Doctor's Life Magazine, Tampa Bay Issue 3, 2013

DOCTOR’SLife www.doctorslifetampabay.com

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MAGAZINE

Business Lifestyles and Opportunities Issue 3, 2013 Tampa Bay Edition

Tips for Physician Financing

PET THERAPY Are Dog’s More Than

Just Man’s Best Friend?

Dr. Bernstein’s Guide for Treating Senior Patients

What’s Inside From the Publisher Exploring Pet Therapy

Page 6

The Benefits of Pet Therapy

Physician Spotlight

Dr. Ralph Rophie, family medicine Page 7

Page 18

Five Tips for Financing

Page 22

Social Media Prescription Should You Outsource?

Page 8

Advertisers Arden Courts Coastal Properties Group

15 16-17

Forte Group

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Greiner’s Clothing

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Health & Wellness Channel

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Hive 12-13 ImageFIRST 9

A Physician’s Guide for Treating Senior Patients

JCON Commercial Thaxton Barclay Group

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USAmeriBank 24

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Doctor’s Life Tampa Bay

Issue 3, 2013

100 n. taMPa st. suite 3530 taMPa, florida 33602 Phone: 813-251-2580 fax: 813-251-2580 www.thaxtonBarclay.coM

Professionals Maintaining your Peace of Mind In today’s tumultuous Medical Malpractice insurance market, you need a company that watches out for their clients’ interests.

At thaxton Barclay group, our loyalty lies with our clients. We offer you the peace of mind that you have the best coverage available for your practice at the most affordable price.

Ask us about the following product offerings: Property • General Liability • Workers’ Compensation • Directors & Officers Coverage Employment Practices Liability • Fiduciary Liability • Product Liability • Cyber Liability Michael P. Shea • mike@thaxtonbarclay.com • Direct: 813-251-2609 • Mobile: 813-385-1352 Michelle Gallagher • mgallagher@thaxtonbarclay.com • Direct: 813-769-2113

From the Publisher

www.doctorslifetampabay.com

W

e are now officially past the half-way point of 2013 and I hope everyone is on track for a great year. In this issue of Doctor’s Life Magazine, we take a look at how physicians, like Dr. Ralph Rophie, and extraordinary companies, like Harmony Home Health, implement Pet Therapy (PT) with their patients and clients, proving that dogs are more than man’s best friend. This is a prescription that can’t be filled at the pharmacy but only by loving Pet Therapy animals like Sadie, as shown on the cover, and Shaggy, the resident PT dog at Dr. Rophie’s office. This is a subject that should be explored.

I know from conversations with Dr. Rophie this has become a tremendous help and joy for his patients.

Our friends over at USAmeribank break down the tips for physicians to obtain financing and outline a road map to help ensure success. If you still have questions about obtaining financing, they are more than willing to assist you and are just a call away.

Dale Griffen’s “Your Social Media Prescription” discusses outsourcing your social media marketing campaign and what you should know or ask prior to doing so. Finally, I think everyone will be able to take something from Dr. David Bernstein’s guide for treating senior patients. Whether you’re treating elderly patients or not, this approach should be a staple for how we treat everyone in our lives.

I hope you enjoy the third issue of DLM and, as always, we thank you for your support, comments and suggestions. Please keep them coming.

-Ed

5

MAGAZINE

Business Lifestyles and Opportunities Issue 3, 2013 Tampa Bay Edition

Tips for Physician Financing

PET THERAPY

Are Dog’s More Than Just Man’s Best Friend?

Dr. Bernstein’s Guide for Treating Senior Patients

Cover photo by Chris Markham

TAMPA BAY Tampa Headquarters 1208 East Kennedy Blvd. #1029 Tampa Fl, 33602 813-444-9204 Tampa Bay Publisher Ed Suyak publisher@doctorslifetampabay.com Creative Director Bryan Clapper Editorial Director Ed Suyak Assistant Editorial Director Danielle Topper Advertising Account Executive CJ Cooper Contributing Writers Dr. David Bernstein Dale Griffen, R.N. Christine Hamacher Doctor’s Life Magazine, Tampa Bay is always seeking events, stories and remarkable physicians.

