entrepreneurs anchor magazine vol 3 issue 3

medical passion

interview with surgical

oncologist

nutrition entrepreneurs

mcci medical Groupone on one with dr. david priscal

paws & effectK9s for warriors

hank c.hillhank c.hill

M.D.M.D.

Volume 3 | Issue 3www.entrepreneursanchor.com

2 Entrepreneurs Anchor Magazine | entrepreneursanchor.com

A Degree with Immediate Payback:With an interactive environment in a state-of-the-art facility,

you will integrate cutting-edge theory with best practices

ready to employ at work. Emphasizing the practice of

business in a dynamic global environment, you will develop

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build your leadership presence and style; and design, drive

and communicate strategic, positive change.

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Mayo Clinic Executive Health ProgramGrounded in a compelling holistic leadership framework,

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knowledge is critical, of course, but we also know that

attention to a leaders physical, emotional and psychological

well-being is equally critical in todays dynamic business

environments. This is why we collaborate with the world

renowned Mayo Clinic in providing an executive health

assessment and seminars for each of our EMBA students

to achieve this goal. The EMBA program is exceptional

in its ability to balance focus and development in all of

these areas.

Youll receive a state-of-the-art preventative medical

examination by specialists in the Mayo Clinic Executive

Health Program designed specifically for top-level

executives. The program includes a complete checkup and

comprehensive lifestyle assessment. Youll discuss your

results face-to-face with a Mayo Clinic physician, who will

guide you in developing a plan based on your personal

objectives. In addition, a series of seminars and workshops

focusing on key wellness and fitness issues is woven into

the Davis EMBA curriculum and delivered by Mayo Clinic

medical staff.

Executive MBA in Leadership DevelopmentIf you are preparing to join an executive leadership team

or launching a significant new venture, then the Davis

Executive Master of Business Administration is designed

for you. Developing a leaders strategic mindset, business

expertise and creative instinctsall grounded in an ethical

and professional foundationare essential. These are the

competencies acquired in this intensive 18-month program.

Beautiful Location, Amazing WeatherJU is located in a scenic riverfront setting in suburban

Jacksonville, across the St. Johns River from downtown

and just minutes from the Atlantic Ocean. Our campus

is close to miles of uncrowded white sandy beaches that

feature oceanfront hotels, great dining, shopping, golf

courses, entertainment, festivals, concerts and much

more. The average temperature in the area is 71 F and its

sunny nearly 270 days of the year. Whether youre into the

beach or the city, JU is in a convenient spot where its easy

to enjoy either one.

Jacksonville University: Developing Effective Leaders

Jacksonville Universitys Executive Master of Business Administration is a signature program that is the epitome of the Universitys mission for student achievement and leadership. We integrate progressive theory with best practices ready to employ in todays complex business environment. For more than 20 years, many of Northeast Floridas most successful business leaders and entrepreneurs have had one thing in common: an Executive MBA from JUs Davis College of Business. Hone leadership skills that last a lifetimeand the relationships you forge with your classmates may be just as invaluable.

JUs focused 18-month EMBA program offers: Holistic leadership emphasis, including: Mayo Clinics Executive Health Assessment Program Certified executive leadership coaching program

Jacksonville Regional Political Leadership Institute International trip to study global businesses Distinguished, world-renowned faculty

To discover how you can take charge of your continued education, visit ju.edu/emba or call 904.256.7811.

Now accepting applications for fall 2012.

Accentuate your signature with an EMBA from JU!What does your signature say about you?

Entrepreneurs Anchor Magazine | entrepreneursanchor.com 3

A Degree with Immediate Payback:With an interactive environment in a state-of-the-art facility,

you will integrate cutting-edge theory with best practices

ready to employ at work. Emphasizing the practice of

business in a dynamic global environment, you will develop

strategic leadership skills with the ability to create and

work through effective leadership teams; deepen your

functional business expertise through practical application;

build your leadership presence and style; and design, drive

and communicate strategic, positive change.

All this with state-of-the-art knowledge and tools, coupled

with the very latest personal management strategies

that is the Davis EMBA, unlike any other program in

the Southeast.

Mayo Clinic Executive Health ProgramGrounded in a compelling holistic leadership framework,

the program recognizes that sustainable high performance

today requires attention to mind, body and spirit. Leader

knowledge is critical, of course, but we also know that

attention to a leaders physical, emotional and psychological

well-being is equally critical in todays dynamic business

environments. This is why we collaborate with the world

renowned Mayo Clinic in providing an executive health

assessment and seminars for each of our EMBA students

to achieve this goal. The EMBA program is exceptional

in its ability to balance focus and development in all of

these areas.

Youll receive a state-of-the-art preventative medical

examination by specialists in the Mayo Clinic Executive

Health Program designed specifically for top-level

executives. The program includes a complete checkup and

comprehensive lifestyle assessment. Youll discuss your

results face-to-face with a Mayo Clinic physician, who will

guide you in developing a plan based on your personal

objectives. In addition, a series of seminars and workshops

focusing on key wellness and fitness issues is woven into

the Davis EMBA curriculum and delivered by Mayo Clinic

medical staff.

Executive MBA in Leadership DevelopmentIf you are preparing to join an executive leadership team

or launching a significant new venture, then the Davis

Executive Master of Business Administration is designed

for you. Developing a leaders strategic mindset, business

expertise and creative instinctsall grounded in an ethical

and professional foundationare essential. These are the

competencies acquired in this intensive 18-month program.

Beautiful Location, Amazing WeatherJU is located in a scenic riverfront setting in suburban

Jacksonville, across the St. Johns River from downtown

and just minutes from the Atlantic Ocean. Our campus

is close to miles of uncrowded white sandy beaches that

feature oceanfront hotels, great dining, shopping, golf

courses, entertainment, festivals, concerts and much

more. The average temperature in the area is 71 F and its

sunny nearly 270 days of the year. Whether youre into the

beach or the city, JU is in a convenient spot where its easy

to enjoy either one.

Jacksonville University: Developing Effective Leaders

Jacksonville Universitys Executive Master of Business Administration is a signature program that is the epitome of the Universitys mission for student achievement and leadership. We integrate progressive theory with best practices ready to employ in todays complex business environment. For more than 20 years, many of Northeast Floridas most successful business leaders and entrepreneurs have had one thing in common: an Executive MBA from JUs Davis College of Business. Hone leadership skills that last a lifetimeand the relationships you forge with your classmates may be just as invaluable.

JUs focused 18-month EMBA program offers: Holistic leadership emphasis, including: Mayo Clinics Executive Health Assessment Program Certified executive leadership coaching program

Jacksonville Regional Political Leadership Institute International trip to study global businesses Distinguished, world-renowned faculty

To discover how you can take charge of your continued education, visit ju.edu/emba or call 904.256.7811.

Now accepting applications for fall 2012.

Accentuate your signature with an EMBA from JU!What does your signature say about you?


Dear Entrepreneurs Anchor readers,

Im inspired by your voice.

First and foremost, I am thankful for your loyalty, your voice

and your emails. As you know, Entrepreneurs Anchor has gone

through a lot of changes in its design, content and layout

within the previous three issues. Over the past year, the

magazines editorial and management staff has also been in

transition. It is for the best!

Its now been two years and four months since the launch of

our inaugural issue. The magazines content and layout inspires

our readers and engenders more fans towards Entrepreneurs

Anchor. Our anchor is that we know and understand what you,

our readers, want and expect from us. You want us to take the

lead role in developing a compelling and instructive business

publication that not only serves Northeast Florida, but which

will eventually expand across the entire Southeast and beyond.

The quality, richness and value of Entrepreneurs Anchor are

not assessed by its owners or management, but by its readers,

advertisers, and fellow business publication professionals.

We have drawn our talented pool of contributing writers from

diverse business backgrounds. I want to take this opportunity

to tell all our writers, past and present, that we appreciate all

their time and energy in helping make Entrepreneurs Anchor

become the best possible magazine/website it possibly can.

