BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
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Posted on April 30, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Consumer sentiment is a statistical measurement of the overall health of the economy as determined by consumer opinion. It takes into account how people feel about their current financial health, the health of the economy in the short-term, and the prospects for longer-term economic growth. It is widely considered to be a useful economic indicator.
Consumer sentiment emerged as an economic statistic during the mid-20th century and has since become a barometer that influences public and economic policy. It is considered a lagging indicator because it takes people several months to notice and feel the effects of changes in economic activity.
American consumers are Worried about the Economy
Consumer sentiment dropped 8% from March to April amid worries about inflation, according to the University of Michigan’s closely watched survey. Though sentiment edged up slightly from an even lower reading earlier in the month, inflation expectations climbed to their highest since 1991 as consumers fret about the potential impact of tariffs.
And even beyond possible rising prices, things could be about to get rougher for consumers: Major retailers have warned that unless President Trump’s tariff policy toward China changes, they’re likely to encounter empty store shelves in a few weeks.
Posted on April 30, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
FUNDAMENTAL INDUSTRY CHANGES
By Staff Reporters
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Index Funds
An index mutual fund or ETF (exchange-traded fund) tracks the performance of a specific market benchmark—or “index,” like the popular S&P 500 Index—as closely as possible. That’s why you may hear people refer to indexing as a “passive” investment strategy.
Instead of hand-selecting which stocks or bonds the fund will hold, the fund’s manager buys all (or a representative sample) of the stocks or bonds in the index it tracks.
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Quantum Computing
Unlike traditional computers that use bits, quantum computers utilize qubits. These qubits are capable of being in a state of superposition, where they can represent both 0 and 1 simultaneously, enabling the processing of multiple calculations at once. This could allow quantum computers to outperform classical computers in solving certain complex problems. However, the field is still overcoming challenges such as qubit stability and decoherence; especially in these three areas:
Quantum computing could fundamentally alter healthcare by accelerating drug discovery and improving individualized medicine. Rapid analysis of enormous volumes of biological data allows quantum computers to find trends that might guide the creation of more potent treatments. In addition to accelerating drug development, this will enable customized treatments tailored to unique genetic profiles.
Faster and more accurate financial models produced by quantum computing will transform the banking sector. Through real-time analysis of intricate financial systems, it can help investors to control risk and make better decisions. More precise market forecasts will help maximize portfolio management and trading strategies.
Through greatly enhanced medical diagnosis and patient care, quantum computing can transform the healthcare industry. Quantum computers can remarkably accurately find trends and possible health hazards by analyzing enormous volumes of medical data in a fraction of the time. Early diagnosis and more customized treatment alternatives follow from this.
B–QTUM Index Fund
Index Description: The BlueStar® Machine Learning and Quantum Computing Index (BQTUM) tracks liquid companies in the global quantum computing and machine learning industries, including products and services related to quantum computing or machine learning, such as the development or use of quantum computers or computing chips, superconducting materials, applications built on quantum computers, embedded artificial intelligence chips, or software specializing in the perception, collection, visualization, or management of big data.
Posted on April 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.
Coca-Cola rose 0.84% after the beverage behemoth beat earnings expectations. Not only that, it also doubled down on its forward-looking guidance, saying that revenue will grow 5% to 6% while comparable earnings per share will jump 2% to 3% in 2025. Tariff mania may raise some costs, but the company said it would be “manageable,” putting it a step ahead of arch-rival PepsiCo.
Pfizer jumped 3.28% today after the pharma giant announced that it expects to cut costs by about $7.7 billion by the end of 2027 thanks to advances in AI and automation. Despite lower sales in Q1, the company managed to keep its 2025 revenue guidance of $61 billion to $64 billion intact. While that forecast takes into account the $150 million blow from tariffs, it does not include any future tariffs (which President Trump has threatened to slap on the pharma industry).—LB
Meta Platforms gained 0.85% after the social media giant announced it will launch a standalone AI app to compete with ChatGPT. Expect more details in its earnings call tomorrow.
JetBlue Airways may have pulled guidance, but investors like the airline’s lower-than-expected loss last quarter so pushed shares 2.70% higher.
Speaking of fintech, PayPal climbed 2.14% thanks in no small part to a 20% pop in Venmo revenue.
Honeywell International gained 5.40% thanks to strong earnings and sales for the manufacturing conglomerate.
Deutsche Bank climbed 4.08% after Germany’s largest lender reported a 39% increase in profit last quarter.
Sherwin-Williams may have missed on revenue last quarter, but the paint company beat earnings estimates and kept its forward guidance intact, so shareholders pushed it up 4.80%.
Royal Caribbean eked out a 0.02% despite reporting record bookings and boosting its profit outlook, a rare move these days amid tariff uncertainty.
Leggett & Platt may not be a household name, but it sells household goods—and the bedding company’s solid earnings and strong fiscal guidance sent shares 31.73% higher.
What’s down
General Motors fell 0.64% after the automaker beat on top and bottom line estimates but warned that it will have to pull its forward guidance and suspend stock buybacks.
Spotify dropped 3.04% despite active monthly users rising 10% last quarter. The problem, believe it or not, was lower guidance.
Regeneron lost 6.87% thanks to disappointing sales for its hit eye drug Eylea.
NXP Semiconductors may have beaten analyst estimates last quarter, but management’s lower-than-expected earnings guidance disappointed investors, and pushed shares 6.94% lower.
The Zweig Breadth Thrust may sound like an extremely difficult yoga position, but it’s actually a bullish technical indicator with an extraordinary record of 100% accuracy that was just triggered.
Created by investment advisor and author Martin Zweig, the indicator takes the 10-day moving average of the number of advancing stocks across the market and divides it by the number of advancing stocks plus the number of declining stocks. When the resulting percentage rises from below 40% to above 61.5% in 10 trading days, it’s a sign that stocks are rapidly going from oversold to overbought.
The math is a bit complicated, but Carson Research’s Chief Market Strategist Ryan Detrick certainly thinks highly of it.
According to the chart that he just posted on X, the Zweig Breadth Thrust has a perfect record of predicting market gains 6 and 12 months after it appears.
With the indicator triggering on Friday, here’s hoping that we can continue to trust the Zweig Thrust.
If you looked at how stocks were doing yesterday morning and then looked away, we’ve got good news.
After a rough start to the day—especially for tech companies, whose earnings are due out soon—stocks mostly turned things around, with the S&P 500 and the Dow ending the day in the green.
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IBM plans to invest $150 billion in the US over five years. That includes $30 billion earmarked for R&D for manufacturing its mainframe and quantum computers in the US. It’s not the only tech company to announce a big commitment to spend in the US since President Trump took office and unveiled steep tariffs on imports from abroad.
Nvidia and Apple have each separately said that they plan to spend $500 billion stateside over the next four years. Companies in other industries, including pharmaceuticals, have also committed to increased US investment.—AR
Posted on April 29, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Rick Kahler CFP™
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Lately, I’ve been hearing the same question from clients and readers alike: “Is Social Security even going to be there in five years?” Fueling this concern is a recent viral comment from Elon Musk, who told Joe Rogan that Social Security is “the biggest Ponzi scheme of all time.” That quote has been repeated in every corner of the internet, stirring up uncertainty and fear.
Elon Musk is a genius, but his brilliance in technology and innovation doesn’t automatically translate into expertise in public policy. When it comes to Social Security, he’s outside his lane. Calling it a Ponzi scheme may make for a great soundbite, but it’s a fundamental mischaracterization.
Social Security is not a Ponzi scheme. Not even close.
A Ponzi scheme is a form of financial fraud that lures investors with the promise of high returns. Instead of earning those returns through legitimate investments, the scheme pays earlier investors using money from newer ones. Eventually, the model collapses when there aren’t enough new participants to keep it going, leaving most people with significant losses. This is what happened to those who trusted Bernie Madoff, operator of one of the worst Ponzi schemes in history. Ponzi schemes are illegal, deceptive, and doomed from the start.
Social Security, in contrast, is a government-run, pay-as-you-go tax program. It’s fully transparent; you know exactly where your money is going. The payroll taxes you and your employer pay are used to provide income to today’s retirees, people with disabilities, and surviving family members of deceased workers. This isn’t a con, it’s a social contract.
