DOCTOR’SLife www.doctorslifetampabay.com
MAGAZINE
Business Lifestyles and Opportunities Issue 2, 2013 Tampa Bay Edition
Transcendental
10
meditation Why Doctor’s Are Recommending It
Steps To Selling a Medical Practice
Social Media Prescription
What’s Inside Transcendental Meditation
From the Publisher
Looking at Transcendental Meditation Page 4
Page 16
Your Most Valuable Asset
Page 10
Physician Spotlight
David Bernstein, author, public speaker and geriatrics specialist Page 5
Alzheimer’s: Thinking Outside the Box
Page 12
Understanding health care reform
Page 22
Social Media Prescription The cost of social media
Page 8
Fit Corner
Pros and cons of a gluten-free diet Page 14
Advertisers Coastal Properties Group
11
The Forte Group
7
The Go Agency
5
Greiner’s Clothing
15
Health and Wellness Channel
19
ImageFIRST 9
Selling a Practice
Page 20
2
JCON Commercial
15
Thaxton Barclay Group
13
USAmeribank 24 Doctor’s Life Tampa Bay
Issue 2, 2013
From the Publisher
www.doctorslifetampabay.com
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his issue of Doctor’s Life Magazine opens the door to a very old technique that is resurfacing in a very mainstream way. Recent studies have shown that the practice of Transcendental Meditation (TM) twice a day for 20 minutes can have overwhelming results for patients with high blood pressure, anxiety and ADHD, just to name a few. Celebrities like Dr. Oz, Jerry Seinfeld, Paul McCartney and Ellen DeGeneres are all speaking out about how a brief meditation session benefits their lives in a huge way. An abundance of doctors and data support the claims of TM, so this subject struck immediate interest with us.
Take a few minutes from your overwhelming schedule and read about 10 key steps to selling your medical practice, Dale Griffen’s Social Media Prescription, three important changes to consider when selling your home, and thinking outside of the box when it comes to caring for your elderly patients. Finally, I and the entire DLM staff would like to thank our readership for all your comments and suggestions. We encourage you to keep sending us ideas and stories that are of importance to you. I hope you enjoy this issue of DLM.
-Ed
www.doctorslifetampabay.com
MAGAZINE
Business Lifestyles and Opportunities Issue 2, 2013 Tampa Bay Edition
TRANSCENDENTAL
10
MEDITATION
Why Doctor’s Are Recommending It Steps To Selling a Medical Practice
Social Media Prescription
Tampa Bay Tampa Headquarters 1208 East Kennedy Blvd. #1029 Tampa Fl, 33602 813-444-9204 Tampa Bay Publisher Ed Suyak publisher@doctorslifetampabay.com Creative Director Bryan Clapper Editorial Director Ed Suyak Assistant Editorial Director Danielle Topper Advertising Account Executive CJ Cooper Doctor’s Life Magazine, Tampa Bay is always seeking events, stories and remarkable physicians. Please email the publisher if you have an event, an editorial idea or you know of a doctor or dentist who may have done something extraordinary. We want your suggestions and feedback. publisher@doctorslifetampabay.com Doctor’s Life Magazine, Tampa Bay does not assume responsibility for the advertisements, nor any representation made therein, nor the quality or deliverability of the products themselves. Reproduction of articles and photographs, in whole or in part, contained herein is prohibited without expressed written consent of the publisher, with the exception of reprinting for news media use. Printed in the United States of America.
Ed Suyak Publisher publisher@doctorslifetampabay.com
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DOCTOR’SLife
Doctor’s Life Tampa Bay
Issue 2, 2013
Physician Spotlight
David Bernstein, M.D. Author, Public Speaker and Geriatrics specialist www.davidbernsteinmd.com
Doctor’s Life wants to know
How long have you been in the Tampa Bay Area? I have lived in the Bay area since 1981. 32 years. What is your favorite Tampa Bay restaurant? I love all types of food. Pizza: Country Pizza Inn; Seafood: Catch 23; Local Italian where they know me by name: La Trattoria de Gaetano Where is your favorite place in Tampa Bay to relax? At my home at the top of Old Tampa Bay--with red wine at sunset can’t be beat What is your favorite event to attend to in Tampa Bay? Tampa Bay Rays baseball games What is the name of your favorite book that you read this year? Unbroken by Laura Hildebrand If you never became a physician, what was your number two choice for a career and why? When I was in eighth grade, I told my lab partner Bill that I wanted to be a doctor. He told me that he wanted to be a firefighter. Neither of us had a “plan B.” We met 20 years later, he was a firefighter, I was a physician! I guess if things didn’t work out, I would have become a neuroscientist or a baseball general manager. What is the most rewarding part of your position as a physician? Receiving notes of gratitude for providing compassionate care to a patient or a family member What is the biggest misconception people have about aging? That aging is a bad thing—on the contrary, many find great happiness by having more freedom and time to do things they couldn’t afford or didn’t have time for when they were younger such as travel or enjoy family and especially time with grandchildren. You recently released a book entitled I’ve Got Some Good News and Some Bad News: You’re Old. Who can benefit from reading this book and why? My book is for anyone—20/30 somethings—who can gain an understanding of aging of their parents/grandparents; Baby Boomers because it provides insights into how to age GRACEfully. Older adults because the stories and insights in the book can validate their experiences and provide a window of what to expect in their later years. Health care workers can gain valuable insights into the lives of aging adults. What are a few key components to consider in order to age gracefully? In my book I talk about the five attributes that I have learned from my patients on aging GRACEfully and coined the acronym G.R.A.C.E. G: Goals. Having goals, plans and purpose in life R: Roots. Knowing your genes, DNA and heredity A: Attitude. Positive attitude, gratitude and sense of adventure C: Companionship. Strong personal relationships and connections E: Environment. Lifestyle: diet, exercise and listening to your doctor’s advice Issue 2, 2013
David Bernstein, MD, is a highly respected physician who is board certified in both Internal Medicine and Geriatrics practicing in Clearwater, Fla. His 30 years of experience have provided him with opportunities to observe and empathize with thousands of adults as they age. His compassion and ability to see the souls of his patients has compelled him to share his stories in his book But Doctor, I am a good Driver—stories told to a Geriatrician. After growing up outside New York City, he went to college at Washington University in St. Louis where he was introduced to a slower paced Midwestern lifestyle while meeting young adults from all over the U.S. and the world. After attending Medical school in Albany, N.Y., he moved to Florida where he has spent 30 years treating aging patients. Has 80 become the new 70 and are people living longer today than 20 years ago? Since people are living longer due to better understanding of improved health practices such as smoking cessation, diet and exercise programs and staying engaged and active along with improved medical technologies, yes, age is just a number and generally people feel younger than their actual age. I know I do and my wife who is pushing 60 looks and acts like 40! In your opinion and from your experience, what is the single best advice you would give to a fellow physician that have elderly patients? Be patient, show interest and compassion while listening intently to your senior patients. These experiences will be rewarding, enlightening and can enrich you as a physician both personally and professionally.
