Enclothed Cognition

I had worked the overnight shift in Peds ER at Mary Immaculate Hospital in Queens, and was driving home to my apartment in lower Manhattan.

Medelita is a unique company in that it sells directly to customers on the internet and typically does not sell through other stores. We do this for a very good reason: we want to maintain full control over the quality of our garments and how they are presented in the marketplace.

By Michele Shermak, MD Reprinted from Young Plastic Surgeons Perspective, April 2003 Plastic Surgery News.Despite exuberant clinical exposure during plastic surgery training, important practical issues related to day-to-day practice as an attending may not be addressed, particularly for private practice situations.

It is with great pleasure that we are able to announce that October 6th - October 12th, 2012 as official Physician Assistant Week in San Clemente, California where Medelita is located. At a meeting with San Clemente's Mayor Jim Evert and the San Clemente City Council, Lara Francisco, PA-C and Founder of Medelita said in a speech to commemorate the occasion, “It’s an honor to promote the PA profession, and National PA Week is an important time to recognize the critical role of PAs working in all medical and surgical specialties." Mayor Jim Evert, whose own daughter works in medicine, emphasized the importance of PAs in the city's numerous public and private healthcare offices and facilities. He also commended the work of Lara Francisco, PA-C who founded a steadily growing business built and currently operating out of one of San Clemente's burgeoning office and commercial centers that caters directly towards increasing the quality of professional life for her colleagues in the PA profession. Lara was presented a plaque (pictured) that states the following:

WHEREAS: Quality, affordable and accessible patient-centered health care, provided by skilled practitioners, contributes to the well-being and quality of life for all citizens of our community; and

WHEREAS: Physician Assistants (PAs) are academically and clinically, trained and licensed to provide patient-centered health care services in partnership with physicians, including examinations, diagnosis, treatment, therapy, and preventive healthcare services, in addition to prescribing medications; and

WHEREAS: Physician Assistants are valuable assets to the medical community, as they work with physicians to expand access to the delivery of high-quality health care for patients, and do so with a level of care that research has shown to be comparable to the quality of care provided by physicians for similar services; and

WHEREAS: Physician Assistants have earned the respect and appreciation of the general public for their skill, dedication and contribution to people’s lives, working in partnership with the health care team to ensure delivery of efficient and effective health care services at a time when the nation is experiencing a shortage of primary care doctors and an aging population has increased the demand for health care services;

THEREFORE, I, JIM EVERT, Mayor of the City of San Clemente, California, by virtue of the authority vested in me by the laws of the City of San Clemente, California, do hereby proclaim the Week of October 6th through October 12th, 2012, as PHYSICIAN ASSISTANT WEEK IN SAN CLEMENTE, CALIFORNIA throughout the city, and I urge my fellow citizens to join me in recognizing PAs for the significant impact they have made and continue to make as critical members of our health care teams.

IN TESTIMONY WHEREOF, I have hereunto set my hand and caused the Seal of the City of San Clemente, California to be affixed this 6th day of October, 2012.

Jim Evert, Mayor

As our customers surely know by now, we have been making every effort to outfit our lab coats with pockets that are large enough and reinforced to comfortably carry an iPad while at work.

This season's best lab coats for men represent a vast improvement over most of the lab coats available on the market today. Gone are the days of flimsy, ill-fitting coats with abrasive fabric that stains easily. The next generation of lab coats are now here to stay, featuring impeccably hand-sewn seams and superior quality fabric that not only resists stains but resembles something more akin to a tailored suit blazer rather than a lab coat. Here are our favorite styles for men this year:

1. Laennec Men's 40" Lab Coat. This lab coat is built for the modern health care professional looking for an updated appearance while on the job. It's the standard size for most male physicians and a favorite among most Medelita-mens customers.
2. Osler Men's 44" Lab Coat. The Men's Osler Lab Coat is the ultimate display of prestige and aptitude for healthcare professionals. It includes five pockets, including one for a normal iPad or any other device.
3. Fauchard Men's 40" Dental Lab Coat. The only lab coat that has it all - snap buttons, cuffed sleeves, ergonomic fit to allow maximum forward pronation, and a high collar for superior protection.
4. Fleming Men's 30" Student Lab Coat. This men's consultation lab coat is perfectly suited to make an impression before, during, and after the white coat ceremony. It is by far the most impressive student lab coat available in the industry today.

Feel free to browse the full list of men's lab coats by Medelita at the Medelita Men's Lab Coats Page.

