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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.

    Professor David Marcinko was a board certified surgical fellow, hospital medical staff President, public and population health advocate, and Chief Executive & Education Officer with more than 425 published papers; 5,150 op-ed pieces and over 135+ domestic / international presentations to his credit; including the top ten [10] biggest drug, DME and pharmaceutical companies and financial services firms in the nation. He is also a best-selling Amazon author with 30 published academic text books in four languages [National Institute of Health, Library of Congress and Library of Medicine].

    Dr. David E. Marcinko is past Editor-in-Chief of the prestigious “Journal of Health Care Finance”, and a former Certified Financial Planner® who was named “Health Economist of the Year” in 2010. He is a Federal and State court approved expert witness featured in hundreds of peer reviewed medical, business, economics trade journals and publications [AMA, ADA, APMA, AAOS, Physicians Practice, Investment Advisor, Physician’s Money Digest and MD News] etc.

    Later, Dr. Marcinko was a vital and recruited BOD  member of several innovative companies like Physicians Nexus, First Global Financial Advisors and the Physician Services Group Inc; as well as mentor and coach for Deloitte-Touche and other start-up firms in Silicon Valley, CA.

    As a state licensed life, P&C and health insurance agent; and dual SEC registered investment advisor and representative, Marcinko was Founding Dean of the fiduciary and niche focused CERTIFIED MEDICAL PLANNER® chartered professional designation education program; as well as Chief Editor of the three print format HEALTH DICTIONARY SERIES® and online Wiki Project.

    Dr. David E. Marcinko’s professional memberships included: ASHE, AHIMA, ACHE, ACME, ACPE, MGMA, FMMA, FPA and HIMSS. He was a MSFT Beta tester, Google Scholar, “H” Index favorite and one of LinkedIn’s “Top Cited Voices”.

    Marcinko is “ex-officio” and R&D Scholar-on-Sabbatical for iMBA, Inc. who was recently appointed to the MedBlob® [military encrypted medical data warehouse and health information exchange] Advisory Board.

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Do New Socialists Really Want Socialism?

Do New Socialists Really Want Socialism?

By Rick Kahler CFP®

Increasingly in the US, it’s becoming more socially acceptable—perhaps even fashionable—to be anti-wealth and anti-capitalism.

Even identifying as a socialist is no longer the dominion of the far left but is gaining popularity. A number of mainstream politicians, including Presidential candidates, are self-identifying as “socialist.” According to a February 19 article by Mike Allen in Google’s Axios, polling shows younger Americans are souring on capitalism and don’t find the label “socialist” scary or demeaning.

Interestingly, the meanings I see thrown about for socialism and capitalism rarely agree with the traditional definitions.

For example, some self-proclaimed socialists call for higher taxes on the rich, more funding for massive infrastructure improvements, and expanding social welfare programs with proposals like “Medicare for all.” These are not necessarily socialism, but rather an expansion of social programs. There is a difference.

Socialism is an economic system in which the means of production and distribution of goods are owned and controlled collectively or by the government. It is characterized by production for use rather than profit, equality of individual wealth and incomes, the absence of competitive economic activity, and government determination of investment, prices, and production levels.

A truly socialistic economy has no privately owned business. Since all business are government-owned, there is no competitive force serving to improve services or drive down prices. Prices are not set competitively but by government policy. Everyone is economically equal, with no rich or poor. At least in theory.

Embracing increased taxes on fossil fuels and more government spending for health care or green initiatives is not inherently a call for a socialistic economy. It is a call for bigger government and placing more restrictions on free enterprise, which is only a step toward socialism.

For example, the Scandinavian countries have massive social programs. Yet they are not socialistic economies. Their systems allow for free markets and the private ownership of business, meaning their social programs are funded by capitalism and free enterprise.

We have yet to see a society that has successfully tried real socialism. Countries that have attempted it, according to Forbes, are China, Cambodia, Cuba, East Germany, Ethiopia, North Korea, Poland, Romania, the USSR, and Venezuela. Even though many of them have abandoned socialism, the effects are long lasting. Of these countries, according to the Economist, in 2016 Poland had the highest standard of living, ranking at 68 worldwide.

Israeli David Rubin, author of the Trump and the Jews, says in a February Yonkers Tribune article, “I must warn my many American friends to learn some critical lessons from Israel’s socialist past.” He points out that Israel’s founders created a socialist-based economy intended to provide financial security for its new citizens, including millions of refugees. The country struggled with economic stagnation, soaring inflation, low wages, and high prices. In the 1980’s Israel began a shift to free market capitalism, and today its economy is thriving.

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An idea strongly identified with today’s self-identified socialists in the US is the “Green New Deal” resolution which failed to pass in the Senate. In addition to proposals to aggressively reduce greenhouse gas emissions and require the use of renewable energy, it also calls for “guaranteeing a job with a family-sustaining wage, adequate family and medical leave, paid vacations, and retirement security to all people of the United States.”

