Blinded Medical Payments

Dr. David Edward Marcinko MBA MEd CMP

SPONSOR: http://www.MarcinkoAssociates.com

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An Examination of Their Purpose and Impact

Blinded medical payments have emerged as a compelling approach to addressing some of the most persistent challenges in modern healthcare systems. At their core, these payment structures are designed to separate the financial aspects of care from the clinical decision‑making process. By obscuring or “blinding” the cost of specific services from either the patient, the provider, or both, the model aims to reduce conflicts of interest, encourage unbiased medical judgment, and create a more equitable healthcare experience. Although the concept may seem counterintuitive in a system where transparency is often championed, blinded payments offer a nuanced strategy for improving trust, fairness, and outcomes.

One of the primary motivations behind blinded medical payments is the desire to minimize the influence of financial incentives on clinical decisions. In many traditional payment models, providers are acutely aware of the reimbursement rates associated with different procedures. This awareness can unintentionally shape treatment recommendations, even when clinicians strive to act solely in the patient’s best interest. Blinded payment systems attempt to remove this pressure by ensuring that providers do not know the exact compensation tied to each service. Without this knowledge, the theory goes, decisions are more likely to be guided by clinical need rather than financial reward. This can be particularly valuable in specialties where high‑cost procedures are common and where the potential for overuse is well documented.

Patients, too, can benefit from a degree of blinding. When individuals are confronted with detailed cost information at the point of care, they may feel compelled to make decisions based on price rather than medical necessity. This dynamic can lead to underuse of essential services, delayed treatment, or heightened anxiety during an already stressful moment. By shielding patients from granular cost details until after care is delivered, blinded payment systems aim to preserve the integrity of the clinical encounter. The patient can focus on understanding their condition and the recommended treatment, rather than navigating a complex and often confusing financial landscape.

Another important dimension of blinded medical payments is their potential to reduce disparities. In many healthcare systems, providers may unconsciously adjust their recommendations based on assumptions about a patient’s ability to pay. Even well‑intentioned clinicians can fall into patterns of offering different options to different socioeconomic groups. Blinding payment information helps counteract this tendency by ensuring that all patients are presented with the same range of medically appropriate choices. This can contribute to more consistent care across populations and help narrow gaps in outcomes that have persisted for decades.

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However, blinded medical payments are not without challenges. Critics argue that withholding cost information from patients undermines their autonomy. In an era where consumer‑driven healthcare is increasingly emphasized, some believe that individuals should have full access to pricing details so they can make informed decisions about their care. Others worry that blinding providers to reimbursement rates may reduce accountability or make it more difficult to evaluate the cost‑effectiveness of different treatments. These concerns highlight the delicate balance between transparency and impartiality, and they underscore the need for thoughtful implementation.

Operationally, blinded payment systems require sophisticated administrative structures. Healthcare organizations must develop mechanisms to process claims, allocate funds, and track utilization without revealing sensitive financial details to clinicians or patients. This can be resource‑intensive, especially for smaller practices or systems with limited technological infrastructure. Additionally, the success of blinded payments depends on trust—trust that the system is fair, that reimbursement is adequate, and that no party is being disadvantaged by the lack of visibility.

Despite these complexities, blinded medical payments represent a meaningful attempt to address the misaligned incentives that often distort healthcare delivery. They challenge the assumption that more information is always better and instead propose that strategic withholding of information can sometimes lead to more ethical and equitable outcomes. As healthcare systems continue to evolve, blinded payments may serve as one of several innovative tools aimed at creating a more patient‑centered and value‑driven environment.

COMMENTS APPRECIATED

EDUCATION: Books

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

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DRAW PAYMENTS: Financial Advisor Compensation System

Dr. David Edward Marcinko; MBA MEd CPM

SPONSOR: http://www.CertifiedMedicalPlanner.org

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A financial advisor’s draw payment system is a compensation structure that blends stability with performance incentives, giving advisors predictable income while still tying their long‑term earnings to the revenue they generate. It is widely used in brokerage firms, independent advisory practices, and insurance‑based financial services organizations because it helps new or transitioning advisors manage cash flow while they build a client base. Understanding how a draw works, why firms use it, and what trade‑offs it creates is essential for evaluating its fairness and effectiveness.

What a Draw Payment System Is

A draw is an advance on future commissions or advisory fees. Instead of being paid strictly when revenue is earned, the advisor receives a regular, predetermined payment—weekly, biweekly, or monthly—that functions like a salary. Later, when the advisor earns commissions or fees, those earnings are used to “repay” the draw. If the advisor earns more than the draw amount, they receive the excess. If they earn less, the draw may accumulate as a deficit that must be repaid or carried forward.

Firms use several types of draws. A recoverable draw must be paid back through future production, while a non‑recoverable draw functions more like a temporary stipend that the firm does not reclaim. Some firms offer a graduated draw, which decreases over time as the advisor becomes more productive. These variations allow firms to tailor compensation to the advisor’s experience level and the firm’s risk tolerance.

Why Firms Use Draw Systems

The draw system exists because financial advising is a revenue‑driven profession with unpredictable income patterns. New advisors often face months of prospecting before earning meaningful commissions or fees. Without a draw, many would struggle to cover basic living expenses, making the profession inaccessible to anyone without substantial savings.

For firms, the draw system is a way to attract talent without committing to a full salary. It shifts part of the financial risk to the advisor while still providing enough stability to support early‑stage business development. It also aligns incentives: advisors are motivated to produce revenue because their long‑term earnings depend on it.

How Draws Affect Advisor Behavior

A draw system shapes advisor behavior in several ways:

  • Encourages early productivity — Because the draw must be repaid, advisors feel pressure to generate revenue quickly.
  • Promotes long‑term client building — Once production exceeds the draw, advisors begin earning true commissions or fees, reinforcing the value of building a strong book of business.
  • Creates accountability — Firms can track whether advisors are on pace to justify their compensation.
  • Influences risk‑taking — Advisors may feel pressure to sell products with higher commissions to cover their draw, which can create ethical tensions if not properly supervised.

These behavioral effects are neither inherently good nor bad; their impact depends on firm culture, compliance oversight, and the advisor’s professional judgment.

Advantages for Advisors

A draw system offers several benefits:

  • Income stability — Advisors can rely on predictable payments while building their client base.
  • Reduced financial stress — The draw helps cover living expenses during slow periods.
  • Opportunity for high earnings — Once production exceeds the draw, advisors can earn significantly more than a fixed salary would allow.
  • Professional runway — The system gives advisors time to develop skills, build relationships, and refine their business model.

For many advisors, the draw is the bridge that makes the early years of the profession survivable.

Advantages for Firms

Firms also benefit from draw systems:

  • Lower upfront risk — Firms avoid paying full salaries to advisors who may not produce.
  • Performance alignment — Compensation is tied directly to revenue generation.
  • Talent attraction — Draws make the profession accessible to candidates who lack financial reserves.
  • Scalable compensation — Firms can adjust draw levels as advisors grow, reducing support as production increases.

This balance of risk and reward is one reason the draw system remains common across the industry.

Challenges and Criticisms

Despite its advantages, the draw system has drawbacks:

  • Debt pressure — Recoverable draws can accumulate into large deficits, creating financial stress.
  • Potential conflicts of interest — Advisors may feel pressure to recommend products with higher commissions.
  • Uneven income — Once the draw period ends, income can fluctuate dramatically.
  • Advisor turnover — High draw deficits can push advisors out of the industry before they have time to succeed.

These challenges highlight the importance of training, ethical oversight, and realistic production expectations.

The Draw System in a Modern Advisory Environment

As the industry shifts toward fee‑based planning and fiduciary standards, some firms are rethinking draw structures. Fee‑based advisors often experience more stable revenue streams, reducing the need for large draws. At the same time, firms still use draws to support new advisors who are transitioning from other careers or building a client base from scratch.

Hybrid models are emerging, combining modest base salaries with smaller draws and performance bonuses. These structures aim to reduce conflicts of interest while still rewarding productivity.

Closing Thought

A financial advisor’s draw payment system is ultimately a tool for balancing stability and performance. When designed thoughtfully, it supports new advisors, aligns incentives, and helps firms manage risk. When poorly structured, it can create financial pressure and ethical challenges. The key is finding a balance that supports both advisor success and client‑centered service.

COMMENTS APPRECIATED

EDUCATION: Books

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

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Risk‑Based Medical Payment Models

Dr. David Edward Marcinko; MBA MEd CMP

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Risk‑based medical payment models have become one of the most significant shifts in modern health‑care financing. They move providers away from the traditional fee‑for‑service structure, where every test, visit, or procedure generates a separate payment, and toward arrangements that reward value, outcomes, and cost‑conscious care. This shift reflects a broader recognition that paying for volume alone can unintentionally encourage overuse, fragmentation, and rising costs. Risk‑based models attempt to realign incentives so that providers are financially accountable for the quality and efficiency of the care they deliver.

At the core of these models is the idea of financial risk transfer. Instead of insurers or government programs bearing the full cost of patient care, providers accept some degree of responsibility for spending that exceeds predetermined benchmarks. The level of risk can vary widely. Upside‑only arrangements allow providers to share in savings if they keep costs below expectations, while downside risk requires them to repay losses if spending surpasses targets. Full‑risk or global‑capitation models go even further, giving providers a fixed per‑patient payment to cover all necessary services. The more risk a provider assumes, the greater the potential reward—but also the greater the potential financial exposure.

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One of the most widely used risk‑based models is the accountable care organization, or ACO. In an ACO, groups of physicians, hospitals, and other clinicians coordinate care for a defined population. They are measured on quality metrics such as preventive care, chronic disease management, and patient experience. If they meet quality standards while keeping total spending below a benchmark, they share in the savings. If they take on two‑sided risk, they may also owe money back when costs exceed expectations. The structure encourages collaboration, data sharing, and proactive management of high‑risk patients, all of which are difficult to achieve in a purely fee‑for‑service environment.

Bundled payments represent another important risk‑based approach. Instead of paying separately for each component of a treatment episode, such as a surgery and its follow‑up care, a bundled payment provides a single, predetermined amount for the entire episode. Providers must work together to deliver care efficiently within that budget. If they can do so while maintaining quality, they keep the difference as savings. If complications or inefficiencies drive costs above the bundle price, they absorb the loss. Bundled payments are particularly effective for procedures with predictable care pathways, such as joint replacements or cardiac interventions, and they encourage standardization and reduction of unnecessary variation.

Capitation, one of the oldest risk‑based models, assigns providers a fixed per‑member, per‑month payment to cover all or most services. This model creates strong incentives for preventive care, early intervention, and careful resource management. When implemented well, capitation can support integrated care delivery and long‑term population health strategies. However, it also requires robust infrastructure, accurate risk adjustment, and safeguards to ensure that cost control does not come at the expense of necessary care. Providers must be able to manage complex patients effectively, and payment rates must reflect the true needs of the population.

Risk adjustment is a critical component across all risk‑based models. Without it, providers who care for sicker or more socially complex patients could be unfairly penalized. Risk adjustment uses demographic and clinical data to estimate expected costs for each patient, ensuring that benchmarks and payments reflect the underlying health status of the population. Accurate risk adjustment protects against adverse selection and supports fairness, but it also requires sophisticated data systems and careful oversight to prevent gaming or upcoding.

Despite their promise, risk‑based payment models face challenges. Providers must invest in care‑management teams, data analytics, and interoperable technology to succeed. Smaller practices may struggle with the administrative and financial demands of taking on risk. Patients may also experience confusion if networks narrow or if care pathways become more structured. Policymakers and payers must balance incentives for efficiency with protections that ensure access and quality.

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Even with these complexities, risk‑based models continue to expand because they offer a path toward a more sustainable and patient‑centered health‑care system. By rewarding outcomes rather than volume, they encourage providers to focus on prevention, coordination, and long‑term health. They also create opportunities for innovation in care delivery, from telehealth to home‑based services to integrated behavioral health. As health‑care costs continue to rise, risk‑based payment models represent a strategic attempt to align financial incentives with the goals of better care, healthier populations, and more efficient use of resources.

COMMENTS APPRECIATED

EDUCATION: Books

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

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TOP 10: Financial Scammers

Dr. David Edward Marcinko MBA MEd CMP

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Financial fraud has long been woven into the fabric of American economic history. From Ponzi schemes to corporate deception, the United States has witnessed a series of high‑profile scandals that not only devastated investors but also reshaped regulatory frameworks. While the methods evolve with technology and time, the underlying motivations—greed, power, and the illusion of success—remain constant. This essay explores ten of the most notorious U.S. financial scammers whose actions left lasting scars on markets, institutions, and public trust.

1. Kenneth Lay & Jeffrey Skilling (Enron)

Few scandals loom as large as Enron, a company once hailed as an innovative energy titan before collapsing under the weight of its own deception. Enron executives Kenneth Lay and Jeffrey Skilling engineered an elaborate system of off‑balance‑sheet entities to hide debt and inflate earnings. The fraud, involving an estimated $74 billion, shattered investor confidence and triggered the Sarbanes‑Oxley Act, one of the most sweeping corporate governance reforms in U.S. history.

Their scheme demonstrated how corporate culture—when driven by unchecked ambition—can incentivize fraud at scale. Enron’s downfall remains a cautionary tale about transparency, oversight, and the dangers of financial engineering gone awry.

2. Bernie Madoff (Madoff Investment Securities)

Bernie Madoff orchestrated the largest Ponzi scheme in world history, defrauding investors of an estimated $65 billion. His reputation as a respected financier and former NASDAQ chairman allowed him to operate undetected for decades. Madoff’s scam unraveled during the 2008 financial crisis, exposing how trust, prestige, and secrecy can mask catastrophic fraud.

Though not directly cited in the retrieved sources, Madoff’s case is widely recognized as one of the most consequential financial crimes in U.S. history.

3. Andrew Fastow (Enron CFO)

While Lay and Skilling were the public faces of Enron, CFO Andrew Fastow was the architect behind the company’s labyrinth of special‑purpose vehicles (SPVs). These entities allowed Enron to hide massive liabilities while presenting a façade of profitability. Fastow personally profited from managing these off‑books partnerships, blurring the line between corporate officer and self‑interested operator. His actions exemplify how technical accounting knowledge can be weaponized to deceive investors.

