Dr. David Edward Marcinko MBA MEd CMP™

VOLATILITY INDICES: In Financial Markets

Posted on November 15, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

SPONSOR. http://www.MarcinkoAssociates.com

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The Role of Volatility Indices in Financial Markets

Volatility is often described as the pulse of financial markets, reflecting the collective emotions of investors as they respond to uncertainty, risk, and opportunity. Among the many tools designed to measure this phenomenon, the CBOE Volatility Index, or VIX, stands out as the most widely recognized. Dubbed the “fear gauge,” the VIX captures market expectations of near-term volatility in the S&P 500, derived from options pricing. Its movements often mirror investor sentiment: rising sharply during periods of crisis and falling when confidence returns. Yet, the VIX is not alone. A family of volatility indices exists across global markets, each offering unique insights into sector-specific or regional risk.

The importance of volatility indices lies in their ability to quantify uncertainty. Traditional measures such as historical volatility look backward, analyzing past price fluctuations. In contrast, indices like the VIX are forward-looking, reflecting implied volatility based on options markets. This distinction makes them invaluable for traders, portfolio managers, and policymakers. For example, a sudden spike in the VIX often signals heightened fear, prompting investors to hedge positions or reduce exposure to equities. Conversely, a low VIX suggests complacency, though it can also precede unexpected shocks.

Beyond the VIX, other indices provide complementary perspectives. The VXN tracks volatility in the Nasdaq-100, often dominated by technology stocks. Because the tech sector is highly sensitive to innovation cycles and regulatory changes, the VXN can diverge significantly from the VIX, highlighting sector-specific risks. Similarly, the RVX measures volatility in the Russell 2000, offering a window into small-cap stocks that are more vulnerable to domestic economic conditions. Internationally, indices such as the VSTOXX in Europe and India VIX extend this framework globally, allowing investors to compare risk sentiment across regions. Together, these indices form a mosaic of market psychology, enabling a more nuanced understanding of global financial stability.

Volatility indices also play a crucial role in risk management. Derivatives linked to these indices, such as futures and exchange-traded products, allow investors to hedge against sudden downturns. For instance, during the 2008 financial crisis, demand for VIX futures surged as investors sought protection from extreme market swings. More recently, volatility products have become popular among retail traders, though their complexity and tendency to lose value over time make them risky for long-term holding.

Critics argue that volatility indices can be misleading. A low VIX does not guarantee stability, and a high VIX does not always signal disaster. Moreover, the rise of volatility-linked products has occasionally amplified market stress, as seen during the “Volmageddon” event of February 2018, when inverse volatility ETFs collapsed. These episodes underscore the need for caution: volatility indices are powerful tools, but they must be used with a clear understanding of their limitations.

In conclusion, volatility indices such as the VIX serve as vital instruments for gauging investor sentiment and managing risk. They provide a forward-looking measure of uncertainty, complementing traditional metrics and offering insights across sectors and regions. While not infallible, their role in modern finance is undeniable.

For traders, analysts, and policymakers alike, these indices are more than numbers on a screen—they are reflections of the market’s collective psyche, guiding decisions in times of both calm and crisis.

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EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com -OR- http://www.MarcinkoAssociates.com

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Filed under: "Ask-an-Advisor", finance, Financial Planning, Funding Basics, Investing, Portfolio Management | Tagged: “Volmageddon”, CBOE, david marcinko, DJIA, ETFs, fear guage, finance, financial advisors, India VIX, Investing, investment advisors, NASDAQ, RVX, stock brokers, stock traders, stocks, VIX, Volatility Index, VSTOXX, VXN | Leave a comment »

SILVER: Role in a Diversified Investment Portfolio

Posted on November 14, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

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Silver occupies a distinctive position within the realm of investment assets, functioning simultaneously as a precious metal and an industrial commodity. This dual nature imbues silver with characteristics that make it a valuable component of a diversified portfolio, offering both defensive qualities and growth potential. While its volatility necessitates careful consideration, silver’s unique attributes warrant attention from investors seeking balance between risk mitigation and opportunity.

Silver as a Hybrid Asset

Unlike gold, which is primarily regarded as a store of value, silver derives a substantial portion of its demand from industrial applications. It is indispensable in sectors such as electronics, renewable energy, and medical technology, with photovoltaic cells in solar panels representing a particularly significant driver of consumption. This industrial utility ensures that silver’s price is influenced not only by macroeconomic uncertainty but also by technological innovation and global manufacturing trends. Consequently, silver provides investors with exposure to both traditional safe-haven dynamics and cyclical industrial growth.

Accessibility and Cost Efficiency

Silver’s affordability relative to gold enhances its appeal to a broad spectrum of investors. Physical silver, in the form of coins and bars, allows individuals with modest capital to participate in the precious metals market. Moreover, financial instruments such as exchange-traded funds (ETFs) and mining equities provide liquid and scalable avenues for investment. This accessibility ensures that silver can serve as an entry point into alternative assets, particularly for those seeking to hedge against inflation without committing substantial resources.

Inflation Hedge and Currency Protection

Historically, silver has demonstrated resilience during periods of inflation and currency depreciation. As fiat currencies lose purchasing power, tangible assets such as silver tend to appreciate, preserving wealth for investors. Although gold is often considered the primary hedge, silver’s similar properties, combined with its lower cost, render it a practical complement. In times of geopolitical instability or monetary expansion, silver can function as a safeguard against systemic risks.

Volatility and Associated Risks

Despite its advantages, silver is characterized by pronounced price volatility. Its smaller market size relative to gold renders it more susceptible to speculative trading and abrupt shifts in investor sentiment. Furthermore, fluctuations in industrial demand can amplify short-term price movements. While this volatility can generate significant returns, it also exposes investors to heightened risk. Accordingly, silver is best employed as a long-term holding within a diversified portfolio rather than as a vehicle for short-term speculation.

Portfolio Diversification and Investment Vehicles

Incorporating silver into a portfolio enhances diversification by introducing an asset class with low correlation to equities and fixed income securities. This non-correlation reduces overall portfolio risk and provides stability during market downturns. Investors may access silver through several channels: physical bullion for tangible ownership, ETFs for liquidity, mining stocks for leveraged exposure, and futures contracts for advanced strategies. Each vehicle entails distinct risk-reward profiles, enabling investors to tailor their approach according to objectives and tolerance.

Conclusion

Silver’s dual identity as both a precious metal and an industrial commodity distinguishes it from other investment assets. Its affordability, inflation-hedging capacity, and diversification benefits make it a compelling addition to portfolios. While volatility requires prudent management, silver’s potential to balance defensive and growth-oriented strategies underscores its enduring relevance in contemporary investment practice.

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MONEY: Macro-Economic Velocity

Posted on November 14, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

BASIC DEFINITIONS

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The velocity of money is a fundamental concept in macroeconomics that measures how quickly money circulates through the economy. It reflects the frequency with which a unit of currency is used to purchase goods and services within a given time period. This metric is crucial for understanding economic activity, inflation, and the effectiveness of monetary policy.

At its core, the velocity of money is calculated using the formula:

Velocity = GDPMoney Supply\text{Velocity} = \frac{\text{GDP}}{\text{Money Supply}}

This equation shows how many times money turns over in the economy to support a given level of economic output. For example, if the GDP is $20 trillion and the money supply (say, M2) is $10 trillion, the velocity is 2—meaning each dollar is used twice in a year to purchase goods and services.

There are different measures of money supply used in this calculation, most commonly M1 and M2. M1 includes the most liquid forms of money, such as cash and checking deposits, while M2 includes M1 plus savings accounts and other near-money assets. The choice of which measure to use depends on the context and the specific economic analysis being conducted.

The velocity of money is influenced by several factors:

Consumer and business confidence: When people feel optimistic about the economy, they are more likely to spend rather than save, increasing velocity.
Interest rates: Higher interest rates can encourage saving and reduce spending, lowering velocity. Conversely, lower rates can stimulate borrowing and spending.
Inflation expectations: If people expect prices to rise, they may spend more quickly, increasing velocity.
Technological and structural changes: Innovations in digital payments and shifts in consumer behavior can also affect how quickly money moves.

Historically, the velocity of money has fluctuated with economic cycles. During periods of economic expansion, velocity tends to rise as spending increases. In contrast, during recessions or periods of uncertainty, velocity often falls as consumers and businesses hold onto cash. For instance, during the 2008 financial crisis and the early stages of the COVID-19 pandemic, velocity dropped sharply due to reduced consumer spending and increased saving.

In recent years, the U.S. has experienced persistently low velocity, even amid significant increases in the money supply. This phenomenon has puzzled economists and raised questions about the effectiveness of monetary policy. Despite aggressive stimulus measures, much of the new money has remained in savings or financial markets rather than circulating through the real economy.

Understanding the velocity of money is essential for policymakers. A low velocity may signal weak demand and justify expansionary fiscal or monetary policies. Conversely, a high velocity could indicate overheating and the need for tightening measures to prevent inflation.

In conclusion, the velocity of money is a dynamic indicator of economic vitality. It helps economists and central banks assess the flow of money, the strength of demand, and the potential for inflation.

While often overlooked by the public, it plays a vital role in shaping economic policy and understanding the broader health of the economy.

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PHYSICIAN PAYMENT: Direct Reimbursement Models

Posted on November 13, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

BASIC DEFINITIONS

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The Direct Reimbursement Payment Model allows physicians to receive payment directly from patients or employers, bypassing traditional insurance systems. This model emphasizes transparency, autonomy, and personalized care, offering an alternative to fee-for-service and managed care structures.

The Direct Reimbursement Payment Model is a healthcare financing approach in which physicians are paid directly by patients or sponsoring entities—such as employers—rather than through insurance companies or government programs. This model is gaining traction as a response to the administrative burdens, opaque billing practices, and fragmented care often associated with traditional insurance-based systems.

One prominent example of direct reimbursement is Direct Primary Care (DPC). In DPC, patients pay a recurring fee—monthly, quarterly, or annually—that covers a broad range of primary care services. These include routine checkups, preventive screenings, chronic disease management, and basic lab work. By eliminating third-party billing, DPC practices reduce overhead costs and administrative complexity, allowing physicians to spend more time with patients and focus on quality care.

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Employers have also embraced direct reimbursement models to manage healthcare costs and improve employee wellness. In such arrangements, employers reimburse physicians or clinics directly for services rendered to their employees, often through a defined benefit structure. This can be part of a self-funded health plan or a supplemental offering alongside high-deductible insurance policies. The goal is to provide accessible, cost-effective care while avoiding the inefficiencies of traditional insurance networks.

Key advantages of the direct reimbursement model include:

Price transparency: Patients know upfront what services cost, reducing surprise billing and financial stress.
Improved access: Physicians often offer same-day or next-day appointments, extended visits, and direct communication via phone or email.
Lower administrative burden: Without insurance paperwork, practices can operate more efficiently and focus on patient care.
Stronger patient-physician relationships: More time per visit fosters trust, continuity, and better health outcomes.

However, the model is not without limitations. Direct reimbursement may not cover specialist care, hospitalization, or emergency services, requiring patients to maintain supplemental insurance. Additionally, the model may be less accessible to low-income populations who cannot afford recurring fees or out-of-pocket payments. Critics also argue that widespread adoption could fragment care and reduce risk pooling, undermining the broader goals of universal coverage.

Despite these concerns, the direct reimbursement model aligns with broader trends in healthcare reform, including value-based care, consumer empowerment, and decentralized service delivery. It offers a viable path for physicians seeking autonomy and for patients desiring personalized, transparent care. As healthcare continues to evolve, hybrid models that combine direct reimbursement with traditional insurance may emerge, offering flexibility and choice across diverse patient populations.

In conclusion, the Direct Reimbursement Payment Model represents a meaningful shift in how healthcare services are financed and delivered.

By prioritizing simplicity, transparency, and patient-centered care, it challenges the status quo and opens new possibilities for sustainable, high-quality medical practice.

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REAL-WORLD FINANCE: How Some RNs Can Retire Richer Than Physicians

Posted on November 13, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

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For generations, the prevailing belief in healthcare has been that physicians [MD, DO and DPM], with their high salaries and prestige, inevitably retire wealthier than nurses. Yet this assumption overlooks the financial realities of different nursing specialties and the long‑term impact of debt, lifestyle, and retirement planning. In fact, some Registered Nurses (RNs)—particularly Certified Registered Nurse Anesthetists (CRNAs), visiting nurses, and those who participate in structured pay programs like the Baylor plan—can retire richer than physicians. The reasons lie in the interplay of education costs, career flexibility, income potential, and disciplined financial planning.

Education Costs and Debt Burden

One of the most decisive factors shaping retirement wealth is the cost of education. Physicians often spend over a decade in training, including undergraduate studies, medical school, and residency. This path not only delays their earning years but also saddles them with substantial student debt. The median medical school debt in the United States exceeds $200,000, and many physicians spend years paying it down.

By contrast, RNs typically complete their training in two to four years, with advanced practice nurses such as CRNAs requiring graduate‑level education. Even so, their debt burden is far lighter, often less than half of what physicians carry. This difference means nurses can begin earning earlier, save for retirement sooner, and avoid the crushing interest payments that erode physicians’ wealth. A CRNA who starts practicing in their late twenties may already be investing in retirement accounts while a physician is still in residency earning a modest stipend.

Income Potential of Specialized Nurses

While physicians generally earn more annually than nurses, the gap is narrower in certain specialties. CRNAs, for example, are among the highest‑paid nursing professionals, with average salaries often exceeding $200,000 per year. This places them in direct competition with some physician specialties, especially primary care doctors, who may earn similar or even lower salaries.

Visiting nurses also benefit from unique financial advantages. Many work on flexible schedules, contract arrangements, or per‑visit compensation models. This allows them to maximize income while minimizing burnout. By avoiding the overhead costs of private practice and the administrative burdens physicians face, visiting nurses can channel more of their earnings directly into savings and investments.

When combined with lower debt and earlier career starts, these income streams can compound into significant retirement wealth.

💰 Highest-Paying Nursing Careers (2025)

Certified Registered Nurse Anesthetist (CRNA) – ~$212,000 annually
Nurse Practitioner (NP) – $120,000–$140,000+ depending on specialty (Family, Acute Care, Psychiatric)
Clinical Nurse Specialist (CNS) – $120,000–$135,000
Nurse Midwife – ~$115,000
Nurse Manager/Administrator – $110,000–$120,000
Informatics Nurse Specialist – ~$115,000
Neonatal ICU Nurse (NICU) – $110,000+
ICU Nurse – $105,000+
Pain Management Nurse – ~$104,000
Oncology Nurse – ~$100,000

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The Baylor Pay Plan Advantage

The Baylor plan, a structured pay program used by some hospitals, allows nurses to work full‑time hours compressed into fewer days—often weekends—while still receiving full‑time pay and benefits. This arrangement provides several financial advantages. First, it enables nurses to earn competitive wages while freeing up weekdays for additional work, education, or entrepreneurial ventures. Second, it reduces commuting and childcare costs, allowing more income to be saved. Third, the plan often includes robust retirement benefits, such as employer‑matched contributions to 401(k) or pension programs.

