October, 2012

MD

PREFERRED

SERVICES THE ADVISOR

IN THIS MONTH’S ISSUE

Blogging for Patients: A Physician's Guide to Blogging Basics By Monique Bryher

The Realities of Family Business Succession By Cade Evans

A Tale of Two Theories By Brad Campbell

Location, Location, Location By Ara Oghoorian

How to Get More Referrals from Patients By Dr. Vicki Rackner

Hedge Funds: Good for Fund Managers, Bad for Investors By Kevin Kroskey

Creating Health - It's All About a Choice By Karen Gray

10 Tips to Choosing Your Bank By Mark Kane

Contractual Agreements for Physician Services By John W. McDaniel

Aging Baby Boomers Face Losing Care as Immigrant Healthcare Providers Go Home By Karen Weinstock

The Recruiters Corner

Is a Captive Insurance Company (CIC) Right for Your Practice? By Guy P. Jones

Physician Opportunities

Blogging for Patients: A Physician's Guide to Blogging Basics By Monique Bryher, MSPH

www.PhysicianRealEstateSpecialist.com

Formerly thought to be the province of computer

geeks, the blog has rapidly overtaken the website as

an effective means for businesses to communicate

and advertise their products and services to their

clients and prospective customers. But what exactly

is a blog and why should you, as a physician,

consider incorporating one into your practice?

According to Wikipedia, the word “blog” is actually a

portmanteau, or combination of two words: “web”

and “log.” It is distinct from a traditional website,

which tends to be a more static assemblage of web

pages and lacks easy use and altering by its owner-

user. The strength of websites and web pages is in

displaying products and services that don’t

necessarily change all that often and when they do,

are usually modified by a web development company

or in-house web specialist.

Most physicians, even those who operate smaller

practice groups, do not have the necessity to employ

and in-house web expert. This makes the blog the

perfect solution for physicians for establishing an

online presence.

The blog began as an alternative and unique means

for individuals to communicate with their target

audiences on the Internet using a journaling

method. Often these were not business undertakings

at all but just ways to convey a political or social

viewpoint. But the blog has truly blossomed so that

now it is an invaluable tool for entrepreneurs and

businesspeople such as physicians to establish and

build their brand, the end goal being to attract new

patients into the practice. Setting up a blog is relatively easy. I advise

physicians that just as they hire an accountant to manage their bookkeeping, an attorney to oversee their legal issues and a financial advisor to manage their money, so should they engage the services of a blog consultant. It’s my own experience that a blog is less expensive and can be up-and-running relatively quickly. You will have to work closely with your consultant to determine the blog’s theme (how it should display), and the major categories that describe the services the physician’s practice offers. Most blogs, by the way, are set-up using software called WordPress, which is the gold standard for blogging software, yet is free or very low cost. But where the blog shines – and why it has become the top means of self-promotion on the Internet – is in its powerful journaling features. Once your blog consultant has your blog running live and tutored you on how to write a “post” (publish an article), you are free to write and post as many articles as you want without having to engage the services of others to publish them for you. As the owner-publisher of several highly-ranked blogs, here is the advice I offer for you to establish a strong brand and hopefully attract more patients into your practice: - Write as often as possible, definitely as least once a week or more for the first 6 months to a year. - Blog posts do not have to be very long; in fact, sometimes 2-4 paragraphs is all you want to write. Provide links to related professional articles and publications using strong keywords that are associated with your practice. Doing this causes search engines to find your blog, which will gradually improve its rankings on the Internet for your type of practice. The higher you are ranked, the more likely prospective patients will be able to find you. Links, by the way, are the Internet’s version of footnotes. - Think of as many keywords as possible that are associated with your type of practice. Either have your blog consultant copy-and-paste them into your blog where the metadata go or show you how you can do this yourself, so you can modify those terms in the future. Use bold-face on all keywords, e.g., plastic surgery, again, to enhance search engine optimization. - There are several types of blog articles you can post:

(1) you can abstract and comment on articles in scientific publications (2) you can write original articles and provide links (footnotes) to supporting articles in other publications (3) you can write a post about a new service or product your practice is offering or a special event that you are holding. A final piece of advice I offer new bloggers is to

firmly resist the siren telemarketing calls of businesses that offer you “search engine optimization,” aka “SEO optimization.” This is usually sold on a monthly fee and can be ridiculously expensive. If you just focus on your writing, do it regularly and remember to write content that includes key words (and that includes your name and that of your practice!), you will improve your rankings on your own and be well on your way to building or expanding your patient base.

Reduce your monthly medical building energy costs by 20% or more Our new partnership with Tec360 allows us to help significantly reduce the monthly energy expenses of physician groups, hospitals and surgical centers. All hospitals and surgical centers and physician group offices with monthly utility bills in excess of $2,500 should revisit the current available energy reduction technology with us. Call us today at 1-877-760-2564 or e mail us at info@physicianspreferredwellnessgroup.com to talk to one of our energy specialists regarding your medical facility and potential monthly energy cost savings. You can also contact us through the following link, www.physicianspreferredwellnessgroup.com/contact.php

http://www.valeriewilsontravel.com

The Realities of Family Business Succession By Cade Evans, Sovereign Financial Group & Insurance Services Many entrepreneurs intend to pass the family business to future generations. Unfortunately, most family businesses fail to survive into the third generation. When considering the passage of a family business, these important realities need to be understood. Death and Disability Will Occur, but the Legacy Will Continue We will all die. However, Paul Simon may have had the same perspective as many of us: [I will] “... continue to continue to pretend that my life will never end... ” Death will happen to all of us—and most of us will suffer at least one period of disability before passing. But estate planning for family businesses is not most fundamentally about death and the taxes that occur at death. It is about planning for the Legacy you will leave behind. This perspective starts with understanding that estate planning does not start with THINGS or the taxes imposed upon them. It starts with PEOPLE: Who you were and are and who your family is and might become. Increasingly, clients and planners recognize there is often a misplaced emphasis which focuses on assets rather than family, on structure and complex techniques over perspective, on tax savings in place of family need. The Estate Tax Is Not Going Away Despite all of the political discussions over the last decade, there is virtually no chance that the federal estate tax will be permanently eliminated. While Congress has provided for higher estate, GST and gift exemptions through 2012, there is no reasonable expectation of an elimination of estate taxes any time in the future. Moreover, a growing number of states are considering an increase in death taxes to shore up their budgets. Income Taxes Are Going Up On January 1, 2013, the top federal income tax rate of 35% is scheduled to increase to 39.6%. On that same date, the special 15% federal tax rate on dividends will be gone (i.e., they will be taxed at rates of up to 39.6%+) and federal capital gain tax rates will go up by 5%. Congress could raise these rates even higher. The social security tax burden may also increase in coming years to fund the shortfalls in the entitlement programs. The 2010

Healthcare Bill includes two significant tax increases on high income earners: • A 0.9% Medicare payroll surtax on wages over $200,000 ($250,000 for joint filers) • A 3.8% tax on investment income, including capital gains, dividends, interest, rents, royalties and other “unearned” income over certain limits. Will Washington extend all or some of the Bush income tax cuts? As with the transfer tax changes, no one knows what legislation may be passed. Will any legislation be another temporary measure like the December 2010 tax bill which provided new rules for two years and rampant uncertainty after the temporary rules expire? The Inevitable Conflict Many business owners intend to pass their businesses to one or more designated family members who will run the business after the entrepreneur’s death or retirement. However, because the business is often the largest single asset of the estate, the owner often passes part of the business ownership to other family members who are not involved in the business. This is almost always a mistake. During the owner’s lifetime, the owner may have been able to maintain peace in the family and serve as the “benevolent dictator” of the family business. Unfortunately, this powerful role disappears with the entrepreneur’s death or incapacity. Sibling rivalry, in-law problems and other issues often begin to come forward, particularly between those who are operate the business and those who are outside the business. Divorces Will Happen Almost 50 percent of all marriages end in divorce. If divorce is such a revalent issue, why do we so often ignore the possibility in estate planning? Planning should include reducing the divorce-driven exposure of parent and an heir. Buy/sell agreements should be drafted to allow the family to repurchase ownership interests which pass to non-blood family members by divorce or death. Trusts may be created which provide long term benefits to family members, but deny such benefits to divorcing spouses or non-blood heirs Although they are not particularly romantic, clients and their heirs should be strongly encouraged to sign pre-nuptial agreements before marriage.

A Tale of Two Theories By Brad Campbell If you ’re an existing client of CRA ,or have followed our writings in the past, you are familiar with our concern stretching over the past several months, regarding the sustainability of record corporate profits and profit margins and the components that may or may not drive profits. Dramatic headlines aside, it is essentially corporate profits that push stock returns, hence our concern regarding this subject. In my readings, I have noted two diverging and competing views emerge among the most reputable and respected firms in the industry. In fact, as I was reviewing two white papers last evening, I was quite intrigued by the direct and not so subtle reference to, and criticism of, each of the opposing views on the subject of the sustainability of corporate profits and profit margins. For simplicity (hopefully) I will refer to the competing theories as (1 ) the mean reversion theory, and (2) the non-mean reversion theory. Although there are several analysts and firms that stand firmly in each of the two camps I will use two of the more prominent firms participating in the debate to demonstrate the divergence of views. In a March 2012 white paper entitled, “What Goes up Must Come Down!” , GMO ’s James Montier, makes the

case for mean reversion. The term “ mean ” in this case refers of course to some type of average. GMO ’s contention is that if you compare the simple trailing (actual past readings ) price to earnings ratios to the long run historic average price to earnings ratios stocks look reasonably priced and could portend for future stock price appreciation. However, if you apply the Graham & Dodd method of smoothing out the price to earnings ratios by using a 10-year moving average of the earnings ( “E” in “P/ E ” ), a dramatically different pricing story is revealed; a P/E of around 24x versus the simple trailing P/E ratio of 15x, indicating a much more expensively priced stock market. If the Graham & Dodd method of averaging seems more accurate to you then you would be in the camp that the market is priced expensively above its long run historical average, and therefore, priced to decline to the long run historical “ mean ” or average.

