Page 13 - Boca Club News - March '21

Boca Club News, Page 13
Medical Matters: A Tradition in the Medical Profession

By Richard Nagler, M.D., a member dressed in cap and gown to present the medical degree to my thorough and competent medical care. Not every baby can
of Broken Sound Club and retired oldest son upon his graduation. On this special occasion, I felt be born perfect, and not every operation succeeds. Disease
physician. After graduating from the enormous pride and joy as my son became a doctor. He was and death are not caused by doctors. Yet, the profession
University of Pennsylvania and New well prepared to provide a difficult, demanding service and remains plagued by the plethora of malpractice suits fueled
York University’s School of Medicine, assume an enormous responsibility. I knew that his youthful by the public’s perception that malpractice is synonymous
Dr. Nagler served his internship and idealism and caring attitude would make him a credit to our with incompetence and negligence. As a matter of fact, most
residency at Baltimore City Hospital profession, and he has fulfilled that obligation. malpractice suits are based on bad results, delayed diagnosis
and Johns Hopkins. He followed that Twenty-five years have passed and his son, one of my and, particularly, informed consent.
with a Fellowship in Gastroenterology grandsons, is presently in his first year of medical school. The legal profession has carried informed consent to such
at Yale University School of Medicine, and was then Chief However, like so many doctors who traditionally encouraged extremes that it has become a serious threat to the appropriate
of Gastroenterology at Fitzimmons General Army Hospital their offspring to follow them and become doctors, we are both delivery of health care. For example, when patients face
in Denver. He returned to the Yale Medical School for one apprehensive about my grandson’s future because the practice surgery they certainly should have an understanding of the
year as an Assistant Professor of Medicine before opening of medicine has changed dramatically from that which my son chance of success, the risks and possible side effects. But how
his own successful private practice in Internal Medicine and I have enjoyed. explicit must a doctor be in order to satisfy the legal definition
and Gastroenterology. During that time, he also served for There have been spectacular technological achievements of informed consent? To burden a patient with very detailed
ten years as Chief of Medicine at Huntington Hospital in in medicine, and a rapidly expanding basic biomedical graphic information serves no purpose other than to promote fear
Huntington, N.Y. knowledge that has had a positive effect on the length and and uncertainty in place of confidence and hope. If a pregnant
As a graduate of the NYU School of Medicine, there is a quality of life. But this has led the public to have unrealistic woman develops a problem which requires drug therapy there
wonderful tradition in which I was invited to be on the stage expectations. Bad results are inevitable in spite of the most is a PDR (Physician’s Desk Reference), which is a compendium
listing of every drug available. With few exceptions it is stated
that “The Safety of This Drug Has Not Been Established in
Pregnancy.” The implication of this warning is that, despite a
pregnant woman being correctly prescribed a drug for some
complication and then subsequently delivers an abnormal child,
the prescribing physician can be liable. Few doctors will take on
Financial Planning - Raymond James Financial Services, Inc. this responsibility alone. The properly informed patient must be
willing to share it with her doctor.
Delayed diagnosis as a basis for malpractice is probably
It Should Be Personal Arthur Rottenstein the most egregious of all. Ideally, a diagnosis is made by
Registered Securities Principal
The Manager of one of Raymond James 561-241-6616 obtaining a careful history, a thorough physical examination
and interpretation of all indicated laboratory data, X-rays,
executive council level branches credits his ArthurRottenstein@ scans and any other indicated modalities. In this manner, a
RaymondJames.com
father, a tuxedo shop owner in Yonkers, New bocaratonfinancialplanner.com physician will invariably make a correct diagnosis and institute
York for his success. Arthur Rottenstein, a appropriate therapy. Realistically, the signs and symptoms of a
Raymond James Registered Securities Principal disease, especially in the early stages, may be nonexistent or so
serving Boca Raton, learned important life subtle as to defy these initial, reasonably thorough diagnostic
lessons from his father, who owned the popular Joseph Carpenito measures. However, because of the specter of malpractice
clothing shop, and his mother, a lifelong today the scenario is quite different. From first patient contact
advocate for the less fortunate. A survivor of the Financial Advisor the doctor is under pressure to not only order a plethora of
often unnecessary tests, but to refer patients to consulting
Nazi Holocaust, his father’s horrific experience 561-241-6616 specialists often just in order to share responsibility. They
did not diminish his benevolence; he genuinely Joseph.Carpenito@ often go to the extreme of performing invasive procedures to
raymondjames.com.
cared about his customers and connected with protect themselves from possible liability. The result is needless
them easily. 301 Yamato Road, Suite 3160 exposure to radiation, increased apprehension, lost time from
Mr. Rottenstein began his lengthy career in Boca Raton, FL 33431 work, enormous cost, increased risk of injury to patients and
finance in 1982, moved his practice to Boca taxing of an already overburdened health care delivery system,
Raton in 1991. Generally, his clients are affluent families and business owners. rather than serving the patient’s best interests.
