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Posted on January 31, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Health Capital Consultants, LLC
In the first days of his second (nonconsecutive) presidential term, Donald Trump and his administration took a number of actions that will affect the healthcare industry in the near- and long-term. Further, the Trump Administration is reportedly poised to take a number of additional actions to pause, end, or otherwise change Biden-era initiatives.
Meanwhile, President Trump’s cabinet pick for the Department of Health & Human Services (HHS) hangs in the balance. This Health Capital Topics article reviews the new administration’s actions impacting the healthcare industry as of the date of publication. (Read more...)
Posted on January 31, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
US stocks gained steam on Thursday afternoon as investors digested megacap tech earnings and waited for Apple (AAPL) results for more clues on prospects for Big Tech. The S&P 500 (^GSPC) gained 0.5%, while the Dow Jones Industrial Average (^DJI) rose nearly 0.4%. The tech-heavy NASDAQ Composite (^IXIC) was up nearly 0.3%.
And, after the Federal Reserve stood pat on interest rates as expected, investors have turned to parsing earnings reports — and in particular, the first wave of results from the “Magnificent Seven” companies that have driven broader stock market gains.
Over the last few years, our portfolio has skewed more international, and this is the topic I want to address today. The US is a wonderful country and has many significant competitive advantages over the rest of the world. Despite all of its flaws, it has the most stable political system. It has great geography: It’s bordered by friendly neighbors to the north and south, and by mostly friendly oceans to the east and west. It has an abundance of natural resources. It is one of the largest democracies and has the right amount of capitalism (though we’ve been slipping in this department). We have the best capital markets, and the US is the best place in the world to start a new business, take risks and innovate. These factors led to the coronation of the US dollar as the world’s reserve currency.Ideally, in a perfect world, we’d want to have a portfolio of only US companies. Not because we are patriots, but because our life at IMA would be so much easier. Let me explain all the extra headaches we incur when we own foreign stocks. European markets open 7–8 hours earlier than ours; Japan is 16 hours ahead.
Thus, we have to place orders early in the morning, sometimes in the middle of the night. Our trading system, which links directly to US exchanges, allows us to buy or sell any US stock electronically, directly through our software. It is not linked to foreign exchanges, thus foreign trading comes with significantly more friction and consumes more time. Foreign stocks have multiple tickers, which constantly confuse our clients – this means we receive more inbound inquiries on them. US trading comes with zero commissions, allowing us to accumulate a position slowly, in tiny increments, with little effort. Brokers charge commissions on foreign stocks, so we have to be sensitive to how we are accumulating or disposing of a stock. I am sure I am missing half a dozen other headaches.
Yes, foreign stocks are a big headache for the IMA team. We are not a masochistic bunch, so let me explain why we go through this brain and time damage.Over the last decade the US has attracted the bulk of the capital flows, and the US stock market is trading at one of the highest valuations in US history. Historically, returns that followed such sky-high valuations have been mediocre at best. I wrote two books on this subject. How much you pay for a business, even if it is a great one, is important, as it is one of the key inputs determining your future returns. When we look for stocks, our searches are global. We look at the US and at foreign markets that have the rule of law. But our goal is to buy the stock that offers the highest risk-adjusted returns. For us to buy a foreign stock, it has to compensate us for the extra time and trouble involved – in other words it has to be a super-attractive investment.
Let me give you a few examples.
When we looked at defense companies, we examined all of them, in the US and internationally. We bought a few in the US but found that European defense companies were a more compelling proposition. First of all, Europe has been sipping Chianti, Bordeaux, Riesling, and Earl Grey for the last thirty years while collecting peace dividends and significantly underinvesting in defense. The US, to a large degree, became NATO.We have more enemies today than at any time in my lifetime, and they are stronger (China has a bigger manufacturing base than the US) and aligning with each other. There is an unthinkable war in Europe, where one country attacked another to steal its territory. China is contemplating invading Taiwan – a tiny island that produces the bulk of the world’s semiconductors. The Middle East is on fire. Rebels most of us didn’t even know existed are making the Red Sea unnavigable.
And from the European perspective, the US is becoming a fickle friend. Europe is racing to create a $500 billion defense fund, per the FT:Trump’s threat to withdraw US security guarantees from underspending Nato allies has spurred European capitals to explore more radical defense funding options, including joint borrowing that has traditionally been ruled out by fiscal hawks in Germany, the Netherlands and Denmark.
European defense spending is going up and will continue to go up, no matter who is in power and regardless of deficits. Thus, when we looked at defense companies, American counterparts were more expensive and had relatively shorter (though increasing) growth runways. We bought European defense stocks, and so far, it looks like we made the right bet.
On the surface, one of the main risks of buying foreign stocks is that we are making a bet against the US dollar. As you’ll see, this is a bit more nuanced than simply where stocks are listed.I don’t know where the dollar will be over the next five or ten years. Nobody does. Currencies are priced relative to one another. Thus, to forecast the US dollar versus the euro, I’d need two crystal balls – one for the US and another for the EU. I don’t have even one.There are a lot of policies the new administration wants to implement that may cause the dollar to appreciate. For instance, less regulation – if Musk succeeds – would be a huge positive for US economic growth. We need a lot more pragmatism in Washington, DC, something we’ve lost over the years.
But then, the US government embracing Bitcoin is probably one of the most idiotic policy ideas I’ve ever seen come from a politician (though there are contenders). It’s especially baffling when you consider that the only reason we’re not dealing with 20% mortgage rates and 30% car loans – despite our $36 trillion (and growing) debt – is that the US dollar remains the world’s reserve currency. The US dollar doesn’t have good contenders, and this is why the US government watering the seeds of one makes little sense to me. (I wrote about the problems with Bitcoin here).
Also, often foreign stocks are only foreign in name. This is where things get nuanced fast. Philip Morris International (PM) is listed on the NYSE but today gets most of its sales from outside the US. British American Tobacco (BTI), listed in London and also trading as an ADR (American depositary receipt) in the US – despite having “British” in its name – gets half of its sales from the US and half from the rest of the world. We own Swedish and Canadian oil companies. When it comes to oil companies, the location of their assets matter far more than where the companies themselves are listed. Most of the oil assets that these companies hold are in Canada. We chose these companies not only because they’re significantly undervalued and have strong balance sheets, but also because they’re led by exceptional management teams who excel at running the business and at capital allocation – an uncommon trait in the commodity space.
