Implications of Portfolio Withdrawals for Physician Investors

Obtaining Income in a Low Interest-Rate Economic Ecosystem
By Jeffery S. Coons; PhD, CFP®
Managing Principal-Manning & Napier Advisors, Inc
The general trend of declining interest rates experienced over the last decade and a-half, part of a long-term trend Manning & Napier Advisors, Inc. had focused on since the early 1980’s, created new challenges for managing investment [...]

Prescription Data-Mines and Insurance “Credit-Reports”

The End to “Rx” Privacy? 
Staff Reporters
Collecting and analyzing [HIPAA protected?] personal health information [PHI] in commercial databases is a fledgling, but exploding industry, despite privacy concerns.
Industry Leaders
For example, Milliman’s IntelliScript provides personal drug profiles to insurers. And, Ingenix’s MedPoint is owned by UnitedHealth, the corporation that owns UnitedHealthCare. UHC is also the nation’s second-largest [...]

Patients Challenging Medical Invoices

Root Cause is Money, Failure-to-Disclose and Frustration
Staff Reporters
Patients are challenging their medical bills with lawyers and lawsuits, out of frustration about the lack of up-front disclosure over costs by doctors and hospitals.
Involve More than a Few Cases
For example, after being charged $82,282 for a 23-hour stay in doctor-owned Westfield Hospital for two operations on [...]

Physician Malpractice Liability Immunity

Free Charity Medical Care?
Staff Reporters
Sen. Mike Enzi [R-Wyoming], the senior Republican on the Senate Health, Education, Labor and Pensions Committee [HELP], recently introduced legislation that would allow physicians and other medical professionals to volunteer their services at charity clinics and community health centers free from medical liability concerns.
Query
What is your opinion on this idea, given [...]

Risk Management: It’s Not All About Medical Malpractice Anymore

Book Review
By Murray J. Goodman; MD
In the narrow world of our day-to-day practice, orthopaedic surgeons often think of risk management strictly in terms of avoiding exposure to medical liability lawsuits. But, in the book Insurance and Risk Management Strategies for Physicians and Advisors, author, physician, and healthcare economist David E. Marcinko has assembled a cadre [...]

Baby Boomers Financially Unprepared

Potential Medical Disability Survey
Staff Reporters
According to findings from a recent Harris Interactive survey conducted on behalf of America’s Health Insurance Plans (AHIP) between April 25 - 29, 2008, baby boomers are financially unprepared if they themselves, or the primary wage earner in their household, suffered a medical disability and was unable to work for [...]

“Loss of Chance” Liability

Judicial Court of Massachusetts
Staff Reporters
The Supreme Judicial Court of Massachusetts [JCM] recently ruled that doctors can be held liable for negligence that reduces a patient’s chance of survival, even if the patient’s prospect for recovery was already less than 50 percent.
“Loss of Chance”
The SJC recognized for the first time a legal doctrine known in [...]

Marital Dissolution, Buy-Sell Agreements and Practice Value

Doctors, Divorce and Medical Practice Worth
By Mark P. Gross; JD
Determining how to value the business interest of each medical partner is a critical element of the buy-sell agreement.
Family law courts, however, have broad discretion about whether to accept or reject the validity and binding effects of the formula stated in these agreements. When assessing [...]

Alphabet Soup: Financial Designations & Certificates

financial-designationsjuly
July 2008:
AUTHORS: Dr. David Edward Marcinko; MBA, CMP™ and Hope Rachel Hetico; RN, MHA, CMP™
POSITION: Publisher-in-Chief, and Managing Editor of the Executive-Post, respectively.
TOPIC: Financial Designations and Certifications [Alphabet Soup of Industry Obfuscation and Self-Promotion, or Real Gravitas – You Decide?]
EXCERPT: “Until recently, most financial advisors were regulated by the NASD, the National Association of Securities [...]

Post-Nuptial Agreements

Protecting Physician Business Assets
Staff Reporters
Pre-nuptial agreements are becoming well known; but post-nuptial agreements are not so known.
Family Business Environment
Prenuptial agreements are increasingly common in family business environments. In some cases, the business owner or a shareholder’s agreement may require certain family members to enter into prenuptial agreements with their prospective spouses.
However, postnuptial agreements are [...]