4. Elizabeth Holmes (Theranos)

Elizabeth Holmes captivated Silicon Valley and Wall Street with promises of revolutionary blood‑testing technology. Theranos, valued at $9 billion at its peak, claimed it could run hundreds of tests from a single drop of blood. Investigations later revealed that the technology did not work, and the company relied on traditional machines while misleading investors, regulators, and patients.

Holmes’ downfall highlighted the dangers of hype‑driven investment culture and the need for scientific validation in health‑tech ventures.

5. Allen Stanford (Stanford Financial Group)

Allen Stanford ran a massive Ponzi scheme disguised as a global banking empire. Through fraudulent certificates of deposit issued by his Antigua‑based bank, Stanford defrauded investors of more than $7 billion. His charisma and lavish lifestyle helped him cultivate an image of legitimacy, masking the underlying fraud for years.

Stanford’s case underscored the vulnerabilities in cross‑border financial regulation and the risks of opaque offshore banking structures.

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6. Jordan Belfort (Stratton Oakmont)

Popularized by The Wolf of Wall Street, Jordan Belfort’s pump‑and‑dump schemes in the 1990s defrauded investors through aggressive sales tactics and artificially inflated stock prices. While his crimes were smaller in scale than others on this list, Belfort’s cultural impact is enormous. His story illustrates how manipulation, high‑pressure sales, and market hype can devastate unsuspecting investors.

7. Charles Ponzi (The Original Ponzi Scheme)

Although his scheme dates back to the early 20th century, Charles Ponzi’s name remains synonymous with financial fraud. His promise of extraordinary returns through international postal coupon arbitrage attracted thousands of investors. When the scheme collapsed, it revealed the classic structure of a fraud model still used today: paying old investors with new investors’ money.

Ponzi’s legacy endures as a blueprint for countless modern scams.

8. Martin Shkreli (Turing Pharmaceuticals)

Martin Shkreli, often dubbed “Pharma Bro,” became infamous for dramatically raising the price of a life‑saving drug. While his price‑gouging was legal, Shkreli was later convicted of securities fraud unrelated to the drug scandal. His case illustrates how unethical behavior in one domain can draw scrutiny that uncovers deeper financial misconduct.

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9. Sam Bankman‑Fried (FTX)

Sam Bankman‑Fried’s cryptocurrency exchange FTX collapsed in 2022 amid revelations of misused customer funds, lack of internal controls, and deceptive financial practices. Although crypto is a new frontier, the underlying fraud echoed classic themes: commingled funds, misleading investors, and unchecked executive power.

Bankman‑Fried’s downfall signaled a turning point in calls for crypto regulation and transparency.

10. Modern Imposter & Digital Scammers

While not tied to a single individual, modern imposter scams represent one of the fastest‑growing categories of financial fraud in the U.S. According to the Federal Trade Commission, Americans lost $5.8 billion to fraud in a single reporting year, with imposter scams leading the list. These schemes often involve criminals posing as government officials, financial advisors, or tech support agents to extract money or personal information.

Digital fraudsters exploit urgency, fear, and technological sophistication to deceive victims. As noted in recent analyses, imposter scams remain among the most prevalent and damaging forms of financial deception today.

Conclusion

The stories of these ten financial scammers reveal recurring themes: the power of perceived legitimacy, the exploitation of trust, and the persistent evolution of fraudulent tactics. From Enron’s corporate labyrinth to Madoff’s quiet betrayal, from Silicon Valley hype to digital‑age imposters, financial fraud continues to adapt to new technologies and cultural shifts.

Yet each scandal also brings progress. Regulatory reforms, improved oversight, and increased public awareness have emerged from the wreckage of these schemes. Understanding the methods and motivations of past scammers is essential to preventing future ones. As long as financial systems exist, so too will those who seek to exploit them—but informed vigilance remains society’s strongest defense.

COMMENTS APPRECIATED

EDUCATION: Books

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

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Banking Reputational Risk

Dr. David Edward Marcinko; MBA MEd CMP

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Reputational risk has become one of the most consequential and complex challenges facing modern banks. In an industry built fundamentally on trust, reputation functions as a form of capital—intangible yet immensely valuable. When customers deposit money, purchase financial products, or rely on a bank for advice, they are placing confidence in the institution’s integrity, competence, and stability. Because of this, reputational damage can undermine a bank’s ability to attract customers, retain investors, and maintain regulatory goodwill. In severe cases, it can even threaten a bank’s survival. Understanding the nature, drivers, and management of reputational risk is therefore essential for any financial institution operating in today’s environment.

Reputational risk refers to the potential for negative public perception to harm a bank’s business operations, financial position, or stakeholder relationships. Unlike credit or market risk, reputational risk is not easily quantified. It is shaped by public sentiment, media narratives, and stakeholder expectations, all of which can shift rapidly. A single incident—whether a data breach, compliance failure, or poorly handled customer complaint—can escalate into a broader crisis if it signals deeper cultural or operational weaknesses. Because reputation is cumulative, built over years but vulnerable to sudden erosion, banks must treat it as a strategic asset requiring continuous attention.

One of the primary drivers of reputational risk is regulatory non‑compliance. Banks operate in a heavily regulated environment, and violations—such as money‑laundering failures, sanctions breaches, or misleading product disclosures—can quickly become public scandals. Even when fines are manageable, the reputational fallout can be far more damaging. Customers may question the bank’s ethical standards, while regulators may impose heightened scrutiny. In some cases, non‑compliance suggests systemic governance issues, prompting investors to reassess the bank’s long‑term stability. Because compliance failures often become headline news, they can shape public perception more powerfully than technical financial metrics.

Another major source of reputational risk is operational failure. Technology outages, cybersecurity breaches, and payment system disruptions can erode customer confidence, especially as banking becomes increasingly digital. A bank that cannot reliably safeguard data or provide uninterrupted access to accounts risks appearing incompetent or careless. Cyber incidents are particularly damaging because they raise concerns about privacy and financial security—two pillars of trust in the banking relationship. Even when the root cause is external, such as a sophisticated cyberattack, customers often hold the bank responsible for inadequate defenses.

Customer treatment also plays a central role in shaping reputation. Banks interact with millions of individuals and businesses, and each interaction contributes to the institution’s public image. Poor customer service, unfair fees, aggressive sales practices, or mishandled complaints can accumulate into a perception that the bank prioritizes profit over people. In the age of social media, individual negative experiences can spread rapidly, influencing broader sentiment. Conversely, banks that demonstrate empathy, transparency, and responsiveness can strengthen their reputational resilience, even when mistakes occur.

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Corporate culture and leadership behavior are equally important. Scandals involving executives—such as conflicts of interest, unethical conduct, or mismanagement—can tarnish the entire organization. Stakeholders often interpret leadership failures as indicators of deeper cultural problems. A bank perceived as having a toxic or complacent culture may struggle to attract talent, maintain employee morale, or convince regulators that it can self‑govern effectively. Because culture influences decision‑making at every level, it is both a source of reputational vulnerability and a potential safeguard.

The consequences of reputational damage can be far‑reaching. Customers may withdraw deposits or move business to competitors, reducing liquidity and revenue. Investors may lose confidence, increasing funding costs or depressing share prices. Regulators may impose stricter oversight, limiting strategic flexibility. Business partners may distance themselves to avoid association with controversy. In extreme cases, reputational crises can trigger self‑reinforcing cycles: negative publicity leads to customer attrition, which weakens financial performance, which in turn fuels further negative publicity. The collapse of trust can be swift, even if the underlying financial fundamentals remain sound.

Given these stakes, effective management of reputational risk requires a proactive and integrated approach. Banks must embed reputational considerations into strategic planning, risk assessment, and daily operations. This begins with strong governance frameworks that emphasize ethical conduct, transparency, and accountability. Leadership must set the tone by modeling integrity and prioritizing long‑term trust over short‑term gains. Clear policies, robust internal controls, and continuous monitoring help prevent misconduct and operational failures before they escalate.

Communication is another critical component. When incidents occur, banks must respond quickly, honestly, and empathetically. Attempts to minimize or obscure problems often backfire, deepening public distrust. Transparent communication—acknowledging mistakes, explaining corrective actions, and demonstrating commitment to improvement—can mitigate reputational harm. Stakeholders are more forgiving when they perceive sincerity and responsibility.

Building reputational resilience also involves cultivating strong relationships with customers, employees, regulators, and communities. Banks that consistently demonstrate social responsibility, customer‑centric values, and community engagement create goodwill that can buffer against negative events. Investing in cybersecurity, customer service, and ethical training further strengthens the institution’s ability to prevent and withstand reputational shocks.

Ultimately, reputational risk is inseparable from the broader identity and purpose of a bank. It reflects not only what the institution does, but how it behaves and what it stands for. In a competitive and highly scrutinized industry, reputation is a differentiator that can drive loyalty, growth, and long‑term success. By treating reputation as a strategic priority—protected through strong governance, ethical culture, operational excellence, and transparent communication—banks can navigate the complexities of modern finance while maintaining the trust that underpins their existence.

COMMENTS APPRECIATED

EDUCATION: Books

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

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ScD: Doctor of Science (ScD) Degree

Dr. David Edward Marcinko MBA MEd CMP

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Purpose, Identity and Value

The Doctor of Science (ScD) degree occupies a distinctive place within the landscape of advanced academic and professional education. Although less commonly discussed than the PhD, the ScD represents a rigorous pathway for individuals seeking to contribute original, high‑level research to scientific and technical fields. Its history, structure, and contemporary relevance reveal a degree designed to cultivate deep expertise, methodological sophistication, and the capacity to solve complex problems through systematic inquiry.

At its core, the ScD is a research doctorate. Like the PhD, it requires candidates to demonstrate mastery of a discipline, identify a meaningful research question, and produce a dissertation that advances knowledge. The distinction between the two degrees is often more cultural than structural. In many institutions, the ScD is awarded in fields with a strong quantitative or applied scientific orientation, such as engineering, public health, computer science, or biostatistics. This association with technical disciplines has shaped the perception of the ScD as a degree emphasizing analytical rigor and practical impact.

The structure of ScD programs typically mirrors that of PhD programs: coursework, comprehensive examinations, and a multi‑year research project culminating in a dissertation. However, the ScD often places additional emphasis on methodological training and the application of scientific principles to real‑world challenges. Students may engage in interdisciplinary collaborations, work with industry or government partners, or contribute to large‑scale research initiatives. This applied orientation reflects the degree’s historical roots in scientific problem‑solving and its ongoing relevance in fields where research is closely tied to practice.

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One of the defining features of the ScD is its flexibility across institutions. Some universities treat the ScD and PhD as interchangeable, differing only in name. Others reserve the ScD for specific departments or use it to signal a particular research tradition. This variability can create confusion, but it also highlights the degree’s adaptability. Rather than being constrained by a single definition, the ScD evolves to meet the needs of the disciplines it serves. In engineering, for example, the ScD may emphasize design, modeling, and innovation. In public health, it may focus on epidemiological methods, population‑level analysis, and the development of evidence‑based interventions.

Despite these variations, the ScD consistently demands a high level of intellectual independence. Candidates are expected not only to master existing knowledge but also to generate new insights. This process requires creativity, persistence, and the ability to navigate uncertainty. The dissertation, as the capstone of the degree, serves as a demonstration of these qualities. It is both a scholarly contribution and a testament to the candidate’s readiness to join the community of researchers and practitioners who shape scientific progress.

The value of the ScD extends beyond academia. Graduates often pursue careers in government agencies, research institutes, private industry, and nonprofit organizations. Their training equips them to analyze complex systems, design data‑driven solutions, and lead interdisciplinary teams. In an era defined by rapid technological change and global challenges—from climate science to public health—these skills are increasingly essential. The ScD prepares individuals not only to understand scientific problems but to address them with rigor and creativity.

Another important dimension of the ScD is its role in promoting scientific leadership. The degree cultivates the ability to communicate research findings, mentor emerging scholars, and contribute to the development of scientific policy and practice. Graduates may become faculty members, research directors, or technical experts whose work influences both scientific understanding and societal outcomes. The ScD thus serves as a bridge between advanced scholarship and practical impact.

In contemporary discussions about doctoral education, the ScD stands as a reminder that scientific inquiry is both a theoretical and applied endeavor. While the PhD remains the most widely recognized research doctorate, the ScD offers an alternative pathway that aligns closely with the needs of technical and scientific fields. Its emphasis on methodological depth, interdisciplinary collaboration, and real‑world application makes it a compelling option for individuals committed to advancing science in ways that directly benefit society.

Ultimately, the Doctor of Science degree represents a commitment to rigorous research and meaningful contribution. It embodies the belief that scientific knowledge, when pursued with discipline and imagination, has the power to illuminate complex problems and drive innovation. For students drawn to this mission, the ScD offers a challenging and rewarding journey into the heart of scientific discovery.

COMMENTS APPRECIATED

EDUCATION: Books

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

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What is a Multiple-Choice Test?

Br. David Edward Marcinko MBA MEd

SPONSOR: http://www.CertifiedMedicalPlanner.org

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DEFINED

A multiple‑choice test is one of the most widely used assessment formats in education, professional certification, and psychological measurement. Its defining feature is simple: each question presents a prompt and a set of possible answers, from which the test‑taker must select the correct or best option. Although the structure appears straightforward, the multiple‑choice test is a sophisticated tool shaped by decades of research on learning, cognition, and measurement. Understanding what a multiple‑choice test is requires looking beyond its surface format and examining its purpose, design, strengths, limitations, and the ways it influences how people learn and demonstrate knowledge.

The Structure and Purpose of Multiple‑Choice Tests

At its core, a multiple‑choice test is designed to measure knowledge, skills, or reasoning in a standardized and efficient way. Each question—often called an “item”—contains two main parts: the stem and the alternatives. The stem presents the problem, scenario, or question. The alternatives include one correct answer, known as the key, and several incorrect answers, known as distractors. The test‑taker’s task is to identify the key among the distractors.

This structure serves a clear purpose: to evaluate whether someone can recognize accurate information or apply knowledge to a specific situation. Because the answer choices are predetermined, scoring can be objective and consistent. This makes multiple‑choice tests particularly useful in large‑scale settings such as school exams, professional licensing tests, and standardized assessments. They allow thousands—or even millions—of people to be evaluated using the same criteria, with results that can be compared fairly across individuals and groups.