As further support of the mean reversion thesis, GMO and Montier use the Kalecki profits equation to explain the driving components of corporate profits and why they may be at risk to decline or at least not increase. Kalecki was a Polish economist who lived around the time of John Maynard Keynes ( 1930 ’s ). Kalecki ’s equation is used to explain where corporate profits come from lays out like this: [PROFITS = INVESTMENT—HOUSEHOLD SAVINGS—GOVERNMENT SAVINGS-FOREIGN SAVINGS + DIVIDENDS] Investment in the equation refers to firms or households buying goods and services from other firms, creating profits for that entity. Household savings is the most obvious drag on profits; if consumers are saving, those are dollars they are not spending in the real economy. The impact of government sector savings on profits is similar to the dynamic stemming from the household sector. As Montier points out in his white paper, there are many ways in which funds are transmitted between the government and business sector but they all net out under the category of government sector savings. Foreign savings ( the current account balance component of the balance of payments equation for the U.S. economy ) also drags on profits, where if the U.S. is running a current account deficit, then we owe the rest of the world and this is lost potential profits for the business sector. Dividends are a form of in-come to the consumer or household sector, which in turn can be used for spending and contributing to corporate profits. Montier ’s paper looks at the actual driver ’ s of corporate profits since 1952, revealing that NET INVESTMENT was by far the prominent factor in the above equation. However, as Montier points out, lately (around late 2008

through to current times ), fiscal deficit running or government spending has taken the lead role as the engine of corporate profits generating 7.6% of 10.2% of GDP that represents corporate profits as a percentage of GDP for 2011. GMO and Montier make the case that because government deficit spending has become such a large and dominating driver of corporate profits in the post -recessionary era, logic would indicate that when the government moves toward a deficit reduction plan, corporate profits will struggle to sustain and margins will ultimately revert back to their long run mean or average as described previously. It would take a structural break in profit margins to support a case for non-reversion to the mean as Montier argues. From a global economic perspective, other countries such as Europe, the U.K. and Japan also have experienced record high corporate profit margins and are therefore at similar risk as described by the case for reversion to the mean or long run average pricing. In the other corner stands the global giant, PIMCO. PIMCO takes issue with the idea that mean reversion is always right in their opposition piece, “ Newtonian Profits ”, where they use the analogy of Newton ’s laws of physics, namely, what goes up must come down (which just happens to be the title of the GMO white paper which was writ-ten in March 2012—the PIMCO piece just came out this week ). Coincidence? I think not. This is a subtle war of financial market and economic theories. I think this wide chasm of views spotlights the difficulty in navigating the post-recessionary marketplace that we hear reverberated around the investment and financial industry on a daily basis. As part of our investment and portfolio construction process we formulate our own views based on volumes of data that we score to assess what the data is telling us or pointing to. We then look to confirm what we think the data is telling us by looking to large firms such as GMO, PIMCO, JP Morgan, BNY Mellon, First Trust, LSA Analytics, Morningstar and others to name just a few more recognizable firms. There has been a divergence of views, of course, among firms, but rarely have we seen such a head to head difference of opinion as we find now. PIMCO ’s view is that, like GMO, there needs to be a catalyst to force the system to revert to the mean ( for example, a significant reduction in government spending/deficit reduction ). Unlike GMO, PIMCO ’s view is that this catalytic event will not occur because “the dysfunction in Washington suggests no meaningful deficit reduction agreement will happen in the near future ”. The piece quickly points out that neither the Democrats or Republicans embraced the recommendations laid out in the serious Simpson-Bowles deficit reduction plan. To provide credence to our discovery of this battle of the two competing theories, the PIMCO piece devotes an en-tire section of the paper to working through the Kalecki profits equation, used by GMO ’s Montier, in an effort to debunk the conclusions drawn from the model by GMO. Again, coincidence? I still think not. PIMCO ’s view includes the notion that analyst from both political parties are fully aware that long term deficits are predominantly driven by demographic changes and the long-term expansion of entitlement programs for our aging society. As such, PIMCO ’s view is that politically, any changes made in this regard will have to be phased-in over the long term, thus significantly reducing if not eliminating any negative impact a reduction in government spending may have on corporate profits and profit margins. Concluding thoughts: We are still concerned about the sustainability of record corporate profits and continue to question whether today ’s stock prices are expensive or reasonable overall . We continue to monitor and look for top line revenue growth to sustain margins and profits and whether the future economic landscape will facilitate such growth. With this back-drop in mind ,we feel the prudent course of action is to continue to play both sides if you will; position for some up-side capture while managing downside potential risk until the path forward becomes more coherent.

MD Preferred October Artist Spotlight Charla Steele

www.charlasteele.com

Charla Steele’s collage work was inspired by her daughter, MacKenzie (Kenzie) and her barnyard nursery theme. Using the various magazine collections in her home, Charla was able to capitalize on the rich color, text and uniqueness of magazine pages as well as benefit her personal recycling effort. The original simplicity began to evolve, mature, and incorporate a variety of subjects such as frogs, flowers, ballet, beach, coffee, wine and the occasional portrait. Each collage is crafted by carefully selecting magazine pages with extraordinary color, depth and texture. The papers are cut into “mosaic-like” shapes or run through a paper shredder, layered onto a substrate then wrapped onto the edges. Once the image is complete, a thick coating is applied to enhance the vibrancy of the image and “bring it to life”. The charm of Charla’s work lies within her ability to capture common subject matter and give it a jovial yet sophisticated personality by redefining the original intention of her medium. Today, Charla’s work continues to address the importance of adding sheer pleasure to the complicated, busy lifestyle. Putting it simply - she creates work to make people smile. Influenced by her interior design background and dealing with spatial elements, Charla is driven to take her medium three dimensionally. She has begun to “sculpt” with her magazine pages resulting in very vibrant and textural wall art as she progresses toward fine art sculpture.

http://www.visalaw.com

The Sagamore Resort

Contact: Krassi Diehl / Sales Manager / 518-743-6174 / 110 Sagamore Road Bolton Landing, NY 12814

The magnificent Sagamore on Lake George has been extending hospitality to visitors of Bolton Landing for over one hundred years. Poised on the southern end of Green Island, The Sagamore commands stunning views of Lake George and the islands that grace its waters. This family friendly golf and lakefront resort offers luxury accommodations, extraordinary dining, superb fitness and spa facilities and a host of opportunities to enjoy the incredible beauty of the Adirondacks.

Check Availability

The Sagamore, located in the heart of the Adirondacks, is an island resort on Lake George anchored in Bolton Landing, New York. Located 60 miles north of Albany via Interstate 87, The Sagamore is a leisurely drive from most Mid-Atlantic, New England, Quebec and Ontario Province metropolitan areas, and is just a four-hour drive from New York City or Boston. From outdoor adventure to peaceful solitude, you will find it here in the Adirondacks. With more than 20 beautiful lakes, countless outdoor activities and dozens of exciting attractions, the Lake George area is the perfect vacationer's paradise.

Location, Location, Location By Ara Oghoorian, CFP®, CFA

You have probably heard the old real estate adage – location, location, location – meaning the location of your house has a great impact on price. The same theory holds true for other investments. Where you hold your assets is almost as important as the assets themselves. Investments grow through interest, dividends, and/or capital gains. In general, interest is paid on bonds and savings accounts; dividends are paid on stocks; and capital gain is the profit you earn when you sell an asset for more than you paid for it. Unfortunately, interest, dividends, and capital gains are each taxed differently, so ensuring investments are held in the proper accounts can maximize your after-tax return. In short, interest earning assets should be in tax-efficient accounts while capital assets in taxable accounts.

Take Control of Your Tax Currently, long-term capital gains are taxed at a maximum rate of 15 percent for the highest tax brackets and zero for the lowest two tax brackets. Conversely, interest and some dividends are taxed at ordinary tax rates which are higher. You cannot control when a bond pays interest or when a stock pays a dividend, so the tax liability is out of your control; however, you do choose when to sell a stock and thus incur capital gains. Therefore, you can control your tax liability by holding capital assets such as non-dividend paying stocks in your taxable accounts and income producing assets, such as bonds and dividend paying stocks, in your retirement accounts. Keep It Simple If you own commodities, as any well diversified investor should, you most likely own them through a mutual fund or ETF; if you own physical commodities, see section on Make Your Gold Shine. Most commodity funds are structured as a partnership, which means that at the end of the year, you will receive a K-1 statement from the partnership showing your share of the partnership’s profits/losses. The K-1 must be entered into your tax returns and can increase your tax preparation costs and complication. One way to avoid having to report a K-1 and still own commodities is to buy them in your retirement accounts. You will still get a K-1 at the end of the year, but there will be no tax ramifications. Make Your Gold Shine If you invest in gold, silver, or other similar assets (i.e., stamps, wine, rugs, etc.), the IRS considers these collectible items. The tax rate for these collectibles is a flat 28 percent if held long term and at your ordinary rate if held less than a year. These unique tax rates still apply even if you hold these investments in an ETF. Since such investments have less favorable tax rates, it would be wise to hold them in an IRA instead of a taxable account. Be Tax Efficient REITs are required to distribute 90 percent of their taxable income to shareholders, which means they generate a high yield; therefore, REITs are more appropriate in a retirement account. In addition, some interest, like those on certain municipal bonds, are exempt from state and federal income taxes, thus making them ideal to hold in a taxable account. Recognizing the type of income received (interest, dividends, or capital gains) and how it is taxed will help you determine where to hold those investments to ensure the most tax efficiency. Originally posted on FPA All Things Financial Planning Blog

How to Get More Referrals from Patients By Dr. Vicki Rackner

Will your delighted patients take the next step and refer family and friends to you? Surprisingly, left to their natural devices, many patients will never think to mention your name, even when they run into people who need your help.

