The current pandemic has noticeably altered the way most industries function. Prior to covid-19, Licensed Real Estate Brokers heavily relied on the ability to meet with possibly buyers/renters in person. Home tours were always in person, and open houses relied on the ability to invite many people into a small space to view the prospective house/condo/apartment prior to applying for it. The ability to meet in person has been heavily altered, and for a time especially toward the beginning of the pandemic, all in person meetings were effectively non-existent. Despite this, the show must go on, and Real Estate Brokers must make clever adjustments in order to reach their clientele and to navigate the housing market underneath these unprecedented terms.

One of the main differences and changes to the industry is the utilization of virtual tours. It was uncommon to organize a virtual tour for a possible buyer prior to covid-19, simply because it’s difficult for the person to gauge the space and to see the details as one would in-person. This type of tour might only occur for possible out-of-state individuals looking to move to this location. With the inability to avoid virtual tours, Real Estate Brokers have had to become adept at using technology to adequately and desirably show the space they are seeking to sell/rent out. There is also a different personal experience with virtual interaction rather than in person interaction, and the onus is certainly on the licensed professional to make the experience comfortable and easy for the interested party. This requires a distinct set of skills that the professional would have to quickly adapt to in order to continue to make money and generate happy clients.

The types of houses and amenities people are seeking out has also changed. With many individuals working from home for the foreseeable future, and some possibly permanently, having a space for a home office is absolutely vital. Because of the prevalence of working from home, individuals who would not normally seek quieter spaces are doing so, which can be a challenge for Real Estate Brokers who practice in places like Chicago. This certainly has encouraged and effectively required the professional to adapt to these particularities and to attempt to anticipate these particular needs from a prospective buyer/renter in the particular circumstances generated by the pandemic.

The U.S. Federal Government has created a partnership with 21 pharmacy networks and partners to begin distribution of vaccines across the United States as a part of a program to broaden the average American citizens’ accessibility to vaccines. Prior to this program, most vaccines were distributed solely to healthcare workers, and then to the most essential frontline workers. Federally speaking, all citizens 16 or older now have access to the vaccine, but that does not mean that they are able to secure a vaccination appointment. Normalizing vaccination availability at pharmacies is just one way that our country is attempting to provide easy access to the Covid-19 Pandemic Vaccine.

By utilizing pharmacies, the federal government can provide vaccination access to most citizens, and most citizens will have multiple options to obtain a vaccine appointment through pharmacies in their neighborhood. It can be hard to travel to governmental mass sites, especially if there is limited access to public transportation or safe transportation in general due to the pandemic. The program bridges the otherwise insurmountable class, economic, and geographical difficulties many communities in America face. The communities who are most gravely affected by the pandemic can get an appointment with ease through this program.

The pandemic will not end, or even slow down, without widespread vaccine distribution. Up until recent weeks, most citizens found it impossible to find a vaccine appointment. If this program provides hundreds of thousands of appointments for the foreseeable future, this puts us closer to the ultimate goal of herd immunity and alleviates much of the horror experienced over the last year. In addition to providing accessibility to large amounts of people who normally would not have access to the vaccine, the vaccine is also completely free.

The veterinary field is highly varied and there are different types of certification and licensing that an individual interested in pursuing the field can obtain. One may choose a particular path dependent on needs, time, salary, and how they would like to put their certification or licensing to use. They also may be limited by their current education or funds. If you end up going the licensed path, we can assist in any matters that may arise.

Veterinary Assistants

If you are interested in pursuing a specialized veterinary route but do not want to commit to licensing or certification and their accompanying fees and time spent, then the Assistant path may be a route to research. Veterinary Assistants do not have any official licensing or certification, and only a high school education or GED is considered necessary to obtain the position. Assistants will often be the go-to person for most tasks in the veterinary office setting. The clinic must be kept sanitary, and assistants will maintain these standards. Besides the important task of clinic upkeep, assistants will help the vet or certified technicians in exams of patients. An assistant may be needed to restrain the animals, comfort them during procedures, and generally assist in any necessary aspect of the exam and appointment. This differs greatly from a general vet receptionist or kennel assistant, who are often unable to interact with animals. This path might be the right route for someone who wants to be involved in animal care, but does not want to/cannot obtain certification.

