Doctor’s Rounds™

*The views expressed by the authors below do not represent the views or opinions of MD Preferred Services.


What Do You Really Want Out of Life?

Friday, September 11, 2015

By: Anthony J. Ogorek, Ed.D., CFP
Ogorek Wealth Management LLC
www.ogorek.com

Few questions are more provocative than asking someone, “What do you really want out of life?” Warren Buffett, jokingly said, when asked the question, that now that he is the world’s richest man, he wants to also be the world’s oldest man!
 
His lighthearted response underscores the sense that most of us are uncomfortable answering questions that could profoundly affect not just our outlook on life, but how we live our lives going forward. I was updating a client’s financial plan this week and in the process was taken aback by how little they spend to maintain their lifestyle. They expected to retire years from now, but based on my calculations, they could walk away from work right now without any financial repercussions.
 
I’m sure it will be an interesting meeting when I present them with my findings, because they will then be confronted with the question. They no longer need to work support their lifestyle. No need to save any further. They are financially secure. No need to really do anything they are not interested in doing. Think about it for a moment: how would you answer the question if you were in their shoes?
 
One of the tough things about answering this question is that life typically presents us with conflicting choices and tradeoffs. These choices have consequences that need to be carefully weighed. Typically there are no clear cut choices. Buffett’s answer may be representative of the opinions of most people – they are more interested in extending their longevity, than finding meaningful ways to spend their remaining time.
 
Money can be like a drug. The more you have, the more you want. The pursuit of wealth has tradeoffs. Most people view those tradeoffs as rewards. The seduction of wealth accumulation is that you do things for money, not necessarily for you. So when you try to answer this question, be sure that you are doing the talking, not your money.    READ MORE

 

Keep Calm and Buy Stocks

Thursday, August 27, 2015

By ACap Asset Management

News of recent market volatility alarmed some investors, sending them scrambling to manage loses. But it’s time to take a breath and avoid panic. Those with a solid financial plan and a diversified portfolio needn’t have worried. 

So what is going on? The Dow Jones Industrial Average (Dow) is officially in a correction, which is defined as a 10 percent decline from its peak. The truth is that markets do not always go up, so it is perfectly natural and expected for markets to decline occasionally. In developing and maintaining investment portfolios for our physician clients, we at ACap Asset Management plan for down-markets as well. Not only do we protect against downturns through strategic portfolio design and diversification, but we also capitalize on down days as buying opportunities.  Because we at ACap have been expecting this correction for some months now, we have been intentionally accumulating cash in our clients’ accounts. We use the cash as an opportunity to buy in a down market. It’s like buying stock on sale. Who doesn’t like a good sale? 

But why did the market take a downturn? While there’s really no clear answer to that question, the likely cause is simply consumer panic.  As the market slowly declines, many investors panic and sell too, which fuels the fire. Selling your investments in a panic is a bad idea.  Those who sell their holdings in an acute down market are often times left in a worse position than they would otherwise have been in if they had held their investments through the market decline and waited for the markets to recover. Markets do recover. And while down markets are never pleasant for investors in the short-term, they are good buying opportunities for the long-term term investor with at least a 5-year holding period. Investing with a shorter time-frame does not always allow for the markets to react and recover to the current world headlines.

So what can you do?  READ MORE

 

Insurance Protection for Physicians – pt 2

Thursday, August 13, 2015

By David I. Katz, AAMS®
connect with me on LinkedIn and Twitter
www.davidikatzauthor.com
Insurance Protection for Physicians pt 1

"One of the best ways to reduce the risk of a malpractice lawsuit is to treat every patient with courtesy and respect."
-Kenneth Fox, a partner with McAloon & Friedman, P.C. in New York City

Medical malpractice insurance protects against the financial risks faced by doctors and dentists. Some types of practices - cardiovascular surgery, and obstetrics-gynecology, for example - carry a higher risk of a malpractice lawsuit, and premiums reflect that difference. For example, a new obstetrician in New York might pay an annual premium of $100,000 to $200,000 for $1.3 million in primary insurance coverage.

State laws vary widely in terms of malpractice insurance requirements. In some states, purchasing a policy is mandatory. In other states, a medical professional can post a bond as surety in the event of a malpractice lawsuit, or even drop coverage altogether. In addition, some state legislatures have set caps on damage awards in malpractice cases, reducing the potential financial risk to a practicing physician.

New physicians and doctors who are changing affiliations should also have a clear understanding with the practice or hospital about how a malpractice lawsuit would be handled.

