THIS MONTH’S ADVISOR IS SONSORED BY…

Integrative Practice Solutions is a complete turn-key practice system that follows a proven model of success established in dozens of multi-million dollar earning multi-disciplinary practices nationwide. Our approach is simple, effective, and easy to duplicate. The secret lies in the fact that while insurance as a whole is being overhauled and reformed on Capitol Hill and in boardrooms nationwide current Medicare recipients have been excluded from coverage reductions and can be targeted as highly profitable niche group. In addition to this fact there are certain treatments that naturally appeal to Medicare recipients such as Viscosupplementation a unique treatment designed to specifically address and correct pain and loss of function associated with Osteoarthritis of the knee. In 2007–2009, 50% of adults 65 years or older reported an arthritis diagnosis. Even worse; 676,000 total knee replacement surgeries were performed in the United States in 2009 alone. This large and highly profitable new patient group is DESPERATELY seeking non-surgical alternatives to knee replacement surgery that actually works. Our system focuses on teaching doctors, physical therapists, and practice owners from across the US how to duplicate our proven successful business model that targets this group and achieves nearly perfect clinical outcomes. Integrative Practice Solutions brings together a diverse, accomplished, and experienced hands-on support team unlike any other practice improvement system available. Our team includes experts in the field of marketing, clinical application, business management, billing, coding, compliance, and much, much more. Our approach is direct, involved, and does not rely on you becoming an expert in every aspect of business, or implementing every strategy yourself. To learn if this opportunity may be right for your practice, schedule a “risk free” site visit by calling: 855-854-6332 or visit www.integrativepracticesolutions.com for more information.

MD Preferred Services is the only comprehensive online resource center for doctors. Each year MD Preferred identifies and promotes uniquely qualified, "doctor friendly", community based preferred professionals from a wide range of disciplines including: Attorneys, Realtors®, Mortgage Lenders, Insurance Agents, Accountants, Commercial Bankers, Financial Planners & Practice Management Services, who are committed to serving the healthcare demographic and offering a superior service experience.

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Personal Finance

Tips & Tools from the world of financial planning Today I’d like to speak directly to young physicians just out of residency or fellowship. Congratulations, you have just moved out of slavery and into the working poor. “Working poor?” you say. “You must be nuts. I just signed a six figure three year contract and my income just tripled.” Ok. Let me ask you a question and you can answer as honestly as you wish. Are you presently saving, consistently, at least 25% of every pay check? I’m talking 25% of your after tax earnings. If you are able to answer yes, than you can pat yourself on the back because you are in the top 5% of young physicians as far as savings go. What many young physicians forget is that you have two big disadvantages to overcome. One, it took you at least seven years longer than your college contemporaries to begin earning. I’m not counting any stipends you may have had. They were meant to keep your cupboard filled with soup, a tenement roof over your head and a half tank of gas in your car. The second problem is medical education debt. And that isn’t going away overnight. So you don’t have as much to work with as you think and you don’t have as much time to save for college education for the kids and a comfortable retirement as you would like. You need to set aside 25% or more of that pay check to have any shot at the future that you dreamed of in med school. Today I’m just going to touch on some of the major mistakes that you may be making that are keeping you from meeting your savings goals.

1. If you haven’t already overspent on your first house you still have time to get some sage advice. Check some

of my precious columns on this topic. Buy what you can afford…not what you would like.

2. If you haven’t already employed a top notch financial advisor and put together a water-tight budget and

financial plan don’t make another single financial decision until you do. Think of your pay check as a sieve

and your budget as the cement that you use to fill the holes.

3. Your car is falling apart. You need a new wardrobe. You haven’t had a vacation in ten years. Your spouse

has supported you throughout your training and deserves some rewards. And you are working hard on

starting your family. Each of these represents a spending trap that can keep you from meeting your savings

goals. Reward yourself and your spouse but do it after you bank your 25%.

4. If you believe that your new social status means that it is beneath you to pay anything but full sticker price

for all that you purchase…you are wrong. Think back to those days when you negotiated for EVERYTHING.

Never pay full price and put the savings in the cookie jar.

5. This may be a tough one to accept, but as the famous comedian once said, “The wise man supports his

spouse in the manner to which she has become accustomed…let her keep her job.” You can reverse the

gender in all parts of that statement but the message is the same. Until you are well established in your

career and the money is truly rolling in, a two income family has a brighter future than one.

