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CASH BALANCE PLANS: Hybrid Retirement Savings for Physicians

Posted on November 17, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

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Retirement planning has evolved significantly over the past several decades, with employers and employees seeking solutions that balance security, flexibility, and predictability. Among the various retirement plan options available today, cash balance plans stand out as a hybrid design that combines features of both traditional defined benefit pensions and defined contribution plans. Their unique structure makes them an attractive choice for employers aiming to provide meaningful retirement benefits while maintaining financial predictability.

At their core, cash balance plans are a type of defined benefit plan. Unlike traditional pensions, which promise retirees a monthly income based on years of service and final salary, cash balance plans define the benefit in terms of a hypothetical account balance. Each participant’s account grows annually through two components: a “pay credit” and an “interest credit.” The pay credit is typically a percentage of the employee’s salary or a flat dollar amount, while the interest credit is either a fixed rate or tied to an index such as U.S. Treasury yields. Although the account is hypothetical—meaning the funds are not actually segregated for each employee—the structure provides participants with a clear, understandable statement of their retirement benefit.

One of the primary advantages of cash balance plans is their transparency. Employees can easily track the growth of their account balance, much like they would with a 401(k). This clarity helps workers better understand the value of their retirement benefits and fosters a sense of ownership. Additionally, cash balance plans are portable: when employees leave a company, they can roll over the vested balance into an IRA or another qualified plan, ensuring continuity in retirement savings.

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From the employer’s perspective, cash balance plans offer several benefits as well. Traditional pensions often create unpredictable liabilities, as they depend on factors such as longevity and investment performance. Cash balance plans, by contrast, provide more predictable costs because the employer commits to specific pay and interest credits. This predictability makes them easier to manage and budget for, particularly in industries where workforce mobility is high. Moreover, cash balance plans can be designed to reward long-term employees while still appealing to younger workers who value portability.

Despite these advantages, cash balance plans are not without challenges. Because they are defined benefit plans, employers bear the investment risk and must ensure the plan is adequately funded. Regulatory requirements, including nondiscrimination testing and funding rules, add complexity and administrative costs. Additionally, while cash balance plans are generally more equitable across generations of workers, transitions from traditional pensions to cash balance designs have sometimes sparked controversy, particularly among older employees who may perceive a reduction in benefits.

In recent years, cash balance plans have gained popularity among professional firms, such as law practices and medical groups, as well as small businesses seeking tax-efficient retirement solutions. These plans allow owners and highly compensated employees to accumulate larger retirement savings than would be possible under defined contribution limits, while still providing benefits to rank-and-file workers. As such, they serve as a valuable tool for both talent retention and financial planning.

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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 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", Accounting, Ask a Doctor, finance, Financial Planning, Glossary Terms, Investing, Portfolio Management, Retirement and Benefits, Taxation, Touring with Marcinko | Tagged: cash balance plans, david marinko, defined benefit plans, doctors, Financial Planning, Investing, personal-finance, physicians, retirement planning, retirement plans, tax, taxes | Leave a comment »

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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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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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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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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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 »

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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NFT: Non-Fungible Tokens Defined

Posted on October 23, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

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NFTs, or Non-Fungible Tokens, are unique digital assets stored on a blockchain that represent ownership of a specific item or piece of content. Unlike cryptocurrencies like Bitcoin or Ethereum, which are fungible and interchangeable, NFTs are one-of-a-kind and cannot be exchanged on a one-to-one basis.

In recent years, Non-Fungible Tokens (NFTs) have emerged as a groundbreaking innovation in the digital world, revolutionizing how we perceive ownership, art, and value online. At their core, NFTs are cryptographic tokens that represent a unique digital item or asset. These tokens are stored on a blockchain—a decentralized digital ledger—which ensures that each NFT is verifiable, traceable, and immutable.

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NFTs 101: Taxes, Risks, and More

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The term “non-fungible” means that each token is distinct and cannot be replaced with another token of equal value. This contrasts with fungible assets like dollars or cryptocurrencies, where each unit is identical and interchangeable. For example, one Bitcoin is always equal to another Bitcoin. However, each NFT has its own metadata, ownership history, and attributes, making it unique and often valuable.

NFTs can represent a wide range of digital content, including artwork, music, videos, virtual real estate, gaming items, and even tweets. Artists and creators have embraced NFTs as a new way to monetize their work, bypassing traditional gatekeepers like galleries and record labels. By minting their creations as NFTs, they can sell them directly to collectors and fans, often earning royalties from future resales thanks to smart contracts embedded in the blockchain.

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IRS: Tax Treatment of NFTs and Crypto-Currency

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One of the most popular blockchains for NFTs is Ethereum, which supports smart contracts and has a robust ecosystem for digital assets. Platforms like OpenSea, Rarible, and Foundation have become marketplaces where users can buy, sell, and trade NFTs. These platforms often require users to have a digital wallet and use cryptocurrency to complete transactions.

The rise of NFTs has sparked debates about their environmental impact, speculative nature, and long-term value. Critics argue that the energy consumption of blockchain networks can be significant, especially those using proof-of-work mechanisms. Others worry that the NFT market is driven by hype and may not sustain its current levels of interest and investment. Nonetheless, proponents believe that NFTs offer a new paradigm for digital ownership and creativity, empowering artists and reshaping industries from gaming to fashion.

In conclusion, NFTs represent a fusion of technology, art, and commerce, offering a novel way to own and trade digital assets. As the technology matures and adoption grows, NFTs may become a standard part of our digital lives, influencing how we interact with content, creators, and each other in the virtual world.

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Understanding 4 Key Financial Psychological Biases

Posted on October 19, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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The following are 4 common financial psychological biases. Some are learned while others are genetically determined (and often socially reinforced). While this essay focuses on the financial and investing implications of these biases, they are prevalent in most areas in life.

STOCK MARKET: https://medicalexecutivepost.com/2024/10/13/stock-market-a-zero-sum-bias/

Loss aversion affected many investors during the stock market crash of 2007-08 or the flash crash of May 6, 2010 also known as the crash of 2:45. During the crash, many people decided they couldn’t afford to lose more and sold their investments.

Of course, this caused the investors to sell at market troughs and miss the quick, dramatic recovery.

Overconfident investing happens when we believe we can out-smart other investors via market timing or through quick, frequent trading.

Data convincingly shows that people who trade most often under-perform the market by a significant margin over time.

Mental accounting takes place when we assign different values to money depending on where we got it.

For instance, even though we may have an aggressive saving goal for the year, it is likely easier for us to save money that we worked for than money that was given to us as a gift.

Herd mentality makes it very hard for humans to not take action when everyone around us does.

For example, we may hear stories of people making significant profits buying, fixing up, and flipping homes and have the desire to get in on the action, even though we have no experience in real estate.

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

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Understanding Investment Fees: A Guide for Physicians

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

SPONSOR: http://www.MarcinkoAssociates.com

By Dr. David Edward Marcinko MBA MEd CMP™

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MEDICAL COLLEAGUES BEWARE!

Investment fees still matter for physicians and all of us, despite dropping dramatically over the past several decades due to computer automation, algorithms and artificial intelligence, etc. And, they can make a big difference to your financial health. So, before buying any investment thru a financial advisor, planner, manager, stock broker, etc., it’s vital to understand these two often confusing costs.

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Fee Only: Paid directly by clients for their services and can’t receive other sources of compensation, such as payments from fund providers. Act as a fiduciary, meaning they are obligated to put their clients’ interests first

Fee Based: Paid by clients but also via other sources, such as commissions from financial products that clients purchase. Brokers and dealers (registered representatives) are simply required to sell products that are “suitable” for their clients. Not a fiduciary.

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 a RFP for speaking engagements: MarcinkoAdvisors@outlook.com

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Understanding Behavioral Finance Paradoxes

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

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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“THE INVESTOR’S CHIEF problem—even his worst enemy—is likely to be himself.” So wrote Benjamin Graham, the father of modern investment analysis.

With these words, written in 1949, Graham acknowledged the reality that investors are human. Though he had written an 800 page book on techniques to analyze stocks and bonds, Graham understood that investing is as much about human psychology as it is about numerical analysis.

In the decades since Graham’s passing, an entire field has emerged at the intersection of psychology and finance. Known as behavioral finance, its pioneers include Daniel Kahneman, Amos Tversky and Richard Thaler. Together, they and their peers have identified countless human foibles that interfere with our ability to make good financial decisions. These include hindsight bias, recency bias and overconfidence, among others. On my bookshelf, I have at least as many volumes on behavioral finance as I do on pure financial analysis, so I certainly put stock in these ideas.