Doctor’s Life Tampa Bay
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Your Social Media
The Cost of Social Media By Dale Griffen, R.N. The Go! Agency USA Well, it’s free! Sort of. We all know the importance of social media, and to utilize it effectively, you’re going to have to spend either time, or money! It’s up to you as to which one you use! Currently ALL of these powerful social media sites are free to use. Sure, there are options that they utilize to try and get your money, from paying for (promoting) your posts, upgrading your account (you probably don’t need to do this) and with e-commerce options. But basically there’s no charge Dale Griffen for using these platforms. But we all know the saying: “Time is money.” To optimize, populate (with a targeted audience), and fill your site (with content that moves your audience to action) takes some time, effort, and planning. Many businesses out there 6
are seriously vamping their following, their sales, and reputation as thought leaders using social media—all the while using social media as a vehicle of P.R. and brand awareness—with speed racer proportions! Are you up to the challenge? Social media platforms are a constantly changing and evolving medium. With that in mind, although we consider ourselves “specialists,” one can never be an “expert,” as all of us are constantly learning these changes, updates, tweaks, and new applications within the platforms. But the general principals with social media, as we mentioned above are: Optimize your site. Make sure your images mirror your website so that your brand carries through. After all, this is a living, breathing, evolving version of your website. Make sure you fill it out completely—people expect it to look as professional, and it is a reflection of you and your business. Be sure that it has your location, contact info, hours and that all the links work. Also, be sure that you aren’t utilizing a personal page for your business. Populate it with people that you feel might be interested (peers, current and potential clients and supporters, industry leaders, and more). Don’t be a wallflower here—reach out and follow/like/connect with at least 10 new businesses or people a day, and leave a comment on their site, letting them know you like something they have posted (if you do, remember - be genuine). Fill your site several times a day with great content (comments, quotes, pictures/videos, questions, tips, news article links,
Doctor’s Life Tampa Bay
Issue 2, 2013
(From left to right)
Evan P. Forte, CRPS® Financial Advisor
Ami K. Forte
Managing Director Wealth Management Wealth Advisor
Chuck D. Riggs III Financial Advisor
Chuck Lawrence
Associate Vice President Financial Advisor
James Streitmatter
Senior Vice President Financial Advisor
CRUCIAL DECISIONS CALL FOR DECISIVE ACTION. Ami Forte named #1 in Barron’s annual list of America’s Top 100 Women Financial Advisors 3 years in a row. *Source: Barron’s “Top 100 Financial Advisors,” April 16, 2012, as identified by Barron’s Magazine, and “Top 100 Women Financial Advisors,” June 4, 2012, using quantitative and qualitative criteria and selected from a total annual pool of over 3,000 nominations. Advisors who are selected have a minimum of seven years of financial services experience. Quantitative factors include, but are not limited to, compliance record, interviews with senior management, and philanthropic work. Investment performance is not a criterion. The rating may not be representative of any one client’s experience and is not indicative of the Financial Advisor’s future performance. Neither Morgan Stanley Smith Barney nor its Financial Advisors pay a fee to Barron’s in exchange for the rating. Barron’s is a registered trademark of Dow Jones & Company, L.P. All rights reserved. The views expressed herein are those of the author and may not necessarily reflect the views of Morgan Stanley Smith Barney LLC, Member SIPC. The strategies and/or investments referenced may not be suitable for all investors. Morgan Stanley Smith Barney and its Wealth/ Financial Advisors do not provide tax advice. Individuals are urged to consult their tax advisor regarding their own tax or financial situation before implementing any strategies. This article is directed to residents in the states where Ami Forte is registered. For more information, please go to my website: http://fa.morganstanleyindividual.com/thefortegroup/
THE FORTE GROUP AT MORGAN STANLEY 4114 Woodlands Parkway, Suite 200 | Palm Harbor, FL 34685
727-773-4610
Morgan Stanley Smith Barney LLC, member SIPC.
