Practice Management Blog

SILKIN MANAGEMENT GROUP: CALCULATING A PERCENTAGE

2011-08-18T11:40:00.000-07:00

On Silkin Management Group’s Tuesday, August 16th blog site, we presented a sample job description for an Accounts Manager in a health care office. This job description is part of Silkin Management Group’s Office Policy and Job Description Manual that every client new to Silkin Management Group’s program receives. You can link to the August 16th Silkin blog site here: http://www.silkinmanagementgroup.blogspot.com/

One of the statistics we discussed in that sample job description was the “percent of collections to service”. To calculate this stat based on just one month’s services and collections would, in most offices, not be an accurate representation. It would not take into account the turn around time for payment, especially if you are in any way using insurance reimbursements as part of your collections.

We suggest to Silkin Management Group clients to use the following formula which more closely represents the effectiveness of the Accounts Manager.

FORMULA:

THIS MONTH’S COLLECTIONS PLUS LAST MONTH'S COLLECTIONS
_______________________________________________________________

LAST MONTH’S SERVICES PLUS SERVICES FROM THE MONTH BEFORE LAST

For example, if the month you just completed was July, you would take the total of July’s collections, plus June’s collections and divide that by the total of June’s services plus May’s services.

The services stat used for this formula would be the adjusted services, meaning the service statistic after subtracting any barter, charitable work or any services that don’t result in monetary collection.

This formula covers the collection and services figures on the basis of the same month (June’s services and collections), a 30 day lag (July’s collections and June’s services) and a 60 day lag (July’s collections and May’s services). This gives you an accurate overall picture of the collection efficiency.

For more information about how Silkin Management Group can help you with your collections, give us a call at 800-695-0257 and visit our website at http://www.silkinmanagementgroup.com

Jack Hennessy
Silkin Management Group Consultant

SILKIN MANAGEMENT GROUP: SOME THOUGHTS ON VACATION POLICIES

2011-08-10T09:14:00.000-07:00

Past Silkin Management Group blogs have discussed the importance of office policies and job descriptions in a health care office. On many of our Silkin Management Group blog sites we’ve presented numerous sample policies that we offer to new clients via the Silkin Management Group Office Policy and Job Description Manual. One of those sample policies concerned vacations.

Given that it is summer time – the most frequent vacation time – we thought we would revisit some aspects of vacations to be aware of in managing an office.

From a legal point of view, the first thing to know is that there are no laws that we are aware of that require any employer to provide any sort of paid or unpaid time off. There are laws, though, that regulate the accumulation and compensation of vacation time which you should be aware of. Consult with your local employment attorney to find out what are the applicable laws in your area.

So what does that mean for you and your office? It means that the vacation activities in your office will most specifically be regulated by any vacation policy you provide your employees. One of the aspects of that policy could and should be that no employee can arrange time off without prior approval of the office manager and/or doctor. This provides you with the control needed to not have random vacations set and upset the ability to properly manage the office and service your patients.

It is important to include in your policy very specific actions that an employee must take in order to take a vacation. For example, the vacation policy should include when such a request must be submitted, that a request’s approval will be based upon the needs of the office to service its patients, times of the year that are not acceptable for vacations, and any other details you require. These types of items in the policy are important as, without them, you could open yourself up to potential discrimination charges when disapproving a vacation request.

As mentioned in previous Silkin Management Group blogs, policy is important to have in order to set the basic operational ground rules of your office, but it is only as useful as it is known, understood and enforced. If you follow your vacation policy for one employee but not for another, you open yourself up to potential discrimination attacks. So, the lesson is: have a policy, but make sure it is followed uniformly for all employees.

Dave McKevitt
Consultant for Silkin Management Group

If you’d like more information about Silkin Management Group’s Office Policy and Job Description Manual, visit our website at www.silkinmanagementgroup.com. You can also reach us at 800-695-0257.

SILKIN MANAGEMENT GROUP: POLICIES ON ATTENDANCE

2011-08-08T11:35:00.000-07:00

Past Silkin Management Group blogs have gone over in detail numerous policies concerning dealing with employees through clear delineation of rules and expectations in your office policies. Examples of these policies can be found in Silkin Management Group’s 400 page Office Policy and Job Description Manual which can easily be adapted and edited for any dental, veterinary and/or optometric practice.

A recent article posted by one of the employment attorneys Silkin Management Group consultants refer clients to reminded me of some key issues to include in any policy regarding attendance. Here is a link to that article: http://www.tbowleslaw.com/blog/?p=871

The basic point made in this article by The Law Offices of Timothy Bowles, an employment law firm was to insure that you have a policy that covers rules on attendance. This policy should include the following:

1. Definitions of work hours including break times, meal times, schedules (start of work, end of work, etc.)

2. What is lateness and what an employee should do if he/she is going to be late.

3. Define what your state laws are regarding the Family Medical Leave Act if they differ in any way from the federal law. The federal law allows eligible employees to have job-protected leaves (unpaid) for certain medical and family reasons. This includes such medical situations as child birth, care of the new born child within one year of birth, adoption, care for an employee’s spouse, child or parent who has a serious medical condition, a serious medical condition of the employee, etc. The point here is to clearly elucidate the points of the law, both federal and state, that apply to your employees.

4. Your office’s policy on what a leave of absence is should your office choose to provide this benefit.

5. Some sort of table of disciplinary actions for specific offenses regarding attendance.

As mentioned, all of these basic policies are included in Silkin Management Group’s Office Policy and Job Description Manual. If you would like more information about this manual and/or the services offered by Silkin Management Group, visit our website at www.silkinmanagementgroup.com

CONSULTANT NAME
Silkin Management Group Consultant

SILKIN MANAGEMENT: HOW TO PREPARE FOR A STAFF MEETING

2011-08-03T11:58:00.000-07:00

Silkin Management Group clients, most of whom are private practice owners in the dental, veterinary and optometric fields, are seldom well educated in practice management. They attend college and professional school for 8 years or more, but rarely receive any instruction in the management of a business. That’s where Silkin Management Group steps in. We provide basic education for the doctor and staff in the essential tools of properly managing a practice.

One of the important actions in practice management is holding regular staff meetings. Staff meetings provide a predictable time for the entire staff to come together to communicate, focus, plan and coordinate as a team. Silkin Management Group clients are taught that staff meetings should be quick, upbeat and productive.

Here are some tips on preparing for a staff meeting.

• Plan the format ahead of time. The Doctor and Office Manager should meet to determine any special topics that they would like to cover with the staff.

• Have the key production graphs of the office updated – minimally the graphs of production, collections and new patients. They should be clearly made so that the staff can easily see the trends.

• Prepare any handouts that you want the staff to go over. This could include new office policies or educational materials that are intended for staff distribution.

• Check over the notes from the last staff meeting and determine if anything from that meeting needs to be followed up.

• Make sure your phone is switched to your answering service, voice mail, etc., so that the meeting isn’t interrupted.

• Insure that all patients have left the office if the staff meeting occurs on a day when patients are treated.

• If the staff meeting is occurring over lunch, see that a nice lunch is brought in.

If you would like more information about Silkin Management Group, or Silkin Management Group’s Office Policy and Job Description Manual, in which information such as the above example can be found, visit our website at http://www.silkinmanagementgroup.com

Dave McKevitt
Silkin Management Group Consultant

SILKIN MANAGEMENT GROUP: RELIEVING REGULATORY STRESS ON SMALL BUSINESSES

2011-07-26T13:04:00.000-07:00

SILKIN MANAGEMENT GROUP
Relieving Regulatory Stress
On Small Business

Silkin Management Group clients are all small business owners. Most of them are private practice owners in the health care field – dentists, veterinarians and optometrists. Because our clients and Silkin Management Group itself are small businesses, we are continually keeping an eye out for government actions, regulations, laws and activities that affect us all. As an example, many of our various Silkin Management Group blog sites have, over the last year, reviewed in detail the specifics of the new health care law and its effects on all of us.

Recently I read an article, written by Representative Sam Graves, chairman of the Small Business Committee, that I thought was very interesting and something worthwhile to pass along to our readers, whether Silkin Management Group clients or not.

Rep. Graves pointed out that the stress of overregulation on small businesses was actually addressed by a piece of legislation passed in 1980, but that this law is rarely followed. The Regulatory Flexibility Act ordered all federal agencies to closely look at the impact of their rules and regulations on small business. And, if those impacts were of considerable significance, the agency must consider less onerous alternatives.

The problem though, as Rep. Graves informs us, is that the law is often ignored and requires continual orders from the Executive Branch to implement.

Rep. Graves points out that the failure of agencies to follow this law creates the following adverse effects:

 Obstruction of business growth
 Job killing
 Decreasing competition
 A cost of $10,500 per employee – 35 percent more than the cost of regulatory compliance for large businesses.

We wrote an article last year that was posted on one of our Silkin Management Group blog sites that showed that less than 10% of our legislators in Washington had ever run a business. With complete lack of experience in business management they continually pass laws that negatively impact business in general. It’s like a grocery store owner passing a law that has to do with how a dentist is suppose to fill cavities.

At least, though, in this case, they were smart enough to pass legislation requiring review and adjustment of overregulation. But nobody seems to follow it. For a full review of Rep. Graves’ article, click on this link: http://www.rollcall.com/issues/57_7/make_agencies_work_small_businesses-207303-1.html?pos=oopih
Bill Hickey
Consultant for Silkin Management Group

For more information about Silkin Management Group and the various services Silkin Management Group offers, visit our website at www.silkinmanagementgroup.com

SILKIN MANAGEMENT GROUP: WHAT THE TAX PACKAGE BILL COULD MEAN FOR YOU

2011-01-14T14:26:00.000-08:00

Part 2

Silkin Management Group’s blog article of January 13th, discussed one aspect of the recently passed legislation called “Tax Relief, Unemployment Insurance Reauthorization and Job Creation Act of 2010”. With a name that long, we should expect some lengthy benefits! And, fortunately for us all, the benefits do exist. Yesterday’s Silkin Management Group blog discussed the reduction of two percentage points in Social Security payroll tax for 2011. You can access that article here: Are You On Top of the New Year Tax Issues For Your Business?

Over the next several days, we’ll discuss on our various Silkin Management Group blog sites some of the other aspects of this bill that any individual and/or employer, whether a Silkin Management Group client or not, should be aware of. Some of these items were discussed towards the end of 2010 on our various blog sites as they were being debated in Congress. Now that the bill has passed, we thought it would be beneficial to Silkin clients and other readers to review the key items in the legislation that will likely affect us all.

Here are the first two:

The current income tax rates will be retained for two years (2011 and 2012), with a top rate of 35% on ordinary income and 15% on qualified dividends and long-term capital gains.

A two-year Alternative Minimum Tax (ATM) “patch” for 2010 and 2011 will keep the AMT exemption near current levels and allow personal credits to offset AMT. Without this patch, an estimated 21 million additional taxpayers would have owed AMT for 2010. This is very good news for many taxpayers.

Over the next few days we’ll go over some more aspects of this legislation that should have a relative positive effect on many taxpayers, including most Silkin Management Group clients. We remind you, though, to please consult your accountant and/or professional tax advisor for specific professional advice.

If you would like to learn more about Silkin Management Group, visit our website at www.silkinmanagementgroup.com or call us at 877-385-0388.

Jack Hennessy
Silkin Management Group Consultant

SILKIN MANAGEMENT GROUP: EXAMPLES OF DISCRIMINATORY HIRING INQUIRIES

2011-01-10T12:07:00.000-08:00

Part 5

Silkin Management Group has presented over the last week a series of articles concerning potential discrimination practices in hiring. Whether you are a Silkin Management Group client or not, it is vital that you are aware of the statues that affect what you ask applicants when you are in a hiring mode.

Many Silkin Management Group clients are expanding, despite the economy, and need more personnel. At the same time, anyone having to let an employee go, will also be in a hiring mode. In either case it is important for you to know what is acceptable to ask and what is improper to ask during the hiring process. Our previous articles have gone over some specific areas to be aware of including race, religion, age, education, etc.

Today we’ll discuss sex and marital status. Here are some examples of potential discriminatory inquiries concerning this subject to avoid in applications and interviews during the hiring process:

• Sex of applicant.
• Marital status of applicant.
• Dependents of applicant.
• Has the applicant made provisions for child-care?
• Is the applicant pregnant or using birth control?
• With whom does the applicant reside?
• Applicant’s maiden name.
• Name of spouse or children
• Child support obligations.

Please note that the above data, as well as the data presented in our previous blogs on this subject, is not to be construed as legal advice concerning the laws and legalities of hiring. We strongly advise all Silkin Management Group clients to contact their local, state and federal agencies as well as a good employment attorney to ensure you are knowledgeable in your sphere of responsibility as an employer.

For more information about Silkin Management Group, visit our website at www.silkinmanagementgroup.com or call us at 877-385-0388.

Bill Hickey
Silkin Management Group Consultant

SILKIN MANAGEMENT GROUP: EXAMPLES OF DISCRIMINATORY HIRING INQUIRIES

2011-01-05T12:14:00.000-08:00

Part 2

Silkin Management Group’s first article in this series, which you can access here: Examples of Discriminatory Hiring Inquires Pt 1, discussed three examples of discriminatory inquiries that anyone hiring new employees should be aware of. For the next few days we’ll continue to post more examples on our various Silkin Management Group blog sites to help educate on this subject anyone reading our blogs, whether Silkin Management Group clients or not.

If you are expanding and need more personnel, you’ll be in a hiring mode. If you have to let an employee go, you’ll be in a hiring mode. In either case it is important for you to know what is safe to ask and what is improper to ask during the hiring process. To reduce the likelihood of discriminatory claims in hiring, it is important for employers to remove inappropriate inquiries from application forms and to refrain from using them as interview questions.

Here are some more examples of discriminatory areas to be aware of:

• Birthplace and Residence: Potential discriminatory inquiries could include asking for the birthplace of the applicant or spouse, the birthplace of the applicant’s parents and/or requirement that the applicant submit birth certificates. It is safe to ask for the applicant’s place of residence and the length of the applicant’s residence in the city where the employer is located.

• Religion: Do not ask for the applicant’s religious affiliation or religious holidays observed by the applicant or whether they have religious beliefs that prevent them from working on some days. You can state the regular work days, hours and shifts to be worked and religious days on which operations are closed.

In tomorrow’s Silkin Management Group blog, we’ll discuss what is acceptable and not acceptable to ask concerning age. This is an area often overlooked in hiring.

As mentioned in earlier Silkin Management Group blogs on this subject, our consultants recommend to their clients to review all employment legal issues with an attorney whose practice involves employment law.

For more information about Silkin Management Group, visit our website at www.silkinmanagementgroup.com or call us at 800-695-0257.

Gary Crawshaw
Silkin Management Group Consultant

SILKIN MANAGEMENT GROUP: WANT TO FIRE AN EMPLOYEE?

2010-12-28T14:34:00.000-08:00

What Are The Key Legal Issues?
Part 2

Silkin Management Group’s article on yesterday’s blog site, which you can link to here http://silkinmanagementgroup.net/silkin-management-group-want-to-fire-an-employee/, discussed 4 key legal issues to look at when you are considering terminating an employee. With hundreds of clients throughout the United States and Canada, Silkin Management Group consultants are frequently working with clients on the handling of employee issues. Termination is certainly the most legally tenuous action you can take with any employee, and one to be as on top of as possible.

We covered 4 key areas in yesterday’s blog at one of our other Silkin Management Group blog sites. They were:

• Do you have an “at will” employment contract?

• Has the employee made complaints about sexual harassment?

• Has the employee made prior complaints about illegal activity in your office

• Is the employee a member of any protected class, thus protected by discrimination laws?

Today, we’d like to cover in a bit more detail, the “at will” concept of an employment agreement. We think this is something all employers, whether Silkin Management Group clients or not, should be educated on.

An “at will” employment agreement means that either the employee or employer can end the working relationship at any time without any reason. This would seem to give you blanket protection from legal attacks from a terminated employee. Don’t be fooled, though, it is not a fool-proof concept. In reality, there are exceptions to the at-will rule and, unless you’ve implemented and followed proper human resource actions, with full and proper documentation, you can still be at risk. In fact, it’s rare that someone terminates an employee for no reason at all – why would you do that? One usually has a reason for termination such as repeated bad behavior, poor production, drug or alcohol use, constant lateness, etc. And, if one of those are the reason for termination, you better have good documentation.

As there are so many “protected classes” of employees these days, any termination puts you at risk of the employee coming back at you for discrimination, sexual harassment, and other legal attack lines. There are plenty of employment attorneys looking for the discrimination case against a doctor or other employer.

Thus, all Silkin Management Group clients are trained on proper human resource administrative best practices to protect themselves from such potential legal mayhem. We’ll cover some of these best practices in future Silkin Management Group blogs. Nothing, though, takes the place of having a good employment attorney at hand to give you exact legal advice.

If you’d like more information about how Silkin Management Group can help you in the management of your practice, contact us at 800-695-0257 or email us at info@silkinmanagementgroup.com

Eric Korb
Silkin Management Group Consultant

SILKIN MANAGEMENT GROUP: THE NEW TAX PACKAGE: WHAT DOES IT MEAN FOR YOU?

2010-12-20T12:15:00.000-08:00

Silkin Management Group consultants have been writing various articles over the past several weeks on our several Silkin Management Group blog sites concerning year end tax planning. One of the items that we pointed out to keep an eye on was the result of the tax package debate – would the previous Bush Era tax cuts be extended and, if so, for whom and what would they mean to our clients?

On Friday, President Obama signed into law the new tax package. Below are the key items from this package that Silkin Management Group clients and any person reading this article should keep in mind relative to year end tax planning and planning for 2011.

• The Bush Era tax cuts have been extended for two more years for all levels of income. Therefore nothing out of the ordinary needs to be done, as would have been recommended had the tax cuts not been extended. Without a higher tax rate next year, there’s no need, relative to taxes, to attempt to increase income this year.
• There will be a payroll tax cut for many tax payers. Social Security taxes will be lowered from 6.2% to 4.2%, thus putting 2% more in the pocket of income earners.
• The elimination of the “marriage penalty”, in which married couples got taxed at a higher rate than non-married couples is extended. That’s good news for married people who were penalized, tax-wise, for being married.
• The doubling of the child tax credit to $1000 per child is also extended.
• The 15% tax rate for long term capital gains will be extended. That is good news for investors.
• Businesses can write off 100% of many capital investments through 2011. As we’ve written about in previous Silkin Management Group blogs, now is the time to make investments such as buying new equipment, computers, etc., if you can afford it. The 100% write off is a huge benefit compared to the previous depreciation tables.

There are certainly many more points in the law, but the above are what we consider the key items for any Silkin Management Group client and any business owner to be aware of.

For more information about Silkin Management Group, email us at: info@silkinmanagementgroup.com or visit our website at www.silkinmanagementgroup.com

Bill Hickey
Silkin Management Group Consultant

SILKIN MANAGEMENT GROUP: HOLIDAY PARTY GUIDELINES

2010-12-13T11:54:00.000-08:00

Silkin Management Group always has a holiday party for its staff. We do this as a great team building activity, getting all the staff more in communication in an informal atmosphere and often present goofy awards and presents in order to have lots of fun. Silkin Management Group clients, all being in the health care profession, often have holiday parties too and we encourage them to do so as it helps create a good ‘esprit de corps” in any office.

At the same time anyone having an office party, whether a Silkin Management Group client or not, should be aware of the risks of providing alcohol at such an activity. One of the attorney’s we work with, and one who several Silkin Management Group clients have used for human resources issues, has written some guidelines for alcohol involved holiday parties that we all should be aware of.

Below is the information provided by The Law Offices of Timothy Bowles, P.C. in Pasadena, CA. (info@tbowleslaw.com). We find the information to be a very useful guideline.

For more information about Silkin Management Group, visit our website at www.silkinmanagementgroup.com or call 800-695-0257.

Dave McKevitt
Silkin Management Group Consultant

_______________________________________________________________
Tradition dictates year-end celebration and resolution. For an office’s annual party, should such a “celebration” include alcohol? If management’s answer is “yes,” then common sense ought to be applied to maximize the safety and well-being of all attending as well as the public. For example:

• Hold the event at a restaurant or other outside facility licensed to serve alcohol;
• Have a “no-host” bar with employees to buy their own alcohol (and with plentiful non-alcoholic drinks provided for free);
• If it’s to be an “open” bar, provide participants with a limited number of “drink tickets,” requiring them to purchase their own past that limit:
• Ensure a professional bartender is handling the purchases and distribution and has definite instructions on limiting service to the attendees;
• Serve food of course, thus avoiding the added intoxicating effect of an empty stomach;
• Serve food low in salt, avoiding the additional thirst potentially created;
• Hold the event within walking distance of the office and make arrangements for safe transportation home for anyone who needs it;
• Include a statement on the party invitation and/or circulate a written reminder to all concerned on the responsibilities to drink only in moderation and to avoid driving after imbibing; and
• Emphasize to management they are the example-setters at the event.
Another option would be to just not serve or provide the opportunity for alcohol at all while holding the event over a lunch time and with work to follow.

SILKIN MANAGEMENT GROUP: SOME MORE IDEAS ON YEAR END TAX PLANNING

2010-12-07T12:05:00.000-08:00

Silkin Management Group articles on our various Silkin Management Group blog sites have, over the last month, presented many ideas and strategies for year end tax planning. Part of those discussions surrounded whether or not certain tax rates would be going up or staying the same. With yesterday’s extension of the Bush tax reductions, we now know that tax rates will not be changing for the next few years.

With that in mind, here are three key things to consider in your year-end look at taxes and items that we recommend all Silkin Management Group clients review for their own situation.

• Have you taken advantage of retirement accounts? You can shelter income and profits in qualified retirement accounts. There are virtually no rule changes on this for 2010. If you have or can set up a Simplified Employee Pension plan (SEP) you can, if you qualify, contribute up to a maximum of $49,000. 401K’s also offer the ability to shelter income from taxes, although less than a SEP.

• Health care coverage. As we’ve discussed in numerous Silkin Management Group blogs, there are many potential tax advantages and incentives with the new health care legislation. There are different rules if you are self employed versus having a corporation, so check with your accountant on this. But it is certainly worth looking into for potential tax savings and tax credits.

• Equipment purchases. This is another item we discussed in more detail in Silkin Management Group blogs last month. There are new expensing rules that are very advantageous for purchasing new equipment or upgrading older equipment. Rather than a slow depreciation schedule as past rules dictated, you can now expense up to $500,000 in the first year of purchase. That could be a very significant tax savings.

There are more tax strategies that you can look at and that we have discussed in previous Silkin Management Group blog articles. And the items mentioned above have been gone over in more detail in some of these articles as well.

Get with your accountant and make sure you are taking full advantage of the year end strategies that are available to you. It could save you a lot of money in taxes.

Gary Crawshaw
Silkin Management Group Consultant

THE CRUX OF THE LEGAL BATTLE OVER HEALTH CARE LEGISLATION

2010-12-01T12:09:00.000-08:00

Silkin Management Group’s various blog sites have posted numerous articles over the past year on the new health care legislation, also referred to by many as “ObamaCare”. As Silkin Management Group clients are all health care practitioners throughout the United States, this legislation has important ramifications on them as health care providers and small business owners.

As we pointed out in a recent Silkin Management Group blog, there are several lawsuits traveling through various federal courts testing the constitutionality of the law. Two courts have issued decisions that the law is constitutional. The judges from those two courts were appointed by the previous Democratic administration. There are two more courts (in Virginia and Florida) that are close to issuing decisions as well and preliminary indications are that they may rule that parts or all of the legislation is unconstitutional. And the judges from these two courts were appointed by Republican administrations.

One of the questions that has come up from Silkin Management Group clients and non-clients alike is, what is the basis of these lawsuits. I read an article today that covered this very well and thought I’d pass it along. You can link to the article here: http://www.newsmax.com/InsideCover/LegalCenterObamacareDevastatesCompanies/2010/11/29/id/378289

The author points out that the argument centers around the “commerce clause” of the constitution wherein Congress has authority to regulate economic activity. As the article points out, the argument being presented in these lawsuits is that “Congress is using the commerce clause to compel individuals to engage in economic activity.” That’s very different than regulating existing activity, per the lawsuits. If you read the full article you’ll get a good understanding of this point of view.

We’ll keep a close eye on the outcome of these suits and post information on it in future Silkin Management Group blogs. At least one of the undecided cases is suppose to be decided before the end of the year.

For more information about Silkin Management Group, feel free to contact us at 800-695-0257 or email info@silkinmanagementgroup.com

Eric Korb
Silkin Management Group Consultant

SILKIN MANAGEMENT GROUP: DID YOU HIRE ANYONE THIS YEAR?

2010-11-23T12:21:00.000-08:00

There Might Be Some Tax Savings
Part 2

In yesterday’s Silkin Management Group blog (which you can link to here: http://silkinmanagementgroup.net/), we wrote about possible savings on social security taxes on certain types of employees hired during 2010. There are very specific terms that must be met for the employee to qualify for this tax savings but, if they do qualify, substantial savings could be realized for Silkin Management Group clients and non-clients alike.

There is one more potential financial gain for Silkin Management Group clients and any business that has hired employees this year. This is a “tax credit for retaining new hires”. Here’s how it works.

Above and beyond the Social Security tax exemption discussed in yesterday’s Silkin Management Group blog, employers can also claim a new tax credit of up to $1000 for wages paid to each qualified new employee. A qualified employee is defined the same way as defined for the above mentioned Social Security tax exemption - that is they are full or part-time workers who: a) start work after February 3, 2010 and no later than December 31,2010 and b) they were not employed more than 40 hours during the 60 day period ending on the start date. They also cannot displace a current employee unless that person quit voluntarily or was discharged for cause.

Here are the requirements to collect this tax credit:
• You must keep the worker on the payroll for at least 52 consecutive weeks
• The wages during the second 26 weeks must equal at least 80% of wages paid during the first 26 weeks.
• The credit equals the lesser of a) 6.2% of qualifying wages paid during the 52 consecutive week period for b) $1000.
• To claim the $1000 credit, the employee must be paid at least $16,130 during the 52 week period.
• The credit is claimed in the tax year that the 52 week period is met for the worker. (Therefore the credit will be on your 2011 return).

Silkin Management Group clients and non-clients alike should look at anyone they hired this year and see if they fit into the parameters outlined above. If so, contact your accountant to make sure you take advantage of this potential tax savings.

If you’d like more information about Silkin Management Group, contact us at 800-695-0257.

Bill Hickey
Silkin Management Group Consultant

SILKIN MANAGEMENT GROUP: MORE IDEAS ON 2010 TAX PLANNING

2010-11-17T12:01:00.000-08:00

Part 6
Should You Convert Your IRA Into a Roth IRA?

Silkin Management Group’s continuing tax planning series that exists on our various Silkin Management Group blog sites continues today with some ideas about IRAs and Roth IRAs. As stated before, Silkin Management Group is a practice management company, not a tax firm and we do not and cannot recommend specific tax advice. But we also try to keep Silkin Management Group clients informed of relevant information that can affect their financial decisions and do so by presenting information from our accounting firm, Carl Foster, LLC.

If you have an IRA and its worth has gone way down, you may be interested in this information.

CONVERT TRADITIONAL IRA INTO ROTH IRA

If your traditional IRA has dropped in value and you expect to pay higher federal income tax rates in future years, now might be a very good time to consider converting all or part of your traditional IRA balance into a Roth IRA. Here’s why.

If you convert, it will trigger a current tax hit on the amount you convert, it will trigger a current tax hit on the amount you convert. But, with your traditional IRA balance at depressed levels (and possibly your overall income too), the tax hit will be less. After the conversion, all the income and gains that accumulate in your Roth IRA, and all withdrawals after you reach age 59 ½, will be totally free of any federal taxes – assuming you meet the tax free withdrawal rules. In contrast, future withdrawals from a traditional IRA could be hit with tax rates that are higher than today’s rates – maybe much higher depending on how things go.

In tomorrow’s Silkin Management Group blog article, we’ll present more information for you to consider on this concept.

If you’d like more information about Silkin Management Group, contact us at 800-695-0257.

Jack Hennessy
Silkin Management Group Consultant

SILKIN MANAGEMENT GROUP: MORE ON OFFICE POLICY

2010-11-08T10:44:00.000-08:00

Silkin Management Group has provided a variety of articles on our various Silkin Management Group blog sites over the last month concerning office policy. We’ve presented suggested lists of items to include in office policy as well as possible wording for some of the items on these lists. Over the next few days we will continue to provide suggested wording for different facets of policy that you can adapt to your office.

Silkin Management Group clients are primarily dentists, veterinarians and optometrists throughout the United States and Canada. None of them were extensively trained in practice management in school. We provide that missing education, and a key part of that education concerns policy. In fact all clients new to Silkin Management Group’s program receive the Silkin Management Group Office Policy and Job Description Manual – over 400 pages of suggested policy and job descriptions for a health care office.

Today we’ll provide some wording out of that manual having to do with policy concerning employees keeping track of their working time.

KEEPING TRACK OF YOUR TIME:

Each staff member is individually responsible for recording work time on the attendance sheet and/or time card when reporting for work, leaving for lunch, returning from lunch and leaving at the end of the day.

The attendance sheet and/or time card is a legal document and must not be destroyed, defaced or removed from the premises. Never allow another employee to enter your time for you and visa versa.

Overtime must be authorized in advance of extra time worked or as soon as possible thereafter. Overtime, changes or omissions on the attendance card must be authorized by the Office Manager and initialed.

