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Posted on July 7, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Rick Kahler CFP™
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One serious risk to financial wellbeing in retirement that is difficult to talk about is financial exploitation. Someone whose cognitive abilities are declining is vulnerable to harm from both financial predators and their own financial misjudgments. Protecting such clients is a crucial part of a financial advisor’s role.
A little-known but important law, the Senior Safe Act, was enacted in 2018. It encourages financial advisors and institutions to report suspected elder abuse by offering immunity from legal liability when reports are made in good faith and with reasonable care. To qualify for these protections, financial professionals must undergo annual training to recognize the signs of exploitation and know how to act on their suspicions.
In many ways, the Senior Safe Act mirrors the duty of therapists to report when clients are threats to themselves, such as when a client becomes suicidal. Just as a therapist must balance confidentiality with the moral and legal responsibility to protect their client from harm, a financial advisor must weigh privacy against the need to prevent financial exploitation. Both roles rely on professional judgment, training, and the courage to act when the stakes are high.
Financial advisors, accountants, and attorneys are often the first to notice troubling signs that someone is being taken advantage of financially. These might include sudden large withdrawals, changes to account ownership or beneficiaries, or a newly and overly involved friend or family member. Behavioral shifts like confusion, anxiousness, secretiveness, or uncharacteristic deference are also red flags. These patterns are unsettling and demand attention, even when stepping in is uncomfortable.
Reporting possible elder abuse isn’t always straightforward, especially if the suspected abuser is a family member. As an advisor, I worry about misunderstandings, potential conflicts with the family, and even the possibility of damaging a relationship with the client. None of this is easy, But when the signs of exploitation become clear, staying silent could mean allowing harm to continue. That’s a risk I can’t take.
One of the tools I started using decades ago is the trusted contact disclosure form. This simple but powerful document allows clients to name someone my firm can contact if they notice unusual activity, such as a suspicious withdrawal or transfer. The trusted contact does not have control over the client’s account but serves as a resource to verify their well-being and ensure that their financial decisions align with their long-term goals. If you as a client have not signed such a form, it’s worth discussing with your advisor as a preventative step.
If you are concerned about the financial well-being of an elderly loved one, it’s crucial to alert not only their financial advisor but also other professionals like accountants, attorneys, or bankers. These professionals may have insights or access to information you don’t have, and by sharing your concerns, you provide a broader picture that can help them detect and address issues more effectively. Even if they are already monitoring for red flags, your input can provide valuable context to guide their next steps.
Difficult though it may be, stepping into uncomfortable territory is often essential to protecting vulnerable individuals. Whether it’s a financial advisor detecting exploitation or a therapist intervening in a mental health crisis, the goal is the same—to prevent harm while respecting the person’s autonomy.
The Senior Safe Act is a reminder that sometimes the most impactful safeguards work quietly behind the scenes. Taking simple steps like completing a trusted contact form or encouraging your loved one to work with a reputable, fiduciary advisor can make all the difference. Vigilance is an act of care that helps protect someone’s financial assets as well as their dignity and well-being.
Posted on July 6, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Health Capital Consultants LLC
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On June 9th, 2025, Oregon’s governor signed into law the country’s strictest corporate practice of medicine (CPOM) prohibition. Senate Bill (SB) 951 will severely curtail the involvement of private equity firms and other corporations in the state’s medical practices.
This Health Capital Topics reviews the bill and discusses the implications on the healthcare industry. (Read more…)
Posted on July 5, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By A.I.
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Medical doctors, dentists, and podiatrists have to undergo extensive training before they can practice medicine independently. Once they receive training, there are opportunities to increase pay and prestige in the medical field through a series of promotions. As a doctor, how much training, experience and skills you have can determine your ability to move upward in these levels. But, personal branding strategies may even be more vital in today’s social media age?
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Physician, medical and healthcare branding is more than just the creation of logos, taglines, or specific brand messaging. It’s about creating a meaningful connection between your mission, vision and values and the people served – from patients and their families to local and global communities.
While there are many different types of branding strategies in marketing science, they all share key elements that serve as the foundation for the strategy. These 9 elements for all physicians and medical professionals include the following:
Brand purpose: The reason the physician is in practice and what he/she is trying to achieve.
Brand vision: The ideas and goals behind the dentist which serve as inspiration for practice growth.
Brand values: The osteopaths beliefs and what they stand for.
Target audience: The demographic(s) and patient targets that the podiatrist is aiming to reach.
Market analysis: An analysis of the marketplace that identifies gaps where the chiropractor has an opportunity to position him/her self based on a unique value proposition.
Awareness goals: The initiatives the doctor will take in order to reach a target market patient demographic.
Brand personality: The human-like attributes of the physician that will help build relationships with patients, consumers and other physicians and practitioners.
Brand voice: The language and tone the doctor uses to communicate with patients, physicians and consumers.
Brand tagline: A memorable slogan that sums up the physician and their medical offering in a few choice words.
And so, physician branding is the development of a easily recognizable identity for a medical practice, clinic or healthcare organization that helps to shape perception by current and prospective patients and the wider world.
Posted on July 3, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By A.I.
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Stocks: Markets wrapped the trading day with another win thanks to a shockingly strong jobs report this morning. Both the S&P 500 and the NASDAQ hit new record highs.
A brand is a name, term, design, symbol or any other feature that distinguishes one seller’s goods or service from those of other sellers. Brands are used in business, marketing and advertising for recognition and, importantly, to create and store value as brand equity for the object identified, to the benefit of the brand’s clients, patients, customers, its owners and shareholders. Brand names are sometimes distinguished from generic or store brands.
Brand management, also known as Marketing, is responsible for the overall management of a brand. This includes everything from product or service development and marketing to advertising and public relations. All of these aspects work together to create a particular image or reputation for a brand. The goal of brand management is to create a robust and positive reputation for a brand that will result in increased sales and market share.This process helps companies create a unique identity for their products or services in the marketplace. A successful brand management strategy can build client, patient and customer loyalty .
Branding is essential for financial advisors, doctors and businesses because it involves creating a unique identity for a company’s products, offerings and services. It can also help build customer, client and patient loyalty and emotionally connect with the practitioner. Branding can be complex, but it is essential to understand the basics before starting a brand strategy.
Thus, doctors, podiatrists, dentists, CPAs, insurance agents, financial advisors and their practices need to understand the different aspects of branding and brand management to create a strong brand identity.
Posted on July 2, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Power station: Crude oil prices reversed as tensions in the Middle East cooled, but AI likely raises electricity demand over the longer term, creating investment opportunities and risks.
Oil supplies now exceed demand, noted Michelle Gibley, director of international research at the Schwab Center for Financial Research, in her latest analysis, though “AI is transforming the energy sector,” raising power shortage concerns.
Solar stocks got a reprieve today after the Senate dropped the excise tax on clean energy projects. Sunrun soared 10.51%, EnphaseEnergy rose 3.18%, SolarEdgeTechnologies popped 7.16%, and ArrayTechnologies climbed 12.54%.
Apple tumbled this summer after investors were disappointed by its AI rollout, but rose 1.29% on the news that the company may pivot to using Anthropic or OpenAI in iPhones instead of building something in-house.
Wolfspeed, the best name for a company that makes computer chips, exploded 98.09% after the company officially filed for Chapter 11 bankruptcy.
Hasbro got a nice 4.29% bump thanks to Goldman Sachs analysts, who are big old nerds who think Magic: The Gathering will boost the toymaker’s sales.
Ford popped 4.61% after the automaker reported an impressive 14% increase in sales last quarter.
Casino stocks soared on the news that gaming revenue in Macau rose 19% in June. WynnResorts climbed 8.85%, Las Vegas Sands added 8.95%, and MGMResorts gained 7.24%.
What’s down
AMC Entertainment tumbled 9.03% after the one-time meme stock announced its new debt restructuring plan.
ProgressSoftware sank 13.03% after the business application software company reported mixed results last quarter, beating on profit but missing on revenue.
JobyAviation fell 7.01% after traders took profits following the air taxi company’s big pop yesterday.
AeroVironment dropped 11.42% after defense contractor announced it’s offering $750 million in common stock and $600 million in convertible senior notes to pay off its debt.
Diabetes device makers tumbled on the news that the government may change the reimbursement rate for glucose monitors and insulin pumps. Insulet lost 4.52%, Dexcom fell 4.25%, and BetaBionics sank 4.26%.
Stocks: The S&P 500 and the NASDAQ started the second half of the year on the wrong foot, while the Dow climbed despite investors’ trepidation about conflict in Congress. But the Senate passed its version of the big, beautiful bill this afternoon, potentially getting us one step closer to ending all the drama.
Bonds: 10-year Treasury yields fell to their lowest level in two months this morning ahead of Jerome Powell’s appearance at a central banking conference today. There, Powell demurred on the possibility of a July rate cut, reiterating his wait-and-see approach.
Safe havens: The US dollar gained ground after a terrible first half of the year, while gold rose as investors braced themselves for the big jobs report on Friday.
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.”
Deals: Stocks popped at the open yesterday on the news that Canada has rescinded the digital services tax in order to lure the US back to the negotiating table. Meanwhile, Bloomberg reported that the EU will accept a 10% universal tariff in exchange for some key concessions.
Stocks: The S&P 500 and the NASDAQ both hit new record highs today, with the S&P 500 wrapping up its best quarter since Q4 20
The Fed: President Trump published a handwritten note asking Jerome Powell to cut interest rates, even as the White House considers new ways to replace the Fed Chair. Meanwhile, Goldman Sachs now sees the chances of the Fed cutting interest rates in September as “somewhat above 50%.”
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…)
Posted on June 30, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By AI
CBOE Volatility Index
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There’s a lot of confidence in markets these days, and nowhere is that more apparent than in the VIX, aka the CBOE Volatility Index, aka aka the Fear Index.
According to Brew Markets, the VIX literally measures the market’s expectation of volatility based on S&P 500 index options, but it’s become a shorthand way of quantifying investors’ fear or confidence. Any time the VIX rises above 30, it’s taken as a sign of some serious trepidation in the market—but anytime it falls below 20, the market is calm, cool, and collected.
The VIX skyrocketed to over 50 on Liberation Day as investors fretted over what tariffs meant for their portfolios, but it’s been gradually falling ever since. As the chart above shows, the VIX just fell below its key support level of 17—a mark it has failed to break below recently, and a move that underlines investors’ confidence that the good times will keep rolling.
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 AUM scenario is when an advisor 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 advisors 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.
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D. E. Marcinko & Associates Core Operating Values
9. We act with honesty, integrity and are always straightforward. 8. We strive to be innovative, creative, iconoclastic, and flexible. 7. We admit and learn from mistakes and don’t repeat them. 6. We work hard always as competitors are trying to catch up. 5. We treat others with dignity and respect. 4. We are the onus of consulting advice for the fiduciary well being of others. 3. We fight complacency as former success is in the past. 2. The best management styles are timeless, not timely. 1. Our clients are colleagues and always come first.
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
Posted on June 29, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By A.I.
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Markets: That feeling when you have a $10 trillion rally. To wit:
The S&P 500 closed at a record high this week despite a brief dip as trade tensions with Canada ratcheted up. That puts the index about 20% up from its April low, when the broad tariff announcement sent it spiraling, and up ~5% for the year.
NVIDIA also hit an all-time high, and it keeps edging closer to becoming the first company to hit a $4 trillion valuation.
Posted on June 28, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By A.I.
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Deals: The US and China revealed the details of their trade deal framework, easing restrictions on rare earth metals and semiconductor chips. Commerce Secretary Howard Lutnick promised up to 10 more deals are on their way ahead of the July 9th tariff-pause deadline, but that probably won’t include Canada: President Trump ended all trade discussions with the country thanks to a dispute over the digital services tax.
Stocks: Indexes climbed at the open thanks to the deal with China, but they tumbled on news of a fallout with Canada. Still, the S&P 500 managed to post its 1,245th new all-time high, while the NASDAQ booked its own record close. The Dow trundled higher as well, though it’s still about 1,600 points below its previous record.
Posted on June 28, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
A June 11th report from global professional services firm Alvarez & Marsal (A&M) predicts that more beneficiaries might soon ditch insurance coverage for options like short-term, limited duration plans or healthcare sharing ministries (HCSMs), which aren’t regulated like health insurance and aren’t required to comply with ACA protections like covering maternity care or pre-existing conditions.
Nvidia extended its winning streak to five days, rising another 1.73% as the AI trade continues to recover.
EchoStar climbed 13.16% after the parent company of Dish TV disclosed that President Trump did in fact prod the FCC to make a deal.
Cyngn soared another 20.07% following a big day of gains after the company that makes self-driving tech for industrial vehicles announced a partnership with Nvidia.
Strong earnings from Nike (more on that later) propelled sporting goods stocks higher today. ONHoldings rose 1.74%, while Dick’s Sporting Goods climbed 3.59%.
Domestic power producers popped on reports that Trump is planning to issue an executive order increasing energy production to meet AI demand. Vistra gained 2.44%, GE Vernova climbed 2.54%, and Vertiv added 2.71%.
