2011 Tax Changes That Impact Physicians

Guest post by Setu Mazumdar MD

The tax laws are changing in 2011. Here's how that will apply to you as a physician.

Recently I sent the following information to my clients regarding the 2011 tax law changes which are almost a done deal. Hope this helps you

You may have heard that a deal for 2011 tax laws is almost a done deal. I'd like to point out several things which will apply to you.

1. Federal income tax rates

Will remain the same as they are now for 2011 and 2012. However, we don't know what the cutoffs for the tax brackets are yet. It's unclear whether phaseouts for deductions on Schedule A of your income tax return will remain as is or will get worse next year. It looks like they will remain the same as now for the next 2 years. Obviously this is good news for high income taxpayers such as all of you.

2. Dividend and capital gains tax rates

Before this deal dividends in taxable accounts were going to be taxed at your highest rate, which was going to be 39.6% as of next month. However even the current dividend tax rate of 15% will stay on for 2 more year. This is also true for capital gains taxes, which were supposed to go up to 20% and instead will remain at 15% for 2 more years. If you have a taxable investment account, this will make it easier for me to rebalance portfolios since the cap gains rate will remain low.

3. Roth IRA conversions

I've already discussed and converted several of your traditional IRAs to Roth IRAs already this year. If you have not converted your traditional IRA to a Roth yet but are considering it, you may be OK doing it next year in order to defer paying taxes on the conversion. However, realize that by converting this year there is an option to spread out the income over 2011 and 2012 and that option is good ONLY for converting in 2010.

The other issue is that for those of you whom we've converted in 2010 already, it is probably more advantageous for you to spread out the income over 2011 and 2012 since tax rates will remain the same. Please discuss this option with your CPA when tax time comes. In other words instead of reporting the income on the conversion for 2010 only (this would be more advantageous if tax rates are going up next year) you may be better off reporting it in 2011 and 2012 in order to defer taxes to those years.

That brings up another issue—estimated tax payments. If your CPA plans on reporting this all in 2010, then adjust your 2010 Q4 estimated tax payment. However, if the plan is to split the income from the conversion in 2011 and 2012, then there may not be a need to adjust your Q4 estimated tax. Instead, you will have to adjust estimated taxes for 2011 and 2012.

And finally if you have nondeductible IRA contributions, remember that portion is not taxed on the conversion.

4. Estate tax

It looks like the estate tax exemption will be $5 million for 2011 and 2012. This changes things like whether to set up life insurance trusts. However, realize that this is once again a temporary rule and eventually this will change again in 2 years. So it may still be better to proactively address these issues rather than to address them later. But at least this might buy some more time.

5. Medicare investment tax is coming

For taxable investment accounts starting in 2013 there will be an additional Medicare investment tax on investments sold for a gain in addition to capital gains tax. This tax will be 3.8% on "high income" earners and will apply to both capital gains and dividends. This was part of the health care law passed earlier this year. Of course the details on this still have to be worked out.

Hope that helps put some of this in perspective. If you have any questions about this, please ask them as a comment and I'll do my best to answer them.

Setu Muzamdar MD blogs on physician investing and wealth management at Freelance MD

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Best Examples Of Bikini Line Hair Removal Advertising

It doesn't take a lot of thought to see where this is going. Sex still sells.

These ads are just a couple Wilkinson's ads for their bikini line razor that ran in the UK. I'm not sure they could get these on the air in the US and no reports here about how effecive they were, but they certainly grab your attention.

And another.

Bikini line laser hair removal is, if anything, growing in popularity. (Underarm / bikini line / lower legs are probably the top three. )

Here is A clever and funny print ad around the bikini line from Veet and a number of other bikini line ads for various products.

 

 

 

 

Defensive Medicine: New Survey

25% of every healthcare dollar spent with no purpose other than CYA defensive medicine and lawsuit protection.

Here's a quote from a survey about defensive medicine published by Jackson Healthcare that looks at defensive medicine and unnecessary testing.

