On “Giving Tuesday” 2022

To Give or Not to Give

By Rick Kahler CFP®

For some, the last Black Friday was a day of fun “hunting” for great deals. For others it can be a day of dread, driven by the obligation to play to the expectation of family and friends.

Ads urge us to buy everything from sweaters to screwdrivers to SUVs on the grounds that they will be perfect gifts to delight our loved ones. Charities send out solicitation letters. “Angel tree” displays in malls and bell-ringers in front of stores.  All of it can be overwhelming.

Money Scripts

We all have our own unconscious beliefs, or money scripts, when it comes to giving. In addition, we’re surrounded by beliefs our society and religions have about giving. Both the personal and the societal beliefs can range across a broad spectrum:

  • “It’s better to give than to receive.”
  • “At this time of year, good people help the needy.”
  • “If poor people weren’t so lazy, they’d provide for their kids at X-mass.”
  • “There are plenty of agencies to take care of those who need help.”
  • “You have so much that you have an obligation to share.”

Like all money scripts, all of these contain partial truths. Giving, whether to family members or to charity, is not a simple black and white issue. Some of the questions it raises might include: How do you know whether you are helping people or enabling them to avoid helping themselves? How do you give to children without encouraging them to be greedy or feel entitled to the latest and greatest of everything? How do you balance helping others and taking care of yourself?

One often overlooked factor is whether the giving is done more to help the recipient or to help the donor feel better.

For example

I remember being in a church group one evening when people were discussing giving. Two of the women there, years earlier when they were struggling single moms with young children, had experienced people from a charity coming to their doors with gift boxes of presents and food for Christmas dinner. Both of them had been humiliated and mortified rather than pleased and grateful. The well-intentioned gifts had felt like a judgment that they weren’t capable of taking care of their own families. No one had asked first whether they wanted or needed any help.

Giving can sometimes be an attempt to hold onto people, to make up to them for one’s past failings, or to be loved by them. One common example of this is divorced parents who overspend on gifts for their children. Public giving may be a way to look good or to gain acceptance or recognition in the community.

One way to respond to the complicated issue of giving is to avoid it. You can close your wallet completely, out of fear that you’ll be taken advantage of, fear that you’ll offend, or simple frustration. Another response is to try to give to every charity that asks and to spend yourself into debt buying lavish gifts for everyone you care about.

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Neither of these makes a lot of sense. Like many other of life’s decisions, the question of how to give, how much to give, and to whom is a personal, individual matter. There isn’t a formula for doing it right.

Assessment

The only suggestion I have is that you give as consciously as possible. Consider the beliefs behind your giving. Discuss giving and receiving with your spouse and your kids. Stop and think before you decide to give or not to give. Then you’re more likely to give wisely and with thoughtful compassion.

Conclusion

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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™

Money and the Drug Aducanumab

BIG PHARMA AND ECONOMICS

By Health Care Renewal

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Aducanumab, sold under the brand name Aduhelm, is a medication designed to treat Alzheimer’s disease. It is an amyloid beta-directed monoclonal antibody that targets aggregated forms of amyloid beta found in the brains of people with Alzheimer’s disease to reduce its buildup.

LINK: https://hcrenewal.blogspot.com/2021/07/money-and-aducanumab.html

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Cureus | Aducanumab as a Novel Treatment for Alzheimer's Disease: A Decade  of Hope, Controversies, and the Future

RELATED: https://hcrenewal.blogspot.com/2021/07/the-future-of-aducanumab-as-medicine.html

CITE: https://www.r2library.com/Resource/Title/0826102549

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“Giving Tuesday” and Pro Bono Medical Care?

For all Physicians and Medical Providers

[By Ann Miller RN MHA]

DID YOU PROVIDE PRO BONO MEDICAL CARE TODAY?

Giving Tuesday, often stylized as #GivingTuesday for the purposes of hashtag activism, refers to the Tuesday after U.S. Thanksgiving in the United States.

According to Wikipedia, it is a movement to create an international day of charitable giving at the beginning of the Christmas and holiday season. Giving Tuesday was initially started in 2011 and called Cyber Giving Monday and was the brain child of the non-profit Mary-Arrchie Theater Company and then Producing Director Carlo Lorenzo Garcia urging donors to take a different approach to filling up an online virtual cart with goods. The push was moved to Tuesday the following year as to not compete with Cyber Monday by the 92nd Street Y and the United Nations Foundation as a response to commercialization and consumerism in the post-Thanksgiving season (Black Friday and Cyber Monday).

The date range is November 27 to December 3, and is always five days after the holiday.

ESSAY: https://medicalexecutivepost.com/2007/11/26/pro-bone-medical-care/

VOTE: https://medicalexecutivepost.com/2019/05/18/are-you-providing-pro-bono-medical-care-a-voting-poll-and-survey/

Assessment: Your thoughts are appreciated.

INVESTING AND INSURANCE TEXTS FOR DOCTORS:

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TEXT: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

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What is a “DEAD CAT” BOUNCE?

HOW IT WORKS

SPONSOR: http://www.CertifiedMedicalPlanner.org

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By Dr. David E. Marcinko MBA CMP®

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In finance, a dead cat bounce is a small, brief recovery in the price of a declining stock.

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See the source image

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Derived from the idea that “even a dead cat will bounce if it falls from a great height”, the phrase, which originated on Wall Street, is also popularly applied to any case where a subject experiences a brief resurgence during or following a severe decline.

  • The dead cat bounce is a sudden and temporary increase in stock price caused by investors erroneously believing that the stock price’s reached its lowest.
  • The dead cat bounce can only be fully accurately determined with concrete data in hindsight.
  • Both falsely identifying a stock price trough (i.e., falling victim to a dead cat bounce) and falsely identifying a true price trough as a dead cat bounce will result in negative financial consequences.

CITE: https://www.r2library.com/Resource/Title/0826102549

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The Bear MARKETS and Cyber ECONOMY

By Staff Reporters

  • Markets: Stocks dropped sharply in the post-Thanksgiving trading session on Friday due to concerns over the new Covid variant, Omicron. The Dow fell 2.5% for its worst day of the year, and the S&P also tumbled 2.3%. Oil prices and travel stocks also got rocked given fresh worries over travel demand, while “stay-at-home” names like Peloton and Zoom got a boost.
See the source image
  • Economy: It’s still way too early to know the impact of Omicron on economic growth. As we laid out last week, the Fed is under pressure to accelerate the winding down of its stimulus measures in order to battle inflation, but the new variant could change the calculus. Investors dialed back their expectations of a sooner-than-expected rate increase on Friday.

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About Pandemic Cyber Monday 2021

How to Do it Like a Pro

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Need help getting the best online deals on Cyber Monday? You may with these shopping tips for our ME-P readers and subscribers, and you’ll be ready for the biggest traditional online shopping day of the year.

Best of all, you can learn a few fun facts along the way!

