1/1/2013

MD

PREFERRED

SERVICES THE ADVISOR

IN THIS MONTH’S ISSUE

Seven Legal Survival Tips for the Office Holiday Party - Asset Protection By Ike Devji

Life Insurance Is Not a Retirement Plan By David I. Katz, AAMS®, COO, CFO Financial Planner

The Capital Investment Blues: Unwinding Robs Funding for a Startup By Randall D. Fisher of the Fisher Law Office

Fringe Benefit Plans - Valuable Planning Tools You Haven't Heard Of By Carole Foos, CPA & Michael Berry, ChFC®

The New 401(k) Plan Disclosure Rules and You By David I. Katz, AAMS®, COO, CFO Financial Planner

Motivation for Change - Problem Solving vs. Desired Outcome By Karen Gray

Impact of the Fiscal Cliff By Brendan Bracken, W.J. Bradley Mortgage Capital, LLC

Dr. Vicki’s Prescription for a Healthy Prosperous Year

By Dr. Vicki Rackner

The Financial Crisis - Lessons Learned By Steve Selengut

Maximizing Retirement Plan Options By Ed Abramowitz*, MBA, CLU & Michael Kirsh*, CFP, CLU, AEP

Women Living Alone Don't Know This Vital Fact By John Spacek, LTCIS

Physician Opportunities

Seven Legal Survival Tips for the Office Holiday Party - Asset Protection By Ike Devji

This week marks the traditional start of the holiday party season for many businesses and most readers will attend multiple holiday parties and perhaps even host one or more. Attending a few of these events myself I’m always surprised to see employers with exemplary employee interaction throw all caution to the wind at this time of year, often with unpleasant results. While I certainly don’t want to scare you out of having a party and sharing the holiday spirit with your valued employees, we must address the way people really behave at these events and what it means for your practice. As discussed in previous columns, employee liability is a major issue that we are always trying to be proactive about. Most employment liability centers around a lack of clear rules and procedures and perhaps most importantly, a set of well enforced

behavioral expectations that they support. Below are some simple tips and issues to consider when planning your party. Invite your “guests” — don’t require their attendance. Make it clear that the party is an optional perk, not a required work activity that is linked to their job requirements. If they are required to attend it raises your liability. Lead by example. “The boss” or some kind of hall monitor being present goes a long way. Be friendly and collegial but control your drinking, get people to eat, and make sure someone is clearly in charge and visible as the host. Many of our clients have been involved in lawsuits related to the conduct of their partners while everyone was making sure the guests were behaving. The rules apply to everyone, especially you and all management. Set the tone with a dress code. Make sure your colleagues and employees understand that this is a business event, not a nightclub atmosphere. Encourage appropriate dress for the event and set guidelines if you know some attending may dress in a manner that is inappropriate or overly suggestive. Communicate it clearly and in advance so your guests are not surprised or embarrassed. Feed them first. Put some food in your guests, before the drinks are really flowing if possible. This will keep them busy, slow their drinking and help ensure they don’t drink until they are full. Control and limit the booze. It’s not realistic to expect that many offices will abstain from serving alcohol completely, but this is the number one source of problems at most parties. Remember that you are responsible for just about everything that happens during and even after the party, including liability for those who may injure themselves or others (even people not in attendance) as a result of excessive drinking or as their lawyer will put it, “being over served.” You can do this by limiting service hours at the bar, providing drink tickets for a specific reasonable number of drinks, or by having the drinks passed and served at intervals. Consider the venue and limit access if it’s at the office. During the day everyone knows where they are allowed to be and what is and is not appropriate, the lines get blurred after a few cocktails. Consider hosting your party off-site. It’s often more fun and helps transfer liability on some issues to the “professional” hosts at a restaurant or other venue. Make sure the venue itself does not create additional liabilities or an environment that may promote inappropriate contact or behavior or excessive consumption; cross the “Home of the Barber Shop Shot Chair and Mechanical Bull” bar off your list. If logistics don’t allow that, limit access to the office and request that the computers not be used. The last thing you want to happen is to have four employees gather in a cubicle watching Internet porn (true story). Make sure that items that are sensitive, controlled, or

dangerous are off limits and inaccessible. Remember that you may have strangers in your office like caterers or delivery people and that no one will be watching them. Have a good time. Have some genuine fun and make sure others are doing the same. We often see that “boring” parties create the most issues as people drink, fight, argue and gossip to keep themselves busy. On the other hand a well-organized party with a flow that keeps people talking, eating, moving, and interacting reduces the opportunity for much bad behavior. This article was originally published at www.physicianspractice.com and appears here with permission. Attorney Ike Devji has nearly a decade of national Asset Protection-only legal practice and helps protect billions of dollars in assets for a national client base including several thousand physicians. He is a national educator for both physicians and their advisors and has been featured in a variety of legal and financial publications including WORTH magazine, ADVISOR TODAY, Public Accountant, and as a featured author in the book, “Optimal Financial Health – The Doctor’s Wealth Management and Preservation Handbook”. Learn more about Ike’s work at www.proassetprotection.com/blog or connect with him on linked-in: www.linkedin.com/in/ikedevji

Life Insurance Is Not a Retirement Plan By David I. Katz, AAMS®, COO, CFO Financial Planner Recently I was asked, to weigh in on life insurance policies in general and more specifically, their place in the retirement planning process. While at first the topic might not seem directly on point for a retirement planning, many life insurance policies are sold under the guise of saving for retirement. Should life insurance be a key part of your retirement plan? Life insurance should be a vital part of your overall financial plan, specifically, if people depend on your income (e.g. your children and your spouse). A sizable income tax free life insurance death benefit payment is the best way to maximize the chance that your dependent's standard of living is not dramatically reduced due to your untimely demise. In fact, income replacement is the number one factor couples site as a reason for purchasing life insurance. Then the question becomes, what type of insurance should you purchase and is it a good idea to use insurance as an investment for retirement. If you listen to Suze Orman, Rick Edelman or other self-proclaimed financial gurus the answer you will get is that there is no reason to buy anything other than term insurance and that permanent insurance helps no one except the agent/advisor that sold the policy. Others will argue that term insurance is a temporary fix and since in generally offers no equity it is like renting an apartment versus buying a home and that you are throwing you money away. Insurance industry legend Bob Castigione, creator of the LEAP selling system, will posit that every investment dollar that you have should be invested in permanent whole life insurance. The truth actually is somewhere in between. When you purchase life insurance to protect your family, you'll want to be sure you buy adequate