FasterCures, the Washington-based center of the Milken Institute, conducted the fourth annual Partnering for Cures meeting Nov. 28-30, 2012 in New York to advance the goal of bringing effective therapies to patients faster. Part of the meeting included an idea hatched by Mike Milken himself: “So many of these amazing doctors are musicians,” he told Musical Director Glen Roven, “I want you to put together a band of doctors.” Thus a live concert by the “Rock Docs” became a part of the meeting. Musical Director Glen Roven chose Medelita Lab Coats to outfit the 15 piece band of National Institute of Health leadership. This photo includes Rock Docs: Sally J Rockey, PhD – Director of Office of Extramural Research, NIH ; Dr. Francis S. Collins, NIH Director; Alan S. Wayne, MD - Head, Hematologic Diseases Section at National Cancer Institute; and John T. Burklow, Director, Office of Communications and Public Liaison, NIH.

A few months ago Ingrid A. Carlson, MD of Mountain View Family Eye Care in Colorado Springs, CO, contacted Medelita to order scrubs to take on her Pediatric Ophthalmology Medical Mission to Grenada. We were immediately inspired by Dr. Carlson’s story, which is outlined below: “Last year while on vacation in the Caribbean I noticed a newspaper photo of Santa Claus with a child on his knee. The child was about 18 months and severely cross-eyed. The picture was supposed to look “cute”, but I knew functional blindness from amblyopia was possible. Out of simple curiosity I said to the receptionist at the hotel, “Oh, back in the states I do that kind of surgery to straighten children’s eyes. Who would this child see here?” She answered, “No one.” Again, I said, “Oh, you mean no one on this island, but surely if he went to a larger island he could see a doctor there.” She replied, “Maybe if his parents are rich they will fly him to Miami, but we have no one in the Caribbean.” Stunned, I returned home and researched this. Sure enough, I could identify no Caribbean pediatric eye surgeon. How could I let the people of these islands I loved, wait on me, clean my room, maintain my hotel grounds, drive me from place to place, and I do nothing in return? So...I sent a few letters out to some of the medical facilities in the Caribbean. Saint George’s University on Grenada responded and invited me to come. I am told we will be the first pediatric eye surgeons on this island in over ten years.” We were so thrilled to be able to contribute what we could for the Mission, and we sent Dr. Carlson a scrub top embroidered with her Mission’s logo. Recently she returned from the trip reporting that her team saw over one hundred children in clinic, and were able to perform “life-changing surgery” on many. She sent us the stories of a couple of her patients in Grenada with pictures included, which we have scanned and posted below (click to enlarge). Medelita would like to congratulate Dr. Carlson and her team for their incredible work improving the lives of those who might otherwise never have this opportunity. Keep up the good work! If you or your group is involved in volunteer work, please tell us about it and we’ll post your story here.

How Do Dentists Rate Medelita Dental Lab Coats?

Reprinted with permission from JP Roach, Associate and Assistant General Counsel at Hughes Marino.

Click here to read the original article.

Finding the right real estate for your medical practice can be laborious, time consuming, and expensive. At Hughes Marino, we help companies make the right real estate decisions for their businesses by delivering great spaces and lower rents. In my role as leader of the Medical Practice Team, I help physicians and other healthcare professionals make the best real estate and space planning decisions for their practices. Medical space is very different from traditional office space with its own set of challenges that require the utmost care when leasing such space. What follows are five mistakes doctors often make when signing a new medical office lease. Our Medical Practice team not only helps you avoid these mistakes, but also guides you through every step of the medical office leasing process to help you find the perfect solution for your practice.

1. Signing a Personal Guarantee

Landlords love personal guarantees. However, as a tenant, you should not. A personal guarantee is a legal contract between a landlord and an individual to guarantee a specific obligation of a business, usually the remaining rental obligation under a lease. Personal guarantees provide the landlord with additional recourse in the event of a default on a lease agreement. The implications of a personal guarantee are significant because your personal assets (e.g., house, cars, retirement funds, etc.) are at risk should you default on your lease. The landlord will tell you the high cost of the tenant improvements that are often needed for medical office space creates additional risk, and that you need to sign the personal guarantee to provide additional security for your full performance of the lease. We disagree. The landlord who owns a medical office building should expect a high level of tenant improvements will be required. Further, the rental rate for medical office space is typically higher because of the tenant improvement contribution by the landlord. This is nothing more than a simple application of risk and reward. Yes, there is risk to the landlord in a real estate lease transaction, but that is why the rental rates for medical office space are higher than those for traditional office space. At the end of the day, it all comes down to the negotiations. If the landlord wants to reduce risk by requiring a personal guarantee, should there not be a corresponding reduction of the rental rate? Are the improvements highly specialized? Is the medical practice a new business, or is there a solid history of financial performance to ease the landlord’s concerns? Are there other suitable properties where a personal guarantee would not be required? If some form of personal guarantee is warranted, there are steps you can take to protect yourself and limit your exposure. For example, if you are in a partnership with multiple doctors, try to limit your guarantee obligation to your percentage ownership in the practice. Also, you should be able to structure a guarantee that declines each year as the landlord’s exposure is reduced. Additional weapons in your negotiating arsenal can include a release of the guarantee based on the percentage of the lease or loan paid off, a specific end date for the guarantee, exclusion of certain personal items from the guarantee, and in some circumstances, personal guarantee insurance.

