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

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

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

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

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

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

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Don’t be a “Fireworks Fourth Fool” [Video]

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By Dr. David Edward Marcinko MBA

[Publisher-in-Chief]

Graphic video image warning!

Back in the day, when I was a surgical resident and fellow, I treated my fair share of electrical, thermal and chemical burn injuries. Some were life, eyeball and limb threatening; but fortunately most were not! Treatment was with local wound care, followed by full, split thickness or postage stamp skin grafts, flaps, or various plastic surgery techniques, etc.

And, many were accidental of course, but a few were simply ill-conceived ideas from dumb or inebriated patients seen through the emergency room of the old Emory University – Northlake Regional Medical Center, in Tucker, GA.

So, for you medical types, here is a recap on the way we doctors classify burns, as referenced in several of my surgical textbooks and related medical publications.

Classification of Burn Depths

A. Superficial burn injury

1st degree burn

  • Limited to the epidermis
  • Presents with erythema and minimal swelling
  • Mild discomfort
  • Commonly treated on outpatient basis

B. Superficial partial-thickness burns

Second Degree Burn

  • Superficial 2nd degree burns
  • Involves the epidermis and superficial portion of the dermis
  • Often seen with scalding injuries
  • Presents with blister formation and typically blanches with pressure
  • Sensitive to light touch or pinprick
  • Commonly treated on outpatient basis; heal in 1-3 wks.

C. Deep partial-thickness burns

Deep 2nd degree burns

  • Involves the epidermis and most of the dermis
  • Patients often require excision of the wound and skin grafting
  • Appears white or poorly vascularized; may not blister
  • Less sensitivity to light touch and pinprick than superficial form
  • Extensive time to heal (3-4 wks)

D. Full-thickness burns

Third Degree Burn

  • Involves epidermis, and all layers of dermis, extending down to subcutaneous tissue
  • Appears dry, leathery, and insensate, often without blisters
  • Can be difficult to differentiate from deep partial-thickness burns
  • Commonly seen when patient’s clothes caught on fire/skin directly exposed to flame
  • Usually require referral to burn surgeon; need skin grafting to heal.

E. Fourth degree burns

Fourth Degree Burn

  • Full-thickness burn extending to muscle or bone
  • Common result of high-voltage electric injury or severe thermal burns
  • Requires hospital admission

Assessment

So, why do we review this clinical material on Independence Day? It is to remind our readers not to drink and shoot fireworks today; or to stop and re-think before proceeding with same. Don’t be like the fool in this YouTube video. I don’t want to see you in any ER; any where today! GOMER.

***

ME-P and Independence Day 2010

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Book Reviews

Written by doctors and healthcare professionals, this textbook should be mandatory reading for all medical school students—highly recommended for both young and veteran physicians—and an eliminating factor for any financial advisor who has not read it. The book uses jargon like ‘innovative,’ ‘transformational,’ and ‘disruptive’—all rightly so! It is the type of definitive financial lifestyle planning book we often seek, but seldom find.
LeRoy Howard MA CMPTM, Candidate and Financial Advisor, Fayetteville, North Carolina

I taught diagnostic radiology for over a decade. The physician-focused niche information, balanced perspectives, and insider industry transparency in this book may help save your financial life.
Dr. William P. Scherer MS, Barry University, Ft. Lauderdale, Florida

This book was crafted in response to the frustration felt by doctors who dealt with top financial, brokerage, and accounting firms. These non-fiduciary behemoths often prescribed costly wholesale solutions that were applicable to all, but customized for few, despite ever-changing needs. It is a must-read to learn why brokerage sales pitches or Internet resources will never replace the knowledge and deep advice of a physician-focused financial advisor, medical consultant, or collegial Certified Medical Planner™ financial professional.
—Parin Khotari MBA, Whitman School of Management, Syracuse University, New York

In today’s healthcare environment, in order for providers to survive, they need to understand their current and future market trends, finances, operations, and impact of federal and state regulations. As a healthcare consulting professional for over 30 years supporting both the private and public sector, I recommend that providers understand and utilize the wealth of knowledge that is being conveyed in these chapters. Without this guidance providers will have a hard time navigating the supporting system which may impact their future revenue stream. I strongly endorse the contents of this book.
—Carol S. Miller BSN MBA PMP, President, Miller Consulting Group, ACT IAC Executive Committee Vice-Chair at-Large, HIMSS NCA Board Member

This is an excellent book on financial planning for physicians and health professionals. It is all inclusive yet very easy to read with much valuable information. And, I have been expanding my business knowledge with all of Dr. Marcinko’s prior books. I highly recommend this one, too. It is a fine educational tool for all doctors.
—Dr. David B. Lumsden MD MS MA, Orthopedic Surgeon, Baltimore, Maryland

There is no other comprehensive book like it to help doctors, nurses, and other medical providers accumulate and preserve the wealth that their years of education and hard work have earned them.
—Dr. Jason Dyken MD MBA, Dyken Wealth Strategies, Gulf Shores, Alabama

I plan to give a copy of this book written
by doctors and for doctors’ to all my prospects, physician, and nurse clients. It may be the definitive text on this important topic.
—Alexander Naruska CPA, Orlando, Florida

Health professionals are small business owners who need to apply their self-discipline tactics in establishing and operating successful practices. Talented trainees are leaving the medical profession because they fail to balance the cost of attendance against a realistic business and financial plan. Principles like budgeting, saving, and living below one’s means, in order to make future investments for future growth, asset protection, and retirement possible are often lacking. This textbook guides the medical professional in his/her financial planning life journey from start to finish. It ranks a place in all medical school libraries and on each of our bookshelves.
—Dr. Thomas M. DeLauro DPM, Professor and Chairman – Division of Medical Sciences, New York College of Podiatric Medicine

Physicians are notoriously excellent at diagnosing and treating medical conditions. However, they are also notoriously deficient in managing the business aspects of their medical practices. Most will earn $20-30 million in their medical lifetime, but few know how to create wealth for themselves and their families. This book will help fill the void in physicians’ financial education. I have two recommendations: 1) every physician, young and old, should read this book; and 2) read it a second time!
—Dr. Neil Baum MD, Clinical Associate Professor of Urology, Tulane Medical School, New Orleans, Louisiana

I worked with a Certified Medical Planner™ on several occasions in the past, and will do so again in the future. This book codified the vast body of knowledge that helped in all facets of my financial life and professional medical practice.
Dr. James E. Williams DABPS, Foot and Ankle Surgeon, Conyers, Georgia

This is a constantly changing field for rules, regulations, taxes, insurance, compliance, and investments. This book assists readers, and their financial advisors, in keeping up with what’s going on in the healthcare field that all doctors need to know.
Patricia Raskob CFP® EA ATA, Raskob Kambourian Financial Advisors, Tucson, Arizona

I particularly enjoyed reading the specific examples in this book which pointed out the perils of risk … something with which I am too familiar and have learned (the hard way) to avoid like the Black Death. It is a pleasure to come across this kind of wisdom, in print, that other colleagues may learn before it’s too late— many, many years down the road.
Dr. Robert S. Park MD, Robert Park and Associates Insurance, Seattle, Washington

Although this book targets physicians, I was pleased to see that it also addressed the financial planning and employment benefit needs of nurses; physical, respiratory, and occupational therapists; CRNAs, hospitalists, and other members of the health care team….highly readable, practical, and understandable.
Nurse Cecelia T. Perez RN, Hospital Operating Room Manager, Ellicott City, Maryland

Personal financial success in the PP-ACA era will be more difficult to achieve than ever before. It requires the next generation of doctors to rethink frugality, delay gratification, and redefine the very definition of success and work–life balance. And, they will surely need the subject matter medical specificity and new-wave professional guidance offered in this book. This book is a ‘must-read’ for all health care professionals, and their financial advisors, who wish to take an active role in creating a new subset of informed and pioneering professionals known as Certified Medical Planners™.
—Dr. Mark D. Dollard FACFAS, Private Practice, Tyson Corner, Virginia

As healthcare professionals, it is our Hippocratic duty to avoid preventable harm by paying attention. On the other hand, some of us are guilty of being reckless with our own financial health—delaying serious consideration of investments, taxation, retirement income, estate planning, and inheritances until the worry keeps one awake at night. So, if you have avoided planning for the future for far too long, perhaps it is time to take that first step toward preparedness. This in-depth textbook is an excellent starting point—not only because of its readability, but because of his team’s expertise and thoroughness in addressing the intricacies of modern investments—and from the point of view of not only gifted financial experts, but as healthcare providers, as well … a rare combination.
Dr. Darrell K. Pruitt DDS, Private Practice Dentist, Fort Worth, Texas

This text should be on the bookshelf of all contemporary physicians. The book is physician-focused with unique topics applicable to all medical professionals. But, it also offers helpful insights into the new tax and estate laws, fiduciary accountability for advisors and insurance agents, with investing, asset protection and risk management, and retirement planning strategies with updates for the brave new world of global payments of the Patient Protection and Affordable Care Act. Starting out by encouraging readers to examine their personal ‘money blueprint’ beliefs and habits, the book is divided into four sections offering holistic life cycle financial information and economic education directed to new, mid-career, and mature physicians.

This structure permits one to dip into the book based on personal need to find relief, rather than to overwhelm. Given the complexity of modern domestic healthcare, and the daunting challenges faced by physicians who try to stay abreast of clinical medicine and the ever-evolving laws of personal finance, this textbook could not have come at a better time.
—Dr. Philippa Kennealy MD MPH, The Entrepreneurial MD, Los Angeles, California

Physicians have economic concerns unmatched by any other profession, arriving ten years late to the start of their earning years. This textbook goes to the core of how to level the playing field quickly, and efficaciously, by a new breed of dedicated Certified Medical Planners™. With physician-focused financial advice, each chapter is a building block to your financial fortress.
Thomas McKeon, MBA, Pharmaceutical Representative, Philadelphia, Pennsylvania

An excellent resource … this textbook is written in a manner that provides physician practice owners with a comprehensive guide to financial planning and related topics for their professional practice in a way that is easily comprehended. The style in which it breaks down the intricacies of the current physician practice landscape makes it a ‘must-read’ for those physicians (and their advisors) practicing in the volatile era of healthcare reform.
—Robert James Cimasi, MHA ASA FRICS MCBA CVA CM&AA CMP™, CEO-Health Capital Consultants, LLC, St. Louis, Missouri

Rarely can one find a full compendium of information within a single source or text, but this book communicates the new financial realities we are forced to confront; it is full of opportunities for minimizing tax liability and maximizing income potential. We’re recommending it to all our medical practice management clients across the entire healthcare spectrum.
Alan Guinn, The Guinn Consultancy Group, Inc., Cookeville, Tennessee