When you leave the premises, let us know. If you have to go out of the office or the building on personal business during your scheduled work hours, first get permission from your supervisor. Then check in and out on your attendance sheet or time card.

In our next article we will offer some suggested wording on other areas having to do with working hours.

If you’d like more information about Silkin Management Group’s Office Policy and Job Description Manual, contact us at 800-695-0257.

Dave McKevitt
Silkin Management Group Consultant

SILKIN MANAGEMENT GROUP: MORE ON EXEMPT AND NON-EXEMPT EMPLOYEES

2010-10-28T13:41:00.000-07:00

Part 2

Silkin Management Group has presented several articles about office policy on our different blog sites over the last several weeks. Yesterday, due to interest from Silkin Management Group clients, we went a little deeper into one area covered in one of our articles on policy – exempt and non-exempt employees. In that article we discussed in much greater detail exempt employees. You can link to yesterday’s article here: http://silkinmanagementgroup.net/silkin-management-group-more-on-exempt-and-non-exempt-employees/.

Today we will cover in greater detail information about non-exempt employees. These are the types of employees that Silkin Management Group clients, or any business should have on an hourly wage basis. The difference between exempt and nonexempt employees is basically who gets paid overtime and who doesn't. If you don’t know the difference, it could be very costly.

Non-Exempt Employees:

Non-exempt employees are employees who are subject to all the provisions of the Fair Labor and Standards Act (FSLA). This is based upon the type of duties performed by the employee and their normal level of decision making authority. These are normally non-professional positions, positions that are not executive or managerial in nature. Non-exempt employees receive hourly wages; they are subject to wage and hour laws, most importantly including overtime pay. Non-exempt employees are normally required to account for hours and fractional hours worked.

For Silkin Management Group clients this category might include receptionists, accounts personnel, and other non-technical and non-managerial positions.

It is extremely important to check with an attorney conversant in labor laws if you have any question about who is an exempt or non-exempt employee. Should you incorrectly classify a non-exempt employee as exempt, it could end up costing you a great deal of money in fines and unpaid overtime. All Silkin Management Group consultants highly recommend to their clients to double check with their attorney on these decisions.

Several good websites to visit that will give you more information on this subject are:
http://humanresources.about.com/od/glossaryn/g/nonexempt.htm
http://www.paychex.com/pdf/exempt.pdf
http://www.hrhero.com/topics/exempt.html

If you would like more information about Silkin Management Group or Silkin Management Group’s Office Policy and Job Description Manual, feel free to contact us at: 800-695-0257.

Gary Crawshaw
Silkin Management Group Consultant

SILKIN MANAGEMENT GROUP: SMALL BUSINESSES ARE SLOW TO RECOVER DURING THESE TOUGH ECONOMIC TIMES

2010-10-19T12:11:00.000-07:00

Silkin Management Group clients are all small business owners. The majority of our clients are private practice owners specializing in dental, veterinary and optometric medicine. Being small business owners they all have to deal with the adverse affects of this economic downturn.

On the whole, Silkin Management Group clients are continuing to grow despite this very rough economy. And, based upon surveys we’ve read in the past and posted on various Silkin Management Group blog sites, most small businesses, including many health care practices, are experiencing decreases in income rather than a continued growth.

Pertaining to this subject I just read an article in Bloomberg Business Week written by Malachi Mixon III, Professor of Entrepreneurial Studies at Case Western Reserve University that discussed why small business owners are still struggling economically. I suggest you read the full article which you can link to here: (http://www.businessweek.com/smallbiz/content/oct2010/sb20101015_444691.htm)

He makes the point that surveys and statistics show that conditions have gotten worse, not better for small businesses since the “economic recovery” began. He says the main reasons for this are:

• Declining home prices.
• Uncertainty about the effects of the new health care legislation and that rates are already rising for health insurance premiums.
• Marginal income tax rates that are high and rising.

Each of these points are discussed in detail in the article. Mr. Mixon also states, “Before investing and hiring, business owners are waiting to see what the current policy environment is going to cost them, and how much they're going to have left over for expansion.”

Due to the management consulting and training that Silkin Management Group delivers – the missing part of a doctor’s education – Silkin Management group clients are, for the most part, growing despite all the reasons why not. And despite many, many of their colleagues experiencing decreases in revenue.

If you are not experiencing growth and not sure what to do about it, you can contact Silkin Management Group at: info@silkinmanagementgroup.com or visit our website at www.silkinmanagementgroup.com. We can help.

Eric Korb
Silkin Management Group Consultant

WEB BASED MARKETING

2010-08-06T16:34:00.000-07:00

Part 3

Over the last year we have offered many marketing tips on our various Silkin Management Group blog sites because our clients and potential clients are always interested in learning more about marketing.

As almost everyone knows, in today’s world, marketing strategy must include the internet if you want to be effective. We are certainly not internet technical experts, but we do know marketing technology and we do work with people who know what they are doing with internet technology. To that end we have previously presented two articles about internet marketing that you can find here: http://blog.silkinmanagementgroup.com/?p=236 and http://www.silkinmanagementgrp.com/2010/08/05/web-based-marketing/.

In today’s blog we offer up Part 3 of this series which we hope Silkin Management Group clients and anyone else reading our blog sites will find useful in learning more about this area.

Today’s we will cover 3 important points regarding Email marketing.

1. Make sure you have a regular e-Newsletter in place. There are numerous templates available that are easy to use and make specific for your office.
2. Have an easy place for your patients/clients to sign up to receive the newsletter. This could be when they are in the office and/or via regular mail.
3. Use a company like Constant Contact, Listrak, ListCast to handle the mailing of the newsletter to maintain compliance with all SPAM rules and regulations so you maintain a good list to mail to.

As mentioned in our earlier articles, you will likely need to hire a professional to help you with the technical areas of internet marketing but, if you keep all the points that we’ve gone over in mind, you will be able to get the type of help you need and better understand what to ask for.

Silkin Management Group has helped nearly 4000 private practices with successful marketing techniques for nearly 30 years to great results. If you’d like to find out more about Silkin Management Group, visit our website at www.silkinmanagementgroup.com.

Eric Korb
Silkin Management Group Consultant

MARKETING CHECKLIST

2010-08-02T09:57:00.000-07:00

Part 1

On our various Silkin Management Group blog sites, we’ve presented over the last few weeks a variety of marketing tips. Due to the great response we’ve gotten, we thought we’d present some more marketing ideas for Silkin Management Group clients and prospective clients.

Below you will find Part 1 of a “marketing checklist” you can use. You’ll find here 10 essential points for a marketing checklist. On a future blog we’ll present another 10 points that you can use.

Put these checklist points in your marketing notes:

1. Practice name/logo.

2. External signage/visibility.

3. Building Design (exterior and interior)

4. Doctor and Staff Appearance.

5. Stationery (business cards, letterhead, envelops, office forms).

6. Practice Brochure.

7. Website.

8. Facebook page.

9. Twitter

10. Advertising based on surveys

If you would like more information about how Silkin Management Group can help you with marketing for new patients, contact us at info@silkinmanagementgroup.com and/or visit our website at www.silkinmanagementgroup.com.

Jack Hennessy
Silkin Management Group Consultant

WHAT ANNOYS YOU ABOUT YOUR EMPLOYEES?

2010-07-26T13:54:00.000-07:00

Part 4

Handling employees is a difficult thing for most new Silkin Management Group clients. It is an area we work closely with them on as they learn effective management tools to run their practice.

In the effort of helping our clients and anyone interested, you’ll find in Silkin Management Group’s blog site of July 20th, July 21st & July 23rd we introduced Parts 1, 2 and 3 of a 5 part series on things staff do to drive their bosses crazy and what to do about them.

Here’s Part 4 of types of employees who drive their bosses a little crazy and what to do with them.

“The Employee that Needs Babysitting.”

This is the employee that shows little to no initiative. This is the one that needs orders and constant supervision. What a pleasure it is to hire someone, and have them jump in, learn what to do, and do it, even when not specifically asked. Contrast that to the employee that just sits at the front desk when there are no patients waiting. Instead of doing the tasks that every office needs—reactivating patients, calling patients/clients for follow-up checks, tidying up the office, checking inventory, placing orders, filing insurance, etc, etc, this staff member is either staring into the reception area, updating their Facebook status, or calling their significant other. None of which produces anything of value for you or the practice.

What do you do? As mentioned in the above referenced blogs, do whatever you can do to weed out such a potential employee BEFORE hiring them. How? Through good screening and testing procedures during the hiring process. And, if they still got hired, you better have good job descriptions, office policies, production metrics and job reviews to catch and handle such an employee. If you don’t….you will continue to be annoyed and exasperated.

Silkin Management Group provides job description and office policy manuals to its clients as well as various tests for screening applicants and production statistics to measure the efficiency of any position. If you’d like more information about this contact us at info@silkinmanagementgroup.com.

Lyn Ribisi
Senior Analyst’s Assistant
For Silkin Management Group

WHAT ANNOYS YOU ABOUT YOUR EMPLOYEES?

2010-07-20T16:05:00.000-07:00

Part 1

One of the biggest areas of difficulty that Silkin Management Group clients come to us with is handling employees. This ranges from how to find the right staff to hire, how to train them and what to do with problem employees.
Given our nearly 30 years in business, having consulted and trained over 4000 health care practices in various aspects of practice management, we are extremely familiar with the types of problems Silkin Management Group clients run into with employees. Therefore we thought we’d present a series of articles on our Silkin blog sites concerning things that staff do to irritate their boss and what you can do about them.

Here’s the first:

1. “It’s Just a Job.” The number one complaint that we hear from Silkin Management Group clients, is “She/he’s just punching the clock. They doesn’t care about the office really.”

I’m sure all of you can point out at least one employee you have now, or have had in the past, that fits into this category.

And I’m sure you can recall your feelings every week when you sign his or her paycheck.

Most all problem staff members have this as a really basic fault. Low responsibility is the underlying problem here.

Lesson: Hire the most responsible person you can find. All else can be handled with training and correction. How do you do that? You need the proper screening and testing procedures for your job applicants. Silkin Management Group can help you with that.

Lyn Ribisi
Silkin Management Group Senior Analyst Assistant

For more information about how Silkin Management Group can help you with employee situations, contact us at info@silkinmanagementgroup.com.

WALL STREET IS HIRING, HOORAY!

2010-07-13T12:55:00.000-07:00

How Stupid Can We Get?

As Silkin Management Group consults small business owners, primarily private health care practices in the dental, optometric and veterinary fields, we are continually aware of how the economic recession of the last few years has adversely affected small businesses throughout the country. People don’t have the income streams they used to have and millions and millions of people are out of work and not able to buy anything but the bare essentials. All of this adds up to a very weak economy felt by businesses throughout the country.

Sunday I ready an article in the New York Times discussing how Wall Street is booming and hiring new people. Boy, I bet that brought joy to all those people out of work. And I don’t think it’s going to mean one pretty penny to 99% of the people in this country, including Silkin Management Group clients.

Doesn’t it just warm your heart to know that the people who caused this economic travesty, the same people who we each individually bailed out with our hard earned tax dollars are now doing so well that they are hiring more people? And the people who we “couldn’t afford to bail out” are still suffering?

I am no proponent of deficit spending but the gigantic amounts of money we’ve spent in the last two years to bail out Wall Street have not helped the average person like you and me, nor helped our clients at Silkin.

There are two Op Ed columns in today’s New York Times that discuss this that I found well written and very ‘to the point”. You can link to them here:
http://www.nytimes.com/2010/07/13/opinion/13herbert.html?th&emc=th
http://www.nytimes.com/2010/07/13/opinion/13brooks.html?th&emc=th

I hope you find these articles educational about who really seems to be in control of our economy.

Jack Hennessy
Silkin Management Group Consultant

If you would like any further information about Silkin Management Group and our services, visit our website at www.silkinmanagementgroup.com.

HOW TO PROPERLY RAISE PRICES

2010-07-06T10:26:00.000-07:00

Silkin Management Group clients often ask us the best way to raise prices. Some consulting companies use price increases as the primary means of increasing income. That’s the lazy way and really presents a false picture of supposedly “increased production” We prefer to create increased production and income through proper marketing for new business and increasing efficiency within a business or practice.

None-the-less, with inflation a continual situation in the economy, Silkin clients do find it necessary to adjust their prices to keep up with inflation and inquire about the best way to go about this. We suggest minor price increases of up to 5%, but to not make them frequent. Do it once a year at the most, depending on how inflation is affecting your overall costs. Our clients have found this to be an effective way to go about increasing prices without scaring patients or clients away.

Silkin Management Group clients and anyone else reading this blog site may also be interested in an article I just read in Business Week concerning price increases for small businesses. You can link to that article here: http://www.businessweek.com/smallbiz/content/jul2010/sb2010076_225313.htm. I found the data in the article useful and interesting.

Dave McKevitt
Silkin Management Group Consultant

If you are interested in finding out more about how we can help you increase productivity and efficiency, visit our website at www.silkinmanagementgroup.com.

REVERSE DISCRIMINATION IN THE WORKPLACE

2010-06-28T15:30:00.000-07:00

In several of our past Silkin Management Group blogs we’ve provided some employment law issues for Silkin clients as well as anyone reading our blog sites. This information comes from a firm we’ve referred Silkin Management Group clients to as they specialized in employment issues. The firm is “The Law Office of Timothy Bowles, P.C.”, located in Pasadena, California.

Today we are presenting an article Mr. Bowles wrote about reverse discrimination. This is different than just discriminating against an employee because of his/her race, gender, religion or other protected classification. In reverse discrimination an employer can get in trouble by insisting an employee follow the employer’s religious beliefs.

I think you’ll find the article interesting and educational.

Bill Hickey
Silkin Management Group Consultant

For more information about Silkin Management Group, visit our website at www.silkinmanagementgroup.com. You can also contact Silkin Management Group at info@silkinmanagementgroup.com.

Reverse Discrimination

“Reverse discrimination” is a variant of religious discrimination. Reverse discrimination means a plaintiff asserts the employer wrongfully discriminated against him/her because plaintiff did not adhere to the employer’s religious beliefs. In reverse discrimination cases, the plaintiff claims religious discrimination based on the religious beliefs of the employer, and the fact that the employee does not share those beliefs. The plaintiff claims his/her lack of adherence to the religious beliefs promoted by company management was what led to the unlawful discrimination the plaintiff later faced. To establish this claim, plaintiff has the burden of proving all of the following: (1) plaintiff was subjected to some adverse employment action; (2) at the time the adverse employment action was taken, plaintiff’s job performance was satisfactory; and (3) plaintiff can show some additional evidence to support the inference that the employment action was taken because of a discriminatory motive based upon plaintiff’s failure to hold or follow his/her employer’s religious beliefs.

In Venters v. City of Delphi, the plaintiff was able to prove she was wrongfully discriminated against based on this theory of “reverse discrimination.” Plaintiff’s supervisor gave plaintiff a bible and other religious materials and then told her she would no longer work at that company unless she started going to church and following God’s way. The supervisor asserted plaintiff practiced incest and bestiality and she should commit suicide. Plaintiff asked supervisor to stop but he continued making similar statements. After her termination, plaintiff sued for religiously motivated discharge.

The court noted that her claim was not that her employer refused to accommodate her religious practices, but that her employer discharged her because she did not measure up to her supervisor’s religious expectations. Plaintiff’s supervisor didn’t simply share his religious beliefs with her; instead he made it clear if she did not conform to those views she would be discharged. The court determined under these circumstances of religion in the workplace, the plaintiff need only show that her perceived religious shortcomings played a motivating role in her discharge. The court concluded plaintiff had a right to work without being compelled to submit herself to her supervisor’s religious scrutiny.

Sincerely,
Tim Bowles

Law Offices of Timothy Bowles, P.C.
One South Fair Oaks Ave., Suite 301
Pasadena, CA 91105

Phone: 626-583-6600
Fax: 626-583-6605
Email: information@bowleslaw.com

NEW RULES FOR EXISTING HEALTH CARE PLANS

2010-06-15T12:33:00.000-07:00

Over the last 6 months on our various Silkin Management Group blog sites we’ve been writing about and updating information on how the new health care legislation impacts small businesses since all of Silkin Management Group’s clients are small businesses.

Yesterday the Obama administration came out with some new guidelines for companies that have existing health insurance policies for their employees. The bill passed in March exempted existing plans from some of the reforms of the bill. But the guidelines that came out from the administration yesterday greatly restricts these exemptions. You can read more about this by linking to this article: http://www.reuters.com/article/idUSTRE65D63220100614?feedType=RSS&feedName=topNews

The new restrictions could result in greatly increased costs for plans held by small businesses. As pointed out in this article, "These rules limit flexibility and severely restrict the last line of defense for an employer before making the difficult decision of having to employ the nuclear option: dropping coverage all together," said the group's vice president, Susan Eckerly. "This is another heartbreaking and discouraging outcome from this new healthcare law." (Susan Eckerly is the Vice President of the National Federation of Independent Business).

I would suggest all Silkin Management Group clients, as well as all small business people, read this article as well as any further information about these new restrictions so that they know how these new rules affect their plans, coverage and costs. We will continue to research this as well and present additional information, as we find it, on our various Silkin Management Group blog sites.

Gary Crawshaw
Silkin Management Group Consultant

For more information about Silkin Management Group and our services, visit our website at: www.silkinmanagementgroup.com. You can also contact us at info@silkinmanagementgroup.com.

WHAT ARE THE BEST CREDIT CARDS TO USE FOR SMALL BUSINESS?

2010-06-10T08:42:00.000-07:00

Many of our Silkin Management Group clients have asked questions about controlling their credit ratings and the best and/or proper use of credit. Some months ago, we posted several articles on our Silkin Management Group blog sites that discussed some of the specifics about how credit ratings were determined.

Today we found a very useful article in Forbes concerning which credit cards provide the best rates and service to small business owners. You can access that article here: http://blogs.forbes.com/moneybuilder/2010/06/08/credit-card-tip-of-the-week-how-to-choose-a-safe-small-business-card/

The key points of the article are to avoid Citibank and American Express cards due to the high penalties they assess for minor infractions or lapses. Interest rates can skyrocket on these cards if you make an error, late payment, etc. As the author points out:

“The terms of small-business cards issued by Citibank and American Express, for example, contain harsh penalties for relatively minor infractions. With Citibank, a single late payment can cause rates to increase to 29.99% on not only future purchases, but on current balances as well. With American Express, it takes two late payments or a returned check to trigger penalty rates ranging from 19.24% to 27.24%.”

Although it is nice to get all those mileage points with American Express which you can use for plane tickets and hotel rooms, if you mess up it may not be worth it.

According to the article, Bank of America cards provide the best rates and service.

We are recommending to Silkin clients to read this article and research the cards they have against the information provided. It may save one a lot of money and headaches.

Jack Hennessy
Silkin Management Group Consultant

To contact Silkin Management Group, you can email us at: info@silkinmanagementgroup.com. Visit our website at www.silkinmanagementgroup.com for more information about our company and services.

HOW DOES THE HEALTH CARE LEGISLATION AFFECT GROUP HEALTH CARE PLANS?

2010-06-03T14:57:00.000-07:00

Part 3

On two of Silkin Management Group’s blog sites, we posted two articles concerning how the new health care legislation affects group plans. You can access Part 1 here www.silkinmanagementgroup.blogspot.com and access Part 2 here www.silkinmanagementgrp.com.

Given that Silkin Management Group clients are small businesses and many of them have group health plans, we are presenting relevant information for our clients and anyone interested concerning group plans and the new legislation.

In this article you’ll find a short summary of the 2011 provisions that might affect your group plan when you renew in January of 2011.

• Employers must report on W-2’s the value of employer sponsored benefits. The government is saying that this is for “informational purposes” only, but I suspect it will be used for possible modifications to the law.

• OTC (over the counter) drugs and medicines will not be able to be reimbursed through flex plans, health savings accounts or any other health reimbursement arrangements unless you have a prescription.

• You will pay an increased penalty if you withdraw funds from an HSA (health savings account) for non-medical reasons. As before, you will be taxed on this money but you will also pay a fine of 20%, up from 10%.

Bill Hickey
Consultant for Silkin Management Group

Silkin Management Group has delivered its practice management program to thousands of businesses over the last 30 years. For more information about Silkin Management Group, visit our website at: www.silkinmanagementgroup.com.

WHAT IS A WORKPLACE BULLY?

2010-05-27T10:21:00.000-07:00

IT MAY COST YOU A LOT OF MONEY TO FIND OUT

On May 19th, we posted an article on one of our Silkin Management Group blog sites, which you can link to here: There Are Some Good Lawyers Around. In this article we presented some information from an attorney about the need to document employee problems in any business. This is something we constantly advice our Silkin Management Group clients on as part of their management consulting.

Employee legal issues are more and more of a potential threat to employers as more and more laws are passed relating to dealing with employees. It is therefore very important for anyone running a business to know what the legal landscape is like and any new issues arising relating to dealing with employees.

Today there was an article in the Wall Street Journal discussing a new employee protection law just passed in New York. You can link to that article here: http://online.wsj.com/article/SB10001424052748704717004575268701579722946.html?mod=dist_smartbrief.

This new law now allows employees to sue their employer for suffering experienced by a “workplace bully”. The first question that comes to mind is, “what is a workplace bully?”

Per the article, “New York's anti-bullying bill defines bullying broadly and includes the repeated use of derogatory remarks, insults and epithets, as well as conduct that a "reasonable person" would find threatening, intimidating or humiliating.”

That, to me, is a pretty broad definition that opens up the threat of suit when one employee may, under stress, get momentarily angry or raises their voice or even pushes someone to do something that maybe they don’t want to do. As the article points out, it opens up a victim mentality in the workplace.

Although this law has only been introduced in New York, it could very easily be picked up by other states and affect all employers.

I recommend all Silkin Management Group clients and all business owners to read this article and get a feel for what to watch for in your workplace. As cases get decided from this new law, we’ll all have a better understanding of how it will affect the workplace.

Dave McKevitt
Silkin Management Group Consultant

For information about Silkin Management Group and our services, visit our website at www.silkinmanagementgroup.com.

IS YOUR BUSINESS ELIGIBLE FOR HEALTH INSURANCE TAX CREDITS?

2010-05-20T14:02:00.000-07:00

What Financial Benefit Can You Receive?

Beginning this year, many small businesses that offer health insurance to their employees may be eligible for a tax credit. It is estimated that there are possibly four million small businesses that may be able to qualify.

All of our clients at Silkin Management Group are small businesses and the great majority of them likely qualify under the new health care legislation. I’ve been looking for a simple way to help Silkin clients find out what type of financial benefit they may receive under this provision and found Small Business Majority’s website that has a great tax credit calculator that anyone can use.

It allows small businesses to find out their financial benefit through a simple process that requires only three inputs: the number of full-time equivalent employees, the total annual wages paid for all employees, and the total annual employer contribution to premiums. Using this calculator will allow you to immediately see how much money you can save in the years leading up to the creation of state health exchanges (2010-2013), and once the exchanges are in place (in 2014) as we’ve written about on our various Silkin Management Group blog sites.

The calculator can be found at: http://smallbusinessmajority.org/tax-credit-calculator/

Bill Hickey
Silkin Management Group Consultant

For more information about Silkin Management Group, visit our website at: www.silkinmanagementgroup.com or contact us at: info@silkinmanagementgroup.com.

THE MOST AND LEAST TRUSTED INSTITUTIONS IN OUR COUNTRY

2010-05-14T11:11:00.000-07:00

Silkin Management Group works with small businesses owners and their staff on effective management of their business through statistical management, proper hiring and training of staff, marketing and many other areas. We were therefore happy to point out in one of our blogs posted on May 4, which you can link to here: Who Do You Trust, that a recent study done by the Pew Research Center ranked small business as the most trusted institution in the country.

I recently read another article which discussed this trust factor and thought I’d refer our readers to it. You can access this article here: http://smallbiztrends.com/2010/05/americans-fed-up-but-like-small-businesses.html

As the author of this article pointed out, “Survey respondents were grouped by whether they were “content,” “frustrated,” or “angry” with the federal government. Among all three groups, small business was the institution that got the most positive response. Asked whether small business has a positive effect on the way things are going in the U.S., 73 percent of the contented respondents, 74 percent of the frustrated respondents and 68 percent of the angry respondents said yes.” There is quite a bit of additional interesting information in the article which I am referring my Silkin Management Group clients to.

If you are interested in reading the entire report, which some Silkin clients are, you can also access the report, dated April 18, 2010 through this link: The People and Their Government: Distrust, Discontent, Anger and Partisan Rancor

I suggest you read through it as you’ll find it very, very interesting.

Gary Crawshaw
Consultant for Silkin Management Group

If you’d like to find out how Silkin Management Group helps small businesses and what our various services are, visit our website at: www.silkinmanagementgroup.com

TIME LINE OF SIGNIFICANT PROVISIONS OF THE HEALTH CARE LEGISLATION - PART 2

2010-05-05T13:08:00.000-07:00

As mentioned in the Silkin Management Group blogs of last Friday, April 30th and Monday, May 3, 2010, which you can link to here: April 30th Blog & May 3rd Blog, we went over that the NFIB (National Federation of Independent Businesses) has done excellent in-depth research on the new health care legislation, especially as it relates to small businesses. Since this law significantly affects all small businesses, and as Silkin Management Group clients are all small businesses, we felt it important to refer Silkin clients and anyone reading our blog sites to this information.

The NFIB website on this subject is excellent. On Monday we presented their information on what will happen over the next two years relative to the implementation of this legislation. Today we will present what the NFIB explained will happen in the years 2012 and 2013.

You can access their site at: http://www.nfib.com/tabid/739/Default.aspx?cmsid=51105. And, if you haven’t already, watch their very entertaining video on this site. You’ll enjoy it.

Jack Hennessy
Silkin Management Group Consultant

For more information about Silkin Management Group and our services, visit our website at: www.silkinmanagementgroup.com. If you’d like to contact Silkin Management Group you can email us at info@silkinmanagementgroup.com">info@silkinmanagementgroup.com.

From the NFIB Website:2012

• 1099 reporting: Businesses will have to send Form 1099s for every business-to-business transaction of $600 or more – a tremendous new paperwork burden for small business.
2013
• Medical device tax: Manufacturers and importers of certain medical devices will face a 2.3% excise tax.
• Fewer deductible medical expenses: New limits are placed on the deductibility of medical expenses on individual income tax returns. This provision raises the 7.5% AGI floor on medical expenses deductions to 10%. The AGI floor for those 65 and older (and their spouses) remains at 7.5% through 2016.
• “Medicare” payroll taxes: The Medicare payroll tax on wages and self-employment income in excess of $200,000 ($250,000 joint) will increase to 2.35% and is not indexed to inflation. This tax marks the first time that funds designated for Medicare will be diverted elsewhere – specifically to pay for the insurance policies of people under the Medicare age. This establishes a precedent for treating this payroll tax as a revenue raiser for other purposes.
• “Medicare” investment tax: In addition to the payroll tax, there will be a 3.8% tax on investment incomes for higher-income taxpayers (“higher-income” is based on wage and self-employment income plus other factors). Like the payroll tax, these funds are officially designated for Medicare but will be spent elsewhere.
• FSA limits: Cafeteria plan FSAs will be limited to a maximum of $2,500 (inflation-adjusted after 2013).

OBAMA-CARE ISN’T HELPING SMALL BUSINESSES

2010-04-29T16:43:00.000-07:00

As we continue to research and write about the new health care legislation on our various Silkin Management Group blog sites we constantly run across good articles that help us, and our Silkin Management Group clients, understand how this bill affects small businesses.

Today I read a very insightful paper written by John Ligon of the Heritage Foundation. In this article he reviews the ineffectiveness of this legislation in helping small businesses and points out how it can stifle job growth. You can access this paper at: http://www.heritage.org/Research/Reports/2010/04/Obamacare-Impact-on-Businesses

The key points of this paper are:

• It will produce higher, not lower, health care premium costs. This is a result of increased federal regulations, mandates to buy insurance and other taxes and fees.
• Ineffective small business tax credits. He points out that, at the most, only 12 percent of businesses with 25 or fewer workers will be impacted.
• Higher regulation costs for businesses. As we’ve pointed out in our blogs, the IRS type forms and regulations to comply with will add administrative costs and burdens to all businesses.
• The increased Medicare taxes on “higher income” earners.

I suggest that our Silkin Management Group clients, and anyone else reading this blog, read this paper for further education on “Obama-care”.

Eric Korb,
Silkin Management Group Consultant

For more information about Silkin Management Group and our services, visit the Silkin Management Group website at: www.silkinmanagementgroup.com or contact us at: info@silkinmanagementgroup.com

SMALL BUSINESSES ARE STILL NOT HIRING

2010-04-26T09:49:00.000-07:00

Silkin Management Group provides management consulting and training to small businesses, primarily privately owned health care practices. We teach our clients basic practice management skills – skills that they were never taught in their specific medical schools as those schools teach medicine, not business administration. But, upon graduating dental, veterinary, optometry or medical school, many doctors go into private practice and end up running their own small business with little to no training in how to do so. That’s where we come in.

At Silkin Mangement Group, we’ve found that a practice only grows to the level of the management skill of the doctor/owner. And, if the doctor/owner doesn’t have much skill in that area, his practice will level out at a certain plateau. At that point he/she needs some form of education in management, especially during these tough economic times.

Silkin Management Group clients are growing, on average, 10-15% during this recession while the average practice is declining at about that rate. This type of growth creates jobs and helps the economy grow. But, as you can see by linking to this article: http://smallbiztrends.com/2010/04/are-small-businesses-hiring-yet.html, most small business are not hiring and are still unwilling to hire. They need to expand their sales and income before they can afford to hire.