Malpractice liability and insurance coverage may also be affected by the structuring or a group practice or collaborative arrangement, such as an accountable care organization (ACO). In a partnership, one physician or dentist may be considered liable for the actions of another partner, said Fox. However, the shareholders in a professional corporation or limited liability company would generally not be liable for another shareholder’s medical malpractice. Instead, a malpractice lawsuit might also be filed against the company as well as the practitioner.  READ MORE

 

How do I hire the right clinical staff?

Wednesday, August 12, 2015

Over the past decade I have been a practice owner and practice manager, as well as a consultant to hundreds of medical service practices of varying scopes nationwide and one of the most common questions I am asked is “How do I hire the right clinical staff?”.

While there are many factors to consider when hiring clinical staff such as; education, experience, professional licensure, “culture fit”, and more there are deeper questions that must be asked in the medical space. In this industry we deal with many regulatory bodies and governing agencies specific to our field such as The Joint Commission (JCAHO), The Agency for Healthcare Administration (AHCA), Office of Inspector General (OIG), and The Food & Drug Administration (FDA), just to name a few… and this is on top of the “usual suspects” such as the Occupational Safety & Health Administration (OSHA). Additionally, we have countless legislative requirements to comply with such as The Healthcare Insurance Portability & Accountability Act (HIPPA), The Health Information Technology for Economic and Clinical Health (HITECH), The Physician Quality Reporting System (PQRS), The Meaningful Use section of The Affordable Care Act (or “Obamacare” as it is more commonly referred to), and more… In an industry were the stakes are so high (very literally “life and death” at times) and the penalties for data breach, ethics violations, and other infractions so severe you MUST weed out new hire candidates that have the potential to put your organization at risk, or cause damage. There is no easy way to do this other than asking the “hard questions” some of which I will share below.

*If the above agencies or listed regulations are unfamiliar to you and you are a practice owner, administrator, or Physician please call 855-854-6332 or visit www.integrativepracticesolutions.com right now for a FREE compliance evaluation. Failure to comply with these agencies and regulations can result in reduction of insurance payments from federally funded programs such as Medicare and Medicaid, suspension or revocation of your clinic or professional license, fines, penalties, and civil or criminal prosecution. IPS, Inc. and I specialize in helping individuals and organizations navigate these oft complex waters with a proven track record of success.

When it comes to hiring clinical licensed staff I have interviewed for positions ranging from Nurse to Neurosurgeon, yet regardless of the level of license, the following questions are always necessary to ask:  READ MORE

 

Collision of the Plans

Monday, August 10, 2015

By: Anthony J. Ogorek, Ed.D., CFP
Ogorek Wealth Management LLC
www.ogorek.com

There are any numbers of people who are pitching ways to get rich. They know that there is no magic to saving regularly and then investing intelligently. So actually leveling with you will not be effective. They need to provide you with a shortcut. Now that has appeal to people.
 
Shortcuts have been used for years to not only sell us dubious propositions, but to make the purveyors wealthy. For instance, you may recall sure fire weight loss schemes that require just taking a pill; or wearing a garment that will melt the pounds off of you, or offer you a return that you know is too good to be true.
 
In a sense you can’t blame us for falling for shortcuts since we all have limited time, and want superlative results. In our experience financial shortcuts may not just disappoint you, but can cause permanent damage to your financial health.
Creating and maintaining a financial plan can be a real effort. The payoff is that you have reasonable assurances that you will not outlive your money, and are managing the full array of risks that can tank your lifestyle. People without a plan often substitute a number for a plan. In other words they boil their future financial security down to a number or two. They may say that they need $1 million in assets and a 5% annual return to hit their retirement objectives. That is their plan.
 
This motivation is so powerful that even some people who already have successful financial plans persist in ignoring their plan and pushing for their number. The danger with this approach is that you may be forcing yourself to accept more risk than necessary to meet your objectives.
 
You may also deprive yourself of one of the most important things in life, peace of mind. Constantly worrying about the future is nobody’s idea of a good time. It is also no fun when you realize that your number forced you to live much more frugally than necessary. I am all for simplification, but mapping out the next 20 or 30 years requires more than a number and a hoped for return on your portfolio.  READ MORE

 

Checking Up On Your Estate Plan

Monday, July 27, 2015

Brought to you by Charlotte A. Dougherty
In conjunction with Lincoln Financial Advisors, a registered investment advisor


You have an estate plan; you probably even remember creating it—making the decisions and pulling together the documents was probably a time-consuming and tedious effort. The initial process of creating an estate plan can be so painful and involved that people may avoid reviewing it again for years. 

