Month: August 2018

Anyone interested in MLB knows that the Baseball Hall of Fame is a treasure trove of interesting and famous memorabilia. Fans of MLB love to visit the Baseball Hall of Fame and players and coaches strive to make a lasting impression on the baseball world by being immortalized inside.

Gotta Have Statistics

For 45 years, Henry Chadwick wrote for the Brooklyn Eagle and brought the love of sports statistics into homes nationwide. He was captivated with statistics; all of the ERAs, RBIs, WHIPs, and WARs. He was instrumental in the decision where to build the Baseball Hall of Fame. He is the only baseball writer to have his very own plaque hanging serenely on a wall in The Baseball Hall of Fame.visit website and see what we mean.

Who Started Baseball?

There were several influential names in early baseball. They include Spaulding, Chadwick, and Cartwright. Who started baseball? Well, there was quite the legal battle. First, on December 30th, 1907 a final report gave Abner Doubleday the credit for the creation of baseball in Cooperstown, New York 1839.

Then, historians decided that baseball had only become its own sport after its rules were changed by Cartwright’s New York Knickerbockers in 1845. These rules established included that there was three outs per inning, specific batting line-ups, and the decision to make all bases an equal distance from the last.

The first game using these new rules was held on June 19, 1846, in Hoboken, New Jersey on the Elysian fields. This is known as the birthplace of baseball as we know it today. Hall of Fame Officials considers Cooperstown, NY as the place that baseball is loved the most. You canget more information here.

How Was The Hall of Fame Established?

First, some of Coopertown’s residents decided to buy a lot to establish in their neighborhood. In 1923, Doubleday Field was opened and the dedication included National League president, John A. Heydler. In 1934, Doubleday Field was nationally recognized. That same year, three miles from Cooperstown, an old baseball was found. It was found in an old trunk owned by none other than Abner Doubleday. Stephen C. Clark, a true fan, bought it and displayed it.

But he didn’t stop there. He continued to build his baseball memorabilia collection until he decided to take the idea for a baseball museum to the National League president at the time, Ford Frick.

Frick loved the idea and decided a Hall of Fame addition was needed. A 100th birthday celebration of baseball was planned in Cooperstown, NY in 1936. Clark used his own money and converted the local gym into the Baseball Hall of Fame.read more here.

What Can You See at the Baseball Hall of Fame?

At the Baseball Hall of Fame, you can experience amazing treasures such as, ironically, the shoes of Shoeless Joe Jackson and Babe Ruth’s bowling ball.

You’ll find millions of documents, photographs, and autographs, as well as The Baseball Hall of Fame plaques. It’s well worth a visit to see what amazing memorabilia you can find.

How to Become a Home Based Medical Coder

Home based medical coders are often self employed as independent contractors. This type of work falls somewhere between being an hourly employee and owning your own business.

An independent contractor is an individual who has contracted with a larger organization that provides work to the home based coder for an agreed upon payment. These independent contractors benefit by working from home, having a flexible schedule, and having a steady and reliable income without assuming the large overhead costs and liability that accompany small entrepreneurships.

The contract agreement entered by the home based medical coder and the organization should specify items like:

Number of Chart Provided/Coded
Payment
Accuracy Standards
Hardware and Software Responsibilities

The number of charts a coder can contract for may depend upon their coding specialty, experience, desired income, and time commitment.

Since rates vary by specialty it is important to know the industry standard for your specific specialty and if you fall within that specialty’s average.

The following is a loose projection home based medical coders can use when negotiating a rate in their contract:

Coding Specialist I:
45 inpatient records daily
2 min/chart or 250/day outpatient and ER records
3.5 min/chart or 130/day ambulatory surgery records

Coding Specialist II:
32 inpatient records daily
2 min/chart or 250/day outpatient and ER records
4 min/chart or 120/day ambulatory surgery records

Coder II:
23 inpatient records daily
3 min/chart or 160/day outpatient and ER records
6 min/chart or 80/day ambulatory surgery records

Coder I:
15 inpatient records daily
4 min/chart or 120/day outpatient and ER records
8 min/chart or 60/day ambulatory surgery records

Home based medical coders who choose to be independent contractors will also need to negotiate their rate of pay. Usually this is a flat rate that is agreed upon in the contract. This rate is then paid on a per chart basis.

