MEDICAL SCHOOLS: What They Do Not Teach About Money!

Posted on October 26, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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WARNING! WARNING! All DOCTORS

What Medical School Didn’t Teach Doctors About Money

Medical school is designed to mold students into competent, compassionate physicians. It teaches anatomy, pathology, pharmacology, and clinical skills with precision and rigor. Yet, despite the depth of medical knowledge imparted, one critical area is often overlooked: financial literacy. For many doctors, the transition from student to professional comes with a steep learning curve—not in medicine, but in money. From managing debt to understanding taxes, investing, and retirement planning, medical school leaves a financial education gap that can have long-term consequences.

The Debt Dilemma

One of the most glaring omissions in medical education is how to manage student loan debt. The average medical student graduates with over $200,000 in debt, yet few are taught how to navigate repayment options, interest accrual, or loan forgiveness programs. Many doctors enter residency with little understanding of income-driven repayment plans or Public Service Loan Forgiveness (PSLF), missing opportunities to reduce their financial burden. Without guidance, some make costly mistakes—such as refinancing federal loans prematurely or choosing repayment plans that don’t align with their career trajectory.

Income ≠ Wealth

Medical students often assume that a high salary will automatically lead to financial security. While physicians do earn more than most professionals, income alone doesn’t guarantee wealth. Medical school rarely addresses the importance of budgeting, saving, and investing. As a result, many doctors fall into the “HENRY” trap—High Earner, Not Rich Yet. They spend lavishly, assuming their income will always cover expenses, only to find themselves living paycheck to paycheck. Without a solid financial foundation, even high earners can struggle to build net worth.

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Taxes and Business Skills

Doctors are also unprepared for the complexities of taxes. Whether employed by a hospital or running a private practice, physicians face unique tax challenges. Medical school doesn’t teach how to track deductible expenses, optimize retirement contributions, or navigate self-employment taxes. For those who open their own clinics, the lack of business education is even more pronounced. Understanding profit margins, payroll, insurance billing, and compliance regulations is essential—but rarely covered in medical training.

Investing and Retirement Planning

Another blind spot is investing. Medical students are rarely taught the basics of compound interest, asset allocation, or retirement accounts. Many don’t know the difference between a Roth IRA and a traditional 401(k), or how to evaluate mutual funds and index funds. This lack of knowledge delays retirement planning and can lead to missed opportunities for long-term growth. Some doctors rely on financial advisors without understanding the fees or conflicts of interest involved, putting their wealth at risk.

Insurance and Risk Management

Medical school also fails to educate students on insurance—life, disability, malpractice, and health. Doctors need robust coverage to protect their income and assets, but many don’t know how to evaluate policies or understand terms like “own occupation” or “elimination period.” Inadequate coverage can leave physicians vulnerable to financial disaster in the event of illness, injury, or litigation.

Emotional and Behavioral Finance

Beyond technical knowledge, medical school overlooks the emotional side of money. Physicians often face pressure to maintain a certain lifestyle, especially after years of sacrifice. The desire to “catch up” can lead to impulsive spending, luxury purchases, and financial stress. Without tools to manage money mindset and behavioral habits, doctors may struggle with guilt, anxiety, or burnout related to finances.

The Case for Financial Education

Fortunately, awareness of this gap is growing. Organizations like Medics’ Money and podcasts such as “Docs Outside the Box” are working to fill the void by offering financial education tailored to physicians.

These resources cover everything from budgeting and debt management to investing and entrepreneurship. Some medical schools are beginning to incorporate financial literacy into their curricula, but progress is slow and inconsistent.

Conclusion

Medical school equips doctors to save lives, but it doesn’t prepare them to secure their own financial future. The lack of financial education leaves many physicians vulnerable to debt, poor investment decisions, and lifestyle inflation. To thrive both professionally and personally, doctors must seek out financial knowledge beyond the classroom. Whether through self-study, mentorship, or professional guidance, understanding money is as essential as understanding medicine. After all, financial health is a cornerstone of overall well-being—and every doctor deserves to master both.

COMMENTS APPRECIATED

EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com -OR- http://www.MarcinkoAssociates.com

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DENTISTRY: Stress, Burnout, Divorce and Practice Turmoil

Posted on October 19, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters and A.I.

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Dentistry is often perceived as a stable and rewarding profession, yet beneath the surface lies a troubling reality: dentists face disproportionately high levels of stress, burnout, divorce, practice turmoil, and even suicide. These issues stem from a complex interplay of emotional, financial, and professional pressures that uniquely affect dental practitioners.

Emotional and Psychological Strain

Dentists frequently operate in high-stakes environments where precision is paramount. The pressure to deliver flawless results while managing patient anxiety and discomfort can be overwhelming. Many patients fear dental procedures, and this fear often manifests as hostility or distrust, placing emotional strain on the dentist. Over time, the cumulative effect of these interactions can lead to compassion fatigue and emotional exhaustion.

The Amazing Future of Dentistry and Oral Health

Isolation and Professional Loneliness

Unlike other medical professionals who often work in collaborative hospital settings, dentists typically operate in solo or small group practices. This isolation can limit opportunities for peer support and professional camaraderie. Without a strong support network, dentists may struggle to process the emotional toll of their work, increasing their vulnerability to depression and burnout.

Financial and Business Pressures

Running a dental practice involves more than clinical expertise—it requires business acumen. Dentists must manage overhead costs, staff salaries, insurance reimbursements, and patient billing. The financial burden of student loans, often exceeding six figures, adds to the stress. Economic downturns or shifts in healthcare policy can destabilize practices, leading to turmoil and uncertainty.

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Work-Life Imbalance and Marital Strain

The demanding nature of dentistry often spills into personal life. Long hours, administrative responsibilities, and the emotional weight of patient care can leave little time or energy for family. This imbalance contributes to high divorce rates among dentists. The stress of maintaining a successful practice while nurturing personal relationships can become untenable, especially without adequate coping mechanisms.

Burnout and Suicide Risk

Burnout in dentistry is alarmingly common. A study by the American Dental Association found that 84% of dentists report experiencing burnout at some point in their careers.

Breaking the Cycle

METAVERSE: Dentistry and Dental Education

Addressing these challenges requires systemic change. Mental health support, peer mentorship, and business education should be integrated into dental training. Encouraging open conversations about stress and providing resources for emotional well-being can help reduce stigma and promote resilience.

By acknowledging the hidden struggles of dentistry, the profession can move toward a healthier, more sustainable future.

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Understanding Doctorate Degrees: A Clear Guide

Posted on October 18, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

Is the Doctor – In?

SPONSOR: http://www.CertifiedMedicalPlanner.org

INFO-GRAPHIC

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What Is a Doctorate Degree?

Doctorate, or doctoral, is an umbrella term for many degrees — PhD among them — at the height of the academic ladder. Doctorate degrees fall under two categories, and here is where the confusion often lies. 

The first category, Research (also referred to as Academic) includes, among others:

  • Doctor of Philosophy (PhD)
  • Doctor of Business Administration (DBA)
  • Doctor of Education (EdD)
  • Doctor of Theology (ThD) 

The second category, Applied (also referred to as Professional) includes, among others:

  • Doctor of Medicine (MD)
  • Doctor of Podiatric Medicine (DPM)
  • Doctor Of Osteopathic Medicine (DO)
  • Doctor of Dental Surgery (DDS)
  • Doctor of Optometry (OD)
  • Doctor of Psychology (PsyD)
  • Juris Doctor (JD) 

As you can see, applied doctorates are generally paired with very specific careers – medical doctors, podiatrists, dentists, optometrists, psychologists, and law professionals. 

When it comes to outlining the differences between a PhD and doctorate, the real question should be, “What is the difference between a PhD and an applied doctorate?” The answer, again, can be found in the program outcomes. The online Doctor of Psychology at UAGC, for example, lists outcomes that are heavily focused on the ability to put theory into practice in a professional setting. For example: 

  • Apply best practices in the field regarding professional values, ethics, attitudes, and behaviors
  • Exhibit culturally diverse standards in working professionally with individuals, groups, and communities who represent various cultural and personal backgrounds
  • Utilize a comprehensive psychology knowledge base grounded in theoretical models, evidence-based methods, and research in the discipline
  • Integrate leadership skills appropriate in the field of psychology
  • Critically evaluate applied psychology research methods, trends, and concepts

Bottom line: As the PhD is more academic, research-focused, and heavy on theory, an applied doctorate degree is intended to master a subject in both theory and practice. 

Can a PhD Be Called a Doctor?

The debate over whether a PhD graduate should be called a doctor has existed for decades, and if you’re a member of this exclusive club, you’ll no doubt hear both sides of the argument during your lifetime. After all, if a PhD is a doctor, can a person with a doctoral degree in music – the Doctor of Musical Arts (DMA) – be called a doctor as well?

Those in favor argue that having “Dr.” attached to your name indicates that you are an expert and should be held in higher regard. For some, the debate is at the heart of modern gender disparity. For example, on social media and in some academic circles, there is an argument that female PhD holders should use the “Dr.” title in order to reject the notion that women are less worthy of adding the title to their name once they have earned a doctoral degree.

The American Psychological Association has, for years, challenged the Associated Press (AP) and other news outlets to broaden its use of “Dr.” beyond those that practice medicine – MDs, podiatrists, dentists, etc. – in its reporting. However, the organization was rebuked, as the AP argued that, “It comes down to a basic distinction. Psychologists earn PhDs, and AP style allows the ‘Dr.’ title only for those with medical degrees.”

The AP has, thus far, refused to change their style guide when it comes to the “doctor question.” 

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Financial Planning for Physicians: Achieve Your Goals

Posted on September 30, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By: http://www.MarcinkoAssociates.com

Your medical practice. Your personal goals. Your financial plan. Our experienced confirmation guide.

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When you know exactly where you are today, have a vision of where you want to be tomorrow, and have trusted counsel at your side, you have already achieved so much success. Marcinko Associates works to keep you at that level of confidence every day. We use a comprehensive economic process to uncover what’s most important to you and then develop a financial strategy that gives you the highest probability of achieving your monetary goals.

We assess, plan, and opine for your success

To accurately see where you are today, chart a strategic path to your goals and help you make the most informed decisions to keep you on financial track, our key services for physicians and high net worth medical clients include:

  • Investment Portfolio Review
  • Fee, Charge and Cost Review
  • Comprehensive Financial Planning
  • Insurance Reviews
  • Estate Planning
  • Investment and Asset Management Second Opinions

We take a deep dive into your financial retirement plans

Physicians and dental employers now have options for how to design and deliver retirement benefits and we can help you make the best choice for your healthcare business. Our services for retirement plans include:

  • Fee, Charges & Fiduciary Review
  • Portfolio Analysis
  • Single Employer Retirement Plan Advisory
  • Retirement Plans Risk Analysis
  • Capital Funding and Financing
  • Business Planning and Practice Valuations
  • Career Development
  • and more!