What’s down
Coinbase Global ended its winning streak, tumbling 5.77% after GENIUS Act hype propelled the crypto stock skyward all week long. Traders took profits in Circle as well, pushing the stablecoin stock down 15.54%.
Chinese EV maker LiAuto fell 1.93% on its weaker-than-expected deliveries forecast for the second quarter.
Fellow Chinese EV maker Xiaomi stunned markets with reports that it received 240,000 orders for its new SUV within 18 hours of its debut, but shares still sank 4%.
Pony.ai lost 6.31% on a report that Uber is considering helping its founder Travis Kalanick fund his acquisition of the US subsidiary of the Chinese autonomous vehicle company.
Gold miners tumbled while the price of the precious metal fell as investors took a risk-on stance. Newmont lost 4.11%, BarrickMining fell 3.44%, and KinrossGold shed 6.18%.
Today’s trade deal reopens the door for Chinese rare earth imports, bad news for US producers like MPMaterials (down 8.59%) and USA Rare Earth (down 12.14%).
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
Posted on June 27, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
BY A.I.
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Stocks: The S&P 500 briefly traded a few cents above its February all-time closing high yesterday afternoon, but couldn’t sustain the gain and fell just short at the end of the day. The NASDAQ remains inches away from its record high as well.
Deals: The end of the 90-day tariff pause is less than two weeks away, but the White House said that the July 9th deadline “is not critical.”
Meanwhile, the Treasury Department is doing everything it can to make the dreaded “revenge tax” in the big, beautiful bill irrelevant.
Commodities: Gold and oil had muted moves upward but copper climbed to a three-month high after Goldman Sachs analysts warned of shortages ahead
Posted on June 26, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By AI
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Stocks: The S&P 500 and NASDAQ started the day inches away from their all-time highs, but the market rally faltered in mid-afternoon as relief from an Israel/Iran ceasefire faded and investors turned their attention to Friday’s PCE report.
Economy: Speaking of inflation, Jerome Powell stuck to his guns during his second day of congressional testimony, endorsing a wait-and-see mentality. President Trump is apparently tired of waiting, and says he has “3 or 4” candidates in mind to replace Powell.
Commodities: Oil bounced back after posting its biggest two-day decline since 2022.
Here is a list of the most common and helpful investment terms you’ll come across and should know.
Ask. The price that someone looking to sell stock wants to receive.
Bid. The price that someone is willing to pay for stock.
Buy. To acquire shares and thereby take a position in a company.
Sell. To get rid of shares whether because you’ve reached your goal or to prevent losses.
Bull market. Market conditions in which investors expect prices to rise.
Bear market. Market conditions in which investors expect prices to fall.
Dividend. A portion of a company’s earnings paid to shareholders.
Blue chip stocks. Shares of large and well-recognized companies that have a long history of solid financial performance.
Earning per share. A company’s net profit divided by the number of outstanding common shares.
Mutual fund. A collection of investments — stocks, bonds, commodities, and more — bundled together and held in common by a group of investors.
Asset. Something you own that could generate a return in the form of more assets.
Asset allocation. Your investment strategy, essentially — the mix of assets you choose to put your money into, whether that be cash, bonds, stocks, commodities, real estate or something else.
Broker. A person or firm — or robot — that arranges transactions between buyers and sellers in exchange for a commission (that is, a fee).
Capital gain (or capital loss). The money you make (or lose) on the sale of an asset.
Diversification. Investing in a variety of sectors, such as health care, energy and IT as well as across different geographic locations.
Dow Jones Industrial Average. A price-weighted list of 30 blue-chip stocks. It’s often used to help get a sense of the overall health of the stock market, even though it only reflects a small portion of the players.
Index fund. A type of mutual fund or exchange-traded fund that allows you to invest in a portfolio that mimics a market index, which is basically a list that tracks the performance of a group of investments either for a specific sector or the overall market.
Hedge fund. A type of investment partnership. Partners pool money from investors and try out a few different investing strategies. Generally, hedge funds will make riskier investments than your typical investor. They’ll also often use leverage (that is, borrowed money) or place bets against the market to get bigger returns. They make their money by charging their investors management fees based on a percentage of their profits.
Expense ratio. The percentage-based fee that mutual fund managers charge you to manage your investments.
Market price. How much it would cost right now to buy or sell an asset or service.
Securities and Exchange Commission (SEC). An independent government body that was created to protect investors and the national banking system. The SEC enforces laws that maintain orderly, fair and efficient markets.
Short selling. A tactic available to investors who predict a stock’s price is about to drop. An investor borrows a quantity of shares through a broker and then sells them, intending to repurchase them later, at a lower price, and return them to the lender.
Stock exchange. A place buyers and sellers come together to buy, sell and trade stock during set business hours. The New York Stock Exchange (NYSE) is the most important stock exchange in the world, but there are a total of 16 exchanges around the world.
Stock market. Refers in general to the collection of markets and exchanges where the buying, selling and trading of investment vehicles takes place.
Price per share. A simple way of calculating a company’s market value at a given moment. To find the price per share, you take a company’s most recent share price and multiply it by its total number of outstanding shares.
Prospectus. A legal document that contains in-depth information about anything you might be planning to invest in: stocks, bonds or mutual funds.
Posted on June 25, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
SPACs, or special purpose acquisition companies, are shell companies that are created just to acquire or merge with an existing company, allowing that company to enter public markets without going through an IPO. The catch, however, is the SPAC sponsors have a small window of time—usually within two years—to find a suitable company to acquire.
Carnival popped 6.91% after the cruise line reported impressive earnings and reiterated its healthy financial guidance.
If you can’t beat ‘em, join ‘em: Mastercard rose 2.80% on the news that it will integrate Fiserv’s new stablecoin into its products. Fiserv gained 1.24%.
Lyft gained 6.09% after TD Cowen analysts upgraded the stock, calling the ride-sharing company their “Best SMIDcap Idea for 2025.”
Falling oil prices helped airline stocks soar today: Frontier Group jumped 7.56%, JetBlue Airways rose 4.15%, and American Airlines added 4.31%.
Ambarella soared 20.61% on reports that the chip designer may be exploring a sale.
Nektar Therapeutics exploded 156.29% thanks to strong results in the Phase 2 trial of its new eczema treatment.
Crypto miners rose as investors took on more risk following a ceasefire in the Middle East: CleanSpark climbed 13.45%, Riot Platforms rose 8.09%, and MARA Holdings gained 4.94%.
What’s down
Oil prices fell on news of a ceasefire between Israel and Iran, pulling oil stocks down with them: Exxon Mobil lost 3.04%, Chevron dropped 2.25%, and Occidental Petroleum fell 3.34%.
The ceasefire also sent defense contractors tumbling: Lockheed Martin lost 2.59%, RTX dropped 2.72%, and Northrup Grumman fell 3.20%.
Krispy Kreme fell 0.76% on the news that its deal with McDonald’s has fallen apart due to rising costs.
Posted on June 24, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By AI
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Stocks: Markets rose tentatively to start the week after the US bombed three nuclear facilities in Iran over the weekend. The rally gained steam in the afternoon after Iran launched a missile strike against a US airbase in Qatar, leaving no US casualties and keeping a path to de-escalation intact.
Safe havens: The US dollar rose to its highest level in nearly a month this morning, up from a three-year low last week, as investors sought safety. Meanwhile, gold inched higher despite pressure from a stronger dollar, a sure sign of investor tension.
Crypto: Bitcoin fell dangerously close to the key support level of $100,000 before recovering later in the day as traders took a risk-on stance.
Posted on June 24, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By A.I.
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Markets: Stocks climbed yesterday as oil prices fell, with investors reacting positively to what appeared to be limited retaliation from Iran in response to the US bombing its nuclear facilities over the weekend.
Meanwhile, Tesla had its biggest jump in two months following the successful, albeit limited, rollout of its robotaxi service in Austin.
Posted on June 23, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By A.I.
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As economist Jason Furman pointed out, 250 years ago the Continental Congress created a brand-new currency and authorized the printing of $2 million worth to help George Washington pay his soldiers and procure weapons and supplies for the war effort.
Markets: Until now, Wall Street has mostly shrugged off the Israel–Iran conflict in the Middle East, with the S&P 500 and NASDAQ closing just a hair lower for the week on Friday. But, investors’ thinking might—or might not—change this coming week, after the US entered the war on Saturday with strikes on key Iranian nuclear infrastructure.
And, eyes are on oil prices, which, due to the war, are having their most volatile stretch since Russia invaded Ukraine in 2022.
Consumer Fraud in the Health Insurance Marketplace
Don’t be a Victim of Consumer Fraud in the Health Care Marketplace
Beware of…
People asking for money to enroll you in Marketplace or “Obamacare” insurance. Legitimate enrollment agents will NOT ask for money.
High-pressure visits, mail solicitations, e-mails, and phone calls from people pretending to work for the government. No one should threaten you with legal action if you do not sign up for a plan. Always ask for identification if someone comes to your door.
People you did not contact who request personal information. They may be trying to steal your identity. No one from the government will call or email you to sell you an insurance plan or ask for personal identifying information. Be careful when giving out personal information, such as credit card, banking, or Social Security numbers.
Sham websites. Always look for official government seals, logos or website addresses.
Note: If you are a Medicare beneficiary, you do NOT need to buy insurance in the new Health Insurance Marketplace.
Although many academics argue that value stocks outperform growth stocks, the returns for individuals investing through mutual funds demonstrate a near match.
Introduction
A 2005 study Do Investors Capture the Value Premium? written by Todd Houge at The University of Iowa and Tim Loughran at The University of Notre Dame found that large company mutual funds in both the value and growth styles returned just over 11 percent for the period of 1975 to 2002. This paper contradicted many studies that demonstrated owning value stocks offers better long-term performance than growth stocks.
The studies, led by Eugene Fama PhD and Kenneth French PhD, established the current consensus that the value style of investing does indeed offer a return premium. There are several theories as to why this has been the case, among the most persuasive being a series of behavioral arguments put forth by leading researchers. The studies suggest that the out performance of value stocks may result from investors’ tendency toward common behavioral traits, including the belief that the future will be similar to the past, overreaction to unexpected events, “herding” behavior which leads at times to overemphasis of a particular style or sector, overconfidence, and aversion to regret. All of these behaviors can cause price anomalies which create buying opportunities for value investors.
Another key ingredient argued for value out performance is lower business appraisals. Value stocks are plainly confined to a P/E range, whereas growth stocks have an upper limit that is infinite. When growth stocks reach a high plateau in regard to P/E ratios, the ensuing returns are generally much lower than the category average over time.
Moreover, growth stocks tend to lose more in bear markets. In the last two major bear markets, growth stocks fared far worse than value. From January 1973 until late 1974, large growth stocks lost 45 percent of their value, while large value stocks lost 26 percent. Similarly, from April 2000 to September 2002, large growth stocks lost 46 percent versus only 27 percent for large value stocks. These losses, academics insist, dramatically reduce the long-term investment returns of growth stocks.
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However, the study by Houge and Loughran reasoned that although a premium may exist, investors have not been able to capture the excess return through mutual funds. The study also maintained that any potential value premium is generated outside the securities held by most mutual funds. Simply put, being growth or value had no material impact on a mutual fund’s performance.
Listed below in the table are the annualized returns and standard deviations for return data from January 1975 through December 2002.
Index Return SD
S&P 500 11.53% 14.88%
Large Growth Funds 11.30% 16.65%
Large Value Funds 11.41% 15.39%
Source: Hough/Loughran Study
The Hough/Loughran study also found that the returns by style also varied over time. From 1965-1983, a period widely known to favor the value style, large value funds averaged a 9.92 percent annual return, compared to 8.73 percent for large growth funds. This performance differential reverses over 1984-2001, as large growth funds generated a 14.1 percent average return compared to 12.9 percent for large value funds. Thus, one style can outperform in any time period.
However, although the long-term returns are nearly identical, large differences between value and growth returns happen over time. This is especially the case over the last ten years as growth and value have had extraordinary return differences – sometimes over 30 percentage points of under performance.
This table indicates the return differential between the value and growth styles since 1992.
YEARLY RETURNS OF GROWTH/VALUE STOCKS
Year
Growth
Value
1992
5.1%
10.5%
1993
1.7%
18.6%
1994
3.1%
-0.6%
1995
38.1%
37.1%
1996
24.0%
22.0%
1997
36.5%
30.6%
1998
42.2%
14.7%
1999
28.2%
3.2%
2000
-22.1%
6.1%
2001
-26.7%
7.1%
2002
-25.2%
-20.5%
2003
28.2%
27.7%
2004
6.3%
16.5%
2005
3.6%
6.1%
2006
10.8%
20.6%
2007
8.8%
1.5%
2008
-38.43%
-36.84%
2009
37.2%
19.69%
2010
16.71%
15.5%
2011
2.64%
0.39%
2012
15.25%
17.50%
Source: Ibbottson.
Between the third quarter of 1994 and the second quarter of 2000, the S&P Growth Index produced annualized total returns of 30 percent, versus only about 18 percent for the S&P Value Index. Since 2000, value has turned the tables and dramatically outperformed growth. Growth has only outperformed value in two of the past eight years. Since the two styles are successful at different times, combining them in one portfolio can create a buffer against dramatic swings, reducing volatility and the subsequent drag on returns.