So why the confusion? Part of the issue is that Social Security does, on the surface, resemble the flow of a Ponzi scheme: money coming in from the young to support the old. But similarity in structure doesn’t make it fraudulent. The program does not promise high returns, it promises a modest, inflation-adjusted benefit to support people as they age.
Social Security does face challenges. The trust fund reserves, built up during years when payroll taxes exceeded payouts, are projected to run dry around 2033. If Congress does nothing, benefits will need to be cut by about 20%. That’s serious, but it’s a solvency issue, not a scam.
And the solvency issue is fixable. There are numerous bipartisan proposals to shore up the system for the long term, from raising the payroll tax cap to gradually adjusting benefits. These aren’t radical ideas, they’re common-sense repairs. A bipartisan mix of 100 CFPs in a room could work out a solution in two days.
When clients ask me if the system will be around in five years, what they’re really asking is: Can I trust it? Can I trust the government? Can I trust that my years of work and tax payments will mean something in retirement? These are not just policy questions. They are emotional questions based on fear of scarcity and a desire for security. When someone with Elon Musk’s influence wrongly calls Social Security a Ponzi scheme, his attention-grabbing soundbite shakes the emotional foundation of that trust.
If we’re serious about preserving Social Security, let’s start by calling it what it is: a commitment to our elders. A tax-supported promise to care for one another across generations.
Social Security is not a fraud, it’s a shared responsibility based on the kind of society we want and woven into the fabric of American life. Yes, it needs some adjustments, but it’s not broken. Rather than eroding public trust with misleading comparisons, we should be focused on debating public policy and how we can strengthen and sustain the program for future generations.
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ME-P NOTE: An increase in Social Security benefits is on the horizon, providing a potential financial cushion against rising inflation. The Cost of Living Adjustment (COLA) for 2025 is set at 2.5% monthly, translating to an average annual increase of approximately $600 for beneficiaries. This adjustment is based on the Consumer Price Index for Urban Wage Earners and Clerical Workers. While not guaranteed annually, COLA has historically been implemented in most years due to persistent inflationary trends.
Posted on April 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.
Plug Power soared 25.68% on the news that the hydrogen fuel cell manufacturer has signed a deal that allows it to issue $525 million in secured debentures.
Tesla eked out a 0.33% gain as investors took profits following the EV company’s strong week in spite of terrible earnings.
IBM rose 1.61% after the tech company pledged to invest $150 billion in US manufacturing over the next five years.
Peloton climbed 4.93% thanks to an upgrade from Truist analysts, who said the home workout company has cleaned up the “BS.”
MGM Resorts International gained 1.71% after reporting an impressive 34% increase in revenue last quarter thanks to its BetMGM platform.
ADMA Biologics popped 12.12% on FDA approval of its new production process that draws 20% more usable material from donated plasma than current methods.
What’s down
Nvidia sank 2.05% on the news that China’s Huawei Technologies is preparing to test a new semiconductor that could rival Nvidia’s most powerful tech.
Coinbase fell 2.08% on a double downgrade from Compass Point analysts, who cited a decline in retail trading activity.
DraftKings dropped 1.51% after Mizuho analysts lowered their price target on the company, cutting their expectations for the gambling stock’s EBITDA.
Posted on April 28, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Health Capital Consultants LLC
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On April 7, 2025, the Centers for Medicare & Medicaid Services (CMS) published their 2026 Rate Announcement for Medicare Advantage (MA) and Medicare Part D Prescription Drug Plans.
For 2026, the payment rate to MA plans will increase 5.06%, the largest increase in the past ten years, and up significantly from the 2.2% rate increase proposed by the Biden Administration.
This Health Capital Topics article will review the Rate Announcement.(Read more…)
Much like a springy inflatable structure often resembling a four-sided building and used by children for jumping for sport and fun, stocks staged a much-needed bounce-house back week on hopes that the trade war would de-escalate, with the S&P 500 climbing for four straight days to close 4.6% higher.
Whether the rally continues this week may depend on the Magnificent Seven earnings on tap—each of those Big Tech stocks has fallen at least 6.5% this year, shedding a combined $2.5 trillion in market value, per the Wall Street Journal.
The fourth market is defined as private transactions made directly between large medical investors, institutions such as banks, mutual funds, and insurance companies, without the use of a securities firm. In other words, fourth market trading is usually one institution swapping securities in its portfolio with another large institution.
From the stock broker’s viewpoint, there is one problem with the fourth market. Since no broker/dealer is involved, no registered representative is involved and there is no commission to be earned. These trades are reported on a system called Instinet.
This is advantageous to larger medical foundations or institutional investors.
What Is Instinet?
Instinet is a global financial securities service that operates an electronic securities order matching, trading, and information system which allows members, primarily institutional traders, and investors, to display bids and offer quotes for stocks, and conduct transactions with each other.
Instinet is an example of a dark pool of liquidity, a private exchange for trading securities that is not accessible by the investing public. The name implies a lack of transparency. and it facilitates block trading by institutional investors who do not wish to impact the markets with their large orders.
According to the SEC, there were 74 registered Alternative Trading Systems, or dark pools, as of February 2024.
Posted on April 27, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Rick Kahler CFP™
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On January 21, 1980, in what I thought was a brilliant financial move, I bought gold. At what was then an all-time high of $873 an ounce.
Fast forward 45 years, and here we are again. Gold is on a tear, priced just over $3,000 an ounce at the time of this writing. It needs to rise another 16% to reach its inflation-adjusted record and many analysts think it might just get there.
What’s driving this gold rally? The same thing that drove it in 1980—fear.
Back then, the U.S. was grappling with rising inflation, double-digit price increases, and interest rates in the high teens. Investors feared that the dollar and stock market would collapse, that their hard-earned savings would erode into oblivion, and that gold was a safe haven. Sound familiar?
Today, inflation is less dramatic and the stock market would have to go a long way down to even register as a bear market, but it’s still a major concern. Central banks are buying gold at record levels. Gold-backed ETFs, which had been seeing years of outflows, are finally pulling investors back in.
For most, gold isn’t just an investment, it’s an emotional hedge against uncertainty. Back in 1980, I wasn’t thinking about long-term strategy. I was reacting to fear. Inflation had hit 14%, and like many others, I was convinced the dollar would soon be worthless. Gold, I thought, was my best shot at preserving wealth.
The problem? Inflation eventually cooled; it had dropped to an average of 3.5% by the mid-1980s. Gold prices tumbled along with it. Investors who, like me, bought at the peak, 45 years later still haven’t broken even on an inflation-adjusted basis. (My $873 purchase price, adjusted for inflation, equates to $3,580 today.) If I had stuck with a well-diversified portfolio, I likely would have fared much better over time.
Over the years, I’ve come to realize that our financial decisions aren’t just about numbers. They’re deeply influenced by our Internal Financial System™, a framework that helps explain why we handle money the way we do. I now see that my decision to buy gold was a battle between different financial “parts” of myself.
One part panicked, convinced that money was about to become worthless. Another saw gold prices soaring and didn’t want to miss out. Yet another part convinced me that buying at the peak was still a smart move. Had I paused and examined these internal voices, I might have made a different decision.
My gold purchase shows why emotionally driven investment decisions rarely lead to great financial outcomes. Instead of asking, “Is gold a smart long-term investment?” I was asking, “How do I make sure I don’t lose everything?” Those are two very different questions.
If you’re thinking about buying gold, I urge you to consider these questions:
“Am I investing from a place of fear or strategy?” If you’re rushing in because you’re scared of inflation, pause and reassess.
“How does gold fit into my broader financial plan?” Gold can be a great hedge—if held in appropriate amounts in a diversified portfolio. It is best viewed as catastrophic financial insurance, rather than an investment.
“Am I reacting to headlines or making a well-thought-out decision?” The financial media loves a good gold rally. But remember, markets move in cycles. Today’s rally may be history repeating itself.
Back in 1980, fear persuaded me that gold was a sure thing. I forgot an essential caveat—there are no sure things in investing. If bad market timing were an Olympic sport, I’d have taken home the gold (pun intended) for least profitable performance.