Inviting your patients to spread the word is a learnable skill. The tools that you will need to transform delighted patients into SENDERS--people who send you patients--include: 1. The right mindset 2. The right language 3. The right habits In this article, you’ll learn about the referral mindset. The referral mindset When I work with medical practices who want to accelerate their practice growth, I often ask, “Do you think that asking your existing patients for referrals is an effective way to get more patients?” Almost 100% of my coaching clients and audience members say, “Yes.” Then I ask the second question. “How often do you ask your patients for referrals?” The most common answer is “Never.” When I was running my own surgical practice, I fell into this group. Then I ask, “Why not?” Here are the most common reasons physicians and medical staff offer:

“I shouldn’t have to ask for referrals; if I do a good job, my patients will automatically tell their friends.”

”It’s unprofessional to ask for referrals. I’ll look like a used car salesman.”

“I don’t want to impose on my patients.”

“I get so busy I forget to ask.”

“Asking for referrals makes my patients uncomfortable.”

“Asking for referrals makes me uncomfortable.”

“Nobody at the office likes likes doing it.”

There’s another way of thinking about referrals; this mindset leads to much better results. 1. Embrace the spirit of service.

You chose a career in medicine to serve others. There’s a group of patients out there who are best served by you. Asking for introductions to best-fit patients is an act of service. You’re asking senders to help you serve patients who genuinely need your help. Enter into conversations with a spirit of service. Referrals are not about you; they’re about the people you serve. 2. Challenge your assumptions about asking for help. Many medical professionals resist asking others for help; they fear it’s a demonstration of weakness that will compromise their stature. I had a patient Becky who was recovering from a long, complex treatment course. Becky was the kind of person who took care of others in their time of need; yet she resisted their offers of help. I asked her to imagine how she felt when she helped others. A smile crossed her face. Then I told her that she had the chance to let others feel this way when she allowed them to help her. The request for help is a gift in disguise; no act of receiving feels as good as the gift of helping others. 3. Challenge your assumptions about your patients’ mindset. Many fear that the request for introductions places a burden on patients. Consider this. Your patients are grateful for your care. They want to give back. When you ask for introductions, you’re telling them exactly what you would most appreciate: the chance to help others. This is like telling a friend what you would like to do on your birthday. You remove the guess-work--and get what you want! Think of referrals as a way to extend your impact. Stay tuned for Part 2: the language of the referral. Want to get more patients? Drawing upon her experience as a practicing surgeon, faculty at the University of Washington School of Medicine and entrepreneur, Dr. Vicki Rackner coaches health care professionals who want to accelerate their practice growth. Sign up for free weekly marketing tips at www.MedicalBridges.com

Hedge Funds: Good for Fund Managers, Bad for Investors By Kevin Kroskey, True Wealth Design Big money can be made from hedge funds. If you run one, that is. That's the conclusion of a new book that says people who invest in hedge funds would have been better off over the past nine years if they had stuck to a broadly diversified portfolio of vanilla stocks and bonds. The book is The Hedge Fund Mirage: The Illusion of Big Money and Why It's Too Good to be True, by Simon Lack, an asset manager who formerly chose hedge funds for major US bank JPMorgan. Lack argues that the 18% cumulative return on hedge funds in the nine years to November 2011 was easily beaten by the cumulative 29% gain from the S&P 500 index. The gap was even starker for investment grade corporate bonds, which in the same period gained 77%, as measured by the Dow Jones Corporate bond index. Of course, the underperformance of hedge funds over this period is even greater once the customary 2% management fee and 20% performance fees charged by hedge fund managers are taken into account. Other fees are often tacked on for accounting services, trader bonuses, and operating expenses. A study by LJH Global Investments, an advisor to hedge fund investors, found that for about one hundred hedge funds the average bill for “other expenses” was 1.95%. Interesting to note that the hedge fund manager receives the 2% management fee regardless of whether the fund performs well. Further, the fund receives 20% of the positive performance, yet doesn’t participate in any downside. This asymmetric characteristic is great for the hedge fund manager but highly undesirable for the investor. If individual hedge fund managers are generating the desired "alpha," or additional returns above a representative benchmark, then the benefits of that skill tend to go to the managers themselves rather than to investors. In fact, Lack estimates that from 1998 to 2010, the hedge fund industry captured at least 86% of the returns it earned for its customers. This might explain why yachts cruising the Caribbean tend to be skippered by hedge fund managers, not investors. For anyone who has followed the hype surrounding hedge funds for many years, this is not really a surprise. A good proportion of the investing public—egged on by the financial media—genuinely wants to believe that consistent market-beating returns are achievable without taking on additional risk and paying excessive fees. Yet there is no such silver bullet. From a marketing perspective at least the appeal is fairly evident. After all, the more exclusive you make a club, the more likely people will pay a premium for joining it. Yet when analyzing the returns mathematically, it is evident that exclusivity doesn’t translate into wealth creation for investors. While the hedge fund industry no doubt would contest the findings of Lack's book, one doesn't have to agree with his numbers to still harbor reasonable doubts about risking one's hard-earned savings by investing in hedge funds. In a recent white paper, Dimensional Fund Advisor’s senior associate in Research Ronnie Shah explains that, due to the lack of disclosure around returns, it is difficult to determine how much alpha, if any, hedge funds generate. Industry groups that report hedge fund returns rely on voluntary disclosures by the funds themselves on the returns they generate. Shah notes this creates potential for biases in the data, such as the omission of poor returns or the dropping out of the returns of failed or discontinued funds. This is in addition to other drawbacks of hedge funds, such as illiquidity, relative lack of oversight, the additional costs of leverage and derivatives and, of course, the substantial fees charged by the managers themselves. Shah's paper concludes that the highly uncertain payoff from hedge funds, the high expense ratios, and the lack of disclosure around them mean that investors should exercise caution before investing in them. David Swenson who manages the Yale Endowment notes when comparing investing in hedge funds to mutual funds, “Investors in hedge funds face dramatically higher levels of prospective failure, due to the materially higher levels of fees.” Probably best to forego joining the exclusive club and opt for a lower cost, transparent, and tax efficient portfolio.

http://www.accessnational.com

Creating Health - It's All About a Choice By Karen Gray Let’s think about this for a moment, is there anything else in our life as important as optimal health? Health deserves to be right up there alongside freedom and the pursuit of happiness as our most prized possessions. We must make the fundamental choice, as Robert Fritz calls, “the choice upon which all other choices rest.” Once we make the choice to be healthy, we made it our business to act in accordance with our goal. We must take full responsibility for our actions rather than letting circumstances drive our decisions. We become the author of our own destiny. According to a study by the National Weight Control Registry (a database of individuals who’ve lost thirty pounds or more and kept it off for at least one year) people who suffer a heart attack, stroke, or other serious medical crisis find themselves more committed to weight loss as a result. In addition, people with these sorts of medical triggers reported greater weight loss and less weight regain. The upshot? As a physician, a medical event provides a teachable moment for weight control with your patients. Retraining the brain to beat obesity We gain weight by eating more than our bodies need for fuel. But why do we eat when we don’t need food? It’s not our stomachs that tell us to eat when we’re not really hungry- it’s our brains. Lucky for us, patterns in the brain are not cast in stone. We can change our habits! The habit-forming “rush” eating The “reward area” of the brain is where we experience pleasure and satisfaction. Dopamine, a chemical that occurs naturally in the body, serves as the messenger of these sensations. Dopamine release is what’s behind the pleasurable “rush” people get from alcohol, drugs, sex, and other behaviors – including eating. The food we crave What are these certain foods? They are the ones that are powerfully tasty, rich in fat, salt, and sugar – and when delivered in super-sized portions, signal an intense rush of dopamine. It’s not an exaggeration to say that friendly foods, sugary sodas and juice drinks, salty snack foods, and other high calorie items can become habit forming. Food manufacturers know this, and some companies and chain restaurants create foods with extra fat, sugar, and salt to make you crave then, buy them, and eat them, over and over again. They are more

concerned about their companies’ profits than your health! Unhealthy eating patterns Eventually, the reward system in our brain breaks down. Normal, healthy food tastes bland and boring. Healthy portion sizes leave us craving second and third helpings. The only thing that seems to satisfy us is fat, salt, and sweets – and in increasingly large quantities as we develop more and more tolerance. An unhealthy habit is born. How do we retain the brain? We fully commit to the goal of getting healthy. We identify the choices that move us closer to the goal, and the ones that move us farther away. One day at a time, we cultivate healthy habits until they become second nature. Step 1: We take a “brain holiday” from nutritional pollution and reset our taste buds with Medifast Meals and other healthy fuelings so eating healthy is pleasurable again. Over time, normal foods in normal portions can become as satisfying as super-sized helpings of fat, sugar, and salt. Step 2: We learn to reward the brain with healthy alternatives to high fat, high sugar foods. We use nonfood, non-drug dopamine stimulants such as exercise to boost natural endorphins and other “feel-good” neurotransmitters Step 3: We commit to controlling stress and other triggers. We limit our exposure to nutritional pollution, especially in our homes. We surround ourselves with healthy people who support our goals. We manage stress, get sufficient amounts of healthy sleep, and pursue a life with meaning and purpose. In this way, step by step, we can live our way into a healthier future, one day, one habit, at a time. Karen Gray, Certified Health Coach with Take Shape for Life, works with clients across the US coaching and support in achieving their optimal weight and overall health, long-term, with the Take Shape for Life (TSFL) program. The TSFL program is based on bringing together medical science and everyday choices. Mrs. Gray also works with physicians that want to offer a solution-based program that will not only benefit their patients in achieving Optimal Health, therefore reducing their risk of disease long term, but will also accelerate their practice revenue. Contact her at grays@teamtsfl.com or (816) 405-0001.