Dr. David Edward Marcinko MBA CMP™ and his team take a seemingly endless stream of disparate concepts and integrate them into a simple, straightforward, and understandable path to success. And, he codifies them all into a step-by-step algorithm to more efficient investing, risk management, taxation, and enhanced retirement planning for doctors and nurses. His text is a vital read—and must execute—book for all healthcare professionals and physician-focused financial advisors.
Dr. O. Kent Mercado, JD, Private Practitioner and Attorney, Naperville, Illinois

Kudos. The editors and contributing authors have compiled the most comprehensive reference book for the medical community that has ever been attempted. As you review the chapters of interest and hone in on the most important concerns you may have, realize that the best minds have been harvested for you to plan well… Live well.
Martha J. Schilling; AAMS® CRPC® ETSC CSA, Shilling Group Advisors, LLC, Philadelphia, Pennsylvania

I recommend this book to any physician or medical professional that desires an honest no-sales approach to understanding the financial planning and investing world. It is worthwhile to any financial advisor interested in this space, as well.
David K. Luke, MIM MS-PFP CMP™, Net Worth Advisory Group, Sandy, Utah

Although not a substitute for a formal business education, this book will help physicians navigate effectively through the hurdles of day-to-day financial decisions with the help of an accountant, financial and legal advisor. I highly recommend it and commend Dr. Marcinko and the Institute of Medical Business Advisors, Inc. on a job well done.
Ken Yeung MBA CMP™, Tseung Kwan O Hospital, Hong Kong

I’ve seen many ghost-written handbooks, paperbacks, and vanity-published manuals on this topic throughout my career in mental healthcare. Most were poorly written, opinionated, and cheaply produced self-aggrandizing marketing drivel for those agents selling commission-based financial products and expensive advisory services. So, I was pleasantly surprised with this comprehensive peer-reviewed academic textbook, complete with citations, case examples, and real-life integrated strategies by and for medical professionals. Although a bit late for my career, I recommend it highly to all my younger colleagues … It’s credibility and specificity stand alone.
Dr. Clarice Montgomery PhD MA, Retired Clinical Psychologist

In an industry known for one-size-fits-all templates and massively customized books, products, advice, and services, the extreme healthcare specificity of this text is both refreshing and comprehensive.
Dr. James Joseph Bartley, Columbus, Georgia

My brother was my office administrator and accountant. We both feel this is the most comprehensive textbook available on financial planning for healthcare providers.
Dr. Anthony Robert Naruska DC, Winter Park, Florida

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Altered Medical Records – OLD SCHOOL!

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DEM white shirtThe health care provider should not alter the medical record under any circumstances.

The office, clinic or hospital must zealously guard its medical records from alterations by physicians or members of the nursing staff.

Even an inconsequential alteration will throw the validity of the entire record into question. If an entry must be changed, a single line should be drawn through the entry, taking particular care to make sure that the original entry is clearly legible. The new entry should be written above or next to the old entry, and the date of the new entry, as well as the name of the person making the entry, should be recorded. The entry must also be signed by that person.

Juries are very intolerant of altered medical records; and even innocent mistakes, such as the loss of a few pages of a record, will be construed as an intentional cover-up. Under no circumstances should materials such as liquid paper or other opaque liquids be applied to the record in order to correct any entry.

Assessment

The health care provider should not alter the medical record under any circumstances.

Conclusion

Is there an emerging migration back to paper medical records?

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

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Enter the Revolution

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By David Edward Marcinko MBBS MBA CMP®

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Enter the CMPs

To understand the MR revolution that has occurred the past decade , place yourself for a moment in the position of third-party payer.

You want to know if Dr. Brown actually gave the care for which he is submitting a bill.  You want to know if that care was needed.  You want to know that the care was given to benefit the patient, rather than to provide financial benefit to the provider beyond the value of the services rendered.

Can you send one of your employees to follow Dr. Brown around on his or her office hours and hospital visits?

Of course not!  You cannot see what actually happened in Dr. Brown’s office that day or why Dr. Black ordered a CAT scan on the patient at the imaging center.  What you can do is review the medical record that underlies the bill for services rendered from Dr. Blue.

Most of all, you can require the doctor to certify that the care was actually rendered and was indicated.  You can punish Dr. White severely if an element of a referral of a patient to another health care provider was to obtain a benefit in cash or in kind from the health care provider to whom the referral had been made [Stark Laws].  You can destroy Dr. Rose financially and put him in jail if his medical records do not document the bases for the bills he submitted for payment.

This nearly complete change in function of the medical record has precious little to do with the quality of patient care. To illustrate that point, consider only an office visit in which the care was exactly correct, properly indicated and flawlessly delivered, but not recorded in the office chart.  As far as the patient was concerned, everything was correct and beneficial to the patient.  As far as the third-party payer is concerned, the bill for those services is completely unsupported by required documentation and could be the basis for a False Claims Act [FCA] charge, a Medicare audit, or a criminal indictment.  We have left the realm of quality of patient care far behind.  Shall we change it back to the way it was?  That is not going to happen.

***

273_1

***

Instead, practitioners must adjust their attitudes to the present function of patient records. They must document as required under pain of punishment for failure to do so.  That reality is infuriating to many since they still cling to the ideal of providing good quality care to their patients and disdain such requirements as hindrances to reaching that goal.  They are also aware of the fact that full documentation can be provided without a reality underlying it.

“Fine, you want documentation?  I’ll give you documentation!”

Some have given in to the temptation of “cookbook” entries in their charts, or canned computer software programs, EHR [electronic medical record] templates, listing all the examinations they should have done, all the findings which should be there to justify further treatment; embedded “billing engines” not with-standing. We have personally seen records of physical examinations which record a patient’s ankle pulses as “equal and bounding bilaterally” when the patient had only one leg; hospital chart notes which describe extensive discussion with the patient of risks, alternatives and benefits in obtaining informed consent when the remainder of the record demonstrates the patient’s complaint that the surgeon has never told her what he planned to do; operative reports of procedures done and findings made in detail which, unfortunately, bear no correlation with the surgery which was actually performed.

***

EMRs

***

Whether electronic medical records (EMR) will really be helpful, in the future, is still not known.

In fact, according to Ed Pullen MD, a board certified family physician practicing in Puyallup WA, electronic health records are defined primarily as repositories of patient data [much like paper records].

But, in the era of meaningful use [MU], patient-centered medical homes, and Accountable Care Organizations [ACOs], mere patient data repositories are not sufficient to meet the complex care support needs of clinical professionals. These complaints arise because EHR systems are being used as clinical care support systems, which means they should enhance the productivity of clinical professionals and support their information needs, not hinder them [personal communication, and DrPullen.com]. 

Conclusion

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

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On Value Investor Guy Spier

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What I Learned from Value Investor Guy Spier 

By Vitaliy N. Katsenelson CFA

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A few months ago I was asked by the CFA Institute to give talks to CFA societies in London (October 27), Zurich (October 29) and Frankfurt (November 3). I enjoy giving occasional talks (but only a few a year, otherwise they become a chore). I also love Europe — history, old buildings and cultures, museums, sometimes a mild adventure. But this offer was much more interesting — I was asked to give a joint presentation with Guy Spier.

About  Guy

Guy Spier is a tremendous value investor who happens to be a good friend whose company I truly enjoy. He is the most cosmopolitan person I know. He was born in South Africa, spent his childhood in Iran and Israel, received his bachelor’s degree from Oxford and MBA from Harvard, lived in New York and in 2008 got sick of the New York hedge fund rat race and moved with his family to Zurich. His wife, Lory, is Mexican, so in addition to being fluent in languages of all the above-mentioned countries, he romances in Spanish.

Last year Guy published a book, The Education of a Value Investor: My Transformative Quest for Wealth, Wisdom, and Enlightenment. It is not a traditional investing book. In fact, I’ll say that differently: This is the most untraditional book on investing you’re likely to run into. It is a self-effacing memoir of Guy’s transformation from a Gordon Gekko wannabe who believes that his Ivy League education entitles him to Wall Street riches to a committed follower of Warren Buffett and his sidekick, Charlie Munger.

It must have taken a lot of guts and self-confidence (overcoming a lot of self-doubt) to write this book. To be honest, I am not sure I could have written it. It is one thing to strive for intellectual honesty; it is another to unearth and expose one’s own greed, arrogance and envy. Many of us are trying to hide such character traits in plain sight, never mind telling the world about them in a popular book.

After all, Guy is not writing about a fictional character; he is writing about himself. The humility he displays is what makes the book so effective — you can clearly follow the deliberate transformation of a cockroach (the Wall Street version of a caterpillar) into a butterfly.

This memoir is able to achieve something that many other investments books don’t (including my own): It reveals the real, practical, behavioral side of investing, not the way you read about it in behavioral finance textbooks but the raw emotions every investor experiences.

There are a lot of lessons we can learn from Guy. The first one — and, for me, the most important one — is that environment matters.

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value

[Eye for Value]

Enter Dan Ariely PhD

Dan Ariely PhD, the well-known behavioral economist, was interviewed on Bloomberg Television and asked, What can one do to lose weight? He said, Start with the environment around you. If you come to work and there is a box of doughnuts on your desk, losing weight is going to be difficult. Also, look in your fridge: All the stuff that is probably not good for your diet is staring you in the face, whereas the fruits and vegetables that are essential to healthy eating are buried in the hard-to-access bottom drawers.

The same applies to investing: We may not notice it, but the environment around us impacts our ability to make good decisions. Guy writes, “We like to think that we change our environment, but the truth is that it changes us. So we have to be extraordinarily careful to choose the right environment — to work with, and even socialize with, the right people.”

I have found that checking the prices of stocks I own throughout the day shrinks my time horizon, impacts my mood and wastes my brain cells as I try to interpret data that have very little information. I am getting better; I am already down checking prices only once a day. My goal is to do it just once every few days.

Guy is ahead of me: He checks them once a week. Recently, I put in price alerts for stocks my firm owns or follows. If a stock price changes more than 10 percent or crosses a certain important (buy or sell) point, I’ll get an e-mail alert.

Guy finds that he isn’t effective when he gets to the office because of external distractions. In his Zurich office he has a quiet room that he calls the library. It doesn’t have phones or computers, and this is where he reads, thinks and naps. Here in Denver, I have a lawn chair (bought at Costco for $50) that I take outside to sit on, put on headphones, and listen to music and read. My friend Chris goes to Starbucks or the local library in the morning for four hours before he goes to his office, and that’s where he does his reading. The key is to figure out what works for you and try not to fight your external environment.

Another lesson I have learned is that misery loves company. I was talking to Guy about his book, and he told me that people who love the book appreciate the fact that he is so honest about the emotions that consume him when he is struggling in the stock market. As investors, we often put on a brave face, but if we aren’t emotionally honest, our opinion of ourselves, our self-worth, may fluctuate with the performance of our portfolio.

Personally, I can really relate to this. When I read Guy’s book the first time (I’ve read it twice), I was going through a tough time with my portfolio. I found this book extremely therapeutic. In fact, I recommended it to a friend of mine who was going through a similar rough patch.

