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The Advisor - April, 2015

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The Advisor is a unique magazine designed to help resident, fellows and practicing doctors throughout their career and personal lives.

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  • This months Advisor is brought to you by

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  • SHOPPING FOR HEALTHCARE A major bank is about to introduce a revolutionary new credit card that allows the

    holder to purchase anything they wish for a flat monthly fee determined in advance

    by demographic tables and limited only by the items covered by the card agreement

    and the stores and distributors participating in the program. Lets say you are 27

    years old and married with one child. You have been employed by the same

    company for five years and have only a car payment and a home mortgage. Your

    monthly fee for the card would be $800 dollars. But you can use the card to buy

    anything you need without regard to cost.

    Want to buy groceries for the family? Why not go to that new gourmet store that only the upper class use. Has your washer

    conked out? Make sure the new washer you purchase with your card has all the bells and whistles. Why shop at Walmart

    for your jeans? You can afford an upscale store now. Simply shop, present your card and let the bank worry about

    payment. As long as you use the stores in their shopping network, demonstrate that you need the item and purchase only

    items that are covered in the agreement. Interested?

    Of course you would be interested. And of course this new credit card is nothing more than my over active imagination.

    But what I have just described is our healthcare distribution system and the insurance industry that manages it. If one really

    looks closely at healthcare in America it is puzzling that anyone should be surprised that it is a disaster.

    You see, health insurance isnt really insurance at all. It is not designed to only protect us from catastrophic unpredictable

    health events. It is merely a mechanism by which we smooth out a lifetime of healthcare expenses by pooling the costs with

    millions of others and letting someone else manage the distribution. Once we are part of the system, our insurance

    premiums give us a healthcare credit card that we can present whenever we feel that we need services. We do not worry

    whether we are getting the most practical, efficient, cost effective care. We just take the word of the provider and let

    someone else negotiate the cost. We are absolved of any responsibility.

    We dont worry about unnecessary tests because we have pre-paid. We dont worry about leading healthy lives and

    avoiding risks because we have pre-paid. And now that we have Obamacare the healthcare credit cards we carry are even

    more attractive. Insurance companies cannot charge sick people higher premiums than healthy people. They have to cover

    an every expanding range of conditions. They cannot deny coverage to people who have an expensive pre-existing

    condition. And, although Obamacare theoretically requires everyone to purchase a policy, the tax penalties are so absurdly

    low that many healthy young folks are simply saying, Go ahead and tax me. Ill get a policy when I get sick.

    Conservatives stick to the mantra that market forces can deliver quality care and keep costs under control. But, as long as

    consumers can access services without regard to price or necessity, prices will continue to soar. As long as consumers with

    the means to afford insurance can wait till their health deteriorates to purchase it and people who are too poor to afford any

    premiums can still access healthcare through their local emergency room without the ability to pay, solutions to our

    healthcare dilemma will be impossible to find.

    As a consumer you would never agree to purchase a car without knowing what it cost. And you would not order options

    that you could not afford, that you did not need and had no intention of using. And that is because you would be picking up

    the tab. Right now our healthcare is dispensed by providers who determine their prices based not on what the patient is

    willing to pay but rather on what the insurance company is willing to reimburse. As long as the consumer is removed from

    the formula, market forces will never control costs or quality.

  • REALESTATE

    Tips & Tools from the world of todays Realtor

    First you slaved away as a medical student, then as a resident and perhaps as a

    fellow. And when I say slaved I mean just that. You left your medical

    training and entered the real world of medicine and landed a lucrative contract

    with a great practice. The future looks bright and its time to start rewarding

    yourself and your family with some of the perks and possessions that you have

    had to do without for oh so many years.

    But you have to be creative in finding the funding for the nice things of life. After all, you are still paying down medical

    education debt. But everyone is being so nice and so accommodating. You cant afford the down stroke for a luxury auto,

    but a lease doesnt require much up front. And the wise young doc is not going to lease just his or her own vehicle while the

    spouse continues to drive the beater. So add two lease payments to your monthly nut.

