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Don’t Be An Agent of Chaos21 Apr

Danilo RizzutiDanilo Rizzuti

Poor Maxwell Smart, the bumbling secret agent of the 1960s TV show, “Get Smart.” He was so clumsy, naive and foolish that he screwed up constantly. Still, he was resourceful enough to always defeat the evil spies from KAOS.

I wish I could say the same about many advisors I see operating today. Clearly, they are fighting for control in a world of chaos. Everything is changing so rapidly—products, regulations, technology, client needs, business procedures—that it’s hard for them to stay current.

Even worse, many appear to lack basic organizational skills. Their self-created chaos spawns errors and omissions that harm clients and kill business reputations. Think about it: When you don’t control your business, you increase the odds of messing up. When this happens, clients will question your competence. From the client’s point of view, one mistake is forgivable. Two mistakes is a problem. Three mistakes is time to start looking for a new advisor.

So how do you exert stronger control over your practice? Here are a few pointers:

First, to manage your time, make effective use of a calendar. Preferably you should use an automated one that runs on a desktop computer, a smart phone and a tablet (should you start using one). One of my favorite activity managers is called Toodledo (www.toodledo.com). It lets you input tasks, store them in folders, attach them to goals and due dates and assign priorities. Toodledo is also a collaboration platform, so you can share your tasks with staff as needed. There are many other options, as well.

Second, be highly disciplined about compiling client data. Again, the solutions are endless. The important thing is to get smart about documenting the outcome of every—and I mean every—client interaction. Many agents use digital recorders or smart phone apps to capture decisions made. Then they turn their audio files over to an assistant for transcription and filing. Another convenient method is to use an inexpensive phone app like Evernote to document outcomes.

Third, stay on top of business workflow. This is pivotal because you need to be able to immediately answer client questions. Fortunately, most insurers and investment companies give advisors the ability to check underwriting or issue status and investment values online in real time. The key here is to know exactly how these systems work so you can do it in your sleep. Or assign the task to your administrative staff.

The point is this: If you care about your long-term business reputation, don’t make phone calls on your shoe or have client meetings in a cone of silence. Just get smart…and get organized.

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New York Life Introduces New Term for Fixed Annuity21 Apr

Photo credit: digitalartPhoto credit: digitalart

New York Life, New York, N.Y., introduced a three-year initial interest rate guarantee and matching three-year surrender charge period on its Secure Term MVA Fixed Annuity. This offering provides a guaranteed 1.15% ratetax-deferred, over the three-year term, compared to the national average of 0.69% for three-year CDs.The three-year term complements the product’s existing five-, six-, seven- and eight-year terms, and is now available to consumers.

The Secure Term MVA Fixed Annuity offers:

  • Multiple initial interest rate guarantee periods, including the new three-year term
  • tax-deferred growth;
  • Access to the funds when needed through a surrender-charge-free window during each policy year;
  • A guaranteed death benefit where beneficiaries receive the policy’s full accumulation value;
  • The ability to convert accumulated assets to guaranteed lifetime income.

LexisNexisRisk Solutions, Atlanta, Ga., appointed Elliott Wallace as vice president and general manager of Life Insurance. Wallace is responsible for developing and implementing the LexisNexis strategy for the life insurance market. This includes leading the company’s data prefill and identity verification solutions to simplify and streamline the application process; underwriting reports to enhance underwriting decisions in real-time; predictive modeling solutions to improve conservation and decrease lapse rates; and solutions that improve policy administration by monitoring books of business and leverage unparalleled resources to locate beneficiaries and deceased insureds.

Before joining LexisNexis, Wallace was the associate vice president of business development for Nationwide Financial Group in its Individual Protection unit. Previously, he was a director with the Allstate Insurance Corp. where he served in a leadership role in both the property and casualty and life insurance business units. Wallace also was a practice director of eBusiness Intelligence at Xpeditor Inc. and a certified senior engagement manager with IBM. He also served as a senior consultant with Ernst Young and a project leader in database administration with Eli Lilly and Company.

 

Allianz Life Insurance Company of North America, Minneapolis, Minn., named Adam Brown as the new assistant vice president of Actuarial Product Development. In this role, Brown heads Allianz Life’s product development area in actuarial for Allianz Life Financial Services LLC Distribution, including the design and pricing of annuity products, as well as their risk management and capital analysis. Brown also partners with the marketing and distribution divisions to support product launches and market positioning.

