Listening to Michael J. Axe’s description of First State Surgery Center almost makes you wish you had a broken bone.
“The atmosphere here is very pleasant, the waiting room is beautiful, there’s plenty of parking and plenty of top-notch professionals to provide the best in orthopedic surgery and recovery,” says Axe, an M.D.
One of the top doctors for sports medicine, Axe’s day surgery practice performs more than 4,000 operations a year in four operating rooms, all while earning a 99 percent patient satisfaction rate. (Less than 1 percent complains about the operating rooms being too cold.)
Surgery centers, also called surgicenters, are appearing across the country, and are fast becoming popular with medical centers and specialty practices. Same-day surgery accounts for more than 75 percent of all surgeries, thanks to advances in technology and anesthesia. “Anesthesia has improved to the extent that pain can be controlled with pill medications, not injections or IVs, both which necessitate overnight stays,” Axe says.
Delaware requires that surgery centers handle only procedures that take fewer than 90 minutes and don’t require an overnight stay. For patients of First State Orthopedics, this means tissue cutting and repair of carpal tunnels, bone-pinnings and arthroscopic surgery.
The team approach to surgery and aftercare is the best a practice with a surgical center can offer, which is often an advantage over hospitals.
“We’re all working together. Each person knows what their role is and can anticipate what I might need during surgery,” says Evan H. Crain, M.D., of First State, who specializes in knee and shoulder surgery. His practice is shared among 14 other surgeons. “We only do orthopedics, so everyone is on the same page during surgery, and the team is well trained. Unfortunately, a person is not going to get that kind of care at a different facility, where I could be working with a nurse who works in a variety of surgery subspecialties.”
There is hopefully a cost savings to the patient. There is definitely a big cost savings to the insurance companies, which don’t have to cover overnight hospital stays.
“Hopefully they pass the savings to the consumer,” says Lynn Truitt, administrator and chief operating officer.
Hospitals bill patients by line-item, but First State Surgery Center works out group pricing. “There is also a savings with respect to a patient’s time,” she says. “At most the patient is here one and a half hours prior to surgery, and recovery time is quicker.”
Loving for the Long haul
They don’t cost a penny, but these gifts that could save a person tens of thousands of dollars as a result of going to divorce court: quality time for nurturing a committed relationship.
“Tending to the relationship is very important, and that means giving quality time to each other and to the relationship,” says Bill Gale, a licensed professional counselor with Middletown Counseling. “Relationships must be nurtured with positive nonverbal actions, such as touching, holding, kisses and hugs. Even good eye contact is important. There is so much busy-ness in today’s society, with people taking care of children and jobs, that couples often won’t take the time to nurture each other because they are taking each other for granted. When that happens, the relationship suffers.”
Gale recommends the following to infuse nurture and care to affection-starved relationships and for those that need to stay healthy:
• Go on a date at least once a week. The ultimate goal is to spend time with each other. The woman in a committed relationship usually does the planning, but it is important that the man make the plans for those special times, as well;
• Stop the mind-reading games. It is important to communicate clearly what your needs are, and do it in a clear, concise way, watching your tone of voice;
• Affirm one another, and show appreciation for the other person;
•Give simple gifts: listen, hug and kiss, and communicate.
It’s Tax Time
It’s time to start looking for those little scraps of paper in your office, wallet, purse, or glove compartment. You know the ones: pay stubs, billing records, statements from stock brokers, mortgage statements, IRAs.
Hopefully, you’ve been saving them all along, because it will be a huge help to you and your accountant in a few weeks.
After the W-2 forms and 1099s have been mailed out in January, February marks the start of tax planning for many folks.
Hiring the right tax preparer will usually result in the filing of a more accurate tax return, which could mean savings. A Dover accountant’s hourly rate may range from $85 to $125 an hour, higher in Wilmington. A basic return costs about $250.
“A taxpayer would really want a paid preparer when they have a taxable transaction they are not familiar with and don’t how to report,” says William F. Winters, a partner in the accounting firm of Mitten & Winters in Dover. He says a paid tax preparer should know the information the taxpayer must provide to accurately report the transactions.
Most taxpayers should be able to prepare their own tax returns when they only have W-2s, interest income, a normal IRA or retirement income, mortgage interest and charitable contributions made with checks. “However, dividend income can get tricky,” Winters warns, “because it could be taxed at different tax rates depending on the type of dividend.”
Winters advises hiring an accountant when you’re faced with the following situations:
• multiple stock transactions when information about purchase dates is limited and-or dividends have been reinvested;
• sale of property (real estate) with depreciation, and allocating the purchase price for different assets included in the sale;
• owning rental properties;
• selling inherited property, which could create a taxable event, and inheriting IRAs, because they could be taxable.
“If the taxpayer makes quarterly estimated taxes for federal and state purposes, additional assistance may be needed,” Winters says. Also, retired people over 70½ may need help determining how much of a required minimum distribution they should take out of retirement plans each year. Some brokerage firms, such as Edward Jones, will list that information on a client’s IRA statement regularly, if the investment adviser has the correction information for making the calculation.
“It’s important to collect your information throughout the year that will affect your tax return,” Winters says. “If there is a taxable event that year, you will need to go back into old records to substantiate your numbers later.”
For people who enjoy working with numbers and serving the community, the Delaware Earned Income Tax Credit Campaign seeks volunteers to provide families with incomes less than $40,000 with free tax preparation. In 2006, 300 volunteers prepared taxes and generated over $15 million in refunds for more than 10,000 Delawareans. For more information, visit www.eitcdelaware.net.