coverage. First and foremost, you want to make sure that if you die there is adequate funds available to take care of your family financially. For many people, that means purchasing Term Insurance which is the most affordable type of life insurance. Others may still consider permanent insurance (Whole Life, Universal and Variable Universal) because they are drawn to the cash value (equity) that the policy builds over time. The problem is that purchasing the cash value insurance, however well-intentioned may leave the family at risk. Let’s take an example of a male age 35 that is in good health and purchases a $1,000,000 whole life insurance policy from a (A+) rated insurance company. His premium as a select preferred rating will be approximately $10,960 per year. The policy will build cash value on a guaranteed basis and may build additional cash value based on what the policy owner chooses to do with any non-guaranteed dividends the company may pay each year. Over time, the policy will build cash value in excess of the actual premiums that were paid. But what if he dies? As Shakespeare so aptly put it, “there’s the rub”. The family will still receive only the death benefit portion (which may increase over time if dividends are paid and used to purchase additional insurance) and not the cash value/savings portion. The same 35 year old man could use the $10,960 premium to purchase a 20 year level term insurance policy with a death benefit of more than $15,000,000. I have been in the financial services business for more than twenty years. At the insured’s funeral no one has ever asked me if the deceased had the “good kind of insurance that builds cash”. All they want to know is if there is enough to take care of the family. This hypothetical 35 year old man may opt for another strategy. Purchase a lower cost $5,000,000 20 year term life insurance policy and invest the cost savings into his company 401(k) plan. In this case, the approximately $3,000 term insurance premium would afford the individual a $7,960 cost savings. Because of the pre-tax nature of 401k investments, the man would be able to invest $12,000 into his 401(k) plan for the

same $7,960 net cost. At the end of the day, he will have five times the insurance protection for his family and a pre-tax deposit of $12,000 going into his 401(k) plan. Caution: This “buy term and invest the difference” strategy only works if you invest the difference. That means either enrolling in or increasing the contributions to your 401(k) or other retirement plan. If you aren’t afforded a plan through your employer, or if you are self-employed, there are other retirement investments designed for you that will give you the same net result. Contact your advisor to review their appropriateness and merits. With the advent of buy term and invest the difference insurance companies began marketing a product called Variable Universal Life Insurance (VUL),which is a hybrid type product and accomplishes the buy term and invest the difference within one plan. Advisors point out the fact that the fact that Variable Universal Life allows the policy owner to choose from an array of separate accounts (mutual funds that are part of the insurance policy). They discuss the tax advantages of the policy (tax deferred growth with tax free access via policy loans). With VUL the individual takes on more risk and has potential of a higher reward in a bull stock market but will also participate in lower returns in a down or bear market. However, the internal costs associated with the policy, including the increasing cost per thousand of insurance reduces the amount of your premium dollars that are actually invested into the separate accounts. So is permanent insurance appropriate as a retirement investment? The answer is not an easy one because of all the potential pitfalls, however, you can begin by asking the question; Do the tax benefits outweigh the costs? The costs associated with permanent polices, which are used to pay commissions, marketing costs etc. are so cumbersome that in many cases the tax benefits are mitigated. Furthermore, since after you withdrawal your cost basis from the policy, you must affect policy loans to benefit from tax free withdrawals, you run the very real risk of an IRS nightmare. If the policy lapses and there are outstanding loans, every dollar of the loans will be taxed as ordinary income to the policy owner. Imagine a situation where you are making $30,000 tax free annual withdrawals from your VUL policy for the first ten years of retirement and negative market returns, coupled with increased cost of insurance and policy loan interest eating away at the policy’s cash value cause an unintentional lapse. You no longer have insurance, but what you do have is a 1099 from the company for $300,000. Another risk inherent in the Life Insurance Retirement Plan (LIRP) concept is the possibility that, in an attempt to maximize retirement savings, the policy will be incorrectly overfunded, resulting in the policy being classified as a Modified Endowment Contract, (MEC). Under the current law, money taken from a MEC in the

form of policy or premium loans, partial surrenders, assignments, pledges, withdrawals, or loans secured by the policy are subject to income tax and possibly penalties. Once classified as a MEC, a policy remains a MEC. The policy status doesn't change even if the policy is changed, adjusted, or reconfigured as a policy that would not otherwise be considered a MEC. A policy received in exchange for a MEC is also considered a MEC, even if the policy received under the exchange wouldn't otherwise be considered a MEC. Yeesh! What a mess. The very tax advantage you bought the policy for is now permanently eliminated. Something else to consider; although insurance plans are sold as more liquid than a retirement plan, in many cases they have exorbitant and extended early withdrawal charge that may prevent the policy owner from using the funds for 10 years or more. But a properly structured LIRP can dilute the effect of fees by aggressively overfunding the policy. The more money that is fed into the policy, the lower fees will be as a percentage of deposits. Policies that charge per deposit fees of 6 percent are obviously not good candidates for a LIRP. The drawbacks of a using a LIRP as a supplemental retirement savings vehicle are less pronounced for high-net-worth families that have already maximized other tax-advantaged retirement accounts. The question for those clients is whether the fees associated with a VUL policy erase the program’s tax advantaged benefits. The key is that they are normally only a supplement to an otherwise robust retirement plan. In closing, if the insured does not have a need for life insurance, the high fees associated with permanent insurance policies can limit the growth of your retirement savings. The potential tax consequences of not properly maintain a plan can be devastating. Low cost term insurance sufficient to cover their family and business needs is a recommendation most planners should make. Maximizing the tax favored retirement investment options that are available while still having enough to live comfortably is another. Only then should you begin looking at alternative options for investment dollars. David Katz is the Chief Financial Officer of Gitterman & Associates Wealth Management a financial and wealth planning firm located in Boca Raton. David can be reached at 561-826-9341 or dkatz@gawmllc.com Securities Offered through Triad Advisors Inc. Member FINRA/SIPC Investment Advisory Services offered through Gitterman & Associates Wealth Management, LLC., a Registered Investment Advisor which is not affiliated with Triad Advisors Inc.

The Recruiters Corner - Tips & Talk from the Inside

Working with a job consultant Whether you are a practicing physician considering a career move or a graduating resident or fellow seeking your first practice opportunity, you will be faced with need to decide whether you’re going to conduct the search on your own or with the assistance of an agency or search firm. Tackling a job search on your own is going to distract you from serving your patients, managing your practice or successfully completing your medical training. After investing enormous time and treasure in your career, it makes little sense to commit inadequate