Im inspired by our talented staff. Our continued success

would not be possible without them. They work tirelessly

in embracing the vision of the magazine; constantly putting

themselves in the place of our readers as a way of determining

and creating the most pertinent, well-written, and attractively

designed articles possible.

Im inspired by our vision and future. Our commitment

to become a leading business publication will not falter.

We believe if we keep working at becoming the best and

continually strive towards continuous improvement, we will

produce a better product for our business-minded readers.

Im happy to report Entrepreneurs Anchor will soon be

launching its application for apple and android users. This

effort is aimed at making our publication accessible on all sorts

of mobile and other smart, digital devices.

As we aspire to be your business magazine of choice, we

know the journey will not always be an easy one. We welcome

those challenges, knowing we have the mindsight to win

and inspire entrepreneurs and business managers, and all

who depend upon Entrepreneurs Anchor for content that is:

Actionable. Timely. Instructive. Relevant.

Happy reading,

Ethelbert Nwanegbo

Publisher/Editor-in-Chief

Editor In Chief Ethelbert [email protected] Managing EditorRobert [email protected]

Layout & DesignAbstract Creative [email protected]

Graphic Artist Intern Kareem Brooks [email protected]

Production ManagementMegan Smith [email protected]

Senior Sales DiretorMichael [email protected]

FROM THE EDITOR

Editorial


Contributing Writers

Priscilla Goudreau-Santos is a marketing and public relations specialist and owner of Priscilla Goudreau Public Relations and Marketing, in Jacksonville, Florida

Robert Kaye is an internationally published national, state and regional award-winning editor/copywriter. He has been published over 400 times in a variety of print and electronic media (TV, radio, Internet).

Michelle Ash, CFP, CDFATM, is Managing Partner and Chief Operations Officer of PARAGON Wealth Strategies, LLCc

J. Dianne Tribble, is the CEO and Founder of At the Table, and is a certified Life Coach and motivational speaker.

Troy PeckContributing Writer

Judith C. Rodriguez, Ph.D., is a Registered Dietitian and Chairperson and Professor in the Department of Nutrition and Dietetics at the Brooks College of Health in the University of North Florida.

Darrell Locket is the owner and director of ABz-Solute, LLC @DEEN (Diabetes and other Health Disparities, Education, Exercise, Nutrition) Wellness Center in Jacksonville, FLlorida

Abigail Slentz has a Bachelor of Science degree, and is a certified Project Management Professional. She is currently a project manager for Memorial University Medical Center in Savannah, GA.

Deborah Austin, LMT, became licensed in Neuromuscular Therapy (in Florida) in 1989. She served as Dean of the Massage program at the Mandarin School of Chinese Medicine

John Perry, Contributing Writer

Michael R. Jones, Ph.D., holds a Doctorate in Health Administration, is a Board Certified Registered Nurse, and a Fellow of the American College of Healthcare Executives


We also offer diabetic cooking classes to improve lifestyles- something that is not done nation wide. Most offices do not have the ability to do that. We have a fully functional kitchen in addition to our specialists that come in and show you some diabetes-friendly cooking. We also provide free transportation for their medical visits.

Fundamentally, we advise exercise, a healthy lifestyle and proper medical care to help patients prevent getting diabetes.

What do you find about MCCI as a medical corporation and its medical care motto how is it different from other medical groups around Florida to your knowledge?It is more of a patient centered approach. It takes in every aspect of a patients life that might be affected. We provide in-patient nurses that follow them. We provide telephonic case managers. We have nurses go out to the home as well as home visit doctors if necessary. Our motto focuses on prevention and, although our centers are very large with a lot of patient traffic, we strive to have each patient feel and know that they are most important.

A lot of medical organizations mandate what medications doctors can and cant use. The 10 years I have been here they have never told me what medications to use. Whatever is necessary for the patient is what is needed.

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MCCI Medical Centers in Jacksonville

CONTENTS

2/3 JU Executive MBA7 PowerHouse Anchor12 Available Pest Control17 JU Nursing Program21 Brysons Furniture23 The Curinton Group23 KB Construction Group23 JAXROOF.COM

28 Jones & Rose28 ANYLABTEST31 The Harper Law Firm36 Watson Realty41 Humana45 Florida Hardest-Hit47 MCCI Jacksonville, FL48 Jacksonville University

Copyright 2012 by Entrepreneurs AnchorTM. All rights reserved. Contents may not be reproduced without written consent of the

publisher.

Disclaimer:Entrepreneurs Anchor TM prov ides genera l information about business topics. It does not provide legal business advice. Views and opinions expressed herein by all articles and advertisements are solely those of the authors and advertisers; they do not necessarily represent those of the magazine, nor its parent organization, Brain Media GroupTM. Therefore, neither entity accepts any liability with respect to any incorrect, incomplete, or unacceptable statements contained within.

advertisers index

Cover Feature08 Dr. Hill Hank Medical Passion

Focus Feature31 Paws & Effect

26 MCCI Jacksonville, FL

13 An Ounce of Prevention

Healthcare & Wellness18 The Game is not Over

29 Hands on Healing

42 Nutrition Entrepreneurs

Business Technology40 Anti-virus Software

37 Healthcare Information Technology

Finance22 Roth 401K

Marketing44 Medical Marketing

Mind Body & Soul20 Putting Passion into Practice

39 Did You Know?

24 On-Site Insite

8

26

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medical Passion in action


The national firm, 21st Century Oncology, with a local office in Jacksonville on Baymeadows Road, has brought together some of the best talent in the medical field, anywhere. In its over 20 years of operation, 21st Century Oncology has developed an operating model which enables its centers to deliver high quality, cost-effective patient care. Its doctors come from some of the most prestigious and recognized medical training centers and universities in the world. It continuously looks for those who excel in their field to join its ever-growing team of professionals so that it can provide its patients with the best oncologic care available. One of the premier doctors working at the Jacksonville location is Dr. Hank C. Hill; Entrepreneurs Anchor had the opportunity to meet with this passionate professional.

Entrepreneurs Anchor (EA): Please tell us about yourself.

Dr. Hill: I am currently a Surgical Oncologist in Jacksonville, Florida at the 21st Century Oncology Cancer Care Center here in Jacksonville. Im part off multidisciplinary group that includes surgical oncologists, medical oncologists, and radiation oncologists. However, I was an ambitious young African-American who grew up in Queens, NY encouraged and motivated by Guyanese immigrants.

EA: And your educational background?

Dr. Hill I was born in Brooklyn, raised in Queens, and attended Long Island University, Brooklyn Campus as a Biology/Pre-Med major. My athletic abilities earned me a tuition-free scholarship allowing me to play for L.I.U Blackbirds Mens Tennis Team (a team that does not exist today). That was great experience for me, not only for

the academics, but to be a scholar athlete helped sustain my drive and motivated me to seek excellence in both areas of my undergraduate years.

After completing the undergraduate degree, I matriculated at Morehouse School of Medicine in Atlanta, Georgia, and obtained my M.D. degree in 1991. After completing that, I sought out surgical residency

and was matched at Harlem Hospital, Columbia/Presbyterian Medical Center in New York City. General surgery residency lasts 5 years, however in order to pursue a career in surgical oncology, I interrupted that training after the third year and spent two years at M.D. Anderson Cancer Center in Houston, Texas as a surgical oncology research fellow. This was encouraged by one of my mentors, Dr. Harold Freeman, who is a Breast Fellowship-Trained Surgical Oncologist and was the Chairman and Director of Department of Surgery at that time. He continues to be a reliable mentor.

After completing the two years of the research fellowship at M.D. Anderson, I returned to Harlem Hospital Center, completed my surgical training, and stayed at Harlem Hospital another year as an endoscopy and critical care fellow. After completing that, I went on to complete my fellowship in surgical oncology in the Roswell Park Cancer Institute in Buffalo, New York. This included an additional year of research, followed by two years of clinical fellowship.

