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Do RetroSpective Thoughts on Apple Inc Hint of the ProSpective Future after the “Crash” Today?

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PART I.

Understanding Apple Requires an Analysis of Fundamentals and Psychology

vitalyBy Vitaliy Katsenelson CFA

So many articles have been written recently about Apple — defending it or explaining why this glorious fruit will turn into a shriveling pumpkin by midnight (with Samsung’s help) — that I really haven’t felt the need to contribute to the unending debate.

But, when Apple’s stock crashed to $450 back in January 2013, we bought a little for our clients. After receiving an outraged e-mail from one of them calling the purchase “irresponsible” and proclaiming that everyone (including his neighbor) knows that Apple is going down to $300, I decided it was time to join the discourse. Clients rarely (almost never) contact us about stocks we own in their accounts. More important, this is far from the most “radioactive” stock we own or have owned.

So, here is a column on Apple, I wrote back then.  I have no intention of defending or prosecuting the company, but I would like to share some thoughts about it that many pundits have either overlooked or ignored.

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Logo of Apple Inc. to be used on a custom landing page/brand page about Apple products on the website of Shopping.com.

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The Psychlogy

What makes Apple stock difficult to own is psychology. The company’s success since 2000 is a black swan. We tend to think of Nassim Nicholas Taleb’s black swans as significant random negative events, but Apple is a positive one. When co-founder Steve Jobs came back to the company in the late ’90s, Apple was about to take its last breath. Jobs pulled off a miracle. He revived the company’s computer product line, making Macs exciting again, and then came out with three revolutionary “i” products in a row: the iPod, iPhone and iPad. You could argue that the success of each “i” product in itself was a black swan, exceeding all rational expectations and revolutionizing, transforming and in some cases creating new categories of merchandise that had never existed before.

Revenue and Market Capitalization

Apple’s revenue and market capitalization deservedly surpassed those of almighty Microsoft Corp. — the hairy monster with stinky breath that performed CPR on dying Apple in the late ’90s by injecting liquidity into the company by buying its preferred stock. We have a hard time processing this highly improbable success and an even harder time imagining that there is another black swan about to take flight from the Apple labs, especially with no Steve Jobs around to sit on the egg.

Black swans come out of nowhere, unannounced, but their impact may be long-lasting. The wildly successful “i” gadgets dug a formidable moat around Apple. They created the most valuable and still most inspirational brand in the world, funded an enormous research and development effort, enabled huge buying power (Apple locks up supply and pays much lower prices than many of its competitors for parts), filled out a mature product ecosystem and stuffed Apple’s debt-free balance sheet with $137 billion — half the market capitalization of Microsoft. The moat is wide, deep and unlikely to be breached any time soon.

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Ex-Cathedra black swan

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High Price

One reason the psychology of owning Apple stock is so difficult: it’s high price. (Note: I am talking not about its valuation but purely about its price.) Apple has had only one stock split since the late ’90s, when it was trading in double digits, and it now changes hands at about $450 (down from $700 just a few months ago). Stock splits create zero economic value in the long run — absolutely none. Apple could split its stock ten to one and you’d have ten $45 shares, and nothing about the company or its business would change. But, I’d argue that a 3 percent “slide” of $1.35 would grab fewer headlines than a $13.50 “drop” — there is a media magnification factor that is hard to ignore.

Hardware versus Software

Is Apple a hardware or a software company? This is a very important question because Apple’s net margins of 25 percent are dangerously higher than those of Microsoft, a software monopoly that, with the minor exception of the Xbox and its new venture into tablets, sells only software, which has a 100 percent incremental margin.

Apple is either a smart hardware company or a software maker dressed in hardware company clothes. Take a look at the PC businesses of traditional “dumb” hardware companies like Dell and Hewlett-Packard Co. (I am not insulting these companies, I am just highlighting their lack of PC-directed R&D.) They buy hard drives from Western Digital Corp., graphic cards from Nvidia Corp., processors from Intel Corp. and an operating system from Microsoft, then they have contract manufacturers put together these parts in Asia and ship PCs all over the world. Dell and HP engineers design the PCs but contribute minimal R&D to their boxes; most of the R&D is done by the suppliers. Dell and HP are really asset-lite marketing and logistics companies — this explains their razor-thin margins. (Side note: Because of a lack of fixed costs, Dell and HP can remain profitable despite the ongoing decline in PC sales.)

Same Surface

On the surface, Apple’s personal computer business is not that much different from Dell’s or HP’s: It uses the same highly commoditized hardware and it also outsources manufacturing, but Apple spends much more on the R&D of its own operating system and creates distinctive, innovative products. Apple gets to keep a slice of revenue that would otherwise go to Microsoft for the operating system. Also, Apple is able to charge a premium (usually a few hundred dollars per PC) for the aesthetic appeal and perceived ease of use of its products.

However, when it comes to the “i” devices, Apple is a much smarter hardware company; its value added goes further than just basic design and software. Though there is a lot of commoditized hardware that goes into an iPhone or iPad, Apple’s skill at fitting an ever-growing number of components into ever-shrinking devices constantly increases. Add world-class touch and feel, superior battery life and durability, and you have a package that turns what would otherwise be commodity items into highly differentiated, and undeniably sexy, products. Apple has even gone a step further and is designing its own microprocessors.

But — and this is a very important “but” — as phones and tablets mature, processor speed, battery life and weight will tend to become uniform across all devices. It is arguable that the competition has already caught up with Apple in the hardware race. As the hardware premium goes away, there will be only two premiums left: Apple’s brand and its ecosystem. (I will go into detail about the “i” ecosystem and what it means for Apple’s margins and profitability in my second essay posted below).

Note that I did not mention the software premium. Unlike Microsoft, which charges for the Windows operating system installed on PCs, Google gives away Android to anyone who dares to make a phone or a tablet. Unless Apple can maintain the operating system lead against Android, that premium will go away.

Assessment

Recently, I spent a few days playing with Nexus 7, Google’s Android-powered 7-inch tablet, which retails for $200 ($130 cheaper than Apple’s iPad mini). Nexus 7 is a good product, but I kept remembering that humans and monkeys share 98 percent of their DNA, and the Android operating system is missing the 2 percent that makes Apple iOS so special.

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PART II.

How Much Would You Pay for the Apple Ecosystem?

Apple’s ecosystem is an important and durable competitive advantage; it creates a tangible switching cost (or, an inconvenience) after Apple has locked you into the i-ecosystem. It takes time to build an ecosystem that consists of speakers and accessories that will connect only via Apple systems: Apple TV, which easily recreates an iPhone or iPad screen on a TV set; the music collection on iTunes (competition from Spotify and Google Play lessens this advantage); a multitude of great apps (in all honesty, gaming apps have a half-life of only a few weeks, but productivity apps and my $60 TomTom GPS have a much longer half-life); and, last, the underrated Photo Stream, a feature in iOS 6 that allows you to share photos with your close friends and relatives with incredible ease. My family and friends share pictures from our daily lives (kids growing up, ski trips, get-togethers), but that, of course, only works when we’re all on Apple products. (This is why Facebook bought Instagram for $1 billion. Photo Stream is a real competitive threat to Facebook, especially if you want to share pictures with a limited group of close friends.)

The i-ecosystem makes switching from the iPhone to a competitor’s device an unpleasant undertaking, something you won’t do unless you are really significantly dissatisfied with your i-device (or you are simply very bored). How much extra are you willing to pay for your Apple goodies? Brand is more than just prestige; it is the amalgamation of intangible things like perceptions and tangible things like getting incredible phone and e-mail customer service (I’ve been blown away by how great it is!) or having your problems resolved by a genius at the Apple store.

Of course, as the phone and tablet categories mature, Apple’s hardware premium will deflate and its margins will decline. The only question is, by how much?

Let me try to answer

From 2003 to 2012, Apple’s net margins rose from 1.1 percent to 25 percent. In 2003 they were too low; today they are too high. Let’s look at why the margins went up. Gross margins increased from 27.5 percent to 44 percent: Apple is making 16.5 cents more for every dollar of product sold today than it did in 2001. Looking back at Nokia Corp. in its heyday, in 2003 the Finnish cell phone maker was able to command a 41.5 percent margin, which has gradually drifted down to 28 percent.

Today, Nokia is Microsoft’s bitch, completely dependent on the success of the Windows operating system, which is far from certain. Nokia is a sorry shell of what used to be a great company, while Apple, despite its universal hatred by growth managers, is still, well, Apple. Its gross margins will decline, but they won’t approach those of 2003 or Nokia’s current level.

For Apple to conquer emerging markets and keep what it has already won there, it will need to lower prices. The company is not doing horribly in China — its sales are running at $25 billion a year and were up 67 percent in the past quarter.

However, a significant number of the iPhones sold in China (Apple doesn’t disclose the figure) are not $650 iPhone 5’s but the cheaper 4 and 4s models. (Also, on a recent conference call, Verizon Communications mentioned that half of the iPhones it has sold were the 4 and 4s models.) Apple’s price premium over its Android brethren is not as high as everyone thinks.

What is truly astonishing is that Apple’s spending on R&D and selling, general and administrative (SG&A) expenses has fallen from 7.6 percent and 19.5 percent, respectively, in 2003 to a meager 2.2 percent and 6.4 percent today. R&D and SG&A expenses actually increased almost eightfold, but they didn’t grow nearly as fast as sales. Apple spends $3.4 billion on R&D today, compared with $471 million in 2001. This is operational leverage at its best. As long as Apple can grow sales, and R&D and SG&A increase at the same rate as sales or slower, Apple should keep its 18.5 percentage points gain in net margins through operational leverage.

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Growth of sales is an assumption in itself. Apple’s annual sales are approaching $180 billion, and it is only a question of when they will run into the wall of large numbers. At this point, 20 percent-a-year growth means Apple has to sell as many i-thingies as it sold last year plus an additional $36 billion worth. Of course, this argument could have been made $100 billion ago, and the company did report 18 percent revenue growth for the past quarter, but Apple is in the last few innings of this high-growth game; otherwise its sales will exceed the GDP of some large European countries.

If you treat Apple as a pure hardware company, you’ll miss a very important element of its business model: recurrence of revenues through planned obsolescence. Apple releases a new device and a new operating system version every year. Its operating system only supports the past three or four generations of devices and limits functionality on some older devices. If you own an iPhone 3G, iOS 6 will not run on it, and thus a lot of apps will not work on it, so you will most likely be buying a new iPhone soon. In addition — and not unlike in the PC world — newer software usually requires more powerful hardware; the new software just doesn’t run fast enough on old phones. My son got a hand-me-down iPhone 3G but gave it to his cousin a few days later — it could barely run the new software.

As I wrote above, Apple’s success over the past decade is a black swan, an improbable but significant event, thanks in large part to the genius of Steve Jobs. Today investors are worried because Jobs is not there to create another revolutionary product, and they are right to be concerned. Jobs was more important to Apple’s success than Warren Buffett is to Berkshire Hathaway’s today. (Berkshire doesn’t need to innovate; it is a collection of dozens of autonomous companies run by competent managers.) Apple will be dead without continued innovation.

Jobs was the ultimate benevolent dictator, and he was the definition of a micro-manager. In his book Steve Jobs, Walter Isaacson describes how Jobs picked shades of white for Apple Store bathroom tiles and worked on the design of the iPhone box. He had to sign off on every product Apple made, down to and including the iPhone charger. His employees feared, loved and worshiped him, and they followed him into the fire. Jobs could change the direction of the company on a dime — that was what it took to deliver black i-swans. Jobs is gone, so the probability of another product achieving the success of the iPhone or iPad has declined exponentially.

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Steve Jobs RIP

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What is really amazing about Apple is how underwhelming its valuation is today — it doesn’t require new black swans.

In an analysis we tried very hard to kill the company. We tanked its gross margins to a Nokia-like 28 percent and still got $30 of earnings per share (the Street’s estimate for 2013 is $45), which puts its valuation, excluding $145 a share in cash, at 10 times earnings. We killed its sales growth to 2 percent a year for ten years, discounted its cash flows and still got a $500 stock.

There is a lot of value in Apple’s enormous ability to generate cash. The company is sitting on an ever-growing pile of it — $137 billion, about one third of its market cap. Over the past 12 months, despite spending $10 billion on capital expenditures, Apple still generated $46 billion of free cash flows. If it continues to generate free cash flows at a similar rate (I am assuming no growth), by the end of 2015 it will have stockpiled $300 of cash per share. At today’s price [2013] it will be commanding a price-earnings ratio (if you exclude cash) of 4.

Of course, the market is not giving Apple credit for its cash, but I think the market is wrong. Unlike Microsoft, which does something dumber than dumb with its cash every other year, Apple has a pristine capital allocation track record. It has not made any foolish acquisitions — or, indeed, any acquisitions of size. Other than buying an Eastern European country and renaming it i-Country, Apple will not be able to acquire a technologically related company of size, nor will it want or need to. The cash it accumulates will end up in shareholders’ hands, either through dividends or share buybacks.

What is Apple worth?

After the financial acrobatics I’ve done trying to murder the valuation of Apple, it is easier to say that it is worth more than $450 than to pinpoint a price target. When I use a significantly decelerating sales growth rate and normalize margins (reducing them, but not as low as Nokia’s current margins), I get a price of about $600 to $800 a share.

Growth managers don’t want Apple to pay a large dividend, as though that would somehow transform this growing teenager into a mature adult. But I have news for them: Apple already is a mature adult. Second, when your return on capital is pushing infinity (as Apple’s is), you don’t need to retain much cash to grow. Two thirds of Apple’s cash is offshore, but that doesn’t make it worthless; it just makes it worth less — only $65 billion, maybe, not $97 billion, once the company pays its tax bill to Uncle Sam.

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Assessment

In the short term none of the things I am writing about here will matter. Remember, “Everyone knows Apple is going to $300,” as a client recently e-mailed me, as everyone knew it was going to a $1,000 a few months ago when Apple’s stock was trading at $700. The company’s stock will trade on emotion, fundamentals will not matter, and growth managers will likely rotate out of Apple, because once the stock declined from $700 to $450, the label on it changed from “growth” to “value.”

