PODCAST: What is Apophenia?

Apophenia is the tendency to mistakenly perceive connections and meaning between unrelated things. The termwas coined by psychiatrist Klaus Conrad in his 1958 publication on the beginning stages of schizophrenia.

Conrad defined it as “unmotivated seeing of connections [accompanied by] a specific feeling of abnormal meaningfulness”. He described the early stages of delusional thought as self-referential, over-interpretations of actual sensory perceptions, as opposed to hallucinations.

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

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Man in the Moon refers to any of several pareidolic images of a human face, head or body that certain traditions recognize in the disc of the full moon.

Pareidolia is the tendency for incorrect perception of a stimulus as an object, pattern or meaning known to the observer, such as seeing shapes in clouds, seeing faces in inanimate objects or abstract patterns, or hearing hidden messages in music. Pareidolia is a subcategory of apophenia.

PODCAST: https://www.bing.com/videos/search?q=Apophenia%3a&ru=%2fvideos%2fsearch%3fq%3dApophenia%253a%26FORM%3dHDRSC3&view=detail&mid=7A6D44176273D21435437A6D44176273D2143543&&FORM=VDRVRV

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The “Middle Class” Defined?

By Staff Reporters

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What’s shrinking in size, overworked and woefully underpaid?

Did you know that only half of U.S. adults live in a household with an annual income of $52,000 to $156,000, the range it takes to be considered middle income, according to the Pew Research Center. That share is significantly lower than it was in 1971, when 61% of the nation’s adults qualified as middle income.

In 2022 — an era of historic inflation and a manic economy in which jobs are plentiful but wages are stagnant — more Americans are living paycheck to paycheck. And it’s affecting more than just their income.

“People judge whether or not they’re achieving the American dream by comparing their income and their lifestyle, or what their income can buy, to what they see around them,” says Isabel Sawhill, a senior fellow at the Brookings Institution.

On paper, middle-class household income has increased considerably in the last 50 years. Measured in 2020 dollars, the median salary of the U.S. workforce is 50% higher now ($90,131) than it was in 1971 ($59,934), primarily thanks to women’s increased participation in the workforce, says Sawhill, who’s a co-author of the Brookings report “A New Contract with the Middle Class.”

Those gains, however, pale in comparison to the 69% growth enjoyed by the wealthiest households. Elisabeth Jacobs, a deputy director at the research nonprofit Urban Institute, said in a 2021 Brookings panel that if middle incomes had grown at the same pace as the top 20% of earners over the past 50 years, a solidly middle-class family would average around $139,000 annually (post-tax).

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MORE: Tax Loss Harvesting

Tax Loss Harvesting

By Vitaliy Katsenelson, CFA

DEFINITION: https://medicalexecutivepost.com/2022/11/06/tax-loss-harvesting-what-it-is/

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Tax Lost Harvesting with Examples

I enjoy writing about taxes as much as I enjoy going to the dentist. But I feel what I am about to say is important. We – including yours truly – have been mindlessly conditioned to do tax selling at the end of every year to reduce our tax bills. On the surface it makes sense. There are realized gains – why don’t we create some tax losses to offset them?

Here is the problem. With a few exceptions, which I’ll address at the end, tax-loss selling makes no logical sense. Let me give you an example.

Let’s say there is a stock, XYZ. We bought it for $50; we think it is worth $100. Fourteen months later we got lucky and it declined to $25. Assuming our estimate of its fair value hasn’t changed, we get to buy $1 of XYZ now for 25 cents instead of 50 cents.

But as of this moment we also have a $25 paper loss. The tax-loss selling thinking goes like this: Sell it today, realize the $25 loss, and then buy it in 31 days. (This is tax law; if we buy it back sooner the tax loss will be disqualified.) This $25 loss offsets the gains we took for the year. Everybody but Uncle Sam is happy.

Since I am writing about this and I’ve mentioned above I’d rather be having a root canal, you already suspect that my retort to the above thinking is a great big NO!

In the first place, we are taking the risk that XYZ’s price may go up during our 31-day wait. We really have no idea and rarely have insights as to what stocks will do in the short term. Maybe we’ll get lucky again and the price will fall further. But we’re selling something that is down, so risk in the long run is tilted against us. Also, other investors are doing tax selling at the same time we are, which puts additional pressure on the stock.