announcements, new products/services, upcoming events/ appearances, achievements, links to your blog/website). Engage with your audience. If someone likes or comments on something you’ve posted be sure to thank them, and maybe even encourage them to sign up for your newsletter or blog “for more great tips like this.” But make it easy for them—include the link that will bring them there. Bit.ly is a great site for shortening and customizing a link. Check it out. (Tip: Always test a link before you send it - for example I recently wrote an article that was published in Doctor’s Life Magazine, and we posted it on our website. I created a short link, but every time I share it, I test it to make sure it’s still valid, or that I didn’t mistype it. Check it out: bit.ly/ SocialMediaRx With that in mind we recommend that everyone complete a simple marketing plan to ensure that you know what you have to do each day and get it done. Much like a diet, exercise plan, or even a road trip, having a pre-written plan or map in front of you makes you much more likely to stick to the proper route and reach your goal more efficiently and effectively. What about the cost? Well, with the platforms being free of charge, what you have to think about in terms of cost is the time factor, and who you will have do all of the above actions. Here are your options: 1. Do it yourself 2. Office manager / marketing manager 3. Receptionist / entry level person 4. Outsourcing Doing it yourself is a great option, as this is your reputation and business that you’ll be promoting. However, it does take you away from what you do best—running your practice. Having an upper management person take over your social media is also a good idea, as they usually have a great understanding of your business, products and services, vision, and goals in mind, but it also takes them away from other duties, and if it’s your marketer, it takes them away from other sales duties, and face to face activities. Additionally, these people tend to be your higher paid employees and if they’re constantly being interrupted or aren’t proficient with social media - the added time equals more money out of your pocket. An entry level person may seem to be a good alternative, they are more economical, sometimes are younger and more proficient on social media—but remember, this is your reputation we’re talking about. Will they deliver the business acumen, professionalism, and deep-digging, laser-focused campaign that you need? Will they be on top of the latest applications and logistics with these platforms that change daily? Outsourcing to a company that specializes in social media may be your best bet! A common misconception is that hiring firms like ours to perform your social media marketing campaign is just too expensive. Having an in-house person do the work, or hiring someone may also include you having to pay for their benefits, taxes, insurance and when that person is out sick, someone else has to do the social media or it doesn’t get done. Our services provide everything listed above so that you and your business can have 100 percent social media management, optimization, engagement, and monitoring taken care of—all for the cost of 4-10 venti coffees a day, depending on the services you choose! 8
Now, it’s obvious, no one drinks that many coffee’s a day, but it’s not out of the question for your sales/marketing rep to bring that many coffees and bagels to the offices that they call on. In fact, I utilize a caterer that specializes in pharmaceutical rep lunches. I asked them what the range and average is that
Dale Griffen, R.N. Head of USA Operations & Sales The Go! Agency USA dale@TheGoAgencyUSA.com 866-926-2636
pharma reps spend on lunches—I was surprised that the range was between $100-$500 per lunch, and the average is $150-175! Many times you have to feed the entire office in hopes of getting to the ONE decision maker that they need an audience with. With social media, you can get directly to that target or decision maker without all that hassle. Think of that in terms of other more “traditional” means of advertising and P.R.—billboards, print and TV ads, trade shows— are all great ways of getting your name out there - however with social media, your message can change several times a day, is portable (it can be shared across the world with the push of a button), looking at peoples comments and the logistics - you are able to see what your following likes to hear about, and most importantly - you can connect with that laser focused target audience - people that WANT to be educated by, entertained by, and engage with YOU. When outsourcing your social media, you may ask how we learn about you, your practice, your business, what sets you apart, what we can post, and to whom—this is where we excel. In the beginning, we have our clients complete a short questionnaire that gives us our parameters to start, and then we give you the option to pre-approve the posts that go out in your behalf. Our team of social media strategists meet regularly to discuss your campaign, how to improve, manage, and innovate your campaign. We also check in with you if anything comes up that is beyond our scope, is a referral, or can be put in your sales funnel for follow up by your sales and marketing team. Speaking of free—if you have any questions, or would like a free evaluation for your business - give us a call!
Doctor’s Life Tampa Bay
Issue 2, 2013
e l b a u l a V t Mos
Your
Asset
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Change # 2 Amenities
By Kerryn Ellson Coastal Properties Group
avigating the process of buying, selling, and investing in Florida real estate can sometimes be a frustrating and an arduous experience. What does the future of real estate look like? If we had a crystal ball, we could easily obtain the answer to this question. The housing market has changed dramatically over the past several years. New technologies have provided a multitude of innovative ways to Kerryn Ellson do business. The way we market, buy and sell properties is very different today than it was in the past. It is critical to work with a real estate firm and agent who knows how to successfully guide you through these changes.
Change #1 the Internet
Twenty seconds for love at first site Approximately 85 percent of home shoppers start their property search on the internet. This means the first point of contact between a potential buyer and your home is that first photo of your property’s exterior. An interesting article in the Wall Street Journal addressed real estate photography and the impact it has on selling a home. Researchers tracked the eye movements of subjects who looked at online home listings and found that 95 percent of users viewed the first photo, typically the photo of a home’s exterior for a total of 20 seconds. After that, their eyes tended to flit all over the screen. One researcher stated that “without an eye catching first photo, the battle is lost before it begins.” You have to pique a viewer’s interest within the first few seconds or lose them forever!
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Men are from Mars and women are from Venus The way men and women view a home’s amenities have surprisingly integrated. A survey conducted online via Harris Interactive QuickQuery Omnibus among 2,236 adults ranked amenities in a home that effect the buying decision of men and women. The master bedroom ranked first among both men and women as the amenity that caused them to fall in love with their home. Walk in closets, a feature usually adored by female consumers was also second among their male counterparts. Both men and women agreed upon a gourmet kitchen as the third most sought-after amenity.
Change #3 Foreclosures
Big discounts on foreclosures fading Homebuyers may not get as great of a deal on a foreclosure as they once did. Foreclosure starts are falling and the inventory of foreclosures has been decreasing, which has caused the discount on foreclosures to lessen. The discount on foreclosed homes compared to other homes has fallen to a 12 percent average. That was about the same percentage prior to the housing crash. Last year the foreclosure discount averaged about 30 percent. As the foreclosure phenomenon fades, so to have the days of offering 50 to 75 percent of the list price of a property in hopes of striking a deal. Pinellas County properties are currently fetching on average approximately 95 percent of their list price. Your home is your most valuable asset, be sure your real estate professional provides both you and your property the expertise it deserves.
