Medical Risk Management and Insurance Planning Practices of Leading CERTIFIED MEDICAL PLANNERS®

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      Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™  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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“BY DOCTORS – FOR DOCTORS – PEER REVIEWED – FIDUCIARY FOCUSED”

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SAMPLE: 21. Practice Risks

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Doctors Selecting the Wrong Financial Advisor [Video]

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Does it Seem Like this … Sometimes?

MD versus FA

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Assessment

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Conclusion

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ME-P Marks Post Number One Thousand

Milestone Reached in Record Time

By Ann Miller; RN, MHA

[Executive Director]dave-and-hope2

I’ve had the great pleasure of working with Dr. Dave Marcinko and Hope Hetico since the launch of this Medical Executive-Post; 18 months ago. To watch its growth, and the momentum of their efforts and passion to share protean knowledge on behalf of the profession, serves as a personal beacon for me. And, our target market; medical executives, financial advisors and related management consultants seems to agree.

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1,000 Posts

When we launched this companion blog to our institutional, 2-volume, print journal, Healthcare Organization [Financial Management Strategies], the attainment of one thousand posts seemed a long way off. We were not even sure we would still be “in-business” today. We are, and with post number 1,010 – time sure does fly.

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Definition of a Post

A post is a unit of knowledge. Think: knol. Our goal for each post is to offer industry essays, insider columnists, interviews, definitions, case models, expert opinions, news, gossip and investigative reportage and comments; all in a moderated business forum ecosystem. New-wave is good; so is professional expertise, as well as a short and pithy writing style; so is leading-edge and next-generation information with “fly.” 

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Congratulations

Dave and Hope deserve a huge Mazel-Tov as the ME-P marches on, connecting medical professionals, financial advisors and management consultants, nationally. Now, by my calculations:

1,000 post / 18 months = 55 post per month / 30 day / month = about 2 cognitive posts per day. Oh, by the way: we don’t include advertising or classified ads in our posting counts. And, let us not forget the support and efforts of our dedicated staff, as well.

Assessment

The motto of the ME-P matches the philosophy of iMBA, Inc:

“Seeking Solutions and Providing Essential Economics Information for Physicians, Business Executives and Financial Leaders of the Healthcare Enterprise” 

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Conclusion

And so, to keep receiving the Medical Executive-Post, please place our widget on your blog, wiki or website; and be sure to actually subscribe today. We enjoy being delivered to your desktop, each day.

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Developing a Financial – Management – Advisory Practice for Doctors

Deep Knowledge and Personalized Marketing Brings in New Clients

By Dr. David Edward Marcinko; MBA, CMP™

BY Professor Hope Rachel Hetico; RN, MHA, CMP™

[ME-P Publisher and Managing Editordave-and-hope]

In any marketing situation, the more you know about your target audience, the more successful you will be. Accordingly, all of the old rules still hold true, such as “do your homework.” Unfortunately, for some financial advisors and management consultants, homework means researching broad (i.e., vague) demographic information such as zip codes, income, and age. This broadband approach to marketing is insufficient and unlikely to succeed. For example, SWOT analysis is best done in-house, while related medical marketing information can be obtained from the Institute of Medical Business Advisors, Inc.

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Focus like a Laser Beam

An absolute of communication is to focus on the person receiving your message. If you don’t know anything about the person, you can’t focus on what is important to him or her, and you end up placing too much emphasis on yourself. Your message then carries less weight and has less impact.

Defining Your Niche

Instead of approaching all people in a certain neighborhood or age group, look for people within professional subcategories—people who use their talents in a specific way. Primary care physicians, dentists, podiatrists and optometrists apply their talents differently than surgeons or pediatricians. And, private management consultants and entrepreneurs use their talents differently than large corporate managers.

Develop a Profile

Let’s look at the medical entrepreneur niche space. Perhaps you regularly work with such entrepreneurs who manufacture or deal in medical gadgets, Durable Medical Equipment [DME], healthcare IT devices, instruments etc., and would like to increase the number of clients you serve in this niche.biz-book

The Process

First, you need to develop a profile that gives you specific information about those who manufacture said medical widgets in your area (i.e., more than just their zip codes), bearing in mind of course, that the profile is a point of departure. The general profile is then divided into several subsets based upon their specialty sales-type, devices, locations, market size, gender, etc. Concentrate on developing niches in which you have existing clients. Next, consider the attitudes, values, and mental processes common to all of your clients within a given niche. Knowing (or at least being able to project) what those qualities are will make your marketing efforts more successful because you already are familiar with who they are, their values, and how they want to receive information.