We take a broad and balanced look at your financial life life

We coordinate our recommendations with your other advisors, including attorneys, accountants, insurance professionals and others, to ensure each decision is consistent with your goals and overall strategy. For example, through our partnerships we offer physician colleagues deeper expanded advisory services, like:

  • Estate, Gift, and Trust Planning
  • Tax Planning and Compliance
  • Medical or Dental Practice Worth
  • Business Succession Planning
  • Practice Exit Planning
  • Transaction Advisory Services
  • and more!

EDUCATION: Books

CONTACT US TODAY: Ann Miller RN MHA at: MarcinkoAdvisors@outlook.com

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Fiduciary Financial Colleagues Advising Medical Colleagues … in Turbulent Times!

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CAPITATION REIMBURSEMENT: A Historical Economic Review

Posted on September 15, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

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By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

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DEFINITION

Capitation is a type of healthcare payment system in which a physician or hospital is paid a fixed amount of money per patient for a prescribed period by an insurer or physician association. The cost is based on the expected healthcare utilization costs for a group of patients for that year.

With capitation, the physician—otherwise known as the primary care physician— is paid a set amount for each enrolled patient whether a patient seeks care or not. The PCP is usually contracted with an HMO whose role it is to recruit patients.

ACOs: https://medicalexecutivepost.com/2024/12/01/record-breaking-savings-for-acos-in-2023/

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CAPITATION REIMBURSEMENT HISTORY

According to Richard Eskow, CEO of Health Knowledge Systems of Los Angeles, capitated medical reimbursement has been used in one form or another, in every attempt at healthcare reform since the Norman Conquest. Some even say an earlier variant existed in ancient China [personal communication]. 

Initially, when Henry I assumed the throne of the newly combined kingdoms of England and Normandy, he initiated a sweeping set of healthcare reforms. Historical documents, though muddled, indicate that soon thereafter at least one “physician,” John of Essex, received a flat payment honorarium of one penny per day for his efforts. Historian Edward J. Kealey opined that sum was roughly equal to that paid to a foot-soldier or a blind person. Clearer historical evidence suggests that American doctors in the mid-19th century were receiving capitation-like payments. No less an authoritative figure than Mark Twain, in fact, is on record as saying that during his boyhood in Hannibal, MO his parents paid the local doctor $25/year for taking care of the entire family regardless of their state of health.

Later, Sidney Garfield MD [1905-1984] is noted as one of the great under-appreciated geniuses of 20th century American medicine stood in the shadow cast by his more celebrated partner, Henry J. Kaiser. Garfield was not the first physician to embrace the notion of prepayment capitation, nor was he the first to understand that physicians working together in multi-specialty groups could, through collaboration and continuity of care, outperform their solo practice colleagues in almost every measure of quality and efficiency. The Mayo brothers, of course, had prior claim to that distinction. What Garfield did, was marry prepayment to group practice, providing aligned financial incentives across every physician and specialty in his medical group, as well as a culture of group accountability for the care of every member of the affiliated health plan. He called it “the new economics of medicine,” and at its heart was a fundamentally new paradigm of care that emphasized – prevention before treatment – and health before sickness.  Under his model: the fewer the sick – the greater the remuneration. And: the less serious the illness, the better off the patient and the doctors.

VBC: https://medicalexecutivepost.com/2018/12/07/the-state-of-value-based-care-vbc/

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Such ideas were heresy to the reigning fee-for-service, solo practice, ideologues of the mainstream medical establishment of the 1940s and ‘50s, of course. Throughout the period, Garfield and his group physicians were routinely castigated by leaders of the AMA and county medical associations as socialistic and unethical. The local medical associations in Garfield’s expanding service areas – the San Francisco Bay Area, Los Angeles, and Portland, Oregon – blocked group practice physicians from association membership, effectively shutting them out of local hospitals, denying them patient referrals or specialty society accreditation. Twice in the 1940s, formal medical association charges were brought against Garfield personally, at one time temporarily succeeding in suspending his license to practice medicine.

Of course, capitation payments made a comeback in the first cost-cutting managed care era of the 1980-90s because fee-for-service medicine created perverse incentives for physicians by paying more for treating illnesses and injuries than it does for preventing them — or even for diagnosing them early and reducing the need for intensive treatment later. Nevertheless, the modern managed care industry’s experience with capitation wasn’t initially a good one. The 1980-90s saw a number of HMOs attempt to put independent physicians, especially primary care doctors, into a capitation reimbursement model. The result was often negative for patients, who found that their doctors were far less willing to see them — and saw them for briefer visits — when they were receiving no additional income for their effort. Attempts were also made to aggregate various types of health providers — including hospitals and physicians in multiple specialties — into “capitation groups” that were collectively responsible for delivering care to a defined patient group. These included healthcare facilities and medical providers of all types: physicians, osteopaths, podiatrists, dentists, optometrists, pharmacies, physical therapists, hospitals and skilled nursing homes, etc.

However, the healthcare industry isn’t collective by nature, and these efforts tended to be too complicated to succeed. One lesson that these experiments taught is that provider behavior is difficult to change unless the relationship between that behavior and its consequences is fairly direct and easy to understand.

MORE: https://medicalexecutivepost.com/wp-content/uploads/2008/11/capitation-actuarial-medical-econometrics.pdf

Today, the concept of prepayment and medical capitation is to uncouple compensation from the actual number of patients seen, or treatments and interventions performed. This is akin to a fixed price restaurant menu, as opposed to an àla carte eatery.

COMMENTS APPRECIATED

EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com -OR- http://www.MarcinkoAssociates.com

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DOCTORS: Early Investing Needed for Retirement

Posted on September 9, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

NEW FINANCIAL STRATEGIES?

By A.I. and Dr. David Edward Marcinko; MBA MEd CMP™

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SPONSOR: http://www.CertifiedMedicalPlanner.org

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Starting early is key to saving for retirement

Although 97% of people aren’t yet millionaires, many could eventually meet that target if they start investing sooner rather than later; especially doctors [MD, DO, DPM, DDS or DMD].

BROKE DOCTORS: https://medicalexecutivepost.com/2025/08/02/doctors-going-broke-and-living-paycheck-to-paycheck/

A 20-year-old, for instance, needs to invest just $330 a month into an asset class that delivers a 7% to 8% annual return to reach $1.26 million by the time s/he turns 65 years old. The luxury of time significantly boosts your chances of becoming a millionaire.

This doesn’t mean it’s too late for middle-aged savers to reach that millionaire milestone, but it will take a significantly greater investment. If a 50-year-old doctor hasn’t started saving for retirement, s/he would need to invest $3,958 a month at a steady 7% return to reach $1.26 million by retirement.

MONEY ADDICTION: https://medicalexecutivepost.com/2025/08/07/moiney-addicted-physicians-the-investing-and-trading-personality-of-doctors/

However, according to one Goldman Sachs report, investors could expect the S&P 500 to deliver just 3% annualized nominal returns over the next 10 years.

After an average 13% yearly return for the past decade, a new strategy outside of the stock market may be needed for that level of outsized gain, especially if you’re late to investing.

RETIREMENT VISION: https://medicalexecutivepost.com/2025/08/04/physicians-determine-your-retirement-vision/

COMMENTS APPRECIATED

EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com -OR- http://www.MarcinkoAssociates.com

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

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PHYSICIAN BANKRUPTCY: Six Total Types to Know!

Posted on September 7, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By A.I. and Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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According to Medical Economics, there were 10 clinic and physician practices filing bankruptcy in 2024, making it the highest level of the last six years, according to a new analysis of cases with liabilities of at least $10 million.

Meanwhile, the Steward Health Care System bankruptcy, which was based in Massachusetts but making headlines across the nation, has become “the largest hospital sector bankruptcy by far in the last 30 years,” according to a new analysis by Gibbins Advisors, based in Nashville, Tennessee.

Health care bankruptcy filings totaled 57 last year, down from 79 in 2023, said “Healthcare Restructuring: Trends and Outlook.” The report analyzed Chapter 11 health care bankruptcy cases with liabilities of at least $10 million, since 2019.

Last year’s total was down 28% from 2023’s peak, but greater than the 2019 to 2022 average of 42 filings a year, the report said.

BROKE DOCTORS: https://medicalexecutivepost.com/2025/08/02/doctors-going-broke-and-living-paycheck-to-paycheck/

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Bankruptcy, often considered a last financial resort, is a legal process that can help alleviate outstanding debts for individuals and businesses. Reasons to file for bankruptcy can include divorce, job loss, exorbitant medical bills or credit card debt.

There are several types of bankruptcy — six, as a matter of fact. The two most common types of bankruptcy for individuals are Chapter 7 and Chapter 13.

But there are four other types as well: Chapter 9, Chapter 11, Chapter 12 and Chapter 15. And, the type of bankruptcy filed depends on the situation.

Regardless of which type, the process is typically the same: You’ll usually retain an attorney and make your case before a judge, who will then erase some debts or set up a repayment plan.

Also note that an eligibility requirement — for all bankruptcy chapters — is that you must undergo credit counseling within the 180 days before filing.

DOCTORS: https://medicalexecutivepost.com/2025/07/17/doctors-and-lawyers-often-arent-millionaires/

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EDUCATION: Books

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PHYSICIANS: Do You Use A Financial Planner?

Posted on July 27, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

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TO: All Physicians and Dentists

QUESTION?

Do you use a financial advisor?

What has been your experience with him or her?

THANK YOU

EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com -OR- http://www.MarcinkoAssociates.com

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PHYSICIANS: Do You Use A Financial Advisor?

Posted on July 26, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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TO: All Physicians and Dentists

QUESTION?

Do you use a financial advisor?

What has been your experience with him or her?

THANK YOU

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DOCTORS AND LAWYERS: Often Aren’t Millionaires

Posted on July 17, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

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BRAND MANAGEMENT: 7 Approaches For Doctors and Financial Advisors

Posted on July 7, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By A.I.

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Any extensive analysis of numerous papers published on brand management leads to the seven approaches mentioned below. This included 300+ articles from Journal of Marketing, Journal of Marketing Research, Journal of Consumer Research, Harvard Business Review and European Journal of Marketing.