OMICRON: https://www.msn.com/en-us/money/other/urgent-push-to-gauge-omicron-threat-on-claim-symptoms-mild/ar-AARe4nj?li=BBnb7Kz

Assessment

When you’ve learned everything you need to know, be sure to bookmark this Cyber Monday page and come back next year to again save on the best holiday gifts in 2022.

Source: overstock.com

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PODCASTS: The GREAT ECONOMIC MODERATION / RESIGNATION in Medicine?

A HISTORICAL REVIEW WITH UPDATE

Dr. David Edward Marcinko | The Leading Business Education Network for  Doctors, Financial Advisors and Health Industry Consultants

By Dr. David E. Marcinko MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

What was the Great Economic Moderation?

The Great Moderation is the name given to the period of decreased macroeconomic volatility experienced in the United States starting in the 1980s.

CITE: https://www.r2library.com/Resource/Title/0826102549

During this period, the standard deviation of quarterly real gross domestic product (GDP) declined by half and the standard deviation of inflation declined by two-thirds, according to figures reported by former U.S. Federal Reserve Chair Ben Bernanke. The Great Moderation can be summed up as a multi-decade period of low inflation and positive economic growth.

But, what about health economics, writ large? And, the actual practice of medicine by physicians in the trenches. Consider this historical review.

GOLDEN AGE OF MEDICINE

The ‘golden age of medicine’ – the first half of the 20th century, reaching its zenith with Jonas Salk’s 1955 polio vaccine – was a time of profound advances in surgical techniques, immunization, drug discovery, and the control of infectious disease; however, when the burden of disease shifted to lifestyle-driven, chronic, non-communicable diseases, the golden era slipped away. Although modifiable lifestyle practices now account for some 80% of premature mortality, medicine remains loathe to embrace lifestyle interventions as medicine Here, we argue that a 21st century golden age of medicine can be realized; the path to this era requires a transformation of medical school recruitment and training in ways that prioritize a broad view of lifestyle medicine. Moving beyond the basic principles of modifiable lifestyle practices as therapeutic interventions, each person/community should be viewed as a biological manifestation of accumulated experiences (and choices) made within the dynamic social, political, economic and cultural ecosystems that comprise their total life history. This requires an understanding that powerful forces operate within these ecosystems; marketing and neoliberal forces push an exclusive ‘personal responsibility’ view of health – blaming the individual, and deflecting from the large-scale influences that maintain health inequalities and threaten planetary health. The latter term denotes the interconnections between the sustainable vitality of person and place at all scales. We emphasize that barriers to planetary health and the clinical application of lifestyle medicine – including authoritarianism and social dominance orientation – are maintaining an unhealthy status quo.

NOTE: https://pubmed.ncbi.nlm.nih.gov/31828026/

GOLDEN AGE OF MEDICAL PRACTICE

To listen to all those desperate to reform health care, you get the impression that physicians are pretty horrible people. We are all sexist, greedy, money grubbing tyrants who will perform unnecessary tests and procedures just to make money. We don’t care about quality or cost. We are killing off 250,000 patients every year with our ignored “errors.”

We purposely keep our patients in pain, or we addict them to narcotics just to shut them up. We are constantly told by lawyers that lawsuits are necessary to protect patients from doctors. We provide unsafe drugs just because the drug reps give us free pens and coffee cups. The government must step in to clean up the mess.

PODCAST: https://www.kevinmd.com/blog/2017/08/9-reasons-golden-age-medicine-golden.html

GOLDEN AGE OF PATIENT TRUST

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THE GREAT PHYSICIAN RETIREMENT AND RESIGNATION: https://medicalexecutivepost.com/2021/11/09/healthcare-industry-hit-with-the-great-resignation-retirement/

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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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Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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PODCAST: Data Science and Statistics in Healthcare

HYPOTHESIS TESTING

BY ERIC BRICKER MD

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CORRELATION / CAUSATION: https://medicalexecutivepost.com/2021/02/05/correlation-is-not-causation/

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Doctors Living With Higher Stock Market Volatility

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Change is afoot in the market, the rally of which lulled many into complacency

DG

By David Gratke

DOW DJI 34,899.34 at close
-905.04 (‎-2.53%)

Volatility, on vacation for most of the past few years, is back this fall for physician investors and us all. It hit a new 52-week high in mid-October, double the level of August. That means change is afoot in the market, whose rally lulled many into complacency. So. this is a good time to see where your portfolio stands in risk terms.

The last time volatility really spiked, as measured by the Standard & Poor’s 500 volatility index, or VIX, was the fall of 2011 when the market last corrected by 20%. Then, the VIX level was twice as high as now. Volatility is market price fluctuation, and it signals greater risk.

Financial Risk

financial risk

The root cause of higher volatility is that the world’s major central banks, including our Federal Reserve, have flooded markets with liquidity – printing money, if you will. In other words, in an effort to jump-start local economies, they have kept rates so low that stocks are artificially higher, and thus ripe for a price-churning correction. The insidious side-effect of this money printing has been to greatly reduce, if not extinguish, historical, and normal, market price fluctuations.

As David Kotok, chairman and chief investment officer of Cumberland Advisors, puts it: “An era is ending: for over half a decade, nearly worldwide, zero interest rates suppressed volatilities. That is over.” The initial indication of this, Kotok says, was when then Fed-Chairman Ben Bernanke indicated that his bond-buying stimulus program was coming to an end. Well, now it’s over and the market fears interest rates are on the way up.

Investor Sentiment

Transferrable  Emotions

Stock market volatility can be measured and is used to gauge investor thinking, or what we call investor sentiment.

The VIX gauges investor sentiment. When volatility is low, the implication is that investors are complacent. Said differently, they are not paying attention to the underlying risks in the marketplace. Also during times of low volatility, markets are often fully valued, or even overvalued due to investor contentment.

When the VIX is high, as it was during the 2008-09 financial crisis, investors exhibited great amounts of fear. They sell out of their investments, and markets are typically undervalued.

Volatility was low prior to 2008, hovering around its historical average of 20. The index then zoomed to 90 during the 2008-09 stock market slide. In recent months, however, most notably June and July, we witnessed a historic low in this index, hovering near 10. Sure enough, there were high levels of margin balances and bullish investor sentiments, along with above-average stock valuations, as seen by lofty price/earnings ratios.

Now, the VIX is slightly below average, at about 15.

Since August, volatility rose from its sleepy historic mid-summer lows for many reasons: Middle East tensions, the Ebola outbreak, low gross domestic product growth, central bank stimulus slowing down, corporate stock buybacks, high P/E ratios, just to highlight a few.

Stock_Market

A New Normal?

Assuming this higher volatility is the new normal, what can you do about it? One alternative is to do nothing and ride this out. Another is to trade options, betting on which way the market will cut. But this is very risky and best done by professionals. Kotok says a volatility surge is a good time to examine your portfolio’s risk profile: His firm’s largest positions are in defensive stocks, like utilities and telecoms – ones that don’t tend to rocket around when the market gyrates.