    And now its time to purchase your first home and in order to do that you have to secure financing. Perhaps your family is

    willing to help with the down payment. Or perhaps your spouse works and together you have managed to set aside a modest

    amount of your own. And you discover to your delight that many of the major lenders have very special loan programs

    designed just for young physicians (visit www.mdpreferredservices.com and search for mortgage services).

    And then you make a grand discovery. There are folks out there that are willing to lend you a great deal more than you

    expected. You may not even have to tap your savings and your family for a down stroke! Wouldnt it be great to finance

    some well-earned luxury items over 30 years at a relatively low interest rate? Its like getting a consolidation loan up front

    before you even have the debts to consolidate! Stop right there. You are about to make two classic blunders that will haunt

    you for generations to come.

    Number one: you are preparing to make a huge personal investment without the counsel of a professional financial advisor

    and without a financial plan. The reason I am certain of this is that any financial planner worth their salt will not permit you

    to finance personal luxuries with a completely inappropriate financing vehicle.

    Number two: you are preparing to spend pretend money you dont have for luxuries you may not need and can probably not

    afford at this point in your young career. And worse yet you are preparing to burden yourself with a long term liability that

    is tied to the vagaries of the real estate market, placing at risk your familys home. You may be confident that you can

    manage the monthly mortgage payment, permitting you to enjoy those baubles and bangles that you have done without for

    far too long. But when it comes time to move or refinance you may find that your house is under water and that those nice

    folks with the easy terms are unwilling to bail you out.

    A home loan is designed to help you put a roof over your head. It is not an ATM for the good life. Get some advice; create

    a plan; live the plan; and avoid the blunders that so many of your young colleagues will come to regret.

  • THE CHANGING DYNAMICS OF

    COLLEGE HEALTH INSURANCE PLANS

    Unless you have a son or daughter attending college, you have probably

    heard very little about health insurance offered by colleges to their

    students. For decades now most colleges have folded health insurance

    premiums into college tuition costs. This mandatory insurance protected

    students from catastrophic health issues and has generally been much less

    expensive than private sector insurance. But times are changing.

    Obama care is at the center of many of these changes. In the past there was often no choice but to accept the coverage or

    provide proof of more expensive coverage from the private sector. Students generally did not have the option of going

    without coverage and hoping for the best. And for the most part, despite spiraling college costs, the health insurance

    component was a very small part of the payment equation. Because college students are young and healthy they are a highly

    desirable demographic for insurance companies and they were very aggressive in signing up colleges with attractive

    premiums.

    But with Obamacare the equation has change in several very important ways. One provision in the Affordable Care Act

    prevents students from receiving subsidies from the new federal and state exchanges when they receive their coverage from

    the college. In more and more cases, a student can qualify for free insurance through an exchange. This is particularly

    relevant in states that are lowering the bar for Medicaid benefits. Most full time students, even those working part time are

    by definition poor.

    Another result of Obamacare is that young people can stay on their parents health insurance until age 26. This is often a

    much cheaper option than the cost of a policy offered by the college. And with the rapidly rising cost of private health

    insurance, many colleges are simply thinking of getting out of the insurance business altogether.

    But the dark side of all of these new options for students and their parents is that the option of going without coverage is

    now once again on the table. But whether or not a student choses to risk a big ticket health event by going naked, many

    colleges can no longer compete on cost alone.

    One wild card in all of the changes is that state and federal mandates make coverage plans very rigid and inflexible. Many

    college plans still offer wider benefits and choices including lower deductibles. One strategy that works well in some states

    that have lowered their Medicaid thresholds is for a student to drop out of their parents policy, work part time, apply for

    Medicaid in their state of residence and qualify for free insurance. It is perfectly legitimate and increasingly available.

    At the end of the day, families with moderate income who make too much to qualify for Medicaid and who are stretching to

    afford tuition and room and board are putting the choice of health insurance coverage in the hands of their students. And

    with even bare bones, high deductible private plan costing just south of $200 per month, some students cannot pay the

    premium.