resources to identifying and pursuing the best available practice opportunity. Medical recruiting agencies and search firms number in the hundreds. Finding a job consultant to assist you can as easy as visiting any major job board and finding an agency with a job listing in your medical specialty and in your target community. But there are a number of factors to consider when selecting someone to help you mount a successful job search. Are you working with a contingency agency or a retained search firm? There is a difference. And it is a big one. A retained search firm generally has an exclusive relationship with the hiring authority and is hired for a specific period of time to identify multiple, fully screened, highly qualified candidates for a specific opportunity. They are generally paid a percentage (30 -35 percent) of the first year compensation regardless of whether a candidate is hired. As a result, they serve the interests of the client above those of any one candidate. In most cases, they will proactively reach out to qualified physicians rather than wait to be contacted by a physician that meets established criteria. A contingency firm is paid a fee (generally 20 – 25 percent) of the first year compensation only if a candidate they have presented is hired. The client will often work with multiple contingency firms and the contingency firm will work with multiple candidates. They will devote their time and energies working with the most viable jobs orders and the most desirable candidates. Although they may serve many masters, the interests of the client paying the fee still supersedes those of the candidate. In many cases, an experienced contingency consultant will immediately “run” a highly qualified physician candidate by presenting them to all of their current employers in the doctor’s target geography and in the absence of a fit will cold call area groups offering the candidate. This is not to say that a good consultant, whether working on a retained or contingency basis, does not provide a valuable service to a candidate with whom they have established a relationship. But their interest is going to be affected by their assessment of the physician’s value to their current or potential clients. Here are a few tips that will help you garner a more dynamic relationship with job consultants: • Make sure you understand how the consultant is paid. • Select a consultant that specializes in placing physicians with your credentials. • Be very clear in your search parameters. Ask the consultant if they believe your criteria are reasonable. • Discuss all current searches in which the consultant is engaged that meet your criteria. • In the absence of any immediate matches, ask the consultant what initiatives they will undertake on your behalf and request an estimated time table for a successful search. • Once a relationship has been established, it is your responsibility to respond in a timely manner to all communications from your consultant. • Remain flexible. In most cases the perfect job does not exist. Be prepared to consider opportunities that meet your major search criteria. Negotiations can often address your further needs. • Be as honest with your consultant as you expect him or her to be with you. Do not commit to expensive site visits just for the sake of interviewing somewhere. If an opportunity generates no interest, move on quickly without wasting everyone’s time. • If you are working with multiple contingency consultants respect the confidential nature of communication from each and never share proprietary information divulged in confidentiality. • Hold your consultant responsible. If there is a lack of communication ask for an explanation. If no justification is provided, find a new consultant. • Finally, don’t rely exclusively on agencies. (Read the trade journals, review classifieds and job boards, network with colleagues)

The Capital Investment Blues: Unwinding Robs Funding for a Startup By Randall D. Fisher of the Fisher Law Office If you’re considering funding a startup or franchise, then you may already be ready for the huge gamble of turning a 401(k) into capital investment for a business: potentially losing the retirement account altogether. But are you committed? The method described above — called a Rollover as Business Startup (ROBS) — injects capital into a business from your 401(k) account. Part of the Employee Retirement Income Security Act of 1974 (ERISA), the ROBS has been popular for years.

The potential payoff is tantalizing, which is why so many aspiring entrepreneurs are willing to put all their chips on the table. Unfortunately, few realize just how difficult it is claw those chips back if they’re dealt a bad hand. A mishandled ROBS is fraught with tax pitfalls. What’s more, the mere act of initiating a ROBS may draw unwanted attention: this type of capital investment is immediately suspicious in the eyes of the IRS. And then you remember that it’s your retirement you’re betting. That retirement risk brought a longtime business client of mine to my door seeking help to unwind his ROBS. After struggling with the ROBS’ administrative hassle (which is often underestimated), the reality that his entire financial future was dependent on a new business in a sputtering economy was just too much. If you’re feeling the heat from a ROBS that you might want to unwind, remember that our door is always open. We’ll talk you through the issues and get you where you want to go. If you’re not sure, call us anyway and we’ll connect you to one of the clients who we’ve helped out of this ERISA nightmare. They’ll show you the path down from the cliff. Before signing off, I’ll leave you with some background on the ROBS, pulled from a 2009 small business guide that my clients have found helpful. Let’s start with ROBS 101 ROBS plans are touted by business brokers and franchise sellers all over the Internet and arranged by investment firms specializing in capital investment. ROBS firms charge a fee to walk clients through the process of creating a C corporation. The new corporation starts its own 401(k) plan or profit sharing plan, which must offer employees the option to purchase stock in the company. The new business owner then rolls over funds from an existing 401(k) into the newly created corporation’s plan.

Because the assets are moved from one tax-exempt vehicle to another, business owners avoid taxes and penalties. The sole participant in the plan (e.g., the owner of a new company) can then direct the investment of the 401(k) account balance into a purchase of employer stock in the new corporation. The transferred funds are used to either purchase a franchise or fund the new business — essentially creating tax-free working capital. But is it too good to be true? A ROBS may be legal, but it operates in a grey area of IRS codes and regulations. To keep a ROBS transaction legal, the business owner must heed a slew of IRS regulations and avoid making certain prohibited transactions. The penalties for not complying with the rules are staggering. For example, if the IRS determines the deal is a prohibited transaction, it can trigger excise taxes. If you run afoul of these prohibited transactions, you can run up 110 percent — or more — in penalties. ROBS deals must be done very carefully and no two cases are exactly the same. This is not something to try with internet software or any law firm that simply “prepares documents at your specific direction,” as they say. You want an attorney who is well-versed in ERISA law before venturing into any ROBS deals. It can also become expensive money. Clients who have used these usually need to hire a “plan administrator”, someone to be sure that all I’s are dotted and T’s crossed. That is an ongoing fee. It also could complicate recruitment of new talent. Anyone added to the payroll has to be given the right to access to the profit sharing plan. Remember: it was funded with your money. So what does the IRS think?

A memo issued by the IRS on Oct. 1, 2008, appears to cast a chill on the ROBS strategy. The 13-page memo concludes that: “ROBS transactions may violate the law in several regards. First this scheme might create a prohibited transaction between the plan and its sponsor. . . . Additionally this scheme may not satisfy the benefits, rights and features requirement of the Regulations. . . . For this reason employee plans specialists are directed to open ROBS cases as described herein.” The IRS looks closely at each case for different things, such as to make sure companies that use ROBS funding offer stock ownership to all employees of the business. Failure for that to happen would violate nondiscrimination rules. Another red flag is when the rollover amount equals the business’ stock value. Such math, in the view of the IRS, usually indicates the rollover’s intent is to be used as business seed money only, rather than to be used as a bona fide employee retirement vehicle. ROBS proponents insist that rollovers performed by reputable companies operate under IRS guidelines and will not raise agency suspicions. In any case, ROBS is not a strategy to be taken lightly. It requires careful thought and scrutiny because you’re putting your retirement plan at risk. It also takes work to get out.

As always, good luck, good hunting and call us if you need us. The Fisher Law Office is renowned for its experience in estate planning, probate administration, asset protection, and business development. Annapolis attorney Randall D. Fisher has practiced for over 20 years, maintains the highest peer review rating for ethics (AV Preeminent) by Martindale-Hubbell, and is a sucker for long walks on the fairways. Find out how to reach Randy via TheFisherLawOffice.com or find him atFacebook.com/FisherLawOffice, on Twitter @thefisherlawoffice, or atLinkedIn.com/in/FisherLawOffice.