Also, oil is a global commodity, and while many factors affect its price, it’s also indirectly a bet on a weakening US dollar, since oil is priced in US dollars. We have to take this into account when constructing our portfolio.Then we have a UK company that makes components for the aerospace industry.
However, aerospace is a global industry, and over the longer term, the company’s stock performance will be tied entirely to what the aerospace industry as a whole is doing. Its performance will be indifferent to where it’s listed. We bought it at a fraction of the valuation of its American counterparts.We pay close attention to our concentration in a particular country, as well as to our exposure to specific currencies and industries. But as you can see, it’s a lot more nuanced and intricate than simply looking at where a company is traded. Our default choice it to buy American companies; but at the end of the day, our goal is to grow your wealth while keeping the volatility of your blood pressure low, so that you don’t have to worry about the markets. Today the average US stock is trading at a nosebleed valuation. High-quality, undervalued, well-managed foreign-listed stocks are where we’re finding opportunities to hopefully achieve this goal, even if it means more headaches for the IMA team. One more thought: In the late 1990s, value investors experienced both paradise and hell. As tech and dotcom stocks soared higher, there were many cheap stocks to choose from that were neglected by the inflating bubble. That was the paradise part – an abundance of undervalued companies to pick from while the crowd stampeded into the bubble. The hell, of course, was the pain of being left behind while the crowd uncorked champagne.Today, if you only invest in the US, you’re experiencing two hells. Your stocks are underperforming, and even inexpensive stocks are expensive.
Yes, welcome to double hell. European stocks, however, offer paradise today. True, Europe is not the place it used to be a few decades ago – which is precisely why nuance and stock picking are so important. Value stocks always look less exciting than the ones everyone is talking about.
I’d love to hear your thoughts, so please leave your comment and feedback here. Also, if you missed my previous article “Embracing Stock Market Stoicism”, you can read it and leave a comment here.
Posted on January 30, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Over half the US population was affected by the Change Healthcare cyberattack last February, according to a statement from its parent company UnitedHealth Group. While United had told the federal government in October that 100 million people were hit by the attacks, an updated estimate on Monday put that number at 190 million.
The tech-heavy NASDAQ Composite (^IXIC) was down about 0.5%, retracing some of a bounce-back rally on Tuesday. The S&P 500 (^GSPC) was also down nearly 0.5%, while the Dow Jones Industrial Average (^DJI) lost 0.3%. In its statement on Wednesday, the Federal Reserve notably removed language from its December statement indicating that it was making progress towards its goal of 2% inflation, stating simply: “Inflation remains somewhat elevated.” Fed Chair Jerome Powell pushed back on that notion, referring to the change as “language cleanup” rather than intending to send a signal. Markets bounced off their lows of the day on Powell’s comments.
I’ve received emails from readers asking my thoughts on DeepSeek. I need to start with two warnings. First, the usual one: I’m a generalist value investor, not a technology specialist (last week I was analyzing a bank and an oil company), so my knowledge of AI models is superficial. Second, and more unusually, we don’t have all the facts yet.
But this story could represent a major step change in both AI and geopolitics. Here’s what we know: DeepSeek—a year-old startup in China that spun out of a hedge fund—has built a fully functioning large language model (LLM) that performs on par with the latest AI models. This part of the story has been verified by the industry: DeepSeek has been tested and compared to other top LLMs. I’ve personally been playing with DeepSeek over the last few days, and the results it spit out were very similar to those produced by ChatGPT and Perplexity—only faster.
This alone is impressive, especially considering that just six months ago, Eric Schmidt (former Google CEO, and certainly no generalist) suggested China was two to three years behind the U.S. in AI. But here’s the truly shocking—and unverified—part: DeepSeek claims they trained their model for only $5.6 million, while U.S. counterparts have reportedly spent hundreds of millions or even billions of dollars. That’s 20 to 200 times less.
The implications, if true, are stunning. Despite the U.S. government’s export controls on AI chips to China, DeepSeek allegedly trained its LLM on older-generation chips, using a small fraction of the computing power and electricity that its Western competitors have. While everyone assumed that AI’s future lay in faster, better chips—where the only real choice is Nvidia or Nvidia—this previously unknown company has achieved near parity with its American counterparts swimming in cash and datacenters full of the latest Nvidia chips. DeepSeek (allegedly) had huge compute constraints and thus had to use different logic, becoming more efficient with subpar hardware to achieve a similar result. In other words, this scrappy startup, in its quest to create a better AI “brain,” used brains where everyone else was focusing on brawn—it literally taught AI how to reason.
Enter the Hot Dog Contest
Americans love (junk) food and sports, so let me explain with a food-sport analogy. Nathan’s Famous International Hot Dog Eating Contest claims 1916 as its origin (though this might be partly legend). By the 1970s, when official records began, winning competitors averaged around 15 hot dogs. That gradually increased to about 25—until Takeru Kobayashi arrived from Japan in 2001 and shattered the paradigm by consuming 50 hot dogs, something widely deemed impossible. His secret wasn’t a prodigious appetite but rather his unique methodology; He separated hot dogs from buns and dunked the buns in water, completely reimagining the approach.
Then a few years later came Joey Chestnut, who built on Kobayashi’s innovation to push the record well beyond 70 hot dogs and up to 83. Once Kobayashi broke the paradigm, the perceived limits vanished, forcing everyone to rethink their methods. Joey Chestnut capitalized on it.
DeepSeek may be the Kobayashi of AI, propelling the whole industry into a “Joey Chestnut” era of innovation. If the claims about using older chips and spending drastically less are accurate, we might see AI companies pivot away from single-mindedly chasing bigger compute capacity and toward improved model design.
I never thought I’d be quoting Stoics to explain future GPU chip demand, but Epictetus said, “Happiness comes not from wanting more, but from wanting what you have.” Two millennia ago, he was certainly not talking about GPUs, but he may as well have been. ChatGPT, Perplexity, and Google’s Gemini will have to rethink their hunger for more compute and see if they can achieve more with wanting (using) what they have.
If they don’t, they’ll be eaten by hundreds of new startups, corporations, and likely governments entering the space. When you start spelling billions with an “M,” you dramatically lower the barriers to entry.
Until DeepSeek, AI was supposed to be in reach for only a few extremely well-funded companies, (the “Magnificent Ones”) armed with the latest Nvidia chips. DeepSeek may have broken that paradigm too.
The Nvidia Conundrum
The impact on Nvidia is unclear. On one hand, DeepSeek’s success could decrease demand for its chips and bring its margins back to earth, as companies realize that a brighter AI future might lie not in simply connecting more Nvidia processors but in making models run more efficiently. DeepSeek may have reduced the urgency to build more data centers and thus cut demand for Nvidia chips.
