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    As a former Dean and appointed Distinguished University Professor and Endowed Department Chair, Dr. David Edward Marcinko MBA was a NYSE broker and investment banker for a decade who was respected for his unique perspectives, balanced contrarian thinking and measured judgment to influence key decision makers in strategic education, health economics, finance, investing and public policy management.

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

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

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

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

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

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

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

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Inviting Patients to Read Their Doctors’ Notes

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OVER HEARD IN THE DOCTOR’S LOUNGE

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By Dr. David E. Marcinko MBA CMP™

In an OpenNotes study, researchers examined the impact on patients and doctors when patients were allowed access to their doctors’ notes via a secure Internet portal.

Through the use of surveys, patients’ benefits, concerns, and behaviors, as well as physicians workload, were measured.

The Study

Beth Israel Deaconess Medical Center (BIDMC) in Boston, Geisinger Health System (GHS) in Pennsylvania, and Harborview Medical Center (HMC) in Seattle were selected for this quasi-experimental year-long study.

The study included 105 physicians and 13,564 of their patients. Patients were notified when their notes were available, but whether or not to open the note was at their own discretion. The authors analyzed both pre- and post-intervention surveys from the physicians who completed the study; 99 physicians submitted both pre- and post-intervention surveys. Of the patients who viewed at least one note, 41 percent completed post-intervention surveys.

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Physician Executive

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Almost 99 percent of patients at BIDMC, GHS, and HMC wanted to have continued access to their visit notes at the completion of the study; no physician elected to end this practice.

Assessment

Although a limited geographic area was represented, the positive feedback and clinically relevant benefits demonstrate the potential for a widespread adoption of OpenNotes.

Moreover, it may be a powerful tool in helping improve the lives of patients.

Citation: Inviting Patients to Read Their Doctors’ Notes: Author(s): Delbanco, T; Walker, J; Bell, SK and Darrer, JD et al: American College of Physicians, Annals of Internal Medicine, October 2012

Open Notes, a grantee of the Robert Wood Johnson Foundation, was developed to demonstrate and evaluate the impact on both patients and clinicians of fully sharing (through an electronic patient portal) all encounter notes between patients and their primary care providers.

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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Tax Planning Strategies for Physicians in 2010-11

Ten Ways to Lower your Taxes

By Sean G. Todd, Esq., M. Tax, CFP®, CPA

1. Buy a home

You can take advantage of a buyer’s real estate market and buy a home at prices not seen for years. We are seeing prices discounted from 10-30%. First time buyers – doctors and other individuals – who haven’t owned a residence in the last three years – can claim up to the $8,000 tax credit. Current homeowners who’ve lived in their residence for five of the eight years before buying can get up to $6,500. Remember a tax credit is a dollar-for-dollar reduction in your tax liability. Taxpayers love tax credits. You must have a contract in place by April 30, 2010, and the deal closed by June 30th to qualify for this outstanding credit.

2. Avoid the Making Work Pay trap 

This is an accounting trick … timing. This tax break was designed to put more money in consumer hands quicker (by under-withholding), but if you work two jobs it may have a tax bite. If you work more than one medical job, check with a tax advisor, or the payroll department at your office to make sure your W-4 is filled out properly at each job.

3. Make a Roth Conversion

The $100,000 income limit has been eliminated in 2010. Now, anyone can now convert a traditional IRA to a Roth retirement account. But, review the numbers.  Everyone’s situation is unique and making the conversion may not be a smart financial decision. But, note that you will have to pay taxes on the previously untaxed amounts in your traditional IRA that you convert. The good news is you can choose to pay half the conversion costs on your 2011 taxes and the other half in 2012.  Beware, making the conversion might push you into the next tax bracket and could cause some deductions to be lost—so you have to run the numbers.

4. Gain tax benefits from improving your home’s energy efficiency

You might be eligible for more tax credits based on your improvements to the principal residence. Making such improvements might just make your home a bit more-cozy. Homeowners can claim up to 30 percent of the first $5,000 spent on qualifying residential energy upgrades, or up to $1,500 in tax credits. A solar home heating system can get you even bigger tax credits.  We are uncertain if these credits will be extended so if you need to make home repairs, consider energy-efficient upgrades now.

