Macro-Finance

A new essay "Macro-Finance," based on a talk I gave at the University of Melbourne this Spring. I survey many current frameworks including habits, long run risks, idiosyncratic risks, heterogenous preferences, rare disasters, probability mistakes, and debt or institutional finance. I show how all these approaches produce quite similar results and mechanisms: the market's ability to bear risk varies over time, with business cycles. I speculate with some simple models that time-varying risk premiums can produce a theory of risk-averse recessions, produced by varying risk aversion and precautionary saving, rather than Keynesian flow constraints or new-Keynesian intertemporal substitution.

How to step on a rake

How to step on a rake is a little note on how to solve Chris Sims' stepping on a rake paper.

This is mostly of interest if you want to know how to solve continuous time new-Keneysian (sticky price) models. Chris' model is very interesting, combining fiscal theory, an interest rate rule, habits, long term debt, and it produces a temporary decline in inflation after a rise in nominal interest rates.  

Protect yourself from an insurance audit with proper documentation

Have any of you been noticing your X-rays being denied more frequently than usual or have you been subject to an insurance audit on excessive X-rays? It is

happening and if you have not seen it yet, you will soon. I want you to be as prepared as possible when the insurance companies come knocking on your door.
 

When I work with dental teams, I often see the practice using the Continuing Care system in Dentrix as a way of tracking when a patient is due for his or her next series of X-rays. Your recare system is the most powerful system in your practice and it is the lifeblood of your practice. If you let patients fall through the cracks, you are letting thousands of dollars walk out the back door and your patients may suffer from unscheduled treatment. I do not doubt that your team has the best patient care at heart when you use the Continuing Care system in Dentrix as a way of staying focused on staying current on your diagnostics for your patients. However, taking X-rays is not based on the insurance frequency nor your “office policy” on BWX frequency.

Diagnostics is the reason for taking X-rays, not frequency. With this being said, your clinical documentation needs to reflect this in order to defend yourself in the case of an insurance denial or insurance company audit. I recently attended a study club meeting presented by my good friend and colleague, Teresa Duncan.  She stressed two main points in your clinical documentation.

Since I help dental practices all the time with their custom clinical note templates, there are two things you need to include in your template.  This can easily added to your clinical note template with a checkbox prompt so you can choose the variable answer for each patient.

• X-rays were reviewed by . . .
• X-rays are needed because of . . .

One office I know has made a new office policy that the doctor comes into the exam before the hygienist or dental assistant starts to take the X-rays so they can be properly diagnosed. I have another office that has changed up its recare appointments so that the X-rays are diagnosed at the current appointment and then scheduled with the next recare visit so they cover all their bases.

Now, I am not suggesting that you stop using the Dentrix Continuing Care system for tracking X-rays. However, I am suggesting that you add the risk assessment and diagnosis in your clinical note to substantiate the taking of the X-rays.

If you would like the full report developed by the ADA and the FDA on this topic, please email me directly and I will send it to you.

Creating rich, meaningful relationships to increase your patient retention

If you have been reading my blog for a while you probably have stumbled across an article or two about Patient Retention and if you have worked with me personally we definitely have discussed ways to improve your patient retention and create more meaningful relationships.  In many of my articles you will find tips on where to document these relationship building tidbits about your patients so you can create a dental experience your patients will rave about online.

I met a company recently that shares my view on creating those meaningful relationships and improving your patient retention.  Social Dental believes that the best practices deserve the best patients. If you share this belief, read on.

By definition, the best patients are engaged. They’re not just “shoppers” who are looking for the lowest price on a one­-time procedure; they’re looking to invest in a long-­term relationship. These “above-­the­-bar” patients keep their appointments. They appreciate the care they receive and they accept and follow through on treatment recommendations. Consequently, these highly engaged patients achieve the best outcomes and the highest levels of patient satisfaction. And engaged patients tend to have friends and family members who are a lot like them. Audience engagement is, of course, the key to a building a successful online presence for your practice. Trust is the currency of the web and being real and authentic online builds trust. Not surprisingly, the most effective way to create engagement is by sharing real photos of real patients. Authentic patient photos (vs. stock photography or manufactured content) open a window into your office culture, helping potential patients feel connected to you before they ever step foot in your office.

Social Dental also makes it easy to quickly request Google Reviews from your patients by getting their attention before the distractions of life take over.