On the other hand (I’m being a two-armed economist here), lower barriers to entry will lead to more entrants and higher overall demand for GPUs. Also, DeepSeek claims that because its model is more efficient, the cost of inference (running the model) is a fraction of the cost of running ChatGPT and requires a lot less memory—potentially accelerating AI adoption and thus driving more demand for GPUs. So this could be good news for Nvidia, depending on how it shakes out.
My thinking on Nvidia hasn’t materially changed—it’s only a matter of time before Meta, Google, Tesla, Microsoft, and a slew of startups commoditize GPUs and drive down prices.
Likewise, more competition means LLMs themselves are likely to become commoditized—that’s what competition does—and ChatGPT’s valuation could be an obvious casualty.
Geopolitical Shockwaves
The geopolitical consequences are enormous. Export controls may have inadvertently spurred fresh innovation, and they might not be as effective going forward. The U.S. might not have the control of AI that many believed it did, and countries that don’t like us very much will have their own AI.
We’ve long comforted ourselves, after offshoring manufacturing to China, by saying that we’re the cradle of innovation—but AI could tip the scales in a direction that doesn’t favor us. Let me give you an example. In a recent
interview with the Wall Street Journal, OpenAI’s product chief revealed that various versions of ChatGPT were entered into programming competitions anonymously. Out of roughly 28 million programmers worldwide, these early models ranked in the top 2–3%. ChatGPT-o1 (the latest public release) placed among the top 1,000, and ChatGPT-o3 (due out in a few months) is in the top 175. That’s the top 0.000625%! If it were a composer, ChatGPT-o3 would be Mozart.
I’ve heard that a great developer is 10x more valuable than a good one—maybe even 100x more valuable than an average one. I’m aiming to be roughly right here. A 19-year-old in Bangalore or Iowa who discovered programming a few months ago can now code like Mozart using the latest ChatGPT. Imagine every young kid, after a few YouTube videos, coding at this level. The knowledge and experience gap is being flattened fast.
I am quite aware that I am drastically generalizing (I cannot stress this enough), and but the point stands: The journey from learning to code to becoming the “Mozart of programming” has shrunk from decades to months, and the pool of Mozarts has grown exponentially. If I owned software companies, I’d become a bit more nervous—the moat for many of them has been filled with AI.
Adapting, changing your mind, and holding ideas as theses to be validated or invalidated—not as part of your identity—are incredibly important in investing (and in life in general). They become even more crucial in an age of AI, as we find ourselves stepping into a sci-fi reality faster than we ever imagined. DeepSeek may be that catalyst, forcing investors and technologists alike to question long-held assumptions and reevaluate the competitive landscape in real time.
I’d love to hear your thoughts, so please leave your comment and feedback here. Also, if you missed my previous article “Escaping Stock Market Double Hell”, you can read it and leave a comment here.
Posted on January 29, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Bellwether Nvidia (NVDA) finished the day up nearly 9% after it shaved off a record $589 billion from its market cap on Monday.
Aided by Nvidia’s gains, the tech-heavy NASDAQ Composite (^IXIC) surged over 2%, coming off a closing loss of more than 3%. The S&P 500 (^GSPC) rose around 0.9%, while the Dow Jones Industrial Average (^DJI) gained roughly 0.3%.
Posted on January 28, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Capital is not flowing from developed countries to developing countries despite the fact that developing countries have lower levels of capital per worker, and therefore higher returns to capital.
Classical economic theory predicts that capital should flow from rich countries to poor countries, due to the effect of diminishing returns of capital. Poor countries have lower levels of capital per worker – which explains, in part, why they are poor. In poor countries, the scarcity of capital relative to labor should mean that the returns related to the infusion of capital are higher than in developed countries.
In response, savers in rich countries should look at poor countries as profitable places in which to invest. In reality, things do not seem to work that way. Surprisingly little capital flows from rich countries to poor countries.
This puzzle, famously discussed in a paper by Robert Lucas in 1990, is often referred to as the “Lucas Paradox”.
Posted on January 28, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Federal health agencies are canceled—well, their meetings are at least. In the days following his inauguration, President Donald Trump’s administration asked officials within the Department of Health and Human Services (HHS)—which has a $1.7 trillion budget and includes the FDA, the CDC, and the National Institutes of Health (NIH)—to stop all external communication, according to an internal memo. This means no new health advisories, social media posts, or website posts.
“As the new administration considers its plan for managing the federal policy and public communications processes, it is important that the president’s appointees and designees have the opportunity to review and approve any regulations, guidance documents, and other public documents and communications (including social media),” the memo read. The pause began on Jan. 21st, and according to the memo, will remain in effect until Feb. 1st
The FTC’s second interim staff report on consolidated pharmacy benefit managers (PBMs) found that the three largest of these middlemen—CVS Health’s Caremark Rx, Cigna Group’s Express Scripts, and UnitedHealth Group’s OptumRx—”marked up two specialty generic cancer drugs by thousands of percent and then paid their affiliated pharmacies hundreds of millions of dollars of dispensing revenue in excess of estimated acquisition costs for each drug annually.”
The NASDAQ tanked on Monday as a Chinese startup rattled faith in US leadership and profitability in AI, taking a hammer to Nvidia (NVDA), wiping out a record $589 billion in market value. The NASDAQ Composite (^IXIC) sank more than 3%, while the S&P 500 (^GSPC) dropped nearly 1.5%. The blue-chip Dow Jones Industrial Average (^DJI), which is less dependent tech stocks gained more than 0.6% as investors flocked to defensive sectors. Shares of Apple (AAPL) and software giant Salesforce (CRM) also bucked the tech rout.
Posted on January 27, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
DEFINITIONS
By Staff Reporters
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Registered Nurse [RN]
RNs must complete an accredited Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) program (or, in rare cases, diploma programs). After that, they become eligible to sit the NCLEX-RN exam and apply for registered nurse licensure in their state.
As a registered nurse, duties include basic patient care but expand to more technical responsibilities like medication administration, performing diagnostic tests, and operating medical equipment. Depending on the role, one may also supervise other healthcare workers like LPNs, certified nursing assistants (CNAs), or even other RNs.
Licensed Practical Nurses [LPN]
LPNs may also be called licensed vocational nurses (LVNs), and like registered nurses, LPNs must also complete an education program before becoming eligible for licensure. LPN programs typically take around one year, and you can find them at community colleges or vocational schools.