Secondly – and this is the most important point – all we are doing is pushing our taxes from this year to future years. Let’s say that six months from now the stock goes up to $100. We sell it, and… now we originate a $75, not a $50, gain. Our cost basis was reduced by the sale and consequent purchase to $25 from $50. This is what tax loss selling is – shifting the tax burden from this year to next year. Unless you have an insight into what capital gains taxes are going to be in the future, all you are doing is shifting your current tax burden into the future.

Thirdly, in our first example we owned the stock for 14 months and thus took a long-term capital loss. We sold it, waited 31 days, and bought it back. Let’s say the market comes back to its senses and the price goes up to $100 three months after we buy it back. If we sell it now, that $75 gain is a short-term gain. Short-term gains are taxed at your ordinary income tax bracket, which for most clients is higher than their capital gain tax rate. You may argue that we should wait nine months till this gain goes from short-term to long-term. We can do that, but there are costs: First, we don’t know where the stock price will be in nine months. And second, there is an opportunity cost – we cannot sell a fully priced $1 to buy another $1 that is on fire sale.

Final point. Suppose we bought a stock, the price of which has declined in concert with a decrease of its fair value; in other words, the loss is not temporary but permanent.  In this case, yes, we should sell the stock and realize the loss. 

We are focused on the long-term compounding of your wealth. Thus our strategy has a relatively low portfolio turnover. However, we always keep tax considerations in mind when making investment decisions, and try to generate long-term gains (which are more tax efficient) than short term gains. 

We understand that each client has their unique tax circumstances. For instance, your income may decline in future years and thus your tax rate, too. Or higher capital gains may put you in a different income bracket and thus disqualify you from some government healthcare program.

We are here to serve you, and we’ll do as much or as little tax-loss selling as you instruct us to do. We just want you to be aware that with few exceptions tax-loss selling does more harm than good.

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Happy [Safer] Thanksgiving Day 2022

2022

By CDC

MORE: https://www.cdc.gov/coronavirus/2019-ncov/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2Findex.html

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DR. ANTHONY FAUCI: Retires after 50 Years of Service

By Dr. David Edward Marcinko MBA

[Editor-in-Chief]

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I first met my esteemed colleague Tony Fauci MD more than 30 years ago as a young surgical resident in Atlanta. My esteem for him has grown immensely since then. After all, he is an American physician-scientist and immunologist serving as the director of the National Institute of Allergy and Infectious Diseases and the Chief Medical Advisor to the President

And so, upon his retirement, Dr. Anthony Fauci urged Americans to get their reformulated Covid boosters in his final White House press briefing yesterday. Fauci, the nation’s top infectious disease official and the leader of the NIAID since 1984, announced recently that he’d be stepping down to “pursue the next chapter” of his career in December, 2022.

Dr. Fauci’s final plea comes as public health officials warn that a “viral jumbalaya” of respiratory infections threatens to push hospitals to the brink this coming winter.

RSV: https://medicalexecutivepost.com/2022/11/19/public-health-rsv-versus-covid/

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Quote: “My final message—maybe the final message I give you from this podium—is that, please, for your own safety, for that of your family, get your updated Covid-19 shot as soon as you’re eligible, to protect yourself, your family, and your community.”

We should all heed his advice.

Thank you for your service, Tony!

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What is EISOPTROPHOBIA?

NOW YOU SEE ME – NOW I DON’T WANT TO SEE MYSELF

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By Dr. David Edward Marcinko MBA CMP®

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DEFINITION: Eisoptrophobia  is the fear of mirrors or, more specifically, of seeing your own reflection in a mirror. Looking into a mirror can cause people with eisoptrophobia shame or distress.

The term is derived from the Greek “eis” and “optikos”. Even though the sufferers know their fear is irrational, they experience excessive anxiety when they look into the mirror.

ASSESSMENT: Your thoughts are appreciated.

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My Pragmatic Philosophy of Education

It is NOT the Boyer Model

[By Dr. David E. Marcinko MBA]

The Boyer Model of Education and Scholarship

OK – I may subscribe to the Boyer Model but with several specific personal variations which I will keep propriety and not disclose here. But, I will discuss my teaching pragmatism, below.

Definition

Boyer’s Model of scholarship and education is an academic model advocating expansion of the traditional definition of scholarship and research into four types of scholarship. It was introduced in 1990 by Ernest Boyer.

According to Boyer, traditional research, or the scholarship of discovery, had been the center of academic life and crucial to an institution’s advancement but it needed to be broadened and made more flexible to include not only the new social and environmental challenges beyond the campus but also the reality of contemporary life.

His vision was to change the research mission of universities by introducing the idea that scholarship needed to be redefined.