But ultimately, fundamentals will prevail. Like the laws of physics, they can only be suspended for so long. And so, do these retrospective thoughts on Apple hint of future prospects?

More: Should You Buy Apple Stock Ahead of Its September Event

ABOUT

Vitaliy N. Katsenelson CFA is Chief Investment Officer at Investment Management Associates in Denver, Colo. He is the author of Active Value Investing (Wiley 2007) and The Little Book of Sideways Markets (Wiley, 2010).  His books were translated into eight languages.  Forbes Magazine called him “The new Benjamin Graham”.  

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Front Matter with Foreword by Jason Dyken MD MBA

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Financial Advice Re-Invented for Medical Professionals?

cmp-logo

By Dr. David Edward Marcinko MBA CMP™

Dr David E Marcinko MBA

http://www.CertifiedMedicalPlanner.org

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Introduction 

Much has been written, said and opined on this ME-P and elsewhere on financial advisory fees, commissions and other means of rumination.

So, what method is really best for the physician or other client? Full service, discounted fee for service, AUMs, commissions, wrap fees, ETFs, load or no-load mutual funds, annuities, stocks or individual bonds, etc? Oh! Did I forget the current [higher] fiduciary standard versus [lower] suitability conundrum? And now, the latest fad is the … Robo-Advisor service.

Of course, the very need for any sort of “professional” financial advisor is often questioned by the DIYer.

The Need

According to some research however, a financial advisor can help improve an investor’s net portfolio returns over time by building a portfolio with low-cost investments, minimizing taxes, and serving as an investing coach during volatile times in the market.

Source: Francis M. Kinniry Jr., Colleen M. Jaconetti, Michael A. DiJoseph, and Yan Zilbering, 2014. Putting a value on your value: Quantifying Vanguard Advisor’s Alpha. Valley Forge, Pa.: The Vanguard Group. For a copy of the research paper, visit vanguard.com/advisorvalue

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The Vanguard Personal Advisor Services

With a new offering from Vanguard Personal Advisor Services, you’ll purportedly work with a financial advisor who’s a Certified Financial Planner® professional. Your dedicated advisor will:

1. Get to know you, your goals, and your unique financial situation.
2. Partner with you to create a custom-tailored financial plan.
3. Put your plan into action and manage your portfolio, allowing you to be as involved as you want to be.
4. Monitor your plan’s progress and keep you informed.
5. Rebalance your portfolio as necessary and partner with you to revise your plan when important changes in your life occur.

Assessment

And, just as you’d expect from Vanguard, the cost for this service is low, about one-third the industry average.

But alsa, no such relationship exists for medical professionals from a Certified Medical Planner™

Source: PriceMetrix, 2013. The industry average fee is 0.99% annually of assets under management compared with Vanguard’s annual cost of only 0.30% of assets under management. For a copy of the complete report, go to pricemetrix.com. Advisor fees may differ depending on the type and nature of the services offered.

More:

Become a CMP

Full Disclosure: I am not affiliated with Vanguard Advisory Services in any way.

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Front Matter with Foreword by Jason Dyken MD MBA

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***

Buying Warren Buffett, Richard Branson and Steve Jobs at a Discount

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On capital allocators with impressive records

vitaly

By Vitaliy Katsenelson CFA

What would you get if you crossed Warren Buffett, Richard Branson and Steve Jobs? Answer: Masayoshi Son, the Korean-Japanese, University of California, Berkeley–educated founder of one of Japan’s most successful companies, SoftBank Corp.

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[A capital allocator]

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Masayoshi Son

Just like Buffett, Son is a tremendous capital allocator with a very impressive record: Over the past nine and a half years, SoftBank’s investments have had a 45 percent annualized rate of return. A big chunk of this success can be attributed to one stock: Chinese e-commerce giant Alibaba, a $100 million investment SoftBank made in 2001 that is worth about $80 billion today. Though you may put Alibaba in the (positive) black swan column, Son’s success as an investor goes well beyond it — the list of his investments that have brought multibagger returns is very long. Today, at the tender age of 57, he is the richest man in Japan, and SoftBank, which he started in 1981 and owns 19 percent of, has a market capitalization of $72 billion.

Son, like Apple co-founder Jobs, is blessed with clairvoyance. He saw the Internet as an amazing, transformative force well before that fact became common knowledge. In 1995 he invested in a then-tiny company, Yahoo!, earning six times his investment. But he didn’t stop there; he created a joint venture with Yahoo! by forming Yahoo! Japan, putting about $70 million in a company that today is worth around $8 billion. (Yahoo! Japan is a publicly traded company listed in Japan).

What is shocking is that Son saw that the iPhone would revolutionize the telecom industry before Apple announced it or even invented it. See for yourself in this excerpt from an interview with Charlie Rose, where Son describes his conversation with Jobs in 2005 — two years before the iPhone was introduced:

“I brought my little drawing of [an] iPod with mobile capabilities. I gave [Jobs] my drawing, and Steve says, “Masa, you don’t give me your drawing. I have my own.” I said, “Well, I don’t need to give you my dirty paper, but once you have your product, give me for Japan.” He said, “Well, Masa, you are crazy. We have not talked to anybody, but you came to see me as the first guy. I give to you.”

Richard Branson

Similar to Virgin Group founder Branson, who had the testicular fortitude to create Virgin Atlantic Airways in the U.K. to compete against the state-owned behemoth British Airways, Son started two telecom businesses in Japan — one fixed-line and one wireless — with which he challenged the state-owned NTT monopoly. In 2001, disgusted with Japan’s horrible broadband speeds, he convinced the government to deregulate the telecom industry. When no other companies emerged to compete with NTT (I don’t blame them, really), Son took it upon himself to start a fixed-line competitor, Yahoo! BB (Broadband). Thanks to him, now Japan enjoys one of the highest broadband speeds in the world and Yahoo! BB is a leading fixed-line telecom.

It took Son four years to bring his broadband business to profitability. This is how the Wall Street Journal described that period in 2012:

“The problems at the broadband unit contributed to losses for the entire company for four consecutive years. Mr. Son set up an office in a meeting room 13 floors below his executive suite to be closer to the problem unit. He slept in the office at times and routinely summoned executives and partners for meetings late at night. . . . He worked out of the meeting room for 18 months, until the broadband unit had cut enough costs and moved enough customers to more lucrative plans.”

A normal person might have taken a break and enjoyed the fruits of his labor at that point, but not Son. Just as his broadband business went in the black, Son executed on his vision for the Internet and bought Vodafone K.K., a struggling, poorly run wireless telecom in Japan. SoftBank paid about $15 billion, borrowing $10 billion.

Fast-forward eight years, and SoftBank Mobile is an incredible success. It is one of the largest mobile companies in Japan, even faster growing than NTT Docomo (a subsidiary of almighty NTT). Today it spits out about $5 billion in operating profits annually — not bad for a $5 billion equity investment.

Like Branson, Son is a serial entrepreneur who has started multiple, often unrelated businesses and has succeeded a lot more than he has failed. SoftBank has built a robot named Pepper that can read human emotions; and after the earthquake that crippled Japanese power generation, Son started a renewable-energy business.

Son has a very ambitious goal for SoftBank: He wants it to become one of the largest companies in the world. Unlike the average Wall Street CEO, whose time horizon has shrunk to quarters, Son thinks in centuries. I kid you not — he has a 300-year vision for SoftBank. Practically speaking, 300 years is a bit challenging even for long-term investors, but at the core of his vision Son is building a company that he wants to last forever (or 300 years, whichever comes first).

He views SoftBank as an Internet company and is committed to investing in Internet companies in China and India. He thinks that as these countries develop, their GDPs will eclipse those of the U.S. and Europe.

Jobs, Branson, Buffett — it is very rare for somebody to embody strengths of all three of these giants. None of them has the qualities of the other two. Buffett is not a visionary, nor does he want to run the companies in his portfolio. Branson is not a visionary — in his book Losing My Virginity he admits he did not see analog music (CDs) being destroyed by digital music (iTunes) and demolishing his music store business. Jobs probably came the closest, as both a visionary and a business builder, but he was not known for his investing acumen.

You’d think SoftBank would be richly priced to reflect Son’s premium. Wrong! Today its stock is trading at about a 40 percent discount to the fair value of its known assets (SoftBank has about 1,300 investments, many of them not consolidated on its financials).This discount is not rational, but maybe the market thinks Alibaba is overvalued, or it expects the Japanese yen to continue its decline (I would not disagree), and thus wholly owned Japanese telecom businesses are going to be worth less in U.S. dollars. Or maybe SoftBank’s Sprint investment is not going to work out. Oh, I forgot to mention that one — let’s address it next.

SoftBank’s Japanese telecom businesses generate about $6 billion of very stable operating income, but there is little room for growth in Japan. Unable to find anything telecom to buy in Asia, in 2013 the company took advantage of the strong yen and bought 80 percent of Sprint for $21 billion, or $7.65 a share. Sprint is the No. 3 mobile company in the U.S., a market dominated by AT&T and Verizon, which together account for about 75 percent of wireless revenue and more than 100 percent of wireless profits (T-Mobile and Sprint are losing money). If I knew no more than that, I’d say Sprint’s chances of success in the U.S. are slim — after all, it is competing against two very profitable giants.

But I would have said the same thing about SoftBank’s adventure into fixed-line and then wireless in Japan, and I would have been dead wrong. Admittedly, Sprint’s turnaround will not be easy and will be far from linear, and its $30 billion debt load will not help. SoftBank is looking to apply the tremendous experience it gained through a lot of hard work in turning an ailing Vodafone K.K. into one of the best wireless companies in the world.

However, this time around SoftBank is even better equipped to fight its competition: It has lots of experience with 2.5 GHz spectrum in Japan, where its network is several times faster than Verizon’s and AT&T’s networks in the U.S. SoftBank brought 200 engineers from Japan to help Sprint design its new network; the two companies combined have tremendous buying power in equipment, second only to China Mobile. In fact, suppliers Alcatel-Lucent, Nokia and Samsung just agreed to provide Sprint with $1.8 billion in vendor financing. But most important, SoftBank has already had success with a telecom turnaround. It is following the same road map with Sprint that it used in Japan with Vodafone K.K.: improve the network, cut costs, provide better customer service and top all that with cutthroat price reductions.

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Sprint News

Over the past several months, the news flow from Sprint has not been great: It cut guidance, and its stock declined to $4 a share. This may explain why SoftBank’s stock is down; however, even if Sprint meets its maker, the impact on SoftBank should be just $5 a share. Sprint’s $30 billion debt is nonrecourse to SoftBank. Even at current market values, SoftBank’s equity stake in Sprint is worth only $12 billion, while its 32 percent stake in Alibaba is worth $80 billion, and its Japanese telecom businesses are worth about $50 billion (at five times earnings before depreciation and amortization). SoftBank’s stake in Yahoo! Japan is worth north of $8 billion.

Softbank

As part of our investment analysis, we tried to hypothetically kill SoftBank — smother it with a pillow — but we simply could not. We assumed that the yen will depreciate against the dollar to 180 from 120 today, slashing the value of Japanese businesses by a third. Alibaba stock is trading at around $100, about 30 times 2015 earnings forecasts; we took the earnings multiple down to 20 times, pricing the stock at $60. We even assumed SoftBank will have to pay capital gains taxes on selling Alibaba. We halved the price of Sprint’s stock. However, even in this fairly grim scenario we could not get SoftBank’s stock to decline much below its current price of $30. In the worst case we are paying fair value for SoftBank’s assets and get Son’s magic for free. This places no value on his 1,300 other investments, either. Sprint may, by the way, actually work out to be a tremendous success for SoftBank.

There are many ways to look at SoftBank. You can think of it as buying a stock at a roughly 50 percent discount to the market value of its assets or as a way to buy Alibaba at less than half its current price. Alibaba is a great play on China — not the China that builds ghost towns and bridges to nowhere but the Chinese consumer, and not just the Chinese consumer but the Chinese consumer who is spending more and more money shopping online. Alibaba is synonymous with Chinese online shopping, whose growth may accelerate with higher smartphone penetration and, just as important, the ongoing rollout of a fast wireless LTE network.

I’d be remiss if I did not discuss an important asterisk in the ownership of Alibaba. Its shares listed on the NYSE and owned by SoftBank don’t have an economic interest in Alibaba, although, through a stake in a Cayman Islands entity, they have contractual rights to profits from Alibaba China. The latter is owned and controlled by Jack Ma, Alibaba’s founder and CEO. This structure is not a by-product of Ma’s evil intent to steal Alibaba from gullible investors but rather is forced by Chinese law that prohibits foreign ownership in certain industries. There is a risk that the Chinese government might find this structure illegal, but at Alibaba’s size — $240 billion — the company is simply too big to be messed with. China’s economy would pay a huge price if its second-largest public company just disappeared due to a legal technicality. This would also turn into an international public relations nightmare for China, not only with the U.S. but with Japan as well. It would make Ma richer at the expense of U.S. shareholders but also at the expense of SoftBank and Japan’s richest man, Son.

(Those who have a problem with Ma maintaining complete operational control of Alibaba should recall that the phenomenon of founder as benevolent dictator is nothing new — just look at Google. In fact, I’d argue that this control has allowed Ma to sustain his long-term time horizon and this is what has helped Alibaba drive eBay out of China; but that’s a discussion for another time).

Assessment

You can also look at SoftBank as a vehicle through which to invest in emerging markets — not just China but India as well. It is almost like hiring the combination of Buffett, Branson and Jobs to go to work for you investing in markets whose economies in a few decades will surpass that of the U.S., while also investing in a segment of the economy — the Internet — that is growing at a much faster rate than the overall economy. And yes, of course, you have Masayoshi Son, the super-Buffett-Branson-Jobs fusion, making these investments for you. With SoftBank at this valuation, you can forget about your emerging-markets mutual fund.