Assessment
In our analysis, the surest way to maximize the benefits of style investing is to combine growth and value in a single portfolio, and maintain the proportions evenly in a 50/50 split through regular rebalancing. Research from Standard & Poor’s showed that since 1980, a 50/50 portfolio of value and growth stocks beats the market 75 percent of the time.
Conclusion
Due to the fact that both styles have near equal performance and either style can outperform for a significant time period, a medical professional might consider a blending of styles. Rather than attempt to second-guess the market by switching in and out of styles as they roll with the cycle, it might be prudent to maintain an equal balance your investment between the two.
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com
Posted on June 21, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By AI
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Stocks: Markets kicked off Friday trading on a high note thanks to comments from Federal Reserve Governor Christopher Waller that the central bank could lower interest rates as soon as next month.
Commodities: Oil prices tumbled at the open after President Trump pushed back his decision to involve the US in the conflict between Israel and Iran by two weeks.
Trade: Stocks gave up their early gains on reports that Japan has canceled high-level meetings with the US after President Trump told the country to spend more on defense.
A psychological paradox is a figure of speech that can seem silly or contradictory in form, yet it can still be true, or at least make sense in the context given.
This is sometimes used to illustrate thoughts or statements that differ from traditional ideas. So, instead of taking a given statement literally, an individual must comprehend it from a different perspective. Using paradoxes in speeches and writings can also add wit and humor to one’s work, which serves as the perfect device to grab a reader or a listener’s attention and/or persuade them to action, sales and closing statements. But paradoxes for the financial sector can be quite difficult to explain by definition alone, which is why it is best to refer to a few examples to further your understanding.
One good psychological paradox example is The Paradox of Thrift which suggests that while saving money is generally considered a prudent financial behavior, excessive saving during times of economic downturn can actually hinder economic recovery. When consumers collectively reduce their spending and increase their savings, it creates a decrease in aggregate demand. This reduction in demand can lead to lower production levels, job losses, and ultimately a decline in economic output. In other words, what may be individually rational behavior (financial saving) can have negative consequences for the overall economy.
The following paradoxical contradictions will help financial advisors guide clients to close more sales to the benefit of both.
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In the intricate world of finance sales, advisors are often at the crossroads of various paradoxes that challenge client decision-making. While the journey towards financial security involves calculated strategies, it’s the nuanced understanding of paradoxes that can help the advisor close more sales.
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But, what seems trueabout money often turns out to be false, according to colleague Finance Professor John Goodell, PhD from the University Akron:
The more we try to trade our way to profits, the less likely we are to profit.
The more boring an investment—think index funds—the more exciting the long-run performance will probably be.
The more exciting an investment—name your latest Wall Street concoction, Special Purpose Acquisition Company [SPAC] or anything crypto—the less exciting the long-term results typically are.
The only certainty is uncertainty and the only constant is change. Today’s market decline will eventually become a bull market, and today’s market leaders will eventually yield to other stocks.
Big market trends play a huge role in investment results, and yet trying to time macroeconomic cycles or guess which market sectors will outperform is a fool’s errand. Many big market rotations are set in motion by something wholly unanticipated, like a virus pandemic or a war.
To be happy when wealthy, we also need to be happy with far less money. The fact is, above a relatively modest income level, no amount of extra money will change our level of happiness. More money might even make us miserable, as many lottery winners have discovered.
The more we hate an investing trait—or any trait for that matter—the more likely it is that we’re resisting seeing that trait in ourselves. It’s what Carl Jung MD called the Shadowof Undesirable Personality Aspects that we hide from ourselves. Do prospects get irritated listening to your unsolicited financial advice? There’s a good chance that you often give unsolicited financial advice but don’t like to admit it.
The more we learn about investing, the more we realize we don’t know anything. We should just buy index funds and instead spend our time worrying about stuff we can actually control.
The more an investor is convinced he’s right, the more likely he is to be wrong. Short sellers, in particular, are likely to succumb to this paradoxical trap.
The more options we have, the less satisfied we’ll be with each one. This is the Paradox of Choice; revised. Anyone who has spent hours “optimizing” his or her portfolio knows this all too well. Its close cousin is information overload, another frustration paradox when investing.
The more afraid we are of losing money, the more likely we are to take unwitting risks that lose us money. Sitting in cash seems wise during market selloffs. But the truth is, none of us can reliably time the market. Pull up any chart of the stock market over any period longer than a decade and you’ll see that the riskiest decision is sitting in cash, which gets destroyed by inflation.
The more we think about our investments and look at our financial accounts, the more likely we are to damage our results by buying high because of greed and selling low because of fear. It can pay to look away.
ASSESSMENT
How should you respond to these financial paradoxes? As you plan for your own financial future, as well as your own client prospecting endeavors, embrace the concept of “loosely held views.”
In other words, make financial and client acquisitions plans, but continuously update your views, question your assumptions and paradoxes and rethink your priorities. Years of experience with clients certainly support the futility of trying to help them change their financial behavior by telling them what they “should” know or do.
CONCLUSION
Remember, it is far more useful to listen to client beliefs, fears and goals, and to suggest options and offer encouragement to help them discover their own path toward financial well-being. Then, incentivize them with knowledge of the above psychological paradoxes to your mutual success!
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
Marcinko, DE and Hetico, HR: Comprehensive Financial Planning Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™]. CRC Productivity Press, New York, 2016.
Marcinko, DE: Dictionary of Health Economics and Finance. Springer Publishing Company, New York. 2006
Marcinko, DE and Hetico, HR: Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™]. CRC Productivity Press, New York, 2015.
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.
Posted on June 20, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By AI
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Stocks: Investors looked past the escalating conflict between Iran and Israel, even as President Trump mulled his options for a US intervention, and stocks rose ahead of today’s Federal Reserve meeting.
Economy: Trump called Jerome Powell “a stupid person” hours before the Fed Chair decided to keep interest rates where they were Stocks fell thanks to the Fed’s prediction that inflation will rise to 3.1% by the end of the year, above previous forecasts of 2.8%.
Commodities: Gold fell just a hair as analysts called the commodity’s top, while platinum climbed to a four-year high.
Much has been written and much has been opined on the topic of health information technology, electronic health records and medical security liability for physicians and healthcare providers in this textbook. But occasionally, we all still get lost in a wide array of acronyms, jargon and terms that are constantly changing in this ecosystem. And so, this brief glossary serves as a ready reference for those who want to know about these definitions in a quick and ready fashion.
Access control: The process of controlling the access of a user
Access security: To allow computer or healthcare network entry using ID / password / secure socket layer (SSL) encryption / biometrics, etc; unique identification and password assignments are usually made to medical staff members for access to medical information on a need-to-know basis, and only upon written authority of the owner of the data.
Access level authorization: Establishes a procedure to determine the computer or network access level granted to individuals working on or near protected health information, medical data or secure health data.
Accredited standards committee: Organization that helps develop American National Standards (ANS) for computer and health information technology; accredited by ANSI for the development of American National Standards; ASC X12N develops medical electronic business exchange controls like 835-Health Care Claim Payment/Advice and 837-Health Care Claim.
Accountability: The security goal that generates the requirement for actions of an entity to be traced uniquely to that entity. This supports nonrepudiation, deterrence, fault isolation, intrusion detection and prevention, and after-action recovery and legal action.
Accounting: Creating an historical record of who was authenticated, at what time, and how long they accessed the computer system.
Administrative simplification: The use of electronic standard code sets for health information exchange; Title II, Subtitle F of HIPAA gives HHS the authority to mandate the use of standards for the electronic exchange of health care data; to specify what medical and administrative code sets should be used within those standards; to require the use of national identification systems for health care patients, providers, payers (or plans), and employers (or sponsors); and to specify the types of measures required to protect the security and privacy of personally identifiable health care and medical information.
Alternative backup sites: Off-site locations that are used for transferring computer operations in the event of an emergency.
American Health Information Management Association: A large trade association of health information and medical data management professionals.
American Medical Informatics Association: An organization that promotes the use of electronic medical management and healthcare informatics for clinical and administrative endeavors.
American Telemedicine Association: Established in 1993 as a leading resource and advocate promoting access to medical care for patients and health professionals via telecommunications technology; membership open to individuals, companies, and other organizations with an interest in promoting the deployment of telemedicine throughout the world.
Anti-virus software: A software package or subscription service used to thwart malicious computer or network attacks, such as: Symantec®, McAfee®, Trend Micro®, Panda Software®, Sunbelt Software®, Computer Associates®, AVG® or MS-FF ®, etc.
ASC X12N: HIPAA transmission standards, specifications and implementation guides from the Washington Publishing Company; or the National Council of Prescription Drug Programs.
Assurance: Grounds for confidence that the other four security goals (integrity, availability, confidentiality, and accountability) have been adequately met by a specific implementation. “Adequately met” includes (1) functionality that performs correctly, (2) sufficient protection against unintentional errors (by users or software), and (3) sufficient resistance to intentional penetration or bypass.
Asymmetric cryptology: The use of two different but mathematically related electronic keys for secure health data and medical information storage, transmission and manipulation.
Asymmetric encryption: Encryption and decryption performed using two different keys, one of which is referred to as the public key and one of which is referred to as the private key; also known as public-key encryption.
Asymmetric key: A half of a key pair used in an asymmetric “public-key” encryption system with two important properties: (1) the key used for encryption is different from the one used for decryption, (2) neither key can feasibly be derived from the other.
Attack tree: An inverted tree diagram that provides a visual image of the attacks that may occur against an asset.
Audio teleconferencing: A multi-simultaneous dual voice communications between two parties at remote locations; two way communications between physician and patient at various locations.
Authentication: The process of verifying and confirming the identity of a user.
Availability: The security goal that generates the requirement for protection against – Intentional or accidental attempts to (1) perform unauthorized deletion of data or (2) otherwise cause a denial of service or data.
Back door: A means to access to a computer program that bypasses security mechanisms, sometimes installed by a programmer so that the program can be accessed for troubleshooting or other purposes.
Back door trojans or bots: Currently, the biggest threat to healthcare and all PC users worldwide according to the MSFT Corporation.®
Bandwidth: The amount of information that can be carried over a communications link.
Bar coding systems: Final FDA ruling issued in February 2004 that required bar codes on most prescription and non-prescription medications used in hospitals and dispensed based on a physician’s order; the bar code must contain at least the National Drug Code (NDC) number, which specifically identifies the drug; although hospitals are not required at this time to have a bar code reading system on the wards, this ruling has heightened the priority of implementing hospital-wide systems for patient-drug matching using bar codes.
Baud: A unit of digital transmission that indicates the speed of information flow. The rate indicates the number of events able to be processed in one second and is expressed as bits per second (bps). The baud rate is the standard unit of measure for data transmission capability; typical older rates were 1200, 2400, 9600, and 14,400 baud; the signaling rate of a telephone line in the number of transitions made in a second; 1/300 sec = 300 baud.
Beta test: The secondary or final stress examination of newly developed computer hardware, software or peripheral devices; site, etc.
Bibliographic database: Indexed computer or printed source of citations of journal articles and other reports in the literature; typically include author, title, source, abstract, and/or related information; MEDLINE® and EMBASE®.
Bioinformatics: The application of medical and biological science to the health information management field.
Biological Information technology: Cross industry alliance of the Microsoft Corporation to enhance the ability to use and share digital health and biomedical data.
Biometric: Personal security identity characteristics, such as a signature, fingerprints, voice, iris or retinal scan, hand or foot vein geometry, facial characteristics, hair analysis, eye, blood vessel or DNA; uses the unique human characteristics of a person as a means of authenticating.
Biometric identification: Secure identification using biometrics that identifies a human from a measurement of a physical feature or repeatable action of the individual (for example, hand geometry, retinal scan, iris scan, fingerprint patterns, facial characteristics, DNA sequence characteristics, voice prints, and hand written signature).
Biopassword: Start-up healthcare IT security pioneer of keyboarding patterns to boost online security through neural network patterns.
Bluetooth® device: Machines, like cell phone with headset, transmitting across communications channels 1 to 14, over time.
Bluetooth® technology: Wireless mobile technology standard built into millions of mobile phones, headsets, portable computers, desktops and notebooks; named after Harold Bluetooth, a 10th century Viking king; healthcare telemetry and rural data transmissions; the Bluetooth Special Interest Group (BSIG) advocates measures aimed at pushing healthcare interoperability for wireless devices and other computers designed for use in the medical field; other wireless stands include: Wi-Fi, ZigBe®, IrDA and RFID.
Buffer: A temporary storage area.
Buffer overflow: A security breach that occurs when a computer program attempts to stuff more data into a temporary storage area than it can hold
Business continuity plan: A plan that outlines the procedures to follow after a business experiences an attack on its security.
California Database Security Breach Act: A state act that requires disclosure to California residents if a breach of personal information has or is believed to have occurred.
Certification authority: An independent third-party organization that assigns digital certificates.
Chain of custody: A process that documents everyone who has had contact with or direct possession of the evidence.