The one thing that makes all of this work is for you and your team to genuinely care about your patients. Otherwise, asking to take a photo with a patient may feel forced and cause your team to feel like they’re imposing. When this happens, the process can feel more like a chore than a celebration and the idea of creating a lasting culture of patient engagement will never take root in your practice.

Developing a culture of appreciation is the most important way to grow your practice—online and offline. Visit www.socialdental.com to schedule a demo and
mention this article and Dayna Johnson and you’ll get a $1000 discount off the set up.  

Blueprint for America

"Blueprint for America" is a collection of essays, organized, edited and inspired by George P. Shultz. You can get an overview and chapter by chapter pdfs here. The hardcover will be available from Amazon or Hoover Press October 1.

Some of the inspiration for this project came from the remarkable 1980 memo (here) to President-elect Ronald Reagan from his Coordinating Committee on Economic Policy.

Like that memo, this is a book about governance, not politics.  It's not partisan -- copies are being sent to both campaigns. It's not about choosing or spinning policies to attract voters or win elections.

The book is about long-term policies and policy frameworks -- how policy is made, return to rule of law, is as important as what the policy is --  that can fix America's problems. It focuses on what we think are the important issues as well as policies to address those issues -- it does not address every passion of the latest two-week news cycle.

The book comprises the answers we would give to an incoming Administration of any party, or incoming Congress, if they asked us for a policy package that is best for the long-term welfare of the country.

The chapters, to whet your appetite:

INTRODUCTION
CHAPTER 1: The Domestic Landscape by Michael J. Boskin
IN BRIEF: Spending by George P. Shultz
CHAPTER 2: Entitlements and the Budget by John F. Cogan
CHAPTER 3: A Blueprint for Tax Reform by Michael J. Boskin
CHAPTER 4: Transformational Health Care Reform by Scott W. Atlas
CHAPTER 5: Reforming Regulation by Michael J. Boskin
CHAPTER 6: National and International Monetary Reform by John B. Taylor
CHAPTER 7: A Blueprint for Effective Financial Reform by John H. Cochrane
IN BRIEF: National Human Resources by George P. Shultz
CHAPTER 8: Education and the Nation’s Future by Eric A. Hanushek
CHAPTER 9: Trade and Immigration by John H. Cochrane
IN BRIEF: A World Awash in Change
CHAPTER 10: Restoring Our National Security by James O. Ellis Jr., James N. Mattis, and Kori Schake
CHAPTER 11: Redefining Energy Security by James O. Ellis Jr.
CHAPTER 12: Diplomacy in a Time of Transition by James E. Goodby
CLOSING NOTE: The Art and Practice of Governance by George P. Shultz

My chapter on a Blueprint for Effective Financial Reform is a better version of the talk on Equity Financed banking which I posted here. (The talk was based on the paper. Now you have the paper.)

My chapter on Trade and Immigration is new, and an uncompromising red-meat free-market view. I don't think one should compromise centuries old economic understanding just because it's not politically popular at the moment.
 
If you got this far, you might also be interested in my Economic Growth essay written for a parallel but similar project.

How can I see which doctor is scheduled to do the exam? Here are 3 ways . . .

One of the most frequently asked questions I receive from multi-doctor practices about the Dentrix appointment book is, “How can we see which doctor is assigned to the patient for the exam?” Since the appointment is set in the provider color (usually the hygienist color), it is difficult to see which patient each doctor needs to see during the day. Another question along these same lines is, “Can I post the exam to the doctor and the cleaning to the hygienist?”

In the past, there was no good answer. 

Now with the release of G6, there is a way to answer both these questions . . . Yeah!

When you schedule a patient for an appointment in G6, you will notice an Addl Provider box in the upper left corner where you can add the specified doctor for this patient’s exam. When you add an additional provider, you will be able to view it in a couple of places depending on your preferences.  

• If your practice is using Route Slips or Patient Visit Forms, then you will see the additional provider in the Appointment Details section of the form.
• Back in (I think) Dentrix G3, they added the Hover. When you let your mouse sit over the top of the appointment, it will pop up a window that will give you more information about the patient such as his or her picture, birthdate, insurance info, etc. One of these new pieces of info in the Hover is the Additional Provider.
• You can add the Additional Provider to the View. From the Appointment Book, click on View from the top toolbar, and select the view you want to edit, then on the right side you will see a bunch of drop-down menus for Appointment Display Info. Here you can select the Additional Provider to show on the appointment book view so you can see visually on every appointment.
  

