The Advisor

By Karen Weinstock, Attorney at Law

It is no secret that the U.S. has a shortage of qualified physicians. Many doctors from foreign countries, many of them are the cream of the crop, choose to relocate to the United States to pursue their careers. The ones who make it through the process to become doctors here are highly desirable and motivated, many of who are giving better healthcare to their patients.
 
“Before being eligible to apply for a post-graduate residency slot in the U.S., graduates of non-U.S. medical schools must go through a rigorous process that tests both the graduate’s education and also their clinical knowledge and skills, so they are verified and re-verified again”, said Karen Weinstock, an immigration lawyer expert in healthcare immigration.
 
According to one study by Health Affairs, U.S. patients of doctors who went to medical school outside the country had a 9 percent lower death rate on average than those whose doctors trained in the U.S. Internal medicine and primary care have failed to attract the best U.S. students because of lower pay, relative to other specialties. U.S. citizens who attended medical schools abroad underperformed graduates of U.S. medical schools. But citizens from other countries who went to school outside the U.S. Internationally trained foreign doctors had a 16 percent lower mortality rate than Americans schooled overseas.
 
“However for a foreign educated physician, internal medicine and primary care still offer attractive salary in comparison to their home countries. True, the cost of living in the U.S. is higher but the overall quality of life is also higher”, added Weinstock, the healthcare immigration attorney.
 
“Since primary care may not be getting the best and the brightest from U.S. medical schools, foreign doctors fill the gap and provide excellent patient care especially in areas where the American doctors may not be interested in going to, including medically underserved areas. Employers will be benefitting their patients and themselves by hiring foreign born doctors”, she concluded.  READ MORE

Provided by Bradly Stevens, a financial representative with SoCal Physicians Financial and Insurance Services, who represents MassMutual and other companies; courtesy of
Massachusetts Mutual Life Insurance Company (MassMutual)

In times like these, good decisions matter. And when it comes to protecting a portion of your
income from disability risks, it’s important to base your decision on the facts. In the case of
disability, some of those facts might surprise you.

For example, more than one-quarter of today's 20 year-olds will become disabled before they retire.1 And if you are covered by a group disability income policy through your employer, you might not know about the likely gap between your policy’s benefits and your family’s actual
needs.

To start with, the typical group plan only covers 50-70% of income. And benefits are often
taxable, have maximum limits, and don’t cover bonuses, commissions or 401(k) contributions. In some cases, worker’s compensation helps bridge the gap, but less than 5% of disabling accidents and illnesses are work related.2

If you run a business, your insurance protection should help cover its operating costs, possibly provide the funds for a partnership buyout, and protect a portion of lost earnings – either yours or your employees’.

The most common way to close the gap between existing coverage and actual needs is to obtain a supplemental individual disability income insurance policy. Because you own it, you can take it with you throughout your career.

And the best way to make a good decision about that policy is to work with a trusted, trained financial professional. No surprise there.  READ MORE

By Glen Gabbard, Physician Preferred Wellness Group

During these challenging economic times, physicians are facing increased expenses, growing government regulation and reduced reimbursement from both private and public insurance.

The latest reductions in Medicare reimbursements may cause many physicians to leave private practice.

At the same time, their patients are facing a number of health issues that require more time and creative solutions from their physicians. Excess weight, elevated cholesterol, sleeplessness and a lack of energy are chronic problems for the majority of our population. The physician of today cannot be someone who simply treats an illness when it surfaces. Today's internet based patient is looking for doctors who offer a wellness focused, preventative oriented practice.

Physician wellness programs have been created during the past decade to provide the tools and education that care givers need to provide meaningful wellness initiatives to their patients. At the same time, the physician is presented with an opportunity to supplement their practice income with a high quality, physician tested, turn-key wellness program.

Typical wellness programs are not tied to insurance reimbursements or co-pays and abide by all Stark Amendment regulations. They normally do not require the physician to hire additional staff, buy new equipment or add to existing office space. Support is usually provided directly from fellow wellness oriented physicians. Programs typically stress treatments that include a combination of prescriptions, PDR listed supplements, exercise, diet and innovative wellness technology.