At the same time, I think we’re being too hard on ourselves when we lay all of these biases at our feet. We shouldn’t conclude that we’re deficient because we’re so susceptible to biases. Rather, the problem is that finance isn’t a scientific field like math or physics. At best, it’s like chaos theory. Yes, there is some underlying logic, but it’s usually so hard to observe and understand that it might as well be random. The world of personal finance is bedeviled by paradoxes, so no individual—no matter how rational—can always make optimal decisions.

As we plan for our financial future, I think it’s helpful to be cognizant of these paradoxes. While there’s nothing we can do to control or change them, there is great value in being aware of them, so we can approach them with the right tools and the right mindset.

Here are just seven of the paradoxes that can bedevil financial decision-making:

There’s the paradox that all of the greatest fortunes—Carnegie, Rockefeller, Buffett, Gates—have been made by owning just one stock. And yet the best advice for individual investors is to do the opposite: to own broadly diversified index funds.
There’s the paradox that the stock market may appear overvalued and yet it could become even more overvalued before it eventually declines. And when it does decline, it may be to a level that is even higher than where it is today.
There’s the paradox that we make plans based on our understanding of the rules—and yet Congress can change the rules on us at any time, as it did just last year.
There’s the paradox that we base our plans on historical averages—average stock market returns, average interest rates, average inflation rates and so on—and yet we only lead one life, so none of us will experience the average.
There’s the paradox that we continue to be attracted to the prestige of high-cost colleges, even though a rational analysis that looks at return on investment tells us that lower-cost state schools are usually the better bet.
There’s the paradox that early retirement seems so appealing—and has even turned into a movement—and yet the reality of early retirement suggests that we might be better off staying at our desks.
There’s the paradox that retirees’ worst fear is outliving their money and yet few choose the financial product that is purpose-built to solve that problem: the single-premium immediate annuity.

How should you respond to these paradoxes? As you plan for your financial future, embrace the concept of “loosely held views.”

In other words, make financial plans, but continuously update your views, question your assumptions and rethink your priorities.

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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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INVESTING TRANSFORMATION: Artificial Intelligence

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

By Co-Pilot and A. I.

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Artificial Intelligence and Investing: A Transformative Partnership

Artificial Intelligence (AI) is revolutionizing the world of investing, reshaping how decisions are made, risks are assessed, and portfolios are managed. As financial markets grow increasingly complex and data-driven, AI offers powerful tools to navigate this landscape with greater precision, speed, and insight.

At its core, AI refers to systems that can perform tasks typically requiring human intelligence—such as learning, reasoning, and problem-solving. In investing, this translates into algorithms that can analyze vast amounts of financial data, detect patterns, and make predictions with remarkable accuracy. Machine learning, a subset of AI, enables these systems to improve over time by learning from new data, making them especially valuable in dynamic markets.

One of the most significant applications of AI in investing is algorithmic trading. These systems can execute trades at lightning speed, responding to market fluctuations in milliseconds. By analyzing historical data and real-time market conditions, AI-driven trading platforms can identify optimal entry and exit points, often outperforming human traders. High-frequency trading firms have long relied on such technologies to gain competitive advantages.

AI also enhances portfolio management through robo-advisors—digital platforms that use algorithms to provide personalized investment advice. These tools assess an investor’s goals, risk tolerance, and time horizon, then construct and manage a diversified portfolio accordingly. Robo-advisors democratize access to financial planning, offering low-cost, automated solutions to individuals who might not afford traditional advisory services.

Risk assessment is another area where AI shines. By processing alternative data sources—such as social media sentiment, news articles, and satellite imagery—AI can uncover hidden risks and opportunities. For instance, a sudden spike in negative sentiment around a company on Twitter might signal reputational issues, prompting investors to reevaluate their positions. AI models can also forecast macroeconomic trends, helping investors anticipate shifts in interest rates, inflation, or geopolitical events.

Moreover, AI is transforming fundamental analysis. Natural language processing (NLP) allows machines to read and interpret earnings reports, SEC filings, and analyst commentary. This enables investors to extract insights from unstructured data that would be time-consuming to analyze manually. AI can even detect subtle linguistic cues that may indicate a company’s future performance or management’s confidence.

Despite its advantages, AI in investing is not without challenges. Models can be opaque, making it difficult to understand how decisions are made—a phenomenon known as the “black box” problem. There’s also the risk of overfitting, where algorithms perform well on historical data but fail in real-world scenarios. Ethical concerns, such as bias in data and the potential for market manipulation, must also be addressed.

In conclusion, AI is reshaping the investing landscape, offering tools that enhance efficiency, accuracy, and accessibility. While it’s not a panacea, its integration into financial markets marks a profound shift in how capital is allocated and wealth is managed. As technology continues to evolve, investors who embrace AI will be better positioned to thrive in an increasingly data-driven world.

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Why You Shouldn’t Trust Your Financial Advisor’s Awards

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

OVERHEARD IN THE DOCTOR’S LOUNGE

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By D. Kellus Pruitt DDS

According to money journalists Max Tailwagger and Allan Roth of MoneyWatch, the trade publication Medical Economics Magazine [“advertising supplement”] nearly listed a dog on its’ 2013 list of Best Financial Advisors for Doctors. Indeed, being listed as a top financial advisor in this publication would enhance any advisor’s credibility as well as reach a high income readership.

For example, several advisors in the Financial Planning Association, mentions this prestigious award year after year. And, the NAPFA organization of fee-only financial planners has issued press releases when member advisors make this annual list. In fact, in 2008, it touted that 52/150 listed FAs were NAPFA members.

Yet, the dog is well known in the financial advisory world, having allegedly received a plaque as one of 2009 America’s Top Financial Planners by the Consumers’ Research Council of America, and has appeared in several books including Pound Foolish and Money for Life. The fee for Maxwell Tailwagger CFP® [a five year old Dachshund] was reported to be $750 with $1,000 for a bold listing. Colorado Securities Commissioner Fred Joseph is reported to have said, “Once again, Max is gaining national notoriety for his astute, and almost superhuman, abilities in the financial arena.”

The only two qualifications for the listing were to pay the fee and not have a complaint against them. In 2009, James Putman, then the NAPFA chairman who touted his own Medical Economics award, was charged by the SEC for securities fraud. NAPFA spokesperson Laura Fisher allegedly opined that “NAPFA no longer promotes the Medical Economics Top Advisors for Doctors list. We felt promoting a list that included stock-brokers was inconsistent with NAPFA’s mission to advance the fee-only profession.” When an advisor name drops an honor to you, congratulate him and then ask how s/he achieved the award. Ask how many nominees versus award recipients there were. What were the criteria for selection and how were they nominated. Ask if they had to pay for the honor, and go online to check out the organization.

Then ask yourself this question: If your financial advisor is buying credibility, do you really want to trust your financial future to him or her?

Source: http://www.cbsnews.com/news/dog-nearly-fetches-prestigious-financial-advisor-honor/

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Using Debt Wisely to Build Wealth

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

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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Sometimes debt is a necessary tool in building wealth

Using debt to build wealth might seem counterintuitive. After all, when you calculate your wealth, you look at what you own (assets) and subtract what you owe (debts and liabilities) to determine what your net worth (wealth) is.

It’s easy to oversimplify that debt is bad and is harmful to your wealth. Because some debt is really harmful, like credit cards, automobile, debt gets lumped into the category of “bad.”

But some types of debt can be useful and sometimes necessary to create wealth; home, education, business, etc. For folks that don’t readily have access to large sums of cash or capital, debt may be the tool that allows them to expand.

Borrow Carefully * Invest Wisely!

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Financial Planning for Physicians: Achieve Your Goals

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

By: http://www.MarcinkoAssociates.com

Your medical practice. Your personal goals. Your financial plan. Our experienced confirmation guide.

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When you know exactly where you are today, have a vision of where you want to be tomorrow, and have trusted counsel at your side, you have already achieved so much success. Marcinko Associates works to keep you at that level of confidence every day. We use a comprehensive economic process to uncover what’s most important to you and then develop a financial strategy that gives you the highest probability of achieving your monetary goals.

We assess, plan, and opine for your success

To accurately see where you are today, chart a strategic path to your goals and help you make the most informed decisions to keep you on financial track, our key services for physicians and high net worth medical clients include:

Investment Portfolio Review
Fee, Charge and Cost Review
Comprehensive Financial Planning
Insurance Reviews
Estate Planning
Investment and Asset Management Second Opinions

We take a deep dive into your financial retirement plans

Physicians and dental employers now have options for how to design and deliver retirement benefits and we can help you make the best choice for your healthcare business. Our services for retirement plans include:

Fee, Charges & Fiduciary Review
Portfolio Analysis
Single Employer Retirement Plan Advisory
Retirement Plans Risk Analysis
Capital Funding and Financing
Business Planning and Practice Valuations
Career Development
and more!

We take a broad and balanced look at your financial life life

We coordinate our recommendations with your other advisors, including attorneys, accountants, insurance professionals and others, to ensure each decision is consistent with your goals and overall strategy. For example, through our partnerships we offer physician colleagues deeper expanded advisory services, like:

Estate, Gift, and Trust Planning
Tax Planning and Compliance
Medical or Dental Practice Worth
Business Succession Planning
Practice Exit Planning
Transaction Advisory Services
and more!

EDUCATION: Books

CONTACT US TODAY: Ann Miller RN MHA at: MarcinkoAdvisors@outlook.com

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Fiduciary Financial Colleagues Advising Medical Colleagues … in Turbulent Times!

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Stocks, Bonds and Crypto-Currrency

Posted on September 26, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By A.I. and Staff Reporters

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Bonds: The 10-year Treasury yield popped on solid economic data yesterday, including weekly jobless claims falling to their lowest since mid-July and Q2 GDP rising unexpectedly.
Stocks: But good news for the labor market and economy is bad news for anyone hoping the Federal Reserve cuts interest rates next month, and the major indexes sank for a third day in a row yesterday. All eyes now turn to today’s key PCE reading.
Crypto: Digital assets continued to tumble yesterday with ether falling below $4,000 for the first time in months. There may be more pain ahead: $22 billion in crypto options expire today.

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Why Many Doctors Struggle Financially: 5 Key Reasons

Posted on September 23, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By A.I. and Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Despite their high salaries, not all doctors are wealthy, and some live paycheck to paycheck. Here are 5 reasons why many doctors today are broke, according to https://medschoolinsiders.com

1 | Believing They Are Universally Smart

The first reason so many doctors are broke is that many doctors believe they are universally smart. While most doctors have deep specialized knowledge, there’s a big difference between being smart in your profession and being smart with money. A physician’s schooling is quite thorough when it comes to the human body, but med school doesn’t include a prerequisite class on how to handle finances.

MORE: https://medicalexecutivepost.com/2022/11/18/what-is-the-dunning-kruger-effect/

Graduating medical school is a major feat and certainly demonstrates superior work ethic and cognitive abilities. But many new doctors believe these accomplishments transcend all aspects of life. If you’re smart enough to earn an MD, you’re certainly smart enough to handle your finances, but only once you properly and intentionally educate yourself.

The truth is doctors, especially traditional graduates, haven’t had an opportunity to manage large sums of money until they become fully trained attending physicians and start pulling in low to mid six figures in income. Prior to that, there was very little of it to manage.

Far too many aspiring doctors, and students in general, don’t take the time to learn financial basics, in part because it’s uncomfortable and seems like something they can figure out “later”, whenever that may be. Their poor spending habits and lack of investment knowledge carry over into their careers, causing many to make irresponsible decisions.

MORE: https://medicalexecutivepost.com/2025/07/17/doctors-and-lawyers-often-arent-millionaires/

2 | Overspending Too Soon

The second factor is overspending too soon, and this comes up at two points in training.

First, it’s natural to want to start spending more as soon as you get into residency and start making a little more money. After all, you’ve been a broke student for 8 or more years, and now you’re finally making a reasonable and reliable wage. But that’s where young doctors get into trouble. Residency pays, but not nearly as much as you will be making once you become an attending physician. The average resident makes about $60K a year, and if you begin spending all of that money right away, thinking you’ll handle your loans once you become an attending, you delay paying off your medical school debt, which means the compounding effect through your student loan interest rate works against you.

Now that $250,000 in student loans has ballooned to over $350,000 by the time you finish residency. The compounding effect, which can be one of your greatest allies in your financial life, becomes an equally powerful enemy when working against you through debt. But of course, pinching pennies is easier said than done, especially when you’re in residency and are surrounded by peers in different professions. They’ve been earning good money much longer than you have, and they can afford more luxurious lifestyles.

They may not be worried about indulging in fine dining or how much a hotel costs when traveling. Students in college and medical school are often confident they will resist the temptations, but the desire to keep up with your friends and family can be difficult to ignore, which causes many to overspend before they technically have the money to do so.

The same is true of attending physicians. As soon as those six-figure salaries come rolling in, many physicians go overboard with spending, trying to make up for lost time and to treat yourself.

Now, we are not suggesting you shouldn’t reward yourself for completing residency, but that reward shouldn’t be a Lamborghini. It’s best to continue living like a resident in your first few years after becoming an attending to pay off loans, put a down payment on a home, and get your financial foundation built before loosening the purse strings.

3 | Decreasing Salaries

Third, doctors continue to make less money than they did before. And this includes nearly all 44 medical specialties. For example, while physician compensation technically rose from $343k to $391k between 2017 and 2022, this rise does not keep up with inflation. The real average compensation in 2022 was less than $325k—a $20k decrease in purchasing power in only six years.

For doctors who are already spending to the limits of their salaries with huge mortgages, car payments, business costs, and other luxuries, a decreased salary can have a huge impact. You might be able to cut back by going on fewer vacations or eating out less frequently, but many accrued costs are locked in, such as a mortgage payment, car loan, or leased rental space for your practice.

4 | Increasing Costs of Private Practice

In the past, running a private practice was much simpler, but recent stricter guidelines and regulations have made it difficult for solo practices to keep up. While regulations like the Health Insurance Privacy and Portability Act, or HIPAA, and mandatory Electronic Medical Records, or EMRs, are necessary to protect patients, they make costs higher for physicians who run their own private practice. These physicians need to spend their own money to set up and maintain EMRs as well as invest in security to ensure patient data is protected.

With the steep rise of inflation we’ve seen over the past couple of years, everything is more expensive, which means costs, such as business space, equipment, and even office supplies, have gone up for private practice physicians while salaries have not. 2013 to 2020 saw an annual inflation rate of anywhere from 0.7% to 2.3%. This skyrocketed to an annual inflation rate of 7.0% in 2021 and another 6.5% in 2022. In fact, the cost of running a private practice has increased by almost 40% between 2001 and 2021.

These increased costs are exacerbated by another problem plaguing private practices; decreased reimbursement. While costs increased by almost 40%, Medicare reimbursement only increased by 11%. When doctors see patients who are insured, the insurance companies pay the physicians for their time. For Medicare, the new proposed rules for 2023 would cut reimbursement by around 5%. When adjusting for inflation, Medicare reimbursement decreased by 20% in the last 20 years.

These costs add up, making it extremely difficult for physicians to thrive financially while running a private practice.

5 | Tuition Debt

Lastly, we can’t talk about a doctor’s finances without mentioning the exorbitant debt so many graduating physicians are left with. It won’t shock you to hear that med school is expensive. Extremely expensive. The average cost of tuition for a single year is nearly $60k, with significant variance from school to school, and that’s before accounting for living expenses.

In-state applicants pay less than out-of-state applicants, and students at private schools typically pay more than students at public medical schools. The astronomical costs mean the vast majority of students can’t pay for medical school out of their own pockets. And unless your family is part of the 1%, even with your parents footing the bill, it’s difficult to cover tuition, let alone rent, groceries, transportation, tech, social activities, exam fees, and application costs.

The average total student debt after college and med school is over $250k. But keep in mind that’s the average, which includes 27% of students who graduate with no debt at all. This means the vast majority of students leave medical school owing much more than $250k.

For some perspective, in 1978, the average debt for graduating MDs was $13,500, which, when adjusted for inflation, is a little over $60,000. There are multiple ways to eventually repay these loans, but time and discipline are essential to ensure this money is paid off as quickly as possible.

MORE: https://medicalexecutivepost.com/2024/12/03/12-investing-mistakes-of-physicians/

THE FINANCIAL FIX

According to financial advisor Dr. David Edward Marcinko MEd MBA CMP™; consider the following:

Place a portion of your salary (15-20% or more) into a savings account, and another portion (10-20% or more) into wise investments [stocks, bonds, mutual funds, and/or ETFs].

Pay off your bills each month, and then use leftover spending money to purchase fun things like vacations and fancy dinners, within your means. Shop sales, buy used clothes, and use credit card points for travel.

Hire an excellent tax professional and meet with an investment advisor once or twice a year about your investment status and strategy. http://www.MarcinkoAssociates.com

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DOCTORS: Early Investing Needed for Retirement

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

NEW FINANCIAL STRATEGIES?

