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COMPOUNDING PHARMACY: Disadvantages

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

By Dr. David Edward Marcinko MBA MEd

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⚠️ Cons of Compounding Pharmacies

1. Quality and Safety Concerns

Medications are not FDA-approved, meaning they don’t go through the same rigorous testing as commercial drugs.
Risk of contamination or incorrect formulation if strict standards aren’t followed.
Potency can vary between batches, leading to inconsistent therapeutic effects.

2. Limited Regulation

Oversight is less stringent compared to mass-produced pharmaceuticals.
Standards may differ depending on the state or the specific pharmacy.
Patients may not always know whether their compounding pharmacy meets high-quality benchmarks.

3. Insurance and Cost Issues

Compounded medications are often not covered by insurance.
They can be more expensive due to customization and small-scale production.

4. Availability and Accessibility

Not all pharmacies offer compounding services.
Patients may need to travel farther or wait longer to receive their medication.

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5. Evidence and Efficacy

Limited clinical trials or scientific evidence supporting compounded formulations.
Effectiveness may rely heavily on anecdotal reports rather than standardized studies.

6. Risk of Errors

Human error in measuring, mixing, or labeling can lead to incorrect dosages.
Lack of standardized packaging may increase confusion for patients.

👉 In short: while compounding pharmacies can provide personalized solutions, the downsides include less regulation, higher costs, safety risks, and limited evidence of efficacy compared to FDA-approved medications.

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EDUCATION: Books

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

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Filed under: "Doctors Only", Drugs and Pharma, Ethics, Health Law & Policy, iMBA, Inc., Marcinko Associates | Tagged: compounding pharmacy, costs, david marcinko, DEA, Drugs, FDA, health, healthcare, medicine, pharmacist, prescriptions, quality, Rx, safety, Technology | Leave a comment »

SOCIAL DETERMINANTS OF HEALTH

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

By Dr. David Edward Marcinko MBA MEd

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Shaping Well-being Beyond Medicine

Health is often thought of as the result of medical care, but in reality, it is deeply influenced by the conditions in which people are born, grow, live, work, and age. These conditions, known as social determinants of health, include a wide range of social, economic, and environmental factors that shape health outcomes. They are responsible for many of the differences in health status between individuals and communities. Understanding these determinants is essential for promoting fairness in health and designing policies that reduce disparities.

Economic Stability

Economic stability is one of the most powerful determinants of health. Individuals with steady income can afford nutritious food, safe housing, and preventive healthcare. Conversely, poverty increases vulnerability to chronic diseases, mental health challenges, and limited access to medical services. Families with fewer financial resources may struggle to afford medications or healthy diets, leading to higher rates of obesity, diabetes, and cardiovascular disease. Unemployment or unstable work further exacerbates stress, which itself is linked to poor health outcomes. Economic inequality directly translates into health inequality.

Education

Education shapes health both directly and indirectly. Higher educational attainment is associated with better employment opportunities, higher income, and improved health literacy. People with more education are more likely to understand medical information, adopt healthy behaviors, and navigate healthcare systems effectively. Limited education can perpetuate cycles of poverty and poor health. For instance, children who grow up in underfunded schools may face restricted opportunities, leading to lower lifetime earnings and poorer health outcomes. Education is therefore a critical lever for breaking intergenerational cycles of disadvantage.

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Neighborhood and Physical Environment

The environment in which individuals live plays a crucial role in determining health. Safe neighborhoods with clean air, accessible parks, and reliable transportation promote physical activity and reduce exposure to pollutants. In contrast, communities with high crime rates, poor housing, and environmental hazards contribute to stress, injury, and illness. Food deserts—areas with limited access to affordable, healthy food—are a striking example of how environment shapes health. Residents in these areas often rely on processed foods, increasing risks of obesity and related diseases. Housing quality also matters: overcrowding, mold, or lead exposure can lead to respiratory illnesses and developmental delays.

Healthcare Access and Quality

Access to healthcare is a fundamental determinant, but it is shaped by social and economic factors. Insurance coverage, affordability, and cultural competence of providers influence whether individuals receive timely and effective care. Marginalized groups often face barriers such as discrimination, language differences, or lack of nearby facilities. Even when healthcare is available, disparities in quality persist. For example, minority populations may receive less aggressive treatment for certain conditions compared to others. Addressing these inequities requires systemic reforms that prioritize inclusivity and affordability.

Social and Community Context

Social relationships and community support networks significantly affect health. Strong social ties provide emotional support, reduce stress, and encourage healthy behaviors. Communities with high levels of trust and civic engagement often experience better health outcomes. Conversely, discrimination, racism, and social exclusion undermine health by increasing stress and limiting opportunities. Social cohesion and equity are therefore vital for fostering healthier societies.

Conclusion

The social determinants of health highlight that medicine alone cannot ensure well-being. Economic stability, education, environment, healthcare access, and social context collectively shape health outcomes and drive disparities. Addressing these determinants requires a holistic approach that integrates public health, social policy, and community action. By investing in education, reducing poverty, improving neighborhoods, and ensuring equitable healthcare, societies can move closer to achieving health equity. Ultimately, health is not just about treating illness—it is about creating conditions in which everyone has the opportunity to thrive.

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Filed under: "Doctors Only", Ask a Doctor, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Quality Initiatives, Touring with Marcinko | Tagged: david marcinko, Ethics, health, healthcare, mental health, Population Health, public health, SDH, social determinants health, wellness | Leave a comment »

LOSS LEADERS: Marketing Tactics Used by Doctors to Attract Patients

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

By Dr. David Edward Marcinko MBA MEd

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Doctors use loss leader tactics—offering discounted or free services—to attract new patients and build long-term loyalty. These strategies are increasingly common in competitive healthcare markets.