In a discussion of competitive healthcare economic models, assumptions must include normal demand quantities, many fully informed patients and the fact that physicians cannot directly influence demand for medical care. These assumptions, although fluid, also preclude that patient buyers are large enough to have any influence over price and result in the following”:
In a “pure monopoly”, there is only one provider with a unique service. The doctor is a “price maker” and charges whatever s/he wishes.
In an “oligopoly”, there are a few physicians who provide similar services. For example, when it becomes clear to Dr. Smith and Dr. Jones that neither can win their price war, oli-gopolists return prices to prior, but still inflated levels!
In “monopolistic competition”, there are many providers with differentiated services. For example, should Dr. Jones decide to have evening hours, she may charge a premium for her fees if Dr. Jones doe not follow suit.
Finally, when “pure competition” occurs, there are many physicians, providing providing similar and substitutable services. Marketing and advertising does not affect fees, and prices are determined by supply and demand. The doctors become “price takers” by accepting fees arrived at by practicing competitively.
COMMENTS APPRECIATED
The Medical Executive-Post is a news and information aggregator and social media professional network for medical and financial service professionals.
Feel free to submit education content to the site as well as links, text posts, images, opinions and videos which are then voted up or down by other members. Comments and dialog are especially welcomed.
Daily posts are organized by subject. ME-P administrators moderate the activity. Moderation may also conducted by community-specific moderators who are unpaid volunteers.
Posted on April 26, 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.
Despite rising Medicare Advantage (MA) utilization, Elevance Health has come out of Q1 2025 unscathed. The company reported adjusted diluted earnings per share of $11.97 and stuck to its prediction of $34.15 to $34.85 adjusted earnings per share for 2025. This contrasts with peer UnitedHealth Group, which lowered its earnings predictions for the year in its call last week following a disappointing quarter. (Elevance released a preview of its earnings in a Form 8-K on April 17, hours after UnitedHealth detailed its surprisingly bad quarter, to reassure investors.)
Tesla gained 9.80% following a White House announcement yesterday that it will loosen US regulations around self-driving cars.
Boston Beer popped 2.26% thanks to strong light beer sales offsetting lower craft beer revenue.
Charter Communications climbed 11.43% after it lost fewer internet customers than last year and beat estimates on both the top and bottom line.
VeriSign rose 8% following strong results for the internet infrastructure company, as well as the announcement of a new dividend.
SoFi Technologies got a 4.63% boost from Citizens JMP analysts, who initiated coverage of the fintech stock with an “outperform” rating and called the company “a compelling long-term investment opportunity.”
What’s down
T-Mobile tumbled 11.22% after the cell carrier added 495,000 new wireless phone subscribers last quarter, below Wall Street’s forecasts.
Gilead Sciences sank 2.81% due to a revenue miss in the first quarter thanks to lower sales of its cancer and Covid treatments.
Avantor plummeted 16.58% after the lab chemicals manufacturer missed estimates, cut its forecast, and announced its CEO is departing.
Saia plunged 30.66% thanks to an enormous first-quarter miss from the shipping company due to customer pullback amid tariff uncertainty.
Investments are soaring: A new SVB report found that women’s health startups saw a whopping 55% increase in VC investments in 2024. Learn about the factors driving this record-breaking funding and the sector’s long-term potential.*
Visualize: How private equity tangled banks in a web of debt, from the Financial Times.
Posted on April 25, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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A thought experiment is an imaginary scenario that is meant to elucidate or test an argument or theory. It is often an experiment that would be hard, impossible, or unethical to actually perform. It can also be an abstract hypothetical that is meant to test our intuitions about morality or other fundamental philosophical questions. The German term Gedankenexperiment was utilized by physicist Ernst Mach
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Mary is a brilliant scientist who is, for whatever reason, forced to investigate the world from a black and white room via a black and white television monitor. She specializes in the neuro-physiology of vision and acquires, let us suppose, all the physical information there is to obtain about what goes on when we see ripe tomatoes, or the sky, and use terms like ‘red’, ‘blue’, and so on.
Question: What will happen when Mary is released from her black and white room or is given a color television monitor? Will she learn anything or not?
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The Medical Executive-Post is a news and information aggregator and social media professional network for medical and financial service professionals. Feel free to submit education content to the site as well as links, text posts, images, opinions and videos which are then voted up or down by other members. Comments and dialog are especially welcomed. Daily posts are organized by subject. ME-P administrators moderate the activity. Moderation may also conducted by community-specific moderators who are unpaid volunteers.
Posted on April 25, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Vitaliy Katsenelson CFA
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Tesla market value of $780 billion mostly reflects Elon’s future dreams, not car sales. The reality? Only $100-180 billion tied to the actual vehicle business.
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Tesla has a market capitalization as of this writing of $780 billion. It made around $14 billion of profit in 2023 and $7 billion in 2024. A good chunk of profit comes not from selling cars but from regulatory credits. It sold fewer cars in 2024 than in 2023. Unless we see a significant shift change in battery capacity, speed of charging, and improved quality and availability of charging infrastructure, we have reached peak EV penetration (I wrote about this earlier).
However, today Tesla is not trading based on car sales but on future dreams of self-driving robo-taxis, robots, semis, and whatever else Elon dreams up. The car company may be worth $100–180 billion; the rest is what investors are willing to pay for Elon’s dreams.
Quick thoughts on each dream:
Self-driving: I would not trust my life or my kids’ lives to a car company that only uses cameras. They are passive sensors that have limited range and are easily impacted by bad weather. I’ve used Tesla self-driving software – it is great most of the time, except when it’s not – and then it might kill you or others.
Robo-taxis: They may work in geo-fenced areas, but they pose a huge reputational risk to Tesla. One death and this business is done. That’s what happened to Uber’s self-driving business, and why Google’s Waymo has taken a much more conservative route. It uses radar/lidar and launched the service in geo-fenced areas first.
Semis: They were announced in 2017 and were going to hit the road the next year. They are still not out there. I suspect Elon is waiting for a breakthrough in battery technology.
Robots: Exciting, huge market, but this will be a crowded field.
New competition: There are lots of Chinese EVs invading Europe and the rest of the world. BYD looks like a real competitor.
China looked like a great opportunity for Tesla, but may turn into a liability if the trade war intensifies.
Finally, though at times he seems superhuman, Musk is constrained by the number of hours in the day. As of today he is running Tesla, SpaceX, Twitter (x.com), xAI (the maker of Grok – a ChatGPT competitor), The Boring Company, Neuralink, and oh, yes, DOGE. The EV market is getting more, not less, competitive.
Posted on April 25, 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.
Merck rose 1.40% today after beating earnings expectations. The problem is that the pharma giant expects a $200 million hit to its bottom line due to tariffs. And that doesn’t count the potential additional pharmaceutical levies Trump has indicated he’s planning.
Alphabet warned some remote employees that they must return to the office three days a week or lose their jobs. Shareholders clearly approve: The stock gained 2.53%.
Amazon and Nvidia executives made it clear that contrary to popular belief, demand for AI data centers isn’t slowing down. Amazon rose 3.29%, while Nvidia climbed 3.62%.
Newmont gained 4.80% after the gold miner reported strong earnings thanks to gold’s incredible run.
ServiceNow soared 15.49% after the enterprise tech company posted a beat-and-raise earnings report.
Texas Instruments popped 6.56% thanks to a strong first quarter and healthy fiscal guidance from the domestic semiconductor company.
Chipotle eked out a 1.60% gain despite a mixed quarter that saw same-store sales fall for the first time since 2020.
What’s down
IBM topped analyst expectations on sales and profits, but the tech stock fell 6.58% thanks to a poor performance from its consulting and its mainframe businesses.
Nokia tumbled 8.65% following a big earnings miss last quarter, and warned that tariffs will take a serious toll on its business this quarter.
Fiserv plunged 18.52% after the software provider beat expectations for profits but missed on revenue.
Procter & Gamble outpaced Wall Street’s forecast for earnings but fell short on revenue and cut its fiscal guidance, pushing shares of the consumer goods giant down 3.74%.
Comcast also beat analyst estimates on both the top and bottom lines, but sank 3.71% after reporting it lost 199,000 broadband customers last quarter.
Posted on April 24, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Alphabet has been declared a monopoly for the second time in under a year. Analysts will have plenty of questions about the repercussions of the most recent ruling, but don’t expect a breakup of Google’s many businesses just yet.