Client Values

How do you find out what someone’s values are? Just watch the person work. Ask questions. What do you want? Why do you do that? What’s important to you? To what words and phrases do you relate? What words and phrases do you resent? What does your desk look like? How do you prefer to receive information? Do you prefer a structured or a more relaxed environment?

The Value of Profiles

Developing profiles of specific groups within any given niche helps you establish rapport with people who are not yet clients. Many marketers make their initial contact through a letter. That’s dangerous, unless you are able to establish rapport in the letter. If not, you have diminished your reputation and accomplished little.

Mirroring

If you understand the concept of mirroring, you know it is important to mimic the other person’s breathing, vocal tonality and body language. That works amazingly well in meetings or even during telephone conversations.

Beware Letters

However, you can’t mimic in a letter, so you have to mirror the other person’s mentality. You have to match his or her attitudes, values, and mental processes in your marketing. Again, to consider sending a marketing letter – without first developing a profile – may be a foolish gamble.

Assessment

In short, relationship niche marketing can work to increase your practice without diminishing your reputation.

fp-book

Enter the Certified Medical Planner™

For those fiduciaries interested in the medical management and the healthcare financial advisory deep-space, for doctors and medical professionals, please visit www.CertifiedMedicalPlanner.com for more information.

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated? Despite the CFP imbroglio, how do you niche market, or attract physicians or other “high-value” clients, to your advisory practice? Do you possess any special deep-knowledge or “gravitational pull?” 

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

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Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Impact of Performance Fees on Mutual Funds and Physician Portfolios

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More Complex than Realized by Some Doctors

[By Dr. David Edward Marcinko; FACFAS, MBA, CMP™]

[By Professor Hope Rachel Hetico; RN, MHA, CMP™]dave-and-hope4

Physician-investors may find themselves paying advisory fees, brokerage commissions, and other sales charges and expenses. All of these layers of expense can reduce or eliminate the advantage of professional management, if not monitored carefully. Also, fees can have a major impact on investment results. As a percentage of the portfolio, they normally range from low of 15–30 basis points (or .15% to .30%, a basis point is one one-hundredth of one percent) to a high of 300–400 basis points or even higher.

Charges are Universal

All portfolio managers, mutual funds, and investment advisors charge fees in one form or another. Ultimately, they must justify their fees by creating value added, or they would not be in business. Value added includes tangibles, such as greater investment return, as well as intangibles, such as assurance that the investment plan is successfully implemented and monitored, investor convenience, and professional service.

Comparisons Required

Always compare investment performance of funds or managed accounts after fees are deducted; only then can adequate comparisons be made. Also, compare fees within asset classes. Management fees and expenses of investing in bonds or bond funds are much different than the fees of investing in, for example, small companies or emerging market stocks. Whereas 100–200 basis points of fees may be appropriate for an equity portfolio or fund, similar charges may offset the advantages of a managed bond portfolio. With managed bond portfolios, real bond returns have limited long-term potential, because returns are ultimately based on interest rates. For example, if a 3% real (i.e., after inflation) return is expected, 200 basis points in fees may produce a negative after-tax result: 3% real return minus 2% fees minus 10% taxes equals a negative 9% total return.fp-book22

Sales Charges

Mutual funds (and some private portfolio managers) charge sales charges to sell or “distribute” the product. Investors who buy funds through the advice of brokers or “commission based” financial planners will pay a sales load. The many combinations of sales charges fall into three basic categories: front-end, deferred (or back-end), and continuous.

Front-End Fees

Front-end fees are a direct assessment against the initial investment and are limited to a maximum of 8.5%. They usually are stated either as a percentage of the investment or as a percentage of the investment, net of sales charges. For example, a 6% charge on a $10,000 investment is really a $600 charge to invest $9,400 or a real charge of 6.4%. Many low-load funds charge in the range of 1% to 3%. Rather than pay brokers or other purveyors, these fund companies or sponsors use the charges to offset selling or distribution costs. Although rare, some funds charge a load against reinvested dividends.

Deferred Charges

Deferred charges (or back-end loads, or redemption fees) come in many forms. Often, the longer the investor stays with the fund the smaller the charge is upon fund redemption. A typical sliding scale used for deferred charges may be 5-4-3-2-1, where redemption in year 1 is charged 5%, and redemption in year 5 is charged 1%; after year 5, there are no sales charges. Sometimes deferred charges are combined with front-end charges.

Redemption Fees

Certain quoted redemption fees may not apply after a period, such as one year. Funds often use such fees to discourage the trading of funds. Frequently, these charges are paid to the fund itself rather than to the fund management company; or broker. Long-term physician investors actually benefit from this fee structure; short-term shareholders who redeem shares bear the additional liquidation costs to satisfy redemption requests.