Doctor’s Life Tampa Bay
Issue 2, 2013
Harbor Bluffs 314 Harbor View Lane
5BR/5.5BA Mediterranean Inspired Waterfront Estate. Protected Deep Water Location with Two Boat Lifts. Visit www.HarborBluffsWaterfront.com Offered at $2,450,000
Breathtaking Gulf Front Parcel With Pristine Beach Frontage
Suitable to Build Your Dream Home or Develop a 1 to 4 Unit Residential Condominium. Bonus Dock on The Intracoastal Waterway. Offered at $1,150,000
Kerryn Ellson 727-408-4888 Kerryn411@gmail.com GulfViewLiving.com
Thinking Outside the Box Care for the Alzheimer’s patient and their caregiver
H
By Bernadette Homan, BSW Arden Courts Memory Care Community
ave you ever met someone and thought, I can’t use their services, I don’t deal with those types of patients? Have you ever had a patient or a patient’s caregiver ask you for help or advice and didn’t know how to help them or who to refer them to? This happens more often than you may think. Take for example a recent scenario that happened to me at a health and wellness expo. I had an opportunity to meet a new podiatrist at this expo and asked him about his practice. I also asked him what would be a good referral for him. I then handed him my card and explained the Bernadette Homan services we provide at Arden Courts. He then preceded to hand me back my card and said, “I don’t have patients with dementia.” I then handed him back my card and said, “You may be caring for a patient who is the caregiver for someone with Alzheimer’s or dementia. They may be coming to see you because of an injury acquired by caring for a person with dementia, caregiver stress, or just talking to you in general.” The latest 2012 Alzheimer’s Statistics from the Alzheimer’s Association show: »» Today, 5.4 million Americans are living with Alzheimer’s disease—5.2 million aged 65 and over, and 200,000 under the age of 65. By 2050, up to 16 million will have the disease. »» Of Americans aged 65 and over, 1 in 8 has Alzheimer’s, and nearly half of people aged 85 and older have the disease. »» Another American develops Alzheimer’s disease every 68 seconds. In 2050, an American will develop the disease every 33 seconds. By comparison, statistics for family caregivers are: »» In 2011, 15.2 million family and friends provided 17.4 billion hours of unpaid care to those with Alzheimer’s and other dementias—care valued at $210.5 billion. »» More than 60 percent of Alzheimer’s and dementia caregivers rate the emotional stress of caregiving as high or very high; one-third report symptoms of depression. »» Due to the physical and emotional toll of caregiving on their own health, Alzheimer’s and dementia caregivers had $8.7 billion in additional health care costs in 2011. »» One in four people who provide care for a family member with dementia have contemplated suicide more than once in the last year. With these statistics, as a physician, you are “dealing” with someone with Alzheimer’s disease or their caregiver. How can you help? If you are not a primary care physician or internist, you can recommend seeking a good diagnostic workup that should include a medical workup (obtain a history about diet, nutrition and use 12
of alcohol and list of medicines including over-the-counter drugs and supplements), physical exam (blood pressure, temperature and pulse) and diagnostic tests (blood and urine). In addition, a neurological exam, such as mental status tests and brain imaging, may be recommended for a true diagnosis and proper care. How can you determine if your patient is showing signs of Alzheimer’s? Here are the 10 warning signs: »» Memory loss that disrupts daily life »» Challenges in planning or solving problems »» Difficulty completing familiar tasks at home, at work or at leisure »» Confusion with time or place »» Trouble understanding visual images and spatial relationships »» New problems with words in speaking or writing »» Misplacing things and losing the ability to retrace steps »» Decreased or poor judgment »» Withdrawal from work or social activities »» Changes in mood and personality If you are treating a patient who is a family caregiver of a person with Alzheimer’s, knowing who to refer them to or recommend will decrease stress, depression, illness and injuries. Thinking outside the box would require you to be open to meeting with and
talking with contacts you ordinarily wouldn’t. Having resources available in your office or waiting room may be a solution, such as a list of support groups (for the caregiver and the early-diagnosed Alzheimer’s patient), placement options, and more. You may want to have telephone numbers of your local Alzheimer’s Association or organizations that provide services for Alzheimer’s and other related dementia. At Arden Courts, We Know, We Care, We Understand. Memory care is all we do. Arden Courts provides a safe and pleasing home for individuals with memory loss, including an enclosed courtyard and walking paths. We are a residential living alternative designed for individuals diagnosed with Alzheimer’s disease and other types of memory impairments. We offer the services traditionally associated with an assisted living residence, while taking into account the special needs of individuals with memory loss including safety, building layout, activities and dietary needs.
Doctor’s Life Tampa Bay
Issue 2, 2013
100 n. taMPa st. suite 3530 taMPa, florida 33602 Phone: 813-251-2580 fax: 813-251-2580 www.thaxtonBarclay.coM
Professionals Maintaining your Peace of Mind In today’s tumultuous Medical Malpractice insurance market, you need a company that watches out for their clients’ interests. At thaxton Barclay group, our loyalty lies with our clients. We offer you the peace of mind that you have the best coverage available for your practice at the most affordable price. Ask us about the following product offerings: Property • General Liability • Workers’ Compensation • Directors & Officers Coverage Employment Practices Liability • Fiduciary Liability • Product Liability • Cyber Liability Michael P. Shea • Thaxton Barclay Group • Office: 813-251-2609 • Cell: 813-385-1352
Fit Corner
Gluten-Free Diet
ASK THE COACH
Pros and Cons
hat is a Gluten-Free Diet exactly? Gluten is a stretchy protein W that remains after the starch from certain carbohydrates is removed during the digestive process. Gluten is a protein found in wheat, barley, rye and triticale (hybrid mix of rye and wheat). Gluten is also an additive to many foods. In addition, while oats are glutenfree themselves, they are almost always contaminated by contact gluten-containing grains during processing. The less obvious sources of Gluten are beer, some salad dressings, marinades and some sauces like teriyaki and soy. The Pros
The Gluten-free diet has recently become a very popular diet fad. Is this diet actually right for everyone? There are claims that when on a glutenfree diet some people feel less tired, less bloated and lose weight. Anytime you eliminate an entire major food group, there will be some weight loss. Despite these perceived benefits, there’s no scientific evidence to support the claim that a gluten-free diet is a healthy choice for people searching specifically for weight loss. Who is this diet medically good for? Anyone that has been properly diagnosed with celiac disease or gluten sensitivity will most likely follow this diet throughout their lives. Following a gluten-free diet with this diagnosis allows for a better quality of life. Most of the time and almost immediately it eliminates majority of the negative symptoms. In this case gluten-free is a major pro!
So what are the cons?
