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11/1/2012
MD
PREFERRED
SERVICES THE ADVISOR
IN THIS MONTH’S ISSUE
Financial Planning Issues Unique to Doctors - Finding an Advisor for Your Needs By Michael J. Searcy, ChFC, CFP®, AIFA®
The Failure Pattern - Diet vs. Exercise By Karen Gray
MD Preferred Artist of the Month – Yale Factor
How Do I Manage My Debt? By Jon Robertson, CFP ®
Recruiters Corner
Are You A Healthcare Provider and a Lender? By Mark Kane
Practice Lease: How to Employ Physicians without Buying their Practices By John W. McDaniel
New Missouri Trust Can Protect Personal Assets from Malpractice Claims By the Kaiser Law Firm, P.C.
How to Get More Referrals from Patients: Part 2 or 3 By Vicki Rackner, MD
Donor-Advised Funds Can Enhance Your Charitable and Tax Planning By Kevin Kroskey, CFP®, MBA
Preparing for the New (Tax) Normal By Tanina Frouge Linden, CFP®
Physician Opportunities
Financial Planning Issues Unique to Doctors - Finding an Advisor for Your Needs By Michael J. Searcy, ChFC, CFP®, AIFA®
As a medical professional, your requirements of a financial advisor are often sophisticated and complex due to the nature of your profession. From managing education debt, negotiating employment contracts, structuring partnership deals and planning for
retirement while owning a business, the financial situations you will face as a medical professional are endless. And, while you understand the value of and need for quality financial planning, you probably haven’t had time to focus on mastering money management between the demands of medical training and starting your career. You want a financial planner you can count on to understand your ‘big picture’ and help you make the best financial decisions for your situation and goals. But, how do you decide which advisor is best? The following five steps can help you in finding an advisor that is right for you. 1. Seek a Qualified Advisor Start by seeking an advisor that is qualified to handle your financial planning. At the very minimum look for an advisor who is a Certified Financial Planner (CFP®) professional; this is the best-known credential in the financial planning profession. To qualify as a CFP® professional, the advisor must successfully complete training in all aspects of financial planning, as well as pass a comprehensive exam and agree to abide by the CFP® Board’s code of ethics. They must also have at least three years of experience in financial planning before they are allowed to use the credential. In addition, they must complete a minimum of 30 hours of continuing education every 2 years to retain the certification. 2. Check an Advisor’s Reputation Always check the compliance history of the advisor with the applicable regulatory agencies: Securities and Exchange Commission (SEC), Financial Industry Regulatory Authority (FINRA), and various state agencies. One isolated complaint may not be a cause for alarm; however, the same complaint over and over should raise some red flags.
3. Confirm Their Area of Expertise Ask the advisor if they have experience working with doctors. Ask them to explain situations they have helped their doctor clients deal with and how working with doctors differs from working with other clients. Next, ask them how they deal with issues that arise which are outside of their scope of understanding or experience. Just as one surgeon cannot possibly be an expert in all areas of surgery, no financial advisor can be an expert in all areas that impact your finances, and a good advisor knows what expertise they do and do not bring to the table. Therefore, it is important the advisor you choose has a plan to compensate for areas of weakness, such as a network of experts available to them for collaborative planning on their client’s behalf. 4. Work with a Fiduciary While the term “fiduciary responsibility” may not be one that you hear in everyday conversation, it is a very important thing to consider when choosing an advisor. If an advisor will accept fiduciary responsibility for your accounts, it means they have to put your interests ahead of their own at all times by providing advice and recommending investments that they view as being the best for you. You might think that all advisors are “fiduciary advisors;” however, many financial advisors work for companies that require them to put their employer’s interest before their clients. This is a huge conflict of interest. Fiduciary advisors have the following characteristics: • They are Registered Investment Advisors (RIAs) or Investment Advisor Representatives (IARs). Note: IARs are employed or licensed by RIAs. • They are held to higher ethical standards than other types of advisors. • They are required by law to put investor interests ahead of their own interests. • They are compensated with fees rather than commissions to help investors achieve their financial goals. • They are paid ongoing compensation to provide ongoing services, for example performance reports. • They have more responsibility and therefore more liability for the quality of their advice. You might also consider an advisor who has designations of Accredited Investment Fiduciary® (AIF®) or an Accredited Investment Fiduciary Analyst (AIFA®) in addition to the CFP®. They have completed the training and testing requirements to be familiar with the twenty-three practices which are intended to provide the foundation and framework
for the disciplined investment process known as the Global Fiduciary Standards of Excellence. 5. Understand How the Advisor is Paid Fees are the only way you can pay advisors for their services on a direct basis. You are the advisor’s only source of payment and the payments should be for specified services. You should look for a financial planner who charges for their services on a fee-based system. There are generally three types of fees: a. Asset-based fees are a percent of the assets for which the advisor provides services. Asset-based fees are almost always expressed annually and billed quarterly. Investment advisory services are almost always asset-based fees. b. Fixed fees are charges for specific services such as a financial plan. c. Hourly fees are based on the number of hours the advisor works for you times the advisor’s hourly rate. Most advisors charge fixed or hourly fees for planning services. Most fee schedules have similar characteristics. The percentage of fees paid generally goes down as your asset amount goes up.
This is called a sliding schedule of fees. Most fee schedules do not have time duration contracts – you can terminate your advisor at any time with minimal notice (generally 30 days). Since fees are a percent of market value, the advisor’s fees go up with the market value of your assets. Consider this the advisor’s reward for doing a good job. There should be no set-up or termination fees. Whether you’ve just started your medical career and are looking for an advisor to help you with debt management and steps toward financial freedom or you’re a seasoned professional needing to prepare for the end of your career, working with an advisor who is prepared to guide you on the journey may be your first step to success. Michael J. Searcy, ChFC, CFP, AIFA, is President of Searcy Financial Services, Inc., a registered investment advisory firm in Overland Park, KS, offering integrated wealth management solutions to doctors. Searcy has been listed by Medical Economics as one of the “Top 150 Financial Advisors for Doctors” in 2002-2006 and 2011. For additional information, visit www.searcyfinancial.com. Follow us on Twitter at @SearcyFinancial.
Reduce your monthly medical building energy costs by 20% or more Our new partnership with Tec360 allows us to help significantly reduce the monthly energy expenses of physician groups, hospitals and surgical centers. All hospitals and surgical centers and physician group offices with monthly utility bills in excess of $2,500 should revisit the current available energy reduction technology with us. Call us today at 1-877-760-2564 or e mail us at [email protected] to talk to one of our energy specialists regarding your medical facility and potential monthly energy cost savings. You can also contact us through the following link, www.physicianspreferredwellnessgroup.com/contact.php
The Failure Pattern - Diet vs. Exercise By Karen Gray In a perfect world, everyone would eat right, workout and live a healthy life. However, the obesity rates continue to rise each year. The Center for Disease Control and Prevention released in May 2012, that 42% of Americans may end up obese by 2030 (up from 36% in 2010), and 11% could be severely obese, roughly 100 or more pounds over a healthy weight (vs. 6% in 2010). Extra weight takes a significant toll on health. It increases the risks of type 2 diabetes, heart disease, stroke, many types of cancer, sleep apnea and other debilitating and chronic illnesses. It simply is not enough to just “diet” or “exercise”. With so many Americans suffering from being overweight or obese, who is a person to turn to for guidance? There are so many “fad” diets and misleading information, that we find ourselves not knowing who to turn to really create health in their life. Many will come to you, their physician. You may recommend that your patient eat less and exercise more, but the truth is most don’t know where to begin. With so many choices of “diets” and the question of what exercise is the “right “ one to do, most people find themselves simply not doing anything. First, we must lose the “diet” mentality; we must focus on healthy fuelings and activity (exercise) that works for each individual. It is reported by that 85% of people who go on a “diet” and succeed only end up gaining their weight back and then some within 2 years. If you can make it through the first phase of weight loss (and many people don’t) then you will have lowered your total energy expenditure per day and therefore lower your metabolic rate. Or by not picking the right fuelings for your body, you’ll lose muscle, therefore entering the cycle of yo-yoing. This resets your body to a lower level than when you began to “diet” and can lead to obesity. We must go into behavior modification mode to keep us from slipping back into our old eating habits and therefore gain our weight back. Second we must understand that we cannot focus primarily on exercise alone, to really lose weight with exercise alone, one would need ninety minutes of strenuous exercise a day, according to the US Institute of Medicine. Let’s be realistic, with the busy schedules of most Americans today, this strict regimen of exercise just simply does not fit in most lives. While exercise is critical for long term weight loss, it must be part of a comprehensive process of building health, and must be done in baby steps. Once we start losing weight, naturally most become more active.
