Pain Relief for Next April 15: 4 Tax Saving Tips You Can Use Now

Lea Chatham January 19th, 2016

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By: David B. Mandell, JD, MBA and Carole Foos, CPA

As a physician, do you realize that, after the tax increases of recent years—between income, capital gains, Medicare, self-employment and other taxes—you likely spend between 45 and 55 percent of your working hours laboring for the IRS and your state? Tweet this Kareo story

Given these sobering facts, the purpose of this article is to show you four ways to potentially save and possibly motivate you to investigate these planning concepts early in the year when you can best take advantage of them. Let’s examine them now:

1. Use the Right Practice Entity/Payment Structure/Benefit Plans
These areas are where the vast majority of tax mistakes are made by doctors today—and where many of you could benefit by tens of thousands of dollars annually with the right analysis and implementations. Issues here include:

  • Using the legal entity with maximum tax/benefits leverage—whether that is an S corporation, C corporation, LLC taxed as S, C, partnership, or disregarded entity.
  • Using a multi-entity structure to take advantage of two types of entities and their tax/benefit advantages.
  • Managing the payment of salary, bonus, distribution, and partnership flow-through to take advantage of maximum retirement benefits and minimize income, social security, and self-employment taxes.
  • Considering benefit plans beyond the typical profit-sharing/401(k) with which most medical practices start and end their benefit planning.

2. Don’t Lose 17-44 percent of Your Returns to Taxes; Explore Investment Managers Who Manage with Taxes in Mind
It is quite well known that most investors in mutual funds have no control of the tax hit they take on their funds. What you might not know is how harsh this hit can be. According to mutual fund tracker Lipper, “Over the past 20 years, the average investor in a taxable stock mutual fund gave up the equivalent of 17 to 44 percent of their returns to taxes.”

How to avoid this problem? Consider working with an investment firm that designs a tax-efficient portfolio for you and communicates with you each year to minimize the tax drag on that portfolio. In a mutual fund, you have only one-way communication—the fund tells you what your return is and what the tax cost is. Working with an investment management firm, you get two-way communication, as the firm works with you to maximize the leverage of different tax environments, offset tax losses and gains, and other tax minimization techniques.

3. Gain Tax-Deferral, Asset Protection through Cash Value Life Insurance
Above, you learned about the 17-44 percent tax hit most investors take on their investments in stock mutual funds. Similar funds within a cash value life insurance policy will generate NO income taxes—because the growth of policy cash balances is not taxable. Also, nearly every state protects the cash values from creditors, although there is tremendous variation among the states on how much is shielded.

4. Consider Charitable Giving
There are many ways you can make tax beneficial charitable gifts while benefiting your family as well. The most common tool for achieving this “win-win” is the Charitable Remainder Trust (CRT). A CRT is an irrevocable trust that makes annual or more frequent payments to you (or to you and a family member), typically, until you die. What remains in the trust then passes to a qualified charity of your choice.

Conclusion
This article gives you a few tax-saving ideas. For larger practices with $3-5 million or more of revenue, there are additional techniques that could offer significantly greater deductions. These are outside the scope of this article, but are mentioned in the articles on our website and are topics of our free e-newsletter. If you want to save taxes, the most important thing you can do is start looking for members of your advisory team who can help you address these issues in advance. Otherwise, you will be in this same position this April 15…and next April 15 and the one after that.

About the Authors

David B. Mandell, JD, MBA, is an attorney and author of five national books for doctors, including For Doctors Only: A Guide to Working Less & Building More, as well a number of state books. He is a principal of the financial consulting firm OJM Group www.ojmgroup.com, where Carole C. Foos, CPA is a principal and lead tax consultant. They can be reached at 877-656-4362 or mandell@ojmgroup.com.

Readers of the Getting Paid Blog can receive a free hardcopy of “For Doctors Only: A Guide to Working Less & Building More” by calling 877-656-4362, or visiting www.ojmbookstore.com and enter promotional code KAREO027 free ebook download of For Doctors Only or the shorter For Doctors Only Highlights for your Kindle or iPad.

About the Author
David B. Mandell, JD, MBA, is former attorney, consultant and author of five national books for doctors, including “For Doctors Only: A Guide to Working Less & Building More,” as well a number of state books. He is a principal of the financial consulting firm OJM Group www.ojmgroup.com. He can be reached at 877-656-4362 or mandell@ojmgroup.com.

