The CORPORATE PRACTICE of Medicine?

Posted on June 2, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA CMP®

SPONSOR: http://www.CertifiedMedicalPlanner.org

CORPORATE PRACTICE OF MEDICINE (CPM) LAWS

OK – I admit that I am not an attorney. But, approximately half of states in the U.S. have made it unlawful for practicing physicians to be employees of corporations. This ban on the corporate practice of medicine (CPM) is intended to keep medical professionals independent and free from financial pressures and influence.

Most states have made exceptions allowing physicians to become employees of not-for-profit organizations and sometimes hospitals. States such as California, Iowa, and Texas, have declined to allow hospitals to employ physicians, although even those states have special exceptions. Iowa hospitals may employ pathologists and radiologists, and Texas public hospitals and California teaching hospitals may employ physicians. Ohio has no ban on the corporate practice of medicine.

ASSESSMENT: Anyone can own a physician practice in Ohio.

QUERY: So, who does the aggrieved patient sue?

YOUR THOUGHTS ARE APPRECIATED

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

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

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THANK YOU

***

Filed under: "Doctors Only", Career Development, CMP Program, Ethics, Health Law & Policy, Professional Liability, Risk Management, Sponsors | Tagged: certified medical planner, CMP, corporate practice medicine, CORPORATE PRACTICE OF MEDICINE LAWS, David Edward Marcinko, medical risk management | Leave a comment »

The Business of Medical Practice [3rd. edition]

Posted on May 30, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

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

Click to access foreword-silva.pdf

SPONSOR: http://www.CertifiedMedicalPlanner.org

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

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

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THANK YOU

***

Filed under: "Advisors Only", "Doctors Only", Accounting, Book Reviews, Career Development, CMP Program, Ethics, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc., Information Technology, Insurance Matters, Managed Care, Marketing & Advertising, Media Mentions and PR, Practice Management, Practice Worth, Professional Liability, Quality Initiatives, Recommended Books, Research & Development, Risk Management, Sponsors, Touring with Marcinko | Tagged: Business of Medical Practice, Certified Medical Planner™, CMP, David Edward Marcinko | Leave a comment »

Health Dictionary Series of Administrative Terms

Posted on May 29, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

To keep up with the ever-changing healthcare industrial complex, we must learn new definitions and re-learn old terminology in order to correctly apply it to practice. By aggregating the most up-to-date abbreviations, acronyms, definitions and terms, the Health Dictionary Series offers a wealth of information to help understand the ever-changing terms-of-art in healthcare today.

Each 10,000 item handbook is essential for doctors, nurses, benefits managers, financial advisors/planners, and insurance agents, CPAs, and administrators; as well as graduate and under graduate students and professors. Our goal to for each dictionary to be designated as a Doody’s Core Title.

Dictionary of Health Insurance and Managed Care

With more than 10,000 definitions, 4,000 abbreviations and acronyms, and a 3,000 item oeuvre of resources, readings, and nomenclature derivatives, this dictionary covers the Medicare, managed care and Medicaid, private insurance, Veteran’s Administration and PP-ACA language of the entire health and long-term care insurance sector.

Dictionary of Health Economics and Finance

Health economics and finance is an integral component of the health care industrial complex. Its language is a diverse and broad-based concept covering many other industries: accounting, mathematics, the actuarial sciences, stochastics and statistics, salary reimbursements, physician payments, compensation and forecasting are all commingled arenas.

Dictionary of Health Information Technology Security

There is a myth that all healthcare stakeholders understand the meaning of information technology jargon. In truth, the vernacular of contemporary systems is unique, and often misused or misunderstood. Moreover, emerging Heath Information Technology (HIT) thru the HITECG initiatives; in the guise of terms, definitions, acronyms, abbreviations and standards; often puts the non-expert in a position of maximum uncertainty and minimum productivity.

FOREWORDS

[Mike Stahl PhD MBA] *** [Foreword Dr.Mata MD CIS] *** [Dr. Getzen PhD]

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Filed under: Career Development, CMP Program, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Information Technology, Investing | Tagged: Certified Medical Planner™, CMP, Dictionary of Health Economics and Finance, Dictionary of Health Information Technology and Security, dictionary of health insurance and managed care, Health Dictionary Series of Administrative Terms | 2 Comments »

THE ANATOMIC BASIS OF HUMAN PHYSIOLOGY AND BEHAVIOR?

Posted on May 24, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

BRAIN ANATOMY

By Dr. David Edward Marcinko MBA CMP©

SPONSOR: http://www.CertifiedMedicalPlanner.org

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.

https://wallpapercave.com/wp/wp3011600.jpg

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™

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

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

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

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THANK YOU

***

Filed under: CMP Program, Investing, Portfolio Management, Professional Liability, Recommended Books, Retirement and Benefits, Risk Management, Touring with Marcinko | Tagged: brain anatomy, Certified Medical Planner™, CMP, Financial Planning, human physiology, Investing, medical risk management, neurology, psychiatrist, psychology | Leave a comment »

Non-Traditional Physician Compensation Models

Posted on May 19, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

Creative Compensation Models

"Advisors Only" | The Leading Business Education Network ...

BY DR. DAVID EDWARD MARCINKO MBA CMP®

A Review of Some Newer Compensation Models

http://www.CERTIFIEDMEDICALPLANNER.org

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.

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

THANK YOU

***

Filed under: "Doctors Only", Career Development, CMP Program, Experts Invited, Health Economics, Health Insurance, Managed Care, Recommended Books, Touring with Marcinko | Tagged: Certified Medical Planner™, CMP, concierge medicine, David Edward Marcinko, direct reimbursement, global healthcare, locum tenens nurses, locum tenens physicians, medical tourism, Non-Traditional Physician Compensation Models, P4P, PQRI | 1 Comment »

OVER HEARD IN THE FINANCIAL ADVISOR’S LOUNGE

Posted on May 15, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

“TAKE THE FIDUCIARY PLEDGE”

FINANCIAL ADVISORS LOUNGE AT iMBA, Inc.

SPONSORED: http://www.CertifiedMedicalPlanner.org

DEFINITION: A fiduciary is a person who holds a legal or ethical relationship of trust with one or more other parties (person or group of persons).

Typically, a fiduciary prudently takes care of money or other assets for another person. One party, for example, a corporate trust company or the trust department of a bank, acts in a fiduciary capacity to another party, who, for example, has entrusted funds to the fiduciary for safekeeping or investment. Likewise, financial advisers, financial planners, and asset managers, including managers of pension plans, endowments, and other tax-exempt assets, are considered fiduciaries under applicable statutes and laws.

In a fiduciary relationship, one person, in a position of vulnerability, justifiably vests confidence, good faith, reliance, and trust in another whose aid, advice, or protection is sought in some matter. In such a relation good conscience requires the fiduciary to act at all times for the sole benefit and interest of the one who trusts.

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

[Fiduciary Pledge]*

I, the undersigned, ___________________________ (“financial advisor”), pledge to always put the best interests of _______________________________ (“client”) first, no matter what.

As such, I will disclose in writing the following material facts and any conflicts of interest (actual and/or perceived) that may arise in our business relationship:

All commission, fees, loads, and expenses, in advance, client will pay as a result of my advice and recommendations;
All commission and commissions I receive as a result of my advice and recommendations;
The maximum fee discount allowed by my firm and the largest fee discount I give to other customers;
The fee discount client is receiving;
Any recruitment bonuses and other recruitment compensation I have or will receive from my firm;
Fees I paid to others for the referral of client to me;
Fees I have or will receive for referring client to any third-parties; and
Any other financial conflicts of interest that could reasonably compromise the impartiality of my advice and recommendations.

Jeff Kuest MBA CFA CFP®

[CounterPoint Capital Advisors]

ASSESSMENT: Your thoughts are appreciated.

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THANK YOU

***

Filed under: CMP Program, Ethics, Financial Planning, iMBA, Inc., Interviews, Investing | Tagged: certified medical planner, Certified Medical Planner™, CMP, CMP Program, David Edward Marcinko, fiduciary, fiduciary pledge, Jeff Kuest, NAPFA | 2 Comments »

COMPREHENSIVE FINANCIAL PLANNING FOR PHYSICIANS & ADVISORS 2.0

Posted on November 27, 2020 by Dr. David Edward Marcinko MBA MEd CMP™

COMPREHENSIVE FINANCIAL PLANNING FOR PHYSICIANS & ADVISORS 2.0
Courtesy: https://lnkd.in/eBf-4vY

BEST PRACTICES OF LEADING CERTIFIED MEDICAL PLANNERs®
Website: https://lnkd.in/eVGcji5

BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS:
1 – https://lnkd.in/ebWtzGg
2 – https://lnkd.in/ezkQMfR
3 – https://lnkd.in/ewJPTJs

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

Thank You
***

Filed under: Financial Planning, iMBA, Inc., Investing | Tagged: About the Certified Medical Planner™ Program, CMP, Financial Planning, Investing | Leave a comment »

Meet David K. Luke MIM CMP™ [An ME-P Thought-Leader]

Posted on December 18, 2018 by Dr. David Edward Marcinko MBA MEd CMP™

A Physician Focused Financial Advisior and Certified Medical Planner™

Financial Management Experience

https://www.medicuswealthplanning.com/team/david-k-luke

David K. Luke focuses on helping physicians, medical professionals, and successful retirees with financial planning, investment and risk management.

In the past 24 years of industry experience, David has held licenses including general securities registered representative, registered investment advisor, Branch management supervision, and Life, Accident, and Health Producers.

David, a fee-only advisor, is able to help his clients to achieve peace of mind and greater assurance with their financial goals by giving advice and providing investment management that is in their best interest, untainted by commissions or sales objectives. Likewise, in a true fiduciary capacity, he is able to help investors determine the reliability and suitability of products and services that they have been sold by other advisors.

David began his career managing money in 1986 in the General Motors of Canada Banking and Investments department where he was engaged in cash management, foreign currency hedging, and the debt issuance of a $100 million Eurobond and a $300 million Note Issuance facility. In 1988 as Supervisor of Borrowings for GMAC Canada David was responsible for the daily average issuance of $125 million in short-term Commercial Paper. David worked as a stock broker and portfolio manager for 2 major national brokerage firms (A.G. Edwards and Wachovia Securities) from 1989 to 2008.

Additionally, at Wachovia Securities David was among an elite group of financial advisors approved as a PIM (Private Investment Management) Portfolio Manager. Prior to joining Net Worth Advisory Group in 2010, David managed his own independent firm, Luke Wealth Strategies, working as a registered representative and investment advisor.

Education and Designations

President 2009/2010, Financial Planning Association (FPA) – Utah Chapter Affiliate
National Association of Personal Financial Advisors (NAPFA)
Member, Medical Group Management Association Master of International Management (Finance concentration)
American Graduate School of International Management Bachelor of Arts, Brigham Young University
Certified Medical Planner™ Professiobnal Designation from iMBA, Inc www.CertifiedMedicalPlanner.org

http://www.CertifiedMedicalPlanner.org

Assessment

David is our newest ME-P “thought-leader”. We look foward to his insider comments and posts. So, please welcome him and give his site a click: http://networthadvice.com/our-team/david-k-luke/

Filed under: CMP Program, Experts Invited, Financial Planning, iMBA | Tagged: •American Graduate School of International Management, CMP, david k. luke, Financial Planning, FPA, Medical Group Management Association, NAPFA, Net Worth Advice, www.certifiedmedicalplanner.com | 1 Comment »

Dr. Marcinko Interviewed on the Physician Credit Crunch

Posted on May 6, 2018 by Dr. David Edward Marcinko MBA MEd CMP™

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.

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 Passion

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.”

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://medicalexecutivepost.com/wp-content/uploads/2009/08/dr-marcinko-interview.pdf

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Tell us what you think. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Join the Medical Executive-Post

Posted on April 28, 2017 by Dr. David Edward Marcinko MBA MEd CMP™

Publishing and Peer-Review Opportunities Always Available

By Ann Miller; RN, MHA

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Top High Yield Dividend Stocks in the Financial Industry

Posted on February 19, 2017 by Dr. David Edward Marcinko MBA MEd CMP™

The Financial Sector Yields

tim

By TIMOTHY J. McINTOSH; MBA, MPH, CFP®, CMP™ [Hon]

The financial sector is a somewhat broad sector, although many of the industries within the sectors tend to move together.

In the last twelve months, the Financial Select Sector SPDR ETF (NYSE: XLF) increased 32%. This compared to an increase of 25% of the S&P 500 index. On a year to date basis, the sector is flat.

***

Continue reading Top High Yield Dividend Stocks in the Financial Industry

***

Conclusion

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Dictionary of Health Insurance and Managed Care

***

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HUMANITARIAN WISDOM IN PATIENT CARE AS A MORAL IMPERATIVE AND …

Posted on December 29, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

…. A MEDICAL RISK MANAGEMENT TOOL in 2018!

***

DEM white shirt

[Dr. David Edward Marcinko CMP™ MBA MBBS]

http://www.CertifiedMedicalPlanner.org

EDITOR-IN-CHIEF

***

In SECTION ONE, of our newest textbook, on medical practitioner personal risk management issues, 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

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

***

http://www.BusinessofMedicalPractice.com

***

MEDICAL Ethics for Challenging Times

[Finding Your Moorings in an Era of Dramatic Change]

Marcinko Ethics

By Render S. Davis MHA

By David Edward Marcinko

***

And so, as you read and reflect on the chapter of SECTION ONE, always remember the words and wisdom of Dr. William Osler, and keep patient welfare as your first priority.