As discussed in past blogs, the incentives offered by the federal government (reduced social security taxes and some possible tax credits) will rarely be enough incentive to hire someone unless the income of a business has increased enough to afford a new employee. The incentives do not provide enough financial inducement when the additional income needed is not there.

If you’d like to find out how to expand your business or practice so that you too can help us out of the recession, contact Silkin Management Group at: info@silkinmanagementgroup.com. You can also call Silkin Management Group at 800-695-0257 or visit our website at: www.silkinmanagementgroup.com.

Gary Crawshaw
Silkin Management Group Consultant

HEALTH CARE LEGISLATION

2010-04-14T16:25:00.000-07:00

The Individual Mandate

We’ve written about the new health care legislation and its ramifications for individuals and small businesses in many of our Silkin Management Group blogs over the last few months. In many of our blogs we have referred and linked to articles by people who have expertly researched this legislation. We are and will continue to researching the effects of this legislation due to its importance to Silkin Management Group clients and their families.

Over the next week or so, we will present on our various Silkin Management Group blog sites more detailed information about many of the specific areas of this legislation. Today we’ll go over the area of “Individual Mandates”.

What is an “Individual Mandate”? It is a requirement that any citizen of the United States and legal residents have qualifying health care coverage and, if they don’t they will be subject to a financial penalty. You could loosely compare it to the requirement of having a driver’s license if you drive a car along with the associated penalties if you are caught driving without a license. In this case, if you live in this country, you must have health insurance unless you fit into the categories outlined towards the end of this article.

Under the new law, those without qualifying health care coverage will pay a tax penalty. The penalty works like this - you will pay the greater amount of:

• $695 per year, up to a maximum of three times that amount ($2085) per family, or
• 2.5% of your household income over the threshold amount of income required for income tax return filing.

The penalty is phased in according to the following steps:

Flat Fees:
• Year 2014: $95
• Year 2015: $325
• Year 2016: $695

Or:
• Year 2014: 1% of taxable income
• Year 2015: 2% of taxable income
• Year 2016: 2.5% of taxable income

After 2016, the penalty will be annually adjusted, upward, based upon a cost-of-living adjustment.

There are some exemptions that can be granted for:

• Financial hardship
• Religious objections
• American Indians
• Those without coverage for less than 3 months
• Aliens not lawfully in the U.S.
• People incarcerated
• If the lowest cost plan exceeds 8% of their household income
• Those with incomes below the tax filing threshold ($9350 for singles and $18,700 for couples as of 2010)
• Those living outside of the U.S.

I won’t comment on the fairness or justice of these categories and the various stipulations of the “Individual Mandate”, although I certainly do have opinions on it. Instead I simply wanted to present the information as delineated in the health care bill.

There will be more on specific categories of this bill in upcoming Silkin Management Group blogs.

Jack Hennessy
Silkin Management Group Consultant

For more information about Silkin Management Group visit our website at www.silkinmanagementgroup.com or email us at info@silkinmanagementgroup.com.

SHOULD YOU OUTSCORCE YOUR MEDICAL BILLINGS?

2010-04-07T09:41:00.000-07:00

Silkin Management Group delivers practice management consulting and training to private practice health care practice owners. As such, many doctors ask us about outsourcing their medical billings to outside services versus using in house software.

I ran across the following article from Chris Thorman at Software Advice, a web site that compares and reviews medical billing software. I thought it was well written and provides good information to help a doctor evaluate this question. I hope you find this article useful, whether you are a Silkin Management Group client or not.

Larry Silver
President, Silkin Management Group

For more information about Silkin Management Group visit our website at www.silkinmanagementgroup.com. You can also contact us at: info@silkinmanagementgroup.com

When Should You Outsource Your Medical Billing?

By Chris Thorman

One of the many business questions physicians face is whether to outsource their medical billing to third-party medical billing services or do it in-house with medical billing software. Some physicians would assume outsourcing billing to a medical billing service makes the most sense. After all, they’re the experts with the resources to properly process your claims, right? Others might want to maintain control of collections and do it all in-house.

Hold on. Don’t make a decision before thinking it through. Both methods of revenue cycle management have benefits and drawbacks. It’s up to the individual practice to weigh the pros and cons before deciding which approach is best.

Software Advice has broken down in-house billing and outsourced billing in terms of cost and qualitative factors. You’ll need to weigh the differences carefully when assessing the needs of your practice and decide if outsourcing makes sense.

Cost Analysis

For many practices, the outsourcing decision boils down to one factor: cost.
To help compare the costs of in-house billing versus outsourced billing, we’ve created a hypothetical, three-physician practice. To arrive at these numbers, we’ve used what we believe to be industry averages. Here are the characteristics of this practice:

• Three primary care physicians;
• Two medical billing specialists;
• 80 insurance claims filed per day (~20,000 per year);
• $125 billed per claim on average (~$2,500,000 per year); and,
• We assume that the billing service has a high collection rate on claims.

So, how much does each billing approach cost? Take a look at the annual costs:

	In-House	Outsourced
Software and Hardware Costs	$7,500	$500
Direct claim processing costs	$3,600	$122,500
Software and hardware costs	$5,500	$2,000
% of billings collected	60%	70%
Collections	$1,370,900	$1,623,000
Collections costs	$129,100	$127,000
Collections, net of costs	$1,241,800	$1,496,000

Some background on our cost assumptions follow.

Billing staff costs.

IN-HOUSE: This was calculated by adding up the median salary of two medical billing employees ($80,000), healthcare costs for two employees ($9,000), federal and state taxes for two ($12,000), and training costs to keep the employees updated on the latest industry developments ($2,000). Finally, we’ve included $15,000 in ancillary costs for statement paper, office space, office hardware and other miscellaneous costs.

OUTSOURCED: We factored in five hours of time per week required to manage tasks related to billing at approximately $15 per hour. Even the best medical billing service will require follow up from a practice about particular issues. That adds up to approximately $4,000 per year in administrative costs.

Software and hardware costs.

IN-HOUSE: We’ve factored in an annual cost of approximately $7,000 for practice management software (~$200 per month, per doctor) and another $500 for computer hardware costs. This does not include the upfront cost of a software system.

OUTSOURCED: This reflects the computer and printer the practice would still need to interact with the billing service and print documents.

Direct claim processing costs.

IN-HOUSE: Clearing house fees for a provider submitting 20,000 claims per year would be approximately $300 per month ($100 per physician), or $3,600 annually.

OUTSOURCED: A medical billing service usually charges a percentage of the amount collected as their fee. The industry average varies widely by specialty. We’ve used 7% for our primary care practice.

Percentage of billing amount collected.

IN-HOUSE: The percentage of revenue that a practice collects varies widely by specialty as well. Our hypothetical practice collects 60% of what it actually bills. According to industry experts, this describes an in-house billing department that is average at bill collection.

OUTSOURCED: A practice can expect a 5% to 15% increase in the amount they’re able to collect by switching to a billing service. We factored in a 10% increase in the amount of money collected by a billing service as an average between the two.

Our cost comparison favors outsourcing billing, mainly based on the ability of a billing service to collect a higher percentage of the billed amount. Of course, this introduces a BIG IF. That is, outsourcing makes more sense IF the billing service improves collections significantly (i.e. on the order of 10%).

But there are other factors – beyond costs – that a provider must consider in its decision making. Let’s examine the two approaches to compare advantages and disadvantages.

In-House Process

The in-house procedure for processing insurance claims involves a number of steps that are universal to every practice. First, employees enter information into the medical billing software program from a “superbill,” which is gathered during a patient’s visit. The superbill contains particular diagnosis and treatment codes, among other patient information, which the insurance company uses to determine if the claim is legitimate.

Via the practice’s billing software, the provider then submits the claim to a medical billing clearing house, which verifies the claim and sends it to the payer. The clearing house scrubs the claim for the errors (for a fee) before passing it on to the payer. By not submitting claims directly to a payer, the provider saves time, money and lowers rejection rates. The clearing house also has the ability to format and submit claim data en masse in the various insurance company formats.

Once the claim is rejected/accepted by the payer, notification of the claim’s status is sent to the clearinghouse, which updates the provider on the status of a claim. If a claim is rejected, the provider’s staff resubmits the claim once additional information has been gathered. The practice will be charge for each claim submission, even if it’s a correction.

EHR software – especially those EHRs with a integrated practice management system – has the potential to make in-house billing easier for a practice. EHR software, when integrated with a practice management system, will populate both system’s data fields. Diagnosis codes and other information needed for billing doesn’t need to be keyed into another system. This eliminates a second round of data entry. This tighter integration may be one factor that helps keep billing in-house.

Outsourced Process

The process for outsourcing billing is more straightforward for practice staff. Superbills and other documents are scanned and electronically sent or mailed to the medical billing service. The medical billing service takes care of the data entry and claim submission on behalf of the provider. Most billing services charge a percentage of the collected claim amount. The industry average is approximately a 7% charge for processing claims through a medical billing service.

The medical billing service takes care of much of the “dirty work” associated with the billing process. It will also follow up on rejected claims, pursues delinquent accounts, and even send invoices directly to patients. The convenience factor is a major reason that providers choose to outsource.

If a practice is using EHR software, then the process is even easier. Information from a patient’s superbill is stored in the EHR and electronically transmitted to the billing service. This eliminates the need to send paper records to the billing service. And because the EHR software eliminates an extra round of data entry, accuracy is also improved.

One possible issue here is data integration between the EHR software and the billing service. The type of data being exchanged between the provider and the billing service will need to match, or else the data will need to be converted to a different format. Depending on the billing service, data conversion may be an option.

Should You Outsource Your Billing?

Besides costs, there are other factors that would spur a provider to consider outsourcing their billing.

• Your billing process is inefficient. If you’ve been watching your collections drop while the time to collect increases, you may have issues in your billing department. Outsourcing to a third-party billing service typically decreases the number of rejected claims and decreases the time it takes to receive payment from a payer.
• You have high staff turnover. Turnover is an issue in any industry but turnover in a provider’s billing department is especially damaging. Claim processing is the economic life blood of a practice and a new addition or replacement in the billing department will inevitably lead to slowdown in the processing of claims.
• You’re not tech savvy. Keeping your billing in-house will require an investment in practice management software. Add in training for your staff and the significance of this investment becomes clearer. If you don’t want to deal with software upgrades and occasional technical issues, outsourcing is probably a good choice.
• You’re a new provider. New providers have plenty to learn and worry about aside from their billing. Outsourcing their billing right off the bat can give them much needed relief from the day-to-day stress of launching a new practice, without a trial by fire in hiring, training and managing employees.
• You have different priorities. Many doctors are not strong on the business side of running a practice. They became doctors to help patients – not worry about the administrative/clerical side of the business. Outsourcing the billing process eliminates the hassle and frees doctors to concentrate on patients.

It’s important to note that a medical billing service isn’t a silver bullet for in-house billing issues. Billing services can vary widely in their efficiency and accuracy when processing claims. If a provider chooses a billing service that is lax and prone to errors, the headaches surrounding billing issues won’t get better – they’ll get worse.

Which Approach Should I Choose?

It’s important for a practice to factor in their individual costs and preferences when deciding whether or not to outsource their medical billing. In an apples-to-apples comparison, we found that outsourcing had the higher net income. However, cost isn’t the only issue practices should consider. There are plenty of other factors involved in this business decision that may be as – if not more – important than costs.

Do you want to learn more about outsourcing your medical billing? Download our free guide to selecting a medical billing service:
________________________________________

Medical Billing Services Selection Guide
Our Best Practices Guide to selecting medical billing services will help you stay organized and make the right choice for your revenue cycle management.
( 11 Page PDF)

This article comes from Chris Thorman at Software Advice, a web site that compares and reviews medical billing software.

THE NEW HIRING BILL

2010-04-01T10:52:00.000-07:00

A Summary for Use

Many of our Silkin Management Group clients have asked us about the bill recently passed in Congress and signed by President Obama concerning possible exemption from Social Security taxes for newly hired employees. As we’ve written in earlier Silkin Management Group blogs, from a management perspective, we don’t think this piece of legislation provides all that much incentive to hire new employees as Social Security taxes make up only 6.2% of a payroll expense. If you can’t afford the other 93.8%, the 6.2% is fairly meaningless.

In any case, we thought we’d provide a concise summary of this law for use by anyone reading this blog, whether or not you are a client of Silkin Management Group.

SUMMARY

What the act provides:

A. Relief from the employer portion of Social Security Tax (6.2%) wages paid from March 19, 2010 to any new employee that was previously unemployed. There is NO exemption from Medicare Tax (1.45%).
B. There is also a Business Tax Credit of up to $1,000 per employee, if the employee remains on the job for 52 weeks.

What are the qualifications?:

1. They must be hired after February 2, 2010 and before January 1, 2011.
2. The person must have been unemployed prior to being hired. Unemployment is defined as not having worked more than 40 hours in the previous 60 days. The employee must sign an affidavit certifying this fact.
3. The hire can be for a new position or to replace an employee, but only if that employee voluntarily resigned or was terminated for cause. The hire cannot be to replace a laid off employee.
4. The employee cannot be related to the employer or anyone owning 50% or more of the employer’s business.
5. Rehiring a former employee is ok as long as they meet the other conditions above.
6. The employer cannot receive the Workplace Opportunity Tax Credit on any wages paid while participating in the HIRE act provisions. Employers may, at their discretion, elect not to participate in the provisions of the HIRE Act (if they deem the WOTC more appropriate for their business).

What is the process?:

1. There will be no change for the first quarter 2010 form 941 or payments. Wages from 3/19/2010 to 3/31/2010 will be used as credits for the second quarter.
2. Beginning in the second quarter, federal payroll tax payments may be reduced to account for the relief on qualified new hires. Form 941 will have provisions to account for the employer relief.

There is one problem already….the IRS hasn’t produced the forms needed! You can always count on the IRS for timely help. If you go to this link you’ll find information from the IRS on this : http://www.irs.gov/newsroom/article/0,,id=220326,00.html?portlet=7

Eric Korb
Silkin Management Group Consultant

For more information about Silkin Management Group visit our website at: www.silkinmangementgroup.com or email us at:
info@silkinmanagementgroup.com

ANOTHER VIEWPOINT ON THE PASSAGE OF THE HEALTH CARE LEGISLATION REFORM BILL

2010-03-24T11:15:00.000-07:00

The recent passage of the new Health Care Reform Bill has created a significant amount of controversy from all sides of the political spectrum. The “left” wanted a government run system similar to what is found in many European countries and Canada, the “right” wanted no government involvement. Both sides have valid arguments from their perspective.

We have attempted to provide in many of our previous Silkin Management Group blogs various points of view and information regarding this legislation and inserting the various opinions of the different blog writers relative to how this legislation affects the management of small businesses.

As President of Silkin Management Group, one of the email subscriptions I have is with the Cascade Policy Institute, a free market research group operating out of Oregon. I find their writings often informative and interesting and certainly providing a different viewpoint than I normally read in the mainstream media. I thought that today, I would provide an article written by the founder and Senior Policy Analyst of Cascade as food for thought on the health care reform debate. Any comments you have on it are welcomed.

Larry Silver
President, Silkin Management Group

For more information about what we do at Silkin Management Group, how we help clients with staff and other practice management issues, visit our website at: www.silkinmanagementgroup.com. You can also contact us at: info@silkinmanagementgroup.com or call 800-695-0257.

Founder's Statement on the Passage of Health Care Bill

By Steve Buckstein

The US Congress has now passed a sweeping health care "reform" bill that, even when "fixed" in the Senate, will represent much more a violation of individual liberty than an improvement in American health care.

When we founded Cascade Policy Institute in 1991 our mission was, and still is, to promote public policy alternatives that foster individual liberty, personal responsibility and economic opportunity. This bill threatens to set us back in all three areas:
Individual liberty will be violated as the federal government takes away even more of our options regarding what insurance, if any, we choose to purchase and how we purchase it.
Personal responsibility will be decimated as the federal government tells us "don't worry about taking care of yourself; we'll do that collectively from now on."
Economic opportunity will be stifled as the tax burden on individual workers, employers and investors go up, not down. Without meaningful cost controls, health care costs will spiral, leading to higher federal deficits and to even more government involvement in the economy.
When supporters tell us that every other industrialized country has national health insurance, our response should be, "America is not every country; America is supposed to be the land of the free."

If we aspire to remain the land of the free, we need to redouble our efforts to educate our fellow citizens about the costs of government intrusion into every aspect of our lives, and about the tremendous benefits of freedom. Here at Cascade Policy Institute, we are committed to do just that. Please join us, and together we can begin moving Oregon and America in the right direction again.

Steve Buckstein is founder and Senior Policy Analyst at Cascade Policy Institute, Oregon's free market public policy research organization.

THE ETHICS OF THE WALL STREET BANKERS AND THEIR BONUSES

2010-03-18T09:55:00.000-07:00

I’ve been reading in some of our Silkin Management Group blogs writings from some of our consultants about the recession caused by the Wall Street financial crisis. In yesterday’s blog, which you can access here WILL HEALTH CARE LEGISLATION BE DECIDED BY WHO HAS THE BEST ADS OR BRIBES? one of our consultants talked about one of the ways that the Wall Street bankers are making money and getting bonuses using our tax dollars.

Today I received a note from the President of Consumers Reports magazine in my email, something I’m sure he sent out to all subscribers. I love to read the magazine as it is factual data oriented to help consumers make rational decisions. It is this type of thinking that we attempt to teach our clients at Silkin Management Group as part of their management training.

I so liked what I read I thought I’d pass it along to our readers. It is great food for thought as well as timely instructions on what we can do to help.

Larry Silver
President, Silkin Management Group

For more information about Silkin Management Group, Silkin’s management programs or any questions about practice management contact us at: info@silkinmanagementgroup.com or visit our website at: www.silkinmanagementgroup.com

Dear Mr. Silver,

What happened to getting a straight-forward home loan, a fair credit card, and respect for the value of the money we deposit?

Over the past twenty years, the big Wall Street financial companies devalued personal responsibility, fair play and thrift and substituted high risk, mind-numbing complexity, and excessive bonuses.

We're in the deepest recession since the Great Depression, with tens of millions out of work, because the incentives in our financial system changed. Financial firms reward people who gamble with borrowed money and show big paper profits for short-term gains — no matter what the long-term cost.

The Senate this week released a financial reform bill, and the banks' top brass know their big bonuses are at stake. Make sure your Senators know their responsibility to voters is at stake.

Tell your Senators to bring back responsibility, fair play and thrift.

Banks dangled too good to be true offers in front of people who refinanced from a perfectly good loan into a risky one. Brokers got higher commissions for hard-selling risky, costly mortgages — like those where the payment didn't cover the interest and the loan actually got bigger over time.

The banks booked higher profits on those crummy deals, then sold the risky loans to investors. When it all fell apart, the mortgage brokers, bank CEOs and the Wall Street traders got to keep their fat bonuses, while millions of families lost their homes or their retirement accounts.

It's been more than a year since the economic meltdown, and needed changes are stalled. While politicians debate about which government agency should do what, there are a handful of common sense rules that would straighten out the incentives and reinforce the right values now:

E-mail Congress now to stop squabbling and fix the problems that got us here!

Wall Street's financial titans oppose these reforms, and they're spending tens of millions lobbying and advertising against them. To them, that's just pocket change compared to the billions in bonuses they have at stake.

But this is a fight we can win because your anger at the banks is well known. Now they need to know that you are paying attention and you expect real progress — real reform with real teeth, and rules that will apply fairly to everyone.

Sincerely,

Jim Guest, President
Consumer Reports

This blog has moved

2010-03-16T09:20:00.001-07:00

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DEALING WITH EMPLOYEES

2010-03-10T14:21:00.000-08:00

At Silkin Management Group our surveying department has found that doctors in all professions encounter staff that create problems and slow production. However, due to the confusion caused by these staff, many doctors can't easily identify which staff are the ones causing all the trouble. This article will offer some simple tools to help you see through the confusion and spot which staff you can trust and which are, or will be, causing you headaches and overwork. These are guidelines we teach all of our Silkin Management Group clients as part of their management consulting and training.

Here are some key datums for you to know when dealing with staff:

•With any staff member, the main coin you have to work with is their willingness to work. Without willingness and desire, you’ll be in a constant battle with any staff member and find them telling you all the reasons something can’t be accomplished.

•There are generally 3 classes of employees or potential employees:
a) again, the willing;
b) people who are lazy and try to do the irreducible minimum;
c) people who are insubordinate and unconstructive in their work.

So look for and hire the willing. Do not hire negative types or the lazy. Hire only those who will help you to produce and, by your production as a team, help others. Do this and you will have taken a very giant step in establishing your practice as a model of sanity, expansion and viability.

The next logical question is how do you know who to hire, how do you spot these categories of potential employees and/or what do you do if you have staff who fit into the wrong categories mentioned above?

At Silkin Management Group, we have answers to these questions. There will be more information about this in upcoming Silkin Management Group blog articles

Richard Safft
Silkin Management Group Senior Service Consultant

If you’d like more information about Silkin Management Group and its services, visit our website at: www.silkinmanagementgroup.com. You can also email us at: info@silkinmanagementgroup.com or call Silkin Management Group at 800-695-0257.

GLOBAL WARMING

2010-03-03T14:53:00.001-08:00

SOME FASCINATING DATA

PARTS 1 - 4

I ran across an extremely interesting and fascinating article about global warming, climate change, bio-fuels, etc. that I thought I would pass along to readers of the Silkin Management Group blog sites. This is a fairly long article, but worth the read. For ease of reading, Parts 1 through 3 are repeated here with Part 4 following below them. The last section will be posted at silkinmanagementgroup.blogspot.com tomorrow.

What is written here is likely to be taken as either very controversial, a “conspiracy theory” or hogwash by many. I am not taking sides one way or the other on it, but I thought it was interesting and relevant and well documented enough to present it to our readers to take a look at for themselves. I certainly found it eye opening.

Silkin Management Group is a management consulting company that has delivered management consulting and training to thousands of health care practices and small businesses over the last thirty years. Our blogs tend to be about relevant business issues such as marketing, dealing with staff, hiring and training, etc. But, when we run across them, we also like to present big picture items that effect us all. This is one of them.

For more information about Silkin Management Group and its services, visit our website at www.silkinmanagementgroup.com or contact us at info@silkinmanagementgroup.com.

Here are PARTS 1 - 4 of this article, entitled “Anatomy of a Con Job”.

Larry Silver
President, Silkin Management Group

ANATOMY OF A CON JOB

“In times of universal deceit, telling the truth will be a revolutionary act.” —George Orwell

PART 1:

If you look with your understanding, the crimes against humanity are written across the rotting visages of Henry Kissinger and Zbigniew Brzezinski.

Like a couple of aging prostitutes, these leading architects of twentieth-century evil still sell their wares to those with an insatiable lust for the power of the crown.

THE CLUB OF ROME

Birth Mother of the Environmental Movement

The moldy twosome have something else in common. Both have been active members of an international think tank from the dark side of the force called the Club of Rome. Founded at the Rockefeller’s estate in Bellagio, Italy, in 1968, some of the other fraternity brothers and sisters include Al Gore, David Rockefeller, Queen Beatrix of the Netherlands, and Mikhail Gorbachev.

And there is no one better to give you the short version of the Club’s agenda than Gorby himself:

“The threat of environmental crisis will be the ‘internal disaster key’ that will unlock the New World Order.”

Who let this guy out of Lubyanka?

Their more precisely stated goal is population control. The solution? Create an environmental catastrophe like, oh, say, “global warming” and blame it on the planet’s most heinous villain—man himself.

But I should let them tell it:

“In searching for the new enemy to unite us, we came up with the idea that pollution, the threat of global warming, water shortages, famine and the like would fit the bill. . . . But in designating them as the enemy, we fall into the trap about which we have already warned, namely mistaking symptoms for cause. All these dangers are caused by human intervention and it is only through changing attitudes and behaviors that they can be overcome. The real enemy, then, is humanity itself.”

Sounds like a good plan . . . if you’re Darth Vader.

In 1972, the Club took the world stage with the publication of a book they had commissioned to be written by a group of MIT scientists. It was called The Limits to Growth. Examining the planet’s population growth in relation to available resources, the report concluded that the planet would run out of resources sometime in the next 100 years, resulting in a catastrophic decline in population and industrial production.

As one reviewer put it, the authors examine

“. . . the impact of humanity on the world ecology and of steps taken toward remediating the accelerating approach to a train wreck that is mankind’s ill-managed and uncontrolled ‘footprint’ on this planet’s environment.”

Still, these trends and their consequences could be altered, it argued; we had to be less, do less and have less. The brand for this Orwellian path to planetary salvation was sustainable development.

Heavily promoted, the book reached opinion leaders in political, scientific and economic circles as it exploded around the planet like the Harry Potter of environmentalism. It sold 12 million copies in thirty languages despite the fact that the research had all the scientific rigor of a plagiarized term paper for a freshman biology class.

“An error does not become truth by reason of multiplied propagation, nor does truth become error because nobody sees it.” —Mohandas Gandhi

Assailed by top scientists, the research was shoddy in the extreme. Population expert and author Professor Julian Simon said, “The Limits to Growth has been blasted as foolishness or fraud by almost every economist who has read it closely or reviewed it in print.”

Yale economist Henry Wallich reviewed the book saying, “. . . the quantitative content of the model comes from the authors’ imagination, although they never reveal the equations that they used.”

But it is a PR world and with the publication of this book, the modern environmental movement was born. Midwifed to life in a blanket of deceit, it was yet hailed as the savior, not of mankind, but of the planet it claimed was being fried to a crisp by humanity’s toxic binge of carbon dioxide.

The scientific fraud is its own malice, but few were able to see the underlying strategy—that the book would serve as the foundation of a global public relations campaign that would mesmerize legislators, educators, and countless organizations of goodwill and would eventually set the stage for the biggest rip-off in human history. But I am getting ahead of myself.

This then was Con #1: The scientific basis of the book that launched the environmental movement calling for “sustainable development” and a reduction of man’s leper-like carbon footprint on the planet was, and is, a scam, a hoax, a falsehood—environmental snake oil.

“Every violation of truth is not only a sort of suicide in the liar, but is a stab at the health of human society.” —Ralph Waldo Emerson

Which leads us to the second piece of the puzzle, Con #2. Who’d have thought that . . .

OIL

Is Not a Fossil Fuel

PART 2:

The immigration officer at Sheremetyevo took my passport and studied it for some time. He didn’t say anything; he just thumbed through the passport and then looked at a computer screen for a couple of lifetimes before stamping it and grunting me on to customs.

The KGB was still manning the borders the first time I went to Moscow shortly after the fall of Communism. Letting Americans walk freely into Mother Russia without official surveillance was driving the man crazy but he had to keep a lid on it.

In fact, Communism had been officially dead for only a few months when the shock troops of capitalism started storming the gates of opportunity in the former Soviet Union. The ghosts of Marx, Lenin and Stalin stalked the halls of the Politburo in horror as entrepreneurs from the United States, Japan and Western Europe tried to cut deals for every asset in Mother Russia that wasn’t nailed down. Banking, hospitality, timber and precious metals came under assault by peculiar partnerships of western capitalists and thugs from the once mighty KGB. During those early years, when Yeltsin (God love him) and his vodka were in office, it was a free-for-all.

The Oklahoma land rush of the 1890s had nothing on Moscow in 1992.

But even then, the oil industry stayed under control of the state—directly or indirectly. In fact, as recently as 2003, the bare-chested former KGB colonel and current premier—soon to be president of Russia . . . again—Vladimir Putin squashed a buyout deal between Russia’s Yukos and Exxon, the largest company in the world.

To understand the reason for this, we return momentarily to the early days of the Cold War when an isolated Soviet Union tasked their top scientists to identify the actual source of oil. Not a weekend homework assignment. After considerable research, in 1956, Russian scientist Professor Vladimir Porfir’yev announced that “crude oil and natural petroleum gas have no intrinsic connection with biological matter originating near the surface of the earth. They are primordial [originating with the earth’s formation] materials which have been erupted from great depths.”

If your eyeballs didn’t fall out when you read that, you might want to read it again.

He said oil doesn’t come from anything biologic, not, as conventional wisdom dictates, from the fossilized remains of dinosaurs and/or ancient plant matter. It comes from very deep in the earth and is created by a biochemical reaction that subjected hydrocarbons (elements having carbon and hydrogen) to extreme heat and intense pressure during the earth’s formation.

Russians referred to this oil (any oil, really) as “abiotic oil” because it is not created from the decomposition of biological life forms, but rather from the chemical process continually occurring inside the earth.

I know, easy for Porfir’yev to say. But it turns out it was more than just a theory.

Because shortly after the Russians discovered this, they started drilling ultra-deep wells and finding oil at 30,000 and 40,000 feet below the earth’s surface. These are staggering depths, and far below the depth at which organic matter can be found, which is 18,000 feet.

Interesting, eh?

The Russians applied their theory of abiotic deep-drilling technology to the Dnieper-Donets Basin, an area understood for the previous half a century to be barren of oil. Of sixty wells drilled there using abiotic technology, thirty-seven became commercially productive—a 62 percent success rate compared with the roughly 10 percent success rate of a U.S. wildcat driller. The oil found in the basin rivaled Alaska’s North Slope.

Let’s say they had a good hair day.

But it doesn’t stop there, not by a long shot. Since their earlier discoveries, the major Russian oil companies have quietly drilled more than 310 ultra-deep wells and put them into production.

Result? Russia recently overtook Saudi Arabia as the planet’s largest oil producer.