 

 

 

 

 

 

 

 

Disclosure: OJM Group, LLC. (“OJM”) is an SEC registered investment adviser with its principal place of business in the State 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.

 

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Are these Weaknesses Lurking in Your LLC or FLP?

Lea Chatham December 3rd, 2015

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By David B. Mandell, JD, MBA and
Jason M. O’Dell, MS, CWM

Over the past twenty years, tens of thousands of physicians have established limited liability companies (LLCs) or family limited partnerships (FLPs) as part of an outside business in order to own real estate, for estate planning and, most often, for wealth protection purposes. The bad news is that in our experience, most physicians’ LLCs and FLPs are not as protective as they believe them to be because their controlling agreement is missing key provisions, or they have not kept up the entity properly on an annual basis. We will focus on the issue of the content or language here.

Language in Operating or Partnership Agreement
An LLC or FLP is only as protective or tax-beneficial as its language dictates, and we have found that most physicians’ LLCs or FLPs are lacking here. Let’s use an analogy of a will. First, you want the will to be valid from a legal perspective—proper signatures, witnesses, etc. This is precisely the weakness of many LLCs and FLPs regarding their ongoing legal requirements. Even if that is properly managed, then—like a will—the LLC or FLP is only as effective as the language in its operational document. A will might dictate that all assets go to one family member, to all family members, or all to charity. Similarly, an LLC or FLP can be written to maximize discounting for gift tax purposes or not. It may be written for solid protection against outside lawsuits…or not. Specifically, on the lawsuit protection perspective, there are a number of key provisions that an LLC or FLP should have. Tweet this Kareo story

We will describe just two of them here.

  1. Language on Distributions: If a physician wants the LLC or FLP to effectively provide a solid shield for LLC/FLP assets against outside lawsuits then proper language regarding distributions is critical. It is especially important that the language not lock in the LLC manager or managing member or FLP general partner to make distributions evenly. This can be problematic if there is ever a lawsuit or judgment creditor against the physician and/or other LLC or FLP owners. Nonetheless, in the typical LLC and FLP “form” agreements we have reviewed over the years, this problematic language is the standard boilerplate. This can be a significant weakness and may undermine the entire purpose of the entity for the physician and his/her family.
  2. Language on Involuntary Transfers: In our estimation, 80% of the hundreds of LLC and FLP agreements we have reviewed do not have adequate provisions regarding involuntary transfers. In other words, what exactly are the rights of a judgement creditor (i.e., successful lawsuit plaintiff) against an LLC or FLP owner’s interests? Most often, the only LLC or FLP language related to this issue is reading the ability of the owner to transfer their interests voluntarily, and they may be quite permissive. If this is the only language related to the issue, a judge may very well interpret that permissiveness to the situation to allow a successful plaintiff to become an owner, have voting rights, and even to take control of the LLC or FLP. Even worse, if the LLC or FLP is completely silent on the issue, then the judge has even more leeway.Ideally, an LLC or FLP defines exactly what occurs in the event of a judgement creditor getting court order against an owner’s interest, or similar involuntary-type of transfer. The language should define not only what circumstances give rise to the clause but also restrict the rights of such an involuntary transferee to the greatest extent of the relevant statute. This is crucial to take advantage of the strongest “outside risk” protections that an LLC or FLP can afford. Without this language, the entity is certainly not ideally protected.

If you have any of these entities in place, make sure that you have them reviewed by experienced experts.

Readers of the Getting Paid Blog can receive a free hardcopy of “For Doctors Only: A Guide to Working Less & Building More” by calling 877-656-4362, or visit www.ojmbookstore.com and enter promotional code KAREO034 for a free ebook download.

About the Author
David B. Mandell, JD, MBA, is former attorney, consultant and author of five national books for doctors, including “For Doctors Only: A Guide to Working Less & Building More,” as well a number of state books. He is a principal of the financial consulting firm OJM Group www.ojmgroup.com. He can be reached at 877-656-4362 or mandell@ojmgroup.com.

 

 

Jason O’Dell is a principal and managing partner of OJM Group. He is an experienced entrepreneur, financial consultant and investment advisor who has worked with physician clients for over 20 years. Jason has co-authored the book For Doctors Only: A Guide to Working Less & Building More, as well as the specialty-specific books Wealth Protection Planning for Dermatologists and Wealth Protection Planning for Orthopaedic Surgeons. Jason has also authored numerous articles on financial topics and has been recognized by Medical Economics as “One of the Best Financial Advisers to Physicians” (2002, 2004, 2006, 2008 – 2013).