10 Tips to Choosing Your Bank By Mark Kane, Health Wise Capital, LLC Did you know that getting the right bank for your practice is a lot like finding a mechanic for your car? You better get some objective information first, and the greatest way to decide whether to use a particular bank is to answer the following 10 questions. This is your jumping off point, but dig deeper if you can. Is the bank healthy with strong financials? The greatest recession since the great depression has caused a rash of bank failures. The number of failed U.S. banks thus far in 2012 is 40. This follows 92 bank failures in 2011, 157 in 2010, 140 in 2009 and 25 in 2008. Do yourself a favor and check the health of any bank you’re seriously contemplating. Save stress and a headache by staying away from a bank that Uncle Sam might be bailing out six months from now. Does the bank focus on lending to healthcare companies? They all will tell you that they do. But you have to be a bit more of a detective and ask specifically what percentage of the bank’s business is geared towards your specific niche? Find out how much they lend to a “theoretical” practice like yours with the appropriate number of years in business and revenue (not to mention credit, collateral, etc.). Connecting with the right person to answer more questions will always yield more information. How does your bank rank with the SBA? This information can be found straight from the SBA. Entrepreneur Magazine created a great website on business-friendly banks, broken down nationally and by state. Will your bank really accommodate your needs? The first question I’m asking is if the bank lends to your type of practice? When you get the bank’s business loan officer on the phone, take the time to explain your practice and tell them what you do, how long you’ve been doing it, and how fast you are growing. Let the bank know what YOU are looking for. Cover both the relationship you would like and the type of financing you want. There’s a chance that they don’t so make certain the loan officer isn’t just trying to open a new account. If the answer is “no,” your local banker knows the competition and should be happy to make recommendations. Banks are like a box of chocolates – you never know what you’re going to get. Don’t be afraid to ask. Believe me when I tell you it’s a pain to have to go to multiple banks to cover all of your

needs. Does the bank offer traditional loans, lines of credit, credit cards or direct deposit? These answers must be discerned after confirming the bank does business in your field. The 3 little bears. It seems reasonable to think that the bank has money, right? But you may be too big. On the other hand what is their average small business loan? Maybe you’re too small. Another question is whether the bank can grow with you? Unlike Goldilocks, there is no “just right.” Small banks may have a limit on how much they can lend to one business, while big national money centers banks will have a minimum amount, which could be much more than you’ll ever need. Meeting with the right person? Can you get introduced or referred to the bank officers who make the decisions? There’s nothing like having a loan officer take an active interest in you, or a referral from a community member that they respect. This won’t guarantee you get a loan, but there’s nothing wrong with a little preferred treatment. Is the banker willing to meet with you at your office? Don’t be afraid to let the banker know that you believe that your time is valuable. If your practice “shows” well, a meeting at your office can be just what the “doctor” ordered. Where are decisions made? Does the bank know what’s really going on in your local economy? Some large banks leave the lending decisions to each branch. That’s definitely to your advantage. If the decisions are made in the home office, there could a disconnect. Here’s my personal favorite – How long has the loan officer been with the bank? Don’t overlook this question. Some branches have a revolving door with loan officers. You should ask what is their level of expertise in working with small and mid-sized medical practices, but really assess whether they understand your practice and what makes it a viable candidate for bank financing. Mark Kane is co-founder of Health Wise Capital. Running a medical practice is hard work. Getting funding from Health Wise Capital is not. Health Wise Capital's performance based funding makes fair financing to millions of well-run health care enterprises that miss the cut for bank loans. If you need help or funding solutions, contact us today. We can be reached at 888.456.9223.

http://www.manageditsolutions.net

Contractual Agreements for Physician Services By John W. McDaniel, MHA

It is not uncommon for hospitals to have contractual agreements with independent physicians for services such as medical directorships, office special leases, on-call arrangements, recruitment agreements and professional services agreements. Many hospitals focus on the initial physician contract development itself, taking steps so that appropriate provisions are included and that the contract is fully analyzed by the legal department of the hospital or by outside counsel. But some hospitals may lack appropriate monitoring procedures that can assist with continued contract compliance. Some of the most common violations hospitals may discover during internal analysis of their physician contractual arrangements can include: • Expired contracts, • Financial relationships where no written contract ever existed, • Undocumented modification of financial terms, • Terms modified during the first year in violation of safe harbors and exceptions available under the Anti-Kickback Statutes and Stark Law, • Agreements that incorrectly describe the service, • Hospital benefits to a doctor that exceed Stark’s minimum exception. If such systems are not already in place, hospitals should consider creating and maintaining a database of existing, new or renewed physician contractual arrangements potentially including the identity of the parties, a description of goods and services provided under the arrangement, compensation methodology and amount. Given the above government enforcement initiatives, hospitals may consider analyzing the documentation available for their physicians’ contractual arrangements. This analysis can assist in identifying potential areas at risk for violations of the Anti-Kickback Statutes or Stark Law. Based on recent enforcement efforts, the analysis may include a focus on problem areas including: • Non-enforcement of late payments or non-

payment for certain months or a lengthy period of time, • Lack of current and/or appropriate fair market value documentation, • Increased space usage by physician tenants without amendments to the applicable lease agreement, • Payments that do not match terms of the lease agreement, • Failure to comply with other terms and conditions set forth in safe harbors or exceptions for lease arrangements under the Anti-Kickback Statutes and Stark Law. Medical Directorship, Physician Services, On-call Agreements Despite agreeing to provide documentation of time spent providing various medical directorship duties, many hospitals may be challenged in getting such documentation on a timely basis from the physician, which can lead to questions as to whether the services were indeed performed. Other potentially risk areas can include: • Lack of current, appropriate fair market value documentation for rates of payment, • Missing or inadequate time sheets or other documentation to support past payments, • Payment for services reflecting renegotiated rates without timely amendments to the effective contract, • Payments made without a current active contract, • Changed or reduced responsibilities for medical directorships without applicable amendments to the effective contract, • Payments that do not match the terms of the written agreement, • Failure to comply with other terms and conditions set forth in safe harbors or exceptions for personal service arrangement under the Anti-Kickback Statutes and Stark Law. Recruiting Agreements Recruiting agreements are possibly among the most challenging agreements to monitor, because revenue guarantee and payback periods can last several years. Potential risks can include: • Lack of current, appropriate fair market value documentation • Lack of appropriate community need documentation, • Payments or re-payments to/from recruited physician not matching contract terms, • Inappropriate financial information provided by

recruited physician to support revenue guarantee payments, • Failure to comply with other regulatory requirements imposed on recruitment arrangement under the Anti-Kickback Statutes, Stark Law or tax-exemption requirements. Conducting an Internal Assessment Based on significant privilege and other issues that an internal assessment may trigger, hospitals can work with their counsel to determine the appropriate scope for an internal assessment of existing physician contractual arrangements. Initial steps may include: • Allocating enough personnel and other resources (such as a contract management system) to conduct the assessment, • Determining the assessment period, • Identifying the scope of the assessment, including the number of arrangements to analyze in detail (that is, deciding between sampling vs. total analysis). Assessment steps can include analyzing and noting whether the following information has been provided for the applicable assessment period: • Signed, written contracts as well as applicable amendments for contractual arrangements to which payments were made or received, • Appropriate documentation of fair market value (developed either internally or provided by a third party consultant) for compensation, income guaranty (e.g., reasonableness of guaranteed compensation levels), loans, and purchase or lease of items or other services (if applicable), • Documentation of community need for recruited physician(s), • Documentation indicating payments made to the physician(s) match the written terms of agreement

(e.g., analysis of accounts payable runs), • Documentation indicating payments received from physician(s) match written terms of agreement (e.g., analysis of accounts receivable runs for leases), • Documentation provided by physician(s) supporting payments made to physician(s) from hospital (e.g., incurred expenses for recruitment agreements, time sheets for services agreements), • Assessment of the hospital’s current system for management and administration of physician contractual arrangements, including the use of a centralized data base. Potential additional assessment tasks can include: • Analyzing the individual contracts and noting whether the responsibilities are listed and are unique in nature compared to the other contracts the physician or physician group might have with the hospital (i.e., each contract “stands on its own” from a responsibility standpoint), • Analyzing the monthly time sheets for the assessment period for each contract provided to the hospital for payment to confirm that the hours worked are within the terms of the individual agreement that the hours submitted for payment don’t “overlap” with other time sheets submitted for a physician’s or a group’s other contracts. • Identifying instances (if applicable) where multiple contracts are in place related to the same services (e.g., multiple medical director agreements for the same department and responsibilities), • Securing other required documentation unique to the specific contract. For further information regarding Fair Market Value

Contractual Arrangements for physicians, please contact:

John W. McDaniel, MHA

President and Chief Executive Officer 800.279.0614

Aging Baby Boomers Face Losing Care as Immigrant Healthcare Providers Go Home By Karen Weinstock, Siskind Susser Immigration Lawyers

The United States, which is among the developed countries that rely on Philippine nurses and Indian doctors to hold down costs in the $6.5 trillion global health-care industry face greater competition for talent just as baby boomers in the U.S., Europe and Japan reach the prime age for medical care. Economic growth in emerging economies, despite some signs of recent slowing, is causing foreign doctors and nurses to stay at home or go somewhere else. There has been a great imbalance that has caused a severe shortage of healthcare workers in developing nations. For example, Japan had 2.2 doctors and 9.5 nurses per 1,000 people in 2009, while the U.S. had 2.4 doctors and 10.8 nurses, according to the OECD. In India it was 0.7 and 0.9 during the same time. It is going to get much, much, worse as baby boomers age and an entire generation of doctors and nurses will retire over the next decade. The Philippines, for example, plans to build and rehabilitate more than 2,700 hospitals, clinics and community health centers next year as part of $9.7 billion investment in infrastructure. The nation’s $225 billion

economy expanded 6.1 percent in the first half, and the peso is the best performer against the dollar among Asia’s 11 most-traded currencies this year, advancing about 5.5 percent. Better jobs are available for its citizens so some of them choose to stay home. Save the Children, an organization based out of Westport, Connecticut, said recently that there is a world shortage of more than 3 million healthcare workers, including at least 1 million community nurses and doctors. In New Zealand, 34 percent of doctors and 21 percent of nurses are from abroad, the highest among developed countries, while in the U.S. 27 percent of doctors and 5 percent of nurses are foreign, the WHO said in its 2006 World Health Report. Philippine and Indian nationals lead the supply, each making up 15 percent of all immigrant nurses and doctors respectively in the 34-member Organization for Co-operation and Development. The cost of healthcare workers is likely to rise, which is good news for immigrant doctors also. But other countries compete with the U.S. For example, a full-time registered nurse in the U.S. makes about $57,000 a year, while in Australia they earn as much as A$75,000 ($78,000). If the U.S. does not ease its immigration requirements for doctors and nurses, they will stay behind with shortages that are about to get much, much worse.