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

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SPONSOR: http://www.CertifiedMedicalPlanner.org

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Starting early is key to saving for retirement

Although 97% of people aren’t yet millionaires, many could eventually meet that target if they start investing sooner rather than later; especially doctors [MD, DO, DPM, DDS or DMD].

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

A 20-year-old, for instance, needs to invest just $330 a month into an asset class that delivers a 7% to 8% annual return to reach $1.26 million by the time s/he turns 65 years old. The luxury of time significantly boosts your chances of becoming a millionaire.

This doesn’t mean it’s too late for middle-aged savers to reach that millionaire milestone, but it will take a significantly greater investment. If a 50-year-old doctor hasn’t started saving for retirement, s/he would need to invest $3,958 a month at a steady 7% return to reach $1.26 million by retirement.

MONEY ADDICTION: https://medicalexecutivepost.com/2025/08/07/moiney-addicted-physicians-the-investing-and-trading-personality-of-doctors/

However, according to one Goldman Sachs report, investors could expect the S&P 500 to deliver just 3% annualized nominal returns over the next 10 years.

After an average 13% yearly return for the past decade, a new strategy outside of the stock market may be needed for that level of outsized gain, especially if you’re late to investing.

RETIREMENT VISION: https://medicalexecutivepost.com/2025/08/04/physicians-determine-your-retirement-vision/

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

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Understanding Newton’s First Law of Start-Up Investing

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

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Understanding Newton’s First Law of Startup Investing

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7 Ways to Fund Your Start-Up Without Venture Capital

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

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7 Ways to Fund Your Startup Without Venture Capital

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PHYSICIANS: Alimony V. Palimony

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

By A.I. and Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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What is Alimony

According to Hello Divorce, alimony, often referred to as spousal support, is a court-ordered payment from one spouse to the other following a divorce or legal separation. Its existence is tied to the legal status of marriage. The underlying principle is that both spouses contributed to the marital standard of living, and the dissolution of the marriage should not cause an inequitable economic outcome for the lower-earning spouse. This support is not intended as a punishment but as a means of mitigating the financial impact of divorce.

The purpose of alimony can vary. In some cases, it is rehabilitative, providing temporary support while one spouse obtains education or job training to become self-sufficient. For longer marriages, it might serve to help maintain the standard of living established during the partnership. Alimony is a legal tool derived from family law statutes to address the financial interdependence created by marriage.

DIVORCE: https://medicalexecutivepost.com/2025/08/14/physician-divorce-within-the-medical-profession/

Note: The federal tax treatment for alimony changed with the Tax Cuts and Jobs Act of 2017. For any divorce or separation agreement executed after December 31st, 2018, alimony payments are no longer tax-deductible for the person paying them. The recipient of the support does not report the payments as taxable income. This change is permanent and does not expire with other provisions of the act.

What is Palimony

According to Wikipedia, Palimony refers to financial support that may be awarded after an unmarried couple separates. Unlike alimony, palimony is not rooted in family law but is a concept derived from contract law. An award depends on the existence of an agreement between the partners. This agreement can be a formal written contract or an oral or implied agreement for support in exchange for services, such as managing the household.

The legal basis for palimony was established by the 1976 California Supreme Court case, Marvin v. Marvin. In that case, the court ruled that unmarried cohabitants could make enforceable contracts for support, as long as the agreement was not based on sexual services. Because it is a contract claim, a palimony case is pursued in civil court, not family court. Palimony is not available in all states and is only recognized in a minority of jurisdictions.

MEDIATION: https://medicalexecutivepost.com/2023/08/12/a-step-wise-approach-to-the-divorce-mediation-process-for-doctors/

Note: The tax implications of palimony are less defined than alimony because the IRS does not have a specific rule for it. How palimony is treated depends on the nature of the underlying claim. If the payments are a settlement for services rendered, they may be considered taxable income to the recipient. If the payments are characterized as a gift, they are not considered taxable income for the recipient.

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PHYSICIANS: Why Salary is Down?

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

MEDICAL PROVIDER PAYMENTS LOWERED

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Statistic: $2.8+ billion dollars

That’s how much Blue Cross and Blue Shield plans agreed to pay to settle litigation over claims they conspired to lower payments to providers. (Healthcare Dive)

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PHYSICIANS BEWARE: The APR Car Lease “Money Factor”

Posted on August 25, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

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

SPONSOR: http://www.CertifiedMedicalPlanner.org

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What is it?

The so-called money factor (abbreviated as MF on invoices) is a number in a decimal form that dealers use to calculate the APR of a car lease. It’s a major part of your monthly payment and dealers are known to jack up the money factor to pad their profits.

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

How it works

Most doctors don’t ask to see it because they’re not aware of it or don’t know how to calculate it. Ask to see the money factor, then multiply it by 2,400.

For example, if the money factor is .00150, you multiply it by 2,400 to get 3.6%. If that’s higher than the prevailing rate, you have room to talk them down.

How to reduce it

So how do you get a good interest rate when you lease a vehicle? The same way you do when borrowing for any other reason, whether it’s buying a home or applying for a personal loan: by having good credit. This may reduce your interest rate because you’ll represent a lower risk to a lender.

A high residual value on the car could also help you get a better interest rate. A higher residual value means you’d have lower monthly payments because there would be less depreciation on the vehicle. Since interest is applied to your monthly payment, a lower monthly payment would equate to reduced interest charges.

MONEY DOCTORS: https://medicalexecutivepost.com/2025/04/08/psychology-a-money-relationship-questionnaire-for-doctors/

Financial implications

The money factor is one of the many numbers you may want to learn about when leasing a car. It’s one of the transactional costs that come with leasing, and allows dealers and finance companies to make a profit on every lease they execute. As a consumer, it’s a smart idea to learn the financial implications of this number and how it’ll affect your overall costs over the course of a multi-year lease.

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If the interest rate is too high, you may need to shop around for a better rate, negotiate with the dealer or lender to lower the money factor, or consider leasing another vehicle that’s more in line with your budget. Either way, make sure you explore all your financial options before taking a car off the lot.

SALARY NEGOTIATIONS: https://medicalexecutivepost.com/2016/08/21/salary-negotiations-skills-for-doctors-hospitalists/

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NET WORTH: Defined for Physicians

Posted on August 23, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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What does net worth really mean?

Net worth is everything you own of significance (Assets) minus what is owed in debts (Liabilities). Assets include cash and investments, real estate, cars and anything else of value.

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

How is net worth calculated? Assets – Debt = Net Worth. Net worth is calculated by adding all owned assets (anything of value) and then subtracting all of your liabilities.

Is net worth yearly? No, net worth is not yearly. Net worth isn’t inherently yearly but is often tracked on an annual basis to assess financial progress year over year.

What net worth is considered wealthy, rich and upper class?
In the U.S. salary average is around $59,000, and only 20% of Americans have a household income of $100,000 or more.

MONEY ADDICTION: https://medicalexecutivepost.com/2025/08/07/moiney-addicted-physicians-the-investing-and-trading-personality-of-doctors/

Is net worth the same as net income? No, net worth is not the same as net income. Net income is what you actually bring home after taxes and payroll deductions, like Social Security and 401(k) contributions.

Can one measure their net worth if they don’t have many assets or a high income? Yes. Knowing your net worth isn’t about the amount you have; it’s about understanding your financial position. It helps you track your progress, informs your financial decisions, and motivates you to improve your financial health, regardless of where you start.

HEDGE FUNDS: https://medicalexecutivepost.com/2025/06/08/hedge-funds-defined-for-doctors/

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SPECIAL PURPOSE VEHICLE: What it Is – When is It Needed?

Posted on August 21, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

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What is an SPV and When Do You Need One?

A SPECIAL MEDICAL-EXECUTIVE-POST GUEST PRESENTATION

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What Is a Special Purpose Vehicle (SPV)?

A special purpose vehicle is a subsidiary created by a parent company to isolate financial risk. It’s also called a special purpose entity (SPE). Its legal status as a separate company makes its obligations secure even if the parent company goes bankrupt. A special purpose vehicle is sometimes referred to as a bankruptcy-remote entity for this reason.

These vehicles can become a financially devastating way to hide company debt if accounting loopholes are exploited, as seen in the 2001 Enron scandal.