Dr. David Edward Marcinko; CMP™ MBA MBBS [Hon]

[Chief Executive Officer]

iMBA Inc., Norcross, GA

References

Penfield W. Neurology in Canada and the Osler centennial. Can Med Assoc J. 1949; 61(1): 69-73
Osler W. Aequanimitas. Chapter 9, P. Blakiston’s Son and Co., Philadelphia, 1925, p. 159
Bean WB. William Osler: Aphorisms, CC Thomas, Springfield, IL, p. 129.
Osler W. Aequanimitas. Chapter 3, P. Blakiston’s Son and Co., Philadelphia, 1925, p. 34
Thayer WS. Osler the teacher. In: Osler and Other Papers. Johns Hopkins Press, Baltimore, 1931, p. 1.
Osler W. The reserves of life. St. Mary’s Hosp Gaz. 1907;13 (1):95-8.
Osler W. Aequanimitas. Chapter 7, P. Blakiston’s Son and Co., Philadelphia, 1925, p. 124
Osler W. Valedictory address to the graduates in medicine and surgery, McGill University. Can Med Surg J. 1874; 3:433-42.
Osler W. Remarks on organization in the profession. Brit Med J. 1911; 1(2614):237-9.
Jacobs. AM: PMNews, April, 2015.

***

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

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

***

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About “Comments” on the Medical Executive-Post

Posted on September 26, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

One of Just Many Ways to Interact with Us

By Ann Miller RN MHA

[Executive-Director]

If you are not reading our subscriber “comments”, you are not getting all you can from each Medical Executive-Post. And, if you are not reading the links in each post, you are not getting all you can from the ME-P.

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***

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Investing and Economics is an Imprecise Science

Posted on June 11, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

BUT … It’s still all about CONSUMERISM!

[By Dr. David Edward Marcinko MBA MBBS [Hon] CMP™]

http://www.CertifiedMedicalPlanner.org

There is a major variable, dominant in any marketplace that pushes an economy in a forward direction. It is called consumerism.

This became apparent while I was waiting in a doctor colleague’s office one recent afternoon.

Scenario:

The front office receptionist, who appeared to be about 21 years old, was breaking for lunch and her replacement, and appeared not much older, came over to assist.

Realizing the propensity for a long wait, one was taken by the size of waiting room and the number of patients coming in and out of the office. [Americans consume healthcare and a lot of it].

There was another notable peculiarity. The sample prescription bags being carried out the door were no match for the bags under everyone’s eyes, including the doctor’s. The office staff was probably working overtime, if not two jobs, and the doctor was working harder and faster in a managed care / ACA system.

***

[Consumerism driving the Stock Market]

***

Why?

So they all could afford to buy and voraciously consume for their children and themselves. Americans indeed work longer hours than any other industrialized nation.

Assessment

Additionally, as women female medical professionals entered the workforce in unprecedented numbers, the stock markets reached an all time high in 2015, even as money was spent at a feverish pace as the Federal Reserve pumped out money in inflammatory fashion.

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.

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Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

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COMPREHENSIVE FINANCIAL PLANNING STRATEGIES for DOCTORS and ADVISORS

Posted on August 30, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

UPCOMING: Our Newest Major Textbook Release

[By Ann Miller RN MHA]

Release: February 19th, 2015 by Productivity Press, Inc

744 Pages | 43 Illustrations

Editor(s): Dr. David Edward Marcinko MBA CMP™ and Professor Hope Rachel Hetico RN MHA CMP™

***

COMPREHENSIVE FINANCIAL PLANNING STRATEGIES for DOCTORS and ADVISORS

[Best Practices from Leading Consultants and

Certified Medical Planners™]

Features:

Engaging content with case models, templates and examples for all medical professionals and their consulting advisors.
Combines holistic financial planning with new topics like hedge funds, investment banking, Wall Street practices and shenanigans; securities markets and margin accounts; alternative asset classes and investment policy creation – all integrated with emerging health industry concerns like the PP-ACA, ACOs, new tax laws and reimbursement models; practice sales, contracting and valuations; social media, hospital employee fringe benefits and PHO stock options.
Presents disruptive theories on industry suitability rules, fiduciary accountability and stewardship principles, and how to select the most knowledgeable and cost-efficient advisor for every life-cycle need.

Summary

Drawing on the expertise of multi-degreed doctors, and multi-certified financial advisors, COMPREHENSIVE FINANCIAL PLANNING STRATEGIES FOR DOCTORS AND ADVISORS[Best Practices from Leading Consultants and Certified Medical Planners™]will shape the industry landscape for the next-generation as the current ecosystem strives to keep pace. Traditional generic products and sales-driven advice will yield to a new breed of deeply informed financial advisor, or Certified Medical Planner™.

The profession is set to be transformed by “cognitive-disruptors” that will significantly impact the $2.8 trillion healthcare marketplace for those financial consultants serving this challenging sector. There will be winners and losers. The text which contains 24 chapters, and champions healthcare providers while informing financial advisors, is divided into four sections compete with glossary of terms, CMP™ curriculum content, and related information sources:

For ALL medical providers and financial industry practitioners
For NEW medical providers and financial industry practitioners
For MID-CAREER medical providers and financial industry practitioners
For MATURE medical providers and financial industry practitioners.

Using an engaging style, the book is filled with authoritative guidance and health care–centered discussions, to provide tools and techniques to create a personalized financial plan using professional advice. Comprehensive coverage includes topics likes behavioral finance, medical risk management, Modern Portfolio Theory (MPF), the Capital Asset Pricing Model (CAP-M) and Arbitrage Pricing Theory (APT); as well as insider insights on commercial real estate; High Frequency Trading platforms and robo-advisors; the Patriot and Sarbanes–Oxley Acts; hospital endowment fund management, ethical wills, divorce and other special situations.

The result is a codified “must-have” book, for all health industry participants, and those seeking advice from the growing cadre of financial consultants and Certified Medical Planners™ who seek to “do well – by doing good”, dispensing granular physician-centric financial advice: Omnia pro medicus-clientis.

RAISING THE BAR

CERTIFIED MEDICAL PLANNER™

“The informed voice of a new generation of fiduciary advisors for healthcare”

[Omnia pro medicus-clientis]

More:

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

Conclusion

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Enter the Financial Advisory Gurus?

Posted on July 25, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

Understanding the Nexus Between Fame and Quality

[By Rick Kahler CFP®] http://www.KahlerFinancial.com

“I see that firm’s ads everywhere.”

“His books are best-sellers.”

“That advisor does all kinds of free seminars for retirees.”

“She’s on TV all the time.”

The Case … For?

When a financial advisor, someone with a radio or television show, or an author of financial books becomes well-known, it’s easy to assume you can trust that person’s advice. This isn’t necessarily the case.

Recently I was selected by an Internet community site called moneytips.com as one of their top 50 “social influencers.” This is a list of professionals in the areas of wealth and personal finance who use social media and other Internet tools effectively.

Among the top three on this list are Dave Ramsey and Suze Orman, whose books and advice include a great deal of solid information to help people get out of debt, manage money well, and provide for the future. Many others in the top 50 are respected financial journalists and advisors.

The Case … Against?

However, the list also includes a few advocates for high-risk investment methods, proponents of dubious get-rich-quick schemes, and purveyors of poorly researched advice. Those who put together the list focused on how well people established a presence on the Internet and used technology to communicate. That’s an assessment completely unrelated to the question of whether the advice or information being communicated was worthwhile.

Financial Planning

Financial planning, just like any other field, has a solid core of practitioners who quietly and ethically serve their clients. It also has its gurus, its outstanding marketers, and its fringe practitioners with extreme ideas. The challenge for consumers is not to assume fame and quality always go together.

Linking Fame and Quality?

Here are a few suggestions for keeping a balanced perspective about famous or familiar financial faces:

1. Knowing about a professional isn’t the same as knowing a professional. Everyone you know may have heard of Noted Local Advisor. That’s not the same as being able to recommend him or her. Get recommendations first-hand, from people who actually are clients of a firm or have used someone’s plan or advice. Ask specific questions about what they’ve done and how it worked for them.

2. Yes, there are shortcuts to building wealth, but they come with very high risks. For most of us, the best ways to build wealth are gradual and even boring: saving part of every paycheck, living on less than we earn, and investing for the long term in a well-diversified portfolio of different asset classes. It’s natural to wish for an easier, faster way, but that desire can make you more vulnerable to high-risk schemes and even scams.

3. Even if a method of building wealth is perfectly legitimate and works for others, it still may not be a good fit for you. If you’re a reclusive introvert, for example, sales is probably not your best path to success.

4. Apply the same common sense and skepticism to financial products or wealth-building methods that you would use anywhere else. For example, you probably don’t assume that a car’s advertised gas mileage is what you’ll actually get under real-world conditions. In the same way, it’s a good idea to assume that your real-world results from a proposed investment or business will be lower than the advertised numbers.

5. Don’t assume every financial guru is a crook. Many reputable professionals can teach you a great deal about money. Your job is to learn the financial basics so you can evaluate them with some educated skepticism.

More:

Assessment

And always keep in mind that a product or idea is not the same thing as the selling of that product or idea. The true genius of some financial “experts,” after all, is marketing.

Conclusion

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Understanding Some Common Portfolio Payout Methods

Posted on July 7, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA CMP™

Recognizing the risk that market volatility represents to long-term portfolio health, investment accounts and endowment funds utilize a variety of methods to calculate periodic payouts.

Investment Yield: An investment portfolio using this method spends only its dividends and interest and re-invests any unrealized and realized gains. There would appear to be two primary disadvantages of this method. First, the payout amount will be extremely volatile as yields on equity and fixed income investments fluctuate. Second, the endowment manager could be encouraged to adopt a short-term focus on yield to the detriment of purchasing power preservation.
Percentage of the Prior Year’s Ending Market Value: An endowment using this method would withdraw some fixed percentage of the prior year’s market value. As with the Investment Yield method, disbursements from the endowment can be somewhat volatile under this method.
Moving Average: This approach, which is most common among educational institutions, generally involves taking a percentage of a moving average of the endowment market value. The percentage commonly approximates 5% over a 3-year period.
Inflation Adjusted: This portfolio method simply adds some factor to the applicable rate of inflation for the institution or investor.
Banded Inflation or Corridor: This account method is similar to the Inflation Adjusted method except that it establishes a corridor or band of minimum and maximum increases in an attempt to limit the volatility of the disbursement amounts.

More:

Stock Market at New Highs!

Conclusion

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Is the CFP-BOD, and the CFP® mark, in Jeopardy? [VOTE]

Posted on June 28, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

Early CFP® Board Leader Says Future of Certification in Jeopardy

[By Staff Reporters]

The CFP® Board’s strategy of punishing some certificate holders over compensation disclosure issues in what critics charge is an arbitrary manner threatens the future of the CFP® designation, according to one of the early leaders of the board who also chaired its disciplinary commission.

Please vote

And so, we ask this question.

Assessment

Link: http://www.financial-planning.com/news/early-cfp-board-leader-says-future-of-certification-in-jeopardy-2686698-1.html?ET=financialplanning:e14975:86235a:&st=email&utm_source=editorial&utm_medium=email&utm_campaign=FP_Weekend__092713

Read More:

Read even more:

2016 Update:

Conclusion

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Seeking Securities Analysts, Stock-Brokers and Investment Bankers for New “Financial Planning Textbook for Doctors”

Posted on December 24, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

Planning our newest major textbook

By Ann Miller RN MHA [ph-770-448-0769]

[Executive-Director]

Dear Stock Brokers, IBs and Securities Analysts,

Greetings from the Institute of Medical Business Advisors, in Atlanta, Georgia.

Historical Review

As you may know, we released: Financial Planning Handbook for Physicians and Advisors, some time ago. It has enjoyed much success and acclaim in the medical and financial service sectors.

Recently, we have been asked to produce the next edition of this book for our target market of physicians, nurses, medical professionals, healthcare administrators – and those in the financial services sector who target this large and fertile, but rapidly changing niche market.

Why Now?

Urgency for the update has been prompted by ARRA, HI-TECH, the flash-crash of 2008 and the day-crash of 2011; by social, macro-economic and demographic changes; by political fiat and especially the PP-ACA.

Our medical colleagues are frustrated, afraid and fearful for their financial futures. They WANT informed advice.

Thus, true integrated financial planning information that targets this market – very expertly and specifically – is greatly needed.

The Invitation

And so, we ask if you are interested in contributing an updated vision of an existing book chapter.

INVESTMENT BANKING-SECURITIES-MARKETS-MARGIN
HOSPITAL EMPLOYEE BENEFITS AND STOCK OPTIONS
INVESTMENT POLICY STATEMENT CONSTRUCTION

Not to worry – The original MS-WORD® chapter files are archived and available for use. We will forward it to you, upon assignment acceptance.

And, we are again fortunate that our Editor-in-Chief will be Dr. David Edward Marcinko FACFAS MBA CMP™ along with Professor Hope Rachel Hetico RN MHA CMP™ serving as Managing Editor.

They opined at a recent interview for the ME-P.

” … We have entered into an emerging era in the financial planning ecosystem. It is a new era where one size does not fit all; and off-the-shelf financial products and mass sales customization is no long adequate for physicians and medical professionals; or their related generic financial planners or wire-house advisors.

It is a period of rapid change, shifting reimbursement paradigms and salary reductions that focus the healthcare industrial complex on pay-for-performance [P4], compensation for value and quality care; rather than procedures performed and quantity of care.

All must learn to do more with less professionally; and plan their personal financial lives more efficiently than ever before. Mistakes will be more difficult to overcome and the wiggle room that high income earning physicians, nurses and medical professionals used to enjoy is being narrowed by demographic, economic, social, technological and political fiat.

This emerging financial planning analog follows the health industry’s fiscal metamorphosis …”

Style Instructions

The look and feel, format and style, and font and size of the book will remain the same. We use endnotes, not foot notes; and include mini-case reports or illustrative case models. It will be a major text; not a handbook.