The Recruiters Corner - Tips & Talk from the Inside

The Phone Interview – When a graduating resident/fellow begins the search for their first job, or when a practicing physician starts looking for a new career opportunity, the

process is going to start with a phone interview. Even with a growing physician shortage, hospitals and private practices are not going to invest thousands of dollars bringing a physician in for a site visit and personal interview based on a resume and cover letter. This is even truer when one considers that over 80% of physicians relocate when accepting a new job. At the risk of stating the obvious, if you cannot perform well in the phone interview, you will not have the opportunity to perform at all in a personal interview. Yet, many young physicians are totally unprepared for this critical first step in the interview process. You may be a perfect match for the opportunity you have targeted. You may have roots in the community and exactly the training and skill sets that the interviewer is seeking. But if you don’t communicate these assets, if you fumble for answers, if you do not have basic information at your fingertips and if you are unable to project enthusiasm and confidence over the phone lines you may not get another opportunity to sell yourself. Some physicians approach the phone interview with little hope of receiving an invitation to visit for a face to face interview. The opportunity may be all the way across the continent and the job description may seem to be a very loose fit. Make no mistake, hospitals and practices are looking for the best people. And with the enormous revenue a quality physician brings to the table, relocation is rarely a consideration. And you may find half way through the phone interview that the opportunity is a much better fit than you first imagined. So my advice to any physician preparing for a phone conversation with a prospective employer is treat the phone interview exactly like you would treat a site visit. And I mean that quite literally. Do your research, have the company or facility web site up on your computer; find a quite spot for the call where there can be NO POSSIBLE INTERUPTIONS; set as your objective nothing less than an invitation to visit the client. Here are some tips that will help you ace the phone interview:

1. Dress for success. It may sound absurd but wear business attire for the call. After over 25 years of interviewing physicians, I can almost visualize how the candidate is dressed by the way they project themselves during a phone interview. If you have just come in from your morning jog and are still in your gym shorts and sweat shirt, you simply cannot project well. Take a shower; slip into your business attire; take a moment to collect your thoughts. 2. I once read that a phone interview is like an open book exam…and it is. Lay out all of the materials that you will need to properly present your case. Have your cover letter, resume, company research, questions you plan to ask and questions you expect to answer. Being prepared will resonate in your voice and come through loud and clear in your complete answers and probing questions. 3. Be prepared to answer the single most important question in any long distance phone interview: “Why are you interested in our community, our practice and our opportunity?” And then be prepared for the follow-up: “Why are you looking to pull up stakes and move your practice and your family half way across the country?” I can’t tell you how many times candidates blew themselves out of the water with answers like: “I really don’t want to relocate but your opportunity aroused my curiosity.” or “I’m looking for the best clinical opportunity; my family will go where I go.” Or my favorite: “I wasn’t aware that relocation would be involved.” 4. Here’s a tip I picked up from Paul Bailo, CEO of Phone Interview Pro and author of "The Essential Phone Interview Handbook." Find a picture of the person with whom you will be interviewing (check LinkedIn, Face Book and other online resources). Tack the picture up above the phone and speak directly to the image. I’ve actually tried the technique and it works! It somehow makes the interviewer more human and less intimidating. 5. If you liked what you heard, ask for the visit. Ask what the next step in the process will be. Ask how your experience and skill sets match up with their opportunity. Express your interest in taking things to the next level. Ask when you can visit them in person. The phone interview is every bit as important, every bit as demanding and potentially just as rewarding as a face to face interview. Remember the Chinese proverb, “The journey of a thousand miles begins with but a single step.”

Is a Captive Insurance Company (CIC) Right for Your Practice? By Guy P. Jones Successful practices face multiple risks in their daily operations including loss of a medical license or professional certification, legal defense reimbursement, medical/Medicare collections risk, HIPAA violations, and reputational risk. Small- to medium-sized practices can benefit from risk-management tools that can help them handle such risks more effectively and reduce their overall insurance costs. To that end, the practice may want to consider the establishment of a Captive Insurance Company (CIC) to protect themselves from risks not typically covered by traditional insurance companies. Captive insurance planning is a strategy for physicians to manage risk through the purchase of a property-casualty insurance policy. Premiums paid by the practice to a properly structured CIC should be tax-deductible to the practice under section 162(a) of the IRS code just like their workers’ compensation or malpractice coverage. When the practice forms a CIC, it receives premium income tax-free up to $1,200,000 per year, per captive. Profits that come out of the CIC come out as a distribution from a C-corp. as qualifying dividends or long-term capital gains, which are currently 15%. Furthermore, the CIC may retain surplus from underwriting profits within reserve accounts, free from income tax. Profits that accumulate within the CIC can be used as a tax-deductible sinking fund in order to save money on malpractice premiums by shifting to a high deductible policy and/or insuring that deductible through the CIC. There are no hard-and-fast rules regarding the minimum amount of gross revenue from a practice or the minimum amount of insurance premiums paid by a practice before considering the establishment of a CIC. Planning Opportunities The establishment of a CIC creates immense planning opportunities for physicians because of the flexible ownership of the CIC. The CIC is set up as a C-Corp and someone or some entity owns the shares of the C-Corp While it’s important to keep in mind the primary business purpose of the CIC is for risk management, some potential planning opportunities include the following: 1. Wealth Accumulation/Surplus Retirement Income: Physicians own the CIC outside the practice for surplus dollars in retirement. 2. Asset Protection Planning: Most physicians have the CIC owned inside an asset protection trust to potentially shield pre-tax dollars and assets from judgment creditors or litigation. 3. Estate Planning/Wealth Transfer: Physicians who don’t need access to this money may be interested in having the CIC owned outside of their estate to also bypass gift and estate taxes with each premium payment. 4. Practice-Owner Benefits: By the CIC not being an employee benefit plan, it is not subject to the non-discrimination rules of ERISA, and therefore only benefits the owners of the practice. 5. Non-Mandatory Participation for Practice Doctors: Doctors at smaller levels can join together to create a CIC for economies of scale. Physicians would be encouraged to discuss the various CIC planning strategies with their tax, estate planning, and other legal professionals to ensure that the most appropriate structure is utilized to fit their unique planning objectives. As part of our services to the practice, we would be happy to meet with the practice management and advisors to answer any questions and start the process of the feasibility of a CIC for the practice. As reassurance, this is already IRS-tested, and we strictly adhere to each IRS Safe Harbor Revenue Ruling for a conservative model offering very predictable risk management and tax planning results. While this is not intended to be a thorough discussion of CICs, it is meant to initiate a conversation with practices or conduct due diligence with their key advisors as to the many potential benefits of establishing a Captive Insurance Company. Mr. Guy P. Jones is a Certified Financial Planner in Houston, TX who has specialized in serving the financial planning needs of medical professionals and their families since 1990. He can be reached at 832.677.1692, email: guypjones@guypjones.com, or by visiting his website:www.guypjones.com

http://www.healthwisecapital.com

Physician Opportunities From MedicalMatch.org

Cardiology - Anderson, SC – Local interventionalist seeks other cardiologists with similar strong work ethic. Adding associates to now-solo practice; ultimately will be five to seven. He is AnMed Health’s top admitter and performs 30% of all caths. High volumes overall: 450 to 550 coronary interventions and 100 to 150 peripheral interventions annually; 50 to 60 nuclear studies and 60 to 70 echos per week. He is published and active in national and international research studies; is the principal investigator for approximately 90 % of current device and medication trials at AnMed Health. And believe it or not, his call is manageable. One office; supportive congenial staff that includes echo, nuclear and vascular technologists. Good payor mix. Superb opportunity for well-trained, energetic interventionalist with shared vision for building group. Must practice high-quality CV medicine. Good comp; first year salary, benefits. Buy in at 12 or 24 months; hard assets only. AnMed Health System - 597 beds. Recipient of 2008 HealthGrades awards in clinical excellence and patient safety. AnMed is number one in SC for cardiac surgery; overall pulmonary services and overall critical care. Anderson is located on 50,000-acre Lake Hartwell….yes, close enough for principal residence…and I-85 which can get you to either Charlotte or Atlanta in two hours. …Charleston is only a morning’s drive. To review this and other opportunities: Contact Sherry Chastain, Dir, Medical Staff Development, AnMed Health Medical Center, Anderson, SC, 800-226-3103, Sherry.chastain@anmedhealth.org