During a recent volatility boost to the current level, in 2013, a Wall Street Journal story offered some market pros’ tips. Examples: putting money in a balanced fund, where stocks and bonds are in roughly equal proportion. Another warned that whenever stock holdings were over 70% of a portfolio, or under 30%, you are most vulnerable.

Regardless, Kotok cautions that “more and exciting volatilities lie ahead.”

Follow AdviceIQ on Twitter at @adviceiq.

About the Author

David Gratke is chief executive officer of Gratke Wealth LLC in Beaverton, Ore.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to 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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PODIATRY PREP: Pass All Your Board Certification Examinations

Celebrating 30 Years of Success!

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Pass ALL the Certification Boards!

By: http://www.PodiatryPrep.org

The Foot and Ankle Research Consortium, Inc. (FARC) is the leading publisher of Podiatric educational software. Since 1992, we have been producing the most effective and innovative method of preparing for ALL the Podiatry Board Examinations.

CURIOUS STUDY: Hallux Valgus Met I

SCARF: scarf osteotomy

This includes: The American Board of Podiatric Surgery, The American Board Of Podiatric Orthopedics and Primary Podiatric Medicine, the American Podiatric Medical Specialties Board, ABLES and the PMLexis. (Now includes the latest information for all Board Re-Certifications).

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SMALL BUSINESS SATURDAY 2021

SPEND AND CELEBRATE

By Staff Reporters

Saturday, November 27, 2021 is Small Business Saturday – a day to celebrate and support small businesses and all they do for their communities.

CITE: https://www.r2library.com/Resource/Title/0826102549

This year, we know that small businesses need our support now more than ever as they navigate, retool and pivot from the effects of the coronavirus pandemic.

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VALUATION of Internal Medicine Services

Valuation of Internal Medicine Services: Reimbursement

BY HEALTH CAPITAL CONSULTANTS, LLC


As noted in the first installment of this five-part series, internal medicine is the largest specialty among physicians and an understanding of the various environments in which these physicians operate is crucial in determining their numerous value drivers.

Learn the Secrets of Creating a Medical Practice Sales ...

In particular, healthcare reimbursement, the process by which private health insurers and government agencies pay for the services of healthcare providers (including internists), is perhaps one of the most important environments to understand, as it comprises a provider’s expectation of future return on investment.

CITE: https://www.r2library.com/Resource/Title/0826102549

This installment will discuss the reimbursement of internal medicine services. (Read more…)

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2021 Black Friday and the Physician Micro-Economy

Is it Good for Retailers … but Bad for Doctors and Consumers!

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If Black Friday 2021 is anything like 2010, retailers are going to be swimming in cash while shoppers bathe in savings. Black Friday deals drew 212 million shoppers to stores in fabulous 2010 and collectively spent $39 billion on products and services.

And, the average amount spent by a Black Friday shopper in 2010 was a whopping $365.34.

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Assessment

We predict Black Friday 2021 sales will almost surpass all records with a slight increase over 2010 because of fewer shopping days; and the pandemic explosion..

But, is Black Friday good for the [healthcare] economics sector post [thu] the pandemic? Do patients go shopping rather than to the doctor? What about inflation?

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Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to 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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What is a SKINNY Health Insurance Network?

NARROW NETWORKS

By Staff Reporters

An increasing number of insurers now promote “narrow network” plans that can be less expensive than more traditional offerings. However, that added affordability comes with a tradeoff that could leave you with fewer options for covered medical services.  

CITE: https://www.r2library.com/Resource/Title/0826102549

Understanding Narrow Networks: Narrow network plans are similar to the health maintenance organizations (HMOs). Like standard HMOs, these plans limit coverage to a select group of physicians, specialists and hospitals. However, narrow network plans can be even more restrictive in the number of providers they include. Those providers generally have been proven to have higher measured quality and better outcomes for patients. They also typically agree to lower reimbursements from insurers, which can mean lower premiums and out-of-pocket expenses for consumers.   You’re more likely to see narrow networks — which include narrow pharmacy networks — if you shop for your own health insurance on HealthCare.gov or your state’s insurance exchange. They’re less common in the plan options provided by private employers.  

Advantages Beyond the Savings The fact that narrow network plans include fewer providers doesn’t mean you’ll be getting lower quality care. In fact, many insurers require providers to have a proven track record that’s focused on their patients’ health outcomes. And they can offer a number of additional advantages, beyond just lower costs:

  • Coordinated care. Working within a single health system can mean better communication between your doctors. You might also have easier access to all your medical records through a dedicated online portal.
  • No referrals. Traditional HMO plans generally require a referral from your primary care physician for any consultations with a specialist. Many narrow network plans eliminate this requirement.
  • Added benefits. Many narrow network plans offer benefits designed to keep high-risk patients healthier. These can include options like free health coaching and live video services that enable remote, online medical consultations.  
Narrow Provider Networks in New Health Plans - RWJF

CONS: The biggest disadvantage to narrow network plans is less choice. Insurers keep these plans more affordable by negotiating lower reimbursements with health care providers. In return, those providers could see patient rosters grow, because smaller networks also mean less competition for those within the network. Smaller networks also can mean:

  • A need to change physicians. Your current primary care physician and specialists might not be included in the plan. This can mean starting over with new doctors who aren’t familiar with your particular health concerns.
  • Longer drives. With fewer choices, you may be forced into a longer commute to see an in-network physician. This could become a hardship for those in rural locations.
  • Lack of specialty options. A smaller network might not include the broad range of specialists large networks typically include.

WHITE PAPER: https://ldi.upenn.edu/wp-content/uploads/archive/pdf/the-skinny-on-narrow-networks.pdf

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Happy Thanksgiving Day 2021

2021

x

The Medical Executive-Post

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Forget about inflation and the $85 dollar turkey this year.

Try a Test-Tube Turkey, Instead? That’ll Be $34,000

  Last year, Paul Mozdziak gave thanks that people are finally paying attention to his big idea: he wants to grow turkey meat in 5,000-gallon tanks.

An increasing number of companies are trying to grow other kinds of meat in the lab, but Mozdziak happens to “find a lot of beauty in turkeys.” His approach uses stem cells from a biopsy of turkey breast, which are grown in a warm broth of glucose and amino acids to build up muscle fibers. The potential is huge: theoretically, a single stem cell could undergo 75 generations of division in three months, forming enough muscle to manufacture 20 trillion turkey nuggets.

But such such efficiencies are yet to be met. Currently, a turkey-sized lump of white meat would require around $34,000 worth of growth serum. At Target, you can pick up a respectable frozen bird for $20-25. But the latter are intensively farmed. If Mozdziak can scale up production, as well as tweaking fat and protein ratios to make his turkey tasty, he could even win over some vegetarians at Thanksgiving.

MIT Technology Review

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PODCAST: The MEDICARE COST REPORT Explained

Not For DoctorsNot Managerial Cost Accounting

By Eric Bricker MD

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CHECKS: Cashier V. Certified V. Money Order V. Bank Draft

By Staff Reporters

Types of Checks

A cashier’s check is a check drawn from the bank’s own funds, not yours, and signed by a cashier or teller. Unlike a regular check, the bank, not the check writer, guarantees payment of a cashier’s check. A cashier’s check can also be called an official check.