Timeline for submission is about 3 months. Additional time is available, if needed, for a comprehensive update. But, we are trying to avoid running too far along into 2014 in order to avoid income tax season and the related time constraints on all concerned.

A Pleasure – Not Burden

This should be a pleasurable project for you; and not anxiety provoking.

So, if you are a medically focused and experienced financial advisor with an: MBA, CFP®, PhD, MD, DDS, MSA/MS, CPA, RN, CMP®, DO, JD and/or CFA degree or designation, etc; please let me know if you are interested in updating and revising our chapters. OR, authoring a new to the world chapter.

Your Payback

In return for your conscientious industry, you will receive a complimentary edition of the entire textbook; be listed on this ME-P as thought-leader with related book advertising content attributed to you; and given e-exposure to our almost 600,000 readers and ME-P subscribers …. Such the deal!

And, you will be added to our roster of experts for potential referrals, interviews, pod-casts and other marketing efforts

Assessment

Regardless of your decision, we remain apostles promoting your core vision of physician focused financial planning whenever possible.

Or, you may suggest another possible author- writer-expert contributor; if you wish.

Just let me know; ASAP [MarcinkoAdvisors@msn.com]

Thank you.
ANN
ANN MILLER RN MHA
[Executive-Director]
INSTITUTE OF MEDICAL BUSINESS ADVISORS, INC.
Suite #5901 Wilbanks Drive
Norcross, Georgia, 30092-1141 USA
[Ph] 770.448.0769

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com

NOTICE: This invitation is not for all readers of the ME-P. It is a privilege invitation intended for those who possess the needed credentials, as decided by us, with an inclination to serve. We reserve the right to accept or reject contributors, and content, at our own non-disclosed discretion.

Filed under: "Advisors Only", Career Development, CMP Program, Financial Planning, iMBA, Inc., Investing, Portfolio Management, Recommended Books, Retirement and Benefits, Taxation | Tagged: About iMBA Inc., authors needed, certified medical planner, CMP, Dr. David Marcinko, financial planning for doctors, hope hetico, invitation | 18 Comments »

How the Medical Executive-Post Survived to our 8th Anniversary?

Posted on October 10, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

And … Why the American Medical News was Shuttered after 50 Years!

[Some Musing on our Eighth Anniversary]

Ann Miller RN MHA

[Executive-Director]

According to well known healthcare industry journalist Kevin B. O’Reilly, a dramatic drop in medical-publishing revenues caused the recent closure of the American Medical News, effective with a final edition of the newspaper published just last month.

Published for more than five decades, AMNews was hit hard by industrywide trends. The newspaper’s revenue fell by two-thirds during the last decade, as reported by Thomas J. Easley, senior vice-president and publisher of periodic publications for the American Medical Association [AMA].

Unsustainable financial losses forced the move despite the newspaper’s editorial quality, the AMA’s senior management reportedly said. But, the Association’s other news operations will be enhanced.

###

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**What the Death of American Medical News Says About the Future of American Medicine**

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How we survive!

We’ve been online for eight years now. We have a skeleton staff, a scalable business model, an almost free distribution model, no print analog, and a tiny electronic advertising revenue stream.

Oh, let’s not forget some brilliant essayists, contrarian contributors, insightful commentators and controversial opinions that are often the elephant in the virtual room.

Our gratitude to you all is without limits.

So, how else do we do it?

Interestingly – Our print books are good, better and best sellers. We’ve been releasing one major, semi-peer reviewed text each year …. and sales are brisk. And, we are now negotiating to begin our next and ninth volume for 2014-15. We maintain our own copy-rights, perform in-house editing, seek out the best contributing authors, and reduce the cost of numerous channels of distribution. How do we do it, year after year? In a word, professional crowdsourcing.

Our consulting business is increasingly robust, too. Cudos to healthcare reform, managed care, and the PP-ACA!

And … another thing

I ask again. How do we do it? How do we stay in business?

Here are some more ways to help-us, do just that:

Subscribe to the ME-P site
Tell a friend or colleague about us
Visit our Blogroll list
Use our classified ads or advertise with us
Purchase a printed handbook, dictionary, software product or textbook
Use our career and educational resources
“Ask a Consultant” for free advice
Request a strategic competitive consultation
Hire us for a medical practice valuation or revenue enhancement review
Request a medical business planning RFP
Purchase a practice management checklist
Seek out our financial planning advice
Ask for second opinion; hire our thought-leaders
Request a healthcare econometrics review
Seek out our practice management or business advice
Become a Certified Medical Planner™ www.CertifiedMedicalPlanner.org
Request a speaker for a pharmaceutical seminar or health convention
Attend a seminar, sponsor or take a learning-teaching cruise with us
Donate to us … and repeat
Buy a link … and repeat again
Send a thank you note to our Publisher-in-Chief and Managing Editor
Visit us often to review, read, rant and rave.

Bottom Line Eight Years Out

The ME-P is an austere … Labor of Love.

Please support us: Support the “Medical Executive-Post”

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Multi-Year Pledge Form: Multi-Year Pledge

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Assessment

So, does the demise of the American Medical News really say anything at all about the ME-P; in addition to the future of domestic medicine? How do we avoid the same fate? Please tell us. Question Everything … Trust No One … Paddle your Own Canoe … Keep the Faith!

Conclusion

Your thoughts and comments on this ME-P are appreciated. Did the AMNews forget the aphorism; No margin – No Mission?

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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BLOG: www.MedicalExecutivePost.com

Filed under: CMP Program, iMBA, Inc., Marketing & Advertising, Op-Editorials, Touring with Marcinko | Tagged: AMA, american medical association, American Medical News, certified medical planner, CMP, institute of medical business advisors, Kevin B. O'Reilly, medical executive post, Thomas J. Easley | Leave a comment »

PP-ACA Physician Ownership Provisions

Posted on July 5, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

Understanding the “whole hospital exception” to the Stark laws

By Dr. David Edward Marcinko MBA CMP®

www.CertifiedMedicalPlanner.org

This was a big week for healthcare reform, wasn’t it? Some provisions of the PP-ACA requiring the employer mandates were delayed another year; until January 1, 2015.

But, before passage of the ACA in 2010, the “whole hospital exception” to the Stark law allowed physicians to have an ownership interest in a hospital to which those physicians refer patients, provided the physician is invested in the whole hospital and not a subdivision of the hospital, with no limitations as to the amount or extent of physician ownership, on either an aggregate or individual basis.

Prohibitions

Now, according to colleague Robert James Cimasi MHA, AVA, ASA, MCBA, CMP®, of www.HealthCapital.com, The ACA completely prohibits physician-owned hospitals which were not Medicare-certified by December 31, 2010.

[1] The ACA allows hospitals with a provider agreement prior to December 31, 2010 to continue Medicare participation if they meet the following four criteria: (1) located in a county with a population growth rate of at least150% the state’s population growth over the last 5 years; (2) have Medicaid inpatient admission percentage of at least the average of all hospitals in the county; (3) located in a state with below-national-average bed capacity; and, (4) have bed occupancy rate greater than state average. [2]

Grandfathered

A very limited number of physician-owned hospital existing in 2010 met or were close to meeting all 4 of criteria.[3] The Reconciliation Act provided a limited exception to the ACA growth restrictions for grandfathered physician owned hospitals that treat the highest percentage of Medicaid patients in their county (and are not the sole hospital in a county).[4]

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Financial Management Strategies for Hospitals and Healthcare Organizations: Tools, Techniques, Checklists and…

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Assessment

Based on these provisions, the 2010 healthcare reform legislation will likely have a considerable negative impact on physician-owned hospitals, in terms of impeding development of new hospitals and expansion of existing hospitals.

Conclusion

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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

[1] “Section-by-Section Analysis with Changes Made by Title X and Reconciliation included within Titles I-IX,” Democratic Policy Committee, http://dpc.senate.gov/healthreformbill/healthbill96.pdf (Accessed 5/24/2010).

[2] “Section-by-Section Analysis with Changes Made by Title X and Reconciliation included within Titles I-IX,” Democratic Policy Committee, http://dpc.senate.gov/healthreformbill/healthbill96.pdf (Accessed 5/24/2010).

[3] “Healthcare Reform: A Brief Analysis on How it Impacts ASCs and Physician-OwnedHospitals – 10 Observations”, By Scott Becker, Leigh Page, and Rob Kurtz, Becker’s Hospital Review, http://www.beckersorthopedicandspine.com/news-a-analysis/legal-a-regulatory/1193-healthcare-reform-abrief- analysis-on-how-it-impacts-ascs-and-physician-owned-hospitals-10-observations (Accessed 5/20/10).

[4] “Section-by-Section Analysis with Changes Made by Title X and Reconciliation included within Titles I-IX,” Democratic Policy Committee, http://dpc.senate.gov/healthreformbill/healthbill96.pdf (Accessed 5/24/2010).

Filed under: CMP Program, Health Economics, Practice Management | Tagged: ACA, CMP, Dr. David Marcinko, physician owned hospitals, Reconciliation Act, robert james cimasi, Stark law, www.CertifiedfMedicalPlanner.org | 2 Comments »

Contribute to the Medical Executive-Post and Tell Us What You Think

Posted on June 11, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

Call for Guest Medical Executive-Posts!

By Ann Miller RN MHA

[Executive-Director]

MarcinkoAdvisors@msn.com

Now that we’ve wrapped up our newest textbook, we thought it would be fun to keep everybody writing to share your best posts and comments with our ever-growing online community.

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We’re open to all kinds of related subjects on the business of medical practice, healthcare economics and finance, HIT and personal financial planning and investing for doctors and all medical professionals.

###

So, if you’d like to comment or be a featured guest on our blog, or know of a great post we should feature or re-print, just let us know by emailing me! BROADCAST yourself.

www.CertifiedMedicalPlanner.org

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Filed under: Book Reviews, CMP Program, iMBA, Inc. | Tagged: certified medical planner, CMP, Medical Executve-Post | 4 Comments »

“Starting a Medical Practice” Webinar with Dr. Marcinko

Posted on January 29, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

SUBSCRIBE TODAY!

Our Next Webinar e-VENT

[Writing 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 www.AUDIOEDUCATOR.com [Knowledge for Healthcare] https://www.audioeducator.com/hospitals-and-health-systems/business-plan-for-medical-practice-013012.html?utm_medium=Email&utm_source=Marcinko_%3cdate%3e&utm_campaign=ETCIGH02

Filed under: Alerts Sign-Up, Career Development, CMP Program, iMBA, Inc., Practice Management, Videos | Tagged: Audio Educator, CMP, david marcinko, Live Audio Conference, medical business plan, www.CertifiedMedicalPlanner.org | 1 Comment »

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

Posted on January 27, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

Crafting 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

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

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 )

Filed under: Breaking News, Career Development, CMP Program, iMBA, Inc., Touring with Marcinko, Videos | Tagged: business plan, CMP, Starting A Medical Practice | 1 Comment »

Hear Dr. Marcinko on Audio-Educator [Do you Need Money to Start or Grow Your Medical Practice?]

Posted on January 13, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

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

By Staf Reporters www.CertifiedMedicalPlanner.org

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.

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 CMP™ 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.

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/

Why use AudioEducator?

Save money on travel. Our conferences are available from the comfort and convenience of your own office or meeting room.
Meet your specific training needs. Whether you attend a live event, load up one of our encore broadcasts, or purchase a CD or PDF transcript — you’ll get the information you need on your schedule.
Keep learning after the event. Every conference purchase includes the speaker’s materials so you can keep learning long after the conference is over.
Save time training your whole staff. Gather around a speaker phone or computer and enlighten your entire team for one low price.
Do you work with a virtual team or multiple locations? Ask our customer specialists about discounts for your whole staff.

REGISTER HERE

http://www.audioeducator.com/speakers/index/speaker/600

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www.BusinessofMedicalPractice.com

Filed under: Career Development, CMP Program, iMBA, Inc., Practice Management, Touring with Marcinko, Videos | Tagged: Audio Educator, business plan, certified medical planner, CMP, Crafting a Business Plan and Starting a Medical Practice, Medical Business Planning, Venture Capital, www.CertifiedfMedicalPlanner.org | Leave a comment »

Fixing the Mental Health Infrastructure of the US

Posted on January 9, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

The Political Topic Du Jour

By David K. Luke MIM CMP™ www.NetWorthAdvice.com

The sad events of the recent tragedy which occurred in at Sandy Hook Elementary School in Connecticut where 20 children and 6 adults were killed painfully reminds us of two problems that are not going away in the United States: continued gun violence and untreated mental illness.

As a Father I could not bear to watch the news coverage. Resolving the problem of high gun violence in this country typically leads to an emotional debate over gun control and gun rights, a debate that in the past has ended with both sides drawing the line and little being accomplished. Politicians that would like to be reelected avoid this emotionally charged hot potato like a leper colony with the hope that the Topic Du Jour will change quickly back to how they can reduce taxes, increase entitlements, or frankly any other issue that will ensure their livelihood for the current elected term. In the meantime, this stalemate is unnecessarily costing the lives of our innocent children and productive citizens that happen to be in the wrong place at the wrong time.

Commonalities

The common thread to almost all of the tragic public gun violence episodes in the past few decades is that the shooter is suffering a serious mental illness. An estimated 26.2 percent of Americans suffer from a diagnosable mental disorder in a given year according to the National Institute of Mental Health (http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america/index.shtml).

