals, such obstetricians work regular shifts for the sole purpose of delivering babies.
  • “Locum Tenens” doctors travel around the country as itinerants [i.e., cruise ships] as temporary substitutes for another the same specialty.
  • “Officists” remain in their own physical practice, and rarely see patients in the hospital, nursing home, patient home, out-patient facility, etc.
  • Finally, “dayhawk physicians” mimic the “nighthawk physician” model where radiologists in remote locations read films in the middle of the night as cash-strapped hospitals often find it cheaper to outsource with better services and more timely interpretations in many cases.

Your thoughts are appreciated.

THANK YOU

***

HUMANITARIAN WISDOM IN PATIENT CARE AS AN ETHICAL AND MORAL IMPERATIVE!

AND … RISK MANAGEMENT TOOL?

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BY DR. DAVID EDWARD MARCINKIO MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

To start, let us all recall the Canadian physician Sir William Osler MD, one of the founders of Johns Hopkins Hospital in my hometown of Baltimore Maryland, and where I played stickball in the parking lot as a kid. He left a sizeable body of wisdom that has guided many physicians in the practice of medicine. So, allow me to share with you some of that accumulated wisdom and the quotes that have served me well over the years.

From Dr. Osler, I learned the art of putting myself in the patient’s shoes. “The motto of each of you as you undertake the examination and treatment of a case should be ‘put yourself in his place.’ Realize, so far as you can, the mental state of the patient, enter into his feelings.” Osler further stresses that we should “scan gently (the patient’s) faults” and offer the “kindly word, the cheerful greeting, the sympathetic look.”1

“In some of us, the ceaseless panorama of suffering tends to dull that fine edge of sympathy with which we started,” writes Osler in his famous essay “Aequanimitas.”2 “Against this benumbing influence, we physicians and nurses, the immediate agents of the Trust, have but one enduring corrective — the practice towards patients of the Golden Rule of Humanity as announced by Confucius: ‘What you do not like when done to yourself, do not do to others.’”

Medicine can be both art and science as many physicians have discovered. As Osler tells us, “Errors in judgment must occur in the practice of an art which consists largely of balancing probabilities.”2 Osler notes that “Medicine is a science of uncertainty and an art of probability” and also weighs in with the idea that “The practice of medicine is an art, based on science.”3,4

Osler emphasized that excellence in medicine is not an inheritance and is more fully realized with the seasoning of experience. “The art of the practice of medicine is to be learned only by experience,” says Osler. “Learn to see, learn to hear, learn to feel, learn to smell, and know that by practice alone can you become expert.”5

Finally, some timeless wisdom on patient care came from Osler in an address to St. Mary’s Hospital Medical School in London in 1907: “Gain the confidence of a patient and inspire him with hope, and the battle is half won.”6

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Osler has also imparted plenty of advice on the business of medicine. In “Aequanimitas,” Osler says there are only two types of doctors: “those who practice with their brains, and those who practice with their tongues.”7

In a valedictory address to medical school graduates at McGill University, Osler suggested treating money as a side consideration in a medical career.8 “You have of course entered the profession of medicine with a view of obtaining a livelihood; but in dealing with your patients let this always be a secondary consideration.”

“You are in this profession as a calling, not as a business: as a calling which exacts from you at every turn self-sacrifice, devotion, love and tenderness to your fellow man,” explains Osler in the address to St. Mary’s Hospital Medical School.6 “Once you get down to a purely business level, your influence is gone and the true light of your life is dimmed. You must work in the missionary spirit, with a breadth of charity that raises you far above the petty jealousies of life.”

It is not easy for doctors to combine a passion for patient care, a knowledge of science and the maintenance of business, according to Osler in the British Medical Journal.9 “In the three great professions, the lawyer has to consider only his head and pocket, the parson the head and heart, while with us the head, heart, and pocket are all engaged.”

While some aspects of practice may fall short or be devoid of appropriate financial remuneration, the giving of one’s time, expertise and experience in improving patient outcomes and the quality of their lives may be the greatest gift. “The ‘good debts’ of practice, as I prefer to call them … amount to a generous sum by the end of each year,” says Osler.9

And so, as you practice medicine and reflect on your career, always remember the words and wisdom of Dr. William Osler, and keep patient welfare as your first priority.

References

1. Penfield W. Neurology in Canada and the Osler centennial. Can Med Assoc J. 1949; 61(1): 69-73

2. Osler W. Aequanimitas. Chapter 9, P. Blakiston’s Son and Co., Philadelphia, 1925, p. 159

3. Bean WB. William Osler: Aphorisms, CC Thomas, Springfield, IL, p. 129.

4. Osler W. Aequanimitas. Chapter 3, P. Blakiston’s Son and Co., Philadelphia, 1925, p. 34

5. Thayer WS. Osler the teacher. In: Osler and Other Papers. Johns Hopkins Press, Baltimore, 1931, p. 1.

6. Osler W. The reserves of life. St. Mary’s Hosp Gaz. 1907;13 (1):95-8.

7. Osler W. Aequanimitas. Chapter 7, P. Blakiston’s Son and Co., Philadelphia, 1925, p. 124

8. Osler W. Valedictory address to the graduates in medicine and surgery, McGill University. Can Med Surg J. 1874; 3:433-42.

9. Osler W. Remarks on organization in the profession. Brit Med J. 1911; 1(2614):237-9.

10. Jacobs. AM: PMNews, April, 2015.

ASSESSMENT: Your thoughts are appreciated.

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

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

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THANK YOU

***

A FRUSTRATED PHYSICIAN ASKS: How Much Insurance is Enough?

OVER HEARD IN THE DOCTOR’S LOUNGE

Image result for Doctor Lounge Signs

I currently have no fewer than 10 separate insurance policies associated with my plastic surgery practice. I understand very little about the policies other than that somebody at some point told me I needed each and every one of them, and each made sense when I bought it. But, I often wonder:  

  • Am I over-insured and thus wasting money? 
  • Am I under-insured and thus at risk for a liability disaster? 

I never really had the means of answering these questions …. Until Now!

Lloyd M. Krieger; MD MBA

[Beverly Hills, CA]

***

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

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

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***

What is Corporate “BOOK VALUE” & “PAR VALUE”?

TWO INVESTING DIFFERENCES = TWO QUICK THOUGHTS

BY DR. DAVID EDWARD MARCINKO MBA MEd CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

BOOK-VALUE: Cost of capital assets minus accumulated depreciation for a healthcare [corporation], or other organization.

The net asset value of a [healthcare] companies common stock. This is calculated by dividing the net tangible assets of the company (minus the par value of any preferred stock the company has) by the number of common shares outstanding.

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PAR VALUE: For common stock, the value on the books of the corporation. It has little to do with market value or even the original price of shares at first issuance.

The difference between par and the price at first issuance is carried on the books of a corporation as “paid-in capital” or “capital surplus.”

***

See the source image

ASSESSMENT: Your thoughts are appreciated.

Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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

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THANK YOU

***

PROCEDURES: Rural v. Urban Hospitals

Appreciating the Number of Procedures Done per Hospitalization

By http://www.MCOL.com

JOURNAL RURAL HEALTH: Rural hospitals are not associated with worse postoperative outcomes for colon cancer surgery: https://onlinelibrary.wiley.com/doi/full/10.1111/jrh.12596

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Hospitals

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ASSESSMENT: Your thoughts are appreciated.