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PHYSICIAN GENDER FINANCIAL DIFFERENCES: In Marriage and Divorce

Posted on August 16, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

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Whatever the statistics regarding physician standard of living, the reality is that within most marriages the husband more frequently takes responsibility for understanding and managing the finances. Additionally, women are more likely to remain in the marital home following a separation, thus inheriting a large fixed expense that may prove be an excessive, albeit short-term burden to them. At the time the decision is made to separate or divorce, many women do not have an understanding of how to manage their household budget, or how to manage their assets and liabilities.

But, this is changing over time.

DIVORCE MONTH: https://medicalexecutivepost.com/2024/01/31/january-doctors-beware-divorce-month/

An issue many divorcing physicians face is that the other spouse (in the past the wife), may have concentrated their energies on managing the home, while the physician concentrated on earning and managing the finances. The problems of the spouse of a physician are often compounded in divorce; not only do they not understand their personal finances, but that their absence from the work force has made them financially dependent on the other.

At what probably be the most emotionally taxing time in their lives, they are forced to play catch-up.

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Taking a more active role in their own financial planning during the marriage may help the spouse of a physician avoid some of the financial pitfalls of separation and divorce.

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BENEFICIARY DESIGNATIONS: Top 10 Tips for Medical Professionals

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NOTE: Barbara Stanny provides an excellent overview and reading bibliography on how people can get smart about money in her book Prince Charming Isn’t Coming. [1]

[1] Penguin USA (paper), 1999.

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PHYSICIANS: Beware “Zombie” Debt and “Phantom” Debt Collectors

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

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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According to Wikipedia, Phantom debt or zombie debt is a debt that is old, defaulted, or not owed and is somehow still being pursued for collection to be paid by the presumed debtor. It generally refers to debt that is more than 3 years old, is long forgotten about or belonged to someone else – like someone with the same name or a deceased parent. The amount owed can grow to hundreds or thousands of dollars more than what was originally owed.

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

An example of this is from George Miller. George missed an 11 cent Verizon bill and seven years later it had grown to $4,000.00.

Sometimes it was never owed, was owed by a deceased parent, or that was previously owed by the presumed debtor, but was previously paid in full, settled, discharged via bankruptcy or a dismissed court case, is beyond the statute of limitations, or is otherwise not legally collectible, but that a collection agency or other similar service is aggressively attempting to collect, often fraudulently.

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MONEY ADDICTED PHYSICIANS: The Investing and Stock Trading Personality of Doctors

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While the concept of phantom debt is quite old, it has gotten a lot of attention since the 1990s.

Very often, collectors of phantom debt use intimidating, abusive, or otherwise illegal tactics in an attempt to collect phantom debt that include frequent phone calls, calls to the victim’s place of employment, or threats of scary consequences against the victim that sometimes include arrest and/or criminal prosecution. In the USA, such tactics violate the Fair Debt Collection Practices Act [FDCPA]

The source of phantom debt may be from collectors who buy the debt from other collectors for pennies on the dollar, some of which take action that is not legal in order to collect that debt. Unlawful techniques used include suing or threatening to sue, re-aging the debt on the victim’s credit report to circumvent limits on reporting, or falsely promising to remove a negative credit report entry in exchange for a partial payment.

PSYCHOLOGY MONEY: https://medicalexecutivepost.com/2025/04/08/psychology-a-money-relationship-questionnaire-for-doctors/

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PHARMACY BENEFITS MANAGER: The Business Model Explained?

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

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

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Business Model Defined

Doctors and dentists earn money by treating patients. CPAs and Attorneys have clients, and retail stores buy items low and sell them at higher prices. This is called a business model.

More formally, a business model identifies the products or services the business plans to sell, the target market, and any anticipated expenses, in order to outline how to generate a profit. Business models are important for both new and established businesses. They help companies attract investment, recruit talent, and motivate management and staff.

Businesses should regularly update their business model, or they’ll fail to anticipate trends and challenges ahead. Business models also help investors to evaluate companies that interest them and employees to understand the future of a company they may aspire to join.

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The Business Model of Pharmacy Benefits Managers

In the United States, health insurance providers often hire a third party to handle price negotiations, insurance claims, and distribution of prescription drugs. Providers that use such pharmacy benefit managers include commercial health plans, self-insured employer plans, Medicare Part D [drug] plans, the Federal Employees Health Benefits Program, and state government employee plans. PBMs are designed to aggregate the collective buying power of en-rollees through their client health plans, enabling plan sponsors and individuals to obtain lower prices for their prescription drugs. PBMs negotiate price discounts from retail pharmacies, rebates from pharmaceutical manufacturers, and mail-service pharmacies which home-deliver prescriptions without consulting face-to-face with a pharmacist.

PBMs DEFINED: https://medicalexecutivepost.com/2019/01/18/on-pbms-pharmacy-benefits-management/

Pharmacy benefit management companies can make revenue in several ways.

First, they collect administrative and service fees from the original insurance plan.

Then, they can also collect rebates from the manufacturer.

Traditional PBMs do not disclose the negotiated net price of the prescription drugs, allowing them to resell drugs at a public list price (also known as a sticker price), which is higher than the net price they negotiate with the manufacturer. This practice is known as “spread pricing”. The industry argues that savings are trade secrets. Pharmacies and insurance companies are often prohibited by PBMs from discussing costs and reimbursements. This leads to lack of transparency.

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Therefore, states are often unaware of how much money they lose due to spread pricing, and the extent to which drug rebates are passed on to en-rollees of Medicare plans. In response, states like Ohio, West Virginia, and Louisiana have taken action to regulate PBMs within their Medicaid programs.

For instance, they have created new contracts that require all discounts and rebates to be reported to the states. In return, Medicaid pays PBMs a flat administrative fee.

PBM PODCAST: https://medicalexecutivepost.com/2023/08/26/podcast-cvs-replaces-its-pbm/

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Why Your Startup Needs to be a C-Corporation

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

A SPECIAL MEDICAL EXECUTIVE-POST PRESENTATION

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Why Your Startup Needs to be a C-Corp

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PROPOSED: 2026 Physician Fee Schedule Payment Increases

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

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On July 14, 2025, the Centers for Medicare & Medicaid Services (CMS) released its proposed Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2026.

In addition to the agency’s suggested increase to physician payments, the proposed rule also announces a new payment model and more tele-health flexibilities.

According to CMS, the “proposed rule is one of several proposed rules that reflect a broader Administration-wide strategy to create a health care system that results in better quality, efficiency, empowerment, and innovation for all Medicare beneficiaries.” (Read more…)

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PARADOX of Financial Health

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

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.CertifiedMedicalPlanner.org

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FINANCIAL HEALTH

Classic Definition: Research from Ernst-Young [Nikhil Lele and Yang Shim] uncovered a chasm between how consumer patients think they’re doing financially, and the actual state of their finances. Even more striking, their study suggested that improving consumers’ financial health will become one of the top imperatives in reframing consumer financial services.

Modern Circumstance: For example, the study asked consumers to rate their own financial health, and 83 percent rated themselves “good,” “very good” or “excellent.” Now, contrast this figure with what is known about their actual situation:

60 percent of Americans say they are financially stressed.
56 percent of Americans have less than $10,000 saved for retirement.
40 million American families have no retirement savings at all.
40 percent of Americans are not prepared to meet a $400 short-term emergency.

Paradox Example: Fortunately, even though the vast majority of consumers rate themselves as financially healthy, the study found that most still want to improve. Importantly for health economists, the attractive 25-34 and 35-49 year-old age groups were most likely to be extremely or very interested in improving their financial and economic health.

Paradox Example: Massively affluent consumer patients are even more interested in improving this paradox than their mass market counterparts.

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CMS Proposes Updates to the OPPS

Posted on July 26, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Health Capital Consultants, LLC

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On July 15, 2025, the Centers for Medicare & Medicaid Services (CMS) released the proposed rule for the Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System for calendar year (CY) 2026.

Among other items, the agency proposes increasing payments to all outpatient providers, eliminating the Inpatient Only (IPO) List, and changing quality reporting programs.

This Health Capital Topics article reviews the proposed updates and changes to outpatient reimbursement. (Read more…)

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Beware of Borrowing That Helps Your Advisor – Not You

Posted on July 21, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Rick Kahler MSFP CFP™

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When Maria needed $400,000 for a down payment on a new home, her broker at a large Wall Street firm offered a solution: “Don’t sell investments and trigger capital gains. Just take out a margin loan.”

A margin loan is a line of credit from a brokerage firm, secured by the client’s investment portfolio. It offers quick access to cash with no immediate tax consequences and minimal paperwork. But the convenience comes at a cost. As of mid-2025, margin loan interest rates range from 6.25% to over 11%.