If your following a gluten-free diet with the intent of losing weight, you’re often eliminating entire categories of food- such as whole-grain breads- and as a result you run the risk of cutting out sources of necessary vitamins, particularly vitamin B’s, niacin, folic acid, iron and zinc. Often people choose items that are less healthy when shopping for Gluten-free. They see a label that says Gluten-free but it is high in fat or sugar. These types of choices would do the exact opposite of what you started the diet for. Most likely you would ultimately gain weight not lose. If you do choose to try a gluten-free diet, make sure you are reading your labels past the glutenfree part. You should all so be supplementing with a multivitamin, especially something with a B-complex to make up for what you’re not consuming. 14
Doctor’s Life Tampa Bay
Question: What do you believe is the best form of dieting? Answer: Making healthy food choices, portion control (palm size) and eating five small meals a day. Sample of five small meals: 1. Breakfast (two egg white omelet with spinach) 2. A Healthy Snack (almonds, fruit or vegetables) 3. Lunch (chicken whole wheat warp) 4. A Healthy Snack (a protein smoothie) 5. Dinner (salmon, brown rice, broccoli)
Tommy Parks Speed and Strength Coach Mississippi State University BA in Exercise Science Professional Baseball for 9 Seasons NFL punter with San Francisco 49ers & NY Jets Issue 2, 2013
GREINER’S CLOTHING
“WHERE LUXURY AND VALUE COEXIST” For 30 years, Greiner’s Clothing has offered the discerning gentleman of Tampa Bay the finest quality casual and professional attire along with expert custom tailoring. Locally owned and operated, this specialty men’s store is located in the heart of downtown Tampa. Greiner’s presents the best of North American and European fashions, as only a specialty store can. Quality collections include Pal Zileri, Samuelsohn, Castangia, Zanella, Robert Talbott and Allen Edmonds. Come see why Greiner’s is continually recognized as the “Best of Tampa Bay” for men’s clothing.
FRANKLIN STREET CLEANERS & ALTERATIONS Downtown Tampa’s premiere destination for quality dry cleaning and alterations, Franklin Cleaners is located in the Franklin Street Esplanade next to the Old Fort Brooke Parking Garage. Come in and see our friendly staff, where we’re exceeding expectations everyday. At Franklin Street Cleaners, “we prefer that you wear out your clothing, not your cleaners!”
GREINER’S CLOTHING 117 Whiting St., Tampa, FL 33602 813.226.3207 // GreinersClothing.com Free parking behind the store.
HOURS: Mon-Fri: 10am-6pm, Sat: Noon-5pm. All other times by appointment.
813.225.5600 Open Mon-Fri: 7:30am-6:30pm. Sat. 9:00am-1:00pm All other times by appointment.
JCON Commercial specializes in Lead Room construction and Medical Build-outs. Design | Engineering | Permitting | New Construction | Remodeling/Renovation
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238 E Davis Blvd. Suite 212 Tampa FL. 33606 Office-813-384-2340 Fax-813-384-2554 www.jconcommercial.com
A company built from the ground up based upon honesty, integrity, thoroughness and diligence.
JCON Commercial Medical Projects: Sensus Health Care | West Coast Dermatology | Associates in Dermatology | Tampa Palms Animal Hospital | Spine Institute of Central Florida | Central Florida Dermatology | Tampa Orthopedic | John Forman M.D. | Dr. Sheehy - Tampa Medical Complex | Michael D. Scannon M.D. | Do Care Clinic | Dr. Moskovitz
l a t n e d n Transce meditation defined By Christopher Clark, M.D.
he Transcendental Meditation technique is a simple, natural, effortless process practiced 15-20 minutes T twice daily while sitting comfortably with eyes closed. It is unique among techniques of meditation, distinguished by its effortlessness, naturalness and profound effectiveness. The TM technique allows your mind to settle inward, beyond thought, to experience the silent reservoir of energy, creativity and intelligence found within everyone—a natural state of restful alertness. During the practice, your brain functions with significantly greater coherence and your body gains deep rest. Daily practice of the TM technique unfolds the mind’s inner potential and awakens the brain’s latent resources, directly enriching all aspects of life. The TM technique is not a religion or philosophy and involves no change in lifestyle. It is easy to learn and enjoyable to practice, requiring no effort, concentration or special skills. Anyone can learn it—even children. The unique state of restful alertness produced during TM practice dissolves stress and fatigue, promoting balanced functioning of mind and body and more harmonious behavior. Scientific research on the Transcendental Meditation program has shown that the daily experience of this state of restful alertness leads to increased creativity, improved learning ability, higher IQ, better moral reasoning, more efficient brain functioning and a wide array of health benefits—ranging from normalized blood pressure, reduced need for doctor visits, to a younger biological age. Over 5 million people worldwide have learned the Transcendental Meditation technique—1.5 million in the U.S. alone—including people from all backgrounds, cultures, races, and religions. More than 600 scientific research studies confirming the benefits of the TM technique for mind, body, behavior, and society have been conducted in 34 countries and at 200 independent research institutions and universities, including Harvard, Stanford, Yale and UCLA Medical School. Over 300 of these studies have been published in leading peer-reviewed scientific journals. Christopher Clark, M.D., is a graduate of Yale University School of Medicine, Department of Psychiatry, and a recipient of a child psychology fellowship from the University of Washington. He has practiced medicine for over 20 years and is currently a psychiatrist in Vero Beach, Fla.
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Doctor’s Life Tampa Bay
Issue 2, 2013
Clinical Applications and Research Review
ecent randomized controlled trials, clinical R studies, and meta-analyses have identified that the Transcendental Meditation program, a non-
pharmacologic method of stress-reduction, leads to improved medical outcomes for patients with cardiovascular disease and its risk factors. These data also support the use of the Transcendental Meditation program in other medical disorders clinically complicated by stress. The rationale for the effectiveness of the Transcendental Meditation program for these conditions is based on two premises: (i) the well-established principle that stress causes, contributes to and/or exacerbates cardiovascular diseases such as hypertension and coronary heart disease, and (ii) a large body of evidence showing that the Transcendental Meditation technique is the most effective stress-reduction technique available for cardiovascular disease patients. Extensive research has shown reductions in hypertension, anxiety, insulin resistance, smoking, and clinical cardiovascular events. Several cost-benefit analyses indicate lower hospitalization rates, lower outpatient utilization rates and longitudinal reductions in health care costs for those who regularly practice this stressreducing meditation technique.
