The Advisor

By Jerry H. Biese, Genworth Life Insurance Company

Pittsburgh is the second largest city in Pennsylvania, located in the Southwestern part of the state. In the past, it has been known as "the City of Bridges," and "the Steel City," but today, is called, "the Burgh." Pittsburgh is considered to be a hidden gem, economically strong and rich in art and cultural offerings. The city boasts a picturesque setting where three major rivers, the Monongahela, Ohio and Allegheny, converge. The low cost of living and wide array of amenities have put Pittsburgh on many "most livable city" lists. The National Geographic lists Pittsburgh as among the "best places in the world" to experience in 2012.

Downtown Pittsburgh has an energetic 14-block cultural district, along with many upscale shops and restaurants, performing arts venues, and sports arenas. Popular area attractions include the Andy Warhol Museum, the Phipps Conservatory and Botanical Gardens, and The Rivers Casino. For sports fans, Pittsburgh offers the Steelers (football), Pirates (baseball), Penguins (ice hockey), and University of Pittsburgh college basketball. So whether you prefer attending a concert or cheering on the home team, Pittsburgh has something for everyone.

From the industrial look of the past to a more vibrant and modern city with tree-lined streets, Pittsburgh has become a top destination for visitors and new residents alike. Old buildings are being gentrified into new housing, shopping centers, and office spaces. The revitalized landscape has also made the city eco-friendly.

Pittsburgh offers prestigious schools, hospitals, and a stable housing market. Unemployment is relatively low, as is the state tax burden — 6% state sales tax and 3.07% flat income tax. Seniors with proper identification are eligible to ride Port Authority buses and trains for free. In addition, there is a low risk of natural disasters in the area, such as earthquakes, tornadoes, hurricanes, and wildfires, adding to its appeal for retirees.  READ MORE

By Michael G. Higgins, Certified Financial Planner professional

Did you know that the same tools that you use to help your patients with their medical needs we use to help clients with their financial needs? These are diagnostic preventative measures to ensure proper health.  Just as you are concerned about measuring your patient’s progress and growth towards health, we are concerned with measuring our client’s progress and growth towards wealth.

As pediatricians you help parents by providing direction and guidance for the health and welfare of their children.  As a financial planner I also provide clients with guidance and direction but for their financial health and the financial health of their families.  In this article I just want to share three simple ideas to gain control and direction of your situation and to achieve financial success for you and your family.  All parents trying to instill in their children an understanding of the effort required to make money have said that money doesn’t grow on trees and that we don’t have a money tree outside that you can just pick anytime you need money.  We all know that is true but by following these three simple ideas you can create the equivalent of a money tree.  READ MORE

Reprinted with permission from Marketware

Physician referral development truly is a roller coaster. Every physician liaison can attest to this fact. Referrals go up and down, physician satisfaction scores go up and down, quality of activities go up and down, and the sanity of a physician liaison goes up and down.

Within in this blog, we will talk about what contributes to the roller coaster in referral development within a physician liaison program and what levers can be pulled to slow down the motion of the ride and get the ride moving in one consistent direction.  READ MORE

Brought to you by Charlotte Dougherty

Grantors who are leery about passing their hard-earned wealth to heirs with relaxed lifestyles and spending habits may find incentive trusts to be useful. Uncertain about the future behavior of their heirs, wealthy families can use incentive trusts to motivate beneficiaries to act in a particular way to earn future benefits.  

Incentive trusts are irrevocable grants of money to your heirs and can be created using insurance trusts, living trusts, credit shelter trusts and dynasty trusts. Perhaps from a desire to control their assets and to inspire their heirs to be responsible, some grantors create extensive provisions within the trust by specifying that the heir be employed, educated, married, starting a business or be free of drug or gambling habits to qualify for distributions.   

Some common examples of incentive trusts include:  READ MORE

According to a survey by The Hartford, the younger the worker, the greater the attraction to having the ability to take at least a portion of a retirement account as guaranteed income. A high percentage of workers in all age ranges found this appealing, but the greatest appeal was among workers under the age of 30, with 95 percent of these workers responding affirmatively to the survey.

I have two reactions to this. First, I'm pleasantly surprised that these young workers are focused on the end of the retirement savings journey. I am the father of an under 30 worker, and I can tell you that my daughter is more financially astute than I was at her age. On the other hand, I was a bit taken aback. Maybe I'm reading more into this than I should, but this result indicates a high level of risk aversion among these younger workers, which concerns me a bit.

I've written about my concerns with annuities in 401(k) plans previously, but that is not my focus here.

Rather, I'm concerned that younger workers are too risk averse. On the one hand, it would be hard to blame anyone whose initial investing experience includes the 2008-09 market decline. For those just a few years older, their initial investing experience might also include the market decline of 2000-02. Living through one or both of these periods as an investor was scary.