6. Credit cards are the enemy. Enough said.

7. If you think you can beat the market than you should be working on Wall Street not in the operating room.

Let a professional handle your investments and stick to what you are trained to do. A fool and his money…

8. If you think you know how much in savings you will need to live at your current level after you retire, you are

probably off by a country mile. Have your financial advisor run the numbers and you will be shocked.

9. Don’t count on social security. It won’t keep the pets fed.

10. As a physician you are truly blessed. Don’t forget to give back some of what you receive.

That’s the sermon for the day. Remember, 25% of what you earn is yours to keep. Pay yourself first.

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REAL ESTATE ADVISOR Tips & Tools from the world of today’s Realtor

Investing in real estate has always been an attractive wealth building strategy for physicians. And although the real estate market from the investor’s perspective has moderated since 2007 when the housing market crash began. The combination of historic low interest rates and property values that have dropped by 30 to 50% is a marvelous combination. And although we may be at or even past the bottom, there is value to be had if one keeps some basic principles in mind.

1. Buy the cheapest house on the block. This basic truism still applies. And for the sophisticated investor that

isn’t afraid to consider distressed properties this strategy has even greater relevance. Purchasing a short

sale, foreclosure or distressed property for $75,000 in a neighborhood where most homes are priced at

$200,000 leaves a good deal of leverage to rehab the property and still retain a nice piece of equity. And

with strong credit it won’t take much of a cash down-stroke to walk away with positive cash flow.

2. Consider a multi-unit property if you are just starting your medical career. Many young physicians coming

out of residency or fellowship with a mountain of medical education debt assume that they can’t qualify for a

mortgage on a single family home let alone a multi-unit property. But the math can be both compelling and

manageable if you are interested in living in one of the units and renting out the others. This may not

represent your dream home near the golf course but it is not impossible to generate substantial equity and

live nearly for free if the deal is well struck. There will be more than enough time to move to the ninth

fairway.

3. If you are a principle in your medical practice and do not presently own your office or for that matter the

entire building, than you should sit down with your financial advisor and learn how to properly structure an

investment in your own space. There are few investments that make more sense or are easier to do. But

there are also some very real legal and tax issues that can jump up and bite you if you don’t’ get the proper

advice.

This may well be the greatest investment environment of our time. Get good advice. Get in the game. Get set for a secure retirement from the returns of a broad real estate investment portfolio.

The Potentially Devastating Impact of ICD-10 on Small Private Medical Practices By Fred Parish, The Profit Experts

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.

Let’s say that a worker breaks his arm on the job and goes to an outpatient center for treatment. The doctor charts

the patient diagnosing the location and severity of the break and treats the patient, documenting each step. The

doctor may or may not be completely aware of every aspect of new ICD-10 standards as they apply to the tens of

thousands of potential patient presentations he may face. Once he has completed treating the patient his chart

enters the reimbursement pipeline. The chart is forwarded to the coding company (5-7 days).

The chart is assigned to a coder who attempts to read and understand the chart and apply new ICD-10 codes (2

days). The coder discovers that the doctor has not provided the needed information in great enough detail and kicks

the chart back to the coding company who in turn kicks the chart back to the practice who in turn kick the chart back

to the doctor. At best the chart is now over two weeks old.

The doctor in all likelihood has no distinct recollection of the patient and even if the doctor could recall the event in

detail may not understand what revisions to the chart are needed. But let’s, for the sake of argument, assume that

changes are made and the chart works its way through the pipeline and arrives at the billing company properly

coded (or as properly as anyone can determine). The chart is now probably 30 days old. The billing company

forwards the chart to the payer (private insurance company, Medicare or Medicaid) and the process comes to a

screeching halt.

No one is sure how the new ICD-10 classifications will be processed by payers. Even the payers are not yet able to

provide useful guidelines. And once new standards are established it is very likely that a significant percentage of

claims are going to be denied on what amounts to technical coding errors. At which point the chart retraces its

journey and ends up back on the doctor’s desk 90 days later. In the past these charts might represent 5% or less of a

practices claims. And in many cases the claims are simply written off as a budgeted cost of doing business. But now

the numbers are simply too significant to ignore. And unless the industry comes to grips with the problem, many

small medical practices could be facing collapse.