Cardiology - Dallas, TX – Outstanding Opportunity for an Interventional Cardiologist. HeartPlace is the past, present, and future of cardiology in North Texas. With HeartPlace, the future of cardiology is truly here. We are currently seeking an Interventional Cardiologist at our S. Fort Worth clinic location. The HeartPlace clinic currently has 1 physician (Non-Interventional) so physician must be comfortable being in a small clinic and being the only Interventionalist at the clinic. Call is 1:4 (1:2 for Interventional). Services offered at the clinic – nuclear (mobile camera), echo, stress echo, pacemaker checks. Hospital (Huguley Memorial Medical Center) has 2 cath labs. Clinic outreach 1 day/week is probability. Physician must have outgoing personality. For further information: Contact James Dooley, Cardiovascular Provider Resources, 14800 Landmark Boulevard, Suite 700, Dallas, TX 75254, 972- 391-2053, rusty.dooley@heartplace.com

Dermatology - Indiana Opportunity – Exceptional opportunity to develop a practice in a thriving community with no other Dermatology services. High community demand and strong primary care referral base make this an outstanding opportunity. Choose the option of employed or income guarantee. Practice would include working with Regional Cancer Center involved in a national melanoma research initiative cutting edge technology. University affiliation; very competitive compensation and comprehensive benefits; located in a mid-sized community with an easy commute to a major metro. The area offers outstanding public and private schools, golfing, fishing, boating, theatre, symphony, music festivals, beautiful parks, college sporting events and much more. This is an excellent opportunity in a combined medical and cosmetic Dermatology practice. Equipment is state-of-the-art, including laser. Large patient base already established by Dermatologist who is retiring. Very competitive compensation and benefit package. Located in one of Indiana's larger cities, the area offers beautiful golf courses, boating, theatre, college sports, excellent schools and much more. For more information contact: Anna McNerney, 888-765-0007 (Toll Free), 574-262-0638 (Direct line), anna@mcphysicians.com

Emergency Medicine - Upstate New York – VISTA Physician Search and Consulting has a client seeking to add a BC/BE Emergency Medicine physician to its group. This is a permanent position. Practice benefits include: Extremely competitive compensation starting at $215,000 with productivity bonuses; Flexible schedule including days, evenings, and nights; Three, 12-hour shifts per week to allow ample time off; No trauma work. Faculty benefits include: Cover two metro area hospitals with 24,000 and 42,000 emergency department annual volumes and one small facility with 13,000 in annual volumes; Double physician coverage days and evenings; double mid- level coverage afternoons and evenings at larger facilities; Admissions sent to admitting physicians; Nationally renowned Neurosurgery program and Stroke Center; Radiology on site; MRI, CT, ultrasound, and other testing services always available. Community benefits include: Close to Lake Erie and major Canadian cities; many parks and recreation sites for outdoor activities; some of the best private and state universities in the Northeast; Excellent public schools with low student-to-teacher ratio. To learn more about this opportunity, please contact Patricia De La Paz at patricia.delapaz@vistastaff.com or call 800.366.1884 ext. 6555. To apply for this opportunity now, please send your CV with cover letter. Click here to view all our permanent jobs.

Emergency Medicine - Tallahassee, FL – Independent democratic group seeks top quality Emergency Medicine Physician for Capital Regional Medical Center in Tallahassee, Florida. Physician must be BE/BC

ABEM/AOBEM certified to work in this 65,000 annual volume ED. Excellent compensation, equal shareholder opportunities, productivity bonuses, health and disability insurance, generous 401K and profit sharing, CMEs and professional expense reimbursement as well as malpractice and tail coverage. Best known as Florida’s capital city, Tallahassee is a fusion of cosmopolitan flair and charming personality. Deep rooted in history and culture, it is where college town meets cultural center, politics meets performing arts and history meets nature. Located just minutes from the Gulf and nearby beaches! For more information, contact Alisha Lane, Titan Emergency Group, (904) 332-4322 or a.lane@titandoctors.com.

Emergency Medicine - Warren, Ohio – St. Joseph Health Center in Warren, Ohio, conveniently located between Cleveland and Pittsburgh, seeks a confident and dedicated emergency medicine physician. Annual volume 34,000; level III trauma center; 12-hour shifts; EM residency program; flexible schedule; physician/physician assistant double coverage! Extremely competitive compensation and benefit package including partner plan, health plan, 401K, malpractice, life and long-term disability. To review this and other opportunities: Contact Erin Waggoner, 4M Emergency Systems, 888-758-3999, ewaggoner@4mdocs.com

Emergency Medicine - Illinois – Primus Trauma Care , Bloomington, IL, is seeking a BC/BE Emergency Medicine physician to join a group of 11 physicians. The hospital you will serve is a state-of-the-art facility with 23 emergency trauma rooms. Highlights of this opportunity include: Student loan assistance, Flexible schedules, 250,000 draw area, and unique partnership opportunities. Bloomington/Normal, IL has been listed as one of Money magazine’s Top 100 Best Places to Live. It has excellent public and private schools and is home to 2 major universities. Bloomington/Normal has a thriving economy with companies such as State Farm, Mitsubishi and Country Financial. It also offers a wide variety of cultural and recreational venues such as the US Cellular Coliseum, The Bloomington Center for Performing Arts and Braden Auditorium. To review this and other opportunities: Contact Bette Luna, Adkisson Search Consultants, 866-311-0000, bette@adkissonsearch.com

Endocrinology - Lafayette, IN – Established Multi-Specialty Group - Sigma Medical Group an established multi-specialty group is seeking a BE/BC endocrinologist. This outpatient/inpatient setting will include a mixture of cases, including diabetes and a flexible call schedule of 1:3 or better. Enjoy the benefits of top-notch, excellent new facilities and exam rooms, providing you with all capabilities to perform all of your procedures. A very competitive two year employed guarantee compensation package waits...at or above the national average, commensurate on experience. Production bonuses, relocation, CME, health benefits, and an incredible pension all are part of this great opportunity. Physicians with Sigma enjoy an outstanding, cooperative working relationship with St. Elizabeth Regional Health. Opening in the fall of 2009, St. Elizabeth East Medical Center, a 150 bed state-of-the-art facility, will afford your patients the latest in hospital technology and care. St. Elizabeth Regional Health is home to the most comprehensive medical care in the region and has traditionally led in providing state of the art equipment, facilities, and physicians to its patients. For further information contact: Courtney Becker, 800-678-7858, x 64401, cbecker@cejkasearch.com, Reference #122940 (30925) B35

Gastroenterology - Southwest Oregon – A spectacular setting often compared with Italy and Southern France, offering a potential income of $700K while only working 2 full days and 3 half days. Live a short drive away from the Pacific Ocean and right in the heart of the region’s wine country. This established group of gastroenterologists is seeking to add to their practice where they enjoy a call schedule of less than 1:5 plus zero HMO and great reimbursement contracts. Quality of life is second to none with plenty of outdoor as well as cultural activities to go around. Keep yourself busy in this economically sound community.

Gastroenterology - Ohio – A busy gastroenterology practice is seeking a board certified or board eligible M.D. or D.O. gastroenterology physician. This physician will enjoy a strong referral base from primary care physicians in a two county area as well as referrals from multiply emergency departments. Employment opportunity will allow the physician to join an existing practice, offering a competitive salary as well as benefits, relocation, and a signing bonus. The population to physician ratios in the service area of the hospitals served along with the outmigration statistics for gastroenterology clearly indicates this qualified physician will develop a successful practice in a very short time. There is a one in two call rotation, and the physician’s offices are located in the endoscopy center and on the campus of Wilson Memorial Hospital with all the amenities of a successful gastroenterology practice. This physician will have the advantage of having access to an early partnership in an endoscopy center located within a short drive of the hospitals served. The practice is located in a family-oriented community that offers easy access to the metropolitan areas of Dayton, Cincinnati, and Columbus. This employment opportunity offers the candidate the full benefits of joining an existing gastroenterology practice while receiving the support of the medical staff and administration of the hospitals this practice serves. For more information, please send a formal CV and inquiries to: David Andrick, Director of Physician Recruitment, Wilson Memorial Hospital, 915 West Michigan Street, Sidney, OH 45365. Phone: 937-498-5503

General Surgery - Opportunities Nationwide – Many General Surgeons are finding a balance between lifestyle and career as locum tenens providers. The locum tenens lifestyle offers flexible work schedules and fewer administrative burdens while preserving the financial security that comes with a challenging professional career. LocumTenens.com provides temporary and permanent placement services for General Surgeons nationwide. We offer: Excellent compensation, Paid medical malpractice insurance, Paid travel and housing expenses, and the freedom and flexibility to decide when, where and how often you want to work. Practice general surgery on your own terms. "Trial Practice Options" with LocumTenens.com provide transitioning residents with the opportunity to try out a variety of practice settings in different geographic locations before making a commitment. If you’d like to hear more about current job opportunities, call 800.562.8663.

Hematology/Oncology - Jackson, TN – Join 3 other hematologist/oncologists in extremely busy large multi- specialty clinic. Inpatient and outpatient position. In office ancillaries and EMR available. Partnership available. Community overview: One hour from Memphis and two from Nashville; Community of 100,000 people and home to 23 Fortune 500 Companies; Excellent private and parochial schools and 5 colleges and universities; 200,000 acres of lakes and rivers; Ballet, Theatre Guild, Arts Council, Symphony, and AA Baseball; Low cost of living and no state income tax; Site Selection Magazine ranks state as the second best location in the country for businesses. Hospital overview: Jackson-Madison County General Hospital; 635 bed tertiary care center; New 9 story bed tower opened September – 2008; New EMR in implementation; 85 Adult ICU beds; 26 ORs in main hospital and 10 in surgery center; 80,000 plus ER visits annually. For additional information contact: Marion Douglass, Physician Recruiter, (866) 891-6055, Marion.Douglass@WTH.org,

Internal Medicine - Midwest Opportunity - group seeking BE/BC physician for traditional internal medicine or inpatient only practice in multi-specialty group affiliated with top 100 Solucent hospital in Midwest. A competitive salary with excellent benefit package is available. Enjoy a relaxed call schedule. Please send resume and references to: Magnolia Critical Care & Internal Medicine, 573-874-3235, MCCIM@centurytel.net

Neurology - Coastal New Jersey – This is a hospital employed neurology position. You can be set up on a net income guarantee or be employed by the Hospital…this choice is yours. The employed position offers a competitive salary and paid malpractice; excellent comprehensive benefits and CME allowance. NYC is just 60 miles north and Philadelphia is about 50 miles to the west. Also enjoy sailing, golf, yachting, fishing in this family oriented community which is host to numerous beautiful parks. Please respond to Margie Quinlan, Lawlor and Associates, 800-238-7150; fax your CV to 610-431-4092 or email: Info@Lawlorsearch.com.