Maybe they are onto something.

Though there were papers written on this early on, almost all were in Russian and few made it to the West. And those that did were laughed at.

No more. With Russia’s rejection of the Exxon-Yukos deal (Putin did not want this technology and their abiotic oil experts exported to the West) and the access to information now available on the Internet, the word has begun to spread rapidly to the West. Still, it hasn’t taken hold yet.

Why not? This is huge. Oil is not a fossil fuel! And it’s renewable! Wow!

There are a couple of factors at play here.

Big oil has a vested interest in pushing the idea that oil is scarce, hard to find, and thus costly to produce—all of which, of course, means increased revenues and profits. This is a story in itself, but not the primary focus here.

More relevant to our story is the fact that a cornerstone of the environmental movement is this: oil is a fossil fuel, a fossil fuel that is scarce, and is in limited and ever decreasing supply. Moreover, its production creates carbon dioxide. Therefore its use, for virtually all productive purposes—agricultural production, real estate construction, auto, truck, train and air transportation, utilities, heating, cooling, communication, ad infinitum (all of them)—must be curtailed.

According to the thirty-year update of the book The Limits to Growth,

“A prime example of a nonrenewable resource is fossil fuels, whose limits should be obvious, although many people, including distinguished economists, are in denial over the elementary fact. More than 80 percent of year 2000 commercial energy use comes from nonrenewable fossil fuels—oil, natural gas, and coal. The underground stocks of fossil fuels are going continuously and inexorably down. . . Peak gas production will certainly occur in the next 50 years, the peak for oil production will occur much sooner, probably within the decade.”

Scary stuff. Frightening. But as false as a hooker’s smile.

Oil is not a fossil fuel.

And it is “renewable.”

While I have never been a fan of Putin the Macho, the Russians have demonstrated the accuracy of their theory in the only place it counts—the oil field. Oil is not only abiotic, it continues to populate fields that were understood to be as dry of petroleum as a desert wind. In fact, some scientists believe it is the centrifugal force of the planet’s rotation that forces abiotic oil toward the planet’s surface on a continuous basis.

“There are some things the general public does not need to know, and shouldn’t. I believe democracy flourishes when the government can take legitimate steps to keep its secrets and when the press can decide whether to print what it knows.” —the late Katherine Graham, owner of the Washington Post

So Con #2 is that oil is a fossil fuel (which it isn’t), that it is scarce and being depleted (which it isn’t), that it is nonrenewable (which it isn’t), and that, as a result, catastrophe looms (which it doesn’t) unless we drastically curtail our use of petroleum.

Lies one and all, which leads us to the granddaddy of con—Con #3:

GLOBAL WARMING—CLIMATE CHANGE

PART 3:

The heart-wrenching icon of a lone polar bear hovering in solitude somewhere in the rapidly disappearing Arctic has become the environmental movement’s most poignant pitchman.

The pitch, however, is bogus. The bears are booming.

According to the Wall Street Journal,

“Nearly everyone agrees that there are more polar bears now than when scientists first started counting: Estimates put the population between 20,000 and 25,000, up from several thousand 50 years ago. In Canada, where two-thirds of the world’s bears live, most populations have grown during the past two or three decades. Arctic residents say they are now bumping into bears wherever they turn.”

The polar bear “debate” cuts to the heart of the foundation on which the environmental movement rests: global warming.

While the Club of Rome’s clarion call for “sustainable development” in The Limits to Growth turned out to be more than a little thin on scientific credibility, and the theory that oil is a scarce and rapidly depleting fossil fuel is untrue, the holy grail of the environmental movement is Global Warming or, as they have renamed it due to the last eleven years of embarrassingly cooler temperatures, Climate Change.

It is the creed upon which the movement is built.

The scripture is as follows: The burning of fossil fuels produces carbon dioxide. This and other “greenhouse” gases create global warming, which will destroy the planet.

To wit, the production of these gases must be “capped.”

Legislation to suppress their use is a first step. Population control, a reduction of the planet’s population, is the real answer because man makes these gases. Fewer people mean less greenhouse gas. Less greenhouse gas means less global warming. Less warming means the earth is saved.

Amen.

Greenhouse gases, by the way, are any of the atmospheric gases, such as water vapor and carbon dioxide, that are said to contribute to the greenhouse effect.

The greenhouse effect is a name for the phenomenon outlined above whereby the earth’s atmosphere traps solar radiation and thereby overheats the planet. According to the theory, these gases in the atmosphere allow sunlight to pass through to the earth, but then absorb the heat radiated back from the planet’s surface.

Shazam! Global warming.

Sounds good. Cut CO2 and you save the world.

A clearly identified evil with an action plan to handle it.

Kind of like the Inquisition—fry the heretics, purify the faith.

Today, global warming heretics are burned in the media not at the stake, but the dogma is no less strident, no less authoritarian, and no less despotic.

SCIENCE SETTLED

Al Gore is the Moses of global warming. He, along with the high priests of the movement, the United Nations’ Intergovernmental Panel on Climate Change (IPCC), has pronounced that the science regarding man-made global warming is “settled.” There’s nothing further to discuss: global warming is real; man-made CO2 is the cause; carbon production must be capped. Done deal.

Al and the IPCC are simpatico on this—which is cool. Harmony in the ranks.

THE OREGON PETITION

But here’s the deal: 31,486 scientists have signed a document called the Oregon Petition lambasting the shoddy research behind global warming, stating quite simply that “. . . any human contribution to climate change has not been demonstrated.”

This is not a gang of political hacks, or George Soros–funded “activists.” No, the signatories include 3,667 atmospheric, environmental and Earth scientists; 4,796 chemists; 2,924 biologists and agricultural scientists; 903 math and computer scientists; and 9,992 in engineering and general science.

Of these, 9,029 have PhDs.

The petition states that there is no convincing scientific evidence that the human release of carbon dioxide or other greenhouse gases is causing or will cause global warming.

It goes on to say that there is substantial scientific evidence demonstrating that atmospheric carbon dioxide produces countless beneficial effects on the plant and animal populations of Earth. (In one of Mother Nature’s most spectacular touches of environmental magic, plants convert carbon dioxide and sunlight into oxygen—you know, the stuff we breathe.)

SENATE COMMITTEE ON THE ENVIRONMENT

In March of 2009 the Senate Committee on Environment and Public Works posted a report of more than 700 international scientists dissenting on the theory of man-made global warming. Several of those joining in on this report were current or former IPCC members.

Several other groups of scientists have issued statements blasting the lack of credible science behind the theory that man-made carbon dioxide and other greenhouse gases in the atmosphere contribute to global warming. Examples include the Statement by Atmospheric Scientists on Greenhouse Warming, the Leipzig Declaration on Global Climate Change, and the Heidelberg Appeal.

THE IPCC COOKS THE BOOKS

You will notice, if you read articles about the environment, that “facts” regarding global warming invariably cite the IPCC as their source

In short, the UN’s Intergovernmental Panel on Climate Change is the planet’s opinion leader on the subject of man-made climate change.

Or at least they were.

On November 19, 2009, one of the largest scientific scandals in history exploded across the international media when thousands of internal e-mails were leaked exposing the organization’s blatant manipulation of climate data. The e-mails revealed that the IPCC had skewed bucketloads of climate information to promote the idea that global warming was a result of an increase in man-made carbon dioxide and other greenhouse gases.

This wasn’t a bunch of stoners in a frat house passing the filched answers to the Geology 101 midterm around. These guys were recognized as the world’s leading “authorities” on climate change, caught red-handed in an intentional plot to mislead environmental groups, governments and the public at large about the current and future state of the planet’s temperature.

This brief excerpt from Canada’s National Post rather tells the story.

“The Climategate Emails describe how a small band of climatologists cooked the books to make the last century seem dangerously warm.

“The emails also describe how the band plotted to rewrite history as well as science, particularly by eliminating the Medieval Warm Period, a 400 year period that began around 1000 AD.

“The Climategate Emails reveal something else, too: the enlistment of the most widely read source of information in the world—Wikipedia—in the wholesale rewriting of this history.”

THE MEDIEVAL WARM PERIOD

Like a cheap Las Vegas lounge act, the pernicious cult of climate change ideologues at the IPCC desperately tried to hide the Medieval Warm Period (MWP)—ditch it, make it disappear. This was the warmest period in modern recorded history and is very well known by climatologists.

Trying a page from Houdini’s playbook, the IPCC created a phony graph of historical temperatures that made the MWP—presto!—vanish.

Cute.

You see, during the MWP temperatures were much warmer than they are today. Agriculture flourished and the Norsemen, taking advantage of the ice-free seas, settled Greenland. There is no evidence of a rise in sea level at that time. None. And ice sheets around Greenland were largely absent. Greenland, get it?

Temperatures soared, but where was the man-made carbon dioxide? Oil had yet to be discovered, factories had not been constructed, and the first Model T was centuries into the future.

There followed a mini ice age, and by 1500 the settlements in Greenland were gone and the Thames froze all the way to London.

There was no “man-made” factor in any of this. These ebbs and flows of the earth’s temperatures were all a product of naturally occurring phenomena, which is discussed in detail below.

But as to the IPCC,

“Research data on climate change do not show that human use of hydrocarbons is harmful. To the contrary, there is good evidence that increased atmospheric carbon dioxide is environmentally helpful.” —The Oregon Petition

FEARMONGERS

In fact, the same mindset that is now promoting the catastrophic consequences of global warming were using the same arguments, almost word for word, to promote the dire consequences of global cooling just a few decades ago.

In 1975, Reid Bryson wrote in Global Ecology:

“The continued rapid cooling of the earth since WWII is in accord with the increase in global air pollution associated with industrialization, mechanization, urbanization and exploding population.”

Yeah, baby! CO2 is causing global cooling.

Or consider Kenneth Watt, writing on Earth Day in 1970:

“If present trends continue, the world will be about four degrees colder for the global mean temperature in 1990, but eleven degrees colder by the year 2000. . . . This is about twice what it would take to put us into an ice age.”

Good call, Ken.

There are more, but you get the idea.

These people, then and now, are fearmongers. They get some kind of perverse joy out of frightening people—in this case, frightening them into acceptance of the greatest con job of all time.

Listen to the climate chaos merchants reviewing a book by a global warming jihadist named James Hansen, who subtitles his book “The truth about the coming climate catastrophe and our last chance to save humanity.”

“Dr. James Hansen is Paul Revere to the foreboding tyranny of climate chaos.” —Robert F. Kennedy, Jr.

“With urgency and authority, Hansen urges readers to speak out—taking to the streets if necessary—to protect the Earth from calamity for the sake of their children and grandchildren.” —Kirkus Reviews

Calamity, chaos and catastrophe: the cocaine of the global warming media extremists.

STATS

The crisis and catastrophe crowd don’t like to talk about the fact that water vapor (not carbon dioxide) accounts for 95% of all greenhouse gases. This is naturally occurring water vapor—99.99% of “greenhouse gas” water vapor is natural. Only .01% (one-hundredth of one percent) of greenhouse water vapor is man-made.

But carbon dioxide is the anointed villain of the piece. It must really pack a punch, because CO2 only makes up 3.6% of greenhouse gases. And here’s the kicker, only 3% of the carbon dioxide—3% of the 3.6%—is man-made. This means .1% (one-tenth of one percent) is man-made CO2.

This, according to the harbingers of climate doom, is what is driving “climate catastrophe.” International conferences are called, governments allocate billions, and corporate PR departments gush over environmental agendas in a universal tsunami of green.

It’s as if someone had turned a programmed cult of global warming druids lose on the planet to shriek the horrors of carbon dioxide to a populace that doesn’t know or can’t confront the blatant lunacy of what they are saying.

In turn, the lapdog media regurgitates the chaos and calamity to millions. Their sole aspiration is to shovel as much death, destruction, filth and depravity into the public’s mind in the shortest possible time. Except somewhere in their collective soul they know . . . and they are sick with shame.

"We allow the most atrocious lies uttered by political and moral prostitutes to go unchallenged. These lies are endlessly recycled in the commercial media until they become ingrained in the public conscience as truth.” —Charles Sullivan, author and philosopher

Can I get an “Amen”?

THE SOLAR CONNECTION

I’m a California boy. I love the sun. During spring break in college, some friends of mine and I would body surf our way down the west coast of Mexico, turning coffee brown in the process, and return to campus as sun-baked bronze gods. The co-eds would swoon. . . . Okay, maybe not swoon, but getting dates was definitely easier.

It never occurred to me in those halcyon days that the sun might play a leading role in an article I would later write about global warming. But it does.

The fact is that Earth has experienced natural warming and cooling cycles all throughout recorded history—cycles that have driven temperatures much higher than anything we are experiencing today.

And what is the source of these fluctuations in the earth’s temperature? Water vapor? No. Carbon dioxide? Eh . . . sorry. Hair spray? You’re joking.

What causes temperature changes on the earth is . . . the sun.

Scientists have discovered that the sun has regular cycles of sunspot activity. Sunspots are regions on the sun’s surface of intense magnetic activity; the more sunspots, the more “active” the sun is.

Sunspots and solar radiation activity virtually parallel temperature changes on Earth. That’s right; it is the sun that is the source of global warming and cooling cycles—not mankind’s “carbon footprint.”

If greenhouse gases were the cause of global warming, how is it that from 1940 to 1975, when there was a dramatic increase in the production and release of CO2, the earth experienced a significant cooling period?

Warming periods on Earth are a direct result of an increase in solar radiation, which prevents cloud formation. Cloud formation has a cooling effect on the planet. This is further borne out by the fact that other planets in our solar system all appear to heat up at the same time. But they’re not driving Chevys on Pluto or burning coal on Mars.

This, then, is Con #3: Global warming is a vast, strategic PR campaign, nothing more. It is not a planetary temperature phenomenon. Sorry, Al.

“Most of the greatest evils that man has inflicted upon man have come through people feeling quite certain about something which, in fact, was false.” —Bertrand Russell

So, what gives? Why all the misleading information and climate change hysteria?

Let me introduce you to Con #4. . . .

END PART 3

BIOFUELS

PART 4

A friend of mine drives around to restaurants late at night and collects used vegetable oil. He uses it in his diesel Mercedes that will qualify for Medicare next year. He has converted the Mercedes to burn vegetable oil as fuel.

One of the solutions to the “carbon crisis” is biofuels.

Biofuels are essentially fuels produced from plants.

There are two basic types of biofuels. Ethanol, which can be used as petrol and is made from corn, sugar cane, beets, wheat and other grains, and biodiesel which is made from oil seeds, tree nuts or waste oil (à la the Medicare Mercedes above).

Biofuels are supposed to be clean, convenient and carbon neutral. But don’t look too closely because the environmental consequences of their use are something out of a Stephen King novel.

DEFORESTATION

The planet’s tropical rain forests are being obliterated as if some frenzied Jolly Green Giant were running an immense weed wacker through the Amazon.

Biofuels are broadly promoted as a solution to the production of carbon dioxide. But a closer examination reveals that they damage the environment on two fronts: the first is massive planetary deforestation.

Tropical forests are the most powerful carbon reservoirs on the planet. In other words, they sequester and store carbon dioxide more effectively than any other resource.

Cutting forests down not only releases massive amounts of carbon dioxide into the atmosphere, it eliminates them as both a carbon reservoir and a generator of oxygen. (Again, for those of you that slept through high school biology, or, like me, never had the guts to take it, plants use carbon dioxide and sunlight to make oxygen.)

But government mandates and corporate greed are pushing the cultivation of biofuels so intently that tropical forests are vanishing from the planet at an appalling rate.

The European Union, for instance, has mandated a 20 percent reduction in carbon emissions by 2020. This is to be partly achieved by mandating that 10 percent of vehicles be powered by biofuel. Financial incentives, which we examine in detail below, have driven global investment in biofuels from $5 billion in 1995 to an estimated $100 billion in 2010. Everyone from George Soros to British Petroleum and Shell Oil are players in this market.

As a result, vast amounts of the Amazon rain forest in Brazil have been destroyed for soybean and sugar cane cultivation. Brazil proudly announced last year that deforestation was on track to double that year.

A report by Friends of the Earth revealed that between 1985 and 2000, the development of palm oil plantations in Malaysia was responsible for the deforestation of 87 percent of the country’s forests. Eighty-seven percent! In fact, palm oil is now referred to as “deforestation diesel.”

In Sumatra and Borneo, 4 million hectares of forest were lost to palm oil farms (9.8 million acres—almost twice the size of the state of New Hampshire).

As an added sucker punch to Mother Nature, biofuel-driven deforestation has also led to Holocaust-like species extinction. The forests in Malaysia and Indonesia are home to the orangutan, Sumatran rhinos, tigers, gibbons, tapirs, proboscis monkeys and thousands of other species, many of which are under serious threat of extinction from habitat loss.

And then there is this troubling little fact: while biofuels generate less carbon emissions than oil, they are doing so by replacing vegetation and soil that suck up even more carbon. In other words, the carbon absorption lost by razing the wilderness to cultivate biofuels is dramatically more than the gains achieved by using the cleaner-burning fuels.

The “inconvenient truth” is that the biofuel craze is destroying nature, and, incidentally, adding to the carbon dioxide on the planet, not decreasing it.

OCEAN POLLUTION AND DEAD ZONES

If you have ever walked by a body of water and noticed an acrid smell, felt your eyes burning or saw that it was blanketed by a thick red, blue or green plant covering, you’ve probably had an unfortunate run-in with an HAB, Harmful Algal Bloom.

In almost all cases, the production of biofuels is accompanied by the use of nitrogen, phosphorous, herbicides, pesticides, insecticides, etc.

Nitrogen, along with other toxic materials, filters downward to the water table and finds its way to rivers, streams and eventually the ocean. There, the nitrogen and, to a lesser degree, the pesticides generate massive, abnormal and very toxic “algal blooms,” which rapidly decay into huge areas of oxygen-sucking dead algae. This is highly destructive of marine life.

Corn cultivation utilizes the greatest application of fertilizers and pesticides. No surprise, then, that the heaviest concentration of these toxins occurs in the U.S. corn belt. The result? Nitrogen and other toxins in the Mississippi River system have mercilessly poured into the Gulf of Mexico creating a dead zone of 22,000 square kilometers (8,492 square miles, an area about the size of New Jersey). It’s not just the Gulf of Mexico. The number of oceanic dead zones has spread around the planet like an environmental cancer.

Since the onset of the biofuel craze in the 1980s, the number of dead zones has increased 450 percent.

But that’s not all.

Species Extinction

There are currently about 405 dead zones on the planet, the largest, 70,000 square kilometers (27,020 square miles—larger than the state of West Virginia), in the Baltic Sea. Species extinction is a direct effect of these zones. In the last ten years, 14,000 dead seals and dolphins have washed up on California’s coast and 650 gray whales have been found beached. In Florida, hundreds of manatees have been killed and 80 percent of the coral reef in the Caribbean has been smothered. Seventy-five percent of California’s fish-rich kelp forest has been ruined and the problem is beginning to affect the availability of seafood for human consumption.

About 1.7 million plant and animal species have been identified on the planet. According to some reports, species extinction is now occurring at the rate of about 20,000 to 30,000 annually. Whatever the number, the endangered species list increased 150 percent last year alone. The single largest reason for this is habitat destruction and pollution, most of which is a result of biofuel production.

Makes you feel warm all over, doesn’t it?

Oxygen Depletion

I don’t know about you, but I’ve grown rather partial to breathing. It brings a certain awareness to life.

So the fact that biofuel production is depleting the planet’s oxygen is more than a little troubling.

Sounds alarmist, doesn’t it? Perhaps even a bit conspiratorial. How could one of the most prolific solutions to global warming be destroying the planet’s supply of oxygen?

The oceans are the planet’s largest carbon sink. (The rain forests are the most effective carbon sinks; oceans are the largest.) It is the algae in the oceans that absorb the bulk of the earth’s CO2. That’s right; the earth’s primary CO2 sponge is the algae in the oceans.

The algae then convert sunlight and the CO2 in the ocean into oxygen.

Seventy to eighty percent (70%–80%) of this planet’s oxygen is produced by the algae in the oceans. Yet the nitrogen, phosphates and other chemicals pouring into the oceans around the world as a result of biofuel production are destroying the very element that produces the bulk of that oxygen—the algae in the oceans.

This is Con #4: Biofuels don’t reduce carbon; they destroy the rain forests and are depleting the very air we breathe. Which begs the question, have these people forgotten to pay their brain bills, are they just plain evil or . . . is there something else at play here?

And that brings us to the last piece of the puzzle and the final con.

END PART 4

© 2010 by John Truman Wolfe. All rights reserved.

For more information about Silkin Management Group and its services, visit our website at www.silkinmanagementgroup.com or contact us at info@silkinmanagementgroup.com

SOME TIPS ON HIRING

2010-02-25T13:02:00.000-08:00

The Use of Tests

In two earlier Silkin Management Group blogs, February 10th and February 11th we discussed specific management systems and technology to help you know which staff members are helping the practice, and which ones might be driving it down. The system is based not on emotion, but on statistical interpretation and performance.

Getting a system like this operating is a big first step, and a very important one. But now what do you do if you find, per actual production measurements that, for example, your receptionist is doing a poor job and driving patients away?
You decide that it’s time to show your receptionist the door, but at the same time have trepidation on being able to know that the new person will be any better. You hate to waste more time and money on hiring and training a new person to only find out you have the same situation on your hands. You just aren’t certain.

You contemplate the possibilities: You would love to have your staff problem solved, but what happens once you fire a staff member? You have to find another competent, intelligent person. You have to find one that will be honest, loyal, and good with your patients and clients. You have to find a person that comes to work on time, works hard throughout the day, and generally has a good work ethic. Oh, and how about someone that doesn’t spend time Twittering, Facebooking, gossiping, and calling her boyfriend while she’s on the job?

None-the-less, you know you have to proceed. After you place your ads and dive into your limited personnel pool, you think you have found your Prospect-from-Heaven! Now all you have to do is train her, establish a working relationship, and integrate her into your office and staff.

Again you wonder: Have you chosen correctly? Is this new staff member really as good as she appears? Does she really like to work hard? Has she really never heard of social networking? Does she really know how to balance the books, make the patients feel like family, sterilize the instruments, and act as a crisis counselor in her spare time?

How do you know, or how does anyone know? But you go ahead and hire her. You face the possibility of a failure, resulting in another turnover. This can be very stressful, time-consuming and expensive.

Silkin Management Group clients have a hidden weapon for effective hiring. This weapon is TESTING.

Silkin Management Group offers its clients a full battery of tests which are extremely effective in making the right choices in the hiring game. Although no test is 100% fool proof and guaranteed to always get you the exact right person, good tests increase your odds tremendously.

According to Ken Derouchie, one of the key writers of The Practice Solution (Silkin Management Group’s on line magazine which can be found at: thepracticesolution.net “People are never going to put on their resume that they have a drug problem, are chronically late and don't get along with people well. You must use testing to get something realistic to base your hiring decisions on, rather than just seeing the resume and getting a ‘feel’ for the person."

With good testing the doctor or manager can pick out the best potential employees for a specific job position which gives one the highest chance of success in achieving a valuable, productive staff member.

For more information about what we do at Silkin Management Group, how we help clients with staff and other practice management issues, visit our website at:www.silkinmanagementgroup.com. You can also contact us at: info@silkinmanagementgroup.com or call 800-695-0257.

Lyn Ribisi
Silkin Management Group
Appointment Coordinator

SOME UNSOUND ECONOMICS

2010-02-12T08:49:00.000-08:00

As a consultant at Silkin Management Group, I’m always looking through various articles in a variety of publications to stay on top of important matters that could effect Silkin Management Group clients. In doing so, I recently read that a well known international economist, Joseph Stiglitz, speaking at the London School of Economics, said that the United States and England should not ever have their bond ratings be anything other than AAA because “all we do is print money to pay it back.” “The notion of a default is so absurd”.

I was a bit amazed at this statement by such an expert, but it also made me realize that this type of thought, promoted by an international expert is part of why the national and international financial scene is in such a mess. Last I heard there were two major countries in Europe that were on the verge of defaulting on loans.

Here’s one way to look at this: if you have to print money to pay your debts, isn’t that a form of defaulting on a loan? I sure wish I could just print some money to pay my house off but, last I heard, I’d get thrown in jail for counterfeiting if I did that.

At Silkin Management Group, we try to teach our clients sound, rational fiscal policies like, “don’t spend more than you make”, “follow a budget”, “pay off debt”, etc. We teach all the obvious, fiscally sound and conservative measures that anyone with any sense agrees with. Why these sound economic principals wouldn’t apply to a government is beyond me. I guess, if I follow the brilliance of the economic policies of most governments in the world, as well as “world renown economists” like Mr. Stiglitz, I should add “print any money you need to pay your bills” to the list too. Hey, great idea Mr. Stilglitz! I’ll do it as long as you cover my jail time.

Gary Crawshaw
Silkin Management Group Consultant

For more information about what we do at Silkin Management Group, how we help clients with financial basics and other practice management issues, visit our website at: silkinmanagementgroup.com. You can also contact us at: info@silkinmanagementgroup.com or call 800-695-0257.

Benchmarks Part II

2010-02-08T09:40:00.000-08:00

In our Silkin Management Group blog posted February 5th on our blogsite www.silkinmanagementgrp.com we discussed the idea of having and knowing benchmarks for various areas of a health care practice. This is important information for any practice owner to know so that he/she can compare how they are presently doing against basic productivity benchmarks that should be able to be easily achieved. We work with our clients on all of these areas and, where they are falling short of these benchmarks, we help them figure out why and implement the proper actions to achieve them.

In Part 1 we went over benchmarks for Production in a health care office, specifically for dentists, veterinarians and optometrists. In today’s blog we will go over benchmarks for Net and Collections percentages.

Net

Obviously, you don’t want to get your gross production into a higher range and then find out that you aren’t taking home a commensurate amount of money. Producing more without netting more is not the way to go! So, here are the minimal net benchmarks for you to know and what we work with Silkin Management Group clients to minimally achieve.

Dentists should be netting 40%

Veterinarians’ net should be at least 30-35%

Optometrists should be taking home 30-35%

Collections

Collections follow production and result in actual income to your practice. But if you aren’t collecting a very high percentage of your production, you are throwing money away. The basic benchmark for collections percentage is 98% of your production. That can and should be achieved. It is not hard to do.

Many of our new clients aren’t aware of how much money can slip between the cracks. A change of just 2% in your collection rate can equal thousands and thousands of dollars in your pocket (or out of your pocket if the collection rate goes down).
To give you a dollars and cents reality on what this can mean, let’s take a typical example. Say your practice is producing at a $50,000 a month level. Every 1% change in your collection percentage equates to $500. So if your collection percent goes down 1%, you lose $500 and if it goes up 1% you make an extra $500. Simple, right? If you are collecting at a 95% rate, 3% below the benchmark mentioned above, you are losing $1,500 per month. Most doctors feel that 95% is good. But the reality is you are losing $1500 a month which is $18,000 a year, straight out of your pocket. That is net income money as it doesn’t cost you any more to collect that extra 3% as long as you have the proper systems in place and trained staff. What if your collection rate was 93% (which many of our new clients are very happy with when they walk in our door). They are losing $2500 a month or $30,000 a year in net income at a $50,000 a month production level. We all can easily imagine what to do with $30,000. A new car? Pay off some bills? School tuition? Retirement funding?
You can do the math using your collection percentage with your level of production compared to the 98% benchmark. Try it and you might find it eye opening.

Silkin Management Group can provide you with all the tools to increase your gross, net and collections to the benchmarks presented. If you are interested in finding out how, call us at 800-695-0257 or email us at: info@silkinmanagementgroup.com. If you’d like to visit our website, check here: www.silkinmanagementgroup.com

Lyn Ribisi
Appointment Coordinator
Silkin Management Group

WHERE IS MY NET PROFIT?

2010-02-02T08:49:00.000-08:00

At Silkin Management Group, we don’t try to just increase the production of your office, we just as importantly want to see a nice increase in net profit for you. Why work on increasing production if you don’t make more money? That would be totally foolish.

You have worked hard all week, the office atmosphere has been snap, crackle, pop; the staff have been getting along with each other; and you are proud of the team spirit they have each shown. In fact, your staff have almost read your mind and anticipated your every need. The patients have all arrived on time for their appointments, and the majority of them have even listened to you and accepted your treatment plans!

Now it’s Friday afternoon, the staff have their paychecks, which include production bonuses because the office has done so well this week. But you look at your bank balance, and you are surprised and seriously disappointed at the lack of funds left over for you.

Where did your net go?

Did you work hard all week to earn less money? The bank balance should be going up, not down!

You wonder if it's worth it. You worked hard all week - only to earn less money. All of that increased production may just have landed you into a higher “office-overhead/higher tax-bracket” situation. It's that frustrating income vortex - the place where despite producing and collecting more, you take home the same or less. And after a few of these "successful" weeks you shake your head and realize that if you have much more of this kind of success, you'll go broke.

A Silkin Management Group consultant would take a look at what might have happened:

Do your staff work overtime? Do you have systems in place to prevent this without being notified?

Do you have redundancy in your staff scheduling? Are you scheduling for efficiency? Do you have 5 staff members on duty when 4 staff will do during the slower times of the day?

Can you consolidate your equipment loans into one loan, thus saving you interest and lowering your payments?

Can you reduce the amount of inventory the practice holds?

Are you collecting all you bills? Are your collections at 98% at least?

Are any staff functions overlapping?

Do you have an efficient office communication system whereby staff are not interrupting other staff when they are doing their jobs, thus reducing efficiency?