A certified check is a personal check that the payer’s bank has certified to be legitimate and has earmarked the funds for the check. It’s a type of “official” payment. People often confuse certified checks with cashier’s checks. … Then, the bank prints a check against the funds they are holding.

MORE: https://www.gobankingrates.com/banking/checking-account/certified-check-vs-cashiers-check/#:~:text=What%20Is%20the%20Difference%20Between%20a%20Cashier%E2%80%99s%20Check,4%20Availability%20of%20Funds.%20…%205%20Safety.%20

A money order is a method of paying for something with cash using a check from a third party. You pay for the money order, and the third party issues you a check that you can give or send to someone. This person deposits the money order in their bank account or exchanges it for cash at a business or post office.

A bank draft is a negotiable instrument where payment is guaranteed by the issuing bank. Banks verify and withdraw funds from the requester’s account and deposit them into an internal account to cover the amount of the draft. A seller may require a bank draft when they have no relationship with the buyer.

CITE: https://www.r2library.com/Resource/Title/0826102549

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Happy [PANDEMIC] Thanksgiving Day 2020-21

2020-21

By CDC

What is an “Inverse” ETF?

WHAT IT IS – HOW IT WORKS

Traditional ETFs: https://medicalexecutivepost.com/2008/01/07/exchange-traded-funds-etfs/

Tax and ETFs: https://medicalexecutivepost.com/2008/01/11/etfs-and-tax-efficiency/

INVERSE DEFINITION:

An inverse exchange-traded fund is an exchange-traded fund, traded on a public stock market, which is designed to perform as the inverse of whatever index or benchmark it is designed to track. These funds work by using short selling, trading derivatives such as futures contracts, and other leveraged investment techniques.

Citation: https://www.r2library.com/Resource/Title/0826102549

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How Inverse ETFs Can Help And Hurt You

READ: https://smartasset.com/investing/inverse-etf

RELATED: https://smartasset.com/investing/what-is-a-leveraged-etf

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PODCAST: NaviHealth Digital Health Start-Up

SOLD TO OPTUM

BY ERIC BRICKER MD

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Today is FIBONACCI NUMBERS DAY

MATH NERDS

By Dr. David E. Marcinko MBA

SPONSOR: http://www.CertifiedMedicalPlanner.org

Fibonacci, also known as Leonardo Bonacci, Leonardo of Pisa, or Leonardo Bigollo Pisano, was an Italian mathematician from the Republic of Pisa, considered to be “the most talented Western mathematician of the Middle Ages”

CITE:https://www.r2library.com/Resource/Title

Today, 11/23, is the second holiest day of the year for math nerds after Pi Day. Why? Because it’s Fibonacci Day. If you forgot about the Fibonacci series from middle school, it goes 0, 1, 1, 2, 3, 5, 8, 13, 21, and so on, formed by taking the sum of the previous two numbers to create the next number in the sequence.

Fibonacci numbers can be found in many aspects of the natural world, including petal arrangements in flowers, the shape of hurricanes, a honeybee’s family tree, and even DNA molecules.

So yeah, to quote Jack Black in School of Rock, “Math is a really cool thing.”

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The Fibonacci Sequence Is Everywhere—Even the Troubled Stock Market |  Science | Smithsonian Magazine

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PODCAST: Five [5] Warning Signs for Virtual Primary Care

FROM HEALTH INSURANCE CARRIERS

BY ERIC BRICKER MD

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What is an “INTERVAL MUTUAL FUND?

By Staff Reporters

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An interval fund is a closed-end mutual fund that buys back shares only during specific intervals. Shares of the First Eagle Credit Opportunities Fund aren’t traded on public exchanges, and purchases or sales take place at the close of business, at the net asset value (NAV).

CITE: https://www.r2library.com/Resource/Title/0826102549

A fund’s NAV is simply the sum of its assets divided by the number of shares. A traditional open-ended mutual fund isn’t publicly traded either, and investors can buy or sell at NAV at the market close every business day. This means the manager of an open-ended fund has limited investment choices because a relatively high level of liquidity is needed to handle daily redemptions.

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Understanding interval funds - Griffin Capital

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An interval fund sets intervals (time periods) during which shares can be sold back to the fund manager and the number of shares it is willing to redeem during any interval. This makes it possible for the manager to go for higher yields by participating in less liquid markets.***

RELATED: https://www.investopedia.com/articles/investing/120516/what-interval-fund.asp

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WHAT IS A CLOSED-END MUTUAL FUND

ON OPEN AND CLOSED MUTUAL FUNDS

By staff reporters

A closed-end fund (CEF) or closed-ended fund is a collective investment model based on issuing a fixed number of shares which are not redeemable from the fund.

CITE: https://www.r2library.com/Resource/Title/0826102549

Unlike open-end funds, new shares in a closed-end fund are not created by managers to meet demand from investors. Instead, the shares can be purchased and sold only in the market, which is the original design of the mutual fund, which predates open-end mutual funds but offers the same actively-managed pooled investments.

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BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS

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Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners(TM)

TEXT: https://www.amazon.com/Comprehensive-Financial-Planning-Strategies-Advisors/dp/1482240289/ref=sr_1_1?ie=UTF8&qid=1418580820&sr=8-1&keywords=david+marcinko

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What is Financial Portfolio “DI-WORSIFICATION”

Versus Di-Versification

BUSINESS MANAGEMENT: The term “diworsification” was coined by legendary investor Peter Lynch in his book, One up on Wall Street, to describe the over-expansion of a company into new growth projects and businesses they do not fully understand and which do not align with the company’s core competencies.

See the source image

PORTFOLIO MANAGEMENT: The term diworsification has since grown to also refer to over-diversifying an investment portfolio in such a way that it reduces the overall risk-return characteristics.

ORDER CITATION: https://www.r2library.com/Resource/Title/0826102549

INVESTOPEDIA: https://www.investopedia.com/terms/d/diworsification.asp

RELATED: https://medicalexecutivepost.com/2021/05/29/modern-portfolio-theory-and-asset-correlation-not-allocation/

MORE: https://medicalexecutivepost.com/2014/11/12/the-negative-short-term-implications-of-diversification/

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PODCAST: Value-Based Care

Ochsner Health Has Real Hospital Success

By Dr. Eric Bricker MD

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Physician Medical Practice “Misrepresentation” Risks

BUSINESS FRAUD RISKS

True Case Report

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By Dr. David Edward Marcinko MBA CMP©

SPONSOR: http://www.CertifiedMedicalPlanner.org

A Medical Practice Misrepresentation Case Model

Let’s say a physician decided to sell his practice and move to another state. The value of the sale was based, in part, on the yearly gross of the practice. The physician accepted installment payment terms from the buyer and moved to the new state. The buyer began to practice medicine at his new office. Although he was busy, his gross never approached the gross of the prior physician.