More: Ode to Steve Jobs

ABOUT

Vitaliy N. Katsenelson, CFA, is Chief Investment Officer at Investment Management Associates in Denver, Colo.

Conclusion

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Front Matter with Foreword by Jason Dyken MD MBA

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

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What does “Retirement” mean to You?

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A Mental Exercise … for You!

By Rick Kahler MS CFP® http://www.KahlerFinancial.com

Rick Kahler MS CFPHere’s a brief mental exercise to try: Quickly, without stopping to think, write down what comes to mind when you imagine yourself being retired.

If you’re 40 or younger, your answers might well include terms like “future” and “old age,” which probably don’t seem especially relevant or urgent at this stage in your life.

If you’re older, chances are you’ve had at least passing thoughts about retirement. You might associate it with concepts like these:

  • Freedom from the daily grind
  • Losing my earning power
  • Losing my identity
  • Enjoying financial independence
  • Being useless
  • Dependency and declining health
  • Doing what I’ve always wanted to do
  • I don’t ever plan to retire

Both the positives and negatives in the above list have one thing in common: they don’t tell the whole story. The idea of retirement is surrounded by a host of delusions, assumptions, and fears. Many of our expectations about it do not match the reality.

Examples:

Here are just two examples from “The 2013 Risks and Process of Retirement Survey,” done by the Society of Actuaries.

  • Of the pre-retirees surveyed, 38% expected to work until at least 65. Another 15% expected not to retire at all. Yet 54% of the retirees surveyed had retired before age 60.
  • Many pre-retirees—59%—planned to stop working gradually. Yet only 22% of retirees had done so. While 35% of pre-retirees intended to keep working part-time, only 10% of retirees actually did.

It’s no wonder that many workers plan to stay employed; they’ll need the money. The 2015 Transamerica Retirement Survey of Workers estimates the median amount that workers in their 50s have saved for retirement at only $117,000. For workers in their 60s and older, it is $172,000. Even combined with Social Security, that’s hardly enough to provide an adequate retirement income.

Yet even if you intend to keep working and earning until you’re 80, you may find your plans derailed. If companies downsize, older workers may be among the first to be laid off. Health problems (your own or those of family members you may need to care for) can force you to retire earlier than you expected to.

And, these are only two of the unfortunate realities that can jolt any of us out of our rosy expectations of enjoying a carefree retirement of good health, comfort, and independence.

Just because we can’t count on carrying out our retirement plans, though, doesn’t mean we should give up on retirement planning altogether.

Some Suggestions

Here are a few suggestions to deal with the realities of retirement:

  1. Save as much as you can. Make funding retirement your priority, especially if it’s too late to start early. Cut your spending, downsize, and pay off debt. Having more money in retirement gives you more options when bad things do happen.
  1. Improve your health: lose weight, exercise more, and eat a healthy diet. Improve your odds for staying well by changing what is within your power to change.
  1. Look at the whole retirement picture. Become willing to consider both the negative and positive possibilities in order to plan appropriately. Unreasonable pessimism and fear are no more realistic than unreasonable optimism.

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7 ways retirement income

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Assessment

Finally, the most realistic viewpoint may be accepting that retirement is no more or less predictable than any other stage of life. We can’t know if we’ll develop serious health problems in our 70s or still be able to go dancing when we’re 102. While we can and should prepare for the future, we also serve ourselves well when we remember to enjoy the present.

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Front Matter with Foreword by Jason Dyken MD MBA

I plan to give a copy of this book written by doctors and for doctors’ to all my prospects, physician, and nurse clients. It may be the definitive text on this important topic.

Alexander Naruska CPA [Orlando, Florida]

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

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R.I.P. these Industry Sectors?

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Can You Think of any Others?

[By Staff Reporters]

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RIP Tech

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[HOSPITAL OPERATIONS, ORGANIZATIONAL BEHAVIOR AND FINANCIAL MANAGEMENT COMPANION TEXTBOOK SET]

Product DetailsProduct Details

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2015 Kent State University College of Podiatric Medicine Holds “White Coat” Ceremony

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Welcome the New KSUCPM “White-Coats”

[By Staff Reporters via PMNews August 14, 2015 #5,445]

Kent State University College of Podiatric Medicine (KSUCPM) recently celebrated the Class of 2019 White Coat Ceremony. The College of Podiatric Medicine welcomed 122 students into the Class of 2019. The ceremony was held in the University Auditorium at Cartwright Hall on the Kent Campus in Kent, OH.

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KSCPM

KSUCPM Class of  2019 at White Coat Ceremony

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Dean Speak

Dr. Allan M. Boike DPM, Dean, stated, “I am very pleased to welcome this remarkable group of students to Kent State University. This class represents 35 states, as well as four nations.”

Keynote Speaker Speak

Dr. Karen Kellogg served as the keynote speaker. She received a Doctorate of Podiatric Medicine from the Ohio College of Podiatric Medicine in 2000. And, she completed a three-year podiatric surgery residency at Dunlap Memorial Hospital in Orrville, OH.

More: 2015 Harvard Medical School Class

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

[HOSPITAL OPERATIONS, ORGANIZATIONAL BEHAVIOR AND FINANCIAL MANAGEMENT COMPANION TEXTBOOK SET]

Product DetailsProduct Details

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The Role of Master Data Management in Health Care

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By MCOL.com

Where are you in the business and data analytics roadmap?

ImageProxy

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Conclusion

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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

[HEALTH INSURANCE, MANAGED CARE, ECONOMICS, FINANCE AND HEALTH INFORMATION TECHNOLOGY COMPANION DICTIONARY SET]

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A [Physician] Investor’s Worst Enemy?

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Fear of Missing Out

By Lon Jefferies CFP MBA

Lon JefferiesFear of missing out (FOMO) is an increasingly powerful emotion in our daily lives – so much so that FOMO was officially added to the Oxford English Dictionary in 2013.

DEFINITION

Have you ever looked at your Facebook feed and been jealous of someone’s picture from a beautiful viewpoint, or enviable of a friend’s photo of an expensive dinner with a strategically placed bottle of fancy wine in the background?

That is FOMO – the fear that at any given moment someone is doing something more appealing than what we are doing at the time.

Part of Life

A fear of missing out has always been part of life, but it has become more prevalent with the emergence of social media. Personally, I can’t help but check my Twitter feed every hour or so to make sure that I’m not missing out on an article published by one of my favorite financial writers. Yet, social media has increased the power of FOMO more than I realized.

Example

I have absolutely zero interest in horse racing – frankly, I dislike the sport. However, due to all the hype on Facebook and Twitter, I couldn’t help but watch the Belmont Stakes out of fear of missing American Pharaoh become the first Triple Crown winner of my lifetime.

FOMO is frequently a counter-productive emotion, leading to jealousy of others, dissatisfaction with our own lives, and bad decision-making processes. Nowhere is the negative impact of FOMO more apparent than in some individuals’ investment strategy. For years, no one has enjoyed going to the neighborhood BBQ only to have to listen to their next door neighbor brag about how his portfolio has outperformed the S&P 500 index over the last six months. Not only is listening to the boasting annoying, it makes us discontent with the return our own portfolio has achieved and makes us wonder if we should adapt a different strategy (i.e. take more risk right after the market achieved a new all-time high).

Social media has expanded the impact of FOMO on investment strategies. For the last year, the internet has ensured we are aware that large cap indexes like the S&P 500, Dow Jones Industrial Average, and NASDAQ are at all-time highs and achieving appealing returns, and we wonder why our more diversified portfolio isn’t behaving in a similar fashion. It is hard to be content with our diversified strategy when every media outlet is constantly reminding us how we are missing out on the stellar performance that could be obtained if only we had a non-diversified portfolio that invested only in the asset category that is currently in the middle of a hot streak.

When it comes to investing, FOMO is significantly impacted by recency bias. Our fear of missing out becomes more and more intense after the market has just experienced an uptick. If we take a couple of steps back, it is clear why we maintain a diversified portfolio – it provides the most appealing tradeoff between maximizing returns and minimizing risk.

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FOMA
                                

Fear Of Missing Out

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Yet, it is hard to remind ourselves of this when it seems like everyone around us is taking advantage of the latest market trends and we are missing out.

Of course, changing our portfolio to try and take advantage of a run that has already taken place would be foolish, as we would be selling assets with prices that have remained flat and may now be undervalued relative to the market in order to buy assets that have recently experience significant growth and are likely now expensive. These are the type of decisions that FOMO can cause and we would be wise to avoid this type of thinking.

A Re-Do?

We have been in this position before. In the late 1990s, people wanted to abandon their diversified portfolio and put a heavy focus on the technology stocks that were making all their neighbors rich. In the mid 2000s, everyone wanted to borrow as much money as possible and utilize the funds to buy and flip real estate.

In the early 2010s, everyone was wondering if they should sell their stocks before a double-dip recession began and use the resulting funds to buy gold. In each of these scenarios we were hearing individual stories of others who had implemented these strategies and were doing better than we were.

Of course, with the benefit of hindsight, we can see that changing our long-term investment strategy due to a fear of missing out on what was working for others over a short time period would have been a drastic mistake in each of these circumstances. After the market has done well, recency bias and FOMO causes investors to be more afraid of missing a bull market than of suffering large losses.

However, in these times, we need to remember that we chose a diversified investment strategy because it provides us with the highest probability of obtaining our financial goals while exposing us to the least amount of volatility possible.

Assessment

When the media and our acquaintances insist on informing us how we would have been better off placing heavy bets on the asset categories that have recently done well, we would be well served to remember that a diversified portfolio strategy will almost certainly provide us with the best chance to achieve long-term investment success. 

Conclusion

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Front Matter with Foreword by Jason Dyken MD MBA

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

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Ratio of [Start-Up] Deals Reviewed to Investments [Ultimately] Made

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Top Ten Most Innovative Healthcare Companies of 2015

Medical Entrepreneurs – Take Note!

Conclusion

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

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***

David Cummings on Startups

Recently, I was reading the limited partner quarterly updates for a fund where I’m an investor. In the update, the author highlighted that the fund had reviewed 1,000 potential deals last year and invested in four companies. At a ratio of 250:1, it’s clear that there are many more startups trying to raise a Series A than there are Series A investments (see the Series A crunch talked about four years ago).

Here’s how the investment process might work at a venture fund:

  • 250 deals reviewed
  • 25 one-on-one pitches (where the entrepreneur pitches a single partner)
  • 5 full partner pitches (where all the partners hear the pitch)
  • 2 term sheets
  • 1 investment

Raising money is much harder than most entrepreneurs expect. With funds seeing so many opportunities, but only being able to invest in 1-2 companies per year per investor, it’s clear that most entrepreneurs will feel rejected when out raising…

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The Ever Changing “Standard of Medical Care”

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Lard and Nicotine

Via Hend:

According to Wikipedia, a standard of care is a medical or psychological treatment guideline, and can be general or specific. It specifies appropriate treatment based on scientific evidence and collaboration between medical and/or psychological professionals involved in the treatment of a given condition.

Some common examples:

1. Diagnostic and treatment process that a clinician should follow for a certain type of patient, illness, or clinical circumstance. Adjuvant chemotherapy for lung cancer is “a new standard of care, but not necessarily the only standard of care”. (New England Journal of Medicine, 2004)

2. In legal terms, the level at which an ordinary, prudent professional with the same training and experience in good standing in a same or similar community would practice under the same or similar circumstances. An “average” standard would not apply because in that case at least half of any group of practitioners would not qualify. The medical malpractice plaintiff must establish the appropriate standard of care and demonstrate that the standard of care has been breached, with expert testimony.

3. A physician also has a “duty to inform” a patient of any material risks or fiduciary interests of the physician that might cause the patient to reconsider a procedure, and may be liable if injury occurs due to the undisclosed risk, and the patient can prove that if he had been informed he would not have gone through with the procedure, without benefit of hindsight. (Informed Consent Rule.) Full disclosure of all material risks incident to treatment must be fully disclosed, unless doing so would impair urgent treatment. As it relates to mental health professionals standard of care, the California Supreme Court, held that these professionals have “duty to protect” individuals who are specifically threatened by a patient. [Tarasoff v. Regents of the University of California, 17 Cal. 3d 425, 551 P.2d 334, 131 Cal. Rptr. 14 (Cal. 1976)].

4. A recipient of pro bono (free) services (either legal or medical) is entitled to expect the same standard of care as a person who pays for the same services, to prevent an indigent person from being entitled to only substandard care.

Source: https://en.wikipedia.org/wiki/Standard_of_care

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B2Q2bSgCUAAu4Aw

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doctors-smoke-camel

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Assessment

We may not recommend this today, but back in the day…..?

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Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Understanding International Bond Advantages?

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In Global Investable Markets

tim[By Timothy J. McIntosh MBA CFP® MPH]

International bonds now account for more than 35% of the world’s investable assets, and yet many physicians and other investors have little or no exposure to these types of securities. International fixed income securities make up a noteworthy portion of the global investable market.

While investors in international bonds are exposed to the hazard of interest rate movements and political risks, the principal factors driving international bond prices are actually uncorrelated to the most common U.S. risk factors. This indicates a true diversification benefit for any investor. International bonds have become more prominent and attractive due to the increase in globalization and the pervasive expansion of debt issuance overseas, primarily by governments. There has been a near doubling of the relative weight of the non-U.S. bond market from approximately 19% in 2000 to approximately 37% in 2011.  Thus, there is more selection of international bonds than ever for U.S. investors.

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shaking-hands

[Global Debt Markets]

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Investing in international bonds involves contact to the movements of global currencies. This is the primary component of determining international bond returns.  Alternations in currencies create an extra layer of volatility in these types of securities.

However, that volatility actually enhances diversification benefits.  One of the key considerations of any purchase of international bonds is whether or not to hedge the currency impact.  These deviations create return volatility above the level inherent to the underlying investment. An allocation to an unhedged international bond does reflect an investor’s bearish view of the U.S. dollar.  This is because as the dollar depreciates against a foreign currency, an international bond will gain in value.  The last 25-plus years have witnessed a long-term decline in the U.S. dollar, actually providing a tail wind for international bond investors.