So, it can be safe to claim that no matter which framework or model one follows it must have originated via one of the seven approaches listed below.

The Seven Branding Approaches are:

  • The economic approach: the brand as part of the traditional marketing mix.
  • The identity approach: the brand as linked to corporate identity.
  • The consumer-based approach: the brand as linked to consumer associations.
  • The personality approach: the brand as a human-like character.
  • The relational approach: the brand as a viable relationship partner.
  • The community approach: the brand as the pivotal point of social interaction.
  • The cultural approach: the brand as part of the broader cultural fabric.

There are multiple theories and model to be followed in the area of brand management with their own school of thought and have been proven to work.

These include the Aaker’s brand identity model, Kapferer’s brand prism or Keller’s customer-based brand equity pyramid. All of them will enhance the brand equity of the product or service but may have evolved from different school of thoughts. Though everyone talks about the different models, rarely we find text on the school of thought rather then the actual model in practice.

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And, you will find the Brand Asset Valuator Model in many books but you might never come to know the author’s perspective.

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BRANDS & BRAND MANAGEMENT: Defined and Explored for Doctors and Advisors

Posted on July 3, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By A.I.

SPONSOR: http://www.CertifiedMedicalPlanner.org

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What Is a Marketing Brand

A brand is a name, term, design, symbol or any other feature that distinguishes one seller’s goods or service from those of other sellers. Brands are used in business, marketing and advertising for recognition and, importantly, to create and store value as brand equity for the object identified, to the benefit of the brand’s clients, patients, customers, its owners and shareholders. Brand names are sometimes distinguished from generic or store brands.

BRANDING: https://medicalexecutivepost.com/2023/02/02/podcast-personal-branding-for-doctors/

What is Brand Management?

Brand management, also known as Marketing, is responsible for the overall management of a brand. This includes everything from product or service development and marketing to advertising and public relations. All of these aspects work together to create a particular image or reputation for a brand. The goal of brand management is to create a robust and positive reputation for a brand that will result in increased sales and market share.This process helps companies create a unique identity for their products or services in the marketplace. A successful brand management strategy can build client, patient and customer loyalty .

BRANDS: https://medicalexecutivepost.com/2021/06/03/physician-branding-post-pandemic/

Branding is essential for financial advisors, doctors and businesses because it involves creating a unique identity for a company’s products, offerings and services. It can also help build customer, client and patient loyalty and emotionally connect with the practitioner. Branding can be complex, but it is essential to understand the basics before starting a brand strategy.

Thus, doctors, podiatrists, dentists, CPAs, insurance agents, financial advisors and their practices need to understand the different aspects of branding and brand management to create a strong brand identity.

SELF BRANDING: https://medicalexecutivepost.com/wp-content/uploads/2011/03/leadership-self-branding-marcinko.pdf

EDUCATION: Books

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Physician V. Doctor V. Provider V. Prescriber V. Medical Others

Posted on May 22, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

HEALTHCARE DEFINITIONS

By Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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When you visit health clinic or hospital for a medical appointment, you’ll be seen by a doctor, healthcare provider and/or medical prescriber. But what do these words really mean?

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Doctors / Physicians

Doctor of Medicine (MD), Doctor of Podiatric Medicine (DPM), Doctor of Osteopathy (DO, or Doctor of Dental Surgery (DDS/DMD). Doctors, also known as physicians, have extensive prescription privileges across various specialties. They can diagnose medical conditions, prescribe medication, and oversee the overall management of patient care. Doctors include general practitioners, specialists such as cardiologists or dermatologists, and surgeons. Their prescription authority encompasses a wide range of medications to address acute and chronic health conditions, ranging from antibiotics to specialized treatments for complex diseases.

MORE: https://medicalexecutivepost.com/2023/06/17/the-md-versus-do-degree/

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Medical Providers

A medical provider is a general term that encompasses a wide range of education levels, skill-sets, and specializations. A provider could be a Physician Assistant (PA), Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Doctor of Medicine (MD), Doctor of Podiatric Medicine (DPM), Dentist (DDSDMD) or Doctor of Osteopathy (DO).

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Medical Drug Prescribers

Generally, psychologists and therapists do not have prescription privileges. They focus on psychotherapy and counseling rather than medication management. However, some jurisdictions may grant limited prescription rights to psychologists who undergo additional training and certification. Like psychologists, therapists typically do not have prescription privileges. They focus on providing counseling and psychotherapy to address mental health issues and emotional concerns.

PHARMACISTS: https://medicalexecutivepost.com/2025/02/12/pharmd-doctor-of-pharmacy/

Psychiatrists are medical doctors (MD/DO) who specialize in the diagnosis and treatment of mental health disorders. They have full prescription privileges and can prescribe a wide range of medications to manage psychiatric conditions.

In most cases, physical therapists do not have the authority to prescribe medication. They primarily focus on rehabilitation and physical interventions to improve mobility and function.

MORE: https://medicalexecutivepost.com/2025/02/23/doctorate-physical-therapy/

Nurse practitioners are advanced practice nurses with the authority to diagnose, treat, and prescribe medication independently in many states and countries. They undergo extensive education and training, which allows them to provide a wide range of healthcare services, including medication management.

Similar to nurse practitioners, psychiatric nurse practitioners have the authority to prescribe medication for mental health conditions. They specialize in psychiatric and mental health care, offering comprehensive treatment that may include medication management.

Chiropractors primarily focus on diagnosing and treating musculoskeletal disorders through manual adjustments and therapies. They do not have surgical or prescription privileges in most jurisdictions.

Optometrists are trained to diagnose and treat vision problems, including prescribing corrective lenses and medications for certain eye conditions such as infections or inflammation.

Registered nurses typically do not have prescription privileges. They work under the direction of physicians and nurse practitioners, assisting with patient care but not prescribing medication themselves.

Dentists have limited prescription privileges related to dental care, such as antibiotics or pain medications for dental procedures. However, they do not have the authority to prescribe general medications outside of their scope of practice.

Nutritionists typically do not have prescription privileges. They specialize in providing dietary advice and counseling to promote health and well-being through nutrition but do not prescribe medication.

Depending on their scope of practice and legal regulations in their jurisdiction, nurse midwives may have limited prescription privileges for certain medications related to prenatal care, childbirth, and postpartum care.

MORE: http://www.HealthDictionarySeries.org

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HEDGE FUNDS: In Individual Retirement Accounts?

Posted on April 2, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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QUESTION: What is a Hedge Fund?

A hedge fund is a limited partnership of private investors whose money is pooled and managed by professional fund managers. These managers use a wide range of strategies, including leverage (borrowed money) and the trading of nontraditional assets, to earn above-average investment returns. A hedge fund investment is often considered a risky, alternative investment choice and usually requires a high minimum investment or net worth. Hedge funds typically target wealthy investors.

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SPONSOR: http://www.MARCINKOASSOCIATES.com

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QUESTION: Can I invest my Individual Retirement Account [IRA] in a Hedge Fund?

This is up to the manager, but there is no legal restriction on a hedge fund accepting individual retirement account (IRA) assets. IRA accounts are not well suited for funds that make extensive use of leverage, however. In such cases, the fund is likely to generate significant amounts of unrelated business taxable income (UBTI) – profits of the fund attributable to the use of leverage. The holder of an IRA account must pay taxes on UBTI, even if the UBTI was generated in an IRA account.

But, today’s hedge funds may or may not use leverage. Many hedge funds are not hedged at all, but rather are just specialized versions of regular long stock portfolios. If such funds do not use much leverage, IRA investors will not encounter much difficulty with UBTI and should not hesitate in considering these funds.

In considering whether to accept IRA money, hedge fund managers must consider several factors. If the only type of retirement money accepted by the hedge funds is IRA money, then the manager has no limit on how much retirement money the fund can accept. If, however, there are other types of retirement money invested in the fund, such as pension funds, IRA money will be counted towards a total of 25 percent of fund assets that can be invested in retirement accounts before the fund becomes subject to the Employment Retirement Income Security Act of 1974 (ERISA). Funds subject to ERISA regulations face a heavy administrative burden and more restrictions than most fund managers like.

Finally, IRA distributions from a hedge fund are subject to the standard 20 percent withholding unless the funds are directly rolled over to other qualified plans.

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DENTAL Care “Deserts”

Posted on March 28, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Dental care in America divides people into two camps: those who can afford regular preventive care and cleanings, and those who can’t.

These so-called dental deserts contribute to a deep disparity in overall health. People who live in these places are more likely to get tooth decay and develop severe health problems. They also spend more money on care, and more time seeking health assistance in an emergency.

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Stat: 25 million. That’s how many US residents live in areas without enough dentists, according to a recent Harvard University study.

A growing movement against fluoride is adding to the risk of tooth decay in these “dental deserts.” (NPR)

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MEDICAL OFFICE: Practice Embezzlement Schemes

Posted on March 26, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

DR. DAVID EDWARD MARCINKO; MBA MEd CMP®

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SPONSOR: http://www.MarcinkoAssociates.com

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Without proper internal accounting controls, a medical practice [MD, DO, DPM, DDS, DMD] might never reach peak profitability. Internal controls designed and implemented by the physician-owner help prevent bad things from happening.

Embezzlement protection is the classic example. However, internal controls also help ensure good things happen most of the time; according to colleague Dr. Gary Bode; MSA, CPA.

Some Common Embezzlement “Old School” Schemes

Here are some ‘old-school” embezzlement schemes to avoid; however the list is imaginative and endless.

  • The physician-owner pocketing cash “off the books”. To the IRS, this is like embezzlement to intentionally defraud it out of tax money.
  • Employee’s pocketing cash from cash transactions.  This is why you see cashiers following protocol that seems to take forever when you’re in the grocery check out line. This is also why you see signs offering a reward if he/she is not offered a receipt. This is partly why security cameras are installed.
  • Bookkeepers writing checks to themselves.  This is easiest to do in flexible software programs like QuickBooks, Peachtree Accounting and related financial software. It is one of the hardest schemes to detect. The bookkeeper self-writes and cashes the check to their own name; and then the name on the check is changed in the software program to a vendor’s name.  So a real check exists which looks legitimate on checking statements unless a picture of it is available.
  • Employees ordering personal items on practice credit cards.
  • Bookkeepers receiving patient checks and illegally depositing them in an unauthorized, pseudo practice checking account, set up by themselves in a bank different from yours. They then withdraw funds at will. If this scheme uses only a few patients, who are billed outside of the practice’s accounting software it is hard to detect.  The doctor must have a good knowledge of existing patients to catch the ones “missing” from practice records. Monitoring the bookkeeper’s lifestyle might raise suspicion, but this scheme is generally low profile and protracted. Checking the accounting software “audit trail” shows the required original invoice deletions or credit memos in a less sophisticated version of this scheme.
  • Bookkeepers writing payroll checks to non-existent employees. This scheme works well in larger practices and medical clinics with high seasonal turnover of employees, and practices with multiple locations the podiatrist-owner doesn’t visit often.
  • Bookkeepers writing inflated checks to existing employees, vendors or subcontractors. Physician-owners should beware if romantic relationships between the bookkeeper and other practice related parties.
  • Bookkeepers writing checks to false vendors. This is another low profile, protracted scheme that exploits the podiatrists-owner’s indifference to accounts payable.