Many professions were forced to abruptly shift to and adopt remote workspaces to be able to safely operate during the pandemic. Many physicians, real estate brokers, psychologists, and other licensed professionals who normally operated solely in person, have suddenly found themselves in a wholly foreign environment – likely their own spare room, interacting with clients and patients through a computer or phone. Certainly, many professionals have adapted to this method of practice over the last year, and some have even embraced it, or prefer it over pre-pandemic practices; however, a daunting oversight for many is the mere fact of cybersecurity. For many of these licensed professionals, client confidentiality and information protection, including HIPAA-aligned protocols, are legally required to operate. For a variety of reasons, including the necessity to suddenly shift to remote work, some professionals may not even realize that they are vulnerable to attack and that their patient/client information could be compromised at any moment.

For most of the licensed professionals listed above (and many who are not listed), patient/client confidentiality and privacy are an integral part of their practice. In addition to the requirement to follow HIPAA, it could also be the policy of the professional to contractually, and ethically, ensure confidentiality and privacy. Practicing from home greatly alters the ability to invoke the same standards that are possible in a private office space. A home office space may include visits from partners, children, roommates, or a variety of other possible visitors, and a closed door does not do much for privacy in the same way that a dedicated office space does. Licensed professionals must conscientiously think about the ways in which these conditions can affect the experience of their patient/client and agree upon a policy with those in their home office space to respect and follow client privacy policies.

Unless the home office was prepared in advance and made to mimic the kinds of resources available to the public office space, it is likely that the same types of cybersecurity programs are not in place. There have been reports of “smart” devices recording sound without the consent of the user, which could result in storage of private personal data, and criminals could access this information. Even though it is not the fault of the professional, it is ultimately their responsibility to protect their clientele through all routes possible.

Although telehealth/e-visits were legitimate options prior to the Covid-19 pandemic, most patients and professionals opted for in-person meetings. Since March 2020, the prevalence of telehealth appointments has skyrocketed, and in some places, it is the only option to get care from a medical professional. With this widespread adoption of a completely different way of seeing patients, there have certainly been challenges, and one that affects a variety of medical professionals.

Difficulty in Connecting with Patients

It’s an unavoidable fact that having a barrier of technology prevents the connections that normally occur in a professional-patient relationship. Treating and diagnosing a patient via phone or video removes the ability to physically connect, and for many, the “connection” that exists in telehealth appointments is superficial. It is also less personable and can feel like a negative, unfulfilling experience for all parties. Telehealth appointments are sometimes considered to be less valid because they are believed to rely on informed guesses rather than close physical examination of the possible medical issue. This does not apply for all appointments, certainly, but many patients wonder how a medical professional could diagnose a broken bone, for example, without examining it in person. This can make a patient less likely to schedule an appointment if they feel the care they receive is less valid through phone or video.

Although telehealth/e-visits were legitimate options prior to the Covid-19 pandemic, most patients and professionals opted for in-person meetings. Since March 2020, the prevalence of telehealth appointments has skyrocketed, and in some places, it is the only option to get care from a medical professional. With this widespread adoption of a completely different way of seeing patients, although challenges have occurred, many medical professionals have noted pointed benefits to this adjustment.

Easier to attend

For some patients, it can be an impossible task to take time off work for a medical appointment. Similarly, for other patients, they do not have the ability to travel to an appointment or would have to plan far in advance to be able to secure transportation to a medical appointment. Having the ease of connecting via phone call or video entirely removes the stress and impossibility of having to coordinate a large chunk of time off work or a particular method of travel to attend the appointment. This not only benefits patients, but benefits medical professionals, too, who now are able to see more patients and care for patients who are normally unable to attend medical appointments.

One tactic used by real estate brokers to advertise to consumers is through the use of “Coming Soon” signs, which advertise property that will be coming on the market. In order to appropriately use “Coming Soon” signs, you must have the appropriate authorization, as such signs serve as both notice of sale and an advertisement. Similarly to pocket listings, there are good reasons to use a “Coming Soon” listing: people may need to prepare their homes for sale or are waiting for their new homes to be completed. And also similarly to pocket listings, these listings create ambiguous ethical issues. 