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russian bonds

[Russian Bond]

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In fact, according to data from Vanguard, unhedged international bonds outperformed hedged bonds by 2.2 percentage points a year since 1987. The diversification benefit from international bonds is also attractive.

For example, from January 1, 1992 to March 31, 2013, the correlation between the Citigroup World Government Bond Index ex-US 1-3 Years index and five-year U.S. Treasury notes was a mere 0.35.  An allocation to international bonds can amplify portfolio diversification across economies, currencies, and yield curves.

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IMG_0737

[iMBA Inc., in Moscow]

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ABOUT

Timothy J. McIntosh is Chief Investment Officer and founder of SIPCO.  As chairman of the firm’s investment committee, he oversees all aspects of major client accounts and serves as lead portfolio manager for the firm’s equity and bond portfolios. Mr. McIntosh was a Professor of Finance at Eckerd College from 1998 to 2008. He is the author of The Bear Market Survival Guide and the The Sector Strategist.  He is featured in publications like the Wall Street Journal, New York Times, USA Today, Investment Advisor, Fortune, MD News, Tampa Doctor’s Life, and The St. Petersburg Times.  He has been recognized as a Five Star Wealth Manager in Texas Monthly magazine; and continuously named as Medical Economics’ “Best Financial Advisors for Physicians since 2004.  And, he is a contributor to SeekingAlpha.com., a premier website of investment opinion. Mr. McIntosh earned a Bachelor of Science Degree in Economics from Florida State University; Master of Business Administration (M.B.A) degree from the University of Sarasota; Master of Public Health Degree (M.P.H) from the University of South Florida and is a CERTIFIED FINANCIAL PLANNER® practitioner. His previous experience includes employment with Blue Cross/Blue Shield of Florida, Enterprise Leasing Company, and the United States Army Military Intelligence.

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

“Physicians who don’t understand modern risk management, insurance, business and asset protection principles are sitting ducks waiting to be taken advantage of by unscrupulous insurance agents and financial advisors; and even their own prospective employers or partners.

This comprehensive volume from Dr. David Marcinko, and his co-authors, will go a long way toward educating physicians on these critical subjects that were never taught in medical school or residency training.”

Dr. James M. Dahle MD FACEP

[Editor of The White Coat Investor, Salt Lake City, Utah, USA]

http://www.CertifiedMedicalPlanner.org

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Dealing with Patients Who Refuse to Pay

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Is your credit card on file?

[By Ann Miller RN MHA]

Handling patients with high deductibles health care plans and/or who refuse to pay in the ACA era is a growing financial risk for private medical practitioners. To help ameliorate the issue, some doctors are using a “credit card on file” program.

Enter “Credit-Card-on-File” Programs

Athenahealth has such a program where, once each year, the doctor swipes the credit card of each patient. Athena’s credit card partner (Elavon) stores the credit card information securely. The patient signs a one-year contract that gives permission to bill that card for any outstanding balances. This is the same concept as having a hotel swipe your credit card when you check-in but not bill you until you have checked-out.

Then, as soon as insurance has adjudicated the claim, the patient receives an email informing them that their credit card will be charged for the remaining balance in 5 days. If they have any issue with the bill they can contact the doctor’s office in that 5 day period. If not, their credit card is automatically charged for the balance due after 5 days. No work on the doctor’s office part is required once the card is swiped.

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Reading the Fine Print of a Legal Agreement

Reading the Fine Print of a CC on file agreement

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Assessment

Advantages include no need to send out patient statements, and days-in-AR for patient balances is reduced. And, essentially no staff time is spent collecting patient balances.

Another company (managemypractice.com) offers helpful online courses on how to set this up a credit card on file program regardless of system used.

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

“This comprehensive text book provides an in-depth presentation of the cyber security and real risk management, asset protection and insurance issues facing all medical profession today. It is far beyond the mere medical malpractice concerns I faced when originally entering practice decades ago.”

Dr. Barbara s. Schlefman MA [Family Foot Care, PA, Tucker, Georgia]

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Blogging for Medical Practice Promotion?

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Strategic Questions for Doctors to Consider

[By staff reporters]

There’s all sorts of advice on why and how to blog in order to promote a medical practice. Yet, most doctors STILL haven’t scratched the surface to understand what blogging is actually about and what roles it may play in their overall Business Plan and strategic presence – on and offline.

But, all practices have different concerns and goals, and every media, communications and marketing strategy is different from the other.

Today, “blogging” just doesn’t mean the publishing of content on a website. It’s more about being proficient in various media: from traditional to emerging; a new set of skills every doctor or physician executive needs to acquire and hone. Blogging is a constant learning process. It’s also a way to reveal strengths and weaknesses inherent in any healthcare organizations, culture and processes.

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Blog

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The Expert Speaks?

According to Phil Baumann RN, of Phil.Baumann.com, the following are helpful to consider when planning a blogging campaign to promote your medical practice:

  1. What’s the purpose? Practice development? Patient availability? A place to house your medical expertise and knowledge? A place to create a [professional or patient] community where ideas and questions can be explored openly? What value do you expect to provide or extract?
  2. Who is your audience(s)? Are you thinking that your only audience would be patients? Or, perhaps your colleagues, other healthcare industry influencers, vendors or the public? Will you be able to track the social footprint of your audience – who they are and where else on the Web they interact?
  3. What kinds of content are you delivering? Is it informational? Editorial? Inspirational? Industrially insightful? Action-calling? How might the kind(s) of content and information you publish influence your audience? Are you willing to let your audience help determine your content?
  4. What kinds of media will you provide on the blog? Text? Video? Audio? Slidedecks? Different media have different properties. Have you thought about the properties of traditional media and how they differ from emerging media? How much of your traditional practice marketing expertise evolved around the properties of print, radio, traditional websites and TV? Given that new media possess different properties, how might your marketing and promotional strategies need to adapt?
  5. Do you know what kinds of assets a blog can build? Appointment leads? A small but relevant community of patients or influencers? Professional or street credibility? Search engine optimization [SEO] and ranking? Which do you need?
  6. How will you distribute your content? Have you developed other web real estate – outposts on Facebook, Twitter, Youtube, Slideshare; or will you use strictly medical networks, healthcare related platforms or build your own? Which ones make the most sense to invest in? Can you build a visual map of your entire Web presence and how different Web and traditional presences relate to the bigger picture?
  7. If you successfully build your community, do you know how to leverage it? Will you be satisfied to just have visitors? Or, will you engage with your community – not only on your blog but elsewhere? Will you continually monitor your efforts and make the best of the connections you make? Will you develop a system to reach your community beyond your blog – either via email or other media outreach?
  8. Do you think blogging is just putting content on a website – or do you believe it is a spectrum of media skills? What’s your conception of medical practice blogging? Might there be more to blogging than what you think you know? What skills may you need to develop or build upon
  9. Do you have a plan on how to distribute your blog content to traditional media (where else is your audience)? What are your overall communications and marketing strategies? How might emerging media not only play a part, but how might their proliferation impact your established practice strategies?
  10. How committed will you be? Is this going to be a chore “to be done” or will you intelligently integrate it into your promotional routine? Do you understand the skills and resources needed to become proficient? When thinking about resources, are you considering time and talent and networks? Or, will you outsource, and can you afford it?
  11. Do you have the stamina to sustain your efforts in the long-term? Investing in new media is about sustaining long-term capital. Given your resources, will you create the kind of working environment for your employees to enjoy the art of creating content, conversing across different networks and advancing the practice’s objectives?
  12. Do you know how to make it easy (and enticing) for your audience to comment? Will you thank and comment back? Is sharing via email and other sources easy?
  13. Are you willing to fail? More importantly: how do you define failure? This is important to know because if you define failure appropriately, then you’re more likely to know what to do when you encounter it: in fact, you may see it as a huge opportunity.

***

hipster

***

Assessment

Take your time answering these questions because they aren’t just about blogging: they’re about your understanding promotional media and your medical practice. What other questions do you think you need to ask yourself?

More:

Conclusion

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

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Product Details

***

Product Details

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***

Online Doctor Reputation Management

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How doctors can protect their online reputation

A continuing series on physician online reputation.  Created in partnership with The Doctors Company as part of their social media resources for physicians

Conclusion

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

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 [Foreword Dr.Mata MD CIS]

RIP Dr. Frances Oldham Kelsey … and other GIANTS

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FDA scientist who kept thalidomide off U.S. market

***

thalidomide (C) FDA, All rights reserved. USA

***

Frances_Oldham_Kelsey

https://en.wikipedia.org/wiki/Frances_Oldham_Kelsey

***

Conclusion

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

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

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Product DetailsProduct Details

***

CMS Home Health Agencies

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Star Ratings

By http://www.MCOL.com

MEDICARE @ 50 [1965-2015]

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More videos:

Conclusion

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

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***

Blue Cross Blue Shield, Independent / Provider – Sponsored Plans

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Transcripts and Slides

DougBy Douglas B. Sherlock, CFA sherlock@sherlockco.com

The Affordable Care Act is intended to create strong incentives to reduce the administrative costs of health insurers. The medical loss ratio rules and the new ACA-related taxes are manifestations of this policy, and the recent announced business combinations between leading national health insurers are adaptations to these incentives.

It follows that the most recent rate of increase in health plan administrative expenses, excluding the new taxes, is dramatically lower than in recent years. Sherlock Company materials summarizing the results of our surveys are found below.

Independent / Provider – Sponsored Plans

Blue Cross Blue Shield Plans

Assessment

The contents above are a very small portion of the 1,000 page Sherlock Benchmarks for each of these universes. The Sherlock Benchmarks are essential tools to manage administrative costs for your health plan.

budget

Conclusion

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

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[Foreword Dr. Phillips MD JD MBA LLM] *** [Foreword Dr. Nash MD MBA FACP]

***

Beware of Sideways Markets

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Are We There … Yet?

By Vitaliy N. Katsenelson CFA

vitaly

NOTE: This article was first written in May 2013, but it is still as relevant today as it was then.

Preface

In early May 2015 I had the pleasure of attending and speaking at the Value Investing Congress in Las Vegas. The last time I had spoken there, it was May 2008 and the market was just coming off its top.  The Standard & Poor’s 500 index was trading at 18 times trailing earnings. Profit margins were at a modern-day high. They subsequently collapsed but came back to set an even higher high. If you normalize profits for high margins and look at ten-year trailing earnings, in 2008 stocks were trading 66 percent above their average. They were at 30 times ten-year trailing earnings.

The Market Repeats

In all honesty, I could do the same presentation today that I did five years ago, since market valuation is not dramatically different from what it was then. A cyclical bear and a cyclical bull market later, the S&P 500 is at (the same) 18 times trailing earnings and 26 times ten-year trailing earnings. Investors who were on the sidelines the past few years and who are now pouring money into stocks, expecting that we are in the midst of a secular bull market, will likely be disappointed. The previous sideways market, of 1966–82, included four cyclical bull markets and five cyclical bear markets. From 1970 to 1973 the Dow went from 700 to 1,000, just to drop again, to 600.

Lost Hope

Sideways markets are there to destroy hope. It is when nobody wants to own stocks ever again, when valuations are below their historical average, that a secular sideways market finally dies (actually, more like goes into hibernation), and the next secular bull market is born. But even that is not enough: Stocks need to spend time at below-average valuations. In the 1966–82 market they spent half of their time at below-average valuations. During the recent crisis we tiptoed into below-average valuations, but we danced right back out.

A present day secular bull market?

To believe we are in the midst of a secular bull market, you have to be very comfortable with three things, starting with profit margins.

  1. Today corporate profit margins are hitting all-time highs. Historically, profit margins have been mean-reverting — high margins were never sustained by corporations over a prolonged period of time because, as legendary value investor Jeremy Grantham puts it, “capitalism works.”  When a company — Apple, for example — starts earning very high margins, its competitors (like Samsung) come in with lower prices. In response, Apple must lower its margins. If margins decline even as the economy grows, earnings growth will be very benign or negative.
  2. Second, even if you are comfortable with high profit margins, you have to make an assumption that economic (revenue) growth will be robust going forward. Given how many headwinds we are facing from Europe, China and Japan, it is hard to develop a high comfort level there.
  3. And finally, you have to believe that price-earnings ratios can expand from their current level. I have news for you: In the past, sideways markets started (bull markets ended) when valuations were at current levels.

Stock returns are driven by two variables, earnings growth and changes in P/Es. Earnings growth for the next five to ten years is unlikely to be exciting and may not even be positive, and P/Es are likely to change for the worse, not the better.

***

silhouettes chart

***

Interest rates

Interest rates were much higher in the ’70s and early ’80s than they are today, and thus stocks may deserve higher valuations than they did then. This applies to all assets. But, the Federal Reserve’s policy may inflate stocks’ valuations for a while. If the Fed succeeds and real growth resumes, then interest rates will rise and (expensive) stocks that were discounting all-time-low rates will get crushed. After all, they — like long-duration bonds — do great when interest rates decline and bite the dust when interest rates rise.

Of course, on many levels things are better now than they were in 2008. The financial crisis and real estate bubble are behind us; we are probably not going to see those again for a while. But their resolution came at a big price: much higher government debt and a command-control interest-rate policy that would have made the Soviets proud.

Today

We’re now living in a Lance Armstrong economy. We’ve consumed so many performance enhancement drugs through endless quantitative easing that it is hard to know how well the economy is really doing. Unfortunately, as Armstrong at some point did, we’ll have an Oprah Winfrey moment when the economy will have to fess up for all the QEs.

We are living through one of the most grandiose and untested lab experiments ever conducted by a central bank: QE Infinity. At the recent Berkshire Hathaway annual meeting, Warren Buffett said, “Watching the economy today is like watching a good movie — you don’t know the ending.” His sidekick Charlie Munger added, “If you are not confused about the economy, you don’t understand it very well.”