Rates of pay are strongly influenced by things like geographical location, coding specialty, experience, and current economic variables. A home based medical coder can use the following as a loose guide to help them in their contract negotiations regarding rates of pay.

Professional Coding/Outpatient:.60 -.75 per chart
Facility Coding/Inpatient:.70 -.85 per. chart
Combination Coding/Both In and Outpatient:.90 – 1.50 per. chart

The rate of charts coded and the rate of pay are the two main influences affecting a home based medical coder’s income. It is important to properly calculate the chart commitment and pay rate and balance it with the amount of time needed to perform the task.

For instance, a medical coder who codes out patient charts may contract for 875 charts each week at a rate of.65 cent per chart. If the week’s commitment is divided by the standard rate of 25 chart per hour the medical coder will need to allot for 35 hours of work time each week (875/25=35). If the medical coder is paid.65 per chart then their weekly income will be $568.75 (875 x.65) and their “hourly” average will be $16.25 ($ 568.75 / 35 hrs).

To hold a profitable home based medical coding job speed and accuracy are of upmost importance. Speed will enable the medical coder to increase their pay and decrease their time commitment. It is possible to achieve “full time pay” working only 20 hours a week, but this takes time to achieve and it is important to remember to maintain accuracy as well.

Most organizations that contract with home based medical coders specify in the contract that the coder must maintain a specific accuracy standard. This standard is usually between 94% – 98% accuracy. Charts that are coded and submitted by the independent contractor are periodically audited to ensure they are being coded correctly. This audit is what produced the accuracy percentage. If accuracy is not maintained the organization may terminate the contract.

Benefits and taxes are other items a home based medical coder must consider prior to becoming an independent contractor.

Benefits such as medical, dental, 401K contributions, vacation, and paid time off are usually not provided since you are considered self employed. Contracting organizations usually do allow for their coder’s to take vacations and sick days, however, since these are usually unpaid they should be budgeted for in advance.

Taxes are also different for the independent contractor. The organization that the medical coder contracts with will usually send their payments out similar to a scheduled paycheck. These checks are paid in gross earning though.

It is the responsibility of the home based medical coder to withhold taxes from each check and set the money aside for payment to the government at the end of the year. When the end of the year arrives the organization will send the coder a 10-99 instead of a W-2 and when filing taxes the independent contractor should file a schedule 1040.

A schedule 1040 allows the home based medical coder to itemize and subtract some items such as medical coding books, computers, internet connections, office supplies, etc. as deductions. Keeping track of work related expenses is important and beneficial come tax time.

Items that are provided by the contracting organization may not be counted as a deduction though. What is provided by an organization and what the home based medical coder is responsible for varies from one organization to another.

Some organizations may provide the medical coding books while other organizations hold the medical coder responsible for their purchase. The most common practice among organization regarding independent medical coders though is to provide them with the medical coding software, a firewall, e-mail, and some technical support.

It is usually the responsibility of the home based medical coder to provide an adequate computer system, medical coding books, an internet connection, and day to day work supplies (paper, pens, etc.)

Technical support is usually limited to the organization’s software, firewall, and e-mail. Hardware failures, internet service interruptions, and items of that nature are usually the responsibility of the independent contractor.

Once a medical coder has informed themselves regarding all of the facts and they are prepared for the specific obligations that accompany home based medical coding and independent contracting they are ready to locate an organization that offers such opportunities.

If searching online avoid searching for phrases such as: “work at home medical coding jobs” and try searching for phrases like “remote medical coding jobs” and “independent contractor medical coding jobs”.

Companies like Avia Code, Med Data, and The Coding Network are just a few that hire home based medical coders as well.