Assessment

Imposing stringent regulations on property owners and businesses isn’t inherently socialistic, although it would raise prices for everyone, especially the low-income Americans the proposal intends to protect.

However, guaranteeing a lifelong sustainable income for every person in the US, and placing health care under the dominion of the government, does take a giant step toward socialism.

Your thoughts are appreciated

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Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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Absolute VERSUS Relative Risk in Medicine

Understanding the Difference

[By staff reporters]

Absolute Risk. The observed or calculated probability of the occurrence of an event, X—e.g., toxic exposure, infection, etc.—in a population relative to its exposure to a specific hazard or pathogen. Absolute risk is risk stated without any context whatsoever.

The relative risk (also called the risk ratio) of something happening is where you compare the odds for two groups against each other. For example, you could have two groups of women: one group has a mother, sister or daughter who has had breast cancer. The other group does not have any close female relatives who have had the disease. The group with close family members who have had the disease are more likely to develop breast cancer (National Cancer Institute). Relative risk is usually reported as a percentage (i.e. 10% more likely) but you’ll also see it written as “x times more likely” (i.e. ten times more likely). Although relative risk does provide some information about risk, it doesn’t say anything about the actual odds of something happening; on the other hand, absolute risk does.

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Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™ Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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AJPH Showcase Articles on Pubic Health

A SPECIAL FEATURE

Dear Dr. David Marcinko

By Alfredo Morabia MD, PhD

This month, AJPH showcases articles on Public Health WINS, research on texting-while-driving, and twitter and health guidelines.

So, please feel free top visit ajph.org for these and other articles from our May 2019 issue:

The mission of the journal is to advance public health research, policy, practice and education. Toward that goal, the journal also produces monthly podcasts in English, Spanish and Chinese.

Be on the lookout for more timely research from AJPH, and consider subscribing or becoming an APHA member for full access.

Sincerely,

Alfredo Morabia, MD, PhD

Editor-in-chief, AJPH

@AlfredoMorabia

@AMJPublicHealth

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What is the Goodhart Economics Principle?

The Goodhart Principle, and related

[By staff reporters]

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Goodhart’s law is a sociological analogue of Heisenberg’s uncertainty principle in quantum mechanics. Measuring a system usually disturbs it. The more precise the measurement, and the shorter its timescale, the greater the energy of the disturbance and the greater the unpredictability of the outcome.
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CAMPBELLS LAW:
“The more any quantitative social indicator is used for social decision-making, the more subject it will be to corruption pressures and the more apt it will be to distort and corrupt the social processes it is intended to monitor.”

The Economic Burden of Diabetes

FY 2017

By http://www.MCOL.com

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Assessment

Your thoughts are appreciated.

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Product DetailsProduct Details

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MARCINKO’s New Risk Management and Asset Protection Textbook for MDs and Financial Advisors

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Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners]

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 Our New Text – “Take a Peek Inside 

Available – ORDER NOW!

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Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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Foreword by J. WESLEY BOYD MD PhD MA

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“BY DOCTORS – FOR DOCTORS – PEER REVIEWED – FIDUCIARY FOCUSED”

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Book Reviews

“Physicians who don’t understand modern risk management, insurance, business and asset protection principles are sitting ducks waiting to be taken advantage of by unscrupulous insurance agents and financial advisors; and even their own prospective employers or partners. This comprehensive volume from Dr. David Marcinko, and his co-authors, will go a long way toward educating physicians on these critical subjects that were never taught in medical school or residency training.”
—Dr. James M. Dahle, MD, FACEP, Editor of The White Coat Investor, Salt Lake City, Utah, USA

“With time at a premium, and so much vital information packed into one well organized resource, this comprehensive textbook should be on the desk of everyone serving in the healthcare ecosystem. The time you spend reading this frank and compelling book will be richly rewarded.”
—Dr. J. Wesley Boyd, MD, PhD, MA, Harvard Medical School, Boston, Massachusetts, USA

“Physicians have more complex liability challenges to overcome in their lifetime, and less time to do it, than other professionals. Combined with a focus on practicing their discipline, many sadly fail to plan for their own future. They need trustworthy advice on how to effectively protect themselves, families and practice, from the many overt and covert risks that could potentially disrupt years of hard work.
Fortunately, this advice is contained within ‘Risk Management, Liability Insurance, And Asset Protection Strategies For Doctors And Advisors: Best Practices From Leading Consultants And Certified Medical Planners™’. Written by Dr. David Edward Marcinko, Nurse Hope Rachel Hetico and their team of risk managers, accountants, insurance agents, attorneys and physicians, it is uniquely positioned as an integration of applied, academic and peer-reviewed strategies and research, with case studies, from top consultants and Certified Medical Planners™. It contains the latest principles of risk management and asset protection strategies for the specific challenges of modern physicians. My belief is that any doctor who reads and applies even just a portion of this collective wisdom will be fiscally rewarded. The Institute of Medical Business Advisors has produced another outstanding reference for physicians that provide peace of mind in this unique marketplace! In my opinion, it is a mandatory read for all medical professionals.”
—David K. Luke, MS-PFP, MIM, CMP™, Net Worth Advisory Group, Inc., Sandy, Utah, USA

“This book is a well-constructed, comprehensive and experiential view of risk management throughout the entire medical practice life-cycle. It is organized in an accessible, high-yield style that is familiar to doctors. Each chapter has case models, examples and insider tips and useful pearls. I was pleased to see multi-degreed physicians sharing their professional experiences in a textbook on something other than clinical medicine. I can’t decide if this book is right on – over the top – or just plain prescient. Now, after a re-read, I conclude it is all of the above; and much more.”
—Dr. Peter P. Sidoriak, Pottsville, Pennsylvania, USA

“When a practicing physician thinks about their risk exposure resulting from providing patient care, medical malpractice risk immediately comes to mind. But; malpractice and liability risk is barely the tip of the iceberg, and likely not even the biggest risk in the daily practice of medicine. There are risks from having medical records to keep private, risks related to proper billing and collections, risks from patients tripping on your office steps, risks from medical board actions, risk arising from divorce, and the list goes on and on. These liabilities put a doctor’s hard earned assets and career in a very vulnerable position. This new book from Dr. David Marcinko and Prof. Hope Hetico shows doctors the multiple types of risk they face and provides examples of steps to take to minimize them. It is written clearly and to the point, and is a valuable reference for any well-managed practice. Every doctor who wants to take preventive action against the risks coming at them from all sides needs to read this book.”
—Richard Berning, MD, FACC, New Haven, Connecticut, USA

“This is an excellent companion book to Dr. Marcinko’s Comprehensive Financial Planning Strategies For Doctors And Advisors: Best Practices from Leading Consultants and Certified Medical Planners™. It is all inclusive yet easy to read with current citations, references and much frightening information. I highly recommend this text. It is a fine educational and risk management tool for all doctors and medical professionals.”
—Dr. David B. Lumsden, MD, MS, MA, Orthopedic Surgeon, Baltimore, Maryland, USA

“This comprehensive text book provides an in-depth presentation of the cyber security and real risk management, asset protection and insurance issues facing all medical profession today. It is far beyond the mere medical malpractice concerns I faced when originally entering practice decades ago.”
—Dr. Barbara s. Schlefman, DPM, MS, Family Foot Care, PA, Tucker, Georgia, USA

“Am I over-insured and thus wasting money? Am I under-insured and thus at risk for a liability or other disaster? I never really had the means of answering these questions; until now.”
—Dr. Lloyd M. Krieger, MD, MBA, Rodeo Drive Plastic Surgery, Beverly Hills, California, USA

“I read and use this book, and several others, from Dr. David Edward Marcinko and his team of advisors.”
—Dr. John Kelley, DO, Orthopedic Surgeon, Tucker, Georgia, USA

“An important step in the risk management, insurance planning and asset protection process is the assessment of needs. One can create a strong foundation for success only after all needs have been analyzed so that a plan can be constructed and then implemented. This book does an excellent job of recognizing those needs and addressing strategies to reduce them.
—Shikha Mittra, MBA, CFP®, CRPS®, CMFC®, AIF®, President – Retire Smart Consulting LLC, Princeton, New Jersey, USA

“The Certified Medical Planner™ professional designation and education program was created by the Institute of Medical Business Advisors Inc., and Dr. David Edward Marcinko and his team (who wrote this book). It is intended for financial advisors who aim specifically to serve physicians and the medical community. Content focuses not only on the insurance and professional liability issues relevant to physicians, but also provides an understanding of the risky business of medical practice so advisors can help work more successfully with their doctor-clients.”
—Michael E. Kitces, MSFS, MTAX, CFP®, CLU, ChFC, RHU, REBC, CASL, http://www.Kitecs.com, Reston, Virginia, USA

“I have read this text and used consulting services from the Institute of Medical Business of Advisors, Inc. on several occasions.”
—Dr. Marsha Lee, DO, Radiologists, Norcross, Georgia, USA

“The medical education system is grueling and designed to produce excellence in medical knowledge and patient care. What it doesn’t prepare us for is the slings and arrows that come our way once we actually start practicing medicine. Successfully avoiding these land mines can make all the difference in the world when it comes to having a fulfilling practice. Given the importance of risk management and mitigation, you would think these subjects would be front and center in both medical school and residency – ‘they aren’t.’ Thankfully, the brain trust over at iMBA Inc., has compiled this comprehensive guide designed to help you navigate these mine fields so that you can focus on what really matters – patient care.”
—Dennis Bethel, MD, Emergency Medicine Physician

MORE: FRONT MATTER Risk Management

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business-valuation1

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Less Pain at the 2019 Easter Sunday Pump? Well, Maybe!

HAPPY EASTER 2019

This ME-P was originally posted in 2014.

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A Visual Guide to How Increasing Gas Prices are Burning Away the American Pocketbook

By Mint.com

Assessment

The times and gas prices have changed since 2014 – when we first started to track this; haven’t they?

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Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Please review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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

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Asking questions others won’t

About Digital X-ray Manipulation!

[By Darrell K. Pruitt DDS]

Today, I shared a video which revealed how images produced by Computerized Axial Tomography [CAT] scanners can be imperceptibly manipulated for nefarious purposes.

Kinda like so-called “Photo-Shopping”

 Injecting and Removing Cancer from CT Scans

While this scary article is on my mind, I will ask a taboo question which will make me even less popular with most dentists: Can images of digital dental radiographs be manipulated to fool insurers into paying for unnecessary treatment?

If so, is there a technical solution capable of protecting the public from unnecessary dentistry based on doctored images? As harsh as it sounds, if it is possible to photoshop digital radiographs, it would be foolish to assume it is not being done.

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ImageProxy

Injecting and Removing Cancer from CT Scans

Assessment

There. I said it. Your thoughts are appreciated.

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Product DetailsProduct Details

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On PBM Business Practices

Unfair -OR- Not?

[By staff reporters]

PBMs, like Prime Theraputics, Optum, CVS/Caremark, Walgreens/prime Mail and Express Scripts, Bring no value but huge expense to pharmaceutical medication prices.

The Trump administration and Congress must repeal the GPO and PBM safe harbor that allows them to extort pharmaceutical manufacturers to the tune of $200 billion a year.

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Assessment:

Your thoughts are appreciated.

Product DetailsProduct Details

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What is the “Ichimoku Cloud”?

No More “Candle Stick” Technical Stock Charts

[By Staff reporters]

The Ichimoku Cloud is a collection of technical indicators that show support and resistance levels, as well as momentum and trend direction. It does this by taking multiple averages and plotting them on the chart. It also uses these figures to compute a “cloud” which attempts to forecast where the price may find support or resistance in the future.

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Free Healthcare for All?

IN INDIA

By President Ram Nath Kovind of India

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MORE: N. Baum MD for DEM

Assessment

Your thoughts are appreciated.

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My Fond Farewell to Tuskegee University

“Testing – Testing: 1, 2 3 and 4”

By Dr. David E. Marcinko MBA

Here I am at the podium for a microphone sound check at the beautiful and iconic Tuskegee University Chapel. Guest speakers have ranged from U.S. Presidents, foreign heads of the state, and other persons of note such as Mary McLeod Bethune and Martin Luther King, Jr.

My Purpose?

Link: https://medicalexecutivepost.com/2019/04/12/my-visit-to-tuskegee-university-in-alabama/

Currently, the Chapel serves as the home of the famed Tuskegee University “Golden Voices” Concert Choir. Read more about the History of the Chapel, right here.

Link: https://www.tuskegee.edu/about-us/chapel

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IMG_7897

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As I toured the historic TU wooden chapel with my host and Dean of the College of Arts and Sciences, Dr. Channa Prakash, I could not help but notice it seemed like a larger version of the famed copper-wooden chapel in Rovaniemi Finland. I mentioned it to the Dean who surprisingly informed me that he too visited and spoke at that same site in Northern Finland, near Lapland, a few years ago. Rovaniemi is Lapland’s capital city, an energetic jewel of the North which lays claim to being the home of Father Christmas.

A “small world” co-incidence!

Link: https://www.dezeen.com/2017/01/08/suvela-chapel-oopeaa-espoo-finland-copper/

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The College of Arts & Sciences Seminar

For the last two decades, I’ve had the opportunity to speak at small informal seminars with a few attendees – to larger more formal international presentations to an audience of thousands. But, success in my mind relates to the engagement, reception and feedback of the audience; not mere size. This was the case at the C&S and affiliated Tuskegee University National Center for Bio-Ethics in Research and Health Care.

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thumbnail_IMG_1663.edit1

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Using this metric, I learned that our niche seminar was indeed a success with dozens of esteemed faculty members, administrators and over a hundred university student – scientists collaborating and challenging me with state-of-the-art comments, insights and experiences that combined the theoretical and applied applications of our subject matter expertise …. followed by a spirited Q-A session. And, for which I am  grateful.

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So, after a post reception gala social event; whole campus, Booker T. Washington and George Washington Carver Museum, and biological laboratory tour, it was time for me to “Drop the Mike” on Tuskegee University.

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Assessment

I then waved good-bye and bid my hosts and new friends a fond farewell – until the next time. Thank you TU.

***all together

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Understanding the Next Generation of “Symptom-Checkers”?