“Coming Soon” listings inform the widest possible audience that the house, while not ready to be seen, is for sale and will be ready for viewings on a specific date. If a seller has not signed a listing contract, the house cannot go into the MLS. This means that a broker can show the house to their own list of potential buyers without consequences. It also means the house receives limited exposure, which could lead to less lucrative offers. Listing a home on the MLS is generally viewed as the best way to inform the vast majority of potential buyers of availability, and if a client seeks to sell their home for the greatest possible price, such interest may be jeopardized by the use of “Coming Soon” signs. This can place a broker in direct conflict with the ethical duty to promote and protect the best interests of the client.

While not an illegal way to sell a home, it does place the broker in a precarious position that skirts ethical and legal boundaries. Failure to be fully transparent about the pros and cons of using a “Coming Soon” listing to a client could result in perceived unethical conduct, putting the broker’s license at risk for disciplinary action being taken by the Illinois Department of Financial and Professional Regulation. If you find yourself facing potential disciplinary action, Williams & Nickl has successfully defended the licenses of hundreds of real estate brokers before the IDFPR.

How many patients can healthcare providers treat while maintaining adequate care? Some patients would be surprised to learn that their physician might see up to 2,500 patients a year—visits during which the physician has to deliver all recommended preventive, chronic, and acute care services required. Nurse staffing has faced this problem as well, with short-staffing at hospitals leading to rising nurse-to-patient ratios. How can these healthcare providers sufficiently handle such clinic loads while providing adequate care?

For physicians, the answer heavily relies on effective delegation of workload. In a 2012 study by the University of California at San Francisco’s Center for Excellence in Primary Care, if a primary care physician does everything on their own, from screening, counseling, immunization, drug prescription, chronic care, and treatment of acute conditions, the physician could only accommodate a maximum panel of 983 patients.

Of these tasks, the time physicians spend on preventative services could be delegated to non-clinician care-team members. Those hours spent managing common chronic conditions could be delegated to other hospital personnel, such as nurses and medical assistants. In appropriately delegating these tasks, it allows a doctor more time to appropriately treat the greatest number of patients while ensuring proper care and treatment.

A pocket listing refers to any property a real estate broker holds a signed contract with but does not advertise on a multiple listing system (“MLS”). While pocket listings have a somewhat negative reputation, there are many reasons why a broker and seller might prefer this method to the traditional listing: the property might not be ready to show, the seller might be subject to a listing agreement to only show to qualified buyers, or brokers strategically use pocket listings to increase an aura of exclusivity related to the home. While these are legitimate reasons, brokers would take care to exercise caution when using pocket listings to avoid any perceived unethical conduct.

If you choose to do a pocket listing, it must be in the best interests of the client. Realtors are ethically required to promote and protect their clients, which means a motivation to undertake pocket listings solely because it could result in a higher commission will raise red flags. In recommending a pocket listing to a client, the broker must thoroughly discuss the pros and cons with the seller and ensure the seller understands the benefits that are being waived by not showing the property on the MLS. By not listing on the MLS, the broker decreases marketing opportunities to reach a larger audience of potential buyers, and what is probably most relevant to the seller, may not bring in the highest possible price for the property. Because a broker is both legally and ethically required to act with the seller’s best interest in mind, a seller seeking the most money with the best terms must be fully informed before pursuing a pocket listing.

Pocket listings are not illegal, but they are viewed as an ethically grey area in the real estate business. In deciding to undertake a pocket listing, a broker must take extra steps to ensure the client’s best interests are being met. If a client ultimately feels like the broker did not receive ethical and adequate representation, a broker could face disciplinary action against their license by the Illinois Department of Financial and Professional Regulation. Williams & Nickl has considerable experience representing real estate brokers and defending their licenses before the IDFPR. If any troubles arise, please contact us for efficient and effective representation.