Margin loan recommendations are often presented by brokers as tax-savvy strategies that allow clients to access “tax-free” cash while keeping their portfolios intact. In many cases, however, the math benefits the advisor more than the investor. The cost of borrowing often exceeds what an investor is likely to earn by holding on.

For example, let’s assume an interest rate of 7.5% on Maria’s $400,000 margin loan. While borrowing delayed the payment of $20,000 in capital gains tax, she will eventually have to pay that tax anyway unless she holds the investments until her death. Two years later, with portfolio returns of 4% annually, she had earned around $32,000 from the $400,000 in investments she might have sold. Meanwhile, she had paid $60,000 in interest—leaving her some $28,000 worse off. That’s without factoring in ongoing interest payments, or the risks of a margin call if the investments securing the loan drop in value.

Why do advisors keep recommending margin loans? Because selling investments reduces the portfolio size and the advisor’s fee. Borrowing keeps the portfolio intact and the compensation unchanged—while the firm receives additional income from interest on the loan. In some cases, advisors suggest using margin loans to buy more investments, increasing both the portfolio and the fee they collect.

None of this is illegal. But when the borrowing cost is higher than expected returns and the advisor benefits financially, the ethics are questionable. The client takes the risk, while the advisor keeps the revenue.

This kind of conflict appears more often in portfolios where compensation is tied to asset volume and the company’s primary culture rewards gathering assets over delivering unbiased advice. By contrast, fee-only financial planning and investment advisors typically operate on simpler hourly, flat, or tiered fee structures. Their compensation doesn’t depend on whether a client borrows, sells, or holds. The culture of the firm focuses on conflict-free advice aligned with the client’s best interest.

Wall Street brokers are often held to a fiduciary standard, but structure still matters. In 2024 the SEC reported their examinations of brokers would continue to focus on advisor recommendations unduly influenced by the company’s compensation and incentives.

There are rare situations where a margin loan may be appropriate. A client with large unrealized gains might use a short-term margin loan to minimize taxes. An elderly investor might borrow tax-free rather than sell assets that will receive a step-up in basis at their death. Even in those cases, the math must be exact and the client must clearly understand the risks, including the possibility of a margin call.

If your advisor recommends a margin loan, especially to buy more investments, ask strong questions. What’s the interest rate? What return is realistic? What are the tax consequences of selling? How does this affect the advisor’s income?

If you don’t get direct answers, that’s a warning sign.

In a high-rate, low-return environment, margin loans rarely favor the client. The exceptions are narrow. The risks are significant. And the conflict of interest is measurable.

Sometimes the smartest move is the simplest: sell what you need, pay the tax, and leave leverage out of your plan.

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PARADOXES: Beware Financial and Investing Contradictions

Posted on July 21, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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As we plan for our financial future, I think it’s helpful to be cognizant of these paradoxes. While there’s nothing we can do to control or change them, there is great value in being aware of them, so we can approach them with the right tools and the right mindset.

Here are just seven of the paradoxes that can bedevil financial planning and investment decision-making:

There’s the paradox that all of the greatest fortunes—Carnegie, Rockefeller, Buffett, Gates—have been made by owning just one stock. And yet the best advice for individual investors is to do the opposite: to own broadly diversified index funds.
There’s the paradox that the stock market may appear overvalued and yet it could become even more overvalued before it eventually declines. And when it does decline, it may be to a level that is even higher than where it is today.
There’s the paradox that we make plans based on our understanding of the rules—and yet Congress can change the rules on us at any time, as it did just a few weeks ago.
There’s the paradox that we base our plans on historical averages—average stock market returns, average interest rates, average inflation rates and so on—and yet we only lead one life, so none of us will experience the average.
There’s the paradox that we continue to be attracted to the prestige of high-cost colleges, even though a rational analysis that looks at return on investment tells us that lower-cost state schools are usually the better bet.
There’s the paradox that early retirement seems so appealing—and has even turned into a movement—and yet the reality of early retirement suggests that we might be better off staying at our desks.
There’s the paradox that retirees’ worst fear is outliving their money and yet few choose the financial product that is purpose-built to solve that problem: the single-premium immediate annuity.

Assessment

QUESTION: How should you respond to these paradoxes? As you plan for your financial future, embrace the concept of “loosely held views.” In other words, make financial plans, but continuously update your views, question your assumptions and rethink your priorities.

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Can You Contribute to Both a Roth IRA & 401(k)?

Posted on July 18, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters, AI and the Linqto Team

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Yes, you can contribute to both a Roth IRA and a 401(k), provided you don’t exceed annual contribution limits for each account.

Determining whether to contribute to a Roth IRA, 401(k), or both can be an important step in planning for your retirement. Here are the key differences, including tax advantages, employer contributions, and investment options.

Eligibility requirements are the first consideration when contributing to a Roth IRA and a 401(k). For Roth IRA contributions, your eligibility is determined by your income. Specifically, if your modified adjusted gross income (MAGI) exceeds certain thresholds, your ability to contribute to a Roth IRA may be reduced or eliminated. However, there are no income limits for contributing to a 401(k), making it accessible to anyone with earned income.

IRS rules do allow for contributions to both a Roth IRA and a 401(k), provided you adhere to the annual contribution limits for each account.

This means you can take advantage of the higher contribution limits of a 401(k) while also benefiting from the tax-free growth of a Roth IRA. This dual approach can be a strategy for maximizing your retirement savings. The advantages to contributing to both accounts present some key benefits, such as:

Tax diversification in retirement, allowing for better management of taxable income.
Potential reduction of overall tax burden.
Maximization of savings potential by taking full advantage of the benefits each account offers.³

Balancing contributions between a Roth IRA and a 401(k) requires careful planning. You might start by contributing enough to your 401(k) to receive the full employer match, which is essentially free money, if your employer offers this. Once you’ve secured the match, consider maxing out your Roth IRA contributions, if you’re eligible.

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DAILY UPDATE: Private Market Investment Retirement Plans Up Along with Stock Markets

Posted on July 18, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

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Daily Update Provided By Staff Reporters Since 2007.
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Stocks up

Lucid exploded 36.24% higher on the news that the EV maker is partnering with Uber to roll out the ridesharing company’s new robotaxis.
PepsiCo popped 7.45% thanks to a strong quarter for the snack and soda giant, while shareholders cheered the details of its turnaround plan.
United Airlines may have missed Wall Street’s revenue forecast, but its profits were enough to impress investors. Shares rose 3.11%.
Reports that Union Pacific is thinking about acquiring a rival sent shares of fellow train operators CSX and Norfolk Southern up 3.73% and 3.65%, respectively.
Sarepta Therapeutics soared 19.53% after the biotech announced it will lay off 500 employees and restructure its entire business.
Quantumscape continued its hot streak, rising yet another 19.82% thanks to its recent battery breakthrough.
Speaking of hot streaks, OpenDoor Technologies rose another 10.74% as retail traders pour into what is quickly becoming the next big meme stock.

Stocks down

GE Aerospace crushed earnings expectations and raised its fiscal guidance, but it still wasn’t enough to impress investors, who pushed shares of the engine maker down 2.10%.
US Bancorp sank 1.03% after revenue and net interest income missed forecasts last quarter.
Abbott Laboratories beat on both top and bottom line guidance, but still fell 8.53% after the pharma company narrowed its fiscal forecasts.
Elevance Health tumbled 12.22% af

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President Trump is expected to sign an executive order in the coming days designed to help make private-market investments more available to U.S. retirement plans, according to people familiar with the matter. The order would instruct the Labor Department and the Securities and Exchange Commission to provide guidance to employers and plan administrators on including investments like private assets in 401(k) plans.

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Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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BETTORS & GAMBLERS: Taxation Update

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

SPONSOR: http://www.CertifiedMedicalPlanner.org

By Staff Reporters

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What’s Different?

Bettors are currently able to deduct 100% of their gambling losses, so they only pay taxes on their winnings. But starting next year, only 90% of gambling losses will be deductible.

So, if a professional gambler wins $100,000, then loses $100,000 that same year, according to the New York Times:

In 2025, that gambler would owe taxes on $0.
In 2026, that gambler would owe taxes on $10,000.

Bettors could even end up paying taxes if they finished the year with a net loss.

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HEALTH CARE SPENDING: Projected to Exceed $8.5 Trillion by 2033

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

By Health Capital Consultants LLC

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On June 25th, 2025, the Centers for Medicare & Medicaid Services (CMS) released its forecast on U.S. healthcare spending through 2033. The analysis, published in Health Affairs, estimated healthcare spending growth in 2024 and projected the growth into 2033. CMS found that overall healthcare spending growth has decreased slightly but is still elevated compared to pre-pandemic levels, and is expected to continue to moderately grow.