Another lesson:

Surround yourself with the right people. Friendships matter. I’ve been blatantly plagiarizing Guy on this for years. Guy created a conference called VALUEx Zurich, a gathering of like-minded people who get together and share investment ideas. I attended the very first one in 2010, and since then I have hosted a very similar event, VALUEx Vail, every year in June.

Guy has a latticework group of eight investors that meets every quarter and discusses the stock market, the investment process and personal issues. I’ve copied that, too. Four of us got together in Atlanta in October. We visited a few companies and debated stocks, industry trends, diets, women . . . okay, you get the point. That was our first latticework event, but I hope we’ll meet a few times a year.

Attending Guy’s conference in Zurich and organizing VALUEx Vail have resulted in enduring friendships. These conferences allowed me to create a large network of like-minded investors I talk to regularly. Every member of my latticework group I met at VALUEx Vail.

(A short side note: One of the most important things we can do as parents of teenage kids is to make sure they have good friends. That’s paramount. We as parents lose influence on our kids when they become teenagers. Their friends have a disproportionately larger impact on their choices than we do. We can influence the environment around our kids by helping them select friends.)

And then there are thank-you cards. Over the years Guy has written tens of thousands of them. He is indiscriminate about them — at one point he wrote to every employee at a boutique hotel he stayed in. All right, maybe he took it too far that time. But, writing a thank-you card to value investor Mohnish Pabrai changed his life. He attended Pabrai Investment Funds’ annual meeting in Chicago. After the meeting he sent Pabrai a thank-you note. A few months later Pabrai came to New York and invited Guy to dinner. This was the start of the Spier-Pabrai bromance. Thank-you cards work because so few people write them. They leave a lasting impression on the receiver because they say, “I like you. You are important to me.”

***

stock-exchange

[Stock-Exchanges]

Mentors

The last point is, Be yourself. Having mentors is important. For many value investors, Buffett and Munger are our north stars. There are lots of things we can learn from them. But we also have to realize that we must be ourselves, because we are not them. I remember reading a long time ago that Buffett did not do spreadsheets. That impacted me for a few months — I stopped building models and creating spreadsheets. I thought, If Buffett doesn’t do it, I shouldn’t do it either. Wrong.

Buffett is a lot smarter than I am; he is able to analyze companies in his head. He is Buffett. I have found that spreadsheets work for me because they help me think. When Buffett and I look at a company philosophically, we are looking for the same things, but I need a computer to assist me, and he doesn’t.

Mohnish Pabrai owns just a handful of stocks. Guy, on the other hand, knows that he would not be able to be a rational decision maker if he had only a handful of stocks. There will be a significant overlap between Guy’s and Pabrai’s portfolios, but Guy’s will have two or three times as many stocks.

Assessment

Dear ME-P Readers, I spoke with your Editor-in-Chief Dr. Dave Marcinko a few weeks ago, and as you can tell from this ME-P essay, I am a very biased book reviewer. I am not even sure this qualifies as a book review. Despite my biases, I can safely say that The Education of a Value Investor is one of the best books I’ve read in 2015. (I promise you that it is not the only book I’ve read this year.) Before you commit your time and money to this book, watch Guy’s presentation on Talks at Google.

ABOUT

Vitaliy N. Katsenelson, CFA, is Chief Investment Officer at Investment Management Associates in Denver, Colo. He is the author of Active Value Investing (Wiley 2007) and The Little Book of Sideways Markets (Wiley, 2010).  His books have been translated into eight languages.  Forbes called him – the new Benjamin Graham.

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About “Comments” on the Medical Executive-Post

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One of Just Many Ways to Interact with Us

By Ann Miller RN MHA

[Executive-Director]

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

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Then, purchase our textbooks, white-papers, handbooks, dictionaries and CDs for deeper integrated and peer-reviewed industry specificity.

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Investing and the “Tragedy of the Commons”

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On Economics, Investing and Behavioral Finance

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[By Dr. David E. Marcinko MBA]

Although I did not fall asleep during my psychiatry rotations, or psychology classes, in medical school; the concept of ToC was not known to me until my first economics class while in B-School.

What it is!

The tragedy of the commons is a term, originally used by Garrett Hardin, to denote a situation where individuals acting independently and rationally according to each’s self-interest behave contrary to the best interests of the whole group by depleting some common resource.

The term is taken from the title of an article written by Hardin in 1968, which is in turn based upon an essay by a Victorian economist on the effects of unregulated grazing on common land.

Commons” in this sense has come to mean such resources as atmosphere, oceans, rivers, fish stocks, the office refrigerator, energy or any other shared resource which is not formally regulated; not common land in its agricultural sense.

The tragedy of the commons concept is often cited in connection with sustainable development, meshing economic growth and environmental protection, as well as in the debate over global warming. It has also been used in analyzing behavior in the fields of economics, evolutionary psychology, anthropology, game theory, politics, taxation, and sociology.

However the concept, as originally developed, has also received criticism for not taking into account the many other factors operating to enforce or agree on regulation in this scenario.

Example: UMD ‘tragedy of the commons‘ tweet goes viral – Baltimore Sun

Investing Behavior?

Today, some financial advisors, wealth managers, doctors and behavioral psychologists believe the ToC is an increasingly important concept in investing.

Source: https://en.wikipedia.org/wiki/Tragedy_of_the_commons

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confirmation-bias

Greed is still trumping fear, and that’s bad for stocks …

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Assessment

So what does all this have to do with investing? Are we experiencing this phenomenon in the markets, today?

Read the article thru the link above; fear and greed.

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“BY DOCTORS – FOR DOCTORS – PEER REVIEWED – FIDUCIARY FOCUSED”

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CRAFTING A BUSINESS PLAN AND STARTING A MEDICAL PRACTICE

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

Dr. DEM

By Dr. David Edward Marcinko MBA CMP™

Medical Office Business Plan

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

Solo Medical Practice NOT Dead!

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

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

Executive Service Line [ESL] education

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

Estimates by Business Week magazine suggest that executive education in the United States is a $900 million annual business with approximately 80 percent provided by university schools. Beside the educational benefits, monetary dividends are reaped as open enrollment eases matriculation access. Similar programs at the Wharton School, Darden, Harvard and the Goizueta Business School at Emory University charge premium rates for the implied institutional moniker.

Assessment

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

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stk166326rke

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Valuing the Private Practice Physician’s Quintessential Alternative Financial Investment

Dr. DEM

By Dr. David Edward Marcinko MBA CMP

As we know, the investment industry and Modern Portfolio Theory [MPT] strives to make optimal ‘allocations’ into different ‘asset classes’; according to some defined risk tolerance level or efficient frontier.

Equities, fixed income, property, private equity, emerging markets and so, are all ‘asset classes’, into which physician investors and mutual fund or portfolio managers will make an allocation of their total funds under management. It is quite proper for them to do this as they seek to balance the risk and potential returns for their own; ME, Inc., or other clients’ money.

And, by creating a “new” asset class, this concept opens the door to significant capital flows; advisory and management fees. Hence; the unrelenting innovation of Wall Street, and its’ commission driven and fee-seeking mavens, is unending.

The Social Security Example:

This concept may be illustrated using Social Security as an example.

Wall Street opines, if you’re not counting on Social Security benefits as a part of an overall asset allocation strategy, you may be missing out on bigger gains in a retirement portfolio. Those of this ilk say that retirement investors should consider the value of their Social Security as a portion of their fixed-income investments …. Others believe it may be too risky.

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Empty Retired Doctor's Lounge

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The Portfolio Shift

Generally, adopting this strategy would mean shifting a big portion of investible assets out of bonds and into stocks and into the hands of money managers, stock brokers and wealth managers for a fee; of course. This is akin to those financial advisors who rightly or wrongly goaded clients to not pay off a home mortgage and instead reposition the free cash flow into a rising; and then falling; market. Of course, there are detractors, as well as proponents of this emerging financial planning philosophy.

For example, Jack Bogle, founder of the Vanguard Group, often cites his penchant for basing one’s asset allocation on age. (If you’re 40 years old, you have 40% of your investments in fixed income and 60% in equities. By the time you’re 60, you’ve got 60% in fixed income, 40% in equities).

Now, let’s again consider Social Security, citing a physician with $300,000 in an investment portfolio, and capitalizing the stream of future payments. If the $300,000 is all in equity funds, even equity-index funds, and $300,000 in Social Security, you are already at 50/50″ fixed income versus equities.

The next step is a conversation as this the nexus of where Social Security meets risk management. So, how will the doctor feel when market goes up and down? Some may believe the concept, but not enjoy the inevitable more fluctuating self-directed 401-k, or 403-b plan. One must be comfortable with taking on a larger stock position.

Sources:

  • Andrea Coombes; MarketWatch, September, 2013.

Others experts, like Paul Merriman, opine that Social Security is not an asset class and the idea is fundamentally flawed and should not be a part of anyone’s portfolio.

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Physician SGR Critics and the Doctor Fix

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Why?

As classically defined, a portfolio is composed of financial assets. A financial asset is something that can be sold. Social Security cannot be bought and sold. Because of that, it has a market value of zero.

Therefore, since a medical practice can be bought or sold, the definitional decision is left up to the informed reader, modern physician or financially enlightened financial advisor; or Certified Medical Planner.

Source:

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WHAT EVERY DOCTOR MUST APPRECIATE … Liability?

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About our litigation system for 2019-2020

[By Dr. David Edward Marcinko MBA]

LINK: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

Dr. Marcinko MBADoctors depend on their trusted advisors to be a source of information on a wide variety of complex topics.

As we have seen, one of the areas in which physicians are increasingly seeking guidance from their attorney, accountant, consultant or financial advisor is in the area of risk management, insurance planning and asset protection.

Risk management

The best experts and consultants seek to create safe steady growth and avoid losses and exposures to things like malpractice judgments integrated with asset protection. A natural extension of this stewardship is making sure that the growth and balance of assets are safe from exposure to an increasingly predatory and hostile litigation system. Most doctors have obvious daily risks like malpractice exposures.

Other sources of exposure are more insidious, such as merely being affluent and visible, owning income property, or something as simple as owning and driving a car every day. The numbers are staggering; we are at a point in our litigation system where we have 70,000 lawsuits filed per day in the United States alone, many without any real merit.

Unfortunately being “right” is not enough to keep physicians safe.

Why doctors are concerned?

As illustrated by the numbers above and below, awards continue to spiral out of control, fueled by litigation attorneys who have become partners in lawsuits and who are economically incentivized to create and magnify adversarial relations between parties who might otherwise reach some reasonable, if not amicable, settlement.

So, here are additional facts about our litigation system to consider, for 2015-16:

  • The average medical malpractice award is now $3.9 MM, and some authorities put this number substantially higher;
  • The average legal costs of settling a frivolous lawsuit is $91,000 – plus the actual settlement amount itself.