Please email the publisher if you have an event, an editorial idea or you know of a doctor or dentist who may have done something extraordinary. We want your suggestions and feedback. publisher@doctorslifetampabay.com Doctor’s Life Magazine, Tampa Bay does not assume responsibility for the advertisements, nor any representation made therein, nor the quality or deliverability of the products themselves.

Reproduction of articles and photographs, in whole or in part, contained herein is prohibited without expressed written consent of the publisher, with the exception of reprinting for news media use. Printed in the United States of America.

Ed Suyak Publisher publisher@doctorslifetampabay.com 6

DOCTOR’SLife

www.doctorslifetampabay.com

Doctor’s Life Tampa Bay

Issue 3, 2013

Physician Spotlight

Ralph Rophie, M.D. Family Medicine

Doctor’s Life wants to know

How long have you been in the Tampa Bay Area?

I was born and raised in the Tampa Bay area What is your favorite Tampa Bay restaurant?

Chang Ma’s and Bobby’s Bistro Where is your favorite place in Tampa Bay to relax?

Relaxing at any of the Tampa Bay beaches or boating What is your favorite event to attend to in Tampa Bay? Clearwater Jazz Festival If you never became a physician, what was your No. 2 choice for a career and why?

Becoming a physician was the only thing I ever wanted to do, there was not a No. 2.

What is the most rewarding part of your position as a physician?

Comforting people We understand that you are a huge advocate of Pet Therapy (PT). In your opinion, what is the biggest misconception with physicians using PT in their practices?

Some people think that pets are dirty and could possibly spread disease in a medical office. Shaggy is a non-shedding breed and all sanitary precautions are always utilized to ensure safety.

Your PT dog is named Shaggy, how did Shaggy become a therapy pet and why did you decide to implement this form of therapy in your practice?

Completely by accident. I had to bring him to work one day when he was a puppy and he was so well liked by the patients that everyone asked that I keep bringing him to work. Getting him certified as a PT dog was the natural next step.

Can any dog become a PT dog and is there some sort of certification?

Sure, any well-behaved dog can become a PT dog; however, they must obtain the proper certification.

How Long have you been using Pet Therapy in your practice?

Six years What patients benefit the most from Shaggy’s presents in your practice and why?

I believe that all my patients receive the benefit of Shaggy because he brings comfort, makes people feel at home and increases the levels of “oxytocin” which provides multiple medical benefits to include: »» lower blood pressure in patients »» stimulates memory and cognitive functioning »» helps in reducing anxiety »» mood improvement »» sense of belonging and increasing social interaction

Issue 3, 2013

Ralph A. Rophie, M.D., practices family medicine in Clearwater. He started his practice in 1989.

Dr. Rophie completed his undergraduate studies at the University of Florida and the University of South Florida, attended medical school at UAG and was a resident at Mount Carmel Medical Center in Columbus, Ohio.

What do you believe is the biggest medical benefit to your patients from the use of Shaggy and why?

I believe that one of the best benefits that Shaggy provides to my patients is the the reduction of anxiety when it comes to visiting my office. Shaggy makes them feel comfortable and at home. I think that is huge quality especially when people often feel that visiting a doctor can be scary and an intimidating environment.

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n o i t p i r c s e r P

Your Social Media

What You Need to Ask Before Outsourcing Your Social Media Marketing Campaign

By Dale Griffen, R.N. The Go! Agency USA In my last two installments of “Your Social Media Prescription” we discussed “Social Media 101” - getting your online marketing efforts up and running, and “The Cost of Social Media” showing you the pros and cons, as well as the true costs associated with social media’s ‘free’ usage.

In this issue, we’ll discuss what you need to know if you decide to refer your social media marketing campaign to an outside provider!