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

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

THANK YOU

***

NHICs = Prepaid Preventative and Maintenance Health Care Networks

Emerging New MEDICAL BUSINESS Models 2.0

By Dr. David Edward Marcinko MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

Many folks feels that private preventative medical contracts may be one possible solution for those Americans going without healthcare; especially the young and healthy. Generally, and generically, they have a moniker like the “No Health Insurance Club”; or similar

Why?

Some pundits are leaning toward universal healthcare, or Medicare-4-All, which seems too socialized for others. Yet, private insurers continue to increase premiums, which prices healthcare out of reach for the average American. Employers can no longer float the cost of insurance so they pass it on to their employees. Patients aren’t the only ones being affected by the current state of healthcare. More and more doctors are going out of business and hospitals are cutting back due to escalating costs and payment defaults.

So, current remedies to this dilemma include major medical insurance policies for catastrophic events with high-deductibles to keep monthly premiums down, Medicaid, mini retail-clinics at grocery stores/pharmacies, and emergency room visits for common illnesses; as well as the PP-ACA.

Medical Maintenance

But, preventative healthcare and medical maintenance is not typically addressed. More than 90 percent of health related issues can be taken care of with preventative care and maintenance but only a small percentage of Americans currently enjoy the benefit of preventative healthcare. Healthcare economists are rethinking healthcare by offering an affordable alternative to traditional insurance options. NHICs, connect patients with participating board certified physicians that will treat and care for preventative healthcare needs for a one-time prepaid annual membership fee.

In this NHIC model:

  • Patients make a one-time annual payment that is typically less than a one-month premium with traditional insurance.
  • Patients receive up to 12 office visits per year that also include immunizations, $10 or less in-office prescriptions, and additional services including blood tests.
  • No deductible, no co-pays, no premiums.
  • No surprise bills to patients.
  • Viable alternative to COBRA for employees disengaged from work.
  • Low cost option for the self-employed.
Yakima DentiFlex Membership Club | Your Dentist in Yakima, WA

The Doctors

What’s in it for the doctors? How about no insurance clerks, no need to snail mail medical insurance claims or use expensive electronic claims submission clearinghouse services, no bad debts or bad expense write-offs, no ARs; and fast cash.

ASSESSMENT: Your thoughts are comments are appreciated.

Product Details

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

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THANK YOU

***

PHYSICIAN BRANDING: Post Corona Virus Pandemic

SELF-BRANDING IN THE MODERN ERA

By Dr. David Edward Marcinko MBA CMP©

SPONSOR: http://www.CertifiedMedicalPlanner.org

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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.”

Branding For A Medical Practice & It's Importance ...

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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The Business of Medical Practice [3rd. edition]

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Hospitals and Healthcare Organizations

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“Money Laundering” in Medical Practice?

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By Dr. David Edward Marcinko MBA CMP©

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MONEY LAUNDERING

Charges of money laundering may seem foreign to the practice of medicine. The term “money laundering” evokes visions of a suitcase of drug cash being brought into a legitimate business and being transformed into that business’s receipts and later tunneled through legal channels.

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

In medicine the route beings with receipt of a claim payment check (i.e., a check as opposed to the drug dealer’s cash). The check is then deposited into the professional corporation’s checking account. The funds are then paid to the physician in the form of wages. Those wages are then deposited into the physician’s personal checking account.

Those funds and other similarly situated funds are then accumulated until a check is written to pay for a new automobile. The money received from the alleged fraudulent insurance claim has successful been “laundered” into a hard asset (e.g., Jaguar XJL-V8 4 door luxury sedan).

YOUR THOUGHTS ARE APPRECIATED

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THE ANATOMIC BASIS OF HUMAN PHYSIOLOGY AND BEHAVIOR?

BRAIN ANATOMY

By Dr. David Edward Marcinko MBA CMP©

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I am not a neurologist, psychologist, or psychiatrist. But, it is well known that emotional and behavioral change involves the human nervous system. And, there are two parts of the nervous system that are especially significant for holistic financial advisor; the first is the limbic system and the second is the autonomic nervous system. 

According to Dr. C. George Boerre of Shippensburg University of Pennsylvania, this is known as the emotional nervous system.

1. The Limbic System

The limbic system is a set of structures that lies on both sides of the thalamus, just under the cerebrum.  It includes the hypothalamus, the hippocampus, the amygdala, and nearby areas.  It is primarily responsible for emotions, memories and recollection. 

Hypothalamus

The small hypothalamus is located just below the thalamus on both sides of the third ventricle (areas within the cerebrum filled with cerebrospinal fluid that connect to spinal fluid). It sits inside both tracts of the optic nerve, and just above the pituitary gland.

The hypothalamus is mainly concerned with homeostasis or the process of returning to some “set point.”  It works like a thermostat:  When the room gets too cold, the thermostat conveys that information to the furnace and turns it on.  As the room warms up and the temperature rises, it sends turns off the furnace.  The hypothalamus is responsible for regulating hunger, thirst, response to pain, levels of pleasure, sexual satisfaction, anger and aggressive behavior, and more.  It also regulates the functioning of the autonomic nervous system, which means it regulates functions like pulse, blood pressure, breathing, and arousal in response to emotional circumstances. In a recent discovery, the protein leptin is released by fat cells with over-eating.  The hypothalamus senses leptin levels in the bloodstream and responds by decreasing appetite.  So, it seems that some people might have a gene mutation which produces leptin, and can’t tell the hypothalamus that it is satiated.   The hypothalamus sends instructions to the rest of the body in two ways.  The first is to the autonomic nervous system.  This allows the hypothalamus to have ultimate control of things like blood pressure, heart rate, breathing, digestion, sweating, and all the sympathetic and parasympathetic functions.

The second way the hypothalamus controls things is via the pituitary gland.  It is neurally and chemically connected to the pituitary, which in turn pumps hormones called releasing factors into the bloodstream.  The pituitary is the so-called “master gland” as these hormones are vitally important in regulating growth and metabolism.

Hippocampus

The hippocampus consists of two “horns” that curve back from the amygdala.  It is important in converting things “in your mind” at the moment (short-term memory) into things that are remembered for the long run (long-term memory).  If the hippocampus is damaged, a patient cannot build new memories and lives in a strange world where everything they experience just fades away; even while older memories from the time before the damage are untouched!  Most patients who suffer from this kind of brain damage are eventually institutionalized.

Amygdala

The amygdalas are two almond-shaped masses of neurons on either side of the thalamus at the lower end of the hippocampus.  When it is stimulated electrically, animals respond with aggression.  And, if the amygdala is removed, animals get very tame and no longer respond to anger that would have caused rage before.  The animals also become indifferent to stimuli that would have otherwise have caused fear and sexual responses.

Related Anatomic Areas

Besides the hypothalamus, hippocampus, and amygdala, there are other areas in the structures near to the limbic system that are intimately connected to it:

  • The cingulate gyrus is the part of the cerebrum that lies closest to the limbic system, just above the corpus collosum.  It provides a pathway from the thalamus to the hippocampus, is responsible for focusing attention on emotionally significant events, and for associating memories to smells and to pain.
  • The ventral tegmental area of the brain stem (just below the thalamus) consists of dopamine pathways responsible for pleasure.  People with damage here tend to have difficulty getting pleasure in life, and often turn to alcohol, drugs, sweets, and gambling.
  • The basal ganglia (including the caudate nucleus, the putamen, the globus pallidus, and the substantia nigra) lie over to the sides of the limbic system, and are connected with the cortex above them.  They are responsible for repetitive behaviors, reward experiences, and focusing attention. 
  • The prefrontal cortex, which is the part of the frontal lobe which lies in front of the motor area, is also closely linked to the limbic system.  Besides apparently being involved in thinking about the future, making plans, and taking action, it also appears to be involved in the same dopamine pathways as the ventral tegmental area, and plays a part in pleasure and addiction.

