Doctor’s Rounds™

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

Physician Burnout Rates Top 50% in latest Mayo Study

Monday, December 14, 2015

By Dike Drummond MD, CEO

- Over 50% of US Physicians now suffering at least one symptom of burnout
- Depression and suicidal ideation rates even more concerning

In our work with thousands of over stressed and burned out doctors, it has been clear that burnout rates in the USA have been rising in the last several years. There is just too much political chaos, marketplace M&A activity and documentation overload for it to be otherwise. 

Finally the research has caught up with our suspicions in the latest version of Mayo's landmark 2011 physician burnout study. Here is our smoking gun at last. 

Sure, burnout rates are up an additional 20% but that is not the most concerning finding.



Four things you need to know about long term care

Monday, December 07, 2015

By Melissa Barnickel- Baygroup Insurance

Chances are, you are going to need it.
70% of today’s 65-year-olds will need long term care at some point.

That means… Only 3 of 10 persons over age 65 will not need assistance with bathing, dressing, eating, transferring,* toileting, continence or cognitive impairment. 

Feeling Lucky? Or do you think it might be time to learn more about how issues related to long term care can impact your future? ….just in case, that is.  READ MORE


The Great California ShakeOut. Are you ready for an emergency?

Thursday, November 19, 2015

On Thursday, October 15, 2015, schools, universities, government agencies, and businesses across California participated in The Great California ShakeOut.  We all know how important it is to be ready with a plan in case of an emergency like an earthquake. Not only did our children participate in this earthquake drill at school, but here at ACap we also participated in the #ShakeOut. Drills and emergency kits (we update ours yearly with medicines, nonperishable foods, clothes, batteries, etc…) are vital for the moments during and immediately following an emergency. But what happens after the ground stops shaking? Equally important to practicing procedures and preparing a physical emergency kit is establishing and maintaining a financial emergency preparedness kit. What is a financial preparedness kit?  READ MORE


Beware of What You Ask For

Thursday, November 12, 2015

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

This week I attended a meeting of the local estate analyst community. This group is comprised of some very high-end accountants, attorneys, and advisors, among others, who were being briefed on some of the intricacies of stretching out required minimum distributions from retirement accounts. Toward the end of the presentation it occurred to me that the advice they were giving, although technical in nature, could conflict with why any of us save money in the first place.
The thrust of the presentation was a reaffirmation of what all of us have been trained to advise our clients: in order to save taxes, defer payments from retirement accounts for as long as possible. “Success” is viewed as keeping the greatest amount of money from Uncle Sam’s hands. The only drawback with keeping it out of our Uncle’s hands is that it also keeps it from our hands! To better frame this conflict, how would you answer this question: ‘Who is wealthier, someone with a $1 million account who refuses to spend it, or someone with $100,000 who intends to spend it on activities that give him or her enjoyment?’ Obviously this is a very skewed example, but you can appreciate the point: does money really matter if you have no intention of deriving any economic value from it?
I am sure that none of the professionals at the meeting would advocate that a client sacrifice their lifestyle in order to save on taxes. However, if saving taxes is your sole gauge of success, perhaps you need to reassess what having money is all about. No one, including yours truly, wants to pay more tax than is required by law. However, there are situations when denying you just to spite the tax man makes little sense.
In our line of work, everything comes with a price. There are no silver bullets that produce remarkable results without creating tradeoffs in other areas of your life. Before you engage any financial professional, be sure that you carefully weigh what you are looking to accomplish, with the tradeoffs that are sure to accompany any strategies you decide to employ.  READ MORE


The potentially devastating impact of ICD-10 on small private medical practices

Monday, October 19, 2015

After years of delay, the U.S. Department of Health and Human Services (HHS) has finally adopted and implemented the International Classification of Disease – 10th Revision (ICD-10) effective October 1st.  A recent survey by the Professional Association of Health Care Office Management estimates that most small medical practices have invested approximately $2,500 per provider to implement the conversion to ICD-10.  They are advising their members to prepare for a potential sharp rise in claim denials and a corresponding drop in revenue. 

The dimensions of the potential train wreck here cannot be understated.  Many industry experts are predicting a 30 percent or greater drop in cash flow over the first 90 days of implementation.   Some trade associations are going so far as to advise their members to set aside cash reserves and apply for a bank line of credit to cover a 50% drop in revenue!  

The heart of the problem is that there is no way to accurately predict how the insurance industry is going to handle the new demands of ICD-10.  Without going into mind numbing technical detail, payers are having to literally rebuild their bundled reimbursement models for everything from an upper respiratory infection to a heart transplant and every medical event in between.  And until they sort these issues out and provide guidance to the billing and coding contractors no one is quite sure how to proceed.  READ MORE


What Do You Really Want Out of Life?

Friday, September 11, 2015

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

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
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 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

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