Eventually the buyer defaulted on the loan. The selling physician sued for the deficit. The defaulting physician and his forensic consultants then performed an in-depth evaluation of the seller’s practice. The buyer and his team noticed some discrepancies in the billing patterns and practices of the seller. Considering these discrepancies to constitute Medicare and insurance billing fraud, the seller counter-sued the buyer on the grounds of misrepresentation, alleging the gross receipts of the practice purchase price, was grossly inflated.

Citation: https://www.r2library.com/Resource/Title/0826102549

ASSESSMENT: Therefore, the buyer determined that the seller had fraudulently misrepresented the potential of the practice. He also notified state and federal authorities and filed complaints of insurance fraud against the seller.

The seller thought that he would move to the good life in the new state, but his old practice kept him in constant legal trouble.

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What is Health Insurance OUT OF NETWORK Medical Care?

By Staff Reporters

What does out of network [OON] really mean?

OON – This phrase usually refers to physicians, hospitals or other medical providers who do not participate in a health insurer’s provider network.

CITE: https://www.r2library.com/Resource/Title/0826102549

This means that the provider has not signed a contract agreeing to accept the insurer’s negotiated prices.

MORE: https://www.healthinsurance.org/glossary/out-of-network-out-of-plan/

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BUSINESS MEDICINE: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko

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WEALTH INCENTIVES: Temptation and Incentives

A WORKING WHITE PAPER

Orazio Attanasio

Agnes Kovacs

Patrick Moran

We propose a rich model of household behavior to study the effect of two important policies: mortgage interest tax deduction and mandatory mortgage amortization. These policies have attracted some controversy, first because they are conceived to increase overall saving, an objective that the literature does not agree they can achieve, and second because they incentivize illiquid savings and may thus increase the share of ‘wealthy hand-to-mouth’ households.

We build a life-cycle model where housing may act as a commitment device to counteract present biases arising from temptation. We show that the model matches several empirical facts, including the large share of wealthy hand-to-mouth households. We evaluate the effect of the two policies and find that they increase wealth accumulation by 7 and 10% respectively.

Our results demonstrate that these policies not only induce portfolio re-balancing, as emphasized by the previous literature, but also increase savings by making commitment more accessible.

See the source image

WHITE PAPER: https://www.nber.org/system/files/working_papers/w28938/w28938.pdf

ASSESSMENT: Your thoughts and comments are appreciated.

THANK YOU

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PODCAST: What are DARK PATTERNS?

Physicians and All Web Surfers Beware!

By Staff Reporters

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Dark Patterns are tricks used in websites and apps that make you do things that you didn’t mean to, like buying or signing up for something. The purpose of this site is to spread awareness and to shame companies that use them.

CITE: https://www.r2library.com/Resource/Title/0826102549

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WTF is dark pattern design? | TechCrunch

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PODCAST: https://www.darkpatterns.org/

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RISK MANAGEMENT: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

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Sexual Harassment in the [Healthcare] Workplace

And … How to Prevent It

By Staff Reporter Ashley

Join Our Mailing List

We’ve written about medical workplace violence and sexual harassment before on the ME-P and in our handbooks and texts. It is an increasingly important issue around the blog-o-sphere and in the real world.

Link: https://medicalexecutivepost.com/2008/08/02/risk-management%e2%80%94it%e2%80%99s-not-all-about-medical-malpractice/

This harassment in the workplace Infographic explains through images what sexual harassment is and how to prevent sexual harassment from happening at your small business or [medical practice, clinic or healthcare entity].

The authors’ research shows that your business [practice] is more at risk than you think and that you need to act now in proactively protecting that business.

Romance Sex Harassment

Assessment

Source: boltinsurance.com

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to 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.

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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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Product Details  Product Details

PODCAST: Health Plan Innovation

ALIGNMENT / MISALIGNMENT INNOVATION?

By Dr. Eric Bricker MD

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“Disruptive” DIGITAL BUSINESS MODELS For Health Insurers

The Top 10 [Ten] Disruptive Digital Business Models For Health Insurers

By Zhang Jie

Digital technologies will transform the health insurance business. Early adopters have started to implement new digital business models with initial success. A new report describes ten digital business models for health insurers that will disrupt the industry.

Dear David,

We are excited to announce the release of Research2Guidance’s new “The 10 Disruptive Digital Business Models for Health Insurers” report.

Please find below the special report story.

Advances in higher-quality digital technology—especially apps, sensors, and artificial intelligence (AI)—along with their proliferation among members have spurred the emergence of new business models.

The new report “The 10 Disruptive Digital Business Models for Health Insurers” published by Research2Guidance describes how start-ups, health insurance and general payer organizations have started using these technologies to venture into new forms of health insurance offerings and increasingly step into the healthcare provider role.

New digital models change the way the insurers interact with patients. For example, digital insurers have reworked the trust equation with the patient, outsourced much of their value chain to their members, and now know much more about them. Digital business models tend to also blur the lines between payer and care giver organizations. Some of the first-movers already crossed the line and started to offer services which have previously been provided exclusively by doctors and nurses. The ten digital business models are defined as follows:

  1. Digitally assisted member acquisition is a freemium business model concept.
  2. Mobile health concierge is a business approach designed for members to complete all health insurance tasks using mobile phones with the support from a concierge team.
  3. Peer-to-peer (P2P) insurance refers to a risk-sharing community.
  4. Mobile micro-insurance refers to the health insurance plans that cover short-term small health events or minimal ongoing health insurance.
  5. Health insurers tech platforms license their technology for the management of health plans and members to their customers.
  6. On-demand insurance is a usage-based model that enables members to access desired health plans upon request with the help of a mobile app.
  7. High-risk patient preventive care model concentrates on insuring and managing potentially costly patient groups.
  8. The payer & provider collaboration model stands for a closer, digitally enabled partnership between payers and care providers, especially hospitals.
  9. The API health insurance model uses a list of pre-defined health insurance products accessible to websites and app providers via an application programming interface (API).
  10. Direct primary care model. Within this model, a care provider or a hospital act like a health insurance company using a monthly subscription model.

First implementations of these models indicate the positive impact that they have on the company evaluation, the ability to attract new members, the cost structure, and new revenue streams. Currently, the main impact of digital business models is on company evaluation, which reflects the hype that some companies have created in the investor community. Companies like Oscar, Clover Health, and Bright Health are valued at over $1 billion USD each after only a few years of operation.

Health insurers and start-ups from the USA and China are the most aggressive in adopting new digital business models. Companies from other regions tend to choose a follower approach or implement copycats.

ASSESSMENT

The report also profiles first-mover digital implementations. Profiles include their target groups, operating models, service offerings, and early evidence for success where available.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to 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.

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DOCTORS:

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“Fiduciary Financial Planning for Physicians” https://tinyurl.com/y7f5pnox

“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8

HOSPITALS:

“Financial Management Strategies for Hospitals” https://tinyurl.com/yagu567d

“Operational Strategies for Clinics and Hospitals” https://tinyurl.com/y9avbrq5

Product DetailsProduct Details

What is a Retirement QCD?