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2. The Autonomic Nervous System

The second part of the nervous system to have a particularly powerful part to play in our emotional life is the autonomic nervous system. 

The autonomic nervous system is composed of two parts, which function primarily in opposition to each other.  The first is the sympathetic nervous system, which starts in the spinal cord and travels to a variety of areas of the body.  Its function appears to be preparing the body for the kinds of vigorous activities associated with “fight or flight,” that is, with running from danger or with preparing for violence.  Activation of the sympathetic nervous system has the following effects:

  • dilates the pupils and opens the eyelids,
  • stimulates the sweat glands and dilates the blood vessels in large muscles,
  • constricts the blood vessels in the rest of the body,
  • increases the heart rate and opens up the bronchial tubes of the lungs, and
  • inhibits the secretions in the digestive system.

One of its most important effects is causing the adrenal glands (which sit on top of the kidneys) to release epinephrine (adrenalin) into the blood stream.  Epinephrine is a powerful hormone that causes various parts of the body to respond in much the same way as the sympathetic nervous system.  Being in the blood stream, it takes a bit longer to stop its effects, and may take some time to calm down again

The sympathetic nervous system also takes in information, mostly concerning pain from internal organs.  Because the nerves that carry information about organ pain often travel along the same paths that carry information about pain from more surface areas of the body, the information sometimes get confused.  This is called referred pain, and the best known example is the pain in the left shoulder and arm when having a heart attack.

The other part of the autonomic nervous system is called the parasympathetic nervoussystem.  It has its roots in the brainstem and in the spinal cord of the lower back.  Its function is to bring the body back from the emergency status that the sympathetic nervous system puts it into.

Some of the details of parasympathetic arousal include some of the following:.

  • pupil constriction and activation of the salivary glands,
  • stimulating the secretions of the stomach and activity of the intestines,
  • stimulating secretions in the lungs and constricting the bronchial tubes, and;
  • decreases heart rate.

The parasympathetic nervous system also has some sensory abilities:  It receives information about blood pressure, levels of carbon dioxide in the blood, etc.

There is actually another part of the autonomic nervous system that is not mentioned too often: the enteric nervous system.  It is a complex of nerves that regulate the activity of the stomach. 

For example, if you get sick to your stomach with a new financial advisory client – or feel nervous butterflies with your first patient encounter as a doctor- you can blame the enteric nervous system.

ASSESSMENT: Your thoughts are appreciated.

Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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Non-Traditional Physician Compensation Models

Creative Compensation Models

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BY DR. DAVID EDWARD MARCINKO MBA CMP®

A Review of Some Newer Compensation Models

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Today, whether independent or employed, physicians can pursue several creative compensation models, other than fee-for service reimbursement based on Current Procedural Terminology [CPT®] codes, not popular a few decade ago:

  • Pay-for-Performance Initiatives [P4P]: According to Mark Fendrick, MD and Michael E. Chernew, PhD, instead of the one size fits all approach of traditional health insurance, a “clinically-sensitive” cost-sharing system that supports co-payments related to evidence-based value for targeted patients is emerging. In 2014, for example, there were a number of changes to Medicare’s pay-for-performance programs [personal communication]. These value-based payment modifiers will show up in physicians’ paychecks in few years, and will be expanded to practices with 10 or more eligible professionals. The program, mandated by the Affordable Care Act, assesses a provider’s quality of care and costs, and increases Medicare payments for good performers and decreases them for bad ones. And, doctor performance will be reflected in adjustments to 2016 payments. As much as 2% of Medicare payments will be at risk in 2021 based on physician performance in 2019. It was only 1% for 2015, which was based on doctors’ 2013 performance.
  • Physician Quality Reporting Initiative Model.  The Centers for Medicare and Medicaid Services [CMS] paid out more than $40 million in monetary incentives to medical providers who reported data on quality of care delivered between July 2020 and December 2020; as part of its PQRI. Under the PQRI, healthcare providers who participated received bonuses of 1.5 percent of their total CMS payments during the reporting period.
  • Direct Reimbursement Payment Model:  A Health Reimbursement Arrangement (HRA) is a tool which is used to provide direct reimbursement by an employer for qualified medical expenses.  The HRA is an employer-established benefit plan, and contributions to the plan may only be made by the employer.  The HRA can be used in conjunction with any insurance plan, including a high-deductible plan. Qualified reimbursements made under the HRA are tax-deductible for the employer, and the payments are not counted as income for the employee.  Any balance in an HRA can generally be carried over to the next year.  This plan allows for flexibility and tailored to meet the particular needs of both employers and employees in a tax-advantaged manner.  From the physician’s perspective, increasing use of HRAs poses new challenges.  Payment for services in the medical office may be required of the patient/employee before reimbursement from the employer occurs.  These extra steps can easily result in delayed payment or non-payment to medical providers who are not prepared to work with this model of reimbursement.  The provisions for this model are outlined in IRS publication 969, http://www.irs.gov/pub/irs-pdf/p969.pdf.
  • Concierge Practice Model:  The concept of concierge medicine (CM), also known as retainer medicine, first emerged in Seattle, Washington in the 1990’s. With CM, the physician charges an annual retainer fee to patients.  The fee usually ranges from $1,000 to $20,000 per year, and the number of patients in a practice is usually limited to a few hundred.  In return, patients receive increased levels of access and personalized care. This often includes same day appointments, extended visit times, house calls, and 24/7 access to the physician by pager and cell phone. An annual executive physical is often included, as well as an increased emphasis on preventive care.  Many physicians choosing this type of practice model do so for lifestyle and control reasons, although the average income for a successful CM primary care physician is higher than that of a typical primary care physician. .
  • Global Healthcare Model: American businesses are extending their cost-cutting initiatives to include offshore employee medical benefits, and facilities like the Bumrungrad Hospital in Bangkok, Thailand (cosmetic surgery), the Apollo Hospital in New Delhi, India (cardiac and orthopedic surgery) are premier examples for surgical care. Both are internationally recognized institutions that resemble five-star hotels equipped with the latest medical technology. Countries such as Finland, England and Canada are also catering to the English-speaking crowd, while dentistry is especially popular in Mexico and Costa Rica. Although this is still considered “medical tourism,” Mercer Health and Benefits was recently retained by three Fortune 500 companies interested in contracting with offshore hospitals and The Joint Commission [TJC] has accredited 88 foreign hospitals through a joint international commission. To be sure, when India can discount costs up to 80%, the effects on domestic hospital reimbursement and physician compensation may be assumed to increase downward compensation pressures.
  • Locum Tenens Practitioner Model: Locum Tenens (LT) as an alternative to full-time employment is enjoying a comeback for most specialties. Some younger physicians enjoy the travel, while mature physicians like to practice at their leisure. Employment factors to consider include: firm reputation, malpractice insurance, credentialing, travel and relocation expenses (which are negotiable). However, a LT firm typically will not cover taxes [NALTO.org and http://www.studentdoc.com/locum-tenens.html%5D

ASSESSMENT: Your thoughts are appreciated.