MORE: https://en.wikipedia.org/wiki/Boyer%27s_model_of_scholarship

ME: Dr. Marcinko Teaching Philosophy

ENTER MY PRAGMATISM

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DEAN: Dean 3.0 Philosophy

Assessment

So, what do you think?

Conclusion

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“Insurance & Risk Management Strategies for Doctors” https://tinyurl.com/ydx9kd93

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“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8

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

Happy Thanksgiving Day 2022

2022

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Forget about inflation and the $125 dollar turkey this year.

Try a Test-Tube Turkey, Instead? That’ll Be $34,000

  Last year, Paul Mozdziak gave thanks that people are finally paying attention to his big idea: he wants to grow turkey meat in 5,000-gallon tanks.

An increasing number of companies are trying to grow other kinds of meat in the lab, but Mozdziak happens to “find a lot of beauty in turkeys.” His approach uses stem cells from a biopsy of turkey breast, which are grown in a warm broth of glucose and amino acids to build up muscle fibers. The potential is huge: theoretically, a single stem cell could undergo 75 generations of division in three months, forming enough muscle to manufacture 20 trillion turkey nuggets.

But such such efficiencies are yet to be met. Currently, a turkey-sized lump of white meat would require around $34,000 worth of growth serum. At Target, you can pick up a respectable frozen bird for $30-35. But the latter are intensively farmed. If Mozdziak can scale up production, as well as tweaking fat and protein ratios to make his turkey tasty, he could even win over some vegetarians at Thanksgiving.

MIT Technology Review

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PHARMACIES: Consumer Centric in the Future?

By Staff Reporters

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Rina Shah has been working at Walgreens her entire career—close to 25 years—but this year she got a shiny new title: vice president of pharmacy of the future. The role was created as part of what CEO Rosalind Brewer said in Walgreens’ latest earnings call is the company’s top priority: creating a consumer-centric healthcare company. The retail pharmacy giant essentially wants to free up its pharmacists’ time so they can go from filling prescriptions all day to engaging more directly with patients.

Shah is heading up these efforts, and she sat down with Neal Feyman to talk about what Walgreens sees when it pictures the pharmacy of the future.

What does “the pharmacy of the future” mean? When we talk about the future of pharmacy, it’s to leverage our pharmacists in a much more data-driven, effective way to lower costs in the system.

For example, in certain states where there’s higher pollen counts and pollution, we’re seeing higher emergency room visits because of asthma. We can educate people on the difference between a rescue inhaler and a maintenance inhaler—and how they can understand triggers—and ultimately impact lower emergency room visits because of that.

What problems are you trying to solve in this role? Prior to the pandemic hitting, we had been asked by providers and payers and other organizations for our pharmacists to do more. We were being asked to provide testing services and in-depth consultations with patients.

However, our operating model didn’t really account for that. Our pharmacists were busy doing many more administrative tasks. We made the decision that we needed to transform the model, which meant really freeing up the capacity of our pharmacists so they could spend time with patients delivering care, as it’s always intended to be. Keep reading here.—NF

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Challenging the 10,000 Hours to Mastery Rule?

Outliers: The Story of Success

[By staff reporters]

This book was the third non-fiction book written by Malcolm Gladwell and published by Little, Brown and Company on November 18, 2008.

In Outliers, Gladwell examined the factors that contribute to high levels of success.

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To support his thesis, he examined why the majority of Canadian ice hockey players are born in the first few months of the calendar year, how Microsoft co-founder Bill Gates achieved his extreme wealth, how the Beatles became one of the most successful musical acts in human history, how Joseph Flom built Skadden, Arps, Slate, Meagher & Flom into one of the most successful law firms in the world, how cultural differences play a large part in perceived intelligence and rational decision making, and how two people with exceptional intelligence, Christopher Langan and J. Robert Oppenheimer, end up with such vastly different fortunes.

Throughout the publication, Gladwell repeatedly mentions the “10,000-Hour Rule“, claiming that it is the key to achieving world-class expertise in any skill.

But, is he correct?

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MORE: https://www.businessinsider.com/expert-rule-10000-hours-not-true-2017-8

Assessment

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

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

Book Marcinko: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.

HOSPITALS:

“Financial Management Strategies for Hospitals” https://tinyurl.com/yagu567d

“Operational Strategies for Clinics and Hospitals” https://tinyurl.com/y9avbrq5

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Public Health Amidst a Smart Pandemic

By Ryan Yonk and April Liu

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READ HERE: https://www.aier.org/article/public-health-amidst-a-smart-pandemic/

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Should Doctors Protect their Turf?