Nurses who consistently participate in such structured pay plans can accumulate substantial nest eggs, often surpassing physicians who delay retirement savings due to debt repayment or lifestyle inflation. The Baylor plan highlights the importance of systematic investing: by automating contributions and focusing on long‑term growth, nurses can harness the power of compound interest. A nurse who invests steadily for 35 years may accumulate more wealth than a physician who begins saving late and inconsistently, despite earning a higher salary.

Lifestyle and Work‑Life Balance

Another overlooked factor is lifestyle. Physicians often face grueling schedules, high stress, and the temptation to maintain expensive lifestyles commensurate with their social status. Luxury homes, cars, and vacations can erode their financial base. Nurses, while not immune to lifestyle inflation, often maintain more modest spending habits.

Visiting nurses, in particular, enjoy flexibility that allows them to balance work with personal life. This reduces burnout and healthcare costs while enabling consistent employment into later years. By living within their means and prioritizing savings, nurses can accumulate wealth steadily without the financial pitfalls that sometimes accompany physician lifestyles.

Retirement Wealth Beyond Salary

Retirement wealth is not solely determined by annual income. It is shaped by debt management, savings discipline, investment strategies, and lifestyle choices. Nurses who leverage high‑paying specialties like anesthesia, flexible arrangements like visiting nursing, and structured programs like the Baylor plan can outperform physicians in these areas.

Consider two professionals: a physician earning $250,000 annually but burdened by $200,000 in debt and high living expenses, and a CRNA earning $200,000 with minimal debt and disciplined savings. Over decades, the CRNA may accumulate more net wealth, retire earlier, and enjoy greater financial security.

Conclusion

The assumption that physicians always retire richer than nurses is outdated. While physicians command higher salaries, their delayed earnings, heavy debt, and lifestyle pressures often undermine long‑term wealth. Nurses, particularly CRNAs, visiting nurses, and those who participate in structured pay programs like the Baylor plan, can retire wealthier by combining lower debt, earlier savings, competitive incomes, and disciplined financial planning.

Ultimately, retirement wealth is not about prestige but about strategy. Nurses who recognize this truth and act accordingly may find themselves enjoying more financial freedom than the very physicians they once assisted.

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PHYSICIAN: Car Repossessions Rise!

Posted on November 12, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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Physicians are increasingly facing car repossessions in 2025 due to rising debt, high vehicle prices, and economic pressures that are reshaping the financial landscape for medical professionals.

Traditionally viewed as financially secure, doctors are now among the growing number of Americans struggling to keep up with auto loan payments. The surge in car repossessions—expected to reach a record 10.5 million assignments by the end of 2025—has not spared the medical community. While physicians often earn higher-than-average incomes, they also carry significant financial burdens, including student loan debt, practice overhead, and personal expenses. These pressures are being amplified by macroeconomic forces such as inflation, high interest rates, and stagnant reimbursement rates.

One of the key contributors to this trend is the soaring cost of vehicles. In 2025, the average price of a new car in the U.S. surpassed $50,000, a dramatic increase from just a decade ago. For physicians who rely on vehicles for commuting between hospitals, clinics, and private practices, owning a reliable car is not a luxury—it’s a necessity. However, the combination of high sticker prices and elevated interest rates—averaging 7.3% for used cars and 11.5% for new cars—has made financing increasingly difficult.

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Even high-income professionals are not immune to the broader auto loan crisis. Subprime auto loan delinquencies reached 6.6% in early 2025, the highest rate in over 30 years.While physicians typically fall into the prime or super-prime credit categories, many are still affected by cash flow disruptions, especially those in private practice or rural areas where patient volumes and insurance reimbursements have declined. Additionally, younger doctors with substantial student debt may find themselves overleveraged, making it harder to keep up with car payments.

The emotional and professional toll of a car repossession can be significant. Beyond the embarrassment and logistical challenges, losing a vehicle can disrupt a physician’s ability to provide care, attend emergencies, or maintain a consistent work schedule. This can lead to further income loss, creating a vicious cycle of financial instability.

To combat this trend, some physicians are turning to financial advisors to restructure their debt, refinance auto loans, or downsize to more affordable vehicles. Others are advocating for systemic reforms, such as student loan forgiveness, higher Medicare reimbursements, and better financial literacy training during medical education.

In conclusion, the rise in car repossessions among doctors is a stark reminder that no profession is immune to economic volatility. As the cost of living continues to climb and financial pressures mount, even those in traditionally stable careers must adapt to protect their assets and livelihoods.

Addressing this issue requires both individual financial planning and broader policy changes to ensure that physicians can continue to serve their communities without the looming threat of personal financial collapse.

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Say’s Law in Classical Economics

Posted on November 12, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

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Say’s Law, named after the French economist Jean‑Baptiste Say, is a foundational idea in classical economics. Often summarized as “supply creates its own demand,” the law suggests that the act of producing goods and services inherently generates the income necessary to purchase them. This principle shaped economic thought throughout the 19th century and continues to influence debates about markets, government intervention, and the causes of economic crises.

Origins and Meaning Jean‑Baptiste Say introduced his law in the early 1800s in his Treatise on Political Economy. He argued that production is the source of demand: when producers create goods, they pay wages, rents, and profits, which in turn become purchasing power. In this view, general overproduction is impossible because every supply of goods corresponds to an equivalent demand. If imbalances occur, they are temporary and limited to specific sectors, not the economy as a whole.

Core Principles Say’s Law rests on several assumptions:

Markets are self‑correcting: Any surplus in one area leads to adjustments in prices and production.
Money is neutral: It serves only as a medium of exchange, not as a driver of demand.
Production drives prosperity: Economic growth depends on increasing output, not stimulating consumption.
No long‑term unemployment: Since supply creates demand, workers displaced in one industry will eventually find employment elsewhere.

These ideas aligned with classical economists’ belief in minimal government intervention and the efficiency of free markets.

Influence on Classical Economics Say’s Law became a cornerstone of classical economics, reinforcing the belief that recessions or depressions were temporary and self‑correcting. Economists like David Ricardo and John Stuart Mill adopted versions of the law, using it to argue against policies aimed at stimulating demand. The law supported laissez‑faire approaches, suggesting that governments should avoid interfering with markets, as production itself would ensure economic balance.

Criticism and Keynesian Revolution Say’s Law faced its greatest challenge during the Great Depression of the 1930s. Widespread unemployment and idle factories contradicted the idea that supply automatically generates demand. John Maynard Keynes famously rejected Say’s Law in his General Theory of Employment, Interest, and Money (1936). Keynes argued that demand, not supply, drives economic activity. He showed that insufficient aggregate demand could lead to prolonged recessions, requiring government intervention through fiscal and monetary policies.

Keynes’s critique marked a turning point in economics. While Say’s Law emphasized production, Keynesian economics highlighted consumption and demand management. This shift reshaped economic policy, leading to active government roles in stabilizing economies.

Modern Perspectives Today, Say’s Law is not accepted in its original form, but elements of it remain relevant. Supply‑side economists, for example, argue that policies encouraging production—such as tax cuts and deregulation—can stimulate growth. In contrast, Keynesians stress the importance of demand management. The debate reflects a broader tension in economics: whether prosperity depends more on producing goods or ensuring people have the means and willingness to buy them.

Conclusion: Say’s Law was a bold attempt to explain the self‑sustaining nature of markets. While its claim that “supply creates its own demand” proved too simplistic in the face of modern economic realities, it remains a vital part of the history of economic thought. The controversy surrounding Say’s Law highlights the evolving nature of economics, where theories are tested against real‑world crises and adapted to new circumstances. Even today, discussions of supply‑side versus demand‑side policies echo the enduring influence of Say’s original insight.

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SINGULARITY: In Finance and Investing

Posted on November 11, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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The singularity promises to revolutionize medicine by accelerating diagnostics, treatment, and longevity—but it also demands ethical vigilance and systemic transformation.

The concept of the technological singularity refers to a hypothetical future moment when artificial intelligence (AI) surpasses human intelligence, triggering exponential advances in technology. In medicine, this could mark a turning point where AI-driven systems outperform human clinicians in diagnosis, treatment planning, and even biomedical research. While the singularity remains speculative, its implications for healthcare are profound and multifaceted.

One of the most promising impacts is in diagnostics and precision medicine. AI systems trained on vast datasets of medical images, genetic profiles, and patient histories could detect diseases earlier and more accurately than human doctors. For example, algorithms already outperform radiologists in identifying certain cancers from imaging scans. As we approach the singularity, these systems may evolve into autonomous diagnostic agents capable of real-time analysis and personalized recommendations, tailored to each patient’s unique biology.

Another transformative area is drug discovery and development. Traditional pharmaceutical research is slow and costly, often taking over a decade to bring a new drug to market. AI could dramatically shorten this timeline by simulating molecular interactions, predicting therapeutic targets, and optimizing clinical trial designs. With superintelligent systems, the pace of innovation could accelerate to the point where treatments for currently incurable diseases—like Alzheimer’s or certain cancers—become feasible within months.

The singularity also opens doors to radical longevity and human enhancement. Advances in nanotechnology, genomics, and regenerative medicine may converge to extend human lifespan significantly. AI could help decode the aging process, identify biomarkers of cellular decline, and engineer interventions that slow or reverse it. Some theorists even envision a future where aging is treated as a curable condition, and mortality becomes a choice rather than a biological inevitability.

However, these breakthroughs come with serious ethical and societal challenges. Data privacy, algorithmic bias, and access inequality are critical concerns. If singularity-level AI is controlled by a few corporations or governments, it could exacerbate global health disparities. Moreover, the replacement of human clinicians with machines raises questions about empathy, trust, and accountability in care. Who is responsible when an AI makes a life-altering mistake?

To navigate this future responsibly, medicine must embrace interdisciplinary collaboration. Ethicists, technologists, clinicians, and policymakers must work together to ensure that AI systems are transparent, equitable, and aligned with human values. Regulatory frameworks must evolve to keep pace with innovation, and medical education must prepare practitioners to work alongside intelligent machines.

In conclusion, the singularity represents both a promise and a peril for medicine. It offers unprecedented opportunities to enhance human health, but also demands careful stewardship to avoid unintended consequences.

As we edge closer to this horizon, the challenge will be not just technological, but deeply human: to harness intelligence beyond our own in service of healing, compassion, and justice.

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SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com

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Understanding the Series 63 Exam: Key Insights

Posted on November 11, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By A. I. and FINRA

SPONSOR: http://www.CertifiedMedicalPlanner.org

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The Series 63 exam — the Uniform Securities State Law Examination — is a North American Securities Administrators Association (NASAA) exam administered by FINRA.

The exam consists of 60 scored questions and 5 unscored questions. Candidates have 75 minutes to complete the exam. In order for a candidate to pass the Series 63 exam, they must correctly answer at least 43 of the 60 scored questions.

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PHYSICIAN NET WORTH: Versus Average Family

For additional information about this exam, including the content outline, please visit the exams page on the NASAA website.

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BAD MONEY MOVES of Physicians!

Posted on November 11, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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Money is a powerful tool. It can provide security, open opportunities, and help build a fulfilling life. Yet, when mismanaged, it can quickly become a source of stress and regret. Understanding the worst ways to use money is essential for anyone who wants to avoid financial pitfalls and build lasting stability.

1. Impulse Spending

One of the most damaging habits is spending without thought. Buying items on impulse—whether it’s clothes, gadgets, or luxury goods—often leads to regret and wasted resources. These purchases rarely align with long‑term goals and can drain savings meant for emergencies or investments.

2. High‑Interest Debt

Credit cards and payday loans can trap people in cycles of debt. Paying 20% or more in interest means that even small purchases balloon into massive financial burdens. Using debt irresponsibly is one of the fastest ways to erode wealth.

3. Ignoring Savings and Investments

Failing to save for the future is another critical mistake. Without an emergency fund, unexpected expenses like medical bills or car repairs can derail financial stability. Similarly, neglecting investments means missing out on compound growth that builds wealth over time.

4. Chasing Get‑Rich‑Quick Schemes

From pyramid schemes to speculative “hot tips,” chasing unrealistic returns is a recipe for disaster. These schemes prey on greed and impatience, often leaving participants with nothing but losses. Sustainable wealth comes from patience and discipline, not shortcuts.

5. Overspending on Status

Many people waste money trying to impress others—buying luxury cars, designer clothes, or extravagant experiences they cannot afford. This pursuit of status often leads to debt and financial insecurity, while providing only fleeting satisfaction.

6. Neglecting Insurance

Skipping health, auto, or home insurance to save money may seem smart in the short term, but it can be catastrophic when disaster strikes. Without protection, one accident or emergency can wipe out years of savings.

7. Failing to Budget

Living without a plan is like sailing without a map. Without a budget, it’s easy to overspend, miss bills, or fail to allocate money toward goals. Budgeting is not restrictive—it’s empowering, because it ensures money is used intentionally.

8. Ignoring Education and Skills

Spending money without investing in personal growth is another hidden mistake. Education, training, and skill development often yield lifelong returns. Neglecting these opportunities can limit earning potential and financial independence.

Conclusion

The worst things to do with money often stem from short‑term thinking, lack of discipline, or the desire for instant gratification. Impulse spending, high‑interest debt, chasing schemes, and neglecting savings all undermine financial health. By avoiding these traps and focusing on budgeting, investing wisely, and protecting against risks, money can serve as a foundation for security and freedom rather than a source of stress.

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TAX: Difference Between Evasion and Avoidance

Posted on November 10, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

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Taxation is a cornerstone of modern governance, providing the financial resources necessary for governments to deliver public services, maintain infrastructure, and support social programs. While paying taxes is a legal obligation, individuals and businesses often seek ways to reduce their tax burden. This pursuit gives rise to two distinct concepts: tax avoidance and tax evasion. Though they may sound similar, the difference between them is profound, hinging on legality, ethics, and consequences.

Tax avoidance refers to the use of lawful strategies to minimize tax liability. It involves taking advantage of deductions, exemptions, credits, and other provisions explicitly allowed by tax laws. For example, individuals may contribute to retirement accounts, claim mortgage interest deductions, or invest in tax-free municipal bonds. Businesses may structure operations to benefit from tax incentives or credits designed to encourage innovation, sustainability, or job creation. In essence, tax avoidance is legal tax planning—a way to reduce obligations while staying within the boundaries of the law.

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By contrast, tax evasion is illegal. It involves deliberately misrepresenting or concealing information to avoid paying taxes. Common forms of evasion include underreporting income, overstating deductions, hiding assets offshore, or falsifying records. Unlike avoidance, which is permitted and often encouraged, evasion constitutes fraud against the government. The consequences are severe: individuals and corporations found guilty of tax evasion may face hefty fines, penalties, and even imprisonment.

The distinction between the two lies in compliance versus deception. Tax avoidance complies with the letter of the law, even if it sometimes exploits loopholes. Tax evasion, however, breaks the law outright. This difference is critical not only legally but also ethically. While avoidance is lawful, aggressive avoidance strategies—especially by wealthy individuals or multinational corporations—can raise moral questions. Critics argue that such practices undermine fairness, shifting the tax burden onto ordinary citizens. Governments often respond by reforming tax codes to close loopholes and ensure equity.

Tax evasion, on the other hand, is universally condemned. It erodes trust in the tax system, deprives governments of essential revenue, and places greater strain on compliant taxpayers. Moreover, evasion can damage reputations, leading to loss of credibility and public backlash for businesses or individuals caught engaging in fraudulent practices.