This Health Capital Topics article examines the factors underlying the forecasts. (Read more…)

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HSA: Avoid Investments in Low-Yield Options

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

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UNHAPPY HOSPITALS: One Big Beautiful Bill Act!

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

SPONSOR: http://www.CertifiedMedicalPlanner.org

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One Big Beautiful Bill Act (OBBBA; OBBB; BBB), or the Big Beautiful Bill, is a budget reconciliation bill in the 119th US Congress.

Hospitals are not happy with the health care provisions of the bill, which would reduce the support they receive from states to care for Medicaid enrollees and leave them with more uncompensated care costs for treating uninsured patients.

“The real-life consequences of these nearly $1 trillion in Medicaid cuts – the largest ever proposed by Congress – will result in irreparable harm to our health care system, reducing access to care for all Americans and severely undermining the ability of hospitals and health systems to care for our most vulnerable patients,” said Rick Pollack, CEO of the American Hospital Association.

The association said it is “deeply disappointed” with the bill, even though it contains a $50 billion fund to help rural hospitals contend with the Medicaid cuts, which hospitals say is not nearly enough to make up for the shortfall.

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Filed under: Accounting, Ask a Doctor, business, Drugs and Pharma, Ethics, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Managed Care | Tagged: AHA, big beautiful bill, congress, CT, Health Insurance, hospitals, Medicaid, medicare, OBBB, OBBBA, rick pollack, uninsured patients | Leave a comment »

Liberation Day Comeback

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

By A.I.

SPONSOR: http://www.CertifiedMedicalPlanner.org

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The S&P 500 closed within a hair of a new record yesterday marking an enormous comeback that followed the April announcement of “Liberation Day” tariffs.

Despite a persistent vibe of uncertainty related to US economic policy and geopolitics:

The S&P 500 closed less than 0.1% away from a record high which it notched in February before cratering nearly 20% in April. The index has regained ground in fits and starts since then and briefly surpassed its record in intra-day trading yesterday.
On Monday, the tech-heavy NASDAQ 100 one-upped the broader market and logged its highest-ever close. It came after President Trump said Israel and Iran agreed to a ceasefire, which eased investors’ concerns about a potential oil crisis.

According to Morning Brew, between unresolved geopolitical conflicts and President Trump’s still-unfolding tariff policies, a portfolio manager with Capital Wealth Planning, Kevin Simpson, told CNBC that he was “surprised by the magnitude of the rebound.”

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Filed under: "Ask-an-Advisor", Accounting, CMP Program, Experts Invited, Financial Planning, Funding Basics, Investing, Marcinko Associates, Portfolio Management | Tagged: Capital Wealth Planning, CMP, Iran, Israel, Kevin Simpson, liberation day, Morning Brew, NASDAQ, S&P 500, tariffs, Trump | Leave a comment »

“BIG BEAUTIFUL BILL”: Not So for Healthcare?

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

By Health Capital Consultants; LLC

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On May 22, 2025, the U.S. House of Representatives moved President Trump’s budget proposal forward, sending to the Senate a budget reconciliation bill (with a one-vote margin) – the One Big Beautiful Bill Act of 2025 – that renews expiring tax cuts and enacts new ones at a cost of almost $4 trillion. These costs would largely be paid for by cuts to other programs, including to federal healthcare programs, which cuts will have significant ramifications for the healthcare industry.

This Health Capital Topics article reviews the current status of the budget bill and healthcare industry implications. (Read more…)

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Filed under: "Ask-an-Advisor", Accounting, Career Development, Drugs and Pharma, Ethics, Funding Basics, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Managed Care, Management, Op-Editorials | Tagged: HCC, Health Capital Topics, Jessica Bailey-Wheaton, One Big Beautiful Bill Act, TODD A. ZIGRANG, Trump | Leave a comment »

SOVEREIGN WEALTH FUND: Defined

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

By Staff Reporters

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A SWF is essentially an investment fund run by the government. Similar to how a hedge fund or a private equity firm operates, the government would set aside a pot of money and invest it in assets such as stocks, bonds, startups, or real estate.

The idea of the US establishing a sovereign wealth fund akin to Norway’s or Abu Dhabi’s gained momentum recently across the political spectrum. Former President Trump endorsed the concept during a speech on his economic policy agenda for a second term, and the Biden administration has been quietly cheffing up a proposal for a wealth fund over the past several months, Bloomberg reported.

Trump and Biden officials described the fund as a key tool the country could deploy to win the global technological arms race and better compete against geopolitical rivals like China.

For example, the wealth fund could finance capital-intensive sectors such as shipbuilding, nuclear fission, and quantum cryptography that don’t offer near-term ROI for private investors.

However, disadvantages of a SWF include:

Non-Guaranteed Returns, with the Risk of Total Loss
Influence on Foreign Exchange Rates, Introducing Uncertainty
Potential Mismanagement of Funds Due to a Lack of Transparency
Dependency on Global Economic Conditions, Impacting Fund Performance
Challenges in Maintaining Accountability and Addressing Ethical Concerns

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Filed under: "Ask-an-Advisor", Accounting, Funding Basics, Glossary Terms, Investing | Tagged: Bloomberg, hedge fund, Private Equity, SOVEREIGN WEALTH FUND: Defined, SWF | Leave a comment »

ASSETS: Under Advisement V. Management

Posted on June 20, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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What are Assets Under Management?

Assets under management (AUM) is a significant parameter in the financial world. It answers financial questions like – how many investments does a company manage? What is the net value of the investments that the company manages? Finally, how many investors have trusted their assets with the company? The higher the answer to these three questions, the more glory to the company.

A wealthy investor who is not concerned by higher fees but wants maximum returns of their asset will probably choose an asset manager based on its AUM. Thus, the AUM indicates the financial performance of the firm. Also, based on the funds under management, the firm collects fees from other clients.

So, what are the investments which qualify as AUM? Any liquid asset of the investor they have entrusted the asset manager with monitoring and control. For example, bank deposits, cash balances, equity shares, bonds, mutual funds, and other investments.

What are the services an asset manager provides to their clients? The most important function is decision-making. With the constant fluctuations and rapid movements in the market, an asset manager has to make decisions about holding or selling an investment. The firm communicates with the investors and advises them about the necessary action.

Once the decision is taken, the firm acts on the decision, i.e., the investor does not have to enter the field. In addition, the asset management company will buy, sell, and make any other transactions on behalf of the investor. Finally, the firm also renders services like accounting, tax reporting, proxy voting (equity shares), client reporting, and other financial services.

What are Assets Under Advisement?

Assets under advisement refer to assets on which your firm provides advice or consultation but for which your firm does either does not have discretionary authority or does not arrange or effectuate the transaction. Such services would include financial planning or other consulting services where the assets are used for the informational purpose of gaining a full perspective of the client’s financial situation, but you are not actually placing the trade.

Assets under advisement could also be those which you monitor for a client on a non-discretionary basis, where you may make recommendations but where the client is the party responsible for arranging or effecting the purchase or sale. A common example of this scenario is when an adviser reviews a participant’s 401(k) allocations. If the adviser does not have the authority or ability to effect changes in the portfolio, these assets are likely considered assets under advisement rather than regulatory assets under management.

Assets under advisement are permitted to be disclosed on Form ADV Part 2A as a separate asset figure from the assets under management. There is no requirement to disclose the assets under advisement figure, but some advisers opt to include the figure to give prospective clients a more complete picture of the firm’s responsibilities. If you choose to report your assets under advisement, be sure to make a clear distinction between this figure and your regulatory assets under management.

NOTE: Essay with thanks to Chat GPT.

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Filed under: "Ask-an-Advisor", Accounting, Experts Invited, Financial Planning, Funding Basics, Glossary Terms, Investing, Portfolio Management, Taxation, Touring with Marcinko | Tagged: advisement, asset management company, assets, assets advisement, assets management, business, ChatGPT, finance, Investing, Management, Marcinko | Leave a comment »

PRIVATE EQUITY: Role in Vascular Medical Care

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

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“Role of Private Equity in Vascular Care,” authored by HCC’s Todd A. Zigrang and Jessica Bailey-Wheaton, as well as Bhagwan Satiani, MD, and Hiranya A. Rajasinghe, MD, was featured in the recent issue of the Journal of Vascular Surgery – Vascular Insights published by the Society of Vascular Surgery.