As a result of all of these new threats to a practice’s very survival, practice managers are turning to a new breed of

medical practice consultant who is prepared to take on the responsibility of analyzing the impact of variations in

patient mix, shifting fee schedules and changing reimbursement rates as well as all other operating factors to

optimize the return on the clinical efforts of the groups providers.

For more information on how your practice can minimize the impact of ICD-10 you can call 214-383-0500 or send a

request to info@profit-experts.com.

THE RECRUITER’S CORNER Tips and Tools from Today’s Physician Recruiter

If you are a resident or fellow getting ready to plunge into the interview season, here is an approach that you won’t hear from your colleagues and professors. I like to call it “walk-a-mile in their shoes.” Yes it is important to properly format your CV and yes a good cover letter is essential in getting the interview. You definitely want to dress for success. But if you want to really prep yourself for the coming interview(s) you may want to spend some time in the shoes of the interviewer. Here are a few techniques to consider: If you go online you can find a virtual encyclopedia of articles and blog posts on the art of acing the interview. And these are a great resource. But change your key search words to “conducting an effective interview” and you will find an equally massive body of advice that interviewers study. Find out what the interviewer has been trained to look for and make sure you have what they are looking for. Study the top 20 questions that interviewers are trained to ask and study the answers that they want to hear. And don’t avoid the tough ones in the hope that they won’t be asked. Be prepared to discuss everything that makes you uncomfortable in the clear and certain knowledge that you will be asked. Ask about the structure of the interview and with whom you will be meeting. These are fair questions and you have the right to expect honest answers. If you are going to be facing the senior partners of the practice DO SOME RESEARCH. Find out where they got their medical training. What would you want to know about them if you were considering them for a position in your practice. You will certainly be encouraged to role play for the interview. And again, this is good advice. Articulating answers to anticipated questions in a simulated interview can give you confidence when it comes time for the real thing. But here is a twist that will give you some unique insight. Play the role of the interviewer and pair up with a colleague. Grill him or her with the toughest questions you can imagine. Toss every curve ball you have. And then evaluate how your colleague handled the interview. Share ideas of how things could have gone better. Arrive on time, wearing your best threads, carrying your sparkling Curriculum Vitae and armed with the confidence that you have spent some time inside the head of the interviewers. “Know thy enemy” may be a bit over the top. But at the very least “know thy interviewer.”

MD Preferred Services is the only comprehensive online resource center for doctors. Each year MD Preferred identifies and promotes uniquely qualified, "doctor friendly", community based preferred professionals from a wide range of disciplines including: Attorneys, Realtors®, Mortgage Lenders, Insurance Agents, Accountants, Commercial Bankers, Financial Planners & Practice Management Services, who are committed to serving the healthcare demographic and offering a superior service experience.

NEW HEALTHCARE OPPORTUNITIES

Provided by MedicalMatch.org

Emergency Medicine - Atlanta, GA - EmergiNet You may know Atlanta as the unofficial capital of the South, but there’s more to this city than its southern location. If you make your home in the Peach City, you’ll find an undeniable mix of Southern charm, sophistication and traditions. Atlanta continues its reputation as a transportation hub with the world’s largest airport and easy access to I-75 & I-85. When it comes to Atlanta’s reputation for growth and innovation, health care tops the list as the city’s facilities expand and improve services across the metro area. Serving some of the fastest growing hospitals is EmergiNet. EmergiNet has positions available for BC/BP, EM residency trained physicians for work in hospitals surrounding the Atlanta metropolitan area. We work as a team emphasizing quality emergency care, dedicated customer service, professional and personal growth. Highlights include: Fee-for-service model having most MD’s starting at around $350k with no ceiling; Profit sharing plan after first year including tax-deferred compensation to supplement 401k(100% vested immediately); Physician-centric practice owned and run by physicians; All facilities located within 30 minute drive from downtown Atlanta. EmergiNet provides a full range of clinical and administrative professional services to the facilities we serve. Our mission is to maximize patient care and facility resources, as well as educate, facilitate and integrate the delivery of health care within the community. We continually seek ways to enhance the level of excellence and quality in the services we provide to our clients. To review this and other opportunities E-mail CV to Neil Trabel, ntrabel@emerginet.com; fax 770-994-4747; or call 770-994-9326, ext. 319. Please visit www.emerginet.com for more information.