The survey of more than 3000 physicians showed that 92% admitted practicing defensive medicine and that, based on physician responses, the annual estimated cost of defensive medicine in the US each year is $650 billion to $850 billion – accounting for $1 out of every $4 spent on US health care.

Of course, the physicians in the survey shouldn't be trusted since they're obviously biased and worried.

Instead, you should listen to the malpractice trial lawyers who have a much clearer opinion about why physicians order so many unnecessary tests and why 'defensive medicine' really doesn't impact the availablity of health care. Here's what lawyers think:

Lawyers who represent patients say one way to slash the exorbitant cost of health care would be to cut down on errors doctors make so that fewer cases wind up in the legal system. The American Association of Justice, an advocacy group for plaintiffs' lawyers, suggests that hospitals should more aggressively report mistakes and state medical boards should impose stiffer penalties on doctors who make them.

As a matter of public policy, it might make sense to spend less money as a society on unnecessary tests. But Jack McGehee, a Houston-based plaintiffs' lawyer, says it is difficult to convince ailing patients that their doctor should order fewer tests.

Ah the clarity that lawyers bring to an argument. It brings a tear to my eye.

While your cosmetic practice is probably not ordering tests, the same basic principals apply. Patients looking for vanity cosmetic treatments can be even more demanding of perfection since they're no expectation other than a perfect outcome.

Anyone have experience with this in a cosmetic practice?

Using LinkedIn As A Physician

One of the first key points of advice I have for physicians interested in non-clinical career expansion is get on LinkedIn.

Why?  Well, for one, it is a major player in the world of networking 2.0.  It has taken the place of the rolodex and become the place to present your professional presence online.  For physicians that have not begun networking, it is a great way to start expanding your circle of contacts from outside of your direct friends and colleagues, to those who are “friends of friends”, 2nd degree connections, and professionals interested in the same things you are.

For docs that are considering expanding into industry, I recently read that more than 60% of Fortune 100 companies use LinkedIn to save time and recruit/hire best candidates.  This means that recruiters from these organizations – some of the largest and most recognized in the world – are on LinkedIn every day to find and vet job candidates.  Hence another reason why you should be on it, and making the most of it.

Here are some ways to make your LinkedIn account work for you:

  1. Make sure that you have a comprehensive, detailed profile set up.  This is the first place people will look to get a sense of who you are.  You want it to be a solid overview of your professional direction, your accomplishments, and a snapshot view of what you “bring to the table”.  Make sure it includes a picture – professional picture only, so that viewers can get a visual of you.  And skip the personal details on your profile – there is no need to include your birthday, your home address, or your personal interests.  This isn’t Facebook!  Your professional  email and (optionally) your work phone number will suffice.  Make sure to check the box that you are open to career opportunities if that’s what you want to reflect.  And make sure you use keywords in your profile set up, so if someone (a recruiter perhaps) is searching for a “CMO”, you will show up in search results. 

  2. Make your profile (or most of it) public so that people who are not within the LinkedIn network can still view it without having to set up an account (although I don’t know why they wouldn’t!).

  3. Join Discussion Groups in your areas of interestDo a search under “groups” for keywords that you’re particularly passionate/knowledgeable about.  For example, if you search for “Healthcare IT” over 5,000 groups are listed!  Be particular, and sign up to join the ones you think would be best (i.e., have a large network, are reputable).  Joining a number of groups will keep you actively engaged with a strong network of people with similar interests, and it will also drive traffic to your profile.  

  4. Participate!  Once you’ve signed up for groups, go on them regularly to either post questions / discussion points, or to participate in dialogues going on over particular topics.  You’ll be amazed at what you can learn from other like-minded professionals.  You can also quickly build a reputation as a subject matter expert in your area of interest.  The key to success?  Contribute thoughtfully and intelligently – your answers become your online professional personae, and you don’t want to come across negatively.  If you post questions, make sure they are of a relevant, interesting topic that you think might be of use to the others in the group.  And if people answer, make sure to thank them.