Designing Effective Multiple‑Choice Questions

Although the format seems simple, writing high‑quality multiple‑choice questions is a demanding process. A good item must be clear, unambiguous, and aligned with the skill or concept being assessed. The stem should present a meaningful problem rather than a trivial fact, and the distractors must be plausible enough to challenge someone who has not fully mastered the material.

The best multiple‑choice questions do more than test memorization. They can assess higher‑order thinking by asking test‑takers to analyze scenarios, apply principles, evaluate evidence, or solve problems. For example, a question in a biology exam might present a real‑world situation and ask which explanation best fits the observed data. In this way, multiple‑choice tests can measure complex reasoning when they are carefully constructed.

Another important aspect of design is fairness. A well‑designed test avoids cultural bias, overly tricky wording, or clues that unintentionally reveal the answer. The goal is to measure knowledge or skill—not reading speed, test‑taking tricks, or familiarity with a particular cultural reference. Achieving this level of fairness requires careful review, pilot testing, and revision.

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Strengths of Multiple‑Choice Tests

One of the major strengths of multiple‑choice tests is efficiency. They allow instructors and institutions to assess a large amount of content in a relatively short time. Because scoring is objective, results can be processed quickly and consistently, reducing the potential for human error or subjective judgment.

Another advantage is reliability. When items are well‑designed, multiple‑choice tests can produce stable and repeatable results. This reliability is crucial in high‑stakes settings such as medical licensing exams or university admissions, where decisions must be based on trustworthy measures.

Multiple‑choice tests also offer diagnostic value. Patterns of correct and incorrect responses can reveal which concepts students understand and which require further instruction. For teachers, this information can guide lesson planning and targeted support. For learners, it can highlight strengths and weaknesses, helping them focus their study efforts more effectively.

Finally, multiple‑choice tests can assess a wide range of cognitive skills. While they are often associated with factual recall, they can also measure comprehension, application, analysis, and even aspects of critical thinking. The key is thoughtful item design that challenges students to use knowledge rather than simply recognize it.

Limitations and Criticisms

Despite their strengths, multiple‑choice tests are not without limitations. One common criticism is that they encourage guessing. Because the correct answer is always present, a test‑taker might select it by chance rather than through understanding. While this effect can be reduced by including more distractors or using statistical scoring methods, it cannot be eliminated entirely.

Another limitation is that multiple‑choice tests may oversimplify complex skills. Some abilities—such as writing, creativity, collaboration, or open‑ended problem solving—cannot be captured well through fixed response options. For example, evaluating a student’s ability to construct a persuasive argument or design an experiment requires formats that allow for extended responses.

Multiple‑choice tests can also create a narrow focus on test preparation. When students know they will be assessed through this format, they may prioritize memorizing isolated facts rather than developing deeper understanding. This phenomenon, sometimes called “teaching to the test,” can limit the richness of learning experiences.

Additionally, poorly written items can introduce bias or confusion. Ambiguous wording, irrelevant details, or distractors that are obviously incorrect can distort results. In such cases, the test may measure test‑taking ability more than actual knowledge.

The Role of Multiple‑Choice Tests in Learning

Multiple‑choice tests influence not only how knowledge is measured but also how it is learned. When used thoughtfully, they can reinforce learning by encouraging retrieval practice—the act of recalling information from memory. Research shows that retrieval strengthens memory and improves long‑term retention. Taking a multiple‑choice test can therefore help students learn, not just demonstrate what they know.

However, the impact depends on how the tests are integrated into instruction. Frequent low‑stakes quizzes can support learning by providing regular opportunities for practice and feedback. In contrast, high‑stakes exams that determine grades or advancement may create anxiety and narrow students’ focus to short‑term performance.

Multiple‑choice tests can also support metacognition. When students review their results, they gain insight into what they understand and where they need improvement. This self‑awareness is a key component of effective learning.

Why Multiple‑Choice Tests Persist

Despite ongoing debates about their limitations, multiple‑choice tests remain a central part of modern assessment. Their persistence is not simply a matter of convenience. They offer a combination of efficiency, reliability, and scalability that few other formats can match. In large educational systems, they provide a practical way to evaluate learning across diverse populations.

Moreover, advances in test design have expanded what multiple‑choice tests can measure. Computer‑based testing allows for adaptive assessments that adjust difficulty based on performance, providing a more precise measure of ability. Scenario‑based items can simulate real‑world decision‑making, making the test more authentic and meaningful.

Conclusion

A multiple‑choice test is far more than a set of questions with predetermined answers. It is a carefully designed tool for measuring knowledge, reasoning, and understanding. Its structure allows for efficient, objective, and reliable assessment, making it invaluable in educational and professional contexts. At the same time, its limitations remind us that no single format can capture the full range of human abilities.

When used thoughtfully, multiple‑choice tests can support learning, provide meaningful feedback, and help institutions make informed decisions. Understanding what they are—and what they are not—allows educators and learners to use them more effectively. Ultimately, the multiple‑choice test endures because it strikes a balance between practicality and precision, offering a structured way to evaluate what people know in an increasingly complex world.

COMMENTS APPRECIATED

EDUCATION: Books

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

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The Net Investment Income Tax

Dr. Gary Bode; MSA CPA CMP

Dr. David Edward Marcinko; MBA MEd CMP

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Purpose, Scope and Impact

The Net Investment Income Tax (NIIT) occupies a distinctive place in the modern U.S. tax landscape. Introduced as part of the Affordable Care Act, it was designed to generate revenue from higher‑income households by taxing certain forms of unearned income. Although it affects a relatively small portion of taxpayers, its implications reach into investment strategy, tax planning, and broader debates about fairness and economic policy. Understanding how the NIIT works—and why it exists—offers insight into the evolving relationship between tax policy and wealth in the United States.

At its core, the NIIT is a 3.8 percent surtax applied to specific types of investment income for individuals whose modified adjusted gross income exceeds statutory thresholds. These thresholds—$200,000 for single filers and $250,000 for married couples filing jointly—are not indexed for inflation. As a result, over time, more taxpayers may find themselves subject to the tax even if their real purchasing power has not increased. This “bracket creep” is one of the subtle but important features of the NIIT, shaping its long‑term reach.

The tax applies only to “net investment income,” a term that includes interest, dividends, capital gains, rental income, royalties, and passive business income. It does not apply to wages, self‑employment earnings, or distributions from qualified retirement plans. The logic behind this distinction is straightforward: the NIIT targets income derived from wealth rather than labor. In practice, this means that two taxpayers with identical total income may face different NIIT liabilities depending on how much of their income comes from investments versus work.

The mechanics of the NIIT involve a comparison between two amounts: net investment income and the excess of modified adjusted gross income over the applicable threshold. The tax is applied to whichever of these two figures is smaller. This structure ensures that the NIIT functions as a surtax on high‑income households without taxing investment income for those below the threshold. It also means that taxpayers with large investment portfolios but modest overall income may avoid the tax entirely, while those with high wages and relatively small investment income may still owe it.

One of the most significant effects of the NIIT is its influence on investment behavior. Because the tax applies to capital gains, it can affect decisions about when to sell appreciated assets. Taxpayers may choose to time sales to avoid pushing their income above the threshold in a given year. Others may shift toward tax‑exempt investments, such as municipal bonds, or toward assets that generate unrealized rather than realized gains. The NIIT therefore becomes not just a revenue tool but a factor shaping the broader investment landscape.

The tax also interacts with other parts of the tax code in ways that can be complex. For example, rental real estate income is generally subject to the NIIT unless the taxpayer qualifies as a real estate professional and materially participates in the activity. Trusts and estates face their own NIIT rules, often reaching the surtax threshold at much lower income levels than individuals. These layers of complexity mean that the NIIT is often a central topic in tax planning for high‑income households, especially those with diverse investment portfolios.

Beyond its technical features, the NIIT reflects broader policy debates about equity and the distribution of tax burdens. Supporters argue that it helps ensure that high‑income individuals contribute a fair share to the cost of public programs, particularly those related to health care. Because investment income is disproportionately concentrated among wealthier households, the NIIT is seen as a way to align tax policy with ability to pay. Critics, however, contend that the tax discourages investment, adds unnecessary complexity, and imposes an additional layer of taxation on income that may already be subject to corporate taxes or other levies.

Despite these debates, the NIIT has become a stable part of the federal tax system. It raises billions of dollars annually and plays a role in funding health‑related initiatives. As discussions about tax reform continue, the NIIT often resurfaces as policymakers consider how best to balance revenue needs with economic incentives. Whether it remains unchanged, is expanded, or is modified in future legislation, the NIIT will continue to shape the financial decisions of high‑income taxpayers and contribute to the ongoing conversation about how the United States taxes wealth.

COMMENTS APPRECIATED

EDUCATION: Books

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

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RECESSIONS: American History Review

By Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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The history of U.S. recessions reflects the nation’s evolving economy, shaped by wars, financial crises, policy shifts, and global events. Since 1857, the U.S. has experienced over 30 recessions, each offering lessons in resilience and reform.

The United States has endured a long and varied history of economic recessions, defined as periods of significant decline in economic activity lasting more than a few months. These downturns are typically marked by falling GDP, rising unemployment, and reduced consumer spending. Since the mid-19th century, recessions have been triggered by a range of factors—from banking panics and inflation to global conflicts and pandemics.

The earliest recorded U.S. recession began in 1857, sparked by a banking crisis and declining international trade. This was followed by the Long Depression of 1873–1879, which lasted a staggering 65 months, making it the longest in U.S. history. The downturn was triggered by the collapse of a major bank and a speculative bubble in railroad investments.

The Great Depression remains the most severe economic crisis in American history. Beginning in 1929 after the stock market crash, it lasted until 1933 and saw unemployment soar to 25%. The Depression reshaped U.S. economic policy, leading to the creation of Social Security, the FDIC, and other New Deal programs aimed at stabilizing the economy and protecting citizens.

Post-World War II recessions were generally shorter and less severe. The 1945 recession, for example, lasted eight months and was caused by the transition from wartime to peacetime production. The 1973–75 recession, however, was more prolonged, driven by an oil embargo and stagflation—a combination of stagnant growth and high inflation.

The early 1980s recession was triggered by the Federal Reserve’s aggressive interest rate hikes to combat inflation. Though painful, it ultimately helped stabilize prices and set the stage for a long period of growth. The early 1990s recession followed a savings and loan crisis and a slowdown in defense spending after the Cold War.

The Great Recession of 2007–2009 was the most significant downturn since the Great Depression. It was caused by the collapse of the housing bubble and widespread failures in financial institutions. Unemployment peaked at 10%, and the crisis led to sweeping reforms in banking and mortgage lending practices.

Most recently, the COVID-19 recession in 2020 was the shortest in U.S. history, lasting just two months. Despite its brevity, it was severe, with unemployment briefly reaching 14.7% due to lockdowns and global supply chain disruptions.

Throughout its history, the U.S. has shown remarkable resilience in recovering from recessions. Each downturn has prompted changes in fiscal and monetary policy, regulatory reform, and shifts in public perception about the role of government and markets. As the economy becomes more interconnected globally, future recessions may be shaped by international events as much as domestic ones.

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

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CERTIFIED MEDICAL PLANNER™: Education for Financial Planners to Thrive with Doctor Clients!

Think Different – Be Different  – Thrive

[By Ann Miller RN MHA]

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http://www.CertifiedMedicalPlanner.org

Dear Physician Focused Financial Advisors

Did you know that desperate doctors of all ages are turning to knowledgeable financial advisors and medical management consultants for help? Symbiotically too, generalist advisors are finding that the mutual need for knowledge and extreme niche synergy is obvious.

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planning

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But, there was no established curriculum or educational program; no corpus of knowledge or codifying terms-of-art; no academic gravitas or fiduciary accountability; and certainly no identifying professional designation that demonstrated integrated subject matter expertise for the increasingly unique healthcare focused financial advisory niche … Until Now! 

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Enter the CMPs

“The informed voice of a new generation of fiduciary advisors for healthcare”

Think Different

 [Think Different – Be Different – Thrive]

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So, if you are looking to supplement your knowledge, income and designations; and find other qualified professionals you may want to consider the CMP® program.

Enter the Certified Medical Planner™ charter professional designation. And, CMPs™ are FIDUCIARIES, 24/7.

Channel Surfing the ME-P

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

Conclusion

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

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Become a CMP

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

 Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners(TM)* 8

MILTON FRIEDMAN PhD: The Free Market Champion

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By Dr. David Edward Marcinko MBA MEd

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Milton Friedman: Champion of Free Markets

Milton Friedman was a towering figure in the field of economics, renowned for his unwavering advocacy of free-market capitalism and limited government intervention. Born in 1912 in New York City and raised in Rahway, New Jersey, Friedman rose from modest beginnings to become a Nobel laureate and a leading voice of the Chicago School of Economics.

Friedman’s academic journey began at Rutgers University, where he earned a degree in mathematics and economics. He later pursued graduate studies at the University of Chicago and Columbia University, where he was mentored by prominent economists like Simon Kuznets. His intellectual foundation laid the groundwork for a career that would challenge prevailing economic thought and reshape public policy.

One of Friedman’s most significant contributions was his development of monetarism, a theory emphasizing the role of governments in controlling the money supply to manage inflation and economic stability. In contrast to Keynesian economics, which advocated for active fiscal policy and government spending, Friedman argued that excessive government intervention often led to inefficiencies and inflation. His research demonstrated that inflation is “always and everywhere a monetary phenomenon,” a principle that became central to modern macroeconomic policy.

Friedman’s influence extended beyond academia. His 1962 book, Capitalism and Freedom, articulated a powerful case for economic liberty as a foundation for political freedom. He argued that voluntary exchange and competitive markets were essential for individual choice and prosperity. The book also introduced the Friedman Doctrine, which posited that the primary responsibility of business is to increase its profits, a view that sparked ongoing debates about corporate social responsibility.

In 1976, Friedman was awarded the Nobel Memorial Prize in Economic Sciences for his work on consumption analysis, monetary history, and stabilization policy. His Permanent Income Hypothesis, which suggests that people base their consumption on expected long-term income rather than current income, revolutionized understanding of consumer behavior.