Disclosure: OJM Group, LLC. (“OJM”) is an SEC registered investment adviser with its principal place of business in the State 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.

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9 Traits Every Medical Practice Manager Must Have

Lea Chatham October 29th, 2015

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By Erin Kennedy, MCD, CMRW, CERW, CEMC, CPRW

To be effective as a medical practice manager, you need a specific set of traits. It’s also important to exhibit these attributes through your actions, as well as any bio on your practice website and social media. While other factors affect your abilities as a medical practice manager, these traits will increase your chances of success. Tweet this Kareo story

You need to be prepared to navigate unknown waters. Here are a few basic points to keep in mind:

  1. Leadership Skills: A personal drive to lead others is a necessity for those who want to serve at the management level. While leadership skills can be acquired traits, an innate tendency to lead will serve you better in a position of power within a practice.
  2. A Realistic Viewpoint: Having a dream and goals is important for a successful career, but a realistic viewpoint is even more critical. You need to be able to recognize what is possible and execute the required processes to achieve those goals.
  3. Patience: Patience is a virtue every manager should have. You can’t expect all of your efforts to produce results immediately. Patiently waiting for the proper timing and the right resources will help you bring your practice to the forefront.
  4. A Broad Perspective: Keeping short-term goals in mind is essential for ensuring daily objectives are met for your practice, but having a broader perspective can be invaluable. Seeing the bigger picture will help you make smaller decisions along the way.
  5. Courage: When most people think of courage, they consider the risks that need to be taken to move forward. However, courage can also be defined as the strength required to stop or change direction.
  6. Financial Expertise: Many practices have a billing manager or biller to handle the day-to-day medical billing and a bookkeeper to handle practice finances. However, the practice manager is often the person who needs to manage the larger budget and understand how money flow factors into the function of the practice. In smaller practices, the practice manager may also manage all or some of the medical billing and accounts payable.
  7. Domain Expertise: Technology has become a major component in healthcare. You should command a basic knowledge of the latest technology as it relates to your industry. The practice manager should initiate discussions about new technology options to enhance the practice.
  8. Honor: The dictionary defines honor as adhering to what is right. In the business world, displaying honor lends an authenticity to your management style. An honorable philosophy and actions allow you to readily connect with your team and your patients on an emotional level.
  9. Perseverance: The healthcare world is rapidly changing, which can make it difficult to keep up and stay on top. This is why the drive to keep going, even when things aren’t proceeding as planned, is important.

This set of traits can help you help your practice to stay independent and succeed even in the most challenging times.

 

Erin KennedyErin Kennedy, MCD, CMRW, CERW, CEMC, CPRW is a Certified Master & Executive Resume Writer/Career Consultant, and the President of Professional Resume Services, Inc., home to some of the best resume writers on the planet. She is a nationally published writer and contributor of 14+ best-selling career books and has written hundreds of career-related articles. Erin and her team of executive resume writers have achieved international recognition following nominations and wins of the prestigious T.O.R.I. (Toast of the Resume Industry) Award and advanced certifications. She also is a featured blogger on several popular career sites.

 

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4th Quarter Tips: What to Do Now to Save on Your 2015 Taxes

Lea Chatham October 1st, 2015

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By David B. Mandell, JD, MBA

As we approach the fourth quarter of the year, most of our physician clients now have a fairly good idea of what their taxable income will be for 2015. If you are like them, you may be wondering, “is there anything I can do now to save taxes on April 15?” The answer is very likely “yes.” In fact, the fourth quarter of the year ending and the first quarter of the new year are the best times for focusing on tax reduction.

 

This short article lays out a few ideas that could save you tens of thousands of dollars on your 2015 income tax bill, depending on your facts and circumstances, as well as explaining some capital gains and planning concepts.Tweet this Kareo story

This is especially important in 2015 as federal income and capital gains taxes are again higher compared to 2012 because of the Fiscal Cliff deal signed in January 2013 and Medicare taxes are higher because of the Affordable Care Act.