Assessment

Operating efficiency, safeguarding assets, compliance with existing laws and accuracy of financial transactions are common goals of internal managerial and cost accounting in medical practice.

CONCLUSION

Hopefully, the above is a good review to prevent common practice embezzlement schemes. Unfortunately, it is a never-ending endeavor.  

References: Marcinko, DE: Dictionary of Health Economics and Finance. Springer Publishing Company, NY 2007.

Related Textbooks: https://tinyurl.com/579rex23

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FINANCIAL ADVISORS & MEDICAL MANAGEMENT CONSULTANTS: Marcinko & Associates, Inc

Posted on March 19, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.MarcinkoAssociates.com

D. E. Marcinko & Associates Core Operating Values

9.   We act with honesty, integrity and are always straightforward.
8.   We strive to be innovative, creative, iconoclastic, and flexible.
7.   We admit and learn from mistakes and don’t repeat them.
6.   We work hard always as competitors are trying to catch up.
5.   We treat others with dignity and respect.
4.   We are the onus of consulting advice for the well being of others.
3.   We fight complacency as former success is in the past.
2.   The best management styles are timeless, not timely.
1.   Our clients are colleagues and always come first.

EDUCATION: Books

SPEAKING: Dr. David Edward Marcinko MBA MEd will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements.

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CONTACT: Ann Miller RN MHA at: MarcinkoAdvisors@outlook.com 

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DENTISTRY: DDS versus DMD Degree

Posted on March 9, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

DENTAL ADA DEGREES

By Colgate and Staff Reporters

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DDS vs. DMD Degree

DDS and DMD are the acronyms of the degrees dentists earn after finishing dental school. DDS means Doctor of Dental Surgery, and DMD can mean either Doctor of Medicine in Dentistry or Doctor of Dental Medicine. While the names are different, the American Dental Association (ADA) explains that they represent the same education. Some universities may grant dental graduates with a DDS, and others grant a DMD, but both degrees have the same requirements.

According to the ADA, the Baltimore College of Dental Surgery established the first Doctor of Dental Surgery degrees in 1840. When Harvard University started its dental school in 1867, their degrees were called Dentariae Medicinae Doctorate (Doctor of Medicine in Dentistry) because Harvard uses Latin names for their degrees. Even though these degrees are based on the same educational requirements, they still have different names.

Difference Between a DDS and a DMD Degree?

Today, many universities award a DMD degree. Dentists with either a DDS or a DMD are educated to practice general dentistry. All dentists receive a rigorous education. First, dental schools typically require a four-year undergraduate education. Afterward, graduates go to dental school for another four years of classroom training, clinical training, and dental laboratory training.

Dental students spend the first two years of dental school studying biomedical sciences courses like anatomy, biochemistry, pathology, and pharmacology. The last two years are focused on clinical and laboratory training.

After graduating from dental school, dentists must pass a national written examination called the National Board Dental Examination, followed by a regional clinical board examination. Dentists must also pass a jurisprudence examination about state laws before being given a license to practice dentistry in that state.

Post Graduate Education After a DDS or DMD

Most dentists stick with practicing general dentistry. However, some choose to specialize in a particular area of dentistry after earning their degree. Training programs range from two to six years, depending upon the specialty area. There are several dental specialties, including endodontics, orthodontics, periodontics, prosthodontics, oral surgery, and pediatric dentistry. The ADA can help you find a dentist with a specialty that fits you best.

Dentists receive a rigorous education and have to pass several exams to be able to practice. Whether they have a DDS or DMD after their name, you should choose a dentist based on their skills, types of services provided, communication, and professionalism.

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2025: National Dentist Day

Posted on March 6, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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March 6th is National Dentist Day, a day to celebrate the men and women who keep our chompers chomping, our gnashers gnashing, and our whites pearly.

Dentists (DDS/DMD) are doctors who specialize in oral health. It’s their job to prevent, diagnose, and treat oral diseases, monitor the growth of our teeth and jaws, and perform surgical procedures on our teeth and mouths!

Dental health is integral to our overall health, so today we salute them not just for keeping our teeth looking good, but keeping our bodies in tip-top shape.

MORE: https://nationaltoday.com/national-dentist-day/

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DENTISTS: Prescribing Limits

Posted on March 1, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

Rx – What Dentists Can’t Do

By Staff Reporters

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Dentists are limited to prescribing medications that address oral and dental health only.

For example, they cannot provide prescriptions for conditions unrelated to dentistry, such as chronic illnesses like diabetes or respiratory infections. Additionally, dentists do not prescribe medications for mental health or hormonal issues.

These limitations ensure that dental professionals focus strictly on oral health and leave more complex medical issues to general physicians or specialists. This distinction helps protect patients from receiving inappropriate or harmful treatments outside the dentist’s expertise.

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IRS: Tax Deductions

Posted on February 28, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

CLARINET LESSONS

By Staff Reporters

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In 1962, a parent was able to deduct the cost of their child’s clarinet lessons and the instrument itself, after they were prescribed by an orthodontist to fix the child’s overbite, according to a report by Boston University School of Law.  

Unsurprisingly, it initially went to court, where it was ruled that it qualified as a legitimate medical expense (despite not being the most traditional treatment).

So, when it comes to the IRS, it’s not always about prescriptions or surgeries — sometimes, even clarinet lessons can count.

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FEBRUARY: National Children’s Dental Health Month

Posted on February 26, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

AMERICAN DENTAL ASSOCIATION

By ADA and Staff Reporters

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Every day should be about children’s dental health

This is the message behind the ADA’s National Children’s Dental Health Month resources for 2025. Observed nationally each February, the recognition brings together thousands of dedicated professionals, health care providers and educators to promote the benefits of good oral health to children, their caregivers, teachers and many others.

The ADA is offering new materials to celebrate and promote the importance of children’s dental health, not only during the month of February, but all year.

Posters and flyers emphasizing the importance of brushing are available for free download in two kid-friendly, topical designs and two sizes, 8.5″x11″ and 11″x17″. Matching coloring sheets are offered in 8.5″x11″. All materials have instructions for proper brushing and are available in English and Spanish from ADA.org/NCDHM.

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In addition, the ADA’s 2025 Brushing Calendar is available for free download. This 12-month calendar is valuable year-round for promoting healthy behaviors like brushing twice a day with a fluoride toothpaste to help prevent dental disease. Kids can track their daily brushing and flossing routines and exercise their creativity by coloring the calendar image for each month.

Another tool, the NCDHM Program Planning Guide, provides resources for program coordinators, dental societies, teachers and parents to promote the benefits of good oral health to children. The guide includes easy-to-do activities, program planning tips, a sample NCDHM proclamation and more.

“The sooner children understand the value of good oral health habits, the more likely they are to continue these habits well into adulthood,” said ADA President Brett Kessler, D.D.S. “The ADA is proud that NCDHM will once again equip some of the most influential figures in kids’ lives — like parents, educators and health care providers — to help set our nation’s kids on the path to a lifetime of healthy smiles and healthier lives.”

National Children’s Dental Health Month observances began with a one-day event in Cleveland and a one-week celebration in Akron, Ohio, in February 1941. Since then, the concept has evolved into a nationwide program.

The ADA held the first national observance of Children’s Dental Health Day on February 8th, 1949. The one-day event became a week long event in 1955, and in 1981 the program was extended to a month long celebration known today as National Children’s Dental Health Month.

For questions about NCDHM resources, please email ncdhm@ada.org. For oral health resources, visit MouthHealthy.org.

EDUCATION: Books

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NEWEST THOUGHTS: Physician Personal Emergency Fund Size is Getting Complicated

Posted on February 23, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.MarcinkoAssociates.com

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By Dr. David Edward Marcinko MBA MEd

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It has been said that most ordinary people should have at least three to six months of living expenses (not including taxes) in a cash-equivalent reserve fund that is easily accessible (i.e., liquid).  The amount needed for a one-month reserve is equal to the amount of expenses for the month, rather than the amount of monthly income. This is because during no-income months there is no income tax.  

However, the situation might not be the same for physicians in today’s harsh economic climate. 

The New Realities

Now, some physician-focused financial advisors, financial planners and Certified Medical Planners™ suggest even more reserve fund savings; up to two years. That’s because many factors come into play when determining how much a particular doctor’s family should have.

For example: 

  • Does the family have one income or two? If the doctor is in a dual-income family with stable incomes and they live on a single income, the need for a liquid reserve is less.  
  • How stable is the doctor’s income source? If a sole provider with an unstable income who spends all of the income each month, the need for a liquid cash reserve is high. 
  • Does the doctor own the practice, work in a clinic, medical group, hospital or healthcare system? In other words – employee (less control) or employer (more control). 
  • What is the doctor’s medical specialty and how has managed care penetrated his locale, or affected her focus? What about a DO, DDS/DMD or DPM, etc.
  • How does the family use its income each month; does it have a saver, spender, or investor mentality?  
  • Does the family anticipate the possibility of large expenses occurring in the future (medical practice start-up costs or practice purchase; children, medical school student debts; auto or home loans; and/or liability suits, etc)?  
  • Pan physician lifestyle?

The Past 

In the ancient past, a doctor may have opted for a nine-twelve month reserve if the need for security was high – and a six-to-nine month reserve if the need for security was low. But today, even more may be needed.  How about 15-18 months, or more? Perhaps even 24 months!

So, the following questions may be helpful in determining the amount of reserve needed by the physician: 

1. How long would it take you to find another job in your medical specialty if you suddenly found yourself unemployed – same for your spouse?

2. Would you have to relocate – same for your spouse? 

3. How much do you spend each month on fixed or discretionary expenses and would you be willing to lower your monthly expenses if you were unemployed? 

Assessment

Once the amount of reserve is determined, the doctor should use the appropriate investment vehicles for the funds. 