OBGYN - Shreveport, LA – CHRISTUS Medical Group is seeking an OB/GYN physician to join a busy, group practice for the Women’s Health Clinic in Shreveport, Louisiana. The position is in response to a growing need in the community. Clinic hours are Mon. – Friday 8:00 a.m. – 5:00 p.m. with call 1:3. Affiliated with CHRISTUS Schumpert Health System, a wide variety of programs and women services are available with the latest information about pregnancy, expert medical care and support. Maternity services provide a rewarding birthing experience founded on personal attention from medical professionals who care. Located in Northwestern Louisiana, Shreveport is a thriving city full of artistry, music, food and fun along with low cost of living, award-winning schools and mild climates for great quality of life. Please send CV and salary requirements to: Glenda Johnston, Sr. Director, Physician Recruitment, 713-277-2223, Glenda.johnston@christushealth.org

OBGYN - New Jersey – Regional Women’s Health Management is a financially sound, well-established group in Southern New Jersey, with a demonstrated need for additional board certified/board eligible OB/GYN practitioners. Our group consists of over 50 physicians in multiple locations with numerous opportunities available. Practice benefits include: Competitive compensation packages with partnership potential for the right candidate; Complete benefit package includes 3% retirement contribution; Affiliated with community hospitals in the region with excellent staff and residents; Support staff includes certified nurse practitioners and physician assistant with a full range of DEXA and U/S services. Community benefits include: Top-rated school systems with excellent nearby colleges and universities; Abundant cultural arts institutions and events, including symphony, museums and art galleries; A short drive or train ride to Philadelphia or New York City; Nearby Philadelphia offers professional sports including football, hockey, and the 2009 World Series champion baseball team; Enjoy summers down the shore; Excellent restaurants; Many organized community programs; The Garden State is home to “Great Destinations in Any Direction” – Enjoy our award-winning golf courses, world-class museums, theatres and prominent restaurants. Explore the splendor of its high mountain peaks, vast open spaces and lush forests to our 127 miles of coastline. Our shore towns boast beautiful beaches, barrier islands and bays illuminated by historic lighthouses. To be considered for this position, please send your CV with cover letter to jobs@rwhm.org.

Pain Medicine - Missouri Opportunities – ID# M64 - A group in Eastern MO has a 100% pain position available. Pain fellowship required. No call, no nights, no weekends. Candidate can have anesthesia or PM&R residency. Offering base salary $250,000, plus production bonus and full benefits including malpractice, paid vacation, medical insurance & retirement plan! Nice family area and excellent school system. For more information about this position, please contact Michael Torbeck at 800-930-0269, please send your CV to miketorbeck@macjobs.net or fax it to 954-337-9208. For a nationwide listing of our pain positions, please visit our website at www.macjobs.net.

Primary Care - Mobile, AL – Franklin Primary Health Center is a community health center located in Mobile, AL seeking BC/BE Family Medicine Physician to join our growing multi-specialty group practice. J-1/H1-B VISA candidates welcome. Franklin Primary Health Center is a Joint Commission accredited community health center with excellent support services with multi-disciplinary model of care that includes Dentistry, Family Medicine, Internal Medicine, Pediatrics, and Women’s Health. Other services include Optometry, Behavioral Health, Pharmacy services, Lab, Radiology, and other select medical specialties. Mobile is located in southwest Alabama on the Mobile River at its entrance to Mobile Bay, 31 miles north of the Gulf of Mexico. The region offers an abundance of cultural and recreational opportunities for people of all ages – a variety of museums, theater, symphony, opera, ballet, fishing, golfing, relaxing at the beach, and much more. Excellent salary and full benefit package which includes: Health and Dental, Malpractice Insurance, Vacation – 15 paid days, Sick Leave – 8 hours/month, 10 Paid Holidays, Life, AD&D, STD, LTD, Flexible Benefit Plan, Incentive Program, 403B Tax Deferred Annuity, Supplemental Retirement Plan, Professional Continuing Education Allowance, Paid Membership, Paid License Fees, Loan repayment program eligible site, Relocation Allowance, Signing bonus. Submit resumes or direct inquiries to: Franklin Primary Health Center, Inc., Attn: Tommie Anderson, COO, P.O. Box 2048, Mobile, AL 36652-2048, (251) 476-7615, tommie.anderson@franklinprimary.org

Primary Care - Marion, OH – A busy private practice physician in Marion, Ohio is in search of an additional physician. The current physician is certified in Internal Medicine-Pediatrics and would consider both IM/PEDS and Family Medicine physicians. With the current high volume the new physician would not only assume some of the current physician's patients but also take on new patients; allowing the new physician to build a practice quickly. This practice is associated with OhioHealth's Marion General Hospital. For more than 90 years, Marion General Hospital's associates, volunteers and physicians have provided patient-focused care in the community. Marion General physicians are known for the exceptional care they provide at this community hospital, which has grown into a regional referral center, offering services and care traditionally found in much larger hospitals. Four generations have come to know Marion General as the largest and most sophisticated hospital in the seven-county service area, providing services that include advanced heart care, a Level II Special Care Nursery; and spine and joint revision surgery. Given the hospital’s strong ongoing service to its seven-county area, the Marion community can rest assured that Marion General Hospital will continue to grow and stay on the cutting edge of medical care as needs and innovation develop. The city is located about 50 miles (80 km) north of Ohio’s capital city, Columbus, due north along U.S. Highway 23. It is the county seat of Marion County. Marion occupies most of Marion Township, which is located just outside of the city limits. Marion is the nation's leader in corn and popcorn produced foods. Marion is home to the Marion Popcorn Festival, an annual event that is held in downtown Marion. The Regional Dog and Pony Show is a regional event that is held annually in Marion. For more information on the position please contact Karlie Sites at 614-544-4223 or send your CV to ksites2@ohiohealth.com

Primary Care - Virginia – Eastern Shore Rural Health System, Inc. is a Community Health Center organization located on the Eastern Shore of Virginia, a 52 mile peninsula nestled between the Chesapeake Bay and Atlantic Ocean. Our rural community offers beautiful scenic views and access to a variety of cultural opportunities. For more information, visit our website at www.esrh.org. As the 10th largest employer on the Shore, ESRHS has much to offer our employees along with an excellent benefits package which includes health & dental insurance, 403(B) matching program, disability insurance, paid CME and more. Candidates must have a valid Virginia license and must be Board eligible or Board certified in a primary care specialty. Skills required include: Planning, organizing and implementing clinical programs and activities, supervising and assisting in training of clinical professionals, ability to work well in a leadership role with a cooperative effort with diverse groups of health professionals and center staff; ability to work independently and to make appropriate clinical decisions which reflect professional strength, confidence and integrity. If you are a mission driven person looking to make a difference, please fax, mail or email a CV to: Jeannette R. Edwards (jeannette.edwards@esrh.org), Fax: (757) 414-0569, P.O. Box 1039, Nassawadox, VA 23413

Primary Care - Panhandle of Florida – Sacred Heart Medical Group, a premier 100+ physician group serving the Panhandle of Florida is seeking Internal Medicine and Family Practice physicians interested in a good career in a beautiful place to live. As a member of Sacred Heart Medical Group you would enjoy: Excellent earning potential –

with almost half of the group earning at or over the 75th percentile nationally; Generous benefits, including disability coverage and robust pension plan; Group has excellent customer relations and ranks at the 85%tile nationally; Only JCAHO accredited physician group in the region; Nationally recognized teaching hospital affiliation with the Florida State College of Medicine; Affiliated with the M.D. Anderson Physicians Network. Plus be a part of a community which offers: Pristine beaches, scenic rivers and bays; Schools within the top 15% in the nation; University town; Active arts community, including symphony, opera, theatre; Cost of living at 92% of national average; No state income tax; Year round outdoor activities. For additional information contact: Physician Recruitment, 800-669-5386, vrbaker@shhpens.org

Primary Care - North Dakota – needed for Rural North Dakota Hospital Employed Opportunity - This town is a growing community with a bright future. Our citizens breathe easy here; we know and care about one another, and we believe every person can make a difference. North Dakota consistently ranks in the #1 safest states, #10 most livable states, and #9 healthiest states in the nation. The city of Williston is nestled in the northwest corner of North Dakota, just 60 miles from the Canadian border and 18 miles from the Montana border. Our economy is enriched by the oil and gas industry, agriculture and the service sector. Economic Development, the Convention and Visitors Bureau, and the Chamber of Commerce all work together to enable Williston to shine as the "Western Star" of North Dakota. Western North Dakota is one of the finest deer and game bird hunting regions in the United States. Williston ranked #18 in the April 2008 edition of Outdoor Life Magazine’s article, "The top 200 towns for the outdoorsman." Lake Sakakawea, located 16 miles east of Williston is the largest man-made lake in the country, and is regarded as one of the premier walleye fishing lakes in the world. Features include: Hospital Employed, Base Salary $230,000, Signing Bonus, Full Benefits, Stipend during Residency. If you’re looking for great quality of life within a city with excellent family values, this city has it all. Please call Robert Overfield at 800-839-4728 or email your CV to overfield@beck-field.com