Brown has spent his entire professional career as an actuary with Allianz Life, starting with the company as an intern in 2003. Most recently, Brown served as a senior director within Actuarial Product Development where he led product development for variable annuities.

Brown holds a Bachelor of Arts degree in general business management and Bachelor of Science degree in actuarial science from the University of St. Thomas in St. Paul, Minn. Brown also holds a FINRA Series 7 registration, is a member of the American Academy of Actuaries and a Fellow of the Society of Actuaries.

 

Reinsurance Group of America Inc., St. Louis, Mo. (NYSE: RGA), appointed Donna Kinnaird as chief operating officer, effective April 2.

Kinnaird brings more than two decades of strategic leadership experience with major global organizations in the life insurance industry. Before joining RGA, she spent 10 years in executive positions with Swiss Re America, most recently as president of Swiss Re Life and Health America Inc. and president and chief executive officer of its Reassure America Life Insurance Company. Earlier in her career, she held chief financial officer and chief operating officer roles in life insurance companies.

Kinnaird earned her Bachelor of Science degree in Accounting (Cum Laude) from Indiana State University, Terre Haute, and her M.B.A. from Butler University, in Indianapolis.

 

Lion Street, Austin, Texas, and American Financial Systems, Inc. (AFS) have formed an alliance to create opportunities in executive benefits for the middle market through a multi-carrier platform featuring single source administration.

Similar programs in the industry are built for large corporate cases. Middle market clients today are left in an underserved space, with turnkey administration and insurance products traditionally offered by single insurance companies.

AFS, serving the supplemental benefit and retirement needs of employers and plan participants throughout the U.S., has reacquired the company from Guardian Life. Lion Street is a privately held, advisor-owned life insurance distribution company based in Austin, Texas.

Lion Street will add 12 new Advisor-Owner firms nationally this year to leverage this new alliance.

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A Communication Guide for Extroverts21 Apr

If you’re an extroverted type of person (and many salespeople are), but your employees are introverted types, you may make the mistake of thinking that they are capable of adapting their behavior to fit your extroverted behavioral style. They can’t.

If your goal is to communicate with, lead and motivate others, it is incumbent upon you, the extrovert, to adapt to others’ introverted style of communication. If you don’t make this adjustment in your approach, you run the risk of appearing patriarchal and arrogant, and the introvert will simply shut down. The harder you push, the less likely the introvert is to respond to an extroverted style of communication.

What your employees need is a leader who can catch them doing things right and compliment them. Praise the way they answer the phone or prepare a file, for example.

The way to improve employees’ performance is to let them know in advance that you are planning to have a review meeting with them in the not-too-distant future (10 days to two weeks). Let them know that you want to talk about what’s working and what needs improvement and that you would like to have their input.

Because they are more introverted, they will not like being put on the spot. Giving them plenty of notice before a performance review will make it less likely that they will shut down in the face of criticism. For best results, after you set a date for a review, send them some questions in advance, so that they have a chance to prepare. For example:

  • What do you like best about your job?
  • Which accomplishments that the company has made in the last 90 days make you happiest?
  • What do you like best about the improvements to your job in the last 90 days?
  • What improvements do you believe the company can make going forward?
  • What improvements do you believe you can make going forward?
  • How can the company help you to do a better job?
  • What are the action steps that you can take?

In conducting the review, let your introverted employee answer each question first. Give them the time to answer. I highly recommend that you use a voice recorder and have minutes typed up. This will help formalize what has been learned throughout the review process and will document the action steps.

You need to recognize that dealing with introverts requires patience. An extroverted behavioral style can appear quite impatient to non-extroverts. They can feel as if they are not being heard. The goal of taking this approach is to allow them to feel as if they have been included in the process and that their concerns are being acknowledged.

If you allow your extroverted behavioral style (which includes quick thought processes and decision-making) to take over and just bark orders, introverted employees may not respond well. You will run the risk that they will not do good work—or may even sabotage your business—or will decide to quit. It’s always cheaper to work with current employees, than to train new ones from scratch.

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Simon Reilly of Leading Advisor Inc. is a financial advisor coach, speaker and writer. Simon writes a daily blog and can be reached at www.leadingadvisor.com/blog.

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Build a Better Mousetrap (With Social Media)20 Apr

Ever played the board game Mouse Trap? The goal is to build a contraption that’s set into motion when a player turns a crank. The crank spins gears that push a lever that smacks a boot that kicks a bucket that spills a marble that rolls down a chute…Well, you get the idea. In the end (if you’re lucky), it catches a mouse.

Seeing how media has evolved reminds me of this old game. You get a mention in a newspaper article and find an online link to share on Twitter. Your followers retweet it to their followers, who post it on Facebook, where someone finds it and mentions it on a talk-radio fan page and, before you know it, you’re a guest on a radio show.

But in order to arrive at this dream outcome, you must first integrate your publicity with social media. At my firm, our social-media campaign manager turns the crank. She writes and posts blogs and comments and tweets updates on behalf of clients. Her aim is to build a large, credible following for them.

Here are a few of her tips

People who use social media casually may send a few tweets, update their Facebook status or write a weekly blog post. They connect with people whose content they’re interested in: family members, friends, co-workers, fellow hobbyists and people who share their interests.

If you have a serious goal, such as building an audience for marketing purposes, however, you need to do all of that and more. One strategy I use for our clients is generating “third-party conversations.” Instead of simply posting on our clients’ own social networking sites, I visit the blogs, websites and fan pages of people with similar interests. I comment on their content in hopes of engaging their audience in a conversation that can drive traffic to our clients’ websites.

For instance, we have a client whose message involves maintaining healthy romantic relationships. I found a great article on this topic and shared it with a comment on other sites. The article prompted a discussion and, when it seemed appropriate, I shared a link to our client’s blog. As a result, she gained some new Facebook and Twitter followers.

Another strategy I use is promoting our clients when they’re featured in traditional media, such as newspapers and radio and TV shows, all of which seemed to have some sort of online presence. One client had signed on for our talk-radio campaign. I promoted her upcoming radio interviews to her friends and followers. I also visited the stations’ Twitter accounts and Facebook pages, friended their friends and plugged the upcoming interviews there. As a result, this client made lots of new connections among the stations’ listeners.

These are strategies anyone can use. They merely require time and imagination. To help ensure your success, here are some tips:

  • Don’t over-promote yourself. This is the number-one rule. People are turned off by those who seem interested only in selling a book or product. A good rule of thumb is to make sure 80 percent of your content is light, interesting, informative or fun.
  • Don’t bury your followers in an avalanche of content. Limit Facebook status updates and tweets to three or four per day.
  • People new to social media often regard those with similar content as rivals or competitors. Actually, they can be your new best friends. Become a partner in sharing with online personalities whose messages are similar to yours, and you’ll soon have a vast support network.

Integrating publicity and social media requires some thought, effort and creativity. But isn’t that always true when you’re trying to build a better mousetrap?

Sign up for The Lead and get a new tip in your inbox every day! More tips:

5 Ways to Boost Your Website’s Marketing Value

Marsha Friedman is the CEO of EMSI Public Relations (www.emsincorporated.com), which provides publicity services nationwide, and the author of Celebritize Yourself.

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Universal Life Riders to the Rescue20 Apr

Restoration of benefits rider

This important rider can help protect the value of the life coverage when paired with a long-term care rider. It restores the death benefit on a monthly basis when long-term care benefits are paid. So instead of the long-term care benefits gradually depleting the value of the life coverage, the full face amount is available should the insured die during the time he or she is receiving long-term care payments. This rider stays in effect until the base policy is terminated, the full death benefit has been restored or the long-term care benefit rider is terminated.

Spouse term rider

This rider allows an employee who purchases a UL insurance policy to add coverage for a spouse without buying a separate spouse policy. Typically, the spouse doesn’t even have to be present at the enrollment to sign the application, making this coverage very convenient to buy at the worksite. This kind of coverage makes sense when the family wants additional protection for a certain period of time, such as until the home mortgage is paid off or the children are out of school and on their own. The rider also typically can be converted to a cash value plan later, without evidence of insurability.

Children’s term rider

A children’s term rider can usually be added to an employee’s UL insurance policy with no health questions for children ages two weeks to 18 years, with coverage staying in effect until age 25. At that point, the child typically can convert the rider to a cash value policy without evidence of insurability. This means if the child develops a health condition that might limit his or her ability to get coverage as an adult, the protection is already in place. Be sure to ask what happens if the employee dies while eligible children are covered by the rider. For example, Colonial Life’s plan provides a paid-up policy for the children until age 25. We find the children’s term rider to be twice as popular as the spouse term rider.

Guaranteed purchase option rider

This rider allows the employee to purchase additional coverage without evidence of insurability at specified dates, such as the second, fifth and eighth policy anniversary dates, or when a specified life event, such as a birth or marriage, occurs. It’s a great option for employees who know they’ll need to increase their amount of coverage later. For example, a recently married employee might anticipate starting a family in the next five years and need additional coverage at that time. The guaranteed purchase option rider makes that convenient and affordable, even if the employee’s health status changes during that time.

Accidental death benefit rider

This rider pays an additional death benefit if the insured dies as a result of an accident before age 70 — in effect, doubling the amount of coverage. It’s a less expensive way to increase the death benefit for those who don’t qualify for or can’t afford more coverage. If your clients have a younger employee base, this rider is worth looking at, since younger people are more likely to suffer accidents. For example, drivers under age 25 are much more likely to be involved in a fatal car accident than older drivers.2 Some riders include extra benefits for accidental death while a passenger on public transportation or while wearing a seat belt.

If the life has gone out of your sales lately, take a new look at the riders available with today’s universal life plans. Look for a carrier that offers a wide variety of riders on its plans so you have many options to help your clients and their employees customize their coverage. Universal life can be more complicated to explain and sell than other types of life insurance, but with even more flexibility thanks to riders, it just might rescue your bottom line.

 

Jeff Koll is assistant vice president of life and disability products for Colonial Life Accident Insurance Company. He can be reached at (803) 678-5456 or jdkoll@coloniallife.com. Colonial Life is a market leader in providing insurance benefits for employees and their families through the workplace, offering disability, life and supplemental accident and health insurance policies in 49 states and the District of Columbia. Colonial Life is based in Columbia, S.C., and is a subsidiary of Unum Group, one of the world’s leading providers of employee benefits. For more information visit www.coloniallife.com.

 

Footnotes

1    CareerBuilder.com, “More Than One-Third of Workers Will Put Their Tax Refund Into Savings, Finds New CareerBuilder Survey,” April 12, 2011.

2    National Safety Council, Injury Facts, “Licensed Drivers and Number in Accidents by Age: 2009,” as reported by the U.S. Census Bureau, 2012.

 

For more on riders, see:

The Legal Status Of Riders: It’s Worth Considering

Riders: The New Selling Point

The hidden benefits of life insurance

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Should Your Clients Wait to Sell?20 Apr

Clients with policies they no longer want, need or can afford face the difficult question of whether they should try to sell now or wait until the life settlement market might improve. We believe the answer to this question is to act now.

Some clients are waiting because the life settlement market today is very different than it was just four years ago. The recession and its impact on the capital markets severely limited the amount of capital available for investment. But now, as we climb out of the recession, the major stumbling block to a robust life settlement market is not the lack of investment capital overall but, rather, a lack of capital willing to invest in life settlements at reasonable rates of return.

In the fall of 2008, two of the major life expectancy appraisal companies made substantial changes to their methodology and significantly increased the length of their life expectancy mortality tables by approximately 30%. Other companies increased their life expectancies gradually but with, essentially, the same result. Although the capital markets have largely recovered, which has reopened the life settlement market, the life expectancy changes will likely continue to stifle the life settlement industry.

Life expectancy, cost to carry the policy (premium) and target rate of return are the three prime factors in pricing a policy on the life settlement market. The longer life expectancies landed a one-two combination punch on the chin of the life settlement market. First, the increase in life expectancies puts many clients beyond the 12-years-or-less sweet spot favored by investors. Second, and perhaps even more importantly, the greatest impact of the life expectancy increase was to damage investors’ confidence in those life expectancies.

Having been burnt once, investors are now somewhat shy. Attracting investors to a market they now consider risky, thanks to the life expectancy changes, requires the prospect of extraordinary returns to compensate for the perceived risk. These high required rates of return mean many policies price much lower than before and many don’t price at all — that is, they have no value over the cash surrender value.

Although the market is not what it used to be, we believe clients should not wait for a number of reasons:

  1. Restoring investor confidence in life expectancies enough to lower their rate of return requirements will likely take years of performance data.
  2. Keeping a universal life policy in force usually either reduces the cash surrender value or requires additional premium outlays by the policy owner.
  3. Without a decline in health, for every year a person lives, their life expectancy does not decline a whole 12 months.   For example, according to the 2001 VBT Mortality Table, a standard 75-year-old male has a life expectancy of about 15 years, but a standard 80-year-old male has a life expectancy of about 11 years. That’s only a four year decrease over five years. What this means for life settlement pricing is that, if you wait, investors will be facing a higher cost to carry the policy, due to cost of insurance charges that increase with age, without a corresponding decrease in life expectancy.

The bottom line is, if you have a client who qualifies for a life settlement and his or her health remains fundamentally the same, the policy could well become less valuable by waiting unless there is a significant change in the marketplace. The market has improved since 2008, as evidenced by the fact that we are getting offers now on policies that were previously declined. But it may take years for confidence to be restored in life expectancies and waiting could well be a costly decision for your client.


For more from Robin S. Weinberger and Peter N. Katz, see:

Don’t Allow Term to Lapse Without Taking a Second Look

Business Changes Can Mean Life Settlement Opportunities

A Real Life “What Would You Do?”

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Adversity Gives You Strength19 Apr

posterizeposterize

How can you stay self-motivated and productive in the midst of turbulent times and a sluggish economy? How do you persevere as a salesperson when times are tough and customers seem to be holding on to every penny in fear of economic uncertainty?

Every challenge, setback and personal difficulty you encounter in life also brings with it the seed of equivalent or greater benefit! The key to overcoming adversity is to avoid the temptation of panic and instead, focus on finding the greater benefit. Adversity will never leave you where it found you; it will either strengthen your character or weaken your resolve.

During the early years of WW II Nazi submarines, operating in wolf packs, roamed the frigid waters of the North Atlantic with impunity sinking an alarming number of British military and merchant ships. Hitler was confident that his U-boats could blockade England and eventually starve the British people into submission.

In the summer of 1940, while the Battle of Britain was being played out over London, the Germans unmercifully sank over 300 British military and merchant ships. Prime Minister Winston Churchill, fearing the negative impact these devastating losses might have on the nation’s morale, ordered the information withheld from the public. In an effort to reduce the appalling number of casualties lost at sea, Churchill instructed the British Royal Navy to begin a study to determine what, if anything, could be done to save more lives during sea rescue.

While interviewing the survivors an interesting discovery was made. To their complete astonishment, the researchers noted that the survival rate for the younger, presumably more physically fit sailors was remarkably lower when compared to their older shipmates. The study concluded that the older sailors had a significantly higher survival rate due to the fact that they had overcome more adversity and therefore, had developed greater confidence in being rescued than the younger, less experienced sailors.

The head of the research project, Kurt Hahn, was so moved by this discovery that he created the Outward Bound program. Hahn designed the Outward Bound program, utilizing a series of progressively rugged challenges, to mentally and physically prepare young British sailors to cope with the adversity of naval combat. Today, the Outward Bound program works with troubled youth to help them develop greater confidence and self-image.

I find it interesting that people faced with similar adversity often experience remarkably different outcomes. Some people become weakened, some become hardened and some become stronger. If you place a carrot, an egg and a coffee bean into a pot of boiling water, each reacts in a completely different manner to their conditions. The carrot goes into the boiling water firm and comes out soft; the egg goes in fragile and comes out hardened; while the coffee bean turns the hot water into coffee by releasing its flavor and aroma!

Selling in these challenging times demands determination and personal fortitude. Having the will to persevere when times are tough is a characteristic commonly found among self-made millionaires. Are you a quitter? The last time you failed, did you stop trying because you failed or did you fail because you stopped trying?

Thomas Edison documented 10,000 failed attempts to develop the electric light bulb. A reporter asked the great inventor how it felt to have failed 10,000 times trying to invent the light bulb. Edison responded, “Young man, I didn’t fail 10,000 times trying to invent the light bulb, I simply documented 10,000 ways that it wouldn’t work.” Imagine how different our world would be today if Edison had been a quitter.

You must expect to encounter detours, roadblocks and potholes of adversity along the road of life. The next time you are faced with adversity, learn from it and know that you are becoming a much stronger person because of it!

John Boe presents a wide variety of motivational and sales-oriented keynotes and seminar programs for sales meetings and conventions. John is a nationally recognized sales trainer and business motivational speaker with an impeccable track record in the meeting industry. To have John speak at your next event, visitwww.johnboe.com or call 937-299-9001. Free Newsletter available on website.

For more sales marketing coverage, see:

5 Sales and Leadership Lessons from Edison

Become a Sales Genius

Don’t Let Fear Get in the Way of Your Goals

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Silence is Golden19 Apr

Recently, I have been discussing strategies for improving your sales negotiations. There are dozens of strategies, techniques and tactics that can influence your results, but I decided to focus on one aspect of negotiation that many people find challenging to effectively execute: silence.

Many salespeople (myself included) find dead air or silence during a sales conversation a difficult concept to manage. I know that I feel extremely uncomfortable when a period of silence engulfs a sales conversation. However, silence is a very powerful weapon when you are negotiating.

It takes discipline. It requires effort. And it takes concentration. Yet, when used properly, it can help you gain a good deal of leverage in a sales negotiation. Here’s how you can use silence to negotiate a better deal:

Many prospects and customers are also uncomfortable with silence. If you pause for three to five seconds before responding to a comment or statement a person has made, the person will often volunteer additional information that he or she would have otherwise kept to secret.

For example, several years ago my wife was speaking to someone who wanted to use one of my articles in a corporate newsletter. At one point during the telephone conversation, she sensed that he wanted to tell her something so she remained completely quiet. A moment later, he said, “But we only have a budget of $300…is that OK?”

At that time, I often allowed companies to reprint my articles at no charge, but the person my wife was talking to was used to paying for them. Her five seconds of silence helped generate a small sale.

A friend of mine is an account manager for an advertising company. He told me how he had been discussing the terms of an advertising campaign with a new prospect. His prospect asked if he could get a better price on the package. My friend remained silent as he considered his options.

After several seconds of complete silence, his prospect said, “Well, if you can’t do that, it’s OK.” Since that day, my friend always pauses after a demand for a concession has been made. He figures this one technique has saved him thousands of dollars.

When I worked in the restaurant business (my first career), I used to have to interview job applicants. A common tactic was called the “pregnant pause.” After someone had responded to a question, I would smile and look at them expectantly. In most cases, the candidate would volunteer more information, and in some cases, this information influenced my decision about whether to hire that person.

The easiest way to use this tactic in sales negotiation is to remain silent anytime someone asks you for a concession. In many cases, the person will modify or retract his or her demand. It’s not easy to do, but the results are worth it.

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Kelley Robertson helps sales professionals master their sales conversations so they can win more business at higher profits. Get a free copy of “100 Ways to Increase Your Sales” and “Sales Blunders That Cost You Money” at http://www.Fearless-Selling.ca.

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An Incorrect Diagnosis: What’s Really Wrong With Medicare19 Apr

Okay, so I had some oxycodone — two on a Friday and one the day following. Why? Because I had shingles, that’s why, and the pain level was pretty high. The real story is the diagnosis process. My doc was away with her husband and kids for spring break (this saga started about three weeks ago), and so I went to the urgent care center recommended by my doctor’s office staff.

My complaint had to with what I thought was an injury to my right ribcage. I had been working out on a machine that employed a hydraulic compensator, and it, by malfunction, electronically increased my weight load to about four times the setting. So, a day or so later, when my ribcage began to hurt, I sought help.     

Urgent care took x-rays to rule out any heart or lung problem, given my age, and I was given a diagnosis of strained ligaments and tendons and sent on my merry way. Given the diagnosis, I went to a chiropractor for some relief, and he used some hand kneading and a few machines to provide help. The problem was not resolved and my chest and ribcage hurt more than ever.   

By this time, my family doc was back from spring break. My pain was increasing, and my wife noted that I had a rash around the right side of my chest. A quick trip to the Internet to confer with a New York customer, a chiropractor, suggested shingles.  He got it in one and without looking at my chest or anything — just from the description. I then I went to my family doctor, and it was confirmed. No tendon or ligament problem at all — it was shingles the whole time. Shingles might as well be called Revenge of the Chickenpox, since, when one has chickenpox, usually at a young age, it leaves a little package of fun that opens later in life, much later.          