2. Underestimating the Cost of Tenant Improvements

Tenant improvements for a medical office suite can be very expensive. Building out space to fit the unique needs of your practice can range anywhere from $50 to $250 per square foot, depending on myriad factors such as the current condition of the existing suite (warm or cold shell), the level of specialized requirements for the practice (e.g., plumbing in exam rooms, lead walls for x-ray units, surgery components, etc.), and personal choice of improvement finishes. It is important to understand the implications of the current condition of the suite and how that affects the purchasing power of each tenant improvement dollar the landlord is providing. A $25-per-square-foot allowance for a second-generation dental practice may be adequate, but the same allowance will barely get you started if you are building out from a “cold shell.” The point is to understand what you are getting into before you sign a lease. Our team helps you assess the current condition of a space by developing a detailed and competitive budget for the construction project while you are still evaluating your options.

3. Underestimating the Timeline and Complexity of the Build Out

Just as the cost for tenant improvements varies by practice specialization and current condition of the suite, so does the project’s complexity, and ultimately, the timeline for delivery of the finished space. For example, a practice requiring a surgery suite and digital x-ray units will take substantially longer to design, permit and build than a family practitioner’s office that may just require individual exam rooms. We typically advise our medical clients to plan for a minimum six-month build-out period in order to design, obtain the appropriate permits, and construct the suite. For expensive and complex medical projects, the build-out period can be a year or even longer. So it is crucial to deploy the right team of experts from the outset. Time is one your best leverage tools in real estate negotiations. If you run out of it, things can get expensive fast. Our team provides professional construction and project management so that you understand the complexity of the project and can plan accordingly.

4. Trusting the Landlords and Their Agents to Represent You

In a lawsuit, it is illegal, unethical – and even illogical — for an attorney to represent both the plaintiff and the defendant. There is an obvious conflict of interest. In real estate transactions this practice is called “dual agency,” and it carries with it the same inherent conflict of interest, except that it is legal and done all the time by so-called “full service” real estate agents. We are unique because we represent only tenants; never landlords. Landlords hire the “full service” real estate agents to find doctors to fill their empty medical office buildings. These agents’ interests are in lock step with their landlord employers and their singular aim is to maximize the rent paid by the medical tenants. On the other hand, tenants want to pay less rent. And yet many unsuspecting physicians trust these very same landlord/full service agents to advise them in their real estate negotiations. These physicians are often later disappointed that their agent did not do more for them in the negotiations. But if they understood the agent’s true allegiance, they would understand their motivation. The inherent conflict of interest that exists in dual agency relationships plagues the commercial real estate industry and should be avoided by physicians – and other tenants – at all costs.

5. Trying to Go It Alone

The old adage may be, “Physician, heal thyself,” but when it comes to real estate, you are best served by an expert who will capitalize on market conditions to obtain the best possible real estate outcome for you and your practice. Every space is different, and each landlord’s situation is unique. How long has the landlord owned the building? How long has the space been empty? Does the building owner have a large loan coming due? Rents are not set by landlords; they are set by tenants. What a landlord is willing to accept is often subject to wide swings based on what the tenant will agree to pay. But don’t try to go it alone. As a physician, your time is best spent focusing on your practice and working with your patients. The same way you hire a practice manager to manage your practice, an attorney to handle your legal affairs, an accountant to handle your taxes, and a financial adviser to manage your wealth, find a qualified, conflict-free medical office expert, someone worthy of your trust, and then empower that real estate professional to guide you in your real estate planning and negotiations to save you time, risk, and money. The first step is to start with Hughes Marino. Please feel free to contact JP Roach, head of Hughes Marino’s Medical Practice division, directly at jp@hughesmarino.com for a complimentary analysis of your practice’s real estate needs. JP Roach is an associate and Assistant General Counsel of Hughes Marino, a San Diego commercial real estate company specializing in San Diego tenant representation and building purchases. Contact JP direct at (619) 238-2111 or jp@hughesmarino.com to learn more.