EA: How did Dr. Freeman impact your surgical training?

Dr. Hill: I would like to believe that Dr. Freeman saw something special about me as a resident and when sharing with him a personal experience regarding my

Our purpose is to serve each other as humans on this planet.

medical Passion in action

an interview with surgical oncologist, Dr. Hank Hill


late fathers diagnosis of stage IV sigmoid (colon) cancer. I shared with him that I would like to be able to be in a position to make a difference in a cancer patients life and to have an impact on reducing cancer disparities. I felt that after witnessing what my father endured, and asked the question why the colon cancer couldnt have been diagnosed at an earlier stage and perhaps become a cancer survivor today. I wanted to put my energies and efforts in becoming a surgical oncologist. Not only for the surgical aspects of treatment, but also in education, prevention, and managing cancer in the global community. Many families know a relative or have a friend who is dealing or dealt with cancer. Today considering cancer rates, and recognizing the influence of environment, and lifestyles choices, were still going to be dealing with cancer for a long time.

EA: Are you still passionate about what you do?

Dr. Hill: Yes. As I matured over the years, I began to realize whats important as it relates to what a surgical oncologist offers a cancer patient. Certainly the greatest joy is having that ability to physically remove solid organ tumors (for example; esophageal, stomach, liver, pancreas or colorectal tumors) from patients I treat. And to provide them with some comfort, first of all, some relief from their cancer, but to assist these patients to become long term cancer survivors. One of the things that is really gratifying about my training, because of the specialty, it allows myself and others who are in this field to actually perform procedures that most surgeons would shy away from. The training allows me to review studies (for example CT scans and PET/CT scans) that are used to evaluate my cancer patient and educate the patient about their chances for removal of the tumor. Additionally, we can perform operations that are quite complex at times and may require more than one surgical specialist. I take responsibility in recruiting a team to provide the best surgical outcome for cancer patients. Sometimes a patient may go to a location that says, We may not be able to operate on you, then if they seek us out for a second opinion, I can reeducate the patient on what surgical options are availableproviding some hope, and coordinating a surgical plan. A clinical trial may be an option. This is why the multidisciplinary approach is so critical for cancer patients.

EA: I often say passion is what allows you to have long-term success; because if you find your root, if you find the thing that God has created you to do, thats when things become easier because that is your innate talent.

Dr. Hill: I agree. I believe theres a calling for each of us. If you dont listen to that calling or perhaps dont tap into what our faith is about, realizing that God is in control of a lot of things that we do and experience, we miss out on what our true purpose is. This is why education is so critical. It allows us to eventually tap into our calling and become whom we are destined to be. Our purposeoverall among anything else we dois to serve each other as humans (with common decency and respect) on this planet. I just happened to find that my service to humankind is through surgical oncology. I enjoy interacting with people. My patients deserve the highest quality of whatever surgical oncology there is today. And I strive to be, if not perfect, then excellent.

It is a tough time for a patient, to think about their diagnosis with cancer. Questions such as whether or not theyre going to live or die from the disease and the impact their diagnosis is going to have. The cancer patient is connected to many other individuals, especially

when they have familyspouse, children, parents, or even grandchildrenthat they may have to take care of. And thats where my passion and drive come in. Ive accepted that responsibility as being a surgical oncologist. And Im always willing to offer them something. The reality discussion sometimes is hard to initiate but I find that when patients are well informed they want to hear what the inevitable may be. Whether

its a procedure, or whether information on alternatives in management, or perhaps preparing them for the end of life, it relates to how we look at the big picture in the treatment of the patient. Its not only just the disease itself; its the spiritual aspect, its the psychological aspect, its the emotional aspect And really, when Ive adopted these patients, Ive adopted the whole family.

EA: How does being a surgical oncologist differ from other medical specialties?

Dr. Hill: Oncology is an area that still has a lot of questions. When I talk about questions its not just really what we understand today, but what we now understand is the uniqueness of the cancer cell and its unique mechanism for immortality. It is very complex and there are millions of research dollars gone into trying to figure out this thing. What is more apparent is just how genetics relates to cancer. Oncology research has opened doors to a lot more questions. Theres so much thats unknown and thats why research is so important in this field. We still dont know everything about cancer. What we do know is that if we can get the cancer out (at an early stage), then we give the patient the best chance

Oncology research has

opened doors to a lot more questions.


for survival. Additionally, we know that technology has been able to interface with this disease in a way that we can recognize the complexity of the cancer cell itself. It behaves completely different from a normal (non-cancer) cell. You have to appreciate that more and more. Were going to be able to open up a whole new concept as to how we treat cancer patients with a customized approached. It gets down to the molecular and genetic levels, and for a surgical oncologist, learning how to implement those applications in the future. Were going to be the specialists wholl be the vehicle for the delivery of that new technology. Furthermore, how to identify the patients who potentially may have a familial inheritance for cancer is another area that is so critical today. When we are dealing with these patients who have cancer, we have to appreciate the patients family cancer history as well. Because, thats a signal. Then we

can come in and educate about what is genetic testing and why it is important in dictating their overall care. Today we can test our patients with a very simple test using a mouth rinse, send it off to the laboratory, and it can identify if the patient has a genetic mutation.

This changes the whole dynamics as to what that patient and their family is about. If they carry the genetic mutation, they can pass it down to the next generation. Then we have to educate that next generation about how we customize their cancer screening and how to offer prophylactic surgery.

EA: How has technology played a role in surgical oncology?

Dr. Hill: Great question. Youve heard of nanotechnology? There are now nanoparticles that are carrying agents and compounds that can help destroy tumor cells. We are at the cuspnot so much here at 21st Century Oncologybut at the big cancer centers, such as Sloan-Kettering in New York City, M.D. Anderson in Houston, and University of Pittsburgh in Pittsburgh. These major, tertiary cancers centers are looking at how nanotechnology can actually introduce cancer-killing agents. There have been some noteworthy successes and clinical trials are underway. Theres also microwave technology thats available. There are nanogold particles that can carry tumor killing agents, which has been shown in research to specifically go to only where the cancer cells are and kill them off, essentially. There is going to be some very interesting progress that will come about in the near future.

EA: You talked about genealogy; what other exposures or activities can cause cancer?

Dr. Hill: Another great question. The simple fact of being a living organism is that we are walking biochemistry sets, if you will. There are some things that go on in our systems that go on from birth, which can put us at risk of developing a cancer cell. The healthiest parts of lives

I think its critical people

listen to their

bodies.


are when we are children and our systems are growing, constantly being influenced by proteins and hormones in our bodies. The thing is; our bodies already have a check-and-balance system for whenever theres a cell that changes genetically to transform into a cancer cell, we have certain enzymes and corrective mechanism in place to stop that cell from moving in that direction. That process is called apoptosis. Now the problem is that we dont get to really appreciateespecially if were undereducatedwe abuse the body and overtax these corrective processes. Most people do not understand that if you consume too much alcohol, it can really affect their body in negative ways. If youre a tobacco smoker ... tobacco smoke contains over 50 known cancer-causing agents. The industry knows it. Those who are study this know it. Messages are out there that talk about smoking and its dangerous consequences. Yet we still have people who ignore the messages. Nicotine is addictive. Some people have to understand that because of their own physiology of who they are in terms of being melanin challenged, with very light complexion, oftentimes with red or light blonde hair, weve identified these individuals who are at higher risk for developing melanoma; they cant be sunbathers. These are things we understand today. So the preventative tact is to reduce ones exposure.