As in your practice, there Dale Griffen are several reasons that you may refer to a trusted specialist. Sometimes you need a second opinion. Other times the needs of your patient may fall outside of your scope of practice.

Maybe you may not be taking on new patients at the time, so you 8

look to other professionals to help out, or take over those tasks.

The same may be true for your social media marketing. If you are finding that you, or the person that handles your social media in the office: • logs into your Facebook, LinkedIn or Twitter account and just doesn’t know what to say several times a day, or...

• scratches their head trying to figure out how to get your current and potential patients and referral sources engaged, knocking on your door or calling for appointments... ...then you may need to outsource! This is exactly what social media marketing firms do! Not only that, but a properly executed campaign: • puts you on the leading edge ahead of your competition; • highlights your expertise in the field; and, • places you in direct communication with other thought leaders - giving your practice a wonderful boost!

Think about it another way, if you wanted to create a TV commercial, billboard or print ad, you wouldn’t try to do the entire thing in your office, would you? You would hire the experts to listen to your ideas and goals, and then using their expertise allow them to come up with a campaign that you will love! Social media is no different.

With that being said, use caution! Obviously, as in any business, not everyone out there that claims to be an expert in the field always is. To avoid wasting time, money and getting a bad

Doctor’s Life Tampa Bay

Issue 3, 2013

taste for social media in general, there are several questions you must ask when choosing a firm to represent your social media marketing campaign. Don’t trust this public relations, brand awareness and relationship-building effort to just anyone. Make sure that they know what they’re doing, have a proven history of success, and that their own reputation, platforms and online following are in line with what you would like for your own.

You need to protect your reputation and to help you do so, we’ve provided 12 questions you may want to ask a potential social media marketing partner...

1.

First, look at their online profiles (the links should be available on their website). Do they have at least daily activity on each channel of Facebook, LinkedIn, Twitter, etc.? Do they have a decent number of followers? Is their brand aligned with the services that THEY provide? Once you get this data, bring it to their doorstep and ask them about the infrequency/frequency of their posts and the quality - will this be what you are going to do for us?

2.

Ask what sets their company a part from other social media marketing firms?

3.

Do they work with medical or healthcare related clients now (or in the recent past)?

4.

Do they know how to deal/work with the healthcare industry, including rules and regulations, patient privacy and HIPAA, to name a few?

5.

Will you be allowed to view and approve all final work before it’s sent out to your audience?

6.

Is all of their work done in-house, or do they work with partners during the delivery process?

7.

How much of the marketing work on the accounts is automated? Can they give you a percentage?

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8.

How many people will be working on your account and have access to your passwords?

9.

Will they be monitoring your brand through the social media channels they are using?

10. Will they share 3-5 past/current clients that you can

Dale Griffen, R.N. Head of USA Operations & Sales The Go! Agency USA dale@TheGoAgencyUSA.com 866-926-2636

speak with about their services?

11. Will you have access to your account(s) during and after the campaign?

12. What happens to your campaign if you stop working with them? Who owns it?

These questions should get you off to a great start. Obviously you want to also ask questions about the campaigns (and how they work), but the questions above should enable you to figure out how credible that potential partner is. Remember – go with your gut. Choose someone you trust or have a good feeling about. If you have distinct reservations, beware.

Remember, social media marketing campaigns can be extremely beneficial in getting the word out about you, your brand, your services and your ‘WOW’ factor!

Should you have any questions about why the above points are important to ask, or have any other questions - be sure to give us a call or send us an email!

Doctor’s Life Tampa Bay

Issue 3, 2013

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A Physician’s Guide for

Treating Senior Patients E

By David Bernstein, M.D.

arly in my career as a primary care physician specializing in geriatrics, I learned a valuable lesson: If you take “good care” of patients, they will form a bond with you, will enthusiastically refer new patients and will remain loyal for years.

“Good Care” to me is described in the following five methods.