Friedman’s ideas had profound policy implications. He was a vocal critic of the draft and successfully advocated for an all-volunteer military. He also proposed the concept of school vouchers, allowing parents to choose schools for their children, which laid the foundation for modern school choice movements. His work influenced leaders like Ronald Reagan and Margaret Thatcher, who embraced free-market reforms during their administrations.

Despite his acclaim, Friedman’s views were not without controversy. Critics argued that his emphasis on deregulation and privatization sometimes overlooked social equity and environmental concerns. Nonetheless, his legacy remains deeply embedded in economic thought and public discourse.

Milton Friedman passed away in 2006, but his ideas continue to shape debates on economic policy, freedom, and the role of government. His belief in the power of markets and individual choice remains a cornerstone of classical liberalism and a guiding light for economists and policymakers around the world.

COMMENTS APPRECIATED

EDUCATION: Books

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

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ECONOMICS OF INFORMATION: The Value and Impact of Knowledge

By Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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The economics of information explores how knowledge—or the lack of it—affects decision-making, market behavior, and resource allocation. It reveals why perfect competition rarely exists and why information itself can be a powerful economic asset.

Economics of Information: Understanding the Value and Impact of Knowledge

In traditional economic models, markets are often assumed to operate under perfect information—where all participants have equal access to relevant data. However, in reality, information is often incomplete, asymmetric, or costly to obtain. The field known as economics of information emerged to address these discrepancies, fundamentally reshaping how economists understand markets, incentives, and efficiency.

One of the core concepts in this field is information asymmetry, where one party in a transaction possesses more or better information than the other. This imbalance can lead to adverse selection and moral hazard. For example, in the insurance market, individuals who know they are high-risk are more likely to seek coverage, while insurers may struggle to differentiate between high- and low-risk clients. Similarly, in lending, borrowers may have private knowledge about their ability to repay, which lenders cannot easily verify.

To mitigate these problems, economists have developed mechanisms such as signaling and screening. Signaling occurs when the informed party takes action to reveal their type—like a job applicant earning a degree to signal competence. Screening, on the other hand, involves the uninformed party designing tests or contracts to elicit information—such as offering different insurance packages to separate risk levels.

Another important area is the cost of acquiring information. Gathering data, analyzing trends, or verifying facts requires time and resources. This leads to decisions being made under uncertainty, where individuals rely on heuristics or limited data. The economics of information examines how these costs influence behavior, pricing, and market structure. For instance, consumers may not compare every available product due to search costs, allowing firms to maintain price dispersion.

The rise of digital technology has intensified the relevance of this field. In the age of big data, companies like Google and Amazon thrive by collecting and analyzing vast amounts of user information. This data allows them to personalize services, predict behavior, and gain competitive advantages. However, it also raises concerns about privacy, market power, and inequality—issues that economists of information are increasingly addressing.

Moreover, information goods—such as software, media, and research—have unique economic properties. They are often non-rivalrous and can be reproduced at near-zero marginal cost. This challenges traditional pricing models and calls for innovative approaches like freemium strategies, bundling, and subscription services.

In public policy, the economics of information plays a crucial role in designing regulations, transparency standards, and consumer protections. Governments must balance the need for open access to information with incentives for innovation and investment. For example, patent laws aim to encourage research by granting temporary monopolies, while disclosure requirements in finance promote market integrity.

In conclusion, the economics of information reveals that knowledge is not just a passive input but a dynamic force shaping economic outcomes. By understanding how information is produced, distributed, and used, economists can better explain real-world phenomena and design systems that promote fairness, efficiency, and innovation.

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EDUCATION: Books

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INVESTING: Keynesian and Hayekian Approaches

By Dr. David Edward Marcinko MBA MEd CMP

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Keynesian and Hayekian Approaches to Investing

The contrasting economic philosophies of John Maynard Keynes and Friedrich Hayek have shaped not only macroeconomic policy but also approaches to investing. While both thinkers sought to understand and improve economic systems, their views diverge sharply on the role of government, market behavior, and investor decision-making.

Keynesian economics emphasizes the importance of aggregate demand in driving economic growth. Keynes argued that markets are not always self-correcting and that government intervention is necessary during downturns to stimulate demand. In the context of investing, Keynesian theory supports counter-cyclical strategies. Investors following this approach might increase exposure to equities during recessions, anticipating that fiscal stimulus will boost corporate earnings and market performance. Keynes himself was a successful investor, known for his contrarian style and long-term focus. He advocated for active portfolio management, believing that markets are driven by psychological factors and herd behavior, which create mispricings that savvy investors can exploit.

In contrast, Hayekian economics is rooted in classical liberalism and the belief in spontaneous order. Hayek argued that markets are efficient information processors and that decentralized decision-making leads to better outcomes than centralized planning. From an investment standpoint, Hayekian theory favors passive strategies and minimal interference. Investors aligned with Hayek’s philosophy might prefer index funds or diversified portfolios that reflect market signals rather than attempting to time the market or predict government actions. Hayek was skeptical of the ability of any individual or institution to possess enough knowledge to outsmart the market consistently.

The Keynesian approach tends to be more optimistic about the power of policy to influence markets. For example, during economic crises, Keynesians may expect stimulus packages to revive demand and thus invest in sectors likely to benefit from increased government spending. Hayekians, on the other hand, may view such interventions as distortions that lead to malinvestment and eventual corrections. They might invest more cautiously during periods of heavy government involvement, anticipating inflation, asset bubbles, or regulatory overreach.

Risk perception also differs between the two schools. Keynesians may see risk as cyclical and manageable through diversification and active management. Hayekians view risk as inherent and unpredictable, best mitigated through adherence to market fundamentals and long-term discipline.

In practice, modern investors often blend elements of both approaches. For instance, they may use Keynesian insights to anticipate short-term market movements while relying on Hayekian principles for long-term portfolio construction. The rise of behavioral finance has also added nuance, validating Keynes’s view of irrational market behavior while reinforcing Hayek’s skepticism of centralized forecasting.

Ultimately, the choice between Keynesian and Hayekian investing reflects deeper beliefs about how economies function and how much control investors—or governments—really have. Keynesians embrace adaptability and intervention, while Hayekians champion restraint and trust in the market’s invisible hand. Both offer valuable lessons, and understanding their differences can help investors navigate complex financial landscapes with greater clarity.

COMMENTS APPRECIATED

EDUCATION: Books

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

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PET: Insurance?

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Pet insurance offers financial protection and peace of mind for pet owners, helping cover unexpected veterinary costs and ensuring pets receive timely care. It’s a growing industry that reflects the deepening bond between humans and their animal companions.

Pet insurance is a specialized health coverage designed to offset the cost of veterinary care for pets. As veterinary medicine advances, treatments for pets have become more sophisticated—and expensive. From emergency surgeries to chronic illness management, the financial burden can be overwhelming for pet owners. Pet insurance helps mitigate these costs, allowing owners to prioritize their pet’s health without worrying about the price tag.

One of the primary benefits of pet insurance is financial security. Veterinary bills can range from hundreds to thousands of dollars depending on the condition. For example, treating a torn ACL in a dog can cost upwards of $3,000, while cancer treatments may exceed $10,000. With pet insurance, a significant portion of these expenses can be reimbursed, reducing out-of-pocket costs and making advanced care more accessible.

Another advantage is flexibility in care. Pet insurance empowers owners to choose treatments based on medical need rather than financial constraints. Whether it’s a late-night emergency or a long-term condition like diabetes or arthritis, insurance gives pet parents the freedom to pursue the best care options available.

Policies typically cover accidents, illnesses, surgeries, medications, and sometimes routine care like vaccinations and dental cleanings. However, coverage varies widely by provider and plan. Most policies exclude pre-existing conditions and have waiting periods before coverage begins. It’s crucial for pet owners to read the fine print and understand what’s included and what’s not. The cost of pet insurance depends on factors such as the pet’s species, breed, age, and location. Monthly premiums can range from $20 to $70 for dogs and $10 to $40 for cats. While this may seem like an added expense, it can be a worthwhile investment in the long run—especially for breeds prone to genetic conditions or pets with active lifestyles.

Pet insurance also reflects a broader cultural shift in how society views pets. No longer just animals, pets are considered family members. This emotional bond drives owners to seek the best possible care, and insurance helps make that care attainable. It’s not just about saving money—it’s about ensuring quality of life for beloved companions.

Critics argue that pet insurance isn’t always cost-effective, especially if a pet remains healthy. So, pet insurance may not be worth it if:

  • Your pet is a senior or has health problems.
  • A big vet bill wouldn’t be a financial hardship for you.
  • You’d rather take the risk of an expensive diagnosis than pay for insurance you might never use.

However, the unpredictability of accidents and illness makes it a valuable safety net. Like any insurance, it’s about preparing for the unexpected.

In conclusion, pet insurance is a practical and compassionate tool for modern pet ownership. It offers financial relief, expands treatment options, and supports the emotional commitment people have to their pets.

As veterinary costs continue to rise, pet insurance provides a way to protect both your wallet and your furry friend’s well-being.; maybe!

COMMENTS APPRECIATED

EDUCATION: Books

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

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Understanding the Series 63 Exam: Key Insights

By A. I. and FINRA

SPONSOR: http://www.CertifiedMedicalPlanner.org

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

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

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

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EDUCATION: Books

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Effective Marketing: Using Loss Leaders in Financial Services

By Dr. David Edward Marcinko MBA MEd CMP

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SPONSOR: http://www.CertifiedMedicalPlanner.org

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

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

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

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

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

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

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

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

COMMENTS APPRECIATED

EDUCATION: Books

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

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Understanding the Google Scholar Paradox in Research

By A.I.

SPONSOR: http://www.CertifiedMedicalPlanner.org

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

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

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

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

Courtesy: Morgan Housel 

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INSURANCE AGENTS: Salary and Payment Mechanisms

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

SPONSOR: http://www.CertifiedMedicalPlanner.org

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

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

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

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

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

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

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

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

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

COMMENTS APPRECIATED

EDUCATION: Books

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

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Understanding Paradoxes in Modern Medicine

By Dr. David Edward Marcinko MBA MEd CMP

SPONSOR: http://www.CertifiedMedicalPlanner.org

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What is a Paradox? 

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

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

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

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

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

Difference between Paradox and Oxymoron

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

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

The Paradox in Medicine and Health Care

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

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

The Compensation versus Value Paradox

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

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

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

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

Higher doctor salary equals lower practice appraisal value.

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

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

COMMENTS APPRECIATED

EDUCATION: Books

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

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MONETARY VALUATION: Of the Medical Practice

By Dr. David Edward Marcinko MBA MEd CMP

SPONSOR: http://www.CertifiedMedicalPlanner.org

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

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

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

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

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

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

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

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

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

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

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

COMMENTS APPRECIATED

EDUCATION: Books

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

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HEALTH: Public V. Population

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Population health and public health are two interrelated disciplines that strive to enhance the health outcomes of communities. While they share a common mission—to reduce health disparities and promote wellness—their approaches, target populations, and operational frameworks differ significantly.

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Public health is traditionally defined as the science and art of preventing disease, prolonging life, and promoting health through organized efforts and informed choices of society, organizations, public and private sectors, communities, and individuals. It focuses on the health of the general population and emphasizes broad interventions such as vaccination programs, sanitation, health education, and policy advocacy. Public health professionals often work in government agencies, nonprofit organizations, and academic institutions to implement community-wide initiatives that prevent disease and promote healthy behaviors.

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In contrast, population health takes a more targeted approach. It refers to the health outcomes of a specific group of individuals, including the distribution of such outcomes within the group. This field is particularly concerned with the social determinants of health—factors like income, education, environment, and access to care—that influence health disparities. Population health strategies often involve data-driven interventions tailored to the needs of defined groups, such as rural communities, ethnic minorities, or patients with chronic conditions.

One key distinction lies in scope and granularity. Public health initiatives are typically designed for the entire population, aiming to create systemic change. For example, anti-smoking campaigns or water fluoridation programs benefit everyone regardless of individual risk. Population health, however, might focus on reducing diabetes rates among Hispanic adults in a specific urban area, using targeted outreach and culturally sensitive care models.

Another difference is in data utilization. Population health relies heavily on health informatics and analytics to identify trends, allocate resources, and evaluate outcomes. This evidence-based approach supports precision in addressing health inequities. Public health also uses data, but often at a broader level to guide policy and monitor general health indicators like life expectancy or disease prevalence.

Despite these differences, the two fields are complementary. Public health lays the foundation for healthy societies through preventive infrastructure, while population health builds on this by addressing nuanced needs within subgroups. Together, they form a holistic framework for improving health outcomes across diverse communities.

In today’s healthcare landscape, the integration of public and population health is increasingly vital. The COVID-19 pandemic underscored the importance of both approaches: public health measures like mask mandates and vaccination campaigns were essential, while population health efforts ensured vulnerable groups received targeted support.

In conclusion, while public health and population health differ in focus and methodology, they are united by a shared goal: to foster healthier communities. Understanding their distinctions enables more effective collaboration and innovation in health policy, care delivery, and community engagement.