Here are four techniques to reduce 2015 income taxes:

  1. Maximize the Tax Benefits of Your Qualified Retirement Plan (QRP): Nearly 95% of physicians have some type of QRP in place. These include 401(k)s, profit-sharing plans, money purchase plans, defined benefit plans, or even SEP or SIMPLE IRAs, for these purposes. However, most of these plans are NOT maximized for deductions for the business/practice owner(s). The Pension Protection Act of 2006 improved the QRP options for practice owners. In other words, many owners may be using an “outdated” plan and forgoing further contributions and deductions permitted under the most recent rule changes. By maximizing your QRP under the new rules, you could increase your deductions significantly for 2015 and reduce your taxes on April 15, 2016.
  2. Implement a Non-Qualified Plan: Unfortunately, the vast majority of physicians begin and end their retirement planning with QRPs. Most have not analyzed, let alone implemented, any other type of benefit plan. Have you explored non-qualified plans in the last two years? The unfortunate truth for many doctors is that they are unaware of plans that enjoy favorable short-term and long-term tax treatment. If you have not yet analyzed all options, we highly encourage you to do so. A number of these plans can help you reduce your taxable income for years as part of a tax diversification plan.
  3. Consider a Captive Insurance Company (CIC): CICs are used by many of the Fortune 1000 for a host of strategic reasons.  For a medical practice, a CIC can be equally beneficial, especially for the practice owners. Here, you actually create your own properly licensed insurance company to insure all types of risks of the practice – often those that have little coverage today. These can be economic risks (that revenues drop), business risks (that electronic records are destroyed), litigation risks (coverage for defense of harassment claims or wrongful termination), and even coverage for surgery centers and real estate. If created and maintained properly, the CIC can enjoy tremendous income tax benefits that can translate into hundreds of thousands of dollars of tax savings annually.
  4. Pre-Pay 2014 Expenses in 2015: As the year winds down, we typically counsel cash basis clients to prepay for some of the following year’s expenses in the present year. As long as the economic benefit from the prepayment lasts 12 months or less, this can be done. Since 2016 highest marginal tax rates will likely be the same those in 2015, this makes sense because of the benefit of the early deduction.

Here are two more techniques to reduce taxes on investments:

  1. Planning for the 3.8% Medicare Surtax: Beginning in 2013, the tax law imposed 3.8 percent surtax on certain passive investment income of individuals, trusts and estates. For individuals, the amount subject to the tax is the lesser of (1) net investment income (NII) or (2) the excess of a taxpayer’s modified adjusted gross income (MAGI) over an applicable threshold amount. Net investment income includes dividends, rents, interest, passive activity income, capital gains, annuities and royalties. Specifically excluded from the definition of net investment income are self-employment income, income from an active trade or business, gain on the sale of an active interest in a partnership or S corporation, IRA or qualified plan distributions and income from charitable remainder trusts. MAGI is generally the amount you report on the last line of page 1, Form 1040 adjusted by the above non-includible items. The applicable threshold amounts are shown below.

    Married taxpayers filing jointly                      $250,000
    Married taxpayers filing separately                 $125,000
    All other individual taxpayers                        $200,000
    A simple example will illustrate how the tax is calculated.Example: Al and Barb, married taxpayers filing separately, have $300,000 of salary income and $100,000 of NII. The amount subject to the surtax is the lesser of (1) NII ($100,000) or (2) the excess of their MAGI ($400,000) over the threshold amount ($400,000 -$250,000 = $150,000). Because NII is the smaller amount, it is the base on which the tax is calculated. Thus, the amount subject to the tax is $100,000 and the surtax payable is $3,800 (.038 x $100,000).

    Fortunately, there are a number of effective strategies that can be used to reduce MAGI and or NII and reduce the base on which the surtax is paid. These include (1) Roth IRA conversions, (2) tax exempt bonds, (3) tax-deferred annuities, (4) life insurance, (5) oil and gas investments, (6) timing estate and trust distributions, (7) charitable remainder trusts, (8) installment sales and maximizing above-the-line deductions. We would be happy to explain how these strategies might save you large amounts of surtax.

  2. Use Charitable Giving for Capital Gains Tax Planning: There are many ways you can make tax beneficial charitable gifts while benefiting your family as well.  Charitable Remainder Trusts (CRTs), Charitable Lead Trusts (CLTs), Private Foundations, etc. These all can be used, within the IRS rules, to benefit charitable causes, reduce taxes, and retain some benefits for families. If you have considered any of these tools in the past, implementing them in a year of high income might be a good idea.