Testing Free-Market Principles and Medical Licensing

By Mike Accad MD

It’s been a little over a 100 years since medical licensing laws were introduced in the US.  If people doubt that slippery slopes are real, they should reflect on that history.

In our latest video, Anish Koka and I discuss a “white paper” jointly written by Jeffrey Flier, former dean at Harvard Medical School, and Jared Rhoads from the Dartmouth Institute, calling for some deregulation of the apparatus that rules the supply of physicians and their scope of work. The paper gives an exhaustive account of the bureaucratic mess and offers some possible remedies.

LINK: http://alertandoriented.com/should-doctors-protect-their-turf/

RELATED: https://medicalexecutivepost.com/2014/09/26/is-medical-licensing-really-necessary/

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The MEDICAL EXECUTIVE-POST [Join Us]

By Staff Reporters

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The ME-P is a reader-supported publication.

To receive new posts and support our work, consider becoming a free or paid subscriber.

SPONSORSHIPS: https://medicalexecutivepost.com/sponsors/

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Over Heard in the DOCTOR’S LOUNGE

On “Hard Working” HMO Physicians

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By Dr. David E. Marcinko MBA CMP®

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One of my favorite patients told me this anecdote as he recalled the story of the old man who spent a day watching his physician son treating HMO patients in the office. 

The doctor had been working at his usual feverish pace all morning, and although he was working hard, bitterly complained to his dad that he was not making as much money as he used to.

Finally, the old man interrupted him and said,

“Son, why don’t you just treat the sick patients?” 

The doctor-son looked annoyed at his father, and responded,

“Dad, can’t you see, I don’t have time to treat just the sick ones.”

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FINANCE: https://www.amazon.com/Comprehensive-Financial-Planning-Strategies-Advisors/dp/1482240289/ref=sr_1_1?ie=UTF8&qid=1418580820&sr=8-1&keywords=david+marcinko

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STOIC: The Philosophy of “Knowing and Doing”

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By Vitaliy Katsenelson CFA

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Introduction to Stoic Philosophy: Knowing and Doing

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The Greek Philosophers & Latin Phrases

A Brief Review

[By Staff Reporters]

We do not have enough space to cover the subject fully. And, “important” does not necessarily  indicate good or bad. But, we will try to review these three Greek Philosophers.

PLATO

Plato is important because his philosophy underpins autocratic political philosophies such as Kant, Nazism and Communism. Metaphysically he fights a war against reality claiming only a superior mind, like his, can be trusted. He had a pessimistic view of human beings.

ARISTOTLE

Aristotle is responsible for the explosion of progress since the Renaissance. His focus on identification (A is A), and reason, as the key to human knowledge and happiness has been a force for good. His heirs like Aquinas and Rand have sought to round out his discoveries. He was the optimist. If you look at the the cultural climate in the USA today, you will see a resurgence of Platonism (socialism).

And, in the face of unparalleled quality of life and prosperity, harbingers of doom capitalize in the unwillingness of many to do the work required for freedom. Identity is ignored in the attempt to avoid the requirements for happiness: Effort and thought. Hopefully the pendulum will swing back to an Aristotelian era.

SOCRATES

Socrates was the bridge between the two great minds of Plato and Aristotle, and a story teller whose skills and abundance ensured the survival of his own.

Assessment

Much as Socrates’ thought systems – so we put our coin on Plato as the premier Greek Philosopher. Without Plato, Socrates’ thought would not have survived a century past his execution; still less a millennia.

Aristotle certainly influenced Alexander, but it’s hard to credit Aristotle for Alexander’s legacy, which was largely military in nature.

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LATIN PHRASES

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Conclusion

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

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

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PUBLIC HEALTH: RSV versus COVID?

[Emergency Request]

By Staff Reporters

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Children’s hospitals are asking the federal government to declare a public health emergency to help them deal with the surge of RSV cases. Infants are being hospitalized at seven times the rate of 2018.

DEFINITION: Respiratory syncytial virus, also called human respiratory syncytial virus and human orthopneumovirus, is a common, contagious airborne virus that causes infections of the respiratory tract. It is a negative-sense, single-stranded RNA virus.

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TODAY: World Pancreatic Cancer Day 2022 [November 19th]

By Staff Reporters

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On World Pancreatic Cancer Day, loved ones, communities and organizations around the world unite to shine a light on pancreatic cancer and share our universal message that it’s about time we all know the symptoms!

Raise awareness on this special day as we share the facts about this disease, survivor stories and what you can do to make an impact.