And, the best business unit of them all these days is YouTube, which has seen a stunning surge in popularity lately that the search company will likely try to capitalize on, while it continues to tinker with its Gemini AI model. Consensus: $2.02 EPS, $89.25 billion in revenue.
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Intel seems like a bit of an also-ran in the AI race these days, with shares down over 40% in the last 12 months. But to bulls, that just means the stock is cheap, while the company itself has plenty of opportunities for growth ahead, including partnerships with Nvidia and TSMC.
And, don’t forget that Intel’s status as a dark horse lets it slip below the tariff radar—the domestic chip producer dodged the latest round of restrictions that hit Nvidia and AMD. Shareholders will be hoping to hear more good news ahead. Consensus: $0.09 EPS, $12.31 billion in revenue.
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The Medical Executive-Post is a news and information aggregator and social media professional network for medical and financial service professionals. Feel free to submit education content to the site as well as links, text posts, images, opinions and videos which are then voted up or down by other members. Comments and dialog are especially welcomed. Daily posts are organized by subject. ME-P administrators moderate the activity. Moderation may also conducted by community-specific moderators who are unpaid volunteers.
Posted on April 24, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters and Lawrence Rosenberg
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Cold calling is a term that is typically applied to telesales, but most new business relationships actually begin with a “cold” contact of some kind. Whether through social media, email over the phone or door-to-door, “cold calling” lives up to its name; you are contacting prospects (hopefully decision makers) sans introduction and without warning. In some, if not many cases, you will be presenting to customers who have never heard of you, your firm, or your product/service prior to you getting a hold of them. You will also find yourself coming up against the palace guards (secretaries and personal assistants) whose most important job is to run interference for the boss and thwart any and all attempts that an unfamiliar caller might make to reach them. But, as the sales game will readily teach anyone with the fortitude to last long enough to learn the lesson, the more resistance one faces in the pursuit of a successful outcome, the bigger the payoff will be if one can muster the grit necessary to tough it out.
However difficult the road to riches, cold calling allows for a complete leveling of the playing field. Those that sweep the streets could tomorrow talk with billionaires; a man of little status or worth could enter into a contract with the founder of a blue chip, multinational firm — all with a single, unexpected phone call. The sheer daring of such an approach, its impromptu nature, works for so many reasons, not least of which is that it opens doors. From the intrigue and urgency the suddenness of the call implies, to the instant access a bold overture provides, cold calling is the great equalizer among executives, and a path to achievement open to all, no matter one’s experience, education or connections. Not that there ever were any truly insurmountable barriers to climbing the corporate ladder or accessing its highest rungs that a motivated self-starter could not overcome, but with the advent of the telephone and the brashness of the cold sell perfected, the most entrenched and frustrating of impediments, bureaucracy and fraternalism, ceased to be an obstacle. Yesteryear’s power elite traditionally only did business with friends, acquaintances and family (or perhaps a member of their local country club or lodge), but at the very least, those that connected in business were routinely introduced through a referral. However, the audacity of the unscheduled contact, the inspired notion of a “cold call,” and the realization that it worked, that a person of great esteem or importance was willing to do business with an unusually forward individual, made the glad-handing salesman who relied on his father’s rolodex obsolete.
With ivory towers toppled, etiquette overturned and tradition tossed out, ambitious men ignored propriety and custom and cold canvassed the board of directors and senior executive staff of companies both large and small. The old boy’s network, favoritism, and the “it’s not what you know, but who you know” principle of doing business crumbled in one fell swoop. The ramparts guarded by all manner of gatekeepers and middle men were trampled the moment the CEO became connected by wires to the outside world. Using nothing more than a telephone, a Horatio Alger-type work ethic and a well-rehearsed voice, the business world was invaded by those without patronage, underdogs and unknowns swarmed the gates. The cold call allowed the unfiltered, unapproved spirit of the upstart, unfettered by lackeys and administrators, to enter the inner sanctum of a chieftain and with the power of speech alone, win hearts and minds.
But, can one’s voice really move mountains? Must one not support the message with documentation and material, nurture relationships with lunches and meetings and personally shake hands to set the wheels of industry in motion? Is one unannounced, unsolicited, unscreened call enough?
The human voice is the master manipulator of sound and when paired with the right words it has a potent and intoxicating effect on behavior. Although some people react more favorably to stimulation of the other five senses, sound on its own can evoke them all. Those that study the science of suggestion will note the immense influence of other stimuli, such as that which affects sight and sensation, on how we make sense of our experiences, on how we make decisions, but it is the way in which such sensory bias is communicated (via the written word, and more powerfully, through speech) that truly tells the tale. The combination to unlocking the interests of many a man’s mind are often verbalized in the common yet telling replies to intriguing, thought provoking questions or action demanding requests.
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It is all a matter of deciphering the code, the clue-laden language:
“What you said really touched me.”
“I see the light!”
“You can smell his fear.”
“Let’s give that guy a taste of his own medicine.”
“You are coming across loud and clear.”
The way in which we describe our observations provides the key to how we interpret data, how that data impacts us, and through what primary pathway we process such information. It is our use of language that exposes how we perceive the world around us, how the gears of our minds are moved, and which of the five senses most effectively winds the springs that turn them.
Many times a prospect will request to have a look at your proposition in writing before moving forward, others will react positively based solely on their impression. Some say seeing is believing, but if it soundsexciting and beneficial, they will take action regardless because it just feels right.
All our senses come alive when the brain is stimulated, some more than others depending on the man and the moment, but the terms, phrases and idioms that we use when speaking (their quality, nuance and character) and the way in which they are expressed, have the power to move us in life-changing ways — the spoken word, when used properly, can play us like a piano.
Whether impacted more by sight, olfaction or incitement of the somatosensory system (the way things feel physically), one can induce the imagery and kinesthesia necessary to motivate and influence a prospect from afar with voice alone. Provocative descriptions, the proper use of tone and inflection, and the strategic interweaving of silence (of which sometimes nothing can be more deafening or exert more pressure) can activate or set in motion all manner of action. Practiced speech can lighten the heaviest heart or wrest tears from the coldest stare, it can conjure up a dream state or snap you back to reality. Never underestimate what a skillful performer can do with the right vocabulary and properly trained vocals. Charlton Heston could inspire awe, Orson Welles conjure intrigue, and Luciano Pavarotti demand devotion with nothing more than the weight and timbre of their words.
You too can affect people, positions and outcomes with sonant spirit and verbal substance. Invest in the greatest tool for success a deal maker has, your lexicon, your locution and your delivery.
Posted on April 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.
OpenAI would be open to buying Chrome if Google is forced by a federal court to sell the web browser, the company’s ChatGPT head said yesterday.
The FDA suspended milk quality tests in some dairy products due to reduced capacity stemming from federal workforce cuts, Reuters reported.
Roche, the Swiss pharmaceutical giant, is investing $50 billion in US manufacturing to circumvent President Trump’s tariffs, the company said yesterday.
Rite Aid is preparing to sell itself in pieces ahead of a possible second bankruptcy, Bloomberg reported.
Oklo gained 8.60% after OpenAI CEO Sam Altman announced he’s stepping down as chairman of the board of the nuclear power startup.
Duolingo popped 10.01% after Morgan Stanley initiated coverage of the language learning company, calling it a “best-in-class consumer internet asset.”
Cava climbed 6.29% due to an upgrade from analysts at Bernstein, who think the bowl slop stock will not only survive but thrive in an economic downturn.
Amphenol rose 8.21% thanks to impressive earnings for the high-speed cable company, coupled with a solid fiscal outlook.
Vertiv Holdings jumped 8.60% after the data center company posted an impressive quarterly profit and raised its fiscal forecast.
Stocks surged first thing this morning after President Trump said the media blew things out of proportion and that he has “no intention” of firing Jerome Powell. He also said he would be “very nice” to China in tariff negotiations.
Treasury Secretary Scott Bessent also did some damage control, touting the opportunity for a “big deal” between the US and China.
The combination sent a relief rally sweeping through markets, and while the euphoria faded by mid-afternoon, all three indexes ended the day in the green.
Gold fell and bitcoin rose as investors took on more risk (see below), while oil dropped on reports that OPEC+ may hike its crude output after its meeting next month.