    As states continue to work the kinks out of their state exchanges and their Medicaid programs, and as middle class families

    evaluate their insurance options, more and more colleges are going to be taking a very hard look at their student insurance

    policies and consider their options as well.

  • ANOTHER MORAL SWAMP

    A recent headline read, Teen Heart Transplant Recipient Dies in Fatal

    Police Car Chase. The young black male referenced in the article that

    followed was pictured as was the wreckage of his vehicle. And the story

    line casts a light on a seldom addressed moral issue relating to organ

    transplant lists that often determine who will live and who will die.

    Anthony Stokes, 17, received a heart transplant in 2013. He had an

    enlarged heart and without a transplant he had less than six months to

    livea sad but not uncommon situation. Except that it was indeed a most

    unique and perplexing situation. Although his situation was critical and there was no reason to believe that he would not

    survive the procedure, he was taken off the list and refused a transplant by doctors who were convinced he would not

    comply with post procedure medical directions.

    Anthonys mother told the media and all who would listen that she was convinced her son was being denied a transplant

    because of his low grades in school and trouble with the law. The simple fact was that Anthony was in and out of scrapes,

    was in numerous fights in school and there was a real chance that Anthony would continue to have social issues after a

    procedure. To put a point on it, doctors didnt think that Anthony deserved a second chance and there was a real probability

    that he would squander the gift of a new heart.

    Whether or not there was a more deserving candidate, the news coverage lead to sufficient pressure to cause doctors to

    rethink their decision. In August 2013 Anthony underwent successful transplant surgery. Fast forward to Tuesday night. A

    masked gunman shot at an 81 year old woman sitting in her home watching television during a failed burglary. A

    description of the car in which the alleged gunman fled matched the description of a car Anthony was driving shortly

    thereafter. When police attempted to pull him over, he refused to stop and sped away. Police gave chase. Anthony

    eventually lost control, struck a pedestrian and smashed into a pole. Anthony died that night from his injuries.

    So, were the doctors right in their original assessment of Anthonys suitability for a transplant? Although in hindsight the

    answer would seem to be yes, at the time that the transplant decision was made, future conduct could only be guessed at.

    But are past acts and behavior legitimate issues in medical treatment decisions. Bioethicists who are second guessing those

    decisions made two years ago are quick to point out that even convicted felons serving time in prison are sometimes eligible

    for organ transplants.

    This is unquestionably an isolated event that in no way proves any moral argument. But it does point to the moral issues

    that doctors increasingly face as technology provide them with the means to extend life while limited resources force them

    to search for objective criteria to determine who lives and who dies.

    MD PREFERRED PHYSICIAN CONSULTANTS

    Dike Drummond MD is a Mayo trained Family Practice Physician with a unique combination of

    ground level experience in medicine, coaching and personal and business development.

    Dikes expertise in personal change was developed through a combination of 11 years as a family

    practice doctor and 10 years as a business coach working with physicians and startup entrepreneurs;

    he has also developed his own unique, interactive guided imagery practice.

  • PERSONAL FINANCE By Michael A Olson, CFP

    Most people would like to have more money in their bank accounts,

    while working less. Although this may seem like a never-ending

    dilemma, there may be a solution. Think about it: The best way to

    stretch the money you make without working more hours is to avoid

    excess spending in the first place. Some people call this a budget but

    you could just as easily call it a spending plan.

    Here are 10 tips to help stretch your hard-earned cash in today's

    challenging economic climate:

    1. Create a spending plan. Many people resist the idea of a budget because they associate it with hardship and sacrifice. But instead, you can create a monthly spending plan for your fixed and discretionary expenses. By planning your spending, you may find that you spend money more wisely because you're consciously taking

    control.

    2. Pay yourself first. Put savings at the top of your spending plan. If you wait until the end of the month to save any leftover cash, you may find yourself without a cushion when you need it most. Be sure to set a savings goal. For

    example, strive to save at least 10% of your income before spending the rest.

    3. Track your spending. Record your expenditures for a month. Be especially careful about keeping track of any small, optional items you purchase. You may be surprised to discover how quickly purchases costing only a few

    dollars can add up. At the end of the month, review your expenditures and adjust your spending plan accordingly.