1) Listen and observe while attending to needs and addressing the layers of conditions presented.

2) Utilize clinical judgment with applied diagnostic focus.

3) Design a tailored POC (Plan of Care) in partnership with patients.

4) Closely monitor outcomes of tests and plan of care and review with patients.

5) Reassess and adjust POC as necessary.

Furthermore, if you do a good job, Dr. David Bernstein your patients will live a long life, and you will not have to continuously market your practice. Their positive recommendations will maintain a steady flow of patients to your practice.

By applying these principles in my practice, the results are positive. I have limited the need for new patients, (we all know that when new patients come along they are often complex and the initial visit can be further complicated by the use of electronic medical record.) The only downside as a geriatrician is that patients may move away to be close to family, or they expire.

Recently during an initial visit with a new patient, I inquired why he wanted to see me (I was curious because I held his previous physician in high regard). This 85-year-old man was a reminder to me what a physician needs to do to care for elderly patients. He began by talking about the “absence of eye contact” complicated by the “physicians obsession with his computer screen” which he perceived as a lack of interest and empathy. As he uttered these words, I abruptly took my eyes off my own computer screen, moved my chair closer to him and leaned in to listen. I watched as he relaxed and opened up about his medical and psychological concerns. He shared his feelings about how he would be able to manage his wife’s progressive Alzheimer’s disease, as his own health was deteriorating.

During the course of my career from experiences like this, I formulated a five letter acronym, Q.U.I.L.L. Its meaning has been a useful tool while addressing the complex needs of elderly patients, not only for primary care physicians, but just about 14

any other specialty. Despite our specialty, all physicians still carry pens to sign prescriptions and orders. In earlier times, as you’ll recall, a quill was a writing instrument, dipping for ink in an inkwell prior and during the writing process. “Quill” is symbolic in this instance reminding us of the long-held traditions of our profession and for the tireless and continuous care needed for the seniors in our care.

Q.U.I.L.L. letters stands for the following: Q – Quality of Care - provided at all times to our patients. Our quality interventions provide the foundation for meeting the goals of our patients. It is not necessarily the quantity of tests or referrals.

Among my senior patients the common theme is Quality of life vs.

Quantity of their days. They prefer having quality of life as opposed to living in pain or suffering.

U - Understanding – treated with dignity and respect as these are essential characteristics that patients expect from their physician above almost any other profession that I’m aware.

I - Promoting Independence – live on their own, taking care of themselves which allows them to “age in place”. Understanding that age is just a number and, whatever that number is, doesn’t limit a person’s ability to live independently.

L - Listen attentively to your patients- most patients look for the professional who can be a confidant, someone who provides good eye contact, is attentive and who they can trust.

L -“Lean in” - shows a genuine interest and empathy. To do this, ask about their lives, their children, their prior occupation and experiences. Also, share some of yourself. To stimulate this conversation, I place photos of my children and travels in my office.

The methods I have identified in this article are my special recipe for caring for my aging patients. As our population ages, we will all find ourselves treating more and more elderly patients. Utilizing these strategies will provide a steady path for our seniors to follow as we guide them through the aging process.

Doctor’s Life Tampa Bay

Issue 3, 2013

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Locally owned and operated, this specialty men’s store is located in the heart of downtown Tampa. Greiner’s presents the best of North American and European fashions, as only a specialty store can. Quality collections include Pal Zileri, Samuelsohn, Castangia, Zanella, Robert Talbott and Allen Edmonds.

Come see why Greiner’s is continually recognized as the “Best of Tampa Bay” for men’s clothing.

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e l b a u l a V t s Mo

Your

Asset

N

By Kerryn Ellson Coastal Properties Group

avigating the process of buying, selling, and investing in Florida real estate can sometimes be a frustrating and an arduous experience.

What does the future of real estate look like? If we had a crystal ball, we could easily obtain the answer to this question. The housing market has changed dramatically over the past several years. New technologies have provided a multitude of innovative ways to do business. The way we market, buy and sell properties is very different today than it was in the past. It is critical to work with a real estate firm and agent who knows how to successfully guide you through these changes.