Posted on April 23, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Classic Definition: Suppose someone tells you “I am lying.” If what he/she tells you is true, then he/she is lying, in which case what he/she tells you are false. On the other hand, if what he/she tells you is false, then he/she is not lying, in which case what he/she tells you is true.
Modern Circumstance: In short: if “I am lying” is true then it is false, and if it is false then it is true.
Paradox Example: The paradox arises for any sentence that says or implies of itself that it is false (the simplest example being “This sentence is false”). It is attributed to the ancient Greek seer Epimenides (fl. c. 6th century BCE), an inhabitant of Crete, who famously declared that “All Cretans are liars” (consider what follows if the declaration is true). The paradox is important in part because it creates severe difficulties for logically rigorous theories of truth; it was not adequately addressed (which is not to say solved) until the 20th century.
Paradox Example: Doctors lie because, as caretakers, our role isto improve the lives of their patients. Re-assuring patients during some of the most difficult times of their lives counts as improving their well being! This is an acceptable practice because it does not cause harm.
Paradox Example: Cultural differences may make a lie of omission or the practice of withholding information from the patient, prudent. For instance, some cultures and religions dictate that the husband or head male family members make all medical decisions for women.
Paradox Example: Many physicians don’t report “near misses” to their patients. But, concealing serious medical errors is something we recommend against.
COMMENTS APPRECIATED
The Medical Executive-Post is a news and information aggregator and social media professional network for medical and financial service professionals.
Feel free to submit education content to the site as well as links, text posts, images, opinions and videos which are then voted up or down by other members. Comments and dialog are especially welcomed.
Daily posts are organized by subject. ME-P administrators moderate the activity. Moderation may also conducted by community-specific moderators who are unpaid volunteers.
An annuity is a contract between you and an insurance company. When you purchase an annuity, you make a lump-sum contribution or a series of contributions, generally each month. In return, the insurance company makes periodic payments to you beginning immediately or at a pre-determined date in the future. These periodic payments may last for a finite period, such as 20 years, or an indefinite period, such as until both you and your spouse are deceased. Annuities may also include a death benefit that will pay your beneficiary a specified minimum amount, such as the total amount of your contributions.
The growth of earnings in your annuity is typically tax-deferred; this could be beneficial as you may be in a lower tax bracket when you begin taking distributions from the annuity.
Warning: A word of caution: Annuities are intended as long-term investments. If you withdraw your money early from an annuity, you may pay substantial surrender charges to the insurance company as well as tax penalties to the IRS and state.
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There are three basic types of annuities — fixed, indexed, and variable
1. With a fixed annuity, the insurance company agrees to pay you no less than a specified (fixed) rate of interest during the time that your account is growing. The insurance company also agrees that the periodic payments will be a specified (fixed) amount per dollar in your account.
2. With an indexed annuity, your return is based on changes in an index, such as the S&P. Indexed annuity contracts also state that the contract value will be no less than a specified minimum, regardless of index performance.
3. A variable annuity allows you to choose from among a range of different investment options, typically mutual funds. The rate of return and the amount of the periodic payments you eventually receive will vary depending on the performance of the investment options you select.
The Medical Executive-Post is a news and information aggregator and social media professional network for medical and financial service professionals.
Feel free to submit education content to the site as well as links, text posts, images, opinions and videos which are then voted up or down by other members. Comments and dialog are especially welcomed.
Daily posts are organized by subject. ME-P administrators moderate the activity. Moderation may also conducted by community-specific moderators who are unpaid volunteers.
Posted on April 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.
Stocks came off of their highs yesterday afternoon trading after US Treasury Secretary Scott Bessentreportedly said in a private speech for JPMorgan Chase that talks between the United States and China had yet to formally start and that negotiations will likely be a “slog.”
Still, US stocks soared on Tuesday following a bruising day on Wall Street, as investors built hope for deescalation on several fronts of President Trump’s trade battles.
Still, markets delivered solid gains with Dow Jones Industrial Average (^DJI) adding over 1,000 points as the benchmark S&P 500 (^GSPC) and tech-heavy NASDAQ (^IXIC) each rose around 2.5% and 2.7%, respectively.
Prior to Bessent’s reported comments, stocks hit earlier session highs as Bloomberg reported the treasury secretary told a closed-door investor summit Tuesday that “the tariff standoff with China is unsustainable and that he expects the situation to de-escalate.”
🟢 What’s up
Amazon rose 3.5% a day after Wells Fargo analysts revealed that the tech giant has paused some of its data center leases, the latest sign of an AI trade slowdown.
The DOJ has called for a breakup of Alphabet’s business. Investors don’t seem to mind: Shares of the search giant rose 2.57%.
Boeing gained 2% after announcing it will sell portions of its digital aviation solutions business to Thoma Bravo for $10.55 billion.
Ford is up 1.90% a day after reports emerged that it has stopped shipping cars to China.
Coreweave rose 8.74% after several Wall Street analysts initiated coverage of the newly public cloud computing company. While the pros lean toward bullish, the stock’s reception has been largely mixed.
Equifax soared 13.84% following strong results for the credit rating company, as well as its announcement of a $3 billion buyback program.
BP managed to gain 2.81% after regulatory filings revealed that Elliott Investment Management has accrued a 5% stake in the oil giant.
Verizon eked out a 0.61% gain after it beat Wall Street forecasts for the first quarter but lost more postpaid net phone subscribers than expected.
What’s down
Halliburtondisappointed shareholders with a decline in both revenue and profits last quarter, sending the oil service company’s shares 5.57% lower.
Defense contractors tumbled after reporting mixed earnings. RTX lost 9.81%, and Northrop Grumman sank 12.66%.
Medpace Holdings crumbled 2.32% after the clinical research company revealed a 19% decline in net new business awards last quarter.
A Certified Public Accountant (CPA) is a licensed professional who has passed an examination administered by a state’s Board of Accountancy. State CPA exams are created under guidelines issued by The American Institute of Certified Public Accountants (AICPA). The Uniform CPA Exam can only be taken by accountants who already have professional experience in the field and a bachelor’s degree.CPAs are not fiduciaries.
Not all accountants are CPAs. Accountants who are CPAs are licensed by their state’s Board of Accountancy after passing the Uniform CPA Exam. CPAs prepare reports that accurately reflect the business dealings of the companies and individuals that hire them. Many prepare tax returns for individuals or businesses and advise them on ways to minimize taxes. Obtaining the CPA designation requires a bachelor’s degree, typically with a major in business administration, finance, or accounting. Other majors are acceptable if the applicant meets the minimum requirements for accounting courses.
Enrolled Agent
Although not a CPA, an Enrolled Agent [EA] is a person who has earned the privilege of representing taxpayers before the Internal Revenue Service [IRS]. This is done by either passing a three-part comprehensive IRS test covering individual and business tax returns, or through experience as a former IRS employee. Enrolled agent status is the highest credential the IRS awards. Individuals who obtain this elite status must adhere to ethical standards and complete 72 hours of continuing education courses every three years.
Certified Managerial Accountant
A Certified Management Accountant (CMA), which is issued by the Institute of Management Accountants (IMA), builds on financial accounting proficiency by adding management skills that aid in making strategic business decisions based on financial data.
Oftentimes, the reports and analyses prepared by certified management accountants (CMAs) will go above and beyond those required by generally accepted accounting principles (GAAP).
For example, in addition to a company’s required GAAP financial statements, CMAs may prepare additional management reports that provide specific insights useful to corporate decision-makers, such as performance metrics on specific company departments, products, or even employees.
Certified Financial Analyst
A Certified Financial Analyst [CFA] is a globally-recognized professional designation offered by the CFA Institute, an organization that measures and certifies the competence and integrity of financial analysts. Candidates are required to pass three levels of exams covering areas such as accounting, economics, ethics, money management, and security analysis. From 1963 through November 2023, more than 3.7 million candidates had taken the CFA exam. The overall pass rate was 45%. From 2014 through 2023, the 10-year average pass rate was 43%.1
CFA Institute. The CFA Institute was formerly the Association for Investment Management and Research (AIMR).
The CFA charter is one of the most respected designations in finance and is widely considered to be the gold standard in the field of investment analysis. To become a charter holder, candidates must pass three difficult exams, have a bachelors degree, and have at least 4,000 hours of relevant professional experience over a minimum of three years. Passing the CFA Program exams requires strong discipline and an extensive amount of studying.