When you go to check out the patient and set the procedures complete, you can assign the exam to the additional provider and give that production to the doctor without having to go to the ledger and change it manually. This will save you a ton of time.  

I hope this tip helps you be more efficient and productive in your everyday routine. You use your practice management software every day and it is the little things that make the biggest impact on your day.

The Thriving Dentist with Gary Takacs - podcast

Practice management software is a critical element in every thriving practice. Yet many Dentists and Team Members are only using a small fraction of the capabilities of their practice management software. In this Thriving Dentist Show, Gary interviews his friend Dayna Johnson on specific tips to optimize your dental practice management software. Dayna is an authority on this subject and passionate about helping her colleagues. In this interview, Gary and Dayna discuss; Why many dental offices are still using a paper chart, the four specific benefits of converting to digital records, the three key elements of a successful paperless transition, important security tips, a fool proof back up system and the five most important statistics that every office should monitor with their practice management software.

CLICK HERE to be directed to the podcast

Immigration sentiment

Above, a lovely graph from The Conversation. A common story says that opposition to immigration comes from people in high-immigrant communities, who suffer externalities from the presence of many immigrants. It is not true.

NYT on zoning

Conor Dougherty in The New York Times has a good article on zoning laws,

a growing body of economic literature suggests that anti-growth sentiment... is a major factor in creating a stagnant and less equal American economy.

...Unlike past decades, when people of different socioeconomic backgrounds tended to move to similar areas, today, less-skilled workers often go where jobs are scarcer but housing is cheap, instead of heading to places with the most promising job opportunities  according to research by Daniel Shoag, a professor of public policy at Harvard, and Peter Ganong, also of Harvard.

One reason they’re not migrating to places with better job prospects is that rich cities like San Francisco and Seattle have gotten so expensive that working-class people cannot afford to move there. Even if they could, there would not be much point, since whatever they gained in pay would be swallowed up by rent. 

Stop and rejoice. This is, after all, the New York Times, not the Cato Review. One might expect high housing prices to get blamed on developers, greed, or something, and the solution to be government-constructed housing, "affordable" housing mandates, rent controls, low-income housing subsidies (which protect incumbent low-income people, not those who want to move in to get better jobs) and even more restrictions.

No. The Times, the Obama Administration, California Governor Gerry Brown, have figured out that zoning laws are to blame, and they're making social stratification and inequality worse.

In response, a group of politicians, including Gov. Jerry Brown of California and President Obama, are joining with developers in trying to get cities to streamline many of the local zoning laws that, they say, make homes more expensive and hold too many newcomers at bay. 

.. laws aimed at things like “maintaining neighborhood character” or limiting how many unrelated people can live together in the same house contribute to racial segregation and deeper class disparities. They also exacerbate inequality by restricting the housing supply in places where demand is greatest. 

“You don’t want rules made entirely for people that have something, at the expense of people who don’t,” said Jason Furman, chairman of the White House Council of Economic Advisers. 

This could be a lovely moment in which a bipartisan consensus can get together and fix a real problem.

The article focuses on Boulder Colorado, where

.. the university churns out smart people, the smart people attract employers, and the amenities make everyone want to stay. Twitter is expanding its offices downtown. A few miles away, a big hole full of construction equipment marks a new Google campus that will allow the company to expand its Boulder work force to 1,500 from 400.

Actually, The reason Google and Twitter are in Boulder is that things are much, much worse in Palo Alto! A fate Boulder may soon share:

“We don’t need one more job in Boulder,” Mr. Pomerance said. “We don’t need to grow anymore. Go somewhere else where they need you.”

Everything Dental Blog - June 2016

The Secret Weapon of every dental office is their practice management software. The big secret is how it is used or underutilized. There are many good systems available to the dental community but most dentists only use a fraction of their utilities capabilities. Looking toward the future, dentists must embrace the power and versatility of their practice management suite. The benefits of a robust PMS can help them become more efficient and even more profitable. Whether you are a solo practitioner or a large group, practice efficiency and seamless technology integration is the goal!

If you assess the business acumen of independent solo dental practices across the USA you will find these four business styles. These styles address leadership, management style and degree of confidence. There is a direct correlation between leadership type and operational efficiency as well as PMS competency and offices that track their key production numbers.

CLICK HERE to continue reading my interview with Jack Abrams from The Abrams Report courtesy of the Everything Dental Blog.