CHANGE #1 THE INTERNET

Twenty seconds for love at first site Approximately 85 percent of home shoppers start their property search on the internet. This means the first point of contact between a potential buyer and your home is that first photo of your property’s exterior.

An interesting article in the Wall Street Journal addressed real estate photography and the impact it has on selling a home.

Researchers tracked the eye movements of subjects who looked at online home listings and found that 95 percent of users viewed the first photo, typically the photo of a home’s exterior for a total of 20 seconds. After that, their eyes tended to flit all over the screen.

One researcher stated that “without an eye catching first photo, the battle is lost before it begins.” You have to pique a viewer’s interest within the first few seconds or lose them forever!

CHANGE # 2 AMENITIES

Men are from Mars and women are from Venus The way men and women view a home’s amenities have surprisingly integrated. A survey conducted online via Harris Interactive QuickQuery Omnibus among 2,236 adults ranked amenities in a home that effect the buying decision of men and women.

The master bedroom ranked first among both men and women as the amenity that caused them to fall in love with their home. Walk in closets, a feature usually adored by female consumers was also second among their male counterparts. Both men and women agreed upon a gourmet kitchen as the third most sought-after amenity.

CHANGE #3 FORECLOSURES

Big discounts on foreclosures fading Homebuyers may not get as great of a deal on a foreclosure as they once did.

Foreclosure starts are falling and the inventory of foreclosures has been decreasing, which has caused the discount on foreclosures to lessen.

The discount on foreclosed homes compared to other homes has fallen to a 12 percent average. That was about the same percentage prior to the housing crash. Last year the foreclosure discount averaged about 30 percent. As the foreclosure phenomenon fades, so to have the days of offering 50 to 75 percent of the list price of a property in hopes of striking a deal.

Pinellas County properties are currently fetching on average approximately 95 percent of their list price.

Your home is your most valuable asset, be sure your real estate professional provides both you and your property the expertise it deserves.

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, e r o M Wag ark Less

By Christine Hamacher Harmony Home Health

B

THE BENEFITS OF PET THERAPY

hose that welcome four-legged companions into their lives understand firsthand the many benefits of T having a ‘pup’ around. Dogs are a living, breathing example of how we can be healthier and happier by spending less time stressed out and more time enjoying life.

Why is this important for you to know? Because all of your patients can enjoy the following benefits of being around a fourlegged friend: • lower stress and anxiety; • more activity and exercise; • higher self-esteem and sense of purpose; and, • socialization and companionship.

You may find that your patients also fit into one of four categories: (1) they are currently a pet owner, (2) they used to have pets, (3) they would love to have a pet again but don’t for some reason or (4) they have never had a pet and wish they did.

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Knowing which categories your patient fits into can help you identify whether or not the wonders of pet therapy are at your disposal as part of their overall treatment plan. Those with pets have ready access to utilizing them in their daily routine. Those that don’t but used to could be very motivated by the use of animals in their rehabilitation and health maintenance. While those interested in having a pet that have physical or other limitations could use your help in exploring pet therapy options. Not only that, knowing the value of Animal Assisted Therapy (AAT) can help you in your own practice and in creating an environment that lowers patient anxiety and helps them feel welcome and

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comfortable inside your four walls.

AAT has been in existence for more than 70 years, reportedly starting when an Army corporal first took his Yorkshire Terrier into a hospital to visit wounded soldiers in the 1940s. Much research has been completed on the different forms and lasting benefits of pet therapy. Findings are largely anecdotal according to medical journals; however, this is a phenomenon not to be dismissed. As physicians, aren’t you always faced with the challenge of relying largely on what your patients tell you to help diagnose and treat them? Therefore, those anecdotal findings are critical to the care of patients who have an affinity to animals. The sum of our life experiences has a significant impact on our minds and our bodies and, most especially, on our ability to cope, adapt and embrace change as we age. AAT or pet therapy is one non-invasive way that medical professionals can take an innovative approach to healthcare that helps their patients ‘bark less and wag more’ when faced with overwhelming changes.