Recently, the housing market has seen an increase in business due to low-interest rates and rising prices. With the increase in business comes more juggling of clients and listings. Because real estate brokers have a duty to act in the best interest of their clients, they are held to higher standards than most. To ensure your conduct is viewed as honest and ethical, keep these considerations in mind:

Advertising and Social Media

Under the NAR Code of Ethics and Standards of Practice, social media is treated as a form of marketing, despite the difficult task of separating the professional and the personal. Because of this, anything you post on a social media account, such as Facebook, Twitter, or Instagram, must be accurate to the best of your knowledge. Any descriptions you make about a property must be accurate, so you should avoid any exaggerations or misrepresentations. Remember to clearly disclose your agency status and professional affiliation. This can be achieved by including the name of your firm in any posts you make.

Proper Property Disclosures

One of the most prominent complaints made by customers relates to improper property disclosures. It is a legal and ethical requirement that real estate brokers disclose all known material facts about a property to interested clients and failure to disclose could land a broker in serious trouble. While you are not obligated to know about latent defects or matters outside the scope of your license, it would be smart to direct your client to an appropriate source. Be sure to disclose all important information affecting the desirability or value of the property being shown.

Due to historically low-interest rates, the housing market has witnessed a boom in business. With this increase in business, it raises possible ethical considerations faced by real estate brokers as they strive to enjoy the strong market. What steps can you take to ensure you remain in good ethical standing?

Presentation of Multiple Offers

Because of the low interest rates and rising prices, it is not uncommon for multiple offers to be made. In handling such offers, it is important to take certain steps to ensure fair dealing. For any offers received, present them as quickly and objectively as possible. If any buyer or fellow broker asks for information regarding any of the offers you have received, remember that you can only disclose the existence of such offers, along with their source, with express approval provided by the seller. Additionally, if you have authorization via a signed agreement to act as the buyer’s representative, you have to make sure the buyer is aware that the seller does not have to treat any offer as confidential, unless required to do so by law, regulation, or agreement.

Prevent Unauthorized Access

In order to avoid violating any terms and conditions a seller has for viewing their property, it is important to be present when a client wants to look at a home and ensure the viewing occurs within the appropriate time window. Never provide a client with unnecessary access to the home, meaning the client should never have a key to the home, the combination of a lockbox, or use of a lockbox key.

Illinois is one of the most popular states for physicians, and depending on your credentials and practice history, the application process could take between 3-6 months. Here are some tips to avoid or minimize unnecessary frustration.

Ensure You Are Eligible

It sounds obvious, but ensuring you meet your board’s eligibility requirements can save time, money, and possibly an appearance before the Illinois Medical Board.

Complete the Application

There are paper and online versions of the application available; however, it is recommended you complete the online application to avoid any unnecessary delays. In either case, you will be required to mail in supporting documents. The application contains questions dealing with adverse or non-routine situations, and if you answer “yes” to any questions related to adverse actions, the Board will require you to provide a written explanation and verifying documentation. Keep in mind the application process requires a criminal background check, which often take 6-8 weeks for the Board to receive. Since your license cannot be issued until the results of a criminal background check have been received, do not delay in submitting it.

An ever-present war has been raging between Zillow and real estate brokers. Zillow believes it filled a gap where NAR failed to provide valuable services for online consumers. Real estate brokers believe Zillow steals listing information from MLS agreements, repackages the information, and then sells the information back to real estate agents who owned it in the first place.

In 2015, upon the merger of Zillow and Trulia into one big company, Zillow Group, the war between brokers and Zillow escalated. And now, the war seems to be entering an escalated phase once again. For several years, Zillow has worked to transition into a buying-and-selling entity, offering iBuying services through Zillow Offers, and mortgage, title, and escrow services through Zillow Home Loans. Taking things a step further, Zillow has now started its own licensed brokerage: Zillow Homes.

Starting in January 2021, Zillow Offers customers in Atlanta, Tucson, and Phoenix will be able to work directly with licensed employees of Zillow Homes. Zillow Homes plans to expand into additional markets later in 2021. Zillow Homes will be licensing existing Zillow employees under the entity, rather than recruiting agents from any other companies. With this move, Zillow will be free to pull directly from the MLS Internet Data Exchange, which it believes will allow Zillow to more efficiently serve mutual customers with MLS partners. Zillow has also announced plans to join local real estate associations, including NAR.