Keeping in mind that there is no “magic” pill coming anytime soon, no perfect exercise routine to do to achieve optimal health long term, we must learn to combine both our diet and our activity to achieve optimal health. If we can learn the Habits of Health, one can achieve their optimal weight and overall health long term. The Habits of Health that I am referring to are as follows: 1. Habits of healthy eating – fueling one’s body to keep metabolism working most effectively. 2. Habits of moving your body – clever strategies that make moving your body easy and fun. 3. Strategic behavioral habits – learning how you make food choices, understanding your patterns and triggers and establishing a good support system. 4. Habit of support through vitanutrients – Fueling your body with the right nutrients and in some cases in the form of vitamins and mineral supplements. 5. Habit of reducing dangerous inflammation –Learning the types of foods that fuel the inflammatory process as well as those that can calm this dangerous state. 6. Habit of good sleep – learning that sleep is the most critical factor in creating overall health and has a direct impact on losing weight and keeping it off. 7. Habit of creating a positive environment – our environment either supports or works against our success of our other health habits, we must learn to take control of our personal environment and create conditions to support long-term health. 8. Habit of support – building a support system, whether it is a friend or a whole network of people. Every day we make choices, and our health is no different. Are we making choices that are leading us down the path to sickness or are we choosing to create optimal health long term? Do we want to live the Habits of Disease or the Habits of Health? The choice is ours and we must choose wisely. Karen Gray, Certified Health Coach with Take Shape for Life, works with clients across the US coaching and support in achieving their optimal weight and overall health, long-term, with the Take Shape for Life (TSFL) program. The TSFL program is based on bringing together medical science and everyday choices. Mrs. Gray also works with physicians that want to offer a solution-based program that will not only benefit their patients in achieving Optimal Health, therefore reducing their risk of disease long term, but will also accelerate their practice revenue. Contact her at [email protected] or (816) 405-0001.
MD Preferred November Artist Spotlight
Yale Factor
www.yalefactorartgallery.com
Yale Factor 2150 S. Canalport - Lacuna Artists’ Lofts #4C5, Chicago, IL.
Narrative Still-life paintings and watercolors that tests our perceptions of reality and illusion. Autobiographical paintings rendered in the trompe l’oeil style bring into a clear focus natural detail that is all too often only vaguely sensed. Each universe created on canvas or paper is a juxtaposition of traditional Renaissance coloring against modern almost scientific rendering. His work has been shown in regional, national and international juried exhibitions, as well as in one-person exhibitions in museums across the nation. After being represented by numerous galleries, the decision was made to open a gallery dedicated solely to his work. The gallery is located just west of the Chicago Loop at the Lacuna Artists’ Lofts. More information can be found at www.yalefactorartgallery.com
How Do I Manage My Debt? By Jon Robertson, CFP ®
Most Americans have some form of debt such as a mortgage, student loans, credit card debt, or business debt. One of the most common questions financial advisors hear
from their clients is “How do I manage my debt?” People maintain debt for many reasons. The most common reason for keeping some debt is competing financial goals: saving for retirement, saving for college, building an emergency fund, or maintaining current lifestyle. If you are thinking about the best way to manage your debt, ask yourself some questions. Should I refinance or renegotiate my interest rates? How do I develop a strategy to pay off my remaining debt? Which debt should I keep? Let’s consider each of those questions in depth. Should I refinance or renegotiate my interest
rate? Lowering your interest rate is often possible. Some ways to lower your interest rate include rolling credit card debt to a lower interest credit card, consolidating student loans, or refinancing your mortgage. Credit card companies frequently make special offers, such as 0% for one year. While this may seem like a good solution to managing debt, one frequently overlooked factor is that while the credit card charges no interest, it may charge a fee for transferring your balance from another card. Carefully read the credit card contract to fully understand potential fees. Then, compare the transfer fees to the interest fees. If you have chosen to transfer your credit card balance, stay mindful of your goal to decrease your overall debt to avoid the pitfall of even more credit card debt. Current mortgage interest rates are exceptionally low. You may want to consider refinancing your mortgage to a lower interest rate to help with your debt. Talk with your banker or mortgage broker for assistance in determining your options for refinancing. Be sure to consider the length of your loan. For example, if you have owned your house for 10 years and are considering refinancing, you may want to consider a 15-year loan rather than a 30-year loan. If you choose the 30-year option, you will be paying for your house for 40 years. You should also consider the total amount of interest remaining on your loan and compare it to the total interest plus the new refinancing fees. A lack of equity in your home due to reduced property values may cause refinancing problems. If this is true for you,
consider paying down your existing mortgage rather than other debts so that you will be eligible to refinance while interest rates remain at a low level. What do I pay down first? One common approach to paying off debt is to rank outstanding loans by their interest rates, and pay down the debts starting with high-interest loans and work down to paying off low interest loans. This strategy makes the most sense from an interest-savings perspective, but can be daunting if the high-interest loan also has a large balance. Another approach to pay off your debt is to start with the loan with the lowest balance, which allows for quick progress and momentum. This method also frees up cash flow. After paying off the low-balance loan, apply the newly created cash flow to pay off the next-lowest balance loan. This process often works well because the personal satisfaction may encourage the debtor to continue paying down debt. Which debt should I keep? The most obvious factor in determining which debt to keep and which debt to pay off is the interest rate of your existing loans. It is important to consider the after-tax interest rates of your loans because some interest payments are tax-deductible. Common examples of tax-deductible interest include mortgages, student loans, and business loans. It is often easy to overestimate the value of your tax deductions. The best way to determine the after-tax benefit of interest payments is to prepare your tax returns as they exist now, and compare the tax returns to how they would be if you were not able to deduct the interest. Developing a plan for managing and paying down debt is a cornerstone to being financially sound. Talk with your financial advisor to develop a plan. Stick to the plan, and you will be well on the path to financial success. Jonathan J. Robertson, CFP ® is a 2004 Magna Cum Laude graduate of Texas Tech University with a B.S. in Personal Financial Planning. Abacus Planning Group, is a fee-only financial planning and investment counsel firm managing over $650,000,000 for 183 clients. Abacus is located at 2500 Devine Street in Columbia, South Carolina and can be reached via the website
or by phone at www.abacusplanninggroup.com(803) 933- 0054.
The Recruiters Corner - Tips & Talk from the Inside
The Thank You Note – So, before I give you my tips, just when is a thank you appropriate? Actually, the thank you is a part of the interview process and not necessarily the end point. Each time you pass a mile stone in the process a thank you is appropriate. You have sent an application to a practice group and they have responded and scheduled a phone interview. Once the interview is over, a brief thank you and indication of interest is appropriate. In this case, an email will probably be an appropriate venue. Thank the interviewer for his or her time and comment favorably
upon the opportunity. If you are interested in pursuing the opportunity, indicate that by asking what the next step in the process is and let them know that you wish to take that step. Thus a thank you serves several purposes. Let’s say that the phone interview went well and you get the opportunity to visit the facility and meet with the players. After the visit a formal thank you is definitely called for. Here are some tips: 1. Don’t Dally…send your thank you within 48 hours. You want your candidacy to be fresh in the interviewer’s mind. Your thank you will reinforce a positive performance. 2. Don’t Ramble…keep on message. The more you say the more the chance that you will say something inappropriate. Make it personal; use the interviewer’s first name. Review your strong points and match them up with the job requirements. If your thank you takes the form of a phone call, speak from notes. 3. Don’t Forget Anyone…if you are sending thank you notes, send one to every player with whom you spoke. If a support person was particularly helpful, include them in your distribution. A good way to make sure you remember all, ask for business cards from all. 4. Don’t Send Form Letters…each note should be unique. Immediately after leaving the facility, take a moment to jot down one personal item about each contact. 5. Don’t Be Illiterate…if you are going to use the written word, don’t mangle the Kings English. Typos, spelling errors and bad grammar will not advance your cause. 6. Don’t Write Like a Doctor…OK, you are a doctor. And doctors are supposed to have illegible hand writing. That’s fine if you are writing a script and the pharmacist has to figure out what you mean. If your hand writing is lacking, type the note. 7. Don’t Be a Miser…spring for some decent writing paper and envelops. Use a quality pen. 8. Once is Enough…say thank you. Let them know you are interested. Compliment everyone. Then back off. If they are interested, they will get back to you. Repeated requests for updates portray a desperate candidate and could annoy the wrong people.
Are You A Healthcare Provider and a Lender? By Mark Kane Think about it. When you deliver your products or services to your patients, and are then forced to wait for your payments from the insurance carriers (including Medicare and Medicaid), you have become a lender to those carriers. That’s right; you are a lender! Now, if you were a bank that would be OK. As a bank you could get paid for lending. There is nothing wrong with being a lender. Why? Very simply, as the bank, you can get paid for the funds you lend. As a lender you are secured with valuable collateral. And let’s not forget that as a lender (the bank) you have large quantities of funds available to you. BUT, you are not a lender. You are a Healthcare provider. So what’s the result of you, the Healthcare provider, having to wait for your payments? LOST OPPORTUNITIES! Waiting 20 to 60 days if not more burdens you with additional expenses, not to mention stress, sleepless nights and morning hangovers without the alcohol. What are your lost opportunities? 1. How about paying your bills on time or taking “early pay” discounts with all of your providers. 2. For those of you in the Durable Medical Equipment or Home Medical Equipment business being able to maintain a large enough inventory to cover your patients and those of your referral sources. 3. If your business is Home Health Care, Medical Transport or Medical Practice, you might have the option of paying your staff on a regular schedule. 4. How about staying current with lease payments on your key diagnostic equipment, especially for those who have Medical Imaging, Medical Labs and Urgent Care Clinics. 5. It could be as simple as having the funds for advertising, selling and marketing your products and services. 6. And let’s not forget the opportunity to expand your practice or business to include new products or services or treatments. So, can traditional financing options solve your problem? Great question. The answer is MAYBE…if you can answer yes to all four of these questions? 1. Is your credit (both personal and business) profile sufficiently strong for a bank loan, especially in today’s lending environment? 2. Can you provide sufficient collateral for the amount of the funds you need? 3. If your accounts receivable are your largest asset, as is the case for most of you, will a bank lend on that one asset? 4. And last but not least, would a traditional loan, even if you could qualify, work for your medical practice? How about a non-traditional, “no-personal guarantee” driven solution? What you need is a lender that will analyze the volume of cash flow in your business, which is a better indicator of your company’s financial health than its credit rating. This allows businesses like yours that would otherwise be locked out of fairly priced capital, a chance to get the funding you need. By changing the evaluation process, you can receive loans at fair rates. ABOUT HEALTH WISE CAPITAL Health Wise Capital looks beyond typical bank products, loans and credit lines to find the right solution for each customer’s requirement. In effect, we can become a partner that understands your business and is flexible enough to work with you to help you move forward. Our unique blend of successful small business entrepreneurship with expertise in the healthcare industry gives us deep insight into the minds of our clients. For additional information contact Mark Kane at 888.456.9223. Go to www.healthwisecapital.com to learn about healthcare financing and why it pays to be a healthcare provider and not a lender.