In the last 40 years, studies have shown that the presence of pets can lower blood pressure, cholesterol and cortisol levels.

They improve sensory stimulation, physical activity and bone health.

Pets have also been credited with reducing the risk of heart attacks and strokes.

Why do they make us feel so good? Scientific studies are showing that answer may be related to the “love” hormone, oxytocin, being released. Feelings of bonding associated with this hormone certainly come into play when we feel connected to each other and the same can be true for our pets. Overall, common sense attributes most of Harmony Home Health’s therapy dog, these positive effects to the Hound named Sadie. components of exercise and companionship. Yet, any pet-lover will tell you there is much more to the equation.

Animals – especially dogs – can teach us a great deal about compassion. They have no judgments and are incredibly accepting and forgiving of limitations due to age, disability or illness. The comfort and joy an animal elicits is, at times, involuntary and can be truly powerful in a patient’s rehabilitation and recovery. What is more motivating as an incentive to exercise – walking a dog or using a piece of stationary equipment? Which is more enjoyable as a rehabilitative dexterity activity – squeezing a ball or scratching the fur on a dog’s back? And what better reward for getting out of Issue 3, 2013

bed and attending to daily activities when you live alone than the adoring gaze of your furry friend? For those that don’t have their own pets, AAT and pet therapy visits can go a long way to lifting spirits and providing positive motivation when it’s needed most.

The fundamental advantage of this type of therapy over any other medical modality is that it allows for the giving and receiving of affection as part of it. That, in and of itself, is the key ingredient to its overwhelming success.

Harmony Home Health started their “Senior Pets Helping Seniors” program to specifically shine a spotlight on the senior population. From working so intensively in homes and in facilities with seniors, Sadie’s owner and Harmony’s Director of Community Relations, Christine Hamacher, was able to see firsthand the benefits of pet therapy at work. The most remarkable moments occur with Alzheimer’s and stroke patients. Sadie’s soulful eyes and gentle spirit have a way of melting anxieties and touching people at the heart. Visits at memory care facilities confirm this when those who are often unable to communicate verbally and seem out of touch with reality, respond to this unique canine caregiver.

The recognition and joy that comes over them as their hands touch Sadie’s soft coat or as they look into her eyes is evident. Stroke patients struggling to regain their words have uttered new phrases and commands such as “Oh wow” and “Please, come” the moment they see her arrive at their door.

Aside from the smiles and lift in spirit that Sadie brings when she walks in a room, she also brings an overwhelming sense a 10-year-old rescued Walker of peace. Last month, Christine and Sadie took part in an ALS clinic at USF. Their visits spanned from those recently diagnosed to those living with this disease for years. Not a single one had ever met Sadie before. Yet, in just a few moments with each patient, Sadie was able to: »» calm a gentleman overwhelmed by paperwork and fear over his new diagnosis; »» ease the pain of a widow coming to the clinic for the first time without her husband; »» soothe the nerves of a 24-hour caregiver tending to his loved one who can no longer speak or move on her own;

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»» encourage a mother and daughter to share stories from her

childhood rather than dwell on the pain of her present situation; »» and reassure a husband and wife that there was still hope for having a beloved pet in their home.

What are your patients most afraid of with any diagnosis you offer as their physician? The dreaded four-letter word...LOSS. Any kind of loss. So whatever you can do to help them hang on to hope and a sense of purpose, joy and laughter in each and every day is a welcome relief to the other challenges they face. Pet therapy can have an enormous impact.

