The job interview...doing your homework before the interview

By Tim Russo, President, US Cardiology Associates

Information is the key to success when a practice opportunity comes along.  When entering the interview process a candidate can expect the practice to have their list of questions in hand.  It is equally important that the physician candidate be prepared to gather the information he will need to make a career decision.  How much, how long, how many are questions that usually come to mind: 

• What benefits does the health system offer?
• How many hours do the doctors work?
• What income can an associate expect?
• What income can a partner expect?
• How long is the track to partnership?
• Is there a buy-in?
• Is there a buy-out when older partners retire?
• Who pays for the buy-out?
• How is the call schedule determined?

But a candidate should not overlook important organizational and strategic considerations. The internet is an important resource. Google the organization to gather additional data.  Visit the hospital or practice web site.  Use both the web browser and the news browser for stories that may have appeared in the press.  I like to call these questions 'fit in' questions:

• Has your education and training prepared you to perform the procedures that the practice or hospital currently perform? 
• Do you possess skill sets that can bring new patients and new procedures to the group?
• Is the group prepared to provide marketing and technology support to help you build your practice?
• Have any partners left the practice recently?
• Why did they leave?
• Does the community need another doctor in your specialty?

And of course there are the family questions:

• Are the schools exceptional?
• Are there private as well as public school options?
• Are the neighborhoods safe and inviting?
• Are real estate values affordable?
• Are there cultural and entertainment opportunities for every member of your family?
• Does the practice or hospital offer a family support system?

Accepting a first practice opportunity out of medical training or relocating to accept a new career opportunity are life changing commitments.  Make sure you have a clear picture of what the employer is looking for in the long run.  Most groups invest in physicians who will be able to contribute to the practice on both a clinical and administrative level.  Expressing a willingness to work hard at building a secure future for the practice may separate you from other candidates.

Make sure you do your home work.  The time you spend before you arrive for the interview can be as important as the time you spend at the interview.

The nations fastest growing medical job board where hospitals, clinics, private practice managers and professional recruiters talk about their opportunities and where graduating residents and fellows, nursing students, practicing physicians, mid level practitioners and nurses go to listen. 

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Hospital Ranking Tools Move to the Internet

Increasingly, patients are turning to the internet to find ranking tools that measure a wide range of healthcare outcomes and delivery systems.  In Illinois, a new web site that ranks hospitals on a wide range of performance and cost parameters was launched recently.  It was so popular that it crashed twice before it managed to get up and stay up.

The sight exceeded many visitor's expectations.  Illinois lawmakers passed legislation in 2003 establishing a state report card for hospitals.  They were one of the first states to do so.  But arranging funding, staffing and procedures took six years.  The site is still a work in progress with new categories such as mortality rates scheduled for inclusion.

A visitor who navigates the site will be impressed with the number of criteria measured.  Quality of care was measured by a hospitals adherence to recommended treatments for pneumonia, heart failure and heart attack.  Patient satisfaction rankings were a problem for some hospitals with rankings as low as 44%.  The top ranked hospital, CentralDuPageHospital in Winfield, achieved a 76% rating.  A measure of how seriously hospitals are taking this process was the immediate implementation of a program to build morale and engagement among front-line caregivers at GlenOaksHospital which ranked at the bottom.

But regardless of how complete the process is at launch, the Illinois site reflects a growing role for internet based ranking programs.  America's Health Rankings, www.americashealthrankings.org, a site boasting "the only 20 year scorecard of our nation's health," ranks each state by dozens of criteria ranging from cancer deaths to air pollution, from per capita primary health care physicians in practice to binge drinking.

The Hospital Compare Site at the Centers for Medicare and Medicaid Services also provides comparative data on hospitals and healthcare delivery systems.  The increasing availability of healthcare data delivered by both the public and private sector should be an important part of any healthcare reform.     

5 Things to Do Before Year-End 2010

With only a few weeks left in 2010, it's a time not only of reflection on the past year's accomplishments, but also a time to prepare your finances for the upcoming year. Here are a few things you can do to make 2010 a more profitable year, and put you on the right financial track for 2011.

Convert Your IRA to a Roth

For anyone planning to convert their traditional IRA(s) to a Roth IRA, executing the conversion in 2010 may be advantageous. The Tax Increase Prevention and Reconciliation Act of 2005 allows anyone, regardless of income, to convert a traditional IRA to a Roth IRA as long as they pay the tax on the converted amount. What's special about 2010 is that the tax liability from conversions made this year can be spread over two years, which can be very beneficial if your IRA is large enough to push you up to a higher tax bracket.

Harvest Your Losses

Tax loss harvesting is the act of intentionally selling an asset at a loss to offset current and/or future capital gains. It is one of the few methods individuals can employ to manage their Adjusted Gross Income (AGI) and hence, reduce their taxes. To reduce their tax liability, many people rely solely on taking itemized deductions, such as mortgage-interest and charitable contributions. While itemized deductions can bring you modest tax benefits, they have no impact on one's AGI. As the adage says, Don't Lose the Forest For the Trees. In other words, be aware that there is a bigger tax benefit in tax loss harvesting and put it to work for you. It is important to note that tax loss harvesting only applies in your taxable accounts, not in your IRAs or 401ks. Each person's tax situation is different, so investors should consult with their financial and tax advisors before engaging in such strategies.