MD Preferred Services invites you to join our LinkedIn group

Networking for Healthcare Professionals is all about our members and the healthcare industry

coming together. Share ideas, opinions and industry news. Establish connections with other MDP

members and share your knowledge with the healthcare field. The goal of this group is to establish

business to physician relations as well as physician to physician networking. We also hope that this

will become a resource for physicians and healthcare professionals looking for tools to help them grow

in their career or career search and meet their everyday needs.

Diagnostic or Interventional Radiologist – Providence, RI A great opportunity for Diagnostic or Interventional Radiologists to join a well-established Imaging Network in Providence, Rhode Island. The group is open to a Diagnostic; Interventional or any other subspecialty you possess. Excellent compensation offered along with generous benefits. In addition, there would be an opportunity to teach and or do research, if desired. One year to partnership for an experienced Radiologist and Two years for a new grad. There is no buy-in…! 1:6 call. Providence has a lot to offer and is just under 45 minutes to Boston. OBGYN – Indiana Exceptional opportunity to join a busy, vibrant team Call 1:6. State of the art Medical Center. Very competitive compensation and comprehensive benefits including Educational Loan Assistance, Signing Bonus, Paid Malpractice, Paid CME, Relocation, and much more. This city offers excellent public and private schools, University/Colleges and airport. Enjoy an abundance of cultural and recreational activities including water sports, low tax base, safe

neighborhoods, low cost of living, and more. Enjoy an exceptional quality of life. Indiana is among the top 3 places in the nation in which to practice medicine due to its favorable malpractice climate. (Medical Economics)

Family Practice – Greenville, IL Greenville Regional Hospital, a 42-bed full-service hospital located in Greenville, Illinois, is seeking a BC/BE Family Medicine Physician to join their team. The ideal candidate will be interested in performing the full range of Family Medicine, have the ability and desire to build long-lasting relationships with patients and be a part of the community. Greenville Regional Hospital is hospital employed, outpatient only; competitive salary with productivity bonuses; relocation reimbursement and sign-on bonus offered; student loan repayment options; full benefits package including malpractice and tail coverage; rural background or preference for rural medicine is a plus. Greenville, Illinois is located approximately 45 minutes east of St. Louis, Missouri. The home of Greenville College, Greenville is a modern small town that offers solid, Midwestern values and an intellectual feel. The community is close to a major metropolitan area and access to cultural events, shopping, sports and other amenities, yet its residents are able to embrace the advantages of a rural setting with a lack of congestion, pollution and crime. Family Practice – Illinois Excellent opportunity to join a very busy practice adding to their team due to continued growth. State of the art, award winning health system. Very competitive compensation and comprehensive benefits including flexible insurance plan, generous vacation, flexible retirement plan, relocation, Academic appointment available, and much more. Located in a vibrant city with excellent public and private schools and numerous cultural and recreational activities. Easy access to Chicago.

MD PREFERRED PHYSICIAN CONSULTANTS

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physician, a family caregiver, a business owner and an entrepreneur – Dr.

Vicki Rackner helps health care professionals thrive in the era of ObamaCare.

This former surgeon and nationally noted authority in the doctor-patient relationship helps

clients achieve the personal, professional and financial goals that drew them to a career in

medicine. She offers a bridge between the world of medicine and the world of business.

Primary Care – Cincinnati, OH Primary Care Cincinnati, Ohio One of the top integrated health systems in Greater Cincinnati is seeking physicians trained in Family Practice, Internal Medicine, Emergency Medicine, Internal Medicine/Pediatrics or Occupational Medicine to practice in one or more of their facilities. These physicians will staff a Priority Care facility for internal primary care patients, as well as community urgent care illnesses. Employed opportunities located in Cincinnati, Ohio Full-time and part-time positions are available No inpatient or call responsibilities Flexible 2015 start dates New state of the art facilities with fully equipped lab and x-ray services Complete benefit package with malpractice, long term disability, medical/dental coverage, relocation, retirement plan with matching employer funding. Competitive guaranteed base with bonus incentives Weekend and holiday pay differential. To learn more, contact Arleen Richardson arleen.richardson@rmmedicalsearch.com Job #21463

Dermatology – Quincy, Illinois Blessing Hospital is seeking a Dermatologist for a full-time employed position with Blessing Physician Services in Quincy, IL. Must be Board Certified or Board Eligible in Dermatology. The candidate must have a solid work ethic and dedication to providing comprehensive healthcare to patients and their families. The ideal candidate will strive to become an active member of the community, as well as uphold the core values of the hospital.