PODCAST: What is a “Potemkin” Village?

“Fake It – Till You Make It”

Courtesy: www.CertifiedMedicalPlanner.org

By Dr. David E. Marcinko MBA

Originally, a Potemkin Village was any construction whose sole purpose was to provide an external façade making people believe a failing country was prosperous.

DEFINITION: https://en.wikipedia.org/wiki/Potemkin_village

The term comes from a fake portable village built to impress Empress Catherine II by her lover Grigory Potemkin, during her journey to Crimea, in 1787.

PODCAST: https://www.bing.com/videos/search?q=potemkin+village&qpvt=potemkin+village&view=detail&mid=D6C49B8CE683A2E7053ED6C49B8CE683A2E7053E&&FORM=VRDGAR&ru=%2Fvideos%2Fsearch%3Fq%3Dpotemkin%2Bvillage%26qpvt%3DPotemkin%2BVillage%26FORM%3DVDRE

The term “Potemkin” has spawned other linguistic machinations, as well:

P-NUMBERS: Are made up and appear to be valid and legitimate but are not based in reality.

P-POLITICS: Candidates who say have a certain amount of donated money but have actually received less.

LINK: https://www.amazon.com/Dictionary-Health-Economics-Finance-Marcinko/dp/0826102549/ref=sr_1_6?ie=UTF8&s=books&qid=1254413315&sr=1-6

P-HOSPITALS: Impressive, but actually sham facades, in Wuhan, China?

P-NETWORKS: Erroneous quantitative data point like “counts”, “likes” or “winks” for posts on social media forums or e-boards; etc.

LINK: https://thefuturebuzz.com/2012/06/12/social-proofiness-spotting-digital-potemkin-numbers/

Conclusion: Do you know of any other word derivations? Please opine.


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PODCAST: How Doctors are Really Paid in Fall 2022?

Learn the Incentives in Physician Compensation


RAND and Harvard University Researchers Recently Published a Study in the Journal of the American Medical Association Examining How Doctors are Paid by Hospital System-Owned Practices. The Study Found that only 9% of Primary Care Physician Compensation was Based on Value (Quality and Cost-Effectiveness) and only 5.3% of Specialist Compensation was Based on Value.

The Study Concluded: “The results of this cross-sectional study suggest that PCPs and specialists despite receiving value-based reimbursement incentives from payers, the compensation of health system PCPs and specialists was dominated by volume-based incentives designed to maximize health systems revenue.”



MORE: https://medicalexecutivepost.com/2020/09/19/what-doctors-must-do-to-file-an-aetna-claim-to-get-paid/?preview_id=237387&preview_nonce=44f9028974&preview=true

RELATED: https://medicalexecutivepost.com/2008/09/12/how-doctors-get-paid/


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


HOSPITALS: https://www.amazon.com/Financial-Management-Strategies-Healthcare-Organizations/dp/1466558733/ref=sr_1_3?ie=UTF8&qid=1380743521&sr=8-3&keywords=david+marcinko



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SCHWAB: Introduces Personalized Indexing

By Staff Reporters



‘Customized portfolio and tax management for a broader spectrum of investors’

The Charles Schwab Corporation (SCHW) announced, on March 31, 2022, the upcoming launch of a new service, Schwab Personalized Indexing. Schwab touts this as a new solution that brings the power of customized portfolio and tax management to a broader spectrum of investors.

Rick Wurster, president of The Charles Schwab Corporation, stated in a press release: “Direct indexing has long been available to ultra-high net worth investors and institutions able to meet very high investment minimums. But now, thanks to technology innovations and industry developments like Schwab’s introduction of online commission-free trading, we’re able to lower the barriers to direct indexing for more investors and the advisors who serve them.” Schwab expects the new service, which is trademarked, to be available by the end of April 2022.

Key Takeaways

  • Charles Schwab (SCHW) is introducing Schwab Personalized Indexing, a direct indexing service for accounts as small as $100,000.
  • Direct indexing involves holding the individual securities in an index, allowing for greater tax management.
  • The service is expected to be available by the end of April 2022, and Schwab expects to add options and features over the next 12-18 months.

Key Features

Unlike an index fund, direct indexing involves direct ownership of the underlying securities in an index. Thus, it may offer a greater level of tax management for the investor. Within separately managed accounts, Schwab Personalized Indexing is based on a proprietary optimization process that includes daily monitoring of client portfolios and tax-loss harvesting technology. Each client account is to be optimized based on its current holdings and the potential capital gains taxes due on unrealized gains.