  5. Don’t try to “sell”.  Add value instead.  One of the things I’ve seen be the kiss of death for peoples’ LinkedIn reputation is the “over-selling” of their products or services to their LinkedIn contacts or within their Discussion Groups.  The purpose of these forums is to network, and if networking is truly about building relationships and looking for strategic alliances, then the better approach is to simply add value.  You won’t need to puff up yourself or your products/services if you simply provide something – be it an opinion, a resource – that gives back to the people in your network.  If they find it useful they will come to you, usually by checking out your profile and seeing who you are and what you do. That is why having a “meaty” profile matters.

  6. Make connections.  Your network is a good reflection of your professional reach.  If you only show 5-10 connections, people don’t know what to think … that you’re a late adopter?  That you’re a technophobe?  That you don’t have any friends or colleagues?  At least 30-60 connections gives a much better impression for people viewing your profile, so the effort it takes to connect with others is worth it.

  7. Protect your network.  My rule of thumb is to connect with people that are either 1)  people I’ve worked directly with and are my “trusted colleagues” that I can vouch for, 2) people that I’ve met through networking events, conferences, etc., who I know fairly well, 3)  people that are work “acquaintances”, but who I am confident will be value-added members of my network, 4) people that are connections of my trusted colleagues, who basically have credibility by affiliation, or 5) people that are members of my trusted LinkedIn groups, based on the same reason as #4.  There are people who will connect with anyone and everyone simply to build their network and rack up numbers.  I am not that way.  Since I view my LinkedIn network as a trusted source of friends, colleagues and professional contacts – as well as a group that overall reflects upon my professional presence online – I make sure that I choose my connections wisely.

For a great series of articles on how to make LinkedIn work for you, see here:  http://linkedintelligence.com/smart-ways-to-use-linkedin/

And for those of you that are really new to LinkedIn (the majority of physicians that I talk to!), here is a real “how-to” for getting started :  http://www.dummies.com/how-to/internet/Blogging-Social-Networking/LinkedIn.html

 See you on LinkedIn!

Ashley Wendel is a physician coach and change management expert who blogs at Freelance MD.

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Are Doctors Terrible At Business?

You've heard it over and over again..."Doctors are terrible business people". I disagree.

Firstly, what do people mean when they say "businesspeople"? My definition is someone who runs a business and can sustain it profitably. Most docs I know who run their own practices (admittedly fewer and fewer as more gravitate to employed positions) do an admirable job keeping all the balls in the air, with minimal training, and seem to take home a paycheck every month.

Second, in addition to how successful physicians are as self-employed owners, the term "business person" also applies to physicians as entrepreneurs, leaders, and investors. Again, while lots of us suffered from the recent economic downturn with a hit to our pensions plans and investments, I haven't seen any evidence that docs did any worse than anyone else.

Finallly, there is considerable overlap between business skills and clinical skills-data acquisition and analysis, risk assessment, problem solving, interpersonal skills, accumulating "clinical judgement" i.e. learning from your mistakes, and lots of others. Docs inherently have business heads that overlap with their clinical heads.

People think doctors are lousy business people because practitioners place patient interests above the bottom line. The result is delivering services that don't generate a profit or inefficiencies in practice management. As more and more doctors pursue non-clinical interests, some for a profit, the unintended consequence and the good news will be a recognition of how good physicians actually are at business when that's the first priority. Unfortunately, it's also the bad news if you are looking for someone to manage your diabetes.

Arlen D. Meyers MD MBA is a professor and physician entrepreneur who blogs at Freelance MD.

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PrintMD.net - Medical Spa Marketing

Print MD.net is now live.

Print MD.net is our newest Select Partner and one that we've built ourselves to address a very specific need for medical spas and cosmetic practices: how to handle direct mail and marketing with professional design that doesn't break the bank.

