Jeff Brown, MD

There may be a lot of turmoil in the health care industry right now, but Jeff Brown thinks that the best is yet to come.

The flawed Medicare system is so tiresome to navigate that many doctors will drop the coverage if possible or close their independent practices in favor of joining a group.

A plea for doctors to wake up and come to grips with the necessities of a personal financial life.

There is often an uneasiness surrounding the concept of tipping as people fret about how much to tip and who gets the money. Just what is the etiquette surrounding this social more?

There are a number of retirement myths that people take as fact. But it's worthwhile to explore them and see how much truth there is.

New scientific technology isn't the only rapid change in the health care industry. Doctors themselves are changing their politics and views as they change their jobs.

I was having dinner with my "Kitchen Cabinet" the other night when one of them asked me how to go about telling his heirs about his estate. It is an important question, and having seen or heard little on that niche aspect of estate planning I immediately put my crack staff to work on it.

The day after Thanksgiving is not the only time to nosh on leftovers. In my financial fridge there are some goodies lurking that didn't make it all the way to prime time in the first pass. So I am going to open them up, lay them out and wish you bon financial appetit!

The young, and especially young doctors, are sometimes full of bravado with freshly minted degrees in hand. Thankfully, some wisdom comes with age, and lessons get learned the hard way. But there are some new, systemic reasons why younger doctors -- the people who can benefit the most from financial advice -- are reluctant to hear it, let alone take.

For many years, the only headlines involving medicine would cover the occasional scientific breakthrough or pandemic. Increasingly, the business of medicine has become the most pressing subject in the media. The case in point was a recent page one headline which proclaimed "More Family Doctors Charging Patients Annual Fees." It sounds ominous, and the implications are ominous.

There are myriad problems besetting medicine that affect outcomes, medical and financial. One of the inherent ones is that many of these problems have intertwining relationships, making it that much harder to parse out for analysis and improvement. Let's look at a few, keeping in mind our blood pressure.

Medical training could serve its patients better by developing a more cost-effective model -- more physician extenders to do triage, prevention and simple problem-solving, instead of more time-consuming and expensive training required for a smaller number primary care docs. We could also do a better job of it in larger, centrally planned groups, using salaried extenders and niche specialists working together. What do you think?

In the interest of transparency and accountability, two things this world is very short on, here are some follow-ups on previous columns and ruminations. Was I right, wrong, incomplete, or just wandering in the fog? Like everything in life, it's probably a mélange of all of the above, so let's see.

We all know that the impression you make in the first 30 seconds of meeting someone can never be redone. And we know from a small series of studies that a physician's appearance is important to a patient's perception of ability and caring. Unfortunately, doctors are known for sometimes being unconcerned about their dress and that can adversely affect our effectiveness, and in turn will have an impact on our economic success.

Travel can be broadening, but it can also be expensive. It doesn't have to be costly particularly, though the fact that a private practice doctor won't be producing revenue to cover ongoing high office overhead makes travel an expensive proposition even before the first ticket is bought.

Implicitly, what every Physicians Money Digest reader is looking for is financial success. But what is it? According to my Kitchen Cabinet of bemused docs, the definition of financial success is "enough." But enough to do what? Enough for security, for power, for bragging rights? What's your definition?

Contrary to "Sticks and stones...," words can actually hurt you -- and cost you money. They are all around us and some are so common that we rarely think about them. Many not only often end up costing us money, but frequently have the additional virtue of aggravating us -- insult on injury. Here are some of the most egregious examples.

We, as a society, are toting around a collective waste dump in our back pockets and purses. We don't think about wallets, we take them for granted and, if asked, become defensive -- about what they contain, about how they look and about their overstuffed size. But our wallets say a lot about us and our attitudes towards money.

I am happy that our competitive consumer system is working, i.e. allegedly keeping prices down. But there are costs to us other than specie that we need to be aware of as we go through our lives. We are battered from all sides all day about "savings," "discounts," "sales," "only here," "time is limited," etc., which noise degrades the quality of our lives, even if we do occasionally save a buck. And keep in mind that "savings" always requires spending. If you really want to save big, don't buy it!

For most of us, the annual ritual of preparing income tax returns is exhausting and cringe-inducing, but it does have its uses -- aside from its costs. Review and planning are the biggest benefits, with financial "Spring cleaning" to round out the trifecta. Oh, and saving money is nice, too.

I've compiled some quotes about money, success and life in general that remind us that we don't have to reinvent the wheel -- we just need to know how to source it. We also learn, yet again, that a felicity of expression is timeless. So read on for some of my favorite quotes, and share some of your favorites with your fellow readers in the comments section.

Did you know that owning stock on the first day of the month only will return 70% more than Warren Buffet's buy-and-hold strategy?

Budgeting is hard work, but there may be some unassayed ore in that slag heap. All of us would rather make smart financial decisions rather than the ones we too often make, and if we were given the data to know and better understand what it is that we are actually doing with our money we could be better off financially and emotionally more secure. Now that's an attractive combination.

Forget about financial resolutions. Follow this checklist of money "dos" and "don'ts" in the coming year and you'll find your finances and yourself happier, healthier and more productive in the new year.

"Wealth management" is a phrase financial advisors use to attract high-earning and/or high-net-worth individuals -- and there is some sense to the concept. Talking a plan through, and then seeing it in writing, can have an impact that is hard to envision otherwise, even if time and circumstances lead to the wholesale revision or even scrapping of elements you once thought essential.

Periodically, I like to delve into financial factoids and accumulated crumbs of wisdom. It is with this in mind that I submit today's offerings.

Do you spend more time mulling the difference in cost of products at the grocery store than you do figuring out whether your home has enough insurance coverage? (Guilty as charged.) When it comes to making financial decisions, we need to keep our individual quirks in mind when it really counts -- not in terms of pennies, but in pounds.

It was my birthday this week, a classic time to take stock. If you had asked me years ago how my attitude toward money might change with age, I probably would have said very little. But events, and especially time, have a way of remolding our certitudes and we realize few money truths are eternal. That's especially true now for young physicians facing an extremely uncertain financial future.

A recent article explains why we need to save more and spend less, for all the obvious reasons. It's too bad that we, as rabid consumers, find it so painful to heed the call. The writer counsels: "You'll be fighting with your brain about money as long as you live. So focus on the war and not the (exhausting) day-to-day skirmishes."

We so much to the wave of technological advances that have enhanced our ability to accomplish our mission. But we also need to do some hard thinking and planning about how best to integrate the rate and means of technological change into the practice of medicine, or run the hazard of having our possible future utopia distort into a dystopia.