The average sexual harassment suit against a small medical practice produces a verdict of $530,000. Employees are suing more often, winning more often and winning proportionally larger judgments. They win 75% of the time. Moreover, only the top 5% of Americans has a net worth of over $1MM. Using this baseline, it’s pretty easy to see where even a doctor who is worth only a few million dollars fits in on the food chain.

Here is more proof why doctors and allied medical providers are sued:

  • MDs are high net-worth, high liability, or they will be soon (i.e. new practitioners)
  • DOs have assets that would be difficult to replace if lost or reduced
  • DPMs have professional surgical liability
  • DDSs have employees and own their own practice
  • CRNs are highly visible, traceable, and or collectible
  • ODs own liability generating assets, i.e. rental property
  • NPs and ANPs have a spouse and/or children.

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meeting-room-

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Assessment

What doctors and all medical professionals must take to heart is that litigation attorneys are in business. Just like any business, including a medical practice, they have weekly meetings in which they examine growth, cash flow, revenue goals and new leads or opportunities. This economic motivation is a key and explains in part why we see awards rising and why plaintiffs’ attorneys regularly seek and obtain awards above the limits of applicable liability insurance policies.

Conclusion

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Automated Medical Office Access Management Systems

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Patient check-in Kiosks

By Dr. David Edward Marcinko MBA

Dr. MarcinkoAccording to a McLean report published in InfoTech:

“Today’s patients demand the same level of self-service convenience in healthcare that they do in other industries. Medical kiosks save money, reduce wait times, and significantly enhance the patient experience. The payback period for medical kiosks is often as short as 180 days”

 Automated medical office access management [AM] or patient self check-in solutions provide a wide range of functionality including patient registration, insurance verification, and demographic-validation, electronically consent form completion, back-end scheduling, financial systems integration, real-time appointment re-scheduling, direction text mapping and way finding; and more.  Often, solutions can be individualized and integrated with HIT systems using HL7, XML, web and other standard data exchange protocols.

Open Access Patient Scheduling

A sub variant of the above is open-access patient self-scheduling, either in full or part. Benefits include reduced patient appointment wait times, matching and scheduling patients with physician, improved continuity of care, increased productivity per patient visits, higher physician compensation and higher net gains for medical offices and clinics.

Real Time Claim Adjudication

Real Time Claim Adjudication [RTCA] or expecting payment at the time of service is becoming the rule, not the exception, in the modern AM era. RTCA makes a medical practice more like other businesses.

Benefit of Automated Medical Office Access Management

  • Streamlines patient flow with focus on improved patient care
  • Real-time insurance verification
  • Capture credit/debit card information with funds verification
  • Improves office cash flow and collections
  • Provides patient payment receipts
  • Decrease accounts receivable [ARs]
  • Save time and office staff resources
  • Increases office return on investment [ROI]
  • Demographic capture and validation improve marketing
  • Continually improve office operations.

Vendors for the above AM processes include: Phreesia.com, KioHealth.com, MediSolve.Ca; VecnaMedical.com; MeridianKiosks.com; AppointmentDesk.com; and KioskMarketPlace.com; etc.

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Guy

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More: Simple Steps to a Patient Registry: Ticket to Care Coordination, Quality Reporting and Pay for Performance

http://store.hin.com/Simple-Steps-to-a-Patient-Registry-Ticket-to-Care-Coordination-Quality-Reporting-and-Pay-for-Performance_p_0-3855.html#

Conclusion

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3 Technologies That Are Revolutionizing the Driving Experience

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Update for Doctors and Medical Professionals

[By Dr. David Edward Marcinko MBA]

[By Nalley Lexus Roswell, GA]

Dr. David E. Marcinko MBA

Auto manufacturers have always been at the forefront when it comes to new technology. In a very competitive market, being able to develop new gadgets and capabilities is critical when it comes to selling new cars.

While new car models feature the latest developments, engineers are already working on the ‘next big thing.’ So what will be the next big developments in technology to revolutionize the driving experience?

The Ideas

Here are three ideas for doctors and medical colleagues. All from a guy who used to change his own oil.

  1. Cars that can communicate with each other

One of the biggest challenges in road safety comes from the independence that one vehicle has over another. Car drivers are almost entirely insulated from each other and the outside world until disaster strikes. One technology that is trying to address this problem is called Vehicle-to-Vehicle communication – or V2V. V2V technology is now being used by manufacturers as potential technology for future cars.

V2V sends wireless signals about a car’s location, speed, and direction. These signals are, in turn, received by other cars, which interpret this information and make appropriate conclusions. That may be simply to warn the driver, or it could mean applying the brakes. A logical progression from V2V is V2I – Vehicle-to-Infrastructure. This would allow cars to talk to traffic signals and other technology to help further control traffic and speeds.

  1. Airbags that prevent collisions

The airbag is almost certainly one of the greatest car safety gadgets and has saved countless lives since the technology was first developed. Airbags are a great example of a passive safety feature, which means that they reduce the risk of death or injury in the event of an accident. The technology could be used, however, as an active safety feature, which could actually help prevent accidents.

Manufacturers are now experimenting with air bags, which would deploy beneath a vehicle in the event that a potential collision was about to occur. A special coating would help slow the car down, helping the driver to stop much more quickly. By lifting the car up, these bags would also reduce the risk of injury from passengers slipping under seat belts and would lessen any potential damage or injury from bumper-to-bumper impact.

  1. Cars that can drive themselves

The ultimate new technology must surely be one that removes the need for a car to have a driver. Any kind of independent driving technology would, of course, ensure that rules were always adhered to and would remove the margin for human error that almost certainly costs many lives every year. The technology giant Google has invested heavily in the self-driving car to date, although the big manufacturers are also likely to adopt this technology. Who knows whether it will be possible to purchase a self-driving production car within ten years?

DEM's 2000 Jag XJ-V8-LJaguar front seat

Jag interior

JaguarBoot

[My 2000 Jaguar XJ-V8 Luxury Touring Sedan] 

Assessment

I covered the ER for more than a decade. If any one of these innovations can save a life; then I am all for it.

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OilChange

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Bridging the Medical School – Financial Services Industry & Business Education Gap

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[By Ann Miller RN MHA]

***

iMBA Inc., routinely presents to residents and fellows across the country on a variety of medical, financial, accounting and practice management related topics.

Whether on-site or via webinar, our educational sessions are tailored to fill the finance, economic, practice management, business and practice management educational gap and to provide physicians and allied healthcare professionals with practical advice and strategies to help make sound financial and business decisions.

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Our firm works exclusively with physicians and their advisors, and we understand the stresses and financial pitfalls that are unique to the medical profession. We are doctors who are passionate about equipping, training, and advising physicians so they can work toward achieving their professional and financial goals.

We can tailor our presentations to the needs of the program or group. Above all, we aim to empower residents and fellows with the knowledge they’ll need to succeed financially as they begin their career in private practice or in academics.

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Successful team of doctors at a meeting

****

In addition to speaking with individual programs, we speak with House Officers Associations, Fellowship & Residency Associations, Spouse Support Groups, etc. We are regularly invited to present at Grand Rounds, weekly practice management gatherings, and after-hours dinners.

Educational sessions can be done either on-site or via webinar.

Assessment

To see a list of presentations and topics, click here:

Channel Surfing the ME-P

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Avatar of Dr. Marcinko Speaking as MSL

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

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Driven Analytics Coming Soon?

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Leveraging connected car technology to provide piece of mind for car owners and effective marketing for Dealers

[By Dr. David Edward Marcinko MBA]

DEM blueWhat it is

Driven Analytics uses connected car technology to better target car owners on behalf of dealerships, all the while reducing the anxiety associated with routine car maintenance for drivers.

How it works

Using advanced algorithms and a data transmission device installed on new cars by the dealership, Driven Analytics provides a marketing platform that allows dealers to advertise maintenance services to their customers exactly when they need them.

***

Jag A (1)***

Jag 3 (2)

***Jag 3 (1)***

Jaguar Sedan***

Sale Disposition

Once a vehicle is sold, Driven Analytics monitors the vehicle’s systems and provides the car owner with actionable maintenance information via a smartphone app, text or email.

Customer Retention

Information includes details about the needed service, as well as discounts and coupons based on their needs. Coupons are designed to bring customers back to the car dealership that sold them their car, increasing customer retention for the dealership and ultimately leading to future sales.

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More Soon: http://www.DrivenInfo.com

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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Why You’re Probably Using the Wrong [Medical] Dictionary [er…ah…Tchotchkes?]

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About the iMBA Inc, Health Glossary and Administration Dictionary Series … with Book Reviews

[By Staff Reporters]

HDS

***

The Health Dictionary Series of Administrative Terms and Definitions

According to James Somers, the way we use an ordinary [medical] dictionary is to look up words, acronyms or initialisms we’ve never heard of; or whose sense we’re unsure of, or need more clarification or spelling direction. Makes sense!

http://jsomers.net/blog/dictionary

But, you would never look up health administration industry specific words or terms in an ordinary medical dictionary — words like HL7, “meaningful-use”, “skinny networks”, managed care organization, hospital cloud computing, patient portal, stop-loss ratio, economic externality, PHO, MPT, SAR-BOX, Fama-French, US Patriot Act, the Treynor index, Asset Pricing Theory, PP-ACA, or ACOs — because all you’ll learn is nothing about what they mean.

Extreme Utility – Not just tchotchkes! 

You would need an industry specific dictionary of health administration terms and definitions, right? And, preferably designated as a Doody’s Core Title for credibility, and written by leading experts.

So; try these 3 dictionaries for 10,000 health 2.0 administration terms and definitions, EACH.

  1. Dictionary of Health Insurance and Managed Care
  2. Dictionary of Health Economics and Finance
  3. Dictionary of Health Information Technology and Security

Product DetailsProduct DetailsProduct Details

Dictionary Forewords

More:

Forget the Paper Weights

According to Wikipedia, a tchotchke (/ˈɒkə/ CHOCH-ka) is a small bauble or miscellaneous item. The word has long been used by Jewish-Americans and in the regional speech of New York City and elsewhere. Tchotchkes are often given at Chanukkah as part of a game.

The word may also refer to free promotional items dispensed at financial services trade shows, medical conventions, and similar large events. They can also be sold as cheap souvenirs which are sometimes called “tchotchke shops”.

***

paperweights

***

Not a Throw-Away

But, if you want to give your hospital, medical clinic or physician clients an advertising item that’s both useful and handy at the same time, try using these dictionaries. Make an IMPACT, and forget those paper-weights.

As a Financial Advisor [FA], or drug rep, you can represent your eagerness to be there for clients and prospects anytime they need your service by having the dictionaries engraved or placing your business card, inside. Plus, they serve as a great addition to a wonderfully decorated medical office or home library. It is an item they will refer to again and again; not just throw-away.

Give one … or all three … they are so reasonably priced.