The Sagamore Resort
Contact: Krassi Diehl / Sales Manager / 518-743-6174 / 110 Sagamore Road Bolton Landing, NY 12814
The magnificent Sagamore on Lake George has been extending hospitality to visitors of Bolton Landing for over one hundred years. Poised on the southern end of Green Island, The Sagamore commands stunning views of Lake George and the islands that grace its waters. This family friendly golf and lakefront resort offers luxury accommodations, extraordinary dining, superb fitness and spa facilities and a host of opportunities to enjoy the incredible beauty of the Adirondacks.
Check Availability
The Sagamore, located in the heart of the Adirondacks, is an island resort on Lake George anchored in Bolton Landing, New York. Located 60 miles north of Albany via Interstate 87, The Sagamore is a leisurely drive from most Mid-Atlantic, New England, Quebec and Ontario Province metropolitan areas, and is just a four-hour drive from New York City or Boston. From outdoor adventure to peaceful solitude, you will find it here in the Adirondacks. With more than 20 beautiful lakes, countless outdoor activities and dozens of exciting attractions, the Lake George area is the perfect vacationer's paradise.
Practice Lease: How to Employ Physicians without Buying their Practices By John W. McDaniel, Peak Performance Physicians
For some time now hospitals and physicians have been exploring meaningful relationships beyond the traditional physician employment
and professional services arrangements. In developing new affiliation models, health systems are focusing their attention on their most important customer: the physician. These new business models are designed to replace under-performing arrangements through a realignment of both parties’ various incentives. The PracticeLease© is one such model. PracticeLease© is a model through which a hospital and medical practice may enter into a relationship tantamount to a practice purchase without many of the disadvantages. This model facilitates the development of sustainable relationships through the private practice model. These relationships can be structured in a manner consistent with various Stark II exceptions and Anti-Kickback Act safe harbors. PracticeLease© involves the creation of a new company (NewCo) by the hospital, through which NewCo enters into an employment agreement with physician(s) that are part of an existing practice. The practicing physicians will work solely for NewCo. This entity can be structured as a group practice under Stark II. Thus, NewCo may compensate the physicians through a combination of salary, bonus, and/or share of NewCo profits (42 C. F. R. § 411.352). To the extent ancillary services are provided by NewCo in a manner consistent with the in-office ancillary services and group practice exceptions to Stark II, each employed physician may share profits, including a share of Medicare/Medicaid designated health services profits, as long as such share is not directly determined in a manner that takes into consideration the volume or value of Medicare/Medicaid designated health services (See 42 C.F.R. §§ 411.352; 4113.55(b)). Furthermore, consistent with Stark II, employed physicians can be required to refer patients to a specific hospital for all services unless the patient requests otherwise, the best interest of the patient dictates otherwise or another Stark II exception-required referral rule applies (See 42 C.F.R. § 411.354(d)(4)). NewCo can contract directly with the pre-existing
practice entity to provide all or some of the following:
Space for the physicians employed by NewCo;
Equipment for physicians employed by NewCo; and
Practice management services. Space and equipment leases and management services agreements must be structured in a manner consistent with the applicable Stark II exceptions and should also comply with the relevant safe harbors under the Anti-Kickback Statutes. This structure provides physicians with two sources of revenue: employment compensation (salary, bonus and share of profits) and distributions from the pre-existing practice entity, which will function as a management services organization. While the benefits to the physicians are obvious, the hospital enjoys all of the benefits of owning a practice with no significant expenditure of capital in order to accomplish this task. Furthermore, should the venture become unsatisfactory or unsuccessful, this arrangement is much easier to unwind than a practice acquisition. Because every hospital has a physician integration strategy as a part of its overall strategic long range plan, and because hospitals are physician driven organizations, hospitals and healthcare systems must explore alternatives like PracticeLease© which create a true partnership. Additional caution should be undertaken in order to ensure reasonable compensation as outlined by “The 2000 EOCTE (Exempt Organizations Continuing Education) Text” as published by the Internal Revenue Service. In the case of not for profit organizations, the IRS considers many factors in determining whether the compensation arrangement between a hospital and physician violates any laws against private inurnment and impermissible private benefit. Since the enactment of intermediate sanctions in 1997 and implementing regulations issued in 2001 by the IRS, physicians who are considered “disqualified persons” risk federal excise taxes for compensation that results in an excess benefit transaction with an exempt organization. This tax ranges from 25% to 200% of the excess benefit. Also, organization managers responsible for the arrangement can also be liable for a tax of 10% of the excess benefit up to $10,000.00 per person. As hospitals and health systems embark upon the
strategy of more formal organizational alignment with physicians, due diligence and education is imperative for both the governing board and senior management. Upon approval to proceed, the hospital/health system should embark upon a process that involves the feasibility, development and implementation phases with respect to any type of hospital/physician affiliation model, including the PracticeLease©. During the feasibility phase, a new physician alignment model must be developed with input from key physician leaders likely to be involved in or affected by the proposed relationship. It is also suggested that a steering committee of physicians be organized in order to gain buy-in from the hospital’s key constituency with respect to the strategic vision for physician alignment. Other considerations that must be addressed involve the corporate practice of medicine. California, Texas and Iowa strictly follow the doctrine. However, even these states have a variety of exceptions that provide mechanisms with respect to employment of physicians by various entities that are not owned or
controlled by physicians, such as charitable institutions, professional LLC’s, etc. PracticeLease© is an excellent solution for both hospitals and physicians who are searching for a meaningful affiliation strategy through the creation of centralized resources for the purposes of improved patient care, enhanced information technology and a collective expertise for the benefit of both parties. Peak Performance Physicians, LLC is the
Practice Advisor that will assist you and your
practice in a variety of ways from personal to
professional. Please feel free to contact our
office via one of the following methods:
Call Toll-free 1-800-764-2633 Ext. 1 E-mail us direct @ [email protected] Write us: 1350 Camp Street, New Orleans, LA 70130
New Missouri Trust Can Protect Personal Assets from Malpractice Claims By The Kaiser Law Firm, P.C. Missouri has recently enacted legislation which may impact your existing estate plan. Before the new law was enacted, assets registered in a Revocable Trust were exposed to the creditors of husband and the creditors of wife. If either husband or wife got sued and lost, their assets in their Revocable Trust were not protected. The new law, with proper planning, will allow a husband and wife to protect their assets that are registered in their Revocable Trust from their separate creditors. OVERVIEW OF THE NEW LAW - The new changes to the Missouri Uniform Trust Code (“Code”) specifically allow a husband and wife to transfer their jointly owned property to a certain type of revocable trust known as a “qualified spousal trust”. If a trust is considered a “qualified spousal trust” under the Code, then the assets in the trust will be protected from the separate creditor claims of either spouse. In addition, the “qualified spousal trust” can also be designed to protect the assets in the trust when one spouse predeceases the other spouse. In other words, if the husband has a judgment against him and his wife predeceases him, the assets in the “qualified spousal trust” can remain protected from the husband’s creditors at the death of his wife. WHAT IS A QUALIFIED SPOUSAL TRUST - A “Qualified Spousal Trust” is a trust created by a husband and wife in the State of Missouri which is revocable by either or both husband and wife acting together while either or both are alive. The qualified spousal trust can contain any other trust terms that are consistent with this new law. A spousal trust virtually can operate the same way as an existing Revocable Trust. With the expertise of an estate and asset protection attorney, an existing Revocable Trust can be converted into an asset protection trust. CONCLUSION - The changes in the Missouri trust law are substantial, but, like anything else, require planning. Estate preservation is an important consideration. If you are interested in learning more about how you and your family can transfer assets into a Qualified Spousal Trust or convert your existing revocable trust under the new trust laws, please call the Kaiser Law Firm, P.C. at (314) 966 7766.
How to Get More Referrals from Patients Part 2 of 3
By Dr. Vicki Rackner
Your patients are more likely to offer your name to friends and relatives if you’re on their minds. Proactively reach out to your patients and offer them tips that will improve the quality of their lives on a regular basis. Publish your own monthly newsletter! It’s easy to implement. What do you write about? Here are a few ideas: Frequently Discussed Topics capture in print the conversations you have with patients on a regular basis. A pediatrician may comment on why antibiotics are not used in ear infections. A sports medicine doctor might offer 5 reasons to avoid steroids.