Primary Care - Reno, NV – The VA Sierra Nevada Health Care System is seeking a BC/BE internal medicine or family practice physician. Major functions include initial evaluation, H&Ps and medical management of veterans in primary care clinics. Diagnoses and advises veterans of clinical problems that may be discovered during an examination. Interprets laboratory and radiological related material. Participates in the teaching programs of the University Of Nevada School Of Medicine. Recruitment incentive may be available. Candidates must be a U.S. citizen. The VASNHCS provides primary and secondary care to a large geographical area that includes 20 counties in northern Nevada and northeastern California. Approx. 120,000 veterans reside in this region. The Reno campus operates 64 hospital beds and 60 Community Living Center beds in addition to three CBOCs. Academic affiliations for VASNHCS are the University Of Nevada School Of Medicine and the East Bay Surgical Program at the University of California, San Francisco. Approximately 45 medical, surgical, and psychiatry residents rotate annually through VASNHCS. Located on the eastern slope of the Sierra Nevada mountain range, Reno is minutes away from beautiful Lake Tahoe. Year round recreation, entertainment, arts, and culture abound. Reno also boasts an average of 260 days of sunshine per year. Best of all, Nevada has no state income tax! A career with the VA offers stable employment and a future that is challenging, satisfying, and rewarding. Our excellent patient care environment includes learning and teaching opportunities, an advanced electronic medical records system, and competitive salaries. Our generous comprehensive benefits include: Recognition for professional achievement; Educational opportunities for professional development; Competitive pay; Liability protection; 26 days (minimum) paid annual leave/year; 13 days paid sick leave per year; 10 paid holidays per year; 15 days paid military leave per year (if applicable); Choice of health insurance options; Dental and vision coverage available; Life insurance coverage; Retirement benefits (three tiered); Thrift Savings Plan (similar to 401k) with agency matching; Student loan debt reduction program. Fax or email CV to Lenore Reinhard, RN, Healthcare Recruiter, 775-328-1250, lenore.reinhard@va.gov

Psychiatry - Kentucky Opportunity – LifeSkills is currently seeking a Board Certified/Board Eligible General Psychiatrist; the position will cover 2-3 clinics in our service area working 40 hours per week. Primary role is to provide psychiatric evaluation and follow-up medication management with child and adult psychiatric patients in an outpatient setting. No weekends or on-call. On-call is available with additional stipend. We offer excellent benefits, State of Kentucky Retirement Plan, 401(k) and 457 saving plans, state health insurance. LifeSkills is South-Central Kentucky’s premier provider of mental health, substance abuse, and developmental services for over 40 years. LifeSkills, headquartered in Bowling Green, operates in a ten county region consisting of Allen, Barren, Butler, Edmonson, Hart, Logan, Metcalfe, Monroe, Simpson, and Warren County. LifeSkills supports individuals as they build meaningful and independent lives by providing more than 50 programs; we firmly believe in making a difference in the lives of our customers. Through our team approach we are able to provide the best services to those we serve. LifeSkills’ Behavioral Health division provides individual, group and family counseling to assist individuals and families who are facing a mental illness or crisis situation. Our mental health services include psychiatry, psychotherapy, case management, day programs, supported employment, supported housing, therapeutic foster

care and crisis stabilization. For more information contact Eileen Williams at 270-901-5000 x 1121 or ewilliam@lifeskills.com. Visit us on-line at www.lifeskills.com. For more information about Bowling Green visit: www.bgky.org

Psychiatry - Georgia - with interests in Adult, Child or Geriatric are needed to join our growing Laurelwood facility. Laurelwood, located on the main campus of Northeast Georgia Medical Center, provides a broad range of services for adolescents and adults experiencing mental health or substance abuse problems. Laurelwood offers a variety of treatment options including detoxification, inpatient treatment, day partial treatment, intensive outpatient treatment, and aftercare support. Inpatient 8am-5pm; Call one day per week 7a-7p and every 4-6 weekends; 40 adult and 14 adolescent beds; Substance abuse and general psychiatry; Short term - Avg. stay 4-5 days. Located 50 miles from Atlanta, GA near the shores of Lake Lanier and the foothills of the North Georgia Mountains. To learn more about these opportunities, please contact Marshall Poole at 770-219-6635 or via email at marshall.poole@nghs.com . Please visit our website at www.practicemedicinehere.com for further information.

Pulmonologist - North Carolina - needed to assume practice in safe, family community as current doctor transitioning to lead local hospitalist program. Less than 2 hours from beaches, Charlotte, RDU, and just 45 minutes from Fayetteville and 35 minutes from Pinehurst. Loan repayment assistance is possible. Laurinburg is only 35 minutes from the golf resort of Pinehurst and 2 hours or less from the Carolina beaches, Charlotte, Raleigh and Greensboro. The closest large city, Fayetteville, is a 45 minute drive. St. Andrews Presbyterian College is located in town and the University of NC at Pembroke, along with the Givens Performing Arts Center, is 20 minutes away. Contact Melisa Ciarrocca, Scotland Health Care System, 910-291-7540, melisa.ciarrocca@scotlandhealth.org

Vascular Surgery - Atlanta, GA - needed for busy practice in metro Atlanta. Our market has a great demand for a new surgeon. The new physician will have full support of Hospital, Surgical Staff, and PC Physicians. This practice does not have to be built or cultivated, referrals and patients from day one. This is a readymade, turnkey practice. Hospitalist service services over 50 patients per day. Endovascular skills are a must with our facility. We offer the opportunity for Private Practice or Hospital Employment. Benefits package will be in Highest Percentile for the metro area. We are located 40 miles from Downtown Atlanta in exclusive North Atlanta. Our team of caring and dedicated physicians and healthcare professionals provide quality medical care which includes these services: a state-of-the-art Emergency Department, Cardiovascular Services, Diagnostic Imaging, Women’s Resource Center, The Birth Place with a Level II Neonatal Intensive Care Unit, Inpatient and Outpatient Surgical Services, Sleep Diagnostics, Outpatient Rehabilitation Services, Diabetes Education, Home Health, and Wound Care. We have faithfully served our suburban community for more than 50 years. To review this and other opportunities: Avery Poe, 404-816-1801, averypoe@bellsouth.net

Vascular Surgery - Muskegon, MI – Progressive surgical practice seeks fellowship-trained vascular surgeon. Well-established multi-specialty surgical group seeks a BC/BE vascular/endovascular surgeon to replace retiring vascular partner. Full complement of open and endovascular procedures performed. Office based vein practice and busy ICAVL vascular lab. Unrestricted access to interventional suites; excellent working relationship with cardiology and interventional colleagues. Muskegon Surgical Associates, PLC (MSA) for more than 40 years has been providing surgical health care services to West Michigan. MSA consists of 3 vascular surgeons, 5 general surgeons, and 2 plastic surgeons. A good payer mix, salary income guarantee, excellent benefits package a beautiful and friendly West Michigan community with excellent schools makes this a must-see opportunity! Our Staff trained in nursing, scheduling, insurance/billing, medical records and office management supports our offices. Meeting the surgical needs of West Michigan is both challenging and rewarding. MSA has met this challenge with years of hard work and dedication by our physicians and staff. We have over 50 other opportunities across the US. Seaboard's over 220 practices can be reviewed by specialty and state at http://www.seaboardhealthcare.org/job_opportunities.php, For additional information contact: W.R. Herrington, Sea Board Healthcare, 877-292-5007, herrington@seaboardhealthcare.com, www.seaboardhealthcare.org.

All Specialties - Opportunities Across the Country – Enterprise Medical Services (EMS) is one of the leading physician recruiting and consulting organizations in the United States, connecting the most progressive hospitals, clinics and medical groups, with the most qualified career-minded physicians. Since 1990, EMS has been committed to leading the market by offering an experienced staff and superior service in order to provide physicians and organizations with a positive recruiting experience. At EMS, we are committed to your success. Our consultants are the best in the business because they work exclusively in the medical specialty they serve. They take pride in building relationships that help communities find physicians. Our reputation and commitment is unparalleled. Let us help you make the recruiting process a worry-free experience. To review our current opportunities visit us online at www.enterprisemed.com, or phone us at 800-467-3737 or email us at info@enterprisemed.com

All Specialties - Practice around the world – Your adventure starts here. Whether you’re nearing the end of your medical studies or ready to launch your new medical career, make locum tenens your first stop. You can travel

the world, maintain your skills, gain valuable experience, and get paid to do it. And you don’t have to stay in one place for too long. Spend six months in New Zealand Zorbing in the world’s adventure capitol or exploring the Southern Alps; or pack up and enjoy a year in Australia tramping in the Outback or diving the Great Barrier Reef. After years of schooling, locum tenens lets you earn a competitive wage while you work less, travel more and—at long last—decompress. After all, practicing medicine is more than lab coats and stethoscopes, it really is an adventure. Global Medical Staffing has Anesthesiology positions available throughout Australia and New Zealand. Give us a call today and let us get started planning your locum adventure. The world is your practice, where do you want to go? For more information contact: Jesse Black, Toll-Free: 800.760.3174, Direct: 801.937.6580, jesseb@gmedical.com, www.gmedical.com

All Specialties - Opportunities Nationwide – Spot On Recruiting was founded by one of the nation's premier physician recruiters, from one of the largest physician recruitment firms in the country. We place physicians in all specialties across the nation. Why us? We will walk you through every step of your career search. We will use our extensive expertise to help you find the right opportunity that fits your needs. We provide free and confidential service. We will spend the time necessary to find out exactly what you are looking for in a career. We will provide you with extensive data on the practice and community. We can introduce you to non-advertised positions that you won't find anywhere else. We will assist you with your interview coordination. We will educate you on the current market conditions. We will prepare you for your interview and assist you with your contract negotiations. If you are looking for perfect, flawless, precise and excellent recruitment, then Spot On Recruiting is the physician recruitment firm for you. To search all our current job listings go to: http://www.spotonrecruiting.com/search/searchjobs. You may also contact us directly at: 866-955-7768 ext. 101 or by email at: jodi@spotonrecruiting.com