Hospitals, rehabilitation centers and assisted living facilities have all opened their doors to AAT. Some psychiatrists, psychotherapists and other medical professionals have taken the leap of hanging a shingle out for their pet as well, realizing the benefits of having them on site for their patients. Pet therapy visits range from oneon-one visits in patient’s rooms to visits in a group setting. Participants can be fully hands-on – petting, hugging, talking to and grooming the animal if they wish. Others can simply observe the interactions of the group and still benefit. Many share stories and some shed tears but all experience a release of emotion and a connection to the pet before them that allows them to feel accepted and loved in the present moment.

That connection also inspires trust.

Like Sadie, animals should be screened and certified before being cleared for these types of visits. Sadie received her certification through a non-profit organization called Project PUP (Pets Uplifting People) that has served all of Tampa Bay since 1984. Animals screened through this program receive annual

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health certifications through their veterinarian and are cleared for temperament and behavior. Patient suitability and health risks, such as allergies and immunosuppressed disorders, should always be considered.

For those who would like to keep or acquire a pet of their own at an older age, people are often concerned about pets getting underfoot and causing a fall. Or they may question if they are able to manage the daily care of a pet when they are already having difficulty with their own personal care. Is that reason enough to remove a pet from the home? Not necessarily. These risks must always be measured and precautions taken. Evaluating the size, appropriate age and temperament of a pet are key, as well as securing assistance with pet care when necessary. Some dogs have even become service dogs specifically for patients at a high fall risk – thus, becoming their lifeline to reducing the risk of a fall, not at all contributing to it. Assistance with daily living tasks is often the first step in maintaining independence in the home environment. For those that need to move on to another type of living community, pets may still be allowed and can be maintained.

In the end, the physical, psychological and emotional well-being of the patient must be considered as a whole and their access to a pet can be an important factor in that equation.

To learn more about how pet therapy can benefit your patients or how to utilize Animal Assisted Therapy in your facility, feel free to contact this writer for more information. In the meantime, you know what to do for yourself and those around you…just follow Sadie’s example and bark less, wag more!

Doctor’s Life Tampa Bay

Issue 3, 2013

5

USAmeriBank worked with Jon Trezona from Greater Florida Anesthesiologists to craft a banking plan for the newly-formed organization.

TIPS WHEN YOU’RE THINKING ABOUT

FINANCING

you’re looking to grow your business, move into a larger office space, expand your team or buy Whether new equipment, here are some things to consider for the financing component.

1. HAVE A GAME PLAN AND BE READY TO PRESENT PAST FINANCIALS. Everything starts with making sure you have a plan in place for your business. Don’t just operate your business out of your checkbook. Whether or not you have a formalized business plan, you want to be able to tell the lender how the proceeds of the loan will be used.

And as you work on a plan, make sure it lays out how you will grow your revenues while still maintaining the current business you have.

“Growing your business may include taking on partners, 22

merging with existing groups or maximizing the operation you have now,” said David Ogburn, who manages Professional and Executive Banking for USAmeriBank, which has a focus on helping doctors and other medical professionals in the Tampa Bay area. “Regardless of what your vision may entail, you need to have a plan in place and the financials information necessary to present to a banker.”

In order to get financing from a bank, you typically need to present the past three years of financial information to the banker.

Depending on the size of the practice, this information could be as simple as tax returns or as complex as audited financial statements.

A smaller practice, with less than five or so partners, requires both

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business and personal tax returns, since in this case, both would be considered in the decision-making process for a loan.

2. UNDERSTAND THE CONSTANT CHANGES UNDERWAY IN THE HEALTHCARE INDUSTRY AND HOW THAT CAN AFFECT YOUR BUSINESS.

“I can’t express how crucial it is for practitioners to understand the changing landscape in the healthcare environment,” Ogburn said. “That’s the biggest factor right now in terms of making financial decisions related to your business.”

Be thinking about what kind of impact the nation’s healthcare changes will have on your business. Those impacts can vary depending on the size and nature of your practice. And even if you’re a sole practitioner or a multi-partner group that doesn’t want to grow, you may be forced to become a bigger operation due to changes coming that will impact smaller practices.