Chain of trust: Suggestion that each and every covered entity and business associate share responsibility and accountability for confidential PHI.
Chain of trust agreement: Contract entered into by two business partners in which it is agreed to exchange data and that the first party will transmit information to the second party, where the data transmitted is agreed to be protected between the partners; sender and receiver depend upon each other to maintain the integrity and confidentiality of the transmitted information; multiple two-party contracts may be involved in moving information from the originator to the ultimate recipient; for example, a provider may contract with a clearing house to transmit claims to the clearing house; the clearing house, in turn, may contract with another clearing house or with a payer for the further transmittal of those same claims.
Children’s Online Privacy Protection Act: A federal act that requires operators of online services or Web sites directed at children under the age of 13 to obtain parental consent prior to the collection, use, disclosure, or display of a child’s personal information.
Cipher lock: A combination lock that uses buttons that must be pushed in the proper sequence in order to open the door.
Clearing house: HIPAA medical invoice, healthcare data transaction exchange and medical data implementation service center that that meets or exceeds Federally-mandated standardized Electronic Data Interchange (EDI) transaction requirements.
Clinger-Cohen Act: Public Law 104-106; Information Technology Management Reform Act (ITMRA) of 1996.
Clinical data: Protected Health Information (PHI) from patient, physician, laboratory, clinic, hospital and/or payer, etc; identifiable patient medical information.
Clinical data information systems: Automatic and securely connected system of integrated computers, central severs and the Internet that transmits Protected Health Information (PHI) from patient, physician, laboratory, clinic, hospital and/or payer, etc.
Clinical data repository: Electronic storehouse of encrypted patient medical information; clinical data storage.
Clinical informatics: The management of medical and clinical data; the use of computers, networks and IT for patient care and health administration.
Clinical information: All the related medical information about a patient; Protected Health Information (PHI) from patients, providers, laboratories, clinics, hospitals and/or payers or other stakeholders, etc.
Clinical information system: A computer network systems that supports patient care; relating exclusively to the information regarding the care of a patient, rather than administrative data, this hospital-based information system is designed to collect and organize data.
Clinical regional health information system: Electronic entity committed to securely share private patient health information among entities like medical providers, clinics, laboratories, hospitals, outpatient centers, hospice and other healthcare facilities; Community Health Management Information Systems (CHMIS), Enterprise Information Networks (EINs), Regional Health Information Networks (RHINs) and Health Information Networks (HINs).
Cold site: An alternative backup site that provides the basic computing infrastructure, such as wiring and ventilation, but very little equipment.
Compact disc – read only memory (CD-ROM): A computer drive that can read CD-R and CD-RW discs.
Compact disc – recordable (CD-R): An optical disc that contains up to 650 megabytes of data and cannot be changed once recorded.
Compact disc – rewriteable (CD-RW): An optical disc that can be used to record data, erase it, and re-record again.
Computer security: A computer or network that is free from threats against it.
Computerized Physician Order Entry System: Automatic medical provider electronic medical chart ordering system that usually includes seven features: medication analysis, system order clarity, increased work efficiency, point of care utilization, benchmarking and performance tracking, on-line alerts and regulatory reporting.
Confidential health information: Protected Health Information (PHI) that is prohibited from free-use and secured from unauthorized dissemination or use; patient specific medical data.
Counter signature: The ability to prove the order of application of signatures; analogous to the normal business practice of signing a document which has already been signed by another party (ASTM E 1762 -95); part of a digital signature.
Covered entity: 42 CFR § 164.504(e)(2)(i)(B). Any of three broadly defined entities that deal with protected health information (PHI): providers, individuals or group health plans, and clearinghouses.
Cracker: A person who breaks into or otherwise violates the system security with a malicious intent.
Cryptography: The science of transforming information so that it is secure while it is being transmitted or stored.
Cyber-terrorism: Attacks by a terrorist group using computer technology and the Internet to cripple or disable a nation’s electronic infrastructure.
Data backup: The process of copying data to another media and storing it in a secure location.
Data encryption standard: An older health or medical data private key cryptology federal protocol for secure information exchange; replaced by AES.
Data interchange standard: X12 HIPAA health data transmission standard format.
Data interchange standard association: The organization that provides X12 HIPAA transmission standards and formats.
Deadbolt lock: A lock that extends a solid metal bar into the door frame for extra security.
Decision support system: Computer tools or applications to assist physicians in clinical decisions by providing evidence-based knowledge in the context of patient-specific data; examples include drug interaction alerts at the time medication is prescribed and reminders for specific guideline-based interventions during the care of patients with chronic disease; information should be presented in a patient-centric view of individual care and also in a population or aggregate view to support population management and quality improvement.
Decryption: Changing an encrypted message back to its original form.
Definition files: Files that contain updated antivirus information.
De-identified health information: Protected health information that is no longer individually identifiable health information; a covered entity may determine that health information is not individually identifiable health information only if: (1) a person with appropriate knowledge of and experience with generally accepted statistical and scientific principles and methods for rendering information not individually identifiable determines that the risk is very small that the information could be used, alone or in combination with other available information, to identify an individual, and documents the methods and results of the analysis; or (2) the following identifiers of the individual, relatives, employers or household members of the individual are removed.
Denial of service: The prevention of authorized access to resources or the delaying of time critical operations.
Designated record set: Contains medical and billing records and any other records that a physician and/or medical practice utilizes for making decisions about a patient; a hospital, emerging healthcare organization, or other healthcare organization is to define which set of information comprises “protected health information” and which set does not; contains medical or mixed billing records, and any other information that a physician and/or medical practice utilizes for making decisions about a patient. It is up to the hospital, EHO, or healthcare organization to define which set of information comprises “protected health information” and which does not though logically this should not differ from locale to locale. The patient has the right to know who in the lengthy data chain has seen their PHI. This sets up an audit challenge for the medical organization, especially if the accountability is programmed, and other examiners view the document without cause.
Designated standard: HIPAA standard as assigned by the department of HHS
Device lock: A steel cable and a lock used to secure a notebook computer.
Digital certificate: A certificate that binds a specific person to a public key.
Digital imaging and communications in medicine: Technology broadband transmission imaging standards for X-rays, MRIs, CT and PET scans, etc; health IT standard transmissions platform aimed at enabling different computing platforms to share image data without compatibility problems; a set of protocols describing how radiology images are identified and formatted that is vendor-independent and developed by the American College of Radiology and the National Electronic Manufacturers Association.
Digital radiology: Medical digital imaging applied to x-rays, CT, PET scans and related non-invasive and invasive technology; broadband intensive imaging telemedicine.
Digital rights management: The control and protection of digital intellectual property.
Digital signature: Encrypted electronic authorization with verification and security protection; private and public key infrastructure; based upon cryptographic methods of originator authentication, computed by using a set of rules and a set of parameters so that the identity of the signer and the integrity of medical or other data can be verified.
Digital signature standard: Encryption technology to ensure electronic medical data transmission integrity and authentication of both sender and receiver; date and time stamps; public and private key infrastructure.
Digital versatile disc – recordable (DVD-R): An optical disc technology that can record once up to 3.95 gigabytes of data on a single-sided disc and 7.9 GB on a double-sided disc.
Digital versatile disc – rewriteable (DVD-RAM): An optical disc technology that can record, erase, and re-record data and has a capacity of 2.6 GB (single side) or 5.2 GB (double side).
Digital versatile disc (DVD): A technology that permits large amounts of data to be stored on an optical disc.
Disaster recovery plan: A process to restore vital health and/or critical healthcare technology systems in the event of a medical practice, clinic, hospital or healthcare business interruption from human, technical or natural causes; focuses mainly on technology systems, encompassing critical hardware, operating and application software, and any tertiary elements required to support the operating environment; must support the process requirements to restore vital company data inside the defined business requirements; does not take into consideration the overall operating environment; an emergency mode operation plan is still necessary.
Disclosure: Release of PHI outside a covered entity or business agreement space, under HIPAA; the release, transfer, provision of access to or divulging of medical information outside the entity holding the information.
Disc – rewriteable (DVD-RW): An optical disc technology that allows data to be recorded, erased, and re-recorded.
Due care: Managers and their organizations have a duty to provide for information security to ensure that the type of control, the cost of control, and the deployment of control are appropriate for the system being managed.
e-health: Emerging field in the intersection of medical informatics, public health and business, referring to health services and information delivered or enhanced through the Internet and related technologies; characterizes not only a technical development, but also a state-of-mind, attitude, and a commitment for networked, global thinking, to improve health care worldwide by using information and communication technology.
Electronic data interchange: Inter healthcare organization computer-to-computer transmission of business or health information in a standard format; direct transmission from the originating application program to the receiving, or processing, application program; an EDI transmission consists only of business or health data, not any accompanying verbiage or free-form messages; a standard format is one that is approved by a national or international standards organization, as opposed to formats developed by health industry groups, medical practices, clinics or companies; the electronic transmission of secure medical and financial data in the healthcare industrial complex; X12 and similar variable-length formats for the electronic exchange of structured health data. The Centers for Medicare and Medicaid Services (CMS) regulates security and Electronic Data Interchange (EDI).
Electronic data interchange standards: The American National Standards Institute (ANSI) set of EDI standards known as the X12 standards. These standards have been developed by private sector standards development organizations (SDOs) and are maintained by the Accredited Standards Committee (ASC) X12. ANSI ASC X12N standards, Version 4010, were chosen for all of the transactions except retail pharmacy transactions, which continue to use the standard maintained by the National Council for Prescription Drug Programs (NCPDP) because it is already in widespread use. The NCPDP Telecommunications Standard Format Version 5.1 and equivalent NCPDP Batch Standard Version 1.0 have been adopted in this rule (health plans will be required to support one of these two NCPDP formats). The standards are designed to work across industry and company boundaries. Changes and updates to the standards are made by consensus, reflecting the needs of the entire base of standards users, rather than those of a single organization or business sector. Specifically, the following nine healthcare transactions were required to use X12N standard electronic claim formats by October 16, 2003.
Electronic health record: A real-time patient health record with access to evidence-based decision support tools that can be used to aid clinicians in decision-making; the EHR can automate and streamline a clinician’s workflow, ensuring that all clinical information is communicated; prevents delays in response that result in gaps in care; can also support the collection of data for uses other than clinical care, such as billing, quality management, outcome reporting, and public health disease surveillance and reporting; electronic medical record.
Electronic medication administrative record: Electrical file keeping computerized system for tracking clinical medication dispensation and use; integrated with TPAs, PBMs, robotic dispensing devices and CPOEs, etc.
Electronic medical (media) claims: Usually refers to a flat file format used to transmit or transport medical claims, such as the 192-byte UB-92 Institutional EMC format and the 320-byte Professional EMC-NSF.
Electronic prescribing: A type of computer technology whereby physicians use handheld or personal computer devices to review drug and formulary coverage and to transmit prescriptions to a printer or to a local pharmacy; e-prescribing software can be integrated into existing clinical information systems to allow physician access to patient-specific information to screen for drug interactions and allergies.
Electronic preventive services selector: A digital tool for primary care clinicians to use when recommending preventive services for their patients unveiled by the Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ), in November 2006; designed for use on a personal digital assistant (PDA) or desktop computer to allow clinicians to access the latest recommendations from the AHRQ-sponsored U.S. Preventive Services Task Force; designed to serve as an aid to clinical decision-making at the point of care and contains 110 recommendations for specific populations covering 59 separate preventive services topics; a real time search function allows a clinician to input a patient’s age, gender, and selected behavioral risk factors, such as whether or not they smoke, in the appropriate fields, while the software cross-references the patient characteristics entered with the applicable Task Force recommendations and generates a report specifically tailored for that patient.
Electronic signature: Various date and time stamped electronic security verification systems, such as passwords, encryption, ID numbers, biometrics identifiers, etc; electrical transmission and authentication of real signatories; signatory attribute that is affixed to an electronic health document to bind it to a particular entity; an electronic signature process secures the user authentication (proof of claimed health identity, such as by biometrics (fingerprints, retinal scans, hand written signature verification, etc.), tokens or passwords) at the time the signature is generated; creates the logical manifestation of signature (including the possibility for multiple parties to sign a medical document and have the order of application recognized and proven) and supplies additional information such as time stamp and signature purpose specific to that user; and ensures the integrity of the signed document to enable transportability, interoperability, independent verifiability, and continuity of signature capability; verifying a signature on a document verifies the integrity of the document and associated attributes and verifies the identity of the signer; there are several technologies available for user authentication, including passwords, cryptography, and biometrics (ASTM 1762-95).
Encryption: Changing the original text to a secret message.
Gigabytes (GB): Billions of bytes of data.
Gramm-Leach-Bliley Act: A federal act that requires private data be protected by banks and financial institutions.
Hacker: A person who possesses advanced computer skills and is adept at exploring computers and networks in order to break into them.
HEALTH 1.0: This is the dying healthcare system of yesterday and today. Information is communicated from doctors to patients. It is a basic B2C [business-to-consumer] website as the internet became one big encyclopedia by aggregating knowledge silos. Some doctors maintain websites, others do not. Nevertheless, Health 1.0 has a command and control hierarchy; doctors on top of the pyramid, patients on the bottom.