Print MD.net is designed to do just that. It's a site that has everything you need, from postcards, business cards, appointment cards and posters, all professionaly created and integrated into 'campaigns'.

View all campaigns

Now you can have your business cards, posters, referral and appointment cards match, ensure the highest quality design and printing, and get the price break. Nice.

Oh, and you can enter your own copy, address and even upload your logo to customize your marketing materials just the way you want. Click here for a demo.

Since we're doing something of a rolling launch, I'll be posting here about how to use Print MD to the greatest effect, but take a gander through the campaigns and see if there's something you like.

I'd also love feedback on the designs, copy etc. so If you'd leave a comment below that let's me know what you think I'ld be most appreciative.

Service In Your Medical Spa

Your medical spa service is determined by what client's feel about it.

This weekend I was eating at one of my favorite restaurants when I noticed something different with the experience.

Usually, after ordering the waitress brings over a basket of magnificent, crusty rolls and cinimon butter. (They're really good and something everyone enjoys.) However, on this night our bread-basket arrived with just three rolls in the basket for a table of four.

When we inquired about this, the waiter informed us that the 'ration' had been cut in order to keep costs down AND prevent diners from filling up on free bread in the hope that they'd order more items from the menu.

I gues that's somewhat logical, but the effect that this actually had was very different. What could have been another great experience was overshadowed by this relatively small event.

This experience and some other posts I've read got me to thinking; there are times when we're all providing 'three roll service'. In the same way that this restaurant made a slight change that saved them a couple of dollars a day, and cost them many times more in lost business. Are are times when I drop the ball with the small things that people remember? I know that there are. Perhaps I don't call someone back as quickly as I could, or I don't take the time in an email exchange to pad the message with a sentence or two and it comes across as terse and angry.

There's a lot we can learn from a three-roll experience. It's always the small things that differentiate an experience.

Freelance MD - The Cure For The Common Physician?

Freelance MD is a new physician-only community for doctors that are looking outside of clinical practice.

We've started a new sister-site of sorts to Medial Spa MD... Freelance MD.

Freelance MD is an active community of physicians that gives you greater control of your medical practice, income, and lifestyle, even if you’re clueless about where to begin and you’re already working 80 hour weeks.

Freelance will cover a host of topics that don't really fit that well into Medical Spa MD like nonclinical medical careers, consulting for industry, wealth management and real estate investing for physicians.

Here's what one of the other founders, Greg Bledsoe MD, posted about Freelance MD and why we started it.

Now that our new community is up and running, I'm already being asked, "What is Freelance MD?"

Great question.

Freelance MD is a physician community site that was borne out of necessity. Physicians today are looking for ways to expand their careers and there is a dearth of honest, practical information for them to access.

I should know.

I am an Emergency Medicine physician who has practiced clinical medicine since I graduated from my residency in 2002. My career has had many twists and turns, but five years ago I set out on a personal journey. My quest was to build a career that was enjoyable, flexible, fun, and still covered my financial obligations. The question was, where do I start? How do I design a career like this? Were there others in medicine who were attempting to do the same thing and if so, where could I find these individuals and how could I learn from them?

I spent countless hours on the internet looking for answers. I spoke to colleagues, went to conferences, read books, interviewed friends in other careers, and still came up lacking. After months of searching, what I found was that there was no hub for physicians like me, no real place to begin. I was overwhelmed, not only because of my narrow medical training, but also because I didn't even know what questions I should be asking. I was concerned about purchasing products I did not need, or signing on for services that didn't work. I needed direction and a mentor, but when I looked around I didn't find anything but murkiness.

Over the course of the past five years I have spent literally thousands of hours developing the idea that has resulted in our Medical Fusion Conference and now Freelance MD .

The idea is to provide physicians with cutting edge information on everything they need to broaden their careers and make their lives more manageable. Our hope is that Freelance MD can become a resource for physicians looking for answers on anything from entrepreneurship to clinical practice management to investments to nonclinical careers and everything in between. 