What You Should Know About Your Medical Spa

Q: Who is the Doctor in charge and where is he?
A: Medical Spas are supposed to have a Physician present to provide medical-grade products and procedures. Unfortunately, the Doctor is often nowhere to be found. All too often, a Doctor whose primary area of interest and income may be something other than Medical Aesthetics signs a contract to be the “Medical Director” of a Medical Spa. He makes some extra income; the Spa staff gets to use prescription-only products and perform complex medical procedures but the Doctor isn’t even present. He could be performing surgery or seeing patients in his own office or even hitting golf balls.

If you are contemplating receiving a Medical Procedure at a Medical Spa, find out if the Doctor will actually be there during your visit.

Q: Will my Medical Procedures be performed by the Doctor?
A: Too often, Medical Spas are revenue “add-ons” to a busy medical practice. The Doctor may be busy seeing medical patients on the medical side of the office while an Aesthetician, Physician Assistant, Nurse Practitioner, or even a Nurse wields potent syringes of Botox and complicated lasers on the Spa side. Even Plastic Surgeons and Dermatologists commonly hire Nurse Practitioners to perform Medical Procedures in their spa.
Before you walk in the door, ask if the Doctor will actually be the injecting the drugs or performing the Medical Procedures. If the answer is something like “No, our Nurse does that, but she’s very good,” do yourself a favor and look elsewhere.

Q: How experienced is the Doctor?
A: Commonly, a Doctor will simply add on a few nicely-appointed rooms to his busy office, buy some lasers, hire an Aesthetician and call it a Medical Spa. These Doctors often have no real interest in Medical Aesthetics and rarely perform any of the procedures themselves. They may be physically nearby but they are generally not well-versed in what works well and what doesn’t.
You should only trust your face to a Physician who practices Medical Aesthetics day in and day out. If the Doctor spends the vast majority of his time practicing day-to-day medicine or performing complex surgery in the O.R., can you really expect him to be up on the latest techniques and equipment used in Medical Aesthetics?

It’s perfectly all right to ask, “How many times per week does the Doctor actually perform this procedure?”

Q: What kind of Aesthetic Training has the Doctor had?
A: Many people assume that Board Certified Dermatologists or Plastic Surgeons make the best Aesthetic Physicians but that isn’t always the case.
Dermatologists spend a majority of their training learning how to treat diseases of the skin and how to recognize when a particular skin condition means that something serious is going on elsewhere in the body. If you have a suspicious or bothersome lesion or rash, you should visit a Dermatologist. If you want to soften a few wrinkles and look more refreshed, a Dermatologist may not always be your best choice.
Plastic Surgeons acquire many complex skills during their extensive training period including hand surgery, breast implants, facial reconstruction, scar revision and complex skin grafting techniques. Plastic Surgeons can work wonders for patients with those sorts of major problems. They may not be the best choice, however, for someone with facial sun damage or pigment irregularities.

Actual training in Medical Aesthetics is absent or only a very small part of many Dermatology and Plastic Surgery training programs. Most physicians who wish to become proficient in the appropriate use of Botox, Facial Fillers, Lasers, and prescription grade cosmeceuticals usually must take multiple courses from national experts on the various aspects of Medical Aesthetics. These courses are expensive and inconvenient but remain the major means for most Doctors to become proficient in these techniques.

Do not be afraid to ask about the training of the Doctor who will be doing your procedure. Do not accept “Dermatologist” or “Plastic Surgeon” as the only meaningful credentials. Ask if the Doctor has taken advanced courses specifically focused on Botox or Fillers or Facial Lasers.

Q: What Medical services are available?
A: A true Medical Spa should be able to design a specific treatment plan that will address all of your aesthetic concerns. Botox and Facial Fillers are just the beginning. Does the Spa have Intense Pulsed Light to erase brown and red spots? What about a Laser to promote new collagen formation and tighten skin? Can they remove unwanted hair? Can you receive expert advice about prescription-strength cosmeceuticals to repair ultra-violet damage and improve texture? Are medical-grade peels available?