HEALTH 2.0:According to Matthew Holt [personal communication] Healthcare 2.0 may be defined as: “The foundation of healthcare 2.0 is information exchange plus technology. It employs user-generated content, social networks and decision support tools to address the problems of inaccessible, fragmentary or unusable health care information. Healthcare 2.0 connects users to new kinds of information, fundamentally changing the consumer experience (e.g., buying insurance or deciding on/managing treatment), clinical decision-making (e.g., risk identification or use of best practices) and business processes (e.g., supply-chain management or business analytics)”.
And so, if Health 1.0 was a static book, Health 2.0 is a dynamic discussion
Example: The power of the internet is illustrated in the phenomenon of “crowd-sourcing.” In this context, the term means to harvest the reach of social networking [wisdom of crowds] to solve a problem. A knowledge seeker asks a question and participants respond. For example, readers can participate on the www.MedicalExecutivePost.com or www.BusinessofMedicalPractice.com sites to improve the administration of any medical practice. And, www.PodiatryPrep.com is an example of how podiatrists connect for global board certification assistance.
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HEALTH 2.0 Plus:The Dictionary of Health Insurance and Managed Care defines this emerging hybrid as a bridge uniting the philosophy of contemporary Health 2.0 with futuristic Health 3.0 technologies. Cisco System’s HealthPresence is one example developed in 2010, by Dr. T. Warner Hudson. Using the network as a platform, HealthPresence combines video, audio and information to create an environment similar to what patients experience when they visit their own doctor.
HEALTH 3.0: Soon, patients will not only be seeking information; but actionable intelligence – whether it is artificial or real. Patients will communicate almost as with another patient or doctor. The internet won’t just blindly do what we tell it to do – it will think and represent some amazing opportunities. For example, imagine your toilet running a SMAC 20 and then being instantly notified of the results by your smart phone? Or; use your iPhone to send pictures and streaming videos of conditions for a second opinion www.KnockingLive.com
Health information technology: The application of information processing involving both computer hardware and software that deals with the storage, retrieval, sharing, and use of health care information, medical data, and knowledge for communication and decision making.
Health information technology auditor: An expert who evaluate a health organization’s computer systems to ensure the proper safeguards are in place to protect and maintain the integrity of the firm’s data; While the position has existed since the mid-1960s, companies that previously employed just a handful of HIT auditors are now significantly adding to their ranks, sometimes doubling, tripling or quadrupling current staff levels; much current demand is due to the Sarbanes-Oxley Act and other legislation aimed at improving corporate governance in the wake of major accounting scandals earlier in the decade; publicly traded hospital systems require the expertise of HIT auditors to meet ongoing compliance requirements; the Gramm-Leach-Bliley Act and the Health Insurance Portability and Accountability Act (HIPAA), among other regulations, also are fueling the need for HIT auditors. Health IT auditors must have a general understanding of accounting principles and the strategic vision to ensure a health organization’s HIT systems allow it to achieve its short- and long-term objectives. Many hospitals promote from within for this role. Health facilities who look outside the organization for these professionals usually seek candidates with experience, knowledge of healthcare of emerging technologies and issues, and increasingly, certifications such as the certified information systems auditor (CISA) designation.
Health information technology promotion act: Legislation to accelerate the adoption of interoperable electronic health records by ensuring uniform standards, championed by Rep. Nancy Johnson, R-Conn, (H.R. 4157) which would: codify the Office of the National Coordinator for Health Information Technology in statute and delineate its ongoing responsibilities; create exceptions to the fraud and abuse statutes to allow certain providers to fund health information technology equipment and services for other providers; and provide for a study of federal and state health privacy policies.
Health Insurance Portability and Accountability Act (HIPAA): A federal act that requires enterprises in the health sector to guard protected health information and implement policies and procedures to safeguard it.
Health level seven: An international community of healthcare subject matter experts and information technology physicians and scientists collaborating to create standards for the exchange, management and integration of protected electronic healthcare information; the Ann Arbor, Mich.-based Health Level Seven (HL7) standards developing organization has evolved Version 3 of its standard, which includes the Reference Information Model (RIM) and Data Type Specification (both ANSI standards); HL7 Version 3 is the only standard that specifically deals with creation of semantically interoperable healthcare information, essential to building the national infrastructure; HL7 promotes the use of standards within and among healthcare organizations to increase the effectiveness and efficiency of healthcare delivery for the benefit of all patient, payers, and third parties; uses an Open System Interconnection (OSI) and high level seven healthcare electronic communication protocol that is unique in the medical information management technology space and modeled after the International Standards Organization (ISO) and American National Standards Institute (ANSI); each has a particular healthcare domain such as pharmacy, medical devices, imaging or insurance (claims processing) transactions. Health Level Seven’s domain is clinical and administrative data.
Hot site: An alternative backup site that contains the same equipment as found in the organization’s actual IT center.
Human firewall: An employee who practices good security techniques to prevent any security attacks from passing through them.
Incident response team: An employee team charged with gathering and handling the digital evidence of an attack.
Individually identifiable health information: Medical information that is created or received by a covered entity; relates to the physical or mental health condition of an individual, provision of health care or the payment for the provision of health care; identifies the individual or there is reasonable belief that the information can be used to identify the individual.
Information security: A computer or network that is free from threats against it.
Integrity: The security goal that generates the requirement for protection against either intentional or accidental attempts to violate data integrity (the property that data has when it has not been altered in an unauthorized manner) or system integrity (the quality that a system has when it performs its intended function in an unimpaired manner, free from unauthorized manipulation).
Intellectual property: Works created by others such as books, music, plays, paintings, and photographs.
IT-related risk: The net mission impact considering (1) the probability that a particular threat-source will exercise (accidentally trigger or intentionally exploit) system vulnerability and (2) the resulting impact if this should occur. IT-related risks arise from legal liability or mission loss due to:
* Unauthorized (malicious or accidental) disclosure, modification, or destruction of information
* Unintentional errors and omissions
* IT disruptions due to natural or man-made disasters
* Failure to exercise due care and diligence in the implementation and operation of the IT system.
Key-in-knob lock: A basic lock that has the lock mechanism embedded in the knob or handle.
Keystroke logger: A type of hardware spyware that captures keystrokes as they are typed.
Logic bombs: A computer program that lies dormant until it is triggered by a specific event.
Lossless: To compress electronic digital data.
Malicious code: Programs that are intentionally created to break into secure computers or to create havoc after the computers are accessed.
Master patient index: Healthcare facility composite that links and assists in tracking patient, person, or member activity within an organization (or health enterprise) and across patient care settings; hardcopy or electronic identification of all patients treated in a facility or enterprise and lists the medical record or identification number associated with the name; can be maintained manually or as part of a computerized system; typically, those for healthcare facilities are retained permanently, while those for insurers, registries, or others may have different retention periods; a database of all the patients ever registered (within reason) at a facility; name, demographics, insurance, next of kin, spouse, etc.
Medically unbelievablE event: Implemented on Jan. 1, 2007, the CMS blockage of payments for medical services that make no sense based on “anatomic considerations” or medical reasonableness when the same patient, date of service, HCPCS code or provider is involved; unlike other National Correct Coding Initiative (NCCI) edits, MUEs can’t be overridden by a modifier because there will never be a scenario where the physician had a good reason to submit a claim for removing a second appendix from the same person; etc.
Megabytes (MB): Millions of bytes of storage.
Memory stick: USB flash or non-volatile storage device; Sony CompactFlash®, pen or mini-drive; flash card, smart media, slang terms.
Mesh: Medical Subject Headings, the controlled vocabulary of about 16,000 terms used for MEDLINE and certain other MEDLARS databases.
Minimum necessary: The amount of protected health information shared among internal or external parties determined to me the smallest amount needed to accomplish its purpose for Use or Disclosure; the amount of health information or medical data needed to accomplish a purpose varies by job title, CE or job classification.
Minimum necessary rule: HIPAA regulation that suggests any PHI used to identify a patient, such as a social security number, home address or phone number; divulge only essential elements for use in transferring information from patient record to anyone else that requires the information; especially important with financial information; changes the way software is written and vendor access is provided. The “Minimum Necessary” Rule states the minimum use of PHI that can be used to identify a person, such as a social security number, home address or phone number. Only the essential elements are to be used in transferring information from the patient record to anyone else that needs this information. This is especially important when financial information is being addressed. Only the minimum codes necessary to determine the cost should be provided to the financial department. No other information should be accessed by that department. Many institutions have systems where a registration or accounting clerk can pull up as much information as a doctor or nurse, but this is now against HIPAA policy and subject to penalties. The “minimum necessary” rule is also changing the way software is set up and vendor access is provided.
Mirror site: A secondary location identical to the primary IT site that constantly receives a copy of data from the primary site.
National health information network: The technologies, standards, laws, policies, programs and practices that enable health information to be shared among health decision makers, including consumers and patients, to promote improvements in health and healthcare; vision for the NHII began more than a decade ago with publication of an Institute of Medicine report, The Computer-Based Patient Record. The path to a national network of healthcare information is through the successful establishment of Regional Health Information Organizations (RHIO).
National provider identifier: Originally was an eight-digit alphanumeric identifier. However, the healthcare industry widely criticized this format, claiming that major information systems incompatibilities would make it too expensive and difficult to implement. DHHS therefore revised its recommendation, instead specifying a 10-position numeric identifier with a check digit in the last position to help detect keying errors. The NPI carries no intelligence; in other words, its characters will not in themselves provide information about the provider. More recently, CMS announced that HIPAA-covered entities such as providers completing electronic transactions, healthcare clearinghouses, and large health plans, must use only the NPI to identify covered healthcare providers in standard transactions by May 23, 2007. Small health plans must use only the NPI by May 23, 2008. The proposal for a Standard Unique National Health Plan (Payer) Identifier was withdrawn on February, 2006. (According to CMS, “withdrawn” simply means that there is not a specific publication date at this time. Development of the rule has been delayed; however, when the exact date is determined, the rule will be put back on the agenda.)
Network: A group of interconnected computers.
Notebook safe: A special safe secured to a wall or the trunk of a car used for storing a notebook computer.
Operating system hardening: Steps that can be taken to make a personal computer operating system more secure.
Optical disc: A disc that uses laser technology to record data.
Password: A secret combination of words or numbers that authenticates or identifies the user.
Patch: A software update to correct a problem.
Patch management: Tools, utilities, and processes for keeping computers up to date with new software updates that are developed after a software product is released.
Pharmacy information system: Drug tracking and dispensation related health management information system for hospitals and healthcare organizations.
PhisHing: An attempt to fraudulent gather confidential information by masquerading as a trustworthy entity, person or business in an apparently official email, text message or website; carding or spoofing; video vishing; phish-tank; vish-tank; slang terms.
Physical security: The process of protecting the computer itself.
Port scanning: Sending a flood of information to all of the possible network connections on a computer.
Ports: The network connections on a computer.
Preset lock: A basic lock that has the lock mechanism embedded in the knob or handle.
Privacy: The quality or state of being hidden, encrypted, obscure, or undisclosed; especially medical data or PHI.
Privacy act: Federal legislature of 1974 which required giving patient some control over their PHI.
Privacy enhanced mail: Email message standard protocol for enhanced medical, health data or other security.
Privacy officer: A medical entity’s protected client information and security officer; required by each covered entity, to be responsible for “the development and implementation of the policies and procedures” necessary for compliance.
Privacy rule: The Federal privacy regulations promulgated under the Health Insurance Portability and Accountability Act (HIPAA) of 1996 that created national standards to protect medical records and other protected health information. The Office of Civil Rights (OCR) within the Department of Health and Human Services (DHHS) regulates the privacy rules.
Privacy standards: Any protocol to ensure the confidentiality of PHI.
Private key system: A means of cryptography where the same key is used to both encrypt and decrypt a message.
Public key system: A means of cryptography where two keys are used.
* Psychotherapy notes recorded (in any medium) by a health care provider who is a mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint, or family counseling session and that are separated from the rest of the individual’s medical record; excludes medication prescription and monitoring, counseling session start and stop times, the modalities and frequencies of treatment furnished, results of clinical tests, and any summary of the following items: diagnosis, functional status, the treatment plan, symptoms, prognosis, and progress to date.
* Public health authority means an agency or authority of the United States, a State, a territory, a political subdivision of a State or territory, or an Indian tribe, or a person or entity acting under a grant of authority from or contract with such public agency, including the employees or agents of such public agency or its contractors or persons or entities to whom it has granted authority, that is responsible for public health matters as part of its official mandate.
* Required by law means a mandate contained in law that compels a covered entity to make a use or disclosure of protected health information and that is enforceable in a court of law; includes but is not limited to, court orders and court-ordered warrants; subpoenas or summons issued by a court, grand jury, a governmental or tribal inspector general, or an administrative body authorized to require the production of information; a civil or an authorized investigative demand; Medicare conditions of participation with respect to health care providers participating in the program; and statutes or regulations that require the production of information, including statutes or regulations that require such information if payment is sought under a government program providing public benefits.