Evidence review
a. Hypertension: A series of nine randomized clinical trials have demonstrated that the Transcendental Meditation program significantly reduces blood pressure in persons with hypertension. A recently published meta-analysis of 107 independent studies on stress-reduction and hypertension found that the Transcendental Meditation program reduced blood pressure to a significantly greater extent than other mind-body interventions that have been studied in this regard. b. Cardiovascular Risk Factors and Intermediate Endpoints: A series of NIH-sponsored clinical trials and metaanalyses found that high-risk patients who were randomly assigned to the Transcendental Meditation program showed significant reductions compared to controls in other risk factors for atherosclerotic cardiovascular disease, including insulin resistance, smoking and alcohol abuse, carotid intima-media thickness, left ventricular hypertrophy, as well as improved functional capacity in patients with chronic heart failure. A nonrandomized trial showed that the Transcendental Meditation program increased exercise tolerance in coronary heart disease patients. c. Cardiovascular Clinical Events: Long-term effects of the Transcendental Meditation program were assessed on allcause and cardiovascular mortality in older subjects with high blood pressure; statistical analysis showed 23 percent reduction in the mortality rate from all causes and 30 percent decrease in cardiovascular disease-related mortality. A subsequent long-term randomized controlled trial of patients with coronary heart disease showed that Transcendental Meditation practice was associated
with a 47 percent reduction in mortality, nonfatal myocardial infarction, and stroke compared to controls over an average of five year follow-up. d. Psychosocial Stress: A meta-analysis of 146 independent studies on the effects of stress-reduction and relaxation techniques on psychosocial stress (anxiety) was performed by Eppley of Stanford University. This study compared the effects of all stress-reduction techniques that had been reported in the scientific literature, including the Transcendental Meditation technique, other stress-reduction techniques, and relaxation techniques. The Transcendental Meditation technique reduced anxiety to a significantly greater extent than other forms of relaxation or stylized rest. These differences were found after adjustment for experimental design, duration of treatment, expectancy of benefits, and experimenter attitude. This meta-analysis has been critically reviewed. Other published studies have reported that the Transcendental Meditation technique reduced stress-related neuroendocrine activation related to CVD, including activation of the sympathetic nervous system and the hypothalamicpituitary-adrenal axis. Additionally, a randomized controlled trial with military veterans with post-traumatic stress disorder found significant reductions in anxiety, insomnia, depression, and alcohol abuse.
Instruction and follow-up
The Transcendental Meditation technique is a simple yet precise mental technique, practiced twice daily for 20 minutes each session, while sitting comfortably with eyes closed. The technique is taught in a standardized protocol, through a systematic program of instruction. As provided in the office setting under medical supervision, the program of instruction and follow-up includes 12 to 14 sessions, as follows: 1. Introductory/Preparatory session, 90 minutes (may be in a group setting). 2. Four instructional sessions, 90 minutes each, provided on four consecutive days. The first of these sessions is individual; the remaining three sessions may be individual or group. 3. Seven to nine follow-up sessions, 30 to 60 minutes each (individual or group), provided at intervals of 2 to 4 weeks.
Cost/benefit
Providing the Transcendental Meditation program in a clinical setting is highly cost-effective in light of the documented benefits. Studies have shown that regular practice of the Transcendental Meditation technique lowers health insurance utilization rates with significantly fewer hospital inpatient days and outpatient visits, and fewer inpatient admissions for all major categories of disease. Across all disease categories, there was a 56 percent lower utilization rate. For two key physiological systems relevant to this proposal, reductions were even greater: 87 percent reductions in utilization rates for both cardiovascular diseases and nervous system disorders. A Canadian study showed a longitudinal reduction in utilization, with a cumulative savings of 13 percent per year in government payments to physicians.
To read the full research paper with references, go to http:// tmhealthprofessionals.org/cardio_oz.html
Issue 2, 2013
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Transcendental Meditation Q&A What is the Transcendental Meditation (TM) technique? It is a simple, natural, effortless procedure practiced 20 minutes twice each day while sitting comfortably with the eyes closed. It’s not a religion, philosophy, or lifestyle. It’s the most widely practiced, most researched, and most effective method of self-development. What happens when you meditate? The Transcendental Meditation technique allows your mind to settle inward beyond thought to experience the source of thought — pure awareness, also known as transcendental consciousness. This is the most silent and peaceful level of consciousness — your innermost Self. In this state of restful alertness, your brain functions with significantly greater coherence and your body gains deep rest. Does the TM program involve adopting a new lifestyle? No, TM does not require a change in lifestyle, nor is it a philosophy or a religion. Over six million people of all ages, nationalities, and religions have learned the Transcendental Meditation technique during the past 50 years. TM practitioners report that the reduced stress and increased clarity of mind has helped them to appreciate life more fully—and, for religious people, to follow their religions more faithfully. Why do people learn to meditate? For a wide range of reasons—for peace of mind, for better health, for better coping ability to handle the stresses of daily life, to do better in school. And the research confirms the benefits. Studies have consistently shown that regular TM practice increases creativity and IQ and improves learning ability among students, decreases anxiety and depression, reduces drug and alcohol abuse, improves memory and a wide variety of health indicators. How many people practice the TM technique? More than five million people worldwide have learned this simple, natural technique, including 1.5 million people in the US— people of all ages, cultures, and religions. Specifically, what happens to the brain during TM practice? EEG research shows that practice of the TM technique increases alpha activity (8 to 12 cycles per second) in all brain areas. Alpha activity is the hallmark of restful alertness, inner silence, and wideawake self-awareness. In addition, TM practice increases coherence in the EEG signals in the frontal lobes—the prefrontal cortex or “CEO” of the brain. Perhaps more significantly, this increased frontal coherence is spontaneously maintained after TM practice during daily activity and has been correlated with improved executive processing—the basis of comprehensive planning, openminded judgment, and wise decision-making.