A psychiatrist may offer an article about the mental health benefits of a daily walk. Next time you find yourself beginning a conversation like this, record it. Get it transcribed and edit it so you deliver the main point in a 250-word article. Breaking Medical News Does your phone ring off the hook when the results of a medical study are announced on the 6:00 news? Offer your own interpretation of the findings. How does an individual patient apply the results in their life? This might be your opinion about cancer screening guidelines, the risks of “safe” interventions like vitamins or surprising medical facts. Helpful Products and Services Has a patient told you about a great product like a light bulb that makes it easier for people with macular degeneration to read? Is there a service that would make patients’ lives easier or better? A business may even be willing to offer your patients a coupon or discount if they mention you. Offer Hope You might offer stories about someone who overcame challenges, achieved a goal or went above-and-beyond to improve the condition of others. You could even offer a “Dear Abby” type of column by inviting patients to write in with embarrassing medical questions, which you would answer. The cost of creating a monthly newsletter can be minimal. A vendor like Constant Contact will generate a sign-up box you can put on your web site, manage your subscribers and send out the newsletter. The return on this investment can be tremendous. You increase your chances of getting referrals. Your list might contributes to your practice value if you decide to sell. Most importantly, you are positioning yourself as the expert you are. Want to get more patients? Drawing upon her experience as a practicing surgeon, faculty at the University of Washington School of Medicine and entrepreneur, Dr. Vicki Rackner coaches health care professionals who want to accelerate their practice growth. Sign up for free weekly marketing tips at www.MedicalBridges.com
Donor-Advised Funds Can Enhance Your Charitable and Tax Planning By Kevin Kroskey, CFP®, MBA
A donor-advised fund is a private fund established to manage charitable donations of individuals, couples, families and institutions and is in many ways similar to a private
foundation. It is sponsored by a 501(c)(3) non-profit organization often through major custodians such as Fidelity or Schwab or through mutual fund companies such as Vanguard. There are also independent funds that can be used at any major custodian and avoid potential conflicts of interest of using proprietary products. Independent funds also permit the use of professional advisors to manage investments and may accept closely held company stock, real estate, and other less liquid assets. The process of gifting through a donor-advised fund works like this. You open and fund an account with a donor-advised fund sponsor. You make an irrevocable contribution of cash, securities, or other assets to the fund and receive an immediate tax deduction. While the fund has legal control over the irrevocable contribution you have made, you or your investment advisor advise the fund where the assets in your account should go and how they should be invested. The fund is the actual grant-maker that writes the checks to the charities and nonprofit groups you recommend. Making a grant is very much like using an online bill pay service that you would use through your checking account. The charity receives a check in the mail from the fund, “The John and Jane Jones Family Donor Advised Fund” for example. If privacy is a concern, full anonymity can also be elected when making a grant. DAFs Offer Control With Flexibility With donor-advised funds, you don’t have the hassles that come with running a private foundation, and you have the ability to advise that the fund make grants to the charities or nonprofits you think are worthy and are approved as a public charity as defined under 501(c)(3). The standard tax deduction for donations to a private foundation is 30% of a donor’s AGI. In a donor-advised fund, a donor can make additional cash donations up to 50% of AGI. Besides the satisfaction of helping charities and the tax deduction, what also makes donor-advised funds
attractive is what you don’t have to do. Since you aren’t creating a private foundation, you don’t have to establish tax-exempt status; you don’t have to form a board that will have fiduciary responsibility and schedule board meetings; you don’t have to pay out at least 5% of asset values for charitable purposes each year; you don’t have to pay set-up fees to attorneys and accountants; you don’t have to file discrete federal and state tax returns annually. You may be able to open up an account in a donor-advised fund with as little as $5,000; minimums are usually in the neighborhood of $10,000-25,000. In contrast, it generally takes at least $1 million to start a private foundation. Fees to the sponsor are typically around 1% of the assets in the donor-advised fund. Examples of DAFs In Action First, suppose that you wanted to teach your children your values in regards to giving. A donor-advised fund is established and you plan to distribute five percent of the fund’s value each year to charities. Of that amount, you allocate $1,000 so that each of your children can participate in recommending grants. The children research causes that interest them and then meet with you to present their recommendations. You then help your children decide which charities the family fund will support. Having a family meeting such as this tied to Thanksgiving or the holiday season where the entire family can participate can be very profound. Second, suppose you regularly give to charities. Also suppose that upon the advice of your wealth manager you are going to execute Roth IRA conversions in 2012 before income tax rates potentially rise in 2013. By accelerating your planned charitable contributions for the next few years into 2012 through the use of a donor-advised fund, you receive a full and immediate charitable deduction and can potentially fully offset the income tax on your Roth IRA conversions. You can also retain assets in the fund and make grants over the next few years as planned. Further, if you can make a gift of appreciated stock, not only do you receive a charitable deduction at the full market value of the stock, but you also avoid any capital gains tax on the stock forever. Third, suppose you own a successful business. You establish a fund and contribute some of the closely held shares in your business to the fund. You could take an immediate income tax deduction on the fair market value of the shares contributed. Had you elected to establish a private foundation, your tax deduction would have been limited to your cost basis on the shares contributed. Also, because of annual
limits on deductions as a percentage of adjusted gross income, you can take income tax deduction more quickly than if a private foundation was utilized. You could then sell the stock through the fund with no capital gains tax liability to the fund or to yourself. If you are making or intend to make charitable contributions, these are just a few of many possible scenarios where using a donor advised fund can enhance your charitable and tax planning.
Kevin Kroskey, CFP®, MBA is President of True Wealth Design, an independent investment advisory and financial planning firm that assists individuals and businesses with their overall wealth management, including retirement planning, tax planning and investment management needs. Kevin can be reached via email at [email protected] or by phone at 330-777-0688.
Preparing for the New (Tax) Normal By Tanina Frouge Linden, CFP®, Futurity Capital LLC
Next year many tax payers can expect their taxes to increase, and in some cases, the increase may be substantial. Current ordinary income tax rates and long-term capital gain
rates, aka the Bush tax cuts, are scheduled to “sunset” at yearend and rates are expected to return to previous higher levels. Originally scheduled to sunset on December 31st, 2010, the Tax Relief Act of 2010 extended the current rates for an additional two years. The combined tax-hiking impact of the Bush tax cut expiration and the looming 3.8% Medicare surtax has been dubbed “Taxmageddon”. 2013 is right around the corner - now is the time to take action! Ordinary Income Current Income Tax Bracket / Proposed for 2013 10% / Eliminated 15% / 15% 25% / 28% 28% / 31% 33% / 36% 35% / 39.5% The difference between a 39.6% and 35% tax is significant: • $100,000 of income taxed at 39.6% = $39,600 • $100,000 of income taxed at 35% = $35,000 The result: 13.1% difference in income tax paid In addition, the phase-out of personal exemptions and itemized deductions will return in 2013, effectively increasing tax rates by 1.2% for many individuals with income over a certain amount (threshold are adjusted annually but if this rule had been in effect in 2011, the income threshold would have been $169,500). Currently, there are no
income limits on the overall amount of itemized deductions or personal exemptions a taxpayer can claim. Also, the standard deduction for married filing jointly taxpayers is expected to decrease (from 200% of the amount for single filers to 176%). Actions to consider: The exercise of non-qualified employee stock option (NQSO) grants that are deep in-the-money and close to expiration. An employee at exercise of a NQSO will recognize W-2 income for the fair market value of the stock over the exercise price. Exercising in 2012 at a lower tax rate would be advantageous.
this year could consider taking their first• IRA owners turning 70 required minimum distribution (taxable) now and not wait until April 1, 2013 when the higher tax rates will be in effect. Capital Gains and Dividends Proposed long-term capital gains tax increases • 15% to 20% (18% for assets held over five years) Qualified dividend tax increase • 5% to ordinary income tax rates While the difference between a 15% and a 20% capital gain may not sound like much of an increase, it can be significant. For example, • $100,000 gain at 20% = $20,000 • $100,000 gain at 15% = $15,000 The result: 33.3% difference in taxes paid Actions to consider: For taxpayers in their 50s and early 60s, selling assets with a low cost basis in 2012 while retaining the more high-basis investments may result in less taxes on Social Security retirement benefits in the future. Additionally, pay close attention to asset location to maximize after-tax returns. For example: consider municipal bonds, as interest payments are federally tax-free and possibly state tax-free. Use tax-deferred accounts (IRAs, 529s) for fixed income, REITs and actively managed investments, and use taxable
accounts for foreign investments, buy-and-hold strategies and other tax-efficient investments. Take Home Pay Scheduled to Drop Social Security taxes for paycheck employees are slated to return to the 6.2% level in 2013. (There has been a reduction to 4.2% in effect since 2011.) If an individual earns $75,000 during 2013, he or she will take home about $1,500 less than in 2012. NOTE: The Social Security's Old Age, Survivors, and Disability Insurance (OASDI) program limits the amount of earnings subject to taxation for a given year. For earnings in 2013, this base is $113,700, which is an increase of 3.27%. This limit changes each year with changes in the national average wage index, which can be found at http://www.ssa.gov/oact/cola/AWI.html. 2010 Healthcare Reform (aka Obamacare) Surtax on Income Beginning in 2013, a 3.8% charge is scheduled on net investment income for individuals and couples whose modified adjusted gross incomes (MAGI) exceed $200,000 ($250,000 in the case of married filing jointly, $125,000 for married filing separately). It would actually be levied on the lesser of two amounts – either an individual’s net investment income or the amount of MAGI above the $200,000/$250,000 levels. A bonus, an IRA distribution, or a sizable capital gain may push a person’s income above these thresholds resulting in a bigger tax bill. (While IRA distributions are not subject to the surtax, they are added to MAGI and may potentially put individuals above the $200,000 threshold.) Additionally, the Healthcare Reform Act will increase taxes by imposing an additional 0.9% tax on wages and income from self-employment in excess of $200,000 ($250,000 for married taxpayers). Impact on Education Savings * Several aspects of education savings will also be impacted by the coming changes to the tax code. * The deductibility of student loan interest will be sharply curtailed * Eligible taxpayers can only claim the deduction for the first 60 months (5 years) of interest payments. The income phase out limits are halved from current levels.