At minimum, the reserve should be invested in a money market fund. For larger reserves, an ultra-short-term bond fund might be appropriate for amounts over three-six months. While even larger reserves might be kept in a short term bond fund depending on interest rates and trends. 

So, what do the initials M.D. really mean? … More Dough!

How much reserve do you have and where is it stashed?

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EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com 

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HEALTH ECONOMICS: Who Should Study and Learn this Dismal Science?

Posted on February 21, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

DR. DAVID EDWARD MARCINKO MBA MEd CPHQ CMP™

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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Who should study health economics?

Understanding how economic behavior factors into health and health care decisions can benefit anyone interested in this field. However, the following groups of individuals may benefit most from the study of health economics:

  • Medical providers: Doctors, nurses, and assistants can evaluate new treatments, technologies, and services to determine ways to deliver value-based care. Medical providers benefit from understanding the economics behind these developments [MD/DO, DPM, DDS/DMD, RN, PA, etc].
  • Administrators: Health care administrators process insurance co-payments and manage financial metrics for health care providers. Learning the intricacies of health care economics can provide the necessary context as they liaise with insurance providers and use new technologies to process payments.
  • Policymakers or public health officials: Those who are in charge of policy decisions at the local, state, federal, or international levels benefit from understanding the economic relationship between stakeholders and the general public.
  • Business leaders: Because many Americans receive private insurance, health care becomes a major expense for employers. Business leaders must understand the health economics outlook to appease their employees, shareholders, and even their customers.

EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com 

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DENTIST OATH: Ethical Patient Care

Posted on February 10, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

EVIDENCE BASED DENTISTRY

By Staff Reporters

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Evidence Based Dentistry?

Despite the high praise for evidence-based dentistry, there are a number of limitation and criticism that has been given to the process. Chambers DW provides quite a bit of criticism, as well as a number of limitations that evidence-based dentistry provides. In no particular order of importance, a number of mentioned objections towards this format are:

  • Evidence-based dentistry is too clumsy due to the concept being poorly defined
  • The implementation of evidence-based dentistry has been distorted by too heavy of an emphasis of computerized searches for research findings that meet the standards of academics
  • Although EBD advocates enjoy sharing anecdotal accounts of mistakes others have made, faulting others is not proof that one’s own position is correct
  • There is no systematic, high-quality evidence that EBD is effective
  • Patient and practitioner values are the shortest leg of the stool. As they are so little recognized, their integration in EBD is problematic and ethical tensions exist where paternalism privileges science over patient’s self-determined best interests.
  • MORE: https://pmc.ncbi.nlm.nih.gov/articles/PMC6375114/

Dental Oath

Although dentists, dental hygienists, and dental assistants may not formally recite the Hippocratic Oath, its principles undeniably apply in their practice, particularly in the high-stakes context of emergency medical care.

By embodying these principles, dental professionals not only fulfill their commitment to ethical patient care but also ensure the safety and well-being of those they serve. 

More: https://www.ada.org/about/principles/code-of-ethics

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COGNITIVE BIAS: In the Dental Community

Posted on February 6, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Cognitive bias is a pattern of thinking in humans that, although flawed, is repeated mindlessly, sometimes resulting in irrational behavior and decisions. Dental personnel need to understand how cognitive biases impact both their patients and their team members. Left unchecked, these automatic associations can cause grave mistakes and injuries, and result in real harm.

This course is designed to help dental team members recognize their own biases and see the need to introspect and self-regulate to change them.

READ: https://dentalacademyofce.com/wp-content/uploads/2022/03/Cognitive-bias-within-the.pdf

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DENTAL OFFICE: Cyber Hacks

Posted on September 10, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Recently, the FBI warned the American Dental Association in May of the potential danger to providers from hackers. In May 2023, hackers attacked Delta Dental of California in a breach exposing the information of around 7 million patients.

And, in April 2023, Aspen Dental—a chain with more than 1,000 dentists’ offices across the country—suffered a ransomware hack that exposed user data, including health insurance information and Social Security numbers.

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DENTAL CARE: Unattainable for Many Patients

Posted on July 20, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

“Crisis”

By Staff Reporters

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A lack of insurance and high out-of-pocket costs make dental care unattainable for 69 million people in the US. (USA Today)

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DENTISTRY: Ransomware e-Dental Records

Posted on February 3, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Darrell Pruitt DDS

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The ransom one pays to extortionists is only part of the costs. Now there are also legal liabilities to paying.

We will be hearing much more about ransomware in dentistry soon.

Guaranteed.

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New Ransomware Reporting Requirements Kick in as Victims Increasingly Avoid Paying

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IRS Inheritance Rule Change and the “Delta Dental” Data Breach

Posted on December 19, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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The IRS is demanding billions from small business who took this credit ...

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The IRS Quietly Changed the Rules on Children’s Inheritance

The IRS just issued Revenue Ruling 2023-2, which had a substantial impact on estate planning, particularly where an irrevocable trust is involved.

In the last decade or so, more families have begun utilizing irrevocable trusts to protect their assets from spend-down in order to qualify for government benefits, such as Medicaid and VA Aid and Attendance. Prior to the issuance of this ruling, it was unclear whether assets passing to beneficiaries through an irrevocable trust would receive a step-up in basis, thereby eliminating any capital gains taxes that would otherwise be owed.

Historically, assets that are disposed of during an individual’s lifetime are subject to capital gains taxes on the increase in value of that asset over time. The amount of capital gains owed is determined largely by the difference between the value at the time of purchase and the value at the time of transfer.

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Delta Dental of California data breach exposed info of 7 million people

“Delta Dental of California and its affiliates are warning almost seven million patients that they suffered a data breach after personal data was exposed in a MOVEit Transfer software breach.Delta Dental of California provides 24 months of free credit monitoring and identity theft protection services to impacted patients to mitigate the risk of their exposed data.”

LINK: https://tinyurl.com/bp4u2chv

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BANKRUPTCY: e-Dental Records

Posted on October 12, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Darrell Pruitt DDS

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Even though the American Dental Association officially disagrees, if you haven’t adopted electronic dental records, now is not the time.

“Ransomware attack threatens to expose McLaren Health patient data” – Michigan Attorney General Dana Nessel notes: “This attack shows, once again, how susceptible our information infrastructure may be”. Organizations that handle our most personal data have a responsibility to implement safety measures that can withstand cyber-attacks and ensure that a patient’s private health information remains private.”

LINK: https://www.mlive.com/crime/2023/10/ransomware-attack-threatens-to-expose-mclaren-health-patient-data.html

I’d give it a few more years. Otherwise, your digital records could be the cause of your bankruptcy.

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Ransomware hits small businesses too

Business Tips from SCORE: Hackers focusing on small businesses. Here’s how to protect yourself, by Marc L. Goldberg for Cape Cod Times, October 8, 2023.

“Ransomware is the type of malware that has been on the rise over the last couple of years. After the ransomware infects the device, you’ll know right away. It encrypts files (or parts of the infrastructure) and displays the ransom message on the screen of the victim. Some strains can steal data making the organization vulnerable. Those that are most vulnerable gather and store lots of data — health care, insurance, banking and credit card providers.”

If a dental office is hacked, and it becomes known in the community that patients’ identities are appearing on the dark web, it is likely to cause bankruptcy.

LINK: https://www.capecodtimes.com/story/business/columns/2023/10/08/small-businesses-are-hacker-targets-heres-how-to-avoid-an-attack/71056009007/

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Costly problem. Cybersecurity is the ultimate risk factor: In 2023, the average cost of a data breach worldwide was $4.45 million, marking a 15% increase in the last three years, according to a 2023 IBM report.

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The “New” Dental Support Organization Business Model

Posted on September 29, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Maia Anderson and Staff Reporters

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Watch out, private practice ownership. According to HealthcareBrew, Dental Support Organizations (DSOs) are the hot new business model for dentistry.

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

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DSOs are companies that take on all the business-related tasks necessary to run a dental practice, like IT support, accounting and billing, marketing, and facility maintenance, Lisa Ward, VP of communications at industry trade group the Association of Dental Support Organizations, told Healthcare Brew.

A DSO can own the dental practice it operates, or a private practice can contract with a DSO. Some DSOs are owned by a group of dentists, but private equity firms own many large DSOs, according to the Academy of General Dentistry.

The idea behind a DSO is that the “dentist can focus on patient care and not have to worry so much about the business side,” Ward said.

The DSO business model was created in 1975 but didn’t become popular until the 1990s, as dentists graduated with piles of student debt and found it hard to open their own practice, according to Huron Consulting Group.

Today, 10.3% of dentists are affiliated with a DSO, per investment banker Harris Williams. In 2020, 30% of dental school seniors said they planned to join a DSO-affiliated practice, compared to 12% in 2015, a survey from the American Dental Education Association found.

The rise in popularity of DSOs has brought about the decline of private practice ownership. In 2021, the number of dentists who owned their practices fell to 73%, according to research from the ADA.

Maia at anderson@morningbrew.com.

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RELATED: https://medicalexecutivepost.com/2007/11/27/ppmc-redux/

MORE: https://medicalexecutivepost.com/2022/11/30/the-benefits-of-dentistry-unhurried/

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DENTAL CLINIC: NYC Health and Bellevue Hospitals Expansion

Posted on September 22, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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NYC Health + Hospitals/Bellevue is seeking approval to expand its outpatient dental clinic, according to Healthcare Brew and plans filed with the state this week.

The $830,000+ renovation of Bellevue’s clinical space would double the number of dental chairs from three to six, and allow the Manhattan public hospital to “meet the existing demand for dental services, meet the training requirements of the dental general practice residency program, and allow for additional growth to meet the oral health needs of the under served and uninsured population in the community,” according to the application.

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

Bellevue reported that each of its dental chairs has an average annual utilization rate of 2,000 visits, or about 6,000 total visits a year. According to the National Maternal and Child Oral Health Resource Center, “most safety net dentists see 2,500–3,200 patient visits per year, with the yearly national average coming in at 2,600.”

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MEDICARE PART B: Dental Care

Posted on September 19, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

Medicare enrollees could save $500+ per year in out-of-pocket spending if federal lawmakers expand parts of the program to include dental services, according to a report released last week.

The Urban Institute analysis—aided by funding from the Robert Wood Johnson Foundation—examined the implications of expanding Medicare Part B, which covers medically necessary and preventive services, to include dental care. The proposed coverage would be subject to Part B deductibles and 20% cost-sharing, and it could lower out-of-pocket expenses by 80%, or $530 per person annually, the report found.