In summary, tax avoidance is legal and strategic, while tax evasion is illegal and punishable. Both aim to reduce tax liability, but they differ fundamentally in method and consequence. Avoidance leverages lawful opportunities provided by tax codes, whereas evasion relies on deception and concealment. Understanding this distinction is vital for taxpayers, as crossing the line from avoidance into evasion can result in serious legal and financial repercussions. Ultimately, responsible tax planning requires not only knowledge of the law but also an awareness of ethical considerations, ensuring that efforts to minimize taxes do not compromise legality or fairness.

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Effective Marketing: Using Loss Leaders in Financial Services

Posted on November 10, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd CMP™

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SPONSOR: http://www.CertifiedMedicalPlanner.org

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In the competitive world of financial services, attracting and retaining clients is a constant challenge. To stand out, many financial advisors employ strategic marketing tactics known as “loss leaders”—free or discounted services designed to showcase value and build trust. These offerings serve as entry points for potential clients, allowing advisors to demonstrate expertise and initiate long-term relationships.

One of the most common loss leaders is the free initial consultation. This no-obligation meeting gives prospective clients a chance to discuss their financial goals, ask questions, and get a feel for the advisor’s approach. For the advisor, it’s an opportunity to assess the client’s needs and present tailored solutions. While no revenue is generated from this meeting, it often leads to paid engagements once the client feels confident in the advisor’s capabilities.

Another popular tactic is offering a complimentary financial plan or portfolio review. These services provide tangible insights into a client’s current financial situation and suggest improvements. By delivering real value upfront, advisors build credibility and demonstrate their analytical skills. Clients who receive actionable advice are more likely to continue working with the advisor on a paid basis.

Educational content also plays a key role in loss leader strategy. Advisors frequently host free webinars, workshops, or seminars on topics like retirement planning, tax strategies, or investment basics. These events not only educate attendees but also position the advisor as a thought leader. Attendees often leave with a better understanding of their financial needs and a desire to seek personalized guidance.

In the digital realm, advisors may offer free tools and assessments on their websites. These include retirement readiness calculators, risk tolerance quizzes, and budgeting templates. Such tools engage users and provide personalized feedback, creating a natural segue into one-on-one consultations. Additionally, offering free newsletters or eBooks helps advisors stay top-of-mind while delivering ongoing value.

Some advisors go further by waiving fees for introductory services, such as account setup or the first few months of investment management. This lowers the barrier to entry and encourages hesitant clients to try the service. Once clients experience the benefits, they’re more likely to commit long-term.

Loss leaders are not limited to high-net-worth individuals. Advisors targeting younger or less affluent clients may offer free debt management plans or budgeting assistance. These services address immediate concerns and build loyalty among clients who may become more profitable as their financial situations improve.

Ultimately, loss leaders are about building relationships. By offering something of value without immediate compensation, financial advisors demonstrate their commitment to helping clients succeed. This fosters trust, encourages engagement, and often leads to lasting partnerships. In a field where reputation and reliability are paramount, loss leaders serve as powerful tools for growth and differentiation.

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RICARDIAN ECONOMICS: Can it Save Medicine?

Posted on November 10, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

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Ricardian economics, rooted in the theories of 19th-century economist David Ricardo, emphasizes comparative advantage, free trade, and the neutrality of government debt—most notably through the concept of Ricardian equivalence. While these ideas have shaped macroeconomic thought, their relevance to medicine and healthcare policy is less direct. Still, exploring Ricardian principles offers a provocative lens through which to examine the fiscal sustainability and efficiency of modern healthcare systems.

At the heart of Ricardian equivalence is the idea that consumers are forward-looking and internalize government budget constraints. If a government finances healthcare through debt rather than taxes, rational agents will anticipate future tax burdens and adjust their behavior accordingly. In theory, this undermines the effectiveness of deficit-financed healthcare spending as a stimulus. Applied to medicine, this suggests that long-term fiscal responsibility is crucial: expanding healthcare access through borrowing may not yield the intended economic or health benefits if citizens expect future costs to rise.

This insight could inform debates on healthcare reform, especially in countries grappling with ballooning medical expenditures. Ricardian economics warns against short-term fixes that ignore long-term fiscal implications. For example, expanding public insurance programs without sustainable funding mechanisms could lead to intergenerational inequities and economic distortions. Policymakers might instead focus on reforms that align incentives, reduce waste, and promote cost-effective care—principles that resonate with Ricardo’s emphasis on efficiency and comparative advantage.

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However, Ricardian economics offers limited guidance on the unique moral and practical dimensions of medicine. Healthcare is not a typical market good. Patients often lack the information or autonomy to make rational choices, especially in emergencies. Moreover, the sector is rife with externalities: one person’s vaccination benefits the broader community, and untreated illness can strain public resources. These complexities challenge the assumption of rational, forward-looking behavior central to Ricardian equivalence.

Additionally, Ricardo’s theory of comparative advantage—where nations benefit by specializing in goods they produce most efficiently—has implications for global health. It supports international collaboration in pharmaceutical production, medical research, and telemedicine. Yet, over-reliance on global supply chains can expose vulnerabilities, as seen during the COVID-19 pandemic when countries faced shortages of critical medical supplies.

In conclusion, Ricardian economics provides valuable fiscal insights that can inform healthcare policy, particularly regarding debt sustainability and efficient resource allocation. Its emphasis on long-term planning and comparative advantage can guide reforms that make medicine more resilient and cost-effective. However, the theory’s assumptions about rational behavior and market dynamics limit its applicability to the nuanced realities of healthcare. Medicine requires not just economic efficiency but ethical considerations, equity, and compassion—areas where Ricardian economics falls short. Thus, while it can contribute to the conversation, it cannot “save” medicine alone.

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PUBLIC RELATIONS: In Medicine

Posted on November 9, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd and Copilot A.I.

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Public relations (PR) in medicine is a specialized field that focuses on managing communication between healthcare organizations, medical professionals, and the public. Unlike traditional marketing, which emphasizes selling services, PR in medicine emphasizes trust, credibility, and education. In a sector where lives and well-being are at stake, effective communication is not optional—it is essential.

1. Building Trust and Reputation

Healthcare institutions rely heavily on public trust. Patients must feel confident in the competence and integrity of hospitals, clinics, and medical professionals. PR strategies such as press releases, community outreach, and media engagement help establish credibility. For example, when hospitals share success stories of medical breakthroughs or highlight patient-centered initiatives, they reinforce their reputation as reliable and compassionate providers.

2. Health Education and Awareness

One of the most important functions of PR in medicine is educating the public. Medical jargon can be complex, and PR professionals translate it into accessible language. Campaigns about preventive care, vaccination, or chronic disease management empower communities to make informed health decisions. By bridging the knowledge gap, PR ensures that medical information is not confined to professionals but reaches the wider population in a clear and actionable way.

3. Crisis Communication

Healthcare organizations often face crises—ranging from disease outbreaks to medical errors. In such moments, PR becomes the frontline defense. Transparent communication, timely updates, and empathy are crucial in maintaining public confidence. For instance, during the COVID-19 pandemic, hospitals and health agencies relied on PR to disseminate accurate information, counter misinformation, and reassure anxious populations. Effective crisis communication can prevent panic and sustain trust even in challenging times.

4. Advocacy and Community Engagement

PR in medicine also involves advocacy for public health policies and community engagement. Hospitals and medical associations often use PR campaigns to support initiatives such as mental health awareness, anti-smoking drives, or nutrition education. By engaging with communities through events, seminars, and social media, healthcare organizations position themselves as partners in public well-being rather than distant institutions.

5. Digital Transformation in Medical PR

The rise of digital media has transformed healthcare PR. Social media platforms, blogs, and online forums allow medical institutions to communicate directly with patients. This immediacy enhances transparency but also requires careful management to avoid misinformation. Digital PR strategies now include online reputation management, patient testimonials, and interactive health campaigns. In this way, PR adapts to modern communication channels while maintaining its core mission of trust and education.

6. Ethical Responsibility

Unlike other industries, PR in medicine carries a profound ethical responsibility. Misleading information can have life-threatening consequences. Therefore, PR professionals in healthcare must prioritize accuracy, sensitivity, and compassion. Their role is not only to protect the image of institutions but also to safeguard public health.

Conclusion

Public relations in medicine is more than a communication tool—it is a bridge between science and society. By fostering trust, educating communities, managing crises, and advocating for health, PR ensures that medical institutions remain credible and compassionate. In an era of rapid medical advancements and global health challenges, the importance of PR in medicine continues to grow, making it an indispensable part of modern healthcare.

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Understanding the Google Scholar Paradox in Research

Posted on November 9, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By A.I.

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Classic Definition: Scientific research depends on the referencing and citing of other research.

Modern Circumstance: The Google Scholar Paradox is that research which gets cited most often is whatever shows up in the top results of Google Scholar searches; regardless of its contribution to the field.

Paradox Example: The Google Scholar effect is a phenomenon when some medical and healthcare researchers pick and cite works appearing in the top results on Google Scholar regardless of their contribution to the citing publication.

Paradoxically they automatically assume these works’ credibility and believe that editors, reviewers, and readers expect to see these citations.

Courtesy: Morgan Housel

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SCHRODINGER’S CAT and Other Thought Experiments

Posted on November 9, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

Thought

By Dr. David Edward Marcinko MBA MEd

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Thought experiments have long been a powerful tool in science and philosophy, allowing thinkers to explore complex ideas without the need for immediate empirical testing. Among the most famous is Schrödinger’s Cat, devised in 1935 by physicist Erwin Schrödinger to highlight the strange implications of quantum mechanics. In this scenario, a cat is placed in a sealed box with a radioactive atom, a Geiger counter, and a vial of poison. If the atom decays, the Geiger counter triggers the release of poison, killing the cat. According to the Copenhagen interpretation of quantum mechanics, until the box is opened and observed, the atom exists in a superposition of decayed and undecayed states. Consequently, the cat is simultaneously alive and dead until observation collapses the wavefunction. This paradox illustrates the difficulty of applying quantum principles to macroscopic objects and remains a central discussion point in debates about the nature of reality.

Schrödinger’s Cat is not unique in its ability to provoke deep reflection. Throughout history, scientists and philosophers have used thought experiments to challenge assumptions and clarify theories. For example, Galileo’s falling bodies experiment imagined two objects of different weights tied together and dropped from a tower. By reasoning through the scenario, Galileo demonstrated that heavier objects do not fall faster than lighter ones, contradicting Aristotelian physics and paving the way for Newtonian mechanics.

Another influential thought experiment is Einstein’s elevator, which he used to develop the theory of general relativity. Einstein imagined an observer inside a sealed elevator, unable to see outside. If the elevator were accelerating upward in space, the observer would feel pressed to the floor, just as if gravity were acting on them. This equivalence between acceleration and gravity became the foundation of Einstein’s revolutionary insight that gravity is not a force but the curvature of spacetime.

In thermodynamics, Maxwell’s demon presents a paradox about the second law of entropy. James Clerk Maxwell imagined a tiny demon controlling a door between two chambers of gas. By selectively allowing fast-moving molecules to pass one way and slow-moving molecules the other, the demon could seemingly decrease entropy without expending energy. This thought experiment sparked debates about the nature of information, energy, and the limits of physical laws, influencing modern discussions in statistical mechanics and information theory.

Philosophy also abounds with thought experiments. Descartes’ evil demon questioned whether our perceptions could be manipulated, casting doubt on the certainty of knowledge. More recently, John Searle’s Chinese Room challenged the idea that computers can truly “understand” language, distinguishing between syntax and semantics in artificial intelligence.

In conclusion, Schrödinger’s Cat remains a symbol of quantum strangeness, but it is part of a broader tradition of thought experiments that have shaped human understanding. From Galileo’s tower to Einstein’s elevator, Maxwell’s demon to Searle’s room, these imaginative scenarios allow us to probe the boundaries of knowledge, test the coherence of theories, and confront paradoxes that empirical experiments alone cannot resolve. They remind us that science is not only about observation but also about the creative power of the human mind to envision possibilities beyond immediate reality.

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DI-WORSIFICATION: Stock Portfolio Pitfalls

Posted on November 8, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

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SPONSOR: http://www.MarcinkoAssociates.com

Diworsification is a term coined by Peter Lynch to describe when investors over‑diversify their portfolios, adding too many holdings and ultimately reducing returns instead of improving them.

Diversification has long been heralded as one of the cornerstones of sound investing. By spreading capital across different asset classes, industries, and geographies, investors can reduce risk and protect themselves against the volatility of individual securities. Yet, as with many strategies, there exists a point where the benefits diminish and the practice becomes counterproductive. This phenomenon, known as diworsification, was popularized by legendary investor Peter Lynch to describe the tendency of investors and corporations to dilute their strengths by expanding too broadly.

At its core, diworsification occurs when the pursuit of safety leads to excessive complexity. For individual investors, this often manifests in portfolios bloated with dozens or even hundreds of stocks, mutual funds, or exchange‑traded funds. While the intention is to minimize risk, the result is frequently a portfolio that mirrors the market index but with higher costs and less focus. Instead of achieving superior returns, the investor ends up with average performance weighed down by management fees, trading expenses, and the difficulty of monitoring so many positions. In essence, the investor has sacrificed the potential for meaningful gains in exchange for a false sense of security.

Corporations are not immune to this trap. In the corporate world, diworsification describes the tendency of firms to expand into unrelated businesses, diluting their competitive advantage. A company that excels in consumer electronics, for example, may attempt to branch into unrelated industries such as food services or real estate. Without the expertise, synergies, or strategic fit, these ventures often fail to deliver value, distracting management and eroding shareholder wealth. History is replete with examples of conglomerates that grew too large, too fast, only to later divest their non‑core businesses in recognition of the inefficiencies created.

The dangers of diworsification are not merely theoretical. They highlight the importance of discipline in both investing and corporate strategy. For investors, the lesson is clear: diversification should be purposeful, not indiscriminate. A well‑constructed portfolio might include a mix of equities, bonds, and alternative assets, but each holding should serve a specific role—whether it is growth, income, or risk mitigation. Beyond a certain point, adding more securities does not reduce risk meaningfully; instead, it complicates decision‑making and reduces the chance of outperforming the market.

Similarly, for corporations, strategic focus is paramount. Expansion should be guided by core competencies and long‑term vision rather than the allure of short‑term growth. Firms that resist the temptation to chase every opportunity are better positioned to strengthen their brand, innovate within their domain, and deliver sustainable value to shareholders.

In conclusion, diworsification serves as a cautionary tale against the excesses of diversification. While spreading risk is essential, overdoing it can undermine performance and clarity. Both investors and corporations must strike a balance between breadth and focus, ensuring that every addition to a portfolio or business strategy enhances rather than dilutes overall strength. In other words, “diversification means you will always have to say you’re sorry.”

True wisdom lies not in owning everything, but in owning the right things.

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Understanding the Risks of Capitation in Healthcare

Posted on November 8, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By A.I.

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The Pitfalls of Capitation in Medicine

Capitation, a payment model in healthcare where providers receive a fixed amount per patient regardless of the services rendered, has been promoted as a way to control costs and incentivize efficiency. However, despite its theoretical appeal, capitation medicine presents significant drawbacks that can compromise patient care, distort provider incentives, and exacerbate systemic inequities.

