For most of our lives many of us have heard the old adage “Money can’t buy happiness.” And we can all think of numerous examples of individuals where this certainly seems to be true – whether among the powerful and famous, or within our own family or group of friends. But is that really true? Research over the last few decades suggests “NO!” In fact, many studies show that in one sense money can buy happiness. But it’s not the amount of money we have, but rather how we SPEND our money that can indeed increase our happiness – although perhaps not in the way Madison Avenue or Amazon Prime would like us to think. First, let’s address the skeptics among you who feel sure that if you simply had MORE money you would indeed be happier. Statistics show that certainly isn’t true, since 70% of all lottery winners or those with a sudden financial windfall end up bankrupt within a few years.1 Carl Jung, famous psychologist, said in fact that the keys to happiness were five things.
Atlanta Financial Blog
What’s Ruining Medicine for Physicians?
Each year, Medical Economics asks physicians about their top challenges for the new year. During the 2018 end-of-the-year polling, this leading healthcare publication posed a more provocative question: “What is ruining medicine for physicians?” An overarching theme that emerged from the 2018 poll centered on how the business side of healthcare is demanding more of physicians’ attention than any other issue – even patient care. From continuing education requirements to continued declines in reimbursement rates to hard-to-use EHR systems and payer relations, there seems to be fewer hours left in physicians’ days to do what they do best and were trained to do – diagnose illnesses and treat patients. As a Wealth Manager and the spouse of a physician, I’ve called out four of the nine “pain points” that I found most relevant to a physician’s finances:
Compensation: On average, primary care physicians have seen their pay rise by more than 10% in the past five years, which is only slightly more than inflation over that same time period but close to double that of specialist compensation. However, even with these gains, compensation of primary care physicians continued to trail that of specialists. While median income for primary care physicians was $257,726 in 2017, that’s significantly less than the $425,136 reported by specialists for the same time period. Compensation becomes increasingly critical to physicians as they continue to face increasing overhead, climbing staff pay, lower reimbursement rates and longer hours.
Administrative burden: Paperwork and administrative tasks topped the list when physicians were asked, “What is ruining medicine?” In fact, the majority of the physicians surveyed (79%) were united in making this claim. That is probably no surprise to anyone, provider or patient, who has been watching the healthcare industry struggle to balance patients’ best interests with what insurers will cover and navigate the myriad of new documentation required to satisfy prior authorizations.
Operating expenses: Primary care physicians found their practices’ median operating expenses up 13% since 2013, which is nearly double the inflation rate. Nationally, nurses’ compensation has risen even faster and is up 19% since 2015. Clinical staff members’ larger paychecks prompt physician employers to expect licensed clinical staff, such as physician assistants and nurse practitioners, to provide the highest level of care their licensure allows. However, these “physician extenders” are limited by their licensure to a specific set of tasks and responsibilities hindering what can be delegated by physicians. Finally, compensation for non-clinical staff, which remains in short supply, was up for 11 of the 12 positions surveyed.
Payer negotiations: Value-based care and ongoing payer consolidation complicate what physicians view to be one of their most burdensome responsibilities: negotiating contracts with payers – the third-party insurers who actually reimburse physicians for patient care. As budgets tighten and the demand for profit escalates, payers are ratcheting up their requirements to justify reimbursement increases – even small ones. In some cases, payers are restricting their networks to only those providers who deliver optimal outcomes at the lowest cost. Attempting to exert leverage into the negotiations is almost a moot point for smaller practices, which typically encounter a “take it or leave it” response from payers. As the healthcare system moves toward a value-based approach, the need to justify requested increases with documentation can be expected to continue resulting in yet more paperwork for medical practices.
All of these pain points impact a physician’s financial picture. In my work with doctors, we consider all of these factors when creating a financial game plan for a physician and his or her family. To be successful in “Making Life’s Journey Richer” for our clients, we must pay very close attention to bumps in the road, both expected and unexpected, particularly for physicians whose financial futures are so uncertain.
To read the other five items physicians say are ruining medicine for them, go to “Top Nine Issues Ruining Medicine for Physicians.”
“How did the new tax bill affect me?” was the question on everyone’s minds this tax season, and for good reason. Even though this was touted as the greatest simplification of the tax code in my lifetime, I didn’t notice any reduction in time spent preparing returns. Those of you who reviewed your returns in detail noticed that the schedules look drastically different although contain all the same information. The short answer for many is that it didn’t materially change your overall tax liability. The outliers fell into one of a few buckets…
No one enjoys thinking about what will happen after they’re gone, but we all want our families to be well cared for. Many people set up trusts to provide for their loved ones, but the trust is only as good as its trustee.Choosing a trustee is one of the more difficult decisions in creating your estate plan. Some attorneys suggest choosing several trustees to promote checks and balances, but sometimes choosing just one trustee can be difficult in light of family relationships and other factors. Choosing a trustee is a very personal and complex decision, but there are some basic guidelines one should consider.
It is that time of year again where school years are coming to a close and many parents are gearing up for a bitter-sweet high school graduation or are celebrating their child being one year closer to a hard-earned college diploma. Whatever the case may be, it is hard to deny the heavy lift education costs can be. You may not be able to shrink the bottom-line cost of attendance any further, and you surely can’t impact how fast many costs are going up, but, you can reduce the weight this line-item carries within your financial plan by remembering these 5 things: