Salary Negotiation – Can’t Hurt to Ask

Dollar_sign2_1Are you planning to change positions, or negotiate a salary increase in your current job? The article Four Negotiation Tips for Women Executives cited below contains this bit of wisdom: Ask — almost everything is negotiable if you see it that way.

If you’re afraid the answer will be no, rest assured it will be if you don’t ask. Salary Negotiation Know How reminds us that it’s probably unwise to expect your boss to simply suggest that you should be earning more money. To help keep it all in perspective however, the author ends with this advice: If you’re happy in your job and the only thing you can’t get is more money, maybe it’s not time to leave. There’s no way to put a price tag on having a job you enjoy.

Negotiate (v) To confer with another or others in order to come to terms or reach an agreement. (  Notice that the goal is to reach an agreement, so don’t feel that you must make demands to get what you want.  Good negotiations leave everyone feeling like a winner.

Four Negotiation Tips for Women Executives – Lee and Jessica Miller

Be yourself, but be the best self you can be
Ask — almost everything is negotiable if you see it that way
Don’t be afraid to use the "no" word
Negotiate for yourself as if you were negotiating for someone else.

Time to ask for more money? - Jeanne Sahadi

Should another employer express interest in you, let your boss know – not in a threatening way, just as an FYI – and at the same time indicate you’re not necessarily interested in the position. The point is to show you’re desired, not dissatisfied. "We all want what others want."

Eleven Commandments for Smart Negotiating – Lee E. Miller

Be prepared
Recognize that employment negotiations are different
Understand your needs and those of the employer
Understand the dynamics of the particular negotiations
Never lie, but use the truth to your advantage
Understand the role fairness plays in the process
Use uncertainty to your advantage
Be creative
Focus on your goals, not on winning
Know when to quit bargaining
Never forget that employment is an ongoing relationship

Salary Negotiation Know-How – Dona DeZube

Know Your True Value

Have you saved your company money, improved a process or met your quota? If you’ve had an impact on the company’s bottom line, know the exact figure…

Be Your Own Advocate
Be willing to step up to the plate and go to bat for yourself. Don’t count on your boss to simply suggest you ought to earn more money or to notice you haven’t had a raise in 10 years.

Don’t Underestimate the Value of Happiness
If you’re happy in your job and the only thing you can’t get is more money, maybe it’s not time to leave. There’s no way to put a price tag on having a job you enjoy.

Physician Imposter Arraigned on Murder Charge

He called himself a doctor and administered anesthesia, but Dean Faiello was unlicensed, untrained, and lethal.

Mr. Faiello was extradited from Costa Rica in May and arraigned on a murder charge in the death of Maria Cruz 35, a financial analyst and "patient" of Mr. Faiello.  Ms. Cruz’ body was found February 18, 2004, buried under a concrete slab at his former New Jersey home, ten months after she vanished.

Update 7/06

Author Diane Fanning is writing a book set for release in April 2007 – Under the Knife, the story of Dean Faiello.

Washington Hospital Receives Preliminary Denial of Accreditation from JCAHO

Good Samaritan Hospital in Puyallup Washington has received a preliminary denial of accreditation from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). The 225 bed hospital is working to clarify the findings and retain their standing as an accredited hospital.  Evidence will be presented at a June 30th meeting.

The Puyallup Herald – Good Samartian Works to Keep Accreditation

The Puyallup Herald – My Turn

The News Tribune – Violations Discovered at Puyallup Hospital

JCAHO Rule for Conditional Accreditation or Preliminary Denial of Accreditation Decision

Switching To Electronic Medical Record Not For The Faint of Heart

If you’re a regular reader of MedPundit, you know that she is a family practictitioner who began incorporating electronic medical records into her private practice several months ago.

She has periodically blogged about the rather painful, and exceedingly time-consuming transition from paper to computerized patient record.  At times she appeared to question whether switching to an EMR had been a good choice.

Therefore, it was good to see her May 27th post.    

It’s been four months now since my office began using an electronic medical record and I can say with a sigh of relief that I’m beginning to see the light at the end of the data entry tunnel.

Although the first month of using he EMR was more stressful than I anticipated, my staff are now EMR boosters.  I’m liking it, too…   It was quite a slog for a while, but I’m finally beginning to feel it was worth it.

