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    Dr. Marcinko is originally from Loyola University MD, Temple University in Philadelphia and the Milton S. Hershey Medical Center in PA; as well as Oglethorpe University and Emory University in Georgia, the Atlanta Hospital & Medical Center; Kellogg-Keller Graduate School of Business and Management in Chicago, and the Aachen City University Hospital, Koln-Germany. He became one of the most innovative global thought leaders in medical business entrepreneurship today by leveraging and adding value with strategies to grow revenues and EBITDA while reducing non-essential expenditures and improving dated operational in-efficiencies.

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Obama and Health IT

Works Progress Administration


By Darrell K. Pruitt; DDS

In an article posted on www.ModernHealthcare.com HITS staff writer Matthew DoBias writes: 


“President-elect Barack Obama said that his economic recovery plan to create 2.5 million new jobs in part will rely on ‘technology and healthcare modernization,’ a nod toward increasing the use of health information technology among physicians and hospitals as well as the trained staff who will be needed to run it.”


Economic Recovery

The title of the article is “Obama links healthcare reform to economic recovery.”


More Expenses

I was afraid that this would happen. It looks like American citizens are going to help pay for economic recovery through the additional medical expenses necessary for trained healthcare IT staff.  I guess it is still a far better plan for getting us out of a depression than a world war.

As a healthcare provider who has many patients who will go without dental care if I raise my fees to cover the cost of healthcare IT, plus the additional costs of HIPAA compliance, doesn’t that make Obama’s plans counter to the Hippocratic Oath?  Don’t forget the indisputable fact that electronic dental records are more likely to cause dental patients harm than good.


Obama scares me. When a customer enters my place of business, they want to pay for safe dentistry, not mandated, busy work jobs carrying tremendous liability that are designed to stimulate the economy.


And so, your thoughts and comments on this Executive-Post are appreciated.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com  or Bio: www.stpub.com/pubs/authors/MARCINKO.htm

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Understanding Earnings per Share

One Component of Fundamental Stock Analysis

Staff Reporters

Savvy physician-investors know that probably the most important influence on the price of a stock is reported earnings per share (EPS). Quarterly earnings are multiplied by 4 to simulate upcoming annual earnings, but sometimes “trailing 4 quarters” (i.e., actual) earnings are used. Analysts usually project earnings for several upcoming quarters, and those estimates are used to project the stock price.


Companies are required to report EPS within 45 days of quarter-end and within 90 days of year-end. According to the Dictionary of Health Economics and Finance [www.HealthDictionarySeries.com], EPS may be defined as follows:

EPS = Net income – Preferred dividends / Number of outstanding shares    

This formula has the same numerator as ROE—income available to common shareholders (after interest and taxes). Undiluted EPS is called primary EPS. If securities exist that are likely to be converted into outstanding common shares (such as convertible preferred stock that is likely to be called, or options held by management that are likely to be exercised), fully diluted EPS are also calculated. EPS states earnings on a per-share basis, which makes it easy to generate the P/E multiple.

Stock Listings

The P/E often appears on website or in newspaper stock listings. With the P/E, the dollar value of current earnings can be backed out using the current stock price. If newly reported earnings are higher than expected, the P/E ratio will be lower than it has been and the stock will be selling at a “discount” to its own prior P/E. If newly reported earnings are lower than expected, the

P/E ratio will be higher than it has been, and the stock is said to be selling at a “premium” to its prior P/E.

Discount/Premium Indicator

A stock’s P/E may also show it selling at a discount or premium to the P/E of the market (an index, like the S&P 500) or the average P/E of other companies in the industry. If compared to the market, it is said to be trading at a high or low relative multiple. Most doctors find that a very high P/E is hard to justify buying—it usually means expectations for future earnings are unrealistic. Small company stocks will tend to have higher P/E ratios than large company stocks. When the multiples of small companies approach those of large companies, it signals a good buying opportunity in small stocks.

Price Tracks Earnings

Over the long term, most charts will show that the price of the stock eventually tracks earnings. The principle of value investing is basically to capture the stock when earnings have risen but the stock price hasn’t caught up and to sell when the price of the stock fully reflects the earnings rise.

A Growth Indicator

A valuable way to look at P/E ratio is to compare it to growth rate. A fairly priced company will have a P/E approximately equal to its earnings growth rate (i.e., a multiple of 12 with an EPS growth rate of 12%). If the multiple is below the growth rate, the stock is considered a bargain. A rule of thumb: A growth rate twice the multiple is a good buy; a growth rate half the multiple means stay away.

The Power of Growth

Physician-investors should never underestimate the power of growth. Even though a company has a high P/E, if the growth rate is also high it will make more money because of the power of compounding. The P/E calculated without cash in the price of the stock could be considered a truer measure of what the operating assets of the company are earning. A physician-investor may break down companies’ P/E further, attempting to find multiples for each business segment of a company.


As seen, if it is likely that convertible securities, warrants, rights, or any other stock equivalents outstanding will be converted into common stock, fully diluted EPS are calculated. The fully diluted calculation adds back interest on convertible securities, assuming it will not be paid, but increases the number of shares outstanding. For companies that pay dividends, the dividend payout ratio is calculated by dividing the annual dividend paid by the EPS. A low dividend payout ratio may not be bad—it could indicate that the company is likely to be able to maintain the dividend level. When the dividend payout ratio for the entire market is low, it indicates that the overall market is at a high.


The dividend yield is calculated by dividing the annual dividend by the current price per share. Yields may look particularly high when share price is depressed and may help sustain demand for stocks like utilities. As in analysis of bonds, valuation of the dividend stream (present value of future cash flow) is often used to determine the intrinsic worth of stocks that pay steady dividends.

And so, your thoughts and comments on this Medical Executive-Post are appreciated. With the recent stock market slump, is this traditional ratio due for a popularity comeback by next-gen physician-investors?

Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com  or Bio: www.stpub.com/pubs/authors/MARCINKO.htm

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