Unique among the developed countries is the position of the United States that those with mental illness, like those with any other disease, can receive treatment as long as they pay for it. Those that can’t or choose not to pay for it often end up in dire straits in one of our emergency rooms (the de facto health care solution in the United States for the uninsured) forcing our overworked and understaffed emergency room health professionals to deal with the problem and our hospital systems with spiraling unpaid ER bills. As a country that was founded on the principles of self-reliance and freedom of choice, we recognize the fact that some individuals may prefer not to pay for their health care by electing to not have private health insurance. Lest we become too judgmental of our fellow citizens that do not have health insurance, we should be reminded that our for-profit health insurance industry in the United States that provides the largest portion of payment for healthcare services also precludes individuals that are unhealthy from purchasing coverage. This is done by hiking premiums to unaffordable levels or simply by flat issuing a denial of coverage. So individuals with mental illness, even those diagnosed with mild depression, are often branded by the system that considers mental health issues as preexisting conditions.

Which brings about the question: How does an individual with a mental health illness in the US normally get medical treatment?

Link: Chapter 07: Workplace Violence

Standard Protocol

Normally, the individual sees their primary care physician, talks about the problem, is diagnosed by the physician and receives treatment, which often includes prescription medications. The individual’s private health insurance plan (or Medicare or Medicaid, depending on the age or financial qualification of the individual), covers all this with typically a small or no copay at the doctor’s office. If a medication is prescribed, the drug (often a generic) is covered typically by a small copay at the pharmacy. Further checkups and treatment are all typically covered by insurance with little money out-of-pocket.

Here are the complications to the “normal” answer regarding an individual with a mental illness in the United States seeking help:

Reasons Mental Illness Goes Untreated That Involve Lack of Access to Medical Care

The individual does not have insurance. The cost to treat the problem may be considered unaffordable.
The individual has insurance but the mental illness has been ruled a preexisting condition and is not covered under the policy. The cost to treat the problem may be considered unaffordable.
The individual does not see a health service provider on a regular basis and may not realize that they are sick with a mental illness or consider that it is just stress or a temporary mood change.

Reasons Mental Illness Goes Untreated In Spite of Access to Medical Care

The individual considers seeing a physician for such an issue to be a hassle or too time consuming. Some primary care practices in some parts of the country require a long wait to be scheduled and then a long wait in the waiting room to be seen.
The individual would like to receive treatment for their mental illness, but knows that such treatment will be recorded on their medical records and likewise have repercussions that could include such events as losing their job, tarnishing their reputation in their community, family, church, or other organization, or denying them access to a gun license, pilot’s license, medical licenses, etc. Military service people and police officers, for example can be rightfully disqualified from their positions if certain mental illnesses were revealed on a medical record. Also having a mental illness on their medical record could increase their cost to get life insurance or their ability to get new health insurance should they leave their current employer. Likewise many of these individuals may seek help “off the record” or may avoid seeking help all together and simply “man up” as expected.
The individual, for reasons mentioned above and regardless of medical care access, avoids professional medical care and self-diagnoses their mental illness. Likewise, an individual suffering from severe depression may decide that they have only mild depression and based on “Dr. Google” may start a regimen of Vitamin B, a chromium supplement, and some St. John’s Wort. Self-treatment of mental illness issues with easy access to information and prescription drugs through the internet lulls some individuals into a false sense that they are on the road to recovery when their condition can actually worsen.
The individual may know they need help, may have access to qualified medical help, but may be discouraged from seeking help due to a trusted family member or friend that assures them professional medical help is not necessary. I have even witnessed a loving father tell his diagnosed schizophrenic son who had just experienced a manic episode to “shake it off and be happy”. Can you imagine telling your child who suffers from a serious chronic disease such as heart disease, cancer, or diabetes to just “shake it off and be happy”?
The individual perceives that continued medical treatment of their mental illness could threaten their personal freedoms, by resulting in a court ordered commitment to a psychiatric facility for example. Fearing such restrictions, the individual cuts off all medical treatment. In fact recent news is now coming forth that Adam Lanza, the 20-year-old Sandy Hook shooter, had been taken to a psychiatrist by his mother and was in fear of being committed to a facility, which may have been part of the motive for the mass shooting spree, which included the killing of his mother.

[Re-Thinking our Gun Control Dialog]

Will the PP-ACA Fix Our Maligned Mental Health Care System?

Mental health services are a part of the services provided under the Affordable Care Act. The Mental Health Parity and Addiction Equity Act, which was signed into law in 2008, also helped increase coverage that includes mental health services by requiring employers with more than 50 workers to cover them at the same level as other medical conditions offered by the insurance plan.

In other words, the plan could not provide fewer inpatient hospital days or require higher out-of-pocket costs for mental health conditions. It is still possible however for larger employers to not offer mental health coverage in their insurance plans even after 2014. The ACA will require small group and individual plans however to offer the coverage in 2014 through health exchanges created under the law. An individual that earns less than 138 percent of the federal poverty level may be eligible for Medicaid coverage in 2014, which offers mental health benefits.

It is estimated that as many as 30 million people will gain insurance coverage and likewise mental health care beginning in 2014. Some estimates are lower, with the expectation that many will forgo the mandated insurance coverage and pay the “tax” instead. Even with more Americans having access to mental health care, many will opt to forgo such care as outlined above in “Reasons Mental Illness Goes Untreated In Spite Of Access To Medical Care”.

For those folks we can fault the independent American spirit, good old fashioned stubbornness, the desire to avoid any stigma attached to mental illness, or simply the desire to be unencumbered by a system that threatens to “lock you up and put you away” for your disease. As with the case of Adam Lanza, access to mental health care does not mean the disease is cured or that the patient is an obedient, willing participant.

Assessment

Sadly, preventing another Sandy Hook from occurring is impossible. Whether or not the gun debate this time around will produce any results remains to be seen. Where is the limit of personal freedoms? However, with increased mental health access beginning in 2014 and with increased mental health awareness and acceptance we can hope that such events in the future will be less common.

About the Author:

David K. K. Luke focuses on helping physicians and successful retirees with financial planning, investment and risk management. In the past 24 years of industry experience, David has held licenses including general securities registered representative, registered investment advisor, Branch management supervision, and Life, Accident, and Health Producers. David, a fee-only advisor, is able to help his clients to achieve peace of mind and greater assurance with their financial goals by giving advice and providing investment management that is in their best interest, untainted by commissions or sales objectives. Likewise, in a true fiduciary capacity, he is able to help investors determine the reliability and suitability of products and services that they have been sold by other advisors. David began his career managing money in 1986 in the General Motors of Canada Banking and Investments department where he was engaged in cash management, foreign currency hedging, and the debt issuance of a $100 million Eurobond and a $300 million Note Issuance facility. In 1988 as Supervisor of Borrowings for GMAC Canada David was responsible for the daily average issuance of $125 million in short-term Commercial Paper. David worked as a stock broker and portfolio manager for 2 major national brokerage firms (A.G. Edwards and Wachovia Securities) from 1989 to 2008. Additionally, at Wachovia Securities David was among an elite group of financial advisors approved as a PIM (Private Investment Management) Portfolio Manager. Prior to joining Net Worth Advisory Group in 2010, David managed his own independent firm, Luke Wealth Strategies, working as a registered representative and investment advisor.

He is also a Certified Medical Planner™ charterholder: www.CertifiedMedicalPlanner.org

Conclusion

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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Learn How to Profit and Thrive in the PP-ACA Era

BOOK FOREWORD / TESTIMONIAL

Filed under: CMP Program, Ethics, Op-Editorials | Tagged: ACA, Adam Lanza, CMP, david k. luke, Fixing the Mental Health Infrastructure of the US, gun control, Mental Health Parity and Addiction Equity Act, Sandy Hook Elementary School, workplace violence, www.CertifiedMedicalPlanner.org | 8 Comments »

The Newtown, Conn School Massacre [Lessons to Learn?]

Posted on December 15, 2012 by Dr. David Edward Marcinko MBA MEd CMP™

REPRINT: This re-publication is provided as a service to our readers, as we mourn the children and victims of the Newtown, Conn massacre. The workplace – healthcare setting analogy is self-evident.

Hospital Workplace Violence Risk Factors

[An NIOSH Summary and Review]

By Dr. Eugene Schmuckler MBA CTS

By Dr. David Edward Marcinko MBA CMP™

www.CertifiedMedicalPlanner.org

Domestically, the impact of workplace violence in the US became widely exposed on November 6, 2009 when 39 year old Army psychiatrist Maj. Nidal M. Hasan MD, a 1997 graduate of Virginia Tech University who received a medical doctorate in psychiatry from the Uniformed Services University of the Health Sciences in Bethesda, Maryland, and served as an intern, resident and fellow at the Walter Reed Army Medical Center in the District of Columbia, went on a savage 100 round shooting spree and rampage that killed 13 people and injured 32 others.

In April 2010 he was transferred to Bell County Jail in Belton, Texas. An Article 32 hearing, which determined whether Hasan would be fit to stand trial at court martial, began on 12 October 2010. Hasan subsequently deemed fit, was arraigned on July 20 2011 and trial was scheduled for March 2012. It was rescheduled again, but is now ongoing and in the news; almost daily.

The NIOSH

The National Institute for Occupational Safety and Health (NIOSH) summarizes the risk factors for occupational violence to hospital workers. These include:

working directly with volatile people, especially if they are under the influence of drugs or alcohol or have a history of violence or certain psychotic diagnoses;
working when understaffed — especially during meal times or visiting hours;
transporting patients and long waits for service;
overcrowded, uncomfortable waiting rooms;
working alone;
poor environmental design;
inadequate and/or ineffective security;
lack of staff training and policies for preventing or managing crises with potentially volatile patients;
drug and alcohol abuse;
access to firearms;
unrestricted movement of the public; and
poorly lit corridors, rooms, parking lots, and other areas.

Occupational Violence

Violence occurring in other occupational groups is most often related to robbery. In healthcare settings, however, acts of violence are most often perpetrated by patients or clients. Family members who feel frustrated, vulnerable, and out of control; and colleagues of patients (especially when the patient is a gang member) are also identified as perpetrators of abuse! However, the presence of co-workers has been identified as a potential deterrent to assault in healthcare.

Healthcare and social service workers face an increased risk of work-related assaults stemming from several factors, including:

the prevalence of handguns and other weapons — as high as 25% among patients, their families, and friends. Handguns are increasingly used by police and the criminal justice system for criminal holds and the care of acutely disturbed, violent individuals;
the increasing number of acute and chronically mentally ill patients now being released from hospitals without follow-up care, who now have the right to refuse medicine and who can no longer be hospitalized involuntarily unless they pose an immediate threat to themselves or others;
the availability of drugs or money at hospitals, clinics, and pharmacies, making staff and patients likely robbery targets;
situational and circumstantial factors such as:
- unrestricted movement of the public in clinics and hospitals;
- the increasing presence of gang members, drug or alcohol abusers, trauma patients, or distraught family members;
- long waits in emergency or clinic areas, leading to client frustration over an inability to obtain needed services promptly;
low staffing levels during times of specific increased activity such as meal times, visiting times, and when staff is transporting patients. This also includes isolated work with clients during examinations or treatment;
solo work, often in remote locations, particularly in high crime settings, with no back up or means of obtaining assistance such as communication devices or alarm systems;
lack of training of staff in recognizing and managing escalating hostile and assaultive behavior; and
poorly lighted parking areas.

OSHA

The Guidelines established by the Occupational Safety and Health Administration (OSHA) seek to set forth procedures leading to the elimination or reduction of worker exposure to conditions causing death or injury from violence by implementing effective security devices and administrative work practices, among other control measures. Healthcare professionals need to be aware that violence can occur anywhere and in any practice settings.

In hospitals and clinics, which are more likely to report incidents of violence than private offices, the most frequent sites are:

psychiatric wards;
acute care settings;
critical care units;
community health agencies;
homes for special care;
emergency rooms; and
waiting rooms and geriatric units.

Impact

The impact of workplace violence is far-reaching and affects individual staff members, co-workers, patients/clients, and their families. Those who have been affected, directly or indirectly, by a workplace violence incident report a broad spectrum of responses — anger is the most common. There are also reports of:

difficulty returning to work;
decreased job performance;
changes in relationships with co-workers;
sleep pattern disturbance;
helplessness and symptoms for post-traumatic stress disorders;
fear of other patients; and
fear of returning to the scene of the assault.

Assessment

Link: Chapter 07: Workplace Violence

More: Medical Workplace Violence

BREAKING NEWS: 3 shot in Alabama hospital *** Two die in Nev. hotel shooting

Conclusion

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

From Our Newest Textbook Release

Learn How to Profit and Thrive in the PP-ACA Era

BOOK FOREWORD / TESTIMONIAL

Filed under: Book Reviews, CMP Program, iMBA, Inc., Risk Management | Tagged: CMP, Conn School Massacre, Dr. David Edward Marcinko MBA CMP™, Eugence Schmuckler, hospital violence, Hospital Workplace Violence Risk Factors, massacre, medical workplace violence, National Institute for Occupational Safety and Health, Newtown Conn, NIOSH, OSHA, www.CertifiedMedicalPlanner.org | 9 Comments »

About the Certified Medical Planner™ Program

Posted on September 15, 2012 by Dr. David Edward Marcinko MBA MEd CMP™

The Virtual Certified Medical Planner™ Program, from iMBA Inc.

Our flagship 500 hour Certified Medical Planner™ professional designation program is designed for fiduciary focused FAs, CFPs®, CPAs, RIAs and other financial services professionals and/or doctors, nurses, health entity CXOs, managers and administrators [medical management consultants] and those in career transition looking to enhance their theoretical knowledge and practical experience in the integrated and expanding fields of medical practice management and personal financial planning.

In all our courses, we cover the full spectrum for any given topic. Best of all, we utilize real-life case studies from the marketplace, either as a financial advisor or medical management consultant, so students can actively participate in a mock “working financial advisory group” or “medical managerial team”.