Perhaps these younger workers saw their parents' accounts take a significant hit during these periods as well.

However, I still contend that younger workers have the greatest retirement savings gift of all: time.

Various studies have shown that the biggest determinant of the amount of retirement accumulation is the amount saved. So the first tip that I would give to younger workers is to defer as much as possible into their retirement from day one. Even if this is a nominal amount, try to increase the percentage you are deferring each year. If there is an employer match, try to defer at least the maximum amount to get the full match as soon as you can afford to do so.  READ MORE

By Karen Weinstock, Siskind Susser Immigration Lawyers

There has been recent news reports (started with a New York Times Article last month) about the United States taking many doctors from Africa and leaving these communities without adequate care, communities that are already suffering from a severe doctor shortage and lack of access to quality healthcare.

While some of these reports are troubling, there is always more than one side to the story. I am a U.S. immigration attorney specializing in offering a complete immigration solution to foreign doctors relocating to the United States, by helping them secure a work visa, permanent residency, or green card, and ultimately U.S. citizenship. We can also help foreign doctors to find employers in the United States if they are unable to do that on their own because many of our healthcare clients always need good doctors especially in remote areas where people do not have good access to a doctor in the Unites States. I help my clients achieve their dream, especially if that dream is to immigrate to the Unites States.

Most of my physicians clients are European and Asian, and much fewer are African. I know it is critical for African countries to be able to retain their qualified doctors. However, at the same time, some of the countries are in such a dire situation that the doctors may be risking their lives on a daily basis just to survive there. Also, there are many specialists who simply cannot practice their specialty back home because of a lack of equipment and facilities, for example: radiation oncology. So the talent and knowledge of these doctors will be wasted if they go back. Investing in cutting edge medical equipment and facilities is something that is lacking in many countries in Africa due to budgets and political issues. So that is not something that is likely to be resolved in the near future.

Most of the physicians that I had the pleasure to help over the years are not the cynical type who will sell their services to the highest bidder and very few of them choose medicine just for the money or lifestyle that it provides. Most of my clients have a true desire to help cure others or improve the lives of their patients. Many of my clients provide service to the remote areas in the Unites States for Americans that otherwise would not have access to a doctor. A number of my clients actually help by contributing their brilliant minds to medical research, helping cure several types of cancer, diabetes, Parkinson’s disease, and other ailments. So it is true that the Unites States offers a better quality of life for doctors and their families and that is a huge consideration in their careers and choice over the long run. However, it is not easy to immigrate here as a foreign doctor and there are many steps along the way where someone can fail, so not everybody can get in. Actually there are less foreign physicians today coming for residency in the United States compared to 5 to 10 years ago because of the tightening of the rules. On the other hand we need more of the brilliant doctors to really come here to help cure diseases and be involved in cutting edge research that they cannot do anywhere else.  READ MORE

Large banks and brokerage firms are in the news again, with word that J.P. Morgan Chase suffered a $2 billion loss while trading for its own investment portfolio.  If you're inclined to be amused by such things, word had apparently leaked out weeks before the losses were spotted that a mysterious individual dubbed "The London Whale,” who we now know is Bruno Michel Iksil, was taking strangely large positions in credit default swaps linked to corporate bonds.  The London Whale was the head of JP Morgan’s Chief Investment Office—a group that was supposed to be in charge of hedging the bank’s credit exposure.

Other traders described the unusual market activities to the Wall Street Journal who then reported on April 6th that the London Whale was rattling debt markets with these large positions.  The WSJ reported on April 10th that the London Whale and his associated group at JP Morgan had stopped trading the positions.

On April 13th, JP Morgan CEO Jamie Dimon described the issue as a “tempest in a teapot” when responding to a question if JP Morgan’s trading operation posed significant risks to the bank. The bank’s CFO went on to say that JP Morgan was very comfortable with the positions they have and that the operations were merely “protecting the balance sheet.” 

During a hastily arranged conference call on May 11th, Jamie Dimon announced the firm’s $2B trading losses and said, “In hindsight, the new strategy was flawed, complex, poorly reviewed, poorly executed, and poorly monitored. The portfolio has proven to be riskier, more volatile, and less effective as an economic hedge than we thought.”

These stories prompted some to speculate that the firm's risk management department stayed diligently on top of the firm's speculative trading activities by carefully reading the newspaper.  READ MORE

Not all REALTORS are created equal. Selecting the right real estate professional will save you lots of time and money. When you are pressed for time and new to the area, it goes without saying that you want to pick a real estate professional who understands the busy lifestyle of a physician. Below are five skills and services that you should quiz a REALTOR about before choosing to work with them.