Do you have any monitoring system to know, factually and statistically who is productive and who isn’t?

Is there any gossiping going on in the office?

Are there any problem staff members who aren’t being handled?

These are just some of the areas that Silkin would look into to help you with the management of your practice and figure out any problems with your net income. Your net should be between 35%-55%, depending on your profession, and area. If it’s not, there’s something wrong with the management of your office.

If you would like help with this area of your practice, feel free to contact us at: info@silkinmanagementgroup.com or call 800-695-0257. You can also visit our website: silkinmanagementgroup.com

All the best,
Lyn Ribisi
Appointment Setter, Silkin Management Group

Please visit our other blog at: silkinmanagementgroup.blogspot.com

The Credit Game and You

2010-01-29T09:36:00.000-08:00

Part Two

In Part 1 of this article, which you can find at below, I mentioned that FICO, the most widely used credit score determining service, had recently opened its “secret vault”. As part of our normal research for our clients at Silkin Management Group, I ran across this information and thought it would be valuable to share with anyone interested in addition to Silkin clients.

I’m sure you have noticed that it is not uncommon to see credit companies mysteriously lowering credit limits, and many are even closing accounts that have no delinquencies or violations on the part of the consumer.

Why is this?

Some credit companies have just tightened up the amount of credit they are willing and/or able to extend and the consumer can’t do much about it. If this has happened to you, then the best advice is to switch credit companies. With a good credit score, you should be able to procure another line of credit easily enough. Of course be aware of the fine print—check for annual fees, rewards programs and, if you plan to carry a balance month-to- month, then obviously search for a card with the best interest rate.

To help you with this there are many websites that offer information and comparison between individual credit cards. creditcards.com is one of many you can try.

However, there is another reason that you might be getting cut off from your lenders, and that is your FICO score. This is a constantly changing number, and it depends on not only on how promptly you pay your credit card bills (of course that is a primary factor), but also on a number of other spending habits. Here are some examples: If you’ve maxed out a card your score will be reduced. How much? Well that’s another interesting point and depends on where your score was. For example if your score is about 680, it will be reduced anywhere from 10-30 points. However, if your score is about 780, then it will drag it down 25-45 points!

If you are 30 days late on a payment, your score can be reduced 60-90 points if you have a 680 score and for the higher FICO range, it is a 90-110 point reduction!
If you choose to go with a debt settlement service, your score will suffer by 45-65 points for the lower FICO range, and 105-125 points if you start with the higher FICO range.

Foreclosures will cost you 85-105 points low range or 140-160 points in the higher range.

And the worst-case scenario, bankruptcy, will take off 130-150 points in the lower credit-score band. For a higher score, count on losing 220-240 points.

Keep these points in mind when using your credit cards and dealing with credit card companies. As noted above, if you max out one of your cards it can cause a significant change in your score, so think about that before you do something like that.

If you’d like more information about Silkin Management Group and its services, visit our website at: www.silkinmanagementgroup.com. You can also email us at: info@silkinmanagementgroup.com or call Silkin Management Group at 800-695-0257.

Lyn Ribisi
Appointment Coordinator
Silkin Management Group

The Credit Game And You

2010-01-28T15:57:00.000-08:00

Part One

You likely have read recently about the ethics of the large banks that were bailed out by you and me…the taxpayers. In fact President Obama is now talking about putting restrictions on the large banks to hopefully prevent this type of catastrophe from occurring again.

Meanwhile, most of our personal credit activities have taken a hit in the last year. You may have experienced this through difficulty in getting a loan or changes in your credit card rules and rates. In fact you might be asking yourself, “What did I do to make my credit card company hate me?” Maybe you’ve had your card limits lowered, or even had some cards canceled for no apparent reason. You have made all your payments on time, and you can’t remember doing anything unusual to have caused such an action against you.

The management team at The Silkin Management Group attempts to watch these activities for its clients in order to offer logical advice. The great majority of Silkin Management Group’s clients are in the health care profession and, as such, their credit ratings are often vital to the operation of their business. Having good credit is vital in getting a lease or loan for new equipment, expanding an existing office or building or buying a new facility.

Unless you’ve been living the last year or so living in an endangered oak tree as a guerilla environmentalist, you are aware that the credit climate in the country has changed. This is not new news. However, it was only recently that FICO, the service most widely used to determine one’s credit-worthiness, has released information about how they arrive at the hallowed number. This is the first time they have opened their secret vault of formulas, calculations, and criteria to the great masses.

Also, Silkin Management Group is a leading vendor for several major lenders to the health care profession. As such we have extensive experience in this field and can help you with understanding this industry and activity as well as aid you in obtaining financing for business needs.

Part 2 of this article will be posted here on January 29th. In Part 2 I’ll go over some of the specifics I’ve found from FICO opening up their secret vault. You’ll find it useful, educational and hopefully helpful in being proactive with your credit rating.

If you’d like more information about Silkin Management Group and its services, visit our website at: www.silkinmanagementgroup.com. You can also email us at: info@silkinmanagementgroup.com

Lyn Ribisi
Appointment Coordinator,
Silkin Management Group

The Key to Patient Appointing

2009-12-17T13:58:00.000-08:00

Clients new to Silkin Management Group often experience various problems with patient scheduling. The first thing that we teach our clients at Silkin with regards to scheduling is that the receptionist must be trained to control the flow of patients/clients at all times.

When a patient or client is allowed to determine when he/she is coming in, the receptionist is relinquishing control of the book to the patient.

The result? Unacceptable numbers of cancellations/reschedules, erratic appointing, dead time in the back, open slots, etc.

Patients should be educated from the initial call to come in when the receptionist can get them in – not when it’s convenient for them to arrive. This is not done in any harsh way or in any way other than the person experiencing top notch service from the office. One would always try to fit a patient/client into an appointment slot that as closely approximates what they need and want. But, at the same time, the receptionist controls when the patient/client can best be serviced.

If you have any trouble thinking with this, realize that when a client calls any other professional office for an appointment - attorney’s office, physicians’ practice, bank manager – nearly always the receptionist will state when the client can be seen, not the other way around. Good communication by the person making the appointment will always result in the person feeling serviced while they are scheduled when the office can see them.

There is no difference in your office. The priority of seeing the doctor must be established in the mind of the patient at all times. As a consultant at Silkin Management Group I insure that all my clients all understand this and that proper job descriptions and role playing is introduced into the training of their receptionist so that this can easily be accomplished.

If you’d like to know more about this or want information about any other practice management actions, contact us at: info@silkinmanagementgroup.com or give us a call at 800-695-0257. You can also visit our website at: www.silkinmanagementgroup.com

Bill Hickey
Consultant, Silkin Management Group

METRICS FOR AN OFFICE MANAGER

2009-12-03T10:07:00.000-08:00

The various Silkin Management Group blogs have recently been running a theme of how to measure productivity in a health care office. Several examples have been given that are used with Silkin clients to help them manage their office better. So far we have covered possible statistics for a receptionist, collection area and exams. Today I thought I’d cover some ideas on how an Office Manager’s production could be measured.

As previous Silkin blogs have covered, the first thing you need to determine a proper statistic for a job or area is figure out the product that job or area should be producing. Here are some ideas for the product of an Office Manager:

An office that is expanding and prospering
A Doctor who only has to wear his/her Doctor and owner hat
Staff members who know their jobs, are thereby productive, and are operating together as a team.
Satisfied patients/clients who continue to come in for care and who refer others to the practice.

All of these points could be considered valid products of an Office Manager and all could be used or they could be used collectively.

With these products in mind, one could use the following statistics to measure the overall productivity of the Office Manager:

Production
Collections
New Patients

Silkin Management Group Clients have found the above products and statistics to be very workable in managing their practices. If you are not using some sort of statistical management system, I suggest you start implementing a system using the advice we’ve presented in these blogs.

If you would like help with any of this, please contact us at: info@silkinmanagementgroup.com. You can also visit our website at silkinmanagementgroup.com

Eric Korb
Director of Consultants

Check out our other blogs about managing by statistics at:
Yet More Ideas on Productivity Measurements in a Health Care Office
Here's More Ideas on Measuring Productivity
How Do You Measure Productivity of All Areas of an Office?

A BIGGER PICTURE LOOK AT HEALTH CARE REFORM

2009-11-24T15:06:00.000-08:00

If you’ve been reading through some or any of Silkin Management Group’s various blog sites, you’ve seen a variety of articles concerning the health care reform bills being debated and voted upon in the House and Senate. Most of those articles have also referenced writings on the subject by a variety of authors.

Since we at Silkin are attempting to stay on top of this vital issue for our clients, we are continually reading different publications that have information about this legislation. Today I read a very interesting article in the New York Times written by David Brooks. I thought his viewpoint was worth passing on as it gave a bigger picture look at the whole health care reform activity.

As Mr. Brooks says: “But the general view among independent health care economists is that these changes will not fundamentally bend the cost curve. The system after reform will look as it does today, only bigger and more expensive.

As Jeffrey S. Flier, dean of the Harvard Medical School, wrote in The Wall Street Journal last week, “In discussions with dozens of health-care leaders and economists, I find near unanimity of opinion that, whatever its shape, the final legislation that will emerge from Congress will markedly accelerate national health-care spending rather than restrain it.”

I suggest you read the whole article as it might give you a different perspective on what is going on. I believe we need fundamental health care reform in this nation. What I don’t believe is that the legislation that seems inevitable to be passed will truly accomplish that. Rather it seems that it will add more government costs and regulations rather than fundamentally change our system for the better. Our government is already fiscally insolvent. It seems to me that this legislation won’t help the matter and only add to the problem for our children and grandchildren.

I invite your comments on any of Silkin Management Group’s blog or social media sites:

Silkin Facebook Page
Silkin Twitter Page
Silkin Squidoo Lens

You can also visit Silkin Management Group’s website at:
silkinmanagementgroup.com

or contact us at:
info@silkinmanagementgroup.com

Gary Crawshaw
Consultant
Silkin Management Group

HELP FOR SMALL BUSINESSES OR JUST MORE HOT AIR?

2009-11-18T16:25:00.000-08:00

From my job as a consultant at Silkin Management Group, I continue to monitor and read about what is happening with small businesses as part of the economic recession we are experiencing. On November 4th my colleague Bill wrote an article on one of Silkin’s blog sites about how, despite the governments statements to the contrary, small business lending is still not happening.

Here it is, two weeks later and, with even more government pronouncements about how the bailed out banks are suppose to now be helping small businesses, per this article from CNN, very little is still happening. Small Business Loans Evaporate

My clients at Silkin and I discuss this not infrequently. How come, we ask, do these huge banking conglomerates that have made bad business decision after bad business decision and get bailed out by our tax dollars, do nothing to help the small businesses that employ the great majority of people in this country. How come the government who give them all this money does nothing effective to help, despite whatever they may be saying.

I’m not making this up. Per the author of this article, “Eight months after President Obama began prodding the nation's banks to increase their small business lending, the loan numbers continue to move in the opposite direction. The 22 banks that got the most help from the Treasury's bailout programs cut their small business loan balances by a collective $10.5 billion over the past six months, according to a government report released Monday.”

It must be nice to get a lot of money to save your business and do nothing to help other businesses, even though lending money to help businesses is the essence of what you do. I guess I’m just jaded.

If anyone reading this blog has any ideas or comments about this, I’d love to hear it. In the meantime, if you need any help with the management of your business or practice, contact us at Silkin Management Group.

We can be reached by:
Email:info@silkinmanagmentgroup.com
Website:silkinmanagementgroup.com
Blog: silkinmanagementgroup.blogspot.com

Jack Hennessy
Consultant
Silkin Management Group

SOME QUESTIONS TO ASK YOURSELF WHEN YOU ARE HAVING TOO MANY CANCELLED AND/OR RESCHEDULED APPOINTMENTS

2009-11-10T09:59:00.000-08:00

As a consultant at Silkin Management Group, one of the management systems we help our clients with concerns various methods for reducing the number of cancelled and/or rescheduled appointments. If a doctor’s office has too much of this going on, it can create havoc with daily production. Normally, when this is going on, it is a sign that the receptionist is not properly trained in scheduling appointments and in how to handle cancels and reschedules.

Here are some questions you can ask yourself regarding cancellations:

Do you re-appoint a cancelled patient right away?

When a cancellation happens, do you find out why and keep track of this information for future reference to implement any needed corrections?

Do you have any patient policy regarding cancellations that is part of your “welcome to the practice” information given to patients/clients?

If you have such policy, do you enforce it?

Here are some questions we go over with Silkin clients regarding “no shows”.

What do you do when someone doesn’t show up for an appointment?

Do you call after a certain amount of time, i.e. 10-15 minutes?

Do you have any patient policy regarding “no shows” that is part of your “welcome to the practice” information given to patients/clients?

Is the patient who “no showed” shown the policy the next time they are in?

The clients I deal with at Silkin Management Group are all given these simple questions, plus many more, to review in terms of any problems they are having with cancels, no shows, and reschedules. We closely evaluate the management systems and training they have in place with the staff members involved and then fix and/or implement the proper procedures to reduce the amount of patient loss. This normally leads to increased production for a Silkin client, without any increase in marketing or staff expense. This,of course, leads to greater efficiency and net in an office.

If you would like to find out more about Silkin Management Group, visit our website at www.silkinmanagementgroup.com, email us at info@silkinmanagementgroup.com, and if you are interested in one of our other blogs, please go to: silkinmanagementgroup.blogspot.com

Jack Hennessy
Silkin Management Group Consultant

HELP FOR SMALL BUSINESSES IS GREAT, BUT WHERE DOES THE MONEY COME FROM?

2009-11-03T14:02:00.000-08:00

In today’s New York Times, I read the following editorial about needed help for small businesses.Help Small Businesses Hire again.

As a management consultant at Silkin Management Group, I consult our clients with the workable management technology that helps their business grow, even during these tough economic times. Silkin clients are all primarily single doctor owned health care practices such as dentists, veterinarians and optometrists. As such they are all small businesses in the truest sense of the word and anything that affects small businesses affects them. That’s why I found this article interesting.

The author points out those businesses with fewer than 20 employees account for 25 percent of all jobs, and that these same small businesses created 40 percent of the job growth during the 2003 to 2007 economic expansion. I know that our Silkin clients had something to do with that because, as they learned to become effective managers, their productivity grew and the need for more staff increased in order to keep up with the increased productivity. Expansion for our clients is the primary goal of Silkin Management Group and, as consultants, that’s what we are expected to produce. With that viewpoint, I fully back any ideas and methods to help small businesses and that’s why this article caught my attention.

But reading further through the article I found some seriously strange concepts. I thought it was a positive note to promote the concept of making it easier for small business to obtain needed credit, and the author discusses why this is still very difficult, despite the President’s recent statements otherwise. But then the author puts out some concepts that frankly seemed strange including refunds for taxes paid in the past in exchange for higher taxes in the future and work share programs paid for by the government. Interesting ideas, but where does the money come from to pay for all this? He doesn’t say anything about this.

At Silkin Management Group we try to teach our clients fiscal responsibility. This would include the very basic idea of not spending more than you make and running very tight budgetary controls. These are not esoteric management concepts. The Silkin clients who apply these basic principals do well financially. The government, and many economists who write columns such as this one, don’t seem to think that such a basic concept has anything to do with government.

You know as well as I do that if you keep spending more than you make, and you keep borrowing and borrowing money, it will catch up with you and take you out. Why would this be any different for the government, other than the fact that they can print as much money as they want in order to have the money needed? But that activity just leads to inflation. All you have to do is look at the price of any commodity 50 years ago compared to today to see the truth of that.

So, as a management consultant for small business at Silkin Management Group, I appreciate the author’s concern for small business. But I also must express that any help must follow basic and workable management technology and not include more and more borrowing, more and more inflationary activities and less and less fiscal responsibility.

I’d love to hear your opinion about this article and my point of view on it.

For more information about Silkin Management Group, visit our website at: silkinmanagementgroup.com or email us at info@silkinmanagementgroup.com

Bill Hickey
Silkin Management Group Consultant

Visit our other blog at: SilkinManagementGroup.Blogspot.com

Where have all the jobs gone?

2009-10-30T11:05:00.000-07:00

As part of our jobs as a consultants at Silkin Management Group, we attempt to stay on top of relevant news that can effect our clients and the management of their business. As part of this I recently read an article that I thought would be interesting, not only to our Silkin clients, but anyone reading this blog. This was an article in Business Week, which, if you are interested, you can access here: A Lost Decade for Jobs

This article points out that private job sector growth has been non existent for a decade! From reading the media over the past year, I had been under the impression that job growth was only a problem in the last year or so, since the economic debacle of a year ago.

This article describes how the only real growth in jobs in the last 10 years or so has been in the government sector which includes jobs controlled and/or sponsored by governments such as education and government sponsored health care. Without this, the article points out, labor growth would have been terrible. After reading this I realized that maybe I’ve been too isolated in viewing what is going on in the business world as I tend to just look at Silkin clients who, for the most part, have been growing and providing more jobs over the last decade.

Here’s a thought…could it be that when the government makes jobs it reduces the potential of the real private sector to provide jobs. Government created jobs have to be paid for by the taxpayers, rather than true productivity in the business market. Given that nearly every state government is experiencing financial meltdowns and the federal government is overspending us into oblivion, maybe we should put more emphasis on private sector productivity and means and methods to help the private sector be more productive. That’s what we try to do at Silkin Management Group.

As a Silkin Management Group consultant, my job is to help our clients, all private business people in the healthcare field, learn and apply effective management systems and technology so that they can be proactive in their approach to living in these very stressful economic times. Most of our Silkin clients are growing, despite the economy, while many other private practice health care providers are declining or barely holding their own. The growth of Silkin clients directly helps provide more jobs in the economy through honest increase in productivity. Activities such as this, helping private sector business people become more proficient in management and thus more productive is, in my opinion, the best method of helping job growth and our economy.

If you’d like to know more about Silkin Management Group, please visit our website at: www.silkinmanagementgroup.com

Jack Hennessy
Consultant for Silkin Management Group

We have another blog at: silkinmanagementgroup.blogspot.com

WHAT TROUBLESOME ECONOMY?!

2009-10-28T10:39:00.000-07:00

I’ve been a practice management consultant at Silkin Management Group for over twenty five years. I’ve helped well over 500 different offices during that time and don’t think there is a management problem or situation that I haven’t run into and helped solve at one time or another with a Silkin client.

I get great joy and satisfaction from seeing our clients increase their productivity and decrease their stress by applying the management principles and techniques that we teach and consult at Silkin. Our job is to supply the basic business management education that a doctor rarely, if ever, gets in his or her medical school training.

What we see over and over again is the doctor graduating from school, all bright and shiny and ready to conquer the world and then either starting a new practice or buying an existing practice. In doing so, he or she takes on the rigors of running a business along with the stress of a serious debt load, and doing this with little or no training in business or management. This, to me, is similar a businessman buying a health care office (for example a veterinary clinic) and now having to perform surgery on a dog with little to no training. The success of that surgery would be limited at best! So we at Silkin help our clients learn the business management principles and technology that they didn’t learn in school. As a result, our clients prosper.

The various consultants at Silkin Management Group have been asked to watch the news of the day and write some information for our blogs that would be relevant to what we do at Silkin for both our clients and anyone reading the blog site. We were also asked to write any management information that we thought the readers mind find useful.

To that end, and following the theme I wrote above, I thought I’d relay a very timely article that one of my clients just sent me. I found both the article, and how it was presented in the newspaper, to be extremely interesting in terms of today’s economy and how our clients at Silkin are thriving despite the frequent bad economic news.

My client, Dr. Kathleen Lackey, a veterinarian in Maryland, recently built a beautiful, state of the art facility as one of the results from her great increase in production and income since becoming a client of Silkin Management Group. Additionally, one of the things we taught her was how to get free publicity using her local newspaper. Once her new clinic opened, she took what she learned and got a three quarter page spread about the new office on the front page of the business section of the paper (the October 2, 2009 edition of The Cecil Whig) that has a readership of tens of thousands of people.

The headline of the piece was: “Elk Neck Vet Clinic Thrives With Expansion”, followed by a lengthy article about her growth and the new, state of the art, clinic. What I found both interesting and a bit humorous was the two other headlines right next to her article on the front page of the business section. These headlines were: “Stocks suffer worst drop in 3 months” and “Jobs and manufacturing data suggest slow recovery”.

So, here was my client, growing rapidly and opening up a brand new clinic in the face of the “gloom and doom” economy. And right there, in the front page of the business section were the headlines and articles touting how bad things are right next to the article about her incredible expansion. It goes to show you that, even in tough times, if you know what you are doing in terms of business and practice management, you can not only hold your own, but thrive even during the toughest of times. That is what we are seeing with most of the Silkin Management Group clients.

Dave McKevitt
Silkin Management Group Consultant

Please visit our other blog:

Silkin Management Grp

QUALITY CONTROL

2009-10-08T10:42:00.003-07:00

A key administrative division in our company is the Quality Control Division. In actual fact, our company operates on an organizational system that divides up any business into 7 different Divisions. A previous blog article has gone through, in a summary form, what each of those divisions are. In future articles I will detail each of those areas more closely and how they apply and can be used in any health care practice. In any case, as stated above, one of those divisions is the Quality Control Division. Any business, whether a health care office, a restaurant, a car dealership, IBM, etc. must have a Quality Control area of the company that inspects the products that are coming out and determine whether the products meet the quality standard expected and, if not, see that both the product and the product producer are properly corrected. This is a routine activity in our company.

I recently asked one of our quality control staff to summarize a recent client completion and thought I'd pass along this summary report to give any reader any idea of what we do with our clients. I hope you enjoy it.

SUMMARY REPORT ON A RECENT CLIENT COMPLETION
Prior to coming to us, this client was aware of problem areas but he wasn’t confident that he had recognized the actual source of the trouble. The solutions he tried to implement were not resulting in the changes he wanted. He was overloaded with administrative duties, scheduling was inefficient and he was not monitoring his expenses closely which was creating financial problems.

After carefully examining and evaluating information about the practice, his consultant created a step-by-step plan tailored for him. One of the first areas addressed was his recall program. The consultant recognized that there was a “gold mine” that had not been tapped due to inefficiency and staff problems. A recall program was established which yielded results right away.

The second problem that was confronted was the doctor’s lack of case presentation skills. With more patients beginning to come in, it became vital for him to develop skills that would allow him to deliver all the treatment they needed. The consultant had the doctor do a specialized training program which teaches effective treatment plan presentation After working with the consultant for three months the practice’s gross income rose from an average of $50,000 per month to an average of $80,000 per month, with no increase in the amount of time worked.

While these situations were being handled, the doctor had his office manager take part in management training at Silkin. Since the doctor had been overloaded with administrative duties when he originally came to us, the increase in business would have created more work without a trained Office Manager. With training, the Office Manager was able to take over the day-today management of the practice. She implemented job descriptions for each position, got office policies in use, managed staff and ensured the scheduling was done correctly and efficiently. This reduced stress in the practice and greatly facilitated the doctor.

All of this client’s staff members have participated in Silkin training seminars and now perform as a cohesive, efficient team. The statistics of the practice remain in a higher range and the growth pattern has continued. He now spends less time in the practice and enjoys working without the stress he once had.

Based upon quality control interviews with the client and his staff we verified that he is a very, very happy client for the following reasons:

a) his office is now well organized and efficient;

b) he has a well trained Office Manager in place that handles the day to day administrative duties;

c) he is working significantly less hours;

d) has much less stress; and e) his personal income has greatly increased.
We welcome any comments. You can do so by clicking on the "comments" link below.

Larry Silver
President, Silkin Management Group

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The Baucus Healthcare Plan: What Small-Business Owners Need to Know

2009-09-28T16:02:00.000-07:00

Every day I get in my email inbox something called the “NFIB Smartbrief”. NFIB is the acronym for National Federation of Independent Businesses. This is the organization that champions small businesses throughout the U.S. and in every single state through extensive lobbying efforts. It is an organization totally dedicated to helping the small business owner. The NFIB Smartbrief contains links to timely articles concerning any important and relevant news that effect small businesses. It is a great way to stay on top of news that can effect us all as small business owners.

The clients of Silkin Management Group are all small business owners, and it is therefore important to me to stay abreast of the news about the issues that are most relevant to our clients. As I’m sure any reader knows, the healthcare legislation that is changing daily while winding its way through Congress will significantly effect small businesses. And, as Silkin clients are both small businesses and health care providers, anything having to do with this legislation is important to stay on top of. Today, while reading the Smartbrief, I found a very good article summarizing the latest potential effects that the legislation, in its existing form, will have on small business. I therefore thought it would be of benefit to our readers to provide that article, published on line by U.S. News and World Reports and written by Mathew Bandyk. The article is reproduced below or you can link to it by clicking here: The Baucus Healthcare Plan.

I hope this article helps you see the latest that is going on with the healthcare legislation. Comments on this are welcomed by clicking on the comments link at the end of this blog.

Larry Silver
President, Silkin Management Group

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The Baucus Healthcare Plan: What Small-Business Owners Need to Know

What business owners should look out for as healthcare reform moves ahead

By Matthew Bandyk

In the battle to pass some form of healthcare reform, small business is a major player. Earlier this year, Congress proposed reform bills that would put in place heavy fines on businesses that fail to provide healthcare for their employees, with the exception of those that have just a few employees. Small-business political associations in Washington quickly denounced these provisions as too burdensome for too many businesses. Now, what's on the table for healthcare reform has changed. In early September, the SenateFinance Committee put forth a new healthcare bill that removes those penalties on businesses. Instead, it offers carrots to employers that provide healthcare, while keeping a few sticks. The bill, associated with its main sponsor, Democratic Sen. Max Baucus of Montana, seeks to expand insurance coverage through the creation of nonprofit insurance exchanges at the state level. These exchanges, under recent amendments Baucus accepted, will be open to small businesses with up to 100 employees.

Although the Senate is currently debating numerous amendments to the bill, many of the most relevant pieces that apply to small business don't seem to be points of contention. One thing is for sure: Many elements of the bill will have a profound impact on how employers seek out and pay for insurance for their employees. 4 Conundrums That Impede HealthcareReform.

Here are, from the perspective of small-business owners, some of the most important pieces of the current plan to reform healthcare.

Tax credits.

The new carrots in the bill are in the form of tax credits for employers that provide their employees health insurance. But not every employer can cash in on these incentives. Only businesses with 25 or fewer employees would qualify. However, about 92 percent of small businesses with employees fall into this category, according to the SBA. There's one further qualification: The average wage of all of the business's employees must be no greater than $40,000. Most business owners will want to pay attention to how much these credits could save them, and when. In 2011 and 2012, the bill would allow employers to deduct from their taxes an amount equal to the dollar amount the employer contributes for each employee's coverage, multiplied by a certain percentage. This percentage would be based on the amount of the employee's total premium contributed by the employer, or the average premium in the employer's state.

Starting in 2013, the state insurance exchanges kick in, and the credit applies only to businesses that purchase insurance through those exchanges. So would these write-offs revolutionize the way small businesses provide employee healthcare? Bill Rys, tax counsel for the National Federation of Independent Businesses, says expectations shouldn't be too high. The size and length of the credit—just four years—aren't high enough for businesses that are strapped for cash to suddenly consider buying healthcare. But the credit could make a difference for business owners "on the cusp"—those unsure if they can afford employee coverage. "It does provide some immediate cost relief," he says. The relief is especially large for the smallest businesses.

Businesses with fewer than 10 employees and less than $20,000 in average wages get to keep the tax credit in full. For larger businesses, it begins to phase out starting in 2013. But there are also some potential problems. If a business owner starts paying employees more and the average wage surpasses the $40,000 mark, the business could no longer be eligible for the credit. That wage requirement could make employers reluctant to give out raises. Rys says that this is a real concern, but he's not too worried. There isn't much incentive for employers to keep average wages down for the same reason that the tax credits won't have small businesses rushing out to buy health insurance. The length of the credits is just too short. "The concern would be greater if the credit were longer, but the credit is for only two years before the exchange starts," Rys says.

Tax penalties.

Although no employer will be automatically punished for not providing coverage, there are still some fines in the bill that apply to firms with 50 or more employees—only 4 percent of all businesses that hire. But for businesses included in that 4 percent, the tax penalties can be hefty. That's because the bill provides subsidies for individuals and families who make up to 300 percent of the federal poverty level to help them buy insurance through the state health exchanges. Employers that don't provide coverage will have to pay a tax penalty for each employee who receives these subsidies. This has been dubbed the "free rider" provision because it is intended to deter employers from "free riding" off the new health insurance exchanges. The penalty is either the average cost of subsidies that year multiplied by the number of employees receiving subsidies or $400 per employee—whichever number is lower. But business owners won't be told what they owe. They'll have to crunch the numbers themselves to determine if they owe the full amount or the minimum, says Judith Solomon, senior fellow at the Center on Budget and Policy Priorities. There are many administrative burdens that could come with this provision. For example, a business owner would have to keep track of which employees qualify for subsidies, if they suddenly become qualified, or if they drop out of the exchange altogether. Some business that want to avoid the penalty can expect disputes with the tax man—it will be up to them to inform the IRS that some former employees who received health insurance subsidies were laid off or no longer work there, says Solomon.

Another complicating factor of the "free rider" provision for employers is that it might make them think twice about whom they hire. "It does distort the hiring decisions in the direction of employers who don't need coverage," says Solomon. A business owner might be inclined to look for potential employees who already get health insurance through their spouse, for example, in order to avoid dealing with the tax penalty. Choosing to hire or not hire someone on that basis could land a business owner in legal trouble.