The FOMC

The Fed’s unprecedented intervention in the economy has increased the possible range and severity of negative outcomes, from runaway inflation to deflation or a freaky combination of the two (freakflation). Deflation (or freakflation) is not good for stocks or their valuations. Just look at Japan. Over the past 20 years, stock valuations declined despite interest rates being at incredibly low levels. Expensive stocks (as I’ve mentioned, stocks in general are very expensive) discount earnings growth. If growth fails to materialize, these P/Es will decline. Unknowns are simply unknown.

Caution

At a time when the market is making all-time highs, it is easy to become complacent and let your guard down. Don’t. • •

ABOUT 

Vitaliy N. Katsenelson CFA is Chief Investment Officer at Investment Management Associates in Denver, Colo. He is the author of Active Value Investing (Wiley 2007) and The Little Book of Sideways Markets (Wiley, 2010).  His books were translated into eight languages.  Forbes Magazine called him “The new Benjamin Graham”.  

Assessment

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

Conclusion

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Front Matter with Foreword by Jason Dyken MD MBA

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

***

 

Can the EHR Save Private Practice?

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OR … Can Private Practitioners Save the EHR? 

By http://www.Kareo.com

***

Kareo EHR Savior

Click to access Kareo_Private_Practice_EHR_Infographic.pdf

[Click Link to Enlarge and Expand]

***

Channel Surfing

Have you visited our other topic channels? Established to facilitate idea exchange and link our community together, the value of these topics is dependent upon your input. Please take a minute to visit. And, to prevent that annoying spam, we ask that you register.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

More:

  1. The Percentage of Office-Based Doctors with EHRs
  2. Do Nurses like EHRs?
  3. EHRs – Still Not Ready For Prime Time
  4. The “Price” of eHRs

Assessment

Has the “tide-turned”, and physician sentiment changed, since creation of this info-graphic?

Conclusion

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

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Sponsors Welcomed

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Compensation Trends for Allied Healthcare Professionals

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Beyond Physician Salary [Average by Position]

By http://www.MCOL.com

***

Compensation

***

More:

  1. Doctor Salary v. Others [Present Value of Career Wealth]
  2. The 2015 Physician Pay Check-Up

***

coders

***

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

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

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

Frankly Speaking on Patient Safety

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First, do no harm

By Frank Phillips

This phrase is a cherished one throughout healthcare, and a principle by which healthcare facilities and providers alike always seek to abide.

So, in 1999, when the Institute of Medicine published their now famous “To Err is Human” report, individuals and organizations both inside and outside of healthcare were shocked by the findings that an estimated 98,000 people a year die due to mistakes in hospitals. In the years since that report, much has changed in healthcare, but what about patient safety?

What is the scope of the problem, what progress has been made and what are the solutions? Take a look.

***Frankly Speaking

***

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

[HEALTH INSURANCE, MANAGED CARE, ECONOMICS, FINANCE AND HEALTH INFORMATION TECHNOLOGY COMPANION DICTIONARY SET]

      Product DetailsProduct DetailsProduct Details

***

Understanding the Psychology of [Medical] Data Analytics

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Right with People

Gary Jackson

By Gary Jackson

[Psychology of the Analytics Dilemma]

What if analytical models would have predicted that same sex marriages were going to be legal in the United States by 2015 way back in 1995?

  • Would the concept have been accepted earlier?
  • Debated earlier?
  • Viewpoints changed?

Assessment

Probably not!

The Psychology of Analytics – Right with People

***

Analytics

***

More:

Even More:

Much More:

About Gary Jackson

Gary Jackson is technologist, a host of a podcast called bigdatastupid.com and a Writer for icrunchdata News Hong Kong, China.

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

“The Certified Medical Planner™ professional designation and education program was created by the Institute of Medical Business Advisors Inc., and Dr. David Edward Marcinko and his team (who wrote this book). It is intended for financial advisors who aim specifically to serve physicians and the medical community.

Content focuses not only on the insurance and professional liability issues relevant to physicians, but also provides an understanding of the risky business of medical practice so advisors can help work more successfully with their doctor-clients.”

Michael E. Kitces, MSFS, MTAX, CFP®, CLU, ChFC, RHU, REBC, CASL

[www.Kitecs.com, Reston, Virginia, USA]

http://www.CertifiedMedicalPlanner.org

***

How Rich – Got Rich?

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Are You Listening – Doctors?

By Rick Kahler MS CFP® http://www.KahlerFinancial.com

Rick Kahler MS CFPAsk ten people how the rich got rich and you will get at least ten opinions.

Some of the more common assumptions are that people become wealthy by inheriting fortunes, taking advantage of those less fortunate, or “playing” the stock market. I even remember one government employee who insisted anyone who obtained wealth had to do so illegally.

While a few people become rich in these ways, they are the exception rather than the rule. A survey by the Spectrem Group asked 132,000 people with a net worth of over $25 million where their wealth came from.

Here are the results: 

  1. Hard Work, 87%. The majority obtained their wealth by working hard. Most millionaires put in long hours, often in careers they love enough so that work becomes play.
  2. Education, 78%. Certainly, people with college educations earn more than those without. However, the right type of education for building wealth may not be found in a college curriculum. For example, I know one person with no college degree who took the equivalent of 75 credit hours of real estate education and amassed large real estate holdings.
  3. Smart Investing, 72%. Don’t confuse smart investing with sophisticated investments. It’s just not that hard to invest smartly: start young, invest regularly, don’t speculate, diversify your investments over multiple asset classes and multiple securities, reduce fees and minimize taxes, and don’t time the markets.
  4. Taking Risks, 63%. I would add, “smart risks.” Actions like starting a business, buying into the company you work for, relocating your family to a city with brighter prospects, changing careers, or borrowing to purchase investment real estate all carry with them a certain degree of risk. And with risk inevitably comes failure. In The Millionaire Next Door, Thomas J. Stanley and William D. Danko point out that the average millionaire makes 3.1 major financial, career, or business mishaps in a lifetime, while the average non-millionaire makes 1.6 such mistakes.
  5. Frugality, 59%. I’ve often called this the common denominator of people that have wealth. My guess is that it didn’t rank higher only because many wealth builders don’t view themselves as frugal. They tend to not have written budgets, they don’t shop at thrift stores, they buy name brands, and they spend everything in their checking account. But what they forget is that they pay themselves first, which includes paying all their bills and taxes, spending heavily for education, and investing 20 to 50% of their paycheck. Then they blow what’s left. I call that frugality.
  6. Being in the Right Place at the Right Time, 56%; and
  7. Luck, 53%. Of course circumstances and luck—factors like timing, knowing people who can help you, and being blessed with abilities and good health—play roles in building wealth. What also matters, however, is being prepared to take advantage of favorable circumstances.
  8. Running a Business, 46%. This fits closely with reason number one: working hard. When you work hard and take smart risks in your own business, or medical practice, you go beyond earning a substantial salary. You build a valuable asset.
  9. Guidance of an Adviser, 35%. Part of reason number three, smart investing, is being smart enough to learn from skilled mentors and advisors.
  10.  Inheritance, 30%. Yes, inheritance is one source of wealth. I’d suggest that most of the inheritors who are able to keep and build on that wealth do so because of factors like hard work, education, and smart investing.

***

Niche

[Not for Everyone]

***

Assessment

It appears that success in building wealth is similar to success in other areas: the harder and smarter you work, the more success you are likely to have. 

More: The “Rich Doctor” Myth

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Front Matter with Foreword by Jason Dyken MD MBA

This book was crafted in response to the frustration felt by doctors who dealt with top financial, brokerage, and accounting firms. These non-fiduciary behemoths often prescribed costly wholesale solutions that were applicable to all, but customized for few, despite ever-changing needs.

It is a must-read to learn why brokerage sales pitches or Internet resources will never replace the knowledge and deep advice of a physician-focused financial advisor, medical consultant, or collegial Certified Medical Planner™ financial professional.

Parin Khotari MBA

[Whitman School of Management, Syracuse University, New York]

http://www.CertifiedMedicalPlanner.org

***

Doubling the S&P 500‏

On the Stock-Splits Newsletter

[By Neil Macneale] http://www.2for1Index.com or http://www.USCFAdvisers.com

nmacnealeJust wanted to say hello!

Many who subscribe, or read this ME-P, are personal friends or subscribers to our 2 for 1 newsletter. Others have connected to me one way or the other, such as on LinkedIn.

You may not be aware of the recent events concerning the 2 for 1 Index® and the 2 for 1® newsletter.

As of 7/31/15, the index has doubled the gain of the S&P 500 over the trailing 12 months. That’s +19% vs +9% since 7/31/2014, a great showing in a rather jittery market.

***

stock splits

***

Assessment

The 2 for 1 Index (NYSE: SPLITS) is comprised of approximately 30 companies which trade on major US stock exchanges. Companies eligible for inclusion have all announced a stock split within the 6 months prior to selection for the Index.  Each month, the 2 for 1 Index is updated on the Friday closest to the 15th of that month. The pool of eligible companies is evaluated and ranked according to a proprietary methodology, and the top ranked candidate is selected for the Index. Sector and market-cap diversification is considered in the selection algorithm. One new stock is added to the Index, and one of the oldest stocks is removed. All positions are rebalanced to equal weight.

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Front Matter with Foreword by Jason Dyken MD MBA

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

***

Happy Birthday Irene Bergman [A 99-year-old financial advisor]

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Happy Birthday – Ring that NYSE Bell

[By staff reporters]

A 99-year-old financial advisor and holocaust survivor will be the oldest person to ring to the bell at the New York Stock Exchange in honor of her 100th birthday; today August. 2nd, 2015.

As a teen, Irene Bergman wanted to follow her private banker father to the Berlin stock exchange, but the Nazis chased them out of Europe in 1942. Now she is a financial advisor at Stralem & Co., overseeing institutional and individual clients, which she advises from her midtown apartment decorated with paintings from Dutch masters and pre-war European furniture.

***

stock-exchange-

***

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

“In an era where doctors must have a solid understanding of the basics of financial management, this book is a must-have on every physician’s private book collection. Although not a substitute for a formal business education, this book will help physicians navigate effectively through the hurdles of day-to-day financial decisions with the help of an accountant, financial and legal advisors.

This book would make an excellent reference for teaching medical students and residents the basics of monetary management. I highly recommend this book and commend Dr. Marcinko and the Institute of Medical Business Advisors, Inc. on a job well done.”

Manuel J. Colón MD

National Mega Health Plans

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Membership Top 10 Largest Plans

By http://www.MCOL.com

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Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

[HEALTH INSURANCE, MANAGED CARE, ECONOMICS, FINANCE AND HEALTH INFORMATION TECHNOLOGY COMPANION DICTIONARY SET]

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[Mike Stahl PhD MBA] *** [Foreword Dr.Mata MD CIS] *** [Dr. Getzen PhD] 

***

A 3-D View of a Chart That Predicts The Economic Future

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Yield Curve 101

[By GREGOR AISCH and AMANDA COX]

The yield curve shows how much it costs the federal government to borrow money for a given amount of time, revealing the relationship between long- and short-term interest rates.

It is, inherently, a forecast for what the economy holds in the future — how much inflation there will be, for example, and how healthy growth will be over the years ahead — all embodied in the price of money today, tomorrow and many years from now.

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3-d

A 3-D View of a Chart That Predicts The Economic Future

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More:

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Front Matter with Foreword by Jason Dyken MD MBA

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

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Some Thoughts on the Role of Animals in Medicine

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The backbone of anatomical, physiological and clinical research

[By Stephanie Eichberg]

In 2012, a book appeared on the shelves of popular science that (re)acquainted the public with a medical revelation; namely that animals share with humans a wide range of acute and chronic diseases as well as psychological disorders, and that they can accordingly ‘teach us about being human’.

From the point of view of the history of medicine, it appears strange that this is presented as ‘new’ knowledge, considering human-animal comparisons have long formed the backbone of anatomical, physiological and clinical research.

No matter what historical period you investigate, you’ll find that the diseased bodies, brains and behaviors of animals have always been serving as surrogates for our own afflicted bodies, brains and behaviors.

 ***

guinea pig

Some Thoughts on the Role of Animals in Medicine

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More: October is “Cut Out Dissection” Month

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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[Foreword Dr. Phillips MD JD MBA LLM] 

Product Details

[Foreword Dr. Nash MD MBA FACP]

FinFair 2015

***

 ADVERTISEMENT

FF

Truly one of the Most Groundbreaking FinTech & Alternative Finance Programs to Come to Wall Street

Discussions will include:

  • Applications of Reg A+ from small business capital formation to private debt securitizations
  • Enhancing small cap deal distribution & aftermarket support
  • How Reg A+ will Impact Community Investing
  • An introduction to next-Gen Broker Dealers and online financing platforms
  • How Financial Advisors and RIAs will benefit from Reg A+
  • Building vibrant venture exchanges
  • New trends in liquidity and clearing
  • Diversifying fixed-income portfolios with P2P, P2B and P2R debt
  • Distinguishing between a FinTech bubble or a financial revolution.

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REGISTER HERE

For those who can’t join us in person on the 29th, feel free to join us virtually.

Clear here for details on FinFair’s live broadcast

***

Some Prognostications On Government Bond Yields?

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Gazing into the Future … Always Dangerous!

tim[By Timothy J. McIntosh MBA CFP® MPH]

Given that government bond yields today are at historical lows, the opportunity for price appreciation is minimal. More likely, the collection of interest payments will provide most, if not all, of market returns.

Additionally, interest rates could also trend up over the ensuing decade.  This would result in capital losses as bond prices decline, reducing total return further.  Much like the decade of the 1940s, total returns from bonds will most likely be subdued as either market interest rates remain constant or interest rates trend upwards.