    Once you see where your money is going, you may decide to make different choices about your spending habits.

    4. Live within your means. Many people feel as if they never have quite enough money to live on, yet they probably know people who successfully manage on less. If your expenses are less than your income, you are

    living within your means.

    5. Shop for value. Look for opportunities to get more value from each dollar you spend. Join a warehouse or shopping club to buy items in bulk. Purchase clothing, furniture, and household goods on sale. Big-ticket items

    like cars and household appliances often depreciate substantially in the first one or two years. So, you may want

    to consider buying a certified, used car with reasonably low mileage or second-hand appliances in good condition

    for less.

    6. Minimize debt. Keep your debt level low. By reducing debt, you also minimize interest and finance charges. When you are tempted to charge a purchase, remember that you are committing to pay for it from income you

    have not yet earned.

    7. Eat In. Dining out can be expensive, since you are paying for the service, as well as the food. Meal taxes are also added to the bill while liquor and desserts, which you may not ordinarily eat at home, boost the tab even higher.

    Therefore, reserve the fine dining for special occasions only.

    8. Reduce housing costs. Housing is a major fixed expense. Consider reducing this cost by buying or renting a smaller place, or one with fewer amenities. If you rent and plan on staying in an area for more than a few years,

    consider buying. Owning a home is often more expensive than renting at first, but can be worthwhile in the long

    run.

    9. Trim transportation costs. Many families now own multiple vehicles and have additional costs for insurance, repairs, fuel, and parking. Consider using public transportation or carpooling with others, whenever possible. The

    savings in vehicle-related expenses may offset any inconvenience.

    10. Create a cash reserve. A cash reserve can help you stick to your spending plan and help keep you out of debt when emergencies, such as a major car repair or short-term disability, arise.

    Cutting back on excess spending does not have to mean continually denying yourself life's simple pleasures. Instead, you

    may find that with living within your means and paying yourself first, your debts will decrease as your savings grow. A

    personalized spending plan can help provide that extra income and stretch your hard-earned paycheck a little further.

    Michael A Olson, CFP, C(k)P Investment Advisor Representative, Platinum Wealth Solutions, LLC, 6250 North

    River Road, Suite 2005, Rosemont, Illinois 60018, 847-698-1542, [email protected], www.michaelaolson.com

  • THE DOC FIX IS FIXEDmore or less

    Breaking newsthe House acts and the Senate dithers. Wait a second,

    that isnt news; its the way things work in Washington. But it would seem

    that the long awaited fix to the payment formula for Medicare physicians is

    closer than ever to reality. With both Democrats and Republicans on

    board, the House passed legislation by a vote of 392-37. That kind of

    unity couldnt normally be mustered in favor of motherhood and apple pie.

    The legislation to end the annual doctor fix will avoid Medicare payment

    cuts to doctors of as much as 21%

    In past issues we have delved into the history of the ongoing struggles to create an acceptable formula for Medicare

    reimbursement that everyone can live with. The problem has always been moneywhere will the cuts or funding come

    from for increased spending. The fact that the annual cuts in Medicare reimbursement have been deferred each year since

    1997 does not seem to make much difference in the minds of conservatives. For years, the GOP has based their approach to

    governing on the principle of no new spending without matching cuts in spending in other areas.

    Now, that is praise worthy philosophy in general. But in some cases, it has hindered the implementation of necessary,

    common sense changes to broken programs in the name of continued funding of pet projects and programs. The fact that the

    current legislation that now moves from the House to the Senate would add $141 billion to the deficit is a measure of just

    how ridiculous the situation has become and how desperate the need for a permanent solution is. Republicans have accepted

    the fact that the imaginary cuts that have now been deferred for decades can no longer be justified.

    The President has signaled that he is prepared to sign the legislation and there is a growing expectation that the feather

    merchants in the Senate, after an appropriate volume of fussing and moaning, will move the legislation along. There are a

    few issues remaining. One is the time line. Without a bill signed into law by Wednesday, the deferred cuts will take effect.