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What exactly is integration and coherence of brain functioning? The restful alertness that is experienced during the TM technique creates more connectedness in the frontal areas of the brain, the areas that control impulsive actions, judgment, and social cues. That means more parts of the brain are working together. This integrated functioning, in turn, strengthens the circuits, creating better communication of one part of the brain with another, so it’s more coherent. How much scientific research has been done on the TM technique? More than 350 research studies confirming the health benefits of the TM technique have been published in leading peer-reviewed scientific journals. Studies have been conducted at over 200 independent research institutions and universities, including Harvard, Stanford, Yale and UCLA Medical School. One of the most important areas of research has evaluated the effects of TM practice in reducing cardiovascular risk factors, including high blood pressure — a silent killer that afflicts as many as 65 million Americans. National Institutes of Health has awarded over $25 million in grant support for research on the effects of TM practice in reducing cardiovascular risk. A recent NIH-funded study published in the American Heart Association journal Circulation (November 2012) found that TM practice was associated with a 48% decrease in deaths, heart attacks and strokes in individuals with known heart disease. Where does the TM technique come from? The Transcendental Meditation technique is thousands of years old—it comes from an unbroken tradition of meditation instruction from ancient India. Maharishi Mahesh Yogi first introduced the technique to the West over 50 years ago. It was Maharishi’s idea to subject the TM technique to scientific scrutiny in order to establish its practical benefits to daily life. Maharishi has trained tens of thousands of TM teachers who are providing TM instruction in all parts of the world. In a recent cover story on science and meditation, Time magazine recently credited Maharishi for the revival of meditation and yoga in the U.S. and around the globe. What if a person is a skeptic? Being skeptical is a good thing these days. Fortunately, no belief or change in beliefs is required to learn and practice the TM technique—and to gain all the benefits. In fact, you can be 100 percent skeptical and the TM technique will work just fine. This is because the technique makes use of a natural mechanism within the mind and body—long forgotten by most people—to settle down and take profoundly deep rest. No amount of belief or disbelief will change that inherent ability.
Doctor’s Life Tampa Bay
Issue 2, 2013
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Steps to Selling a Medical Practice
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By The Forte Group at Morgan Stanley
octors continue to wrestle with the question of what will ultimately be their most advantageous business model. In some cases, hospitals looking for new sources of patients and referrals have sought to acquire high quality, well established private medical practices. Physicians who sell their practice frequently cite reduced reimbursements, more uninsured patients, increased government audits and the growing expense of information systems as important reasons for their decision. For now, most medical professionals are in a holding pattern, waiting to see the final provisions of the Affordable Care Act and new Medicare billing rules—and hoping to see values rise from an improving economy.
a valuation expert to help arrive at a realistic estimate of what the practice is worth.
4. Maximize the value of your property.
If you own your building, consider setting up a sale leaseback. This should be done when your retirement and/or sale date is still five to seven years away.
5. Don’t be a landlord once your practice is sold. Hanging on to real estate that you no longer need can be expensive, inefficient and a headache.
If you are thinking about selling your practice, here are some key things to consider.
1. There is no good solution for the last minute.
Plan five or ten years in advance and review your plan at regular intervals to be sure it continues to fit your needs.
2. Separate practice and property.
When it’s time to set a value on your practice, the two major components will be the practice itself and the office building, assuming you own it. It is generally a good idea to deal with them separately.
3. Diligence and patience can help maximize goodwill. The value of the practice encompasses equipment, receivables and goodwill. For a well-established practice, goodwill should capture the value of the client relationships you have built over the years. As such, in most cases it will be the largest component of total value. Some of the things to consider in arriving at an estimate for goodwill include referral patterns, patient loyalty and even “brand recognition” that your practice has established within the community. In most cases, we recommend that doctors hire
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The Forte Group at Morgan Stanley. Center: Ami Forte, Managing Director-Wealth Management Wealth Advisor; from left to right: Jim Stretimatter, Senior Vice President, Financial Advisor; Evan Forte, CRPS Financial Advisor; Charles “Chuck” Riggs III, Financial Advisor; Chuck Lawrence, Associate Vice President, Financial Advisor.
6. Eliminate the front-end burden on new physicians—make it affordable.
According to the Physicians Foundation, the average medical student graduated with over $108,000 in debt in 2011. Also, recent graduates desire more work-life balance than their baby boomer cohorts, and therefore focus on the certainty of salaries. Retiring partners must make buy-in affordable enough to attract these young physicians.
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For a well-established practice, goodwill should capture the value of the client relationships you have built over the years. As such, in most cases it will be the largest component of total value.
7. Consider self-funding your buyout.
Bookkeeping— remove expenses that corporations wouldn’t likely show, those of a more personal or family nature Right-size— be sure the number of employees is right for efficient workflow Assess your strengths— build and promote ancillary profit centers »» A market specialty due to special training »» Community prominence, such as team physician to local high school
Split-dollar plans A form of life insurance co-ownership that allows one party, often the employer, to help another person carry life insurance protection. Generally, the insured pays the portion of the premium attributable to the life insurance protection while the other party pays the portion attributable to the cash value buildup—which can act as a sinking fund to purchase the practice.
Decide your desired plan for compensation— cash or productivity based models »» Turn-key cash sale, no further income »» Large payment up front, with a small income stream »» Small or no payment up front, with a significant income stream
Here are examples of strategies that can be used to fund a buyout. Depending on the strategy you choose, it may take five to 10 years to build your fund. Non-qualified deferred compensation A non-qualified deferred compensation plan or agreement simply defers the payment of a portion of the employee’s compensation to a future date. Funds from junior members can be earmarked for future purchase of the practice.
Employee stock option plans Many companies use employee stock options plans as an incentive—to retain and attract employees. They are mostly offered to management as part of their executive compensation package, but the funds generated may be used to purchase the practice.
8. Think about whether you want to continue to have a role in your practice.
If so, be sure you and the buyer are on the same page when it comes to your responsibilities and the amount of time you will stay involved.