This article gives you a few ideas for potential tax savings for 2015 income and beyond. The key is to take the time to evaluate which of these concepts, or others not mentioned in this short article, may work for you. In 2015, all physicians need to be as financially efficient as possible.

Readers of the Getting Paid Blog can receive a free hardcopy of “For Doctors Only: A Guide to Working Less & Building More” by calling 877-656-4362, or visit www.ojmbookstore.com and enter promotional code KAREO06 for a free ebook download.

About the Author
David B. Mandell, JD, MBA, is former attorney, consultant and author of five national books for doctors, including “For Doctors Only: A Guide to Working Less & Building More,” as well a number of state books. He is a principal of the financial consulting firm OJM Group www.ojmgroup.com. He can be reached at 877-656-4362 or mandell@ojmgroup.com.

 

Disclosure: OJM Group, LLC. (“OJM”) is an SEC registered investment adviser with its principal place of business in the State 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.

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Two Ways for New Physicians to Protect Future Income

Lea Chatham September 3rd, 2015

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By David B. Mandell, JD, MBA

As advisors to new physicians across the country, we’re often asked the question: “What is the most important thing I should be doing financially in the first years of practice?” Our answer is simple: “You need to build a solid foundation.”

 

Young Physicians’ Greatest Asset: Future Value of Income
The most important factor in the building of a foundation is to protect what the young physician has already built. For many young doctors with little savings and large student loan debts, their question is “what have I built? I am in debt!” The answer is that they have actually built a significant asset that needs protecting—the value of their future income.

What is needed to protect this asset? That depends on who they are protecting it for—themselves or others dependent on them. For both types of doctors, they need to protect their ability to earn this income in the future. That is why disability income insurance is so critical—and is tool #1 for young doctors.

Protecting Future Income for the Physician & Dependents
Disability income insurance conceptually is straightforward; if one becomes disabled it will pay the disabled doctor. For young physicians (and doctors typically into their 50s) this protection is critical because they have not accumulated the savings to support themselves and their families in case they cannot work as a doctor.

When looking at purchasing individual disability income insurance, physicians need to determine what their true need is, not how much they can get. If monthly expenses are $3,000/month, but an insurance salesman says you can get $5,000/month, you are over insuring yourself. While having more coverage than what’s needed is not always wrong, controlling expenses in order to build the proper foundation is more important.

Physicians will also want to make sure they’re purchasing adequate coverage. The definition of disability should be occupation specific, thus a physician cannot be forced to go back to work in another field. Residual or partial disability rider is another important part of the contract, in case the physician suffers a partial disability they can still work part-time in their occupation. Typically there has to be an income loss of 20% or greater. Also, in the event of a long-term disability, having a cost of living rider as an inflationary protector is important.

Protecting Future Income for Dependents
For young doctors with financial dependents—typically, children or spouses, but sometimes other family members—they need to focus on protecting their future income value not only against disability, but also against death. This is why life insurance is tool #2 that we typically recommend.

Much like disability income insurance, you need to first determine what your need is from a death benefit perspective to make sure you are being cost efficient. The way to determine your need is to decide what expenses would need to be covered. For example: mortgage, education funding for children, car loans & other debts, income support for spouse.

Young physicians in a position of purchasing life insurance should probably consider term insurance as their best option. Term insurance is inexpensive and provides a death benefit for period of time (10, 20, 30 years). This does not mean term insurance is the only or best type of insurance, it is generally best for a young physician who has a specific need. Permanent life insurance can be a very tax efficient saving vehicle that provides tax-free growth and tax-free distributions, if structured properly, and can provide great asset protection depending on the state of residence. For these reasons, permanent (cash value) insurance is often selected even by young physicians as a wealth accumulation and protection vehicle.

Readers of the Getting Paid Blog can receive a free hardcopy of “For Doctors Only: A Guide to Working Less & Building More” by calling 877-656-4362, or visit www.ojmbookstore.com and enter promotional code KAREO06 for a free ebook download.

About the Author
David B. Mandell, JD, MBA, is former attorney, consultant and author of five national books for doctors, including “For Doctors Only: A Guide to Working Less & Building More,” as well a number of state books. He is a principal of the financial consulting firm OJM Group www.ojmgroup.com. He can be reached at 877-656-4362 or mandell@ojmgroup.com.