There are more than 200,000 CFA charter holders worldwide in 164 countries.The designation is handed out by the CFA Institute, which has 11 offices worldwide and 160 local member societies.
Posted on April 22, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
OFTEN CONFUSING TO ALL
By Staff Reporters
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A vehicle typically has two prices: the manufacturer’s suggested retail price (MSRP) and the invoice price. The MSRP is the sticker price, while the invoice price is what the dealer paid the manufacturer for the vehicle. The MSRP includes a hefty profit, so that’s what dealers want you to focus on. However, your goal should be to get the invoice price and focus on that for your negotiations.
However, finding invoice pricing on new cars can be difficult when going through the dealer. Dealers don’t want their invoice price on a vehicle to be public knowledge because that gives customers more leverage when it comes to negotiations. Just like any company, car dealers are in the business to make money. They can’t make money if they give you a huge discount on a car.
What is a Vehicle Invoice Price?
When it comes to the car buying process, there are several other terms and types of pricing you should understand. One of them is the vehicle invoice price. This is also known as the dealer cost, or what a car manufacturer charges the dealer for that specific vehicle. Freight charges are typically included in this total.
However, the numbers on the invoice may not be the true price the dealer paid for the vehicle, because it has hidden profits already built-in. Dealers are often given manufacturer rebates, allowances, discounts, and other incentives for selling a car. The invoice price on a vehicle may range from several hundred to several thousand dollars below its sticker price, which is why service will help you determine what the real numbers look like.
So, once you determine the car invoice price, you have added leverage when it comes to negotiating the best price possible with the auto dealer.
Posted on April 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.
Meta’s antitrust trial resumes: The FTC is accusing CEO Mark Zuckerberg of purchasing Instagram and WhatsApp to gain an unfair monopoly in the social media space, while the defense is expected to argue that the success of those apps is a product of Meta’s acquisition. Testimony will continue this week, with one Vanderbilt law professor telling Quartz that she expects to hear more expert testimony: “Judges tend to put a lot of stock in expert opinion in antitrust cases, especially when it comes to market definition and monopoly power.”
Netflix rose 1.57% on a strong vote of confidence from Wall Street pros: After last week’s earnings blowout, the streaming service received price target upgrades from JPMorgan, Wells Fargo, Goldman Sachs, Evercore ISI, Morgan Stanley and Piper Sandler today.
Discover Financial Services climbed 3.53% after its merger with Capital One got the greenlight from regulators. Capital One rose 1.54%.
MicroAlgo exploded 74.93% after the tech holding company became the latest hot penny stock du jour.
Gold miners continue to mint big gains as the hot commodity broke yet another record. Barrick Gold gained 1.39%, while AnglogoldAshanti climbed 2.13%.
Hertz Global gave up some of last week’s big gains today, dropping 4.98% as investors took profits following Bill Ackman’s hint that the rental car company may team up with Uber.
Speaking of, Uber fell 3.08% after the FTC sued the ride-hailing company for “deceptive billing and cancellation practices.”
Amazon lost 3.11% thanks to a downgrade from Raymond James analysts. They believe the e-commerce titan’s retail and advertising businesses are too exposed to tariffs.
Salesforce stumbled 4.45% on a downgrade from DA Davidson analysts, who say the SAAS company is too focused on AI and not on its core business.
Deutsche Post AG, better known as DHL, announced it is suspending shipments worth over $800 as the international shipping company struggles with tariffs. Shares fell 1%.
Now that the US government is negotiating drug prices directly with manufacturers, states want to get in on the action, too. These efforts vary by state, but generally involve creating a board to review drugs’ affordability and sometimes setting upper price limits (UPLs). While none have implemented UPLs as of April, as the idea gains momentum, there are questions about UPLs and boards’ legality, practicality, and whether they will actually lower costs for patients.
Visualize: How private equity tangled banks in a web of debt, from the Financial Times.
In finance, a “Dead Cat Bounce” is a small, brief recovery in the price of a declining stock.
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 market decline.
Named for a U.S. economist, the JB Taylor Rule is a mathematical monetary-policy formula that recommends how much a central bank should change its nominal short-term interest rate target (such as the U.S. Federal Reserve’s federal funds rate target) in response to changes in economic conditions, particularly inflation and economic growth. It’s typically viewed as guideline for raising short-term interest rates as inflation and potentially inflationary pressures increase. The rule recommends a relatively high interest rate (“tight” monetary policy) when inflation is above its target or when the economy is above its full employment level, and a relatively low interest rate (“easy” monetary policy) under the opposite conditions.
To illustrate, the monetary policy of the FOMC changed throughout the 20th century. The period between the 1960s and the 1970s is evaluated by Taylor and others as a period of poor monetary policy; the later years typically characterized as stagflation. The inflation rate was high and increasing, while interest rates were kept low. Since the mid-1970s monetary targets have been used in many countries as a means to target inflation.
However, in the 2000s the actual interest rate in advanced economies, notably in the US, was kept below the value suggested by the Taylor rule.
Posted on April 21, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
BREAKING NEWS
Artificial Intelligence Enhanced
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Markets drop as tariff concerns shake the market
Key takeaways (1:30 EST)
The Dow Jones Industrial Average experienced a significant drop of more than 1,100 points, reflecting investor anxiety over tariff policies finance. The S&P was down 150 and the NASDAQ was down 550.
This decline is part of a broader trend affecting the S&P 500 and NASDAQ, as geopolitical tensions and economic uncertainties weigh heavily on market sentiment finance.yahoo.com .
Investors are closely monitoring developments regarding trade policies and their potential impact on the economy, leading to heightened volatility in the stock market
Several years ago a group of highly trusted and deeply experienced financial advisors, insurance service professionals and estate planners noted that far too many of their mature retiring physician clients, using traditional stock brokers, management consultants and financial advisors, seemed to be less successful than those who went it alone. These Do-it-Yourselfers [DIYs] had setbacks and made mistakes, for sure. But, the ME Inc doctors seemed to learn from their mistakes and did not incur the high management and service fees demanded from general or retail one-size-fits-all “advisors.”
In fact, an informal inverse related relationship was noted, and dubbed the “Doctor Effect.” In others words, the more consultants an individual doctor retained; the less well they did in all disciplines of the financial planning and medical practice management, continuum.
Of course, the reason for this discrepancy eluded many of them as Wall Street brokerages and wire-houses flooded the media with messages, infomercials, print, radio, TV, texts, tweets, dinners and internet ads to the contrary. Rather than self-learn the basics, the prevailing sentiment seemed to purse the holy grail of finding the “perfect financial advisor.” This realization confirmed the industry culture which seemed to be:
Bread for the advisor – Crumbs for the client!
And so, Marcinko Associates formed a cadre’ of technology focused and highly educated multi-degreed doctors, nurses, financial advisors, attorneys, accountants, psychologists and educational visionaries who decided there must be a better way for their healthcare colleagues to receive financial planning advice, products and related advisory services within a culture of fiduciary responsibility.
We trust you agree with this specific niche knowledge, and collegial consulting philosophy, as illustrated thru our firm and these two books.
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com
Posted on April 20, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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According to colleague Dan Ariely PhD, Bereavement Sex is one of those coping mechanisms that sounds strange but makes sense when you think about it. In the face of loss, our brains crave connection and comfort.
Engaging in sex after a significant loss can be a way to feel alive and regain a sense of control. It’s a testament to our complex emotional wiring, where grief and intimacy intertwine.
The VIX soared to 60.13 last Monday before plummeting all the way to 33.76 on Wednesday, the day after the president paused tariffs. But while the VIX has since settled down a bit, investor fear is still high. The VIX closed above 30 for 10 straight trading sessions and the last time that happened was during the bear market back in October 2022, according to MarketWatch—not exactly a comforting comparison.
Then again, just because fear skyrocketed last week doesn’t mean the markets will tank in turn. “Since 1997, there have been 11 times the VIX spiked above 45—and 10 out of 11 times, the S&P 500 was higher four months later by an average of +6.4%,” noted Austin Hankowitz in the latest edition of the Rich Habits newsletter.