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Fringe Benefit Plans - Valuable Planning Tools You Haven't Heard Of By Carole Foos, CPA & Michael Berry, ChFC® As authors of two books on financial planning specifically for physicians, we have had the opportunity to speak with hundreds, if not thousands, of doctors of various ages over the past decade. What we have seen is that two doctors of the same specialty with similar incomes can have very different income levels in retirement. Why? Three reasons physicians may have very different qualities of life in retirement are: 1. Devastating Incident (lost lawsuit or divorce) 2. Poor investments 3. Lack of attention to taxes Fortunately, both qualified retirement plans and fringe benefit plans can help you address the three challenges above in significant ways. Unfortunately, most physicians only utilize traditional qualified plans — such as pensions and 401(k)s - which are restrictive and burdensome, while completely ignoring the more flexible fringe benefit plans. In fact, only a handful of the thousands of the doctors we have spoken with over the years employ fringe benefit plans in a significant way. This is unfortunate. In this article, we will discuss the basics of qualified and fringe benefit plans. Qualified Plan Basics The term “qualified” plan (“QP”) means that the plan meets the definition of a retirement plan under Department of Labor and Internal Revenue Service rules created under the Employee Retirement and Income Security Act (ERISA). These plans may be in the form of a defined benefit plan, profit sharing plan, money purchase plan, 401(k), or 403(b). Properly structured plans offer a variety of benefits: you can fully deduct contributions to a QP, funds within the QP grow tax-deferred, and (if non-owner employees participate) the funds within a QP enjoy superior asset protection. Despite the benefits QPs can offer, there are a host of disadvantages that physicians must understand: • Mandated maximum annual contributions for defined contribution plans ($50,000 for pensions. profit-sharing plans, $17,000 employee deferral for 401(k) plans in 2012) • Mandatory participation by employees • Potential liability for management of employee funds in plan • Controlled group and affiliated service group restrictions • Penalties for withdrawal prior to age 59½ • Required distributions beginning at age 70½ • Full ordinary income taxation of distributions from the plan • Full ordinary income taxation AND estate taxation of plan balances when you die (combined tax rates on these balances can be over 70%) Despite these numerous disadvantages, nearly all physicians in the US participate in QPs. The tax deduction is such a strong lure, it often cannot be resisted. For some doctors, this makes sense. But for many, the cost of contributions for employees, potential liability for mismanagement of employee funds, and the ultimate tax costs on distributions to you and your family may outweigh the current tax savings offered by QPs. This is especially true if you believe that income tax rates, especially the higher marginal rates, will go up over the coming decades. That is because, when you use a QP, you trade today’s tax rates on your contribution for the tax rates in the future when you pull the money out of the plan. If rates rise in the future, the QP might prove not to be a good deal at all. While none of us know what the future will bring, we do know that the highest marginal federal tax rates in the U.S. were well above 50% for most of the 20th century and that the highest rates today are the 3rd lowest they have ever been in the nearly 100-year history of the federal income tax. Thus, the QP tax rate bet is one that, at minimum, should he hedged against — which can be done with certain fringe benefit plans (see below). SEP-IRAs SEP-IRAs are not officially QPs — they are custodial accounts, yet, in many ways, they are similar. You have the same tax restrictions on annual contribution amounts, penalties for early withdrawals, mandatory withdrawal rules, and taxation on distributions and plan balances at death as you have with a QP. One big difference is that a SEP-IRA may not enjoy the same level of asset protection that a QP does. The protection is not “federally mandated” but rather handled on a state by state basis. For these reasons, a SEP-IRA is typically no better financially than a QP. Fringe benefit Plan Basics Fringe benefit plans are, astonishingly, relatively unknown to physicians. This is true, despite the fact that most Fortune 1000 companies make fringe benefit plans available to their executives. While many of these plans in public companies cannot he used in a private medical practice (think stock options) many use structures that a physician

certainly could easily employ in a practice. Although fringe benefit plans are not subject to the qualified plan rules listed above, they are based on many of the same tenets. Some are explicitly compensation plans that provide some long-term retirement benefits and present tax reduction benefits to the key employee(s). Other plans are aimed primarily at a goal other than compensation, such as asset protection or employee retention. EXAMPLE: FRINGE BENEFIT PLAN Let’s examine one such fringe benefit plan that could be utilized by nearly all medical practices. It has been in the tax code for decades and the IRS issued safe harbor’ rules related to the plan within the last decade. This makes the plan straightforward to implement properly from a tax point of view —just follow the rules already established. Other benefits of the plan include: • Utilization of the plan in addition to a qualified plan like pension, profit-sharing plan/401(k) or SEP IRA; • Contributions qualify for current tax deductions; • The plan assets grow tax-deferred and can be accessed tax-free; • The plan acts an ideal “tax hedge” technique against future income AND capital gains tax increases — thus it can be used to “hedge” against the tax rate risk inherent in QPs described above • Maximum contribution levels are $100,000 per doctor in practices with l0 employees or less. In larger practices, these levels can be even higher; • In a group practice, not every doctor need contribute the same amounts — extremely beneficial for group practices who have doctors who want to “put away” differing amounts; • Employee participation requires a minimal funding outlay; • There are no minimum age requirements for withdrawing income (no early withdrawal penalties); • The transfer of assets at the doctor’s death is income tax-free to heirs While these benefits arc powerful, this plan is not for everyone. Like most plans, this benefit plan is only appropriate for physicians who are looking to build long term wealth. It is not one that is designed for contributions, growth and access in a short time frame. Conclusion Every successful physician should consider a fringe benefit plan. Qualified Plans are burdened with a host of restrictions, costs and tax limitations. This often makes them extremely expensive for the physicians and does not allow for significant retirement wealth accumulation. Fringe benefit plans do not have these restrictions and, therefore, are relatively inexpensive to implement. If building your retirement wealth is an important goal for your financial plan, we highly recommend you investigate fringe benefit plans in your practice. Michael Berry, ChFC is a co-author of our recent book For New York Doctors; A Guide to Asset Protection, Tax Reduction, Practice & Wealth Management and managing director with OJM Group. Carole Foos, CPA is a tax consultant at OJM Group. They can be reached at mberry@ojmgroup.com , or 203-449-7100. For a complimentary download or copy please contact Michael at mberry@ojmgroup.com. Disclosure: OJM Group, LLC (“OJM”) is an SEC registered investment adviser with its principal place of business in the Stale of Ohio. OJM and its representatives are in compliance with the current notice filing and registration requirements imposed upon registered investment advisers by those states in which OJM maintains clients. OJM may only transact business in those states in which it is registered, or qualifies for an exemption or exclusion from registration requirements. For information pertaining to the registration status of OJM, please contact OJM or refer to the Investment Adviser Public Disclosure web site (www.adviserinfo.sec.gov). For additional information about OJM, including fees and services. send for our disclosure brochure as set forth on Form ADV using the contact information herein. Please read the disclosure statement carefully before you invest or send money. This article contains general information that is not suitable for everyone. The information contained herein should not be construed as personalized legal or tax advice. There is no guarantee that the views and opinions expressed in this article will be appropriate for your particular circumstances. Tax law changes frequently, accordingly information presented herein is subject to change without notice. You should seek professional tax and legal advice before implementing any strategy discussed herein.