And, our unique CMP™ teaching methodology uses “live” dedicated instructors to help [adult-learners] students understand how to fully integrate quantitative and qualitative analysis when advising clients.

We offer 24/7/365 classes designed for working professionals with a heavy workload or travel schedule. In addition, our courses can be taken without ever having to leave your desk, home, office, practice, or even your hotel room.

Our training program is internet based so most of our students take the course virtually. Nevertheless, while our service delivery model is virtual – the educational benefits and notoriety you receive are REAL!

More info:

Ann Miller RN MHA

[Executive-Director]

www.CertifiedMedicalPlanner.org

###

Filed under: Career Development, CMP Program, Financial Planning, iMBA, Inc., Practice Management | Tagged: About the Certified Medical Planner™ Program, certified medical planner, CMP, financial planning doctors, medical practice management, www.certifiedmedicalplanner.com, www.MedicalExecutivePost.com | 6 Comments »

A Simple Formula For Financial Sobriety

Posted on September 4, 2012 by Dr. David Edward Marcinko MBA MEd CMP™

On Changing Financial Behaviors

By Rick Kahler MS CFP® ChFC CCIM www.KahlerFinancial.com

From time to time I offer financial courses through Community Education of the Black Hills. Classes on the fundamentals of making good investments and how to do your own financial planning usually fill quickly.

But, a class on “financial sobriety”—how to change your psychological behaviors around money and begin making wiser money decisions—had only one person sign up. Based on my 30 years of financial advising, this wasn’t a big surprise.

The Research

Research tells us 70% of US citizens have no savings and live month to month or are insolvent. Only 9% have saved over $100,000 and just 3% over $500,000. The stats for medical professionals are not so transparent.

Why is this? The simple answer is Americans have a significant resistance to saving, including some doctors, according to ME-P Editor-in-Chief, Dr. David Edward Marcinko FACFAS MBA CMP® www.CertifiedMedicalPlanner.org

Mathematically, the solution to this is very simple. Out of every dollar earned, do this: First, pay taxes. Second, save and invest 20% or more. Third, live on the rest. This formula has a high probability of successfully creating financial independence.

So, why are fewer than one in 10 Americans able to follow this simple formula? The answer to that isn’t so simple.

Psychological Responses

The first response to these options is often, “I can’t.” Non-savers tell themselves there is nowhere to cut. When put in context of maintaining their current lifestyle, this is true—and therein lies the problem. When you’re living month to month, becoming a saver inherently means either reducing your lifestyle or increasing your income.

Unfortunately, too many people vaguely intend to start saving when their income goes up. This is backwards. Focusing instead on reducing your lifestyle is what creates the habit of saving.

For some people, downsizing a lifestyle can mean switching kids from private to public schools or selling expensive cars and homes.
For others, downsizing can mean getting rid of cable TV, buying generic brands, and shopping at garage sales instead of Walmart. Most budgets have room for at least a few small cuts. We just can’t see the options, because our brains tell us that reducing our lifestyle will be a fate worse than death.

It may seem that a lifestyle reduction would be a lot easier for high income earner. Yet I’ve seen those earning $750,000 have as much trouble saving $10,000 a year as those earning $50,000. The self-talk and reasons why it’s impossible to cut spending are exactly the same.

Not about Money

It’s not about the money. It’s never about the money. It’s not that most non-savers don’t know the solution to saving more; it’s that they don’t like the solution. We cannot change what we refuse to confront.

It takes a lot of courage to admit you have to change and then take action to actually put a plan into motion. It can feel overwhelming, embarrassing, and fearful. It’s hard saying goodbye to the old lifestyle and the trappings we come to enjoy.

Adaptable Humans

Fortunately, the difficult times are temporary. Humans are very adaptable. Before long you will settle into the new “normal.” You will discover you can be just as happy with your new lifestyle as you were in the old. The anxiety of losing that lifestyle will be replaced with the satisfaction of watching your savings and investments grow, knowing you will someday be able to support yourself without working.

Assessment

Eventually, you will experience much less anxiety than you did when you were living in denial. Knowing you have enough savings to see you through a job loss or other financial calamity is a real anxiety buster.

You may even choose not to increase your lifestyle as your income increases. You’ll be too busy enjoying the financial serenity, satisfaction, and joy that comes with living on less than you earn and building financial independence.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: CMP Program, Events-Planner, Financial Planning | Tagged: behavioral finance, budgeting, CMP, Financial Planning, Financial Sobriety, Rick Kahler CFP®, www.certifiedmedicalplanner.com | 2 Comments »

On Hospital Tax-Exempt Debt

Posted on August 27, 2012 by Dr. David Edward Marcinko MBA MEd CMP™

An important means of external financing for hospitals

By Calvin W. Wiese CPA CMA

By Dr. David Edward Marcinko MBA

www.CertifiedMedicalPlanner.org

Tax-exempt debt has become an important means of external financing for hospitals, primarily because its cost is very attractive. Interest rates on tax-exempt financing are lower than interest rates on financing that is not tax-exempt because the interest income earned by the holders is exempt from federal income tax. In some states, it is also exempt from state income tax and in some cities; it is also exempt from city income tax. Thus, the holders of these debt instruments (usually bonds) are willing to accept lower rates of interest.

State and Local Governments Only

Hospitals themselves are not capable of issuing tax-exempt debt. Only state and local governments are. A state or local government issues tax-exempt debt for hospitals and then loans the proceeds to hospitals. This is called “conduit” financing: the state or local government acts as a conduit through which hospitals can access tax-exempt debt markets. State and local governments are authorized to loan proceeds of their bond issues to hospitals through state statutes, and each state statute is different. Some states authorize any state or local government to issue bonds to loan to hospitals. Other states restrict such power to special purpose governmental entities only. And some states restrict this power to a single governmental entity that is specially formed for the sole purpose of issuing tax-exempt bonds on behalf of hospitals.

The IRS

The Internal Revenue Service (IRS) regulates the issuance of tax-exempt financing. While the IRS code nominally provides that debt instruments issued by state and local governments are exempt from federal income tax, it imposes special rules on conduit issues. Thus, tax-exempt issues whose proceeds are loaned to hospitals must comply with special IRS rules. Although very complex, these rules primarily regulate the use of proceeds, restricting the use of tax-exempt proceeds to the acquisition of property, plant components and equipment.

Given state statutes, IRS code and applicable security laws (both state and federal), issuing tax-exempt bonds is legally complex. Many lawyers get paid handsome fees every time tax-exempt debt is issued. The quarterback of the legal team is the bond counsel who represents the interests of the bondholders; the bond counsel issues the critical tax opinion that investors rely upon to claim tax-exemption on the interest from these instruments. Everything revolves around getting this opinion.

The Underwriter’s

Given its critical nature, only highly qualified lawyers are accepted by the market to provide this opinion. Underwriter’s counsel represents the interests of the investment bankers; their primary concern is compliance with security laws. Issuer’s counsel represents the interests of the state or local government, and hospital counsel represents the interests of the hospital; both have relatively minor roles. In the event credit enhancement is involved, credit enhancement counsel represents their interests and has significant influence on the process.

The Trustees

Another unique party to most tax-exempt bond issues is the bond trustee. The bond trustee is usually a bank who performs a fiduciary duty on behalf of the bond holders throughout the life of the bonds. The face of the faceless bond holders, they act on their behalf. And they, too, are represented by counsel in the bond issuance process.

State or local government typically appoints bond counsel. In many cases, they work with only a single firm. Not unusually, these relationships are quite cozy, and often result in fees being paid that are well in excess of what otherwise would be paid.

The Documents

An excess of documents is involved in most tax-exempt financings. The heart of the documents is the indenture, which is the agreement between the bond trustee (on behalf of the bond holders) and the state or local government issuer. It contains the promises made to the bond holders, and it describes the work of the bond trustee. The bond trustee will only perform actions on behalf of bond holders that are explicitly set forth in the bond indenture. The bond indenture is the security given to the bond holders, describing all their recourses.

Assessment

The bond indenture is typically supported by the loan agreement between the state or local government that issues the bonds and the hospital to which the proceeds are loaned. Its terms complement the terms of the bond indenture, which together, form the conduit.

Conclusion

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

From Our Newest Textbook Release

Learn How to Profit and Thrive in the PP-ACA Era

BOOK FOREWORD / TESTIMONIAL

Filed under: Book Reviews, CMP Program, Healthcare Finance, iMBA, Inc. | Tagged: "conduit" financing, certified medical planner, CMP, Dr. David Marcinko, hospital financing, IRS, municipal bonds, On Hospital Tax-Exempt Debt | Leave a comment »

Vital iMBA Inc Links for Savvy Doctors and their Financial Advisors

Posted on July 21, 2012 by Dr. David Edward Marcinko MBA MEd CMP™

An Educational Resource Supporting Doctors and their Consulting Advisors

We are an emerging online and onground community that connects medical professionals with financial advisors and management consultants. We participate in a variety of insightful educational seminars, teaching conferences and national workshops. We produce journals, textbooks and handbooks, white-papers, CDs and award-winning dictionaries. And, our didactic heritage includes innovative R&D, litigation support, opinions for engaged private clients and media sourcing in the sectors we passionately serve.

Through the balanced collaboration of this rich-media sharing and ranking forum, we have become a leading network at the intersection of healthcare administration, practice management, medical economics, business strategy and financial planning for doctors and their consulting advisors. Even if not seeking our products or services, we hope this knowledge silo is useful to you.

In the Health 2.0 era of political reform, our goal is to: “bridge the gap between practice mission and financial solidarity for all medical professionals.”

Join the ME-P Nation today … and tell us what you think!

###

We are sponsored by the Institute of Medical Business Advisors, Inc

www.MedicalBusinessAdvisors.com

INSTITUTE OF MEDICAL BUSINESS ADVISORS, INC.
Suite #5901 Wilbanks Drive
Norcross, Georgia, 30092-1141 USA
Phone: 770.448.0769

ADMINISTRATORS: http://www.springerpub.com/Search/marcinko
PHYSICIANS:www.MedicalBusinessAdvisors.com
PRACTICE: www.BusinessofMedicalPractice.com
PODIATRISTS: www.PodiatryPrep.com
HOSPITALS:http://www.crcpress.com/product/isbn/9781439879900
ADVISORS:www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com

Assessment

Link: Letterhead.iMBA_Inc.

Link: Letterhead CMP

Conclusion

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

Filed under: "Doctors Only", Estate Planning, Financial Planning, iMBA, Inc., Insurance Matters, Investing, Recommended Books, Retirement and Benefits | Tagged: CMP, Dr. David Edward Marcinko MBA, iMBA, Inc., institute of medical business advisors, www.certifiedmedicalplanner.com, www.medicalbussinessadvisors.com | 1 Comment »

Transitioning and Appraising a Podiatry [Medical] Practice

Posted on July 18, 2012 by Dr. David Edward Marcinko MBA MEd CMP™

A Round Table Fair Market Valuation Discussion of One

By Dr. David Edward Marcinko MBA CMP™

[Former – American Society of Health Economists (ASHE) member]

[Editor-in-Chief]

www.CertifiedMedicalPlanner.org

Recently, I was asked to participate in a roundtable of expert’s discussion on the worth or fair market value [FMV] of a typical podiatric [medical] practice on an “ongoing concern” basis.

Of course, this is the type of engagement we often perform at the www.MedicalBusinessAdvisors.com And, I have written about this topic informally on this blog, and more formally in our white-papers and books: www.BusinessofMedicalPractice.com

So, I was pleased to add my experienced opinion to the discussion sponsored by a trade industry magazine upon the invitation of Editor Dr. Barry H. Block JD.

LINK: Podiatry Mgmt Round Table

Assessment

Due to copyright issues, I posted only my comments to the questions posed to all participants. Nevertheless, they are very representative of most medical practices with the exception of the noted podiatric-specific differences.

Invitation: Letterhead.iMBA_Inc.

Conclusion

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

Filed under: CMP Program, Health Economics, iMBA, Inc., Practice Worth | Tagged: certified medical planner, CMP, Dr. Barry H. Block JD, Dr. David Edward Marcinko MBA, FMV, FMV medical practice, How much is a Podiaty Practice Worth? | Leave a comment »

Promoting the ME-P Holistic Physician Lifestyle

Posted on July 15, 2012 by Dr. David Edward Marcinko MBA MEd CMP™

Enter the Certified Medical Planners™

By Ann Miller RN MHA

[Executive-Director]

Life planning and behavioral finance, as proposed by physicians and financial advisors, and as integrated by the Institute of Medical Business Advisors (iMBA), emanates from a holistic union of personal financial planning and medical practice management solely for the healthcare space.

Source: https://www.mapsforthat.com/map.php?m=587

The CMP™ Difference

Unlike pure life planning, pure financial planning, or pure management theory, it is both a quantitative and qualitative “hard and soft” science. It has an ambitious economic, psychological and managerial niche value proposition never before proposed and codified, while still representing an evolving philosophy. Its’ zealous practitioners are called Certified Medical Planners (CMPs).

Assessment

Health 2.0 focused physician baby boomers & modern Gen-X financial advisors can help transition you successfully through medical practice and life changing financial events by exchanging knowledge, experiences and inspiration with industry professionals and peers in the casual and friendly atmosphere of the ME-P. Join us today.

More: https://medicalexecutivepost.com/2009/10/20/understanding-behavioral-finance/

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: CMP Program, Financial Planning, iMBA, Inc., LifeStyle, Practice Management | Tagged: behavioral econmomics, CMP, Dr. David Edward Marcinko MBA, holistic life planning, medical executive post, www.certifiedmedicalplanner.com, www.medicalbusinessadvisors.com | 6 Comments »

About the Institute of Medical Business Advisors, Inc

Posted on July 8, 2012 by Dr. David Edward Marcinko MBA MEd CMP™

iMBA, Inc

[www.MedicalBusinessAdvisors.com]

Championing the Financial Success of

Doctors and their Consulting Advisors

[Career Development Products and Services]

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

Your Personal DR. Invitation: Letterhead.iMBA_Inc.