Insurance taxes.

One of the most controversial aspects of the Baucus bill is that, if passed, it would be partially funded by an excise tax on health insurance companies. In 2013, a 35 percent tax would kick in on insurance policies in which premiums are above $8,000 for single people and above $21,000 for families. It might not seem as if a tax on insurance companies would have much to do with small businesses, especially considering that few small businesses have the type of gold-plated, "Cadillac" health insurance plans to which the tax applies. But Keith Ashmus, the chair of the National Small Business Association, says these taxes could be passed down to all employer health insurance plans—not just the gold-plated ones—in the form of higher premiums. "The tax will be part of the entire cost structure of the insurer," he says. "[So] the trigger will be a high-cost plan by company Y, but the impact will be felt by everyone." The good news is that as the Senate has negotiated aspects of the bill this week, Baucus appears to be willing to ease the impact of the excise tax—but not eliminate it.

2009-09-22T15:58:00.000-07:00

We've recently presented the first two parts of a fascinating article by Bruce Wisemen concerning the Goldman Sachs connection to the financial crisis. Below is the third and final installment of this series. I hope you find it as interesting as I did. Silkin Management Group specializes in delivering practice management consulting and training to health care professionals. Although these recent articles are not specific to managing a practice, they are very relevant to the financial welfare of every one of us. Knowing the causes of macro events that effect our lives is, we feel, as important as knowing the
various systems and techniques that we provide to help make a practice more productive and profitable. We welcome any comments by clicking on the "comments" button below.

Larry Silver
President, Silkin Management Group

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THE GOLDMAN CONNECTION
NEIL LEVIN
THE DERIVATIVES BOOM

The acknowledged boogie-man of the world’s financial crisis were mortgages, many of which were sub-prime, packaged up into investment products called mortgage backed securities - also called derivatives because the package, the security, derived its value from the underlying mortgages. There is much more to this story (See: The Financial Crisis: A Look
Behind the Wizard’s Curtain) but the point here is that these mortgages were a critical component to the crisis.

For reasons we detail in a follow up article, The Financial Crisis: The Hidden Beginning, the explosive growth of these products was due in large part to the fact that the securities carried a AAA investment grade rating. That rating was granted because Goldman Sachs and other banks were able to purchase what was essentially credit insurance for the investment. In other words, if the investment went bad, it was “insured” against loss.

This kind of protection was called a credit default swap. Though “swaps” looked like insurance and acted like insurance, they were remarkably adjudicated not to be so, thus eliminating the need for the “insurer” to hold reserves against possible losses. This opened the door to a torrent of speculation in the derivatives.

Let Matt Taibbi tell it.
“AIG, a major purveyor of default swaps, approached the New York State Insurance Department in 2000 and asked whether default swaps would be regulated as insurance. At the time, the office was run by one Neil Levin, a former Goldman vice president, who decided against regulating the swaps. Now freed to underwrite as many housing-based securities and buy as much credit-default protection as it wanted, Goldman went berserk with lending lust. By the peak of the housing boom in 2006, Goldman was underwriting $76.5 billion worth of mortgage-backed securities - a third of which were subprime - much of it to
institutional investors like pensions and insurance companies.”

GARY GENSLER
THE COMMODITIES EXCHANGE

But not to worry. We’re protected now. The regulation of many derivatives and other exotic financial instruments - the $5 trillion dollar commodity futures industry (gold, silver, oil, treasury bills, corn, cotton, sugar, etc.) - has recently been delegated by President Obama to Gary Gensler.

Gensler was confirmed as the head of the commodity Futures Trading Commission (CFTC) in May, but it took a little arm twisting. Some members of Congress had misgivings. You see, back in 2000, when he was at Treasury, Gensler advocated legislation, which eventually passed exempting - credit default swaps and some other derivatives from regulation.

Still, it’s hard to argue with his understanding of derivatives. He spent 18 years at Goldman Sachs, the most aggressive derivative trader on Wall Street, where he became a Partner. He subsequently went to the Treasury Department where he pushed for the deregulation of the industry. Now President Obama has put him in charge of it.

Change we can believe in…

DUNCAN NIEDERAUER
THE NEW YORK STOCK EXCHANGE

Goldman alumni not only control the commodities markets, but the major stock markets of the world, as well. In May of 2007, the grand daddy of stock markets, the New York Stock Exchange (NYSE), bought Euronext (a pan-European stock exchange with subsidiaries in Belgium, France, Netherlands, Portugal and the United Kingdom) which, now branded as NYSE Euronext, operates the largest securities exchange on the planet. To run the show, the newly combined entity brought in Duncan Niederauer and appointed him Chief Executive Officer. Niederauer had been a Partner and Managing Director at Goldman Sachs before joining NYSE Euronext.

STEPHEN FRIEDMAN
THE NEW YORK FED

The Federal Reserve System controls the country’s money supply. Nice gig if you can get it. It is made up of a Board of Governors (7) appointed by the President for 14 year terms, and 12 Federal Reserve Banks around the country. The New York Fed is a first among equals. An institution of awesome power, it supervises and controls the major money center banks in New York, the capital of the US financial industry.

The New York Fed worked closely with Treasury Secretary Paulson on numerous aspects of the bailout during the chaos of the financial meltdown in the Fall and Winter of ’08. Much of this work was carried out by Timothy Geithner, then President of the New York Fed until Rubin helped get him the job as the Secretary of the Treasury. The Chairman of the New York Fed at this time was Stephen Friedman. He picked up the reins when Geithner left while looking for a replacement.

Friedman was a former CEO of Goldman Sachs, and later Chairman at Goldman. He’d left Goldman in 2002 to oversee economic policy in the Bush White House as the Chairman of the National Economic Council. Later, Bush appointed him to the Chairmanship of the President’s Foreign Intelligence Advisory Board.
In 2004, he returned to New York and the Chairmanship of the Fed. He also returned to Goldman to become its Chairman while he was also the Chairman of the Federal Reserve Bank of New York.

WILLIAM DUDLEY

To replace Geithner as President of the NY Fed, Friedman selected William Dudley. Dudley had been a Partner and Managing Director at Goldman Sachs for ten years prior to the Fed appointment.

Incest doesn’t begin to say it.

From the White House to Treasury; from the New York Fed to AIG; from the Commodity Futures Trading Commission to the New York Stock Exchange, Goldman is there.

Robert Zoellick
THE WORLD BANK AND INTERNATIONAL MONETARY FUND

But it doesn’t stop at our shores. It’s a global economy today, which requires global control. The World Bank was founded in 1945 to help with the reconstruction of Europe after the Second World War. Over the years, their mission changed.

Today they claim that their purpose is to eliminate world poverty. Kind of a pin-striped Mother Theresa for the planet. Unfortunately, this is at odds with what they actually do. If they were achieving their aims, the countries that they worked with would be prospering. But the reverse is true. In fact, an objective view of the results of the bank’s activities leads one to the inescapable conclusion that what the World Bank produces is indebted nations.

In their beneficence, the World Bank makes loans to third world countries, countries that can’t borrow elsewhere. The loans carry conditions that dictate domestic policy “adjustments” in health, education, tax policy, judicial matters, agriculture, manufacturing…

You get the picture. The Bank and its sister organization, The International Monetary Fund,
have about ¾ of the planet in debt like this.

Medieval doctors always prescribed the same “cure”; no matter what the ailment, they applied leeches to patients and bled them. For the past decade and a half, critics have likened the World Bank and the International Monetary Fund (IMF) to these doctors.

The two institutions have thrown millions of people deeper into poverty by promoting the same harsh economic reforms… regardless of local culture, resources or economic context.

Strapped with heavy debts, most developing countries have reluctantly accepted these reforms, know as Structural Adjustment programs (SAPS), as a condition for receiving IMF or World Bank loans.

In recent years, the doctors’ harsh medicine has been exposed in dozens of studies and in increasingly vocal street protests. In response, the World Bank and the IMF have been
attempting to revamp their public image into that of anti-poverty crusaders. from The IMF and World Bank's Cosmetic Makeover

The President of the World Bank is Robert Zoellick. In this position, Zoellick walks in the shoes of great Humanitarians like uber-Neocon Paul Wolfowitz, “Architect of the Iraq War”, and Robert McNamara, the Johnny Appleseed of Agent Orange.

Zoellick is in charge of spreading loans around the world to eliminate poverty, not unlike McNamara’s blanketing of South East Asia with Agent Orange to stop Communism. Both agendas produce the same results – toxicity, and in some cases, death – of the corporal body or the body politic.

Prior to joining the World Bank, Zoellick served as Vice Chairman, International, of the

Goldman Sachs Group.

You gotta love these guys.

The World Bank and the International Monetary Fund (whose most powerful Board member is our very own Timothy Geithner) are the key tacticians in ensuring that the planet’s smaller economies remain deeply in debt. But they are no longer at the apex of international finance today.

As I have made clear in our earlier articles, The purpose of this financial crisis was to take down the United States and the U.S. dollar as the stable datum of planetary finance and, in the midst of the resulting confusion, put in its place a Global Monetary Authority—a planetary financial control organization to “ensure this never happens again.”

This purpose has now been accomplished.

To explain how, I quote from an article I wrote on this subject a few weeks ago.

THE FINANCIAL STABILITY BOARD

On April 2, 2009, the members of the G-20 (a loose-knit organization of the central bankers and finance ministers of the 20 major industrialized nations) issued a communiqué that gave birth to what is no less than Big Brother in a three-piece suit.

The communiqué announced the creation of the all too Soviet sounding Financial Stability Board (FSB).The Financial Stability Board. Remember that name well, because they now have control of the planet’s finances . . . and, when one peels the onion of the communiqué, control of much, much more.

THE 12 INTERNATIONAL STANDARDS AND CODES

While several press releases from the G-20’s London conclave reference these codes as though they were handed down from a fiscal Mount Sinai, finding the specifics takes some digging. But then the Bank for International Settlements (BIS), out of which the FSB operates, has never seen transparency as one of its core values. In fact, given its fascist pedigree, transparency hasn’t been a value at all. Known as Hitler’s bank, the Bank for International Settlements worked arm in arm with the Nazis, facilitating the transfer of gold from Nazi-occupied countries to the Reichsbank, and kept their lines open to the international financial community during the Second World War.

The BIS is completely above the law.

It is like a sovereign state. Its personnel have diplomatic immunity for their persons and papers. No taxes are levied on the bank or the personnel’s salaries. The grounds are sovereign, as are the buildings and offices.

The Swiss government has no legal jurisdiction over the bank and no government agency or authority has oversight over its operations.

In a 2003 article titled “Controlling the World’s Monetary System the Bank for International Settlements,” Joan Veon wrote: “The BIS is where all of the world’s central banks meet to analyze the global economy and determine what course of action they will take next to put more money in their pockets, since they control the amount of money in circulation and how much interest they are going to charge governments and banks for borrowing from them. . .

“When you understand that the BIS pulls the strings of the world’s monetary system, you then understand that they have the ability to create a financial boom or bust in a country. If that country is not doing what the money lenders want, then all they have to do is sell its currency.”

And if you don’t find that troubling, the “Key International Standards and Codes” just adopted by the Financial Stability Board cover such things as:

specification of the structure and functions of government;(!)

data gathering from ministries of education, health, finance and other agencies;

matters dealing with personal savings accounts, retirement incomes.
Here’s an example of the FSB in action from an article written by former Clinton advisor and
political strategist Dick Morris for The Bulletin on April 6, 2009. “The FSB is also charged with ‘implementing . . . tough new principles on pay and compensation and to support sustainable compensation schemes and the corporate social responsibility of all firms.’

“That means that the FSB will regulate how much executives are to be paid and will enforce its idea of corporate social responsibility at ‘all firms.’”

Almost no one on the planet has grasped what has occurred here.

Most central banks are answerable to no one. The U.S. Federal Reserve, for instance, is a private bank. It is owned by shareholders. Yes, the President appoints the Chairman, and the Chairman must testify before Congress, but no one gives them orders or tells them what to do. Again, they are a private, not government, institution (a very good reason to support Ron Paul’s bill [H.R. 1207] calling for congressional authority to audit the Fed – something they currently have no right to do.) And it is the newly created Financial Stability Board, operating as an arm of the Bank for International Settlements, that now structures and dictates the rules and regulations to be carried out by the central banks of the world.

And given the fact that central banks essentially operate independently of their national congresses or parliaments, the FSB now controls the monetary policy of the planet.

It is now, for all practical purposes, the Politburo of international finance. And who is the Chairman of this little known entity based in Basel, Switzerland? Mario Draghi. Draghi was a Partner at Goldman Sachs, until, like Henry Paulson, he left Goldman in 2006.

Paulson took over the U.S. Treasury and Draghi become the Governor of the Bank of Italy (Italy’s central bank) and in April of this year, Chairman of the Financial Stability Board. Draghi is also a member of the Board of Directors of the Bank for International Settlements.

In fact, the BIS board reads like a Goldman reunion committee. Mark Carney, had a thirteen year career with Goldman Sachs where he became the Managing Director of Investment Banking before becoming the Governor of the Bank of Canada and a member of the BIS Board.

William Dudley, President of the New York Fed and former Partner at Goldman Sachs is also a member of the Board, along with Draghi.
And there, you have it. Complete financial control of U.S. financial policy and markets, from the White House, Treasury, the New York Fed and the New York Stock Exchange and the

Commodity Futures Trading Commission. Control of the World Bank, most powerful member of the International Monetary Fund and, at the top of the fiscal food chain, the Bank for International Settlements and its Financial Stability Board.

This is my fourth article in a series about the financial crisis. Despite our exposure of

what some commentators have called Goldman’s economic terrorism, it is important to understand that they are but a part – soldiers in pin-stripes - of a more basic agenda, which is nearly complete at this point.

This agenda is set forth in my previous articles – A Peek Behind The Wizard’s Curtain, Hitler’s Bank Goes Global and The Hidden Beginning – which can be found at www.brucewiseman.com.

But “nearly complete” is not a fait accompli. And so I am providing you here with the link to “Hitler’s Bank goes Global,” the closing paragraphs of which set out specific actions to take to help bring this situation under control.

Goldman is like a Rottweiler on a leash. The key is bringing the handler, the Bank for International Settlements, under control.

Best,
Bruce
Bruce Wiseman is financial consultant and writer living in Los Angeles. He can be contacted at the address below.
bruce@brucewiseman.net
www.brucewiseman.net
© 2009 Bruce Wiseman.
All rights reserved.

More on the Sources of the Financial Crisis - Part 2

2009-09-17T14:30:00.000-07:00

If you haven't read our previous blog of a few days ago concerning some of the "players" deeply involved in the creation and benefits of our financial crisis, please do so before reading the continuation of the article, by Bruce Wiseman, below. I hope you find it as fascinating as I did. There will be two more installments that will complete this series. Keep an eye out for them!

Feel free to make any comments regarding this post by clicking on the "comment" link at the end of this post.

Larry Silver
President, Silkin Management Group

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The Goldman Connection, Part 2

By Bruce Wisemen

LIDDY

AIG
Perhaps nothing so demonstrated this scam as the government bailout of American International Group (AIG), the country’s largest insurance company. On September 16th, Paulson coughed up $85 billion of your tax dollars to take control of AIG. The $85 billion loan got the government 80% ownership of the insurance giant. Just what I always wanted from my government, a bankrupt insurance company.

It turns out the $85 billion wasn’t enough. AIG has continued to hemorrhage losses and Uncle has now poured a total of $182 billion into the insurance company.

Jefferson and Adams weep.

Sticky constitutional issues aside, many have found it more than curious that when the government granted the loan, AIG turned right around and paid it out to the investment banks to which it owed money. The bank that got the largest payout was… of course, Goldman Sachs – a cool $13 billion. The money simply passed from your paycheck to the US Treasury, from the Treasury to AIG and from AIG to Goldman (and other banks).

Of course, Paulson didn’t provide the loan without ensuring that Goldman and fellow banksters would be repaid in full. No, no. He made sure the transfers would occur without any objection from AIG or unseemly negotiations with the banks. To do this, he tapped Goldman Sachs board member, Ed Liddy to be the new CEO of AIG. The goodhearted Mr. Liddy took the gig for a dollar a year in salary from AIG. But he held on to his $3 million in Goldman stock.

Cute, eh?

Goldman made billions from AIG earlier as well. AIG didn’t know this. Neither did Goldman’s clients. You see, despite the fact that they had collected enormous fees selling financial products which were “insured” by AIG, Goldman simultaneously sold AIG short. You get this? On the one hand, they sold financial instruments to their clients, which carried high investment ratings because AIG insured the buyer against loss. At the same time, they made investment “bets” for their own account against AIG. Estimates are that they made $4.7 billion betting against AIG while selling the AIG guaranteed products to their clients.“Greed clarifies and cuts through and captures the essence of the evolutionary spirit.”
Gordon Gekko.

AIG behind him, Hammering Hank marched on.

LEHMAN BROTHERS

He had worked out strategies to have Bear Stearns purchased by JP Morgan in March of ’08 and had committed $200 billion to rescue Freddie and Fannie in early September, but when Goldman’s chief rival, Lehman Brothers, began to waver in mid Summer, he turned a blind eye. Lehman went bankrupt and sent the already declining stock market into a colossal rout. The next day, he helped arrange an $85 billion bailout for AIG.

Following Lehman’s collapse, Goldman and Morgan Stanley were the only remaining pure investment banks left on Wall Street.

THE BAILOUT
Congress was next.

The Four Horsemen of the Apocalypse have nothing on Paulson and his lap dog Bernanke’s assault on Congress. With threats of riots and martial law as they fear-mongered the Troubled Asset Relief Program (TARP) through the House and Senate - winding up with a cool trillion dollars to “save” the banks.

Congresses’ actions remind me of a bad Godzilla movie with masses of panicked Japanese citizens fleeing the fire-breathing monster who is lumbering through the city toppling buildings and devouring cars.

The legislation drafted by our elected officials sounds like something issued to Stalin by the Politburo. They granted Paulson complete dictatorial powers over the bailout money. The TARP read in part: Decisions by the Secretary pursuant to the authority of this Act are non-reviewable and committed to agency discretion, and may not be reviewed by any court of law or any administrative agency. Calling the multi-billion dollar bailout a “stimulus” program is but a cruel joke. This was nothing more complicated than a coup - a transfer of hundreds of billions of dollars from American taxpayers into the Armani clad arms of major Wall Street banks.

You won’t be surprised to learn, I’m sure, that Goldman Sachs got a cool $10 billion of TARP funds. And if you followed the billions pouring from your paychecks to Wall Street, you might remember that Bank of America at first received $25 billion. Then, in the midst of the chaos, they agreed to purchase Merrill Lynch. As it turned out, however, Merrill’s losses were $15 billion more than B of A had expected. This was due in part to $4 billion in bonuses paid out by Merrill’s CEO, John Thain, who pushed the bonuses through his books just before the Bank of America deal closed.

Bank of America was taken by surprise by the losses and the purchase of Merrill Lynch started to go shaky to which Comrade Paulson coughed up another $20 billion of your tax dollars. You guys are so cool bailing out these banks. I mean it. It brings tears to my eyes. Oh, I should mention that John Thain, the guy who pushed through the last minute billions in bonuses, had been the President and Co-chief Operating Officer at Goldman Sachs before becoming the President of Merrill Lynch.

ROBERT K. STEEL
TREASURY TO WACHOVIA

Another Goldman alum to drive his bank headlong into the merger-mania chaos of the financial crisis was Robert Steel. Steel had worked with Paulson at Goldman for 30 years and eventually rose to the position of Vice Chairman of the firm. He followed Paulson to the US Treasury in 2006 and became his top financial policy adviser. In July of 2008, he left the government and became the CEO of Wachovia bank, the sixth largest bank in the country.

How did he wind up at Wachovia? Three weeks earlier, Wachovia - who had paid Goldman Sachs $77 million in fees for financial advice - also sought their assistance in finding a new CEO.

Steel was the man. Three short months later, Steel struck a deal with Citibank to buy Wachovia – a deal that required hundreds of billions in loan guarantees from the government. Then he changed his mind and sold Wachovia to Wells Fargo without the government involved and became a member of the Wells Fargo Board of Directors.
According to Taibbi’s article: “Robert Steel, the former Goldmanite head of Wachovia, scored himself and his fellow executives $225 million in golden-parachute payments as his bank was self-destructing.”

Other articles claim that Steel himself did not take a bonus.

Regardless, you have Goldman getting millions in fees to advise Wachovia on, among other things, the selection of a new CEO, who, it turns out is a former Goldman Vice Chairman. Nothing illegal about it, but the financial incest begins to smell pornographic.

NEEL KASHKARI
TARP FRONT MAN

Paulson is nothing if not thorough. While he ultimately called the shots, he brought in someone else to oversee the allocation of the TARP funds and take the Congressional heat. This was thirty-five year old Goldman Vice President, Neel Kashkari who, as the head of the Office of Financial Stability at Treasury, was in control of the $700 billion in bailout funds. It was Kashkari who had to testify about the TARP to Congress - a hot seat whose temperature started to soar shortly after Paulson’s scam began to dawn on the legislators.

THE TAKEOVER

There were others. In fact, Paulson brought so many former Goldman executives to Treasury the New York Times noted the “…appearance that the Treasury Department has become a de facto Goldman division.”

These included:

Reuben Jeffrey

Dan Jester

Steve Shafran

Kendrick Wilson III

Edward Forst

Current or veteran Goldman executives all, they worked on everything from the bailout of Fannie and Freddie to the capital restructuring of the nation’s banks.
All of which makes Andy Borowitz’s article in the Huffington Post this month all the more understandable. The lead reads: In what some on Wall Street are calling the biggest blockbuster deal in the history of the financial sector, Goldman Sachs confirmed today that it was in talks to acquire the U.S. Department of the Treasury.

No surprise that the first two people I showed the article to thought it was real.

JOSHUA BOLTON
THE WHITE HOUSE

Paulson and his Goldman gladiators also had air cover from the White House. George Bush’s Chief of Staff during the bailout blizzard was none other than Josh Bolton. Bolton had become Chief of Staff in April of 2006 and is credited with persuading the President to recruit Paulson as the Treasury Secretary.

No surprise since Bolton had been the Executive Director, Legal & Government Affairs for Goldman Sachs International before joining the Bush 2000 presidential campaign.

Powerful friends. Powerful places.

But the Goldman virus has not been confined to the White House and the Treasury, not by a long shot.

Final installment to come.

Bruce Wiseman
Bruce Wiseman is financial consultant and writer living in Los Angeles. He can be contacted at the address below.
bruce@brucewiseman.net
www.brucewiseman.net
© 2009 Bruce Wiseman.
All rights reserved.

More on the Sources of the Financial Crisis - Part 1

2009-09-11T16:02:00.000-07:00

Some time ago, I presented a several part article on our blog page concerning the financial crisis that has engulfed the nation and planet. It was written by Bruce Wiseman and provided some fascinating and gut wrenching information about the people, actions and organizations that led to the meltdown.

I recently came across some additional writings by Mr. Wiseman that sheds even more light on the American side of the bailout and who profited from it. Surprise, surprise...many of those who profited were also involved in creating the mess! I think you'll find the information in this four part blog extremely interesting.

I invite you to share any thoughts you may have on this post. You can do this by clicking on the "comments" link directly below this post.

Larry Silver
President, Silkin

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Larry Silver
President, Silkin Management Group

THE GOLDMAN CONNECTION

by Bruce Wiseman

There will be a war. I’m certain of it.

No, not with Iran, though I’d like to introduce Mahmoud – I refuse to wear a neck tie under any circumstances – Ahmadinejad to a woman I met several years ago. She and her twin sister had been experimental subjects of Nazi madman, Dr. Joseph Mengle. Mengle had tried to change the color of their eyes with dye. The woman was blind. Her sister died at Auschwitz.

Mahmoud, who thinks the Holocaust was a hoax, forgot to pay his brain bill.
And they are a few clowns short of a circus in Pyongyang. Still, I don’t think the Chinese will let Kim Jon Il and his newly appointed secret police chief son, Kim Jon Un, drag the West into a military confrontation on the Korean peninsula. It’s a little too close to home and a Korean War II is not part of Beijing’s master plan.

At least not yet.

No, this is a war brewing between two iconic American institutions that couldn’t be more different: the voice of America’s rock culture, Rolling Stone Magazine, and the country’s premier, Armani clad investment bank, Goldman Sachs.

Rolling Stone recently published an article called The Great American Bubble Machine, a masterful expose by Matt Taibbi revealing Goldman’s greed and corruption in the creation of several investment “bubbles” that have made the firm and its partners – the term “filthy rich” comes to mind – but that have been devastating to Americans and to the US economy.

I rarely use those two words together. I have no problem with people making money – barrels of the stuff. Boat loads. But this needs to be done with some sense of ethics. Some sense of morals. Some sense of responsibility toward one’s fellow man. I was informed that Goldman is preparing a response. One wonders if the Wall Street veneer will crack: if they’ll come out with their pinstripes pressed or PR guns blazing trying to marginalize Taibbi.

As those of you who have followed my recent articles on the financial crisis know, I have pointed out the all too coincidental participation of Goldman executives in the creation of the financial crisis. Machiavelli himself would be proud of what has been nothing less than a coup d’etat of the planet’s financial systems. The Guys from Goldman have played their part.

While I have previously drawn attention to a few of the key figures, Taibbi has peeled the onion on several of the investment bank’s schemes and has also laid bare the army of Goldman alumni that have turned up at critical decision points in the universe of credit, investment and finance.

His orientation was such that he omitted a few that I will cover below. But the article is exhaustively researched and ties Goldman to everything from the Great Depression to speculation in oil futures before last year’s election that sent gas prices to $5.00 a gallon here in the land of many freeways. My focus, on the other hand, has been exposing the actual cause of the worldwide financial crisis. And our paths have crossed at a few key junctures.

Junctures that bring to mind the great Gordon Gekko - Michael Douglas’ character in Oliver Stone’s Wall Street. Preening in front of the Board of Directors and up and down the aisle among the shareholders of Teldar Paper, Douglas shares the philosophy of the successful investment banker as if handing down commandments from Mount Wall Street: “Greed is good. Greed is right. Greed works. Greed clarifies and cuts through and captures the essence of the evolutionary spirit.”

Yeah, Baby.

But is it more than greed? Are Goldman Sachs alumni part of a broader agenda that has not only lined their pockets with the spoils of corruption that Taibbi has exposed, but has also helped facilitate an international financial coup – a coup that has put the control of the planet’s financial affairs into the hands of small group of central bankers that hold secret meetings at what is nothing less than the Vatican of international finance – The Bank for International Settlements located in Basel, Switzerland?

If you’ve had a suspicion that bankers are running Washington, then hang on to your Calvins because while it starts in DC, this story is global in reach and is rolling out before your eyes – if you are willing to look.

ROBERT RUBIN

I could start this part of the story with Henry Fowler, who, after serving as the 35th Secretary of the Treasury, in 1969 became a partner at Goldman after leaving office. But that’s not how things worked in the nineties and beyond. Oh no. The current sequence is very different.

Pictures of Robert Rubin always remind me of the cartoon character, Droopy. He seems to be in a perpetual state of sad worry. Hard to know what he’s worried about, having received $50 million in compensation from his last employer (CitiBank). Perhaps it’s because the financial website Marketwatch recently named him as one of the "10 most unethical people in business."

More to the point of our story, having served 26 years with Goldman Sachs, ascending to the position of Co-Chairman, Rubin came to Washington with the Clinton Administration, as the Assistant to the President for Economic Policy. Bill must have dug the Wall Street touch, because in January of 1995, he appointed Rubin the 70th Secretary of the Treasury of the United States.

This could be called the start of the modern era of what the New York Times has referred to as the modern era of Government Sachs.

The hallmark of Rubin’s years in Washington was deregulation - specifically, deregulation of the financial industry. Turn the financial industry loose. Let the big dogs eat. Let them earn. They have Porsche payments to make.

Working with Greenspan, he kept interest rates implausibly low and ensured that regulatory safeguards were gunned down like victims in an LA drive-by shooting. The Glass-Steagall Act is a prime example. A piece of depression era legislation that kept investment banks and commercial banks from committing fiscal incest, it was repealed - charged with being out of touch with the global financial structure. What it was out of touch with was an agenda to open the floodgates to unbridled speculation by banks that set the industry up for a financial Hiroshima.

It takes a great deal of power and influence to get a federal law repealed in this country – especially one that has served the country well for 70 years. But Rubin, with a little help from his friends – Larry Summers and Alan Greenspan – got it done.

These and other similar actions helped pave the way for an economic crisis that would soon engulf the entire planet.

“The housing bubble has burst. The financial services industry is a ward of the state. Insurance companies and automakers are tottering on the brink of bankruptcy. Consumer credit is drying up along with consumer confidence. Banks have stopped lending money, and big corporations have started laying workers off. The stock market is at a five-year low. But amid the greatest financial panic since the Great Depression, the market for one asset stubbornly resists correction: the immaculate reputation of Robert Rubin, former treasury secretary and pre-eminent economic wise man of the Democratic Party. But the financial deregulation that allowed markets to boil over began well before President George W. Bush took office. Three decisions relevant to the market meltdown…can be attributed to Rubin.” By Timothy Noah, Robert Rubin’s Free Ride.

MEXICO

Let’s set aside for the moment that when Rubin was Co-Chairman of Goldman, the firm underwrote billions of dollars in bonds for the Mexican government. When the Mexican Peso tanked a few years later, Rubin, as Secretary of the Treasury arranged a multi-billion dollar taxpayer bailout which, according to reports, saved Goldman a cool $4 billion. Kind of a dress rehearsal for Hank Paulson’s trillion dollar raid on the US Treasury which channeled tens of billions into the womb from which he came – Mother Goldman. But we’ll get to that.