Finally, the VIX closed above 30 Thursady as tariff talk and monetary policy pivots keep investors on their toes. But while worries might keep investors on the sidelines, some on Wall Street are taking this opportunity to be greedy while others are fearful.
Posted on April 20, 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.
Markets: The markets were closed for Good Friday giving investors time to take a breather amid tariff-induced volatility after all three major indexes finished the short trading week in the red.
Stock spotlight: As a sign of just how confusing it is out there, United Airlines stock rose this week after the company released two different forecasts—one for a stable economy and one for a possible US recession.
A $35 billion merger between Capital One and Discover that would make Capital One the nation’s largest credit card issuer cleared a major regulatory hurdle this week, according to multipleoutlets, as the Justice Department told antitrust officials it did not find reasons to block the deal, paving the way for a potentially historic shakeup of the American credit card space.
There’s often a disconnect between physicians, insurance agents and financial advisors and the patients and clients they’d like to serve. Both might ostensibly share the same goal but there’s often a big difference in perspective. Advisors / Physicians and would-be clients / patients likely have different communication styles, especially in an age where technology has greatly changed the way we talk with one another. Their expectations and priorities can also often dramatically diverge. Those structural gaps can hinder collaboration and trust.
To bridge this divide, you must understand how prospective clients and patients think nowadays and be able to adjust your M.A.S. approach accordingly.
THE BASICS
Marketing is the business process of identifying, anticipating and satisfying patient’s, client’s or customers’ needs and wants. It is your unique value proposition or strategic competitive advantage. Marketers can direct product to other businesses or directly to consumers. But, we believe it is actually your strategic competitive advantage [SCA] which differentiates yourself from competitors. It is the “moat” around your business.
Advertising is a marketing communication that employs an openly sponsored, non-personal message to promote or sell a product, service or idea. Sponsors of advertising are typically businesses wishing to promote their products or services. Advertising is communicated through various mass media outlet, including traditional media such as newspapers, magazines, television, radio, outdoor advertising or direct mail; and new media such as search results, blogs, social media, websites or text messages. The actual presentation of the message in a medium is referred to as an advertisement, or “ad” or advert for short. But, we believe that is simply how you disseminate your strategic competitive advantage [SCM] to potential clients.
Sales close the deal and collects money. Sales are activities related to selling or the number of goods or services sold in a given targeted time period. The seller, or the provider of the goods or services, completes a sale in response to an acquisition, appropriation, requisition, or a direct interaction with the buyer at the point of sale. There is a passing of title (property or ownership) of the item, and the settlement of a price, in which agreement is reached on a price for which transfer of ownership of the item will occur. The seller, not the purchaser, typically executes the sale and it may be completed prior to the obligation of payment. In the case of indirect interaction, a person who sells goods or service on behalf of the owner is known as a salesman or saleswoman or salesperson, but this often refers to someone selling goods in a store/shop, in which case other terms are also common, including salesclerk, shop assistant, and retail clerk.
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DERIVATIVE THOUGHTS
Public Relations [PR] is differentiated than advertising from in that an advertiser pays for and has control over the message. It differs from personal selling in that the message is non-personal, i.e., not directed to a particular individual. We pay for advertising but pray for public relations. But public relations are not controllable but it is free, while advertising is not. PR suggests that “good news or bad news”; just spell the name correctly
Change Management is the discipline that guides how we prepare, equip and support individuals to successfully adopt to change in order to drive organizational success and outcomes.
Crisis Management is the precautions and identification of threats to an organization and its stakeholders, and the methods used by the organization to deal with these threats.
MODERNITY NOW
CRM stands for Customer Relationship Management, which is a system for managing all interactions with current and potential customers, clients or patients. The goal is simple: improve relationships to grow your business or medical practice. CRM technology helps companies stay connected to customers, streamline processes, and improve profitability.
When people talk about CRM, they’re usually referring to a CRM system: software that helps track each interaction you have with a prospect, patient or customer. That can include sales calls, treatment plans or service interactions, marketing e-mails, and more. CRM tools can unify customer and company data from many sources and even use Artificial Intelligene [AI] to help better manage relationships across the entire customer – patient lifecycle – spanning departments described in the M.A.S. basics, above.
Decoy Bias Effect is a dubious phenomenon in decision-making where the introduction of a third, less attractive option (the “decoy”) influences individuals to change their preference between two other options.
The decoy bias effect describes how, when we are choosing between two alternatives, the addition of a third, less attractive option (the decoy) can influence our perception of the original two choices. Decoys are “asymmetrically dominated:” they are completely inferior to one option (the target) but only partially inferior to the other (the competitor). For this reason, the decoy effect is sometimes called the “asymmetric dominance effect.”
EXAMPLE: This bias is commonly used in financial planning sales; as well as marketing and mutual fund, ETF, REIT, stock broker, insurance agent and financial advisor pricing strategies to manipulate investor choices.
Posted on April 19, 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.
Stat: $30,000–$50,000. That’s the estimated cost to address one case of measles, making the growing outbreak quite pricey for the US public health system, a CDC official said Tuesday. (NBC)
Quote: “These are still children with illnesses, and they want to be in their home city, where their family can visit them.”—Cynthia Rogers, a pediatric psychiatrist at St. Louis Children’s Hospital, on resistance against pediatric mental health hospitals being built in some communities (KFF)
When you buy a share of stock, you are taking ownership in a company. Collectively, the company is owned by all the shareholders, and each share represents a claim on assets and earnings. If the company distributes profits to its shareholders, you should receive a proportionate share of the earnings.
Stocks are often categorized by the size of the company, or their market capitalization. The market capitalization is determined by multiplying the number of outstanding shares by the current share price. The most common market cap classes are small-cap (valued from $100 million to $1 billion), mid-cap ($1 billion to $10 billion), and large cap ($10 billion to $100 billion).
Stocks are also categorized by their sector, or the type of business the company conducts. Common sectors include utilities, consumer staples, energy, communications, financial, health care, transportation, and technology.
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Stocks are often viewed as being in one of two categories — growth or value.
Growth stocks are ones that are associated with high quality, successful companies that are expected to continue growing at a better-than-average rate as compared to the rest of the market.
Value stocks are ones that have generally solid fundamentals, but are currently out of favor with the market. This may be due to the company being relatively new and unproven in the market, or because the company has recently experienced a decline due to the company’s sector being affected negatively. An example of this would be if the federal government was to levy a new tax on all cell phones, thus negatively affecting all cell phone company stocks.
History has shown that, over time, stocks have provided a better return than bonds, real estate, and other savings vehicles. As a result, stocks may be the ideal investment for investors with long-term goals.
Posted on April 18, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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U.S. stock and bond markets will be closed on Good Friday. Many global markets will also be closed Friday. Exceptions include Japan and mainland China, which will be open as usual. U.S. markets will reopen Monday. Many international markets will remain shut to mark Easter Monday, including Australia, Hong Kong, and exchanges in France, Germany and the U.K.
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YESTERDAY 4/17/25
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🟢 What’s up
TSMC eked out a 0.10% gain after the semiconductor maker reported a 60% increase in profits last quarter and downplayed the effects of tariffs.
Charles Schwab isn’t just the guy who made $2 billion from market chaos last week. It’s also the brokerage that reported record quarterly revenue, but shares only rose 0.65%.
Hertz climbed another 43.87%, tacking on another day of big wins after Bill Ackman’s Pershing Square Capital took a stake in the rental car company.
Trump Media & Technology Group popped 11.65% after the company asked the SEC to investigate a hedge fund with a $105 million short bet against it.
Chinese tea chain Chagee soared 15.86% in its first day of trading on the Nasdaq.
DR Horton missed analyst expectations last quarter and lowered its fiscal year guidance, but investors quickly forgave the country’s largest homebuilder and pushed shares up 3.16%.
What’s down
Alphabet took a 1.38% hit after a federal judge ruled that Google is a monopoly. This marks Alphabet’s second antitrust loss since last August.
Alcoa fell 6.98% after the aluminum mining behemoth announced it ate about $20 million in tariff-related costs last quarter, noting that this figure could rise to $90 million in the current quarter.
Posted on April 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.
Stocks ended the shortened trading week on a mixed note.