Filed under: "Advisors Only", "Doctors Only", Career Development, CMP Program, Financial Planning, Health Insurance, iMBA, Inc., Information Technology, Insurance Matters, Investing, Marketing & Advertising, Portfolio Management, Practice Management, Practice Worth, Professional Liability, Recommended Books, Retirement and Benefits, Risk Management | Tagged: Championing the Success of, CMP, doctors, Dr. Marcinko, financial advisors, institute of medical business advisors, podiatrists, www.CertifiedMedicalPlanner.org, www.medicalbusinessadvisors.com, www.PodiatryPrep.com | 2 Comments »

Taxes and the SCOTUS ACA Decision

Posted on July 1, 2012 by Dr. David Edward Marcinko MBA MEd CMP™

My Synopsis for Physician Investors

By Dr. David Edward Marcinko FACFAS MBA CMP™

www.CertifiedMedicalPlanner.org

[Publisher-in-Chief]

I was at Emory University this past weekend for an unrelated colloquium. But all the chatter, of course, was about SCOTUS, taxes and the just announced ACA decision.

Most doctors I know – just don’t like paying needless taxes. So, what’s the buzz for physicians and other medical professional investors, and their financial advisors [FAs]?

The Synopsis

The taxes to pay for the Affordable Care Act include a new tax on medical devices that will increase costs to individuals and healthcare providers.

There also is a new 3.8% Medicare tax. It applies in 2013 to income and capital gains.

If the expected post-election tax bill extends the current 15% capital gain rate, then the capital gains tax rate will be 18.8% in 2013. However, if the 15% federal capital gains tax rate is increased to 20%, then the new rate in January of 2013 will be 23.8%.

In addition to dividend seeking investors, the increase in capital gains rate may also influence charitable gifts of appreciated property in 2013.

Assessment

Please weigh-in all you FAs and healthcare focused CPAs. What is a physician investor supposed to do, now?

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: Health Insurance, Health Law & Policy, iMBA, Taxation, Touring with Marcinko | Tagged: ACA, CMP, Dr. David Edward Marcinko MBA, Health Insurance, SCOTUS, Taxes and the ACA SCOTUS Decision, www.certifiedmedicalplanner.com | 4 Comments »

A Resource For Financial Planners Who Advise Doctors and Medical Professionals

Posted on June 8, 2012 by Dr. David Edward Marcinko MBA MEd CMP™

Emerging Education Network with Professional CMP™ Designation

Wealth managers, CPAs, JDs, MBAs, MDs, RNs, CFPs, RIAs and financial advisors etc., with an interest in physician clients, the healthcare space, ecoonomics, practice management and medical social media, can now indulge their tastes in all with a new venture by the Institute of Medical Business Advisors, Inc.

Education and Certification: www.CertifiedMedicalPlanner.org

Professional Network: www.MedicalExecutivePost.com

Invitation to Matriculate: Letterhead CMP

Assessment

CERTIFIED MEDICAL PLANNER™ – Entering a niche market, with focused advice from educated advisors and consultants, is the ‘win-win’ business model of the future.

Conclusion

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

Filed under: "Advisors Only", "Doctors Only", Career Development, CMP Program, iMBA, Inc. | Tagged: certified medical planner, CMP, physician career change, www.CertifiedfMedicalPlanner.org | 5 Comments »

EHRs – Still Not Ready For Prime Time

Posted on April 24, 2012 by Dr. David Edward Marcinko MBA MEd CMP™

At Least … Not Yet!

By David K. Luke MIM, Certified Medical Planner™ candidate

www.CertifiedMedicalPlanner.org

Since Feb 17, 2009 when President Obama signed into legislation the Health Information Technology for Economic and Clinical Health Act (HITECH) as a part of the 2009 stimulus package, the incentives were promised for the adoption in health care practices of Electronic Health Records (EHRs).

The Carrot and the Stick

The incentives payments for “meaningful use” range from $63,750 over 6 years by Medicaid to maximum payments of $44,000 over 5 years for Medicare. The penalty for not adopting by Medicare will be 1% of Medicare payments in 2015, increasing to 3% over 3 years. Stimulus money is granted based on meaningful use of an EHR system.

The Reality

Stories are rolling in by early adopters now that give cause for a prudent physician to rethink implementation anytime soon of an EHR for his/her practice. Here is a sampling:

EHRs can be hacked and doctors will be held accountable. A total of 385 breaches of protected health information affecting over 19 million records have been reported since August 2009 (Redspin Breach Report 2011). Redspin also reports that industry estimates have put the value of a stolen health record on the black market at about $50 per record. For me, this is the biggest red flag for implementing an EHR now. Vendors are offering solutions in the form of data “masking”, but this could increase the cost of the systems.
EHRs have stringent audit requirements under the HITECH Act. Health care organizations are expected to monitor for breaches of PHI. Audit logs must be kept. Audit strategy, process, and implementation tools must be used to meet stage 1 meaningful use criteria. Sanctions to employees for not following protocol. Healthcare facilities leave themselves vulnerable to individual and class action lawsuits when they do not have a strong enforcement and audit program in place for their EHR.
EHRs are expensive to implement, both in terms of money and in terms of time. Dollar costs range from free (Practicefusion) to $50,000+ for such EHR vendors as Allscripts or eClinicalWorks + ongoing maintenance costs. But don’t’ forget the time investment. Even small EHR systems can take 2 years to implement. I have just witnessed a client’s large pediatric practice literally crippled with the initial time investment required for staff and physicians to learn the system. Half staffing the front desk and other areas so employees can go to training has caused a drain on both patient and employee morale.
Legal concerns are still unanswered regarding EHRs. Currently the debate is still on about who owns the electronic data. The EHR vendor will tell you that you do. HIPPA gives the patient the right to see their record or chart, and the right to have a physical copy of their record based on a reasonably cost for copying and postage. Typically doctors share medical records with other health care providers as a professional courtesy. Empowered patients think they own their records. According to a reference regarding an HIMSS white paper, a patient owns the data in a Continuity of Care Document and has the ability to input and access that information.
Obtaining meaningful use stimulus payments is not a given. I met with a physician owner client a few months ago in Arizona that has implemented an EHR for their pediatric practice and was hoping to receive the stimulus payment for stage one by completing the 20 criteria needed. After plowing through the 31-page “Arizona Medicaid EHR Incentive Program” guide provided by The Arizona Health Care Cost Containment System Administration or AHCCCS, which is the Arizona arm of Medicaid he turned in his application, which was denied. His initial reaction was that the program did not have the funding in Arizona, but that seems not to be the case as a number of large payments have been made now in the state. Banner Healthcare, which operates the largest hospital system in the state with thirteen inpatient facilities, reported a total of $12.4 million in Medicaid booty for implementation of its NextGen Healthcare EMR systems in 2011. It appears that there is a learning curve involved here and the smaller practices will catch up while the hospitals currently seem to have better systems in place to capture the stimulus money. An entire MU industry has emerged to help physicians such as my client perfect their stimulus applications.

Risk vs. Reward

In the investment world I am always comparing risk vs. return when managing my client’s portfolios. At times in the marketplace, for various reasons, it just does not make economic sense to make certain investments as the possible risks far outweigh the potential return. An easy example now is the investment in “safe” longer-term treasury bonds. With a near 40-year low in interest rates, the 30-year treasury today yields 3.18 %. Yet if interest rates rise 1% in the marketplace, that 30-year treasury can drop 12%. A 2% rise can result in a fall of 22% in value. It would take 7 years accumulating 3.18% to offset the loss in value caused by a 2% rise in rates. I do not think rates are going up 2% tomorrow, but I just do not like the risk/reward spectrum here. Likewise, the biggest concern currently I have with EHRs is data breeches, as mentioned above, and the stiff penalties involved currently. Paper systems look a whole lot cheaper and safer when considering the ease at which a data breech can occur with electronic data. Fines, criminal sentencing, and disciplinary action by licensing boards are risks not worth taking considering current history on data breeches. Losing your license or your business or personal freedom because of an employee’s careless actions is not worth it. Lest you think I exaggerate, consider the following examples from the past few years enforced by the Office for Civil Rights (OCR), the enforcement side of the US Department of Health and Human Services that enforces HIPAA, and by employers and licensing boards:

Incident: A terminated researcher at UCLA School of Medicine retaliated by accessing UCLA patient records (many celebrities) 323 total times over the next four weeks.

Penalty: 4 years in prison for the terminated researcher for violating HIPAA Privacy Rules

Incident: Thirteen staff members at UCLA hospital accessed Britney Spears’ medical records without authorization.

Penalty: UCLA fired the 13 individuals, suspended another six.

Incident: A doctor and two hospital employees accessed the medical records of a slain Arkansas TV reporter. Details were leaked to the press of her attack.

Penalty: All pled guilty to misdemeanors for violating HIPAA privacy rules and were sentenced to one-year probation. The three all were curious about the case and “peeked” at the patient’s record as employees of the hospital, even though she was not their patient. The doctor’s privileges were suspended by the hospital for two weeks; he was fined $5,000 and ordered to perform 50 hours of community service by speaking to medical workers about the importance of patient privacy. The two other employees were terminated.

Incident: Cignet denied 41 patients, on separate occasions, access to their medical records when requested.

Penalty: Initial violation was $1.3 million. OCR concluded that Cignet committed willful neglect to comply with the Privacy Rule and fined an additional $3 million.

Incident: 57 unencrypted computer hard discs containing PHI of more than one million people was stolen from a storage locker leased by Blue Cross Blue Shield of Tennessee (BCBST).

Penalty: OCR fined BCBST $1.5 million in settlement. The fact that BCBST secured the information in a leased data closet that was secured by biometric and keycard scan in a building with additional security was not enough. BCBST also spent $17 million in investigation, notification and protection efforts and had increased future compliance costs.

Incident: Health Net discovered that nine portable hard drives that contained PHI and personal financial information of approximately 1.5 million people were missing. The hard drives in question went missing from an IBM-operated datacenter in Rancho Cordova, California.

Penalty: The complaint alleged violations of HIPAA. Connecticut Insurance Commissioner wins a $375,000 fine for failing to protect member information and not reporting in a timely manner just months after the Connecticut AG won a $250,000 settlement for the breach. Vermont’s AG jumps in and gets a settlement of $55,000 to the State because 525 Vermonters were on the lost drive.

Incident: WellPoint / Anthem Blue Cross became aware that its customers’ health applications and information website, which contained up to 470,000 applicant’s information, was potentially publicly accessible when an applicant alerted the company that altered URLS after an upgraded authentication code could allow access to other people’s information.

Penalty: WellPoint / Anthem agreed to the terms of a class action lawsuit filed in California that will provide $1.5 million in general settlement, with an additional donation of $250,000 to two non-profit organizations aimed at protecting consumer’s rights, $150,000 donated to Consumer Action and $100,000 donated to the Public Law Center in Orange County. WellPoint / Anthem also agree to pay $100,000 to the state of Indiana for the data breach that exposed 32,000 state residents. A 2009 Indiana law requires companies to notify the state of certain data breaches within a certain period that was not met.

An Investment?

I bring up these examples to make a point. The EHR vendor will talk about your EHR being an “investment”. You cannot have an ROI if you lose money. Notice that most cases were due to careless, innocent lapses of judgment. Also in many cases actual damages either did not occur or were hard to prove. The new HITECH act extends HIPAA to allow the states’ attorney general to also bring actions, which adds more salt to the wound. Some of these cases do not appear to be done yet either as far as the lawyers are concerned. Also, notice that even when the health care provider regarding storing the data exercised extreme care (BCBST with biometric, keyscan leased lockers and Health Net employing IBM’s “secure” datacenter), the health provider was sued and fined. Smaller medical practices I believe are even more susceptible to EHR data breaches, where bad password management practices and website maintenance problems are more common and often protocols and training are not firmly in place.

Assessment

The widespread use and integrated implementation of EHRs are going to happen, no doubt. Your practice will eventually have one. 2015 is still a few years off before the first 1% Medicare penalties hit. Tell the EHR vendor to call back in 2014 once the kinks are worked out. Waiting two more years may not prevent a costly incident due to the vengeful fired employee or due to a careless slip in protocol. Those landmines will always be there.

But, two more years will allow the EHR stakeholders more time to improve their product, namely the security and encryption of the data in case of a breach, and two more years will allow the OCR and the state AG’s to fill up on the low hanging fruit and make their point.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: CMP Program, Information Technology | Tagged: CMP, Continuity of Care Document, david luke, EHRs, EHRs - Not Yet Ready For Prime Time, EMRs, HIPAA, HITECH Act, medical records, OCR, www.CertifiedfMedicalPlanner.org | 21 Comments »

How the ME-P Helps Doctors Become and Remain Professionally and Personally Fiscally Fit

Posted on March 15, 2012 by Dr. David Edward Marcinko MBA MEd CMP™

Sponsored: www.CertifiedMedicalPlanner.com

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Please 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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Practice Management: http://www.springerpub.com/product/9780826105752

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###

TESTIMONIAL

In his book Financial Planning Handbook for Physicians and Advisors, Dr. David E. Marcinko, MBA CMP® CFP® provides us with a simple and yet very complete view on the basics of financial planning that every physician should know in order to maximize our chances for success in the financial aspect of our medical careers and personal lives.