One of the most concerning aspects of capitation is the potential for under-treatment. Since providers are paid a set fee per patient, regardless of how much care that patient requires, there is a financial incentive to minimize services. This can lead to situations where necessary tests, referrals, or treatments are delayed or denied in order to preserve profit margins. Patients with complex or chronic conditions—who require more frequent and intensive care—may be especially vulnerable under this model. The risk is that medical decisions become driven by cost containment rather than clinical need, undermining the ethical foundation of healthcare.

NURSING CAPITATION: https://medicalexecutivepost.com/2024/07/07/on-nursing-capitation-reimbursement/

Capitation also introduces challenges in maintaining quality standards. Unlike value-based care, which ties reimbursement to outcomes, capitation focuses solely on cost predictability. Without robust oversight and accountability mechanisms, providers may cut corners or avoid high-risk patients altogether. This can result in cherry-picking, where healthier individuals are favored, and sicker patients are subtly discouraged from enrolling. Such practices not only distort the patient pool but also deepen health disparities, particularly among marginalized populations who already face barriers to care.

Furthermore, capitation can strain the provider-patient relationship. Physicians may feel pressured to limit time spent with each patient or avoid costly interventions, leading to a sense of transactional care rather than personalized attention. This erosion of trust can diminish patient satisfaction and reduce adherence to treatment plans. In a system where providers are rewarded for doing less, the intrinsic motivation to go above and beyond for patients may be compromised.

Operationally, capitation demands sophisticated infrastructure to manage risk, track utilization, and ensure compliance. Smaller practices or those serving underserved communities may lack the resources to implement such systems effectively. This can create a two-tiered system where well-funded organizations thrive while others struggle to deliver basic care. Additionally, the administrative burden of managing capitation contracts, monitoring performance metrics, and navigating complex reimbursement rules can divert attention from clinical priorities.

Critics also argue that capitation may stifle innovation. When providers are locked into fixed budgets, there is little room to experiment with new technologies, therapies, or care models that might improve outcomes but carry upfront costs. This conservative approach can hinder progress and limit access to cutting-edge treatments.

CAPITATION HISTORY: https://medicalexecutivepost.com/2025/09/15/capitation-reimbursement-a-historical-economic-review/

In conclusion, while capitation medicine aims to control costs and streamline care, its inherent risks—under-treatment, inequity, and diminished quality—make it a problematic model when not carefully regulated. To truly reform healthcare, payment systems must balance financial sustainability with ethical responsibility, ensuring that every patient receives the care they need, not just the care that fits a budget.

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BAYLOR PLAN: Nursing Shift Payments

Posted on November 8, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd and Copilot A.I.

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The Baylor method of nurse payments is a scheduling and compensation model that allows nurses to work weekend shifts while receiving full-time pay and benefits, offering flexibility and helping healthcare facilities address staffing shortages.

The Baylor method, also known as the Baylor Plan or Baylor Shift, originated at Baylor University Medical Center in Dallas, Texas, as a strategic response to nurse shortages and burnout. It was designed to retain experienced nurses by offering a more flexible work schedule that still met the demands of patient care. Under this model, nurses typically work two 12-hour shifts on the weekend—Saturday and Sunday—and receive compensation equivalent to a full 40-hour workweek.

This approach has become increasingly popular in hospitals, long-term care facilities, and other healthcare settings. The core idea is simple: by concentrating work hours into the weekend, nurses gain more time off during the week while employers maintain adequate staffing during traditionally hard-to-fill shifts. For many nurses, this arrangement provides a better work-life balance, allowing them to pursue education, spend time with family, or take on additional employment during the week.

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Financially, the Baylor method is attractive to both nurses and employers. Nurses benefit from full-time pay and benefits—including health insurance, retirement contributions, and paid time off—while only working two days per week. Employers, on the other hand, can reduce turnover and improve weekend staffing without increasing overall labor costs. Some facilities even offer Baylor shifts with added incentives, such as shift differentials or bonuses, to further encourage weekend coverage.

However, the Baylor method is not without its challenges. Working two consecutive 12-hour shifts can be physically and emotionally demanding, especially in high-acuity units. Nurses may experience fatigue or burnout if they are not adequately supported. Additionally, because Baylor nurses are paid for 40 hours while only working 24, scheduling extra shifts during the week can complicate overtime calculations. Typically, overtime pay only kicks in after 40 actual hours worked, not hours paid, which can lead to confusion or dissatisfaction if not clearly communicated.

From an operational standpoint, the Baylor method helps facilities maintain consistent staffing levels during weekends, which are often underserved due to lower availability of part-time or weekday-only staff. It also allows for more predictable scheduling and can improve patient outcomes by ensuring continuity of care. Facilities that adopt the Baylor model often report higher nurse satisfaction and retention rates.

In conclusion, the Baylor method of nurse payments is a creative and effective solution to some of the most persistent challenges in healthcare staffing. By offering full-time compensation for weekend work, it provides nurses with flexibility and financial stability while helping facilities maintain high-quality care. As healthcare continues to evolve, models like the Baylor shift demonstrate the importance of innovative scheduling strategies that support both caregivers and patients.

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Understanding Dow Jones Weighting of Stocks

Posted on November 7, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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Dow Jones Companies

The thirty companies included in the Dow Jones Industrial Average are listed in the updated chart below.

The list is sorted by each component’s weight in the index. The weight of each company is determined by the price of the stock. A $100 stock will be weighted more than a $30 stock. If a stock splits its corresponding weighting in the Dow Jones will be reduced as its price will be about half of what it was prior to the split.

CHART: https://www.slickcharts.com/dowjones

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Site-Neutral Payments Still a Long Ways Off

Posted on November 7, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Health Capital Consultants, LLC

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An October 2025 Health Affairs study found that payment equity between facilities owned by hospitals, known as hospital outpatient departments (HOPDs), and independent outpatient facilities such as ambulatory surgery centers (ASCs), is still far from reality. Comparing payments for common procedures, researchers found commercial prices were 78% higher in HOPDs compared to ASCs, although payment differentials varied considerably.

This Health Capital Topics article reviews the article and potential policy implications. (Read more…)

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Understanding NASDAQ: The Digital Revolution in Stock Trading

Posted on November 7, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By A.I. and Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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The NASDAQ, short for the National Association of Securities Dealers Automated Quotations, is one of the largest and most influential stock exchanges in the world. Founded in 1971, it was the first electronic stock market, revolutionizing how securities were traded by replacing traditional floor-based systems with computerized trading platforms. This innovation made transactions faster, more transparent, and accessible to a broader range of investors.

Unlike the New York Stock Exchange (NYSE), which historically operated through physical trading floors, the NASDAQ is entirely virtual. It connects buyers and sellers through a sophisticated network of computers, allowing for rapid execution of trades. This digital-first approach has made it particularly attractive to technology companies and growth-oriented firms, earning it a reputation as the go-to exchange for innovative and high-tech businesses.

Companies Listed on the NASDAQ The NASDAQ is home to some of the most prominent and influential companies in the world. Giants like Apple, Microsoft, Amazon, Google (Alphabet), Meta (formerly Facebook), and Tesla all trade on the NASDAQ. These companies are part of the NASDAQ-100, an index that tracks the performance of the 100 largest non-financial companies listed on the exchange. The NASDAQ Composite Index, which includes over 3,000 stocks, provides a broader snapshot of the market’s overall health and direction.

How It Works The NASDAQ operates as a dealer’s market, meaning transactions are facilitated by market makers—firms that stand ready to buy or sell securities at publicly quoted prices. These market makers help maintain liquidity and ensure that trades can be executed efficiently. Prices are determined by supply and demand, and the electronic nature of the exchange allows for real-time updates and high-speed trading.

Significance in the Global Economy The NASDAQ plays a vital role in the global financial system. It provides companies with access to capital by allowing them to issue shares to the public, and it offers investors a platform to buy and sell those shares. The performance of the NASDAQ is often seen as a barometer for the health of the technology sector and, more broadly, the innovation economy. When the NASDAQ rises, it typically signals investor confidence in growth and future earnings; when it falls, it may reflect concerns about economic stability or company performance.

Global Reach and Influence Though based in the United States, the NASDAQ’s influence extends worldwide. Many international companies choose to list on the NASDAQ to gain exposure to U.S. investors and benefit from the prestige associated with being part of a leading global exchange. Its technological infrastructure and regulatory standards make it a model for other exchanges around the world.

NASDAQ 100: https://medicalexecutivepost.com/2023/07/24/nasdaq-100-re-balanced-index/

In summary, the NASDAQ is more than just a stock exchange—it’s a symbol of innovation, speed, and global connectivity. Its pioneering approach to electronic trading has reshaped the financial landscape, and its roster of companies continues to drive technological progress and economic growth across the globe.

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INSURANCE AGENTS: Salary and Payment Mechanisms

Posted on November 7, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd CMP™ and Copilot A.I.

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Insurance agents are primarily paid through commissions, but may also earn salaries, bonuses, and fees depending on their employment model and the types of policies they sell.

Insurance agents play a vital role in helping individuals and businesses navigate the complex world of insurance. Their compensation structures vary widely, influenced by factors such as the type of insurance they sell, whether they work independently or for a company, and the specific agreements they have with insurers. Understanding how insurance agents are paid is essential for consumers who want to make informed decisions and for aspiring agents considering a career in the industry.

The most common form of compensation for insurance agents is commission-based pay. Agents earn a percentage of the premium paid by the customer when they successfully sell a policy. These commissions can vary depending on the type of insurance. For example, first-year commissions for auto and homeowners insurance typically range from 5% to 20%, while commercial property and casualty policies may offer 10% to 15%. Life insurance policies often provide higher initial commissions, sometimes exceeding 50% of the first-year premium, followed by smaller renewal commissions in subsequent years.

There are two main types of insurance agents: captive agents and independent agents. Captive agents work exclusively for one insurance company and usually receive a combination of salary and commissions. Their compensation may also include performance bonuses and incentives tied to sales targets. Independent agents, on the other hand, represent multiple insurers and rely more heavily on commissions. They have the flexibility to offer a wider range of products, but their income is directly tied to their ability to sell policies and maintain client relationships.

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In addition to commissions, some agents earn fees for services such as policy reviews, risk assessments, or consulting. These fees are more common in commercial insurance or financial planning contexts, where agents provide specialized expertise. However, fee-based compensation is less prevalent in personal lines of insurance like auto or home coverage.

Bonuses and incentives are another component of agent compensation. Insurance companies often reward agents for meeting sales quotas, retaining clients, or selling specific types of policies. These bonuses can significantly boost an agent’s income, but they may also create potential conflicts of interest if agents prioritize higher-paying products over client needs.

Some agents, particularly those employed by large firms or call centers, receive a fixed salary. This model provides stability but may limit earning potential compared to commission-based roles. Salaried agents may still receive performance bonuses or profit-sharing depending on company policy.

Ultimately, an insurance agent’s earnings depend on their business model, experience, and ability to build a loyal client base. While commissions remain the cornerstone of insurance compensation, the rise of fee-based services and hybrid models reflects a shift toward more transparent and client-focused practices.

Consumers should feel empowered to ask agents about their compensation structure to ensure they receive unbiased advice tailored to their needs.

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SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com

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RULE 3-5-7: Investor Trading Strategy

Posted on November 6, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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The 3-5-7 Rule is a trading strategy that helps investors manage risk and maximize gains by setting clear limits on losses and targets for profits. It’s a simple yet powerful framework for disciplined decision-making.

In the volatile world of trading, success often hinges not just on identifying opportunities but on managing risk with precision. The 3-5-7 Rule is a widely respected risk management strategy designed to help traders protect their capital while pursuing consistent returns. This rule provides a structured approach to trading by setting specific thresholds for risk exposure and profit expectations.

At its core, the 3-5-7 Rule breaks down into three key components:

3% Risk Per Trade: Traders should never risk more than 3% of their total account value on a single trade. This limit ensures that even if a trade goes against them, the loss is manageable and doesn’t jeopardize their overall portfolio.
5% Total Exposure Across All Positions: The rule advises that total exposure across all open positions should not exceed 5% of the account value. This prevents over-leveraging and reduces the impact of correlated losses during market downturns.
7% Profit Target: For every trade, the goal is to achieve a profit that is at least 7% greater than the potential loss. This risk-to-reward ratio helps ensure that even with a lower win rate, traders can remain profitable over time.

The beauty of the 3-5-7 Rule lies in its simplicity and adaptability. It can be applied across various asset classes—stocks, forex, crypto—and suits both beginners and seasoned traders. By enforcing discipline, it helps traders avoid emotional decisions, such as chasing losses or holding onto losing positions too long. Moreover, this rule encourages thoughtful position sizing. Traders must calculate their entry and exit points carefully, factoring in stop-loss levels and account size. This analytical approach fosters better trade planning and reduces impulsive behavior.

Another advantage is its scalability. As a trader’s account grows, the percentages remain constant, but the dollar amounts adjust accordingly. This keeps the strategy relevant and effective regardless of portfolio size. In practice, the 3-5-7 Rule acts as a safety net. It doesn’t guarantee profits, but it significantly reduces the likelihood of catastrophic losses. It also promotes consistency, which is crucial for long-term success in trading.

In conclusion, the 3-5-7 Rule is more than just a guideline—it’s a mindset. It teaches traders to respect risk, plan strategically, and aim for favorable outcomes.

By adhering to this rule, traders can navigate the unpredictable markets with greater confidence and control.

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Understanding Parkinson’s Law: Importance vs Attention

Posted on November 6, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

The Attention a Problem Gets is Inverse to its’ Importance

Courtesy: http://www.CertifiedMedicalPlanner.org

By Dr. David Edward Marcinko MBA, MEd CMP

Historian Cyril Parkinson’s wrote in his book Parkinson’s Law,

“The time spent on any item of the agenda will be in inverse proportion to the sum [of money] involved.”

EXAMPLE: Parkinson described a fictional finance committee with three tasks: approval of a $10 million nuclear reactor, $400 for an employee bike shed, and $20 for employee refreshments in the break room.

The committee approves the $10 million nuclear reactor immediately, because the number is too big to contextualize, alternatives are too daunting to consider, and no one on the committee is an expert in nuclear power.

Bike Shed Effect: The bike shed gets considerably more debate. Committee members argue whether a bike rack would suffice and whether a shed should be wood or aluminum, because they have some experience working with those materials at home.

Employee refreshments take up two-thirds of the debate, because everyone has a strong opinion on what’s the best coffee, the best cookies, the best chips, etc.

Absurd: The world is filled with these absurdities. In personal finance, Ramit Sethi recently said we should stop asking $3 questions (should I buy coffee?) and ask more $30,000 questions (should I buy a smaller home?). Most people don’t, because it’s hard and intimidating. In any given moment the easiest way to deal with a big problem is to ignore it and fill your time thinking about a smaller one.

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Assessment: Your thoughts and comments related to the post Corona Virus Pandemic, meetings and time management and psychology are appreciated.

THANK YOU

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Understanding Goodhart’s Law and Its Impact on Healthcare Artificial Intelligence

Posted on November 6, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters and Copilot A.I.

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Goodhart’s law is an adage often stated as, “When a measure becomes a target, it ceases to be a good measure”. It is named after British economist Charles Goodhart, who is credited with expressing the core idea of the adage in a 1975 article on monetary policy in the United Kingdom:

Any observed statistical regularity will tend to collapse once pressure is placed upon it for control purposes.