In order for us to provide the best information, we had to assemble the best team to speak on the subjects about which physicians were interested in learning. Take a moment and review the bios of our authors. This group is an incredibly talented bunch who are passionate about teaching their skills to interested medical professionals.  We've assembled this group from word of mouth recommendations from trusted friends and colleagues, and we're excited about what they'll be teaching all of us on Freelance MD. What's even better is that even more authors are coming on board in the near future to add even more depth to Freelance MD.

In short, if you're a physician like me who is eager to expand their career, or simply a curious person who loves to continue learning, FreelanceMD is the community website for you. Our goal is to provide teaching and mentoring-- physician to physician-- to those who want to continue growing.  

So take a moment and check us out. Comment on our posts and recommend us to a friend. Together as physicians, we'll lock arms and begin moving forward together. It's going to be a lot of fun, and we'd really enjoy including you on the journey.

6 Signs For Physicians That Social Media Is Not For You

Here are the 6 signs that social media is not for you.

Social media is here to stay, and it's only going to grow. Facebook now has 500 million members and, unless you're in geriatrics, the majority of your patients are already on it. We sing the praises of physician/patient connection, but it isn’t for everyone.

(Note: While Facebook, LinkedIn and Twitter may not be for you, they're manditory for your medical spa or cosmetic practice.)

Here are 6 signs (for physicians) that social media is not for you:

1.  You hate what you do. Social involvement requires some degree of passion for what you’re discussing. If you’re unhappy at medicine and you’re generally an angry sort you might keep things to yourself. Unless of course you’re passionate about creating a community of angry doctors.

2.  You are a paranoid, risk-averse milquetoast. Every now and again I bump into a doctor who tells me about all the trouble I could be getting myself into. And they usually have a hundred ideas why I need to keep my door shut. Open dialog requires something of a leap of faith. In order to make any of this work you need to live without the looming belief that every post is a lawsuit-in-waiting. Tweet smart but understand the real risk-benefit.

3.  You work 170 hours a week.  Sure social media takes time. And yes, this can be a challenge if you work 170 hours a week. But there are some really useful ways you can be social as a doctor on a time budget. For starters, limiting your social properties and your connections. Small and real is better than nothing at all. I think I’ll stop there and turn this one into a post for tomorrow. Or the next day.

4.  You want to hire someone to do it. I recently tried to sell one of my fertility friends on developing a presence for himself.  He was really interested but at the end he winked and said, “Send me some info.  I’ll have my girls get on it.”  Oiy. Colleagues and patients want you, not your logo, office manager, or your “girls.”  If you can’t do at least some of it yourself you should reconsider doing it at all.

5.  You don’t need the patients. Boutique specialties see social as part of their personal branding strategy,  and for good reason. But let’s face it, unless you’re banding stomachs or peddling bioequivalent hormones, you’ve probably got your hands full with more than enough patients.  Internists don’t think about their personal brand, footprint or outreach. What they do think is how their going to keep the lights on after the Government slashes Medicare.

6.  You don’t want anyone to know what you think. Admittedly, public dialog done right requires some degree of disclosure. If you’re averse to anyone knowing what you are thinking, what you believe, or what (God forbid) you may be passionate about, you may just as well hide securely under your exam table and leave the dialog to the rest us.

But in the end, you may not have a choice. When Bryan Vartabedian MD, a pediatric gastroenterologist at Texas Children's Hospital/Baylor College of Medicine who writes and thinks about the convergence of social media and medicine crowdsourced suggestions about this on Twitter, a point was made that the use of social media is becoming no longer optional. It is, as the reply put it, “a mandatory transformation in order to evolve as a society.”

Now I can’t beat that.

Talk amongst yourselves.