Since I have a fair complexion, I tend to get rashes from time to time, and I don’t think about them. If the doctor who had examined me at the urgent care outfit had looked at my chest, he probably would have been able to diagnose the condition almost instantly, since the rash was pretty specific and one-sided. If the chiropractor had looked at my chest, he, too, might have been able to diagnose my condition. The thing is that both men spent money on various tests and treatments that had nothing to do with my condition, and the cost (and the two visits to the chiropractor) could have been avoided totally if the urgent care doctor simply had looked at my chest.

I wouldn’t complain about this so much if it hadn’t taken my wife more than two years to get a diagnosis for her rheumatoid arthritis. We went to specialist after specialist, and she came close to death before, finally, someone got it right. Maybe the problem with Medicare isn’t so much the large number of people covered, but the large number of incorrect diagnoses.

Try to find the book “How Doctors Think,” by Jerome Groopman. It’s a wonderful book that spends a lot of time on diagnosis.   He’s a Harvard Medical School professor who also writes for the New Yorker.

There’s a lot of waste in Medicare, and I suspect much of it comes from poor diagnostic ability. In an age of specialization, each doctor seems to try to make the illness of a person fit his or her specialty, at least until a number of expensive tests rule it out. I have not yet seen the amounts paid, but Medicare and my supplement probably paid close to $1,000, needlessly. The money spent on x-rays and chiropractic work was useless and, if my wife hadn’t noticed the rash, might have continued. My wife? Diagnosing her RA cost thousands and thousands of dollars. My guess would be at least $40,000 over two years, maybe more…  

See also: House Kills Medicare Rationing Board

The oxycodone?  I’ve had three tablets in two days, and I suspect I’ll be off — without going to Betty Ford — within the next two days. 

Have a great week and find a good diagnostician. And you might read “How Doctors Think.” It’s a great book.  

 

For more from Richard Hoe, see:

Do Yourself a Favor

Some Nice Words About Ron Paul

Unemployment, Republicans and the Market

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Slideshow: Nursing Homes and Natural Disasters18 Apr

You find a qualified prospect for long-term care insurance (LTCI).

Your customer buys coverage, then uses the benefits to pay for nursing home care, assisted living facility care or home care.

Then a tornado, hurricane, or earthquake heads toward your client’s residence.

What then?

One answer is that LTCI agents ought to recommend a professional review of homeowners insurance and personal property-casualty coverage when LTCI clients change living arrangements.

Another answer is that some long-term are (LTC) facilities and home care providers take disaster preparedness more seriously than others

The Office of Inspector General (OIG) at the U.S. Department of Health and Human Services (HHS) highlighted planning gaps in a nursing home disaster preparedness report released this week.

The HHS OIG investigators looked at nursing homes because HHS has the authority to oversee disaster preparedness at nursing homes; state government agencies are responsible for reviewing assisted living facilities’ preparedness plans.

The investigators conducted in-depth reviews of 24 homes that have experienced natural disasters in the past few years. The investigators had enough candidates to choose from that they were able to limit the reviews to nursing homes that still have the same administrators and nursing directors they had at the time of the disasters.

In real disasters, investigators say, the 24 nursing homes reviewed reported having more trouble than they had expected with matters such as rounding up backup staff, providing drinking water, and transporting medical records in an emergency.

The challenges can lead to serious hardship. Analysts at the U.S. Centers for Disease Control and Prevention (CDC) note in a background paper that people ages 60 and older made up just 15% of the population of New Orleans in 2005, when Hurricane Katrina hit, but that people in that age group suffered about 70% of the reported mortalities.

“Data from the Louisiana Department of Health show that almost 70 nursing home residents died in their facilities,” the CDC analysts report. “Many were allegedly abandoned by their caretakers. Almost no information is available on what happened to residents of assisted living, board and care homes, and other less-regulated facilities.”

Some disaster-prone states such as California and Florida, keep careful watch on assisted living facilities, but some other states have been less vigilant. The Assisted Living Federation of America, Alexandria, Va., has tried to fill the gaps by publishing a detailed preparedness guide for member facilities.

Meanwhile, here is a glimpse at the kinds of disasters that affected the nursing homes the HHS OIG inspectors reviewed.

 

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