It was used to criticize the British Margaret Thatcher Government for trying to conduct monetary policy on the basis of targets for broad and narrow money, but the law reflects a much more general phenomenon.

And so, aother famous Goodhart’s Law example is the cobra effect, where well-intentioned government policies inadvertently worsened the problem they were designed to solve.

For example, the British colonial government in India, concerned about the increasing number of venomous cobras in Delhi, began offering a bounty for each dead cobra that was delivered. Initially, this strategy was successful as locals brought in large numbers of slaughtered snakes. Over time, however, enterprising individuals started breeding cobras to kill them for supplemental income. When the government abandoned the bounty, the cobra breeders released their cobras into the wild, leading to a surge in Delhi’s snake population.

The cobra effect, where efforts to control a problem lead to unintended and often worse outcomes, serves as a cautionary tale for health care AI. If developers or health care institutions focus too narrowly on specific performance AI metrics, they risk undermining the system’s overall effectiveness, leading to suboptimal patient outcomes. Physicians must be vigilant in ensuring that health care AI systems are not only optimized for performance metrics but are also truly beneficial in practical, clinical applications.

Modified: Dr. Neil Anand via Kevin MD

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HIGH-FREQUENCY TRADING: Algorithmic Computerized Stock Trading

Posted on November 6, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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High-frequency trading (HFT) is a form of algorithmic trading that uses powerful computers and complex programs to execute thousands of trades in fractions of a second. It has transformed modern financial markets by increasing speed, liquidity, and efficiency—but also raised concerns about fairness and stability.

High-frequency trading emerged in the early 2000s as technological advances allowed financial firms to process market data and execute trades faster than ever before. HFT firms use sophisticated algorithms to analyze multiple markets and identify short-term opportunities. These trades are often held for mere seconds or milliseconds, and profits are made by exploiting tiny price discrepancies across assets or exchanges.

One of the defining features of HFT is its reliance on speed. Firms invest heavily in infrastructure—such as co-location services near exchange servers and fiber-optic cables—to gain microsecond advantages over competitors. This race for speed has led to a technological arms race, where milliseconds can mean millions in profit.

HFT contributes significantly to market liquidity, meaning it helps ensure that buyers and sellers can transact quickly at stable prices. By constantly placing and updating orders, HFT firms narrow bid-ask spreads and reduce transaction costs for other market participants. This has made markets more efficient and accessible, especially for retail investors.

However, HFT is not without controversy. Critics argue that it creates an uneven playing field, where firms with access to advanced technology and capital can dominate markets. Concerns about market manipulation—such as quote stuffing (flooding the market with orders to slow competitors) or spoofing (placing fake orders to move prices)—have led to increased regulatory scrutiny.

The 2010 Flash Crash is often cited as a cautionary example of HFT’s potential risks. During this event, the Dow Jones Industrial Average plunged nearly 1,000 points in minutes before rebounding. Investigations revealed that automated trading systems, including HFT algorithms, contributed to the sudden loss of liquidity and extreme volatility.

Regulators have responded by implementing safeguards such as circuit breakers, which pause trading during extreme price movements, and requiring firms to register and disclose their trading strategies. The Securities and Exchange Commission (SEC) and Commodity Futures Trading Commission (CFTC) continue to monitor HFT’s impact on market integrity.

Despite its challenges, HFT remains a dominant force in global finance. It accounts for a significant portion of trading volume in equities, futures, and foreign exchange markets. Many institutional investors rely on HFT strategies to manage large portfolios and hedge risks.

In conclusion, high-frequency trading represents both the promise and peril of technological innovation in finance. While it enhances market efficiency and liquidity, it also introduces new risks and ethical dilemmas.

As markets evolve, balancing innovation with fairness and stability will be essential to ensuring that HFT serves the broader interests of investors and the economy.

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MEDICAL PRACTICE MARKETING: Strategies for Success

Posted on November 5, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

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In today’s competitive healthcare landscape, effective marketing is essential for the growth and sustainability of a medical practice. Gone are the days when word-of-mouth alone could sustain a clinic. Patients now seek providers who not only offer excellent care but also communicate their value clearly and consistently. Strategic marketing helps medical practices attract new patients, retain existing ones, and build a strong reputation in the community.

🎯 Understanding the Target Audience

The foundation of any successful marketing strategy is a deep understanding of the target audience. Medical practices must identify the demographics, needs, and preferences of their ideal patients. For example, a pediatric clinic will focus on parents, while a dermatology practice may target young adults concerned with skin health. Tailoring messages to resonate with these groups ensures that marketing efforts are relevant and effective.

🌐 Building a Strong Online Presence

In the digital age, a robust online presence is non-negotiable. A professional, user-friendly website serves as the virtual front door of the practice. It should include essential information such as services offered, provider bios, contact details, and online appointment scheduling. Search engine optimization (SEO) ensures the site ranks well on Google, making it easier for potential patients to find the practice.

Social media platforms like Facebook, Instagram, and LinkedIn offer additional avenues to engage with the community. Regular posts about health tips, staff spotlights, and patient testimonials humanize the practice and foster trust. Paid advertising on these platforms can also target specific demographics, increasing visibility and driving traffic to the website.

🗣️ Leveraging Patient Reviews and Testimonials

Online reviews are a powerful form of social proof. Encouraging satisfied patients to leave positive feedback on platforms like Google, Yelp, and Healthgrades can significantly influence prospective patients. Testimonials can also be featured on the practice’s website and social media channels. Responding to reviews—both positive and negative—demonstrates attentiveness and a commitment to patient satisfaction.

📬 Utilizing Email and Content Marketing

Email marketing remains a cost-effective way to stay connected with patients. Monthly newsletters can include health tips, updates on services, and reminders for annual checkups or vaccinations. Content marketing, such as blog posts and educational videos, positions the practice as a trusted authority in healthcare. This not only boosts SEO but also builds credibility and patient loyalty.

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🤝 Community Engagement and Partnerships

Participating in local events, offering free health screenings, or partnering with schools and businesses can enhance visibility and goodwill. These efforts show that the practice is invested in the well-being of the community, which can translate into increased patient referrals and long-term relationships.

📊 Measuring Success

Finally, tracking the performance of marketing campaigns is crucial. Metrics such as website traffic, appointment bookings, social media engagement, and patient acquisition rates provide insights into what’s working and what needs adjustment. Regular analysis ensures that marketing efforts remain aligned with business goals.

Marketing a medical practice requires a thoughtful blend of digital tools, patient engagement, and community outreach. When done right, it not only drives growth but also reinforces the practice’s mission to provide compassionate, high-quality care.

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Understanding the Scitovsky Paradox in Welfare Economics

Posted on November 5, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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According to colleague Dan Ariely PhD, the Scitovsky Paradox and using the Kaldor–Hicks criterion, allocation A may be more efficient than allocation B, while at the same time B is more efficient than A.

Moreover, the Scitovsky paradox in welfare economics which is resolved by stating that there is no increase in social welfare by a return to the original part of the losers. It is named after the Hungarian born American economist, Tibor Scitovsky. According to Scitovsky, ther Kaldor-Hicks criterion involves contradictory and inconsistent results.

What Scitovsky demonstrated was it is possible that if an allocation A is deemed superior to another allocation B by the Kaldor compensation criteria, then by a subsequent set of moves by the same criteria, we can prove that B is also superior to A.

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The Sraffa–Hayek Economic Debate

Posted on November 5, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

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The Sraffa–Hayek debate stands as a pivotal moment in the history of economic thought, highlighting deep philosophical and methodological differences between two influential schools: the Austrian School, represented by Friedrich Hayek, and the neo-Ricardian or Cambridge School, represented by Piero Sraffa. Taking place primarily in the 1930s, this intellectual exchange centered on the nature of capital, the role of equilibrium, and the validity of marginalist theory.

Friedrich Hayek, a staunch advocate of Austrian economics, had developed a theory of business cycles rooted in the mis allocation of capital due to artificially low interest rates. In his framework, interest rates serve as signals that coordinate inter temporal production decisions. When central banks distort these signals, they cause over investment in capital-intensive industries, leading to unsustainable booms followed by inevitable busts. Hayek’s theory was grounded in a time-structured view of capital, emphasizing the importance of temporal coordination in production.

Piero Sraffa, a Cambridge economist and close associate of John Maynard Keynes, challenged Hayek’s assumptions in a 1932 review of Hayek’s book Prices and Production. Sraffa’s critique was both technical and philosophical. He questioned the coherence of Hayek’s notion of a uniform natural rate of interest in a complex economy with heterogeneous capital goods. Sraffa argued that in such an economy, there could be multiple natural rates of interest, making it impossible to define a single rate that equilibrates savings and investment across all sectors.

Moreover, Sraffa criticized the Austrian reliance on equilibrium analysis in a world characterized by uncertainty and institutional complexity. He contended that Hayek’s model was overly abstract and detached from real-world dynamics. This critique foreshadowed Sraffa’s later work, Production of Commodities by Means of Commodities (1960), which laid the foundation for the neo-Ricardian critique of marginalist economics. In that work, Sraffa demonstrated that prices and distribution could be determined without recourse to subjective utility or marginal productivity, challenging the core of neoclassical theory.

The debate had far-reaching implications. For the Austrian School, it exposed vulnerabilities in their capital theory and prompted refinements in their approach to intertemporal coordination. For the broader economics profession, Sraffa’s critique contributed to a growing skepticism about the internal consistency of marginalist value theory, influencing the Cambridge capital controversies of the 1950s and 1960s.

While the Sraffa–Hayek debate did not produce a definitive victor, it underscored the importance of foundational assumptions in economic modeling. It also highlighted the tension between abstract theoretical elegance and empirical relevance—a tension that continues to shape economic discourse today. Ultimately, the debate enriched the intellectual landscape by forcing economists to confront the limitations of their models and to grapple with the complex realities of capital, time, and uncertainty.

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K-SHAPED ECONOMY: An Uneven and Divided World

Posted on November 4, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

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The term “K-shaped economy” emerged during the COVID-19 pandemic to describe a recovery marked by stark divergence—where some sectors and social groups rebound rapidly while others continue to decline. Unlike traditional V-shaped or U-shaped recoveries, which imply uniform economic improvement, the K-shaped model reflects a split trajectory: the upward arm of the “K” represents those who thrive, while the downward arm captures those left behind. This phenomenon has profound implications for economic policy, social equity, and long-term stability.

At the heart of the K-shaped economy is inequality. High-income individuals, white-collar professionals, and large corporations often benefit from technological advances, remote work flexibility, and access to capital. For example, tech giants like Apple, Microsoft, and Alphabet saw record profits during the pandemic, fueled by digital transformation and cloud services. Meanwhile, lower-income workers—especially in hospitality, retail, and service industries—faced job losses, reduced hours, and limited access to healthcare or financial safety nets. This divergence widened existing income and wealth gaps, exacerbating social tensions.

Sectoral performance also illustrates the K-shaped divide. Industries such as e-commerce, software, and logistics surged, while travel, entertainment, and small businesses struggled. The rise of automation and artificial intelligence further tilted the scales, favoring companies that could invest in innovation while displacing low-skilled labor. In education, students from affluent families adapted to online learning with ease, while those from disadvantaged backgrounds faced digital barriers and learning loss. These disparities underscore how economic recovery is not just uneven—it’s structurally imbalanced.

Geography plays a role too. Urban centers with diversified economies and strong tech sectors rebounded faster than rural or manufacturing-heavy regions. Housing markets in affluent areas soared, driven by low interest rates and remote work migration, while renters and first-time buyers faced affordability crises. Even within cities, neighborhoods with better infrastructure and public services recovered more quickly, deepening the urban-suburban divide.

Policymakers face a daunting challenge in addressing the K-shaped recovery. Traditional stimulus measures may not reach the most vulnerable populations without targeted interventions. Expanding access to education, healthcare, and digital infrastructure is essential to leveling the playing field. Progressive taxation, wage support, and small business aid can help bridge the gap, but require political will and fiscal discipline. Central banks must balance inflation control with inclusive growth, avoiding policies that disproportionately benefit asset holders.

The long-term consequences of a K-shaped economy are significant. Persistent inequality can erode trust in institutions, fuel populism, and hinder social mobility. Economic growth may slow if large segments of the population remain underemployed or financially insecure. To build a resilient and inclusive future, governments, businesses, and civil society must collaborate to ensure that recovery lifts all boats—not just the yachts.

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Understanding the Edgeworth Paradox in Economics

Posted on November 4, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Irish economist Frances Edgeworth put forward the Edgeworth Paradox in his paper “The Pure Theory of Monopoly”, published in 1897.

It describes a situation in which two players cannot reach a state of equilibrium with pure strategies, i.e. each charging a stable price. A fact of the Edgeworth Paradox is that in some cases, even if the direct price impact is negative and exceeds the conditions, an increase in cost proportional to the quantity of an item provided may cause a decrease in all optimal prices. Due to the limited production capacity of enterprises in reality, if only one enterprise’s total production capacity can be supplied cannot meet social demand, another enterprise can charge a price that exceeds the marginal cost for the residual social need.

And so, according to colleague Dan Ariely PhD, the Edgeworth Paradox suggests that with capacity constraints, there may not be an equilibrium.

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Senate Hearing Signals Potential Changes to the 340B Drug Discount Program

Posted on November 3, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

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By Health Capital Consultants, LLC

On October 23, 2025, both Democratic and Republican lawmakers expressed support during a Senate Health, Education, Labor, and Pensions (HELP) Committee hearing for reforming the 340B Drug Discount Program. Although senators acknowledged that any reform would necessitate an intentional, considered approach to mitigate unintended consequences, the bipartisan agreement (particularly during a government shutdown deadlocked on healthcare) indicates that changes to the program may be on the horizon.

This Health Capital Topics article outlines the 340B program, discusses issues that have made the program controversial, and discusses potential reform options. (Read more…)

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Understanding the Exercise Paradox in Weight Control

Posted on November 3, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko; MBA MEd

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Classic Definition: In “The Exercise Paradox,” Herman Pontzer asserts that greater physical activity does not allow people to control weight. He goes on to describe studies on how the human body burns calories that help to explain why this is so.

FINANCE PARADOX: https://medicalexecutivepost.com/2025/05/26/financial-paradox-compounding-interest-and-time/

Modern Circumstance: But in one of these studies, “couch potatoes” expended an average of around 200 fewer calories a day, compared with moderately active subjects. A difference of 200 fewer calories a day equates to more than 20 fewer pounds a year. Year after year after year, that really adds up.

GENDER PARADOX: https://medicalexecutivepost.com/2025/05/19/gender-two-modern-paradoxes/

Paradox Example: Cyclists participating in the Tour de France are said to ingest more than 5,000 calories a day. This would seem to be way too much. So why do they do it? And why don’t they become obese?

PHYSICIAN PARADOX: https://medicalexecutivepost.com/2025/04/23/liar-liar-the-physician-paradox/

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The Medical Executive-Post is a news and information aggregator and social media professional network for medical and financial service professionals. Feel free to submit education content to the site as well as links, text posts, images, opinions and videos which are then voted up or down by other members. Comments and dialog are especially welcomed. Daily posts are organized by subject. ME-P administrators moderate the activity. Moderation may also conducted by community-specific moderators who are unpaid volunteers.

