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

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

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

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

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

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

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

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Dr. Marcinko Interviewed on the Physician Credit Crunch

Financial Experts Share Tips on Obtaining Loans to Start or Expand a Medical Practice

By Michael Gibbons

Editor: ADVANCE Newsmagazines

Maybe you’re a young dermatologist or plastic surgeon who dreams of starting your own practice. Or maybe you’re an established professional but want to expand your palette of anti-aging services. Either way, you’ve probably made an unpleasant discovery: Banks are leery about lending today. Global recessions with seemingly no end in sight tend to give loan officers sticky fingers.HO-JFMS-CD-ROM

Dermatologists and Plastic Surgeons

We have it on good authority that dermatologists and plastic surgeons as a group are less affected by this problem than physicians in some other branches of medicine. Still, there’s no better time than now to absorb some sound advice on how to approach banks for loans—whether you’re a fresh-faced newcomer to the fresh-face business or a wrinkled veteran at eliminating wrinkles.

Start Small

There’s no soft-soaping it: Starting a healthy aging practice is much harder than expanding an existing practice, even in the flushest of times.

“For young dermatologists starting out, I recommend you start small,” advises Jerome Potozkin, MD, who offers facial rejuvenation, liposuction, body contouring and dermatological care through his practice in Walnut Creek, CA. “You can always expand. Keep your overhead low. Know what your credit score is and do everything you can to improve it. Pay your bills on time.”

Lasers aren’t cheap. Besides the initial acquisition costs, a service contract can cost $7,000 to $12,000 a year, according to Dr. Potozkin. “Don’t feel you have to buy every new laser under the sun,” he says. “In fact, renting rather than purchasing is an option many companies offer. When your volume is low you can rent and schedule laser days—although the pitfall there is you don’t have lasers available whenever patients come in.”

Also, young dermatologists “will probably have an easier time getting a loan if they go to a relatively underserved area, as opposed to an area that has a large number of dermatologists per capita,” says Dr. Potozkin, who began practicing 10 years ago. “There are two schools of thought on this: Go where you want to live to start a practice or go to where there’s a need and be instantly successful. I chose the former. It took me longer to get started but I’m very happy where I am.”

Patience, Prudence and Passiondem2

Be patient, prudent, passionate—and start with a spare office and as little debt as possible, advises Dr. David E. Marcinko MBA, a financial advisor and Certified Medical Planner™. Marcinko, a health economist,  is CEO of the Institute of Medical Business Advisors Inc., a national physician and medical practice consulting firm based in Norcross, GA www.MedicalBusinessAdvisors.com

“Patients are looking for passion from you, not lavish trappings,” Dr. Marcinko says. “When a banker or a loan officer sees $175,000 or more of debt they are loath to give a loan—and it’s hard to blame them. Purchase a home after you become a private practitioner. You need to be as close to debt-free as you can be.

Exit Strategy

“Another thing bankers want to know is, ‘If we give you a loan and you start a practice and it fails, how will we be paid back?’ They want an exit strategy.”

The good news is dermatology “remains a very lucrative specialty, and in most parts of the country they are in a shortage position, particularly with the aging population,” says Sandra McGraw, JD, MBA, principal and CEO of the Health Care Group, a financial and legal consulting firm based in Plymouth Meeting, PA., that advises the American Academy of Dermatology, among other groups.

“I would start with a realistic business plan for why you think this practice can succeed, in the specific location,” McGraw says. “How many patients do you expect to see? How will they know you are there and available? Remember that banks lend to all kinds of people, so keep your numbers realistic. Overestimating expenses is as bad as underestimating them. Then determine how you want the money—usually a fixed loan for a period of time and then a line of credit as you get your practice going and sometimes need the cash flow.”biz-book

Expanding a Practice

Established dermatologists should have an easier time getting loans to expand their practices. They have, one hopes, a track record of success and assets to put up as collateral.

Mid-career physicians “have cash flow, physician assets and equity to some degree in a house and personal assets,” Dr. Marcinko observes. “Banks can attach loans to personal assets and savings accounts. Ninety-nine percent of times you must sign a personal asset guarantee. Mid-lifers have assets young ones don’t, so mid-lifers aren’t quite the risk. They have businesses that have value and cash flow. Banks like cash flow.”

However, even veterans must do some homework before approaching a bank. “You still want to establish why you want the money and how the expansion will increase your income,” McGraw says.

Another tip: If the bank has loans out with reputable vendors, you might ask the loan officer to recommend them to you as potential contractors. “Sometimes keeping it local and supporting others with loans at the bank can be helpful,” she says.