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Physician Recruitment and Executive Search Firms

Facts about Physician Recruiters and Executive Search Firms

May Launches the Busy Season

By Dr. David E. Marcinko MBA CMP®

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1) If you are job hunting, you should send your resume to recruiters

Different recruiters know about different positions. They do not usually know about the same ones. This is particularly true with retained firms. By sending your resume out widely, you will be placed in many different confidential databases and be alerted of many different positions. If you send your resume to only a few, it may be that none you send to will be working with positions which are suited for you. Throw your net widely.

If you change jobs, it is also wise to send follow-up letters to the recruiters and alert them of your new career move. Many search firms follow people throughout their careers and enjoy being kept up-to-date. It is a good idea to have your resume formatted in plain text so you can copy and paste it into email messages when requested to do so. Then, follow up with a nicely formatted copy on paper by postal mail.

Some estimate that only 1% to 3% of all resumes sent will result in actual job interviews. So, if you only send 50 resumes, you may only have less than 2 interviews, if that many. Send your resume to as many recruiters as you can. It is worth the postage or email time. Generally, recruiters will not share your resume with any employer or give your name to anyone else without obtaining your specific permission to do so. The recruiter will call first, talk to you about a particular position and then ask your permission to share your resume with that employer.

2) Your resume will be kept strictly confidential by the executive search firm.

It is safe to submit your resume to a search firm and not worry that the search firm will let it leak out that you are job hunting. Recruiters will call you each and every time they wish to present you to an employer in order to gain your permission. Only after they have gained your permission will they submit your name or resume to the identified employer. The wonderful aspect of working with search firms is that you can manage your career and your job search in confidence and privacy.

3) Fees are always paid by the employer, not the job candidate.

Recruiters and search firms work for the employer or hiring entity. The employer pays them a fee for locating the right physician for the job opening. This is important to remember, in that when you interact with executive recruiters, you are essentially interacting with an agent or representative of the employer. Recruiters are more loyal to employers than they are to job candidates because they work for the employer. This should not present a problem, but, should cause you to develop your relationship with the recruiter with the same integrity and professionalism that you would with the employer.

Recruiters are paid fees in one of two ways – retainer fees or contingency fees. This is an important distinction and will affect your process with both the employer and the recruiter. Some employers prefer working with contingency firms and some with retained firms. Both are respected by employers and useful in your job search, but, the two types of firms will not be handling the same positions with the same employers simultaneously.

A “retained recruiter” has entered an exclusive contract with an employer to fill a particular position. The retained recruiter, then, is likely to advertise a position, sharing the specifics of the position, location and employer openly. The retained firm feels a great obligation to fulfill the contract by finding the best person for the job.

A “contingency recruiter” on the other hand, usually does not have an exclusive relationship with the employer, and is only paid a fee if the job search is successful. Often, if the employer uses contingency firms, there will be more than one contingency firm competing to fill a certain position. As a job hunter, if you are sent to an interview by a contingency firm, you may find that you are competing with a larger number of applicants for a position. Generally, retained firms only send in from 3 to 5 candidates for a position.

Recruiters will be paid fees equal to about 25% to 35% of the resulting salary of the successful candidate plus expenses. This does not come out of the job candidate’s salary. This is paid to the recruiter through a separate relationship between the employer and the search firm. This may seem like a large fee, but, keep in mind that recruiters incur a great many expenses when searching for successful job candidates. They spend enormous amounts of money on computer systems, long distance calls, mail-outs, travel and interviews. Recruiters work very hard for these fees. Employers recognize the value of using recruiters and are more than willing to pay recruiters the fees. All you have to do is contact the recruiter to get the process moving. 

4) Not all medical recruiters work only with physicians.

Some search firms work exclusively with physicians or in healthcare, while others may work in several fields at once. Some of the larger generalist firms will have one or more search consultants that specialize in healthcare. It is important for you, as a job hunter, to assess the recruiters’ knowledge of your field. If you use industry or medical specialty buzz words in describing your skills, experience or career aspirations, you may or may not be talking a language the recruiter understands fully. It is wise to explore fully with the recruiter his understanding of your field and area of specialization.

5) Recruiters and search consultants move around.

Recruiters, like many professionals, move to new firms during their careers. Often you will find that recruiters will work at several firms during their careers. Since it is much more effective to address your letters to a person rather than “to whom it may concern”, it is smart for job hunters to have accurate and up-to-date information about who is who and where, since this can change frequently. Search firms also move their offices, sometimes to another suite, street or state. If you have a list of recruiters that is over one year old, you will certainly waste some postage in mailing your resumes and cover letters. Many of your mail-outs will be returned to you stamped “non-deliverable”, unless you obtain an up-to-date list. A resource, like the Directory of Healthcare Recruiters is updated very frequently, usually monthly [www.pohly.com/dir3.html].

6) Most search firms work with positions all over the country.

If you are from a particular state, and want to remain in that state, don’t make the mistake of only sending your resume to recruiters in your state. Often the recruiters in your state are working on positions in other states, and recruiters in other states are working on positions in your state. This is usually the case. Very few recruiters work only in their local area, most work all around the US and some internationally. Regardless of your geographic preference, you should still send your resume to all the healthcare recruiters. If you really only want to remain in your area, you can specify that preference in your cover letter.

7) Recruiters primarily work with hard to fill positions or executive positions.

Some recruiters specialize in clinical positions for physicians, managed care executive positions, healthcare financial positions or health administration positions. Others may specialize in finding doctors, nurses or physical therapists. Generally, an employer does not engage a recruiter’s assistance in filling a position unless it is hard to fill. Sometimes employers will engage search firms to save them the valuable time of advertising or combing through dozens of resumes.

A Career in Medical Recruiting - The Campus Career Coach

ASSESSMENT

Contingency recruiters tend to work with more mid-level management and professional positions, but, this is not always the case. Retained firms generally work with the higher level clinical or administrative positions.

One thing you will be assured of is that if a recruiter is working on a position that means that the employer is willing to pay a fee. That usually means that the position is a valued position and one worth closer inspection on your part. Even in healthcare, with certain exceptions, our economy is an “employer’s market”. This means that employers receive a deluge of resumes for their open positions. Increasingly, employers are using recruitment firms to handle their openings and schedule the interviews because employers simply do not have the manpower or time to handle the many resumes they receive.

Therefore, if a job hunter is submitted by a recruiter, that job hunter has a great advantage over all other applicants.

Your thoughts are appreciated.

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EDITOR’S PRIVILEGE: The Pandemic and Going Mask-Less

EDITOR’S POINT OF PRIVILEGE

This week, for the first time in a year, I took a walk without wearing a mask. It was all going great until I saw a woman walking her dog approach me. She was wearing a mask, and my body instinctively moved to cross the street to give her space. It made me realize that we’ve been living in fear of other humans, which is pretty sad.

Pandemic-era habits die hard, but I’m confident we can once again re-wire our brains to view other people not as biological vectors for disease, but as … people, just with germs.

So, here’s to hoping this summer, we’ll learn to come together as quickly as we learned to distance.

DAVID EDWARD MARCINKO

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What Exactly is a D.O.?

DOCTOR OF OSTEOPATHIC MEDICINE

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By Dr. David Edward Marcinko MBA CMP®

[Editor-in-Chief]

OK; I admit it. I have a formal educational background in allopathic, podiatric and osteopathic medicine. I also have both earned and conferred medical degrees from the States as well as Europe. I even dropped out of dental and law school back in the day … Such the protean dilettante!