Ensuring the Welfare of a Disabled Child

Special Financial Planning Techniques Required
By Roger J. Warrum
If a doctor or medical professional has a mentally or physically disabled child, special estate provisions are needed to ensure the continued care and comfort of that child after the parents’ deaths.
Estate Planning
When designing an estate plan for a doctor with a disabled child, it must provide [...]

The Uniform Prudent Investor’s Act

A Trust Primer for Physicians
By Charles L. Stanley; CFP™ ChFC
Since inception, the Uniform Prudent Investor Act (UPIA) has changed the financial advisory landscape. Essentially, the act modified the legal criteria of “prudent investing” for trusts.
Now, all assets owned by a trust are considered “investments” for purposes of the Uniform Prudent Investor Act. Consequently, for [...]

IRS Offers-in-Compromise

Understanding the IRS Tax Reform Act
Staff Writers
In 1998, the IRS received 105,255 offers-in-compromise, but accepted only 25,052 offers—a mere 24%; and the exact number for medical professionals is unknown.
The IRS Reform Act
However, the IRS Reform Act later revamped the provisions for offers-in-compromise and the IRS, reacting to the changes, announced that it would [...]

Alimony versus Child Support

Tax Consequences for Physicians
Staff Writers
Tax considerations are critical when preparing divorce agreements; and an understanding of the applicable sections of the Tax Code is essential for all medical professions in this situation.
In short, alimony is deductible for the payer while child support is not; so it is important for a separation agreement to stipulate [...]

Ask an Advisor

Second-to-Die Life Insurance
QUESTION: Why has second-to-die life insurance become so popular with medical professionals and others?
Conclusion
Your thoughts and comments are appreciated.

Related Information Sources:
Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759
Physician Financial Planning: http://www.jbpub.com/catalog/0763745790
Medical Risk Management: http://www.jbpub.com/catalog/9780763733421
Healthcare Organizations: www.HealthcareFinancials.com
Health Administration Terms: www.HealthDictionarySeries.com
Physician Advisors: www.CertifiedMedicalPlanner.com
Subscribe Now: Did you like this Executive-Post, or find it helpful, interesting and informative? Want to get the [...]

Improving Patient Communications

Managed Care Ethical Considerations
By Render S. Davis; MHA, CHE
In contemporary medicine, and managed care, ethical dilemmas in communications are increasingly common and may come in many different forms. For example: 

Physician’s failing to communicate necessary clinical information to patients in terms and language the patients can truly understand;

Physicians’ offering only limited treatment choices to patients because [...]

Risky Business of Web 2.0 Doctor Bloggers

A Mashed-Up Opinion
By Dr. David Edward Marcinko; MBA, CMP™
Publisher-in-Chief
Today, after personally reviewing far too many blogs, and according to www.NPR.org, there are more than120, 000 health care forums on the Internet with opinions ranging from pharmaceuticals, to sexual dysfunction, to acne.
The same goes for commercial doctor blogs that promote lotions, balms and potions, diets [...]

Physician Peer Review

New Era Risks
By Dr. David Edward Marcinko; MBA, CMP™
Publisher-in-Chief
The Center for Peer Review Justice is a group of physicians, podiatrists, dentists and osteopaths who have witnessed the perversion of medical peer review by malice and bad faith.
Raison D’etre
Like the American Association of Neurological Surgeons [AANS], they have seen the statutory immunity, which is provided [...]

Expert Witness Risks

A New Emerging Modern Peril
By Dr. David Edward Marcinko; MBA, CMP™
Publisher-in-Chief
In the past, a physician expert witness for the plaintiff was merely an opposing opinion by a learned and/or like colleague. Today, it is becoming a risk management minefield as the AMA and other groups are urging state medical licensing boards to police expert witnesses, [...]

Failure 2 Rescue

Attention “Condition H” 
Staff Reporters
For the fifth straight year, an analysis of errors in our nation’s hospitals found that the most reported patient safety risk is a little-known, but always-fatal, problem called “failure to rescue.”
Definition
The term Failure-To-Rescue [FTR] refers to cases where hospital doctors, nurses or caregivers fail to notice symptoms, or respond adequately [...]