Will SCs  become one of the killer applications in digital health?
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By Ralf Jahns [Berlin, Germany]
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Dear David and ME-P Readers,
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Next generation of symptom checkers are entering the healthcare market with the intention to disrupt the way health services are provided. Symptoms checkers have a chance to belong to the set of killer applications within digital health market next to telehealth, e-prescription and chronic health management solutions. Market potential differs significantly country per country and could go up as high as 8 Bn EUR p.a. Payer and pharma companies must hurry up to close partnership deals as prices go up quickly.
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Symptom Checkers
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There are hundreds of symptom checker solutions available in the market for long. Quite a few have gone out of business or changed their business model (e.g. Medlanes) due to having started too early in a market either using B2B or B2C business models. Over the last few years a new generation of symptom checkers have been launched. These tools are building on AI for data management and a chat bot functionality for user communication. They also expanded into other service areas not only concentrating on offering expertise medical diagnostic advice, but also allowing to search for a doctor, remote HCP consultations, or shopping features for over-the-counter medicines.

Symptoms checkers have the potential to belong to the solution suite that will open up the traditional healthcare system for digital health solutions, similar to telehealth or chronic patient’s self-management services. They not only allow patients to remotely 24/7 access advice on their symptoms but are more and more used also by HCPs to support their diagnosing process.

The following list of next generation of symptom checkers shows current ranges of services, reach and business models.

  • Ada Health – a free symptom checker exclusively available as a mobile app. The app provides symptom advice for more than 6,000 diseases. The ADA app has 6 million users and 10 million assessments completed, it’s available in 5 languages and ranked as #1 medical app in over 130 countries. The Berlin-based company employs 130 workers and over 40 doctors and medical editors.
  • Your.MD – symptom checker and health tracker. The app for diagnosis, partners with online medical service providers and refers its apps users to pharmacies, test centers, doctors’ offices or recommends other medical apps which are suitable for them.
  • Sensely – an app for pre-diagnosis, video doctor consultation, allows remote monitoring, links user with local medical services and self-care resources. Currently Sensely app is available by an access code from an employer/health plan.
  • Infermedica – Symptomate is a suite of web, mobile and voice apps that help patients assess their symptom when they feel sick. The solution covers 13 languages and is available in three major voice platforms: Amazon Alexa, Microsoft Cortana and Google Assistant. According to the company the audience includes mainly young adults and more than 55% of the users are aged 18 – 30. Some of the most commonly reported symptoms include headaches, back pains, mild abdominal pains and overall fatigue.
  • Ask NHS – Virtual Assistant” app (powered by Sensely). A virtual assistant named Olivia asks questions about the symptoms and suggests what the problem is. If needed, Olivia arranges a call back from a “111 nurse” to discuss the symptoms further. Patients can also search NHS approved healthcare advice, and schedule GP appointments.
  • Isabel is a similar solution to Ada or Symptomate. The end users are patients, but the company – Isabel Healthcare – also makes the APIs available to others to integrate the symptom checker into their own systems.
In general, market readiness seems to be more advanced in terms of payer and user willingness to use and pay compared to few years back. Also, symptoms checkers are now seen as tools which not only substitute or shorten HCP visits by remote, anonymous and free-of-charge health assessments, but which also enable patient activation tools for pharma companies and enhance products by tech-companies.
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Research2Guidance Cost Savings Potential Opportunity For Sympoms Checkers Vary Between 0,5 BN and 8 BN Euros

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Market potential is big. 400 million people especially in developing economies lack access to essential health services. The situation in developed economies is different. Shortage of doctors, especially in rural areas also exists but the problem that symptoms checkers could address is the large amount of doctor visits. In the USA alone there are around 1.3 Bn visits to GPs in a year. Japan has an even higher GP visit numbers as people tend to go 3 times more often to a doctor compared to their US counterparts.By reducing the number of HCP visits (here only GP visits are shown), symptom checkers promise to have a significant impact on healthcare costs within each country. Regardless whether 5% or 10% of GP visits will be made obsolete, the cost saving potential is enormous. In the US alone a 5% reduction would lead to annual cost savings of 8 Bn EUR! Second biggest market opportunities are in Japan with potential cost savings of 6 Bn EUR, followed by Germany and Canada (1 Bn EUR).

Not surprisingly payer organizations in western countries have started to offer symptoms checker solutions to their member base but also to HCPs. For example, Ada and German health insurer Techniker Krankenkasse(TK) are offering the symptoms checker in emergency rooms. Patients insured by TK might be asked to complete in a waiting room an assessment on Ada. Depending on the results, the patient may be redirected to a nurse or a doctor. In another trial run with a large NHS GP clinic, 14% of patients that completed an Ada assessment in the waiting room said that if they had used Ada at home, they would not have felt the need to come to see the doctor that day.”

Babylon a telehealth service also using symptoms checkers is now embedded into Samsung Health, which is available on millions of Samsung mobile devices in the UK and US, and has recently signed major partnership agreements with Tencent, Bupa and Prudential.