The book is well structured, organized and easy to read. Divided in ten chapters, it covers important aspects of personal financial planning such as insurance, home mortgages, retirement plans, auto buying, taxes and more. In an era where doctors must have a solid understanding of the basics of financial management, this book is a must-have on every physician’s private book collection.

Although not a substitute for a formal business education, this book will help physicians navigate effectively through the hurdles of day-to-day financial decisions with the help of an accountant, financial and legal advisors. This book would make an excellent reference for teaching medical students and residents the basics of monetary management.

I highly recommend this book and commend Dr. Marcinko and the Institute of Medical Business Advisors, Inc. on a job well done.

Manuel J. Colón, MD

Filed under: "Advisors Only", "Doctors Only", CMP Program, Financial Planning, iMBA, Inc., Recommended Books | Tagged: CMP, david marcinko, Financial Planning for Physicians and Advisors, How the ME-P Helps Doctors Become and Remain Professionally and Personally Fiscally Fit, Manuel J. Colon MD, www.certifiedmedicalplanner.com | 2 Comments »

Physician’s Update on Dividend-Paying Stocks

Posted on March 13, 2012 by Dr. David Edward Marcinko MBA MEd CMP™

But Some Doctors Ask – Why All the Hype?

By David K. Luke MIM CMP™ candidate [www.CertifiedMedicalPlanner.com]

www.NetWorthAdvice.com

In an effort to help the US economy recover, the Federal Reserve has lowered interest rates to historically low levels. Furthermore, the Fed has announced its intent to keep interest rates low until 2014. Classic income-producing investments such as savings accounts and certificates of deposit pay next to nothing.

Borrowing Good – Saving Bad!

Borrowers are being rewarded, but savers are being punished. Low interest rates may have spurred the economy somewhat, but they have been devastating for retired people who have a low tolerance for risk. Physicians, other investors and their advisors are turning toward alternatives that pay higher returns, but these vehicles necessarily carry more risk. Among these alternatives, some investors are considering the purchase of stocks that pay reliable dividends.

Assessment

But, is this an appropriate strategy for mature doctors and similar retirees? What are the potential benefits and drawbacks?

Conclusion

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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: Alternative Investments, Investing, Retirement and Benefits | Tagged: Alternative Investments, CMP, david k. luke, Federal Reserve, Investing, low interest rates, retirement planning, Update on Dividend-Paying Stocks, www.certifiedmedicalplanner.com, www.NetWorthAdvice.com | 10 Comments »

Are “Financial Advisors” True Professionals or Employed Sales Representatives for Retail Products?

Posted on February 9, 2012 by Dr. David Edward Marcinko MBA MEd CMP™

White House Sides With Sales Reps On Overtime

Dr. David Edward Marcinko MBA CMP™

[ME-P Editor-in-Chief]

www.CertifiedMedicalPlanner.org

As the US Supreme Court is preparing to review the contentious debate about overtime pay for sales reps, the US Solicitor General has filed an amicus curaie, or friend of the court brief, and sided with pharma reps. The move is not surprising, given that the US Department of Labor has, several times, taken a similar step in federal courts around the country where cases were heard.

Far Reaching Implications?

The review is expected to have far-reaching implications for the pharmaceutical industry, and I believe the financial services industry, as well. Why?

Both sectors have been fighting a growing number of cases nationwide over the past several years, but has had mixed results as the issue has continually divided the courts. At the same time, drug makers, Wall Street and broker-dealers have been laying off thousands of sales reps – “financial advisors”, “wealth managers” and stock brokers – as they try to cut costs and alter their business models to prepare for some level of fiduciary accountability.

The Issue

At issue is whether drug reps, and FAs by extension, are exempt from overtime provisions of the Fair Labor Standards Act. The FLSA overtime compensation requirement does not apply to employees who work as outside salespeople, but the law does require employers to pay overtime for hours worked beyond 40 hours a week, unless a FLSA exemption applies.

Link: http://www.pharmalot.com/2012/02/white-house-sides-with-sales-reps-on-overtime/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+Pharmalot+%28Pharmalot%29

My Issue

And so, does this mean that most “financial advisors” are really stock-brokers and product pushers after all? At least in medicine, we doctors know what a pharmaceutical rep is – and we understand his/ her roll is to push pharma products, DME and drug sales.

Shouldn’t a salesman – be a salesman – and an “advisor” – be an RIA or RIA rep? I don’t often agree with the White House, but I do on this one.

FAs can’t be independent client advocates – and employees – at the same time

Now, isn’t it time for the public to know that the vast majority of FAs are just salesmen [still SBs], too? Just selling retail financial products to doctors and others; not drugs. After all, FAs can’t be independent client advocates – and employees – at the same time. And, it appears with this potential filing and ruling; that they truly wish to be the later. Now FAs, admit it!

Assessment

Why do you think FAs are licensed as “registered representatives”? Rarely; a fiduciary among them!

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: Career Development, CMP Program, Drugs and Pharma, Ethics | Tagged: Are Financial Advisors Professionals or Employee Sales Representatives?, CFP, CMP, Dr. David Marcinko, fiduciary, financial advisors, RIA, stock-brokers, wealth managers, www.certifiedmedicalplanner.com | 10 Comments »

How to Become A Financial Advisor [Learned Profession or Professional Sales Force?]

Posted on January 31, 2012 by Dr. David Edward Marcinko MBA MEd CMP™

A Recent E-mail that I Received

By Dr. David Edward Marcinko MBA, CMP™

www.CertifiedMedicalPlanner.com

[Editor-in-Chief]

As a former certified financial planner for almost 15 years, I was surprised to recently receive the following unedited e-mail correspondence.

Dear Marcinko,

If you are clever, have a way with people, or are a born salesperson, then becoming financial advisor could be your ticket to paradise.

Maybe not exactly paradise, but you could definitely have a ticket to a rewarding career. If you’re thinking about starting out as a new financial advisor – you may already be half the way there.

Why?

Because it’s an occupation where your life challenges will give you the understanding and empathy needed to work with your clients. Have you ever been in the position where you had to figure out a budget for your children’s education? Or manage an over extended credit card? These life situations will aid an individual on the path to become a financial consultant.

Requirements to Be a Financial Advisor

Even though a formal education is not a necessity to become financial adviser, it helps if you’ve taken certain courses.

What degree do you need to become a financial advisor? A bachelor’s degree in Finance, Economics, Accounting, Commerce, Business or Marketing would be a good start. A degree won’t assure you of a startling career but it may help get your foot in the door.

Rumor has it that a degree in psychology is also an asset as financial advising is as much about counseling as it is about advising. There are a plethora of people with all sorts of emotional entanglements around their financial lives.

Licenses

So, what licenses do you need to be a financial advisor? Some companies will assist a newbie in the financial advisory business and place them into a special program that will help them to obtain the required regulatory licenses such as a Series 66, this license permits them to vend annuities and mutual funds. It’s also possible to manage your own training. You can take part-time courses in order to qualify for the CFP (Certified Financial Planner) exam.

There are roughly over 286 universities and colleges that will assist you in preparing for the CFP exam. How long does it take to become a financial advisor? In order to qualify for the exam you will also need three years full-time working experience with a financial planning establishment.

Statistics state that over 40% regularly fail this all important exam. It’s worth the time and effort as with this certification you are deemed as a certified financial planner and demand a higher salary.

Assessment

Hot tip: Stay away from insurance companies for financial employment. They’ll insist that you sign everyone including the dog and your grandmother. Then get rid of you if you don’t procure sufficient business. Banks are better they will bring in the clients for you.

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Are financial advisors true professionals; or a truely professional sales force?

Please 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. Are financial advisors true professionals, or a professional sales force?

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Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

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Filed under: CMP Program, Financial Planning | Tagged: certified financial planner, CFP, CMP, CMP Program, financial advisor, financial planner, FINRA, How to Become A Financial Advisor, RIA, SEC, Series 63, Series 65, Series 7, stock-brokers, www.certifedmedicalplanner.com | 3 Comments »

On “Financial Planning for Physicians AND their Advisors”

Posted on January 29, 2012 by Dr. David Edward Marcinko MBA MEd CMP™

Financial Planning Handbook for Physicians and Advisors

www.CertifiedMedicalPlanner.com

Filed under: CMP Program, Financial Planning, Investing, Recommended Books | Tagged: CMP, Dr. David Marcinko, Financial Planning, Financial Planning Handbook for Physicians and Advisors, www.certifiedmedicalplanner.com | 1 Comment »

VOTE-Would You Retain a Bankrupt CFP® for Financial Advice?

Posted on January 27, 2012 by Dr. David Edward Marcinko MBA MEd CMP™

ME-P Readers Respond

Sponsored by: www.CertifiedMedicalPlanner.org

###

According to colleague and financial advisor, Mike Kitces CFP®:

As the difficult economic environment continues, bankruptcy filings in the United States continue to occur at an elevated rate.

And it appears that financial planners are having their share of bankruptcies as well … requiring the CFP Board via their disciplinary process to adjudicate whether a CFP® certificant should receive a public letter of admonition, or has his/her marks suspended or revoked.

With a rising number of financial planner bankruptcies putting pressure on their disciplinary resources, the CFP Board has proposed a change to how it treats such bankruptcy situations. The upshot: a bankruptcy by a financial planner will no longer bar him/her from getting or keeping the CFP® marks. However, going forward, any bankruptcy by a financial planner will be publicly disclosed for the following 10 years on the CFP Board’s website.

Question: And so, as a doctor, nurse, management consultant or even another financial advisor, would you ever retain a Certified Financial Planner® who had declared bankruptcy?

VOTE AND OPINE

Assessment

Link: http://www.kitces.com/blog/archives/240-CFP-Board-Relaxes-Its-Position-On-Financial-Planner-Bankruptcies…-Sort-Of.html

Conclusion

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Filed under: CMP Program, Ethics, Financial Planning, Voting Polls | Tagged: certified financial planner, certified medical planner, CFP Board, CMP, financial planner bankruptcies, Mike Kitces, Would you Retain a Bankrupt CFP® for Advice? | 23 Comments »

The One-Woman Physician Investors Should Not Trust

Posted on December 19, 2011 by Dr. David Edward Marcinko MBA MEd CMP™

Why We Should “Run” from the SEC’s Mary Schapiro

By Dr. David Edward Marcinko MBA CMP™

[Publisher-in-Chief]

OK, I’ve opined about fiduciary accountability for stock brokers, FAs and FPs – as well as Mary Schapiro [Chairman of the SEC] before – on this ME-P. And usually, in not so glowing terms!

But now, Mary really chaps my ethical and linguistic sensibilities.

Why I’m So P…… Off!

According to Bloomberg, and Advisor One [a financial services industry trade magazine], the chairwoman is considering something called the “business model neutral” rule that retains proprietary financial products, and brokerage sales commissions.

This concept of ‘business neutral’ is the one sought by many in the brokerage and insurance industry in order to redefine the term ‘fiduciary’ as an enhanced form of ‘suitability’ with opt-out provisions.

But, it is not sought by me, and should not be accepted by physicians.

Definitions

Suitability Rule – According to the Free Dictionary:

A stated or implied requirement by a regulatory body that a broker or investment adviser must reasonably believe that a certain investment decision will benefit a client before making a recommendation to him/her. That is, the broker or investment adviser must act in good faith, and may not knowingly recommend bad investments. Different regulators and self-regulating organizations incorporate suitable rules in different places in their bylaws. Two commonly referenced suitability rules are Rule 2310 for the Financial Industry Regulatory Authority and Rule 405 for the NYSE. See also: Due diligence, Prudent-person rule, Twisting.

Fiduciary Rule – According to the Free Dictionary:

A uniform standard for financial advisors that requires them to put retail customer interests ahead of their own financial interests.

This is clearly a higher duty [level of care] than suitability. Insurance agents, stock brokers, BDs and most “financial advisors” hate it.

Link: http://www.advisorone.com/2011/12/09/reaction-to-schapiro-comments-on-fiduciary-rule-ar?ref=hp

“Suitability on Steroids”

Some pundits suggest we think of this new “business model neutral” rule as “suitability on steroids.”

However, as most of us in medicine know, steroids are not a panacea and are typically used as a quick fix for short term gain, only.

Otherwise, the excessive use of anabolic steroids is bad for our physical health. Just like Mary Schapiro is bad for our fiscal health. But, a Certified Medical Planner™ is a fiduciary at all times http://www.CertifiedMedicalPlanner.org

More: Enter the CMPs

Assessment

And so, your thoughts and comments on this ME-P are appreciated. I was an insurance agent and certified financial planner for almost 15 years [Series 7, 63 and 65] before I resigned all – in disgust over the fiduciary flap.

Doctors are fiduciaries. I am a fiduciary, a doctor, and a financial advisor. Shouldn’t all physician-investors demand same from their own financial advisors [NASD-FINRA, RIAs, RIA-Reps]?

But hey – I’m just a medical provider.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants

Front Matter with Foreword by Jason Dyken MD MBA

[BY DOCTORS – FOR DOCTORS – PEER REVIEWED – NICHE FOCUSED]

***

Filed under: CMP Program, Ethics, Glossary Terms, Investing, Op-Editorials | Tagged: certified financial planner, certified medical planner, CFP, CMP, david marcinko, fiduciary, financial advisors, FINRA, Mary Schapiro, NASD, RIA, suitability rule, www.certifiedmedicalplanner.com | 17 Comments »

Why I’m Joining the Physician Nexus Medical Advisory Board

Posted on December 14, 2011 by Dr. David Edward Marcinko MBA MEd CMP™

On My Non-Linear … and Sometimes Concurrent Career Path

By Dr. David Edward Marcinko MBA CMP™

[Publisher-in-Chief]

As Medical Executive-Post readers know, I am a big believer in career and change management; evolution if you will. As an entrepreneurial doctor, writer, publisher, speaker, financial advisor, economist, management consultant and business owner, with a non-linear career spanning more than 30 years, I’m acutely aware that to thrive, I must evolve.