    And there is no way that the Senate can complete its current dithering with the 2016 budget resolution any earlier than

    Thursday. And it is more likely that the debate will slide into next week.

    And there is the matter of funding for CHIP a federal program that pays for insurance for low income children whose

    parents arent poor enough to qualify for Medicaid. The House legislation provides a funding extension of two years.

    Democrats in the Senate want four years. The current legislation provides $7.2 billion in funding for community health

    centers. Democrats are objecting to the fact that federal funds will still be subject to the Hyde Amendment that says federal

    money may not be used for abortions except in the cases of rape, incest or to save the life of the mother. This of course has

    been in place for decades but now it is an issue that is being tossed on the table again.

    How will the billions of deferred rate cuts and the proposed modest annual increases in doctor, nursing home and hospital

    reimbursements going forward be paid for? Well, the fact is it wont be paid forat least not for the first ten years or so and

    not in its entirety. But one thing that I have been forecasting will happen. The wealthiest 2% of Medicare patients will have

    to pay more for their services. It wont be a huge increase but it is a first step down the slippery slope of means testing.

    As far as missing the March 31st deadline goes, Washington will use smoke and mirrors for the next few days to keep any

    cuts from being implemented. With all of its blemishes our elected officials may have actually done the peoples work and

    produced something of value. But lets hold the celebration until the ink dries on the parchment.

  • INDIANAS RELIGIOUS FREEDOM BILL

    An objective reading of the legislation (an activity in which most social

    commenters customarily do not engage) leaves one with the distinct and uneasy

    feeling that it is targeted at the gay community and is distressingly ambiguous in

    its definitions of key elements of the bill, namely religion and denial of service.

    The bill seeks to provide individuals and corporations with a legal defense when

    sued for denying service to an individual based on specific religious tenants to

    which the corporation or individual adheres.

    There is no doubt that the legislation is treading on very thin ice. There are some pretty extreme and bizarre religious

    institutions out there. I myself ride my motorcycle with a group called the Patriot Guard Riders. Many of us are veterans

    and we were founded in reaction to the heinous and inexcusable activities of Westboro Baptist Church members who

    demonstrate at veteran funerals claiming that God approves of the death of veterans because of our countrys gay and

    lesbian citizens. I have no doubt that, were they based in Indiana, they would take refuge in the law each time they refused

    to host a same sex marriage ceremony or reception.

    Now, what relevance does this legislation have to physicians and the healthcare community? Well, taking the law to the

    extreme, would this law provide legal cover to a clinic that refuses abortion services based solely on the religious beliefs of

    one or more of the doctors? Could they refuse general medical services to gays and lesbians? Could they claim their

    religion somehow proscribes service to descendants of African atheists? Can a catholic doctor refuse to provide services to

    a Protestant?

    OK, so Im going a bit over the edge here. But any time you start to mix religion with business in my opinion you are

    starting down a road that will often lead to places you dont want to end up. Perhaps the healthcare industry is largely

    immune to business practices limited by religious dogma. But how does legislation like this impact the growing number of

    openly gay and lesbian physicians and healthcare professionals? The manner in which they are treated in their communities

    cannot help but color their commitment and dedication to the health and wellbeing of a patient who earlier in the day refused

    them service or access to their enterprise.

    I will give the governor and his PR team credit for creativity for the manner in which they handled the signing ceremony.

    The standard official photo of a signing ceremony customarily has the governor front and center at his desk, pen in hand

    backed by a crowd of legislators who sponsored or voted for the legislation. And they make sure that the photos caption

    spells their names correctly. The press is always welcome. This time however, the press wasnt even allowed in the

    building; none of the folks in the picture are identified by name; and only six legislators showed up to stand behind the

    governor. The rest of the crowd is comprised of no less than seven nuns, two monks, a priest a rabbi and a minister. Sounds

    more like a politically incorrect joke than a legislative victory party.

    MD PREFERRED PHYSICIAN CONSULTANTS

    Drawing on personal experiences on all sides of health care as a patient, a 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.