I think its critical people listen to their bodies. A lot of the things that we deal with have to do with physical stress. Among many of the things we deal with, in America, is that were living a very fast-paced world. Its not only whats going on in the U.S. but its a global issue as we are all connected. Countries that were once considered underdeveloped have now become industrialized. And were missing out. Or especially stateside, theres a lot of misconception about what

the rest of the world is about. There are a lot of things we dont understand in the corporate world that affects our financial well-being and concurrently our health and wellness. Were so knowledgeable in so many areas, but we are left out of the most important things. Approaching our lives in selfish view, promotes an imbalance in our world system of natural order. You know, we talked about surgical oncology, technological breakthroughs, proper screening, etc. But theres a mental health issue that is significant in this country, which really doesnt get sufficient attention the way it should. Depression and other mental illnesses are plaguing our communities. And that disease plays havoc on all the physiology within our systems.

Another issue is health care disparities. Lower social-economic populations, and especially African Americans have a greater risk of presenting with stage IV disease because of lower education and not having the financial resources for healthier options, such as healthier foods, the opportunity to engage in exercise or sporting activities, as well as reduced access to physicians. They dont have adequate health insurance; therefore they dont see a physician regularly and seek medical care through emergency room services. Ultimately that leads to and propagates an unhealthy lifestyle. So the behavior is one that condones eventually, after many years, a cancer if not diabetes, hypertension, and obesity. Not just that, but heart, lung, liver and pancreas disease, along with other life-threatening or debilitating (chronic) illnesses.

If you would like to refer a cancer patient to Dr. Hill, or if you have a question related to cancer, you may contact his office at 904-562-4360.

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By Robert Kaye

Even with the Supreme Courts recent upholding of President Obamas The Affordable Care Act, or what has commonly been called Obamacare, many health care pundits still feel the law didnt go far enough to significantly change our countrys health care system, which many have described as being dysfunctional. In other words, were still in condition critical.

Thats just what the innovative, Jacksonville-based firm, U.S. Preventive Medicine, is all about. Based in south Jacksonville, U.S. Preventive Medicine is accredited in Wellness and Health promotion by The National Committee for Quality Assurance (NCQA) as well as disease management by URAC. The company has developed a collection of prevention, early detection and chronic condition management products and services, which help improve health outcomes while reducing health care costs.

Frederic Goldstein serves as President for U.S. Preventive Medicine, which features a comprehensive suite of proprietary, technology-based products and services to the marketplace to meet the prevention needs of 300 million consumers. Mr. Goldstein is also chair-elect of the Care Continuum Alliance, an organization that advances strategies to improve care quality and outcomes, and reduce preventable health care costs.

Entrepreneurs Anchor (EA): Even with all the technological, pharmacological, ongoing research, and other advances in medicine and surgery, many who study the health care fieldincluding doctors themselvesstate that the best way to cut health care costs in the U.S. is by instigating serious, actionable preventive health care programs in the workplace and for the private sector.

Frederic Goldstein (FG): Id most certainly agree with that. Studies from the CDC [Centers for Disease Control & Prevention] have shown that up to 80% of Type 2 diabetes and heart disease, and up to 40% of cancers are preventable. And those statistics are based on if people would just do four consistent things: Dont smoke, exercise, watch your weight, and eat nutritiously.

EA: How do you define preventative health care and/or preventative medicine?

FG: Theres actually a clinical specialization, a specific board certification for doctors in Preventive Medicine. It has three componentsPrimary, Secondary and Tertiary prevention. Primary prevention is keeping the healthy people healthy. Doing all those things to keep yourself well such as eating right, getting regular exercise, watching your weight all of activities youd do, or not do in the case of not smoking or drinking excessive alcohol, not using recreational or misusing prescription drugs, and the like, to maintain optimal health. Secondary prevention is the early detection of individuals who or are at-risk or have a condition theyre unaware of.

EA: And that includes getting regular check-ups, etc.?

FG: Right. Screenings, as appropriate, supported by evidence-based guidelines according to your age gender, evaluating possible risk factors and knowing your familys health history, where thats allowed. Studies have shown that some tests arent necessarily carte blanche per se. It comes down to whats appropriate for a particular individual. Thats something worth discussing with your physician and also understanding yourself. For example, we know today there are over 70 million people today who have pre-diabetes and a huge number of those individuals dont even know it. Thats why getting a screening test to determine if you might be a pre-diabetic is very important. Similarly, there are millions of Americans who dont even know that they actually do

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have diabetes. The earlier you can intervene, the better. Thats why getting appropriate screenings for your particular situation is important. Tertiary Prevention, then,

is evidence-based medical management for individuals who already have a specific condition. For instance, if they have diabetes, make sure that theyre getting treated appropriately, the patient understands their treatment plan, and theyre following through with the recommendations for their particular ailment. Those, in essence, are the three components of Preventive Medicine that really need to be integrated in to a program for individuals to help them better manage their own health.

EA: The next three questions will be in tiers, so to speak. First, why is preventative health important to the individual?

FG: Obviously, the better you do at maintaining your own health, the more vitality you have. The better your life can be. If you can keep yourself healthy by doing appropriate things such as living a healthy lifestyle, watching your weight, not smoking, etc., then you have a better chance of enjoying your life in general and especially in your older years being healthier overall. Youre better able to do things, live independently, enjoy your life more, versus suffer from some disability or multiple medical conditions that may seriously hinder your ability to do things by yourself , or at all, in some cases.

EA: Moving up a notch, why is preventative health so important for an employer?

FG: Two key reasons here. One of them is, in our countrys present health care model, employers tend to cover a majority or a fair amount of the health care costs for the individual. We tend to be an employer-based health solution, with many employers paying the health care costs for their employees. Even more importantly today, studies have now shown that the full cost of employees poor health to their employer is even greater than the insurance costs. For every dollar a company typically spends on the health care cost for each employee, theyre losing two to three dollars in productivity losses if that employee becomes ill. Its a fact: the employee who suffers from certain conditions or who has higher health risks or other health-related conditions is absent from work more often. Or they have whats called presenteeism, which means theyre

not as functional when theyre at work. There are conditions, particular diseases or genetic precursors that can lead individuals to experience debilitating conditions that are not lifestyle related. So then the key becomes a Tertiary Prevention issue. How do we effectively help that individual deal with their sudden onset condition or malady?

EA: Expanding our perspective one step further, why is preventive health so important to our countrys somewhat discombobulated and still politically contentious health care policies?

FG: We have a system today thats set up in some ways its backwards. In order to access our health care system, for the most part but not completely, you have to have a medical condition. Providers get paid to deal with somebody who is sick. We actually have a Sick Care System. Providers dont get paid, in the majority of cases, but in not totally, to keep people healthy. The question then becomes how to change that system? Clearly Ben Franklin had it right 200 years ago when he

said, An ounce of prevention is worth a pound of cure. And thats what certain organizations are striving to change the system to do. Not only our company, but I think around the country, prevention as a concept and practice is beginning to take hold. There are also groups like The Partnership to Fight Chronic Disease, The Partnership for Prevention, the Care Continuum Alliance, and certain medical groups such as the American College for Preventive Medicine. And there are many advocacy organizations such as the American Diabetes Association and the American Heart Association. These types of groups are all working to get policy makers to recognize that if we invest upfront, if we all take some proactive role and responsibility to help keep ourselves healthy, as well as change the system, then we can create a much less expensive health care system in the U.S. Because then we wont need as many of the expensive medical services that are now being provided to people who

We actually have a

Sick Care System.


are becoming sick. In other words, if we can be more proactive and preventative, well have fewer people suffering from heart disease, diabetes, some cancers and other avertable conditions.

EA: This is all particularly germane given the statistics were now seeing around the country about childhood obesity and its negative ramifications. Some are even calling it an epidemic; children and teenagers showing evidence of being pre-diabetic

FG: Or even contracting diabetes. What we have is a situation where Type 2 diabetes, not Type I, but Type 2, which used be called Adult Onset Diabetes is showing up in younger and younger individuals. It definitely is related to lifestyle factors, which is why we no longer refer to it as Adult but Type 2 because we now have kids with it. Its a dichotomy, really. Because one of the saddest things is it is a snapshot, and not a very attractive one at that, of the current state of our nations health. But the other side of the coin, which is encouraging, is that Type 2 diabetes is preventable.