READ: https://pancreaticcanceraction.org/take-action/raise-awareness/pancreatic-cancer-awareness-month/world-pancreatic-cancer-day/

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BEAR MARKETS: Passive Income?

By Staff Reporters

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DEFINITION: Passive income is a type of unearned income that is acquired automatically with minimal labor to earn or maintain. It is often combined with another source of income. In the United States, the IRS divides income into three categories: active income, passive income, and portfolio income.

CITE: https://www.r2library.com/Resource/Title/082610254

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Bear markets can accelerate your passive income

For those physicians fully invested in non-dividend-paying stocks, bear markets are a difficult time. However, they’re an opportunity for those with cash or income-producing assets.

WY? Bear markets can accelerate any investors’ capacity to generate passive income because they can turn dividend income and idle cash into bigger income streams. That can enable investors to make more money in the future, putting them even closer to reaching their financial goals.

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

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MIDDLE CLASS: Once-in-a-Generation Wealth Boom Ends?

By Staff Reporters

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DEFINITION: The Pew Research Center defines the middle class as households that earn between two-thirds and double the median U.S. household income, which was $65,000 in 2021, according to the U.S. Census Bureau. 21 Using Pew’s yardstick, middle income is made up of people who make between $43,350 and $130,000.

CITE: https://www.r2library.com/Resource/Title/0826102549

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The American middle class is facing the biggest hit to its wealth in a generation going into the midterm election, although it is also entering the vote richer than it has ever been thanks to a decade of cheap money and the wealth boom it fed.

That’s the conclusion of a Bloomberg News examination that paired new wealth data with an exclusive Harris Poll of attitudes of the 100 million adults who sit at the core of the US economy and its politics ahead of the election.

READ HERE: https://www.bloomberg.com/graphics/2022-us-midterms-middle-class-wealth/?leadSource=uverify%20wall

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What is Hermeneutics?

To Understand … and be Understood

By Dr. David E. Marcinko MBA

Hermeneutics (/ˌhɜːrməˈnjuːtɪks/) is the theory and methodology of interpretation, originally the interpretation of biblical texts, wisdom literature, and philosophical texts.

Hermeneutics is more than interpretive principles or methods we resort to when immediate comprehension fails. Rather, hermenetics is the art of understanding and of making oneself understood.

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MORE: https://medium.com/@danpantelo/hermeneutics-why-people-interpret-things-differently-870f35436fe8

Conclusion

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

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

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What is the Dunning–Kruger Effect?

On illusory superiority and physicians

[By Staff reporters]

In the field of psychology, the Dunning–Kruger effect is a cognitive bias in which people of low ability have illusory superiority and mistakenly assess their cognitive ability as greater than it is.

The cognitive bias of illusory superiority comes from the inability of low-ability people to recognize their lack of ability; without the self-awareness of metacognition, low-ability people cannot objectively evaluate their actual competence or incompetence.

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More: https://www.cmu.edu/dietrich/sds/docs/loewenstein/physicianNarcissism.pdf

Assessment

On the other hand, people of high ability incorrectly assume that tasks that are easy for them are also easy for other people. And so, are doctors especially guilty of this effect?

Conclusion

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PODCAST: Healthcare Finance [Recorded Live] Q and A Session

By Eric Bricker MD

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PODCAST: What is a “Potemkin” Village?

“Fake It – Till You Make It”

Courtesy: www.CertifiedMedicalPlanner.org

By Dr. David E. Marcinko MBA

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

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

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

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

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

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

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

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

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

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

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

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

THANK YOU

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SCHWAB: Introduces Personalized Indexing

By Staff Reporters

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

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

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

Key Takeaways

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

Key Features

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

Available Strategies

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

Account Minimums and Fees

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

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

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

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PODCAST: Medical Billing Charge Abuse by Radiologists

By Staff Reporters

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BIG TECH: Digital Wrecks!

By Staff Reporters

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According to journalist Neal Freyman:

The days of an internet company trying to e-scooter their way to solving world hunger through solar-powered NFT horse racing just to compete with Disney+ are over. Futuristic projects that were once a staple of Big Tech line items are getting squeezed in this “we definitelycan’t afford that anymore” economy.

That was made very clear yesterday.

1. As part of its anticipated mass layoffs this week, Amazon began to cut employees who were working on its AI assistant, Alexa. That division has an operating loss of more than $5 billion per year.