5. Buy a hybrid car now…but not just any hybrid

The hybrid credit is set to expire in 2010. The credit remains good only with manufacturers that have not sold 60,000 eligible cars. So shop carefully to make sure the hybrid you are looking at qualifies.  Be sure to get the salesman’s representation that this vehicle qualifies and the manufacturer has sold less than the above amount to qualify.

6. See an Estate Tax Professional

Right now–everyone is trying to figure this area out. Since Congress has really messed this area up by the lack of clarity and with our deficit spending, you can expect that money hungry legislators will want to reclaim more of your money they don’t deserve. Ask a licensed Tax Attorney or CPA to help you arrange your affairs to make sure you and your heirs do not give the IRS more than necessary.

7. You must take your Required Minimum Distributions for your retirement accounts

Many doctors utilize tax-deferred savings plans such as traditional IRAs or workplace 401(k)s or 403(b)s to save for retirement. Now, the IRS is again telling us you have to start taking money out of these accounts via required minimum distributions, or RMDs, once you turn 70 1/2.  You were given a reprieve in 2009 from taking RMDs.

8. Plan for rising income tax rates

By law, the Bush tax cuts expire at the end of 2010. Tax rates go up for higher income earners and the 10 percent rate is eliminated for lower earners. One can only speculate what Congress will do in the light of trillion dollar deficits, but keep an eye out and plan accordingly. Be proactive and not reactive. Do not be afraid to call your Senators and Congressperson and let them know how you feel about tax hikes.

9. Act now to take capital gains at lower rates

George W. Bush’s tax cuts included reductions in capital gains tax rates based on taxpayer adjusted gross income. Right now the highest rate is 15 percent for individuals in the 25 percent to 35 percent tax brackets.  Taxpayers in the 10 percent and 15 percent tax brackets pay no capital gains tax at all. Current law says this is scheduled to change in 2011.The top rate will return to 20 percent; the zero rate will revert to 10 percent. And with this administration and the party controlling Congress, this could get worse. Here is the wildcard: there is no guarantee they won’t make retroactive changes, either.

10. Watch out for health care changes

In light of the Massachusetts special election going to a Republican, health care changes could jump off the fast track; but nevertheless there could be ramifications for you tax wise if something does finally pass. Keep your eye on this and stay out from under the surgeon’s knife on this one!

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Assessment

There is nothing like a good tax advisor, and it pays to be as informed as possible.

Conclusion

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

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How to Become a ME-P Thought-Leader

Answering a Growing Chorus of Inquiries

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

[Managing Editor]hetico

The Medical Executive-Post is the complimentary companion blog to the premium peer-reviewed quarterly subscription journal: Healthcare Organizations [Financial Management Strategies]. While the perspective of our blog is private medical practitioners, the focus of our e-journal on CD-ROM is large medical groups, healthcare organizations, hospitals, healthcare-systems, ASCs, emerging healthcare institutions and medical business entities  TABLE OF CONTENTS

HOFMS

The ME-P is for Doctors

 

Currently, the ME-P is being developed as a common venue for medical professionals to share their insights on how to best manage a private medical practice. A well-established practice will have a solid financial and executive-management foundation, and will have protocols, procedures and contingency plans in place before they are ever needed in an emergency. And so, we seek new-wave and next-generation input from physicians, osteopaths, podiatrists, dentist, nurses, PAs, CRNAs and optometrists who have experience starting and running medical practices in the Health 2.0 modern era. The goal is better patient care as doctors avoid costly or tragic management mistakes.

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The ME-P is for Financial Advisors and Management Consultants

Physician advisors like attorneys, accountants, practice managers, medical billing experts, insurance agents, commercial realtors, healthcare IT experts and others are invited to display their expertise, too. You may not become rich here, but you may become famous, or at least develop an excellent client base from the doctors and practitioners reading your articles, posts and comments! Financial advisors, CMAs, CFAs, MBAs, PhDs, CFP® and Certified Medical Planners [CMP™] are also invited to strut “cognitive-stuff”, as free-labor publishing entrepreneurs! Then, we aim to unite both sectors for success.  