“We’ve seen practices merge, join larger groups, create specialty units or sell to a hospital,” Ogburn said. “At the same time, we’re noticing that large insurers appear to prefer working with and negotiating with larger practices.”

Merging or combining with other practices and hospitals can help small groups adapt to healthcare reform. But as this happens, physicians and their financial advisors need to keep in mind how these changes could affect reimbursement rates, relationships with carriers, employee benefits and purchasing power.

3. WORK WITH ADVISORS WHO UNDERSTAND YOUR BUSINESS AND LOOK AT THE BIG PICTURE. Make sure you’re working with financial advisors; CPAs, attorneys and insurance professionals that specialize in the medical field. A solid understanding of how your business may be impacted can make all the difference in how these professionals can help you and be sure their goal is to find a solution that best suits your financial needs.

“It is critical to have the right professionals that can give the right advice,” Ogburn said. “There are nuances to the medical profession and differences specific to the industry.”

Finding someone with the knowledge and expertise to know the ins and outs of the industry, along with how healthcare reform could affect your business, will help you develop a better financial plan for your practice.

As an example, USAmeriBank worked with Jon Trezona and the other physicians at what is now the Clearwater-based Greater Florida Anesthesiologists to understand the company’s specific banking needs and how the bank could assist the newly-formed organization.

“As a new anesthesia group practice that resulted in the merger of five different organizations, our banking needs were unique,” said Trezona, executive director of Greater Florida Anesthesiologists. “We had specific banking needs for each division as well as the company as a whole. The financial advisors at USAmeriBank listened to our story and crafted a banking plan that met all of our needs, done uniquely for our organization.”

4. MAKE SURE YOU HAVE STRONG PRACTICE ADMINISTRATORS WHO CAN HELP YOUR BANKER FULLY UNDERSTAND YOUR PRACTICE. “From the financing perspective, it’s important to have a practice administrator that is knowledgeable about finances in general,” Ogburn said. “Someone who is organized and really has it together in terms of communicating and providing information to the bank is a definite asset to a medical practice.”

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David Ogburn is Senior Vice President and Professional and Executive Banking Manager for USAmeriBank, which specializes in helping physicians and physician groups in the Tampa Bay area with their professional and personal banking needs. Through its divisions Connelly, Carlisle, Fields and Nichols and Aliant Financial Services, USAmeriBank is also well suited to help customers with insurance and wealth management needs.

To contact David, email dogburn@usameribank.com, or call him at 813-739-3361.

A strong practice administrator should be responsible for providing financial statements as well as other information, including accounts receivable data, collection percentages and contractual obligations from a payment and collection perspective.

On an ongoing basis, sending financial reports to the lender in a timely fashion makes it easier on the practice as well as the banker.

5. DEVELOPING A FACE-TO-FACE, PERSONAL RELATIONSHIP WITH YOUR BANKER CAN HAVE BENEFITS THAT ONLINE SERVICES DON’T BRING TO THE TABLE. While going online and applying for a loan can be quick and convenient, there are benefits to having a personal relationship with a banker.

“Having a personal banking relationship is absolutely key,” Trezona said. “A professional who takes the time to understand your business and financing needs is an invaluable resource, and that person can be critical if you are trying to get financing approved by a loan committee that’s trying to decipher your business and your plans for the future.”

Working with a financial advisor who has an understanding of the industry can bring value to a physician or group that you can’t get online. Such a professional may suggest enhancements, costsaving tools or new services that could assist your business.

And while an online transaction is a one-time deal, working with a banker is an ongoing relationship that is constantly focusing on the bigger picture for the group and the physicians involved.

“At some point a physician will likely have a financing need or a need to modify an existing financing arrangement.

This could be due to an unforeseen event in their personal life, such as a divorce, or a business-related issue like the breakup of a multi-partner practice” Ogburn said. “These lifealtering events will undoubtedly impact them financially. It is during these times that they will find a relationship with their banker is very important.”

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