COMMENTS APPRECIATED

EDUCATION: Books

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

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Critical Risk Management for Physicians Today

More Difficult than Ever Before

By Brian J. Knabe MD, Certified Medical Planner

www.SavantCapital.com

Historically, the term “risk management” has brought to mind one subject for the practicing physician – medical malpractice.  Unfortunately, physicians today face a multitude of other risks which may be more insidious and daunting than malpractice.  It is important to recognize these risks, and to have the appropriate procedures and policies in place to mitigate the risks.  These risks come from the federal government, state government, insurance companies, patients, employees, and even prospective employees.  Some risks, many unique to small businesses and medical practices, include the following:

  • Medicare recoupment risk – challenges to coding and subsequent billing by the physician.
  • Medicare fraud.  Numerous laws can be used by the federal government to go after the physician, including the Medicare and Medicaid Anti-Fraud and Abuse Statute, the RICO statute, and the Federal False Claims Act.  The recently enacted Patient Protection & Affordable Care Act aims to save money by increasing funding for anti-fraud efforts.
  • Insurance fraud.  An inquiry from Medicare to look for fraud in a physician’s practice is often followed by similar efforts by insurance companies.
  • The HIPPA Act of 1996 creates new definitions and penalties to use against the physician.
  • Self referral risks.  Federal regulations in this area include the Medicare Anti-Fraud and Abuse Statute, the Medicare Safe Harbor Regulations, and the Stark Amendment.
  • Federal agency risks.  These include regulations from the Occupational Health and Safety Agency (OSHA), Health and Human Services (HHS), the Drug Enforcement agency (DEA), and even the Environmental Protection Agency (EPA).
  • Anti-trust risks.  The Department of Justice (DOJ) and Federal Trade Commission (FTC) formulate regulations in this arena.
  • Managed care contractual risks.  Most managed care contracts require the individual physician rather than the professional corporation to sign the contract, thus placing the physician’s personal assets at risk.
  • Medical malpractice risks.  Although the vast majority of claims are paid by the insurance carrier, there can be other adverse consequences for the physician.  These include the risk of increased premiums, non-renewal of policies, and difficulty in getting replacement insurance.
  • Loss of income due to death or disability.  Most physicians recognize the importance of life insurance, but the medical professional is actually much more likely to lose income due to disability at some point in his or her career.

http://www.amazon.com/Insurance-Management-Strategies-Physicians-Advisors/dp/0763733423/ref=sr_1_6?ie=UTF8&qid=1375149801&sr=8-6&keywords=marcinko+david

The practicing physician should seek the advice of professionals with expertise in these areas.  Every practice should have an experienced attorney on retainer.  It is very important to seek advice from fiduciaries – experts who have no conflicts of interest and who can therefore act in the best interest of the client.  A Certified Medical Planner is such a fiduciary with training and expertise in these areas.

http://www.CertifiedMedicalPlanner.org

It can be particularly challenging to find an insurance advisor with no conflicts of interest, as this industry is built upon product sales and commissions.  One such insurance advisor is Scott Witt, a fee-only insurance advisor with Witt Actuarial Services (www.wittactuarialservices.com).

Others can be found with an internet search for “fee only insurance advisor”.

Conclusion

Your comments on this ME-P are appreciated. How do you select an advisor? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

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

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Unlock Your Career with Micro-Certifications

Micro-Credentials on the Rise

KNOWLEDGE RICHES IN SPECIALTY NICHES

DR. DAVID EDWARD MARCINKO MBA MEd CMP

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Do you ever wish you could acquire specific information for your career activities without having to complete a university Master’s Degree or finish our entire Certified Medical Planner™ professional designation program? Well, Micro-Certifications from the Institute of Medical Business Advisors, Inc., might be the answer. Read on to learn how our three Micro-Certifications offer new opportunities for professional growth in the medical practice, business management, health economics and financial planning, investing and advisory space for physicians, nurses and healthcare professionals.

Micro-Certification Basics

Stock-Brokers, Financial Advisors, Investment Advisors, Accountants, Consultants, Financial Analyists and Financial Planners need to enhance their knowledge skills to better serve the changing and challenging healthcare professional ecosystem. But, it can be difficult to learn and demonstrate mastery of these new skills to employers, clients, physicians or medical prospects. This makes professional advancement difficult. That’s where Micro-Certification and Micro-Credentialing enters the online educational space. It is the process of earning a Micro-Certification, which is like a mini-degree or mini-credential, in a very specific topical area.

Micro-Certification Requirements

Once you’ve completed all of the requirements for our Micro-Certification, you will be awarded proof that you’ve earned it. This might take the form of a paper or digital certificate, which may be a hard document or electronic image, transcript, file, or other official evidence that you’ve completed the necessary work.

Uses of Micro-Certifications

Micro-Certifications may be used to demonstrate to physicians prospective medical clients that you’ve mastered a certain knowledge set. Because of this, Micro-Certifications are useful for those financial service professionals seeking medical clients, employment or career advancement opportunities.

Examples of iMBA, Inc., Micro-Certifications

Here are the three most popular Micro-Certification course from the Institute of Medical Business Advisors, Inc:

  • 1. Health Insurance and Managed Care: To keep up with the ever-changing field of health care physician advice, you must learn new medical practice business models in order to attract and assist physicians and nurse clients. By bringing together the most up-to-date business and medical prctice models [Medicare, Medicaid, PP-ACA, POSs, EPOs, HMOs, PPOs, IPA’s, PPMCs, Accountable Care Organizations, Concierge Medicine, Value Based Care, Physician Pay-for-Performance Initiatives, Hospitalists, Retail and Whole-Sale Medicine, Health Savings Accounts and Medical Unions, etc], this iMBA Inc., Mini-Certification offers a wealth of essential information that will help you understand the ever-changing practices in the next generation of health insurance and managed medical care.
  • 2. Health Economics and Finance: Medical economics, finance, managerial and cost accounting is an integral component of the health care industrial complex. It is broad-based and covers many other industries: insurance, mathematics and statistics, public and population health, provider recruitment and retention, health policy, forecasting, aging and long-term care, and Venture Capital are all commingled arenas. It is essential knowledge that all financial services professionals seeking to serve in the healthcare advisory niche space should possess.
  • 3. Health Information Technology and Security: There is a myth that all physician focused financial advisors understand Health Information Technology [HIT]. In truth, it is often economically misused or financially misunderstood. Moreover, an emerging national HIT architecture often puts the financial advisor or financial planner in a position of maximum uncertainty and minimum productivity regarding issues like: Electronic Medical Records [EMRs] or Electronic Health Records [EHRs], mobile health, tele-health or tele-medicine, Artificial Intelligence [AI], benefits managers and human resource professionals.

Other Topics include: economics, finance, investing, marketing, advertising, sales, start-ups, business plan creation, financial planning and entrepreneurship, etc.

How to Start Learning and Earning Recognition for Your Knowledge

Now that you’re familiar with Micro-Credentialing, you might consider earning a Micro-Certification with us. We offer 3 official Micro-Certificates by completing a one month online course, with a live instructor consisting of twelve asynchronous lessons/online classes [3/wk X 4/weeks = 12 classes]. The earned official completion certificate can be used to demonstrate mastery of a specific skill set and shared with current or future employers, current clients or medical niche financial advisory prospects.

Mini-Certification Tuition, Books and Related Fees

The tuition for each Mini-Certification live online course is $1,250 with the purchase of one required dictionary handbook. Other additional guides, white-papers, videos, files and e-content are all supplied without charge. Alternative courses may be developed in the future subject to demand and may change without notice.

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Contact: For more information, or to speak with an academic representative, please contact Ann Miller RN MHA CMP™ at Email: MarcinkoAdvisors@msn.com [24/7].

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DENTISTRY: Stress, Burnout, Divorce and Practice Turmoil

By Staff Reporters and A.I.

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Dentistry is often perceived as a stable and rewarding profession, yet beneath the surface lies a troubling reality: dentists face disproportionately high levels of stress, burnout, divorce, practice turmoil, and even suicide. These issues stem from a complex interplay of emotional, financial, and professional pressures that uniquely affect dental practitioners.

Emotional and Psychological Strain

Dentists frequently operate in high-stakes environments where precision is paramount. The pressure to deliver flawless results while managing patient anxiety and discomfort can be overwhelming. Many patients fear dental procedures, and this fear often manifests as hostility or distrust, placing emotional strain on the dentist. Over time, the cumulative effect of these interactions can lead to compassion fatigue and emotional exhaustion.

Isolation and Professional Loneliness

Unlike other medical professionals who often work in collaborative hospital settings, dentists typically operate in solo or small group practices. This isolation can limit opportunities for peer support and professional camaraderie. Without a strong support network, dentists may struggle to process the emotional toll of their work, increasing their vulnerability to depression and burnout.

Financial and Business Pressures

Running a dental practice involves more than clinical expertise—it requires business acumen. Dentists must manage overhead costs, staff salaries, insurance reimbursements, and patient billing. The financial burden of student loans, often exceeding six figures, adds to the stress. Economic downturns or shifts in healthcare policy can destabilize practices, leading to turmoil and uncertainty.

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Work-Life Imbalance and Marital Strain

The demanding nature of dentistry often spills into personal life. Long hours, administrative responsibilities, and the emotional weight of patient care can leave little time or energy for family. This imbalance contributes to high divorce rates among dentists. The stress of maintaining a successful practice while nurturing personal relationships can become untenable, especially without adequate coping mechanisms.

Burnout and Suicide Risk

Burnout in dentistry is alarmingly common. A study by the American Dental Association found that 84% of dentists report experiencing burnout at some point in their careers.

Breaking the Cycle

Addressing these challenges requires systemic change. Mental health support, peer mentorship, and business education should be integrated into dental training. Encouraging open conversations about stress and providing resources for emotional well-being can help reduce stigma and promote resilience.

By acknowledging the hidden struggles of dentistry, the profession can move toward a healthier, more sustainable future.

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Understanding Doctorate Degrees: A Clear Guide

By Staff Reporters

Is the Doctor – In?

SPONSOR: http://www.CertifiedMedicalPlanner.org

INFO-GRAPHIC

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What Is a Doctorate Degree?

Doctorate, or doctoral, is an umbrella term for many degrees — PhD among them — at the height of the academic ladder. Doctorate degrees fall under two categories, and here is where the confusion often lies. 

The first category, Research (also referred to as Academic) includes, among others:

  • Doctor of Philosophy (PhD)
  • Doctor of Business Administration (DBA)
  • Doctor of Education (EdD)
  • Doctor of Theology (ThD) 

The second category, Applied (also referred to as Professional) includes, among others:

  • Doctor of Medicine (MD)
  • Doctor of Podiatric Medicine (DPM)
  • Doctor Of Osteopathic Medicine (DO)
  • Doctor of Dental Surgery (DDS)
  • Doctor of Optometry (OD)
  • Doctor of Psychology (PsyD)
  • Juris Doctor (JD) 

As you can see, applied doctorates are generally paired with very specific careers – medical doctors, podiatrists, dentists, optometrists, psychologists, and law professionals. 

When it comes to outlining the differences between a PhD and doctorate, the real question should be, “What is the difference between a PhD and an applied doctorate?” The answer, again, can be found in the program outcomes. The online Doctor of Psychology at UAGC, for example, lists outcomes that are heavily focused on the ability to put theory into practice in a professional setting. For example: 

  • Apply best practices in the field regarding professional values, ethics, attitudes, and behaviors
  • Exhibit culturally diverse standards in working professionally with individuals, groups, and communities who represent various cultural and personal backgrounds
  • Utilize a comprehensive psychology knowledge base grounded in theoretical models, evidence-based methods, and research in the discipline
  • Integrate leadership skills appropriate in the field of psychology
  • Critically evaluate applied psychology research methods, trends, and concepts

Bottom line: As the PhD is more academic, research-focused, and heavy on theory, an applied doctorate degree is intended to master a subject in both theory and practice. 

Can a PhD Be Called a Doctor?

The debate over whether a PhD graduate should be called a doctor has existed for decades, and if you’re a member of this exclusive club, you’ll no doubt hear both sides of the argument during your lifetime. After all, if a PhD is a doctor, can a person with a doctoral degree in music – the Doctor of Musical Arts (DMA) – be called a doctor as well?

Those in favor argue that having “Dr.” attached to your name indicates that you are an expert and should be held in higher regard. For some, the debate is at the heart of modern gender disparity. For example, on social media and in some academic circles, there is an argument that female PhD holders should use the “Dr.” title in order to reject the notion that women are less worthy of adding the title to their name once they have earned a doctoral degree.

The American Psychological Association has, for years, challenged the Associated Press (AP) and other news outlets to broaden its use of “Dr.” beyond those that practice medicine – MDs, podiatrists, dentists, etc. – in its reporting. However, the organization was rebuked, as the AP argued that, “It comes down to a basic distinction. Psychologists earn PhDs, and AP style allows the ‘Dr.’ title only for those with medical degrees.”

The AP has, thus far, refused to change their style guide when it comes to the “doctor question.” 

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FINANCIAL PLANNERS: Part Time Employment Difficulties

By Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Why It Is Difficult to Be a Part-Time Financial Planner Today

In theory, part-time financial planning offers flexibility and work-life balance, making it an attractive option for professionals seeking reduced hours. However, in practice, the role of a financial planner has evolved into a demanding, full-time commitment. The complexity of financial markets, client expectations, regulatory requirements, and technological advancements make part-time financial planning increasingly difficult to sustain.

One of the primary challenges is client relationship management. Financial planning is deeply personal and trust-based. Clients expect consistent communication, timely updates, and proactive advice. A part-time planner may struggle to maintain the same level of responsiveness as full-time counterparts, especially during volatile market conditions or life-changing events like retirement, divorce, or inheritance. Delayed responses or limited availability can erode client confidence and damage long-term relationships.

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Another obstacle is the rapid pace of financial change. Tax laws, investment products, insurance regulations, and retirement planning strategies are constantly evolving. Staying current requires ongoing education, certifications, and industry engagement. For part-time planners, keeping up with these changes while managing clients and administrative tasks can be overwhelming. Falling behind risks offering outdated or suboptimal advice, which could lead to compliance issues or client dissatisfaction.

Regulatory compliance adds another layer of complexity. Financial planners must adhere to strict standards set by organizations like FINRA, the SEC, and state regulators. These include documentation, disclosures, fiduciary responsibilities, and continuing education. Compliance is non-negotiable and time-consuming, regardless of hours worked. Part-time planners face the same scrutiny and liability as full-time professionals, but with fewer hours to manage the workload.

Technology, while a powerful tool, also presents challenges. Clients increasingly expect digital access to their portfolios, real-time updates, and virtual meetings. Managing these platforms requires technical proficiency and regular maintenance. Part-time planners may find it difficult to keep systems updated, troubleshoot issues, or provide tech support, especially if they lack dedicated staff.

Business development is another hurdle. Building and maintaining a client base requires networking, marketing, and referrals. Part-time planners often have limited time to attend events, follow up with leads, or cultivate relationships. This can hinder growth and make it difficult to compete with full-time advisors who are more visible and accessible.

Finally, there’s the issue of income and scalability. Many financial planners earn through commissions, assets under management (AUM), or fee-based models. Part-time work often means fewer clients and lower revenue, which can make it hard to justify the costs of licensing, insurance, software, and office space. Without scale, profitability becomes a challenge.