Now, today there are about 950,000 allopathic physicians, 20,000 podiatrists, 150,000 dentists and 50,000 osteopaths. And, from this cohort of medical professionals, the Doctor of Osteopathic Medicine [DO] seems to be the least well understood practitioner.

And so, I thought this essay from Very Well Health might be helpful to all our Medical Executive-Post readers and subscribers [Differences Between a DO Physician and an MD – Comparing Osteopathic and Allopathic Medical Training].

LINK: https://www.verywellhealth.com/do-doctors-vs-md-doctors-whats-the-difference-3157310

ASSESSMENT: Your thoughts are appreciated.

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DAVID EDWARD MARCINKO IS AT YOUR SERVICE IN 2021

DAVID EDWARD MARCINKO IS AT YOUR SERVICE IN 2020-2021

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EDITOR

TO SCHEDULE A SEMINAR, SPEAKING ENGAGEMENT, POD OR VLOG-CAST:
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Book Dr. Marcinko for your Next Seminar!

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Book Speaker Dr. David E. Marcinko CMP® MBA for your Next Medical, Pharma, Hospital, University or Financial Services Seminar or Personal and Corporate Coaching Sessions 

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Dr. David Edward Marcinko, editor-in-chief, is a next-generation apostle of Nobel Laureate Kenneth Joseph Arrow PhD, as a health-care economist, insurance advisor, financial advisor, risk manager, and board-certified surgeon from Temple University in Philadelphia.

In the past, he edited eight practice-management books, three medical textbooks and manuals in four languages, five financial planning yearbooks, dozens of interactive CD-ROMs, and three comprehensive health-care administration dictionaries.

Internationally recognized for his clinical work, he is a past endowed chair; professor of health economics, finance and public health policy management; and distinguished visiting professor of surgery as a Bachelor of Medicine–Bachelor of Surgery (MBBS) degree recipient from Marien Hospital in Aachen, Germany.

He provides litigation support and expert witness testimony in state and federal court, with medical publications archived in the Library of Congress and the Library of Medicine at the National Institutes of Health.

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

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

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[HOSPITAL OPERATIONS, ORGANIZATIONAL BEHAVIOR AND FINANCIAL MANAGEMENT COMPANION TEXTBOOK SET]

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[Foreword Dr. Phillips MD JD MBA LLM] *** [Foreword Dr. Nash MD MBA FACP]

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

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

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https://davidedwardmarcinko.com/speaking/

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Pass Your Foot & Ankle Surgical Board Exams

PASS ALL YOUR FOOT & ANKLE SURGICAL BOARD CERTIFICATION EXAMS
Courtesy: www.PodiatryPrep.org

PURCHASE * PREPARE * PASS
Electronic Study Guides to Pass the 1st. Time

NEXT-GEN SAMPLE COGNITIVE STYLED “ORAL” COMPUTERIZED QUESTIONS
CBPS: https://lnkd.in/eTv_Ynj
LEARN MORE: https://lnkd.in/djmFRfg
ORDER: https://lnkd.in/e3uy6qB
Thank You
***

A Real [FREE-MARKET] Hospital Bill

CIRCA 1969 = Morristown Memorial Hospital, NJ, USA

By Anonymous

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“DICTIONARY OF TERMS FOR THE BUSINESS OF MEDICINE”
DHEF: https://lnkd.in/dqdbWM9
DHIMC: https://lnkd.in/e9AmEhd
DHITS: https://lnkd.in/eWx3WjZ
MORE: https://lnkd.in/eVGcji5

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I rotated thru this facility back when I was at Temple University

Dr. David Edward Marcinko MBA

ME-P Editor-in-Chief

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Take the “FACE MASK PLEDGE”

Pledge to Protect – One Another

By Dr. David E .Marcinko MBA

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Your thoughts and comments are appreciated.

BNG AND INSURANCE TEXTS FOR DOCTORS:USINESS, FINANCE, INVESTI

1 – https://lnkd.in/ebWtzGg

2 – https://lnkd.in/ezkQMfR

3 – https://lnkd.in/ewJPTJs

THANK YOU

***

ANOSMIA, HYPERSOMIA, AGEUSIA, HYPOGEUSIA, DYSGEUSIA and the CORONA VIRUS?

WHAT IS “ANOSMIA”

By Darrell Pruitt DDS and David E. Marcinko MBBS, MBA

Anosmia, also known as smell blindness, is the loss of the ability to detect one or more smells. Anosmia may be temporary or permanent. It differs from Hyposmia which is a decreased sensitivity to some or all smells.

According to Wikipedia, Anosmia can be due to a number of factors, including an inflammation of the nasal mucosa, blockage of nasal passages or a destruction of one temporal lobe. Inflammation is due to chronic mucosa changes in the lining of the paranasal sinus and in the middle and superior turbinates. When anosmia is caused by inflammatory changes in the nasal passageways, it is treated simply by reducing inflammation. It can be caused by chronic meningitis and neurosyphilis that would increase intracranial pressure over a long period of time, and in some cases by ciliopathy, including ciliopathy due to primary ciliary dyskinesia. The term derives from the New Latin anosmia, based on Ancient Greek ἀν- (an-) + ὀσμή (osmḗ, “smell”; another related term, hyperosmia, refers to an increased ability to smell). Some people may be anosmic for one particular odor, a condition known as “specific anosmia”. The absence of the sense of smell from birth is known as congenital anosmia.

Ageusia is the loss of taste functions of the tongue, particularly the inability to detect sweetness, sourness, bitterness, saltiness, and umami. It is sometimes confused with anosmia – a loss of the sense of smell. Because the tongue can only indicate texture and differentiate between sweet, sour, bitter, salty, and umami, most of what is perceived as the sense of taste is actually derived from smell. True Ageusia is relatively rare compared to Hypogeusia – a partial loss of taste – and Dysgeusia – a distortion or alteration of taste.

ASSESSMENT:

If you should suddenly lose your sense of smell (anosmia), you might want to get tested for COVID-19 – even without the presence of other symptoms.

“A majority of COVID-19 patients experience some level of anosmia, most often temporary. Analyses of electronic health records indicate that COVID-19 patients are 27 times more likely to have smell loss but are only around 2.2 to 2.6 times more likely to have fever, cough or respiratory difficulty, compared to patients without COVID-19.”

See: “How COVID-19 Causes Loss of Smell – Olfactory support cells, not neurons, are vulnerable to novel coronavirus infection.” By Kevin Jiang for Harvard Medical School, July 24, 2020.

https://hms.harvard.edu/news/how-covid-19-causes-loss-smell

Your thoughts and comments are appreciated.

BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS:

1 – https://lnkd.in/ebWtzGg

2 – https://lnkd.in/ezkQMfR

3 – https://lnkd.in/ewJPTJs

THANK YOU

***

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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SOME “MEMORIAL DAY” THOUGHTS FOR 2021

“Decoration Day”

By Dr. David E. Marcinko MBA

”Memorial Day (Decoration Day) is a federal holiday in the United States for honoring and mourning the military personnel who died while serving in the United States Armed Forces. The holiday is now observed on the last Monday of May, having been observed on May 30th from 1868 to 1970.