Companies wanting to enter the market should hurry up as development times of symptoms checkers are long and existing players are closing deals with payers and tech companies at high speed. Ada, for example, claims to have spent seven years to build up their database of symptoms and recommendations, while integrating more than 6.000 diseases linked to symptoms including 1,100 rare diseases curated by HCPs.

On the other side, payerspharmahospitals and tech companies that want to enrich their service offering with next generation of symptoms checkers are urged to start selection and further on integration process of next generation symptoms checkers as prices go up quickly and flexibility to incorporate specific change requests will go down with increasing success of symptoms checkers.

P.S. If you need any insights or quotes about the digital health, digital diabetes and / or the digital respiratory markets, please do not hesitate to contact me. I will be happy to provide you with reliable data and latest market insights.

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My Upcoming Trip to Tuskegee University in Alabama

VISITING WORLD FAMOUS TUSKEGEE UNIVERSITY

Dr. David E. Marcinko MBA

Just a quick announcement that I will be at Tuskegee University on Friday April 12th to keynote a niche seminar on biological sciences, medical education and contemporary healthcare career trends.

Link: https://www.tuskegee.edu/programs-courses/colleges-schools/cas/office-of-the-dean-cas

The gracious invitation was extended by College of Arts & Sciences Dean Channa Prakash PhD and Assistant Dean Dr. Joe Jimmeh; with renowned faculty and basic science researchers Dr. Marcia Martinez, Dr. Richard Whittington, Dr. Albert Russell, Dr. Clayton Yates; and Professor of Mathematics Dr. Mohammad Qazi to attend. 

Link: https://www.tuskegee.edu/programs-courses/colleges-schools/cas/cas-faculty-and-staff

I am especially eager to tour the historic TU campus, and meet two-time graduate Dr. Roberta Troy who is Founding Director of the Health Disparities Institute for Research and Education (HDIRE). As a native of Baltimore, Maryland, this is an important issue to me. And, Dr. Troy was just appointed new University Provost. I understand she is a true academic dynamo and congratulate her, collegially.

Of course, I will be sure to order a slice of Dorothy Restaurant’s specialty key-lime pie at the Kellogg Conference Center during the post-reception dinner. Yummy!

HOPE TO SEE YOU, THERE!

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What is the Einstellung Effect?

What it is – How it works?

[By Staff reporters]

Einstellung is the development of a mechanized state of mind. Often called a problem solving set, Einstellung refers to a person’s predisposition to solve a given problem in a specific manner even though better or more appropriate methods of solving the problem exist.

The Einstellung effect is the negative effect of previous experience when solving new problems.

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Hospital Spend Concerns and Top Planned Cuts

The Top Five [5] for Healthcare Organizations

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On Stock Investing Fear!

vitaly

By Vitaliy Katsenelson CFA

Stock Investors: You Have Nothing to Fear but Fear Itself

    

This article is Part 1 of a 3-part series discussing how investors can avoid acting irrationally. Read Part 2 and Part 3.

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Advertise on the Medical Executive-Post and Reap the Benefits

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By Ann Miller RN MHA [Executive-Director]

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The Medical Executive Post [ME-P] is the premier online community and marketing platform that allows you to profile your company’s product and services to financial advisors, stock brokers, insurance agents, financial planners, accountants, wealth-managers and their highly-targeted healthcare professional clients.

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  • E-mail us for a full packet, but give a look to these results from the ME-P’s annual reader survey:
  • 89% of readers said the ME-P influences their perception of products and companies
  • 34% said that ME-P sponsorship alone give them a higher interest or appreciation for those companies
  • 754% said the ME-P has some, a good bit, or a lot of industry influence

Contact us and I’ll e-mail you a rate card. Your support makes a difference!

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We have great sponsor packages, but maybe you want to run a short-term ad — a position listing, an announcement, or your booth number at an upcoming conference. Or, perhaps your company is between budget cycles and can’t commit to sponsorship yet. We’ve got an answer – ME-P text ads.

Text ads are up to five lines long and are highly cost-effective. You’ll get about 25-35,000 impressions per week, reaching the ME-P’s highly targeted and loyal audience of decision-makers. Think small text ads don’t work? They’ve made two Google kids billionaires!

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So, advertise with the Medical Executive-Post and Reap the Benefits

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Inflation is Higher Than You Think

Consumer Price Index

By Forbes Wealth

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cpi

Inflation is Higher Than You Think

Macro-Economics and What the ‘Chained CPI’ Could Mean for Social Security?

MORE: https://forbeswealthblog.ca/2019/01/11/how-high-can-interest-rates-go-2019/

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Bitcoin

The Beginners Guide

By Forbes Wealth

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Bitcoin Part 1: The Beginners Guide

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Medicare and Medicaid Overall Penetration

Population by State

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BUSINESS, ORGANIZATIONAL BEHAVIOR & FINANCE FOR DOCTORS:

THANK YOU

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What is the Overton Window?