Katherine Hempstead, a Robert Wood Johnson Foundation senior policy advisor, said the proposed expansion is “an opportunity to increase equity and close long-standing gaps in access to dental services.” Low-income older adults currently “bear the brunt” of Medicare’s lack of dental coverage, she added.

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DENTAL DATA BREACH: Paper is Safer – It Always has Been!

Posted on June 3, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Darrell K. Pruitt DDS

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PAPER IS SAFER – IT ALWAYS HAS BEEN!

“9M dental patient records published following LockBit ransomware attack”

–By Duncan Riley for Silicone Angle, May 30th, 2023
READ: https://siliconangle.com/2023/05/30/9m-dental-patient-records-published-following-lockbit-ransomware-attack/

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We knew digital dental records were never safe, even though our trusting patients had no idea. I started warning dentists about sudden public rejection of electronic dental records over a decade ago. In fact, that is why the Texas Dental Association suspended my membership.

It’s the start of the predictable end of digital records in most dental offices. The TDA and the ADA were repeatedly warned, but chose to say nothing about the comparative security of paper to dues-paying members. In fact, the American Dental Association marketed its own digital dental record system until a few years ago when over 500 dental practices using their system were hacked. Then the ADA quietly sold it.

“The records of nearly 9 million people have been published online following a LockBit ransomware attack on Managed Care of North America. The company, also known as MCNA Dental, is a leading provider of dental plans in the U.S., serving private employers, individuals and families through a range of Medicare, long-term and commercial plans. MCNA is also the largest dental insurer for government-sponsored Medicaid and Children’s Health Insurance Program, programs.”

The question is, what will this news do to huge, multi-location dental franchises such as Aspen Dental, Monarch, Medicare and other discount dentistry centers. Dentists have proven they can run successful, large practices using pegboards, ledger cards and bulky, loud metal filing cabinets without risking their patients’ privacy.

By the way, my practice is accepting new patients. Oh yea: TDA, you still owe me $200 in prorated dues for the remainder of the year you kicked me out. Idiots!

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The DENTA-VERSE [A Dental Web 3.0 & Virtual Reality Community

Posted on March 30, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

Connecting the future of dentistry in 3D

By Staff Reporters

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Dentaverse was born in the heart of Europe between young professionals. A combination of Dental, Finance, 3D and web professionals coming together to connect dental dots. In doing so Dentaverse has grown in to a deep integration of dental know-how and innovative technologies like: Metaverse (VR), blockchain, web3 tech and education.

Accelerating personal and professional growth by connecting dental students, universities, professionals and suppliers in virtual reality.

WEBSITE: https://www.dentaverse.io/

Related: Google Health rolls out new tech offerings to improve access to care, health outcomes

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

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DAILY UPDATE: Wall Street’s Hell Week & National Dentist’s Day

Posted on March 6, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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National Dentist’s Day falls on March 6th every year. It was established as a way to show appreciation and thanks for dentists. It’s also a way to bring awareness to dentistry so that people will know more about how to care for their teeth. It also encourages people who may have avoided going to the dentist to come in for a checkup.

MORE: https://nationaldentistsday.com/

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“WALL STREET Hell Week: Features several potential landmines for the stock market. One of them is the jobs report on Friday. Employment numbers have been on the rise, and continued strength in the labor market could lead to more interest rate hikes. Another key event this week: FOMC Chair Jerome Powell’s testimony on Capitol Hill. He’s expected to field questions on the trajectory of inflation and the looming debt-ceiling crisis.

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

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METAVERSE: Dentistry and Dental Education

Posted on November 30, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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The use of artificial intelligence (AI) is now a reality in dentistry. A significant advancement is the use of haptic gloves that would let dental students feel virtual objects while practicing suturing or giving a nerve block – this can significantly improve the students’ technique over time and give them, for example, immediate feedback with respect to needle point insertion.

While initial costs for such systems might seem high now, the hardware is proven to be cost-effective in the long term.

READ HERE: https://www.nature.com/articles/s41415-022-3990-7

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

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MEDICARE: Expanding Dentistry?

Posted on October 25, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Dental coverage under Medicare could soon start expanding for seniors under a new proposal from the U.S. Centers for Medicare and Medicaid Services (CMS). Still, the proposed rules would not provide full coverage for regular dental care, which has been explicitly excluded from Medicare since the program’s founding in 1965.

“Traditional Medicare doesn’t cover routine preventive dental services, such as exams, cleanings, X-rays, nor more expensive services such as fillings, crowns or dentures,” said Meredith Freed, a Medicare expert with the Kaiser Family Foundation.

However, the new proposal would effectively open the door to Medicare potentially covering a wider array of dental services if medical science can demonstrate that oral health substantially improves the

READ: https://www.govinfo.gov/content/pkg/FR-2022-07-29/pdf/2022-14562.pdf

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

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SDOH = Social Determinants of Oral Health

Posted on May 23, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Social determinants of oral health and tooth loss

A study led by investigators at the Harvard School of Dental Medicine suggested that “machine-learning algorithm models incorporating socioeconomic characteristics were better at predicting tooth loss than those relying on routine clinical dental indicators alone.”

CITE: https://www.r2library.com/Resource/Title/082610254

Furthermore, new research reported that

  • adults living in urban areas visited the dentist more than those in rural areas
  • women were more likely than men to visit the dentist in both rural and urban areas
  • the number of adult dental visits increased as family income increased
  • non-Hispanic white adults were more likely than Hispanic and non-Hispanic black adults to have a dental visit in urban areas.

Therefore, it is important to consider how disparities in access to and use of dental care impact not only tooth loss but also oral and overall health.

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9 TECHNOLOGIES THAT WILL SHAPE THE FUTURE OF DENTISTRY

Posted on April 22, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

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By BertalanMesko MD PhD

9 TECHNOLOGIES THAT WILL SHAPE THE FUTURE OF DENTISTRY

Can you imagine that you might get your 3D-printed prosthesis in an hour instead of 4-5 sessions at the dentist? How about having a tele-dentist consultation? Or being able to grow new teeth at the age of 80?

Here are 9 technologies that will shape the future of dentistry!

READ MORE

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INDEPENDENT DENTAL PRACTICE: Start-Up Costs?

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

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imba inc

BY THE INSTITUTE OF MEDICAL BUSINESS ADVISORS, Inc.

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

How much will it cost you to start a dental practice – with Business Plan? 

There are many costs to consider to set up a successful dental practice. Note that the following values are not the exact amount but an average of setting up a dental practice:

  • Purchase price – this includes valuation fees of between $1,000-4,500, solicitor fees of between $4,000 – 17,000, accountancy and bank fees of around $3,000, and bank solicitors, which can be up to $3,500. Many of these can be reduced or obliterated.
  • Materials – $40,000
  • Lab fees – $36,000
  • Staff costs – $82,000
  • Other costs (associates fees) – [$245,000 – $295,000]
See the source image

Other Factors

  1. “Big” Tech – Many startup doctors want to include CBCT or CAD/CAM or 3D printing in their startup, any of which can add $25,000-$175,000. In other situations, waiting is the best option.
  2. Cabinetry Preferences – Costs for cabinetry can range from $5,000 to $175,000.
  3. Practice Management Software (PMS) – Pricing will range from a few thousand dollars to $25,000; OR none at all.
  4. Mechanical Delivery – Typically referred to as chairs, lights, and units, this category of dental equipment costs will range between $5,000 and $100,000 based on your startup plans.

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

Vision – Ignore the so-called “experts” who will try to create a cookie-cutter model for your equipment costs. That is the thinking of corporate dentistry. You want a customized private practice vision that allows you to create a model matching your standards. Prioritize your vision, so your values and philosophy will lead your dental equipment budget and purchasing decisions. Your equipment budget will be—and should be—customized.

BUSINESS PLAN: https://medicalexecutivepost.com/2017/08/17/business-plan-for-creatives-and-doctors/

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ORAL HEALTH AND EQUITY

Posted on September 14, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

BY NIHCM

INFO-GRAPHIC
Gum disease remains one of the most prevalent chronic diseases in the United States with 46% of adults over 30 showing symptoms. Although significant improvements have been made to improve oral health in America, many people still experience barriers to preventive or essential dental care.

Black Americans, Latinos, and Native Americans, as well as low-income populations, children and pregnant women are at greater risk of oral health diseases. The disparities experienced by these populations have only been exacerbated by the pandemic. 

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Image result for caries

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In this infographic highlights the challenges to achieving optimal oral health and identifies opportunities for advancing health equity moving forward. 

INFO-GRAPHIC: https://nihcm.org/publications/oral-health-health-equity?utm_source=NIHCM+Foundation&utm_campaign=901307447a-Oral_Health_Infographic_091421&utm_medium=email&utm_term=0_6f88de9846-901307447a-167744768

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In Defense of the eDR Industry

Posted on November 3, 2011 by Dr. David Edward Marcinko MBA MEd CMP™

One Dentist Consultant’s Opinion

By Paul L. Child Jr, DMD, CDT
CR Foundation
3707 North Canyon Road, Building 7
Provo, UT 84604

Three days ago, I shared the email I sent to Dr. Paul Child and Kathleen Noll concerning their claims that electronic dental records offer dentists a return on investment (ROI). Dr. Child responded yesterday.

Darrell K. Pruitt DDS

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Dear Dr. Pruitt,

Thank you for your recent communication and questions regarding my recent article in Dental Economics, specifically your question: Does the ROI for Practice Management systems include the cost of HIPPA compliancy?

In regards to your communications with QSI, I cannot comment as I do not represent them. Unfortunately, I too am not able to give you the “proof” you are seeking, as I do not have a specific chart nor do I plan on fabricating one to “prove” the efficacy of computers in the dental office (although a controlled study would be interesting, I’m not sure it would be an effective use of funds to prove something that is already proven in every other industry).

However, I will provide you with information from thousands of our readers at CR as well as many more in our lectures worldwide.

The section of the article to which you are referring is under the title of: Practice and patient records management and patient education. Specifically, the paragraph states:

“Implementation of computers into each operatory and throughout the practice is the first and most frequent adoption of digital dentistry. In North America and most developed countries, this has reached the “early majority” stage as all of the criteria for being an advantage have been met. Dentists who have not yet adopted this prerequisite for digital dentistry should do so now! Daily advances and improved software adapted from other industries allow this technology to be affordable, attain the fastest adop¬tion rate, and offer a high return on investment. Current and highly effective systems include Eaglesoft (Patterson), Dentrix (Schein), PracticeWorks (Carestream Dental), and Web-based software such as Curve Dental” (underlines added for emphasis).