The New 401(k) Plan Disclosure Rules and You By David I. Katz, AAMS®, COO, CFO Financial Planner As 401(k) plans have become more popular and plan participants have become increasingly responsible for making their own investment decisions with respect to their retirement, the Department of Labor (DOL) has become concerned that participants in self-directed 401(k) plans are not made fully aware of critically important information that will ensure that they make informed investment decisions. In particular the DOL is concerned that participants have every pertinent bit of information about their accounts including investment choices, fees, and expenses. In an effort to ensure the likelihood that every participant will be provided this important information, the DOL issued new regulations that require self-directed 401(k) plans to provide detailed information to participants about the plan and its investments on a regular and periodic basis so that participants can make informed investment decisions. If your company is sponsoring a self-directed 401(k) plan for your employees and is like most plans, you must ensure that your employees receive the initial annual disclosure no later than August 30, 2012. The first quarterly statement must be furnished no later than November 14, 2012 (for July through September). Although the DOL had already passed a series of regulations regarding these disclosures employer compliance with the older regulations was voluntary, whereas the new disclosure rules are mandatory for all self-directed 401(k) plans. Even participants in plans that previously complied with the earlier disclosure rules will see some changes when the new regulations take effect. Perhaps the most important is that the plan participant will receive more detailed information about investment fees and expenses. Another change is that plan investment information must be provided in a chart, so that the plan participant will be better able to compare investment alternatives. These new disclosure rules apply to 401(k) plans and other plans that allow participants to direct their own investments, however, they do not apply to IRAs, SEPs, or SIMPLE IRA plans.

IRAs vs. Qualified Plans

Retirement plans are usually either IRA-based (like SEPs and SIMPLE IRAs) or "qualified" (like 401(k)s, profit-sharing plans, and defined benefit plans). Qualified plans are generally more complicated and expensive to maintain than IRA-based plans because they have to comply with specific Internal Revenue Code and ERISA (the Employee Retirement Income Security Act of 1974) requirements in order to qualify for their tax benefits. Also, qualified plan assets must be held either in trust or by an insurance company. With IRA-based plans, your employees own (i.e., "vest" in) your contributions immediately. With qualified plans, you can generally require that your employees work a certain numbers of years before they vest. Let’s explore the merits of SEPs and Simple IRAs with the understanding that if the plan sponsor can keep fees low, these plans may actually be a better alternative for the corporation and the plan participant than their “qualified” sister plans. Tax advantages of retirement plans A retirement plan can have significant tax advantages: • Your contributions are deductible when made (unless it’s a Roth version) • Money in the retirement program grows tax deferred (or, in the case of Roth accounts, potentially tax free) • Plan assets aren't taxed to an employee until distributed from the plan (except in the case of a Roth version, in which case it is not taxed on distribution) When deciding on which plan is right for you? With an array of retirement plans to choose from, each with unique advantages and disadvantages, you'll need to clearly define your goals before attempting to choose a plan. For example, do you want: • To maximize the amount you can save for your own retirement? • A plan funded by employer contributions? By employee contributions? Both? • A plan that allows you and your employees to make pretax and/or Roth contributions? • The flexibility to skip employer contributions in some years? • A plan with lowest costs? Easiest administration? The answers to these questions can help guide you and your retirement professional to the plan (or combination of plans) most appropriate for you. So, what do you take away from this?

1. It is critically important in these litigious times that employers are aware of exactly what retirement plan is most appropriate for their company and their employees. 2. The employer must understand and take seriously his/her fiduciary responsibility to educate the employee and provide them every bit of information they need to make informed retirement investment decisions. David Katz is the Chief Financial Officer of Gitterman & Associates Wealth Management a financial and wealth planning firm located in Boca Raton. David can be reached at 561-826-9341

Securities Offered through Triad Advisors Inc. Member FINRA/SIPC

Investment Advisory Services offered through Gitterman & Associates Wealth Management, LLC, a Registered Investment Advisor which is not affiliated with Triad Advisors Inc.

Motivation for Change - Problem Solving vs. Desired Outcome By Karen Gray

It’s that time of year when so many are making that age old

New Year’s resolution to lose weight and get healthy,

however, the reality of this is that many will start 2013

with good intentions of eating healthier and going to the

gym, but many will fall short and unfortunately give

up! So let’s talk about motivation for change, and find out

how we can help others create the health they desire and

deserve!

We must first find out why an individual wants to change –

although the answer might seem obvious, so obvious that we often don’t think of asking the question, or to consider

our answer. If someone is overweight, has health problems, feels tired, and lacks energy, the answer is that they want

to change in order to solve these problems. This is true of most changes that we try to adopt; they are based on solving

a problem or getting rid of an unwanted situation. This type of motivation almost never leads to lasting change. Take

the New Year’s resolution, you have good intentions, and start making changes, but soon you fall back into old ways of

behaving. Why? Because whenever we experience emotional conflict (negative feelings) we want them to stop. Who

wants to feel uncomfortable? We think about our health problems, or how much we dislike the way we look, and our

natural response is to feel terrible. In order to end these feelings, we must take actions to make us feel better about

ourselves. Simply going on a “diet” or vowing to get off the couch and start exercising, are not actions motivated by

what you want – an outcome you desire – and so they lead you into a predictable cycle. 1. Emotional conflict leads you to act. 2. Taking action, makes you feel better – even if the situation has not changed much. 3. When you feel better the pressure decreases, which lessens the emotional conflict. 4. Less emotional conflict means there’s less reason to do the things that reduce the conflict in the first place. 5. Feeling better allows you to no longer feel the pressing need to follow through on your actions. 6. And the original behavior returns. It’s a typical yo-yo pattern. The most natural thing in the world is to fall back into your previous habits, eating or smoking or whatever it is that you are trying to change. In fact, it’s more than natural – it’s inevitable. Despite the fact that relying on self-control is nearly impossible and unlikely to lead to long-term success, most of us regularly use this sort of conflict manipulation to try to lose weight. It just doesn’t work long term, especially if you are an “emotional eater”. One must change the way we motivate ourselves and in the process create a fundamental new Habit of Health. Changing our emphasis from what we are against to what we are for has a dramatic impact. Are we merely against something, or do we want to create an important result? We can try to adopt the healthiest diet that ever existed, but if our motivation is to fix a health problem that you have now or might have in the future, we will be back to our old tricks in two years, with our weight back on and in worse

shape ever. No wonder so many people feel helpless after trying to lose weight again and again. They don’t know why they can’t pull it off, they are sincere about wanting to lose the weight, and they know the stakes are high. So choosing the right way to eat is one of the most critical factors in creating health. So how does one make a new approach to a true lifestyle change, one that will last beyond the two year life span of most diets? As vitally important as the right approach to eating may be, that alone is not enough to do it. That is why reaching one’s healthy weight is only the beginning of the journey. The motivation factor is what makes all the difference between yo-yoing (losing weight only to gain it back) and creating optimal health by adopting health habits one can live with. So what does that mean for so many of us? If we are adopting a new eating approach because we are reacting to the conflict we are feeling at the moment, we won’t be able to maintain our initial success. Basically, we revert back to our old habits once the pressure to change diminishes. This is where we can recalibrate our motivation, with three simple steps: 1. Make the decision to take the step forward. 2. Be open to allow the change process to succeed. 3. Stay committed to your desired positive outcome. It is important to set goals; however, one must have structure that supports the goals. Know your starting point; get a realistic picture of where you are now. Track your progress, be honest with yourself and know that the power lies in your choices. If one’s desire is to have optimal weight and live optimally healthy, then all choices that one makes must support that primary goal. Life is full of choices, we either decide to take the path to sickness or the path to being optimally healthy, which do you choose? 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 grays@teamtsfl.com or (816) 405-0001.

http://www.valeriewilsontravel.com

MD Preferred November Artist Spotlight Gregory Prestegord

www.gregoryprestegord.com

Impact of the Fiscal Cliff By Brendan Bracken, W.J. Bradley Mortgage Capital, LLC

The fiscal cliff, the popular term for the upcoming tax increases and spending cuts if legislators fail to intervene, is

weighing on the minds of most Americans. Caught up in the midst of the fiscal cliff debate are pieces of real estate

legislation that housing experts say could significantly impact the housing recovery.