Is it a metaphor for other Industries?

[By Dr. David E. Marcinko MBA]

According to Wikipedia, the Overton Window is the range of ideas tolerated in public discourse, also known as the window of discourse.

The term is named after political scientist Joseph P. Overton, who claimed that an idea’s political viability depends mainly on whether it falls within a range acceptable to the public, rather than on politicians’ individual preferences.

According to Overton, the window contains the range of policies that a politician can recommend without appearing too extreme to gain or keep public office in the current climate of public opinion.

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Assessment:

How does the Overton Window relate to the following?

  • Education
  • Healthcare
  • Parenting
  • Athletics; etc.

In fact, what does it NOT relate to? Your thoughts are appreciated.

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Consider Taxes Before Retiring Abroad

Physicians Considering Retirement in Another Country?

By Rick Kahler CFP®

One way for a retiring doctor to stretch a retirement nest egg is to relocate your retirement nest. Finding a place with a lower cost of living can include considering retirement in another country.

International Living

According to International Living, Panama is one of the best options for Americans looking for affordable living costs, good medical services, and an appealing climate. Costa Rica, Mexico, and Belize are also good possibilities.

Before you pack your sunhat and flip-flops and head for a low-cost retirement haven like Panama, however, take a look at all the factors affecting your retirement income and expenses. One of those is taxes.

Taxes

Moving out of the country does not mean your tax bill to the US government or your current state will decrease. Short of giving up your US passport, there is nothing you can do to escape paying US taxes on your income, even if you don’t live in the US. We are one of two countries worldwide—the other is Eritrea—that taxes our citizens based on both residence and citizenship.

You might assume, however, that moving out of the country would end your liability for state income taxes. That isn’t always the case. Some states still want to tax your income even though you don’t live there. According to Vincenzo Villamena in a December 2018 article for International Living magazine titled “How to Minimize Your State Tax Bill as an Expat,” it’s especially problematic if you end up returning to your old address in the state and start filing an income tax return. Eventually, he says, “the state will see the gap” and may require you to pay taxes on the missing years.

You have nothing to worry about if you live in one of the seven states with no income tax: South Dakota, Wyoming, Nevada, Washington, Texas, Florida, and Alaska. Tennessee and New Hampshire aren’t bad, either, as they don’t tax your earnings but they do tax your investment income. Most other states will let you off the hook if you submit evidence that your residence is in another country and you haven’t lived in the state for a while.

Then there are the states that won’t let go of their former residents easily. Those are California, Virginia, New Mexico, South Carolina, North Carolina, Massachusetts, and Maryland. Assuming that when you leave you will be coming back, they require that you continue to pay state tax on your income.

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Solutions?

The solution to this issue takes a little financial planning and some extra time. The best way to escape paying taxes to a state you no longer live in is to move to a state with no income tax first before relocating abroad. You must prove to your old state that you have left and have no intention of ever coming back.

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This means moving for real—cutting as many ties to your old state as possible and establishing as many as possible in your new state. You will want to sell your home, close bank accounts, cancel any mailing addresses, change healthcare providers and health insurance companies (including Medicare), be sure no dependents remain in the state, and register to vote and get a driver’s license in the new state. As a final good-bye you will want to notify the tax authorities that you are filing a final tax return for your last year that you lived in the state.

Assessment

In case you need a good state from which to launch your leap into expat status, consider South Dakota. Not only would my income tax-free home state let you go easily, it would welcome you back if you should decide to return to the US.

Your thoughts are appreciatedBook of Month

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A ‘Flawed’ SEC Program [A Retrospective “April Fool’s Day” Analysis]

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SEC Failed to Rein in Investment Banks [April Fool’s Day – 2015]

By Ben Protess, ProPublica – October 1, 2008 5:01 pm EDT

Editor’s Note: This investigative report was first published ten years ago. And so, we ask you to consider – on this April Fool’s Day 2019 – how [if] things have changed since then?  

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The Securities and Exchange Commission [SEC] last week abolished the special regulatory program that it applied to Wall Street’s largest investment banks. Known as the “consolidated supervised entities” program, it relaxed the minimum capital requirements for firms that submitted to the commission’s oversight, and thus, in the view of some experts, helped create the current global financial crisis.

But, the SEC’s decision to ax the program currently affects no one, since three of the five firms that voluntarily joined the program previously collapsed and the other two reorganized.

The Decision – 18 Months Ago

The decision came last Friday, one day after the commission’s inspector general released a report [1] (PDF) detailing the program’s failed oversight of Bear Stearns before the firm collapsed in March. The commission’s chairman, Christopher Cox, a longtime opponent of industry regulation, said in a statement [2] that the report “validates and echoes the concerns” he had about the program, which had been voluntary for the five Wall Street titans since 2004.