Assessment

Dr. Marcinko adds, “Bankers today want you to come in with a well-reasoned, well-thought-out and well-written business plan. Give bankers a 30-second elevator speech on why you are different. It’s really important to ask yourself, ‘What can I offer the community as a doctor in my specialty that nobody else can?’ If you bill yourself as the first dermatologist to do laser surgery, that’s a perceived advantage. You purchased the equipment and learned to use it. But anyone can do that. If you can come up with something that nobody else has or can do, that’s how you’re successful in anything.”

Link: Dr. Marcinko Interview

Link: https://healthcarefinancials.files.wordpress.com/2009/08/dr-marcinko-interview.pdf

Conclusion

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“Blowing up the Business Plan” at U.C. Berkeley Haas Business School

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Berkeley’s Lester Center for Entrepreneurship

Entrepreneurship is a Calling

***

By Steve Blank

During the Cold War with the Soviet Union, science and engineering at both Stanford and U.C. Berkeley were heavily funded to develop Cold War weapon systems. Stanford’s focus was Electronic Intelligence and those advanced microwave components and systems were useful in a variety of weapons systems. Starting in the 1950’s, Stanford’s engineering department became “outward facing” and developed a culture of spinouts and active faculty support and participation in the first wave of Silicon Valley startups.

At the same time Berkeley was also developing Cold War weapons systems. However its focus was nuclear weapons – not something you wanted to be spinning out. So Berkeley started a half century history of “inward facing innovation” focused on the Lawrence Livermore nuclear weapons lab. (See the presentation here.)

Given its inward focus, Berkeley has always been the neglected sibling in Silicon Valley entrepreneurship. That has changed in the last few years.

Today the U.C. Berkeley Haas Business School is a leader in entrepreneurship education. It has replaced how to write a business plan with hands-on Lean Startup methods. It’s teaching the LaunchPad® and the I-Corps for the National Science Foundation and National Institutes of Health, as well as corporate entrepreneurship courses.

Here’s the story from Andre Marquis, Executive Director of Berkeley’s Lester Center for Entrepreneurship.

 ***

Blowing up the Business Plan at U.C. Berkeley Haas Business School

[Synopsis]

  • Early-stage investors don’t read business plans
  • We are in the middle of a shift in entrepreneurship education from teaching the waterfall model of startup development (enshrined in business plans) to teaching the lean startup model
  • The Lean LaunchPad process works across a wide range of domains – from science and engineering to healthcare, energy, government, the social sector and for corporate innovation
  • Customer Development works outside Silicon Valley. In fact, it works globally
  • The Lean LaunchPad is a business process that teaches entrepreneurs and innovators to make business-focused, evidence-based decisions under conditions of chaos and uncertainty. It’s a big idea.

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Conclusion

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“When a practicing physician thinks about their risk exposure resulting from providing patient care, medical malpractice risk immediately comes to mind. But; malpractice and liability risk is barely the tip of the iceberg, and likely not even the biggest risk in the daily practice of medicine. There are risks from having medical records to keep private, risks related to proper billing and collections, risks from patients tripping on your office steps, risks from medical board actions, risk arising from divorce, and the list goes on and on. These liabilities put a doctor’s hard earned assets and career in a very vulnerable position.

These new books from Dr. David Marcinko and Prof. Hope Hetico show doctors the multiple types of risk they face and provides examples of steps to take to minimize them. They are written clearly and to the point, and are a valuable reference for any well-managed practice. Every doctor who wants to take preventive action against the risks coming at them from all sides needs to read these books.”

Richard Berning MD FACC [New Haven, Connecticut, USA]

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CRAFTING A BUSINESS PLAN AND STARTING A MEDICAL PRACTICE

[Understanding Business Models, the Entrepreneurial Spirit and Obtaining Capital]

Dr. DEM

By Dr. David Edward Marcinko MBA CMP™

Medical Office Business Plan

We have been involved in the highly competitive private, and/or “for-profit”, education sector for two decades. Yet, are also familiar with the larger public university and sustainable ecosystem.

Solo Medical Practice NOT Dead!

For example, we’ve participated in start-up business competitions, and refereed PhD / MBA Capstone presentations at Georgia State University, Emory University and the Georgia Institute of Technology; including at Triangle Technology Park, NC; and the Whitman School of Business in Syracuse, NY.

Funding was achieved for emerging initiatives deemed most efficient and profitable; like solo and small group medical practices and clinics.

Executive Service Line [ESL] education

Also known as Executive Service Line [ESL] education, this business model refers to academic programs for business leaders and 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. Beside the educational benefits, monetary dividends are reaped as open enrollment eases matriculation access. Similar programs at the Wharton School, Darden, Harvard and the Goizueta Business School at Emory University charge premium rates for the implied institutional moniker.