Podiatrist Gets Death Sentence for Woman’s Murder

On May 23rd a federal jury condemned a Chicago podiatrist to death for murder.  Dr. Ronald Mikos fatally shot Joyce Brannon 54, a disabled former nurse, at point-blank range in 2002, just four days before she was to testify against him in a $1 million Medicare fraud case.

Chicago News Target

California Board of Podiatric Medicine


Revised HR 1.20 Becomes Effective July 1, 2005

Effective July 2005, JCAHO standard HR.1.20 has been revised to require primary source verification for all clinical staff who are required by the organization or the state to have licensure, registration or certification:  The organization has a process to ensure that a person’s qualifications are consistent with his or her job responsibilities. The intent of the revised standard is to lower the risk of fraudulent credentials.

Surgeon Fined $175,000 for Product Endorsement

In a lesson both to consumers, who despite contrary evidence still shop for weight-loss/muscle-toning miracles, and physicians who may be asked to endorse them, a California physician has found himself caught up in an "electrical storm."

On May 23, 2005  Sign-on San Diego reported that a California orthopedic surgeon has been ordered to pay $175,000 for his endorsement of the AbEnergizer, a device that claimed to tone muscles by sending an electric current into the users’ body.

Dr. Michael J. Skyhar was also forced to make a public retraction of his endorsement of the product.

Target, Walgreens and Wal-Mart have collectively agreed to pay more than $1 million in restitution for selling the unapproved medical devices.

WebMD’s 2002 Article on Electrical Muscle Stimulation Devices

Despite numerous skeptics, EMS devices have supporters in the medical community. Michael J. Skyhar, MD, a sports orthopaedic surgeon and a staff member of Damluji Research of San Diego, is a spokesperson for Electronic Products Distribution, maker of the Ab Energizer. He spoke with WebMD in March.

"Electrical muscle stimulation is well established in the medical literature as having therapeutic benefits," says Skyhar. "It’s a comfortable, safe, and simple way for my patients to strengthen lower back and abdominal muscles."

But the high visibility these products get on TV and the sweeping claims made about their effectiveness have brought them under greater scrutiny.

Why We Do What We Do

We all have days when we wonder whether we should keep doing what it is we do.  We could certainly choose a career that’s easier, different, less stressful, than whatever function it is we perform to keep the giant wheels of medicine churning forward.

Having worked for a number of years in an Emergency Department, I can appreciate first hand the kinds of stresses those folks deal with day after day.  Everything from the chronic visitors who discover some urgent health problem at least once a week, to the truly chaotic nights where one life and death drama after another plays out inside those walls.

Therefore, I read with interest a recent Medical Economics article by a senior ED physician who faced down burnout and skillfully handled a midnight emergency. Reminds us why we’ve chosen to do what we do.


It could only happen to a gangster—or to an ED doctor like me. Three minutes ago, I’d never seen the guy. Now, with one slash of the scalpel, I slit his throat. From start to finish, it takes fewer seconds to do it than to tell you about it…   
Alonzo brought me back to life

Physician Family Members

From time to time questions arise as to who the government and insurance companies identify as a family member of a Family_clip_3physician.  These regulations affect who a physician may submit a bill for to a government agency, and issues relating to Stark Regulations and conflict of interest. 

In addition to billing and potential conflict of interest matters, there are of course ethical and practice issues related to treatment of someone close, particularly for serious health problems.

The links below may be helpful in sorting it all out.

First, the AMA Guidelines regarding Self Treatment or the Treatment of Immediate Family Members:

Physicians generally should not treat themselves or members of their immediate families.  Professional objectivity may be compromised when an immediate family member or the physician is the patient… 


Secondly, the language of the US Code
, Title 42, Chapter 7, Sec. 1320a-7, par ( j )

j) Definition of immediate family member and member of household
  For purposes of subsection (b)(8)(A)(iii) of this section:
    (1) The term ”immediate family member” means, with respect to a person -
      (A) the husband or wife of the person;
      (B) the natural or adoptive parent, child, or sibling of the person;
      (C) the stepparent, stepchild, stepbrother, or stepsister of the person;
      (D) the father-, mother-, daughter-, son-, brother-, or sister-in-law of the person;
      (E) the grandparent or grandchild of the person; and
      (F) the spouse of a grandparent or grandchild of the person.
    (2) The term ”member of the household” means, with respect to any person, any individual sharing a common abode as part of a single family unit with the person, including domestic employees and others who live together as a family unit, but not including a roomer or boarder.

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