The report found that the SEC division that oversees trading and markets was “not fulfilling its obligations. “These reports are another indictment of failed leadership,” said Sen. Charles Grassley (R-Iowa) who requested the inspector general’s investigation.

The SEC program, approved by the commission in 2004 under Cox’s predecessor, William Donaldson, allowed investment banks to increase their amount of leveraged debt. But, there was a tradeoff: Banks that participated allowed their broker-dealer operations and holding companies to be subject to SEC oversight. Previous to 2004, the SEC only had authority to oversee the banks’ broker dealers.

Longstanding SEC rules required the broker dealers to limit their debt-to-net-capital ratio and issue an early warning if they began to approach the limit. The limit was about 15-to-1, according to the inspector general report, meaning that for every $15 of debt, the banks were required to have $1 of equity.

But the 2004 “consolidated supervised entities” program revoked these limits. The new program also eliminated the requirement that firms keep a certain amount of capital as a cushion in case an asset defaults.

Bear Sterns

As a result, the oversight program created the conditions that helped cause the collapse of Bear Stearns. Bear had a gross debt ratio of about 33-to-1 prior to its demise, the inspector general found. The inspector general also found that Bear was fully compliant with the programs’ requirements when it collapsed, which raised “serious questions about whether the capital requirement amounts were adequate,” the report said.

The report quoted Lee Pickard, a former SEC official who helped write the original debt-limit requirements in 1975 and now argues the 2004 program is largely to blame for the current Wall Street crisis.

“The SEC gave up the very protections that caused these firms to go under,” Pickard said in an interview with ProPublica. “The SEC in 2004 thought it gained something in oversight, but in turn it gave up too much public protection. You don’t bargain in a way that causes you to give up serious protections.”

Pickard, now a senior partner at a Washington, D.C.-based law firm, estimated that prior to the 2004 program most firms never exceeded an 8-to-1 debt-to-net capital ratio.

The previous program “had an excellent track record in preserving the securities markets’ financial integrity and protecting customer assets,” Pickard wrote [3] in American Banker this August. The new program required “substantial SEC resources for complex oversight, which apparently are not always available.”

Asked if he believes the 2004 program was a direct cause of the current crisis, Pickard told ProPublica, “I’m afraid I do.”

The New York Times reported Saturday that the SEC created the program after “heavy lobbying” for the plan from the investment banks. The banks favored the SEC as their regulator, the Times reported, because that let them avoid regulation of their fast-growing European operations by the European Union, which has been threatening to impose its own rules since 2002.

SEC Spokesman

A SEC spokesman declined to comment for this article, referring inquires to Chairman Cox’s statement. In the statement, Cox admitted the program “was fundamentally flawed from the beginning.” But Cox, a former Republican congressman from California, offered mild support for the program as recently as July when he testified before the House Committee on Financial Services. The program, among other oversight efforts, Cox said, had “gone far to adapt the existing regulatory structure to today’s exigencies.” He added that legislative improvements were necessary as well, and has since told Congress that the program failed.

More Questions

So why did the commission not end the program sooner? Some say that the program’s flaws only recently became apparent. “As late as 2005, the program seemed to make a lot of sense,” said Charles Morris, a former banker who predicted the current financial crisis in his book written last year, The Trillion Dollar Meltdown [4]. The SEC “didn’t know it didn’t work until we had this stress.”

And leverage does not always spell trouble. In a strong economy, leverage can also be attractive because it can increase the profitability of banks through lending.

In his recent statement, Cox said the inspector general’s findings reflect a deeper problem: “the lack of specific legal authority for the SEC or any other agency to act as the regulator of these large investment bank holding companies.”

Secretary of the Treasury Henry Paulson has called for a refining of the regulatory structure to reflect the global and interconnected nature of today’s financial system. In any case, the program’s failure can be seen in the disappearance of the participating banks: Bear Stearns, Lehman Brothers, Merrill Lynch, Morgan Stanley and Goldman Sachs.

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Assessment

Merrill Lynch’s leverage ratio was possibly as high as 40-to-1 this year and Lehman Brothers faced a ratio of about 30-to-1, according to Bloomberg [5].

The Fed and Treasury Department forced Bear Stearns into a merger with JPMorgan Chase in March. And the last two months, Lehman Brothers went bankrupt and sold their core U.S. business to British bank Barclays PLC, and Merrill Lynch was acquired by Bank of America. Morgan Stanley and Goldman Sachs, the two remaining large independent investment banks, changed their corporate structures to become bank holding companies, which are regulated by the Federal Reserve.

As these banks have folded or reorganized over the last several months, the Federal Reserve has largely assumed the SEC’s oversight responsibilities, though the commission will still have the power to regulate broker dealers.

Original Essay: http://www.propublica.org/article/flawed-sec-program-failed-to-rein-in-investment-banks-101

Conclusion

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