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THEORY: Short Interest Investing

Posted on November 3, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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Short Interest Theory suggests that high levels of short interest in a stock may actually signal a potential price increase, contrary to traditional bearish interpretations.

Short Interest Theory is a contrarian investment concept that challenges conventional wisdom in financial markets. Traditionally, a high short interest—meaning a large percentage of a company’s shares are being sold short—is seen as a bearish signal, indicating that many investors expect the stock’s price to decline. However, Short Interest Theory flips this assumption, proposing that a high short interest can actually be a bullish indicator, suggesting a potential upward price movement due to a phenomenon known as a “short squeeze.”

To understand this theory, it’s important to grasp the mechanics of short selling. When investors short a stock, they borrow shares and sell them on the open market, hoping to repurchase them later at a lower price and pocket the difference. However, if the stock price rises instead of falling, short sellers face mounting losses. To limit these losses, they may be forced to buy back the stock at higher prices, which increases demand and drives the price up even further. This chain reaction is what’s known as a short squeeze.

Short Interest Theory posits that when short interest reaches unusually high levels, the stock becomes a prime candidate for a short squeeze. Investors who follow this theory look for stocks with high short interest ratios—often measured as the number of shares sold short divided by the stock’s average daily trading volume. A high ratio suggests that it would take many days for all short sellers to cover their positions, increasing the likelihood of a rapid price surge if positive news or buying pressure emerges.

This theory gained widespread attention during the GameStop (GME) saga in early 2021. Retail investors noticed that GME had an extremely high short interest—more than 100% of its float—and began buying shares en masse. This triggered a historic short squeeze, sending the stock price soaring and forcing institutional short sellers to cover their positions at massive losses. The event served as a real-world validation of Short Interest Theory and highlighted the power of collective investor behavior in modern markets.

Despite its appeal, Short Interest Theory is not without risks. Betting on a short squeeze can be speculative and volatile. Not all heavily shorted stocks experience upward momentum; some may continue to decline if the negative sentiment is justified by poor fundamentals or weak earnings. Moreover, timing a short squeeze is notoriously difficult, and investors can suffer significant losses if the anticipated rebound fails to materialize.

In conclusion, Short Interest Theory offers a compelling contrarian perspective on market sentiment. By interpreting high short interest as a potential bullish signal, it encourages investors to look beyond surface-level indicators and consider the dynamics of market psychology and trading behavior. While it can lead to lucrative opportunities, especially in the context of short squeezes, it also demands careful analysis and risk management. As with any investment strategy, understanding the underlying fundamentals and market context is essential for making informed decisions.

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LIFE CYCLE HYPOTHESIS: A Framework for Financial Behavior

Posted on November 2, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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The Life Cycle Hypothesis (LCH) is a foundational theory in economics and personal finance that explains how individuals plan their consumption and savings behavior over the course of their lives. Developed in the 1950s by economists Franco Modigliani and Richard Brumberg, the LCH posits that people aim to smooth their consumption throughout their lifetime, regardless of fluctuations in income. This theory has had a profound impact on how economists, financial planners, and policymakers understand saving patterns, retirement planning, and fiscal policy.

At its core, the LCH assumes that individuals are forward-looking and rational. They anticipate changes in income—such as those caused by retirement, unemployment, or career progression—and adjust their saving and spending accordingly. During high-income periods, typically in mid-career, individuals save more to prepare for low-income phases, such as retirement. Conversely, in early adulthood and old age, when income is lower, individuals are expected to dissave, or spend from their accumulated savings.

One of the key insights of the LCH is that consumption is not directly tied to current income but rather to expected lifetime income. This means that temporary changes in income should not significantly affect consumption patterns, as individuals base their spending decisions on long-term expectations. For example, a young professional may take out a loan to buy a car, anticipating higher future earnings that will allow them to repay the debt without drastically altering their lifestyle.

The LCH also provides a framework for understanding the role of pensions, social security, and other retirement savings mechanisms. By recognizing that individuals need to save during their working years to maintain consumption levels in retirement, the theory supports the development of policies that encourage long-term savings and financial literacy. It also helps explain why some people may under-save or over-consume if they misjudge their future income or lack access to financial planning resources.

Despite its elegance, the Life Cycle Hypothesis has faced criticism and refinement. Behavioral economists argue that individuals are not always rational and may struggle with self-control, procrastination, or lack of financial knowledge. These limitations have led to the development of the Behavioral Life Cycle Hypothesis, which incorporates psychological factors such as mental accounting and framing effects. Moreover, empirical studies have shown that many people do not smooth consumption as predicted, often due to liquidity constraints, uncertainty, or cultural influences.

Nevertheless, the LCH remains a powerful tool for analyzing financial behavior across different stages of life. It has influenced retirement planning strategies, tax policy, and the design of financial products. By emphasizing the importance of long-term planning and the intertemporal nature of financial decisions, the Life Cycle Hypothesis continues to shape how individuals and institutions approach economic well-being.

In conclusion, the Life Cycle Hypothesis offers a compelling lens through which to view personal finance. While it may not capture every nuance of human behavior, its emphasis on lifetime income and consumption smoothing provides a valuable foundation for understanding and improving financial decision-making.

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The Hidden Risk of Trusting Friends in Finance

Posted on November 2, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

Here’s a risk to your financial health that may surprise you!

Rick Kahler MS CFP

By Rick Kahler CFP™

There are two reasons for this.

First, we tend to trust and rely on people we know.

Second, research finds that humans have a deep-seated desire to meet the needs of others, so “helping” a relative or friend get started in their financial sales career is just human nature. Unfortunately, brokerage and insurance companies know this. They train their new agents that the easiest sales to make when getting started are to relatives and friends.

Any time I find an ill-advised financial product a client has purchased from a relative or friend, I cringe, anticipating the client’s resistance to canceling it. Regardless of how bad the advice was or how outrageous the fees of an investment product may be, the deeper the relationship the more difficulty there will be in changing course.

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Here’s a typical example

Jim and Sofia, two young professionals, married at around the same time Jim’s uncle went to work for a financial services company. The uncle sold Jim a $250,000 Variable Universal Life (VUL) policy with a $500 monthly premium. Jim and Sofia were happy, thinking they had made a prudent choice to start saving for retirement and help out a relative at the same time.

When Sofia became pregnant, the couple decided to engage a fee-only financial planner. She found they were under insured to provide for a family and also that the VUL policy was incredibly expensive and ill-advised for their needs. She recommended canceling the VUL policy with its $500 monthly premium, instead paying $300 monthly for two $1 million term life insurance policies and putting $200 a month into a tax-free Roth IRA.

Sofia and Jim told this to their uncle, who was “shocked” at the planner’s “poor advice.”

He contended that any competent financial planner would know a person needs permanent insurance as a foundation to “raise their child in the case of a premature death, fund their retirement, pay estate taxes and just like a Roth, it is tax free.”
Sadly, the uncle was unwilling to admit that $250,000 of insurance wouldn’t be enough to raise their child, fund their retirement, and pay estate taxes; nor was it truly tax free. He also didn’t mention that he had a vested interest in their keeping the policy. While he probably earned 55% to 100% of the first year’s commission, it is common practice that an agent will also receive 10-15% of the annual premium from years 2-10.

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Sofia and Jim agreed with the financial planner’s recommendation. They could see the sense in having $1 million of insurance on each of them instead of $250,000 on just Jim for almost half the price, plus the tax-free growth of $200 a month in the Roth IRA.

Yet they didn’t follow the planner’s advice, because they didn’t want to upset their uncle. They chose to weaken their financial health, plus risk the well-being of their family if one of them died prematurely, in order to enrich their uncle for fear of offending him.

This happens more frequently than you would think. And it isn’t limited to life insurance. I’ve seen clients invest in a variety of “opportunities,” based on advice from a family member, that were not in their best interest.

Assessment

Next time a friend or family member offers to sell you a financial product or give you some great advice, you may want to do yourself a favor and decline. If you really want to help them out, invite them over for dinner.

Conclusion
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Contact: MarcinkoAdvisors@outlook.com

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Filed under: "Ask-an-Advisor", Experts Invited, Financial Planning, Insurance Matters, Investing | Tagged: financial advice, Financial Planning, insurance, Investing, investments, Rick Kahler CFP®, Variable Universal Life, vul | Leave a comment »

Government Shutdown Update: Healthcare Impacts Deepen

Posted on November 2, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Health Capital Consultants, LLC

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Since lawmakers failed to pass a bill to fund the federal government before the September 30, 2025 deadline, lawmakers have remained deadlocked over the spending bill. The deadlock is centered on the continuation of health insurance exchange subsidies, but the shutdown has broader implications on the healthcare industry.

This Health Capital Topics article provides an update on the continuing saga. (Read more…)

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Understanding Managerial Accounting Concepts

Posted on November 1, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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Product Costing and Valuation

Product costing deals with determining the total costs involved in the production of a good or service. Costs may be broken down into subcategories, such as variable, fixed, direct, or indirect costs. Cost accounting is used to measure and identify those costs, in addition to assigning overhead to each type of product created by the company.

Managerial accountants calculate and allocate overhead charges to assess the full expense related to the production of a good. The overhead expenses may be allocated based on the number of goods produced or other activity drivers related to production, such as the square footage of the facility. In conjunction with overhead costs, managerial accountants use direct costs to properly value the cost of goods sold and inventory that may be in different stages of production.

Marginal costing (sometimes called cost-volume-profit analysis) is the impact on the cost of a product by adding one additional unit into production. It is useful for short-term economic decisions. The contribution margin of a specific product is its impact on the overall profit of the company. Margin analysis flows into break-even analysis, which involves calculating the contribution margin on the sales mix to determine the unit volume at which the business’s gross sales equals total expenses. Break-even point analysis is useful for determining price points for products and services.

Cash Flow Analysis

Managerial accountants perform cash flow analysis in order to determine the cash impact of business decisions. Most companies record their financial information on the accrual basis of accounting. Although accrual accounting provides a more accurate picture of a company’s true financial position, it also makes it harder to see the true cash impact of a single financial transaction. A managerial accountant may implement working capital management strategies in order to optimize cash flow and ensure the company has enough liquid assets to cover short-term obligations.

When a managerial accountant performs cash flow analysis, he will consider the cash inflow or outflow generated as a result of a specific business decision. For example, if a department manager is considering purchasing a company vehicle, he may have the option to either buy the vehicle outright or get a loan. A managerial accountant may run different scenarios by the department manager depicting the cash outlay required to purchase outright upfront versus the cash outlay over time with a loan at various interest rates.

Inventory Turnover Analysis

Inventory turnover is a calculation of how many times a company has sold and replaced inventory in a given time period. Calculating inventory turnover can help businesses make better decisions on pricing, manufacturing, marketing, and purchasing new inventory. A managerial accountant may identify the carrying cost of inventory, which is the amount of expense a company incurs to store unsold items.

If the company is carrying an excessive amount of inventory, there could be efficiency improvements made to reduce storage costs and free up cash flow for other business purposes.

Constraint Analysis

Managerial accounting also involves reviewing the constraints within a production line or sales process. Managerial accountants help determine where bottlenecks occur and calculate the impact of these constraints on revenue, profit, and cash flow. Managers then can use this information to implement changes and improve efficiencies in the production or sales process.

Financial Leverage Metrics

Financial leverage refers to a company’s use of borrowed capital in order to acquire assets and increase its return on investments. Through balance sheet analysis, managerial accountants can provide management with the tools they need to study the company’s debt and equity mix in order to put leverage to its most optimal use.

Performance measures such as return on equity, debt to equity, and return on invested capital help management identify key information about borrowed capital, prior to relaying these statistics to outside sources. It is important for management to review ratios and statistics regularly to be able to appropriately answer questions from its board of directors, investors, and creditors.

Accounts Receivable (AR) Management

Appropriately managing accounts receivable (AR) can have positive effects on a company’s bottom line. An accounts receivable aging report categorizes AR invoices by the length of time they have been outstanding. For example, an AR aging report may list all outstanding receivables less than 30 days, 30 to 60 days, 60 to 90 days, and 90+ days.

Through a review of outstanding receivables, managerial accountants can indicate to appropriate department managers if certain customers are becoming credit risks. If a customer routinely pays late, management may reconsider doing any future business on credit with that customer.

Budgeting, Trend Analysis, and Forecasting

Budgets are extensively used as a quantitative expression of the company’s plan of operation. Managerial accountants utilize performance reports to note deviations of actual results from budgets. The positive or negative deviations from a budget also referred to as budget-to-actual variances, are analyzed in order to make appropriate changes going forward.

Managerial accountants analyze and relay information related to capital expenditure decisions. This includes the use of standard capital budgeting metrics, such as net present value and internal rate of return, to assist decision-makers on whether to embark on capital-intensive projects or purchases. Managerial accounting involves examining proposals, deciding if the products or services are needed, and finding the appropriate way to finance the purchase. It also outlines payback periods so management is able to anticipate future economic benefits.

Managerial accounting also involves reviewing the trendline for certain expenses and investigating unusual variances or deviations. It is important to review this information regularly because expenses that vary considerably from what is typically expected are commonly questioned during external financial audits. This field of accounting also utilizes previous period information to calculate and project future financial information. This may include the use of historical pricing, sales volumes, geographical locations, customer tendencies, or financial information.

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Filed under: "Ask-an-Advisor", Accounting, Financial Planning, Funding Basics, Glossary Terms, iMBA, Inc., Investing, Marcinko Associates | Tagged: Accounting, accounts receivable, AR, bookkeeping, business, cash flow analysis, CFA, CMA, CPA, CVPA, finance, financial leverage, forecasting, managerial accountant, managerial accounting, managerial accounting terms, Marcinko | 1 Comment »

Understanding Paradoxes in Modern Medicine

Posted on November 1, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

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What is a Paradox?

A paradox is a figure of speech that can seem silly or contradictory in form, yet it can still be true, or at least make sense in the context given. This is sometimes used to illustrate thoughts or statements that differ from traditional ideas. So, instead of taking a given statement literally, an individual must comprehend it from a different perspective. Using paradoxes in speeches and writings can also add wit and humor to one’s work, which serves as the perfect device to grab a reader or a listener’s attention.

But paradoxes can be quite difficult to explain by definition alone, which is why it is best to refer to a few examples to further your understanding.

A good paradox example is in the famous television show House. Here, Dr. House is a rude, selfish, and narcissistic character who alienates everyone around him, even his own colleagues. However, he is also a brilliant doctor who is committed to saving lives. Regardless of his mean exterior, Dr. House is a moral and compassionate man who cares about his patients. The paradox here is how the character strives to save people’s lives despite his ruthless personality and behavior.

Modern health care appears to be rich in contradictions, and it is claimed to be paradoxical in a number of ways. In particular health care is held to be a paradox itself: it is supposed to do good; but is also accused of doing harm.

The expression “first do no harm,” which is a Latin phrase, is not part of the original or modern versions of the Hippocratic Oath, which was originally written in Greek (“primum non nocere,” the Latin translation from the original Greek.)
The Hippocratic Oath, written in the 5th century BCE, does contain language suggesting that the physician and his assistants should not cause physical or moral harm to a patient.
The first known published version of “do no harm” dates to medical texts from the mid-19th century, and is attributed to the 17th century English physician Thomas Sydenham.