Some Medical Spas are even able to offer body sculpting using a laser like the SmartLipo Laser. They are able to tighten skin and melt away fat from the waistline, thighs, hips, arms and even the neckline.

Make a list of what services you might be interested in and ask about them when you call. A true Medical Spa should be able to offer you a comprehensive program to assess your needs and address your concerns.

Q: What Aesthetic services are available?
A: Besides the medical-grade Aesthetic services like microdermabrasion and advanced chemical peels, a full-service Medical Spa should offer a selection of anti-aging and revitalizing facial treatments as well as a full menu of cosmetic and aesthetic services like waxing, paraffin treatments, permanent make-up and even detailed instruction on make-up application.

Ask what is available and check the web site for details.

Q: What will the Aesthetician do for me and what is her experience?
A: The key component of a professional Medical Spa experience is the consultation with the Aesthetician. It is the Aesthetician who will delve into the details of your skin care history, investigate the products you are presently using, analyze the condition of your skin and tailor a treatment program to address your concerns. If you need Medical procedures, it is the Aesthetician who involves the Physician at the appropriate times to get you the optimal results. If this consultation step is skipped, you are getting an inferior service and will have inferior results.

It takes years of experience for an Aesthetician to obtain the level of knowledge and understanding to perform a detailed and accurate consultation. Don’t be afraid to ask how long your Aesthetician has been practicing and whether a detailed consultation is a part of the service.

Q: How will my care be documented?
A: Before-and-after photo documentation is a must. Most advanced Medical Spas use a sophisticated camera system like the Canfield Visia to guide and document your treatment program. The Visia takes multiple photographs using various filters and then it applies complex software algorithms to your photos to highlight specific areas of skin damage. There should be no charge for this service. Ask how your Medical Spa plans to document your treatment program.

Q: What other Spa services are available?
A: Generally, most Medical Spa clients want to look more youthful and refreshed, but that is simply not enough. Spa clients want to feel better as well. Stress reduction is a major part of the modern spa experience. How this is accomplished varies greatly from spa to spa.

Most spas offer massage. Ask about what type of massages are available. Deep neuromuscular may work well for the active athlete but the stressed-out executive may prefer Japanese Hot Stones or Lomi Lomi. Is the therapist experienced in Pregnancy Massage? What about Reflexology? Or Aromatherapy?
If you need a few hours or relaxation, will your spa get you a cappuccino and some lunch? Do they have a concierge service? Can they get your car washed, pick up your dry cleaning, or make your dinner reservations while you unwind? Will they provide limo service for your spa day?

You may not be looking for this level of service every time you visit a Medical Spa, but you should ask about it anyway. If your Spa is willing to provide concierge-level service, you can be confident that their dedication to all aspects of customer service is unparalleled.

Q: What will my Spa experience be like?
A: This is easy. When you walk in, you should immediately experience an overwhelming sensation of tranquility and relaxation. Every one of your senses should be involved. The surroundings should be visually beautiful. The sounds should be light and airy. There should be a subtle scent that calms the mind and soothes the spirit. You should be offered a beverage that reduces stress and pleases the palate. The robes should be plush. The touch of your therapists should be confident and gentle.

In short, you should be ushered into a sanctuary of calm where the stresses of the world can be left behind and you can become refreshed, revitalized and feel more beautiful inside and out.

Reasons Why Your Medical Career Crashes

Once you become a doctor, it marks a turning point at which most doctors start slipping backwards. There’s a reason! 
Your burning passion and rugged determination for your medical career goals is not enough to overcome the barriers to your planned and expected maximum success in medical practice. It’s a reality that you shouldn’t have to face, and that you don’t deserve.

There are reasons why and what you can do about it. It’s one of the most distressing, yet understandable, factors leading to career failure. The meaning of failure as used here is the complete inability of over 95% of doctors to reach their maximum potential as a doctor.