Assessment

And, an imperative is that electronic technology be used to expand the universe of targeted adult-learners. This is for aspiring professionals and executives, or those already in the workforce. The tuition gathering universe is thus expanded beyond the School. We have developed and launched several such successful programs that were merged or sold to private investors, colleges and hedge funds

***

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What’s the Chance a Startup Business will Fail?

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On Survival Rates

By Radel Artida (radel@staff.com

Blame it on the media when people seem to think that their hot tech startup will make them a billionaire by their mid-20s. And, doctors are not immune.

Startup

Assessment

On a lesser level, doctors and medical professionals who seek independence and their own practice should be aware of the factors that contribute to a startup’s success. So, we created this infographic on those factors, or chances, that your startup will fail or succeed.

This also includes some research on projections for the best sectors to start your new business, if you seek another industry.

Conclusion

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

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Crafting a Business Plan and Starting a Medical Practice “Live” Audio Conference

Medical Office Business PlanCrafting A Business Plan And Starting A Medical Practice
Speaker: Dr. David Edward Marcinko MBA CMP
Live Audio Conference
Date:Wednesday, January 30, 2013 Time: 1 pm Eastern | 12 pm Central | 11 am Mountain | 10 am Pacific Length: 60 Minutes
 Order
Do you need money to start or Grow your medical practice?
The “Business Plan” is a key tool for raising start-up capital for a new medical practice, or financing a medical / surgical service line extension for a mature one. It is also used for acquiring loans to finance growth of an existing practice. Although long recognized as a quintessential business tool, its’ formal structure and mental rigor are only now being recognized in the medical community as competition increases in the healthcare industrial complex. There are many reasons to write a medical practice business plan. The process of gathering, compiling and analyzing information is an invaluable experience to the beginning practitioner, or experienced veteran physician. Our expert Dr. David, will discuss all these, step by step in this 1-hour enlightening event. See the steps below:

  • Determine the feasibility of a new practice start-up.
  • Raise money from investment bankers for a new practice.
  • Obtain financing to expand an existing office or turn-around a declining satellite.
  • Develop an operational strategic plan and conduct due diligence.
  • Create a budget, time frame or business direction for a practice.
  • Unmask potential problems, risks or benefits of a medical practice.
  • Focus on market opportunities by determining revenue centers or cost drivers.
  • Persuade third party payers, networks and insurance carriers that your practice has a future and represents a viable synergistic partner for their organization.
  • And more
As a attendee you will get:

  • Power Point slide presentation.
  • Time-line checklist to new medical office launch.
  • Topical comprehensive white paper.
  • Electronic blog forum for further information.
  • And more
Dr. David in this 60-minute conference will present to you:

  • Executive Summary: Where you concisely state the purpose of the loan, the exact amount of money required, an explanation of what the loan will be used for and why it’s needed.
  • Pro-forma Cash Budgets and Financial Statements:You’ll learn to how effectively use your data and underlying assumptions to prepare information that your banker can easily read and buy into.
  • Doctor’s Personal Financial Statements: Learn how to use copies of the last 3 years of personal tax returns for the bank as well as identify the collateral being pledged as security for the loan.
  • Representation: Here is where this presentation is invaluable.
  • And more
Order
Call 1-866-458-2965 and mention code STCIGH02
Ask a question at the Q&A session following the live event and get advice unique to your situation
About Our Speaker
Dr. David Edward Marcinko MBA CMP is founding CEO of the Institute of Medical Business Advisors, Inc www.MedicalBusinessAdvisors.com and Publisher of the Medical Executive-Post www.MedicalExecutivePost.com iMBA Inc is a leading national scope provider of real time medical practice management reports, books, dictionaries, journals, financial planning and advisory opinions, Fair Market Value appraisals and educational seminars www.CertifiedMedicalPlanner.org  The firm serves physicians, nurses and medical societies; financial advisors, wealth managers and CPAs; emerging healthcare entities, hospitals, clinics, IPAs and their CXOs; the press, media and all related organizations. Read more
Get $20 Off On Registering NOW!(Use Codé “David20” at Checkóut )

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Crafting a Business Plan and Starting a Medical Practice [A “Live” Audio-Conference]

Conference Registration: http://www.audioeducator.com/hospitals-and-health-systems/business-plan-for-medical-practice-013012.html

Wednesday, Jan 30th, 2013 at 1 PM, EST for 60 minutes

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By Staf Reporters www.CertifiedMedicalPlanner.org

Dr David E Marcinko MBAThe “Business Plan” is a key tool for raising start-up capital for a new medical practice, or financing a medical / surgical service line extension for a mature one. It is also used for acquiring loans to finance growth of an existing practice.
Although long recognized as a quintessential business tool, its’ formal structure and mental rigor are only now being recognized in the medical community as competition increases in the healthcare industrial complex.