Most certainly, physicians and all investors, cannot expect an average long term return of 5.40%.  A 3% total return over the ensuing decade is most probable.  The problem with this examination is that most individual investors have a substantial portion of their assets in bonds, especially of the government sort.  As the average total portfolio return target for most investors is 6-8% on an annualized basis, investors must expect either a substantial decline in interest rates from the current historic lows, or that stocks will make up the difference.

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Portrait of two surgeons in a operating theatre

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Although bonds do present moderate investments returns for today’s investor, without bonds as part of a portfolio, investment losses could be a much higher percentage if invested in stocks alone.  But, stocks do generate a higher rate of return over a long period, in short or immediate term, they may well be outperformed by bonds, especially at critical periods in the economic cycle. Bonds in general are known for the stability and predictability of returns. Bonds, especially those of the government kind, have a low standard deviation (volatility).

In fact, bonds are one of the least risky asset classes an investor can own.  When combining bonds in a diversified portfolio, you will lower your overall risk.  The tradeoff, of course, is the return will be lower than an all stock portfolio.

Most investors have money parked in bonds of the government type, i.e. notes, bills, or bonds.  The reason for this has to do with risk and diversification.  Government bonds have one of the lowest risk profiles of any asset class, and have generally produced consistent returns.  Government bonds are also thought to maintain a very low correlation (a statistical measure of how two securities move in relation to each other) with equities.  The long-term average correlation is about 0.09.

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Bonds

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However, this verity has to be examined on a long-term framework.  In fact, correlations between U.S. stocks and treasury bonds have swung widely over the past eighty years. The correlation was positive for most of the late 1930s and throughout the 1940s.  In the 1950s, the correlation was actually negative as stocks advanced strongly and bonds suffered from declining prices (due to increasing interest rates).  From the mid-1960s until 2000 there was a positive correlation, averaging about 0.50.  The correlation turned negative once gain during the past decade.

This was primarily due to the fact that stocks struggled mightily with two large bear market declines (2002, 2008), while bonds rallied strongly as interest rates declined.  So much of the supposed low or negative correlation depends upon what time period you examine. The principal problem with owning government bonds is the negative correlation an investor is looking for only appears sporadically throughout history.

Assessment

There are a number of risk variables to consider when investing in bonds as they may affect the value of the bond investment over time. These variables include changes in interest rates, income payments, bond maturity, redemption features, credit quality, priority in capital structure, price, yield, tax status and other provisions.

ABOUT

Timothy J. McIntosh is Chief Investment Officer and founder of SIPCO.  As chairman of the firm’s investment committee, he oversees all aspects of major client accounts and serves as lead portfolio manager for the firm’s equity and bond portfolios. Mr. McIntosh was a Professor of Finance at Eckerd College from 1998 to 2008. He is the author of The Bear Market Survival Guide and the The Sector Strategist.  He is featured in publications like the Wall Street Journal, New York Times, USA Today, Investment Advisor, Fortune, MD News, Tampa Doctor’s Life, and The St. Petersburg Times.  He has been recognized as a Five Star Wealth Manager in Texas Monthly magazine; and continuously named as Medical Economics’ “Best Financial Advisors for Physicians since 2004.  And, he is a contributor to SeekingAlpha.com., a premier website of investment opinion. Mr. McIntosh earned a Bachelor of Science Degree in Economics from Florida State University; Master of Business Administration (M.B.A) degree from the University of Sarasota; Master of Public Health Degree (M.P.H) from the University of South Florida and is a CERTIFIED FINANCIAL PLANNER® practitioner. His previous experience includes employment with Blue Cross/Blue Shield of Florida, Enterprise Leasing Company, and the United States Army Military Intelligence.

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

“Physicians who don’t understand modern risk management, insurance, business and asset protection principles are sitting ducks waiting to be taken advantage of by unscrupulous insurance agents and financial advisors; and even their own prospective employers or partners.

This comprehensive volume from Dr. David Marcinko, and his co-authors, will go a long way toward educating physicians on these critical subjects that were never taught in medical school or residency training.”

Dr. James M. Dahle MD FACEP

[Editor of The White Coat Investor, Salt Lake City, Utah, USA]

http://www.CertifiedMedicalPlanner.org

We’ve seen the Future of Translational Medicine

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An Encore Presentation

[By Steve Blank]

A team of 110 researchers and clinicians, in therapeutics, diagnostics, devices and digital health in 25 teams at UCSF, has just shown us the future of translational medicine.  It’s Lean, it’s fast, it works and it’s unlike anything else ever done.

It’s going to get research from the lab to the bedside cheaper and faster.

Lean LaunchPad for Life Sciences and Healthcare

Welcome to the Lean LaunchPad for Life Sciences and Healthcare (part of the National Science Foundation I-Corps).

This post is part of our series on the Lean Startup in Life Science and Health Care.

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disruptive

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We’ve seen the Future of Translational Medicine and it’s Disruptive

The Class

Our class talked to 2,355 customers, tested 947 hypotheses and invalidated 423 of them.  They had 1,145 engagements with instructors and mentors. (We kept track of all this data by instrumenting the teams with LaunchPad Central software.)

In a packed auditorium in Genentech Hall at UCSF, the teams summarized what they learned after 10 weeks of getting out of the building. This was our version of Demo Day – we call it “Lessons Learned” Day. Each team make two presentations:

  • 2 minutes YouTube Video: General story of what they learned from the class
  • 8 minute Lessons Learned Presentation: Very specific story about what they learned in 10 weeks about their business model

Assessment

In the next few posts I’m going to share a few of the final “Lessons Learned” presentations and videos and then summarize lessons learned from the teaching team.

We’ve seen the Future of Translational Medicine and it’s Disruptive

Conclusion

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Product Details

Product Details

Product Details

“When a practicing physician thinks about their risk exposure resulting from providing patient care, medical malpractice risk immediately comes to mind. But; malpractice and liability risk is barely the tip of the iceberg, and likely not even the biggest risk in the daily practice of medicine. There are risks from having medical records to keep private, risks related to proper billing and collections, risks from patients tripping on your office steps, risks from medical board actions, risk arising from divorce, and the list goes on and on. These liabilities put a doctor’s hard earned assets and career in a very vulnerable position.

These new books from Dr. David Marcinko and Prof. Hope Hetico show doctors the multiple types of risk they face and provides examples of steps to take to minimize them. They are written clearly and to the point, and are a valuable reference for any well-managed practice. Every doctor who wants to take preventive action against the risks coming at them from all sides needs to read these books.”

Richard Berning MD FACC [New Haven, Connecticut, USA]

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Financial Projections for Startups

David Cummings on Startups

Recently I saw another one of the dreaded financial charts in a startup’s executive summary: $0 revenue today and $25 million in revenue in year three. Whenever I see this, I immediately know that the CEO either a) doesn’t have any startup experience or b) hasn’t done the appropriate homework. Can a company go from $0 to $25 million in three years from a cold start? Yes. Does it make the startup look credible in an executive summary? No.

Here are a few thoughts on financial projections for startups:

  • Study the Inc. 500, especially technology companies. What does the revenue ramp look like there? These are some of the fastest growing companies in the country, and annual revenueslike $1M to $4M to $10M are more the norm (and incredibly high growth).
  • Build a bottom-up forecast based on number of leads generated, conversion from lead to opportunity, number of trained…

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Investing and the “Tragedy of the Commons”

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On Economics, Investing and Behavioral Finance

DEMM high-def White

[By Dr. David E. Marcinko MBA]

Although I did not fall asleep during my psychiatry rotations, or psychology classes, in medical school; the concept of ToC was not known to me until my first economics class while in B-School.

What it is!

The tragedy of the commons is a term, originally used by Garrett Hardin, to denote a situation where individuals acting independently and rationally according to each’s self-interest behave contrary to the best interests of the whole group by depleting some common resource.

The term is taken from the title of an article written by Hardin in 1968, which is in turn based upon an essay by a Victorian economist on the effects of unregulated grazing on common land.

Commons” in this sense has come to mean such resources as atmosphere, oceans, rivers, fish stocks, the office refrigerator, energy or any other shared resource which is not formally regulated; not common land in its agricultural sense.

The tragedy of the commons concept is often cited in connection with sustainable development, meshing economic growth and environmental protection, as well as in the debate over global warming. It has also been used in analyzing behavior in the fields of economics, evolutionary psychology, anthropology, game theory, politics, taxation, and sociology.

However the concept, as originally developed, has also received criticism for not taking into account the many other factors operating to enforce or agree on regulation in this scenario.

Example: UMD ‘tragedy of the commons‘ tweet goes viral – Baltimore Sun

Investing Behavior?

Today, some financial advisors, wealth managers, doctors and behavioral psychologists believe the ToC is an increasingly important concept in investing.

Source: https://en.wikipedia.org/wiki/Tragedy_of_the_commons

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confirmation-bias

Greed is still trumping fear, and that’s bad for stocks …

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Assessment

So what does all this have to do with investing? Are we experiencing this phenomenon in the markets, today?

Read the article thru the link above; fear and greed.

More:

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Product DetailsProduct DetailsProduct Details

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

Front Matter with Foreword by Jason Dyken MD MBA

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

***

Connect to the ME-P Searchable Virtual Library

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Our Searchable, and Ranking, Knowledge Portal

By Ann Miller RN MHA

[Executive Director]

We’ve collected all of our best research, solution information, and social buzz to create the Medical Executive-Post Portal and new virtual, and real, library.

From the new ME-P Portal, you can search, sort, and filter through our information archives to quickly find what you’re looking for—or feel free to browse and explore a variety of topics when you have a few minutes to spare.

From subject-specific original, or curated, blog posts and researched-based white papers, to solution overviews, e-Briefs, infographics, dictionaries, CD-ROMs, handbooks, major textbooks and more; you’ll find the answers to your healthcare economics, administration, financial planning and medical practice management and business questions here.

And explore a library of answers to your complex healthcare business decisions

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Learn more – to earn more

Even better, our web-based platform serves up the content you want most in your preferred format. Choose a user-friendly text-file, web-based flip book, e-file, or download, save, and print a PDF – or order a soft back or hard cover book – it’s your choice.

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Product DetailsProduct DetailsProduct Details

Product Details  Product Details

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Product DetailsProduct Details

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

Well-Being Rankings for Older Americans

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States with the Highest Scores

By http://www.MCOL.com

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ImageProxy-2

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Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

“With time at a premium, and so much vital information packed into one well organized resource, this comprehensive textbook should be on the desk of everyone serving in the healthcare ecosystem. The time you spend reading this frank and compelling book will be richly rewarded.”

Dr. J. Wesley Boyd MD PhD MA

[Harvard Medical School, Boston, Massachusetts, USA]

Visiting MorbidAnatomy.com

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Surveying the Interstices of Art and Medicine, Death and Culture

[By Ann Miller RN MHA]

Since 2007, Morbid Anatomy has been excavating and celebrating the obscure, the forgotten and the macabre via a blog, lecture series, workshops, parties, and open to the public research library. They are now taking Morbid Anatomy to the next level with the creation of The Morbid Anatomy Museum: a new 4,200 square foot non-profit institution opened in April 2014.

Morbid Anatomy Museum 

The Morbid Anatomy Museum features a much expanded lecture/workshop space, a bar/cafe, a gift shop, an expanded library and permanent collection and temporary exhibition space where they showcase, among other things, the eccentric taxidermy of Walter Potter, the art of death and 17th Century Dutch “artist of death” Frederik Ruysch among others.

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ghoul

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http://morbidanatomy.blogspot.com

Assessment

Much like this ME-P, Morbid Anatomy will never appeal to a mass market. This, we believe, is part of its charm.

Note: Graphic content but well worth a look!

Conclusion

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

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

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[Mike Stahl PhD MBA] *** [Foreword Dr.Mata MD CIS] *** [Dr. Getzen PhD] 

Is Social Security a Rip-Off?

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 “WHERE DID THAT MONEY GO?”

Rick Kahler MS CFP

By Rick Kahler MS CFP http://www.KahlerFinancial.com

A reader recently forwarded me an email that began, “Who died before they collected Social Security?” It asked how many people only collected a small portion of what they paid into Social Security because they, or a spouse, died soon after retiring. Then it screamed in all caps, “WHERE DID THAT MONEY GO?”

Introduction

The rest of the piece, after calculations of how much an average person pays into Social Security, suggested the government is short-changing those who die before they receive back in benefits everything they paid in. It claimed that Social Security premiums were to have been put in a “locked box,” that instead they were loaned to the US Treasury, and that Social Security is therefore running out of money.

The many misstatements and errors in this piece highlight a common misunderstanding about the Social Security insurance program. It is not an income tax. Nor; is it actually insurance – or an investment!

Example:

If you earn a salary, you are familiar with the FICA (Federal Insurance Contributions Act) tax that, like federal income tax, is withheld from your paycheck. Everyone must pay it on their first $118,500 of earned income. The current rate for employees is 7.65% (6.2% for Social Security and 1.45% for Medicare), an amount matched by employers. The self-employed pay 15.3%.

FICA payments are not an income tax, but are insurance premiums used to fund the Social Security program. It is a direct transfer program, meaning the money coming into the plan is immediately paid out to retired or disabled participants. The proceeds are not directly deposited to the general account to be spent however Congress wishes.

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train station

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The Tipping Point?

However, in the past, because more money came into Social Security than was paid out in benefits, the program did loan the excess to the US Treasury Department (receiving bonds in return) to fund the operating expenses of the federal government. The program built up a significant investment in US Treasuries until 2010, when it began paying more out in benefits than it receives from participants. The program is now beginning to redeem the bonds. Officials project that in 2033 the program will have depleted the investment in bonds and will need to either adjust benefits, raise the payroll tax, or borrow from the US Treasury.

What it’s not?

  • Social Security isn’t insurance in the sense that insurance pays only when a person suffers a loss. With Social Security, everyone who has worked for more than 10 years will collect a monthly income upon retirement.
  • SS is also not a savings account or a retirement plan like an IRA or a 401(k). It is not set aside in a segregated account with your name on it. The money you pay in doesn’t accumulate or earn interest. If Social Security were designed as a retirement plan that would refund what participants pay in, plus some type of return, the payroll tax would far surpass 15.3%.