In 2019, there was a substantial drop in the number of physicians meeting with pharma sales reps. According to a report conducted by the Decision Resources Group, just over half of physicians polled met with a pharma sales rep. Certain practice areas are also seeing an increase in the number of physicians not interacting with sales reps. What’s the cause and what are physicians turning to instead?

The main factor affecting sales rep contact is a lack of time. Between caring for patients and accomplishing necessary administrative tasks, physicians are less available to meet and spend a substantial amount of time with pharma reps. Medical Marketing & Media reported that zero to 2% of polled doctors favor a 30-minute phone call, web conference, e-detail, and in-person visit, leaving pharma sales reps with limited windows to effectively interact with physicians.

For pharma reps who do manage to get in the door and speak with physicians, the most effective way of engaging the physician is to present information less through the perspective of the pharma company, but rather from the perspective of the customer. Technological devices such as tablets have also proven an effective way of presenting information when meeting with physicians, as they allow easy access to animations and videos facilitating demonstrations of how treatments work. 

In recent years, the nursing field has undergone unprecedented growth that shows no signs of slowing down anytime soon. This growth is occurring alongside healthcare needs which are becoming increasingly complex. The result is a widening array of specializations in which nurses are able to practice. Specializations may involve either a narrowing and deepening of some focus or a combination of aspects of different areas with a simultaneous narrowing of focus. Common areas of focus include psychiatry, obstetrics, and geriatric nursing, among a variety of other options. What are the benefits these specializations are bringing to the nursing profession?

In nursing, there has become a greater demand at higher levels of the practice than lower ones, and those who specialize find that they are in higher demand. This enables those nurses to command higher salaries. Specialization also enables a nurse to become an expert in the area in which he/she is providing care, which can increase opportunities for career advancement. With more research and technological advancements emerging, specialization in the nursing career path has led to numerous opportunities.

Specialization, along with subsequent certification, gives patients and medical institutions a sense of assurance that a nurse is highly competent and skilled in a specific area of care. What’s more, it provides nurses with the opportunity to pursue work that is personally meaningful and fulfilling by specializing in an area of nursing care that is of the most interest to you.

A rising trend in the nursing world is taking on travel nurse opportunities. Travel nurses are RNs that work for independent staffing agencies, taking on assignments in different care areas on a temporary basis in order to fill short-term employment gaps. Due to nationwide nursing shortages, health care facilities turned to travel nurses to fill the void. Through the use of travel nurses, nurse-patient ratios have balanced out, which leads ultimately to patient safety and lower patient mortality.

The position of travel nurse is ideal for those who enjoy adapting to different work environments and traveling to new places. Travel nurses also experience higher-than-average pay, adding another facet to the profession that many find attractive.

Not only has the nursing field expanded to suit a travel-friendly lifestyle, but nursing has expanded from the traditional hospital setting to more outpatient settings, enabling nurses to work closer with communities. Ambulatory nurses can work in such areas as home health, military health clinics, community health centers, and telehealth. This shift toward ambulatory care nursing resulted from a need to control health care costs and the development of new health care technologies allowing for quality treatment outside of the typical hospital setting.

A relatively new health care option that is changing the way patients interact with their doctors and nurses is telehealth. Telehealth is the method of providing healthcare services from a different location than where the patient is through the use of technology. Telehealth has provided patients with a sense of control over their own health care, resulting from easier access to their medical documents and doctors/nurses from home. What common forms does this take, what are the perceived pros and cons of this trending healthcare service?

There are three main forms of telehealth: live video conference, store-and-forward, and remote patient monitoring. Live video conferencing includes such circumstances as a nurse walking patients through pre-op preparation or examining a rash. Store-and-forward occurs in instances where a patient takes a photo of a mole and sends it to his/her doctor, and remote patient monitoring is when certain devices measure and wirelessly transmit such information as blood pressure and heart rate.