Prospective LPNs must then take and pass the NCLEX-PN exam to become licensed. As an LPN, focus is on patient care tasks like monitoring vitals and changing bandages as part of a care team supervised by a physician or RN.
Posted on January 27, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
The S&P 500 (^GSPC) just capped its best first four trading days under a new president since Ronald Reagan’s first week in 1985. And, the week ahead will bring investors a deluge of news that will put that rally to the test.
Earnings from more than 100 members of the S&P 500 — highlighted by results from tech heavyweights Meta (META), Microsoft (MSFT), Apple (AAPL), and Tesla (TSLA) — are set for release, with Wednesday serving as the week’s busiest. Starbucks (SBUX), Exxon (XOM), and Chevron (CVX) are also set to report.
On this coming ednesday afternoon, the Federal Reserve will also announce its latest monetary policy decision, with the central bank expected to keep interest rates unchanged and investors focused on what Fed Chairman Jay Powell has to say about the balance of 2025.
Last week, the S&P 500, NASDAQ Composite (^IXIC), and Dow Jones Industrial Average (^DJI) each rallied during a holiday-shortened four day trading week. Over the last five days, the S&P 500 and Dow have gained more than 2.8%; the tech index is leading gains over that period, rising more than 3.1%.
The FTC’s second interim staff report on consolidated pharmacy benefit managers (PBMs) found that the three largest of these middlemen—CVS Health’s Caremark Rx, Cigna Group’s Express Scripts, and UnitedHealth Group’s OptumRx—”marked up two specialty generic cancer drugs by thousands of percent and then paid their affiliated pharmacies hundreds of millions of dollars of dispensing revenue in excess of estimated acquisition costs for each drug annually.”
People have been concerned about the future of Medicare for years. Now that Donald Trump has begun his second term in office, the question becomes: What will happen next?
According to the JAMA Network and ABC News, here are some predictions for what may come:
There will be greater price transparency: During his first term, Trump worked to make prices more transparent to both individuals and health care organizations. This may very well continue.
More emphasis on Medicare Advantage plans: Under Project 2025, it’s possible that Medicare Advantage plans will become the “default option for Medicare coverage.” This could lead to a privatization of the program.
Medicare’s future remains to be seen. For now, the best thing current and future retirees can do is keep an eye on their coverage options and costs.
Posted on January 26, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Cognitive Dissonance is the discomfort experienced when holding conflicting cognitions, like believing in healthy eating while munching on a doghnut. It’s a mental tug-of-war that makes us squirm.
To reduce this discomfort according to colleague Dan Ariely PhD, we often change our beliefs or behaviors to align them. This is why smokers might downplay the health risks of smoking. Understanding cognitive dissonance helps us recognize these mental gymnastics and strive for consistency in our beliefs and actions.
So, next time you feel that mental itch, it’s cognitive dissonance asking for some resolution.
Posted on January 25, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Ego-Protection refers to psychological strategies individuals use to defend their self-esteem and sense of self-worth against threats or failures. This can include attributing failures to external factors, minimizing the importance of negative feedback, or comparing oneself to others in ways that maintain a positive self-image.
According to colleague Dan Ariely PhD, ego-protective mechanisms help people cope with setbacks and maintain mental well-being, although they can sometimes prevent individuals from learning from mistakes or accepting constructive criticism.
Posted on January 24, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Nash equilibrium, in game theory, is an outcome in a noncooperative game for two or more players in which no player’s expected outcome can be improved by changing one’s own strategy.
The Nash equilibrium is a key concept in game theory, in which it defines the solution of N-player non-cooperative games. It is named for American mathematician John Nash, who was awarded the 1994 Nobel Prize for Economics for his contributions to game theory.
Posted on January 24, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
At the closing bell, the blue-chip Dow Jones Industrial Average was up 0.9% to 44,565.
And a late-day surge carried the NASDAQ Composite into positive territory in the aftermath of Wednesday’s prodigious AI-driven rally, the tech-heavy index rising 0.2% to 20,053.
Posted on January 23, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Fighting or arguing over text is also known as “fexting.”
While for some it might be more practical, it can harm relationships.
Misunderstandings and misinterpretations are more likely to happen over text.
Frequent arguments and disagreements between partners over text, also known as “fexting,” have become commonplace because of the convenience and ease of expressing your thoughts with text messages. We are all so used to communicating digitally in our daily lives that it can become an unconscious habit to express our feelings and frustrations via text message [SMS].
MBA is the common abbreviation for a Master of Business Administration degree, and recipients typically stop attending school after receiving it.
However, those who are interested in conducting business research may decide to pursue a doctorate in business or management. Such students can earn a Ph.D. or a Doctor of Business Administration degree, commonly known as a DBA.
What ‘MSHA’ Stands For?
Master of Health Administration (MHA) and Master of Science in Health Administration (MSHA) are largely equivalent designations for degree programs that focus primarily on leadership and management of hospitals, healthcare organizations, and businesses that operate in the healthcare sector.
In contrast, an MBA in Health Administration is a Master of Business Administration degree program with a concentration, track, or specialization that provides students with several courses in topics specific to healthcare management and administration. Most of the coursework in an MBA program is devoted to general training in business functions, such as accounting, finance, logistics, marketing, personnel and project management.
MHA and MHSA programs devote all or most of their curriculum to studying the healthcare system, healthcare policy, and the application of business principles in the field of healthcare. MBA in Healthcare Administration programs devote only a portion of their curricula to topics specific to the healthcare sector.
Dr. David Edward Marcinko works with doctors, nurses, technicians and healthcare professionals who struggle with professional disillusionment, burnout, financial distress and an unbalanced life–all of which can happen at any stage of a medical career. Through our coaching sessions, medical and healthcare professionals can achieve a more meaningful, purposeful, and flourishing life.
Posted on January 23, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Tech stocks led the market on Wednesday as Netflix (NFLX) stock surged to a record, while President Donald Trump’s boost to AI demand hopes outweighed fresh tariff worries.
The NASDAQ Composite (^IXIC) rose nearly 1.3%, bolstered by a jump in Netflix shares on the heels of surprisingly strong earnings. The S&P 500 (^GSPC) climbed more than 0.6% to close just shy of its record high of 6,090.
Posted on January 22, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Stocks ended firmly higher on Tuesday, with the S&P 500 rising 0.88% and reclaiming the 6,000 point mark amid a pullback in Treasury yields and optimism over Donald Trump’s focus on deregulation, focused tariff strategies and the prospect of solid corporate earnings into the fourth quarter reporting season.