 

Disclosure: OJM Group, LLC. (“OJM”) is an SEC registered investment adviser with its principal place of business in the State 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.

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Navigating Uncertain Times at Work (ICD-10 Anyone?)

Lea Chatham August 5th, 2015

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By Erin Kennedy, MCD, CMRW, CERW, CEMC, CPRW

Healthcare is often uncertain, but some times are more challenging than others. ICD-10 is a perfect example of an uncertain time that goes beyond a small bump in the road. When there is an issue that has big impact on healthcare, it can impact your job. Tweet this Kareo story

You need to be prepared to navigate unknown waters. Here are a few basic points to keep in mind:

  • There will occasionally be uncertain times – look back in history and you can see that crises happen all the time, all over the world. But, if your job is uncertain, then you have every reason to be concerned enough to do something about it. Job-related stress has symptoms, but it also has resolutions.
  • It is always a good idea to prepare for uncertain times – work on paying off your debt load even if all you can do is pay a little more than the minimum every month. Put some money in savings every payday, and don’t use it unless it is a last resort. Work out your budget so you have a handle on what you are doing with your money. Talk with your family about how you will get through a crisis; it’s like a fire drill that prepares you for emergencies.
  • Don’t waste today’s energy on worrying — do something about what stresses you. Take a walk every day instead of eating a donut for breakfast (not that I object to donuts–believe me, I don’t–but a walk is de-stressing where sugary snacks backfire). Look at your worries and work on what you are in control of. If you can’t control the thing that worries you, how will worry help? Answer: it won’t.
  • Forget about drama and smile at the people in your life – we are in the boat together. It makes the journey so much easier when we treat one another with kindness. The people you work with, the people you live with, and the people you interact with as you go through your day are all on the same ocean, and we all do better when we are smiling.

About the Author

Erin KennedyErin Kennedy, MCD, CMRW, CERW, CEMC, CPRW is a Certified Master & Executive Resume Writer/Career Consultant, and the President of Professional Resume Services, Inc., home to some of the best resume writers on the planet. She is a nationally published writer and contributor of 14+ best-selling career books and has written hundreds of career-related articles. Erin and her team of executive resume writers have achieved international recognition following nominations and wins of the prestigious T.O.R.I. (Toast of the Resume Industry) Award and advanced certifications. She also is a featured blogger on several popular career sites.

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Professional Voicemail Skills Still Matter

Lea Chatham June 3rd, 2015

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By Erin Kennedy, MCD, CMRW, CERW, CEMC, CPRW

Are you one of the people they were talking about on NPR recently? Please Do Not Leave A Message: Why Millennials Hate Voice Mail is taking a look at the way that leaving a message is fast falling out of favor as a communication mode. You don’t have to be part of the Millennials to hate voice mail because it can be a sudden challenge you don’t do well. But there’s a problem with refusing to deal with voice mail because it is used in business all the time.

If you are searching for a job, there’s a good chance you will need to leave a voice message. If you are contacting your manager or a client, there’s an equally good chance that voicemail will be involved. The game of Phone Tag came about because of the way busy people can’t always pick up the phone and being able to text doesn’t exactly replace it.

If you know you struggle with sounding professional at the sound of the recording beep, you can learn how to deal with it and do it right. Think about the goal of your call and have a message prepared if you have to leave a voice mail. If you have to write it down before you make the call, that’s practice for the next time you need to use the skill.

The same basic rules that apply to a phone interview apply to a business call, and therefore also apply to a business voice mail. Tweet this Kareo story

  • Don’t make a call from a noisy environment. Go to a spot that is quiet and allows your voice to be heard.
  • It should be obvious that nothing is in your mouth, right?
  • Be prepared to state your name, phone number, the reason for the call, and repeat the name & number. Keep it short.
  • Speak clearly and don’t try to cram too much into the message. You can tell them more when they call you back.

Whether you are leaving a message for business or as part of your job search, this is one business skill that you really do need to make sure you can do even if you hate voice mail.

About the Author

Erin KennedyErin Kennedy, MCD, CMRW, CERW, CEMC, CPRW is a Certified Master & Executive Resume Writer/Career Consultant, and the President of Professional Resume Services, Inc., home to some of the best resume writers on the planet. She is a nationally published writer and contributor of 14+ best-selling career books and has written hundreds of career-related articles. Erin and her team of executive resume writers have achieved international recognition following nominations and wins of the prestigious T.O.R.I. (Toast of the Resume Industry) Award and advanced certifications. She also is a featured blogger on several popular career sites.