Type 2 diabetes now accounts for approximately 85 to 90 percent of all the diabetics in the country. One of the big tragedies is that were seeing children being afflicted with Type 2 diabetes due to them becoming overweight at earlier and earlier ages. The other important thing that needs to be said is that Type 2 diabetes is associated with heart disease, and that's why its so important to not only treat the glucose levels, but also to attack blood pressure and cholesterol levels as well. As one physician I once heard said, We ought to recognize and call it Adult Onset Diabetes again because every time it happens to a child, we ought to think of it as our failure, because we know we can prevent Type 2 diabetes if we recognize it at an early stage.

EA: In some instances the challenge is compounded, as certain school systems have cut back on physical

education programs, or dont teach students about the importance good nutrition and portion control. Even the controversy that made national headlines last year, where Congress declared that a slice of pizza should be counted as a vegetable, when fed to school children.

FG: Its a cultural issue that we all need to work with. And youre beginning to see some unique solutions. For example, when I was a kid growing up in California, I used to ride my bike to school. Today, for whatever reasonsthe transportation system itself, or there arent safe roads, or just parental fearkids dont ride their bikes to school as much anymore. A community in Oregon came up with a cool program called The Walking Bus. They got seniors to volunteer to help walk students a couple of blocks to the next senior, whod walk the kids a couple of blocks to the next senior and so on to the school grounds. So the kids walk to and from school, and get some exercise. Those are the kind of things that communities can kind of look to as a model. And there are probably hundreds, if not thousands of examples all across different communities where there are creative solutions, to look broader, to create those opportunities for kids to get adequate exercise and appropriate nutrition. Another example is the Lets Move program from the White House, where you see First Lady Michelle Obama leading that effort [www.letsmove.gov]. Its going to take individuals and communities working together to really solve this issue. Its not just one thing. Its going to take a lot of sandbags to stop the flood, so to speak. You cant just put up one sandbag and hope, Well change the school lunch program and that will fix it. It will be part of the solution, but theres much more to it.

EA: We have another major health issue on the opposite side of the age fence, as you might say. And that is the massive number of Baby Boomers now approaching their mid-50s and early 60s, who are going to require greater access to health care and medical resources. But nationally, medical schools havent been graduating enough primary care doctors to serve this burgeoning population. So the quandary becomes, whos going to provide the first line of health care defense for this ever-enlarging, aging population?

FG: Its a major issue thats going to require serious rethinking there are several things we can do to solve it. For example, enabling Physician Assistants, Nurse Practitioners/Advance Practice Registered Nurses [APRNs] to step up and become those primary care providers, giving them more authority regarding writing prescriptions and what procedures theyre allowed to do. There are clearly ways to change the current health care system and make it more efficient. Thats one of them, using extenders and others like that to broaden the range of primary care. EA: What are some others?


FG: Were now seeing this move towards a patient-centered medical home, where each individual has their own medical center. It tends to be a little bit broader, as there are several health care specialists versus just one physician in this one locale. Its essentially a clinic set up more around a team approach, where you might see a nutritionist, a dietician, an exercise physiologist, a social worker, and nurses to help better manage patients with diabetes, or pre-diabetics or other conditions. And you may see other types of therapists in there as well. So theyre looking at the client/patient more holistically, versus a theyre in here for this illness or that medical condition type of mindset. Were beginning to see some companies try to focus on more of those preventive approaches.

EA: So one would go to one of these patient-centered medical homes versus seeing their regular primary care doctor?

FG: Yes, and the idea, too, would be to change the [insurance] reimbursement structure so its not necessarily that they would get reimbursed for each service as its structured now, where the more services or procedures a doctor does, they more they get paid. But maybe they have a population of patients, and therefore part of their reimbursement is based on the overall health on that population. For instance, if their clients received appropriate screenings, how many patients had better results and those types of parameters? Now it becomes more of an outcome-based payment versus a service delivery payment. Those are the kinds of models youre beginning to see more often. That is, patients going to medical homes and the new groups of accountable care organizations that are broader structures than hospitals, physicians and services, which are now looking more holistically at the population of individuals they serve. Their focus being, How do we maximize the health of this population versus just treating their diseases? Then instigate particular payment structures to reward those accountable care organizations or providers for delivering higher quality of preventive care. Instead of getting paid every time you get a patient visit, you may get a flat rate for a given population, and if you keep that population healthier overall, you may get bonuses, or things like that. Those are some of the things that are being explored right now, like these different types of health care delivery models. I dont think policy makers have gone far enough to recognize how important it is to work with individuals to keep them healthy and employing those services to facilitate doing that. But theyre getting there. You can see Medicare now has The Annual Wellness Visit to establish a personalized health care plan. Essentially it includes a health risk appraisal, some lab work, maybe a few other tests. The provider gives the individual their report, explains what their risks are, and what they need to do to get healthier and/or keep themselves healthy. They meet

with a doctor and then receive referrals to other service providers to help them, if necessary. Again, it may be a nutritionist, exercise physiologist, social worker, or whatever is appropriate for that patients needs.

EA: Another challenge we face, as a consumer-based marketplace, is that were bombarded by companies and products whose nutritional value or overall impact on ones health can be decidedly negative. Im talking about canned and processed foods with too much refined sodium and sugar and laden with trans fats, and, of course, all the junk and unhealthy fast-food products such as supersized double cheeseburgers, with an extra large order of fries, and a mega-sized, sugar-laden carbonated beverage and so on.

FG: I think we could do a better job about nutritional education in general, and clearly provide better access to food thats good and healthy for you. Some of this weve known, such as eating more fresh fruits and vegetables in our diets every day, drinking adequate quantities of water, those kinds of things. Its also a matter of making individuals aware, and then providing them with opportunities to get those healthier foods more readily, versus the so-called fast foods that are pre-processed and that we may know, or not even know, whether theyre harmful or not. One thing we do know is that if you stick to the basics, and eat that way regularly, you tend to do better.

EA: However, there are so many readily availableand heavily marketedproducts that are chocked full of ingredients that arent healthful, such as high fructose corn syrup, refined grains, monosodium glutamate, aspartame, hydrogenated oils

FG: Right. I think what we also need to do, at the end of the day, is to have studies to show whether an ingredient is harmful or not. And when the studies do show that particular ingredients are harmful, we should ensure those are not included in our foods, or their levels are lowered or whatever. But youre certainly correct. I remember a health coach once telling me, When you read the food labels, if theres anything on there that you dont understand, or dont know what it is, or the name is a super long-sounding chemical ingredient, or you cant even pronounce it, then you probably want to stay away from that product. [Laughs.]

U.S. Preventive Medicine is accredited in Wellness and Health promotion by The National Committee for Quality Assurance (NCQA) as well as disease management by URAC. For more information visit: www.uspreventivemedicine.com, www.thepreventionplan.com, and/or http://macawapp.com.

Creating Nursing Leaders for the Next GenerationJacksonville Universitys School of Nursing develops self-assured, competent, caring professional nurses, who practice in an evolving, complex health care environment. Become a professional caregiver who thinks critically and communicates e ectively through a quality, private education with small class sizes, one-on-one attention and distinguished faculty.

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Master of Science in Nursing Prepares experienced Registered Nurses to assume leadership roles and negotiate advanced practice roles in providing direct and indirect patient care. Campus-based MSN concentrations in education, leadership in healthcare systems, Family Nurse Practitioner, or Emergency Nurse Practitioner. Or, choose an online format with a specialization in education or leadership in healthcare systems.

Clinical Nurse Educator Prepares students pursuing a Nurse Educator position or to provide highly quali ed direct patient services and discipline-speci c educational concepts to nursing practice. All courses are taught within the School of Nursing with 18 hours completed in the Graduate core and another 15 hours in the specialty cognate area.