Rubin did more than pave the road to a financial Armageddon with Maestro Greenspan. His spawn have helped ensure that the crisis came off as planned and that it was solved with the creation of a global financial dictator, who – prepare to be shocked - is also a Goldman alum. But, again, I’m getting ahead of myself.

THE ACOLYTES

Summers

At Treasury, Rubin groomed two protégés that helped craft the multi-trillion dollar financial bailout and that are today in charge of US financial policy: Larry Summers and Timothy Geithner.

Summers, though not a formal Goldman alum, is a fully certified Rubin-deregulation clone. He was the Chief Economist for the World Bank in the early 90s and later served as Rubin’s Deputy Secretary of the Treasury. When the Rubin left, Summers took full control of Treasury for the last year and a half of the Clinton administration. Today, Summers is the Director of the National Economic Council, which means he is in the commanding position of being the senior advisor to President Obama on domestic and international economic policy.

Geithner

Geithner, like Summers, worked for Rubin at Treasury during the Clinton administration and was a Rubin favorite. He stayed on during Summers’ tenure and then snagged the powerful presidency of the New York Federal Reserve Bank. It was Rubin who got Geithner the gig at the New York Fed and it was Rubin who hooked him up with Obama, who appointed him as his Secretary of the Treasury.

In case there is any doubt about Geithner’s loyalties, it is widely known on Wall Street and inside the Beltway, that Goldman filed adoption papers on him years ago. In an interview on July 3rd, 2009 the Former US Assistant Secretary Of The Treasury, Dr. Paul Craig, was asked "Does the US Secretary of the Treasury work for the people or does he work for the banking system on Wall Street?" to which he replied "Geithner works for Goldman Sachs."

So, for those who thought that Rubin had left the stage of US economic policy, think again. Because not only has Rubin himself been named as an advisor to President Obama, but another of his groupies, Christina Romer has been named as the Chairman of the White House Council of Economic Advisors.

Even today then, Goldman’s former Co-Chairman is advising Obama behind the scenes and his acolytes are in charge of the US Treasury (Geithner), the White House Council of Economic Advisors and the National Economic Council. (The White House Council of Economic Advisors is made up of academicians who provide the President with economic statistics and other information on domestic and international financial matters [Romer]. The National Economic Council brings together key administration players and agency heads to coordinate and see to the implementation of the administration’s economic policy. The Chairman [Summers] is the President’s senior economic advisor.)

You’d think with this crew in place, Goldman would have had the White House covered. But Obama apparently went for their two-for-one sale. In addition to Rubin, another former Goldman Chairman, the controversial Jon Corzine, has been a top Obama economic advisor. In fact he was on the short list to become Secretary of the Treasury. But Rubin ruled and Geithner got the gig.

Given that Goldman employees gave more money to Obama ($994,000) than any other commercial enterprise in the United States, and that the White House is awash in Goldmanites, it is no surprise that 1600 Pennsylvania Avenue is viewed as one of the bank’s more important operating divisions.

PATTERSON

Even with the White House under control, Geithner beefed up his G-man staff at Treasury. He named yet another Goldmanite as his Chief of Staff. Mark Patterson was selected to help him run the government’s financial circus. Patterson gave up his plum position as the Vice President for Government Relations at Goldman -meaning he was the investment bank’s chief Lobbyist - to become the number two man at Treasury.

I know, I know. Obama said no lobbyists in his administration, but well, Mark is family. Sort of a fiscal fraternity brother – Alpha Delta Goldman.

PAULSON

But before Obama was Bush. And with oh-so-propitious timing, before the news of the financial crisis began to go mainline in 2007, a new Goldman CEO descended from his throne on Wall Street to come to Washington and help his government manage the nation’s financial affairs.

We love you, Hank.

Viewed from the boardrooms of Wall Street, Henry Paulson’s blitzkrieg of the nation’s capital was nothing short of stunning: A George Patton in pinstripes – except Patton was fighting a real enemy, not one that he, himself, had created.

LIAR, LIAR PANTS ON FIRE

At first, he used PR spin to calm the multitudes. As the crisis began to unravel, in August, 2007 Paulson assured the American people that the subprime mortgage problems were nothing to be concerned about, that they would remain contained due to the strong global economy.

Reuters - U.S. Treasury Secretary Henry Paulson said on Wednesday that the market impact of the U.S. subprime mortgage fallout is largely contained and that the global economy is as strong as it has been in decades.

Not.

The stock market peaked two months later followed by a crash that wiped out trillions.

In July of 2008, after the fall of Indymac bank, Paulson told the public that the banking system was safe and sound and that the situation was very “manageable.” Twenty-five banks failed in 2008. Sixty-four have gone under in the first six and a half months of 2009. Another 309 are now listed as “problem banks.”

In fact, according to FDIC Chairman, Shelia Bair, in March, 2009, unless the FDIC gets more revenue, they themselves are going to be broke.

“Without additional revenue beyond the regular assessments, current projections indicate that the fund balance will approach zero." In a television interview on Meet The Press on August 10, 2008, Paulson stated that he would not be putting any capital into Fannie Mae or Freddie Mac. Three weeks later, he took them over and committed $200 billion in bailout funds. $60 billion has already been spent. When I was growing up, we’d call this kind of guy a “bullshit artist.” But that didn’t stop him from staging a raid on the US Treasury in broad daylight that would have made Dillinger weep with envy. This, while Congress – a Democratic Congress at that - stood around with their thumbs up their butts.

Written by Bruce Wiseman
© 2009 Bruce Wiseman.
All rights reserved.
www.brucewiseman.net

MORE TO COME IN THE NEXT BLOG

Increasing Compliance to Treatment Plans is a Quick Way to Increase Practice Income

2009-05-06T15:09:00.000-07:00

Are You Getting Enough Compliance to your Treatment Plans?

We have found over the years that one of the most rapid ways to increase practice production is to increase patient compliance to recommended treatment plans. This increase in production can be done without increasing the number of new patients. A minor 10% increase in compliance can result in tens of thousands of dollars of additional production and income with no change in overhead. The biggest single factor in increasing patient compliance is the doctor's ability to properly present treatment plans to the patient. Below you will find some helpful tips along this line.

Treatment Presentation Tips

A sale is an exchange whereby all parties involved receive something of value. In health care professions, a patient/client receives care to remedy a health problem and/or to maintain good health. In exchange for the work done, the staff and doctor are paid. A successful practice has doctors and staff members in it who care enough to sell patients exactly what they need.

The doctor's role in the sale cycle is to diagnose and plan treatment for the correct care. Without that, there would be nothing to sell. Does this sound easier than it actually is? Most doctors would say "yes".

From working with doctors for over 25 years, we've isolated many common mistakes doctors make when presenting treatment plans. Three of those are covered below.

Convincing vs. Selling

Convincing people they need to buy something is different than selling them on an idea, service or product. Selling is really nothing more than obtaining agreement. A patient/client who understands the treatment needed, agrees that it needs to be done and commits to doing it is the result of a successful treatment plan presentation. In an attempt to convince a patient/client to accept a plan, doctors often talk too much which, in most cases, works against them. Don't overwhelm your patients/clients with information or with too much communication.

Plan A vs. Plan B vs. Plan C

Do you give your patients/clients too many choices? Your patients/clients don't know what's best for them. They rely on you to tell them what they need. If you don't do that, but give them a choice between Plan A, Plan B or Plan C, the patient/client will naturally ask the cost of the different plans and select the least expensive one. Asking someone to make a choice between a $600 plan, a $350 plan and a $195 plan can even cause suspicion. The patient/client may wonder why you would do a $600 plan if a $195 plan will suffice. Don't let the patient/client decide what he/she needs or what is best for them. That's your job. You are the professional and should give your professional opinion as to what is the right thing for them to do.

"Maybe" vs. "You Need"

As mentioned, you know what your patients/clients need in order to be in good health now and in the future. You spent years and years and years in school learning this. However, when discussing treatment with patients/clients, doctors will often "water down" the presentation. Phrases such as "I think" or "Maybe it's a good idea" instead of "You need" create uncertainty in the patient's/client's mind. If a patient/client needs a specific treatment that may be costly, and this is presented to them with obvious hesitation, they will follow your lead and get the idea that it's an optional treatment. They may not understand that it's vital to their well-being. When you have confidence in the treatment you're providing, you don't need to back off from stating it with certainty. Your patients/clients will appreciate your sincerity, honesty and competence. A very successful application of this concept is to say, "If it was my situation, I would do....". As long as that is the truth, and you say it with sincerity and certainty, the patient/client will follow your lead.

Try following the above tips and I think you'll find an increase in your patient compliance to the treatment plan you present.

We invite your feedback to this blog. Feel free to comment by clicking on the "comments" link below this post.

Larry Silver
President, Silkin Management Group

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WHAT ACTIONS SHOULD YOU TAKE DURING THIS RECESSION?

2009-03-13T10:54:00.000-07:00

I mentioned in my last blog that I would give you an article we wrote several months ago for our clients and prospective clients that addresses both a viewpoint and specific actions one should be looking at during tough economic times like these. We feel that it is still relevant, even if written some months ago. If you have any feedback on this, let us know by visiting our discussion forum at: Facebook.

Larry Silver
President, Silkin

Not a day goes by without more information coming to light regarding the economic situation we are all experiencing in this country and around the world.

It is very clear that we are now seeing the very obvious signs of a national recession, despite whatever spin may be put on it by the politicians from both sides of the aisle. This crisis is not limited to the finance sectors or the housing market and is effecting many people and numerous businesses. It is likely to get worse before it gets any better, and as the economic problems go deep, it could possibly be as much as a decade before we’re able to fully recover.

That’s what’s happening today.

Silkin has worked with health care professionals for over 25 years and during that time, we’ve seen several periods of economic difficulty with different names attached to them. Some called them recessions, some called them "stagflation", as well as a variety of other names. Whatever cute label one wants to attach to tough economic times, there is no fooling people with the fact that the economy in general, and their specific economic situation is far from ideal. And today, some economists are stating that this is the worst economic situation since the Great Depression of the 1930’s.

During a recessionary period such as this we oftentimes see practitioners "tightening up", meaning they manage through fear, worry, and reduction. Promotional efforts are decreased and doctors often let go of staff. They may cut corners and consequently the quality of their service may begin to suffer. It’s a proven fact that doctors who act in this manner will begin to lose some portion of their patient base. This can make it a perfect time for doctors who don’t succumb to such thinking to capture more market share and increase their productivity.

Our clients generally thrive during recessions because they know what to do. They’ve learned how to manage their practices through objective means. They know how to effectively market without it costing an arm and a leg. We’ve been through three of these economic downturns/recessions and we’ve seen how our clients are able to take advantage of the situation rather than be the adverse effect of it. In fact, a recent survey of our clients showed that our clients who are trained and skilled in practice management have been increasing their productivity by 10% to 15% during those years the nation has been in recession. And this includes all socioeconomic areas of the country. This type of growth is generally not true for the average practice owner. In fact recent industry surveys have shown an average decrease of 10% to 15% for the average practice during the recessionary period we are now experiencing.

Our clients thrive because they are able to prepare for down economic periods. They make realistic plans based on objective data and systematically hire, train and monitor staff efforts in alignment with a business plan, marketing plan and financial plan. They know how to closely monitor all of the key areas of the practice and thus are in control of the practice. They know if they are understaffed or overstaffed, or if they have under utilized staff. They have efficient systems that keep "busy work" off their desks and don’t have a desk full of backlogged activities. This is called running good control over your practice. And that doesn’t mean, as some people think, that it results in not having fun at work or not having relaxed staff people or having people obsess constantly over profit instead of paying attention to people and service. It simply means that you know what is going on in your practice, that your staff know their jobs and work well as a team together and, because of that, you and your staff enjoy the work environment much more.

Objective systems are the components that allow staff people to remain calm and competent. When they know their jobs inside and out, it allows them to respond creatively to unique and unanticipated situations. It allows them to be calm and composed even when work backs up or the amount of office traffic increases greatly. Staff become accountable and self motivated because their work is measured by objective statistics. They are productive rather than just busy. Prior to the current economic situation, we have seen a large percentage of practices and businesses supported and inflated by the bullish economy. It normally does not take superior management skill to grow during such periods. Now that credit is less available and people have less disposal income, it becomes obvious which offices have the management skill and resulting infrastructure capable of handling the change. It isn’t enough to do the same old thing. Every income source must be maximized and must be maximized with the best interest of the patient in mind. Staff must be able to communicate the importance of delivering the highest quality of care without seeming to be solely motivated by profit.

Everyday we work with practice owners to put together proper business, marketing and financial plans and help them properly implement those plans in a time frame that allows the creation of a stable infrastructure. We do this so practice owners are able to grow and thrive in a sane manner, during either good times or bad. To survive any activity, you must be trained and knowledgeable in that activity. You wouldn’t be an effective doctor if you weren’t adequately trained in your profession. It is no different in terms of managing a practice.

The business environment is very tough right now. The better you are trained in practice management, the better you will be able to not only survive this economic crisis, but to actually be able to expand during these difficult times. You can accomplish this if you approach management training with the same dedication as your professional training. That's what Silkin does. Feel free to contact us if you wish to discuss this further. We can be reached through our website at: www.silkinmanagementgroup.com, or emailing us at info@silkinmanagementgroup.com, or calling 800-695-0257.

THERE IS FISCAL SANITY IN MISSOURI: You can do the same.

2009-03-03T14:11:00.000-08:00

In my never ending reading and research to keep up to date on what is going
on with our economy and the myriad of solutions being presented, I ran
across this facinating blog in BizJournals -
http://www.bizjournals.com/stlouis/stories/2009/03/02/daily17.html

The state of Missouri actually turned down $133 million dollars from the
Federal Government that is part of the stimulus package. No, they didn't
turn it down because their coffers were full - in fact their coffers are far
from full. The state is in just as much budgetary difficulties as most any
other state in the union. But what they so aptly observed was that taking
the $133 million required, with all the strings attached, a commitment to
further expenditures that they could not afford. They refused to take a
short term "fix" that would end in in further long term difficulties.
Hooray for the Missouri legislators for understanding that there truly is no
"free lunch".

This parallels an article I read last week about an ambassador from an
African country who stated boldly that she was adamantly against her country
continuing to recieve economic aid from the United States. She pointed out
that her country had been receiving this aid for decades and it had done
little to nothing to improve her country - rather she felt that it hurt her
country greatly. Why? Because there was no incentive for her country to
figure out ways for her country to stand on its own two feet and develop
their economy. A great deal of the money ended up in the pockets of the
rulers and little ended up helping the population.

These two stories reminded me of a basic management and financial philosophy
that we teach our clients: rewarding production will get you more
production while, similarly, rewarding lack of production will simply get
you more of the same. We teach and provide bonus systems for staff that
provide incentives for each staff member and the office as a whole to be
more productive. Done correctly we regularly see significant increases in
individual and office wide production and greater net for the practice
owner. Using these bonus systems we've seen entire staff's take trips to
Hawaii or Mexico with each staff member making more money and the
doctor/owner greatly increasing his net and take home. Everybody wins.
They win because production is being incentivized and rewarded. It works!

So, if you want to control your own economy during this recession, if you
want to provide your own economic stimulus package try implementing bonus
systems that reward individual and office wide production and you'll see
production increase.

We'd love to hear from anyone who has tried such bonus systems and hear what
has worked best for you. Feel free to post your comment below.

Larry Silver
President, Silkin

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It's all in the Details

2009-02-04T12:03:00.001-08:00

Do you have job descriptions and office policies in your office? If not, the attached article from USA Today shows you why not paying attention to the details of jobs can cause havoc in an office.
Supposedly Small Details Can Matter

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America's Small Businesses Struggling

2009-02-03T09:19:00.000-08:00

"While the financial difficulties facing large companies and the related job cuts make the headlines, America's small businesses are also struggling with the current economic environment," a recent Wells Fargo/Gallup Small Business Index report noted.

http://www.hispanicbusiness.com/entrepreneur/2009/126weak_economy_strangling_small_businesses.htm

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Getting the Best Insurance for Your Small Business

2009-01-30T12:59:00.001-08:00

Cost savings on any fixed expense is very important in these economic times. Here is some very useful information for how to shop for proper insurance coverage for your office.

Tips on Getting the Best Insurance for Your Small Business from smartbiz.com

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Alternatives to Laying off Staff

2009-01-29T11:24:00.001-08:00

If you are looking at reducing staff costs, here's a possible alternative to layoffs.
CNNMoney.com

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Help for Small Businesses

2009-01-28T11:08:00.000-08:00

President Obama's team is looking at helping small businesses, which would include health care practices, through small business tax breaks. This could be great news for small businesses during these tough economic times.

Baltimore Sun - Don't Derail Little Engine

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Ways to Cut Energy Costs

2009-01-27T10:20:00.001-08:00

Looking for ways to cut energy costs in your office or home? This article may help.

BusinessWeek/Today's Tip

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Businesses gave staff time for inauguration

2009-01-26T09:07:00.001-08:00

Did you use the inauguration of President Obama as a means to make your staff more of a team? Many businesses did.

http://www.post-gazette.com/pg/09021/943159-431.stm

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Help with Payroll Decisions

2009-01-23T10:13:00.000-08:00

Are you wondering, in these tough economic times whether to cut staff and payroll costs? There are a few things that are helpful to know when adjudicating this important economic decision.

http://www.salesandmarketing.com/msg/content_display/training/e3ied80d20a4b4691a4511cc62e7a5bff74

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Obama's plan to Rejuvenate the Economy: How will it effect you?

2009-01-22T11:40:00.000-08:00

Obama's plan to rejuvenate the economy and create jobs could positively
effect your practice, your ability to get new patients, and your overall
practice productivity - that is, if the plan works! Let's hope it does.

http://money.cnn.com/2009/01/12/news/economy/stimulus_101/index.htm?postversion=2009011214

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Should You Sell Your Practice?

2009-01-21T10:47:00.001-08:00

Are you looking at selling your practice any time soon? With the
economy in the shape it is in, now is not the best time go attempt this.

http://www.eweek.com/c/a/Midmarket/Small-Business-Sellers-Find-Few-Takers/

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Sentiment for small business success is the 2nd worst in 35 years.

2009-01-19T16:18:00.000-08:00

Sentiment for small business success is the 2nd worst in 35 years.
Owners of small businesses, which would include health care private
practices, are not optimistic about the economy at this point in time.
This can certainly effect attracting new patients and will require good
business acumen by all private practice owners.

http://www.reuters.com/article/ousiv/idUSTRE50C31Q20090113

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How to Survive Today’s Economic Times

2009-01-13T14:02:00.000-08:00

By Shaw Millerman

Not a day goes by without more information coming to light regarding the economic situation we are all experiencing in this country and around the world. It is very clear that we are now seeing the very obvious signs of a national recession, despite whatever spin may be put on it by the politicians from both sides of the aisle. This crisis is not limited to the finance sectors or the housing market and is effecting many people and numerous businesses. It is likely to get worse before it gets any better, and as the economic problems go deep, it could possibly be as much as a decade before we’re able to fully recover.

That’s what’s happening today.

Silkin has worked with health care professionals for over 25 years and during that time, we’ve seen several periods of economic difficulty with different names attached to them. Some called them recessions, some called them “stagflation”, as well as a variety of other names. Whatever cute label one wants to attach to tough economic times, there is no fooling people with the fact that the economy in general, and their specific economic situation is far from ideal. And today, some economists are stating that this is the worst economic situation since the Great Depression of the 1930’s.

During a recessionary period such as this we oftentimes see practitioners “tightening up”, meaning they manage through fear, worry, and reduction. Promotional efforts are decreased and doctors often let go of staff. They may cut corners and consequently the quality of their service may begin to suffer. It’s a proven fact that doctors who act in this manner will begin to lose some portion of their patient base. This can make it a perfect time for doctors who don’t succumb to such thinking to capture more market share and increase their productivity.

Our clients generally thrive during recessions because they know what to do. They’ve learned how to manage their practices through objective means. They know how to effectively market without it costing an arm and a leg. We’ve been through three of these economic downturns/recessions and we’ve seen how our clients are able to take advantage of the situation rather than be the adverse effect of it. In fact, a recent survey of our clients showed that our clients who are trained and skilled in practice management have been increasing their productivity by 10% to 15% during those years the nation has been in recession. And this includes all socioeconomic areas of the country. This type of growth is generally not true for the average practice owner. In fact recent industry surveys have shown an average decrease of 10% to 15% for the average practice during the recessionary period we are now experiencing.

Our clients thrive because they are able to prepare for down economic periods. They make realistic plans based on objective data and systematically hire, train and monitor staff efforts in alignment with a business plan, marketing plan and financial plan. They know how to closely monitor all of the key areas of the practice and thus are in control of the practice. They know if they are understaffed or overstaffed, or if they have under utilized staff. They have efficient systems that keep “busy work” off their desks and don’t have a desk full of backlogged activities.

This is called running good control over your practice. And that doesn’t mean, as some people think, that it results in not having fun at work or not having relaxed staff people or having people obsess constantly over profit instead of paying attention to people and service. It simply means that you know what is going on in your practice, that your staff know their jobs and work well as a team together and, because of that, you and your staff enjoy the work environment much more.

Objective systems are the component that allow staff people to remain calm and competent. When they know their jobs inside and out, it allows them to respond creatively to unique and unanticipated situations. It allows them to be calm and composed even when work backs up or the amount of office traffic increases greatly. Staff become accountable and self motivated because their work is measured by objective statistics. They are productive rather than just busy.

Prior to the current economic situation, we have seen a large percentage of practices and businesses supported and inflated by the bullish economy. It normally does not take superior management skill to grow during such periods. Now that credit is less available and people have less disposal income, it becomes obvious which offices have the management skill and resulting infrastructure capable of handling the change. It isn’t enough to do the same old thing. Every income source must be maximized and must be maximized with the best interest of the patient in mind. Staff must be able to communicate the importance of delivering the highest quality of care without seeming to be solely motivated by profit. Everyday we work with practice owners to put together proper business, marketing and financial plans and help them properly implement those plans in a time frame that allows the creation of a stable infrastructure. We do this so practice owners are able to grow and thrive in a sane manner, during either good times or bad.

To survive any activity, you must be trained and knowledgeable in that activity. You wouldn’t be an effective doctor if you weren’t adequately trained in your profession. It is no different in terms of managing a practice. The business environment is very tough right now. The better you are trained in practice management, the better you will be able to not only survive this economic crisis, but to actually be able to expand during these difficult times. You can accomplish this if you approach management training with the same dedication as your professional training. Silkin Management Group can help!

We have been successfully training doctors in practice management for over 25 years. We offer a complimentary practice analysis for those who are interested in finding out the strengths and weaknesses of their practice and what steps they can take to improve any undesirable practice situations. Through this process you’ll be able to discover where and how improvements could be made that would result in more production, more profitability with less stress. Be sure to let us know if you are interested in scheduling an analysis and we’ll work with you to make the arrangements.

www.silkinmanagementgroup.com
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Steps to Safeguard Your Practice against Embezzlement

2009-01-13T13:59:00.000-08:00

Note from the editor:

In our first issue of Solutions Magazine, we published an article entitled "Steps to Safeguard Your Practice against Embezzlement."
As our research staff continues to discover that this issue is still prevalent with doctors nation-wide, we are re-visiting this same article with additional advises.

Minimize the Risk

More than likely, you've heard some horror story about a colleague who had a trusted employee embezzle money from him/her. There are steps you can take to minimize the risk of embezzlement.

The following procedures are recommended by an accountant and should be part of your normal routine as safeguards against embezzlement:

Cash Handling:
1.Firm policy that every patient/client gets a receipt whether they pay or not.

2.Cash handling and cash record-keeping duties need to be segregated. Have one person collect patient/client portions over the counter and another person post balances. Have a third person do bank deposits. As owner, play an active role in monitoring sales and cash if you have too few employees to fully separate the duties for handling cash and collections.

3.Each month, compare the amount of your collections that was cash. There will be some fluctuation, of course, but if it goes low one period, it is suspicious.

4.Start a patient/client sign-in sheet where patients/clients simply sign-in. Compare this on a daily basis to an over-the-counter-collections report (and day-sheet or equivalent), looking for inconsistencies such as patients/clients who are on the sign-in sheet but not listed on the day-sheet report. Spot check by phone call to patients/clients who are reported to not have paid a portion due that day. This can be done as a "quality control" call to the patient/clients. Of the questions asked one might be something like, "It's our policy that all patients/clients who pay any cash on the day of service receive a receipt. Did you receive a receipt today for any cash paid?" Implement this policy in writing and DO IT. This will make it far more dangerous to attempt embezzlement.

5.Have a written policy to conduct unannounced checks of petty cash and other cash accounts on a regular (bi-weekly or monthly) basis. Conduct these checks without fail.

Accounts Receivables and Statements:
6.Review your accounts receivable aging report monthly. Look for changes from the last month's report that don't make sense. Scrutinize any balance over sixty days old as its existence normally does not make sense and minimally means a dropped ball by someone if not hanky-panky on collections.

7.Have a written policy that no balance write-offs or account adjustments are permitted without written Doctor approval. If possible, consider a 'lock-out' (in your computer software) to allow ONLY the owner the ability to write-off balances.

8.Spot check day-sheets against patient/client charts, ledger cards (or patient/client account records) and the schedule book at least once a quarter, looking for any discrepancies. That you do this - sporadically - should be overtly promoted to the staff.
9.Routinely check with visiting patients/clients who have balances over thirty days old - and with past-due patients/clients you are calling - to ensure they've received a statement from you. The idea here is to look for incidents of the collections person throwing statements out versus mailing them in order to cover a payment embezzlement.

10.Become suspicious if you find you are all of a sudden paying a lot of refund checks to patients/clients.

Accounts Payables and Purchasing:
11.Ensure all expenditures are authorized (via written request) and documented.

Safeguarding Records and Miscellaneous:
12.If using paper day-sheets, then remove these day-sheets from the office each quarter, and store them at home or in a safe deposit box.

13.Always change the locks immediately when a key-holding employee leaves employment.

14.The last thing to remember is to assume that if someone can rip you off, they will - and take steps to prevent it; and if your antenna goes up on some circumstance, you carefully check into it.

www.silkinmanagementgroup.com
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Search Engine Marketing for Doctors

2009-01-13T13:57:00.000-08:00

By Lisa Thayer,

GoldfishNetwork.com

Surveys show that over 80% of internet users find new web sites by using search engines.

The question that seems to be on everyone's minds today is "How do I get my website top placement on the search engines?" If you have a website, you may have found other websites above yours when you have looked for your site in Google. In order to answer the previous question, I need to give you a little background on the way search engines work.

There are two primary ways (out of many) that your website gets to the top of search engines: one is to pay for placement, the other is to market and design your website so that it rises up through the page ranks "organically" in search engine results.

Before I begin to discuss pay-for-placement online marketing, I have to get on my soap box and make a special announcement: If you glean nothing else from this article, remember this - having a baseline BEFORE you start paying money for advertising is imperative as is tracking results of an online marketing program. A baseline is the point at which you begin a marketing campaign so you can compare the effectiveness of the campaign.

Programs such as Google's AdWords and AdSense or Yahoo's Sponsored Search are good examples of paying for placement. Each search engine has their own individual fee structure. The price you pay to advertise in this manner depends on the "keywords" you choose and the competition for those placements. Keywords can be thought of as the words a person would type into the search box on search engines. They can consist of words, phrases, or alphanumerical terms. If you are spending your marketing budget on keyword ads, you need to choose your keywords carefully.

Using keywords that are overly broad such as "best dentist USA" can result in bringing more traffic to your website, but if you only have dental offices in California, that search probably won't result in a new patient. Conversely, choosing keywords that are overly specific might bring in too little traffic, like "veterinarians who graduated from Purdue in 1983". Keywords are so important in fact, that selecting keywords has become an industry all its own.

The two top search engines used by the general public are Google and Yahoo. Google and Yahoo also supply some of the smaller search engines such as AOL, My Space Search, Netscape, Alta Vista, etc. with their search results. In fact, if you added up the huge market share of Google it would account for almost 70% of all searches!

As previously mentioned, having a baseline BEFORE you start paying money for advertising is imperative as is tracking results of an online marketing program. You obtain a baseline by having your web designer add a tracking program/ code to your website. We set up Google Analytics on all of our client's websites.

Google Analytics (GA) is a free service offered by Google that generates detailed statistics about the visitors to a website. Its main highlight is that a webmaster can optimize his/her marketing campaigns through the use of GA's analysis of where the visitors came from, how long they stayed on the website and their geographical position. Users can define and track conversions, or goals. Goals might include sales, lead generation, viewing a specific page, or downloading a particular file. By using this tool, marketers can determine which ads are performing, and which are not, as well as find unexpected sources of quality visitors.
Many of my clients have asked, "Wait a minute…why is Google Analytics free?" The simple answer is that Google knows that if you have the information to make informed online advertising decisions, you will be more likely to advertise. And, since Google is the giant of the search engine world, chances are they will be able to earn your business.

Next time, I'll discuss spiders and crawlers and bots…oh my!