The Mortgage Forgiveness Debt Relief Act and Debt

Cancellation

The Mortgage Forgiveness Debt Relief Act is set to expire on Dec. 31,

2012. The law, enacted in 2007, temporarily amended the federal tax

code to enable taxpayers to omit income debt reduction or

cancellation on their primary residence. Debt reduction through

restructuring of a mortgage, for example, refinancing and debt

forgiveness through a foreclosure generally qualify under the law.

Why the Expiration Matters

An estimated 11 million homeowners are underwater. Any

homeowners who participate in a short sale that closes after Jan. 1,

2013, will be subject to taxation on the amount of debt forgiven if the

law is not extended.

In addition, the $25 billion settlement states reached with five top mortgage lenders over the so-called robo-signing

scandal urges lenders to forgive billions in mortgage debt next year and in the future. The expiration of the tax relief

act could deter Americans from taking part in the settlement, according to attorneys general of the participating states.

Housing experts argue that the expiration of the law would cause significant financial pain for a large group of

homeowners who are already under duress. The Mortgage Interest Deduction As legislators propose ways to reduce the deficit and avert the fiscal cliff, legislators are proposing reducing the mortgage interest deduction. The mortgage interest deduction lets homeowners reduce their annual taxable income by the amount of interest paid on their mortgage. The deduction is the largest of its type in the tax code, accounting for an estimated $90 billion in reduced income tax revenue. The housing industry is fighting changes to the policy, arguing it would hurt the housing recovery, and therefore the economic recovery. "This is the last thing Congress should be considering when what we're trying to do is stabilize the economy," Jerry Howard, head of the National Association of Home Builders, told The Hill.

http://www.visalaw.com

Dr. Vicki’s Prescription for a Healthy Prosperous Year By Dr. Vicki Rackner If you make new year resolutions, here’s a prescription for enhanced physical, emotional and financial health:

Be who you are. Know what you know. Do what you need to do.

As Oscar Wilde said, “Be yourself; everyone else is taken.” You have a unique set of skills, gifts and passions. Put them to work for you. Gifts are often hidden in plain sight. When you tap into your innate talent–whether it’s a gift for music or organizational skills or a flare for design–it’s like riding a bike downhill. How easy to forget that for others the same path is an uphill climb. Find your gifts. Ask people you know, “If I were on the cover of a magazine, what would

the magazine be and what would the article be about?” Embrace your small, still voice that tells you things about yourself, about others and about the world around you. Science cannot always explain how and why you know things. As a practicing surgeon, I would often ask patients referred to me for a breast mass or an abnormal mammogram whether or not they had breast cancer. Almost 100% were proven right when the pathology report arrived. How many times have you gotten in trouble when you dismiss your intuitive wisdom? As Gavin de Becker says in his book The Gift of Fear, “Denial is a save now, pay later scheme.” Attempting to pretend you don’t know something is like holding a beach ball under water. It diverts energy that could be better invested in health-promoting activities. As you own what you know, you’ll gain clarity about what you need to do. Just do it! Sometimes it’s uncomfortable to do the things you need to do. Very few people enjoy the act of exercising; what they enjoy is the feeling that comes with regular exercise. Temporary discomfort is a small price for a big life. Sometimes it takes great courage to follow this prescription for healthy living. You may have encountered painful experiences being who you are, knowing what you know and doing what you need to do. Painful life experiences can be like a skiing accident. The immediate pain –whether it’s from a broken bone or a broken heart or a broken promise–gives you time to heal. Your actions can accelerate the healing process–or slow it down. Once injuries heal the pain stops. Then you have a choice. What next? Do you avoid the ski slopes all together? Do you ski as if nothing happened? Or do you return to the slopes you love, and ski smarter? Health is not determined by when or not you stumble. Spills are part of the human condition. Your health is shaped by the choices you make in the peaks and valleys. Your resilience, optimism and sense of hope are your true measures of health. Be who you are. Know what you know. Do what you need to do. Souza says it more poetically: “Dance as though no one is watching you, Love as though you have never been hurt before, Sing as though no one can hear you, Live as though heaven is on earth.” Thank you for the opportunity to be a part of your life this past year. I wish you all the best in this coming year!

http://www.accessnational.com

The Financial Crisis - Lessons Learned By Steve Selengut

You need to be looking at this chart to appreciate the

analysis:

http://www.sancoservices.com/MCIMvsSP500.

xls

On November 30th 2012, the S & P 500 (recognized

benchmark for assessing the performance of

investment managers of all shapes and sizes) was at its

highest level in five years.

Shockingly to 401(k), IRA, Mutual Fund and ETF

investors (and the Wall Street community as a whole)

this translates into a loss of roughly 4% --- and, hold on

to your wallets, negative numbers since year end 1999

when reality was about to poke a hole in the dot-com

bubble.

During the same five years, the Investment Grade

Value Stock Index (IGVSI) achieved new All Time

Highs (ATH) starting late in 2010, with a recent "peak"

on November 30th --- a solid 7.5% gain during what

most experts agree has been the most difficult

investment environment in, well, forever.

The IGVSI selection medium contains no NASDAQ

companies --- historically profitable, dividend paying

companies only are invited. So there was no "dismal

decade" (now 13 years) for the IGVSI --- or for

portfolios operated using only investment grade value

stocks.

Adding insult to injury, the Working Capital Model

Select Income CEF Index (WCMSI) also outperformed

the stock-market-only S & P 500. The WCMSI tracks

price performance of high quality, taxable and tax free

income closed end funds paying roughly 7% per year in

dividends.

No, the dividends have not been added back into the

numbers; yes, the income was maintained at pretty

much the same level throughout the financial crisis.

(Yes, shocking as this may sound to Modern Portfolio

Theory and passive ETF investment advocates, etc, it is

just what it appears to be --- if only their eyes would

open as widely as their mouths must be right now.)

So what if these new-to-you indices aren't prepared by

Wall Street institutions or their flunkies, here's what

they tell us:

They tell us that there are independent, outside-the-

mainstream-beltway, investment managers out there

who have the courage to approach investing differently.

They tell us that Investment Grade Value Stock

investing (totally different from "value stock" investing)

just has to blow away the scientific correlating,

analytical guesswork, and passive prophesies pushed

by lower Manhattan's cadre of armchair-experienced-

only economic soothsayers.

They tell us that a portfolio comprised of IGVSI

companies and high quality, managed, long track

record, income CEFs certainly should outperform

mutual fund, ETF, and other portfolio designs by a

wide margin --- even through one of the most

devastating periods in financial market history.

They tell us that the average investor might be well

served by the small number of financial professionals

who are familiar with these numbers, these concepts,

and the people who developed them --- real world

investors, without the pin stripes, that they can sit

down and talk to, face-to-face over a milkshake...

OK, back to the chart, but imagine a different set of

dates, and the stock market investors of the 1987 Crash

and later not-so-bad corrections through 1997. What if

they had been:

... taking profits in a disciplined manner through the

run-ups, hoarding "smart cash" until IGVSI company

prices fell to the "ok to buy levels" of their management

plan, fully invested at or before the '87 bottom; close to

the same during the next two? Hmmmm.

Back to the current chart, as an investor during the

huge 2006 to 2007 rally, what if your investment

strategy, once again:

... made you take profits on your IGVSI holdings during

the trip up and then insisted that you buy back in

slowly, at ever lower prices on the way down, to a fully

invested equity allocation at the bottom?

Flashback to 1987, visualize your income securities,

maintaining their payments throughout the fiasco, and

barely a dividend hiccup among your IGVSI equities.

More recently, during the financial crisis, think how

you were able to add to your income CEF holdings,

thus raising yields, reducing cost per share and setting

the stage for obscene profit taking just a few months

later.

Dot Com Bubble, you say. Well there was none in

IGVSI stocks or in high quality income securities.

Appreciate this --- if my program manager

implemented: no NASDAQ, no mutual funds, and no

IPOs, I would be the happy faced guy on the hill,

watching the Wall Street lemmings going over an

earlier financial cliff.

One more slap in the face, sorry. Where did the "smart

money" go after the bubble burst, or perhaps just

before if you are a conspiracy theorist? Right. The flight

to quality pushed Investment Grade Value Stock prices

upward creating the 3nd largest profit taking binge

in Market Cycle Investment

Management (MCIM) history ...

Send me an e-mail naming the other two to obtain a

free "Brainwashing" e-book.

The various disciplines within MCIM allow investors

(and certified MCIM investment managers) to embrace

the changing directions of markets without straying

from strict requirements of quality in selection,

diversification in positions, and income generation

from every holding. No fads, no passive cop outs, and

no MPT. MCIM is the active personal portfolio

management that the average investor can't get on Wall

Street.

The MCIM methodology was developed and

implemented in the seventies --- intended for use by

the family and friends of investment manager Steve

Selengut. It has been available to a select group of

clients ever since, and only on a personal contact,

individual portfolio containing individual securities

basis.

Not familiar with: Working Capital Model. Smart Cash,

Investment Grade Value Stocks, Income CEFs, Market

Cycle Investment Management, Asset Allocation

Buckets, The Investor's Creed, etc? Time to get your

copy of The Brainwashing of the American

Investor: The Book That Wall Street Does Not

Want YOU to Read.

This Article (c) for 2013 by Steve Selengut

Maximizing Retirement Plan Options By Ed Abramowitz*, MBA, CLU & Michael Kirsh*, CFP, CLU, AEP

In today’s economic environment, it is becoming extremely difficult to gain control of one’s financial future. This is

especially true for hard working professionals. Fortunately, there is a great financial tool that many have at their

disposal---the qualified retirement plan. Typically, though, the partners of law firms are too busy building their

practices to keep current with opportunities available in retirement plan design.

The driving force behind a retirement plan is in its ability to save taxes. One thing that is certain amidst all of the

uncertainty is that taxes will be rising at some point. Although there was a recent extension of the Bush tax cuts, this is

only a two year reprieve. High earners will see higher effective tax rates resulting from provisions of healthcare

reform, such as Medicare surtax on investment income beginning in 2013. Congress and state governments

continually are looking for politically pain-free ways to bring deficit spending and accumulated public debt under

control. Who will they focus on? Top earners, of course! Therefore, the tax-sheltering potential of a well-designed and

cost efficient retirement plan is extremely powerful and valuable.

The retirement plans that we have seen while working with many law firms are fairly typical. Most are a standard

401(k) plan built on an insurance company group annuity platform that was adopted years ago. Many plans have not

been reviewed in years. Usually, it is because nobody has an incentive to do so. The insurance agent or investment

advisor who put the plan in place is sometimes no longer in the business or no longer has a relationship with the

firm. The administrator is very happy to keep earning a fee. Why rock the boat? Clients may have unreasonable

expectations that their accountant is “taking care of it”. Think about all that an accountant has to know and do with

the everyday operation of the firm! Retirement plan design is a very specialized area. Most accountants are in the dark

here. Plan neglect by the Partners is also a factor in unrealized potential. Many, extremely busy in their practice, take

the position of “if it’s not broke, don’t fix it”. This is not very useful or efficient in today’s economic

reality. Fortunately, there is a technique to address this—the plan review. The plan review is a discovery process which sheds light on plan options; options that may be available, but not yet seen. The US Labor Department and congressional focus has recently been on retirement plan investment and

administrative fee transparency. Not surprisingly, many firms have not scrutinized their plan administration, record-keeping and investment management costs. Many are paying very high fees and have no idea what these fees are for. The plan remains on auto-pilot without periodically reviewing the plan’s cost competitiveness and the effectiveness of its service providers. This falls short of the fiduciary obligations of a plan trustee (usually a Partner of the firm). A review pulls the back the layers to examine and see where costs can be reduced while maintaining or increasing efficiency and employee satisfaction. Many firms do not know about, and therefore have not examined, other options. However, simply ensuring that the retirement plan is administered properly and at a reasonable price does not begin to unleash the plan’s potential to address the personal financial objectives of the Partners. Key to this process is the basic determination of how much cash flow a partner can and should put away in a tax-deferred vehicle. More often than not, the answer turns out to be a lot more than is currently going into the plan. Many times, people simply do not know that more could be contributed. If more tax savings are wanted, there are ways to accomplish this. The Pension Protection Act of 2006 is monumentally important to this discussion. This Act revolutionized retirement plan design, actually in favor of the highly compensated Partner. The retirement plan can be “turbo-charged’ by adding a second layer, such as a Cash Balance Plan. One of the best features of this method is individual selectivity based on need. A partner who still has children in college and needs cash flow can choose not to participate or participate at a lower level. An older partner, at a different stage of life and wanting to “catch-up”, may choose to put away as much as the plan allows. These are outcomes that can be achieved without necessarily increasing employee costs. How much can be stashed away? Under the typical 401(k) profit sharing approach, the most that can be allocated to an employee is $49,000 ($54,500 if age 50 or above). Depending on age and income, a cash balance plan may be able to raise this to $150,000+. Quite a difference! Let’s look at an example on how combining a 401(k) profit sharing plan with a Cash Balance Plan can have a huge impact for a typical law firm. We received the following information from a partner in a law firm. We were asked for our opinion to determine if this plan provided any value to the partners or would they be better off terminating the plan.