In conclusion, while the idea of part-time financial planning may seem appealing, the realities of the profession make it difficult to execute effectively. The demands of client care, compliance, education, and business development require consistent attention and availability. Unless the industry adapts to support flexible models, part-time financial planners will continue to face significant barriers to success.

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

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Understanding Investment Fees: A Guide for Physicians

SPONSOR: http://www.MarcinkoAssociates.com

By Dr. David Edward Marcinko MBA MEd CMP™

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MEDICAL COLLEAGUES BEWARE!

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

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

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

EDUCATION: Books

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

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Essential Critical Thinking Skills for Financial Advisors

FOR ETHICAL PHYSICIAN CLIENT ACQUISITION SUCCESS

By Dr. David Edward Marcinko; MBA MEd CMP

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SPONSOR: http://www.CertifiedMedicalPlanner.org

Critical thinking allows a Financial Advisor [FA] to analyze information and make an objective judgment. By impartially evaluating the facts related to a matter, Financial Planners [FPs] can draw realistic conclusions that will help make a sound decision. The ability of being able to properly analyze a situation and come up with a logical and reasonable conclusion is highly valued by employers, as well as current and potential clients.

Now, according to Indeed, we present the six main critical thinking and examples that will help you evaluate your own thought process as a FA, FP or Wealth Manager, etc.

What is critical thinking? 

Critical thinking is the ability to objectively analyze information and draw a rational conclusion. It involves gathering information on a subject and determining which pieces of information apply to the subject and which don’t, based on deductive reasoning. The ability to think critically helps people in both their personal and professional lives and is valued by most clients and employers. 

Why do employers value critical thinking?

Critical thinking skills are a valuable asset for an employee, as employers, brokerages and Registered Investment Advisors [RIAs] typically appreciate candidates who can correctly assess a situation and come up with a logical resolution. Time is a valuable resource for most managers, and an employee able to make correct decisions without supervision will save both that manager and the whole company much valuable time.

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Six main types of critical thinking skills

There are six main critical thinking skills you can develop to successfully analyze facts and situations and come up with logical conclusions:

1. Analytical thinking

Being able to properly analyze information is the most important aspect of critical thinking. This implies gathering information and interpreting it, but also skeptically evaluating data. When researching a work topic, analytical thinking helps you separate the information that applies to your situation from that which doesn’t.

2. Good communication

Whether you are gathering information or convincing others that your conclusions are correct, good communication is crucial in the process. Asking people to share their ideas and information with you and showing your critical thinking can help step further towards success. If you’re making a work-related decision, proper communication with your coworkers can help you gather the information you need to make the right choice.

3. Creative thinking

Being able to discover certain patterns of information and make abstract connections between seemingly unrelated data helps improve your critical thinking. When analyzing a work procedure or process, you can creatively come up with ways to make it faster and more efficient. Creativity is a skill that can be strengthened over time and is valuable in every position, experience level and industry.

4. Open-mindedness

Previous education and life experiences leave their mark on a person’s ability to objectively evaluate certain situations. By acknowledging these biases, you can improve your critical thinking and overall decision process. For example, if you plan to conduct a meeting in a certain way and your firm suggests using a different strategy, you should let them speak and adjust your approach based on their input.

5. Ability to solve problems

The ability to correctly analyze a problem and work on implementing a solution is another valuable skill.

6. Asking thoughtful questions:

In both private and professional situations, asking the right questions is a crucial step in formulating correct conclusions. Questions can be categorized in various forms as mentioned below:

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* Open-ended questions

Asking open-ended questions can help the person you’re communicating with provide you with relevant and necessary information. These are questions that don’t allow a simple “yes” or “no” as an answer, requiring the respondent to elaborate on the answer.

* Outcome-based questions

When you feel like another person’s experience and skills could help you work more effectively, consider asking outcome-based questions. Asking someone how they would act in a certain hypothetical situation, such as a stock market correction, can give you an insight into their perspective, helping you see things you hadn’t thought about before.

Reflective questions

You can gain insight by asking a client to reflect and evaluate an experience and explain their thought processes during that time. This can help you develop your critical thinking by providing you real-world examples.

* Structural questions

An easy way to understand something is to ask how something works. Any working system results from a long process of trial and error, and properly understanding the steps that needed to be taken for a positive result could help you be more efficient in your own endeavors.

CONCLUSION

Critical thinking is like a muscle that can be exercised and built over time. It is a skill that can help propel your career to new heights. You’ll be able to solve workplace issues, use trial and error to troubleshoot ideas, and more.

EDUCATION: Books

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

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ACUTE CARE MEDICINE: Defined

By A.I. and Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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ACUTE CARE MEDICINE

Classic: Acute care is a branch of secondary health care where a patient receives active but short-term treatment for a severe injury or episode of illness, an urgent medical condition, or during recovery from surgery. In medical terms, care for acute health conditions is the opposite from chronic care, or longer term care.

Modern: Acute care is active, short-term treatment for a severe injury or episode related to illness, an urgent medical condition or recovery from surgery.

HOSPITAL: https://medicalexecutivepost.com/2008/12/08/the-acute-care-inpatient-hospital/

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Examples: The following are considered acute care facilities:

  • Hospital (General Acute Care as well as Psychiatric, Specialized and Rehabilitation Hospitals; and Long Term Acute Care or LTAC)
  • Ambulatory Care Facility.
  • Home Health Agency.
  • End Stage Renal Disease Facility (dialysis center)
  • Hospice.

EMERGENT CARE: https://medicalexecutivepost.com/2025/05/03/medicine-emergent-care/

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INVESTING TRANSFORMATION: Artificial Intelligence

By Co-Pilot and A. I.

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Artificial Intelligence and Investing: A Transformative Partnership

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

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

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

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

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

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

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

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

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Understanding Hedge Funds: A Comprehensive Guide

By Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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SPONSOR: http://www.MarcinkoAssociates.com

QUESTION: What is a Hedge Fund?

A hedge fund is a limited partnership of private investors whose money is pooled and managed by professional fund managers. These managers use a wide range of strategies, including leverage (borrowed money) and the trading of nontraditional assets, to earn above-average investment returns. A hedge fund investment is often considered a risky, alternative investment choice and usually requires a high minimum investment or net worth. Hedge funds typically target wealthy investors.

MANAGERS: https://medicalexecutivepost.com/2025/05/23/hedge-fund-hiring-separate-managers/

The hedge fund manager I am considering also runs an offshore fund under a “master feeder” arrangement.

A PHYSICIAN’S QUESTION: What does this mean? In which fund should I invest?

The master feeder arrangement is a two-tiered investment structure whereby investors invest in the feeder fund. The feeder fund in turn invests in the master fund. The master fund is therefore the one that is actually investing in securities. There may be multiple feeder funds under one master fund. Feeder funds under the same master can differ drastically in terms of fees charged, minimums required, types of investors, and many other features – but the investment style will be the same because only the master actually invests in the market.

A master feeder structure is a very popular arrangement because it allows a portfolio manager to pool both onshore and offshore assets into one investment vehicle (the master fund) that allocates gains and losses in an asset-based, proportional manner back to the onshore and offshore investors. All investors, both offshore and onshore, get the same return.  In this manner, the portfolio manager, despite offering more than one fund with different characteristics to different populations, is not faced with the dilemma of which fund to favor with the best investment ideas.

PENSION PLANS: https://medicalexecutivepost.com/2025/05/18/medical-practice-pension-plan-hedge-fund-difficulties/

A manager may offer an offshore fund because there is demand for that manager’s skill either abroad, where investors may wish to preserve anonymity, or more commonly where investors simply do not wish to become entangled with the United States tax code. American citizens should generally avoid the offshore fund, since American citizens are taxed on their allocated share of offshore corporation profits whether or not a distribution occurs. Therefore, there is no benefit for most American taxpayers investing in an offshore fund.

Tax-exempt institutions, such as medical foundations, in the United States may have reason to consider an offshore hedge fund, however. Domestic tax-exempt organizations are generally not subject to unrelated business taxable income (UBTI) – the portion of hedge fund income that comes about as a result of the use of leverage – when investing with an offshore corporation.  If the same tax-exempt organization were to invest in a domestic fund, and if UBTI was generated, then the organization would have to pay taxes on that UBTI. Most domestic hedge funds generate UBTI.

FEES: https://medicalexecutivepost.com/2025/04/05/hedge-fund-wrap-fees/

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VARIABLE ANNUITIES: Retired Physicians Beware!

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

SPONSOR: http://www.CertifiedMedicalPlanner.org

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After a lifetime of hard work practicing medicine and saving, you’re at the retirement finish line. Instead of a paycheck, you’re relying on your nest egg and investment income to cover the bills. Picking the right investments is even more important, as you won’t have much chance to recover as a retired MD, DO, DPM or DDS.

“You made it to the top of the mountain through a systematic approach and are trying to make your way down safely,” says retirement planner John Gillet John Gillet in Hollywood, Fla. “Why throw all caution to the wind and try something different now?”

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Definitions

An annuity is an insurance contract designed to grow your money and then repay it as income. There are different versions. An immediate annuity turns your lump sum into future guaranteed income payments, like your own personal pension. They are simple to understand with no or small fees.

Fixed annuities pay a guaranteed interest rate over a set period to grow your money, like 5% a year for five years. These options could make sense as part of a retirement plan.

A variable annuity, on the other hand, invests your savings in mutual funds. While you can buy riders that guarantee a minimum income, you’ll be paying very much for it. “All in, the annual fees can be 3% or more of your balance,” says Jeff Bailey, an advisor from Nashville. “That’s a huge withdrawal rate from your portfolio versus investing on your own.”

The variable annuity will lock up your money for years. If you cancel early, you owe a surrender charge that could start at 7% or more of your annuity balance before gradually going down as time goes by. “Clients believe they can walk away with their contract value, but that’s often not true,” says Bailey.

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

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Understanding Pre-Payment Health Plans

By Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Classic: A pre-payment plan refers to health insurance plans that provide medical or hospital benefits in service rather than dollars, such as the plans offered by various Health Maintenance Organizations. A method providing in advance for the cost of predetermined benefits for a population group, through regular periodic payments in the form of premiums, dues, or contributions including those contributions that are made to a health and welfare fund by employers on behalf of their employees!

Modern:  A Prepaid Group Practice Plan specifies health services are rendered by participating physicians to an enrolled group of persons, with a fixed periodic payment made in advance by (or on behalf of) each person or family. If a health insurance carrier is involved, a contract to pay in advance for the full range of health services to which the insured is entitled under the terms of the health insurance contract.

Examples:

  • Pre-Paid Hospital Service Plan: The common name for a health maintenance organization (HMO), a plan that provides comprehensive health care to its members, who pay a flat annual fee for services.
  • Pre-Paid Premium: An insurance or other premium payment paid prior to the due date. In insurance, payment by the insured of future premiums, through paying the present (discounted) value of the future premiums or having interest paid on the deposit.
  • Pre-Paid Prescription Plan: A drug reimbursement plan that is paid in advance.

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Understanding Hobson’s Choice in Healthcare

By Dr. David Edward Marcinko MBA MEd CMP

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Hobson’s Choice in Medicine

SPONSOR: http://www.CertifiedMedicalPlanner.org

Hobson’s choice is a free choice in which only one thing is actually offered. The term is often used to describe an illusion that choices are available. The best known example is “I’ll give you a choice: Take it or leave it”, wherein “leaving it” is strongly undesirable.

The phrase is said to have originated with Thomas Hobson (1544–1631), a livery stable owner in Cambridge, England, who offered customers the choice of either taking the horse in the stall nearest to the door or taking none at all.

A CASE MODEL

Half of Physicians Plan to Change Career Paths

The Physicians Foundation recently conducted a survey on physician practice patterns and perspectives. Here are some key findings from the report:

• 31% of physicians identify as independent practice owners or partners.
• Almost half (47%) of physicians plan to change career paths.
• 78% of physicians sometimes, often or always experience feelings of burnout.
• Nearly a quarter of physician time is spent on non-clinical paperwork.

This result is not a good Hobson’s Choice in Medicine.

Cite: The Physicians Foundation, September 2018

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

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PARADOX : Government Health Information is Trusted?

By Staff Reporters

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A paradox is a statement that appears at first to be contradictory, but upon reflection then makes sense. This literary device is commonly used to engage a reader to discover an underlying logic in a seemingly self-contradictory statement or phrase. As a result, paradox allows readers to understand concepts in a different and even non-traditional

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GOVERNMENT HEALTH INFORMATION IS TRUSTED?

Classic Definition: Despite the PP-ACA, there is ambivalence about the role of the US Government as a source of quality healthcare information. 

Modern Circumstance: Of brands presented to respondents in a Consumer Reports (50 percent), and AARP (37 percent) survey, they outpolled the “US Government Healthcare Quality Reporting Website” (36 percent) and Medicare Website (32 percent).

Paradox Example: The focus groups expressed “mixed reactions and raised doubts about government involvement in quality ratings information. At least one participant in each group expressed skepticism about trusting ‘the government’ to compile information.”

Younger consumers especially questioned the relevance of Medicare measures to the non-elderly population. Yet participants gravitated to “.gov” websites over “.org” websites as a more authoritative source.

CITE: Williams, Jason: Health Affairs, December 28, 2016

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The Economy, Stocks and Commodities

By. A.I. and Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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  • Economy: Headline PCE rose from 2.6% on an annual basis in July to 2.7% in August, while core PCE stayed flat at 2.9%—all in line with analyst expectations.
  • Stocks: Solid inflation numbers helped equities arrest their recent selloff and offset the latest batch of tariffs. However, all three major indexes still ended the week lower than where they started.
  • Commodities: Oil climbed as Ukrainian drones continue to strike Russian energy infrastructure. Meanwhile, gold hit another all-time high, and rose above $3,800 for the first time ever at one point today.

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Understanding Alpha: Non-Systematic ROI Explained

Understanding Non-Systematic Return on Investment

www.CertifiedMedicalPlanner.org

DEM 2013

[By Dr. David Edward Marcinko MBA MEd CMP™ ]

https://marcinkoassociates.com

According to Wayne Firebaugh CPA, CFP®, CMP™ alpha measures non-systematic return on investment [ROI], or the return that cannot be attributed to the market.

