By Carole C. Foos, CPA, David B. Mandell, JD, MBA

With the legislation President Obama has signed into law this year, nearly all physicians will see their federal income, Medicare and capital gains taxes increase in the coming years. When you add to these federal tax increases, the various proposals in place to increase state and municipal taxes and fees, you could see your combined marginal tax rate increase by 10% (up to 45% to 58%, depending on your state). This could be an increase of up to 20% on the taxes paid on dollars earned over $250,000. This is no small set of changes and they should not be taken lightly.
Though many of your colleagues are complaining and some have been threatening to leave the country, we want to offer more practical advice in this article. The good news is that there are techniques most doctors can implement in 2010 to help reduce your taxes in 2011… and beyond. Many of these techniques are powerful enough to equalize or go beyond the proposed tax increases. Savvy doctors who take advantage of these strategies could expect to reduce their annual tax liabilities – even if all the proposed tax increases become law.

By Jeff Segal

A patient fractured his cervical vertebrae (the result of a horseback riding accident) but was neurologically intact. The surgeon evaluated the patient and performed a posterior cervical fusion to reduce the fracture and stabilize the neck. As a result, the patient remained neurologically intact without any deficits. The neurosurgeon instructed the patient to return to normal activities three months-postop and the neurosurgeon discharged the patient after several months of follow-up.

By Jeff Segal

As in poker, you play the hand you are dealt. Occasionally doctors are sued where, each side, plaintiff and defendant, has strengths and weakness. These cases often linger unabated toward trial. The patient may have significant injuries, was a high earner, and likely to connect emotionally to a jury. On the other hand, his argument that the doctor’s actions caused the injuries might be weak.

What does each side want? Each side wants to win completely, of course.

By Jeff Segal

The hallmark of the Internet is its ability to increase the free exchange of ideas. The ease with which information is proliferated increases the damage caused by false or harmful information, stretching the bounds of defamation.

The Internet gives the average person an opportunity to express their opinion, anonymously, well-beyond any other venue. An individual now has the ability to publish statements and articles across the world in an instant, without the guidelines or checks and balances of traditional publishing. Thereafter, online erroneous statements may linger for months, or even years, almost impossible to recover, amend and remove. Internet defamation lawsuits are on the rise and the number of people sued over online speech is increasing sharply, according to statistics from the Citizen Media Law Project at Harvard's Berkman Center for Internet and Society.

By Jeff Segal

Patients suffering from serious illness often cannot participate in their own healthcare decisions. From the physician’s point of view, the incapacitated patient presents not only medical conditions in need of treatment, but also legal issues to be addressed. Physicians must turn to the patient’s guardian, power of attorney, or surrogate for assistance in determining the preferred course of treatment. This article explores the legal issues related to the relationship between the physician, the incapacitated patient, and surrogate.

Incapacitation of acute medical in-patients is prevalent. Some studies place the percentage of incapacity amongst acute medical in-patients at forty percent (40%). These incapacitated patients and their physicians must rely upon surrogates to select and consent to a course of medical treatment. Unfortunately, studies show that many patients and physicians are ill-prepared to handle this situation.

By Vincent Gallo

Planned gifts that allow the donor to retain an income stream for life or a term of years include charitable remainder trusts, charitable gift annuities, and pooled income funds (collectively, charitable life income plans). A related technique is the gift of a remainder interest in a house or farm, which allows the donor to retain the use of the house or farm for life or a term of years.

By Brent King

A few recent examples of acronyms come to mind. Let's start with the relatively new federal agency, Immigration Compliance and Enforcement (ICE). Briefly, this is the agency that inspects and audits employee files and Form I-9, Employment Eligibility Verification. Now, improper completion of I-9's carries a monetary penalty. There are about forty different opportunities to create a mistake on each I-9 - with each mistake carrying a specific monetary penalty.

By Carole C. Foos, CPA, David B. Mandell, JD, MBA

The recent Medicare cuts in reimbursements for most physicians go from frustrating to downright scary. Layer on top of this any proposed healthcare overhaul (which may now be difficult to pass), and it starts to feel like the federal government is determined to make it difficult for physicians to prosper.

By Jeff Moffatt, CPA, CVA

Some tips for reviewing your billing and coding practices.

By Elizabeth Wertz Evans

Patient harm is usually caused by the failure of practice systems rather than negligence. Physicians and administrators are key players when it comes to creating and implementing patient safety procedures that minimize medical errors and unwanted outcomes. Discover tools and examples you can use to improve overall patient safety in the three important areas of: working as a patient safety team, assessing current patient safety procedures, and creating medication safety.