Tech stocks are likely to pace early gains in the Wednesday session, however, following the unveiling of a new AI joint venture called ‘Stargate’ that will include an initial $100 billion investment from SoftBank, Oracle Corp. (ORCL) and OpenAI.
Executive Order 14009, titled “Strengthening Medicaid and the Affordable Care Act,” includes several key components designed to increase access to affordable health care and reduce the number of uninsured Americans:
Reversal of Trump administration policies: The order sought to undo measures that limited ACA provisions or made healthcare less accessible.
Longer enrollment periods: The order encouraged states to lengthen enrollment periods and provided additional federal support. As a result, many states extended their enrollment windows to ensure broader access to affordable healthcare.
Restoration of pre-existing condition protections: Reaffirmed protections for individuals with pre-existing conditions and reinforced nondiscrimination policies in healthcare.
Immediate review of agency actions: The order directed various executive departments and agencies to review existing regulations, orders, and policies to ensure they align with the goal of strengthening Medicaid and the ACA.
xecutive Order 14070, titled “Continuing To Strengthen Americans’ Access to Affordable, Quality Health Coverage,” aimed to maintain and enhance Medicaid and the ACA. Key components included:
Enhanced marketplace subsidies: The order highlights the positive impact of the American Rescue Plan Act on access to coverage, including enhanced marketplace subsidies.
Extended postpartum Medicaid coverage: It provides options for states to extend postpartum Medicaid coverage.
New incentives for Medicaid expansion: The order includes new incentives for states to expand their Medicaid programs.
While IAs and FAs may seem the same, they are not the same. The Financial Industry Regulatory Authority (FINRA) and the Securities Exchange Commission (SEC) have clearly defined investment advisors as distinct from financial advisors.
The term financial advisor is a generic one that can encompass many different financial professionals, although it most commonly refers to stock brokers (individuals or companies that buy and sell securities).
Investment advisor, on the other hand, is a legal term and thus has a more clear-cut definition – or at least as clear as legalese is apt to be.
KEY DIFFERENCES:
Financial advisors help with all aspects of your finances, including saving, budgeting, insurance, retirement planning, and taxes.
Investment advisors focus specifically on choosing and managing investment portfolios.
Financial advisors offer broader financial guidance, while investment advisors concentrate solely on investments.
Investment advisors are held to the fiduciary standard, while financial advisors who work as brokers may operate under different rules.
Posted on January 21, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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According to colleague Dan Ariely PhD,Pre-Procurement Ownership is when you start to feel ownership over something before you actually have it. It’s like mentally moving into a house or car before you’ve signed the papers and moved in or driven away
This psychological quirk makes us more likely to commit to purchases because we’ve already imagined them as ours. Marketers exploit this by encouraging us to “try before you buy.”
So, next time you’re trying on a new men’s suit or woman’s skirt, be aware: your brain might already be claiming ownership.
Posted on January 20, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
BREAKING NEWS
By Staff Reporters
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WASHINGTON: 8:15 am: The President Joe Biden administration just preemptively pardoned Anthony Fauci, MD.
“Our nation relies on dedicated, selfless public servants every day. They are the lifeblood of our democracy,” Biden said in a statement just hours before President-elect Donald Trump is sworn into office.
“The issuance of these pardons should not be mistaken as an acknowledgment that any individual engaged in any wrongdoing, nor should acceptance be misconstrued as an admission of guilt for any offense,” Biden said in a statement.
U.S. Markets will be closed for Martin Luther King Jr. Day this Monday
The U.S. Markets will be closed on Monday, January 20th, 2025. Please be aware that, when making transactions after 4 p.m. EST on Friday, January 17th, 2025, you will receive the closing price as of Tuesday, January 21st 2025.
Martin Luther King Jr. Day is observed in the United States on the third Monday of January. This year coincides with the inauguration of President-elect Donald Trump.
Banks and government offices
Martin Luther King Jr. Day is a federal holiday, which means banks will be closed and government services as well, such as city offices, animal services, administrative offices of the police department, and administrative offices of fire department.
The U.S. Postal Service will not operate on Monday, along with other shipping services.
Posted on January 19, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
BREAKING NEWS!
By Staff Reporters
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Sorry, TikTok isn’t available right now
A law banning TikTok has been enacted in the U.S. Unfortunately, that means you can’t use TikTok for now.
We are fortunate that President Trump has indicated that he will work with us on a solution to reinstate TikTok once he takes office. Please stay tuned!
In the meantime, you can still log in to download your data.
MBBS Degree [Bachelor of Medicine, Bachelor of Surgery]
The MBBS is usually a five-year undergraduate degree that medical students complete when they want to become doctors. However, some programs take six years to complete because the institution expects you to earn a Bachelor of Science (BSc) in your training.
By the time a student applies to a medical program, they have likely taken several foundational science courses as part of their high school (or secondary) education. For example, medical applicants in the United Kingdom are often expected to show high scores on their General Certificate of Secondary Education (GCSE) and A-levels.
Earning an MBBS means that students are certified to care for patients as junior physicians without specialized training. Graduates are expected to complete two years of additional training, which rotates them through different specialties. Once they identify a specialty they like, they can apply for additional training, which can take anywhere between three and eight years.
MD Degree [Doctor of Medicine]
The acronym “MD” stands for the Latin term “Medicinae Doctor,” which translates to “Doctor of Medicine” in English.
It refers to the title that students from the United States of America obtain after finishing medical school. Some countries consider the “MD” title a postgraduate doctoral degree that MBBS graduates can obtain with additional years of training.
Posted on January 19, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Vitaliy Katsenelson CFA
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Embracing Stock Market Stoicism
2024 brought me back to a core Stoic principle that I hold close to my heart: the dichotomy of control. Here’s the gist: Some things are within our power—our values, our character, our decisions—and some aren’t—like your brother-in-law’s random (and possibly dumb) comment, your spouse’s mood, or the fact that every traffic light turns red right as you pull up.
In investing, it’s the same. We can control:
The quality of our research—being logical and thorough in our research
Our decisions and discipline—systematically following our research
Our reactions—how we react to the news and external environmental pressure (I will discuss this at the end of the letter)
The market can price our stocks however it pleases on a month-to-month—or even year-to-year—basis. That’s the part we can’t control. We have to remember that these market prices are merely opinions, not final verdicts. The Stoics teach us to focus our energy on what we can influence (our process) and accept what we can’t (the market’s whims).