“I keep my book of business to a manageable level. It’s all-important to me to know we provide The most tragic consequence of all this is the deterioration
our clients high quality and dedicated personal service and demonstrate that we genuinely care. of the essential doctor-patient relationship. Doctors are
Advisors who try to work with 500 to 600 and more investors at one time can’t possibly keep up intimidated by the potential threat patients can represent,
with their clients’ changing financial lives and family dynamics,” says Rottenstein. and as a result may view them as adversaries. Dedicated
professionals have been vilified, humiliated and ridiculed by
the unconscionable legal jargon used in malpractice litigation,
Genuine Compassion, Remarkable Creativity both in depositions and in the court room. Respected physicians
have been called incompetent, negligent and a disgrace to their
Like father, like son, Mr. Rottenstein has instilled many of the same traits in his team. In recruiting profession. This is devastating and cannot be assuaged even
professionals to his practice, he first and foremost seeks out those who share his commitment to client with a favorable verdict. The effect that this has had on doctors
care, like Joseph Carpenito, a young man he hired and has trained for about 10 years. “My primary is explained by the facts that so many of them burn out and
concern is ensuring my clients will be well-served for decades and generations ahead,” he says. retire early. The suicide rate of doctors is the highest of any
Rottenstein, Carpenito, and the rest of the Boca Raton Financial Planners team take an profession in the nation. Young doctors simply can’t start a solo
individualized approach to retirement planning, estate planning, money management, and more. practice as they are usually heavily in debt and can’t afford
As fee-only advisers, they tailor plans and strategies for each individual, taking into account to equip an office with very expensive necessary equipment
foreseen risks while considering the unexpected. “Each client has the advantage of our collective and pay excessive malpractice insurance premiums. Group
experience and training,” explains Rottenstein. “This collaborative approach allows us to find practices are reluctant to expand with the costs involved that
often exceed the new doctor’s salary.
creative solutions.” Rottenstein and his team also manage client accounts to help minimize tax At the same time, other negative developments have taken
burdens and capitalize on market opportunities. place which has made the practice of medicine less appealing
The group is well respected for their work in the area of estate planning. “Creativity is key,” and gratifying. The public no longer holds doctors with quite
says Rottenstein, who has worked with family owned businesses, and helped with various aspects the same high regard and respect that they once enjoyed. The
such as transitions, and business sales. “The use of trusts and other strategies helps ensure a reason is complicated, but I would suspect that a major factor
client’s assets are passed down to heirs in accordance with the client’s wishes, while minimizing is the erosion of the doctor-patient relationship manifested by
tax obligations to the extent possible. a more intimate patient contact being replaced by the attention
Despite their focus on a manageable book of business rather than seeking high volume, Boca of the doctor to a computer, and often too busy to take the time
Raton Financial Planners is ranked in the top 23 percent of Raymond James branches nationwide to listen, to counsel and give comfort. With almost all doctors
as of April 2019 and Mr. Rottenstein was included in the Executive Council* of Raymond James now in group practices, patients are often disappointed when
four out of the last five years. they cannot see their own doctor, especially at night or on
weekends, and especially in the hospital. Patients kept waiting
“We’re very proud of our track record of success,” says Rottenstein. “But above all, developing unduly for their scheduled appointments are understandably
strong client relationships and satisfaction is and will always be our priority.” antagonized by an indifferent and even discourteous attitude
by some doctors, and especially by their staffs. A doctor glut
of specialists in many highly desirable areas of the country,
Arthur Rottenstein is a Registered Securities Principal and Branch Manager with Raymond James Financial Services, Inc. in Boca coupled with a critical shortage especially of primary care
Raton and founder of Portfoliorepair.com. He has been managing the financial affairs of a number of select families in South Florida
since 1982. Please feel free to call for an appointment at (561) 241-6616 or email him at arthur.rottenstein@raymondjames. doctors, especially in rural America, has been an ongoing
com. Please feel free to visit his website at bocaratonfinancialplanner.com. Securities offered through Raymond James Financial problem. With insurance payments from Medicare at lower
Services, Inc., member FINRA/SIPC. Investment Advisory services offered through Raymond James Financial Services Advisors, Inc. levels, fees have increased for the majority of patients, and
there has been an incentive to order dubious expensive
*Membership is based on prior fiscal year production. Re-qualification is required annually. The ranking may not be representative procedures and consultations with other specialists in order
of any one client’s experience, is not an endorsement, and is not indicative of advisors’ future performance. No fee is paid in
exchange for this award/rating. Investing involves risk and investors may incur a profit or a loss. This material is being provided for to maintain income levels.
information purposes only and is not a complete description, nor is it a recommendation. Any opinions are those of the author and Doctors are not inclined to do much to correct all of this.
not necessarily those of Raymond James. You should discuss any tax or legal matters with the appropriate professional. They are too busy and too small a group to have any significant
As Seen In Kiplinger’s
Medical Matters on page 14