Continuous Charges

Continuous sales charges, known as 12b-1 fees for the SEC rule governing such charges, represent ongoing charges to pay distribution costs, including those of brokers who sell and maintain accounts, in which case they are known as “trail commissions.” The fund company may be reimbursed for distribution costs as well. In the prospectus, funds quote 12b-1 charges in the form of a maximum charge. This does not mean that the full charge is incurred, however. For example, a fund with a .75% 12b-1 approved plan may actually incur much lower expenses than .75%. Compared to front-end charges, a .75% per year sales charge of this type could be more costly to investment performance, given enough time.

Sales Loads

Portfolio managers can charge sales loads as well, usually in the form of a traditional WRAP fee arrangement (the investor pays a broker an all-inclusive fee that covers portfolio manager fees and transactions costs). No-load funds can be purchased through brokers or discount brokerage firms. The broker charges a commission for such purchases or sales.

Management Advisory Fees

Private account managers and mutual funds charge a fee for managing the portfolio. These fees typically range between 25 and 150 basis points. Bond funds tend to charge in the range of 25 to 100 basis points, and equity funds charge 75 to 150 basis points. Fees charged by private account managers usually are higher because of the direct attention given to a single doctor client. These managers do not pass along additional administrative costs, however, because they pay them out of the management fee. These management fees come in many forms. Tiered fees can charge smaller accounts a higher fee than larger accounts. Mutual funds often charge “group fees”: a fund family may tier its fee structure to encompass all funds offered by the fund family or by a group of similar funds (such as all international equity funds). Performance fees, although subject to SEC regulations, may be charged as well. A performance fee may be charged if the manager exceeds a certain return or outperforms a particular index or benchmark portfolio.

Administrative Expenses and Expense Ratios

Most private managers are compensated with higher management fees, as mentioned above. Therefore, many private accounts usually do not incur separate administrative expenses. Some management firms charge custodial fees or similar account maintenance fees. Mutual funds incur a number of administrative expenses, including shareholder servicing, prospectuses, reporting, legal and auditing costs, and registration and custodial costs. Mutual funds report these expenses and management fees as an expense ratio—the ratio of expenses to the average net assets of the fund. Expense ratios also include distribution costs or 12b-1 charges.insurance-book10 

Brokerage Commissions

Almost all buyers and sellers of securities incur brokerage commissions. Private “wealth managers” usually provide commission schedules to prospective physician-investors or current clients. Some private managers charge higher management fees and a discounted commission schedule, while others charge lower fees and higher commissions. These combinations of management and commission fees make comparison of prospective managers’ cost structures a difficult task. Most portfolio managers obtain research from brokerage firms, which can affect the commission relationship between broker and manager. Reduced commission schedules exchanged for information are known as “soft dollar costs.” Mutual funds may negotiate similar reduced commission schedules. In this regard, more-competitive brokerage firms can charge lower fees to investors. Commissions are not part of the expense ratio, because they are a part of the security cost basis. Firms with higher portfolio turnover are more likely to have higher commission costs than those with low turnover. Asset class impacts such costs as well. For example, small-cap stocks may be more expensive than large-cap stocks, or foreign bonds may be more expensive than domestic bonds.

Total Cost Approach

To arrive at a relevant comparison of fees among funds and managers, and to see what the total effect of fees on investment performance is, analyze the various charges on a net present value basis. Begin with a given investment amount (e.g., $10,000) and factor in fees over time to arrive at the present value of those fees. Present the comparisons in an easy-to-use table.

Sources of Fee Information

Consult the mutual fund prospectus for fee information. The prospectus has a fund expenses section that summarizes sales charges, expense ratios, and management fees; it does not cover commissions, however. Expense ratios usually are reported for the past 10 years. Commission or brokerage fees are more difficult to find. The statement of additional information and often the annual report disclose the annual amounts paid for commissions. When the total commission paid is divided by average asset values a sense of commission costs can be determined. Private wealth managers disclose fee structures in the ADV I filed with the SEC. Managers must disclose these fees to potential and current clients by providing either ADV Part II or equivalent form to the investor.

Reporting Services

Reporting services, such as Morningstar and Lipper, provide similar information from their own research of mutual funds. These services can be extremely beneficial, because fee information is summarized and often accounted for in the reports’ investment return calculations. This helps the investor and planner make good comparisons of funds. Information services that cover private managers provide information, primarily about management fees.

Assessment

To the extent that online trading, deep discount brokerages, lack of SEC and FINRA oversight, and the recent financial, insurance and banking meltdown has affected the above, it is left up to your discretion and personal situation. Generally, all fess are, and should be, negotiable.

Disclaimer: Both contributors are former licensed insurance agents and financial advisors.

Conclusion

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

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

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