Master of Science in Nursing/Master of Business Administration Dual-degree program preparing experienced Registered Nurses for global administration positions in a variety of healthcare systems.

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Discover how you can take charge of your career at JUs School of Nursing. Visit us onlineat ju.edu/cps or call the Center for Professional Studies at (904) 256-7811 to learn more.


Creating Nursing Leaders for the Next GenerationJacksonville Universitys School of Nursing develops self-assured, competent, caring professional nurses, who practice in an evolving, complex health care environment. Become a professional caregiver who thinks critically and communicates e ectively through a quality, private education with small class sizes, one-on-one attention and distinguished faculty.

Doctor of Nursing Practice A practice-focused doctorate that prepares experienced Advanced Practice Registered Nurses to translate research into practice and expand clinical knowledge and skills.

Master of Science in Nursing Prepares experienced Registered Nurses to assume leadership roles and negotiate advanced practice roles in providing direct and indirect patient care. Campus-based MSN concentrations in education, leadership in healthcare systems, Family Nurse Practitioner, or Emergency Nurse Practitioner. Or, choose an online format with a specialization in education or leadership in healthcare systems.

Clinical Nurse Educator Prepares students pursuing a Nurse Educator position or to provide highly quali ed direct patient services and discipline-speci c educational concepts to nursing practice. All courses are taught within the School of Nursing with 18 hours completed in the Graduate core and another 15 hours in the specialty cognate area.

Master of Science in Nursing/Master of Business Administration Dual-degree program preparing experienced Registered Nurses for global administration positions in a variety of healthcare systems.

Tina DavisNurse Practitioner Student

Discover how you can take charge of your career at JUs School of Nursing. Visit us onlineat ju.edu/cps or call the Center for Professional Studies at (904) 256-7811 to learn more.


Like most health law watchers, I was surprised by the Supreme Courts decision to uphold President Obamas Affordable Care Act. Im sure that on this issue, as with everything else, zealous responses rationalize the result and split the country down the middle.

I expected the Court to be purely partisan, but apparently Chief Justice John Roberts, acknowledging the gravity of his role, saw his way clear to support the law with some constraints. Heres the comment from Supreme Court of the United States (SCOTUS) Blog: Salvaging the idea that Congress did have the power to try to expand health care to virtually all Americans, the Supreme Court on Monday upheld the constitutionality of the crucialand most controversialfeature of the Affordable Care Act. By a vote of 5-4, however, the Court did not sustain it as a command for Americans to buy insurance, but as a tax if they don't. That is the way Chief Justice John G. Roberts Jr., was willing to vote for it, and his view prevailed. The other Justices split 4-4, with four wanting to uphold it as a mandate, and four opposed to it in any form.

It undoubtedly weighed on Chief Justice Roberts that his decision could mollify or exacerbate a Washington free-for-all that affects nearly one-fifth of the US economy. He may also have wanted to gently rebuke Congress for pushing the Commerce Clause too far, though he let it slide as a tax.

Even so and important as it is, the Fat Lady hasn't sung yet. Its important to place this ruling in context. Virtually every DC health care and party-aligned organization was poised to spin the result, no matter what that result looked like. Today and into the foreseeable future, the parties are far apart and not likely to compromise. The same organizations that, in 2009, contributed $1.2 billion to Congress in exchange for influence over the law's formulation remain unrelentingly engaged. Princeton Professor of Public Affairs Julian Zelizer, observing the quid pro quo exchanges in the ferocious lobbying environment then quipped, They cut it. They chopped it. They reconstructed it. They didn't bury it. I don't think they wanted to.

By Brian Klepper, Ph.D


While the individual mandate will allow us to spread risk more broadly and make access more available, especially to lower income Americans, it isn't perfect. The dire problems of extravagant health care utilization, unit pricing and cost remain largely untouched by the law in its current form. Half or more of all U.S. health care spending provides no value by design, meaning that Americans pay double for health care compared to citizens in other developed nations, and our quality is spottier. The requirement to keep up with this excess through the mandate will be onerous for many Americans. As analyst health care analyst Bob Laszewski points out, a $60,000 annual income household will need to find 9.5%, or $5,700, in its tight budget, for the premium. But the threat of health care costs extends beyond individual households to our national economic security. A recent RAND study showed that, in the decade leading up to 2009, 79% of all growth in U.S. household income was siphoned off by health care. That leaves only one in five new dollars available for other purposes, like education and infrastructure replacement, a frightening prospect. This is the direct result of Congress embrace of money for influence, the embodiment of regulatory capture.

In the face of this national paralysis, pragmatists solutions will be found in the marketplace rather than in policy. Meaningful approaches (e.g., empowered primary care, data collaboratives, large case management, medical destinations, incentive programs, collaborative benefit design, paying for management rather than volume) do dramatically drive down costs while improving quality, though of course some are more powerful than others and some vendors execute better than others.

It is as though there is an awakening in the health care marketplace, as the pressures intensify for purchasers and, now, health care vendors. Many purchasers are finding that they can gain a competitive edge by exploiting health cares egregious market vacuums, and if it is at the expense of the brokers, the health plans, the hospitals, the specialists or the suppliers who have driven excess in the past, so be it. Some vendors are realizing that they can win by changing course and by delivering more efficiency in exchange for greater market share.

The rancor preceding and surrounding the Supreme Court decision is, to some degree, a reflection of our national dysfunction: our inability to have fact-based discussions and our unwillingness to directly confront dire problems that threaten the public interest. We swim in a media-rich, content-poor environment fueled by lobbying, where buzzwords, sound bites and the special interest trump thoughtful discourse and the public interest. It has become impossible to fix our health system through law and statute.The decision is a fascinating and, to some degree, heartening study in national legal process, but the game isnt nearly over. The tug-of-war will continue and become more ferocious. Nothing in the larger game has changed, an election is around the corner, and, literally, trillions of dollars are at stake.

But for those who are watching, the real game for health care now is in the market, which cares only about value.

This article originally appeared on Medscape Connect (medscape.com) on June 29, 2012. It is used by permission of its author.


By:Diane Tribble

There comes a time in everyones life when passion screams to be released, demonstrated or put towards active use. Theres a sense that somethings missing and it must be discovered. Becoming cognizant of your passion may require inquisitive actions, but doing so will be well worth your quest. Once unleashed, passion can bring the most fulfillment to your life.

So what is passion? (Were not talking about the romantic version here, but what fuels your very being.) Passion is what brings you the most satisfaction. Your zeal personified. An intense interest. It is what makes you shine and stand out like the brightest crayon in the box. Passion is what you are willing to do with a smile on your face in the absence of being paid to do it. It is directly linked to your purpose, and oftentimes, success in life. Passion helps to complete you; however, it is not to be confused with your own gifts, talents, skills or abilities.

Think back to your earliest memories as a child growing up. What thoughts immediately come to mind? Were you the adventuresome kid that one day wanted to become a firefighter or a policeman? Ladies, did you line your dolls up and teach them math or English? What did you want to become when you grew up? What could you be found doing on rainy or snowy days? These questions may provide clues to tapping in to your passion.

Day in and day out, countless numbers of women and men faithfully go to work to support themselves (and their families). If theyre lucky, their gifts, talents, skills and abilities are used in support of their companies vision. Unfortunately, passion, for many, is put on hold as the primary focus becomes just working for a living. While working to meet fundamental expenses is necessary to keep food on the table and a roof overhead, not to mention being honorable and responsible, again the question is worth repeating: What about your passion?

Unveil your passion through the process of reflection, acknowledgement and

execution.

Putting Passion into Practice


Is it possible to ignore it, as if it doesnt exist? In answering this question, keep in mind that your passion is resilient. No matter how hard you or others may try to snuff it out, your passion always resurfaces anew. Why? Because it defines who are. It is directly connected to your purpose in life. It cannot be ignored forever. Left unaddressed, there will be times when the flames of passion will be fanned, renewing the zeal within. It may lie dormant for a season or more, but it does not disappear.