9. Allow enough time to prepare for the actual sale.
Here are things you may want to consider in the two to five years before you actually complete the sale of your practice. Files— organize and purge to build confidence in quality of the business by potential purchaser
10. Review Your Plan Often.
You don’t need us to remind you that your business is changing rapidly. For this reason, it’s important to assess your long-term plan on a regular basis, keeping the following considerations in mind: »» Does the plan still make sense for your life? »» Have the laws or the business itself changed? »» Know, and keep updated, the value of your business using more than one method of calculation
At the Forte Group, we have helped thousands of professionals navigate important transitions. Careful planning yields the greatest degree of success, and we are dedicated to the highest standards when it comes to preparing, executing and monitoring a strategy that meets your needs. If you are considering selling your medical practice, we understand that the proceeds of this transaction may have to meet your needs for the rest of your life. Our experience can help make sure that your life’s work gives you the retirement you deserve.
Morgan Stanley Smith Barney LLC, member SIPC Issue 2, 2013
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Understanding health care reform
Dr. Dan Diaco, a Tampa-based plastic surgeon, consults with a patient.
Experts available to help understand new laws
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By Justin Treece, Insurance Advisor, Connelly, Carlisle, Fields & Nichols
t’s a question you may be asking: How are the changes in the nation’s health care system going to affect my medical practice? Many of the details of what’s commonly known as “healthcare reform” or “Obamacare” will become more clear over the next several years as the program is fully implemented. But in the meantime, there are a number of changes that are already rolling out, and some things that business owners in the medical field should be aware of. There’s a good chance that the changes may affect your medical practice in two areas that raise important questions. One, how will the changes in the healthcare system affect what your practice is being reimbursed or paid for your services? And two, how will healthcare reform affect how you offer benefits for employees? “Everywhere, there is pressure to reduce the cost of healthcare,” said Dr. Dan Diaco, a well-known Tampa-based plastic surgeon. “This is going to impact doctors everywhere, and there is a lot of anxiety right now about what the changes could
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mean. It’s important that people in the medical profession start planning now for what’s coming.” Doctors and medical directors we talk to in our work as insurance advisors worry about the complexity of the new law, which consists of several thousand pages of information, and the difficulty in figuring out how changes will impact the medical industry. With this in mind, here are five things to think about as you prepare your business for the coming sea changes in medical care:
Doctor’s Life Tampa Bay
Issue 2, 2013
1. Understand the differences in requirements for coverage if you have fewer than 50 full-time or “full-time equivalent” employees vs. more than 50.
To explain the term “full-time equivalents,” an elementary example would be if two workers are each working 20 hours a week, that would be equivalent to one full-time equivalent when it pertains to the new healthcare law. The differences in requirements are substantial. And no matter the size of your practice, the key is to determine how best to help your employees obtain adequate coverage, while keeping costs at a level you can live with. For some companies, it may be worth it to simply pay the penalties involved for not offering employee coverage. But bear in mind that with more and more employers cutting health coverage, offering quality health insurance can be a major factor as you work to attract and retain good employees.
2. Rates may increase for covering your practice’s employees, but there are many factors that go into that equation.
We expect many considerations to come into play that didn’t before. For example, while someone’s geographic location will continue to be important in determining the cost of coverage, lifestyle choices like smoking will be more important. In particular, the impact on smaller groups may be significant, due to changes in how insurance carriers underwrite these groups. It will be interesting to see how rates for certain groups change due to these factors. In the small group market we might see a younger, heavier male populated group getting discounted rates; this will likely not be the case anymore, as gender is no longer factored in. As we track all the changes, we have to also consider that healthcare reform was not built state by state, but on a federal level. While it isn’t uncommon to currently see deductibles over $2,000 in Florida, a number of other states average much lower deductibles. This will change, because the new federal law requires plans to have certain caps on deductibles and out-ofpocket expenses. Due to these changes, some groups that have used higher deductible plans to help control costs may be forced to make the decision to shed benefits all together.
3. Healthcare reform’s potential impact on your revenues and profitability may be hard to predict at this point, but the need for financial and business planning is a certainty.
In a nutshell, it’s important to do some risk planning. What if healthcare reform-related changes cause your business’ revenues to fall by, say, 10 percent? What would you do? Are there efficiencies you should look at now as you prepare for the possibility of a negative impact on the business? Also, for many medical professionals, business and personal finances are tied closely together. For instance, if you own your medical office facility, that may be directly connected to your personal finances. So don’t only think about consulting with an insurance professional. Think about talking to bankers, wealth management professionals or others who could help you do the proper planning now.
Issue 2, 2013
ABOUT THE AUTHOR Justin Treece is a Benefits Advisor with Connelly, Carlisle, Fields & Nichols, one of the top insurance agencies in Florida. CCF&N helps a wide range of customers with both business and personal insurance needs, and has a particular focus on helping doctors and other medical professionals. CCF&N is a division of USAmeriBank, a full-service, independent bank based in Tampa Bay, with 11 branches and over $2.6 billion in assets. USAmeriBank helps businesses and individuals with a wide range of banking and wealth management needs.
4. We expect that audits will increase in this new system, so it will be important to be compliant with all applicable laws.
It’s expected that the Department of Labor will be doing more audits on employee benefit programs, and we find that many businesses are not 100 percent complaint when its comes to following government rules. We are often asked, “Do we really need all these documents that are supposedly required?” Our short answer is yes, and an insurance professional can help your staff walk through what will be a maze of regulations and paperwork. Consider getting outside help that you can see as an extension of your team. This is critical because most smaller practices don’t have a specialist for human resources or benefits issues. Often, there is one administrator in charge of everything related to the office, so it’s important to have other people helping you who have specialized knowledge in these areas.
5. Work through an experienced, licensed insurance advisor as you figure out your options and what various coverages and costs might be. For many medical practices, benefits and insurance questions have been rather simple. But that is about to change dramatically, and it may be time to seek out more knowledgeable help. Find an advisor who is taking the time to truly understand healthcare reform, which is quite a challenge. This could bring significant value as you prepare for the changes ahead.
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