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

How to Protect Your Vehicle During Long-Term Storage

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Hibernation and Your Luxury Car

silver balls on snow with snowfall - blue heaven

[By Dr. David Edward Marcinko MBA]

[By Nalley-Lexus Roswell, GA]

An ME-P Special Winter Report

***

DEM at Univ of Pittsburgh

***

I was speaking at a seminar in Pittsburgh PA recently, and I realized how cold it gets there. Moreover, I just learned of an impeding Christmas Eve storm this year.

Hence this ME-P.

***

Many car drivers use their vehicle every day, but from time to time – and during the winter – it’s necessary to consider long-term storage. Some physicians however, don’t use their car over the winter months, or need to leave the country for a while on vacation, and this means that it’s time to store away that luxury automobile.

The Storage Steps:

So, if you need to put your car into long-term storage, use the following tips to make sure that your vehicle remains in excellent working order.

Find a good place to store the car

You probably won’t want to leave your car exposed to the elements if you’re not going to use it. Find a sheltered place to keep the car like a garage, shed, or outhouse that can protect the vehicle from the rain. Search local ads for reasonably priced accommodation if you don’t have your own garage. If there’s nothing available, invest in a high-quality weatherproof car cover which will at least protect your car from the weather.

Thoroughly clean the car

Dirt and debris on your car may cause damage, so give the car a thorough clean before storing it. Remove bird droppings or tree sap, which can both damage paint work, and get rid of mud or oil from the wheels and fenders. Apply a good quality wax or sealant to the exterior, as this will protect the paint from any dirt or dust that accumulates in storage.

Fill up your gas tank

Some doctors and other drivers make the mistake of emptying the gas tank when they put their cars into storage.

Follow your car dealer recommendations but use premium if you can. Topping off your gas tank stops moisture from accumulating inside the tank, and will also make sure the seals don’t dry out. Gas is cheap currently, so do not forget this step.

And, consider adding a fuel stabilizer, which may protect the engine from rust and ensure the fuel doesn’t deteriorate [debatable issue].

Charge the battery

Even though you aren’t going to drive the car for a while, it’s a good idea to make sure the battery charge doesn’t run out. If you can’t get somebody to come and visit the car, charge and disconnect the battery completely.

Otherwise, you can buy a battery tender [not trickle charger] that plugs into the electricity supply and continuously gently charges the battery. I have one for my vintage 2000 Jaguar XJ-V8-XL and they are great.

Inflate your tires

It’s always a good idea to inflate your tires to the manufacturer’s recommended pressure. While the car is stationary, the weight of the vehicle pressing on the tires can cause damage, particularly in cold temperatures.

Another solution to consider is removing all four wheels and jacking the car up on all four corners. This is hard work, but it’s worth it for cars that will be stored for a month or more.

***

My Jaguar XJ-V8

***

My Jaguar***

JaguarBoot

***

Protect the car from pests

Cars give rats and mice lots of places to hide and keep warm and these creatures can cause damage if they gnaw at wires. Plug obvious places (like the exhaust pipe) where rodents could get in, and consider laying traps or poison. Make sure you close all the car windows tightly and remove any food or trash from the car that may attract pests.

Don’t cancel your insurance

Your car is a valuable asset. Even though it’s not on the road, it could still suffer damage in storage. If you cancel your insurance, you may have to pay more when you decide to start driving it again. Talk to your insurance company about the options available to you.

More:

Assessment

It’s important to prepare your car properly for long-term storage. Your vehicle is probably worth a lot of money, so protect your investment and make sure your car is just the way you left it when you come back.

Channel Surfing the ME-P

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Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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***

Doctors and Rental Cars

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Obtaining and Making the Most of an Upgrade

[By Dr. David Edward Marcinko MBA]

[By Nalley Lexus Roswell, GA]

Dr David E Marcinko MBADoctors and other medical professionals typically rent automobiles; and frequently.

When you rent a car, the rental company will normally have a range of different types available, each priced according to the size and class of car.

While you will almost certainly have booked one class of car, very often the rental company will be in a position to offer you a free upgrade to a larger or more luxurious model.

The Upgrade

So how do you increase your chances of getting a free vehicle upgrade? Here are some ideas:.

  1. Use the same office

If you regularly hire cars, try to make a point of using the same company. If you use a local office (or the same rental office) then the staff members will probably start to recognize you, which might increase your chances of being offered a free upgrade. The car rental business is very competitive, especially in certain locations, so these businesses will be looking to find ways to please you.

  1. Get to the office early

While car rental offices are turning over a number of cars throughout the day, most cars will be returned between the hours of 9 a.m. and midday. If you get to the office early, the staff members may actually have a shortage of cars in the class that you have ordered, which could force them to offer you something larger or more luxurious.

  1. Join loyalty schemes

Some car rental companies have loyalty schemes or member’s clubs, where you may be offered special deals. In exchange for a few personal details, you will receive regular mailings about discounts and offers, some of which will include a free upgrade if you fulfill certain conditions. Even if there is no offer in place, make sure the staff members know that you’re a member of the scheme, as it may just sway their opinion.

  1. Use the personal touch

The way in which you interact with the office personnel may influence the likelihood that you will get a free upgrade. Bear in mind that staff members deal with hundreds of people every day. Somebody that smiles and is patient and friendly is much more likely to be welcome in the office and may be rewarded. Chat with the staff member dealing with you and, if necessary, show your interest in one of the larger, more luxurious cars. It might just sway them in your favor!

  1. Choose a popular model

When you make a reservation, make a point of talking to the office directly so that you can use the staff member’s local knowledge. Ask the office which class or type of car is the most popular and then book that one. That way, there is a higher likelihood that the office will be out of stock when you arrive.

***

001

[Classic Jaguar XJ-V8 Luxury Touring Sedan]

***

Assessment

In all cases, be aware that many offices will try and push an upgrade charge on you, which may range from $5 upwards per day. Don’t be bullied into accepting this charge!

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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Enter “Population Health” Management

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Understanding the Costs and Risks

Dr. DEM

[By Dr. David Edward Marcinko MBA]

By http://www.MOL.com

Gratefully, our book, Financial Management Strategies of Hospitals and Healthcare Organizations [Tools, Techniques, Case Studies and Checklists] has become an academic best seller.

It contains a chapter on Wellness and Population Health 2.0; included here for your review [By Jennifer Tomasik, Carey Huntington, and Fabian Poliak].                 .

Population Health

I am especially proud of this work for 2016.  This managerial book mimics the popular style of colleague Atul Gawande MD in his acclaimed work The Checklist Manifesto.

Why? All hospitals are still subject to the imperative: No Margin – No Mission.

***

Pop Health

 ***

Assessment

In an example of population health management and policy leadership, another colleague, David B. Nash MD MBA of the Wharton School, and Endowed Dean of Jefferson University Medical School [father of population health], even wrote the “Foreword”.

Click on this link to read it entirely.

Link: Foreword.Nash

More:

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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***

Invite Dr. Marcinko

***

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

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Planning our newest major textbook

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

[Executive-Director]

Dear Stock Brokers, IBs and Securities Analysts,

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

Historical Review

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

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

Why Now?

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

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

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

The Invitation 

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

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

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

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

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

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

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

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

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

Style Instructions 

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

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

Writers Search

A Pleasure – Not Burden 

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

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

Your Payback 

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

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

Assessment

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

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

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

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

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

Product Details  Product Details

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

##

Modern Office Management Skills for Savvy Physicians

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“Learning” about The Business of Medical Practice in Modernity

By Ann Miller RN MHA

www.BusinessofMedicalPractice.com

###

Medical Business Advisors

###

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###

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

###

Some Modern Issues Impacting Hospital Revenue Cycles

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By Carol S. Miller RN CPM MHA

By Dr. David Edward Marcinko MBA CMP™

Carol S. Miller “Collectively the healthcare industry spends over $350 Billion to submit and process claims while still working with cumbersome workflows, inefficient processes, and a changing landscape marked by increasing out-of-pocket cost for patients as well as increasing operating costs.”

The Norm Continues Downhill

For many years hospitals and healthcare organizations have struggled to maintain and improve their operating margins.  They continue to face a widening gap between their operating costs and the revenues required to cover not only current costs, but also to finance strategic growth initiatives and investments.

Faced with increased operational costs and associated declines in rates of reimbursement, many healthcare hospital executives and leaders are concerned that they will not achieve margin targets.  To stabilize the internal financial issue, some hospital have focused on lowering expenses in order to save costs – an area they control and an area that will show an immediate impact; however, that is not the best solution.

Beware Cost Reductions

Hospital executives are concerned with the effect that these reductions may have on patient quality and service.  Finding ways to maximize workflow to lower operating costs is vital.  Every dollar not collected negatively impacts short- and long term capital projects, lowers patient satisfaction scores and possibly affects quality of patient care.

Status Today

Hospitals, healthcare organizations and all medical providers are under great pressure to collect revenue in order to remain solvent. And so, here are some of the issues impacting the modern hospital revenue cycle as Obama-Care, or the PP-ACA of 2010, is launched next month?

Issues Impacting the Revenue Cycle

Several of the major leading issues facing the revenue cycle are:

  • Impact of Consumer-driven Health – This process has emerged as a new approach to the traditional managed care system, shifting payment flows and introducing new “non-traditional” parties into the claims processing workflow.  As market adoption enters the mainstream, consumer-driven health stands to alter the healthcare landscape more dramatically than anything we have seen since the advent of managed care.  This process places more financial responsibility on the consumer to encourage value-drive healthcare spending decisions.
  • Competing high-priority projects –Hospitals are feeling pressured to maximize collections primarily because they know changes are coming down the pike due to healthcare reform and they know they will need to juggle these major initiatives along with the day-to-day revenue cycle operations.
  • Lack of skilled resources in several areas – Hospital have struggled to find the right personnel with sufficient knowledge of project management, clinical documentation improvement, coding and other revenue cycle functions, resulting in inefficient operations.
  • Narrowing margins – Declines in reimbursement are forcing hospitals to look at their organization to determine if they can increase efficiencies and automate to save money.  Hospitals are faced with the potential of increased cost to upgrade and adapt clinical software while not meeting budget projections.  There are a number of factors contributing to the financial pressure including inefficient administrative processes such as redundant data collection, manual processes, and repetitive rework of claims submissions.  Also included are organizations using outdated processes and legacy technologies.
  • Significant market changes – Regardless of what happens with the Patient Protection and Affordable Care Act, hospitals will have to deal with fluctuating amounts of insured and uninsured patients and variable payments.
  • Limited access to capital – With the trend towards more complex and expensive systems, industry may not have the internal resources and funding to build and manage these systems that keep pace with the trends.
  • Need to optimize revenue – There are five core areas hospitals have to examine carefully and they are:
    • ICD-10 – This is an entirely new coding and health information technology issue but is also a revenue issues
    • System integration – Hospitals need to look at integrating software and hardware systems that can combine patient account billing, collections and electronic health records.
    • Clinical documentation – Meaningful use will require detailed documentation in order for payment to be made and this is another revenue issue.
    • Billing and claims management – Reducing denials and reject claims, training staff, improving point-of-service collections and decreasing delays in patient billing can improve the revenue cycle productivity,
    • Contract analysis – Hospitals need to focus more on negotiating rates with insurers in order to increase revenue.