Read Here

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EDUCATION: Books

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Filed under: "Advisors Only", "Ask-an-Advisor", Accounting, Experts Invited, Funding Basics, Health Economics, Health Insurance, Healthcare Finance, Interviews, Investing, Media Mentions and PR, Taxation | Tagged: helth capital consultants, Jessica Bailey-Wheaton, Private Equity, TODD A. ZIGRANG, vascular care, vascular medicine | Leave a comment »

Open Call for ME-P Contributors

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

Call for Manuscripts, Articles, Essays, Comments or Opinions

Dear Medical and Financial Services Colleagues, Health Economists, CPAs, JDs, Insurance Agents and Consultants,

The Medical Executive-Post (ME-P), supported by iMBA Inc., with (ISSN 13: 978-1-4665-5873-1] is currently accepting manuscripts for publication.

The ME-P is an open access, multidisciplinary, international, blind peer-reviewed and non-peer-reviewed electronic forum which publishes high-quality solicited and unsolicited research, commentary, opinions, curated news and review articles in English, in all areas of Physician Focused Financial Planning, health economics, finance, accounting, medical practice management, health law, IT, policy and administration. We have over 50 topic channels.

Rapid Response Peer-Review

ME-P is a rapid response forum that publishes daily. One of our objectives is to inform contributors (authors) of the decision on their manuscript(s) within 48 hours of submission. Following acceptance, a paper would be published in the next available issue. The ME-P provides immediate open access to published articles without any barrier.

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[ME-P Fast Review, Turn-Around and Publishing Time]

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Broad Exposure Potential

Publishing your news, opinions or comments, essays or articles with the ME-P means that they will be available to millions of readers and researchers because our large and diverse readership base comprises millions of collaborators. Our forum supports the free downloading of published articles by scholars for use as materials for lecture, by government officials for policy making, professors, colleges, universities and educators, and by corporate researchers and FAs to selected firms and organizations world-wide.

Blog Citations

Assessment

Also, ME-P is a member of several local and international organizations, making it possible for the far and wide distribution of published materials. We ask you to support this initiative by publishing your thoughts, comments, articles and original paper(s) 0n this forum, and in our textbooks and white-papers, etc.

About ME-P Plagiarism and Cryptomnesia

Authors should send their materials or manuscript(s) as attached MSFT Word files to the following email: MarcinkoAdvisors@outlook.com

Best regards,

Ann Ann Miller RN MHA

[Executive-Director]

http://www.MedicalExecutivePost.com

Filed under: "Advisors Only", "Doctors Only", Accounting, Career Development | Tagged: Call for ME-P Contributors, Financial Planning, health administration, Health Economics, health management, health policy | 3 Comments »

INVESTING: Stocks, Bonds & Oil Updates

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

Generated by AI

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Stocks: The S&P 500 touched 6,000 points for the first time since February and wrapped up its fifth positive week in the past seven following a better-than-expected jobs report. The vibes got even better in the afternoon following a President Trump announcement that the US and China trade teams will meet in London on Monday. STOCKS: https://medicalexecutivepost.com/2025/04/18/stocks-basic-definitions/
Bonds: Treasury yields ticked up in response to the solid May jobs report, a sign that investors were reducing bets on the scale of rate cuts this year. That’s not what Trump wants to hear: He urged Fed Chair Jerome Powell to slash interest rates by a jumbo-sized full point to pour “rocket fuel” on the economy. REVENUE BONDS: https://medicalexecutivepost.com/2024/12/20/bonds-revenue/
Oil: Oil prices have gone sideways for three straight weeks now, trading within a $4 range around $65/barrel since the middle of May. We’ll let you know when something interesting happens. CRUDE OIL: https://medicalexecutivepost.com/2024/08/14/wti-crude-oil/

EDUCATION: Books

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Filed under: "Ask-an-Advisor", Accounting, CMP Program, Financial Planning, Funding Basics, Investing, Portfolio Management | Tagged: bonds, CMP, crude, DJIA, DOW, ETFs, fed, financials, FOMC, interest rate, Investing, JeromePowell, jobs, oil, Portfolio Management, S&P 500, stocks, Trump, wealth management | Leave a comment »

EMPLOYMENT: Growing Slowly

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

By AI

BREAKING NEWS

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Job growth is slowing, but still bigger than expected

US employers added 139,000 jobs last month, government data released yesterday shows—that’s less than the down-wardly revised 147,000 new jobs that were added in April, but more than economists had predicted. Meanwhile, the unemployment rate held steady.

MAY: https://medicalexecutivepost.com/2025/06/06/may-jobs-report/

Overall, the highly anticipated jobs report reflects employers growing more cautious in the face of the economic uncertainty brought on by the trade war, but so far, there doesn’t seem to be a steep drop off in the labor market. That could give the Fed reason to stay in wait-and-see mode on interest rates, though President Trump still used the occasion to urge Jerome Powell to cut rates “a full point” on Truth Social.

PHYSICIAN EMPLOYMENT CONTRACTS: https://medicalexecutivepost.com/2024/01/12/sample-new-physician-letter-of-employment-contract/

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Filed under: "Ask-an-Advisor", Accounting, Breaking News, business, Career Development, CMP Program, economics, finance, Investing, Management | Tagged: CMP, employment, hiring, interest rates, Jerome Powell, jobs, jobs report, Trump, Truth Social, unemployment | Leave a comment »

The Shift to Value-Based Care: Evidence of Progress

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

By Health Capital Consultants, LLC

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A recent joint report by the National Association of Accountable Care Organizations (NAACOS) and Innovaccer Inc., a healthcare artificial intelligence (AI) company, found tangible evidence that the U.S. healthcare delivery system is indeed moving toward value-based care (VBC).

Fifteen years after the passage of the Patient Protection and Affordable Care Act (ACA), which promoted VBC through the advent of ACOs and other alternative payment models, there is finally evidence that providers are actually moving in that direction.

This Health Capital Topics article reviews the joint report on “The State and Science of Value-based Care 2025.” (Read more…)

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PARADOX VBC: https://medicalexecutivepost.com/2024/10/25/paradox-value-based-care/

VBC: https://medicalexecutivepost.com/2018/12/07/the-state-of-value-based-care-vbc/

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

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Filed under: "Ask-an-Advisor", Accounting, Career Development, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance | Tagged: ACA, ACO, ACOs, capitation, Health Capital, Innovaccer, Jessica Bailey-Wheaton, NAACOS, PP-ACA, TODD A. ZIGRANG, VBC | Leave a comment »

DONOR ADVISED FUND: Defined

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

WHAT IS A DONOR ADVISED FUND?

Sponsor: http://www.CertifiedMedicalPlanner.org

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A donor-advised fund is a private account created to manage and distribute charitable donations on behalf of an organization, family, or individual. Donor-advised funds can democratize philanthropy by aggregating the contributions of multiple donors, thus multiplying their impact on worthy causes. Donor-advised funds also have abundant tax advantages.

DONOR DEPENDENCY: https://medicalexecutivepost.com/2025/01/02/culture-donation-dependency/

Donor-advised funds have become increasingly popular, as they offer the donor greater ease of administration while still allowing them to maintain significant control over the placement and distribution of charitable gifts. But, unlike private foundations, donor-advised fund holders enjoy a federal income tax deduction of up to 60% of adjusted gross income (AGI) for cash contributions and up to 30% of AGI for the appreciated securities they donate. Donors to these funds can contribute cash, stock shares, and other assets. When they transfer assets such as limited-partnership interests, they can avoid capital gains taxes and receive immediate fair market value tax deductions.

MEDICAL ETHICS: https://medicalexecutivepost.com/2024/06/20/medical-ethics-physician-and-financial-organizations/

According to the National Philanthropic Trust’s 2023 Donor-Advised Fund Report, these funds have continued to grow in recent years, despite some headwinds including the Covid-19 pandemic and occasional stock market setbacks. Total grants awarded by donor-advised funds in 2022 increased by 9% to $52.16 billion, while total contributions rose by 9% to $85.5 billion.

Many donor-advised funds accept non-cash assets—such as checks, wire transfers, and cash positions from a brokerage account—in addition to cash and cash equivalents.

Donating non-cash assets may be more beneficial for individuals and businesses, leading to bigger tax bigger write-offs.

PHILANTHROPY: https://medicalexecutivepost.com/2021/11/15/national-philanthropy-day-2021/

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Filed under: "Ask-an-Advisor", Accounting, Alternative Investments, CMP Program, Ethics, Financial Planning, Glossary Terms, Investing, Marcinko Associates | Tagged: AGI, CMP, DAF, donor advised fund, Donor Advised Funds (DAF)., Estate Planning, Ethics, FMV, Marcinko, philanthropy | Leave a comment »

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