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Two Ways To Enhance Your Medical Career

Lea Chatham April 23rd, 2015

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Tweet this Kareo storyby Erin Kennedy, MCD, CMRW, CERW, CEMC, CPRW

Did you know that anybody can enhance their life, and thus their career, by improving some simple, basic skills? Once you have a handle on these skills, there’s no telling what can happen but you have to apply them consistently: everybody needs to learn how to learn and learn how to teach.

Learn How to Learn
Learning is essentially acknowledging that you don’t know everything and being open to expanding your horizons.Tweet this Kareo story

 

  • What are you reading? If you don’t read, start slow and it will get better quickly.
  • If you are always reading a novel, try reading some non-fiction regularly.
  • If you never do fiction, start with some short stories and work up.
  • Take a class in something that appeals and intimidates you.
  • Play games on  your phone or computer that are not in your comfort zone, like words for a math whiz and numbers for the linguist.
  • Learn how to use your hands or your body a different way, like dancing or knitting or soccer or anything fun.

I bet you thought I’d be telling you to work on a career skill, and that certainly is a good idea. But for many of us, we need to start developing the ability to learn first. When you start with what you like and stretch your mind a little bit, you are learning how to learn.

Learn How To Teach
Teaching is not being a windbag standing in front of suffering students and talking to hear themselves. Good teachers listen to their students and try to understand how they perceive things so the facts being communicated get through to the brain. A teacher needs to have a good grasp of the subject in order to explain it effectively.

  • Offer to explain something you are good at to a friend who wants to know how.
  • Show a newbie some tips about a skill you have.
  • Write instructions just to see if they make sense when you follow them.
  • Improve your writing skills so you can communicate better.
  • Rewrite things that are confusing to make the meaning clearer.
  • Research the styles of learning and figure out how to explain to each style.

The truth is that we all teach, whether we realize it or not. The goal is to be a teacher of good, helpful things who passes on all you have learned. When a person continually is learning, and is also continually sharing their knowledge, it completes the circle of intelligent growth. It also keeps you in a positive stance for whatever your career is doing and enhances any job.

About the Author

Erin KennedyErin Kennedy, MCD, CMRW, CERW, CEMC, CPRW is a Certified Master & Executive Resume Writer/Career Consultant, and the President of Professional Resume Services, Inc., home to some of the best resume writers on the planet. She is a nationally published writer and contributor of 14+ best-selling career books and has written hundreds of career-related articles. Erin and her team of executive resume writers have achieved international recognition following nominations and wins of the prestigious T.O.R.I. (Toast of the Resume Industry) Award and advanced certifications. She also is a featured blogger on several popular career sites.

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4 Things to Consider When Staffing a New Medical Practice

Lea Chatham April 13th, 2015

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Register Now for webinar on best practices to start a new medical practiceAudrey Christie McLaughlin, RN

How many people does it take to run a medical practice? Sounds like the beginning of bad joke right? It can be, but in this case it is the beginning of how many new medical practices hemorrhage money. When it comes to a straight forward family practice, a few simple tweaks can really improve overhead.Tweet this Kareo story

So how many people does it take to run an office? Assuming the team is properly trained and motivated and the right systems are in place…surprisingly few. For a single physician clinic seeing an average of 30 patients per day (without any ancillary services), you should have three to four team members other than the physician in the entire clinic. Often, I see family practice clinics of this size trying to start with upwards of seven staff members (check in receptionist, check out receptionist, billing specialist, lab tech, two medical assistants and an office manager).