Lisa Thayer is owner of GoldfishNetwork.com, a website design and marketing company located just south of Portland, Oregon. GoldfishNetwork.com serves clients across the U.S. Lisa can be reached at 503-783-0440 or by e-mail: Lisa@GoldfishNetwork.com

Extending Credit: Tips to Control Your Accounts Receivable

2009-01-13T13:48:00.000-08:00

Assess the patient/client's credit worthiness before extending any sort of credit. Have them fill out a "credit application" (see sample in the Form section,) and verify the information supplied.

Always charge for any credit extended, using a monthly percentage or a flat service fee.

When extending credit of any kind, have the patient/client sign an agreement covering the terms of the credit. Ensure that they fully understand and agree to the terms of payment.

Monitor all accounts monthly so that you know who may be delinquent. Take immediate action on any account over 30 days past due. The older an account gets, the more difficult it will be to collect. Call the patient/client right away and make arrangements to bring the account current.

Flag past due accounts by putting a red self-adhesive dot on the upper right corner of the patient/client's chart folder. In this way it is easier for any staff person to see that the patient/client has a past due account and it will be more likely to get addressed.

Each day review the schedule for the next day so that you will be prepared to see any patients/clients whose accounts need addressing. Confer with the receptionist on anyone who will need to be seen after their appointment, or from whom the receptionist would collect over-the counter.

If a patient/client you had planned to collect from has forgotten his/her checkbook or does not have the agreed upon amount, the receptionist should contact the accounts manager or the office manager so that the matter can be addressed.

Patients/clients with delinquent accounts, who are not making an attempt to handle it, should be sent to a collection agency. Again, this should be done as soon as possible before the account gets too old to realistically expect payment.

Ensure that statements are accurate and are being mailed out every month on time and without fail. Utilize appropriate labels on the statements such as: "Thank you for your payment."

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You can't control the economy...

2009-01-09T12:44:00.000-08:00

You can't control the economy, but you can control your practice.  By: Ken DeRouchie  

I have recently been interviewing doctors around the country regarding how the economy has been affecting their practice and what they have been doing to keep their practice financially viable. I have found that many of the doctors I've spoken to have simply shrugged their shoulders and accepted the down-turn in the economy. Many say there's nothing they can do about the economy and, because of that, are producing less and making much less money. At the same time, most of them who feel this way have done little to nothing in terms of making any changes in the management of their practice to combat the exterior forces that are impeding the growth and solvency of their business.  This brings to mind an old saying: "If you always do what you've always done, you'll always get what you've always gotten". Simply put, if everything is changing around you and you don't change and adapt with it, you will be unable to combat the external forces - very real forces - that are slowing or stopping your practice growth. It is imperative that if you want to continue growing in the economic environment that we are all experiencing, you must be able to adapt the management of your practice to the current state of your area, your local economy, the changing demographics of your area, etc. Most practice owners can grow in a booming economy. We've seen that during good economic times. But only those who are have management skills, either inherently or through training, can adapt successfully to difficult times.  In August of 2007 I conducted a user poll on the Solutions Magazine web site in which 169 practice owners participated. The survey question was "The economy of the past 6 years has negatively affected my practice?". 51% of the doctors answered :yes".  I decided to follow this up with another user poll in November of 2007. 171 practice owners participated.  The topic of this was "When there are slow periods of the year, I …".  46% of the doctors replied that [they] "live with it until it picks up again"  24% of the doctors replied that [they] "do extra marketing/promotion to make sure we don't lose money"  16% of the doctors replied that [they] "schedule vacations at that time"  4% of the doctors replied that [they] "have a hard time making payroll"  11% of the doctors replied that [they] "wish there was something I could do to counter this"  You can see that only 24% of the doctors surveyed were actually doing something proactive to handle the slow periods! Obviously, you aren't in a position to change the country's economy, but you can , if you know how, make effective changes in your practice to combat slow periods.  Realize that the above surveys' were conducted prior to the recent economic collapse. I therefore conducted a third survey in the last few months in which 71 practice owners took part. Since effective marketing of a practice is essential during poor economic periods, I decided to ask the question "On your new patient/client forms, when you ask the question "How did you find out about our practice", what do you do with the answers?"  65% said [they] "Do Nothing" 1% said [they] "Enter it into a data base then nothing" 20% said [they] "Send a thank you card" 2% said [they] "Too busy to do anything with it." 11% said [they] "Use this info for future marketing campaigns"  As you can see, only 11% were doing something useful with this vital data!  From these 3 surveys I conclude that:

Many practices across the country are hurting from the effects of the economy.
Most of them aren't doing anything about it.
When they are getting new patients in they don't even bother to strengthen or further the actions that got those new patients in.

The ultimate result of all of this is most practice owners that are completely the effect of the economic environment and not in control of their practice.

  If this in any way sounds somewhat or a lot like what you are going through, read on. .  Things that you CAN control:  The following list includes links to articles written about specific areas in your practice that YOU DO have control over. If you are feeling a negative impact from the economy, I highly recommend that you hunker down and dig in. There's a lot of ground to cover here but you will find this time well spent.. You do NOT just have to shrug your shoulders and "live with it", you CAN take back control of your practice! These articles and others in this issue of Solutions can help you.  - Your appointment schedule - Cancellations/No-shows-rescheduled appointments

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Silkin Management Group Saves Dental Practices While Many Fail

2009-01-09T11:04:00.000-08:00

Lake Oswego, OR – Silkin Management Group (http://www.silkinmanagementgroup.com)

, a 25 year old health care practice management firm, saves dental practices in the toughest economic times since the 1930s with recommendations most failing practices ignore. Many very good and talented dentists are making the wrong business decisions and end up losing their practice.

“In recessionary times such as these, we see dentist/owner of stand alone practices tighten their belts in unhealthy ways. By this we mean that they get very worried and reduce their promotion,” reports Fred King, CEO of Silkin Management Group. “They may start letting go of staff and making do with fewer personnel.”

Current economic conditions seem to demand that dentists cut corners but this causes lower standards of service and patient care. When the quality of service goes down patients become unhappy and start looking for another dentist. Most patients already have some aversion to going to the dentist which magnifies the effects for this category of health care provider.

“This situation makes it a perfect time for dentists making the correct management decisions to capture more market share and increase their productivity,” explains King.
“We help dental practices know exactly what to do to in each economic cycle so they are making correct management decisions that continually grow their practice.”

For those dentists wanting to take advantage of these tough economic times but who don’t want to start with any financial investment, Silkin Management Group offers a 2 hour practice analysis at no-charge. All the dentists’ questions are answered by a veteran senior analyst. Silkin analysts have worked with dental practices in every part of the country. They have a wealth of experience and an understanding of the issues dental practices have to deal with on a daily basis.

Silkin Management Group Rescues Veterinary Practices As Many Hit Bottom

2009-01-08T15:57:00.000-08:00

Dec 08, 2008 – Lake Oswego, OR – Silkin Management Group (http://www.silkinmanagementgroup.com)

,
a 25 year old health care practice management firm, rescue Veterinary practices in the what is being called the worse economic times in 50 years with recommendations most faltering practices neglect. The great majority of veterinarians are held in the highest esteem by their clients, whether a small pet owner, equestrian professional or farmer, due to their medical expertise. Yet, many make poor business decisions and are losing their practice.

“In economic turn downs, such as the ones we are experiencing now, we see veterinary practices tighten their belts in unhealthy ways. By this we mean that they get very worried and reduce their promotion,” reports Fred King, CEO of Silkin Management Group. “They may start letting go of staff and making do with fewer personnel.”

Current economic conditions seem to demand that veterinarians cut corners but this causes lower standards of service and patient care. When the quality of service goes down clients become unhappy with their pet or animal’s care and start looking for another vet. That clients demand good animal health care is demonstrated by a 2006 survey of 50,000 pet owners that revealed almost all pet owners feel a strong human-animal bond. About 49.7 percent of survey respondents consider pets to be family, and 48.2 percent consider pets to be companions.

“This situation makes it an excellent time for veterinarians making the correct management decisions to capture more market share and increase their productivity,” explains King. “We help veterinary practices know exactly what to do to in each economic cycle so they are making correct management decisions that continually grow their practice.”

For those veterinarians wanting to take advantage of these tough economic times but who don’t want to start with any financial investment, Silkin Management Group offers a 2 hour practice analysis at no-charge. All the veterinarians’ questions are answered by a veteran senior analyst. Silkin analysts have worked with veterinary practices in every part of the country. They have a wealth of experience and an understanding of the issues veterinary practices face on a daily basis.

The Secret To Getting New Patients or Clients

2008-01-02T14:15:00.000-08:00

I have met with and helped hundreds of dentists, optometrists and veterinarians in my 8 years working for Silkin Management Group. One of the things that many of the doctors I met with wanted to know is “What is the secret to getting new patients?”

While there are many avenues to take when trying to get new patients and clients through both external and internal promotion, the most effective means is through referrals.

The reason referrals are so valuable is because word or mouth is both free and extremely effective. Your patients or clients speaking positively about your practice to people they interact with is a sure-fire way to increase the number of people walking through your doors.

The real problem with referrals is how to get your staff to successfully speak to patients or clients in order to get them to refer your practice to their friends and family. There is a right way to do this and a very wrong way. The information in this article will show you how your staff can successfully get patients to refer people they know.

The most important thing to know when asking patients or clients to refer your practice to their friends and family is that people contribute to expansion and growth. I’m sure you know examples of this, if a nice mall is built in a community other businesses and people move into the area. If a great new restaurant opens in an area people go to it and recommend that people go try it out. Those people in turn try it out and recommend it to their friends.

On the other hand it is important to know that the main reason people don’t refer their friends and family is that they are never asked to, or they just don’t think about it.

Keeping this in mind the proper way to ask a patient or client is the following:

“Hello Sue, how was your service? Great. Did you know that we are expanding? In fact we have hired new staff so that we can help better service our patients. We are also taking on more patients and if you have any friends or family who you think could be helped by [your medical field] care, have them come in for a consultation. Here are a couple of our business cards for you.”

Communicating it in this manner gives the patient or client the feeling that you are growing and puts the idea in their mind that they should recommend the practice. In addition, it avoids making the patient feel put on the spot or uncomfortable about having to give you names and numbers. Of course you will have to adjust this to your specific circumstances. If you haven’t hired new staff you don’t want to lie to your patients. You could find another type of expansion such as the purchase of new equipment, renovations, a new computer system, etc.

Here is an improper way to ask a patient:

“Hello Sue. Hey do you have anyone you know that needs [your medical field] care? We really would like them to come in if you do. Do you think you could ask them?”

You should have your staff practice correctly asking for referrals with one of your other staff or with you until they can do it easily and comfortably.

After that it is a matter of ensuring they do it and you should increase your new patients in no time!

Best of Luck,

Murray Marvin
Senior Analyst
Silkin Management Group

(If you find this information of use, find more articles and solutionsmags.com or at silkinmanagementgroup.com)

New Issue of Solutions Magazine Helps Boost Income

2007-12-17T09:37:00.000-08:00

The new issue of Solutions Magazine tackles the tough issues regarding all facets of practice finance. With issues such as Streamlining Your Collections and Collecting Past Due Accounts, it provides simple tools and advice that is relevant to your practice. Check it out at www.solutionsmags.com to see how you can benefit from the information.

Small Business Administration and Katrina loans

2007-03-27T10:36:00.000-07:00

If you are recovering from the hurricanes of the Gulf Coast, here is some new information from the Small Business Administration regarding loan disbursements. If you're trying to rebuild your practice, this may help:

SBA Fully Disburses 100,000th Disaster Recovery Loan to Gulf Coast

WASHINGTON – More than 100,000 disaster loans have been fully disbursed by
the U.S. Small Business Administration, totaling $4.8 billion to Gulf Coast
residents who suffered losses in the aftermath of Hurricanes Katrina, Rita
and Wilma, the agency announced this week. SBA has now disbursed three-
quarters of the total amount approved for borrowers rebuilding from the
Gulf hurricanes. Including loans that have been partially disbursed, the
agency has made full or partial disbursements on 98 percent of the net
approved loans, for a total of $5.3 billion.

Operational reforms in SBA’s disaster loan program rolled out last June
contributed substantially to the quicker disbursement of disaster loan
funds.

“Last summer we moved 1,300 staff and revamped their work flow, forming
teams that integrated loan processing, decision making and legal
functions,” said SBA Administrator Steven Preston. “We also contacted
90,000 borrowers in the Gulf to introduce them to the new process, while
creating more consistent dialog with our customers through the
implementation of case managers for each loan applicant. The full
disbursement of SBA disaster loan funds will go a long ways towards
rebuilding the region, one homeowner and one business at a time.”

Preston also said additional enhancements to the disaster loan program,
which include ongoing reform of the disaster loan process, improving
automation, and developing a detailed playbook for future large scale
disasters, are underway.

The SBA has approved a net of almost 120,000 disaster loans totaling $7.13
billion in the aftermath of the Gulf Coast hurricanes. The vast majority of
the remaining borrowers have drawn on some of their SBA-approved disaster
loans. Home loans disbursed in the region total $4.23 billion, while $1.16
billion has been disbursed to businesses.

The SBA makes low-interest loans to homeowners, renters and non-farm
businesses of all sizes following a Presidential disaster declaration.
Homeowners may borrow up to $200,000 to repair or replace damaged real
estate. Individuals may borrow up to $40,000 to cover losses to personal
property.

Non-farm businesses and non-profit organizations of any size may apply for
up to $1.5 million to repair or replace disaster damaged business assets
and real property. Small businesses that suffered economic losses as a
direct result of the declared disaster may apply for a working capital loan
of up to $1.5 million, even if the property was not physically damaged.

Disaster loan borrowers who have questions should call SBA’s Customer
Service Center at 1-800-659-2955, or send an e-mail to
disastercustomerservice@sba.gov. The Center handled over two million calls
in response to the Gulf Coast Hurricanes.

To learn more about the SBA’s disaster assistance program visit the Web
site at www.sba.gov/disaster.

New Issue of Solutions Magazine is online

2007-02-13T16:42:00.000-08:00

The newest issue of Solutions Online Magazine is available for viewing. The key practice management articles address achieving a higher net profit through proper collections. The issue also offers articles on conflict resolution by Daniel Bobrow of American Dental Company and dental fraud by Dr. Barry Levy.

Back to Blogging!

2007-01-29T14:35:00.000-08:00

After a year and a half hiatus, the Practice Management Blog is back into production. Many people who encounter this blog might not be familiar with Solutions Online Magazine, published by Silkin Management Group. There is a wealth of practice management information in that magazine and so I'll be publishing articles from there onto this blog on a relatively consistent basis.

Below is an article on possible ways to terminate an employee who no longer fits with your practice, this is not legal advice - always check with your attorney if you are ever concerned about the legal rightness or wrongness of a business decision:

TERMINATION OF AN EMPLOYEE

Of the many responsibilities of the office manager, having to terminate an employee is one of the most troublesome and difficult. Termination is the final step of investment protection, one in which the return on investment is wholly inadequate, justifying ending the investment. However difficult, it is part of the job and must be done in as timely and humane a manner as possible.

The materials that follow will help you make a better decision and, hopefully, provide face-to-face communication guidelines for handling the situation as confidently and gracefully as possible.

A major issue over which the office manager has a great deal of control and influence is whether the employee is motivated to fight back after being discharged, or will that employee simply move on to a new endeavor. We cannot forget that after the bad news is communicated to an employee, many thoughts rush through the employee's mind, provoking varying levels of feelings. These feelings about the situation, and how it was handled, determine if the employee will even call a lawyer and begin legal action against the practice. In other words, taking action against the practice depends on the employee's frame of mind and perceptions surrounding the entire termination process. Those perceptions are well within the ability of the practice to mold and influence.

How a termination decision is made, how the organization handles problems before termination, and how the news is conveyed face-to-face, all impact strongly on the employee's perceptions and consequent motivation to move on or to fight back.

MAKING THE TERMINATION DECISION
Deciding to terminate an employee is serious business for all involved. Considering the increase in litigation over terminations and the losses incurred by employers who have made unwise decisions, the termination must be based on a reasonably thorough assessment of the employment relationship. After all, that is what is being terminated, not merely the employee or the position.

Work is an investment relationship. However different or lopsided, the employee has invested something in the job and practice, and the practice has invested in the employee. Termination ends that investment. People don't abandon investments unless the return is unfavorable. Remember, the employee's investment is more risky (bills to pay; life to support), so he/she will have a hard time understanding why the company's "investment" is being withdrawn and this will present a greater challenge to the office manager to communicate.

BASIC GUIDELINES TO BE AWARE OF IN MAKING THE DECISION TO TERMINATE:

Protected Group: If the employee belongs to a protected group (minority), the likelihood of legal action is increased. Have all your documentation and facts clearly prepared.
Defensible Paper Trail: Make sure that the decision to terminate is backed in writing by specific, detailed documentation.
Risk Potential: Is the law clear or fuzzy regarding the facts of your case? Second opinions from labor lawyers are probably advised.
Public Image: Can your practice withstand any adverse public exposure through the spreading of the bad news in the community?
Organizational Culpability: A "failed relationship" usually has plenty of blame to spread around. To what extent has the practice "failed" the employee? Does the practice have a clear definition of its responsibilities to marginal or unsatisfactory employees?
Continued Damage Potential: Assuming the employee is not terminated and situation doesn't improve, can you stand continued "repeat performances"? What is at stake if improvement is not forthcoming?
Remaining Morale: Management credibility is really on the line in termination cases:

a. What impact would failing to terminate have on morale?
b. What impact would terminating have on morale?
Twelve Strangers: How would 12 people completely unfamiliar with you, your practice and the employee judge the termination? With the record you have, would they conclude the action was reasonable?
Consistency: How have like situations involving other employees been handled? If differently, what differences justified such treatment?
Shooting From the Hip: Are you just trying to get rid of someone you don't like or does the evidence justify dismissal?
Procedural Consistency: Have published guidelines for company disciplinary procedures been followed to the letter up to this point?
Skeletons and Pretext: Sometimes companies try to cover up the "real" reason for termination and offer something that sounds plausible. Cover-ups usually unravel at very inopportune times, like with investigators and judges.
Motivation to Organize: Terminations can impact on seeking representation for employees. Do all the factors guiding your decision and your company's termination policies provide adequate "protection" against the perception of unfairness?
Receptivity to Help: To what extent has assistance been offered and how has the employee responded? Demonstrated willingness to cooperate and improve? Evidence?
Influence of Personal/External Difficulties: Are there any off-job problems which, in not being resolved, create or add to on-job performance?
Track Record: Why consider termination now? Does the employee have a history or track record of problems or is this something new?
Undeveloped Potential: Does the employee have potential for success in another job or part of the company? Working for a different supervisor?
Pre-termination Conference: Having followed the pre-termination warning and gotten nowhere, have you talked with the employee and given full hearing to his/her side of the situation? Assuming the stories differ significantly, have you accounted for why the differences exist?

GUIDELINES TO FOLLOW WHEN TERMINATING

When to do it: The best advice is to communicate the decision as soon as possible to the employee.
Time of day: The end of the workday is preferable when everyone else has left; this saves embarrassment.
Witness: Do have a witness present. This offers protection as well as evidence that various things were or were not communicated.
What to tell others: Simply let your staff know that ____________ (name) is no longer with the practice. If anyone has questions, tell them it is company policy that they would have to ask the person themselves.
After the News: It is wise to escort the employee out of the practice or else the anger often present could result in some destructive actions; necessity depends on the person and particulars of the situation.
Reasons: An employee deserves the respect and the dignity of knowing why they have been discharged. To fail to communicate or to try to cover something up with the employee is sure to provoke more outrage on the part of the employee. Convey the reason very simply; do not engage in a long discussion about it. Communicate it with respect. However, you need to use caution in what you communicate; we are in a litigious society and you don't want to give them grounds for a wrongful termination suit.
Firing Your Friend: This is hard to do, but has the built-in trust that will allow communication between you and your friend to help them understand. This does require you to be tough, as it would not be good for you to continue to carry a friend in a job when their performance is disastrous.
References: The safest policy to use as your guideline is the work history, their statistics, their performance review results, written warnings and reprimands, etc.
When the Employee Begs: If an employee begs for a second chance, you have got to be tough and be willing to explain things, yet without the slightest indication that you don't stand by your decision.
Arguing The Reasons: Don't argue with the employee. Indicate that you have the specific documentation supporting the reasons. If, on the other hand, the employee's arguing convinces you something has been overlooked, then indicate you will check it out immediately or as quickly as possible.
Breakdown: Do nothing unless your safety seems to be at stake. Let the catharsis run its course, then resume appropriate discussions. If the breakdown continues, let the employee know that you understand and that you will give a moment to regain their composure before completing the meeting.
Written statement: Providing a written termination statement for the employee is a bold communication that relays your ultimate confidence in the matter. Understand that the written statement could become part of the legal record and must be clear and strong enough to stand up in a legal arena.

GOALS FOR A CONSTRUCTIVE FACE-TO-FACE TERMINATION
The person doing the termination will be less likely to get distracted by emotions if the goals are kept in the forefront during the process. Concentrate on what is being attempted, not just the fact that you have to convey bad news, and the anticipated fear and discomfort usually can be minimized.

Five goals could provide direction for communication when announcing the termination:

Convince It's Best For Everyone: If the guidelines for making a termination decision are followed, you will probably have a good termination. Most employees who are in trouble know there is trouble but for economic reasons just can't admit that a termination might be justified. They are usually quite unhappy in their work and, were another job to be readily available, would probably (maybe at least in their own minds) thank you for the termination.

In short, they know it's a bad relationship that is extracting costs that are probably even more troublesome. Your goal is to try to help them understand that larger perspective; the relationship isn't working out and should be terminated.
Minimize Possibility of Legal Action: How the employee is treated during communication of the termination makes a significant difference in his or her state of mind immediately following the announcement. In short, how employees are handled can encourage or discourage them to "fight back" or move on with their lives. You want them to "move on". Treat them with respect and understanding, yet firmness throughout the process.
Provide A Positive Exit; Build Self-Esteem: Few people are total washouts. Termination represents ending a relationship as opposed to indicating that the employee is a failure. Focus on this fact in an effort to make him/her feel worthwhile. Avoid anything that smacks of humiliation since you don't intend to decrease his/her self-esteem.
Minimize External/Internal Adverse Impact: Employees who are terminated usually have friends left behind; how you handle the termination can impact on the morale of those people. Your goal is to minimize injuring that morale. How you convey the bad news can demonstrate a caring, sensitive organization or one that is arbitrary, uncommunicative, and insensitive. The employees left behind will have perceptions one way or another. You want them to be positive.
Facilitate Orderly Departure: Tools, uniforms, etc., have to be turned in and various documents must be processed and signed. The employee's cooperation is needed to do this; therefore, communication must not give the employee an additional motive for obstructing an orderly departure.

THE FACE-TO FACE TERMINATION
Knowing that this is a "good" termination does not make the face-to-face encounter less difficult. It is intense. It is a task few people want, much less perceive as a constructive learning and growth experience for the employee. A reasonably humane, sympathetic attempt to end the painful encounter as quickly as possible is tempting.

However difficult, termination can be a relatively productive experience if handled properly, with finesse, tact and directness. Some situations will make the attempt at being positive, forward looking, and constructive out of the question. But the attempt should be made.

The ideas listed below offer ways of making the difficult encounter a reasonably productive one:

Indicate Intent - Be Direct: "Sally, the practice has made the decision to terminate your employment here (don't' say 'terminate you'). The decision has been reviewed, but we need to discuss a number of issues. I hope we can do so in a reasonably friendly manner. You have a right to be upset, etc., and I will understand."
Don't Apologize: Don't say:

"It's hard for me to do this" or

"I really hate to have to tell you this" or

"We have tried to help you, but it just hasn't worked" or

"You have left us no choice" or

"I'm sorry" or

"The doctor is making me do this."

All of these phrases just make matters worse and make the practice look cheap and blameless. They add fuel to the emotions already operating and serve no constructive or situation-strategic purpose.
Allow Ventilation and Catharsis: If the employee starts swearing, yelling, bad-mouthing, crying, etc., just sit there and don't respond. He / she needs that emotional release for any constructive discussion to take place later on. Do not be tempted to put your arm around their shoulder, pat them on the back, etc. These innocent actions could be misconstrued as sexual harassment, even female to female.
Explain Reasons Specifically: Don't say things like "poor attitude" or "insubordination" unless you can cite the specific behaviors. Generalized statements leave too much room for interpretations and argument. You don't want that now, so have the hard evidence or documentation in hand.
Avoid Counseling: Trying to help him or her understand "where he / she went wrong" is productive if placed in the context of how it could be avoided elsewhere in a future position. Anything short of such a context not only won't work, but probably will add to the employee's emotional upheaval, or even begging for another chance, saying they'll change.
Discuss Remedial Actions: Offer Direction: Tell him or her how to apply for unemployment compensation, vocational training for skill development - anything which gives the employee hope for the future. Indicate that although the relationship hasn't worked out, you still feel a social/moral obligation to try to help the person adjust to the situation.

The above are guidelines intended to help you in this area. It is not intended to be, nor is it, legal advice. You should consult an attorney on any specific legal problems that might come up with employee discharge

Hurricane Katrina Veterinary Support

2005-09-22T16:45:00.000-07:00

Just got this via e-mail:

OVMA e-News: September 2005News affecting OVMA members and the practice of veterinary medicine in Oregon.

Support the OAHF's Hurricane Relief Efforts for Veterinarians and Animals: How You Can Help
In response to the tragic effects of Hurricane Katrina, the Oregon Animal Health Foundation, the charitable arm of the Oregon Veterinary Medical Association, has established a disaster relief fund to support animal care and rescue efforts and to help restore veterinary services in the impacted areas. Tax-deductible contributions made to the OAHF's disaster relief fund will be forwarded to veterinary-related organizations in Alabama, Louisiana or Mississippi. The OAHF is a 501(c)(3) charitable organization; donations are tax-deductible as permitted by law. 100% of your donations will be distributed for disaster relief. No portion of your donation will be used for administrative costs.

*Checks: Please make checks payable to the Oregon Animal Health Foundation and write Disaster Relief Fund on the memo line. Send donations to: OAHF, 1880 Lancaster Dr. NE, Suite 118, Salem, OR 97305*Credit cards: To donate by Visa or MasterCard, please call the OAHF/OVMA office at 800.235.3502 during normal business hours.

For more information on the OAHF's contributions to the relief efforts, and how your clients can help, please visit: http://www.oregonvma.org/news/relief.asp.

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Assisting Veterinary Staff Displaced by Hurricane Katrina
In an effort to assist veterinarians, veterinary technicians and other veterinary staff affected by Hurricane Katrina, the AVMA is establishing a list of people and clinics willing to offer temporary employment and/or housing to these displaced individuals. These offers will be posted on the AVMA Web site. In addition, the AVMA wants to establish a database of displaced veterinarians, veterinary technicians and veterinary staff so it can assist these individuals with finding temporary employment or housing.

If you are interested in offering temporary employment/housing, e-mail vetcareers@avma.org or call Cindy Coy at (800) 248-2862, ext. 6683. Please put "Katrina" in the subject line of your e-mail and include your full name and phone number. The AVMA will contact you for more information.

Veterinary Practice News

2005-09-15T12:00:00.000-07:00

The September issue of Veterinary Practice News contains an article regarding employee manuals which mentions Silkin Management Group. The author of the article, Rebecca Sweat interviewed Vice President for Consulting Eric Korb and one of Silkin Management Groups' clients, Dr. Doug McInnis.

The article can't be read online unfortunately but you may be able to get a free copy from VPN. Or contact me directly.

Larry Silver
503-726-1810

Hurricane Katrina Dental Support

2005-09-08T11:49:00.000-07:00

Silkin Management Group has partnered with the Academy of Comprehensive Esthetics and genR8TNext in promoting a Hurricane Katrina disaster relief fund to help dentists and their staffs who have been displaced or who have had their livelihoods destroyed by the hurricane.

Below is a release I sent out regarding the fund:

Professional Dental Communities Coalesce to Help with Hurricane Katrina Relief

Academy of Comprehensive Esthetics, genR8TNext, Silkin Management Group and Others Join Forces to provide Hurricane Relief

Berlin, CT: Hurricane Katrina’s devastation is still being assessed and numerous groups are severely affected who will not be helped by governmental disaster relief. Many disparate professional dental groups, led by Dr. Mike Maroon founder of genR8TNext, have joined together to help dentists and dental professionals in Louisiana, Mississippi and Alabama who have had their lives disrupted and livelihoods potentially destroyed by Katrina.

Dr. Maroon, a founder of the Academy of Comprehensive Esthetics, has created the GenX/ACE Hurricane Relief Fund. The genesis of the fund was formed via online dental communities like genR8TNext, http://www.generationnext.com/ and Dental Town, http://www.dentaltown.com/ The GenX/ACE Hurricane Relief Fund has so far collected over $30,000 and is continuing to grow daily.

"We, as a dental community, need to pull together to help our colleagues. There are hundreds of displaced professionals throughout Louisiana, Mississippi and Alabama and they need our support." said Dr. Maroon.

Many groups have joined with Dr. Maroon and the GenX/ACE Hurricane Relief Fund in support of the victims of Katrina including Discus Dental, Silkin Management Group, Ultradent Inc., Heartland Dental Care, Coast Dental, and many individual dental practitioners all over the country.

To donate to the fund, contact Dr. Maroon at HurricaneRelief@genXACE.com or send a contribution check to Dr. Mike Maroon, 39 Webster Square Rd., Berlin, CT 06037, attn: Hurricane Relief Fund. More information can also be found at www.GenerationNext.com.

Dr. Mike Maroon is a Founder of genR8TNext and a Founder & Fellow of the Academy of Comprehensive Esthetics.