Hospital

Conclusion

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

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***

It’s Here: Financial Management Strategies for Hospitals and Healthcare Organizations

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Finally … Our Newest ME-P Textbook Release

By Ann Miller RN MHA

[Executive-Director]

In this book, a world-class editorial advisory board and an independent team of contributors draw on their experience in operations, leadership, and Lean managerial decision making to share helpful insights on the valuation of hospitals in today’s changing reimbursement and regulatory environments.

Using language that is easy to understand, Financial Management Strategies for Hospitals and Healthcare Organizations [Tools, Techniques, Checklists and Case Studies]  integrates prose, managerial applications, and regulatory policies with real-world case studies, models, checklists, reports, charts, tables, and diagrams. It has a natural flow, starting with costs and revenues, progressing to clinic and technology, and finishing with institutional and professional benchmarking. The book is organized into three sections:

  1. Costs and Revenues: Fundamental Principles
  2. Clinic and Technology: Contemporary Issues
  3. Institutional and Professional Benchmarking: Advanced Applications

The text uses healthcare financial management case studies to illustrate Lean management and operation strategies that are essential for healthcare facility administrators, comptrollers, physician-executives, and consulting business advisors. Discussing the advancement of financial management and health economic principles in healthcare, the book includes coverage of the financial features of electronic medical records, financial and clinical features of hospital information systems, entity cost reduction models, the financial future of mental health programs, and hospital revenue enhancements.

CASE MODEL: Managerial Costs

###

book

Description

Table of Contents

Editor Bio(s)

Reviews

Foreword.Baum

Foreword.Nash

###

The Companion Text

Product Details

BOOK FOREWORD / TESTIMONIAL

Conclusion

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

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

And, send us a book review; the good, bad and ugly!

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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What is Denial Management?

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Of Healthcare Claims [What it is – How it works]

Dr. David Edward Marcinko MBA

[Editor-in-Chief]

NEU Dr. MarcinkoTypically, denied and rejected healthcare claims quickly surface as a source of multi-millions in revenue leakage and unnecessary expense for doctors, clinics and hospitals, etc.

Why?

Payers have been struggling with increased costs.  They thoroughly inspect claims for errors and have become adept at using their rules to deny and delay claims.

For example, Zimmerman reported the denied percentage of gross charges climbed from 4% in 2000 to 11% in 2011.  In contrast, providers typically lack the tools to aggressively manage current denied claims and prevent future ones.

Financial Recognition

Without denial tracking, an organization may not recognize the heavy financial impact of denied claims.

A HARA [Hospital Accounts Receivable Analysis] report indicates that bad debt and gross days are declining. However, a majority of providers write off denials as contractual allowance, distorting the numbers but not the resulting lower margins and reduced cash.

H*Works reported that the typical 350-bed hospital loses between $4 million and $9 million each year in earned revenue from denials and underpayments (assume $103 million annual gross revenue and 40% contractual allowance). Recouping lost revenue from denials and underpayments will, according to H*Works, increase an organization’s operating margin by 2.6%.

Industry estimates report that at least 50% of denials are recoverable and 90% are preventable with the appropriate workflow processes, management commitment, strong change leadership, and the correct technology. H*Works estimates that for a revenue capture of $3 million from denials and underpayments, the recovery infrastructure costs are only about 3%.

###

Product DetailsProduct Details

Assessment

With all this in mind, better management of rejections and denials, as well as the information necessary to resolve and prevent them, surfaces as probably the best strategy to improving financials. By streamlining the revenue cycle, managing rejections and denials proves to be less expensive and to provide faster returns than initiating new services.

Conclusion

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

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

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

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

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

Physician Advisors: www.CertifiedMedicalPlanner.org


[1]   For further information, see http://www.advisoryboardcompany.com

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On Replacing Doctors with Computers and Smart Phones [video]

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Eric Topol on Replacing Clinicians with Algorithms

By Dr. David Edward Marcinko MBA CMP™

[Editor-in-Chief]

BU Dr. MarcinkoRecently, I wrote an ME-P questioning the need for a medical license in order to treat patients.

Boy, did I receive unkind private comments and phone calls on that op-ed piece!

The idea was not my own and, in fact, was proposed more than a decade ago by Shirley Svorny PhD, chairwoman of the economics department at California State University, Northridge. She holds a PhD in economics from UCLA

Her simple rationale was that licensure may be a barrier to competition and hence health care.

Link: Will Future Doctors Need a Medical License?

Enter Dr. Topol

Now, we learn that Eric Topol MD, Director of the Scripps Translational Science Institute and [Editor-in-Chief of Medscape] is questioning whether doctors will be replaced by algorithms. He cites dermatology, optometry and pediatrics as first-mover smart-phone applications.

The idea was really precipitated by Vinod Khosla at the Rock Health Program on Health Innovation, when he said that 80% of doctors are going to be replaced by algorithms [Pareto’s rule].

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Doctor joining the ME-P

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Video

And so, please enjoy this video presentation of Eric as he describes his healthcare vision of the future.

Link: http://www.medscape.com/viewarticle/805212?src=wnl_edit_specol&uac=193200AX

Assessment

Of course, this flies in the face of all those projections about hundreds of thousands of doctor shortages over the next 10 years because of the Baby Boomer problem, the aging of the population, as well as the chronic disease burden.

More:

Conclusion

And so, will doctors worker harder, or smarter, in the future? Will the lack of capacity be countered by improvements in efficiency? What will happened to provider reimbursement?

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

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PP-ACA Physician Ownership Provisions

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Understanding the “whole hospital exception” to the Stark laws

By Dr. David Edward Marcinko MBA CMP®

www.CertifiedMedicalPlanner.org

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

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

Prohibitions

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

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

Grandfathered

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

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

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Assessment

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

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

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

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

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

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

Physician Advisors: www.CertifiedMedicalPlanner.org


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

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

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

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

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Automobile Safety, Financial and Related Topics of Import for Physicians

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Leisure and LifeStyle Activities

By Dr. David Edward Marcinko MBA

[ME-P Publisher and Editor-in-Chief]

DEM's Jaguar

My Vintage British circa 2000 Jaguar Touring Sedan

XJ-V8-LWB Jaguar touring sedan

Hood Ornament “The Leaper”

DEM's Jaguar

Inner and Outer Glass Headlight Globes

Classic XJ-V8-WB Jaguar

“Saw Toothed” Grill with Curve-Lined Bonnett [Hood]

DEM's Jaguar

Extended Antenna with Satellite – SiriusXM Radio

More:

Assessment

GAMy near showroom and mint conditioned 2000 Jaguar XJ-V8-L is a full-size luxury sedan, offers sporting drive characteristics, mixed with a classic style and interior comfort. It was available in multiple trims which all came very well equipped with upscale amenities.

And, this extended wheelbase version offers much more rear seat leg room for long and winding Georgia road trips. The standard steel engine [not nikasil] in this XJ is a 4.0L V8 which produces 290 hp. The upper and lower timing chain tensioners are original, second generation metal, not plastic.

There is also a supercharged version of this vehicle which bumps output to an impressive 370 hp. Even with all of its power and weight, my XJ-8-L is still rated at over 20 mpg on the highway. Ammenities and upgrades include a mobile phone, Magellan GPS, LoJack theft recovery system, CD and MP-3 players, with internal and external cable antenna for satellite radio.

What a Cat? She is my third favorite female after my intelligent and beautiful wife, and smart and lovely daughter.

Wikipedia link: http://en.wikipedia.org/wiki/Jaguar_XJ8

Conclusion

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

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

Our Other Print Books and Related Information Sources:

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

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

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

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

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

Physician Advisors: www.CertifiedMedicalPlanner.org

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Books for Savvy Doctors and their Financial Advisors and Management Consultants

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Learn and Prosper from the ME-P

By Ann Miller RN MHA

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Assessment

Click on each image for more information.

Feel free to write a review and tell us what you think?

Conclusion

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

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

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The Perils of Distracted Driving

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Risks Varied and Increasing this Holiday Season

By Dr. David Edward Marcinko MBA

[ME-P Editor-in-Chief]

Editor-in-ChiefOur daily lives have become easier over the years. Just take a look at the gadgets we own and the amount of corners we cut.

One of the major problems of this new daily ease is high distractions. These distractions can be deadly when it comes to driving, in which case, there should not be any corners to cut.

So, here is a visual guide to the true cost of driving while distracted. It may be especially important during this holiday season.

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Distracted-Driving

Assessment

Are doctors especially culpable with their tablet computers, smart phones, eHRs, PCs and CPOESs, etc?

Conclusion

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

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

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

Our Other Print Books and Related Information Sources:

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

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

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

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

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

Physician Advisors: www.CertifiedMedicalPlanner.org

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Medical Practice and Health 2.0 Risk Management is Now a Part of Financial Planning for Doctors

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Ann Miller RN MHA [Executive-Director]

http://www.CertifiedMedicalPlanner.org

About Us

Our ME-P Editor, Dr. David Edward Marcinko MBA CMP™, is a nationally recognized healthcare financial and business advisor to physicians, clinics, hospitals and medical practices. Based in Atlanta Georgia, as a Certified Medical Planner™, Dr. Marcinko leads the industry delivering expert financial and managerial advice to all healthcare entities and stakeholders regarding managed care contracting, operations, strategic planning, revenue growth, health 2.0 business modeling and physician litigation support.

Dr. Marcinko is a sought-after author and speaker with three-decades of expert healthcare consulting experience. He has authored hundreds of healthcare business, finance, economics and management articles and dozens of text books. He is a chosen speaker among prominent national healthcare groups and financial services associations.

Committed to addressing the needs of each client, Dr. Marcinko and the iMBA Inc team takes great pride in personally leading every consulting team that produces effective response time and measurable results for satisfied colleagues and corporate clients www.MedicalBusinessAdvisors.com 

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Educational Inititatives

That’s why the R&D efforts of our governing board of physician-directors, accountants, financial advisors, academics and health economists identified the need for integrated personal financial planning and medical practice management as an effective first step in the survival and wealth building life-cycle for physicians, nurses, healthcare executives, administrators and all medical professionals.

Now – more than ever – desperate doctors of all ages are turning to knowledge able financial advisors and medical management consultants for help. Symbiotically too, generalist advisors are finding that the mutual need for extreme niche synergy is obvious.

But, there was no established curriculum or educational program; no corpus of knowledge or codifying terms-of-art; no academic gravitas or fiduciary accountability; and certainly no identifying professional designation that demonstrated integrated subject matter expertise for the increasingly unique healthcare focused financial advisory niche … Until Now!