Evolution not Revolution

Most of our readers know my career story, but you probably don’t know that even now, my career continues to evolve. For example, I recently accepted a position on the Physician Nexus Medical Advisory Board http://physiciannexus.com/page/nexus-board-of-advisors

THINK: Evolution; not revolution.

Am I Un-Happy?

Why did I embark on this project? Am I giving up my day job at this ME-P? Am I moving on from my business? These are questions I’ve been asked, and I’ve given them all some thought. The nature of these questions signifies a fundamental assumption that, to be considered stable and sane, we must remained attached to “one occupation”, and that if anything changes in that equation, we are surely about to make a move because we are unhappy www.BusinessofMedicalPractice.com

Not so!

Last Gen Parents – Next Gen Son

Don’t believe m? Just ask me about the time I told my last-generation dad and mom I was going to business school, after medical school www.CertifiedMedicalPlanner.org then promptly started an online educational and testing firm for doctors, financial advisors, CPAs and stock brokers. Or; when I sold my ambulatory surgery center – and later still – my private practice, etc! Can you say ballistic?

I added this new patch work to my career quilt because I accepted an opportunity – a chance to do things that I truly love; have engaging clients, speak and write about it. But, don’t worry about me! I’ve got the support of my next-generation wife.

iMBA Inc

And, as we at the www.MedicalBusinessAdvisors.com continue to consult with medical practices to improve their operational results … or with doctors for their financial planning needs, I’m always keeping my eyes open for the next opportunity that catches my fancy.

A Kindred Spirit

Like my colleague Philippa Kennearly MD MPH, over at the Entrepreneurial MD http://www.entrepreneurialmd.com I’m here to argue that the contemporary career of an entrepreneurial physician can and perhaps should be a non-linear projection; it can contain clinical practice AND an Internet business AND writing books AND taking on clients AND seminar speaking and consulting projects AND being part of a family and community.

Just recall, Bill Gates of Microsoft said that most contemporary knowledge workers will follow a career path that changes every seven [7] years. But, I don’t know if he meant doctors, as well?

Assessment

Doesn’t that sound more exhilarating to you than feeling stuck in one gear? Isn’t it time to shift that gear from either … or to and … and, as Philippa is prone to say?

Conclusion

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Filed under: "Doctors Only", Career Development, iMBA, Inc., Op-Editorials | Tagged: CMP, david marcinko, entrepreneural MD, healthcare innovation, medical career development, medical career management, medical change management, Philippa Kennearly, Physician Nexus, www.BusinessofMedicalPractice.com, www.certifiedmedicalplanner.com, www.healthcarefinancials.com, www.medicalbusinessadvisors.com | 2 Comments »

Saying “Thanks” to Patients and Clients

Posted on November 26, 2011 by Dr. David Edward Marcinko MBA MEd CMP™

On Doctors and Financial Advisors Saying “Thank You”

By ME-P Staff and Reporters [A family of communication and educational companies]

In 1621, our settlers acknowledged a large autumn harvest feast as one of the first Thanksgiving celebrations in the colonies. But, it wasn’t until 1863, in the midst of the Civil War, that President Abraham Lincoln proclaimed a national Thanksgiving Day to be held each November. Ever since, Americans have used this gathering time to be with family and friends and reflect on those things we are most thankful for in our lives.

Note: click the image

So here we are, ramping up to celebrate the anniversary of that first Thanksgiving some 148 years ago. This year, let’s take the same reflective approach and apply it to our ME-P work worlds.

For example, whether a doctor, nurse, CXO or financial advisor, when was the last time:

You expressed gratitude to your key patients, hospitals, employees or clients?
You recognized a newer prospect referral for sending a patient or client your way?
You were truly grateful for those patients and clients who keep your medical practice, financial advisory or medical management business viable – and you showed it?
You said “thank you” to one of your referring physicians, attorneys or accountants?

Assessment

This time of year is a good reminder to show your appreciation to patients, customers, vendors and clients—not from only a monetary perspective, but for all they contribute to your relationships.

Our Question

As so, what are some of the helpful and creative ways that you say “thank you” this season for all your loyal fans?

Of course, we also extend our gratitude and say “thanks” to all clients, readers, providers, sponsors, advertisers and subscribers to this Medical Executive-Post.

Happy Thanksgiving Weekend 2011, and thank you for your continued support!

Conclusion

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

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

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

Filed under: iMBA, Inc. | Tagged: CMP, thanksgiving, thanksgiving thank you, www.BusinessofMedicalPractice.com, www.certifiedmedicalplanner.com, www.healthcarefinancials.com, www.medicalbussinessadvisors.com | Leave a comment »

On Healthcare Collaboration Trends

Posted on November 24, 2011 by Dr. David Edward Marcinko MBA MEd CMP™

A Lay Perspective

By David K. Luke MIM CMP

[Investment Advisor]

http://www.CertifiedMedicalPlanner.org

Collaboration within healthcare has sprung from the general body of health communication research; ie., crowd-sourcing, etc..

And, there are a number of other emerging trends, visible to the lay man or woman, in the patient collaboration arena today.

1. Cross-Discipline Communication Teams

One trend is the formation of cross-discipline communication teams among health care professionals. Different disciplines in pairs, small groups and teams now collaborate directly with each other. This is an important development in improving the healthcare delivery process to the patient.

Typically health care providers tend to identify strongly with their own discipline and likewise cross collaboration may be very difficult. But this trend is developing so that Nurses, Social workers, pharmacists and others work with physicians with a full realm of issues. Likewise we see now the Nurse/Physician collaborative, Nurse Practitioner/Physician Collaborative, Social Worker/Physician, Pharmacist/Physician and even Physician/Physician collaborative groups.

2. Clinical Health Care Teams

A second trend in patient collaboration is Clinical Health Care Teams. A team approach to care and measurable patient outcomes has shown in studies (Cooke, 1997; Cooley, 1994: Fagin, 1992, et al.) as improving overall care for patients. These multidisciplinary teams facilitate and improve training of students in medicine and nursing and other related fields as well.

3. Informal Backstage Communication

Finally, a third emerging patient collaborative trend is the increase is informal backstage communication.

Typically communication in the healthcare setting regarding the patient has been done among the team members in a team meeting setting for a one to two hour collaboration session.

Now we see the emergence of the backstage regions such as the break rooms, hallways, clinic computer desk, work tables, photocopy rooms, and offices. While these encounters between team members are often fleeting and “messy”, the environment within a practice setting can be consciously created to allow for this increased interaction among team members that will certainly improve the care of the patient.

Of course social media and e-communication facilitates this trend.

Conclusion

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

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

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Invite Dr. Marcinko

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Filed under: CMP Program, Practice Management | Tagged: CMP, cross-discipline healthcare communication teams, david k. luke, Health Care Teams, Healthcare Collaboration Trends, www.certifiedmedicalplanner.com, www.NetWorthAdvice.com | 1 Comment »

How Good Looks Lead to Higher [MD] Paychecks

Posted on November 23, 2011 by Dr. David Edward Marcinko MBA MEd CMP™

Even for Medical Professionals?

DEM 2

By Dr. David Edward Marcinko MBA CMP™

www.CertifiedMedicalPlanner.org

[Editor-in-Chief]

Beauty seems like enough of a reward in and of itself, but a wealth of research reveals that it comes with extra perks too.

Prettier people earn more money, find higher-earning and more attractive spouses, and even get better mortgage deals!

And, now that more than 40% of young new physicians are seeking employment, do looks really matter?

Assessment

Source: www.onlinembaprograms.net

Conclusion

Is this controversial thought true for doctors and learned medical professionals? How about publishers and editors? Do you have any real-life examples to share with the ME-P? Your thoughts and comments 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

Our Other Print Books and Related Information Sources:

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

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

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

Filed under: "Doctors Only", Career Development | Tagged: CMP, David Edward Marcinko, doctor paychecks, Good Looks Lead to Higher Paychecks, higher earners and attractive spouses, physician pay, physician salaries, www.BusinessofMedicalPractice.com, www.certifiedmedicalplanner.com | 5 Comments »

Financial Services Career Evaluation [An Opinion and Voting Poll]

Posted on November 14, 2011 by Dr. David Edward Marcinko MBA MEd CMP™

Would You Continue to Work if Financially Independent?

By staff reporters

Studs Turkel, in his outstanding book Working, made the comment that work is the mechanism by which many of us get our daily bread and our daily purpose.

If this is to be the case, then the modern financial services sector may need a lift to offer something more than a paycheck. This may especially be true when one considers the recent shenanigans on Wall Street, the slow decline of the broker-dealer business and product model – and considering that RIA, fiduciary and/or niche marketing models are slowly rising http://www.CertifiedMedicalPlanner.org

A General Survey

The Wilson Learning Corporation surveyed 1,500 laypeople, asking “If you had enough money to live comfortably for the rest of your life, would you continue to work?

Seventy percent said that they would continue to work, but 60 percent of those said they would change jobs and seek “more satisfying” work.

But more specifically, regardless of whether you are called a Financial Advisor, Stock-Broker, Wealth Manager or Financial Planner – how about you?

Assessment

If financially independent, would you continue to be a financial consultant [regardless of nomenclature]?

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: "Advisors Only", Career Development, CMP Program, Voting Polls | Tagged: CMP, Financial Services Career Evaluation, www.certifiedmedicalplanner.com | Leave a comment »

A Look at Level Life Insurance Commissions!

Posted on November 2, 2011 by Dr. David Edward Marcinko MBA MEd CMP™

Will It Ever Happen?

[By David K. Luke; MIM]

Investment Advisor

www.NetWorthAdvice.com

The current structure of the life insurance industry regarding cash-value life insurance policies with most major insurance companies is to reward the selling agent with the entire commission upfront on a newly issued policy.

The criticism to this practice is that this of course reduces the needed client-agent reviews and interaction and generates more “churning” and “flipping”.

Unscrupulous agents are tempted to sell clients another policy for another commission rather than encourage them to maintain and keep their existing policy, which most likely would have lower costs than any new policy considering the client was younger and most likely in better health with the existing contract. A model in which the insurance agent would have a financial incentive for their client’s continued patronage could create a win-win for both parties. We see this “pay as you” model currently operating successfully with wealth advisors and property/casualty agents, why not life insurance agents?

A Flawed Argument

There are some flaws to this argument. The reality is that the captive life insurance industry and their agents prefer this form of lump compensation. The claim is that selling an individual a life insurance policy (the ultimate intangible product) is hard work, and likewise the 70% – 105% of the first year premium is fair compensation for the efforts.

For existing agents to reduce their current income to a fraction of this commission upfront, but convert it into a trail over a multiyear period is actually quite distasteful. Therefore, this change will likewise not be initiated from the Insurance agent or insurance industry side unless other forces prevail.

Consumers [Even some Doctors] are Un-Aware

The drive by the consumer to change this up front lump form of compensation has not yet presented itself in full force. After all, why does the consumer care about how the agent is paid if the consumer is satisfied with the end result? One must acknowledge that the drive to reduce commissions and up front loads in the investment advisory business was driven by the consumer that insisted on lower fees and costs.

However, the relevant costs of a life insurance policy are not quite as obvious. Only by comparing a quote from different companies can a consumer compare costs, and even then it is unknown and not understood how the pricing mechanisms used by the insurance company work. The advent of non-agent sold policies however is decreasing the cost of life insurance (there is no big commission check written to the selling agent) and is hitting the radar of consumers. The consumer can notice this difference if the consumer compares the proposed agent sold policy premium with one sold directly by a financial institution such as USAA or AARP. These companies have a work force of sales people that are compensated primarily on salary. Likewise the company can structure more competitive pricing, and in effect offers a levelized cost (in place of commission) insurance product.

A Personal Opinion

Mark Maurer CFP® of Low Load Insurance Services believes that a levelized compensation basis will not occur unless all the insurance companies were to go to such a plan all at once. If an agent can “pick and choose” he/she may use a “levelized compensation” policy when in a competitive situation, as such a policy should in theory make a policy more inexpensive. An agent would then use the higher “front-end” policy when there is a large up-front premium or in a scenario with limited competition.

Mark believes the answer to the whole argument is full disclosure. Both agents and home offices would not want the purchaser to know that 100% or more of their premium is going to sales costs and that products would then get better.

Assessment

The insurance industry has a powerful lobby in Washington. I believe that only market pressure will cause a change in this decades old insurance industry practice that has made many life insurance policies expensive and inefficient. Pricing from non-agent sold life insurance companies will be the impetus that drives the old-line Insurance companies to restructure their commissions to agents.

I remember the days of 8% load mutual fund commissions and minimum $60 dollar commissions on stock trades in the late 1980’s when I first became a stockbroker! That is an inflation equivalent of more than $130 a trade minimum commission. The current investing world would laugh at these costs [charges] today. When the consumer realizes, through full disclosure and outside competitive market pressures, that life insurance protection can be more affordable from other non-traditional channels, then the consumer will insist on a better, more affordable product. Then the big agent driven life insurance companies will have to change their commission structure. The transition is currently in process. Only time will tell now.

Editor’s Note: David K. Luke is currently enrolled in the online http://www.certifiedmedicalplanner.org chartered professional designation program.

More: Can the Hourly FA Survive?

Channel Surfing

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Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: CMP Program, Insurance Matters | Tagged: AARP, “churning” and “flipping”, cash-value life insurance, certified medical planner, CMP, david k. luke, Level Life Insurance Commissions, Low Load Insurance Services, Mark Maurer, USAA, www.certifedmedicalplanner.com | 3 Comments »

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