Here are some related thoughts:

HISTORY: https://medicalexecutivepost.com/2018/05/26/the-history-of-memorial-day/

WW-II VETS: https://medicalexecutivepost.com/2018/05/28/living-u-s-world-war-ii-veterans/

SUICIDE: https://medicalexecutivepost.com/2017/11/21/veteran-suicide-in-front-of-va-clinic/

MEDICAL CHOICE: https://medicalexecutivepost.com/2015/11/09/about-the-surface-transportation-and-veterans-health-care-choice-improvement-act-of-2015/

PANDEMIC: https://www.msn.com/en-us/news/us/memorial-day-even-more-poignant-as-veterans-die-from-virus/ar-BB14wGhH?li=BBnb7Kz&ocid=SK2LDHP

HELP A VET: https://medicalexecutivepost.com/2019/11/11/help-a-veteran-with-pro-bono-medical-care-or-financial-planning/

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ASSESSMENT: Your thoughts and comments are appreciated.

THANK YOU

***

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.

***

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.

***

BUSINESS, FINANCE AND INSURANCE TEXTS FOR DOCTORS

1 – https://lnkd.in/ebWtzGg

2 – https://lnkd.in/ezkQMfR

3 – https://lnkd.in/ewJPTJs

THANK YOU

***

Medical Laboratory Test SENSITIVITY “versus” SPECIFICITY

Obvious Covid-19 Implications

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

cropped-dem

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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BUSINESS, FINANCE AND INSURANCE TEXTS FOR DOCTORS

1 – https://lnkd.in/ebWtzGg

2 – https://lnkd.in/ezkQMfR

3 – https://lnkd.in/ewJPTJs

THANK YOU

***

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

***

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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MY SEARCH EXPERIENCE FOR A C.M.I.O JOB

Chief Medical Information Officer

Courtesy: www.CertifiedMedicalPlanner.org

[Including Interview Preparation List and Study Rubric]

By Dr. David E. Marcinko MBA

Last year I was a job finalist as Chief Medical Information Officer for the State of Georgia. It did not get the job. And yes, it was before the data breech at the State House, Health Insurance Commissioner’s Office and Court House.

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

FOREWORD: https://medicalexecutivepost.com/2008/02/29/richard-j-mata-md-ms-ms-cis-cmp%e2%84%a2-hon/

The CMIO was a C-Suite executive position responsible for championing institutional security. Physician awareness of electronic and HIPAA policy and procedure developments, while working to ensure compliance with internal and external standards related to medical information security, was vital. The CMIO was appointed, and reported, directly by the Governor.

ESSAY: https://medicalexecutivepost.com/2010/07/07/understanding-clinical-and-financial-features-of-medical-practice-emrs-hospital-it-systems/

And so, I developed the following list of duties and responsibilities in my preparation quest. It is offered to those seeking similar opportunities. No guarantees, implicitly or explicitly, are implied. Good Luck!

RUBRIC: https://medicalexecutivepost.com/wp-content/uploads/2008/01/hit-security.pdf

Conclusion: And so, your thoughts are appreciated.

THANK YOU

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OFFSETTING COSTS FOR CARDIO-THORACIC SURGICAL HEART SERVICES

ON NATIONAL “GO RED DAY”

My Case Model Used in Business School

Courtesy: www.CertifiedMedicalPlanner.org

By Dr. David E. Marcinko MBA

An MCO asked the Hospital of St. Mackenzie to provide coronary artery bypass graft (CABG) services, with catheterization, for its insured patients. The CFO at St. Mackenzie was pleased to review their request for proposal (RFP) as this was the exact type of patient needed to help offset costs of the new heart surgical services wing at the hospital.

Following some discussion, the MCO offered to pay the hospital $34,805 for a normal triple artery CABG without complications.

The CFO reviewed the standard treatment protocol and standard cost profile for the procedure. To her dismay, she discovered that the hospital’s cost would be $36,000 with a six-day average length-of-stay in the new wing.

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QUERY: What should she do and what facts are needed to make an informed decision?

ANSWER: https://medicalexecutivepost.com/wp-content/uploads/2007/12/cvpa-3.pdf

Conclusion: Your thoughts are appreciated.

THANK YOU

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THE CORONA VIRUS and Ro [r-NOUGHT]

THE CORONA VIRUS & Ro [r-NOUGHT] IN HEALTH EPIDEMIOLOGY?

Courtesy: https://lnkd.in/eBf-4vY

By Dr. David E. Marcinko MBA

[A Relationship to Investing and the Stock Markets?]

DJIA 28,256.03 ▼ -603.41 [-2.09%]

DJIA 28,399.81 Today: ▲ DJIA: +143.78+0.51%

The Ro Value, [r Nought), of an infection is the number of cases it generates on average over the course of its infectious period, in an otherwise uninfected population.

LINK: https://lnkd.in/e9AmEhd The metric determines if a disease can spread through a population. LINK: https://lnkd.in/e2VXwcz

FORMULA: When R0 < 1, the infection will die out in the long run. But, if R0 > 1, the infection will spread in a population. The larger the value of R0, the harder it is to control the epidemic.

LINK: https://lnkd.in/eXYpEUm METRICS: Recently, Corona virus estimates ranged from 1.4 to 5.5. The WHO range was 1.4 and 2.5. In comparison, seasonal flu affects millions each year but has an R0 of just 1.3.

QUERY: What are the stock market & economic effects of Corona?

GLOBAL: https://lnkd.in/epKhamj

DOMESTIC: https://lnkd.in/eBxwRDW

Conclusion: Your thoughts are appreciated.

Product DetailsProduct DetailsProduct Details

THANK YOU

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A SYNOPSIS OF MY ADVISORY FEES & BUSINESS MODEL

A SYNOPSIS OF MY ADVISORY FEES & CONSULTING BUSINESS MODEL

Courtesy: https://lnkd.in/eVGcji5

[Authentic Consulting for Physicians & Medical Colleagues]

My fee is $250 per hour prorated, so you only pay for the time used. This fee covers almost any medical practice management, insurance and risk management, personal financial planning or investment related topic, including document review, phone or Skype® consultation, research and/or written investment strategies.

MODEL: https://lnkd.in/eVWcyaq

IOW: No high water marks, no claw-back fees, sales or commissions, front or back end loads, 12[b]-1 fees or Assets Under Management [AUM] charges; etc. “Pay-as-you-Go”; period! Client Centricity.

TOPICS: https://lnkd.in/e7WrDj9

2nd OPINIONS: https://lnkd.in/dw7FHyP

INVITE: https://lnkd.in/e3-SFmb Your thoughts are appreciated.

CONTACT: Ann Miller RN MHA CMP® PHONE: 770-448-0769

EMAIL: MarcinkoAdvisors@msn.com

BUSINESS, FINANCE, INVESTING & 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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INVITE A DOCTOR – FINANCIAL ADVISOR TO YOUR NEXT EVENT

INVITE A PHYSICIAN & TRUSTED FINANCIAL ADVISOR COLLEAGUE TO YOUR NEXT SEMINAR, MEETING OR EVENT

Courtesy: https://lnkd.in/eBf-4vY

Dr. David E. Marcinko MBA CMP®

Your Audience Deserves a Nationally Known Speaker and Colleague.

[Professor Dr. David E. Marcinko MBA CMP® is Now at Your Service]

CONTACT: Ann Miller RN MHA

THANK YOU

avatar-of-dr-marcinko-speaking

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All about Titles and University Professors in the USA

Academic Titles are Different in Europe

By Dr. David E. Marcinko MBA

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I’ve taught in medical, graduate and business school academia for a while now, and served as instructor, adjunct, assistant, associate and full professor in the USA and Europe. I even held chair and endowed positions. But, the precise definition of these titles has always eluded me. So, I did a bit of research to arrive at the following conclusions mingled with my personal experiences..