  • THE COPERNICUS EFFECT

    For centuries before Copernicus posited that the sun not the earth was at the

    center of our planetary system mathematicians created marvelous

    computations that sought to explain how the objects in the heavens moved

    and where they could be found at any moment in time. These models were

    incredibly complex and had to be updated continuously as more precise

    telescopes kept finding objects where they shouldnt be. And no matter how

    hard they tried, they simply couldnt come up with a simple mathematical

    formula that worked because their underlying principles were wrong.

    Enter Obama care 467 years later. And we are faced with the same problem. No matter how hard politicians work to create

    a model that will provide universal healthcare at affordable prices they are failing because their underlying principle simply

    isnt accurate. On one side we have liberal Democrats who want a federal system that provides healthcare services through

    the government for everyone, controlling access and cost from Washington. On the other side we have conservative

    Republicans who adamantly oppose any government intervention in the market place and believe that capitalism can most

    efficiently moderate the spiraling rise in healthcare costs.

    And to prove their point both sides have created incredibly complex legislation. The Affordable Care Act (ACA or

    Obamacare for short) is hundreds of pages of contorted prose and complex formulas that even the authors cant explain or

    defend. And many of those in Congress who voted for the bill never read it before the vote. The conservatives who have

    been fighting a five year war to overturn the legislation propose even more complicated and contorted rules and regulations

    that make even less sense.

    The simple fact of the matter is that no one wants to admit that medicine and healthcare has become a utility. Most citizens

    accept that electricity delivery and pricing is a monopoly that is best dealt with through government mandated service

    standards and pricing. No one wants to be at the mercy of a profit driven capitalist when they go to draw a glass of water.

    Die hard conservatives admit that the market cant be relied upon to equitably and sensibly regulate every segment of the

    economy. And staunch liberals blanch at the thought of healthcare being rationed and priced by the same house of fools that

    run the post office, social security and the military industrial complex.

    So everyone tries to dance around the issues by proposing models that can never work because they wont accept the

    underlying principles driving costs and access. No one will ever accuse this author of being a liberal. But I am coming to

    believe that universal health coverage provided by the government such as exists in varying incarnations in Canada and

    Europe may be the only way to address the explosions of technology and pharmacology and enormous costs of training new

    physicians.

    Yes we are talking about someone stepping up to the plate and saying that some form of healthcare rationing is necessary.

    But rationing is already happening through managed care and government mandates. And yes it means that doctors and

    hospitals may have to accept that medicine is no longer the path to vast wealth. But many doctors and hospitals are facing

    ruin under the current set of rules and regulations. Until we accept that our model of the healthcare universe will never fit

    until we put the pieces in their proper orbits around a central authority capable of managing the entire system we will

    continue to create increasingly complex and dysfunctional legislation that will do little to manage the challenges before us.

  • OPERATION CHOKE POINT In case you havent been monitoring the news carefully, you may have

    missed the most recent medical procedure introduced by Chairman Obama.

    Some are calling it the Obamlich Maneuver. As with most things federal, it

    starts out with noble intentions and ends up wreaking havoc on American

    freedoms. Here is how this most recent power grab played out.

    Operation Choke Point is a recent law enforcement tool that has caused

    banks and legitimate businesses across the country genuine concern. And even die hard Obama allies are supporting

    Congressional inquiries set to begin in Washington. At the bottom of the outcry is the fact that under these new enforcement

    guidelines, banks and financial institutions are being leaned on by the Justice Department (now theres an oxymoron if ever

    I heard one) to choke off access to financial services for targeted businesses.

    The original list of companies do indeed seem, at least on the surface, to be comprised of legitimate bad guysgun runners,

    drug dealers, organized crime. But then, when there was little initial opposition, the Obama justice department began to

    expand the list to businesses that Obama simply didnt approve of. And remember this is not enforcement based on the law

    of the land. It is based on no current laws or legislation. It is simply a case of the Justice Department telling the financial

    community that certain categories of business were not deserving of access to financial services. And the gentle suggestion

    that banks should choke off access had the subtle subscript of or else.