This probably sounds straightforward, but there’s a twist that makes it harder for you, the client, to see how this all plays out in real time. You can easily check the portfolio’s value—my decisions, not so much. In theory, I could make subpar investments and hide behind fancy Stoic talk.
That’s exactly the why of these very detailed letters: to show you our thinking, walk you through our individual decisions. I write, you read—that’s our agreement. You’re the judge of whether my process makes sense. But I can’t do that part for you.
The CPA and CMA designations cater to distinct professional focuses within the accounting and finance fields. A CPA is often seen as the gold standard for public accounting, emphasizing auditing, tax, and regulatory compliance. This certification is highly regarded for roles that require a deep understanding of financial reporting and external auditing. CPAs are frequently employed by public accounting firms, government agencies, and corporations that need to ensure their financial statements adhere to strict regulatory standards.
On the other hand, the CMA designation is tailored for professionals who aim to excel in management accounting and strategic financial management. CMAs are trained to analyze financial data to inform business decisions, focusing on internal processes and performance management. This makes the CMA particularly valuable for roles in corporate finance, strategic planning, and management consulting. Companies looking to optimize their internal financial operations and drive business strategy often seek out CMAs for their expertise in cost management, budgeting, and financial analysis.
The educational and experiential requirements for these certifications also differ. To become a CPA, candidates typically need to complete 150 semester hours of college education, which often includes a bachelor’s degree in accounting or a related field. Additionally, CPAs must pass the Uniform CPA Examination and meet specific state licensing requirements, which usually include a certain amount of professional experience.
In contrast, the CMA certification requires a bachelor’s degree in any discipline, two years of relevant work experience, and passing the two-part CMA exam. This flexibility in educational background can make the CMA more accessible to a broader range of professionals.
The ICE 3-Month USD LIBOR interest rate is the average interest rate at which a selection of banks in London are prepared to lend to one another in American dollars with a maturity of 3 months.
The Bank of America US High Yield Constrained Index is a market value-weighted index of all domestic high-yield bonds and Yankee high-yield bonds (issued by a foreign entity and denominated in U.S. dollars), including deferred interest bonds and payment-in-kind securities.
The ICE BofA BB-B US High Yield Constrained Index is composed of U.S. dollar-denominated corporate debt publicly issued in the U.S. market rated BB through B, based on an average of Moody’s, S&P and Fitch ratings, with issuer exposure capped at 2%.
ICE BofA U.S. Convertible Index tracks the performance of publicly issued, exchange-listed US dollar denominated convertible securities of US companies with at least $50 million face amount outstanding and at least one month remaining to the final conversion date. Index constituents are market capitalization-weighted and rebalanced monthly.
ICE BofA ML MOVE Index is a widely used measure of bond market volatility, similar to the VIX Index for stocks. The MOVE Index (also known as the Merrill Lynch Option Volatility Estimate) is a yield-curve-weighted index that tracks the market’s expectation of volatility in the U.S. bond market based on 1-month Treasury options.
ICE Exchange-Listed Preferred & Hybrid Securities Index tracks the performance of exchange-listed US dollar denominated hybrid debt, preferred stock and convertible preferred stock publicly issued by corporations in the US domestic market. Preferred stock and notes must have a minimum amount outstanding of $100 million; convertible preferred stock must have at least $50 million face amount outstanding. Index constituents are market capitalization-weighted subject to certain constraints. The index is re-balanced monthly.
Posted on January 18, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
WASHINGTON — The US Supreme Court on Friday delivered a blow to TikTok by upholding a law that could potentially lead to the video-sharing social media platform being banned in the United States. The justices in an unsigned opinion with no dissents rejected a free speech challenge filed by the company, meaning the law is set to go into effect on Sunday as planned. The bipartisan law requires China-based TikTok owner ByteDance to divest itself of the company by Sunday, the day before President-elect Donald Trump is to take office. If no sale takes place, the platform used by millions of Americans will in theory be banned.
Legendary short seller Nate Andersonannounced this week that he is shutting down his firm, Hindenburg Research, due to extreme job stress. With only 11 employees, Anderson took gargantuan swings at companies—and their billionaire leaders. Hindenburg published deeply researched reports about companies it believed were overvalued and rife with corruption. It got its big break when it shorted electric truck-maker Nikola in 2020, calling the company an “intricate fraud.” Regulators took note, and it led to three fraud convictions for Nikola founder Trevor Milton.
US stocks jumped on Friday amid a tech stock revival as investors assessed a week of key data and earnings reports alongside potential policy shifts under a Trump administration.
The Dow Jones Industrial Average (^DJI) gained 0.8% while the S&P 500 (^GSPC) rose 1%, coming off a losing day for the major gauges. The tech-heavy NASDAQ Composite (^IXIC) put on 1.5% as Nvidia (NVDA) and Tesla (TSLA) shares nudged back into the green.
The US Department of Justice (DOJ) filed a lawsuit against Walgreens (WBA), one of the nation’s largest pharmacy chains, alleging widespread prescription drug practice violations. According to the DOJ, Walgreens improperly dispensed millions of prescriptions from August 2012 to the present day that either lacked “legitimate medical purpose” or were otherwise invalid.
Posted on January 17, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Premature Closure is the tendency to make quick, decisive judgments without considering all the evidence. It’s like jumping to conclusions on a trampoline – fast and often wrong. Our brains crave certainty and dislike ambiguity, leading us to close the case prematurely. This can save time but often results in mistakes and oversights. To avoid premature closure, take a step back, gather more information, and keep an open mind about this cognitive bias.
And so, colleague Dan Ariely PhD suggests that we remember: haste makes waste, especially in decision-making.
The Bloomberg U.S. Universal Index represents the union of the U.S. Aggregate Index, U.S. Corporate High Yield Index, Investment Grade 144A Index, Eurodollar Index, U.S. Emerging Markets Index, and the non-ERISA eligible portion of the CMBS Index.
The index covers USD-denominated, taxable bonds that are rated either investment grade or high-yield. Some Bloomberg U.S. Universal Index constituents may be eligible for one or more of its contributing sub-components that are not mutually exclusive. These securities are not double-counted in the index.
The Bloomberg U.S. Universal Index was created on January 1st, 1999, with index history back-filled to January 1st, 1990.
Posted on January 17, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
The FTC’s second interim staff report on consolidated pharmacy benefit managers (PBMs) found that the three largest of these middlemen—CVS Health’s Caremark Rx, Cigna Group’s Express Scripts, and UnitedHealth Group’s OptumRx—”marked up two specialty generic cancer drugs by thousands of percent and then paid their affiliated pharmacies hundreds of millions of dollars of dispensing revenue in excess of estimated acquisition costs for each drug annually.”