In this case the each partner was allocated $54,500 (total of $109,000 for both) with a total cost of $161,039. In order to answer the question about maintaining or terminating the plan, we turned to our Plan Design Specialist to determine what may be possible. The following is the result:

For a total increase in employee cost of less that $2000 ($52,039 vs. $53,996 for the other employees), we have increased the allocation for each partner from $54,500 to $240,050 ($480,100 total for each). Under current rules, each partner will be able to accumulate up to $2.2 million dollars in the Cash Balance Plan, in ADDITION to the value in the 401(k) plan. The benefits are straight forward. Partners can selectively contribute more, which will save more taxes and help to amass more wealth. This can be accomplished at minimal employee costs. Yet many firms do not know that this is even possible. There are many Partners in law firms who are very fortunate to have done extremely well. These people have the financial luxury of doing what they want. Sometimes they are not spending all that they earn. In these cases, why pay taxes on money that you do not need? Wouldn’t it make more sense to put away as much as possible into a retirement plan? It has been said that life is not a dress rehearsal. Sometimes there are no second chances. It really is important to get it right the first time. None of us wants to have the regret of “what could have been”. Most firms already have a retirement plan (or should have). They are in a great position to move forward. Imagine and focus-in on how stress-free life will be when you know that one aspect of your practice that you control, your retirement plan, has been maximized. An all-encompassing review will examine and help you take full advantage of the potential of what your plan can accomplish. This is a great step toward securing and protecting your financial future. As Judge Learned Hand said: “Anyone may arrange his affairs so that his taxes shall be as low as possible; he is not bound to choose that pattern which best pays the treasury. There is not even a patriotic duty to increase one’s taxes. Over and over again the Courts have said that there is nothing sinister in so arranging affairs as to keep taxes as low as possible. Everyone does it, rich and poor alike and all do right, for nobody owes any public duty to pay more than the law demands” * Investment Advisor Representative. Securities and Investment Advisory Services offered through Woodbury Financial Services, Inc. Member FINRA, SIPC, Registered Investment Advisor. Kirsh Financial Services, Inc. and Woodbury Financial Services, Inc. are not affiliated entities.

http://www.manageditsolutions.net/healthcare.html

Women Living Alone Don't Know This Vital Fact By John Spacek, LTCIS

This is a provocative headline designed to draw the attention of women who are single, women who are divorced or

widowed and even for women who are presently married because chances are, at some point in the future, you will be

living alone.

The topic is long term care insurance and there is a single, incredibly important fact and tip, that no one ever shares

with women living alone. I won't even make you read the full article to get to it. The fact is that women receive most of

the long-term care today and get two-thirds of all long-term care insurance benefits. Here comes the tip: currently,

long term care insurance rates are the same for men as for women. But I don't believe it will stay that way forever and

that results in an important savings opportunity. Keep reading.

Long term care planning is especially important for women because women are often impacted as providers of care for

another family member and, ultimately, women have a higher likelihood of needing what we refer to as long term

care. We'll look at insurance as part of that plan in a moment.

The greater need to plan for the greater risk of needing care is primarily the result of the fact that women live longer

than men, about five years longer. According to the Woman's Guide To Long-Term Care Insurance which I authored

for the American Association for Long-Term Care Insurance, here are the relevant facts.

o Women are far more likely (than men) to reach age 85 o Women age 75+ are far less likely to be married (38%) than men (74%) o Women over age 65 are twice as likely to be living alone o Women over 65 include 980,000 nursing home residents versus 337,000 men o Women are far more likely to suffer from Alzheimer's Disease Women who are married have spouses to turn to when care is needed. Often they have adult children and extended families. No one likes to turn spouses, loved ones or family members into unpaid caregivers but it happens every single day. The government estimates nearly 40 million provide free care to an elderly family member. Women living alone don't have the built-in network. And a need for long term care is not like a flu where you'll be back on your feet in a few days. You can be incapacitated for weeks, for months, for years. WOMEN BENEFIT THE MOST FROM LONG-TERM CARE INSURANCE Each year the Association studies the long term care insurance industry market. Last year insurers paid some $6.6 billion in claims (benefits) to over 200,000 individuals. And 65 percent of all new claims started (opened) in 2011 were for women, about half of those started as claimants who received care in their own home. As an aside, the largest claim still being paid is covering care for a women who has been receiving care for almost 15 years. Over $1.7 million in benefits have been paid. The nation's two largest insurers Genworth Financial (NYSE: GNW) and John Hancock owned by Manulife Financial (NYSE:MFC) each have over a million policyholders and have paid billions of dollars in claims. So, women have the greater need for long term care. And, they get the greater benefit from owning long term care insurance. It would be reasonable to assume that women pay more for equal insurance coverage. After all, bad drivers pay more than good drivers. But that is currently not the case. Insurers use 'unisex' rates and as a result a single woman currently pay the same as a single man; all other things being equal. This is a situation that will likely not last forever as leading insurers who are committed to the marketplace develop newer products for today's economic realities. Those who lock in coverage before a change will not lose the savings benefit should insurers abandon the unisex approach to pricing. It's my opinion that both men and women -- especially those over the age of 50 -- need to have a plan for living a long life, into your 80s, 90s or beyond. The decision to include some long term care insurance is, in my opinion, an even smarter move for women -- especially women living alone today (as well as those who worry they may be at some time in the future).

Finally, there are about a dozen leading insurance companies today who offer this coverage. Some of the publicly held companies include Transamerica owned by Aegon (NYSE: AEG) and there are also linked-benefit policies offering life insurance with LTC benefits from companies like Lincoln Financial Group, owned by Lincoln National Corp (NYSE: LNC). The costs and policy provisions can vary significantly and for that reason we advise you to work with a knowledgeable long term care insurance specialist who is 'appointed' to sell multiple insurance policies. A FINAL TIP FOR WOMEN BUSINESS OWNERS Long term care insurance tax deductions are for business owners and with more women heading their own company or being self-employed, the tax advantages are just one more reason to look into this coverage sooner rather than later. "Reprinted with permission from American Association for Long Term Care Insurance" and include a live link to www.aaltci.org John Spacek, LTCIS Long Term Care Services Long Term Care Insurance Specialist Virginia State Partnership Approved www.ltcsva.com John@LTCSVA.COM 804-339-3532

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, Sherry.chastain@anmedhealth.org

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, rusty.dooley@heartplace.com

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), anna@mcphysicians.com

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 patricia.delapaz@vistastaff.com 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 a.lane@titandoctors.com.

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, ewaggoner@4mdocs.com

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, bette@adkissonsearch.com

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, cbecker@cejkasearch.com, 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, Marion.Douglass@WTH.org,

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, MCCIM@centurytel.net

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: Info@Lawlorsearch.com.

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, Glenda.johnston@christushealth.org

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 jobs@rwhm.org.

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 miketorbeck@macjobs.net 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, tommie.anderson@franklinprimary.org

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 ksites2@ohiohealth.com

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 (jeannette.edwards@esrh.org), 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, vrbaker@shhpens.org

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 overfield@beck-field.com

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, lenore.reinhard@va.gov

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 ewilliam@lifeskills.com. 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 marshall.poole@nghs.com . 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, melisa.ciarrocca@scotlandhealth.org

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, averypoe@bellsouth.net

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, herrington@seaboardhealthcare.com, 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 info@enterprisemed.com

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, jesseb@gmedical.com, 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: jodi@spotonrecruiting.com

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