A Tax-Efficient Way to Donate Money to Charity

By Staff Reporters

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A qualified charitable distribution (QCD) is a withdrawal from an individual retirement arrangement (IRA) that’s made directly to an eligible charity.

CITE: https://www.r2library.com/Resource/Title/0826102549

IRA account holders who were at least age 70.5 as of Dec. 31, 2019, can contribute some or all of their IRAs to charity.

LINK: https://6acebc46b9e64340fdc1a8917e0c290a.safeframe.googlesyndication.com/safeframe/1-0-38/html/container.html

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Creative Giving Strategies: The QCD - Nebraska Cultural Endowment

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It might seem counterintuitive that anyone would want to give their savings away after making contributions for years in anticipation of the day when they would retire, but there can be tax advantages for doing so.

IRS: https://www.irs.gov/retirement-plans/retirement-plans-faqs-regarding-iras-distributions-withdrawals

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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™ book cover

RISK MANAGEMENT: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

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Finance Tips for Your Mid-Life Crisis

Jaguar Sedan

 Finance Tips for Your Mid-Life Crisis

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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PODCAST: The EMTALA Law

Hospitals Must Treat All Patients

BY ERIC BRICKER MD

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The Emergency Medical Treatment and Active Labor Act is an act of the United States Congress, passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act

CITE: https://www.r2library.com/Resource/Title/0826102549

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MORE: https://medicalexecutivepost.com/2009/04/26/understanding-the-emergency-medical-treatment-and-active-labor-act/

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RISK FACTORS COMMON TO PHYSICIANS

SOME COMMON RISK FACTORS FOR MEDICAL COLLEAGUES TO APPRECIATE

BY DR. DAVID E. MARCINKO MBA CMP®

CMP logo

SPONSOR: http://www.CertifiedMedicalPlanner.org

AN INCOMPLETE LIST = T.N.T.C.

  • Do you and or any family members drive a vehicle?
  • Do you have employees?
  • Do you have a professional malpractice exposure?
  • Do you have legal responsibility to protect medical, EMRs or personal and patient financial data?
  • Are you married and do you have assets not protected by a prenuptial agreement?
  • Do you have a current tax obligation?
  • Do you own a business?
  • Are you a board member, officer, or director of a corporation, foundation, religious or educational organization?
  • Do you engage in activities like hunting, flying, boating, etc?
  • Do you have business or domestic partners whose actions create joint and several liabilities for you?
  • Do you have personal guarantees on real estate or for business loans; or family members?
  • Do you have tail liability for professional services performed in the past?
  • Have you made specific legal or financial representations that others have relied upon in a business context?
  • What kind and what dollar amount of insurance and legal planning have you implemented against these exposures?

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FOREWORD BY J. WESLEY BOYD MD PhD MA

[Professor of Psychiatry Harvard and Yale University]

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ASSESSMENT: Your thoughts and comments are appreciated.

ORDER TEXTBOOK: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

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PODCAST: IATRO-GENESIS Explained

Harm from Physicians and Health caRE

By Eric Bricker MD

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Iatrogenesis is the causation of a disease, a harmful complication, or other ill effect by any medical activity, including diagnosis, intervention, error, or negligence.

CITE: https://www.r2library.com/Resource/Title/0826102549

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On Traditional v. Behavioral Finance

A Comparison Chart

[By staff reporters]

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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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OPEN LETTER on Dental Practice Management Ransomware

By Darrell Pruitt DDS

Dear Kiltesh Patel

CEO of tab32 dental practice management software

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A recent report says “60% of organizations hit by ransomware-as-a-service attacks in the past 18 months.”

LINK:https://venturebeat.com/2021/11/15/report-60-of-orgs-hit-by-ransomware-as-a-service-attacks-in-the-past-18-months/

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See the source image

QUERY: Doesn’t that mean that 60% of tab32 customers have been hit by ransomware as well?

QUERY: Have you yet come to the conclusion that ignoring dentists’ and patients’ concerns about security is a bad business decision?

Give it time! 

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Real Estate Market Values Always Local

Location – Location – Location

By Rick Kahler CFP 

What investment asset class grabs the most attention of the average American?

My guess is that it isn’t the stock market, but a category many people don’t even think of as an investment—the local real estate market. While I don’t have data to back up this assumption, I find that people tend to be more interested in what’s happening in their local real estate markets than on national stock exchanges.

Why?

I think the reason is simple. Houses are tangible, understandable assets that we can see and touch. Most of us live in them, and some of us are in love with our homes. You likely know the ballpark value of your house from the annual assessed value you receive from the county. Chances are you know what repairs your home needs and have an idea of the rent you could charge for it. You probably have an idea of the price trends in your neighborhood or city. You know the best areas in which to live and the neighborhoods to avoid. You know these things because all real estate is local. There is no “national” real estate market.

Not so with common stocks. Because most of us own our stocks in mutual funds and exchange traded funds, we often don’t really know what companies we own, what town their headquarters are in, the price of the stock, the current yield, the trend of the company or sector, and any weaknesses or strengths of the company. Unlike real estate, publicly traded stocks are priced based on national rather than local influences. Further, we don’t work for or live in the companies in our portfolio. And few of us are in love with our portfolio of stocks.

It’s no wonder that most of us are far more interested in the economics of our homes than our stocks. This is even less of a surprise when we consider the average American has more invested in their home than they do the stock market.

Research

According to CoreLogic, the average annual price increase of real estate has slowed down in 2019. “During the first two months of the year, home price growth continued to decelerate,” said Dr. Frank Nothaft, chief economist for CoreLogic in an April 2, 2019 press release.

But that is just the average. Annual price changes range from an increase of 10.2% in Idaho to a decrease of -1.7% in North Dakota. South Dakota showed a 1.6% increase over the past 12 months.

Also according to CoreLogic, of the country’s top 100 housing markets, 35 percent are overvalued, 38 percent were at value, and 27 percent were undervalued. An under- or overvalued market is one in which home prices are at least 10 percent above or below the long-term sustainable level.

While my hometown of Rapid City, SD, is not among the top 100 markets, home prices are booming, according to Jeremy Kahler, a Realtor with Keller Williams of the Black Hills. He indicates that through April, the 12-month price increase in Rapid City is over 7%, which puts our local market into the top quartile for price increases on a national level. Zillow shows our average sales price as $204,100 compared with the national sales price of $226,800, so my hunch is that the Rapid City market might be at value to undervalued.

Assessment

However, I think it’s a reasonable generalization that most homes in flyover country are priced lower than their coastal cousins. Some of the reasons are what I call the snowflake discount, seasonal weather patterns, and the distance from major metropolitan areas. Those that can cope with those challenges are rewarded with lower housing costs.

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homes

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Opine: Your thoughts are appreciated.