    The target list which rapidly morphed into a hit list began to include such businesses as gun stores, casinos, tobacco

    distributors, pay day lenders and others. Now, you may or may not agree that smoking is bad for you, that guns kill people

    not people kill people and that gambling is a vice. And some Pay-Day loan operations charge usurious fees approaching

    200%. But in this country even middle school students who didnt sleep through social studies class understand that the

    legislative branch writes the laws, the administrative branch enforces those laws and the judicial branch protects citizens

    from the other two branches.

    History has taught us that the Obama administration has seldom been troubled by the absence of laws on the books as he

    works to reshape America as he believes it should be. A decision is made that pay day loans are a bad thing; there are no

    laws on the books making them illegal; no problem. Just lean on the banks; tell them to choke off their access to bank

    accounts, loans and other financial services which all legitimate businesses need to survive and prestoproblem solved.

    Now, this may be an appropriate way to regulate the economy in say North Korea or Russia. But it set such a dangerous

    precedent that even Obamas staunchest supporters in Congress blanched.

    And here is where the healthcare industry might want to pay attention. If the antics of an out of control President and his

    legal beagles can squash legitimate gun stores and other businesses without any laws declaring their activities illegal, then

    what is to stop them from deciding what medical procedures are in the best interests of society? What if the Justice

    Department has a quiet conversation with an abortion clinics bankers and suddenly their bank accounts are cancelled and

    any business loans they may have are called in. Ridiculous? Couldnt happen? Nonsense?

    It used to be an article of faith that this sort of government abuse was something that only third world dictators attempted.

    Now responsible politicians on both sides of the aisle are beginning to worry. Keep your eyes open and talk to your

    representatives. Its time to reign in the man in the White House

  • THE RECRUITERS CORNERTips and Tools from Todays Physician Recruiter

    I have argued here before and I continue to believe that the only purpose a CV or

    resume serves is to get you a phone or personal interview. Even the best CV will

    not get you a job. With that said, there are things that should never make it into

    your CV that can keep you from getting an interview and ultimately the job you

    want. So what blunders should you avoid at all costs?

    Practice managers and in-house recruiters dont need to know your age. They really dont. If you are a graduating resident

    or fellow, they are going to look at the dates of your medical training (college graduating date for one) and do the math. If

    you are a practicing physician and list the dates of your medical school, they will still do the math. If you list your training

    without dates (my recommendation for practicing docs) you can still invite age discrimination with an opening statement of

    Seasoned physician with over 40 years of practice experience. Good luck. And for a hospital that is seeking a seasoned

    practitioner, including age information might brand you as too young and inexperienced for the job.

    A related gaff is to list every job you have ever had. A practice manager or interviewer is not going to be interested in non-

    medical part time jobs that you held while in high school. Im sure mom and dad were proud of your first lemonade stand

    but it is not going to help you land a vascular surgery post at an academic hospital. Keep focused and highlight your last ten

    to fifteen years of practice experience.

    When building your CV honesty is always the best policyup to a point. Dont try to hide any bumps in your career road

    but dont focus on the negatives. You will have plenty of time in a site visit or phone interview for that matter to discuss

    and explain problems in your past. Remember the purpose of your CVgetting an interview where you can promote your

    successes and skills.

    There is a fine line between experience and credentials. The effective CV focuses on results not assignments. Holding the

    post of chief of surgery is important and impressive. Far more impressive, however are the accomplishments and

    contributions during your tenure. What impact did your presence generate? How did your administrative skills positively

    impact the profitability of your organization? How many young physicians did you mentor? What clinical breakthroughs

    happened on your watch? What positive impact can a potential employer expect if they bring you on board? In other

    words, tell me what you have done, not where you have been.