Reasons for the Plan

There are many reasons to write a medical practice business plan. The process of gathering, compiling and analyzing information is an invaluable experience to the beginning practitioner, or experienced veteran physician. Our expert Dr. David E. Marcinko MBA CMPwill discuss all these, step by step in this 1-hour enlightening event.

See the steps below:

  • Determine the feasibility of a new practice start-up.
  • Raise money from investment bankers for a new practice.
  • Obtain financing to expand an existing office or turn-around a declining satellite.
  • Develop an operational strategic plan and conduct due diligence.
  • Create a budget, time frame or business direction for a practice.
  • Unmask potential problems, risks or benefits of a medical practice.
  • Focus on market opportunities by determining revenue centers or cost drivers.
  • Persuade third party payers, networks and insurance carriers that your practice has a future and represents a viable synergistic partner for their organization.

Medical Office Business Plan

As an attendee you will get:

  • Power Point slide presentation.
  • Time-line checklist to new medical office launch.
  • Topical comprehensive white paper.
  • Electronic blog forum for further information.

Dr. Marcinko in this 60-minute conference will present to you:

  • Executive Summary: Where you concisely state the purpose of the loan, the exact amount of money required, an explanation of what the loan will be used for and why it’s needed.
  • Pro-forma Cash Budgets and Financial Statements: You’ll learn to how effectively use your data and underlying assumptions to prepare information that your banker can easily read and buy into.
  • Doctor’s Personal Financial Statements: Learn how to use copies of the last 3 years of personal tax returns for the bank as well as identify the collateral being pledged as security for the loan.
  • Representation: Here is where this presentation is invaluable.

Ask a question at the Q&A session following the live event and get advice unique to your situation, directly from our expert speaker.

Who should attend? Medical students, interns, residents and fellows, New, mid-career and mature medical practitioners, Office managers, clinic administrators, healthcare CXOs and physician / nurse executives, All doctors who wish to be employers; not employees.

http://businessofmedicalpractice.com/chapter-3-2/

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  • Save money on travel. Our conferences are available from the comfort and convenience of your own office or meeting room.
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  • Keep learning after the event. Every conference purchase includes the speaker’s materials so you can keep learning long after the conference is over.
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Crafting a Medical Practice Business Plan

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By Dr. David Edward Marcinko MBA

An Essential Document for Start-Up Practices

The analog to a personal financial plan is the medical practice business plan. While mature practitioners may casually be familiar with some elements of the former by default, most new physicians are totally unfamiliar with requirements of the later.  

The Need 

Unfortunately, without an initial business plan, the need for a personal financial plan may become moot. This is because absent financial backing from family, friends or a cushy nest egg, the business plan is a key tool for raising start-up capital for a new medical practice. It may also be demanded by a commercial bank, or the Small Business Administration (SBA), for a loan to finance growth of an existing practice; despite the use of new asset based lending and accounts receivable factoring techniques.  

On the other hand, a comprehensive business plan may be required by investment bankers for funding purposes; in exchange for a healthy percentage of your future large group practice. 

Standard Plan Format 

The following format for medical business plan writing can be used for every new practice, established practice or simply an existing practice that wishes to expand or establish a new service or product line to its existing offers.  

The format for any written business plan is somewhat standard. It usually contains at least the following topics and sub-topics, and perhaps many more depending on your specialty with a varying emphasis on some sections or a de-emphasis of others; also depending on the practice and covering no more than 25-40 numbered pages:

· Cover Sheet

· Table of Contents

· Physician Executive Summary (Statement of Purpose)

· Physician Credentials

· Mission Statement

· Goals and Objectives (Risks and Rewards)

· Business Office Form

· Operational and Facilities Management

· Marketing Plan

· Business Competition

· Patient Targeting

· Advertising Methodology

· SWOT Analysis

· Practice Philosophy

· Human Resources and Personnel

· Financial Management

· Financial and Operating Budget

· Proforma Financial Statements

· Exit Strategy

Assessment

In the past, perhaps the two most important components of a medical business plan were [1] physician credentials and [2] the business model. Today; it is the exit strategy! 

Have you ever written a medical office business plan and what was the outcome? 

Link: MBA Capstone Business Planning

Conclusion

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

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