Regional health information organization: A multi-stakeholder organization that enables the exchange and use of health information, in a secure manner, for the purpose of promoting the improvement of health quality, safety and efficiency; the U.S. Department of Health and Human Services see RHIOs as the building blocks for the national health information network (NHIN) that will provide universal access to electronic health records; other experts maintain that RHIOs will help eliminate some administrative costs associated with paper-based patient records, provide quick access to automated test results and offer a consolidated view of a patient’s history.
Risk assessment: The process of identifying the risks to system security and determining the probability of occurrence, the resulting impact, and additional safeguards that would mitigate this impact.
Risk management: The total process of identifying, controlling, and mitigating information system–related risks. It includes risk assessment; cost-benefit analysis; and the selection, implementation, test, and security evaluation of safeguards. This overall system security review considers both effectiveness and efficiency, including impact on the mission and constraints due to policy, regulations, and laws.
Royalties: Payment to the owner or creator of intellectual property for their work.
Sarbanes-Oxley Act (Sarbox): A federal act that enforces reporting requirements and internal controls on electronic financial reporting systems.
Scanning: Locating a computer that can be broken into.
Script kiddies: Younger and less sophisticated users who break into a computer with malicious intent.
Secure virtual private network: Cryptographic tunneling protocols to provide the necessary health data confidentiality (preventing snooping), sender authentication (preventing identity spoofing), and message integrity (preventing message alteration) to achieve the medical privacy intended. When properly chosen, implemented, and used, such techniques can provide secure communications over unsecured networks.
Security: A set of healthcare information technology system characteristic and mechanisms which span the system both logically and physically; electronic access control against unauthorized intervention, both friendly or malicious; encompasses all of the safeguards in an information system, including hardware, software, personnel policies, information practice policies, disaster preparedness, and the oversight of all these areas; the purpose of health information security is to protect both the system and the information it contains from unauthorized access from without and from misuse from within; through various security measures, a health information system can shield confidential information from unauthorized access, disclosure and misuse, thus protecting privacy of the individuals who are the subjects of the stored data; security life cycle.
Security administration: The physical and electrical protection features of an IT health system needed to be managed in order to meet the needs of a specific installation and to account for changes in the healthcare entities operational environment.
Security compromise: Physical or electronic data, file, program or transmission error due to malicious miscreants or software interventions; health data confidentiality breach.
Security configuration: Measures, practices, and procedures for the safety of information systems that must be coordinated and integrated with each other and other methods, practices, and procedures of the organization established in order to credential safekeeping policy; provides written security plans, rules, procedures, and instructions concerning all components of a healthcare entity’s security; procedures must give instructions on how to report breaches and how those breaches are to be handled within the organization.
Security configuration management: The measurement of practices and procedures for the security of information systems that is coordinated and integrated with each other and other measures, practices and procedures of the organization so as to create a coherent system of health data security (NIST Pub 800-14).
Security domain: A set of subjects, their information objects, and a common security policy; foundation for IT security is the concept of security domains and enforcement of data and process flow restrictions within and between these domains.
Security goals: The five security goals are integrity, availability, confidentiality, accountability, and assurance.
Security information system: security is a system characteristic and a set of mechanisms that span the system both logically and physically.
Security policy: A formal written policy that outlines the importance of security to the organization and establishes how the security program is organized.
Share: An object that is shared with others over a computer network.
Signature files: Files that contain updated antivirus information.
Smart card: A device that contains a chip that stores the user’s private key, login information, and public key digital certificate.
Sniffing: Listening to the traffic on a computer network and then analyzing it.
Social engineering: Relying on trickery and deceit to break security and gain access to computers.
Spam: Unsolicited e-mail messages.
Spy: A person who has been hired to break into a computer and steal data.
Spyware: Hardware or software that “spies” on what the user is doing and captures that activity without their knowledge.
Stealth signal transmitter: Software installed on a notebook computer that sends a signal that can be traced.
Threat analysis: The examination of threat-sources against system vulnerabilities to determine the threats for a particular system in a particular operational environment.
Threat modeling: A process of constructing scenarios of the types of threats that assets face.
Threat: The potential for a threat-source to exercise (accidentally trigger or intentionally exploit) a specific vulnerability.
Threat-source: Either (1) intent and method targeted at the intentional exploitation of a vulnerability or (2) a situation and method that may accidentally trigger a vulnerability.
Token: A security device used to authenticate the user by having the appropriate permission (like a password) embedded into the device.
USA Patriot Act: A federal act designed to broaden the surveillance of law enforcement agencies to enhance the detection and suppression of terrorism.
Username: A unique identifier of a person used to access a computer system.
Virus: A program that secretly attaches itself to other programs and when executed causes harm to a computer.
Vulnerability: A flaw or weakness in system security procedures, design, implementation, or internal controls that could be exercised (accidentally triggered or intentionally exploited) and result in a security breach or a violation of the system’s security policy.
Vulnerability assessment: A process to determine what vulnerabilities exist in the current system against these attacks.
Vulnerability assessment managed services: Agencies that use scanning devices connected to probe an organization’s security to look for vulnerabilities.
War driving: A technique used to locate wireless local area networks (WLANs).
WiMax: A more powerful version of Wi-Fi that can provide wireless Internet access over wider geographic location such as a city; an acronym that stands for Worldwide Interoperability for Microwave Access, and is a certification mark for products that pass conformity and interoperability tests for the IEEE 802.16 standards. IEEE 802.16 is working group number 16 of IEEE 802, specializing in point-to-multipoint broadband wireless access.
Wireless hot spot: Specific geographic location in which an access point provides public wireless broadband network services; security is risky for PHI; hotspot.
Wireless local area networks: A computer network that uses radio waves instead of wires to connect computers.
Worm: A program that does not attach itself to other programs or need user intervention to execute.
Posted on June 18, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
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By Dr. David Edward Marcinko MBA MED CMP™
SPONSOR: wwwCertifiedMedicalPlanner.org
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Crisis Management is the precautions and identification of threats to an organization and its stakeholders, and the methods used by the organization to deal with these threats.
For example, recall in 1982, that Tylenol™ commanded 35 percent of the over-the-counter analgesic market in America and it represented nearly 17 percent of Johnson & Johnson’s profits. But, when seven people died from consuming the tainted drug, a national panic ensued. Moreover, Americans started to question the safety of all over-the-counter medications.
Fortunately, J&J commenced the proto-typical good crisis response in the following way:
J&J acted quickly, with complete candidness about what happened and within hours of learning of the deaths, J&J installed toll-free numbers for consumers, sent alerts to healthcare providers nationwide, and stopped advertising the product. J&J recalled 31 million bottles of Tylenol™ capsules and offered replacement products free of charge. J&J did not wait for evidence to see whether the contamination might be more widespread.
J&J’s leadership was in the lead and seemed in full control throughout the crisis. The chairman was admired for his leadership to pull Tylenol™ capsules off the market and his forthrightness in dealing with the media. The Tylenol™ crisis led the news every night on every station for six weeks.
J&J placed consumers first. J&J spent more than $100 million for the recall and re-launch of Tylenol™. The stock had been trading near a 52-week high just before the tragedy, dropped for a time, but recovered to its highs only two months later.
J&J accepted responsibility. The disaster could have been described in many different ways: as an assault on the company, as a problem somewhere in the process of getting Tylenol™ from J&J factories to retail stores, or as the acts of a crazed criminal.
J&J sought to ensure that measures were taken to prevent a recurrence of the problem. J&J introduced tamper-proof packaging that would make it much more difficult for a similar incident to occur in the future.
J&J presented itself prepared to handle the short-term damage in the name of consumer safety. Within a year of the disaster, J&J’s share of the analgesic market, which had fallen to 7 percent from 37 percent following the poisoning, had climbed back to 30 percent.
This wildly successful response in now the stuff of graduate and business school case models for excellence in teaching!
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
Correlation measures the relationship between two investments–the higher the correlation, the more likely they are to move in the same direction for a given set of economic or market events. Correlation, in the finance and investment industries, is a statistic that measures the degree to which two securities move in relation to each other. Correlations are used in advanced portfolio management, computed as the correlation coefficient which has a value that must fall between -1.0 and +1.0.
So if two securities are highly positively correlated, they will move in the same direction the vast majority of the time. Negatively correlated investments do the opposite–as one security rises, the other falls, and vice versa. No correlation means there is no relationship between the movement of two securities–the performance of one security has no bearing on the performance of the other.
Correlation is an important concept for portfolio diversification--combining assets with low or negative correlations can improve risk-adjusted performance over time by providing a diversity of payouts under the same financial conditions.
The average directional movement index (ADX) was developed in 1978 by J. Welles Wilder as a technical indicator of trend strength in a series of prices of a financial instrument. ADX has become a widely used indicator for technical analysts, and is provided as a standard in collections of indicators offered by various trading platforms.
The ADX is a combination of two other indicators developed by Wilder, the positive directional indicator (abbreviated +DI) and negative directional indicator (-DI). The ADX combines them and smooths the result with a smoothed moving average.
The average directional index (ADX) is a technical indicator used by traders to determine the strength of a financial security’s price trend. It helps them reduce risk and increase profit potential by trading in the direction of a strong trend. Many traders consider the ADX to be the ultimate trend gauge because it is so reliable.
ADX quantifies trend strength by measuring the degree of directional movement in price. ADX calculations are based on a moving average of price range expansion or contraction over a given period. The default setting is 14 periods, although other settings can be used.
ADX can be used with any financial security, including stocks, exchange-traded funds, and futures.
Posted on June 17, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By AI
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Stocks: Israel and Iran exchanged missile strikes for a fourth day, but investors are betting that the conflict will remain at least somewhat contained. Reports that Iran wants to de-escalate the conflict and even restart nuclear talks seemed to underline that idea, and markets rose strongly throughout the afternoon.
Commodities: Gold fell as hopes of a ceasefire between Israel and Iran made investors more bullish, while Iranian oil infrastructure was spared from the attacks, pushing crude prices lower.
Bonds: A $13 billion 20-year bond auction this afternoon yielded strong demand, rounding out a series of solid auctions over the last few days that seemingly point to renewed investor confidence in US fixed income.
Alternatively Weighted Exchange Traded Funds are designed to track an index that is constructed based on criteria other than market capitalization (the methodology used for most traditional indexes).
Instead, alternatively weighted indexes select and weight securities based on other factors, such as growth, valuation, and price momentum, among others. Examples include:
Invesco S&P 500 Equal Weight ETF (NYSEARCA: RSP)
SPDR Technology ETF (NYSEARCA: XNTK)
First Trust NYSE Arca Biotechnology Index Fund (NYSEARCA: FBT)
Amplify Online Retail ETF (NASDAQ: IBUY)
iShares MSCI USA Equal Weighted ETF (NYSEARCA: EUSA)
Posted on June 16, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
BREAKING NEWS!
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Markets: Brace for +/- volatility as US markets reopen this morning, with the escalating Israel–Iran conflict dominating investors’ Bloomberg Terminals.
Stocks fell the most in nearly a month on Friday, and the prospect of an oil supply shock sent crude prices 7% higher, their biggest one-day gain in years. Through it all, the S&P 500 is less than 3% from its record high.
Combined, both the DOW and NASDAQ are up over 750 points, today!
here are many ways for a doctor, osteopath, podiatrist or dentist to financially invest. Traditionally, this meant picking individual stocks and bonds. Today, there are many other ways to purchase securities en mass. For example:
MUTUAL FUND: A regulated investment company that manages a portfolio of securities for its shareholders.
Open End Mutual Funds: An investment company that invests money in accordance with specific objectives on behalf of investors. Fund assets expand or contract based on investment performance, new investments and redemptions. Trade at Net Asset Value or the price the fund shares scheduled with the US Securities and Exchange Commission (SEC) trade. NAV can change on a daily basis. Therefore, per-share NAV can, as well.
Closed End Mutual Funds: Older than open end mutual funds and more complex. A CEMF is an investment company that registers shares SEC regulations and is traded in securities markets at prices determined by investments. Shares of closed-end funds can be purchased and sold anytime during stock market hours. CEMF managers don’t need to maintain a cash reserve to redeem or / repurchase shares from investors. This can reduce performance drag that may otherwise be attributable to holding cash. CEMFs may be able to offer higher returns due to the heavier use of leverage [debt]. They are subject to volatility, less liquid than open-end funds, available only through brokers and may sells at a heavily discount or premium to [NAV] determined by subtracting its liabilities from its assets. The fund’s per-share NAV is then obtained by dividing NAV by the number of shares outstanding. .
Sector Mutual Funds: Sector funds are a type of mutual fund or Exchange-Traded Fund (ETF) that invests in a specific sector or industry such as technology, healthcare, energy, finance, consumer goods, or real estate. Sector funds focus on a particular industry, allowing investors to gain targeted exposure to specific market areas. The goal is to outperform the overall market by investing in companies within a specific sector that is expected to perform well. However, they are also more susceptible to market fluctuations and specific sector risks, making them a more specialized and potentially higher-risk investment option.