Emergency Room and On-Call Risks

Next-Gen Doctors Opting-Out
By Dr. David Edward Marcinko; MBA, CMP™
Publisher-in-Chief 
Of course, it’s getting more expensive these days to take hospital call as physicians are electing not to take this responsibility because of decreased reimbursement rates. Others opt-out because of a desire to spend more time with family, and/or scheduling conflicts. And, let’s not forget the liability [...]

Hospital Acquired Conditions

Clarifying “Never-Events” Terminology
Dr. David Edward Marcinko; MBA, CMP™
Publisher-in-Chief  
Did you know that “never-events” are also being called “hospital acquired conditions”; in some cases? 
Of Terms and Definitions 
Below is the list of conditions that the Centers for Medicare and Medicaid Services (CMS) selected in its FY 2008 final rule: 
 

Serious Preventable Event — Object Left in Surgery
Serious Preventable [...]

Managed Care Contract De-Selection Risks

Origins of Medical Practice Patient Flow
By Dr. Charles F. Fenton III; Esq 
 
In the current medical environment a physician’s practice does not consist of a collection of individual patients, or even of the “charts.”  
Rather, a physician’s practice consists of a number of managed care contracts that allows the physician to be a member of a panel [...]

Managed Medical Care Contract Risks

More than Malpractice Liability
By Dr. Charles F. Fenton III; Esq 
 
Attorneys are becoming more aggressive in suing HMOs and other managed care companies.  
A Review 
Historic bars to such suits are declining simultaneously with recent Federal ERISA protection erosion. The upshot is that more litigation against managed care companies, their affiliates, and their health care providers are likely.  
Doctor [...]

Patterns of Medical Practice Risks

Applied Statistics and Large Numbers
By Dr. Charles F. Fenton III; Esq  
One of the next big areas of medical practice risk management that will surface in the near future is the Pattern of Practice Risk.   
Pattern of Practice refers to the way that a particular physician practices medicine. With computers, standardized diagnosis and treatment codes - [...]

Civil Asset Forfeiture in Medicine

Understanding the Risks
Dr. Charles F. Fenton III; Esq. 
 
We have all heard stories of civil asset forfeiture run amok and out-of-control.  
For example, the family that lost their home because a child had marijuana in his bedroom; or the man who lost his boat because a friend who (unknown to the owner) borrowed it and used it [...]

Money Laundering in Modern Medicine

Understanding the Charges
Dr. Charles F. Fenton III; Esq. 
Charges of money laundering are serious and may seem foreign to the practice of medicine.  
The term “money laundering” evokes visions of a suitcase of drug cash being brought into a legitimate business and being transformed into that business’s receipts and later tunneled through legal channels.  
Following the Money Route 
In [...]

Credit Risk

Understanding Company Specific Risk
By Julia O’Neal; MA, CPA  
 
There are several kinds of investing risk, for example:

Credit or company specific risk refers to the firm’s business and financial risks.

Business risk is the risk inherent in the nature of the business.

Financial risks are those in addition to business risk that arise from financial leverage [credit [...]

New Pilot Program to Audit Hospital Bills

Medicare Program Promotes Bounty-Hunter “Zeitgeist” Mentality
By Dr. David Edward Marcinko; MBA
Publisher-in-Chief 
 
 
According to a recent report in the Wall Street Journal, hospital groups have launched a vigorous campaign against expanding a pilot program to audit Medicare claims. And, it seems the most onerous aspect of the program is a contingency fee-schedule that encourages auditors to be [...]

“Wrong Profession” Insurance for Physicians

Framing Livelihood Insurance as a Risk Management Product [One Healthcare-Executive’s Experiential Opinion]

By Dr. David Edward Marcinko; MBA, CMP™
By Hope Rachel Hetico; RN, MHA, CMP™
Publishers: The Executive Post for www.HealthcareFinancials.com 
Founder and CEO: www.MedicalBusinessAdvisors.com 
Academic Provost: www.CertifiedMedicalPlanner.com 
Editor-in-Chief: www.HealthDictionarySeries.com 
 
Some might say that this is not a good time to be practicing medicine?  
Why? The reasons are TNTC.
But, increased [...]