Maximize Your Retirement Contributions

The easiest way to reduce your tax liability immediately is to have less taxable income. Employer sponsored retirement plans are one of the best ways to accomplish this, because any contribution made to such plans reduces your taxable income. Whether you are self-employed or are an employee, the IRS has limitations on how much you can contribute to your retirement accounts each year. If you are an employee, the total amount you can put into your 401k in 2010 is $16,500. So for example: if you make $100,000 a year in salary, and contribute $16,500 into your 401k plan, you are then taxed on only $83,500. If you're in the 28 percent tax bracket, that's an immediate tax savings of $4,620! Check your year-to-date 401k contribution, and if you haven't yet met the annual IRS limit, increase your contribution for the month of December.

Check Your Credit

With every online mouse click, query, and purchase, we increase our risk of identify theft. And since credit checks are prerequisites for just about anything you do, it is imperative that you make sure your credit report is accurate and favorable. Under current laws, you are entitled to a free copy of your credit report each year. Don't be fooled by those catchy commercials directing you to order your "free" credit report with their company; there is only one government authorized website to order your truly free report - www.annualcreditreport.com. According to the Federal Trade Commission, other websites that claim to offer "free credit reports," "free credit scores," or "free credit monitoring" are not part of the legally mandated free annual credit report program. Once you have looked over your credit report, if you feel there is a mistake, there are steps you can take to correct it.

Meet With an Estate Attorney

Even in 1789, Benjamin Franklin knew that "nothing is certain but death and taxes." While many people strive to reduce their living-years taxes, fewer recognize that tax planning extends beyond the living years. A well designed estate plan will not only help reduce your taxes during your lifetime, but also reduce taxes paid on your assets after you pass. More importantly, it will help ease potentially difficult decisions your heirs would have had to make such as: Who will look after your minor children? Who can act on your behalf if you become incapacitated? Who will inherit your assets when you pass?  -  Most people are quick to dismiss the need for a comprehensive estate plan because they believe an "estate" is that of the ultra-rich with mansions, expensive cars, and other large assets. However, simply stated, your estate is comprised of all the things you own, including your bank accounts, car(s), furniture, lawnmower, books, musical instruments, and even your pots and pans! Don't you want a say in what happens to your estate once you pass? If so, then it's important to schedule an appointment to speak with a qualified estate attorney who can draft an estate plan for your unique goals and circumstances.  

Starting to get cabin fever?  - Now might be a good time to buy a vacation rental.

By Harry Salzman, Salzman Real Estate Services, MD Preferred Real Estate, harrysalzman-42854@rps-mail.com,

Right now, the languishing housing market offers some lingering upsides for those who have a pot of investment dollars to burn. Home prices are low, financing is cheap, inventories are bulging and vacation rentals represent a great opportunity to grab a piece of the American Dream as a solid, long-term investment.

"Vacation homes are almost always a good investment," says vacation rental guru Christine Karpinski, director of Owner Community for HomeAway.com, the global leader in vacation rentals, hosting some 540,000 vacation rental listings.

"First, if you're looking for a good long-term investment, real estate tends to be a good bet. Second, vacation properties have the ability to pay for themselves, and owners often earn a profit in rental income. Third, the investment comes with the desirable perk of having a place at the beach or in the mountains to call your own," says Karpinski, a vacation rental owner herself.  Here's why you might want to move on that vacation rental now.

Prices are as low as they are going to go.

Property prices are as low as they've been in ten years. Procrastination won't keep them low. Analysts say the housing market is scraping bottom and poised to move up.

Interest rates are likewise as low as they are likely to go.

Rates on non-owner occupied properties are only about a half a percentage point higher than residential rates-- with a virtually mandated 20 to 30 percent down payment.

Markets are flush with inventory.

The slow economy and even slower housing market has left vacation markets brimming with buying opportunities, from sellers looking to move on or up, to foreclosures that warrant careful scrutiny. "And as market demand has surged, organizations like HomeAway.com have sprung up on the Internet to help connect potential renters with your vacation rental" Karpinski said.

Buy now, beat the 2011 peak season rush.

Buy now and you've got plenty of time to prepare yourself and your property for the peak rental season. Rental fees generated during the twelve weeks between Memorial Day and Labor Day can pay your mortgage for an entire year. Most inquiries come in between January and March.

However, before you let yourself fall in love with a property, make sure it is legal to rent it out as a vacation home. "Some areas and homeowners' associations do not allow short-term rentals," Karpinski warns.

International nutrition and weight management organization offers unique source of income for hard pressed primary care physicians

Medicare and Medicaid reimbursements continue to drop.  HMO penetration in many areas is increasing.  Malpractice premiums are rising at an alarming rate.  And, healthcare reform will soon overwhelm private practice groups across the country with 31 million new patients.  In response, many physicians are turning to the Physician Wellness Group and their unique office based nutrition business model that enables a practice to provide additional health care options to their patients.  The Physician Wellness business model offers full-time business support, income not tied to insurance reimbursements, separate tax benefits; all with no additional overhead. 