EXCHANGE TRADED FUNDS: ETFs are a type of fund that owns various kinds of securities, often of one type. For example, a stock ETF holds stocks, while a bond ETF holds bonds. One share of the ETF gives buyers ownership of all the stocks or bonds in the fund. If an ETF held 100 stocks, then those who owned the fund would own a stake – albeit a very tiny one – in each of those 100 stocks.
ETFs are typically passively managed, meaning that the fund usually holds a fixed number of securities based on a specific preset index of investments. These are tax efficient. In contrast, many mutual funds are actively managed, with professional investors trying to select the investments that will rise and fall.
The Standard & Poor’s 500 Index is perhaps the world’s best-known index, and it forms the basis of many ETFs. Other popular indexes include the Dow Jones Industrial Average and the National Association of Securities Dealers Automated Quotations [NASDAQ] Composite Index.
ETFs based on these funds are called Index Funds and just buy and hold whatever is in the index and make no active trading decisions. ETFs trade on a stock exchange during the day, unlike mutual funds that trade only after the market closes. With an ETF you can place a trade whenever the market is open and know exactly the price you’re paying for the fund.
INDEX FUNDS: Index funds mirror the performance of benchmarks like the DJIA. These passive investments are an unimaginative way to invest. Passive index funds tracking market benchmarks accounted for just 21% of the U.S. equity fund market in 2012. By 2024, passive index funds had grown to about half of all U.S. fund assets. This rise of passive funds has come as they often outperform their actively managed peers. According to the widely followed S&P Indices Versus Active (SPIVA) scorecards, about 9 out of 10 actively managed funds didn’t match the returns of the S&P 500 benchmark in the past 15 years.
ASSESSMENT
Investing in individual stocks is psychologically and academically different than investing in the above funds, according to psychiatrist and colleague Ken Shubin-Stein MD, MPH, MS, CFA who is a professor of finance at the Columbia University Graduate School of Business When you buy shares of a company, you are putting all your eggs in one basket. If the company does well, your investment will go up in value. If the company does poorly, your investment will go down. Fund diversification helps reduce this risk.
CONCLUSION
Investing in the above fund types will help mitigate single company security risk.
References:
1. Fenton, Charles, F: Non-Disclosure Agreements and Physician Restrictive Covenants. In, Marcinko, DE and Hetico, HR: Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™]. Productivity Press, New York, 2015.
Readings:
1. Marcinko, DE and Hetico, HR; Comprehensive Financial Planning Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™] Productivity Press, New York, 2017
2. Marcinko, DE: Dictionary of Health Economics and Finance. Springer Publishing Company, NY 2006
4. Shubin-Stein, Kenneth: Unifying the Psychological and Financial Planning Divide [Holistic Life Planning, Behavioral Economics, Trading Addiction and the Art of Money]. Marcinko, DE and Hetico, HR; Comprehensive Financial Planning Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™] Productivity Press, New York, 2017
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com
Posted on June 14, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By AI
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The National Debt Explained
The national debt is the amount of money the federal government has borrowed to cover the outstanding balance of expenses incurred over time. In a given fiscal year (FY), when spending (ex. money for roadways) exceeds revenue (ex. money from federal income tax), a budget deficit results. To pay for this deficit, the federal government borrows money by selling marketable securities such as Treasury bonds, bills, notes, floating rate notes, and Treasury inflation-protected securities (TIPS).
The national debt is the accumulation of this borrowing along with associated interest owed to the investors who purchased these securities. As the federal government experiences reoccurring deficits, which is common, the national debt grows.
Simply put, the national debt is similar to a person using a credit card for purchases and not paying off the full balance each month. The cost of purchases exceeding the amount paid off represents a deficit, while accumulated deficits over time represents a person’s overall debt.
Posted on June 13, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
DEFINED
By CoPilot AI
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Barcodes and QR codes are basically two forms of machine-readable codes that contain data and are useful in various sectors such as retail, logistics, and marketing. While both appear to fulfill the function of storing information, they have differences based on structure and storage size as well as the function they perform. This makes it easier for businesses to distinguish what is relevant in barcodes and what is relevant in QR codes so that they can be in a position to adopt the right technology that will suit their needs well.
Barcode provides us with a way to store numbers in a computer-understandable format. This is used to store information in a 1D or 2D format that can be scanned for data retrieval. It is used by stores’ back-off sweaters for keeping track of the patients just in case of rental car services to track where the car is in cases of airline luggage.
Simplicity: Barcodes are easy to implement and can be put into use within a short span of time and with comparatively less investment.
Low Cost: The equipment and technology required in the generation as well as the scanning of the bar codes are relatively cheap.
Quick Scanning: As has already been discussed, barcodes are easy to scan and this makes them suitable for_numeric environments such as the retail sector.
Disadvantages of Barcodes
Limited Data Capacity: Barcodes also have a limited data processing capability with limited numerical values, of between 8-20 characters per barcode.
One-Dimensional: Barcode is more vast than OWLT and cannot contain complex information since it is one-dimensional.
Prone to Damage: That is why they can be barely scratched or damaged in such a manner that they will not scan properly.
What is QR code?
QR codes are a way of storing data in the form of computer understandable format, that can be scanned by using QR code scanner to retrieve the data. These are widely used nowadays for cashless and UPI payment services. They can be used in case of identifications and are also used for sharing photos, videos and other files.
High Data Capacity: QR codes contain the ability to enclose thousands of characters that include numbers, letters and even the binary data.
Small Physical Footprint: In fact, most QR codes are small in size even though they have a high storage capacity thereby making it possible to print them despite the limited amount of space.
Error Correction: QR codes are also created with erasure correction, so the code can still be scanned even if SOME of the dots are scratched out.
Versatile Applications: According to the functional aspect QR codes can be used in marketing, payments, wither links, multimedia information storage etc.
Disadvantages of QR Codes
Requires Specific Software: Unlike barcodes that can be scanned by an ordinary laser scan gun, QR code must be scanned with a QR code scanner or simply an advanced telephone or tablet with a QR code scanner application.
Overuse in Marketing: The use of QR codes has been popularized mainly in the marketing sector, hence consumers are used to seeing it and may opt to look the other way.
Posted on June 12, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
A Basic Overview for Emerging Physician and Medical Professional Investors
By Somnath Basu; PhD, MBA
There are three basic considerations in any investment decision.
1] The first is the understanding of the investment objective or why the investment is being made. While this may seem somewhat irrelevant at first – why would you be investing if you do not know what you are doing – combining investment objectives can pose problems down-stream.
For example, if you are saving for your retirement so that you can afford the retirement lifestyle you desire (the investment objective), your saving plan should not include any savings you are making for your children’s education (a separate investment objective). Compounding the two savings streams in one plan can very easily lead to one or both of the plans failing.
2] The second consideration is the time horizon of the investment. As a rough guide, investments that need to mature in the next 5-7 years can be considered as short term, 8-15 years as medium term and the rest as long term.
3] Finally, and probably the most important consideration of all is the importance you attach (priority) to achieving your investment objective; in other words, how safe and secure should your investments be. For example, if you are 70 years old and considering how you should invest your retirement funds so that your expenses are covered say for the next 25 years, you do not want a large margin of error in how your investments turn out; you can ill afford to be broke when you are older and hence you want your investments to be as secure as possible.
On the other hand, if the investment is for a second home or a boat, for example, you may wish to engage in some risk taking which may help in lowering your upfront investment needs. It is very important for any investor to clearly understand how much loss they can bear from any investment decision.
Decision Matrix
It is useful to express the investment framework described above as a simple decision matrix. Using the matrix (shown below) as a decision support system should clarify and simplify most investment decisions.
Understanding where in the matrix your decision falls is a very good first step of your decision. Both these elements (safety and time) will ultimately decide the kinds of financial instruments that will reside in your portfolio. We will examine the structure of each of the 9 possible combinations shown in the matrix. Before doing so, let us start by examining the various investment alternatives (e.g. stocks, bonds, etc.) since they have an implicit connection with the two dimensions portrayed in our matrix.
Stocks
Stocks are the most well known and popular form of financial investments. Stocks may be further segregated between large cap and small cap stocks, where the term “cap” is surrogate for the size of the underlying corporation or firm.
Stocks may represent investments in both domestic and international companies. Within the international category, stocks may represent corporations registered in developed (safer) or emerging (riskier) markets. In terms of our matrix dimensions, stocks are best suited when the decision is of medium or long term. In terms of safety, large cap (both domestic and international) stocks are the safest, while small cap and emerging market stocks are the most risky. The riskier the stock, the greater are the profit possibilities as are the chances of large losses.
Bonds
The second common type of investment are bonds Generally, bonds are much safer than stocks with the exception of a class of bonds known as high yield (or junk) bonds. Bonds are issued by companies, governments (domestic and international) and other agencies such as local governments (municipal bonds or “munis” which are especially desirable for those in high income tax rate categories) and quasi-government agencies such as Federal Home Loan Bank, Student Loan Administration, Agricultural Cooperative Banks, etc (collectively known as “Agency” bonds such as Ginnie/Fannie/Sallie Mae, Freddie Mac, etc.).
Government bonds are the safest, followed by agency and municipal bonds and then by bonds issues by corporations.
Corporate bonds may be safe (which are assigned credit safety ratings such as AAA, AA, BBB, etc.) or risky (junk bonds with ratings such as BB, CCC, CC etc.).
Bonds can be used for all time horizons, their maturities ranging from 3 months to 30 years. Very short term bond and bond like instruments (with maturities of one year or less) are known as money market securities which are generally safer than most other investments.
Alternate Investments
Other types of investments include real estate (long term, risky), commodities (such as energy, basic building materials, precious metals, etc.) which are also risky and which may be used for both short term and long term purposes and provide a good hedge (counter balance) in an inflationary environment, derivatives (options and futures) which are very risky and typically short term in nature. Derivatives are generally suggested for very sophisticated investors and are best left alone otherwise.
Risk Reduction
A very important feature about investments is that when various types of investments are bundled together in a portfolio, they help to reduce the risk of the investment decision without affecting the profits in a comparable way. This basic aspect of mixing various kinds of investments (stocks, bonds, etc) to reduce risk is known as diversification and it is a “must” for any investment portfolio. It is a “must” because this technique of risk reduction is generally costless (unless you are paying a financial advisor to do this for you) and it is very worthwhile. All other methods of risk reduction have cost implications.
Scenario Matrix
Armed with this nomenclature regarding various investment types we can now go about examining what the 9 combination (Scenario) portfolios may look like for investment purposes.
Starting with Scenario 1, if you wish to make a short term decision that is very important to you and needs to be very safe, investments should be made in very short term bonds (government or treasury bills)and other similar money market (short term, safe) securities. International short term bonds of developed countries may also be included. Such investment products are generally available through mutual funds or Exchange Traded Funds (or ETFs). ETFs are just like mutual funds except that they are usually cheaper, much easier to buy and sell and may provide tax deferral benefits.
If your investment falls in the Scenario 2 category, include agency/municipal bonds as well as some domestic and international (developed country) large cap stocks while for Scenario 3, smaller portions of small cap and emerging market stocks may be added proportionately while reducing some of the safer investments.
If your investment was a Scenario 4 type of investment, corporate large cap stocks (both domestic and international) could be added to agency or corporate (domestic and international) bonds. Before investing in stocks (in any Scenario) for this Scenario 4, a good question to ask is the following: how profitable were stock investments in the last 3-5 years? If the answer is “very profitable” then reduce the proportion of stocks as compared to bonds in the portfolio. If the last few years were not good, then it would be good to increase their comparable shares. The main reason for this “fine tuning” is that the fortunes of stocks (and many other types of investments) follow a cyclical pattern and the cycle is related to the general cycle of economic (GDP) growth and contraction.
It can be seen now how Scenarios 5 and 6 (as also 8 and 9) will follow a similar pattern as before, increasing proportionally in stocks (of all sizes, domestic/international), real estate, commodities, etc. Portfolios falling in these groups may also include some small cap and emerging market stocks as well as high yield or junk bonds. The proportion of these riskier investments would of course be higher for Scenario 6 over Scenario 5 (and Scenario 9 over 8).
For Scenario 7, the investment portfolio would typically resemble one that would be like an opposite of the portfolio in Scenario 1 and would include a greater proportion of large cap (domestic/international) stocks and a much smaller proportion of bonds. As we move towards Scenarios 8 and 9, the portfolios would be dominated by small cap and emerging market stocks as well as junk bonds.
Assessment
In the discussion above, I have tried to generalize the investment decision in a simplifying way. While the discussion may have centered more on stocks and bonds, it is important to note that all portfolios must “diversify” the investment risks by expanding upon the various types of investment products contained in the portfolios. The very fact that a portfolio contains various types of investments will ensure that the portfolio will perform better than those which are not as well diversified. This will be so in spite of any one of the investment types underperforming at any point in time and the diversification benefit will be received consistently over long periods of time. A popular analogy to this diversification benefit is the common phrase of not putting all eggs in one basket.
Editor’s Note: Somnath Basu PhD is program director of the California Institute of Finance in the School of Business at California Lutheran University where he’s also a professor of finance. He can be reached at (805) 493 3980 or basu@callutheran.edu
Conclusion
The above approach to investment decision-making can be considered as a basic template that can be used universally. For those seeking greater sophistication and who have a foundation built on the above model, expert advice is strongly recommended.