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A “Professor-of-the-Practice” or P-O-P is a non-tenured person appointed to the academic staff of an American university with  exceptional experiences in their “practice” (profession) and holding a terminal doctoral degree.

I’ve seen this position in medical schools and allied health care institutuions.

NOTE: In American universities, a “professor” is practically any lecturer with a doctor’s degree, whereas in most of the world the title is reserved for senior academics; including most Commonwealth Nations (United Kingdom), German-speaking nations and Northern Europe. It may also be a department head or specifically bestowed chair. A professor is a highly accomplished and recognized academic, and the title is awarded only after decades of scholarly work. In the United States and Canada the title of professor is granted to all scholars with doctorate degrees (typically Ph.D.s) who teach in two and four year colleges and universities, and used in the titles Assistant Professor and Associate Professor, which are not considered full professorship level positions elsewhere.

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A Scholar-in-Residence can serve a university in a full-time, visiting, or part-time capacity. A full-time SIR will be provided on-campus housing and is asked to: hold 2-5 office hours/programs per week in the community. A part-time SIR will host at least 2 programs/activities during the appointment and attend appropriate community meetings.

I’ve seen this position mostly in the graduate school universe.

Finally, an “Entrepreneur-in-Residence” is a position typically held by successful entrepreneurs in venture capital firms, private equity firms, startup accelerators, law firms, or business schools. The EIR typically leads a small, early-stage, emerging company deemed to have high growth potential, or has demonstrated high growth. The university endowment fund provides the Entrepreneur-in-Residence with working capital to nurture expansion, new-product development, or restructuring of the company’s operations, management, and/or ownership.

This is likely the newest business school nomenclature iteration IMHO.

Assessment: So, how did I do with these definitions which still may vary among different colleges, universities and institutions? Your thoughts are appreciated.

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Invite Dr. Marcinko

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Is it Time for “HEALTH CARE COLLECTIVISM”©

 Collectivism in Health Care?

By Dr. David Edward Marcinko MBA

Collectivism is the moral stance, political philosophy, ideology, or social outlook that emphasizes the significance of groups—their identities, goals, rights, outcomes, etc.—and tends to analyze issues in those terms.

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A BIZARRE QUESTION?: Would you subtract one day off your life to collectively help solve the domestic health care crisis?

A crazy question; perhaps not so much as the blog-o-sphere is asking a related query.

THE R.B.G QUESTION?: If it were possible, would you subtract one day off you life and add it to Ruth Bader Ginsburg’s life for one extra day of good health?

LINK: https://twitchy.com/brettt-3136/2019/01/07/not-a-cult-who-wants-to-shave-off-a-day-of-their-life-and-give-it-to-ruth-bader-ginsburg/

FORGET BUSINESS SOLUTIONS

So, forget business solutions and marketplace strategy, SDOH, competitive forces, economics, taxation, SWOT analysis, Medicare-for-All,  and potential new-wave disruptors such as ABJ Health Ventures and related initiatives.

NOTE: ABJ Health Ventures = look it up.

THE HEALTH CARE COLLECTIVISM QUESTION?: If it were possible, would you subtract one day off you life and add it to another’s life for one extra day of good health?

THE HEALTH CARE COLLECTIVISM RESULTS: If just 10,000 people did this, it would add about 27 productive years,  in the aggregate, to all participating individual citizen lives.

ar

Assessment

Your thoughts are appreciated.

NOTE:Health Care Collectivism”© -AND- Healthcare Collectivism”© David Edward Marcinko. All rights reserved, iMBA Inc., USA.

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.

Book Marcinko: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.

HOSPITALS:

“Financial Management Strategies for Hospitals” https://tinyurl.com/yagu567d

“Operational Strategies for Clinics and Hospitals” https://tinyurl.com/y9avbrq5

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My Upcoming Trip to Tuskegee University in Alabama

VISITING WORLD FAMOUS TUSKEGEE UNIVERSITY

Dr. David E. Marcinko MBA

Just a quick announcement that I will be at Tuskegee University on Friday April 12th to keynote a niche seminar on biological sciences, medical education and contemporary healthcare career trends.

Link: https://www.tuskegee.edu/programs-courses/colleges-schools/cas/office-of-the-dean-cas

The gracious invitation was extended by College of Arts & Sciences Dean Channa Prakash PhD and Assistant Dean Dr. Joe Jimmeh; with renowned faculty and basic science researchers Dr. Marcia Martinez, Dr. Richard Whittington, Dr. Albert Russell, Dr. Clayton Yates; and Professor of Mathematics Dr. Mohammad Qazi to attend. 

Link: https://www.tuskegee.edu/programs-courses/colleges-schools/cas/cas-faculty-and-staff

I am especially eager to tour the historic TU campus, and meet two-time graduate Dr. Roberta Troy who is Founding Director of the Health Disparities Institute for Research and Education (HDIRE). As a native of Baltimore, Maryland, this is an important issue to me. And, Dr. Troy was just appointed new University Provost. I understand she is a true academic dynamo and congratulate her, collegially.

Of course, I will be sure to order a slice of Dorothy Restaurant’s specialty key-lime pie at the Kellogg Conference Center during the post-reception dinner. Yummy!

HOPE TO SEE YOU, THERE!

tuskegee_university_campus_01

 

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Invite Dr. Marcinko

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How Should We Define “Patient Engagement?”

What Are We Measuring, and Does It Matter for Patient Care?

[By Dr. David Edward Marcinko MBA]

OK; I admit it. I edited three major dictionaries on health insurance and managed care, health economics and finance, and health information technology and security. Each tome was comprised of 10,000 peer-reviewed terms, definitions, initialisms, acronyms and syllogisms, etc; for a total of 30,000 peer-reviewed entries. They have been very successfully received to date; throughout the entire medico-legal-business ecosystem.

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So, imagine my surprise when I just leaned that the concept of “patient engagement’ within the context of shared decision making [SDM] – which has been bantered about on this forum and the medical, nursing, legal, public health policy and  management community without real precision for decades – is in definitional limbo. And, I quote:

“In a rigorous systematic review, Dukhanin and colleagues categorize metrics and evaluative tools of the engagement of patient, public, consumer and community in decision-making in healthcare institutions and systems. The review itself is ably done and the categorizations lead to a useful understanding of the necessary elements of engagement, and a suite of measures relevant to implementing engagement in systems. Nevertheless, the question remains whether the engagement of patient representatives in institutional or systemic deliberations will lead to improved clinical outcomes or increased engagement of individual patients themselves in care. Attention to the conceptual foundations of patient engagement would help make this systematic review relevant to the clinical care of patients.”

Assessment

The publication is from the “International Journal of Health Policy and Management”, January 2019.

Now, I was asked to serve on their editorial review board about a year ago but demurred due to time constraints. Nevertheless, I am glad that the IJHPM is thriving and challenging conventional wisdom and the shibboleths we all seem to accept without proof.

And perhaps, SHOULD NOT.

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http://www.ijhpm.com/article_3550_3c3a114acab2338b472d63428ee3de5d.pdf

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Conclusion

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

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

Book Marcinko: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.