Bryan Vartabedian, MD  is a pediatric gastroenterologist at Texas Children's Hospital/Baylor College of Medicine who writes and thinks about the convergence of social media and medicine at 33Charts.com

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Physician Entreprenurs & Cosmetic Medicine

The Medical Fusion Conference was held this last weekend in Las Vegas.

A number of the physicians that I've interviewed on the Medical Spa MD Podcast were there as speakers, and a number of physicians that I met at the conference are going to be on the podast.

The Medical Fusion Conference is still relatively small. I think there were less than 100 physicians attending.

(There were a few Medical Spa MD Members that I got to say hello to which was very nice. I didn't come close to going bankrupt with my offer to pay for a month of Frontdesk SEO oursource marketing services which I think of with somewhat mixed blessings.)

I'd attended the conference for a number of reasons; Medical Fusion is one of our Select Partners, I wanted to find out what value the conference held for physicians, and I wanted to guage the reaction of the physicians who attended.

Across the board it was all positive. Every physician I spoke to gave the conference two thumbs up and described it as an excellent overview of potential options in non-clinical medicine that had the wheels spinning. One of the take-aways was that every physician is looking for what the military world calls 'actionable intelligence', ways to put these strategies and information into action.

As a result, I'm launching a new site for physicians that want to gain more control of their career, income and lifestyle.

Healthy Aging's Annual "Top of Class" Survey

Our friends over at Healthy Aging are gathering their annual "Top of Class" votes for our industry.  Cast your votes and we will publish their results in January.

Physicians must stay on the cutting-edge of technology. Your knowledge of leading industry reps, manufacturers and distributors can assist your colleagues during crucial equipment selection and purchasing decisions. Share your experience with colleagues in our annual "Top of the Class" survey, which allows dermatologists, estheticians and plastic surgeons to identify companies they feel are "among the elite."

Review the categories listed below, then cast your vote for your favorite vendors* by Dec. 30, 2010. We’ll tabulate the results and share the "Top of the Class" vendors online in January 2011. 

Click here for the survey.

Physicians' Need to Understand & Influence Their Online Reputation

Here's some very good advice from one of our Select Partners, Medical Justice.  

The observation that social media is experiencing explosive growth is hardly novel. Moreover, social media is significantly influencing the medical profession.  CNN Money.com reported that Facebook passed the milestone of half a billion signed on users half a year into 2010.  The professional and legal ramifications from the rapid growth of social media touch almost every aspect of physicians practicing today.  One of the most challenging of these ramifications is a physician’s online reputation.

Pew Internet and American Life Project recently released numbers that document just how important of the source of information regarding medicine and physicians the internet has become.  Sixty-one percent (61%) of American adults look on-line for health information. Forty-nine percent (49%) of Internet users report researching a specific disease or medical problem on the Internet.  Forty-seven percent (47%) report seeking information about their physician or other healthcare professionals from on-line sources.

Finally, five percent (5%) of “E-Patients” have posted a review online of a doctor. It is these very reviews from a small subset which form the basis of a physician’s reputation on-line.

Reputations are forged when people make judgments upon the mosaic of information available about us.”  Viewed in this light, ratings, blog postings, and web pages are the pieces of the reputation mosaic.  Unfortunately, all it takes is one or two bad pieces for the mosaic to be marred.  The implications of a damaged online reputation are extensive."

Most physicians equate a tainted online reputation with a direct loss of business.  The analysis is simple; the worse the online reputation, the fewer the patients.  There are certainly many examples to support this reasoning. 

Dr. Linda Morrison, a physician practicing in Indiana, experienced first hand the harm that arises from an online reputational attack.  In July of 2000, Dr. Morrison noticed that an anonymous individual was posting defamatory statements about her via the internet.  Dr. Morrison received e-mails from this individual under a pseudonym “Surfycity45” that, among other things, made threats against her medical license.  The attacks continued into the fall of 2000.  Dr. Morrison ultimately learned that “Surfycity45” had been circulating defamatory comments about her while simultaneously encouraging others to do the same.  “Surfycity45” worked hard to organize a cyber mob with Dr. Morrison as its target.  