The American Opportunity tax credit is currently a four-year, dollar-for-dollar tax reduction of up to $2,500 for the first $4,000 in eligible educational expenses (tuition, fees, course-related supplies, etc.). Up to 40% of the credit is a refundable tax credit. The American Opportunity tax credit will expire on January 1, 2013 and be replaced with the
Hope Scholarship credit, a nonrefundable credit with stricter income requirements; it is worth up to $1,800 for two years of qualified educational expenses. Coverdell Education Savings Accounts - the following changes will occur: * Only postsecondary education expenses will qualify for the tax law; K-12 expenses will no longer be eligible. * The annual contribution limit will be reduced from $2,000 per beneficiary to $500 per beneficiary. * Distributions will be tax-free only for those taxpayers who do not claim a Hope Scholarship or Lifetime Learning Credit (if eligible) in the same year. Actions to consider: The changes to education planning tools underline the importance of a starting a good 529 Plan account for your child. A 529 account will allow your investment to grow federal tax free and may be a deduction on your state income taxes as well. Estate and Gift Exemptions May Shrink Significantly The (unified) lifetime federal gift and estate tax exemption is currently set at $5.12 million. It will drop to $1 million in 2013 unless Congress acts to change that fate. Federal gift tax and estate tax rates are also slated to increase to a max of 55% in 2013, as opposed to 35% maximum rate now. Currently, the unused portion of a $5.12 million lifetime exemption is portable to a surviving spouse - in 2013, that portability is expected to disappear. The loss of estate and gift tax exemption portability between spouses will exacerbate any lack proper of planning for married couples. Although many analysts and economists think that Congress will eventually abide by President Obama’s wishes and reinstate the 2009 tax code of a $3.5 million estate tax exemption, a $1 million lifetime gift tax exemption, and a 45% maximum estate and gift tax rate, nothing is certain at this point. There has been some reluctance to take advantage of the current $5 million gift tax exclusion due to fear of a potential “claw back”. These individuals believe that if the exemption amount is lower in the year of the donor’s death, his estate will be liable for taxes on the value of the previously tax-free gifts. Most tax experts and financial planners feel a “claw back” is unlikely as it would be contrary to public policy to penalize individuals who are simply relying on current tax law. Actions to consider: • Review wills and trusts to determine if any changes are necessary. In some cases, property may
need to be retitled to ensure both spouses’ exemption amounts are used • Shift Property to Lower Income Family Members In 2012, the long-term capital gain rate for individuals in the 10% and 15% ordinary income brackets is 0%. Individuals might consider gifting appreciated property to family members in these lower income brackets, allowing them to dispose of the property without incurring a capital gains tax. The annual gift tax exclusion for 2012 will remain at $13,000 for individuals and $26,000 for couples who utilize “gift splitting”. Be aware that that recognizing a significant capital gain can push lower-income earners into a higher income tax bracket. Also, be aware of the “kiddie-tax” that applies to unearned income, including capital gains, of dependents under age 19 and dependent full-time students under age 24. All amounts in excess of $1,900 are taxed at the parent’s higher rates. Retirement Some taxpayers may be interested in moving to a more “tax-friendly” state at retirement but may fear that their IRA savings may still be subject to tax in the higher-tax state in which they were first earned. Fear not - qualified plan and IRA distributions are taxed only in the state of domicile or residence at the time of distribution, not in the state where the earnings accumulated tax-deferred. Roth Conversions With the coming tax tsunami, there has been much talk about Roth conversions. With Roth IRAs, an individual basically agrees to pay any taxes now in exchange for tax-free treatment when the funds are withdrawn at retirement – contributions into a Roth are made with after tax dollars. A conversion, simply put, means taking money from your traditional IRA account and putting it into a Roth IRA account. This action will be treated as a taxable distribution from your traditional IRA, triggering a bigger federal and state income tax bill for this year. Since today's federal income tax rates might be the lowest for quite some time, paying taxes on your IRA now could be a good move. And qualified Roth
are federal income tax free. Anotherwithdrawals taken after age 59 positive about a Roth conversion is that you have until Oct. 15, 2013, to "recharacterize" (undo) a 2012 conversion should you change your mind. A conversion makes sense if: 1. You expect your tax bill to stay the same or be higher in the future. If your income is low, you can convert a portion of your IRA at a low tax rate. And if your income is high, your tax bracket in the future
is liable to be higher than it is now as the Bush tax cuts expire. 2. You have an IRA that could be converted. The larger it is, the more important it is to do a Roth conversion. Because the IRS will force you to start taking RMDs from a traditional IRA at age 70, those distributions could push you into a higher tax bracket. Converting some of your IRA to a Roth will reduce the value of your IRA and lower the distributions you ultimately will have to take. If you have a 401(k) from a previous employer, you can roll it into an IRA and then convert the IRA to a Roth. But if you only have your 401(k) from your current employer, in-service withdrawals will probably not be allowed. 3. You have sufficient assets to pay the tax from your nonretirement accounts. You lose many of the benefits of a Roth conversion if you withhold taxes from your IRA account rather than paying the tax from your salary or taxable assets. Having sizable taxable savings allows you to be able to take advantage of tax planning. 4. It pays to enlist the assistance of a fee-only financial planner and a CPA to help with your conversion – it is a complex subject and you want to be sure you know what you are getting into. A bonus for the charitably-inclined - since there is no phase-out of itemized deductions for higher income taxpayers in 2012, unlimited itemized deductions, such as charitable giving, can be used to offset the incremental income resulting from a Roth IRA conversion, dollar-for-dollar. Maximize Employer Retirement Plan Contributions There perhaps has never been a better time to take advantage of employer-sponsored retirement plans to potentially lower one’s tax liabilities. In 2012, the maximum deferral to a 401(k), 403(b) or 457 plan is $17,000 (individuals age 50 and older can defer an additional $5,500.) Business owner or those with self-employment income have a number of options to consider. For example, businesses using a SEP IRA or Keogh profit sharing plan should consider a New Comparability 401(k) profit sharing plan. These plans generally allow higher contributions to selected, key-employees. Business owners should consult a retirement plan expert before setting up company plans, as the correct choice of plan is complicated and dependent on many factors.
Physician Opportunities From MedicalMatch.org
Cardiology - Anderson, SC – Local interventionalist seeks other cardiologists with similar strong work ethic. Adding associates to now-solo practice; ultimately will be five to seven. He is AnMed Health’s top admitter and performs 30% of all caths. High volumes overall: 450 to 550 coronary interventions and 100 to 150 peripheral interventions annually; 50 to 60 nuclear studies and 60 to 70 echos per week. He is published and active in national and international research studies; is the principal investigator for approximately 90 % of current device and medication trials at AnMed Health. And believe it or not, his call is manageable. One office; supportive congenial staff that includes echo, nuclear and vascular technologists. Good payor mix. Superb opportunity for well-trained, energetic interventionalist with shared vision for building group. Must practice high-quality CV medicine. Good comp; first year salary, benefits. Buy in at 12 or 24 months; hard assets only. AnMed Health System - 597 beds. Recipient of 2008 HealthGrades awards in clinical excellence and patient safety. AnMed is number one in SC for cardiac surgery; overall pulmonary services and overall critical care. Anderson is located on 50,000-acre Lake Hartwell….yes, close enough for principal residence…and I-85 which can get you to either Charlotte or Atlanta in two hours. …Charleston is only a morning’s drive. To review this and other opportunities: Contact Sherry Chastain, Dir, Medical Staff Development, AnMed Health Medical Center, Anderson, SC, 800-226-3103, [email protected]
Cardiology - Dallas, TX – Outstanding Opportunity for an Interventional Cardiologist. HeartPlace is the past, present, and future of cardiology in North Texas. With HeartPlace, the future of cardiology is truly here. We are currently seeking an Interventional Cardiologist at our S. Fort Worth clinic location. The HeartPlace clinic currently has 1 physician (Non-Interventional) so physician must be comfortable being in a small clinic and being the only Interventionalist at the clinic. Call is 1:4 (1:2 for Interventional). Services offered at the clinic – nuclear (mobile camera), echo, stress echo, pacemaker checks. Hospital (Huguley Memorial Medical Center) has 2 cath labs. Clinic outreach 1 day/week is probability. Physician must have outgoing personality. For further information: Contact James Dooley, Cardiovascular Provider Resources, 14800 Landmark Boulevard, Suite 700, Dallas, TX 75254, 972- 391-2053, [email protected]
Dermatology - Indiana Opportunity – Exceptional opportunity to develop a practice in a thriving community with no other Dermatology services. High community demand and strong primary care referral base make this an outstanding opportunity. Choose the option of employed or income guarantee. Practice would include working with Regional Cancer Center involved in a national melanoma research initiative cutting edge technology. University affiliation; very competitive compensation and comprehensive benefits; located in a mid-sized community with an easy commute to a major metro. The area offers outstanding public and private schools, golfing, fishing, boating, theatre, symphony, music festivals, beautiful parks, college sporting events and much more. This is an excellent opportunity in a combined medical and cosmetic Dermatology practice. Equipment is state-of-the-art, including laser. Large patient base already established by Dermatologist who is retiring. Very competitive compensation and benefit package. Located in one of Indiana's larger cities, the area offers beautiful golf courses, boating, theatre, college sports, excellent schools and much more. For more information contact: Anna McNerney, 888-765-0007 (Toll Free), 574-262-0638 (Direct line), [email protected]
Emergency Medicine - Upstate New York – VISTA Physician Search and Consulting has a client seeking to add a BC/BE Emergency Medicine physician to its group. This is a permanent position. Practice benefits include: Extremely competitive compensation starting at $215,000 with productivity bonuses; Flexible schedule including days, evenings, and nights; Three, 12-hour shifts per week to allow ample time off; No trauma work. Faculty benefits include: Cover two metro area hospitals with 24,000 and 42,000 emergency department annual volumes and one small facility with 13,000 in annual volumes; Double physician coverage days and evenings; double mid- level coverage afternoons and evenings at larger facilities; Admissions sent to admitting physicians; Nationally renowned Neurosurgery program and Stroke Center; Radiology on site; MRI, CT, ultrasound, and other testing services always available. Community benefits include: Close to Lake Erie and major Canadian cities; many parks and recreation sites for outdoor activities; some of the best private and state universities in the Northeast; Excellent public schools with low student-to-teacher ratio. To learn more about this opportunity, please contact Patricia De La Paz at [email protected] or call 800.366.1884 ext. 6555. To apply for this opportunity now, please send your CV with cover letter. Click here to view all our permanent jobs.