Groups such as MD Preferred Services screen physician friendly programs and vendors. They identify a national base of companies committed to helping doctors and medical professionals manage and improve their business and personal lives. "Doctors are very busy professionals," observed Michael O'Malley, CEO of MD Preferred Services. "When it comes to finding service providers and creative business partners, they appreciate an organization that has done much of the work for them."  READ MORE

By Cyndi Carver

To sell or not to sell, that is the question. I know there are people out there that are in the same boat we are in. We are making our payments on time, we are stretching to make our payments on time. But we can't sell our home because we are upside down (more owing than the value of the home). We met, fell in love and both sold our homes at the peak of the market (didn't know it was the peak at the time) and bought at the peak of the market. Lo and behold, 6 years later, our huge down payment has disappeared into thin air!

Well, we were told that we couldn't get a loan modification because we weren't behind. We couldn't refinance because our loan to value exceeded the 110% (congress said to go up to 125% but none of the lenders went along with that, at least not the ones we talked to). Our loan wasn't sold to FNMA or FHLMC, so we didn't qualify for that program! Than earlier this year, Congress approved this program whose loan wasn't sold to FNMA or FHLMC. Boy, were we excited! We trapes down to the bank and said, okay, we now qualify. Then after they looked up our loan, they said, no we don't. Why, I thought they just approved that program for us non-fannie freddie people? Oh, that's only for the people who took out their mortgage after 2008! Those people were the ones that were mistreated by the big lenders, according to the study, and people with those loans were going to be compensated. I was beginning to wonder if they took our loan and wrote programs around our loan so that we wouldn't qualify no matter what new program comes out.

So, what to do what to do? Well, we decided that we were going to continue to keep the house in fine shape and working order. Improve on things in the house that needs to be improved on and someday soon, when the economy improves and value of homes start ascending again, the condition of our home will still be in top shape so the it is not descending. Somehow, if we maintain the condition of our home rather than let it descend, it will someday even up.

That being said, we are off to the remodeling show to keep up with the current trend in kitchens, bathrooms, floorings and colors. After all, we still have to live in our house, so we might as well keep this one looking as new as possible.  READ MORE

If you want to give your portfolio every chance of success, do not overlook Risk. Managing risk may be the single most important element to a portfolio's success yet I am often surprised how much risk self-proclaimed "conservative" investors are exposing them to. Here are 4 questions every investor should ask themselves on a regular basis: 


1.     Do I have too much risk? 

2.     Do I have enough risk? 

3.     What is the appropriate amount of risk for my particular circumstances? 

4.     How do I quantify risk in my portfolio?

I recommend reviewing market related portfolio’s quarterly, as I do with my clients, to determine the answers to these questions. Very often no change in the amount of risk is necessary if properly allocated in the first place, especially if a portfolio is reviewed regularly. However, over time risk tolerance does and should shift towards a more conservative approach, absent of any sudden and dramatic life changing events such as illness, death of a spouse, divorce, etc.

So let’s look at these questions a little more in depth; as in building a house, let’s start from the bottom up. You have to have a strong foundation or what you build on top of it is likely to crumble.  READ MORE

By Stacie Strassberg, Mortgage Planning Specialist, California Mortgage Advisors, Inc

Despite what you may have heard or read, employers do not have access to job candidates' credit scores. That should come as a relief to cash-strapped job seekers with maxed-out credit cards or other score-busting blemishes.

But your prospects for getting hired aren't immune from a poor credit history. In most states, employers are able to check a potential or current employee's credit report, which lists information such as balances on your loans and credit accounts, late payments, and debt collections.

About 13% of employers check credit reports for all candidates and 47% check for those applying to selected positions, according to the Society for Human Resource Management. Employers are usually most interested in the credit backgrounds of applicants who will handle finances, hold an executive-level position or have access to other employees' confidential information (such as human-resources professionals). The black marks that might give an employer pause are ones that leave the deepest stains on your record: a loan default, a bankruptcy, a debt that's gone to collection.

An employer must obtain your permission to pull your credit report. But declining is "like saying no to a Breathalyzer test," says John Ulzheimer, president of consumer education for SmartCredit.com. "The consequences are sometimes worse than just getting it over with," he says – namely, the employer could choose another applicant for the job if you are secretive.