Works around your schedule and communicates electronically.
Doctors do not work a typical 9-5 day and are pressed for ‘free’ time. Therefore, your real estate agent should work around your schedule and be available ‘after hours’ to communicate with you.  Equally important is how they communicate.  Email and text messages are often much more efficient and effective than phone conversations. Most of the communication during a real estate transaction, both pre and post purchase and sale, can be effectively handled via email. It provides a written record of all communications, allows documents to be attached, references web sites and can be written and checked any time of day. Make sure the agent you select is comfortable with advanced email usage.  Amazingly enough, there are many agents who do not check their email as often as they should in order to communicate effectively.  Text messaging can also be a big time saver. Try texting a prospective agent to see how quickly they reply back as a test.

Provides useful, current community information regarding towns, cities, schools, and amenities.
Part of the decision to take a new job is based on the neighborhood and town you will be living in. You’ll want to know what the schools are like, where the highways are, what types of recreation are available, and what it is like to live in a new town. Your real estate professional should be able to provide you with extensive information on the towns you are considering.  Some knowledge may be from personal experience and other data will be online. The real estate agent who understands how precious a doctor’s time is will do the research and condense the information making it easy for you to compare neighborhoods. If you are moving from out of state, the real estate agent’s ability to research and communicate the resources you need to make an informed decision about where you live become even more important.

Gather and prepares real estate market data so you don’t over pay.
Once you narrow your search to a geographic region, you’ll need to know what the real estate market looks like. What is the average sales price? What are the short and long term trends in these towns? How is the market performing in different price bands? Is the upper price tier improving faster than the general market? Working with a real estate agent who knows how to gather and interpret this data can help you save thousands during negotiations. Before you commit to an agent, ask them how they research comparable sales and ask for some sales trend graphs to be emailed to you.

Preview and documents homes for sale.
If you are transferring from more than a few hours away, it can be difficult to get away to tour and preview homes.  A real estate agent used to working with out-of-state buyers understands this and will offer to preview homes, document them with photos and/or video, and post that content online for your review. This process can save extra trips to your new city and save you from looking at homes that do not fit your criteria.  READ MORE

By Tony Kendzior, CLU, ChFC

Last month I posted a blog entitled “Malpractice Insurance – The Financial Black Hole”. The “black hole” analogy is that regardless of how well you practice medicine, and have few or no claims against you, those premium dollars are gone forever. Over a career in medicine, that can be a huge sum. Well, not anymore.

I practice finance in the State of Florida. The Florida Office of Insurance Regulation publishes an annual report, the latest of which is entitled 2011 Annual Report – October 1, 2011. This document summarizes the medical malpractice insurance market in Florida and the following numbers come from this report.

In 2010, total earned premiums paid in Florida for Medical Malpractice Insurance totaled $559,038,326. Direct losses incurred were approximately $140,000,000. Much of the difference was used to pay 1) Agent commissions and brokerage fees; 2) Taxes and licensing fees; and 3) Defense cost containment. 23 companies licensed in Florida accounted for 80% of the above earned premiums.

The report also states that “the average countrywide return on surplus for Florida’s leading medical malpractice writers was 12.2% in 2010, which represents the seventh consecutive year of profitability.” And yes, the premiums for coverage in the State of Florida are trending downward, but premiums in the $40,000 – $60,000 range per year are still considered normal.

While no one disputes the need for this coverage, no one, until recently, has figured out how to reward those insureds whose practice habits largely preclude claims and as a result, have and maintain a stellar record as their medical career unfolds. Until now.

You can purchase a medical malpractice insurance policy, with coverage similar to what you have now, at a similar price, from Physicians Benefit Resources Risk Retention Group. This company is currently approved to sell medical malpractice insurance coverage to physicians in 14 states, one of which is Florida. As one of those RRGs referenced earlier, it has the ability to be registered in any of the 50 states where there is a demand for coverage.  READ MORE

By Hale Stewart

I've written the ten questions of captive insurance to help prospective captive insurance company owners determine if forming a captive is an appropriate decision.  

Even if you have an insurance policy, it’s likely there are big gaps in your coverage. For example, most manufacturers have inadequate (or non-existent) product liability and product recall insurance. As an example, several years ago, I formed a captive for a company that made parts for the aerospace industry.  While they had a standard commercial general liability policy, they did not have coverage for product liability and product recall -- which was an obviously large exposure.

Another example is more recent and occurred while I was looking at an employment practices policy for a company that had an annual cap of $300,000 — which is not going to provide adequate coverage in case of a large claim. 

In short, most policies don’t have adequate coverage for certain risks that, should they occur, could seriously jeopardize a company’s financial well-being.  A captive insurance company can help to fill gaps in coverage, ultimately creating what I call an insurance tapestry where third party policies cover standard risk and the captive covers specialty risk.   READ MORE