Emergency Medicine - Tallahassee, FL – Independent democratic group seeks top quality Emergency Medicine Physician for Capital Regional Medical Center in Tallahassee, Florida. Physician must be BE/BC
ABEM/AOBEM certified to work in this 65,000 annual volume ED. Excellent compensation, equal shareholder opportunities, productivity bonuses, health and disability insurance, generous 401K and profit sharing, CMEs and professional expense reimbursement as well as malpractice and tail coverage. Best known as Florida’s capital city, Tallahassee is a fusion of cosmopolitan flair and charming personality. Deep rooted in history and culture, it is where college town meets cultural center, politics meets performing arts and history meets nature. Located just minutes from the Gulf and nearby beaches! For more information, contact Alisha Lane, Titan Emergency Group, (904) 332-4322 or [email protected].
Emergency Medicine - Warren, Ohio – St. Joseph Health Center in Warren, Ohio, conveniently located between Cleveland and Pittsburgh, seeks a confident and dedicated emergency medicine physician. Annual volume 34,000; level III trauma center; 12-hour shifts; EM residency program; flexible schedule; physician/physician assistant double coverage! Extremely competitive compensation and benefit package including partner plan, health plan, 401K, malpractice, life and long-term disability. To review this and other opportunities: Contact Erin Waggoner, 4M Emergency Systems, 888-758-3999, [email protected]
Emergency Medicine - Illinois – Primus Trauma Care , Bloomington, IL, is seeking a BC/BE Emergency Medicine physician to join a group of 11 physicians. The hospital you will serve is a state-of-the-art facility with 23 emergency trauma rooms. Highlights of this opportunity include: Student loan assistance, Flexible schedules, 250,000 draw area, and unique partnership opportunities. Bloomington/Normal, IL has been listed as one of Money magazine’s Top 100 Best Places to Live. It has excellent public and private schools and is home to 2 major universities. Bloomington/Normal has a thriving economy with companies such as State Farm, Mitsubishi and Country Financial. It also offers a wide variety of cultural and recreational venues such as the US Cellular Coliseum, The Bloomington Center for Performing Arts and Braden Auditorium. To review this and other opportunities: Contact Bette Luna, Adkisson Search Consultants, 866-311-0000, [email protected]
Endocrinology - Lafayette, IN – Established Multi-Specialty Group - Sigma Medical Group an established multi-specialty group is seeking a BE/BC endocrinologist. This outpatient/inpatient setting will include a mixture of cases, including diabetes and a flexible call schedule of 1:3 or better. Enjoy the benefits of top-notch, excellent new facilities and exam rooms, providing you with all capabilities to perform all of your procedures. A very competitive two year employed guarantee compensation package waits...at or above the national average, commensurate on experience. Production bonuses, relocation, CME, health benefits, and an incredible pension all are part of this great opportunity. Physicians with Sigma enjoy an outstanding, cooperative working relationship with St. Elizabeth Regional Health. Opening in the fall of 2009, St. Elizabeth East Medical Center, a 150 bed state-of-the-art facility, will afford your patients the latest in hospital technology and care. St. Elizabeth Regional Health is home to the most comprehensive medical care in the region and has traditionally led in providing state of the art equipment, facilities, and physicians to its patients. For further information contact: Courtney Becker, 800-678-7858, x 64401, [email protected], Reference #122940 (30925) B35
Gastroenterology - Southwest Oregon – A spectacular setting often compared with Italy and Southern France, offering a potential income of $700K while only working 2 full days and 3 half days. Live a short drive away from the Pacific Ocean and right in the heart of the region’s wine country. This established group of gastroenterologists is seeking to add to their practice where they enjoy a call schedule of less than 1:5 plus zero HMO and great reimbursement contracts. Quality of life is second to none with plenty of outdoor as well as cultural activities to go around. Keep yourself busy in this economically sound community.
Gastroenterology - Ohio – A busy gastroenterology practice is seeking a board certified or board eligible M.D. or D.O. gastroenterology physician. This physician will enjoy a strong referral base from primary care physicians in a two county area as well as referrals from multiply emergency departments. Employment opportunity will allow the physician to join an existing practice, offering a competitive salary as well as benefits, relocation, and a signing bonus. The population to physician ratios in the service area of the hospitals served along with the outmigration statistics for gastroenterology clearly indicates this qualified physician will develop a successful practice in a very short time. There is a one in two call rotation, and the physician’s offices are located in the endoscopy center and on the campus of Wilson Memorial Hospital with all the amenities of a successful gastroenterology practice. This physician will have the advantage of having access to an early partnership in an endoscopy center located within a short drive of the hospitals served. The practice is located in a family-oriented community that offers easy access to the metropolitan areas of Dayton, Cincinnati, and Columbus. This employment opportunity offers the candidate the full benefits of joining an existing gastroenterology practice while receiving the support of the medical staff and administration of the hospitals this practice serves. For more information, please send a formal CV and inquiries to: David Andrick, Director of Physician Recruitment, Wilson Memorial Hospital, 915 West Michigan Street, Sidney, OH 45365. Phone: 937-498-5503
General Surgery - Opportunities Nationwide – Many General Surgeons are finding a balance between lifestyle and career as locum tenens providers. The locum tenens lifestyle offers flexible work schedules and fewer administrative burdens while preserving the financial security that comes with a challenging professional career. LocumTenens.com provides temporary and permanent placement services for General Surgeons nationwide. We offer: Excellent compensation, Paid medical malpractice insurance, Paid travel and housing expenses, and the freedom and flexibility to decide when, where and how often you want to work. Practice general surgery on your own terms. "Trial Practice Options" with LocumTenens.com provide transitioning residents with the opportunity to try out a variety of practice settings in different geographic locations before making a commitment. If you’d like to hear more about current job opportunities, call 800.562.8663.
Hematology/Oncology - Jackson, TN – Join 3 other hematologist/oncologists in extremely busy large multi- specialty clinic. Inpatient and outpatient position. In office ancillaries and EMR available. Partnership available. Community overview: One hour from Memphis and two from Nashville; Community of 100,000 people and home to 23 Fortune 500 Companies; Excellent private and parochial schools and 5 colleges and universities; 200,000 acres of lakes and rivers; Ballet, Theatre Guild, Arts Council, Symphony, and AA Baseball; Low cost of living and no state income tax; Site Selection Magazine ranks state as the second best location in the country for businesses. Hospital overview: Jackson-Madison County General Hospital; 635 bed tertiary care center; New 9 story bed tower opened September – 2008; New EMR in implementation; 85 Adult ICU beds; 26 ORs in main hospital and 10 in surgery center; 80,000 plus ER visits annually. For additional information contact: Marion Douglass, Physician Recruiter, (866) 891-6055, [email protected],
Internal Medicine - Midwest Opportunity - group seeking BE/BC physician for traditional internal medicine or inpatient only practice in multi-specialty group affiliated with top 100 Solucent hospital in Midwest. A competitive salary with excellent benefit package is available. Enjoy a relaxed call schedule. Please send resume and references to: Magnolia Critical Care & Internal Medicine, 573-874-3235, [email protected]
Neurology - Coastal New Jersey – This is a hospital employed neurology position. You can be set up on a net income guarantee or be employed by the Hospital…this choice is yours. The employed position offers a competitive salary and paid malpractice; excellent comprehensive benefits and CME allowance. NYC is just 60 miles north and Philadelphia is about 50 miles to the west. Also enjoy sailing, golf, yachting, fishing in this family oriented community which is host to numerous beautiful parks. Please respond to Margie Quinlan, Lawlor and Associates, 800-238-7150; fax your CV to 610-431-4092 or email: [email protected].