Enter the Certified Medical Planner™ charter professional designation www.CertifiedMedicalPlanner.org

Assessment

And so, for all financial services professionals interested in the fast-moving healthcare advisory space: Medical Practice and Risk Management is Now a Part of Financial Planning for Doctors

Certified Medical Planner

Conclusion

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

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

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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

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On Hospital Tax-Exempt Debt

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An important means of external financing for hospitals

By Calvin W. Wiese CPA CMA

By Dr. David Edward Marcinko MBA

www.CertifiedMedicalPlanner.org

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

State and Local Governments Only

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

The IRS

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

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

The Underwriter’s

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

The Trustees

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

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

The Documents

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

Assessment

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

Conclusion

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

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

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

Our Other Print Books and Related Information Sources:

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

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

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

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

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

Physician Advisors: www.CertifiedMedicalPlanner.org

     From Our Newest Textbook Release

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Want to Write for the Medical Executive-Post?

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Brand Your Self

By Professor Hope Rachel Hetico RN MHA CMP™

[Managing Editor] MarcinkoAdvisors@msn.com

Dear Readers and Subscribers,

Thank you for your interest in being part of the ME-P writing community.

The ME-P publishes original news content, opinion pieces, trending topics and breaking stories in the protean space of heath care administration, financial planning for medical professionals, health economics and information technology.

Articles must be written in English, published first on the ME-P, and will be reviewed by the “seasoned” ME-P Editorial Team. Unique re-prints or encore presentations are sometimes accepted.

The ME-P Advantages

The advantages of writing for the ME-P include:

  • Writing for one of the most well-respected, well-known and most resourceful websites that is synonymous with the health 2.0 blogosphere
  • Read by a several hundred thousand viewers every month
  • Gain visibility of your personal brand and writing samples, since all articles are syndicated nationally thru multiple sources
  • Develop oneself into an expert in your own field and helping you further establish your online brand
  • Receive interesting and timely story ideas
  • Receive access for interview and PR opportunities

If you have any questions about our policies, writer guidelines or areas of need in terms of content, email me.

Assessment

Please take a minute or two to submit a writing sample. We will get back to you with all due haste. Thank you for your interest in writing for the ME-P and we look forward to hearing from you!

Respectfully

Hope

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

Our Other Print Books and Related Information Sources:

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

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

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

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

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

Physician Advisors: www.CertifiedMedicalPlanner.org

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How Smart Doctors Can Save Big at the Pump

Easing the Pain of High Gas Prices

By Dr. David Edward Marcinko MBA CMP®

[Editor-in-Chief]

We published a popular post on Easter Sunday 2012 about high gas prices. It was well received. So, since medical professionals often drive expensive, and inefficient cars [read expensive gas guzzlers], I thought it might be a good idea to relay my personal driving tips on how medical and all ME-P colleagues [MDs and FAs], can save big [or at least a bit] at the gas pump.

Link: https://medicalexecutivepost.com/2012/04/08/pain-at-the-2012-easter-sunday-pump/

Guilty – as Charged?

Look, I am a doctor and financial advisor, as well as journalist, editor, surgeon and expert legal witness. I wear many hats and my one indulgence is my pearl white Jaguar XJ-V8-LWB. This classic baby was a gift from my wife who bought it from a singular previous owner [software mogul] in pristine physical and engineering condition after years of meticulous and loving garaged care.

In other words, she let some someone else take the huge depreciation hit on a luxury European touring vehicle that originally sold for up to $100,000 direct from Coventry England. Fortunately, this is not a primary vehicle and I use it only on the weekends, weather permitting. What a joy to drive. Smooth and quiet; just like a hybrid vehicle. And, it is not unusual for nearby folks to stop, stare and even wave at me as I drive by.

 

Why?

So, if rising gas prices are making a huge dent in your wallet, I have a solution to save you money at the pump! Try these simple tips and you’ll find the savings quickly add up.

Tips and Quips

* At least once a month, make sure your tires are properly inflated according to the vehicle’s specifications. Over-inflating tires by even a pound or two might improve fuel mileage in the short run, but it causes tires to wear prematurely. The money you save in fuel is less than what you would pay to replace the tires. But, I am guilty of this tactic because I have Pirelli tires on my Jag.

* Buy the right octane. Look in your vehicle’s owner’s manual for the correct octane level for your car’s engine. Odds are that it will be regular unleaded. Your vehicle should run just fine on regular if that’s what the manual recommends; and it costs less. Again, I use and need 93 plus Octane.

* An annual full-vehicle inspection, including the air conditioning system, may help you avoid costly repairs. I detail and check out my automobile every quarter.

* Vehicles use less fuel the more slowly they travel. Try dropping your highway speed by 10 mph to see big savings at the pump. Here, I follow the rules.

* Extra weight in your vehicle makes it work harder, hence less fuel mileage. If you have a trunk full of junk, empty it out for better fuel economy and to save money. My Jag weighs 4,800 pounds.

* Nothing can put a damper on spring travel plans more than unpredictable gas prices. Search for the best price before you go to fill up. I use a smart-phone and auto navigation system for this chore.

Assessment

With such gorgeous weather, driving your car with sunroof open might be the first thing on your mind. So, just by taking a few small steps, you’ll save money on your vehicle, meaning more money stays in your wallet – while enjoying it more.

Conclusion

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

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

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

Our Other Print Books and Related Information Sources:

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

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

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

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

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

Physician Advisors: www.CertifiedMedicalPlanner.org

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More photos: DEM’s JAGUAR

What is a Social Impact Bond?

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New Financial Product – or Societal Economic Hammer

By Dr. David Edward Marcinko MBA CMP™

At a time when government finances are stretched there is growing interest in finding new ways to fund public services [healthcare, for example] which improve social outcomes [public health]. And, one new funding model currently being tested, in the United Kingdom, is Social Impact Bonds (SIBs).

Definition

A SIB is a form of payment by results (PBR) in which funding is obtained from private investors to pay for interventions to improve social outcomes. If these interventions succeed in improving outcomes, they should result in savings to the Government and provide wider benefits to society. Of course, as part of a SIB, the Government agrees to pay a proportion of these savings back to the investors. If outcomes do not improve, investors do not receive a return on their investment.

Link: http://en.wikipedia.org/wiki/Social_impact_bond

Wall Street’s Securitization

Wall Street can securitize almost any asset for a commission, or to hold it for profit or loss. Remember David Bowie bonds?

“Securitization” is the process through which an issuer creates a financial instrument by combining other financial assets and then marketing different tiers of the repackaged instruments to investors. The process can encompass any type of financial asset and promotes liquidity in the marketplace.

Link: http://thehealthcareblog.com/blog/2012/03/05/could-social-impact-bonds-help-restore-public-budgets/

SIBs

SIBs may be an example of securitization. By combining small debt into one large pool, the issuer can divide the large pool into smaller pieces based on each individual bond’s inherent risk of default, and then sell those smaller pieces to investors. The process creates liquidity by enabling smaller investors to purchase shares in a larger asset pool. Individual retail buyers, like physician-investors and others, are able to purchase portions the bond. Without the securitization, retail investors might not be able to afford to buy into a large pool of bonds.

Read more: http://www.investopedia.com/terms/s/securitization.asp#ixzz1oGtOPTvZ

Assessment

This is the first time we’ve discussed SIBs on this ME-P. But, they should get much more attention from our CPA, investment advisor [IA] and financial advisory [FA] readers now that President Obama has announced his support for this British idea like getting private investors to pay for public services such as housing for the homeless, health care for vulnerable populations; or even education. It could work for anything that can save the Government money in the long run, but costs money up front, as long as we can measure it.

Link: http://www.fastcompany.com/1728321/the-most-exciting-00003-of-obama-s-budget-social-impact-bonds

Conclusion

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

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

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How We Use the ME-P to Market and Reach Our Target Audience

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A Marathon –  Not a Sprint

By Dr. David Edward Marcinko MBA CMP™

[Publisher-in-Chief]

I am a runner on LSD. I have been running long, slow, distances for more than three decades. And, this is our advertising philosophy at the ME-P. Say What?

Goals and Objectives

The goal is simple enough to state, but reaching it is a challenge. The ever-rising expectations of social media, e-connectivity and Internet users require us to make constant improvements to the ME-P so that our visitor’s experience is relevant, meaningful and worthy of recommending to others.

Going Viral

For example, the humorous “viral videos” that often appear on YouTube, and elsewhere, may get forwarded in emails and generate millions of viewers for a few days, but then drop out of sight quickly. This is not an ME-P goal for our staff, expert contributors, and informed readers and subscribers. Such a “spike and drop” phenomenon is interesting, of course, but it is not our focus.

So, much like my LSD metaphor, we favor LSD … and are on cognitive steroids, of sorts.

The ME-P Way

Instead, at the ME-P, we post short and long topical essays, comments, graphics, videos and other website URLs with a much different goal in mind. What is it? To market to our niche audience, and obtain higher search engine rankings over the long term, in our areas of expertise and on a continuing basis. Sound like a long term stock-market investor, or LSD runner? You bet!

Assessment

We trust all ME-P readers, subscribers, advertisers and visitors agree.

Conclusion

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

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

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

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

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

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Healthcare Organizations

Personal Budgeting Guidelines for Doctors

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Some Cost of Living and Expense Benchmarks for Us All

By Dr. David Edward Marcinko MBA

[Editor-in-Chief]

There are many types of budgets. Fixed and variable budgets; semi-variable, cost plus/minus, managerial and even zero-based budgets! And, we’ve written about some of them on this ME-P.

Nevertheless, I’ve never been a big fan of personal budgeting. For clients, they seem to be a neurotic crutch, and for me a pointless exercise as I make sure I live on less than I make. Yet, this philosophy is most unusual in the financial advisory world.

But, like minds to the contrary do exist. Just ask my colleague, and financial planner, Rick Kahler CFP® MS ChFC CCIM.

Link: https://healthcarefinancials.wordpress.com/2011/12/27/can-doctors-achieve-financial-independence-without-budgeting/

Still, this visual will give you a rough idea of the average cost-of-living as a percentage of income for laymen.  We all love benchmarks; don’t we?

Assessment

But, does the above infographic relate to medical and financial services professionals; why or why not, and if so, how?

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

 

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The Joy of Healthy [Clean] Hands

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Handwashing Revisited for Laymen and Physicians

[By Staff Reporters]

Some laymen in the office were recently wondering about hand washing. Why do we wash our hands after using the restroom? Why do we not wash our hands prior to “doing our business”? And is it really necessary to wash every single time?

So, after some research, the short answer to that last question seems to be a resounding yes. Want to know why?

Source: tradewindsimports.com

Publisher’s Note:

As most ME-P readers are aware, I am a HAI fanatic and even edited and wrote a medical textbook on bone and soft tissue extremity infections, back  in the day. And so, for our medical professional readers, this encore report by www.PodiatryPrep.com will review surgical sterilization and disinfection procedures for doctors and surgeons.