Difference between Paradox and Oxymoron

Most people tend to confuse a paradox with an oxymoron, and it’s not hard to see why. Most oxymoron examples appear to be compressed version of a paradox, in which it is used to add a dramatic effect and to emphasize contrasting thoughts. Although they may seem greatly similar in form, there are slight differences that set them apart.

A paradox consists of a statement with opposing definitions, while an oxymoron combines two contradictory terms to form a new meaning. But because an oxymoron can play out with just two words, it is often used to describe a given object or idea imaginatively. As for a paradox, the statement itself makes you question whether something is true or false. It appears to contradict the truth, but if given a closer look, the truth is there but is merely implied.

The Paradox in Medicine and Health Care

Dr. Bernard Brom [Editor: SA Journal of Natural Medicine] suggests modem medicine is riddled with paradoxes. Most doctors live with these paradoxes without being aware of the conflict of interest that these paradoxes represent. Intrinsic to a general understanding of science is the idea that science frees us from misunderstanding and guides us towards clear decision making.

Most veteran doctors with experience know that medical science still does not give definitive answers, that each individual is unique, that one can never be sure how a patient will respond to a particular drug, or what the outcome of a particular operation will be. Human beings are not machines and therefore do not respond according to Newtonian logic, and therefore a paradox in medicine is not surprising. Medicine is an art which uses scientific techniques and approaches. It is, however, important to face these paradoxes. It is both humbling and enlightening, enriching those who consider the implications deeply enough.

The Compensation versus Value Paradox

Regardless of specialty, degree designation or delivery model, private practice physician salary is traditionally inversely related to independent medical practice business value.

SALARY: https://medicalexecutivepost.com/2024/07/21/medicare-doctor-salary-rates-would-cut-pay-3/

In other words, the more a doctor takes home in compensation from his practice, the less ownership in a private practice is worth, and vice versa.

VALUE: https://medicalexecutivepost.com/2008/01/11/how-to-maximize-medical-practice-value/

Higher doctor salary equals lower practice appraisal value.

BROKE DOCTORS: https://medicalexecutivepost.com/2025/08/02/doctors-going-broke-and-living-paycheck-to-paycheck/

This is the difference between a short-term and long-term compensation strategy.

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Understanding the Halloween Indicator Strategy

Posted on October 31, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

SELL IN MAY – AND GO AWAY

By Staff Reporters

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Essentially, the HALLOWEEN INDICATOR is a market-timing strategy. It argues that, by buying into the stock market after Halloween and selling at the end of April, investors would generate a better annual return on their portfolio than if they had remained invested throughout the year. Sell in May and go away is an investment strategy for stocks based on a theory that the period from November to April inclusive has significantly stronger stock market growth on average than the other months

The practice of abandoning stocks beginning in May of each year is widely thought to have its origins in the United Kingdom. The privileged class would leave London and head to their country estates for the summer months, where they would largely ignore their investment portfolios. To this day, many stock market watchers have postulated that the corresponding impact of summer vacations on market liquidity and investors’ risk aversion is at least partly responsible for the difference in seasonal returns.

In what is considered to be a seminal piece of research on the subject, “The Halloween Indicator, ‘Sell in May and Go Away’: Another Puzzle,” authors Sven Bouman and Ben Jacobsen were among the first to document a strong seasonal effect in global stock markets. In 36 of the 37 developed and emerging markets they studied between 1973 and 1998, the authors found returns in the November through April period to be, on average, significantly higher than those in the May through October period, even after taking transaction costs into account. What puzzled the authors was the fact that, while the anomaly was widely known and seemed to offer considerable economic rewards, it had not been arbitraged away.

More recently, Jacobsen partnered with Cherry Zhang on a follow up study, titled, “The Halloween Indicator: Everywhere and All the Time,” and extended the research to 108 stock markets using all historical data available. The result was a sample of 55,425 monthly observations (including more than 300 years of UK data), which helped to rebut any criticisms of data mining and sample selection bias. The results were compelling, as the November through April “winter” period delivered returns that were, on average, 4.52% higher than the “summer” returns. The Halloween effect was evident in 81 out of 108 countries. The size of the Halloween effect varied across geographies. It was found to be stronger in developed and emerging markets than in frontier markets.

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MORE: https://medicalexecutivepost.com/2021/10/30/the-halloween-index-investment-strategy/

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Rethinking Productivity in Wealth Management

Posted on October 31, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Vitaliy Katsenelsen CFA

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One of the biggest hazards of being a professional money manager is that you are expected to behave in a certain way.

One of the biggest hazards of being a professional money manager is that you are expected to behave in a certain way: You have to come to the office every day, work long hours, slog through countless emails, be on top of your portfolio (that is, check performance of your securities minute by minute), watch business TV and consume news continuously, and dress well and conservatively, wearing a rope around the only part of your body that lets air get to your brain. Our colleagues judge us on how early we arrive at work and how late we stay. We do these things because society expects us to, not because they make us better investors or do any good for our clients.

Somehow we let the mindless, Henry Ford–assembly-line, 8:00 a.m. to 5:00 p.m., widgets-per-hour mentality dictate how we conduct our business thinking. Though car production benefits from rigid rules, uniforms, automation and strict working hours, in investing — the business of thinking — the assembly-line culture is counterproductive. Our clients and employers would be better off if we designed our workdays to let us perform our best.

Investing is not an idea-per-hour profession; it more likely results in a few ideas per year. A traditional, structured working environment creates pressure to produce an output — an idea, even a forced idea. Warren Buffett once said at a Berkshire Hathaway annual meeting: “We don’t get paid for activity; we get paid for being right. As to how long we’ll wait, we’ll wait indefinitely.”

How you get ideas is up to you. I am not a professional writer, but as a professional money manager, I learn and think best through writing. I put on my headphones, turn on opera and stare at my computer screen for hours, pecking away at the keyboard — that is how I think. You may do better by walking in the park or sitting with your legs up on the desk, staring at the ceiling.

I do my best thinking in the morning. At 3:00 in the afternoon, my brain shuts off; that is when I read my emails. We are all different. My best friend is a brunch person; he needs to consume six cups of coffee in the morning just to get his brain going. To be most productive, he shouldn’t go to work before 11:00 a.m.

And then there’s the business news. Serious business news that lacked sensationalism, and thus ratings, has been replaced by a new genre: business entertainment (of course, investors did not get the memo). These shows do a terrific job of filling our need to have explanations for everything, even random events that require no explanation (like daily stock movements). Most information on the business entertainment channels — Bloomberg Television, CNBC, Fox Business — has as much value for investors as daily weather forecasts have for travelers who don’t intend to go anywhere for a year.

Yet many managers have CNBC, Fox or Bloomberg TV/Internet streaming on while they work.

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NEPO BABIES: Broke Too Often!

Posted on October 31, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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Nepo babies often go broke due to a mix of financial mismanagement, lack of resilience, and the illusion of inherited success. Their privileged upbringing can mask the need for discipline, adaptability, and long-term planning—traits essential for sustaining wealth.

The term nepo baby—short for nepotism baby—refers to children of celebrities or influential figures who benefit from family connections to launch careers, especially in entertainment, fashion, or media. While these individuals often start with significant advantages, including wealth, fame, and access, many struggle to maintain financial stability over time. The reasons are complex and rooted in both personal and systemic factors.

First, many nepo babies lack financial literacy. Growing up in environments where money flows freely, they may never learn budgeting, investing, or the value of money. Without these skills, they’re prone to overspending, poor investments, and unsustainable lifestyles. Lavish purchases—designer clothes, luxury cars, expensive homes—can quickly drain even sizable inheritances if not managed wisely.

Second, the illusion of guaranteed success can be dangerous. Nepo babies often enter industries where their family name opens doors, but that doesn’t guarantee longevity. Fame is fickle, and public interest can fade. If they don’t develop their own talents or work ethic, they may find themselves unemployable once the novelty wears off. This overreliance on family reputation can lead to complacency, making it harder to adapt when challenges arise.

Third, many nepo babies face identity crises and public scrutiny. Constant comparisons to their successful parents can erode confidence and create pressure to live up to unrealistic expectations. Some rebel by distancing themselves from their family’s legacy, while others try to prove themselves in unrelated fields. Either way, this struggle can lead to erratic career choices and unstable income streams.

Fourth, fame without privacy can fuel destructive habits. The entertainment world is rife with stories of young stars—many of them nepo babies—falling into substance abuse, reckless behavior, or toxic relationships. These issues not only affect mental health but also lead to legal troubles and financial loss. Without strong support systems or accountability, it’s easy to spiral.

Finally, inherited wealth can disappear quickly without proper estate planning. Trust funds and inheritances may be mismanaged or depleted by taxes, lawsuits, or poor financial advisors. Some nepo babies assume the money will last forever and fail to plan for long-term sustainability. Others are exploited by opportunistic friends or partners who take advantage of their naivety.

In contrast, those who succeed often do so by acknowledging their privilege, developing their own skills, and surrounding themselves with trustworthy mentors. They treat their inherited platform as a launchpad—not a safety net—and work to build something lasting.

In short, nepo babies go broke not because they lack opportunity, but because opportunity without discipline is a recipe for downfall. Wealth and fame are fleeting without the grit to sustain them. The lesson here isn’t just about celebrity—it’s a universal truth: success inherited must still be earned.

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Understanding Whole Life Insurance for Medical Professionals

Posted on October 30, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

Insurance Basics for Medical Professionals

By Jeffrey H. Rattiner, CPA, CFP®, MBA via iMBA, Inc.

After determining the need for insurance and the amount to purchase, the doctor-client and financial planner’s next task is to match those needs to the client’s objectives to determine what type of policy the client should purchase. The life insurance industry features more products today than ever before. One reason for this change is that, clearly, the insurance industry has expanded its product base to become more competitive. Another reason is that clients’ needs are constantly changing and the insurance companies must keep up with those needs or run the risk of having funds withdrawn from their companies. New and different types of life insurance products are here to stay. Since life insurance represents a significant part of a client’s risk-management program, planners have to be versed in the specifics of the varied product base.

Term Insurance Alternative

Whole life insurance was introduced as an alternative to term insurance. Whole life is often called cash value insurance or permanent insurance to distinguish it from term insurance. The cash value in whole life insurance arises because of the level premium system and the need to account for prepaid premiums. Whole life insurance offers permanent protection at a level premium for the entire lifetime of the insured. Premiums remain fixed and are paid throughout the insured’s entire lifetime. The premium level can remain constant throughout the life of the policy because premiums are higher during the early years. The excess charge in the early years makes it possible to build up a reserve, which will be needed, together with interest earned, to keep premiums level throughout the life of the policy. Older clients then pay the same premium in later years as they did when they were younger.

Cash Value

The cash value of a whole life policy serves a variety of purposes:

• It can be used for collateral for an insurance company loan.

• If the insured decides to terminate the policy, he or she can elect to receive the policy’s cash value at that time.

• The cash value balance can be remitted to the insurance company to purchase a reduced paid-up insurance policy. This will provide coverage until the funds are insufficient to pay the premiums. This cancellation feature is also referred to as a non-forfeiture value.

• If the policy is not canceled, the accumulated cash value becomes part of the death benefit paid upon the insured’s death (which makes this type of policy similar to a decreasing term policy). It can reduce cash flow by taking some of the investment results out of the contract either through dividends or through policy loans.

General Accounts

With a whole life policy, the insured does not control the investment vehicle. Policies are invested in the insurance company’s general account through the purchase of long-term bonds and mortgages. As a result, during a period of decreasing interest rates, whole life products can be expected to produce superior results since rates can be locked in when interest rates in general are higher. In contrast, rates in an increasing environment are locked in to their portfolios until maturity. There is no flexibility within a whole life policy. Premium payments, type of investment vehicle, and change in death benefit are all fixed. The safety of cash value is high, but the potential rate of return is low to moderate. If interest rates are rising, the price of the policy is declining, and you may want to suggest replacing the policy. (See Planning Issue 10.)

If the premiums paid to the insurance company turn out to be more than the company needs because expenses are lower than expected, the company’s portfolio investment return will be larger than the company expected. As a result, the company will then return some of the excess premium to the policyholder as a dividend or excess interest. Life insurance dividends are not taxable as income because they represent an excess of premium.

Premium Payments

The premium consists of mortality charge, policy expense, and a cash value. When the insured reaches 100 years of age, the policy endows with the face amount of the policy collectible by the insured. Since mortality tables end at age 100, the insurer considers the client dead and pays the face amount of the policy.

Whole life policies are packaged in a variety of ways. One policy, a limited-pay whole life policy, is a whole life policy with a death benefit continuing through age 100. The only difference between this and the traditional whole life policy is that premiums are paid only for a specified period, for example, seven years. In other words, the policyholder prepays the policy. A policy is considered to be fully paid up when the cash value of the basic contract plus the value of the dividend additions or deposits equals the net single premium for the policy in question at the insured’s attained age. The premium-paying period influences the cash value buildup in the policy. This is accomplished by using part of the investment return or dividends from long-term bonds and mortgages to pay the mortality and the expense charges on the policy for the rest of the policyholder’s life.

Advantages and DisAdvantages

Advantages of a whole life policy include lifetime coverage for the insured, a forced savings element, loan privileges, and a variety of premium payment plans. Over time, the cost is lower than term, the rate of return if the policy is kept until death is quite reasonable, and the policy will do a better job than universal life in keeping up with inflation. Disadvantages include a higher cost of death protection, a low rate of return, lack of flexibility, and incompatibility with inflation.

Assessment

Whole life policies are most appropriate for people who want or need a forced savings arrangement and for people who want lifetime coverage. As interest rates increased during the late 1970s, the returns received from insurance companies on long-term bonds and mortgage portfolios of whole life portfolios declined. As a result, in order to prevent policyholders from borrowing their cash reserves and investing these funds in other financial products, the insurance industry offered the following incentives:

• Existing policyholders were given the option to have their policies upgraded to reflect current market rates. Policies were upgraded through higher interest rates on cash values and higher future dividends and rates on policy loans.

• New types of policies were introduced—such as universal life, which tied cash value to short-term money market rates.

• Variable life insurance and universal variable life insurance were introduced, which segregated policy assets into a separate account.

Conclusion

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Filed under: Experts Invited, Insurance Matters, Risk Management | Tagged: cash value insurance, Jeffrey H. Rattiner, Whole life Insurance | 5 Comments »

CRYONICS: Search to Preserve Human Life?

Posted on October 30, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

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Cryonics is a scientific and philosophical endeavor that seeks to preserve human life by freezing individuals at ultra-low temperatures after legal death, with the hope that future medical advancements may allow for revival and healing. Though still a speculative and controversial field, cryonics has captured the imagination of futurists, scientists, and ethicists alike.

What Is Cryonics?

Cryonics involves the process of cryopreservation—cooling the body, or sometimes just the brain, to -196°C using liquid nitrogen. The goal is to halt all biological activity, particularly decay, immediately after death. This is not the same as freezing; rather, it involves vitrification, a process that turns bodily fluids into a glass-like state to prevent ice crystal formation, which can damage cells. Once preserved, the body is stored indefinitely in a cryogenic chamber until such time that revival is theoretically possible.