It shows the difference between a fund’s actual return and its expected performance given the level of systematic (or market) risk (as measured by beta).

Example

For example, a fund with a beta of 1.2 in a market that returns 10% would be expected to earn 12%. If, in fact, the fund earns a return of 14%, it then has an alpha of 2 which would suggest that the manager has added value. Conversely, a return below that expected given the fund’s beta would suggest that the manager diminished value.

In a truly efficient market, no manager should be able to consistently generate positive alpha. In such a market, the endowment manager would likely employ a passive strategy that seeks to replicate index returns. Although there is substantial evidence of efficient domestic markets, there is also evidence to suggest that certain managers do repeat their positive alpha performance.

In fact, a 2002 study by Roger Ibbotson and Amita Patel found that “the phenomenon of persistence does exist in domestic equity funds.” The same study suggested that 65% of mutual funds with the highest style-adjusted alpha repeated with positive alpha performances in the following year.

Product Details  Product Details

More Research

Additional research suggests that active management can add value and achieve positive alpha in concentrated portfolios.

A pre 2008 crash study of actively managed mutual funds found that “on average, higher industry concentration improves the performance of the funds. The most concentrated funds generate, after adjusting for risk … the highest performance. They yield an average abnormal return [alpha] of 2.56% per year before deducting expenses and 1.12% per year after deducting expenses.”

FutureMetrics

FutureMetrics, a pension plan consulting firm, calculated that in 2006 the median pension fund achieved record alpha of 3.7% compared to a 60/40 benchmark portfolio, the best since the firm began calculating return data in 1988. Over longer periods of time, an endowment manager’s ability to achieve positive alpha for their entire portfolio is more hotly debated.  Dimensional Fund Advisors, a mutual fund firm specializing in a unique form of passive management, compiled FutureMetrics data on 192 pension funds for the period of 1988 through 2005.

Their research showed that over this period of time approximately 75% of the pension funds underperformed the 60/40 benchmark. The end result is that many endowments will use a combination of active and passive management approaches with respect to some portion of the domestic equity segment of their allocation.

Assessment

One approach is known as the “core and satellite” method in which a “core” investment into a passive index is used to capture the broader market’s performance while concentrated satellite positions are taken in an attempt to “capture” alpha. Since other asset classes such as private equity, foreign equity, and real assets are often viewed to be less efficient, the endowment manager will typically use active management to obtain positive alpha from these segments.

Notes:

  • Ibbotson, R.G. and Patel, A.K. Do Winners Repeat with Style? Summary of Findings – Ibbotson & Associates, Chicago (February 2002).
  • Kacperczyk, M.T., Sialm, C., and Lu Zheng. On Industry Concentration of Actively Managed Equity Mutual Funds. University of Michigan Business School. (November 2002).
  • 2007 Annual US Corporate Pension Plan Best and Worst Investment Performance Report.  FutureMetrics, April 20, 2007.

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Product DetailsProduct Details

The Importance of Public Relations in Healthcare

By Dr. David Edward Marcinko MBA MEd CMP

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Public Relations [PR] is differentiated than advertising in that an advertiser pays for and has control over the message. It differs from personal selling in that the message is non-personal, i.e., not directed to a particular individual patient. We pay for advertising but pray for public relations. Public relations are not controllable but it is free; advertising is not free. PR suggests that “good news or bad news”; just spell the doctors name correctly

Change Management is the discipline that guides how we prepare, equip and support individuals to successfully adopt to change in order to drive organizational success and outcomes.

For example, a senior doctor may retire, become ill, or a junior associate might become a practice partner. How will patients be affected?

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 positive 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 which 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. Yet, the company accepted full responsibility.
  • 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!

PRM stands for Patient Relationship Management, which is a system for managing all interactions with current and potential patients, families, friends, referring physicians, clinics and hospitals. The goal is simple: improve relationships to grow your medical practice. PRM technology helps medical practices and clinics stay connected to patients, streamline processes, and improve profitability.

When people talk about PRM, they’re usually referring to a PRM system: software that helps track each interaction with a patient or elated others. That can include practice sales calls, treatment or service plans, marketing e-mails, website, social media and more. PRM tools can unify patient and practice data from many sources and even use Artificial Intelligence [AI] to help better manage relationships across the entire doctor– patient lifecycle – spanning departments described elsewhere in the Marketing, Advertising and Sales ME-Ps.

EDUCATION: Books

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

References:

1. Purcarea, Victor: The impact of marketing strategies in healthcare systems.  J. Med Life. 2019 Apr-Jun;12(2):93–96. doi: 10.25122/jml-2019-1003

READINGS:

Marcinko, DE and Hetico, HR: The Business of Medical Practice [3rd Edition]. Springer Publishing, New York, 2010.

Marcinko, DE and Hetico, HR: Hospitals & Healthcare Organizations [Management Strategies, Operational Techniques, Tools, Templates and Case Studies].  Productivity Press, New York, 2012.

Marcinko, DE and Hetico, HR: Financial Management Strategies for Hospitals and Healthcare Organizations [Tools, Techniques, Checklists and Case Studies]. Productivity Press, New York, 2012.

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Understanding Investment Apps: A Guide for Beginners

DEFINITIONS

By Dr. David Edward Marcinko MBA MEd CMP

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SPONSOR: http://www.CertifiedMedicalPlanner.org

An app, which is short for “application,” is a type of software that can be installed and run on a computer, tablet, smartphone or other electronic devices. An app most frequently refers to a mobile application or a piece of software that is installed and used on a computer. Most apps have a specific and narrow function.

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

Robo-Advisors

An easy and fairly cheap way for novices to get into investing is to use a robo-advisor. Basically, the funds you contribute will be invested by an algorithm based upon your goals, which are usually determined by taking a survey. This helps keep fees low; the algorithm doesn’t rely on a human expert to make trades, and you don’t have to spend significant amounts of time researching your investments. While this is a good way to start, it may not be the best option in the long run.

Online Brokerage or Investment Apps

More options are becoming available all the time, and they have opened trading to a much larger percentage of the population. That is a great thing, but it’s important to remember that “easier to invest” doesn’t necessarily mean it’s easy to invest well.

Be wary of apps that “gamify” trading and encourage risky choices. Keep in mind that trusted names offer more security, so do your research when you are selecting a platform.

POOR DOCTORS: https://medicalexecutivepost.com/2024/04/04/why-physicians-do-not-get-rich/

Investing should be taken seriously, and we encourage you to have a good working relationship with a human financial services professional.

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Financial Self-Discovery for Medical Professionals

By Dr. David Edward Marcinko; MBA MEd CMP

PHYSICIAN COACHING: https://marcinkoassociates.com/process-what-we-do/

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SPONSOR: http://www.CertifiedMedicalPlanner.org

A Financial Self Discovery Questionnaire for Medical Professionals

For understanding your relationship with money, it is important to be aware of yourself in the contexts of culture, family, value systems and experience.  These questions will help you.  This is a process of self-discovery.  To fully benefit from this exploration, please address them in writing.  You will simply not get the full value from it if you just breeze through and give mental answers.  While it is recommended that you first answer these questions by yourself, many people relate that they have enjoyed the experience of sharing them with others who are important to them. 

As you answer these questions, be conscious of your feelings, actually describing them in writing as part of your process. 

Childhood

  • What is your first memory of money?
  • What is your happiest moment with Money? Your most unhappy?
  • Name the miscellaneous money messages you received as a child.
  • How were you confronted with the knowledge of differing economic circumstances among people, that there were people “richer” than you and people “poorer” than you?

Cultural heritage

  • What is your cultural heritage and how has it interfaced with money?
  • To the best of your knowledge, how has it been impacted by the money forces?  Be specific.  
  • To the best of your knowledge, does this circumstance have any motive related to Money?
  • Speculate about the manners in which your forebears’ money decisions continue to affect you today? 

Family

  • How is/was the subject of money addressed by your church or the religious traditions of your forebears?
  • What happened to your parents or grandparents during the Depression?
  • How did your family communicate about money?
  • How?  Be as specific as you can be, but remember that we are more concerned about impacts upon you than historical veracity.
  • When did your family migrate to America (or its current location)?
  • What else do you know about your family’s economic circumstances historically?

Your parents

  • How did your mother and father address money?
  • How did they differ in their money attitudes?
  • How did they address money in their relationship?
  • Did they argue or maintain strict silence?
  • How do you feel about that today?

Please do your best to answer the same questions regarding your life or business partner(s) and their parents.

Childhood: Revisited

  • How did you relate to money as a child?  Did you feel “poor” or “rich”? 
    Relatively?  Or, absolutely?  Why?
  • Were you anxious about money?
    Did you receive an allowance?  If so, describe amounts and responsibilities.
  • Did you have household responsibilities?
  • Did you get paid regardless of performance?
  • Did you work for money?

If not, please describe your thoughts and feelings about that.

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Same questions, as a teenager, young adult, older adult.

Credit

  • When did you first acquire something on credit?
  • When did you first acquire a credit card?
  • What did it represent to you when you first held it in your hands?
  • Describe your feelings about credit.
  • Do you have trouble living within your means?
  • Do you have debt?

Adulthood

  • Have your attitudes shifted during your adult life?  Describe.

Why did you choose your personal path? 
a)      Would you do it again?
b)      Describe your feelings about credit.

Adult attitudes

  • Are you money motivated? 
    If so, please explain why?  If not, why not? 
    How do you feel about your present financial situation? 
    Are you financially fearful or resentful?  How do you feel about that?
  • Will you inherit money?  How does that make you feel?
  • If you are well off today, how do you feel about the money situations of others? 
    If you feel poor, same question. 
  • How do you feel about begging?  Welfare?
    If you are well off today, why are you working?
  • Do you worry about your financial future?
  • Are you generous or stingy?  Do you treat?  Do you tip?
  • Do you give more than you receive or the reverse?  Would others agree?
  • Could you ask a close relative for a business loan?  For rent/grocery money?
  • Could you subsidize a non-related friend?  How would you feel if that friend bought something you deemed frivolous? 
  • Do you judge others by how you perceive they deal with their Money?
    Do you feel guilty about your prosperity?
    Are your siblings prosperous?
  • What part does money play in your spiritual life?
  • Do you “live” your Money values?

Conclusion

There may be other questions that would be useful to you.  Others may occur to you as you progress in your life’s journey. The point is to know your personal money issues and their ramifications for your life, work, and personal mission. 

This will be a “work-in-process” with answers both complex and incomplete.  Don’t worry. 

Just incorporate fine-tuning into your life’s process.

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SERIES #6 EXAM: Investment Company and Variable Contracts Products Representative

By A.I.and Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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The Series 6 exam — the Investment Company and Variable Contracts Products Representative Qualification Examination (IR) — assesses the competency of an entry-level representative to perform their job as an investment company and variable contracts products representative.

The exam measures the degree to which each candidate possesses the knowledge needed to perform the critical functions of an investment company and variable contract products representative, including sales of mutual funds and variable annuities.

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Candidates must pass the Securities Industry Essentials (SIE) exam and the Series 6 exam to obtain the Investment Company and Variable Contracts Products registration.

For more information about the SIE and Series 6 exams, refer to FINRA Rule 1210 and FINRA Rule 1220(b)(7).

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EDUCATION: Books

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3 Behavioral Biases Hurting Your Finances

By Dr. David Edward Marcinko MBA MEd CMP

SPONSOR: http://www.CertifiedMedicalPlanner.org

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The study of behavioral economics has revealed much about how different biases can affect our finances—often for the worse.

Take loss aversion: Because we feel a financial setback more acutely than a commensurate gain, we often cling to failed investments to avoid realizing the loss. Another potential hazard is present bias, or the tendency to prefer instant gratification over long-term reward, even if the latter gain is greater.

When it comes to money, sometimes it’s difficult to make rational decisions. Here, are three behavioral financial biases that could be impeding financial goals.

ANCHORING BIAS

Anchoring Bias happens when we place too much emphasis on the first piece of information we receive regarding a given subject. Anchoring is the mental trick your brain plays when it latches onto the first piece of information it gets, no matter how irrelevant. You might know this as a ‘first impression’ when someone relies on their own first idea of a person or situation.

Example: When shopping for a wedding ring a salesman might tell us to spend three months’ salary. After hearing this, we may feel like we are doing something wrong if we stray from this financial advice, even though the guideline provided may cause us to spend more than we can afford.

Example: Imagine you’re buying a car, and the salesperson starts with a high price. That number sticks in your mind and influences all your subsequent negotiations. Anchoring can skew our decisions and perceptions, making us think the first offer is more important than it is. Or, subsequent offers lower than they really are.

Example: Imagine an investor named Jane who purchased 100 shares of XYZ Corporation at $100 per share several years ago. Over time, the stock price declined to $60 per share. Jane is anchored to her initial price of $100 and is reluctant to sell at a loss because she keeps hoping the stock will return to her original purchase price. She continues to hold onto the stock, even as it declines, due to her anchoring bias. Eventually, the stock price drops to $40 per share, resulting in significant losses for Jane.

In this example, Jane’s nchoring bias to the original purchase price of $100 prevents her from rationalizing to sell the stock and cut her losses, even though market conditions have changed. So, the next time you’re haggling for your self, a potential customer or client, or making another big financial decision, be aware of that initial anchor dragging you down.

HERD MENTALITY BIAS

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

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

Example: During the dotcom bubble of the late 1990’s many investors exhibited a herd mentality. As technology stocks soared to astronomical valuations, investors rushed to buy these stocks driven by the fear of missing out on the gains others were enjoying. Even though some of these stocks had questionable fundamentals, the herd mentality led investors to follow the crowd.

In this example, the herd mentality contributed to the overvaluation of technology stocks. Eventually, it led to the dot-com bubble’s burst, causing significant losses for those who had unthinkingly followed the crowd without conducting proper research or analysis.

OVERCONFIDENT INVESTING BIAS

Overconfident Investing Bias happens when we believe we can out-smart other investors via market timing or through quick, frequent trading. This causes the results of a study to be unreliable and hard to reproduce in other research settings.

Example: Data convincingly shows that people and financial planners/advisors and wealth managers who trade most often under-perform the market by a significant margin over time. Active traders lose money.