Here is what you need:

  1. Office Manager: In a practice that sees 30 patients per day or less, your office manager should be spending the majority of his or her time assisting with the billing. Your office manager should also back up the receptionist on the phones and check in/checkout. She/he should also be competent enough to fill in for the medical assistant when help is needed on the clinical side. The office manager should be the liaison between the physician and the staff for routine issues (i.e. vacation/sick days, tardiness, payroll, accounting, posting payments, etc.). Remember if you give your office manager the responsibilities, you must also give her the authority to handle issues when they arise without interrupting you several times per day. One great hire for an Office Manager position is an RN with a clinic background, often times they are well versed in the clinical side as well as the billing side of practices.
  2. Receptionist: Your receptionist should be responsible for answering the phone by the second ring (you may elect to have an automated system to answer your phones. I believe a live person is best, but automated will work in a pinch), transferring those phone calls, checking patients in and out, and initiating the billing process at the end of the day. The receptionist, believe it or not, should at a minimum be able to help room patients and understand the flow of the clinical side as well.
  3. Medical Assistant: Your medical assistant (MA) should be able to do his primary jobs quickly and accurately and utilize communication to move the patients through the clinic quickly while anticipating the needs of the patient and physician. MAs should take vitals, height and weight, get a brief description of the reason for the visit, and walk the patients to and from the front desk/waiting room. The physician should never be standing around waiting on the next patient. In addition, your MA should be the backup for the receptionist and have an understanding of the billing side so they can fill in there as well. (Those types of fill-ins may be necessary when the physician is out of town or in the case of one and a half MA’s on staff.)
  4. Billing Specialist OR Outsourced Billing: Depending on the rates and benefits you can negotiate from billing companies, it may be in your best interest to utilize a billing company rather than a live body in your office. The billing position is one of the few positions that I don’t believe should habitually dual-role. You want your biller focused on your billing and revenue. Consider outsourcing your billing and hiring an additional part-time Medical Assistant if you feel the drag with less than four staff members.

If you haven’t noticed the pattern already, I am going to spill the beans: Everyone in your clinic should be cross-trained and eager to jump in wherever and whenever it is needed. Tweet this Kareo story
This is critical to the success of a practice of any size, but especially important when you are conserving overhead and launching a new medical practice.

As you grow in patient volume or practitioners, it will become necessary to add additional staff members. Typically, that begins with an additional MA to help first, then additional reception help and finally (if you aren’t using a service) additional billing help.

To find out more about best practices to start a new medical practice, join me for my upcoming free webinar, 10 Step Plan to Launch a Successful Medical Practice, on April 22. Register Now!

About the Author

Audrey MAudrey “Christie” McLaughlin empowers physicians to grow their practices and better the lives of the patients they serve. Audrey is the CEO of McLaughlin Sales Group LLC, creator of the series Customer Service from the HEART, and creator of physicianspracticeexpert.com, a sales and consulting firm that specializes in the business of medicine. Audrey has more than 12 years of experience in helping physicians and hospitals provide the best medical care while growing revenue and keeping costs down. She is an expert, entrepreneur, author, speaker, and is active volunteer in her community.

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AAMC Releases New Data on Pending Provider Shortages

Lea Chatham April 7th, 2015

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It isn’t news that recent studies have projected a shortage of primary care providers over the next ten years. The latest report, released March 2015 by the Association of American Medical Colleges (AAMC), provides updated projections through 2025.

This study estimates a shortage of:

  • 12,500 to 31,100 primary care physicians
  • 28,200 to 63,700 non-primary care physicians

This is down a bit from earlier estimates but still significant. As baby boomers age, the need for primary care services is growing. Tweet this Kareo story
This compounds the problem of the physician shortage. “The doctor shortage is real—it’s significant—and it’s particularly serious for the kind of medical care that our aging population is going to need,” AAMC President and CEO Darrell Kirch, M.D., said in a release. “The solution requires a multi-pronged approach.” He added that it would include, “continuing to innovate and be more efficient in the way care is delivered as well as increased federal support for graduate medical education to train at least 3,000 more doctors a year to meet the healthcare needs of our nation’s growing and aging population.”

Others have suggested that increasing the workforce of mid-level providers to meet the primary care shortage is a valuable alternative to consider as well. Physician Assistants (PAs) and Nurse Practitioners (NPs) can provide many of the basic primary care services patients need. They can also specialize. The study suggested surgical specialties are the specialty areas most likely to see shortages. NP and PAs who choose to specialize in an area like orthopedic surgery can help alleviate shortages by seeing patients for needed follow up or other non-surgical tasks. As a result, the physician can put his or her resources where they are most needed.

Technology can also play an important role, not by reducing the shortage, but by making providers more efficient and enabling them to see more patients without necessarily working more hours. As shown in this infographic, the right technology used in the right way can reduce administrative tasks for providers so they can focus on patient care.

Download Healthcare Demand Is Growing Infographic

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