And so, your thoughts and comments on this ME-P are appreciated. Financial advisors please chime in on the debate? Is Basu correct; why or why not? Review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@outlook.com
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Posted on June 12, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
Accidental Death and Dismemberment
By AI
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What is AD&D insurance?
AD&D insurance combines two types of coverage: an accidental death policy that pays out if you die in an accident, and a dismemberment policy that pays out if you have a serious injury such as losing a limb or becoming paralyzed because of an accident. The beneficiary of your AD&D policy (such as your spouse) collects the money in the case of an accidental death, and you collect it if you suffer one of the injuries outlined in the policy.
Here’s the catch: The death or injury must be the direct result of an accident. So, for example, if you have a heart attack while you’re driving and get into a fatal car crash, your beneficiaries probably won’t receive any money.
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While AD&D insurance can offer financial peace of mind to you and your loved ones in the event of an accident, it won’t pay out if you die from natural causes or a terminal illness — so it’s not a replacement for life insurance. And since it doesn’t cover all injuries or disabilities, it isn’t as comprehensive as disability insurance either.
Be aware that insurers often sell accidental death insurance without dismemberment coverage. These policies pay out only if you die and won’t cover an accident that leaves you seriously injured but alive.
Bonds: The 10-year yield fell after CPI came in lower than analysts expected. The Treasury Department’s auction of 10-year bonds also went well, with strong participation from traders a key sign of demand for fixed income. Zero Coupon: https://medicalexecutivepost.com/2024/11/12/bonds-zero-coupon/
FIVE INVESTING MISTAKES OF DOCTORS; PLUS 1 VITAL TIP
As a former US Securities and Exchange Commission [SEC] Registered Investment Advisor [RIA] and business school professor of economics and finance, I’ve seen many mistakes that doctors must be aware of, and most importantly, avoid. So, here are the top 5 investing mistakes along with suggested guideline solutions.
Mistake 1: Failing to Diversify Investment but Beware Di-Worsification
A single investment may become a large portion of your portfolio as a result of solid returns lulling you into a false sense of security. The Magnificent Seven stocks are a current example:
Apple, up +5,064%% since 1/18/2008
Amazon, up +30,328% since 9/6/2002
Alphabet, up +1,200% since 7/20/2012
Tesla, up +21,713% since 11/16/2012
Meta, up +684% since 2/20/2015
Microsoft, up +22% since 12/21/2023
Nvidia, up +80,797% since 4/15/2005
Guideline: The Magnificent Seven [7] has grown from 9% of the S&P 500 at the end of 2013 to 31% at the end of 2024! That means even if you don’t own them, you’re still very exposed if you have an Index Fund [IF] or Exchange Traded Fund [ETF] that tracks the market. Accordingly, diversification is the only free lunch in investing which can reduce portfolio risk. But, remember the Wall Street insider aphorism that states: “Di-Versification Means Always Having to Say Your Sorry.”
The term “Di-Worsification” was coined by legendary investor Peter Lynch in his book, One Up On Wall Street to refer to over-diversifying an investment portfolio in such a way that it reduces your overall risk-return characteristics. In other words, the potential return rises with an increase in risk and invested money can render higher profits only if willing to accept a higher possibility of losses [1].
A podiatrist can easily fall into the trap of chasing securities or mutual funds showing the highest return. It is almost an article of faith that they should only purchase mutual funds sporting the best recent performance. But in fact, it may actually pay to shun mutual funds with strong recent performance. Unfortunately, many struggle to appreciate the benefits of their investment strategy because in jaunty markets, people tend to run after strong performance and purchase last year’s winners.
Similarly, in a market downturn, investors tend to move to lower-risk investment options, which can lead to missed opportunities during subsequent market recoveries. The extent of underperformance by individual investors has often been the most awful during bear markets. Academic studies have consistently shown that the returns achieved by the typical stock or bond fund investors have lagged substantially.
Guideline: Understand chasing performance does not work.Continually monitor your investments and don’t feel the need to invest in the hottest fund or asset category. In fact, it is much better to increase investments in poor performing categories (i.e. buy low). Also keep in remind rebalancing of assets each year is key. If stocks perform poorly and bonds do exceptionally well, then rebalance at the end of the year. In following this strategy, this will force a doctor into buying low and selling high each year.
Often doctors make their investment decisions under the belief that stocks will consistently give them solid double-digit returns. But the stock markets go through extended long-term cycles.
In examining stock market history, there have been 6 secular bull markets (market goes up for an extended period) and 5 secular bear markets (market goes down) since 1900. There have been five distinct secular bull markets in the past 100+ years. Each bull market lasted for an extended period and rewarded investors.
For example, if an investor had started investing in stocks either at the top of the markets in 1966 or 2000, future stock market returns would have been exceptionally below average for the proceeding decade. On the other hand, those investors fortunate enough to start building wealth in 1982 would have enjoyed a near two-decade period of well above average stock market returns. They key element to remember is that future historical returns in stocks are not guaranteed. If stock market returns are poor, one must consider that he or she will have to accept lower projected returns and ultimately save more money to make up for the shortfall. For example,
The May 6th, 2010, flash crash, also known as the crash of 2:45, was a United States trillion-dollar stock market plunge which started at 2:32 pm EST and lasted for approximately 36 minutes.
And, investors who have embraced the “buy the dip” strategy in 2025 have been handsomely rewarded, with the S&P 500 delivering its strongest post-pull back returns in over three decades.
According to research from Bespoke Investment Group, the S&P 500 has gained an average of 0.36% in the trading session following a down day so far in 2025. The only year with a comparable performance was 2020, which saw a 0.32% average post-dip gain [2].
The most recent example came on May 27, 2025 when the S&P 500 surged more than 2% after falling 0.7% in the final session before the holiday weekend. The rally was sparked by President Trump’s decision to scale back huge previously threatened tariffs on EU —a recurring catalyst behind many of 2025’s rebound.
Guideline: Beware of projecting forward historical returns. Doctors should realize that the stock markets are inherently volatile and that, while it is easy to rely on past historical averages, there are long periods of time where returns and risk deviate meaningfully from historical averages.
Some doctors believe they are “smarter than the market” and can time when to jump in and buy stocks or sell everything and go to cash. Wouldn’t it be nice to have the clairvoyance to be out of stocks on the market’s worst days and in on the best days?
Using the S&P 500 Index, our agile imaginary doctor-investor managed to steer clear of the worst market day each year from January 1st, 1992 to March 31st, 2012. The outcome: s/he compiled a 12.42% annualized return (including reinvestment of dividends and capital gains) during the 20+ years, sufficient to compound a $10,000 investment into $107,100.
But what about another unfortunate doctor-investor that had the mistiming to be out of the market on the best day of each year. This ill-fated investor’s portfolio returned only 4.31% annualized from January 1992 – March 2012, increasing the $10,000 portfolio value to just $23,500 during the 20 years. The design of timing markets may sound easy, but for most all investors it is a losing strategy.
More contemporaneously on December 18th 2024, the DJIA plummeted 2.5%, while the S&P 500 declined 3% and the NASDAQ tumbled 3.5%
Guideline: If it looks too good to be true, it probably is. While jumping into the market at its low and selling right at the high is appealing in theory, we should recognize the difficulties and potential opportunity and trading costs associated with trying to time the stock market in practice. In general, colleagues are be best served by matching their investment with their time horizon and looking past the peaks / valleys along the way.
Mistake 5: Failing to Recognize the Impact of Fees and Expenses
A free dinner seminar or a polished stock-broker sales pitch may hide the total underlying costs of an investment. So, fees absolutely matter.
The first costing step is determining what the fees actually are. In a mutual fund, these costs are found in the company’s obligatory “Fund Facts”. This manuscript clearly outlines all the fees paid–including up front fees (commissions and loads), deferred sales charges and any switching fees. Fund management expense ratios are also part of the overall cost. Trading costs within the fund can also impact performance.
Here is a list of the traditional mutual fund fees:
Front End Load: The commission charged to purchase a fund through a stock broker or financial advisor. The commission reduces the amount you have available to invest. Thus, if you start with $100,000 to invest, and the advisor charges up to an 8 percent front end load, you end up actually investing $92,000.
Deferred Sales Charge (DSC) or Back End Load: Imposed if you sell your position in the mutual fund within a pre-specified period of time (normally one – five years). It is initiated at a higher start percentage (i.e. as high as 10 percent) and declines over a specific period of time.
Operating Fees: Costs of the mutual fund including the management fee rewarded to the manager for investment services. It also includes legal, custodial, auditing and marketing fees.
Annual Administration Fee: Many mutual fund companies also charge a fee just for administering the account – usually under $100-150 per year.
Guideline: Know and understand all fees.
For example: A 1 percent disparity in fees may not seem like much but it makes a considerable impact over a long time period.
Consider a $100,000 portfolio that earns 8 percent before fees, grows to $320,714 after 20 years if the investor pays a 2 percent operating fee. In comparison, if s/he opted for a fund that charged a more reasonable 1 percent fee, after 20 years, the portfolio grows to be $386,968 – a divergence of over $66,000!
This is the value of passive or index investing. In the case of an index fund, fees are generally under 0.5 percent, thus offering even more savings over a long period of time.
One Vital Tip: Investing Time is on Your Side
Despite thousands of TV shows, podcasts, textbooks, opinions and university studies on investing, it really only has three simple components. Amount invested, rate of return and time. By far, the most important item is time! For example:
Nvidia: if you invested $1,000 in 2009, you’d have $338,103 today.
Apple: if you invested $1,000 in 2008, you’d have $48,005 today.
Netflix: if you invested $1,000 in 2004, you’d have $495,679 today.
Unfortunately, this list of investing mistakes is still being made by many doctors. Fortunately, by recognizing and acting to mitigate them, your results may be more financially fruitful and mentally quieting.
REFERENCES:
1. Lynch, Peter: One Up on Wall Street [How to Use What You Already Know to Make Money in the Market]: Simon and Shuster (2nd edition) New York, 2000.
1. Marcinko, DE; Comprehensive Financial Planning Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™] Productivity Press, New York, 2017.
2. Marcinko, DE: Dictionary of Health Economics and Finance. Springer Publishing Company, New York, 2006.
3. Marcinko, DE; Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™] CRC Press, New York, 2015.
BIO: As a former university Professor and Endowed Department Chair in Austrian Economics, Finance and Entrepreneurship, the author was a NYSE Registered Investment Advisor and Certified Financial Planner for a decade. Later, he was a private equity and wealth manager
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
Posted on June 11, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Tesla climbed another 5.67% on signs that Elon Musk and President Trump are mending fences and on hype around the robotaxi reveal this week.
TSMC rose 2.63% after the semiconductor company reported that its revenue in the month of May rose 39.6% year over year.
Disney rose 2.65% higher a day after agreeing to purchase Comcast’s stake in streaming service Hulu for $438.7 million. Comcast climbed 2.95%.
Solar stocks got a bit of hope after the Wall Street Journal reported that tech companies are lobbying Congress to keep clean energy subsidies in the tax and spending bill. SolarEdge rose 11.81%, and Sunrun gained 7.13%.
Insmed exploded 28.65% thanks to strong results for the biopharma company’s new treatment for pulmonary arterial hypertension.
Casey’s General Store rose 11.59% after the retailer crushed Wall Street’s profit expectations last quarter and raised its dividend.
McDonald’s lost 1.43% thanks to a double downgrade from Redburn Atlantic analysts, who think the fast food titan’s slowing foot traffic and headwinds from obesity drugs will hurt its growth. That’s the company’s third downgrade in three days.
Stocks: Markets meandered higher as investors awaited news from ongoing US & China trade negotiations in London. Commerce Secretary Howard Lutnick said talks were going well and could continue into tomorrow.
Commodities: Oil soared to its highest price since April on hopes that a trade deal between the world’s largest economies could spur demand, but plunged back to earth after the US said oil output will fall next year.
Crypto: After just barely holding on last week, Bitcoin has now stayed above $100,000 for 30 days straight for the first time ever—a signal to traders that there’s a new level of support for the crypto king.
Posted on June 10, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Health Capital Consultants, LLC
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On May 13th, 2025, the CMS Center for Medicare & Medicaid Innovation (CMMI) introduced a new strategic plan for its models going forward. After ending four payment models early and canceling two not-yet-implemented models in March 2025, the agency had promised to release a new strategy. Nearly two weeks later, CMMI released that strategy, as well as a preliminary evaluation of, and changes to, one of its core payment models.
This Health Capital Topics article will review CMMI’s recent actions and what initial indications these actions provide. (Read more…)
Posted on June 10, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By AI
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Stocks: Equities inched higher on a handful of optimistic headlines. First, the US and China trade teams met in London today with hopes the two superpowers could resolve disputes over export curbs. Also, a new survey from the New York Fed found that consumer expectations for inflation eased across all time horizons in May. STOCKS: https://medicalexecutivepost.com/2025/04/18/stocks-basic-definitions/
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