2. The hedge fund TCI Fund Management, which has a $6 billion stake in Alphabet, urged Google’s parent company to join its Big Tech peers in laying off workers yesterday, saying it’s overstaffed and paying its employees too much. It took specific aim at Google’s famous Other Bets division that incubated “moonshot” projects like Waymo, the autonomous vehicle company. That Other Bets unit brought in $3 billion in revenue over the last five years, but incurred $20 billion in operating losses, TCI’s letter to CEO Sundar Pichai said.

Big picture: While Snap and Microsoft are also nixing riskier long-term bets, the big Big Tech exception is Meta. Zuckerberg has cut back on some experimentation, but is staying committed to spending billions on the metaverse, despite investor concerns.

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PODCAST[s]: Medicare Re-Admission Penalties

UPDATE 83% Penalized!

By Eric Bricker MD

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HRRP PODCAST: https://www.youtube.com/watch?v=mwRrKM83CVQ

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JOIN & PARTNER with the Medical Executive-Post!

By Staff Reporters

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MEDIA / INTERVIEW REQUESTS

We like to talk: MarcinkoAdvisors@msn.com

BLOGGING / VLOGGING / CROSS AND RE-POSTS

Yes. We’re looking for writers & cross-posts.

Send them to us: MarcinkoAdvisors@msn.com

WHAT WE’RE LOOKING FOR

Op-eds. Cross and Re-Posts, Links and Columns. Great ideas for improving physician focused financial planning, health insurance, economics and the financial ecosystem; etc. Pitches for healthcare-focused startups and business. Write-ups of original research. Reviews of new health care products, DME and AI. Data driven analysis of health care trends. Policy proposals; etc.

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WORLD POPULATION: 8 Billion?

By Staff Reporters

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The world’s population will likely hit an estimated 8 billion people today, according to a United Nations projection.

READ: https://reliefweb.int/report/world/worlds-population-hits-8-billion-people-un-calls-solidarity-advancing-sustainable-development-all

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PODCAST: What is Anscombe’s Quartet?

The Need for Data Visualization

Courtesy: www.CertifiedMedicalPlanner.org

Anscombe’s Quartet comprises four data sets that have nearly identical simple descriptive statistics, yet have very different distributions and appear very different when graphed. Each dataset consists of eleven (x,y) points.

LINK: https://www.amazon.com/Dictionary-Health-Information-Technology-Security/dp/0826149952/ref=sr_1_5?ie=UTF8&s=books&qid=1254413315&sr=1-5

They were constructed in 1973 by the statistician Francis Anscombe to demonstrate both the importance of graphing data before analyzing it and the effect of outliers and other influential observations on statistical properties. He described the article as being intended to counter the impression among statisticians that “numerical calculations are exact, but graphs are rough.”

So, always plot that data!

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PODCAST: https://www.bing.com/videos/search?q=Anscombe%e2%80%99s+Quartet%3a+&&view=detail&mid=68A62E7AB26B2B6EE69668A62E7AB26B2B6EE696&&FORM=VRDGAR&ru=%2Fvideos%2Fsearch%3Fq%3DAnscombe%25e2%2580%2599s%2BQuartet%253a%2B%26FORM%3DHDRSC3

Assessment: Your thoughts and comments are appreciated.

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PODCAST: What is the McNamara [Bio] Statistics Fallacy?

A Metaphor for the Corona Virus Pandemic!

Courtesy: www.CertifiedMedicalPlanner.org

By Dr. David E. Marcinko MBA

A belief that rational decisions can be made with quantitative data and measures alone, when in fact the things you can’t measure are often the most consequential.

Secretary McNamara, who tried to quantify every aspect of the Vietnam War.

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PODCAST: https://www.bing.com/videos/search?&q=McNamara+Fallacy&view=detail&mid=201A0081979919F8D651201A0081979919F8D651&form=VDRVSR&ru=%2Fvideos%2Fsearch%3Fq%3DMcNamara%2BFallacy%26FORM%3DHDRSC3&ajaxhist=0

QUERY: Is this also a metaphor for the “Art” and Science of Medicine and Economics?

Assessment: Your thoughts and comments are appreciated.

HEALTH DICTIONARIES FOR PHYSICIAN-EXECUTIVES AND MEDICAL CXOs

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PODCAST: Hospital-Insurance Contracting [“Carve-Out” Prices Explained]

By Eric Bricker MD

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DAILY UPDATE: New IRS 1099-K Reporting Rule

By Staff Reporters

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IRS

The IRS just noted that there are no changes made to the taxability of income but only in the reporting rules for Form 1099-K. Taxpayers are still required to report all income on their tax return unless it is excluded by law. This is whether they receive a Form 1099-NEC, Nonemployee Compensation; Form 1099-K; or any other information return.