Please note that the sentence in which “high return on investment” is mentioned is referring to “advances and improved software adapted from other industries”. As such, other industries (too many to count) have proved without a doubt, the massive improvement in return on investment in the following areas: improved efficiency (eg. Legible records vs. scribbles, or worse off, incomplete records), improved accuracy of records, use of computers for rapid recollection of stored data, rapid recording of data, time savings, standardization, and many more. A brief look at the medical industry and literature (our closest industry – of which we are a part of) can demonstrate the above. In addition, the observations I made are directed to the use of computers in a practice.

Finally, proper implementation of practice and patient management systems can easily improve ROI, via better record taking, accurate financial statements that can be easily generated daily for better practice management, treatment planning with all options, benefits, and risks recorded – then printed for the patient, and most of all – time savings. What is a dentists time worth? My time is priceless (as is most dentists I know). Yes, there are clearly unknown aspects of this digital transformation from paper to digital. Government and controlling organizations may make new rules and regulations that can positively or negatively affect this process.

But, from our observations of thousands of other dentists that have made this transition, very few – if any, would even think about reverting back to paper.

To your question regarding HIPPA compliance, YES, the overall ROI would include even this. HIPPA compliance is still relatively new to many dentists, even though it has existed for years. This compliance in important for all the reasons you already know. As dentistry evolves and new technologies are introduced (and ruling bodies continue to make new rules and regulations), this digital evolution will continue to prove itself an EXCELLENT ROI for today’s and tomorrow’s dentists.

Best regards,

Paul L. Child Jr., DMD, CDT

Conclusion

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Dental Compensation Different than Docs

Posted on September 29, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

On Medical Professional Salaries

Staff Reporters

www.BusinessofMedicalPractice.com

A 2003 Survey of Dental Practices reported net income from dentistry-related sources.

Dentists Differ from Doctors

Dentists differ from physicians in that 90% are in private practice. In 2002, the average practitioner’s net income was $174,350. The average dental specialist’s net was $291,250. These figures represent a 0.7% and a 5.8% increase over 2001, respectively.

Assessment

Net income rose steadily since 1986, when general dentists made an average of $69,920 and specialists an average of $97,920. But, by 2010, according to PayScale.com, the average general dentist earned $98,276 – $157,437; a decreasing trend allocated as follows.

Compensation Chart 

Salary  $92,689 – $147,682
Bonus  $1,996 – $19,727
Profit Sharing  $1,038 – $27,514
Commissions  $480.74 – $32,500

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.

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

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The IPS Dentist

Posted on July 10, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

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Dental Consultants

We’re a highly skilled team of dental consultants with over 45 years of combined dental, medical and management experience.

Multi-Venued

Through a combination of personal on-site visits and modern video conferencing we consult with any practice across the nation to help them increase their profits and create a more successful working environment. We evaluate our clients’ exceptional professional services and add to them to improve patient loyalty and harmony among the staff. We will provide your practice with the tools to have complete control over exponentially increasing accomplishments and professionalism.

Our Commitment

We stand tall on our commitment to making skilled professionals more successful in their day to day transactions with incredible results on our clients’ bottom lines.
IPS works to implement key systems:

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Assessment

ipsdentist.com
ipsdentist@yahoo.com

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Some Dental Consultants Say the Most Incredible Things

Posted on June 7, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Are Dentists like … Rodney Dangerfield? 

By Darrell Kellus Pruitt; DDS

“Let’s face it — in our world dentists do not get the respect they deserve. They are not perceived to be ‘real’ doctors … Perhaps the lack of sex appeal in dentistry is part of why dental coverage for everyone is an afterthought in the national health care conversation.”

Gary Kadi DDS, DentistryiQ

http://www.dentaleconomics.com/index/display/article-display/4196579430/articles/dental-economics/volume-100/issue-5/features/the-cavity_in_the.html

Even if Dr. Kadi is correct, and the barrier between a 12 year old and his toothbrush is a world-wide lack of respect of dentistry, that hardly means that electronic dental records (eDR) are going to make the kid brush any better. Experience tells me that if mom’s nagging won’t motivate the stinker, the computer won’t either.

eDR Rationalization?

For those who read the article, did you notice how Dr. Kadi, a dental practice consultant, attempts to subtly insert a fat rationalization for adopting eDRs into the middle of a comment lamenting dentistry’s lack of respect? Tricks like Kadi’s make stakeholders look silly at times, and it bothers me that hardly anyone notices and appreciates the humor that these pros bring to marketplace conversation. That’s why I like to point out mistakes like Kadi’s when I come across them. It’s getting harder to find these kinds of articles about eDRs. My pleasure!

Working Both Sides of the Consulting Fence

As far as I can tell, all but a few dental consultants work both sides of the fence in order to please vendors who give them good deals, as well as dentists who pay for unbiased help. Sponsorship by vendors is the bottom level of a consultant career if one chooses to make a living at selling advice. In this way, the dental consultant business is a lot like the financial advice business. Some advisors push their favorite investments that serve them well no matter what happens to their clients’ money. If a client wants advice, but prefers not to pay full price, interested vendors can be counted on to quietly chip in on an advisor’s bill. And that is why the customer must always be cynical. What’s more, it is arguably one’s community obligation to publicly challenge such artists by luring them out into the open to explain further what they meant to say to naïve people. Dr. Kadi begins:

“The national health-care debate cannot be complete unless we include dental care as part of the discourse.”

He then presents oft-repeated, convincing findings which support the widely held conclusion that one’s overall health is dependent on one’s oral health. Even though this chunk of common sense has recently been supported with well-respected research, the news isn’t a revelation. Other stakeholders have proclaimed the findings as an example of ultra-modern “Evidence-Based Dentistry,” and proof of the need for thousands of their dental products. However, let’s not kid ourselves. A healthy mouth has less to do with computerization than the proper application of a low-tech toothbrush. 10,000 years ago, even buzzards recognized that bad breath from advanced gum disease smells like imminent death from a long way off if the wind is right. The results Dr. Kadi leans his reasons against only confirm traditional Evidence-Based Superstition.

eDR Lobbying 

By half-way through the article Dr. Kadi turned “The cavity in the health-care debate” into a PR piece for eDRs. He’s in so deep that he cannot recognize that his misplaced concerns about image have nothing to do with dental patients’ oral health. Image is only cosmetic.

“A validation [of bringing “sex appeal” to the profession] is the inclusion of dentistry in the recently mandated National Healthcare Information Infrastructure (NHII). The purpose of the NHII is to create an information network to facilitate the creation of an electric health record [eHR] for all aspects of health care. The primary impetus is to achieve interoperability of health information technologies used in the mainstream delivery of health care.”

Note: Dr. Kadi admits that the goal is HIT, and sharing health information is the tool – not the other way around. As anyone can see, that kind of nonsense will never work out well in the US. Why that would be as foolish as stuffing a certifying commission for eHRs with industry, government and academic leaders rather than providers – and then tossing billions of dollars that could otherwise be used for treating disease out in the street for the biggest and fastest stakeholders who grab the most. That would be simply ridiculous.

Dr. Kadi bravely continues: “This will enable an individual’s health care information to be shared by all the necessary health care parties in a secure manner, including dentistry. It will improve patient care and reduce the number of patients, currently 100,000 plus, who die each year due to a lack of accurate, complete, or timely information. The federal government estimates a cost savings of $85 billion to $100 billion per year with electronic health records [eHR].”

Is HIT – Or any IT – Really Secure? 

In a secure manner – really? There are so many other misleading statements in this paragraph as well. First of all, how can an eDR improve a dentist’s chance of successfully extracting a molar in one piece? It can’t. Secondly, how many of the alleged 100,000 victims died because of lack of electronic DENTAL records? Third, how many patients will die because of faulty information in interoperable records that would not have occurred if the records were paper? Fourth, to insinuate that patient information can only be shared over the Internet is plain silly. Telephone, fax and the US mail have been sufficient for dentistry for decades, and none involve HIPAA. Finally, the $85 to $100 billion in savings Dr. Kadi casually throws out is based on a five year old Rand study that’s been widely trashed for being biased in favor of the stakeholders who funded the research. That happens. It just amazes me that anyone in the healthcare industry who knows anything about HIT is foolish enough to still shop discarded garbage. And once again, regardless of the success of electronic medical records, how will eDRs save even $10 in dentistry? It’s impossible without re-defining “savings.”

Cost Savings

“Dentists and hygienists will play a vital role in this cost savings because people who go for regular cleanings will have their medical history updated in the shared system during each visit. In some cases, dental cleanings may be the only medical attention a person receives yearly.”

“Cost savings”? Where have I heard that term? And why didn’t Dr. Kadi simply say “savings”?

Now I remember. It was Dr. Robert Ahlstrom, the ADA’s eDR expert, who coined the handy buzzword in his testimony describing the benefits of paperless dental practices for the US Department of Health and Human Services in July of 2007. “Cost savings to providers and plans will translate in less costly health care for consumers. Premiums and charges will be lowered.” That would be the seventh of his 11 reasons that are each one so lame that other than Dr. Kadi, stakeholders never borrow them. Although it is undeniable that electronic records benefit insurers and the government more than the patient, if Ahlstrom hadn’t been coy, and had clearly stated that eDRs will save money in dentistry, his testimony would have been false. By calling it a “cost savings,” Ahlstrom technically concedes that using eDRs will indeed require an increase in cost of overhead – which dental patients will ultimately have to pay to obtain dental care. The saving part comes from “what could have been.” Whatever that could possibly mean, HHS Secretary Michael Leavitt bought it.

The PennWell Article

Because of a situation beyond my control, I am unable to provide a link, but to find more of my opinion of Ahlstrom’s testimony that is still used by lawmakers to establish national policy, simply google “Dr. Robert Ahlstrom.” My PennWell article from a year ago or so, “Dr. Robert H. Ahlstrom’s controversial HIPAA testimony,” is probably still his first hit. It could be on his first page the rest of his life.

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Assessment

If necessary, I’ll make a few more examples of insensitive HIT stakeholders who know better than to offer such crap to the nation’s lawmakers as well as providers who are too busy to pay attention to the welfare of their profession. The ADA should reassure the nation that there are cheap, effective low-tech ways dental patients can stay healthy that don’t risk their identities and won’t bankrupt a dental practice because of a stolen computer. But; they won’t do it.