OBGYN - Shreveport, LA – CHRISTUS Medical Group is seeking an OB/GYN physician to join a busy, group practice for the Women’s Health Clinic in Shreveport, Louisiana. The position is in response to a growing need in the community. Clinic hours are Mon. – Friday 8:00 a.m. – 5:00 p.m. with call 1:3. Affiliated with CHRISTUS Schumpert Health System, a wide variety of programs and women services are available with the latest information about pregnancy, expert medical care and support. Maternity services provide a rewarding birthing experience founded on personal attention from medical professionals who care. Located in Northwestern Louisiana, Shreveport is a thriving city full of artistry, music, food and fun along with low cost of living, award-winning schools and mild climates for great quality of life. Please send CV and salary requirements to: Glenda Johnston, Sr. Director, Physician Recruitment, 713-277-2223, [email protected]
OBGYN - New Jersey – Regional Women’s Health Management is a financially sound, well-established group in Southern New Jersey, with a demonstrated need for additional board certified/board eligible OB/GYN practitioners. Our group consists of over 50 physicians in multiple locations with numerous opportunities available. Practice benefits include: Competitive compensation packages with partnership potential for the right candidate; Complete benefit package includes 3% retirement contribution; Affiliated with community hospitals in the region with excellent staff and residents; Support staff includes certified nurse practitioners and physician assistant with a full range of DEXA and U/S services. Community benefits include: Top-rated school systems with excellent nearby colleges and universities; Abundant cultural arts institutions and events, including symphony, museums and art galleries; A short drive or train ride to Philadelphia or New York City; Nearby Philadelphia offers professional sports including football, hockey, and the 2009 World Series champion baseball team; Enjoy summers down the shore; Excellent restaurants; Many organized community programs; The Garden State is home to “Great Destinations in Any Direction” – Enjoy our award-winning golf courses, world-class museums, theatres and prominent restaurants. Explore the splendor of its high mountain peaks, vast open spaces and lush forests to our 127 miles of coastline. Our shore towns boast beautiful beaches, barrier islands and bays illuminated by historic lighthouses. To be considered for this position, please send your CV with cover letter to [email protected].
Pain Medicine - Missouri Opportunities – ID# M64 - A group in Eastern MO has a 100% pain position available. Pain fellowship required. No call, no nights, no weekends. Candidate can have anesthesia or PM&R residency. Offering base salary $250,000, plus production bonus and full benefits including malpractice, paid vacation, medical insurance & retirement plan! Nice family area and excellent school system. For more information about this position, please contact Michael Torbeck at 800-930-0269, please send your CV to [email protected] or fax it to 954-337-9208. For a nationwide listing of our pain positions, please visit our website at www.macjobs.net.
Primary Care - Mobile, AL – Franklin Primary Health Center is a community health center located in Mobile, AL seeking BC/BE Family Medicine Physician to join our growing multi-specialty group practice. J-1/H1-B VISA candidates welcome. Franklin Primary Health Center is a Joint Commission accredited community health center with excellent support services with multi-disciplinary model of care that includes Dentistry, Family Medicine, Internal Medicine, Pediatrics, and Women’s Health. Other services include Optometry, Behavioral Health, Pharmacy services, Lab, Radiology, and other select medical specialties. Mobile is located in southwest Alabama on the Mobile River at its entrance to Mobile Bay, 31 miles north of the Gulf of Mexico. The region offers an abundance of cultural and recreational opportunities for people of all ages – a variety of museums, theater, symphony, opera, ballet, fishing, golfing, relaxing at the beach, and much more. Excellent salary and full benefit package which includes: Health and Dental, Malpractice Insurance, Vacation – 15 paid days, Sick Leave – 8 hours/month, 10 Paid Holidays, Life, AD&D, STD, LTD, Flexible Benefit Plan, Incentive Program, 403B Tax Deferred Annuity, Supplemental Retirement Plan, Professional Continuing Education Allowance, Paid Membership, Paid License Fees, Loan repayment program eligible site, Relocation Allowance, Signing bonus. Submit resumes or direct inquiries to: Franklin Primary Health Center, Inc., Attn: Tommie Anderson, COO, P.O. Box 2048, Mobile, AL 36652-2048, (251) 476-7615, [email protected]
Primary Care - Marion, OH – A busy private practice physician in Marion, Ohio is in search of an additional physician. The current physician is certified in Internal Medicine-Pediatrics and would consider both IM/PEDS and Family Medicine physicians. With the current high volume the new physician would not only assume some of the current physician's patients but also take on new patients; allowing the new physician to build a practice quickly. This practice is associated with OhioHealth's Marion General Hospital. For more than 90 years, Marion General Hospital's associates, volunteers and physicians have provided patient-focused care in the community. Marion General physicians are known for the exceptional care they provide at this community hospital, which has grown into a regional referral center, offering services and care traditionally found in much larger hospitals. Four generations have come to know Marion General as the largest and most sophisticated hospital in the seven-county service area, providing services that include advanced heart care, a Level II Special Care Nursery; and spine and joint revision surgery. Given the hospital’s strong ongoing service to its seven-county area, the Marion community can rest assured that Marion General Hospital will continue to grow and stay on the cutting edge of medical care as needs and innovation develop. The city is located about 50 miles (80 km) north of Ohio’s capital city, Columbus, due north along U.S. Highway 23. It is the county seat of Marion County. Marion occupies most of Marion Township, which is located just outside of the city limits. Marion is the nation's leader in corn and popcorn produced foods. Marion is home to the Marion Popcorn Festival, an annual event that is held in downtown Marion. The Regional Dog and Pony Show is a regional event that is held annually in Marion. For more information on the position please contact Karlie Sites at 614-544-4223 or send your CV to [email protected]
Primary Care - Virginia – Eastern Shore Rural Health System, Inc. is a Community Health Center organization located on the Eastern Shore of Virginia, a 52 mile peninsula nestled between the Chesapeake Bay and Atlantic Ocean. Our rural community offers beautiful scenic views and access to a variety of cultural opportunities. For more information, visit our website at www.esrh.org. As the 10th largest employer on the Shore, ESRHS has much to offer our employees along with an excellent benefits package which includes health & dental insurance, 403(B) matching program, disability insurance, paid CME and more. Candidates must have a valid Virginia license and must be Board eligible or Board certified in a primary care specialty. Skills required include: Planning, organizing and implementing clinical programs and activities, supervising and assisting in training of clinical professionals, ability to work well in a leadership role with a cooperative effort with diverse groups of health professionals and center staff; ability to work independently and to make appropriate clinical decisions which reflect professional strength, confidence and integrity. If you are a mission driven person looking to make a difference, please fax, mail or email a CV to: Jeannette R. Edwards ([email protected]), Fax: (757) 414-0569, P.O. Box 1039, Nassawadox, VA 23413
Primary Care - Panhandle of Florida – Sacred Heart Medical Group, a premier 100+ physician group serving the Panhandle of Florida is seeking Internal Medicine and Family Practice physicians interested in a good career in a beautiful place to live. As a member of Sacred Heart Medical Group you would enjoy: Excellent earning potential – with almost half of the group earning at or over the 75th percentile nationally; Generous benefits, including disability coverage and robust pension plan; Group has excellent customer relations and ranks at the 85%tile nationally; Only JCAHO accredited physician group in the region; Nationally recognized teaching hospital affiliation with the Florida State College of Medicine; Affiliated with the M.D. Anderson Physicians Network. Plus be a part of a community which offers: Pristine beaches, scenic rivers and bays; Schools within the top 15% in the nation; University town; Active arts community, including symphony, opera, theatre; Cost of living at 92% of national average; No state income tax; Year round outdoor activities. For additional information contact: Physician Recruitment, 800-669-5386, [email protected]
Primary Care - North Dakota – needed for Rural North Dakota Hospital Employed Opportunity - This town is a growing community with a bright future. Our citizens breathe easy here; we know and care about one another, and we believe every person can make a difference. North Dakota consistently ranks in the #1 safest states, #10 most livable states, and #9 healthiest states in the nation. The city of Williston is nestled in the northwest corner of North Dakota, just 60 miles from the Canadian border and 18 miles from the Montana border. Our economy is enriched by the oil and gas industry, agriculture and the service sector. Economic Development, the Convention and Visitors Bureau, and the Chamber of Commerce all work together to enable Williston to shine as the "Western Star" of North Dakota. Western North Dakota is one of the finest deer and game bird hunting regions in the United States. Williston ranked #18 in the April 2008 edition of Outdoor Life Magazine’s article, "The top 200 towns for the outdoorsman." Lake Sakakawea, located 16 miles east of Williston is the largest man-made lake in the country, and is regarded as one of the premier walleye fishing lakes in the world. Features include: Hospital Employed, Base Salary $230,000, Signing Bonus, Full Benefits, Stipend during Residency. If you’re looking for great quality of life within a city with excellent family values, this city has it all. Please call Robert Overfield at 800-839-4728 or email your CV to [email protected]