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™

[Dr. Cappiello PhD MBA] *** [Foreword Dr. Krieger MD MBA]

Front Matter with Foreword by Jason Dyken MD MBA

Book of Month

 

 

A Review of Investing Expenses

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Peeling Back the Layers of Fees

By PALADIN [Research & Registry]

Advisor Pay

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Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to 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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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Socially Responsible and ESG Investing!

S.R.I.

[By Rick Kahler CFP®]

The concept of socially responsible investing is far from new; the first SRI fund appeared in 1952. Since then, these funds have used social and ethical screens to exclude companies selling products like tobacco, alcohol, or firearms.

You may not have heard of the next generation of SRI funds, called ESG funds, which means environmental, social and governance funds. Social responsibility is just one-third of the expanded focus of these funds, which also look to include companies that are sensitive to the environment and have more holistic corporate governance.

Updates

In recent years, ESG investing has exploded. According to a July 11, 2018, article in Forbes, The Remarkable Rise of ESG, by Georg Kell, over $20 trillion is invested in ESG funds. This accounts for 25% of all the professionally managed assets in the world. There are currently 275 ESG mutual funds and ETF’s from which to choose.

Yet one facet of investing in ESG funds is widely misunderstood. While ESG investing may help you feel better about yourself, it does not actually impact or hamper the companies you choose not to own.

This may come as a surprise to many ESG investors, who commonly believe that by not owning the shares of an offensive company they are restricting the flow of capital to that company, thereby imperiling its existence. For the most part, that isn’t the case.

The offenders

Listed among the worst offending companies by several ESG organizations are Philip Morris, WalMart, Tyson Foods, Pepsi Corporation, Coca-Cola, and Chevron. No dedicated ESG investors would have these companies in their portfolios. None of these companies would care or be hurt in the least if you didn’t own any of their shares.

Why?

The only time a company benefits from a sale of stock is when the company initially goes public (called an initial public offering, or IPO) or issues additional new shares to raise capital. These are actually fairly rare events.

Most stocks are bought and sold in the “secondary” market through exchanges like the New York Stock Exchange. These platforms facilitate transactions between individuals or institutions wanting to buy or sell shares in a company. The money moves between the buyer and the seller; none of the money goes to the company.

Another way companies receive funding to support their ventures is to borrow money from investors. This is called issuing a bond and is similar to an IPO, only the investor receives a promise from the company to pay them back at some future date and receives interest on the loan in the meantime.

Just like stocks, bonds are only issued by a company once. From then on, buying and selling bonds is done on the open market, and none of the money paid or received goes to the company.

So if you want to punish a company, don’t buy stocks or bonds it issues directly. Otherwise, excluding its shares from your portfolio has no effect on the company’s profits or cash flow.

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Assessment

But if no one bought a company’s shares on the secondary market, wouldn’t that have an impact? Yes, it most certainly would. If the demand for the shares of a company dried up, the company’s stock price would plummet.

The problem is the demand for the shares of these companies isn’t going away as long as they remain profitable. If 25% of investors purchase ESG funds,  that leaves 75% of the market willing to buy these companies. This includes the 20% of stocks owned by passive index funds, which own the entire market.

CONCLUSION

Your thoughts and comments on this ME-P are appreciated. Feel free to 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.

Book Marcinko: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.

DOCTORS:

“Insurance & Risk Management Strategies for Doctors” https://tinyurl.com/ydx9kd93

“Fiduciary Financial Planning for Physicians” https://tinyurl.com/y7f5pnox

“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8

HOSPITALS:

“Financial Management Strategies for Hospitals” https://tinyurl.com/yagu567d

“Operational Strategies for Clinics and Hospitals” https://tinyurl.com/y9avbrq5

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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™

More on Medical Practice Business Costs

Unknown and Under-Appreciated by Many

By Rick Kahler CFP®

I recently talked with an administrator of a private medical practice about some of the financial challenges she faces in dealing with the medical system, insurers, and patients.

Some of the insights she gave me into the realities that private physicians face in providing medical care were rather disturbing.

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Here are a few of them.

Let’s start with the insurers who account for the bulk of their revenue. Many payments for procedures from insurance companies (including Medicare) are below the cost of providing the service. This forces physicians to make up the difference on other procedures or find other sources of income to sustain the profitability of the practice.

Conversely, in markets that have just one hospital, the insurance companies have no leverage. If the insurers won’t pay what the hospitals demand, the hospitals can threaten to drop out of the network, leaving the insurers with nowhere to send their insureds in those markets. The insurers end up agreeing to pay the hospitals more.

Charges for services provided in-house at the hospital can end up being substantially higher than those same services done by outside providers.

Example:

She gave me an example of a lab test that cost $1,500 to $2,000 at the hospital lab but $35 to $80 at an independent lab. Patients do have the option to direct the hospital to use an independent lab. But, how many people know that and will have the presence of mind to make the request? While it makes financial sense to price-shop if you have a high deductible HSA plan, there isn’t much incentive if your plan has low deductibles.

Collections

Another challenge is collecting from patients. She says a surprising percentage of Americans maintain checking accounts with no money or keep checks from accounts which have long been closed. While writing bad checks is a crime, those who game the system know they can probably get by with writing a low-dollar check because the cost of pursuing justice is much more than the check is worth.

Most companies would never do business with such a person again. Healthcare professionals tend to have a bias toward giving everyone services, so these same people do return requesting care. She said she and her physician employer have had huge internal arguments about this. Her position is that these people take advantage of the physician in a premeditated fashion and don’t deserve to be extended services. The physician argues that everyone, even deadbeats, deserves healthcare. Since the practice doesn’t provide life-and-death services, she was able to get the physician to agree that if someone has an outstanding bill they need to settle it upfront, in cash, before any new services are provided.

Then there are those who use credit cards and then fraudulently dispute the charges. Some providers let this go because of the difficulty of proving that the charge is legitimate. It requires photographs of customers during the transaction, copies of driver’s licenses, customers’ signatures on the paperwork, and notarized statements from the provider verifying that this was the person who received services and presented the credit card.

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http://www.CertifiedMedicalPlanner.org

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SSNs

A final interesting point concerned patients’ Social Security numbers. She said the only time these are ever needed is when an outstanding bill is sent for collection. Otherwise, they are never accessed or used.

Assessment

Finally, she was quick to add that only a small fraction of their patients premeditate stealing from them. She also stressed that not all insurance companies or hospitals behave unethically, and some do wonderful, humane acts of kindness. Nevertheless, the lack of integrity that does occur on both sides is infuriating and adds to the cost of health services.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to 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

Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, I.T, business and policy management ecosystem.

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“MY TEACHING PHILOSOPHY”

TO H.R. RECRUITERS, UNIVERSITY HIRING MANAGERS & SEARCH COMMITTEES

Sooth My Academic Teaching and Classroom Withdrawal Pangs!
“MY TEACHING PHILOSOPHY”

cropped-dem

I’m screening for my next university Dean, Chair or teaching Professorship opportunity.

Currently, an endowed Resident-Scholar completing a text book production assignment complete with aligned case models, tests, quizzes, rubrics, curriculum teaching portfolio, and accreditation review.