Link: Surgical Sterilization and Disinfection

Dr. David Edward Marcinko MBA  

 

www.PodiatryPrep.com

Channel Surfing the ME-P

Have you visited our other topic channels? Established to facilitate idea exchange and link our community together, the value of these topics is dependent upon your input. Please take a minute to visit. And, to prevent that annoying spam, we ask that you register. It is fast, free and secure.

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

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White House Sides With Sales Reps On Overtime

Dr. David Edward Marcinko MBA CMP™

[ME-P Editor-in-Chief]

www.CertifiedMedicalPlanner.org

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

Far Reaching Implications?

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

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

The Issue

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

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

My Issue

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

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

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

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

Assessment

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

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Managing and Mitigating a Doctor’s Risky Life

Insurance and Risk Management Strategies for Doctors

and their Advisors

Book Preview 

http://www.amazon.com/Insurance-Management-Strategies-Physicians-Advisors/dp/0763733423/ref=sr_1_4?s=books&ie=UTF8&qid=1328701489&sr=1-4

ORDER HERE

http://www.jblearning.com/catalog/9780763733421/

On “Financial Planning for Physicians AND their Advisors”

Financial Planning for Physicians

A Handbook for Doctors and their Financial Advisors

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Financial Planning Handbook for Physicians and Advisors

Book Review and Summary

Financial Planning for Physicians and Advisors describes a personal financial planning program to help doctors avoid the perils of harsh economic sacrifice.

It outlines how to select a knowledgeable financial advisor and develop a comprehensive personal financial plan, and includes important sections on: insurance and risk management, asset diversification and modern portfolio construction, income tax and retirement planning, and medical practice succession and estate planning, etc.

When fully implemented with a professional’s assistance, this book will help physicians and their financial advisors develop an effective long-term financial plan.

Order now: http://www.jblearning.com/catalog/0763745790/

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

###

About Hospitals & Healthcare Organizations

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

Healthcare Organizations: Management Strategies, Operational Techniques, Tools, Templates and Case Studies

Conclusion           

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

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

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

Our Other Print Books and Related Information Sources:

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

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

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

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

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Ring In the Year with a Subscription & Donation to the ME-P

An ME-P Staff Impact Round-Up for 2011

Join Our Mailing List 

By Dr. David Edward Marcinko FACFAS, MBA, CPHQ, CMP™

[Founding Publisher, CEO and Editor-in-Chief]

By Professor Hope Rachel Hetico RN, MHA, CPHQ, CMP™

[Managing Editor]

By Ann Miller RN, MHA

[Executive-Director]

And, with Edward, Mackenzie and Cecelia [staff members]

This has been a year of incredible impact for the ME-P. And, as volunteers, we’re making a vital difference.

So, as 2011 comes to a close, please formally subscribe to us for free, cease the “lurking” -and-  consider making a monetary donation to help us continue this important work.

Subscription link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Donation link: www.e-junkie.com/ecom/gb.php?c=cart&i=641232&cl=109140&ejc=2 

Our Impact?

What do we mean by impact? We hope these three examples, each from the integrated sectors we serve, give you an idea.

The Financial Services Industry

First is the essay on Mary Schapiro, the current SEC Chairwoman. In it we advocate for all investors, not just physicians and medical professionals, so that everyone receives trusted financial advice and not just the bastardized contortion that she – and those on Wall Street that she is beholden to – dreamed up in some linguistically parsed, ethically challenged and obtusely regulated mashup definition of honesty.  Demand fiduciary accountability at all times; period. Just as one can’t be a little pregnant – “financial advisors”, planners, and stock-brokers can’t be a little honest.

Link: https://medicalexecutivepost.com/2011/12/19/the-one-woman-physician-investors-should-not-trust/

The Health Care Sector

Then, there is the essay from investigative reporter Darrell K. Pruitt DDS that not only humiliated the ADA and toppled a dental management CEO and his embarassed company, but who also repeatedly warned all medical professionals on the risks and benefits of eHRs. Although not technophobes, we do believe – like the silent majority – that while eHRs are indeed the future, they are not currently ready for meaningful use, real security or the user friendly prime time they promise, despite PPACA, HITECH and ARRA legislation. Incentives, mandates and financial credits promote bubbles, not a competitive marketplace of true innovation.

Link: https://medicalexecutivepost.com/2011/11/15/on-the-leadership-shake-up-at-the-cr-foundation/

The Medical Management Consultants

Finally, our impact can – and should also be – more personal. For example, we continued writing about the future of medical practice, evolving and emerging models and those economic consultants who advise, suggest, recommend, appraise, manage and value healthcare business entities. The work of colleague Robert James Cimasi MHA, AVA, CMP™ and the folks at Health Capital Consultants LLC, come quickly to mind. Without them, our newest textbook for 2012, Hospitals and Healthcare Organizations, would not be the financial management opus it is sure to become.

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

ASSESSMENT

And so, your support is needed in 2012. Have a Happy and Healthy New Year!

Donate: www.e-junkie.com/ecom/gb.php?c=cart&i=641232&cl=109140&ejc=2 

Conclusion      

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

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

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

Our Other Print Books and Related Information Sources:

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

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

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

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

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Caffeine, Health and Health Insurance Premiums

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Physically Harmful, Risk Premium Rated — or Not?

[By Dr. David Edward Marcinko MBA CMP™]

[Editor-in-Chief]

Q: As both a doctor and health insurance agent, back in the day, many patients asked me about the health effects of caffeine consumption; especially malpractice attorneys during my expert witness depositions.

Other clients often wondered about how consumption affected their health insurance premium quotes.

A-1: Here are some reported effects of caffeine. The following effects are commonly attributed to over-use of caffeine. While reading them, bear in mind that what is true for one person may not be true for someone else:

1. Stimulates your heart, respiratory system, and central nervous system

2. Makes your blood more `sludgy’ by raising the level of fatty acids in the blood

3. Causes messages to be passed along your nervous system more quickly

4. Stimulates blood circulation

5. Raises blood pressure

6. Causes your stomach to produce more acid

7. Irritates the stomach lining

8. Makes digestion less effective by relaxing the muscles of your intestinal system

9. Its diuretic effect caused increased urination – although you’d have to drink about 8 coups of coffee in one sitting for this to occur

And so, here is an additional sampling of information about the health effects of caffeine.

A-2: And, caffeine has no affects on health insurance premium rates; smoking does!

Assessment

Source: www.freeinsurancequotes.net

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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About ME-P Seminars

Book Dr. David E. Marcinko for your Next Seminar

By Ann Miller RN MHA

[Executive-Director]

Why Book Dr. DEM?

Dr. Marcinko believes nothing is purely management -or- medical -or- business -or- financial anymore – and nothing is purely personal.

Background and Credentials

David Edward Marcinko is CEO of the Medical Executive-Post [www.MedicalExecutivePost.com] and Founder of iMBA Inc [www.MedicalBusinessAdvisors.com] the parent holding company of several related communications firms [www.CertifiedMedicalPlanner.com].

He is a frequent education and motivational speaker on the business integration between medical practice management and financial planning for all healthcare professionals, in the US and Europe.

Understanding New Medical Practice Business Models

As a doctor, physician-executive and successful entrepreneur who transitioned out of clinical medicine, Marcinko understands how the practice and financial aspects of physician lives are tied together and how recognizing this makes it easier to make sound decisions in two areas; traditionally and for the new-wave narrative known as collaborative medicine and Health 2.0.

After all, he has been writing, speaking and publishing on all of it – and more – for the past three decades www.HealthcareFinancials.com

Interactive Philosophy

In his interactive seminars, participants can share as much or as little of their stories as they wish, but David describes them as being aimed at demonstrating where practice and money is concerned, nothing is purely “health economics”, nothing is purely “business management”, and nothing is purely “personal.”

Dr. Marcinko believes that only when this philosophy is understood, can doctors really take control of their present economic lives, current medical practices and future dreams.

Targeted Delivery

Dr. Marcinko’s presentations are generally aimed at a specific life-cycle: new practitioners, mid-life providers, and/or mature medical professionals.

Assessment

Dr. DEM is also available to speak to medical and financial services societies, at insurance or business development centers, pharmaceutical meetings and other like-minded organizations to deliver either contemporaneous seminars – or tailoring presentations to specific audience needs.

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

 

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“Health Care Organizations” [Announcing our Newest Print Book for 2012]

Management Strategies, Operational Techniques, Tools, Templates and Case Studies [in-progress]

By Dr. David Edward Marcinko; MBA CMP

By Prof. Hope Rachel Hetico; RN MHA CMP

Price:  $69.95 est.
Cat. #:  K13750
ISBN:  9781439879900
ISBN 10:  1439879907
Publication Date:  April 15, 2012 est.
Number of Pages:  400 est.
Binding(s):  Hardback

TABLE OF CONTENTS [tentative] 

  1. Market Competition in Healthcare [Understanding the Current Strategic Eco-System]
  2. Medical Career Development [Transformation of Next-Generation Physician Executives and Leaders]
  3. Medical Process Strategic Improvement [Tracking Care with Outcomes Reporting] 
  4. Capital Formation Strategies for Hospitals [Institutional Types, Essentiality and Governance]
  5. Hospital Revenue Cycle Management [Strategic Monitoring and Augmentation] 
  6. Managing Health Information Technology [Exchanging Patient Data – The Benefits and Rewards]
  7. Strategies for Health Information Technology Security and Privacy [Understanding the Rules, Regulations, Penalties and Recovery Efforts]
  8. Lean Six Sigma Healthcare Operations [Improving Healthcare Quality]
  9. Strategic Financial Management Implications of the USA PATRIOT and Sarbanes-Oxley Acts [Health Policy for Affected Hospitals and Healthcare Organizations] 
  10. Collaboration to Improve Operating Performance [Opportunities are Widespread] 
  11. Healthcare Supply Chain Inventory Management [Data Capture, Just-in-Time Strategies and Economic Order Quantity Analysis]
  12. Improving Hospital Flow Through Efficiency, Operations and Logistics [Seeking Leaner and Faster Organizations with Sustainable Improvements]

Pre-Order Now

In-Process from: (c) Productivity Press 2012
http://www.crcpress.com/product/isbn/9781439879900

Conclusion

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

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

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

Our Other Print Books and Related Information Sources:

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

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

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

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

Product Details 

Knowledge Doctors Need to Survive the Financial Crisis on Wall Street

Dictionary of Health Economics and Finance 

 

Dictionary of Health Economics and Finance

 
 

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

 

Dr. David E. Marcinko is “In-the-News”

Our ME-P Editor is an Industry “Mover and Shaker”

By Ann Miller RN MHA

[Executive-Director]

Link: http://www.physiciansmoneydigest.com/search?get1=search&get2=marcinko

Link: www.medicalbusinessadvisors.com_forum-books.asp

Our Other Print Books and Related Information Sources:

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

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

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

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

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