The Affordable Care Act Guarantees Coverage for Millions, Falls Short on Physician Availability

Successful implementation of the Affordable Care Act will provide tens of millions of previously uninsured Americans with healthcare coverage.  However, when these individuals seek medical care outside the emergency room or charity clinic setting will there be practitioners to serve them? The answer is clearly no (J Am Med Assoc, Sept 2009). The facts are that this surge in demand for primary care, will markedly exacerbate the already problematic geographic maldistribution of number and type of physician practice across the United States.

According to the American Association for Family Practice (June 2013), there is presently one family practitioner for every 1470 rural residents compared to one physician for every 1190 residents of urban areas. This projects to a deficit of 2,000-3,000 physicians that will be needed by 2020. Even these numbers belie the supply vs demand mismatch.  In addition to comparative deficiency by population density, there are well-served and underserved populations primarily determined by market forces of family income and education.

Pundits from the Robert Graham Center and the Health Resources Administration provide three part strategy to encourage a more equal distribution of healthcare professionals and resources.

  1. Target future physicians who would commit to working in underserved communities at the time of selection and education of medical students.
  2. Incentivize present practitioners to relocate with financial rewards (“carrots”) and regulatory measures (“sticks”).
  3. Accept a lower staffing level for these populations, but focus on improved productivity by increased utilization of physician extenders, technology such as telemedicine, and air transport of providers to more centralized outreach facilities.

But these are the sterile pontifications of the ivory tower. You can not debunk the general suggestions to pay doctors more and give them more resources to provide care; however, the devil is in the details. What is lacking is a canvassing of those already in the arena to find out what specifically it would take to relocate their practice. The battles are being fought by those of us actually on the frontlines. We hope that opening a dialogue in this forum can be productive as this issue will not go away. Better that physician input be focused constructively and proactively rather than centered on impeding externally imposed change.

By Norman Silverman, MD, with Ryan McKennon, DO and Ren Carlton

Make Angel Investments That Go 10x, Unleashing Monster Returns for a Family Juice Business

I look for angel investments that have the potential to produce a 10x return on my investment in 5 years. Startup investing is one of the more risky investment categories. Therefore, you should expect these businesses to have the possibility of doing well. If you invest in 10 businesses, and nine of them fail, the remaining business needs to give you a 10x return just to break even. Ideally, you will do better than that and enjoy healthy returns.

Build Your List of Potential Investors, Pitch Investors Properly, How Kevin Systrom Raised $500,000 in Two Weeks to Launch InstagramFind Angel Funding & Venture Capital for Business Startups, Entrepreneurs, & First Time Founders – Episode 12

Most startups need funding at some point. Once you have the addressed all of the items in the previous episodes, it is time to build your list of potential investors and start the conversations. They can be friends, family, social network, social media contacts, work colleagues, people in the business industry, etc. Try to put together a list of at least one hundred people. A list of one hundred potential investors may seems like a lot, but the more people you have on the list, the better your chances are of success.

Making Money With Your Business, Profit and Cash Flow, Five Sustainable Companies That Make a Lot of MoneyFind Angel Funding & Venture Capital for Business Startups, Entrepreneurs, & First Time Founders – Episode 10

It is time to make money! You have been through a couple of rounds of market testing now you feel like you are on to something. The next step is to run the numbers to make sure that the business is sustainable. There are two sides to making money, profitability and cash flow.

Why Competition Is Good For Entrepreneurs and How Blockbuster’s $50 Million Mistake Helped Reed Hastings and Netflix Destroy a $6 Billion Empire Find Angel Funding & Venture Capital for Business Startups, Entrepreneurs, & First Time Founders – Epis

When battling for resources or investment, early-stage entrepreneurs may believe that competition is a bad thing. On the surface, they are correct. There are a limited number of angel investors willing to provide a finite amount of venture capital to founders.

Upscaling and Scaling Business Ideas into Reality – Jeff Bezos takes Amazon from Online Bookstore to Global DominanceFind Angel Funding & Venture Capital for Business Startups, Entrepreneurs, & First Time Founders – Episode 4

Congratulations, your market testing worked and you were able to find customers, or at least one customer. Your beta test was successful and you are confident that you are ready for more. What do you do when you start getting customers or users? I recommend you do some scaling or upscaling.

What Kind of Business Should You Start? – How Mark Zuckerberg Pivoted From Rating Hotness to FacebookFind Angel Funding & Venture Capital for Business Startups, Entrepreneurs, & First Time Founders – Episode 1

When it comes to brainstorming startup ideas, new entrepreneurs and even seasoned ones scratch their heads in confusion. Living in the information age, you can scan the current market and see countless new business ideas. With so many options out there, how do you know which one is right for you?

Why Would a Doctor Abandon a Steady Paycheck to Become an Entrepreneur?

As physicians, we are expected to be compliant with rules, restrictions, and regulations. We are expected to be risk averse. We are expected to be “providers,” but not necessarily innovators or leaders. As the healthcare system becomes increasingly consolidated into large overcrowded clinics, we are required to perform to the standards set by bureaucrats and clinic managers. These rules are often at odds with the best interests of patients and with our sanity.
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