Previously businesses would generally receive a 1099-K tax form only when their gross payments exceeded $20,000 for the year and the business conducted at least 200 transactions.

According to the new 1099-K rule, the gross payments threshold has been lowered to just over $600 for the year with the transactions threshold no longer applying. Now a single transaction exceeding $600 can trigger a 1099-K. This includes transactions through credit cards, debit cards, banks, PayPal, Uber, Lyft, and other third-party payment settlement entities.

The 1099-K form includes information about the payment processor and the company receiving payments, and a monthly breakdown of total payments, among other information.

According to the IRS, the lower information reporting threshold and the summary of income on Form 1099-K will make it easier for taxpayers to track the amounts received.

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MDs Must Know When it’s OK to be Average

Should Active Investors Expect to Lose?

Rick Kahler MS CFP

By Rick Kahler MSFS CFP®

When it comes to investing, it’s a losing proposition to try and be anything better than average. Even if you are a doctor.

I was recently reminded of this important investing precept when I attended a presentation by Ken French, a noted professor of finance at Dartmouth College.

Dr. French Speaks

“The theory is institutions are smarter than ‘dumb’ individual and can add value,”

said French.

“That is simply not true.”

His research has found that institutions are no better at trying to beat the market than individual investors. When you pay someone to do better than the market, French told us,

“You should expect to lose. It’s really hard to identify the great managers. You are wasting your time and money trying to beat the market.”

If there’s no point in trying to beat the market through “active” investing, what is the best way to invest? Through “passive” investing, that accepts average market returns. You need to reduce expenses, diversify your portfolio into index funds of various asset classes, minimize taxes, and exhibit discipline.

  1. Reduce expenses. Passive investing generally costs around 0.20% a year in fees, compared to around 1.35% for active investing.
  2. Diversify into index funds. Simply select an index in the asset classes you want to hold. The inherent strategy of the index will determine when to buy and sell. For example, the inherent strategy of the S&P 500 is to own a fraction of the largest 500 companies in the US. Every June, those companies that fell out of the top 500 largest are sold and those that made it into the top 500 are purchased.
  3. Minimize taxes. The limited buying and selling of passive investing tends to reduce investment-related taxes.
  4. Exhibit discipline. Relying on the inherent strategy of an index fund puts some distance between you and buying/selling decisions, making it easier to maintain your investment discipline during market fluctuations.

You may be thinking that, if “passive” is the way to go, you might as well make things even simpler. Why not just put your retirement money in the bank and forget it? While you can certainly do that, the results may be disastrous. If you want more than just Social Security for your retirement, you need your money to grow.

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stock-exchange

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Considerations

In 1913, nine cents bought a quart of milk. In 1963, the same nine cents bought a small glass of milk. In 2015, nine cents bought seven tablespoons of milk. Clearly, putting money under the mattress doesn’t work for the long term. The culprit of the declining purchasing power of that nine cents is inflation. The moral of this story is to make sure your money grows at least as fast as inflation. That requires investing it.

Example:

It would require $13 today to equal the purchasing power that $1 provided in 1926. Had you put one dollar in the bank in 1926, you would have $21 today. Having invested the dollar in long-term bonds would give you $132. However, invested in the S&P 500 Index (stocks), you would have $5,386.

A Mix

Does that mean you should invest all of your retirement assets in stocks? If you are one year old, probably so. If you are 60 years old, probably not. For most of us, a mixture of index funds that include many asset classes—such as global stocks, global bonds, global real estate, and commodities—is the best strategy.

Assessment

Research supports the value of diversified passive investing as long-term strategy. According to a study by Dalbar, Inc., average passive investors earn 3% to 4% more annually than average active investors. Over time, that makes a huge difference.

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

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On Elon Musk’s Twitter Purchase

A Guest Column by Ryan Bernier

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What the Skeptics and Naysayers Miss about Elon Musk’s Twitter Purchase

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EDITOR’S NOTE: I first Met Richard Helppie when I was in business school. He was the CEO of Superior Consultant at the time and very gracious to me with with his advice. Today he is a respected philanthropist and publisher of The Common Bridge. -David E. Marcinko

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Wither DROP-IN Group Medical Appointments?

THE RE-EMERGING RE-VOLUTION!