DOCTORS:

“Insurance & Risk Management Strategies for Doctors” https://tinyurl.com/ydx9kd93

“Fiduciary Financial Planning for Physicians” https://tinyurl.com/y7f5pnox

“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8

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HOSPITALS:

“Financial Management Strategies for Hospitals” https://tinyurl.com/yagu567d

“Operational Strategies for Clinics and Hospitals” https://tinyurl.com/y9avbrq5

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PODCAST: Off Road Christmas Touring with Dr. Marcinko

City Lights in Baltimore, Maryland

By Dr. David Edward Marcinko; MBA, CMP™

[Editor-in-Chief]

I stopped off in Baltimore, Maryland during the recent holidays to visit current clients, prospect for new ones, do a little public speaking and promote our book [Business of Medical Practice, third edition].

Of course, we stopped by Johns Hopkins University where my sister worked, and promoted the Medical Executive-Post, as well.

Enter Christmas Street

And so, it was with great anticipation that we agreed with our host to visit Baltimore’s Christmas Street, in a section of the city known as Hampden. For 65 years, the residents of Baltimore’s 34th Street have drawn crowds from all over the world to view their display of Christmas lights.

Assessment

Crowd favorites are the motorized robot, the hubcap “Christmas tree”, and “snowmen” made from bicycle tires. The eaves of houses drip with strings of lights that illuminate Nativity scenes, while glowing candy canes light the sidewalks.

And, the hot chocolate and pizza, down the street at Angelo’s Restaurant, was especially delicious on any cold wintry night.

Video link: https://www.youtube.com/watch?v=hwk5N6qBx8Q

Channel Surfing

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.

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 ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

Sponsors Welcomed

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

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

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Book Dr. David E. Marcinko MBA for your Next Seminar

 Join Our Mailing List

Schedule Marcinko for Your Next Seminar!

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http://www.CertifiedMedicalPlanner.org

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Book Dr. David Edward Marcinko CMP®, MBA, MBBS for your Next Medical, Pharma or Financial Services Seminar or Personal and Corporate Coaching Sessions 

Dr. Dave Marcinko enjoys personal coaching and public speaking and gives as many talks each year as possible, at a variety of medical society and financial services conferences around the country and world.

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

Topics Link: toc_ho

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

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

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[HOSPITAL OPERATIONS, ORGANIZATIONAL BEHAVIOR AND FINANCIAL MANAGEMENT COMPANION TEXTBOOK SET]

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[Foreword Dr. Phillips MD JD MBA LLM] *** [Foreword Dr. Nash MD MBA FACP]

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Popular Pre-Halloween Content for 2019

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Aggregating Content – Disseminating Knowledge

By Dr. David Edward Marcinko MBA [Editor-in-Chief]

Nathaniel Potter MD

Halloween (also spelled Hallowe’en) is an annual holiday celebrated on October 31st.  It has roots in the Celtic festival of Samhain and the Christian holy day of All Saints.

Today, it is largely a secular celebration but some have expressed strong feelings about perceived religious overtones.

Here are two interesting and popular ME-P articles for this Halloween season.

Poe: https://healthcarefinancials.wordpress.com/2009/08/27/off-road-touring-with-dr-marcinko-part-vi/

Potter: https://medicalexecutivepost.com/2009/08/27/off-road-touring-with-dr-marcinko-part-vi/

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“DANCE OF DEATH”

[Copyright 2018 iMBA Inc., All rights reserved. USA]

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:

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

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Are You a Continuing Education Pioneer?

More on Lifelong Learning

[By Dr. David Marcinko MBA]

Today, it is increasingly imperative for colleges and universities to expand the universe of targeted adult-learners. This is for aspiring professionals, managers, executives and leaders, or those already in the workforce. The tuition gathering universe is thus expanded beyond graduation.

I developed and launched several such successful CE programs that were merged or sold to private investors, colleges and hedge funds

SAMPLE: www.PodiatryPrep.org

Also known as Executive Service Line [ESL] education, this business model refers to academic programs for adults that are generally non-credit and non-degree-granting, but may lead to professional certifications.

Estimates by Business Week magazine suggest that executive education in the United States is a $900 million annual business with approximately 80 percent provided by university schools.

SAMPLE: www.CertifiedMedicalPlanner.org

In addition to the educational benefits, monetary dividends are reaped as enrollment eases matriculation access. Similar programs at the Wharton School, Darden, Harvard, Duke, Yale and the Goizueta Business School at Emory University charge premium rates for the implied institutional moniker.

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ASSESSMENT: Your thoughts are appreciated. Are you a continuing education pioneer?

MORE BUSINESS AND INVESTING FOR DOCTORS:

“Insurance & Risk Management Strategies for Doctors” https://tinyurl.com/ydx9kd93

“Fiduciary Financial Planning for Physicians” https://tinyurl.com/y7f5pnox

“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8

THANK YOU

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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Three things hospitals can do to improve their financial situation?

Join Our Mailing List 

About the Dupont Decomposition Equation [DDE]

DEM blueBy Dr. David E. Marcinko MBA CMP

[Editor-in-Chief] http://www.CertifiedMedicalPlanner.org

According to the Dupont Decomposition Equation – which involves the conglomeration of net operating income, revenues, expenses and average operating assets – ROI and economic profit is increased in three prioritized ways:

  1. Cost and expense reductions.
  2. Revenue increases [Rev]
  3. Reduced average operating assets [AOO]

Note: ROI = NOI / Rev X Rev / AOO

Cost and expense reductions

Although many hospitals have reduced expenses, postponed projects and put clinical or information technology projects on hold because of the MU conundrum, this may be unwise and quality may suffer. And, mental health care programs are almost always the first cost center to be reduced in tough times.

Upgrades today, especially with concurrent marketing and advertising promotions, may well be considered a strategic competitive advantage, and at bargain basement prices for those with cash or credit. This cost reduction is easy because it gives the biggest buck-bang in the ROI equation, and is the first line of ROI augmentation by savvy administrators and CEOs. It is also intuitive and wholly “wrung-out” in the marketplace, to date.

Revenue increases

On the other hand, revenues can usually be only incrementally increased by improving services like emergency care, urgent care, wellness, out-patient and/or surgical departments. This is the more difficult part of the equation and yields a positive, but lesser return in the ROI equation.

Three Modern Collections Rules

The following medical practice procedures will markedly increase upfront office collections:  

  • Train staff to handle exceptions. What is your policy if the patient payment is significant? Will you allow 25% payments—one today and three over the next three months? Communicate your policy to all staff. What will you do if a patient shows up without an insurance card? There will be other exceptions. Train employees to call the appropriate practice-management contact when an exception does not fit in the categories you provide and make sure those managers are responsive.
  • Understand that not everyone will shine in collections. The value of this new front-desk function should be reflected in job descriptions and wages. Track staff performance and hold employees accountable for collection goals. The most successful practices collect in the 90% range.
  • Provide professional signage that states your basic policy. “Payments are due at time of service.” Avoid typewritten, lengthy explanations taped to walls or desks that look like clutter.

Reduced average operating assets

Finally, any delay in updating facilities – while easy and may reduce operating assets – there is little ROI advantage and profit potential. Of course, facility asset upgrades mean borrowing funds through tax-exempt bonds – the main source of debt for most hospitals – and is currently difficult or impossible in this climate. Loans from banks, private investors, angels, venture capitalists or other financial institutions are similarly difficult to obtain. Thus, this part of the equation may often be neglected; as is the case now.

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hospital

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Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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About Dr. David Edward Marcinko MBA CMP™

At Your Service

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Chief Executive / Education Officer * Speaker * Author * Researcher and Professor of Health Economics, Finance & Policy Management 

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http://www.DavidEdwardMarcinko.com

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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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