    The fact that you enjoy hang gliding and mountain climbing will probably not play a deciding role in your interview success

    unless you are going into mountain rescue operations. The fact that you are a female will probably come out during the

    interview process. Being Hawaiian or Puerto Rican or Russian for that matter will be of little interest to an interviewer

    unless you have Visa issues or unless they are targeting ethnic minorities with language skills. Hobbies and unrelated

    passions have no place on your CV. Once again, remember the purpose of your resumegetting an interview. During the

    interview if you discover that the senior partner of the medical practice maintains a sail boat at the San Diego yacht club,

    you can point with pride at the fact that you crewed on an Americas Cup contender during your youth.

    Keep it simple. Keep it relevant. Keep it brief

  • NEW HEALTHCARE OPPORTUNITIES

    Provided by MedicalMatch.org

    Emergency Medicine - Atlanta, GA - EmergiNet

    You may know Atlanta as the unofficial capital of the South, but theres more to this city than its southern location. If you make your home in the Peach City, youll find an undeniable mix of Southern charm, sophistication and traditions. Atlanta continues its reputation as a transportation hub with the worlds largest airport and easy access to I-75 & I-85. When it comes to Atlantas reputation for growth and innovation, health care tops the list as the citys 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 MDs 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, [email protected]; fax 770-994-4747; or call 770-994-9326, ext. 319. Please

    visit www.emerginet.com for more information.

    Neurologists with stroke experience Tulsa, OK AIM Consultants

    AIM Consultants is currently recruiting 2 Neurologists with stroke experience to join the Neurohospitalist

    program at Hillcrest Medical Center, the flagship hospital of the Hillcrest HealthCare System, licensed for 691

    beds and located in Tulsa, Oklahoma. We also have a new Neurology position in Oklahoma City!

    Staff Physician Needed Toledo, OH The Pediatric Center

    Staff Physician needed immediately to join an established Pediatric practice. You will be joining a medical staff

    that includes 3 physicians, 6 mid-level providers, supported by 12 nurses. The practice is affiliated with 5

    hospitals. Our physicians round on newborns only. We do not attend c-sections. We utilize pediatric hospitalists

    and/or specialists for patient admissions. Mid-level providers are on call for parents/patients.

    Internal Medicine or Family Practice Columbus, OH OhioHealth

    OhioHealth has an immediate, full-time opportunity for an Internal Medicine or Family Medicine Physician. Join

    a team of experienced physicians in a very busy practice. The ideal candidate will be BC/BE in Internal Medicine

    or Family Medicine and willing to work in an outpatient setting.

  • Interventional Pain Specialist Florida All Care Consultants

    Established Rehab facility seeks full time interventional pain (neurologist, anesthesia, physiatrist, orthopedic

    surgeon) physician for outpatient clinics. We have five established locations, and opening a sixth. We are looking

    for a physician with good beside manners, strong diagnostic skills, and a team player. Our current clinicians

    consist of general physiatrists, interventional pain physiatrist, neurology, primary care, and midlevel providers.

    We are equipped with C-Arms, X-Ray, MRI, and technicians to assist physicians.

    Managing Physician Toledo, OH The Pediatric Center Managing Physician needed immediately. Established Pediatric office has an immediate need for a Physician to

    provide medical supervision for a 4 office, privately owned practice. Position includes development of medical

    policies, procedures and practices to be followed by medical staff. Current medical staff includes 4 physicians, 6

    mid-level providers, supported by 12 nurses.

    Neurology - Central Utah - L Marsh & Associates

    Establish a General, adult, solo, private practice in central Utah with possible shared Call. This is a new position.

    Both inpatient and outpatient. Hospital employed position with full benefits, paid malpractice and sign-on bonus

    or go Private Practice with income guarantee and all overhead expenses paid. Physician will see full range of

    neurological conditions including stroke, dementia, movement disorders, headaches, epilepsy, sleep disorders,

    chronic pain management, multi sclerosis and neuromuscular diseases. Candidates with a Fellowship in stroke,

    epilepsy, sleep EMG, or pain management, etc., are welcome but will also do general neurology and recognize

    there is not enough population to support much specialization. BC/BE required. Hospital has CT scanner, MRI,

    and Sleep Lab. Call 10 days/month. Practice location is in city of 10,000 one plus hour from Provo.