It also includes your inability to create and maintain a medical practice that will ever reach the profitability potential it has the capacity to foster. In clearer terms, unless you are prepared to do what needs to be done to reach those highest levels of accomplishments, you will fail to a significant degree.

The inability refers to the absence of training and education that are required to rise above the others. As a result you are effectively programmed to fail by the institution that qualified you to be a doctor.

Consider a few factors that lead you to this unholy position: 
You have not been provided with the essential tools to run your medical practice business efficiently and profitably. It means you have no business or marketing training or education.

A challenge to your intellect and common sense:
Is it possible in our present economic environment to create a successful, constantly growing, medical practice business when the doctor owner has no real knowledge about how to do that effectively without expert help?

A “no” answer indicates you are quite comfortable about extracting from your medical career just enough abundance and satisfaction to make do. In other words, you are a hostage to your circumstances.

A “yes” answer indicates that you have not yet matured in business far enough to recognize that all of your sheer-brilliance in medical knowledge is never enough to create a maximally productive medical practice business-just enough to get by with for a while.

You have “educational burnout” without even recognizing it. The evidence of this is obvious when you consider these issues:

  • Why is it necessary to require doctors to complete CME hours for maintaining medical licensure?
  • Why is it compulsory to recertify for specialty credentialing?
  • Why is it that once you start medical practice there is no urgency or self-implied obligation to voluntarily maintain and continually update your medical knowledge?
  • Why is it that the need to have a business education is such an unnecessary and objectionable necessity that is totally ignored by most doctors? Yes, you promised yourself there would be no more burning the midnight oil again.

What possible reason would medical education pundits have to neglect the need to provide a business as well as medical education to medical students? Could it be that they knew about the educational burnout phenomenon and didn’t want that to happen during your medical education and training? But was it OK if it came afterwords?

Your passion for practicing medicine gradually becomes crowded out of your mind. That’s because once you become aware of the fact that your medical career is not able to provide you with the higher goals you had in mind at the start and turned out to be only a pipedream in reality.

For those doctors who already have wealth and adequate funding, there seems to be no real concern about these kinds of issues. However, for most doctors that is not the case. My concern is about the latter.

The real life examples of how these arcane factors are born:
The sequence of ominous changes in your passion for your medical career is one of the most distressing, yet understandable, factors leading to career failure. It begins with graduation from medical school, sometimes even sooner. It’s something older doctors see in their rear view mirror.

Prestige, recognition, fulfillment, happiness and expectations in your medical career seldom increase with time but rather fade with time. As you proceed in your medical career goal setting beyond medical school, the bright lights, celebrations and spectacular accomplishments disappear in the sunset. It starts almost immediately on entering your medical practice.

The day you completed your internship, were you given a loud sendoff, glory and recognition that would shake the pillars of medicine? Did you deserve that? Absolutely… but it doesn’t happen.

The revelation suddenly hits you in the face that there will be no more public pats-on-the-back. From now on your dedication to your obligations and career success becomes an investment in personal satisfaction.

Your reward for completing a residency in your specialty is simply whittled down to a medical certificate of residency completion, not a rousing cheering crowd. Your self-esteem benefits, but your wallet suffers.

Either you are headed for private medical practice of some nature, or you are feeling the overpowering need for security by becoming an employed physician.
Right here at the end of all your formal medical training, you are at the highest level of your medical knowledge with the incredible skills and ambition to take-on any of medical practice challenges put in front of you. From here on you are on your own.

No one is there to push or inspire you further and higher, except yourself. Previously, you had back up. Now you don’t. Even your family that has not lived in your shoes themselves can’t really help you much in your medical career choices and goals.

The next step in your career is even more stressful. And it’s outrageously insulting to all new doctors. Why? Because you don’t deserve this second step of disappointment as your reward for years of sacrifice and struggle.

Medical practice becomes your next teacher and mentor:
This new environment of medical practice has a bundle of harsh lessons to teach you. Of course, no one has discussed these things with you in any depth because they didn’t want to discourage you. These soft lies of omission leave scars. It leaves you naïve and vulnerable, which is much worse than giving you the truth to begin with.