What it is?

So if Social Security isn’t an income tax, an insurance plan, or a retirement plan, what is it? It’s an annuity. Participants are guaranteed a monthly income for life; a lesser amount if they retire at age 62 or a higher amount if they wait until full retirement age or later.

Like any annuity, when you die the payments stop. The amount of the payroll tax/premium incorporates actuarial estimates of how many people will die before the average mortality age or live long past it. The money paid in by people who die early is not “missing.”

Assessment

If you have questions about Social Security, you can find detailed information at www.socialsecurity.gov. It’s a much more reliable source than anonymous forwarded emails.

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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


“The medical education system is grueling and designed to produce excellence in medical knowledge and patient care. What it doesn’t prepare us for is the slings and arrows that come our way once we actually start practicing medicine. Successfully avoiding these land mines can make all the difference in the world when it comes to having a fulfilling practice. Given the importance of risk management and mitigation, you would think these subjects would be front and center in both medical school and residency – ‘they aren’t.’

Thankfully, the brain trust over at iMBA Inc., has compiled this comprehensive guide designed to help you navigate these mine fields so that you can focus on what really matters – patient care.”

 Dennis Bethel MD [Emergency Medicine Physician]

 

On the State of Medical Provider Directory Accuracy?

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Across the USA

By http://www.MCOL.com

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directory

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Conclusion

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

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

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Health Organizations Slammed by Cyber Breaches

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Top TEN Health Organizations Slammed by Cyber Breaches

Last year, the FBI released a private notice to the healthcare industry warning providers that their cybersecurity systems are lax compared to other industries, according to Reuters.

The notice reportedly stated, “The healthcare industry is not as resilient to cyber intrusions compared to financial and retail sectors, therefore the possibilities of increased cyber intrusions is likely.”

More: http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/ten-health-organizations-slammed-cyber-breaches?page=0,1

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lock

READ: Under Attack: Executives Face Rising Cybersecurity Risks

***

Considering the recent outbreak of major breaches affecting the industry, it appears that those concerns were warranted. The healthcare industry accounted for 43% of major data breaches reported in 2014, according to the Identity Theft Resource Center.

While 2015 data are not yet available, the steady stream of cybersecurity breaches has continued, and many organizations have already reported major breaches. Here are 10 recent victims.

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

***

[Foreword Dr.Mata MD CIS]

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

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“Physicians have more complex liability challenges to overcome in their lifetime, and less time to do it, than other professionals. Combined with a focus on practicing their discipline, many sadly fail to plan for their own future. They need trustworthy advice on how to effectively protect themselves, families and practice, from the many overt and covert risks that could potentially disrupt years of hard work. Fortunately, this advice is contained within Risk Management, Liability Insurance, And Asset Protection Strategies For Doctors And Advisors [Best Practices From Leading Consultants And Certified Medical Planners™].

Written by Dr. David Edward Marcinko, Nurse Hope Rachel Hetico and their team of risk managers, accountants, insurance agents, attorneys and physicians, it is uniquely positioned as an integration of applied, academic and peer-reviewed strategies and research, with case studies, from top consultants and Certified Medical Planners™. It contains the latest principles of risk management and asset protection strategies for the specific challenges of modern physicians. My belief is that any doctor who reads and applies even just a portion of this collective wisdom will be fiscally rewarded. The Institute of Medical Business Advisors has produced another outstanding reference for physicians that provide peace of mind in this unique marketplace! In my opinion, it is a mandatory read for all medical professionals.”

David K. Luke MS-PFP, MIM, CMP™ [Net Worth Advisory Group, Inc., Sandy, Utah, USA

http://www.CertifiedMedicalPlanner.org

How Emotional Intelligence Can Make You a Better Investor

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IQ versus EQ

vitaly

By Vitaliy Katsenelson CFA

Your knee hurts, so you pay a visit to your favorite orthopedist. He smiles, maybe even gives you a hug, and then tells you: “I feel your pain. Really, I do. But I don’t treat left knees, only right ones. I find I am so much better with the right ones. Last time I worked on a left knee, I didn’t do so well.”

Though many professionals — doctors as well as lawyers, architects and engineers — get to choose their specializations, they rarely get to choose the problems they solve. Problems choose them. Investors enjoy the unique luxury of choosing problems that let them maximize the use of not just their IQ but also their EQ — emotional intelligence.

Let’s start with IQ

Our intellectual capacity to analyze problems will vary with the problem in front of us. Just as we breezed through some subjects in college and struggled with others, our ability to understand the current and future dynamics of various companies and industries will fluctuate as well. This is why we buy stocks that fall within our sphere of competence. We tend to stick with ones where our IQ is the highest.

Though we usually think about our capacity to analyze problems as being dependable and stable over time, it isn’t. It might be if we were characters from Star Trek, with complete control over our emotions, like Mr. Spock, or who lacked emotions, like Lieutenant Commander Data. This is where our EQ comes in.

I am not a licensed psychologist, but I have huge experience treating a very difficult patient: me. And what I have found is that emotions have two troublesome effects on me.

First, they distort probabilities; so even if my intellectual capacity to analyze a problem is not impacted, my brain may be solving a distorted problem.

Second, my IQ is not constant, and my ability to process information effectively declines under stress. I either lose the big picture or overlook important details. This dilemma is not unique to me; I’m sure it affects all of us to various degrees.

The higher my EQ with regard to a particular company, the more likely that my IQ will not degrade when things go wrong (or even when they go right). There is a good reason why doctors don’t treat their own children: Their ability to be rational (properly weighing probabilities) may be severely compromised by their emotions.

Example:

A friend of mine who is a terrific investor, and who will remain nameless though his name is George, once told me that he never invests in grocery store stocks because he can’t be rational when he holds them. If we spent some Freudian time with him, we’d probably discover that he had a traumatic childhood event at the grocery store (he may have been caught shoplifting a candy bar when he was eight), or he may have had a bad experience with a grocery stock early in his career. The reason for his problem is irrelevant; what is important is that he has realized that his high IQ will be impaired by his low EQ if he owns grocery stocks.

There is no cure for emotions, but we can dramatically minimize the impact they have on us as investors by adjusting our investment process. First and foremost, investors have the incredible advantage of picking domains where they can remain rational.

For instance, I would not be able to keep a cool head if I owned gold. I can recite the arguments for and against gold (lately, with negative interest rates in certain European countries, the “for” arguments have started to make even more sense). But, intellectually, I cannot reconcile the fact that gold is an asset that generates no cash flows, and thus to me it has no financial center of gravity. I have no idea what it is worth. The very idea of owning gold bothers me, and therefore I know that if I did own it, my EQ would be low. I’d be buying high and selling low.

Now, as a value investor, when I buy a stock and it declines 30 percent, I want to buy more of it (assuming its business has not changed). I wouldn’t trust that I could do this in the gold market.

To be a successful investor, you don’t need Albert Einstein’s IQ (though sometimes I wish I had Spock’s EQ). Warren Buffett undoubtedly has a very high IQ, but even the Oracle of Omaha chooses carefully his battles; for instance, he doesn’t invest in technology stocks.

***

masks

Our Luxury

Investors have the luxury of investing only in stocks for which both their IQ and EQ are maximized, because there are tens of thousands of stocks out there to choose from, and they need just a few dozen.

Assessment

Meanwhile, I hope when I go see the doctor, he will tell me, “I don’t do left knees,” because the best result will come from a doctor who while treating me will utilize both IQ and EQ.

ABOUT

Vitaliy N. Katsenelson, CFA, is Chief Investment Officer at Investment Management Associates in Denver, Colo.

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

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

Written by doctors and healthcare professionals, this textbook should be mandatory reading for all medical school students—highly recommended for both young and veteran physicians—and an eliminating factor for any financial advisor who has not read it.

The book uses jargon like ‘innovative,’ ‘transformational,’ and ‘disruptive’—all rightly so!

It is the type of definitive financial lifestyle planning book we often seek, but seldom find.

LeRoy Howard MA CMPTM [Candidate and Financial Advisor, Fayetteville, North Carolina]

http://www.CertifiedMedicalPlanner.org

Do you Want to be a Millionaire?

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Millionaire versus Billionaire

By Rick Kahler MS CFP®  http://www.KahlerFinancial.com

Rick Kahler MS CFP

Doctor – Would you like to build up a million-dollar nest egg by the time you retire?

For middle-class earners, that goal is challenging but possible if you start at age 25 and save $1750 a month. Many married couples could do this by maxing out their 401(k) contributions. Or; you could take the route that many people follow and build a small business – or medical practice – into a million-dollar asset.

FREE WHITE PAPER [Is Medical Practice a New Asset Class?] from iMBA, Inc

Billion … with a “B”

What if you want to accumulate a billion-dollar nest egg instead? Starting at the same age of 25, you would need to save $21 million a year. Good luck with getting any employer match on that.

There’s a vast difference between a million and a billion. It’s completely misleading when activists, politicians, and the media refer glibly to “millionaires and billionaires” as if the two are almost interchangeable. Someone with a net worth of one million dollars isn’t even close to being in the same category as someone worth one billion.

Here are a few more examples to clarify the difference:

  • One million seconds from now is about 11 and a half days away. One billion seconds from now is about 31 and a half years in the future.
  • A million hours ago was 114 years in the past, early in the 20th century; our ancestors were using electricity and telephones. A billion hours ago was over 114,155 years in the past; our ancestors had evolved into Homo sapiens but were still using primitive stone tools.
  • Put one million ants on one side of a scale and a female Asian elephant on the other side. The million ants, at around six pounds, would hardly register against the elephant’s three tons. Put a billion ants on the scale, however, and they would balance or even outweigh the elephant.
  • One million pennies stacked on top of each other would make a tower nearly a mile high. One billion pennies stacked on top of each other would make a tower almost 870 miles high.
  • If you earned $45,000 a year and stashed it all under your mattress, you’d have one million dollars at the end of 22 years. To accumulate one billion dollars at that same rate, you’d need the help of your many-times-great grandchildren, because it would take 22,000 years.

Security versus Wealth

In today’s world, being a millionaire represents financial security, not vast wealth. At a withdrawal rate of 3%—the amount most experts consider sustainable—an investment portfolio of one million dollars will provide an income of $30,000 a year. Combined with Social Security, that would be enough to live comfortably but not lavishly in retirement.

Three percent of one billion dollars, on the other hand, will furnish an income of $30 million a year; definitely private jet and gated estate territory.

If millions and billions aren’t challenging enough, here’s a quick look at trillions. One trillion is a million millions, or a thousand billions. It would take one thousand elephants to balance the weight of one trillion ants. Astronomers estimate the number of stars in our Milky Way galaxy between 100 billion and 400 billion; not even close to a trillion. No wonder it’s so hard for most of us to wrap our minds around information like, “The current US national debt is more than 16.7 trillion dollars.”

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how-much-is-a-trillion

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Assessment

Becoming a millionaire? It’s not only achievable, but wise if you want financial security in old age. Becoming a billionaire? You’d better plan to invent something amazing, write several dozen international best-sellers, or build an incredibly successful business. Becoming a trillionaire? Don’t waste your time thinking about it. For good reason, the word isn’t even in the dictionary.

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Personal financial success in the PP-ACA era will be more difficult to achieve than ever before. It requires the next generation of doctors to rethink frugality, delay gratification, and redefine the very definition of success and work–life balance. And, they will surely need the subject matter medical specificity and new-wave professional guidance offered in this book.

This book is a ‘must-read’ for all health care professionals, and their financial advisors, who wish to take an active role in creating a new subset of informed and pioneering professionals known as Certified Medical Planners™.

Dr. Mark D. Dollard FACFAS [Private Practice, Tyson Corner, Virginia

http://www.CertifiedMedicalPlanner.org

Invite Dr. Marcinko

US Real Estate Investing Index 2015

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Update July 2015

pb

Patrick Bourbon CFA

[Bourbon Financial Management

***

real estate

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

“The medical education system is grueling and designed to produce excellence in medical knowledge and patient care. What it doesn’t prepare us for is the slings and arrows that come our way once we actually start practicing medicine. Successfully avoiding these land mines can make all the difference in the world when it comes to having a fulfilling practice. Given the importance of risk management and mitigation, you would think these subjects would be front and center in both medical school and residency – ‘they aren’t.’

Thankfully, the brain trust over at iMBA Inc., has compiled this comprehensive guide designed to help you navigate these mine fields so that you can focus on what really matters – patient care.”

  Dennis Bethel MD [Emergency Medicine Physician]

The Road to Crowd-Centric Retail Alternatives and the Future of Financial Products

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Including an Evolutionary Info-graphic

dara-pic

By Dara Albright

In simpler times, American workers relied on pensions to secure their retirement. Those who desired a supplement to their pension income opted to save during their pre-retirement years. Like television stations, investment options were primarily limited to three main providers. Instead of being bogged down with choices, savers essentially had their pick of placing money in interest bearing savings accounts, stocks or bonds. With the exception of occasionally having to get up from the sofa to change the television channel, life was pretty uncomplicated.

Then the 70s arrived – bringing a rash of polyester and laying the groundwork for sweeping changes throughout the financial system.

Ever since, our capital markets have been in a perpetual state of transformation fueled by innovations in brokerage services, advisory tools, investment products, retirement plans, financial technology and shifts in both the political as well as economic climate. The confluence of these evolutions – as depicted in the infographic below – continues to not only redefine retail investing, but America’s entire retirement framework.

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the-road-to-crowd-centric-alternatives1

[Check out this spectacular infographic depicting the evolution of financial services and where it’s all headed]

Click photo twice to enlarge

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From salespeople into asset gatherers

During the past four and a half decades the brokerage business has moved online, slashed commissions and turned its commission-based securities salespeople into asset gatherers. As the number of brokerage firms steadily declined, online alternative asset marketplaces began to rise.