By Dr. David Edward Marcinko MBA CMP®

CMP logo

SPONSOR: http://www.CertifiedMedicalPlanner.org

HISTORY

DIGMAs (Drop-In Group Medical Appointments) are medical office appointments with a patient’s physician that take place in a supportive group setting. The model, developed in 1996 by Kaiser Permanente psychologist Dr. Ed Noffsinger, is a combination of an extended medical appointment with the patient’s own physician and effective group learning and support.

The group consists of the physician, a behavioral health professional, and patients from the physician’s panel. DIGMAs are best suited for routine appointments. Unfortunately, the nascent concept was met with mockery and great derision after the PP-ACA era.

PRANKSTERS: https://medicalexecutivepost.com/2016/01/31/group-drop-in-doctor-visits-evolving/

Today, after the pandemic and with the rise of tel-health and tele-medicine, Shared Medical Appointments (SMAs), also known as Group Medical Visits [GMVs], are again a growing topic of discussion among providers and health economists, looking for ways to increase access to care and improve efficiency. The group visit format is also getting more attention in recent years as a strategy to add value for the patient. They typically involve up to a dozen patients or so and offer various efficiencies as well as benefits of shared discussion and experiences.

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Behavioral Changes

Moreover, physicians and medical providers know that simply telling patients what to do often does not improve their health. The basic premise of DIGMAs, SMAs and GMVs is to build more patient engagement and inspire lasting behavior change by offering patients the opportunity to share their personal experiences not only with their provider but also with other patients dealing with similar issues.

NEWER REALITY: https://www.hqontario.ca/Portals/0/Documents/qi/learningcommunity/Roadmap%20Resources/Advanced%20Access%20and%20Efficiency/Step%205/pc-nha-group-medical-appointments-manual-en.pdf#:~:text=DIGMAs%20%28Drop-In%20Group%20Medical%20Appointments%29%20are%20medical%20appointments,that%20take%20place%20in%20a%20supportive%20group%20setting.

BILLING: https://www.aafp.org/family-physician/practice-and-career/getting-paid/coding/group-visits.html

QUERY: Might this be an approach for tele-health visits as well as rural healthcare, etc.

ASSESSMENT: Your thoughts are comments are appreciated.

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What is the “Doppler” Effect?

How does it work?

[By staff reporters]

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The Doppler effect (or Doppler shift) is the change in frequency of a wave (or other periodic event) for an observer moving relative to its source. It is named after the Austrian physicist Christian Doppler, who proposed it in 1842 in Prague. It is commonly heard when a vehicle sounding a siren or horn approaches, passes, and recedes from an observer.
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An animation illustrating how the Doppler effect causes a car engine or siren to sound higher in pitch when it is approaching than when it is receding. The pink circles represent sound waves.

Passing car horn

Wikipedia: The reason for the Doppler effect is that when the source of the waves is moving towards the observer, each successive wave crest is emitted from a position closer to the observer than the crest of the previous wave. Therefore, each wave takes slightly less time to reach the observer than the previous wave. Hence, the time between the arrivals of successive wave crests at the observer is reduced, causing an increase in the frequency. While they are traveling, the distance between successive wave fronts is reduced, so the waves “bunch together”. Conversely, if the source of waves is moving away from the observer, each wave is emitted from a position farther from the observer than the previous wave, so the arrival time between successive waves is increased, reducing the frequency. The distance between successive wave fronts is then increased, so the waves “spread out”.

For waves that propagate in a medium, such as sound waves, the velocity of the observer and of the source are relative to the medium in which the waves are transmitted. The total Doppler effect may therefore result from motion of the source, motion of the observer, or motion of the medium. Each of these effects is analyzed separately. For waves which do not require a medium, such as light or gravity in general relativity, only the relative difference in velocity between the observer and the source needs to be considered.

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

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COVID: US Public Health Emergency Extended

By Staff Reporters

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The US will extend its Covid public health emergency through the spring of 2023 in anticipation of another winter surge.

The emergency, first issued in January 2020, broadens eligibility for both Medicaid and the Children’s Health Insurance Program, and the government estimates that ~15 million people will lose their benefits from those programs once it ends.

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What Doctors Must Do to File an AETNA® Medical Claim to Get Paid?

WITH ADJUDICATION CONSIDERATIONS

By Anonymous MD

Now you will learn and know just one reason why doctors are pulling their hair out, felling stress, burn out and may even consider suicide?

Only 54 pages of steps for one electronic claim.

READ: https://www.aetnabetterhealth.com/florida/assets/pdf/provider/Claims%20Training%20Powerpoint1.pdf

  AETNA® – We are NOT glad we met ya!

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