The S&P 500 fell 0.2%. The NASDAQ 100 lost 0.7%. The Dow Jones Industrial Average slid 0.2%. A gauge of the “Magnificent Seven” megacaps slipped 1.9%. The Russell 2000 added 0.2%. The KBW Bank Index declined 0.2%.
The yield on 10-year Treasuries declined four basis points to 4.61%. The Bloomberg Dollar Spot Index rose 0.1%.
Posted on January 16, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Cognitive Dissonance is the discomfort experienced when holding conflicting cognitions, like believing in healthy eating while munching on a donut. It’s a mental tug-of-war that makes us squirm.
To reduce this discomfort, we often change our beliefs or behaviors to align them. This is why smokers might downplay the health risks of smoking. Understanding cognitive dissonance helps us recognize these mental gymnastics and strive for consistency in our beliefs and actions.
So, according to colleague Dan Ariely PhD, the next time you feel that mental itch, it’s cognitive dissonance asking for some resolution.
HFRX Equity Hedge Index serves as a daily-priced proxy for alternative strategies that maintain positions long and short, primarily in equity and equity derivative securities.
HFRX Fixed Income – Credit Index serves as a daily-priced proxy for alternative strategies that provide exposure to credit strategies. Credit strategies refers to a wide range of sub-strategies and may include corporate, sovereign, distressed, asset-backed, capital structure arbitrage, and other relative value approaches. Strategies may also include and utilize equity securities, credit derivatives, commodities, or currencies.
A Junk Rally is a general trend of out performance by companies that tend to score poorly along several dimensions, such as price-to-earnings (P/E) ratios, return on assets (ROA), balance sheet strength, levels of debt and volatility.
Posted on January 16, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
The U.S. Department of Labor reported a 0.4% increase in the monthly CPI after seasonal adjustment, overshooting the forecast of 0.3% and the previous value of 0.3%. On an annual basis, inflation climbed to 2.9%, up from 2.7% in November, the highest rate since July 2024.
US stocks ripped higher on Wednesday as high hopes for bank earnings paid off and a crucial consumer inflation update showed key prices increased less than expected in December.
The benchmark S&P 500 (^GSPC) popped more than 1.8%, while the Dow Jones Industrial Average (^DJI) rose more than 1.6%, or over 700 points. Meanwhile, the tech-heavy NASDAQ Composite (^IXIC) soared 2.5%.
Stocks took a leg higher after the Consumer Price Index (CPI) showed progress toward the Fed’s 2% inflation target in December. Prices climbed 0.2% month-on-month on a “core” basis, which strips out the more volatile costs of food and gas, an easing from November’s 0.3% gain. Over last year, core CPI rose 3.2%.
Capital One is being sued by the US government’s consumer watchdog agency for “cheating millions of consumers” and not paying more than $2 billion in interest to holders of its high-interest savings accounts.
As of January 1st 2025, beneficiaries enrolled in Part D prescription drug plans will have their out-of-pocket spending capped at $2,000 for the year. This new policy was part of President Joe Biden’s 2022 Inflation Reduction Act (IRA), which included other drug pricing measures such as capping the cost of insulin at $35 per month for seniors.
But only a small share of Medicare enrollees will benefit from the cap, according to an analysis from nonprofit organization AARP’s Public Policy Institute, as most don’t spend more than $2,000 annually on their medications after hitting their deductible (which is up to $590 for standard plans in 2025). Beneficiaries spent an average of $400 to $500 per year as of 2022, the Hill reported, citing data from the US Department of Health and Human Services (HHS).
Posted on January 15, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
The Producer Price Index, which tracks price changes companies see at a wholesale level, rose 3.3% over last year, up from 3% in November but less than economists expected. It rose 0.2% over the previous month, also less than expected. The report lays the groundwork for Wednesday’s heavily anticipated CPI print.
Investors will now turn their attention to Wednesday morning’s update on consumer prices, which are expected to remain sticky as the Federal Reserve continues its inflation fight.
On Tuesday, the benchmark S&P 500 (^GSPC) finished the trading day about 0.1% higher, while the tech-heavy NASDAQ Composite (^IXIC) dropped around 0.2% following a bumpy session on Wall Street. The Dow Jones Industrial Average (^DJI) moved roughly 0.5% higher to cap off back-to-back winning days for the blue chip index.
Posted on January 14, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Selective Mutism: Some people experience selective mutism, a condition where intense trauma or anxiety leaves them temporarily unable to speak. It’s a defense mechanism that shields them from emotional overwhelm. It is characterized by:
A person’s inability to speak in certain social settings, even though they are otherwise capable of speech.
Triggers for selective mutism can include specific situations, places, or people.
People with SM can speak comfortably and communicate well in other settings, such as at home with family.
For many, according to colleague Dan Ariely PhD, this silence is involuntary, reflecting how deeply emotions affect speech.
Academic Team of Internationally Known Contributors
D. E. Marcinko & Associates is one of the most academically published authorities on the topic of financial planning and private wealth management for physicians, nurses and medical professionals. We have published 33 major peer reviewed textbooks redacted in the Library of Medicine, Institute of Health and the Library of Congress, in four languages, with over 5,025 online white papers, web-posts and related publications. These cover a range of financial planning topics from medical malpractice, risk management and insurance, to investment policy statement analysis and endowment funding management, and to taxation, retirement, estate and legacy planning.
Financial planning, business and strategic management, FMV for practice and clinics and related “hard” topics are included.
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We also include “soft” subjects from investor psychology, ethics and lost fortunes to luxury spending, from understanding the middle-class millionaire to the political philosophies of physicians and the affluent. Our corpus of work is regularly consulted by doctors, medical, business, graduate and nursing schools, to elite advisors, private and investment bankers, wealth managers, venture capitalists, academics and the press.
Posted on January 14, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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In-group bias refers to the unfair favoring of someone from one’s own group. You might think that you’re unbiased, impartial, and fair, but we all succumb to this bias, having evolved to be this way.
That is, according to colleague Dan Ariely PhD, from an evolutionary perspective, this bias can be considered an advantage—favoring and protecting those similar to you, particularly with respect to kinship and the promotion of one’s own line.
Did you know that at MARCINKO & Associates, all medical colleagues throughout the United States may contact us when they are considering the sale, purchase, strategic operating improvement, merger, acquisition and/or other financial business or related personal financial planning transaction?