The IRA and 401(k) transformed America’s retirement structure as pension plans became less and less prevalent. These new retail retirement vehicles fed the mutual fund business, and in tandem both industries ballooned into multi trillion dollar markets.

Tools were developed that would enable financial advisors to navigate across a growing number of asset classes and help ensure the proper diversification of retail portfolios. These advisory resources also contributed to the proliferation of new asset classes and retirement accounts.

Legislative changes coupled with technological achievement led to the democratization of both financial products as well as market data. This “poli-tech” dynamic not only furthered the growth of conventional asset classes, it inspired a host of innovative online investing platforms, lending models, equity financing structures and the creation of new asset classes.

A groundswell of investment products

Over the years, a groundswell of investment products has been engineered for the mass market resulting in the flow of retail dollars across money markets, mutual funds and ETFs. Particularly during the recent years, as interest rates reached historic lows and equity markets became excessively volatile, there has been an upsurge of interest in uncorrelated alternative assets.

To meet the mounting demand, a wave of retail alternative products entered the market. According to McKinsey, retail alternatives will soon account for almost 50% of total retail revenues. Furthermore, Goldman Sachs believes that retail alternatives are in the early stages of a 5-10 year growth trend – reminiscent of early-stage ETF growth and capable of becoming a $2T AUM opportunity.

As financial advisors were becoming acquainted with a growing number of retail alternative products packaged through mutual funds and ETFs, a new niche of alternatives known as crowd-centric alternatives had been gaining popularity – particularly among institutional and internet savvy retail investors.

These crowd-centric alternatives – designed to bring non-correlated yield and pre-IPO equity growth to mainstream investors’ portfolios – are made up of public as well as private funds, managed accounts and online platforms that provide investors with access to peer-to-peer, peer-to-business and peer-to-real estate debt as well as JOBS Act inspired equity offerings.

While momentum continues to build for crowd-centric alternatives, an interesting phenomenon has been brewing in the retirement plan industry. Flaws in the current IRA and 401(k) structures as well as the social security system have legislators as well as economists scrambling to prevent a looming retirement crisis. Thus far, none of the publicly proposed solutions even begin to scratch the surface of the predicament. That is until now.

Fortunately, a soon-to-be-unveiled RE-defined contribution retirement plan will resolve inherent issues by 1) unleashing a new generation of plan sponsors more inclined to match contributions, 2) providing lower-wage earners with a more realistic and achievable savings plan, and by 3) bringing higher yielding institutional-grade alternatives to the masses. (A new white paper: “The RE-defined Contribution Plan: Powering Economic Growth While Preventing a National Retirement Crisis” will be released shortly)

Fascinatingly, the RE-defined contribution plan and crowd-centric alternative assets have the potential to power one another’s expansion in much the same way that the IRA, 401(k) and mutual fund industry fueled each other’s massive growth in prior decades.

***

conference room

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Crowd-centric alternatives

While the existing statistics for retail alternatives are staggering, none of the forecasters have even accounted for crowd-centric alternatives. If history is any guide, crowd-centric alternatives are about to catapult the retail alternative industry to unforeseen heights – particularly given the following key factors:

  • The surfacing of a more proficient retirement vehicle that accommodates alternative investing;
  • The introduction of new tools designed to assist financial advisors in managing their client’s crowd-centric holdings;
  • A growing number of financial advisors and next-gen BDs emerging to help retail investors access crowd-centric alternative products;
  • The prolific growth of marketplace lending;
  • Traditional offline private debt businesses migrating online;
  • The influx of P2P, P2B, P2RE managed products;
  • The maturation of the infrastructure to support crowd-centric alternative investing;
  • Venture capital is pouring into fintech (projected to nearly triple in the next 3 years). This will enthuse innovation and lead to greater sophistication of products, platforms and infrastructure;
  • The implementation of additional key components of the JOBS Act will inspire the creation of new investment products for the masses as well as provide liquidity for private alternatives.

Assessment

Although I cannot promise that polyester and orange shag carpets won’t make a comeback, I can absolutely guarantee that financial services will continue to evolve through the progression of new ideas, products, tools and technology.

More:

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Health professionals are small business owners who need to apply their self-discipline tactics in establishing and operating successful practices. Talented trainees are leaving the medical profession because they fail to balance the cost of attendance against a realistic business and financial plan. Principles like budgeting, saving, and living below one’s means, in order to make future investments for future growth, asset protection, and retirement possible are often lacking. This textbook guides the medical professional in his/her financial planning life journey from start to finish. It ranks a place in all medical school libraries and on each of our bookshelves.

Dr. Thomas M. DeLauro DPM [Professor and Chairman – Division of Medical Sciences, New York College of Podiatric Medicine]

The Surgeons Scorecard

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Coming Soon: ProPublica’s Surgeon Scorecard

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sergtech

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Millions of patients a year undergo common elective operations – things like knee and hip replacements or gall bladder removals.

But, there’s almost no information available about the quality of surgeons who do them. ProPublica analyzed 2.3 million Medicare operations and identified 67,000 patients who suffered serious complications as a result: infections, uncontrollable bleeding, even death.

We’ll be reporting the complication rates of 17,000 surgeons — so patients can make an informed choice.

***

Product DetailsProduct Details

[Foreword J. Phillips MD JD MBA] [Foreword D. Nash MD MBA]

Conclusion

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Question Authority: The Need for Anti-Authoritarians in the Medical Profession

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Michael Lawrence Langan, M.D.

[Boston, Massachusetts]

M.D. Harvard Medical School, Massachusetts General Hospital 1997-2013. Geriatric Medicine, Internal Medicine

***

iMBA Inc Textbooks

Product DetailsProduct Details

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

Disrupted Physician

Screen Shot 2015-05-30 at 7.27.10 PM
Anti-authoritarians question whether an authority is a legitimate one before taking that authority seriously.  images-24To evaluate the legitimacy of  an authority it is necessary to:
1. Assess whether they actually know what they are talking about.
2. Assess whether the authorities are honest in their intentions.  When anti-authoritarians assess an authority to be illegitimate, they challenge and resist that authority.
There is a paucity of anti-authoritarianism in the medical community concerning groups who have gained tremendous sway in the regulation of the medical profession.    There is an absence of anti-authoritarian questioning  of  what is essentially illegitimate and irrational authority.
images-26In order for these organizations to maintain power it is necessary that their authoritative opinion remain unquestioned and unchallenged.  Consciously manufactured propaganda has persuaded regulatory and public opinion of their value and to maintain power it is necessary that this authority remain insulated from outside evaluation because the entire system is based…

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I-Corps at the NIH

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More on Evidence-Based Translational Medicine

By Steve Blank

We have learned a remarkable process that allow us to be highly focused, and we have learned a tool of trade we can now repeat. This has been of tremendous value to us.

Andrew Norris

Principal Investigator BCN Biosciences

Over the last three years the National Science Foundation I-Corps has taught over 700 teams of scientists how to commercialize their technology and how to fail less, increasing their odds for commercial success.

To see if this same curriculum would work for therapeutics, diagnostics, medical devices and digital health, we taught 26 teams at UCSF a life science version of the NSF curriculum. 110 researchers and clinicians, and Principal Investigators got out of the lab and hospital, and talked to 2,355 customers. (Details here)

For the last 10 weeks 19 teams in therapeutics, diagnostics and medical devices from the National Institutes of Health (from four of the largest institutes; NCINHBLI, NINDS, and NCATS) have gone through the I-Corps at NIH.

87 researchers and clinicians spoke to 2,120 customers, tested 695 hypotheses and pivoted 215 times. Every team spoke to over 100 customers.

Three Big Questions
The NIH teams weren’t just teams with ideas, they were fully formed companies with CEO’s and Principal Investigators who already had received a $150,000 grant from the NIH. With that SBIR-Phase 1 funding the teams were trying to establish the technical merit, feasibility, and commercial potential of their technology. Many will apply for a Phase II grant of up to $1 million to continue their R&D efforts.

Going into the class we had three questions:

  1. Could companies who were already pursuing a business model be convinced to revisit their key commercialization hypotheses – and iterate and pivot if needed?
  2. Was getting the Principal Investigators and CEO out of the building more effective than the traditional NIH model of bringing in outside consultants to do commercialization planning?
  3. Would our style of being relentlessly direct with senior scientists, who hadn’t had their work questioned in this fashion since their PhD orals, work with the NIH teams?

I-Corps at the NIH: Evidence-based Translational Medicine 

Evidence-based Translational Medicine
We’ve learned that information from 100 customers is just at the edge of having sufficient data to validate/invalidate a company’s business model hypotheses. As for whether you can/should push scientists past their comfort zone, the evidence is clear – there is no other program that gets teams anywhere close to talking to 100 customers. The reason? For entrepreneurs to get out of the building at this speed and scale is an unnatural act. It’s hard, there are lots of other demands on their time, etc. But we push and cajole hard, (our phrase is we’re relentlessly direct,) knowing that while they might find it uncomfortable the first three days of the class, they come out thanking us.

The experience is demanding but time and again we have seen I-Corps teams transform their business assumptions. This direct interaction with potential users and customers is essential to commercialize science (whether to license the technology or launch a startup.) This process can’t be outsourced. These teams saved years and millions of dollars for themselves, the NIH and the U.S. taxpayer. Evidence is now in-hand that with I-Corps@NIH the NIH has the most effective program for commercializing science.

Lessons Learned Day
Every week of this 10 week class, teams present a summary of what they learned from their customers interviews. For the final presentation each team created a two minute video about their 10-week journey and a 8-minute PowerPoint presentation to tell us where they started, what they learned, how they learned it, and where they’re going. This “Lessons Learned” presentation is much different than a traditional demo day. It gives us a sense of the learning, velocity and trajectory of the teams, rather than a demo day showing us how smart they are at a single point in time.

BCN Biosciences
This video from team BCN Biosciences describes what the intensity, urgency, velocity and trajectory of an I-Corps team felt like. Like a startup it’s relentless.

BCN is developing a drug that increases anti-cancer effect of radiation in lung cancer (and/or reduces normal tissue damage by at least 40%). They were certain their customers were Radiation Oncologists, that MOA data was needed, that they needed to have Phase 1 trial data to license their product, and needed >$5 million and 6 years. After 10 weeks and 100 interviews, they learned that these hypotheses were wrong.

If you can’t see the BCN Biosciences video click here

The I-Corps experience helped the BCN Bioscience team develop an entirely new set set of business model hypotheses – this time validated by customers and partners. The “money slides” for BCN Biosciences are slides 22 and 23.

I-Corps at the NIH: Evidence-based Translational Medicine 

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Product Details

Product Details

Product Details

“When a practicing physician thinks about their risk exposure resulting from providing patient care, medical malpractice risk immediately comes to mind. But; malpractice and liability risk is barely the tip of the iceberg, and likely not even the biggest risk in the daily practice of medicine. There are risks from having medical records to keep private, risks related to proper billing and collections, risks from patients tripping on your office steps, risks from medical board actions, risk arising from divorce, and the list goes on and on. These liabilities put a doctor’s hard earned assets and career in a very vulnerable position.

These new books from Dr. David Marcinko and Prof. Hope Hetico show doctors the multiple types of risk they face and provides examples of steps to take to minimize them. They are written clearly and to the point, and are a valuable reference for any well-managed practice. Every doctor who wants to take preventive action against the risks coming at them from all sides needs to read these books.”

Richard Berning MD FACC [New Haven, Connecticut, USA]

Patient Use of Digital Communication Tools

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An Info-Graphic

http://www.MCOL.com

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digital tools

***

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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Product DetailsProduct Details

[Foreword Dr. Phillips MD JD MBA LLM] *** [Foreword Dr. Nash MD MBA FACP]

Calculate the Odds that your Job will be Stolen by a ROBOT?

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What are your chances?

[By staff reporters]

In an increasingly digital world the workforce is becoming more automated than ever before. In this decade we’ve faced the challenge of interactive POS systems impacting the retail employment sector, but what industries are next?

Understanding the future of your job role can help you plan your career path more effectively, and decide if it’s time to change direction.

Using NPR’s handy calculator you can see just how safe your job is from the robots. To save you some time we’ve listed the top industries and their rankings

  • Sales: 99% chance of being automated
  • Accountants: 93.5% chance of being automated
  • Retail: 92.3% chance of being automated
  • Programmers: 48% chance of being automated
  • Housekeeping: 68.8% chance of being automated
  • Lawyer: 3.5% chance of being automated
  • Teaching: >1% chance of being automated

***

Feeling pretty confident? Congratulations!

SplitShire-

Source:

http://www.npr.org/sections/money/2015/05/21/408234543/will-your-job-be-done-by-a-machine

***

Assessment

Even if you are a doctor, nurse, accountant or financial advisor – use the calculator to check it out.

More:

Even More:

The Great and Powerful WOZ Speaks:

Steve Wozniak, Other Geniuses Debate Whether Robots Will Tend To Our Every Whim Or Murder Us

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

I read and use this book, and several others, from Dr. David Edward Marcinko and his team of advisors.

JOHN KELLEY; DO

Transparency Program Obscures Pharma Payments to RNs and PAs

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New data largely excludes nurse practitioners and physician assistants

By Charles Ornstein | @charlesornstein  |  Pro Publica

New data on drug and device company payments to doctors largely excludes nurse practitioners and physician assistants, though they play an ever-larger role in health care.

One advanced-practice nurse pleaded guilty last month to taking drug company kickbacks.

NOTE: This story was co-published with NPR’s Shots blog.

pill mill

More:

http://www.propublica.org/article/transparency-program-obscures-pharma-payments-nurses-physician-assistants?utm_source=et&utm_medium=email&utm_campaign=dailynewsletter&utm_content=&utm_name=

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Although this book targets physicians, I was pleased to see that it also addressed the risk management, financial planning and employment benefit needs of nurses; physical, respiratory, and occupational therapists; CRNAs, hospitalists, and other members of the health care team….highly readable, practical, and understandable.

Nurse Cecelia T. Perez RN [Hospital Operating Room Manager, Ellicott City, Maryland