But your estate plan does not exist in a vacuum. Life events such as marriage, separation, divorce, births, deaths, relocations and tax law changes all impact your estate planning needs. By revisiting key elements of your estate plan annually, you can correct errors, make adjustments for life changes and guarantee that your current wishes are known. Here are some items to review:  READ MORE

 

Navigating the Top Five Retirement Risks

Friday, July 24, 2015

Brought to you by Charlotte A. Dougherty
In conjunction with Lincoln Financial Advisors, a registered investment advisor


Longer lives and better health translate into longer retirements and new concepts of what retirement should be. Many of today’s retirees view retirement as a time to shift gears but not necessarily to slow down.

They keep their skills sharp in new job roles or by starting businesses. They continue learning new skills by going back to school as both teachers and students. Some choose to serve on boards of directors or to pursue creative and artistic passions. 

However you define retirement for yourself, the bottom line is that you want to have enough money to live your life without constantly worrying that you’ll run out. It certainly pays to be prepared and to stay on plan.  READ MORE

 

Insurance Protection for Physicians – pt 1

Thursday, July 23, 2015

by David I. Katz, AAMS®
connect with me on LinkedIn and Twitter
www.davidikatzauthor.com

Successful medical professionals accumulate assets as they build their net worth, but it’s important to protect those assets from a variety of perils, including losing all your savings and having to start over again. Managing those risks in a cost-effective manner, while still saving and investing for the future involves maintaining a delicate balance. 

Purchasing insurance protection is an important piece of the financial package you should assemble as you begin your professional career. There may be financial benefits in purchasing multiple types of coverage from one insurer, and you may also have the benefit of single-source accountability. You should also consider your income level, personal circumstances and personal wealth as you make decisions about coverage.  READ MORE

 

A Number is Not a Plan

Monday, July 13, 2015

By: Anthony J. Ogorek, Ed.D., CFP
Ogorek Wealth Management LLC
www.ogorek.com

There are any numbers of people who are pitching ways to get rich. They know that there is no magic to saving regularly and then investing intelligently. So actually leveling with you will not be effective. They need to provide you with a shortcut. Now that has appeal to people.

Shortcuts have been used for years to not only sell us dubious propositions, but to make the purveyors wealthy. For instance, you may recall sure fire weight loss schemes that require just taking a pill; or wearing a garment that will melt the pounds off of you, or offer you a return that you know is too good to be true.

In a sense you can’t blame us for falling for shortcuts since we all have limited time, and want superlative results. In our experience financial shortcuts may not just disappoint you, but can cause permanent damage to your financial health.

Creating and maintaining a financial plan can be a real effort. The payoff is that you have reasonable assurances that you will not outlive your money, and are managing the full array of risks that can tank your lifestyle. People without a plan often substitute a number for a plan. In other words they boil their future financial security down to a number or two. They may say that they need $1 million in assets and a 5% annual return to hit their retirement objectives. That is their plan.

This motivation is so powerful that even some people who already have successful financial plans persist in ignoring their plan and pushing for their number. The danger with this approach is that you may be forcing yourself to accept more risk than necessary to meet your objectives.

You may also deprive yourself of one of the most important things in life, peace of mind. Constantly worrying about the future is nobody’s idea of a good time. It is also no fun when you realize that your number forced you to live much more frugally than necessary. I am all for simplification, but mapping out the next 20 or 30 years requires more than a number and a hoped for return on your portfolio.  READ MORE

 

Don't let the additional work of ICD-10 drive you into physician burnout

Monday, July 06, 2015

In my work with hundreds of over stressed and burned out physicians, one thing is constant. Documentation is always one of their biggest sources of stress. 

In fact, if you ask the average working doctor to make a list of their top five stresses, documentation chores will take up three of the five slots.

EMR - especially if you use multiple EMR software programs that don't talk to each other
Dealing with lab reports and refill requests
Returning patient and consultant calls and documenting them adequately
and all the other places information streams have to be forced together by the sweat of your brow.

The average doc is walking the cliff edge of overload on a significant number of office days in any given month. Now comes ICD-10 and my biggest fear is the extra work of the new coding system will push many physicians over the edge into burnout.

How much more time will ICD-10 take?

I have talked with several ICD-10 implementation experts who toss out comments like, "Only a couple minutes per patient", as if that were no big deal. If you see 25 patients a day, that is 50 minutes added to your office day starting October 1st. That amount of additional documentation work will drive many docs over the edge if you don't start preparing now.   READ MORE