There are those who have already identified their passions. They can be found operating in one aspect or another of their fondest interests. For others, passion has to be rediscovered and identified.

Unveiling your own passion is achievable by going through this three-fold, introspective process:

Reflection: While it may not be the easiest thing to do, seek quiet times and places to spend quality time thinking and reflecting on your personal interests. Revisit those childhood dreams. This is a good time to do some journaling, affording you the opportunity to capture your thoughts on paper. List activities you enjoy doingwhich ones bring a smile to your face, as well as a sense of pleasure and satisfaction. Ask yourself the question, If money was not an issue, what would I like to be doing? Soliciting the help of family, friends and co-workers may be beneficial in composing your list. Once complete, narrow your list down by drawing a line through items of less personal significance until you are able to determine with confidence, what your passion is.

Acknowledge: Once identified, acknowledge and research your passion. Keep up your journal entries as you continue this process of self-discovery. Brainstorm ways of implementing your passion in to your life. Draw mind-maps, pouring all your ideas around your rediscovered passion on to paper.

Execute: By now you have discovered and acknowledged your passion. Whats next? Follow through. Set a course of action in place to make room for your passion in your life. Spend time in prayer and meditation for your next steps. Set goals with a series of actions steps in place. You didnt stop journaling, did you? Write down your goals and success plan on paper. You may want to consider partnering with a life coach or mentor. A good mentor will impart wisdom and direction.

Were all hard-wired with our own passion(s). Identifying what it is and furthermore, allowing it to flow through you, can lead to a sense of completeness and satisfaction. Unveil your passion through the process of reflection, acknowledgement and execution. Then be ready to shine forth as the brightest crayon in the box.

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By Michelle Ash

Nearly everyones heard of a 401(k), and some have heard of the Roth IRA. Now theres a new retirement plan available that you might not have heard about. As its name implies, the Roth 401(k) is an employer retirement plan combining features of the classic 401(k) with opportunities for post-tax contributions that grow tax-free for the future. If tax-free retirement income is something of interest to you, read on.

The Roth 401(k) has been around since January 1st of 2006, but wasnt made permanent in legislation until the Pension Protection Act of 2006, which was passed in August of that year. Like anything new, it can take some time to learn its benefits and uses.

The Roth 401(k) has some particularly attractive features for proprietors of the Owner-only small business (commonly referred to as a sole proprietorship) since owners serve as both a working employee and the owner/employer in such an operation. The contribution limits of the Roth 401(k) are the same as a standard 401(k). As the companys employee, the owner/worker could start contributing up to $17,000 of his or her salary in 2012. Individuals age 50 and older were allowed to contribute a catch-up contribution of an additional $5,500 in 2012 as well, totaling a $22,500 maximum contribution. And, as the companys employer, the owner/worker can make a tax-deductible contribution of the lesser of 25% of the owners W-2 salary, or $33,000, to the employee (that is, him or herself). The real power of the Roth 401(k) plan occurs for the Owner-only business proprietor who is taking home high levels of income. (Congratulations, BTW, on your success!) Lets compare the contribution limits of the Owner-only Roth 401(k) with the Simplified

Employee Pension IRA, or SEP-IRA, using a 45-year old proprietor of the Owner-only S-Corporation business with $100,000 of W-2 income. Both plans allow the same level of employer contributions: up to 25% of the Annual Gross Income (AGI) equaling $25,000. However, with the Owner-only 401(k), he or she is also allowed to contribute $17,000 as an employee salary deferral (Roth or pre-tax). The result? Total contributions to the Owner-only 401(k) equal $42,000, while the SEP-IRA only allows maximum contributions of $25,000.

The contribution limits, and overall contribution comparisons to the SEP-IRA are actually the same whether you use a standard 401(k) or the Roth 401(k). Where the Roth 401(k) sets itself apart is that it has no income limitations to determine investor eligibility. This can be an important benefit, since many high-income

individuals who would like the opportunity to put away dollars for tax-free future income make too much money to utilize a Roth IRA. In 2012, Roth IRA eligibility phases out for a single taxpayer beginning at $110,000, and at $183,000 for a taxpayer filing married and jointly. If an individual is eligible for a Roth IRA, however, it may be used in addition to the opportunity presented by the Roth 401(k). Not bad!

The Owner-only Roth 401(k) plan is the only type that allows both Roth plans (after-tax) and pre-tax contributions, in any combination of amounts the account holder desires. Contributions are discretionary in any given year, offering maximum flexibility as business income fluctuates. The Roth 401(k), similar to a standard 401(k), also offers the opportunity for business owners to take tax- and penalty-free loans from the account: up to the lesser

of $50,000 or 50% of their account balance. Another opportunity is that an Owner-only 401(k) may be used in conjunction with a SEP-IRA or defined benefit plan. So, a business owner can make the employee deferral to the Roth 401(k) account while continuing to make the employers tax-deductible contribution to the SEP-IRA or defined benefit plan.

As with everything in life, theres a give and take to consider when choosing whether the Roth 401(k) is right for you. A business owner must choose between getting a tax deduction today in a standard 401(k), or paying taxes today on the Roth dollars and getting tax-free income in the future. A qualified financial professional can assist a business owner in determining which plan makes better sense in the short- and long-term, given a business owners individual circumstances.

Other items to consider when determining feasibility of the Roth 401(k) include noting that Roth contributions are irrevocable. Once contributions have been allocated to a Roth 401(k) account, they cannot be shifted to a pre-tax account. Also, qualified, or tax-free distributions from the Roth account will be allowed only in the cases of death, disability, or attainment of age 59-and-a-half, as long as it has been at least five years since the initial Roth 401(k) contribution was made. As with any tax situation, consult with your CPA to determine the tax ramifications to your individual situation.

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By Troy Peck

My name is Troy L. Peck, and Im a college entrepreneur. Currently, Im a junior at Florida State College at Jacksonville, pursuing a Bachelors degree in Supervision and Management. Im the former 2010-2011 Vice President of the Student Government Association, FSCJGA Legislative Liaison for District 4, and Student Community Volunteer of the year. I have also been honored as a recipient of the 2012 Herbert W. Scheidel Community Leadership in Action Award. The Scheidel scholarship recognizes students whose volunteer work has expanded the opportunities of those who are less fortunate, and who have the passion to continue their community work.

Im also the owner/President of River City Safety Solutions, Inc., (RCSS). My business partner and I started RCSS in April of 2012. Our mission is to help companies develop and train a safe and healthy workforce. RCSS offers such services as OSHA 10- and 30-hour construction safety training, consultation and private inspection for storm water erosion and sediment control, customized two- and four-hour construction safety awareness workshops, site-specific safety inspections, and job training consultation services. Due to the diverse demographic of our community, we offer all of our services in English and Spanish.

Companies also benefit by having their employees obtain certification in either the 10- or 30- hour OSHA Safety Training course. Its a proven fact that when employees receive standardized in-service safety training, the number of on-the-job injuries decrease dramatically. OSHA safety training is beneficial to the employee because it enhances the employees overall job safety performance and can lower the number of workers compensation claims that are filed. From the employers perspective, aworkforce that has received certified OSHA Safety and Health training can help lower the insurance rates that a company can be charged.

I have faith that RCSS will make a difference in our immediate community. While the job market has come to a stand still for many Americans, this is the perfect opportunity for many job seekers to receive additional job training that will enable them to become more employable in the future; especially considering that

most companies are far more likely to hire individuals who have received OSHA training than not.