This one thing is far more damaging to your medical career than you can believe. Every medical doctor is affected to a significant degree during his or her career as a result of being forced to adapt to the persistence of unexpected events that they could have prepared for if someone had told them what’s ahead.

Can you imagine how much stress in your practice over the years could have been prevented by knowing and preparing?

What are your options for avoiding or resolving these destructive factors regarding your medical practice career?
As with the activities and strategies required for success, there is no one simple laser-guided response for every person to follow to arrive at their personal highest level of achievement that they call “success.”

However, there is only one commonality found among the successful people that you may not care to hear about.

“It is a stronger, deeper, more unrelenting commitment to success far beyond what most ever marshal.”
(Source: No B.S. Marketing Letter, GKIC, Dan S. Kennedy, Nov. 2012)

This simple golden rule of success implies that we must reach a point in time when our minds become aware of the chain of events, predictable side effects, and consequences that are adherent to your decisions. Thus, it enables you to correctly ascertain whether a decision you make is complimentary to your objective, diverges from your objective or is in direct conflict with your objective.

Your decisions about your medical career are even more complex than any you have previously made. It involves making good decisions at the start but doesn’t exclude good decisions being made throughout your medical practice years.

For most doctors and other medical professionals who haven’t lost their desire to perform at maximum levels, it will often require one or more of the following:

1. You must know yourself:
What are your skills, talents, interests, activities that create satisfaction, biases, and toleration limits, among others? You need to spend a few hours quietly putting these attributes in order, even in priority. Sometimes it takes several sessions with other people (usually parents) who know you quite well and listening to what they see in you that you don’t see.

Many college graduates are unaware of who they really are inside, and what capacity they have to succeed. Therefore, they stumble along relying on their “above average” intelligence to keep them on track to a few objectives.

If you aren’t aware of what you need to do to be happy with your life and profession by the time you finish college, you are likely not to discover that later on. This factor becomes a life long millstone around your neck.

2. You must continue to set goals to be accomplished during your whole life: 
Without goals, you lose your passion and determination. Over 95% of doctors are hamstrung because they either have no idea what they are really capable of accomplishing, or have fears that prevent them from moving to higher levels of accomplishment such as:

  • Fear of being taken advantage of-easily led astray-analytical minded.
  • Fear of not being a success-of failing.
  • Fear of not fitting in-ostracized by peers-not a leader-hidesin the herd.
  • Fear of lack of approval of peers and friends-always social, energetic and fun-loving are the cover-up features.

You don’t set goals because of these same fears. It’s why so many great people tell you to face you fears and go right on through them no matter what.

3. Don’t expect a blueprint for success: 
Lee Milteer, professional highly regarded business mentor, says, “Success Is an Inside Job”. She teaches that you create your own success using the path from “visualization” to “mindset”. If you don’t understand that process, you need to find out how it works and trust it.

4. Create a laser focus on one primary objective: 
When you dilute your path with multiple goals, you are multitasking and are constantly changing decisions. You have set yourself up for a watered-down life and career.

If you find you have chosen the wrong objective, then move to a new focus on another primary objective. Never focus on more than one.

5. Real success in your medical career often results from maintaining your family obligations: 
Your level of success is corrupted when you neglect your family relationships. Divorce, broken homes, financial disasters, and lack of a religious heart results in not being able to fully enjoy your success when and if it arrives.

6. Make your personal integrity the basis of your career: 
Your integrity creates your character that others see and respect. You maintain the principles you live by under all circumstances in your profession. When your “word” is unreliable, you corrupt everything around you one way or another. You then live off the garbage other people discard.

There are many more examples of solutions you probably have experienced and know the value of that may be just as important as the ones I’ve mentioned above. If you thought I was going to give you a 1-2-3-4-5 answer to gaining total control of your medical career, you haven’t been reading between the lines of this article well enough.

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