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Steps to Becoming a Thought-Leader

1. Send us an email with your bio and contact info.

2. Tell us why you want to write for the ME-P.

3. Send in an original writing sample.

We may follow-up and discuss your credentials and the topics you’re interested in writing about.

Assessment  

Speaking engagements, travel to exotic locales, and print or e-book chapter contributions may all be in your future because of your career launching contributions to the ME-P. Everyone has something to share and teach, and we look forward to learning from everyone joining us here. And, please feel free to contact us for deeper involvement in all www.MedicalBusinessAdvisors.com, www.HealthDictionarySeries.com or www.CertifiedMedicalPlanner.com activities. Take your career to the next level with the ME-P.

HDS

Conclusion

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

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

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

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How to Hire a Medical Accountant

Seek Healthcare Specificity

Staff Reporters

Use these 25 questions to educate yourself about accountants. And, use this 25-point checklist on how to pick a good healthcare focused CPA. It can be a powerful list for any medical professional and might help you bring in extra money, immediately.

Other Areas

In the areas of estate planning and financial planning, it is essential that doctors have a good team of financial professionals. This usually involves, at the very least, a CPA, an attorney, and a fiduciary focused financial advisor [maybe].

CPAs

If you are a CPA for docs, use this list as a reference for your doctor-clients. By bringing up the concept of due diligence on your own, it strengthens your position and makes a perfect opportunity to ask for referrals. You may also want to use this list as a newsletter insert or advertisement of some sort. Put a brief notice at the top of the list stating that doctors should ask their CPAs these questions, and if they need someone who fulfills these requirements, you would be glad to meet with them to discuss the questions.

Financial Advisors

As an FA, use this list as a networking tool. Refer your clients to a competent CPA who you already do business with or would like to do business with. When you refer clients to a good CPA, you open the opportunity for him or her to return the favor. Send this list to your existing clients at tax time as a neutral third party to help them find a good CPA (they already have a good financial advisor—you).

Attorneys

As an attorney, use this list the same way a financial advisor or account would—to network with the top CPAs and MDs in town. You can make it a standard piece in your mailings or newsletters once a year. When you start giving leads to other financial professionals, it will open up referrals that will be beneficial to your business.

Certified Medical Planner®

And, if you are a CPA, FA or attorney, be sure to promote your hard-won credentials for healthcare specificity; like the Certified Medical Planner® designation, for example.

 25 Questions to Ask Your Future Accountant

  1. What designations or credentials do you have?
  2. Are you in practice full-time?
  3. How many years of experience do you have in tax practice?
  4. Do you do all your returns by computer?
  5. What are your fees, and do you have a schedule that I can see?
  6. Can you provide references from other businesses similar to my own?
  7. Do you use any checklists to maximize my deductions?
  8. How soon do you return calls from clients?
  9. Do you teach any tax courses or have you written for any tax publications?
  10. Are you conservative, aggressive, or somewhere in the middle?
  11. What review process do you use in order to ensure a quality product?
  12. Do you specialize in taxes?
  13. What percentage of your practice relates to taxes?
  14. What other accounting services do you personally perform?
  15. May I look at your tax library?
  16. What do you do after tax season?
  17. How often do you take tax courses?
  18. What is your attitude toward audits?
  19. How do you treat gray areas?
  20. Have you ever been disciplined by the IRS, the SEC, or any accounting society?
  21. How many other clients like myself do you have?
  22. Do you offer pre-year-end tax planning as part of your tax service? If so, is there      an extra fee for this?
  23. Are you generally familiar with current health law and managed care policy?
  24. Do you offer any tax planning during the year?
  25. Can you give me a recent tax planning tip or tax change that may benefit me?

Finally, and most importantly of all; how do all of the above synergize into medical and healthcare specificity, for me?

Assessment

As you likely now realize, this list is not for CPAs only; but as a due diligence reminder for most fiduciary financial advisors professionals or attorneys who wish to work with doctor clients; “often the most difficult clients in the business.”

Disclosure

Dr. David E. Marcinko MBA, our Publisher-in-Chief and former CFP®, is founder of the online CMP® program in healthcare economics, management and finance for advisors www.CertifiedMedicalPlanner.com

Conclusion

Your thoughts, opinions and comments are appreciated.

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

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