RCSS is also poised to dive right into the information workshop consortium. We want to offer individuals and employers the opportunity to receive training about site-specific personal protection equipment. I say site-specific, because each job site is a little different from the next, requiring particular personal protective equipment and having its supervisors and workers be aware of the regulations pertaining to each specific site. Work hazards can vary from one site to the next. We can assess the natural environment in which a company conducts its operations by evaluating soil types, landscape, and conditions at the worksite, then develop a work plan and site-specific safety manual for a particular contract.

My education, job experience and specific training make me uniquely qualified to operate a business that focuses on safety training. Ive recently been employed part-time as a Student Assistant in the Brownfields Job Training Program at the MPSS division of Florida State College at its Jacksonville Downtown Campus. While working in the Brownfields Job Training Program, I received 40-hour HAZWOPER training, lead worker and lead renovator training, confined space entry, EPAs 40-hour health and safety training, asbestos and mold awareness, deconstruction, environmental math, CPR and First Aid certification, along with soil sampling and analysis training.

The mission of River City Safe Solutions, Inc., is to help companies develop and train a safe and healthy workforce.

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Ive spent the past year assisting the Brownfields Program Coordinator with EPA reporting, student tracking, weekly reports, quarterly reports, and job placement. My primary responsibility has been assisting the students with rsum building, interview etiquette and job placement.

The EPA Brownfields Job Training Program is a grant that focuses on restoring our local community by offering job training and job placement for low income, displaced workers.

Ive developed a strong desire to serve my community by offering job training, creating job opportunities, and creating safety awareness in the work place. My active involvement in community empowerment, environmental certifications, and my own certification as an OSHA Authorized Construction Safety Trainer have given me the expertise and to offer my services to the private sector.

I have always had an entrepreneurial spirit. I co-owned and operated a print publication called NtoU Magazine in the Jacksonville area from 2004 to 2008. Although NtoU was primarily an advertising and marketing entity, the experience I gained from that venture has proven to be invaluable as I embark on my new projects. My reputation as a respectable business owner has already been established through my previous clients and business contacts.

My advice to anyone student who wishes to start a business is to find a service that you can perform or product that you can actually produce. Make sure to do your research so you can ascertain if theres actually a need for what youre offering. Every service provider has to have a market or niche.

As a business owner, your most important asset is your word. Whatever you promise your clients, make sure that you can deliver and provide them with even more services. The more you can exceed someones expectations, the better. Also, never ignore the benefits of bartering, as many business services are simply traded between B2B and B2C.

Other essential recommendations:

Develop a solid business plan; its your roadmap to

success.

You will eventually need a website. Many potential and current clients perceive that a company with a well-designed, functional website is a valid firm, because not many companies will take the time to put up a high-quality website.

Make sure to research special programs that offer government and state aid to small businesses and especially businesses under minority ownership.

Ensure all your paperwork and licensing is in order so you can operate legally.

Jacksonville Wealth Builders

Oprah - Entrepreneur Queen

Google Juice - Part 2

A Bankers View: Business

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What kind of medicine do you practice and how long?Family Practitioner for about 11 years.

How long have you been working for MCCI? What is so great about working with MCCI?Ive been working for MCCI for 10 years. There are physicians who have been working for MCCI for 20+ years, which speaks volumes for an organization.

MCCI gives me the opportunity to just practice medicine; that is why I have stayed here. They tell me Whatever it takes; you know your patients better than we do. We trust you know what to do. I chose this company because I was able to practice what I was taught and and I am given no limitation of my opinion toward medical care for my patient.

How long has MCCI been around?Close to 25 years. We have been present in Jacksonville for around four and a half years and opened 5 new centers in the last year. We have two business models: independent doctors in larger groups in the city that have previously been well established and wholly owned centers where we employ all the doctors.

How is the market in Jacksonville different from the market in Miami as far as caring for their pa-tients and culture?There are cultural differences between cities that we evidently have to acknowledge but we do not treatanybody differently. The medical problems are usually the same no matter the location: COPD, diabetes, congestive heart failure, heart disease and any variation of it. We practice medicine the way it should be: focusing on preventive care.

We take the time to understand and know our patients not only from a medical standpoint but also personally. This gives us the opportunity to be able to aid them if they cannot access health care appropriately.

Diabetes diagnoses have been increasing over the passed years. What do you think about that?I think the FDA does a poor job of policing our food supply.

If one is diagnosed with diabetes, what medical problems can develop?It can absolutely affect your body. Symptoms include: vascular disease, losing vision, higher chances of heart attack and/or stroke, foot amputation, to name a few.

Does exercising help regulate diabetes symptoms? If so, what are the best exercises?Yes, exercise definitely helps. There are no prescriptions that any physician can give that will do as good to your body as regular exercising will do. Before a diabetes patient starts any exercise regimen, though, they should follow up with their primary care physician to evaluate if they can tolerate a strenuous exercise. Especially if they havent exercised in a while.

What does MCCI do to advise your patients of prevention of diabetes?We currently have a program for diabetes that includes diabetic teaching classes from our nurses. These classes explain why medications are taken at certain times,side affects associated with medications, dangers

Dr. David PriscalMCCI Jacksonville, FL

We also offer diabetic cooking classes to improve lifestyles- something that is not done nation wide. Most offices do not have the ability to do that. We have a fully functional kitchen in addition to our specialists that come in and show you some diabetes-friendly cooking. We also provide free transportation for their medical visits.

Fundamentally, we advise exercise, a healthy lifestyle and proper medical care to help patients prevent getting diabetes.

What do you find about MCCI as a medical corporation and its medical care motto how is it different from other medical groups around Florida to your knowledge?It is more of a patient centered approach. It takes in every aspect of a patients life that might be affected. We provide in-patient nurses that follow them. We provide telephonic case managers. We have nurses go out to the home as well as home visit doctors if necessary. Our motto focuses on prevention and, although our centers are very large with a lot of patient traffic, we strive to have each patient feel and know that they are most important.

A lot of medical organizations mandate what medications doctors can and cant use. The 10 years I have been here they have never told me what medications to use. Whatever is necessary for the patient is what is needed.

1-888-577-6224 www.mccigroup.com

Beach Boulevard

11744 Beach Blvd, Jacksonville, FL 32216

Callahan

4496211 US Highway 301, Ste 110, Callahan, FL 32011

Dunn

3450 Dunn Ave, Ste 210, Jacksonville, FL 32218

MCCI Provides All the Medical Services You Need Under One Roof.

Primary Care Physicians

Lab Drawing Stations

Transportation

Group Wellness & Education Programs

Convenient Locations

Normandy

8225 Normandy BlvdJacksonville, FL 32221

Gateway

5238-16 Norwood Ave, Jacksonville, FL 32208

MCCI Medical Centers in Jacksonville


What kind of medicine do you practice and how long?Family Practitioner for about 11 years.

How long have you been working for MCCI? What is so great about working with MCCI?Ive been working for MCCI for 10 years. There are physicians who have been working for MCCI for 20+ years, which speaks volumes for an organization.

MCCI gives me the opportunity to just practice medicine; that is why I have stayed here. They tell me Whatever it takes; you know your patients better than we do. We trust you know what to do. I chose this company because I was able to practice what I was taught and and I am given no limitation of my opinion toward medical care for my patient.

How long has MCCI been around?Close to 25 years. We have been present in Jacksonville for around four and a half years and opened 5 new centers in the last year. We have two business models: independent doctors in larger groups in the city that have previously been well established and wholly owned centers where we employ all the doctors.

How is the market in Jacksonville different from the market in Miami as far as caring for their pa-tients and culture?There are cultural differences between cities that we evidently have to acknowledge but we do not treatanybody differently. The medical problems are usually the same no matter the location: COPD, diabetes, congestive heart failure, heart disease and any variation of it. We practice medicine the way it should be: focusing on preventive care.

We take the time to understand and know our patients not only from a medical standpoint but also personally. This gives us the opportunity to be able to aid them if they cannot access health care appropriately.

Diabetes diagnoses have been increasing over the passed years. What do you think about that?I think the FDA does a poor job of policing our food suppl

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