Primary Care - Reno, NV – The VA Sierra Nevada Health Care System is seeking a BC/BE internal medicine or family practice physician. Major functions include initial evaluation, H&Ps and medical management of veterans in primary care clinics. Diagnoses and advises veterans of clinical problems that may be discovered during an examination. Interprets laboratory and radiological related material. Participates in the teaching programs of the University Of Nevada School Of Medicine. Recruitment incentive may be available. Candidates must be a U.S. citizen. The VASNHCS provides primary and secondary care to a large geographical area that includes 20 counties in northern Nevada and northeastern California. Approx. 120,000 veterans reside in this region. The Reno campus operates 64 hospital beds and 60 Community Living Center beds in addition to three CBOCs. Academic affiliations for VASNHCS are the University Of Nevada School Of Medicine and the East Bay Surgical Program at the University of California, San Francisco. Approximately 45 medical, surgical, and psychiatry residents rotate annually through VASNHCS. Located on the eastern slope of the Sierra Nevada mountain range, Reno is minutes away from beautiful Lake Tahoe. Year round recreation, entertainment, arts, and culture abound. Reno also boasts an average of 260 days of sunshine per year. Best of all, Nevada has no state income tax! A career with the VA offers stable employment and a future that is challenging, satisfying, and rewarding. Our excellent patient care environment includes learning and teaching opportunities, an advanced electronic medical records system, and competitive salaries. Our generous comprehensive benefits include: Recognition for professional achievement; Educational opportunities for professional development; Competitive pay; Liability protection; 26 days (minimum) paid annual leave/year; 13 days paid sick leave per year; 10 paid holidays per year; 15 days paid military leave per year (if applicable); Choice of health insurance options; Dental and vision coverage available; Life insurance coverage; Retirement benefits (three tiered); Thrift Savings Plan (similar to 401k) with agency matching; Student loan debt reduction program. Fax or email CV to Lenore Reinhard, RN, Healthcare Recruiter, 775-328-1250, [email protected]
Psychiatry - Kentucky Opportunity – LifeSkills is currently seeking a Board Certified/Board Eligible General Psychiatrist; the position will cover 2-3 clinics in our service area working 40 hours per week. Primary role is to provide psychiatric evaluation and follow-up medication management with child and adult psychiatric patients in an outpatient setting. No weekends or on-call. On-call is available with additional stipend. We offer excellent benefits, State of Kentucky Retirement Plan, 401(k) and 457 saving plans, state health insurance. LifeSkills is South-Central Kentucky’s premier provider of mental health, substance abuse, and developmental services for over 40 years. LifeSkills, headquartered in Bowling Green, operates in a ten county region consisting of Allen, Barren, Butler, Edmonson, Hart, Logan, Metcalfe, Monroe, Simpson, and Warren County. LifeSkills supports individuals as they build meaningful and independent lives by providing more than 50 programs; we firmly believe in making a difference in the lives of our customers. Through our team approach we are able to provide the best services to those we serve. LifeSkills’ Behavioral Health division provides individual, group and family counseling to assist individuals and families who are facing a mental illness or crisis situation. Our mental health services include psychiatry,
psychotherapy, case management, day programs, supported employment, supported housing, therapeutic foster care and crisis stabilization. For more information contact Eileen Williams at 270-901-5000 x 1121 or [email protected]. Visit us on-line at www.lifeskills.com. For more information about Bowling Green visit: www.bgky.org
Psychiatry - Georgia - with interests in Adult, Child or Geriatric are needed to join our growing Laurelwood facility. Laurelwood, located on the main campus of Northeast Georgia Medical Center, provides a broad range of services for adolescents and adults experiencing mental health or substance abuse problems. Laurelwood offers a variety of treatment options including detoxification, inpatient treatment, day partial treatment, intensive outpatient treatment, and aftercare support. Inpatient 8am-5pm; Call one day per week 7a-7p and every 4-6 weekends; 40 adult and 14 adolescent beds; Substance abuse and general psychiatry; Short term - Avg. stay 4-5 days. Located 50 miles from Atlanta, GA near the shores of Lake Lanier and the foothills of the North Georgia Mountains. To learn more about these opportunities, please contact Marshall Poole at 770-219-6635 or via email at [email protected] . Please visit our website at www.practicemedicinehere.com for further information.
Pulmonologist - North Carolina - needed to assume practice in safe, family community as current doctor transitioning to lead local hospitalist program. Less than 2 hours from beaches, Charlotte, RDU, and just 45 minutes from Fayetteville and 35 minutes from Pinehurst. Loan repayment assistance is possible. Laurinburg is only 35 minutes from the golf resort of Pinehurst and 2 hours or less from the Carolina beaches, Charlotte, Raleigh and Greensboro. The closest large city, Fayetteville, is a 45 minute drive. St. Andrews Presbyterian College is located in town and the University of NC at Pembroke, along with the Givens Performing Arts Center, is 20 minutes away. Contact Melisa Ciarrocca, Scotland Health Care System, 910-291-7540, [email protected]
Vascular Surgery - Atlanta, GA - needed for busy practice in metro Atlanta. Our market has a great demand for a new surgeon. The new physician will have full support of Hospital, Surgical Staff, and PC Physicians. This practice does not have to be built or cultivated, referrals and patients from day one. This is a readymade, turnkey practice. Hospitalist service services over 50 patients per day. Endovascular skills are a must with our facility. We offer the opportunity for Private Practice or Hospital Employment. Benefits package will be in Highest Percentile for the metro area. We are located 40 miles from Downtown Atlanta in exclusive North Atlanta. Our team of caring and dedicated physicians and healthcare professionals provide quality medical care which includes these services: a state-of-the-art Emergency Department, Cardiovascular Services, Diagnostic Imaging, Women’s Resource Center, The Birth Place with a Level II Neonatal Intensive Care Unit, Inpatient and Outpatient Surgical Services, Sleep Diagnostics, Outpatient Rehabilitation Services, Diabetes Education, Home Health, and Wound Care. We have faithfully served our suburban community for more than 50 years. To review this and other opportunities: Avery Poe, 404-816-1801, [email protected]
Vascular Surgery - Muskegon, MI – Progressive surgical practice seeks fellowship-trained vascular surgeon. Well-established multi-specialty surgical group seeks a BC/BE vascular/endovascular surgeon to replace retiring vascular partner. Full complement of open and endovascular procedures performed. Office based vein practice and busy ICAVL vascular lab. Unrestricted access to interventional suites; excellent working relationship with cardiology and interventional colleagues. Muskegon Surgical Associates, PLC (MSA) for more than 40 years has been providing surgical health care services to West Michigan. MSA consists of 3 vascular surgeons, 5 general surgeons, and 2 plastic surgeons. A good payer mix, salary income guarantee, excellent benefits package a beautiful and friendly West Michigan community with excellent schools makes this a must-see opportunity! Our Staff trained in nursing, scheduling, insurance/billing, medical records and office management supports our offices. Meeting the surgical needs of West Michigan is both challenging and rewarding. MSA has met this challenge with years of hard work and dedication by our physicians and staff. We have over 50 other opportunities across the US. Seaboard's over 220 practices can be reviewed by specialty and state at http://www.seaboardhealthcare.org/job_opportunities.php, For additional information contact: W.R. Herrington, Sea Board Healthcare, 877-292-5007, [email protected], www.seaboardhealthcare.org.
All Specialties - Opportunities Across the Country – Enterprise Medical Services (EMS) is one of the leading physician recruiting and consulting organizations in the United States, connecting the most progressive hospitals, clinics and medical groups, with the most qualified career-minded physicians. Since 1990, EMS has been committed to leading the market by offering an experienced staff and superior service in order to provide physicians and organizations with a positive recruiting experience. At EMS, we are committed to your success. Our consultants are the best in the business because they work exclusively in the medical specialty they serve. They take pride in building relationships that help communities find physicians. Our reputation and commitment is unparalleled. Let us help you make the recruiting process a worry-free experience. To review our current opportunities visit us online at www.enterprisemed.com, or phone us at 800-467-3737 or email us at [email protected]
All Specialties - Practice around the world – Your adventure starts here. Whether you’re nearing the end of your medical studies or ready to launch your new medical career, make locum tenens your first stop. You can travel the world, maintain your skills, gain valuable experience, and get paid to do it. And you don’t have to stay in one place for too long. Spend six months in New Zealand Zorbing in the world’s adventure capitol or exploring the Southern Alps; or pack up and enjoy a year in Australia tramping in the Outback or diving the Great Barrier Reef. After years of schooling, locum tenens lets you earn a competitive wage while you work less, travel more and—at long last—decompress. After all, practicing medicine is more than lab coats and stethoscopes, it really is an adventure. Global Medical Staffing has Anesthesiology positions available throughout Australia and New Zealand. Give us a call today and let us get started planning your locum adventure. The world is your practice, where do you want to go? For more information contact: Jesse Black, Toll-Free: 800.760.3174, Direct: 801.937.6580, [email protected], www.gmedical.com
All Specialties - Opportunities Nationwide – Spot On Recruiting was founded by one of the nation's premier physician recruiters, from one of the largest physician recruitment firms in the country. We place physicians in all specialties across the nation. Why us? We will walk you through every step of your career search. We will use our extensive expertise to help you find the right opportunity that fits your needs. We provide free and confidential service. We will spend the time necessary to find out exactly what you are looking for in a career. We will provide you with extensive data on the practice and community. We can introduce you to non-advertised positions that you won't find anywhere else. We will assist you with your interview coordination. We will educate you on the current market conditions. We will prepare you for your interview and assist you with your contract negotiations. If you are looking for perfect, flawless, precise and excellent recruitment, then Spot On Recruiting is the physician recruitment firm for you. To search all our current job listings go to: http://www.spotonrecruiting.com/search/searchjobs. You may also contact us directly at: 866-955-7768 ext. 101 or by email at: [email protected]