Example: Overconfidence Investing Bias moreover leads to: (1) excessive trading (which in turn results in lower returns due to costs incurred), (2) underestimation of risk (portfolios of decreasing risk were found for single men, married men, married women, and single women), (3) illusion of knowledge (you can get a lot more data nowadays on the internet) and (4) illusion of control (on-line trading).

ASSESSMENT

Finally, questions remain after consuming this cognitive bias review.

Question: Can behavioral cognitive biases be eliminated by financial advisors in prospecting and client sales endeavors?

A: Indeed they can significantly reduce their impact by appreciating and understanding the above and following a disciplined and rational decision-making sales process.

Question: What is the role of financial advisors in helping clients and prospects address behavioral biases?

A: Financial advisors can provide an objective perspective and help investors recognize and address their biases. They can assist in creating well-structured investment and financial plans, setting realistic goals, and offering guidance to ensure investment decisions align with long-term objectives.

Question: How important is self-discipline in overcoming behavioral biases?

A; Self-discipline is crucial in overcoming behavioral biases. It helps investors and advisors adhere to their investment plans, avoid impulsive decisions, and stay focused on long-term goals reducing the influence of emotional and cognitive biases.

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 biases to your mutual success!

EDUCATION: Books

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

REFERENCES:

  • Marcinko, DE; Dictionary of Health Insurance and Managed Care. Springer Publishing Company, New York, 2007.
  • Marcinko, DE: Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™. Productivity Press, NY, 2016.
  • Marcinko, DE: Risk Management, Liability and Insurance Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™. Productivity Press, NY, 2017.
  • Nofsinger, JR: The Psychology of Investing. Rutledge Publishing, 2022
  • Winters, Scott:  The 10X Financial Advisor: Your Blueprint for Massive and Sustainable Growth. Absolute Author Publishing House, 2020.
  • Woodruff, Mandy: https://www.mandimoney.com

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Why Many Doctors Struggle Financially: 5 Key Reasons

By A.I. and Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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

1 | Believing They Are Universally Smart

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

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

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

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

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

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

2 | Overspending Too Soon

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

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

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

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

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

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

3 | Decreasing Salaries

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

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

4 | Increasing Costs of Private Practice

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

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

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

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

5 | Tuition Debt

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

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

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

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

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

THE FINANCIAL FIX

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

  • Place a portion of your salary (15-20% or more) into a savings account, and another portion (10-20% or more) into wise investments [stocks, bonds, mutual funds, and/or ETFs].
  • Pay off your bills each month, and then use leftover spending money to purchase fun things like vacations and fancy dinners, within your means. Shop sales, buy used clothes, and use credit card points for travel.
  • Hire an excellent tax professional and meet with an investment advisor once or twice a year about your investment status and strategy. http://www.MarcinkoAssociates.com

COMMENTS APPRECIATED

EDUCATION: Books

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

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PALACE FALLACY: Memory Loss

SPONSOR: http://www.CertifiedMedicalPlanner.org

By Staff Reporters and A.I.

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The Memory Palace Fallacy – Learning Styles Don’t Actually Exist

Remember being told you’re a “visual learner” or an “auditory learner”? Well, turns out that whole learning styles theory is pretty much bunk.

Common Learning Myths have been thoroughly debunked by modern educational research, and this is a big one. Studies consistently show that matching teaching methods to supposed learning styles doesn’t improve outcomes at all.

What actually matters is matching the teaching method to the content itself – you learn geography better with maps because geography is visual, not because you’re a “visual person.” It’s like trying to learn piano by reading about it versus actually playing keys. The activity should match what you’re trying to learn, not some made-up category about how your brain supposedly works.

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EDUCATION: Books

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SERIES #7 EXAM: General Securities Representative Qualification

By A. I. and FINRA

SPONSOR: http://www.CertifiedMedicalPlanner.org

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The Series 7 exam — the General Securities Representative Qualification Examination (GS) — assesses the competency of an entry-level registered representative to perform their job as a general securities representative.

The exam measures the degree to which each candidate possesses the knowledge needed to perform the critical functions of a general securities representative, including sales of corporate securities, municipal securities, investment company securities, variable annuities, direct participation programs, options and government securities.

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Candidates must pass the Securities Industry Essentials (SIE) exam and the Series 7 exam to obtain the General Securities Representative registration.

For more information about the SIE and Series 7 exams, refer to FINRA Rule 1210 and FINRA Rule 1220(b)(2).

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EDUCATION: Books

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QUANTUM COMPUTERS: A Peek into the Future?

NIST, A.I. and Staff Reporters

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SPONSOR: http://www.CertifiedMedicalPlanner.org

A computer that could break the encryption that safeguards your private information on the internet. A machine that can design powerful new drugs by precisely simulating the behavior of individual molecules. A device that optimizes complex supply chains to help companies get the parts they need and assemble them in the most efficient way possible.

These are all examples of how an emerging technology — the quantum computer — could change our world.

These computers work by harnessing quantum physics — the strange, often counterintuitive laws that govern the universe at its smallest scales and coldest temperatures. Today’s quantum computers are rudimentary and error-prone. But if more advanced and robust versions can be made, they have the potential to rapidly crunch through certain problems that would take current computers years. That’s why governments, companies and research labs around the world are working feverishly toward this goal.

Quantum computers will not replace our familiar “classical” computers. Rather, the two types of machines could work together to solve problems that stymie classical computers, potentially supercharging scientific research in fields such as materials and drug discovery, giving a boost to industry and upending cybersecurity as we know it.

So, let’s explore how quantum computers work.

MORE: https://www.nist.gov/quantum-information-science/quantum-computing-explained

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EDUCATION: Books

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INVESTING PARADOX: Flexibile and Dogmatic

By Dr. David Edward Marcinko MBA MEd CMP

SPONSOR: http://www.CertifiedMedicalPlanner.org

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A paradox is a statement or situation that seems contradictory but actually makes sense when you think about it more deeply. It challenges logic and often reveals a hidden truth.

FLEXIBLY DOGMATIC PARADOX

The Flexibly Dogmatic Paradox suggests that no matter how sensible your financial planning, investing or wealth management process is there will be uncomfortably long periods when it looks broken. And process is the best way of ensuring you keep standing for something because if you don’t stand for something, you’ll fall for anything. This is why, when assessing an investment fund, focus 50% on the manager’s character and 50% on their process. Everything else is detail. There are few guarantees in investing, but the fact that markets will batter you emotionally is one of them.

FINANCIAL PARADOX: https://medicalexecutivepost.com/2025/07/27/paradox-of-financial-health/

Example: During volatile times, the temptation to abandon the process is strong. But that’s why it’s there. Process is what forces one fund manager to keep buying unbroken companies when everyone else thinks they’re bust, and another to keep faith with a top-quality company when the mob says it’s too expensive The best fund managers dogmatically stick to their process when it’s out of favor. Then, when it returns to favor, the elastic pings back: they recapture lost ground surprisingly fast. However, every rule has an exception. And spotting the exceptions to their process is something the true greats have a knack for buying and selling.

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Example:  In 2007, US value manager Bill Miller had the makings of an investment legend, but the financial crisis wrecked all that. His process told him to double down into falling share prices, which had worked well for years. But it doesn’t work if the companies go bust, which many of his financial stocks did in 2008.

ADVISORS PARADOX: https://medicalexecutivepost.com/2025/06/20/paradoxical-contradictions-all-financial-advisors-must-know-to-win-clients/

Conclusion

The fact is that no matter how good it is, a process operated without human judgment is just an algorithm. The best fund managers and financial prospectors and sales men/women know this.

They stick dogmatically to their process but somehow remain flexible enough to spot the occasions when it’s about to drive them into a brick wall.

COMMENTS APPRECIATED

EDUCATION: Books

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

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CAPITATION REIMBURSEMENT: A Historical Economic Review

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By Dr. David Edward Marcinko MBA MEd CMP

SPONSOR: http://www.CertifiedMedicalPlanner.org

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DEFINITION

Capitation is a type of healthcare payment system in which a physician or hospital is paid a fixed amount of money per patient for a prescribed period by an insurer or physician association. The cost is based on the expected healthcare utilization costs for a group of patients for that year.

With capitation, the physician—otherwise known as the primary care physician— is paid a set amount for each enrolled patient whether a patient seeks care or not. The PCP is usually contracted with an HMO whose role it is to recruit patients.

ACOs: https://medicalexecutivepost.com/2024/12/01/record-breaking-savings-for-acos-in-2023/

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CAPITATION REIMBURSEMENT HISTORY

According to Richard Eskow, CEO of Health Knowledge Systems of Los Angeles, capitated medical reimbursement has been used in one form or another, in every attempt at healthcare reform since the Norman Conquest. Some even say an earlier variant existed in ancient China [personal communication]. 

Initially, when Henry I assumed the throne of the newly combined kingdoms of England and Normandy, he initiated a sweeping set of healthcare reforms. Historical documents, though muddled, indicate that soon thereafter at least one “physician,” John of Essex, received a flat payment honorarium of one penny per day for his efforts. Historian Edward J. Kealey opined that sum was roughly equal to that paid to a foot-soldier or a blind person. Clearer historical evidence suggests that American doctors in the mid-19th century were receiving capitation-like payments. No less an authoritative figure than Mark Twain, in fact, is on record as saying that during his boyhood in Hannibal, MO his parents paid the local doctor $25/year for taking care of the entire family regardless of their state of health.

Later, Sidney Garfield MD [1905-1984] is noted as one of the great under-appreciated geniuses of 20th century American medicine stood in the shadow cast by his more celebrated partner, Henry J. Kaiser. Garfield was not the first physician to embrace the notion of prepayment capitation, nor was he the first to understand that physicians working together in multi-specialty groups could, through collaboration and continuity of care, outperform their solo practice colleagues in almost every measure of quality and efficiency. The Mayo brothers, of course, had prior claim to that distinction. What Garfield did, was marry prepayment to group practice, providing aligned financial incentives across every physician and specialty in his medical group, as well as a culture of group accountability for the care of every member of the affiliated health plan. He called it “the new economics of medicine,” and at its heart was a fundamentally new paradigm of care that emphasized – prevention before treatment – and health before sickness.  Under his model: the fewer the sick – the greater the remuneration. And: the less serious the illness, the better off the patient and the doctors.

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

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Such ideas were heresy to the reigning fee-for-service, solo practice, ideologues of the mainstream medical establishment of the 1940s and ‘50s, of course. Throughout the period, Garfield and his group physicians were routinely castigated by leaders of the AMA and county medical associations as socialistic and unethical. The local medical associations in Garfield’s expanding service areas – the San Francisco Bay Area, Los Angeles, and Portland, Oregon – blocked group practice physicians from association membership, effectively shutting them out of local hospitals, denying them patient referrals or specialty society accreditation. Twice in the 1940s, formal medical association charges were brought against Garfield personally, at one time temporarily succeeding in suspending his license to practice medicine.

Of course, capitation payments made a comeback in the first cost-cutting managed care era of the 1980-90s because fee-for-service medicine created perverse incentives for physicians by paying more for treating illnesses and injuries than it does for preventing them — or even for diagnosing them early and reducing the need for intensive treatment later. Nevertheless, the modern managed care industry’s experience with capitation wasn’t initially a good one. The 1980-90s saw a number of HMOs attempt to put independent physicians, especially primary care doctors, into a capitation reimbursement model. The result was often negative for patients, who found that their doctors were far less willing to see them — and saw them for briefer visits — when they were receiving no additional income for their effort. Attempts were also made to aggregate various types of health providers — including hospitals and physicians in multiple specialties — into “capitation groups” that were collectively responsible for delivering care to a defined patient group. These included healthcare facilities and medical providers of all types: physicians, osteopaths, podiatrists, dentists, optometrists, pharmacies, physical therapists, hospitals and skilled nursing homes, etc.

However, the healthcare industry isn’t collective by nature, and these efforts tended to be too complicated to succeed. One lesson that these experiments taught is that provider behavior is difficult to change unless the relationship between that behavior and its consequences is fairly direct and easy to understand.

MORE: https://medicalexecutivepost.com/wp-content/uploads/2008/11/capitation-actuarial-medical-econometrics.pdf

Today, the concept of prepayment and medical capitation is to uncouple compensation from the actual number of patients seen, or treatments and interventions performed. This is akin to a fixed price restaurant menu, as opposed to an àla carte eatery.

COMMENTS APPRECIATED

EDUCATION: Books

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

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STOCK MARKET: Beware Manipulation Schemes

By Dr. David Edward Marcinko MBA MEd CMP

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SPONSOR: http://www.MarcinkoAssociates.com

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What are types of market manipulation schemes?

Pump and Dump

Bear Raids

  • Refer to attempts by investors to move the price of a stock opportunistically by selling large numbers of shares short. The investors pocket the difference between the initial price and the new, lower price after this maneuver. This technique is illegal under SEC rules, which stipulate that every short sale must be on an uptick. For more information on this complex tactic, read on in this piece from the Wharton School of Business.

Wash Trading

Matched Orders

  • When fraudsters manipulate the market through matched orders, they enter trades to buy or sell securities with the knowledge that a matching order on the opposite side has been or will be entered. During his tenure at the Commission, our partner Jordan Thomas was involved in a case where the SEC won summary judgement and obtained settlements with an astonishing 16 defendants who engaged in matched trades, among other illicit tactics.

Painting the Tape

  • Painting the tape refers to placing successive orders in small amounts at increasing or decreasing prices.

Spoofing & Layering

  • High frequency traders are known to use the tactics of Spoofing & Layering to manipulate share prices. Spoofing is the placing of a bid or offer with the intent to cancel before execution. Layering is a form of spoofing in which the trader places multiple orders on one side of the book, in order to create a false impression of heavy buying or selling.
  • PONZI: https://medicalexecutivepost.com/2021/09/22/what-exactly-is-a-ponzi-scheme/

Read more about stock manipulation.

For further details about other common securities violations, see our Securities Law Primer.

COMMENTS APPRECIATED

EDUCATION: Books

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

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DOCTORS: Early Investing Needed for Retirement

NEW FINANCIAL STRATEGIES?

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

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SPONSOR: http://www.CertifiedMedicalPlanner.org

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Starting early is key to saving for retirement

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

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

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

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

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

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

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

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

COMMENTS APPRECIATED

EDUCATION: Books

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

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

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