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Scientific and Technological Challenges

Despite its futuristic appeal, cryonics remains highly experimental. No human has ever been revived from a cryopreserved state, and current technology cannot reverse the damage caused by the preservation process itself. While scientists have successfully frozen and revived small biological samples like sperm and embryos, scaling this to entire human bodies presents enormous challenges.

The hope lies in future breakthroughs in nanotechnology, regenerative medicine, and artificial intelligence that could repair cellular damage and cure the diseases that led to death in the first place.

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Filed under: Ask a Doctor, Ethics, Marcinko Associates | Tagged: AI, cell damage, cold, cold body, cryonics, Ethics, freezing individuals, legal death, Marcinko, preserve human life, search human life, ultra low temperatures | Leave a comment »

How a Broke 50-Year-Old Doctor Can Still Retire at 65?

Posted on October 29, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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Turning 50 with little to no savings can be daunting, especially for a doctor who has spent decades in a demanding profession. Yet, all is not lost. With strategic planning, discipline, and a willingness to adapt, a broke 50-year-old physician can still build a solid retirement foundation by age 65.

First, it’s essential to confront the financial reality. This means calculating current income, expenses, debts, and any assets, however small. A clear picture allows for realistic goal-setting. The target should be to save aggressively—ideally 30–50% of income—over the next 15 years. While this may seem steep, doctors often have above-average earning potential, even in their later years, which can be leveraged.

Next, lifestyle adjustments are crucial. Downsizing housing, eliminating unnecessary expenses, and avoiding new debt can free up significant cash flow. If possible, relocating to a lower-cost area or refinancing existing loans can also help. Every dollar saved should be redirected into retirement accounts such as a 401(k), IRA, or a solo 401(k) if self-employed. Catch-up contributions for those over 50 allow for higher annual deposits, which can accelerate growth.

Investing wisely is non-negotiable. A diversified portfolio with a mix of stocks, bonds, and alternative assets can provide both growth and stability. Working with a fiduciary financial advisor ensures that investments align with retirement goals and risk tolerance. Time is limited, so the focus should be on maximizing returns without taking reckless risks.

DYING BROKE: Frugality OR Freedom

Increasing income is another powerful lever. Many doctors can boost earnings through side gigs like telemedicine, consulting, teaching, or locum tenens work. These flexible options can add tens of thousands annually without requiring a full career shift. Additionally, monetizing expertise—writing, speaking, or creating online courses—can generate passive income streams.

Debt reduction must be prioritized. High-interest loans, especially credit card debt, can erode savings potential. Paying off these balances aggressively while avoiding new liabilities is key. For student loans, exploring forgiveness programs or refinancing options may offer relief.

Finally, mindset matters. Retirement at 65 doesn’t have to mean complete cessation of work. It can mean transitioning to part-time roles, passion projects, or advisory positions that provide income and fulfillment. The goal is financial independence, not necessarily total inactivity.

In conclusion, while starting late is challenging, a broke 50-year-old doctor can still retire comfortably at 65. It requires a blend of financial discipline, income optimization, smart investing, and lifestyle changes. With focus and determination, the next 15 years can be transformative—turning a precarious situation into a secure and dignified retirement.

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Filed under: "Ask-an-Advisor", Accounting, finance, Financial Planning, Funding Basics, Investing, Portfolio Management, Taxation, Touring with Marcinko | Tagged: broke DO, broke doctors, broke DPM, broke MD, broke physicians, budgeting, credit cards, david marcinko, debt, finance, Income, ivesting, money, personal-finance, rretirement | Leave a comment »

LEVEL FUNDED HEALTH CARE: A Middle Ground Solution

Posted on October 29, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

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Level-funded health care is an increasingly popular option for small to mid-sized businesses seeking a balance between cost control and comprehensive employee coverage. It blends features of fully insured and self-funded health plans, offering employers greater flexibility and potential savings while minimizing risk.

In a traditional fully insured plan, employers pay a fixed premium to an insurance carrier, which assumes all financial risk for employee claims. In contrast, self-funded plans allow employers to pay for claims out-of-pocket, which can lead to significant savings—but also exposes them to unpredictable costs. Level-funded plans sit between these two models, offering a structured and predictable approach to self-funding.

With level-funded health care, employers pay a fixed monthly amount that covers three components: estimated claims funding, stop-loss insurance, and administrative fees. The estimated claims portion is based on actuarial data and reflects the expected health care usage of the employee group. Stop-loss insurance protects the employer from catastrophic claims by capping their financial exposure. Administrative fees cover third-party services such as claims processing and customer support.

One of the key advantages of level-funded plans is the potential for cost savings. If actual claims fall below the estimated amount, employers may receive a refund or credit at the end of the year. This incentivizes wellness programs and preventive care, as healthier employees lead to lower claims. Additionally, level-funded plans often provide more transparency into claims data, allowing employers to better understand health trends and make informed decisions about benefits.

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Another benefit is flexibility. Level-funded plans can be customized to suit the needs of a specific workforce, offering a range of coverage options and provider networks. This contrasts with the rigid structure of many fully insured plans. Employers also gain more control over plan design, which can help attract and retain talent in competitive job markets.

However, level-funded health care is not without challenges. It requires careful planning and a solid understanding of risk. Employers must be prepared for the possibility that claims may exceed projections, although stop-loss insurance helps mitigate this. Additionally, level-funded plans may not be suitable for very small groups or those with high-risk populations, as the cost of stop-loss coverage can be prohibitive.

Regulatory considerations also play a role. Level-funded plans are typically governed by federal ERISA laws rather than state insurance regulations, which can affect compliance and reporting requirements. Employers should work closely with benefits consultants or brokers to ensure they understand the legal landscape and choose a plan that aligns with their goals.

In conclusion, level-funded health care offers a compelling alternative for businesses seeking to manage costs while providing quality coverage. By combining predictability with the potential for savings and customization, it empowers employers to take a more active role in their health benefits strategy. As the health care landscape continues to evolve, level-funded plans are likely to remain a valuable option for organizations looking to strike the right balance between affordability and employee well-being.

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Filed under: "Ask-an-Advisor", Ethics, finance, Glossary Terms, Health Insurance, Healthcare Finance, Taxation | Tagged: david marcinko, ERISA, health, Health Insurance, health insurance plans, healthcare, insurance, insurance claims, level funded healthcare, level funded insurance, medicare, self fund health plans, stop loss insurance | Leave a comment »

A MODERN PRESCRIPTION SHOWDOWN: Amazon Pharmacy VS. GoodRx

Posted on October 28, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

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In the evolving landscape of digital health care, Amazon Pharmacy and GoodRx have emerged as two leading platforms offering consumers affordable and convenient access to prescription medications. While both aim to simplify the process of obtaining prescriptions, they differ significantly in their approach, pricing models, and user experience.

Amazon Pharmacy, launched in 2020, is a full-service online pharmacy that allows customers to order medications directly through Amazon. It offers fast, free delivery for Prime members and integrates with most insurance plans. One of its standout features is RxPass, a subscription service available to Prime members for $5 per month, which covers unlimited eligible generic medications. This model is particularly attractive to individuals who take multiple generics regularly, as it can significantly reduce out-of-pocket costs.

In contrast, GoodRx, founded in 2011, operates primarily as a price comparison and discount platform. It does not dispense medications itself but partners with local and mail-order pharmacies to help users find the lowest prices. GoodRx provides coupons that can be used at thousands of pharmacies nationwide, often resulting in substantial savings—especially for those without insurance. It also offers GoodRx Gold, a paid membership that unlocks deeper discounts and telehealth services.

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When comparing the two, pricing transparency is a key differentiator. GoodRx excels in showing users a range of prices across different pharmacies, empowering them to choose the most cost-effective option. Amazon Pharmacy, while competitive, typically offers fixed prices and focuses more on convenience and integration with its broader ecosystem.

Convenience is another area where Amazon Pharmacy shines. With its streamlined ordering process, automatic refills, and integration with Amazon’s delivery network, it appeals to users who prioritize ease and speed. GoodRx, while convenient in its own right, requires users to present coupons at the pharmacy or use mail-order services, which may involve more steps.

Insurance compatibility also varies. Amazon Pharmacy accepts most major insurance plans, making it a viable option for insured individuals. GoodRx, on the other hand, is often used by those without insurance or with high deductibles, as its discounts can sometimes beat insurance copays.

However, both platforms have limitations. Amazon Pharmacy’s RxPass is restricted to generic medications and excludes certain states due to regulatory issues. GoodRx’s discounts may not apply to all medications, and prices can fluctuate depending on location and pharmacy.

In terms of user experience, Amazon offers a seamless, tech-driven interface with customer support and medication management tools. GoodRx provides educational resources, price alerts, and a mobile app that helps users track savings and prescriptions.

Ultimately, the choice between Amazon Pharmacy and GoodRx depends on individual needs. For those seeking a one-stop solution with predictable costs and fast delivery, Amazon Pharmacy may be ideal. For users who want to shop around for the best deal or lack insurance, GoodRx offers unmatched flexibility and savings.

As digital health continues to grow, both platforms are reshaping how Americans access medications—making prescriptions more affordable, transparent, and accessible than ever before.

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Filed under: Ask a Doctor, Drugs and Pharma, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Marcinko Associates | Tagged: Amazon Pharmacy, david marcinko, drug discount platform, drug price comparison, drug refills, Drugs, GoodRx, goodRX gold, health, Health Insurance, healthcare, insurance, Managed Care, medicare, prescriptions, price comparisons for drugs, RxPass, teleHealth, telemedicine | Leave a comment »

AUSTRIAN ECONOMICS: Can it Save Healthcare?

Posted on October 27, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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The global healthcare sector faces mounting challenges: rising costs, inefficiencies, limited access, and bureaucratic entanglements. In response, some economists and policymakers have turned to Austrian Economics for answers. Rooted in the works of Ludwig von Mises and Friedrich Hayek, Austrian Economics emphasizes individual choice, market-driven solutions, and skepticism toward centralized planning. But can this school of thought truly “save” healthcare?

At its core, Austrian Economics champions the idea that decentralized decision-making and free-market mechanisms lead to more efficient and responsive systems. In healthcare, this would mean reducing government control and allowing competition to drive innovation, lower costs, and improve quality. Proponents argue that when patients act as consumers and providers compete for their business, the system becomes more accountable and efficient. For example, direct primary care models—where patients pay physicians directly without insurance intermediaries—reflect Austrian principles and have shown promise in improving care and reducing administrative overhead.

Austrian theorists also critique the price distortions caused by third-party payers like insurance companies and government programs. According to them, when consumers are insulated from the true cost of care, demand becomes artificially inflated, leading to overutilization and waste. By restoring price signals—where patients see and respond to the actual cost of services—Austrian economists believe the market can better allocate resources and curb unnecessary spending.

However, critics argue that healthcare is not a typical market. Patients often lack the information, time, or capacity to make rational choices, especially in emergencies. Moreover, healthcare involves significant externalities and moral considerations that pure market logic may overlook. For instance, should access to life-saving treatment depend solely on one’s ability to pay? Austrian Economics offers little guidance on equity or universal access, which are central concerns in modern healthcare debates.

Austria itself provides an interesting case study. Despite the name, Austrian Economics is not the guiding philosophy behind Austria’s healthcare system. Instead, Austria operates a social insurance model with near-universal coverage, funded through mandatory contributions and managed by a mix of public and private actors. While recent reforms have aimed to streamline administration and reduce fragmentation he system remains largely collectivist—contrary to Austrian ideals.

In conclusion, Austrian Economics offers valuable insights into the inefficiencies of centralized healthcare systems and the potential benefits of market-based reforms. Its emphasis on individual choice, price transparency, and entrepreneurial innovation can inspire meaningful improvements. However, its limitations in addressing equity, access, and the unique nature of healthcare suggest that it cannot “save” the system on its own. A hybrid approach—blending market mechanisms with safeguards for universal access—may offer a more balanced path forward.

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Filed under: Ask a Doctor, economics, Glossary Terms, Health Economics, Marcinko Associates | Tagged: Austrian Economics, can austrian economics save health casre?, david marcinko, economics, finance, Friedrich Hayek, global healthcare, Ludwig Von Mises Institute | Leave a comment »

MONETARY VALUATION: Of the Medical Practice

Posted on October 27, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Valuing a medical practice involves assessing its financial performance, assets, and intangible factors like goodwill and patient loyalty to determine its fair market worth.

Determining the value of a medical practice is a nuanced process that blends financial analysis with strategic insight. Whether you’re preparing to sell, merge, or bring in a partner, understanding how to value your practice ensures informed decision-making and fair negotiations.

There are several recognized methods for valuing a medical practice, each suited to different scenarios. The most common include the income approach, market approach, asset-based approach, and the rule-of-thumb method.

HEALTHCARE VALUATION: Terms and Definitions

The income approach focuses on the practice’s ability to generate future earnings. This method involves analyzing historical financial statements, projecting future cash flows, and discounting them to present value using a risk-adjusted rate. It’s particularly useful when the practice has stable revenue and predictable expenses. Key metrics include net income, physician productivity, and reimbursement rates.

The market approach compares the practice to similar ones that have recently sold. It relies on data from comparable transactions, adjusted for differences in size, specialty, location, and profitability. This method is ideal when reliable market data is available, though such data can be scarce for niche specialties or rural practices.

The asset-based approach calculates the value of tangible and intangible assets. Tangible assets include medical equipment, office furniture, and real estate. Intangible assets—like patient records, brand reputation, and goodwill—are harder to quantify but can significantly impact value. Goodwill, for instance, reflects the practice’s reputation, patient loyalty, and referral networks.

The rule-of-thumb method uses industry benchmarks, such as a multiple of annual revenue or earnings. For example, a general practice might be valued at 60–80% of annual gross revenue. While quick and easy, this method oversimplifies and may not reflect the unique strengths or weaknesses of a specific practice.https:/https://medicalexecutivepost.com/2025/03/17/medial-practice-valuation-adjustments//medicalexecutivepost.com/2025/03/17/medial-practice-valuation-adjustments/

Beyond these methods, several qualitative factors influence valuation. These include the size and diversity of the patient base, the practice’s specialty, use of technology (like EHR systems or telemedicine), and whether key physicians will remain post-sale. A practice heavily reliant on one provider may be less valuable than one with a strong team and succession plan.

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MEDICAL PRACTICE: Valuation Adjustments

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Timing also matters. Economic conditions, regulatory changes, and shifts in healthcare reimbursement can affect practice value. Tax implications and deal structure—such as asset sale vs. stock sale—should also be considered during negotiations.

Ultimately, valuing a medical practice is both art and science. Engaging a professional appraiser or valuation expert can help ensure accuracy and objectivity. They bring experience, access to market data, and the ability to tailor valuation methods to your specific situation.

In summary, a comprehensive valuation considers financial performance, assets, market trends, and intangible factors. By understanding these elements, practice owners can make strategic decisions that reflect the true worth of their medical enterprise.

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Filed under: "Ask-an-Advisor", "Doctors Only", CMP Program, finance, Funding Basics, Glossary Terms, Health Economics, Marcinko Associates, Practice Management | Tagged: asset based approach, CMP, david marcinko, healthcare, income approach, market approach, medical practice, medical practice value, rule thumb, stocks, Technology, valuation | Leave a comment »

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