Our difference is “hard” knowledge and insider financial guidance that helps medical colleagues, nurses, private practitioners, clinics, ambulatory surgery, radiology and outpatient wound care centers realize their ultimate economic goals. This typically includes managerial and cost accounting, financial ratio analysis, fair market valuation business appraisals, business plan creation and personal financial planning.
Our “expert witness” business litigation support service and divorce mediation, arbitration, asset division, settlement and second opinion offerings are always available, as well.
And, our “soft” skill professional career guidance and mentoring center includes executive coaching, consulting and mentoring advisory programs for stressed, conflicted or burned-out physicians and medical practitioners.
Most importantly, our professional fees are reasonable and always transparent.
MARCINKO & Associates also serves universities, medical, business, graduate and nursing schools; physicians, dentists, podiatrists, optometrists and legal societies. This includes accountants, financial service providers, wealth and hedge fund managers, emerging entities, hospitals, CEOs and their BODs, the press, media and related organizations.
Posted on January 14, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Stocks closed mixed on Monday, with Big Tech names paring losses as the dollar and bond yields climbed amid fading hopes for interest rate cuts ahead of this week’s key consumer inflation reports.
The S&P 500 (^GSPC) settled almost 0.2% higher after falling as much as 1% during the session, while the NASDAQ Composite (^IXIC) fell 0.4%. Shares of Nvidia (NVDA) and Apple (AAPL) closed off their session lows, though most “Magnificent Seven” tech megacaps fell during the session.
The blue-chip Dow Jones Industrial Average (^DJI), which includes fewer tech stocks, rose 0.8%, or more than 350 points.
Stocks navigated another volatile session after Friday’s plunge, which wiped out all year-to-date gains for Wall Street’s major gauges. A hot December jobs report rattled markets, spurring concern that signs of strength in the economy will encourage the Federal Reserve to keep rates higher for longer.
Extended equity strategies attempt to provide better returns than possible with long-only investments.
An example of an extended equity strategy is a 130/30 portfolio, which gets its designation from taking a 130% long position and a 30% short position. In practice, this would mean $100mm invested in stocks that are viewed as attractive. Next, the manager would borrow and sell short $30mm of unattractive stocks. Then the manager uses the proceeds from the short sale to buy an additional $30mm of attractive stocks. This results in a portfolio that has 130% long and 30% short exposure to stocks, or “extended” exposure to equities relative to a long-only, 100% stock portfolio.
Nevertheless, it’s important to point out that here is the risk of theoretical unlimited amount of loss with short selling, (i.e. the price of the short-sold stocks increases; the long position can only go down to $0).
Posted on January 13, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Healthcare insurance plans could undergo major changes under the incoming Trump administration thanks to a new bill being introduced this week seeking to reform health savings accounts. Rep. Chip Roy (R-TX) introduced the Healthcare Freedom Act on Thursday seeking to reform the healthcare system by expanding health savings accounts to broaden coverage for U.S. taxpayers and “give Americans the quality of care they deserve.”
Barron’s estimates that Bank of America’s paper losses on a portfolio of $568 billion of bonds, mostly U.S. agency mortgage securities, could widen to $111 billion or more, compared with $86 billion at the end of September.
US stocks plunged Friday as investors digested a better-than-expected jobs report that soured expectations of future rate cuts from the Federal Reserve. The Dow dropped by 697 points, closing at 41,938, while the S&P 500 fell by 1.5% and the tech-heavy NASDAQ index was lower by 1.6%. The three indices all finished the week in the red as Friday’s selloff erased the week’s previous gains.
The selloff comes as the economy added 256,000 jobs in December, far outpacing expectations of around 153,000 jobs. While strong job growth signals a healthy economy, it raises the question of how soon the central bank needs to cut interest rates again. Traders now expect just a 2.7% chance the Fed will cut rates at its policy meeting later this month, according to the CME FedWatch Tool.
At DEMarcinko & Associates an “expert witness” possesses specialized knowledge in a particular field and is qualified to provide deposition or testimony in court and under oath. This testimony can be based on their personal experience, education, training or research. The role of an expert witness is to provide objective and unbiased opinions, analysis, and insights to help a lawyer, judge and/or jury understand technical or complex issues related to the case.
An expert witness can be called by either the prosecution or the defense in a legal case. The expert witness may be required to provide a written report or affidavit detailing their opinions, analyses and conclusions, and they may be asked to testify in court to provide oral testimony and answer questions from the judge and lawyers.
Carry-oriented currencies are higher-yielding currencies of countries where interest rates are generally higher than those of countries with lower-yielding currencies.
These higher-yielding currencies are targeted for “carry trades,” where investors borrow money in a low-interest rate currency and invest in a higher yielding currency, potentially profiting from the difference in interest rates.
You can listen to a professional narration of this article on iTunes & online.
I have a problem with both growth and value demagogues.
Growth demagogues will argue that valuation is irrelevant for high-growth companies because the price you pay for growth doesn’t matter. They usually say this after a very extended move in growth stocks, where these investors look like gods that walk on water. They call value investors “accountants.”
The price you pay matters (this is not a new message). As we’ve discussed in the past, if you bought great, high-growth companies near the end of the Nifty Fifty bubble in the 1960s or near the end of the dotcom bubble in the 1990s, it took more than a decade to break even (after first struggling through double-digit losses).
Posted on January 11, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Dr. David Edward Marcinko MBA MEd
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Saying a patient’s name in the emergency room will almost ensure that person comes in that day.
A code cart next to an unstable patient is said to ward off evil spirits.
Traditional healers usually use superstition in their practices to manage human health problems and diseases.
Such practices create a conflict with the medical profession and its evidence-based practices.
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So, what exactly is a Superstition? Does superstition change a measurable patient outcome, such as decreased anastomotic leak rate, surgical site infection, or mortality? Hard to say. But does it improve the surgeon’s confidence, thereby improving their performance? Likely so.
Science is not the opposite of superstition; it is the result of superstition, the result of humans trying to make sense of the world and prove each other wrong. We keep doing the things we do to maintain some semblance of control. In further defense of superstition, ritualistic behaviors ensure that the necessary boxes are checked and that we pay attention to the details. In surgery, details matter.
“Superstition is the irrational belief that an object or behavior has the power to influence an outcome, when there’s no logical connection between them. Most of us aren’t superstitious – but most of us are a ‘littlestitious.’” – Gretchen Rubin
So, until there is evidence to the contrary, I will keep tearing off the little patient labels and keeping their names with me in hopes that they do well after surgery.
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