Dr. Morrison, via counsel, attempted to enjoin Defendant American Online, Inc. from the continued posting of the defamatory statements about her by the anonymous subscriber.  For a variety of legal reasons, the United States Northern District Court of Indiana ruled against the injunction.  Although Dr. Morrison alleged that “Surfycity45” statements were false, defamatory, and had resulted in damage to her professional reputation as a physician, she was unable to have these remarks removed from the Internet in a timely fashion.  The damage was done.

The implications of a physician's online reputation now extends beyond patients.  At least twenty seven (27) states have a recognized cause of action for negligently credentialing a physician.  Given this liability, credentialing committees will likely perform detailed background checks using all available search tools, including social network sites.

Health institutions making credentialing or hiring decisions currently face a dilemma when it comes to information about physicians contained in social network profiles.  Although there may be some risks in searching against them (as discussed in the next section), the potential liability for making a panel decision in the absence of such information likely tips the balance."

It is not just patients and credentialing committees which are scrutinizing physicians’ online reputations.  In any  medical malpractice action, physicians should assume that the plaintiff’s attorney will checking the doctor’s online reputation.  Geoffrey Vance, a thirty eight (38) year old partner at McDermott, Will and Emry, makes use of social networking sites to gather facts about the opposing side for trials.  “I make it a practice to use as many sources as I can to come up with and to find information about the other side” Vance said.  “We used to run Lexus Nexus; we still do that.  We always look at cases, and now we use the internet – Google, and social networking sites.”

Mr. Vance is not alone.  Paul Kiesel, a lawyer in Los Angeles County, admits to using social media not only to investigate the opposing side, but also to help select jurors.  “Last month I had fifty (50) jurors, and as the Court Clerk read out the names, I had two (2) people in the courtroom and the third person back at the office, with all three (3) of them doing research.”

Lawyers are not the only actors in a courtroom who are using social media at trial.  Courts across the country are grappling with the serious problem of “Internet-tainted” jurors.  In case after case, judges and lawyers have discovered that jurors are doing independent research via cell phone during trials.  Last year in Arkansas, a state court judge allowed a 12.6 million dollar verdict to stand even though a juror sent eight (8) messages via Twitter from his cell phone.

 In another case, a juror decided to seek the wisdom of the masses by holding a Facebook online poll. “I don’t know which way to go, so I’m holding a poll, wrote the democratic juror.”  Upon learning of this misadventure, the juror was dismissed and the case proceeded.

Physicians’ online reputations are being examined with increasing frequency at crucial moments in their professional career.  It is no longerprudent for a physician to fail to monitor his or her online reputation.  “Physicians should carefully monitor their online reputation.  I have seen examples of ex-spouses, past employees, and competitors all posing as disgruntled patients in an online effort to damage a physician’s reputation.  This is a real threat that is not going away,” says Rivera.

In the words of Benjamin Franklin “It takes many good deeds to build a good reputation, and only one bad one to lose it.”

Resource: Physicians + Facebook Marketing - How to do it correctly!

Guest post by Joy Tu of Medical Justice.


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Chicago Doctor Sues Over Yelp & Citysearch Reviews

The next time three of Dr. Jay Pensler's patients could be seeing him will be in a court of law. But it's probably not what you're thinking. Pensler's patients aren't suing him -- he's suing them.

Pensler is upset about negative remarks they made about him on Yelp and Citysearch , two websites where customers can anonymously post reviews about almost anything and everything.

I was trying to prevent what happened to me from happening to other women," one of his former patients told FOX Chicago News. "I didn't want people to go through the same thing I went through."

If you want to know exactly what the women who posted reviews went through, they said the pictures speak for themselves. One woman's breasts are clearly uneven and the nipples point in different directions. The X-ray from another woman who received a tummy tuck showed an object that looks like a staple. She said it is actually the head of a needle Pensler left in her body, but Pensler says was left by another doctor in a previous procedure.