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The DDS / Doctor [Salesman] will See [Up-Sell] you Now

Posted on May 25, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Blurring the Line between Medical Professionalism … and Mercantilism

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

Concerns and complaints about pushy dentists are apparently becoming more numerous among consumers, as elective cosmetic treatments and marginally effective tests and modalities are increasingly available from the same providers that patients formerly turned to for unbiased dental advice and oral healthcare. All for a price!

http://www.msnbc.msn.com/id/37198272/ns/health-oral_health

So, enter the cosmetic [rank-and-file] dentists and the elective renaissance of the profession – at least economically. An entire industry has even sprung up teaching dentists how to sell various products, and up-sell related services and procedures.

[picapp align=”none” wrap=”false” link=”term=dentists&iid=166771″ src=”0163/1731b859-b744-4a0e-b055-a9e985ad8673.jpg?adImageId=12959860&imageId=166771″ width=”372″ height=”459″ /]

Root-Cause [pun intended]  

Why is this happening? Economics of course! Dental profession success in eradicating cavities, caries and other common mouth disorders – which used to comprise 80% of dental procedures and income – is now a two-edge sword working against their financial self interests … damn!

In fact, I recall about three decades ago when the situation first became acute, as more than a few of our nation’s dental schools closed for lack of interest in matriculation. Right here in Atlanta, the prestigious Emory University School of Dentistry closed its doors while I myself was a patient there; and employed as a surgical resident at a nearby acute care hospital. Contemporaneous cocktail party talk and medical gossip centered on the “death of dentistry” as I exhaled a sigh of relief at my career choice.

Going forward, years later, far too many managed care contracts reimbursed so poorly that they became a loss-leader [access portal to a patient population] for dental practitioners. In other worlds, lose money or break-even on the covered services contract, but profit handsomely by offering [pushing] non-covered services to cohort contract members … and their sphere of influence.

One Word from Mrs. Robinson – Plastics

Plastic surgeons, of course, are still the doctors most commonly associated with non-covered and purely cosmetic and elective treatments such as Botox injections, facelifts and tummy tucks. But, similar elective procedures — which generally aren’t covered by insurance — are being offered by a wide variety of medical specialists.

For example, many dermatologists, who treat patients for skin cancer and other diseases, also promote treatments to smooth wrinkles, lighten age spots and remove hair. Otolarnygologists, who care for patients with conditions of the ear, nose and throat, commonly perform nose jobs, brow lifts and eyelid surgery. And, podiatrists, who are often experts at foot reconstructive, diabetic and ankle surgery, sell shoes, shoe-inserts, laser beam treatments for fungus toenails and various cosmetic and prosthetic devices for deformed toenails and crooked digits.

Medicare Limits – Privates Don’t

At least Medicare requires an ABN [advanced beneficiary notice] for non-covered medical services, and limits non-participating doctors to 115% of the Medicare fee schedule for all providers. Increasingly, some private health plans are doing and proposing, same.  

Practice Management Guru

Now, I have no issue with efficient medical practice management operations, for any specialty. In this era of managed care and health 2.0, governmental intervention is onerous, competition is fierce and patient empowerment is reversing the aging command-control medical establishment. Nor, do I have a problem with offering the entire range of therapeutic and/or elective options to any patient. This is a “good – better – best” elective marketing concept.

In fact, the third edition of our best-selling book, the Business of Medical Practice [Transformational Health 2.0 Skills for Doctors] will soon be released this autumn www.BusinessofMedicalPractice.com. In it, we seek to educate doctors about modern business, management and economics practices; as well as the emerging participatory health 2.0 philosophy and information technology skills. Our goal is enhancing the survival potential of the independent practicing medical professional.

But, the ever expanding menu of treatment options – promoted by a trusted medical professional – should include procedural risks and complications, period of recovery and alternatives, including benign neglect [watchful waiting], marginal benefit and marginal utility, as well as price transparency.

Call this new-wave litany, a type of “informed patient business consent”.

[picapp align=”none” wrap=”false” link=”term=doctor+money&iid=182012″ src=”0178/66353b45-9776-48b9-9bdd-2993a48f32bf.jpg?adImageId=12959922&imageId=182012″ width=”372″ height=”459″ /]

Aphorisms of the Past

Over the years, we have heard phrases like the following from all sorts of independent specialists. I know I have, and so have you. Many are the butt of “insider” jokes:

MD: I’m sure that appendix is hot – I have a car payment to make

DPM: Even the normal foot can be surgically improved

DO: Now, I can bill like a real MD

DDS: We can straighten out – the straightest teeth

DC: I’ll crack your back in only forty sessions … and I finance

But, these are aphorisms of the last-generation. Today we are responsible adults. Let’s grow up and become medical professionals and “DOCTORS” again … not healthcare merchants, sales sharks or equipment shills that offer strategic competitive advantages; but not real patient benefits.  

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Assessment

The old practice management business adage of yesteryear – to work longer hours, see more patients quicker, up-sell marginally effective procedures, or do more treatments in order to realize more income – will not necessarily hold true in the modern era.

http://www.washingtonpost.com/wp-dyn/content/article/2010/05/17/AR2010051703034.html

According to colleague, financial advisor and ME-P thought leader Brian J. Knabe MD – a primary care physician and current www.CertifiedMedicalPlanner.com matriculant – and textbook chapter 27 co-author on physician compensation and salary:

In the environment of Healthcare 2.0, those doctors who embrace efficiency, innovation and appropriate business models will be better positioned to optimize their incomes. 

http://businessofmedicalpractice.com/chapter-27-salary-compensation-2/

Conclusion

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I Want Obama Transparency for the ADA

Posted on January 22, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

No More Hiding Places

By D. Kellus Pruitt; DDS

Today, Ed O’Keefe of the Washington Post posted “New Obama Orders on Transparency, FOIA Requests.”

http://voices.washingtonpost.com/federal-eye/2009/01/_in_a_move_that.html

O’Keefe writes:

“In a move that pleased good government groups and some journalists, President Obama issued new orders today designed to improve the federal government’s openness and transparency. The first memo instructs all agencies and departments to ‘adopt a presumption in favor’ of Freedom of Information Act requests, while the second memo orders the director of the Office of Management and Budget to issue recommendations on making the federal government more transparent.”

Soon, other ADA members are going to bluntly ask Pres Dr. Ron Tankersley:

“If the President of the United States has the courage to face those whom his actions affect, why oh why doesn’t the President of the American Dental Association support transparency in the non-profit organization that belongs to dues-paying members?” After all, ADA members pay more than $1000 per year for ADA services.”

“If you are an ADA leader, pay close attention. This is the future I warned you about that far too many of you avoided out of convenience. As you can read below in his memos, Obama promises, “The Government should not keep information confidential merely because public officials might be embarrassed by disclosure, because errors and failures might be revealed, or because of speculative or abstract fears.”

Who will be held accountable for the ADA/IDM blunder… among other bone-head ideas?

Obama promises that his administration:

“Will work together to ensure the public trust and establish a system of transparency, public participation, and collaboration. Openness will strengthen our democracy and promote efficiency and effectiveness in Government.”

I think openness will do the same in healthcare if we can move a handful of entrenched ADA leaders on down the road. They are weighing us down with their selfish special interests.

Assessment 

Did you hear that, Dr. Ron Tankersley, President of the American Dental Association? There are simply no more hiding places for the anonymous ADA hobbyists who elected you. I’m sure the long run of irrelevant ADA Presidents was fun before electricity and social networks, though.

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Top Ten Signs the ADA is Hunkering Down

Posted on November 23, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

About the American Dental Association

By Darrell K. Pruitt; DDS

Today, I especially cherish my right as a dues-paying member of the ADA – and as an American – to share my blunt, un-requested opinion as if you were a colleague, a patient or disinterested lawmaker.

For by early 2011, such liberty could warrant official sanction by the yet to be revealed national enforcer of the 2010 ADA Code of Conduct … if by then they find someone in the ADA capable of publicly announcing my crimes with a straight face, just before I receive a good talking-to about professionalism. If the future Ethics Enforcer would like me to help burnish his or her brand new gunslinger reputation quickly and deeply, I will gladly link any ADA official’s name to mine, and we’ll be companions for as long as I feel our union helps bring even more transparency to my profession. I’ve been an SEO assist for several ADA leaders for a couple of years already. Just ask ADA President Dr. Ron Tankersley – or – just Google his name.

Getting Spanked? 

I’m not too worried about getting spanked. What can the ADA possibly do to me? Besides, officially, nobody will utter as much as a peep because of the transparency thing. Unofficially, ADA officials will privately send more attaboys because they trust me. They know by now that I never betray friends. I’m selectively transparent – which is my right but not yours, non-profit ADA. I think we both know, Dr. Tankersley, that I’m not the only one who thinks a minority of ADA leaders are playing naïve, childish and costly games.

Then again, it could just be my persistent, egocentric stage of emotional development that causes me to imagine that Resolution 82 is pointed directly at the nose of D. Kellus Pruitt; DDS.

“Patient rights, ethics considered” was posted on Nov 16 on the ADA News Online, and was written by Jennifer Garvin 

http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=3843

Garvin writes, “Res. 82 asks that the following principles be considered for an ADA member Code of Conduct:”

1. Members will maintain high standards of integrity and conduct their dealings as members of the Association in a professional manner.

2. Members will treat other members and Association officers, trustees and staff with courtesy and respect, and shall refrain from conduct that is unreasonably disruptive or is harassing.

3. Members will respect the decisions and polices of the Association and will not engage in conduct that is disruptive to Association staff or causes the Association to expend an unreasonable amount of time or effort to address.

4. Members are encouraged to use proper Association channels of communication to address differences.

5. Members will comply with all applicable laws and regulations, including but not limited to antitrust laws and regulations.

6. Members will respect and protect the intellectual property rights of the Association, including any trademarks, logos and copyrights.

7. Members will not use Association membership lists for personal solicitation purposes.

8. Members will not use all or part of Association lists, including membership directory, online member listings, conference attendees and education course participants for selling, prospecting or creating a directory or database.

9. Members will treat all information furnished by the Association as confidential and will not reproduce materials without the Association’s written approval.

10. Members will avoid conflicts of interest.

Assessment

Garvin concludes: “The resolution also states that a proposed member code of conduct, together with proposed sanction and enforcement procedures, be presented for consideration by the 2010 House of Delegates.”  It is probably earthly unprofessional to make light of authoritarian bluster, but this really reminds me of the John Landis film “Animal House” when Dean Wormer put John Belushi and other ΔΤΧ Fraternity misfits on double secret probation. ADA Trustees shouldn’t take themselves so seriously. It looks silly to those watching. Or then again, keep it up. After all, it looks silly to those watching.

Toga Party! Dentures 2 for 1! Just ask for Dr. Ron.

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