Two-decades of domestic and international teaching experience and credentials in health economics, finance, investing, business, policy, risk management, IT and administration. Hundreds of peer-reviewed and trade publications [TNTC] with 30 major textbooks redacted in more than a thousand university libraries [NIH, Library Congress and National Institute Health, etc]. Public and population health global speaker and thought leader. Wall Street experience as start-up founder, entrepreneur and CXO.

Ideal mentor for under graduate thru post-doctoral and fellowship students [PhD, DBA, MD/DO, MHA and MBA, etc].

Compensation important, but fit is paramount as servant-leader.
[+] RANKED: Google Scholar and “H” Index
CV available upon request.

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Dr. Marcinko Teaching Philosophy Continue reading

PODCAST: Ascension Non-Profit Hospital System

THE LARGEST IN THE USA

BY DR. ERIC BRICKER MD

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Bundle Charitable Giving Through Donor Advised Funds

Bundle Charitable Giving Through Donor Advised Funds

By Rick Kahler CFP®

With changes to standard and itemized deductions under the new tax law, many CPA’s and tax attorneys are recommending a strategy of bunching or bundling deductible spending into alternate years. I wrote about this approach a few weeks ago.

One way to bundle charitable deductions efficiently and effortlessly is through a Donor Advised Fund (DAF).

Here’s how it works

Suppose you budget $15,000 a year for charitable donations. Around half of this goes to local charities you support regularly. The rest you give in different ways, depending on the needs you become aware of throughout the year.

You could double your denotations to charities you support regularly and give directly to them every other year, but you would lessen your ability to give spontaneously. Giving through a DAF allows you to keep that spontaneity. A DAF allows you to make a large, tax-deductible gift in one year, but decide in the future (a day, ten years, or 100 years later) when and how to distribute that gift. The money stays with the DAF, which invests it, until you instruct the DAF to disburse the funds to the charity of your choice.

New tax laws

With the advent of the new tax law, DAFs have become all the rage in charitable giving. According to an article in Advisor Perspectives by Ken Nopar, the senior philanthropic advisor for the American Endowment Foundation, there are now 300,000 DAF accounts. This is twice the number eight years ago and nearly four times the number of private foundations. But all DAFs are not equal, so establishing one should be done only after some thorough investigation.

Some of the areas the article suggests that you explore with your financial planner or tax preparer are:

1. What is the appropriate amount to donate to a DAF account? Donate too much or too little, and you may not realize the maximum benefit from your gift. Be sure to check with your tax preparer.

2. With some DAF sponsors, it’s possible for your financial advisor to continue to manage your assets in well-diversified, low-cost investments. Otherwise, you may be forced to choose from a very limited number of funds with higher expenses—funds your advisor would be unlikely to recommend. Management by your advisor, in many cases, can produce greater returns, actually allowing you to donate more.

3. Investigate these things before choosing a DAF: The fees they charge, whether they appear to have enough staff and experience to administer the DAF properly, how promptly they send out grants, whether they can accept complex assets like appreciated real estate, and whether you could transfer the fund to another DAF sponsor if you should want to do so.

4. Also ask about limitations and requirements. Some DAFs may limit how much you can give each year to individual charities. Others require a certain percentage (sometimes 50% or more) to be donated to the DAF sponsor itself. A DAF’s rules may require the entire balance to be distributed to the DAF sponsor upon a donor’s death.

As Advisor Perspectives notes, many CPAs and attorneys are providing wise advice in recommending that clients establish DAF accounts. It would be a good idea to take that advice one step further and consult your financial advisor first. Otherwise you might end up with a DAF sponsor that may not be the best fit for your needs or those of the charities you support.

Assessment

As good as bundling donations to a DAF can be, don’t make a decision to use one based on the tax advantages alone. Just as with any investment, it’s important to do your research carefully before you write a check.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to 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.

Book Marcinko: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.

DOCTORS:

“Insurance & Risk Management Strategies for Doctors” https://tinyurl.com/ydx9kd93

“Fiduciary Financial Planning for Physicians” https://tinyurl.com/y7f5pnox

“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8

HOSPITALS:

“Financial Management Strategies for Hospitals” https://tinyurl.com/yagu567d

“Operational Strategies for Clinics and Hospitals” https://tinyurl.com/y9avbrq5

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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National Philanthropy Day 2021

CELEBRATE AND GIVE TODAY?

By Staff Reporters

National Philanthropy Day is an observance designated by the Association of Fundraising Professionals.

Image result for national philanthropy day

It is a day to celebrate charitable activities, in the form of donated financial, in-kind and volunteering support. It is celebrated with blog postings by AFP highlighting outstanding charitable activities, as well as luncheons and awards throughout the USA by different AFP chapters.

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YOUR COMMENTS ARE APPRECIATED.

Thank You

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PODCAST: Microsoft Buys Nuance; IPOs

By THCB

Today on Health in 2 Point 00, Jess DaMassa claims to be blameless for the drama between Jonathan Bush and Glen Tullman. On Episode 198, we talk about Microsoft buying Nuance for $16 billion and $3 billion in debt – is Microsoft taking over healthcare, and is this going to slow Nuance down?

IPOs

Cohere Health raises $36 million in a Series B, working on improving prior authorizations between health plans and providers. We wrap up with a lightning round of IPO rumors regarding Privia Health, VillageMD, and Bright Health.

MORE: https://thehealthcareblog.com/blog/2021/04/13/healthin2point00-episode-198-microsoft-buys-nuance-lots-of-ipo-rumors/

Your thoughts are appreciated.

THANK YOU

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3 FINANCIAL SLANG “T” Terms

DEFINITIONS Physician-Investors Need to Know

By. Dr. David E. Marcinko MBA CMP®

CMP logo


SPONSOR: http://www.CertifiedMedicalPlanner.org

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Trading AheadUnethical and illegal trading by specialists or market makers.
A specialist may buy a stock for themselves from Dr. John Q. Public even though a better price is available from another seller. The specialist can view bid and ask prices and then manually mis-match them, or see ahead to a less favorable price. It happens in this editor’s experience, by observing how long it takes for a stop order to execute after the stop price was reached.
This practice is a form of shimming.
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Trading ImbalanceA situation where a large block of stock is put up for sale, but not enough buyers are available for purchase, and a market maker is unable to buy the imbalance. Lightly traded and tightly held stocks are considered temporarily illiquid during such imbalances.
On occasion, a trading halt is put into place until enough buyers are available to purchase the deficit. On rare occasion, a handful of buyers can buy the stock at a huge discount if the stock was not halted during the imbalance.
On the New York Stock Exchange, large stocks usually have a “delayed open” for such imbalances, as a trading specialist will fill the order by lining up buyers for the block, and then open trading for the stock for the day.
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Triple Witching HourThe final hour of trading on a Friday when stock index futures, stock index options, and stock options all expire. This happens on the third Friday in March, June, September, and December. See Quadruple Witching Hour.
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CITE: https://www.r2library.com/Resource/Title/0826102549

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