Some people call him a butcher, which I agree with," another woman who went to Pensler told us.

Like the other patients we interviewed, she asked we don't identity her because she's embarrassed and scared what she says can be used against her in a trial. Since seeing Pensler, she said she's been operated on twice by another surgeon to correct Pensler's work.

Pretty harsh stuff. Click here for the rest of the article.

Dr. Pensler is in way over his head of course since he's got no recourse if either the patient's claims are true or they're the patients opinions. The law suit that Dr. Pensler was hoping would keep negative reviews of his practice off of the internet are having exactly the oposite effect. His lawyer should have told him as much.

Medical Spas & Groupon Group Buys

Group Buying & Medical Spas

Social networks and social media (Facebook, Twitter, blogs, etc.) get a lot of attention as marketing vehicles in the cosmetic medical world, and with good reason – your potentail patient are already there and are spending more hours being social online than ever before. However, another major marketing movement may have a much larger impact on how medical spa marketing is changing... discounted group buying sites.

How Group Buying Sites Are Impacting Medical Spas & Physicians

A recent Forbes profile on Groupon reported that the group buying site’s sales have reached $500 million and that the company’s valuation is now $1.3 billion. Groupon will be the fastest company ever to reach $1 billion in sales, and they were profitable seven months after inception. In just three years, there are now 200 competitors to Groupon in the U.S. alone (over 500 internationally, says Forbes), and this number is growing — not to mention the likelihood that Facebook, Yelp, Foursquare, and niche publishing sites seem likely to get in on this model of selling. Clearly, group purchasing has resonated with the market... including medical spas, plastic surgeons and cosmetic physicians.

This model is simple: a massive discount with urgency and strong merchandising. In Groupon’s case, a 50%+ discount will definitely drive sales. (It’s important to realize, however, that they are unprofitable sales. According to the article, the retailer only gets half of their discounted deal, netting only up to 25% of the list price. No, the retailer doesn’t make money; however, they do get eyeballs on their company and product. The bet is this exposure will attract full price customers, offsetting the loss.)

A couple things will happen with medical spas that advertise on sites like Groupon. First, it's difficult to get off the “crack” of sales from these deals. Groupon reports 97% of their retailers want to be featured again. And with 200 group buying sites, and more coming, many retailers may just make the rounds of discount after discount. This is a recipe for losing money and commoditizing your entire business with treatments that are not turning a profit. Unless – and this is the big caveat – your medical spa sees sustained profitable sales from returning customers.

Of course this is the same methodology that many of our Select Partners use to aggregate the bying power of our individual physician members to drive down the cost across the entire network. Examples would be when Sciton offered $15,000 of of a new BBLs IPL platform and the $349 Group Buy Botox offer.

Which brings us to the second and more salient point: Groupon reports only 22% of customers who buy a deal return to buy full price. (There are no statistics about cosmetic medicine deals on Groupon). If you're dealing with treatments that come with high fixed costs that can cause all sorts of problems, especially if you have any form of 'commission' payments with your staff.

Discounted medspa customers only return if:

  1. They had a great experience with the product or service.
  2. If, at full price, the experience is still a great value.
  3. If they're not hopping from discount to discount, which many of them are.

What percentage of medical spas will clear that high bar? Medical spas and physicians must become amazing to attract profitable customers back, or they may discount themselves out of business with unprofitable treatments that are filling their treatment rooms, and that’s where Groupon shines a light on the need for a superior customer experience.

Most medical spas try to get around the 'loss leader' aspects by offering treatments with no consumables (Botox, Restylane, Juvederm, Thermage etc.) and offering purely cosmetic treatments like facials or high margin treatments like laser hair removal.

If you've had an experience with Groupon or other group buy site's, please leave a comment and let us know about your experience and what you learned.

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