The Pros

Telehealth has enabled many patients who experience chronic conditions to replace the frequent in-person visits with remote patient monitoring, allowing for more convenient contact between patient and nurse. Telehealth has significantly increased access to healthcare services for patients living in more rural areas, where those in need of healthcare services usually must travel hundreds of miles to receive treatment. Telehealth is also resulting in personal savings to patients. With no travel time required and no need to wait in a doctor’s office, patients are able to save what would otherwise be wasted time. Moreover, telehealth means patients can avoid urgent care or emergency room visits, leading to cost savings for patients.

According to the U.S. Bureau of Labor Statistics, nearly 1.1 million new registered nurses will be needed by 2022. These new nurses will replace the expected 500,000 retirees and fill the 100,000 new RN positions created each year. With this need for new nurses comes a need for nurse educators to provide proper training. Nurse educators play the crucial role of ensuring that new nurses are prepared to meet the growing demand for their services.

There has been a shift in thinking for hospitals, with more seeking nurses who have acquired a bachelor’s in nursing (BSN) under the belief that such training leads to better expected patient outcomes. Nurse educators are in an important position within this hospital system. They are trained nurses who can deliver the most crucial information to new nurses, given their intimate understanding of the challenges of the profession and how to best convey critical knowledge that is essential to a hospital’s success. As for nurses, this increasing need in the education field has a certain additional incentive. There is a reported $20,000-$30,000 pay gap between nursing faculty and practicing nurses, inducing more nurses to turn to teaching.

Another area offering career and education growth for nurses is through the Doctor of Nursing Practice programs. Due to a physician shortage, there is an increased need for direct providers, and nurses are entering such programs in order to fill the gap. The doctoral programs prepare nurses for careers in health administration, education, clinical research and advanced practice, allowing nurses to become experts in their profession and assume a variety of leadership roles.

On Thursday, November 19, 2020, the Department of Justice (“DOJ”) announced that it planned to file a lawsuit against NAR, along with a proposed settlement that targeted NAR’s rules, policies, and practices, which the DOJ says are anticompetitive. The DOJ’s proposed settlement attempts to bring a level a transparency and competition to the real estate industry.

The proposed settlement posed by the DOJ would require NAR to change rules regarding broker commissions and service charges. NAR would have to change rules that currently enable MLS participants to not display or distribute MLS listings based on the compensation offered to the brokerage or agent, and rules that permit MLS participants to represent/suggest that their services are free to a client with no cost. The proposed settlement also calls for an end to limiting access to lock boxes to real estate brokers with respect to those properties listed on the MLS.

NAR agreed to comply with the proposed DOJ settlement agreement and will modify some of its rules and repeal others in order to resolve the antitrust lawsuit. NAR must comply with the settlement agreement within 45 days.

When seeking out medical treatment, the most important relationship that arises is between the doctor and the patient. One of the main problems threatening that relationship is third-party payer interference. Third-party payers have seen a rising power in the exam room over the actual doctors treating patients. While the medical field has sought to empower patients in making their own medical decisions, third-parties are interfering with this ability. How have third-party payers acquired such influence?

Even though doctors are taught to recognize the patient as top priority, third-party insurers make the ultimate determination related to patient access to treatments and medications doctors have recommended, not only to improve patient health, but to save their lives. As unfathomable as it may seem, it is fairly common practice for patients to be denied the treatments their doctors have described. Patients are often unaware that when insurers deny this access, they can appeal the decision and fight to receive the treatment their doctors recommended. However, obstacles to overturning the insurers’ denial, even if patients are aware of this option, often scare off patients from pursuing claims.

As frustrating as denial is on the patient side, it likewise hinders a doctor’s ability to most effectively treat their patients. It is generally unethical to deny a patient treatment, especially if other treatments have proven ineffective. Yet, doctors are required to jump through third-party insurers’ hoops to eventually provide the treatment they recommended in the first place. For instance, certain types of therapy treatment require that a patient must first fail on a less expensive medication, even if it is likely to be less effective. Doctors also find themselves caught up in a situation where patients must independently prove they require the treatment or medication recommended by a doctor. Patients must demonstrate this through a doctor using certain diagnostic procedures or lab studies in coming to a conclusion regarding treatment.