Be honest and upfront about any problems. A potential boss may be sympathetic to the financial trauma that a layoff and long bout of unemployment have caused. And keep in mind that your credit record is only one piece of your profile. According to the SHRM, credit history ranked lowest among criteria employers used to vet candidates.

Reprinted with permission. All Contents ©2012 The Kiplinger Washington Editors. www.kiplinger.com.   READ MORE

As parents age, their children often must become increasingly involved in their daily lives.  Physical issues such as diminished mobility, incontinence and impaired eye sight can have a profound impact on the simplest of daily activities.  Social isolation is often a byproduct of such health issues.  Mental health and acuity can magnify physical problems as well.  

As this author has moved into the daily minefields of parental care, I can testify to the challenges involved in meeting a senior’s needs.  One of the greatest of these challenges is finding out where to look for help.  A short list of the questions that a caregiver faces includes:

•    When is it time to move a parent from their home into an assisted living environment?
•    How do you help your parent accept and adapt to the need for assistance?
•    Where do the financial resources come from to pay for an assisted living facility?
•    What role should medical professionals play in helping with these life challenges?

In future blog posts I hope to address the issues that adult caregivers face with their parents.  I’ll share resources, strategies and tips that I receive from professionals, friends and my own parents.  I hope our readers will forward their experiences and advice as well.

Stay tuned.  READ MORE

Jonathan Fleece is a leading health care attorney in the U.S. and the co-author of The New Health Age: The Future of Healthcare in America.

Depending on which economist has the stage, America's economy is either experiencing slow growth, remains dismally flat, or stands ready to fall off a cliff. Nearly everyone agrees that the economy needs help. The nation's debt and budget deficits are reaching, or have already reached, fiscal crisis levels. Historians will analyze someday how close the United States came during this period to reaching the economic breaking point as a nation. Truth be told, some fear that the breaking point may still occur.

The health of Americans is in shambles. This fact is certainly a contributor to the nation's weak economic strength. How can the nation's fiscal status improve if the country's state of health remains so poor?  READ MORE

Let's be clear, while I'm not a fan of these products, I'm not dismissing them either. My major beef with Equity-Indexed Annuities (EIAs) and related products with similar names is the way they are sold. This often involves preying on the fears of investors as a major theme.

According to FINRA's website: "EIAs are complex financial instruments that have characteristics of both fixed and variable annuities. Their return varies more than a fixed annuity, but not as much as a variable annuity. So EIAs give you more risk (but more potential return) than a fixed annuity but less risk (and less potential return) than a variable annuity. EIAs offer a minimum guaranteed interest rate combined with an interest rate linked to a market index. Because of the guaranteed interest rate, EIAs have less market risk than variable annuities. EIAs also have the potential to earn returns better than traditional fixed annuities when the stock market is rising."

First of all, in my opinion, no financial adviser should lead with the suggestion of a particular financial product. This is akin to a doctor suggesting brain surgery when he hasn't even examined the patient. The right way to start a financial relationship is via a financial plan. Only then should implementation via financial products begin.

Understand that EIAs and many other variations of this type of product are quite lucrative for the registered rep. While this in itself isn't bad, potential buyers of EIAs need to understand this and to realize that these lucrative payments are coming out of the returns they could be earning and could be behind the enthusiasm many reps have for selling EIAs.

FINRA cites several concerns and suggests asking many questions before purchasing an EIA. A few of these concerns are summarized below.  READ MORE

If you sell your house after 2012 you will pay a 3.8% national sales tax on it.  That's $3,800 on a $100,000 home.  When did this happen?  It's in the health care bill and goes into effect in 2013.  If you sell a $400,000 home, there will be a $15,200 tax.  You do the math.  

This bill is bad news for the retiring generation who often downsize their homes.  What an interesting coincidence that this “healthcare reform” policy goes into effect AFTER the November elections.

"Democracy is two wolves and a lamb voting on what to have for lunch.  Liberty is a well-armed lamb contesting the vote." -- Benjamin Franklin  READ MORE