Available Strategies

Investors initially can choose among three index-based strategies that can be customized. These are a U.S. large cap strategy based on the Schwab 1000 Index, a U.S. small cap strategy based on the S&P SmallCap 600 Index, and an environmental, social, and governance (ESG) strategy based on the MSCI KLD 400 Social Index. Each strategy seeks index-like returns with enhanced after-tax benefits. Schwab expects to add more strategies and features during the next 12-18 months.

Account Minimums and Fees

Schwab Personalized Indexing initially will require an account minimum of $100,000. Schwab notes that most direct indexing offerings currently on the market start at $250,000 or higher.1

Fees start at 0.40% of assets. Schwab indicates that this is less expensive than many direct indexing programs currently available to advisors and investors.

CITE: https://pressroom.aboutschwab.com/press-releases/press-release/2022/Schwab-Introduces-Schwab-Personalized-Indexing/default.aspx



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ORDER: https://www.routledge.com/Comprehensive-Financial-Planning-Strategies-for-Doctors-and-Advisors-Best/Marcinko-Hetico/p/book/9781482240283


Why Physicians DO NOT Get Rich?


“Physicians have a significantly low propensity to accumulate substantial wealth.”

Thomas Stanley – Author “The Millionaire Next Door”

[New York Times]

How come doctors fail to get rich? Re-read the above!

By Dr. David Edward Marcinko MBA CMP®

CMP logo

SPONSOR: http://www.CertifiedMedicalPlanner.org

The Institute of Medical Business Advisors Inc identified several reasons based on observations working with medical professional and physician clients over the years.

A late start

By the time doctors finish medical school and residency they’re typically in their middle or late thirties. Many have families to feed, and substantial student loans to pay off. It will be years before they can even start accumulating wealth. Consider that physicians typically enter careers at later ages, often with larger debts from training. Some specialties may not lead a case until 10 years of practice, and many specialties have limited longevity. Peak earning years may also be shorter for health care providers than other professionals. Financial survival skills are paramount for converting the limited earnings time period to personal financial security.

Challenging socio-political environment

It is increasingly challenging to practice medicine. With the Medicare Trust Fund slated to go bust in 2019, the Center for Medicare and Medicare Service (CMS) is increasingly resorting to cutting physician reimbursements and implementing capitation and bundled value based medical payments models. The medical reimbursement effects of the PP-ACA are not yet fully discerned; but appear to continue the decline in compensation. And to illustrate this potential governmental control, in what other industry can participants debate the simple question, “who is the customer?”

Lifestyle expectations

Society expects a doctor to live like a doctor, dress like a doctor, and drive like a doctor. Meeting social expectations can be quite expensive.

Time and energy

A doctor can’t be just a doctor any more. S/he also has to deal with ever increasing regulatory mandates, paperwork requirements by state and federal agencies and capricious insurance companies. It is estimated that for every hour spent on patient care, and additional half-hour is spent on paperwork. To-date, the use of electronic medical records has exacerbated; not ameliorated this problem. The demand on their time is mind-boggling. A typical doctor works a ten- to twelve-hour day. After work and family, they simply don’t have time and energy left to do comprehensive financial planning.

Financially naïve

Doctors are smart. They’re highly trained in their area of expertise. But, that doesn’t translate into understanding about finance or economics. Because they are smart, it’s easy for them to think they can easily master and execute concepts of personal financial planning, as well. Often, they don’t.

Lack of trust and delegation

Many doctors don’t trust financial advisors working for major Wall Street banks. They have the good instinct to realize that their interests are not aligned. Not knowing there are independent advisors out there who observe a strict fiduciary standard, they tend to do everything by themselves.

In fact, Paul Larson CFP®, President-CEO of the firm LARSON Financial Group LLC, noted a disquieting trend among physician client in his firm [personal communication]. Almost 90% of them fail to take care of their own family finances in a comprehensive manner; while only 10% are succeeding.  The strategies in this chapter and book are common to their success.

Too Trusting

Another aspect of naivety, many physicians do not realize that the financial advisory industry lacks the same discipline and regulation that the average physician operates in. A primary care doctor would never even attempt a complicated surgery on a patient, but is trained to refer such patients to a specialist in the field with the proper training and experience. Financial Advisors often come from a sales background and are trained to keep a client in house even if the advisor is lacking in expertise. Also, many physicians are not trained to discern a qualified financial advisor from a sales person dressed up like a financial advisor. It is illegal to call yourself a physician in the United States unless you have the credentials to back it up; yet, anyone in the US can legally call themselves a financial advisor or a financial planner.

Your thoughts are appreciated.

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

SECOND OPINIONS: https://medicalexecutivepost.com/schedule-a-consultation/

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PODCAST: Medical Billing Charge Abuse by Radiologists

By Staff Reporters



ORDER: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4



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