Physician Wellness was recently recognized for its creative business model, proven track record and high business standards, winning the MD Preferred Service Award for Excellence in Service to the Medical Community.  To be considered for an MD Preferred Service Award, an organization must demonstrate their commitment to making the lives of physicians better.  They must be good community citizens with the resources, staff, services and products to meet the very special needs of the medical community.  "Doctors are very busy professionals," observed Michael O'Malley, CEO of MD Preferred Services.  "When it comes to finding service providers and creative business partners, they appreciate an organization that has done much of the research for them."

All Physician Wellness nutritional products are listed in the Physicians Desk Reference and are produced in FDA regulated manufacturing facilities.  At a time when revenues are dropping and costs are on the rise, over 2,000 physicians offices have turned to the Physicians Wellness Program to supplement their practice cash flow and avoid increased patient loads and service cutbacks.

For more information about the Physicians Wellness Program call (800) 606-2884 or e-mail info@physicianspreferredwellnessgroup.com

Strategies to Maximize Social Security Benefits

Contributed by:  Alex Chastain, Abacus Planning Group, 2500 Devine Street, Columbia, SC, 803-933-0054

The decision to claim Social Security benefits could possibly be one of the most important financial decisions any of us will make in our lifetime.  The idea of a guaranteed income for life that keeps pace with inflation is very reassuring, especially during times of stock market uncertainty and in an era when pensions are a thing of the past.  Awareness that Social Security can provide an income on which to rely during retirement is becoming more prevalent and becoming more intentional about how to claim Social Security Benefits is the result.    Most of us are aware that monthly benefits increase if we wait until later to claim Social Security.  What may not be known is that there are choices available to us that may expand options and increase income benefits. 

Option 1: File and Suspend

The File and Suspend Strategy allows for married taxpayers to optimize their benefits. In this scenario the higher income earner in the family, upon reaching full retirement age,    would file for retirement benefits and then immediately suspend the benefits.  At this point, the lower earning spouse would claim on the earnings record of the higher earning spouse  at a reduced benefit (while the high income earner delays his/her claim until later, the result being  a larger benefit).  This strategy works best if one spouse has substantially higher lifetime earnings than the other.  For example, John would file for his benefits which are $2,344 a month at his full retirement age of 66 and suspend his benefits immediately. His wife Jane, at age 65, would file on John's earnings record and receive $977.45 a month which is her reduced spousal benefit and is significantly more than the amount for which Jane is eligible based on her own earnings record.  At age 70, John would claim his benefit, which will be $3,094 a month (or 32% more than his benefit would have been had he filed at age 66).  By employing this strategy, John is able to increase his own lifetime benefit as well as Jane's spousal and survivor benefit.

Option 2:  Collect Now and Later (Restricted Application)

The Collect Now and Later or Restricted Application Strategy means claiming the highest benefit available to you, whether based on your earnings record or that of your spouse, before you reach full retirement age.  However, at (or after) full retirement age, you may limit your claim (which is called restricting an application) to spousal benefits, delay your benefit, and then claim later for a higher benefit.  This strategy works best for a couple with comparable incomes.  For example, at full retirement age (66) Fred would claim spousal benefits based on his wife Ethel's earnings and would begin to receive $500 a month (or $6,000 a year) from Ethel's record until he turns 70.  At age 70, Fred would file for full benefits on his own earnings record and begin to receive $1,980 a month, which is $480 more a month than he would have received had he filed on his own earnings record at age 66.  The result is a higher survivor benefit for Ethel should she outlive Fred.

Option 3:  Resetting Your Benefit (Retirement Do-Over) *

Do you regret your Social Security decision?  The Retirement Do-Over Strategy allows those who regret taking Social Security early at a reduced benefit to turn back the clock.  By choosing to repay received benefits plus interest and a penalty, it becomes possible to reapply for a bigger monthly check at an older age.  In order to do so, IRS Form 521 "Request for Withdrawal of Application" must be filed at the local Social Security office. Benefits will stop immediately, along with those of your spouse if he/she is receiving benefits based on your earnings record.  The Social Security Administration will send a letter detailing how much to repay including spousal benefits.  (Be mindful that it may take some time to receive the letter from SSA with the repayment figure.)  Once the received benefits have been repaid, it becomes possible to reapply for a higher payment amount based on your current age.   This is a win-win situation since your spouse may collect spousal or survivor benefits based on your "new" stepped-up amount.  As an added incentive, you can claim an itemized deduction or tax credit - whichever is better - for taxes paid on SS benefits in the year you repay them (see IRS Pub 915).  The entire process takes time and effort, so you will need to think about these issues when considering whether or not the Retirement Do-over Strategy makes sense for you.  It is important to note that when your benefits stop, so do the automatic deductions that cover Medicare.  In the interim, you will not have income from Social Security so you will need to pay your Medicare premiums.

How to claim Social Security benefits is one of the most important financial decisions you will ever have to make.   With research and careful planning, it is possible to increase your peace of mind along with your financial benefits.