The Dow sank all day long, while the NASDAQ and S&P 500 struggled to stay out of negative territory. The S&P 500 squeaked by with a win, but the NASDAQ fell into the red just before the closing bell.
The WSJ reported that President Trump has explored firing Jerome Powell for months now. “If I want him out he’ll be out of there real fast, believe me,” Trump told reporters at the White House today.
Carried interest accounts for the bulk of private equity fund managers’ compensation. It is calculated as a share of fund profits, historically 20% above a threshold rate of return for limited partners.
In contrast with most other forms of employment compensation and business income, carried interest earned from fund investments held for at least three years is taxed as a long-term capital gain at a rate below the top marginal income tax rate.
Critics of the provision contend it taxes highly compensated private equity managers at a lower rate than comparably paid providers of labor or business services.
Defenders of carried interest argue taxing it as income would be unfair because it represents capital gains even if they’re not derived from recipients’ capital.
Posted on April 17, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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UnitedHealth stock nosedived 20% in morning trading, falling by $116 per share from Wednesday’s $585 close to $469. The Minnesota-based firm is on track for its steepest daily loss since Aug. 6, 1998.
The losses came after UnitedHealth’s first-quarter financial report was worse than analysts expected across each of the three major quarterly yardsticks: revenue, earnings per share and future earnings outlook.
Furthermore, after the opening bell, the Dow Jones Industrial Average tumbled 1.3%, or around 500 points. The S&P 500 moved up 0.4%, while the tech-heavy NASDAQ composite gained 0.5%.
Abbott Laboratories gained 2.77% after the pharma company missed sales estimates but still beat earnings forecasts.
Gold miners continue to climb as gold keeps hitting new highs. Newmont rose 2.51%, while Gold Fields gained 3.35%.
What’s down
Tesla sank 4.94% after the company’s share of EV sales in California fell below 50% in the first quarter, while export controls threaten plans to produce Cybercabs in the US.
United Airlines fell 0.01% despite reporting its “best first-quarter financial results in five years,” according to management. The airline took the unique measure of providing two different financial outlooks for the year ahead: one for a stable economy, and one for a recession.
Lyft shed just 0.46% on the news that the ride-hailing company is acquiring European taxi app Free Now for $199 million.
Interactive BrokersGroup reported a 47% increase in trading volume last quarter that helped it beat revenue expectations, but the brokerage still tumbled 8.95% after missing profit forecasts.
Palantir gave up some of its recent gains following its big NATO announcement, sinking 5.78% today as investors collected profits.
JB HuntTransport Services’ management team warned that the logistics company sits squarely in the crosshairs of the trade war, pushing shares down 7.68%.
Omnicom Group tumbled 7.28% after the advertising firm missed revenue estimates thanks to economic uncertainty.
Classic: An arrangement by which a patient requests that their health benefit payments be made directly to a designated person or facility, such as a physician or hospital. It is a legally binding agreement between patient and Insurance company asking them to send your reimbursement checks directly to your doctor.
Modern: To accept assignment means that the provider agrees to accept what ever the insurance company allows or approves as payment in full for the claim. The patient signs paperwork requiring his health insurance provider to pay his physician or hospital directly. EXAMPLES:
CMS: The approved amount, also known as the Medicare-approved amount, is the fee that Medicare sets as how much a provider or supplier should be paid for a particular service or item. Original Medicare calls this “assignment.”
Tardiness: When a medical office accepts an assignment of benefits, the insured patients may have to wait several months for their insurance reimbursement to arrive.
Classic: It’s no surprise that people are more honest when they know that they’re being watched. But what about just reminding them of the idea of being watched, without them actually being watched?
Modern: Researchers at the University of Newcastle’s Division of Psychology have an honor (or trust) system where they are requested to deposit payment for coffee in an “honesty box.” There was a note saying how much they should pay.
In 2006, Dr. Melissa Bateson and colleagues decided to do a little experiment: they placed an image above the note. They alternate between two pictures: one week they would use a picture of alleged human eyes and the other week, flowers. After 10 weeks, they plotted the amount of money received versus drinks consumed and found that people paid nearly three times as much for their drinks when eyes were displayed.
“There’s an argument that if nobody is watching us it is in our interests to behave selfishly. But when we think we’re being watched we should behave better, so people see us as co-operative and behave the same way towards us,” — Dr Bateson said
EXAMPLE:
Tax: This has great exemplar potential in things like federal, state and local income tax preparation, etc.
Insight: “It’s a definite that you’re all going to screw up, but it’s not a definite that any of you will learn from that,” declared one of our medical school instructors, years ago. “Cultivate the attitude that allows you to own your mistakes, and then, not repeat them” — reported Monique Tello MD MPH.
Posted on April 16, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Investors were apparently tired of all the volatility yesterday, leading to a relatively calm day where indexes ever-so-slightly slipped. But it was a big day for Netflix after the Wall Street Journal reported that the streaming giant has plans to double its revenue and reach a $1 trillion valuation by 2030.
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🟢 What’s up
Hewlett Packard Enterprise popped 5.11% after Elliott Investment Management took a $1.5 billion stake in the tech company.
Rocket Lab rocketed (sorry) 10.14% higher after the space stock inked deals with both the US Air Force and the UK Ministry of Defense.
Netflix rose 4.83% on a report from the Wall Street Journal that the streaming giant plans to hit a $1 trillion market capitalization and double its revenue by 2030. The company announces earnings on Thursday.
Bank of America and Citigroup both posted strong Q1 earnings that beat analyst forecasts (more on that below). BofA climbed 3.60%, while Citi rose 1.76%.
Albertsons tumbled 7.49% after the grocer’s full-year guidance came in below expectations.
Allegro Microsystems sank 9.68% on the news that ON Semiconductor has withdrawn its offer to acquire the chipmaker.
Applied Digital plummeted 35.94% after the digital infrastructure company missed analyst revenue estimates, despite sales climbing 22% last quarter.
#recessionindicator: Coty sank 8.57% after the beauty retailer was double downgraded by Bank of America analysts, citing a slowdown in makeup spending.
Posted on April 16, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
***
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 started the day strong but the rally eventually fizzled out as reports of trade talks between the US and EU making “little progress” left all three major indexes in the red.
The dreaded death cross has arrived: The S&P 500’s 50-day moving average is now below the 200-day moving average for the first time since 2022, a bearish technical indicator that has investors worried.
10-year Treasury yields fell to a one-week low, letting traders breathe a small sigh of relief after tariffs upended the status quo last week.
Posted on April 15, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
WARNING – WARNING
By Staff Reporters
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A “retirement account scam” is a type of online fraud that occurs when a third party administrator (TPA) for retirement investment accounts is tricked into authorizing a money distribution to an imposter posing as the true account holder.
The imposter often starts the scam by calling the TPA, identifying himself or herself as an actual account holder, and requesting a withdrawal distribution form. Once the imposter receives the withdrawal distribution form, the imposter returns the completed form to the TPA. The form is completed with the account holder’s real personal identifying information (PII)—often stolen via schemes, data breaches, and other hacking offenses—and bank account information for an account controlled by the imposter or the imposter’s conspirators.
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After the TPA processes the fraudulent request, the request is forwarded to the investment firm responsible for managing the account holder’s investments, and the funds—often the account holder’s life savings—are then directed to the imposter’s designated bank account.
Posted on April 15, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Natural Disaster Insurance
Protecting accumulated assets by insuring them against the wrath of Mother Nature
Most homeowners’ insurance policies do not cover damages arising from floods or earthquakes. If a home, or any other real property like a vacation home or beach condo, is in an area subject to floods or earthquakes, consider the value of purchasing insurance that covers such catastrophes.
Take the time to review your homeowners’ policy, making sure that it will repair or replace your roof if damaged by hail, and will apply in the event of high winds, rather than only in tornadoes. The key to the maintenance of any type of insurance is to anticipate all of the possible calamities, and then to decide whether you can afford to lose the assets exposed to those calamities.
Posted on April 15, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Stocks kept the good vibes going for a second trading day yesterday with tech companies like Apple rising as investors reacted to the weekend’s news that smartphones and computers would be temporarily exempt from “reciprocal” tariffs—at least until new semiconductor tariffs are imposed.
Car companies also jumped after President Trump suggested he wanted to “help” as automakers try to transition their production to the US in the face of 25% auto tariffs.