In today’s healthcare landscape, physicians and clinics face intense competition for patient attention. Traditional referral systems are no longer sufficient, as patients increasingly rely on online reviews, social media, and digital advertising to choose providers. To stand out, many doctors have adopted loss leader marketing tactics—a strategy borrowed from retail where a business offers a product or service at a loss to attract customers and stimulate future sales.

A loss leader in healthcare typically involves offering free consultations, discounted exams, or low-cost procedures. For example, aesthetic clinics might advertise free skin evaluations or reduced-price Botox sessions. Primary care practices may offer complimentary wellness screenings or discounted flu shots. These services are not intended to generate immediate profit but to introduce patients to the practice, build trust, and encourage them to return for more comprehensive—and profitable—care.

This tactic works particularly well in specialties where patients have discretionary choice, such as dermatology, dentistry, chiropractic care, and cosmetic surgery. By lowering the barrier to entry, doctors can attract hesitant or price-sensitive patients who might otherwise delay care. Once inside the practice, patients experience the quality of service firsthand, increasing the likelihood of repeat visits and word-of-mouth referrals.

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Digital marketing amplifies the effectiveness of loss leader strategies. Physicians use platforms like Google Ads, Facebook, and Instagram to promote their offers to targeted demographics. A well-designed landing page might advertise a “$49 New Patient Exam” with a clear call to action and online booking. These campaigns often include retargeting ads and email follow-ups to nurture leads into loyal patients.

However, loss leader tactics must be carefully managed. Offering services below cost can strain resources if not paired with a clear conversion strategy. Doctors must ensure that the initial offer leads to higher-value services, such as diagnostic testing, treatment plans, or elective procedures. Additionally, practices must maintain ethical standards and avoid misleading promotions that could erode patient trust.

Reputation management plays a crucial role in sustaining the benefits of loss leader marketing. Positive patient experiences from initial discounted visits often translate into glowing online reviews, which further attract new patients. Conversely, poor execution—such as rushed appointments or upselling pressure—can backfire and damage the practice’s credibility.

Ultimately, loss leader marketing is not about giving away services indefinitely. It’s a strategic investment in patient acquisition, brand building, and long-term growth. When executed thoughtfully, it allows doctors to showcase their expertise, differentiate their practice, and foster lasting relationships with patients.

In conclusion, loss leader tactics have become a powerful tool in the modern physician’s marketing arsenal. By offering low-cost entry points to care, doctors can attract new patients, build trust, and grow their practice sustainably.

As competition intensifies, those who master this strategy—while maintaining quality and transparency—will be best positioned to thrive in the evolving healthcare marketplace.

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Filed under: "Doctors Only", Ask a Doctor, Career Development, Drugs and Pharma, Glossary Terms, Health Economics, Health Insurance, Healthcare Finance | Tagged: david marcinko, DC, DDS, DO, doctors, DPM, Free consultations, loss leaders, Marketing Tactics Used by Doctors to Attract Patients, medical competition, physcians, reputation management | Leave a comment »

CRISIS MANAGEMENT: In Medical Practice and Healthcare

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

Dr. David Edward Marcinko MBA MEd

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Crisis Management in Medical Practice

Healthcare is a field where crises are not hypothetical but expected realities. From pandemics and natural disasters to cyberattacks and sudden staff shortages, medical practices must be prepared to respond swiftly and effectively. Crisis management in medical practice refers to the structured approach of anticipating, preparing for, responding to, and recovering from disruptive events that threaten patient safety, organizational stability, or community trust.

🌐 Nature of Crises in Healthcare

Crises in medical practice can take many forms:

Public Health Emergencies: Outbreaks of infectious diseases, such as COVID-19, demand rapid adaptation of protocols and resources.
Operational Disruptions: Power outages, supply chain breakdowns, or IT failures can halt essential services.
Human Resource Challenges: Sudden staff shortages due to illness or burnout can compromise patient care.
Reputation and Legal Risks: Medical errors or breaches of patient confidentiality can escalate into crises requiring immediate management.

Each type of crisis requires tailored strategies, but all share the common need for preparedness and resilience.

🔑 Principles of Crisis Management

Effective crisis management in medical practice rests on several key principles:

Preparedness: Developing contingency plans, conducting drills, and maintaining emergency supplies ensure readiness.
Leadership and Decision-Making: Strong leadership is critical for making rapid, evidence-based decisions under pressure.
Communication: Transparent, timely communication with staff, patients, and external stakeholders reduces panic and builds trust.
Collaboration: Coordinating with hospitals, public health agencies, and community organizations strengthens response capacity.
Flexibility: Crises are unpredictable; adaptability in protocols and resource allocation is essential.

⚙️ Crisis Management Frameworks

Healthcare organizations often adopt structured frameworks:

Incident Command System (ICS): Provides a standardized hierarchy for managing emergencies.
Risk Assessment Models: Identify vulnerabilities and prioritize mitigation strategies.
Business Continuity Planning: Ensures essential services continue despite disruptions.

These frameworks help medical practices move from reactive responses to proactive resilience.

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💡 Challenges in Crisis Management

Despite planning, medical practices face significant challenges:

Resource Limitations: Smaller practices may lack the financial or logistical capacity to implement robust crisis plans.
Staff Stress and Burnout: Crises often demand long hours and emotional resilience, which can strain healthcare workers.
Rapidly Changing Information: In public health emergencies, evolving guidelines can create confusion.
Patient Expectations: Maintaining quality care during disruptions is difficult but essential to preserve trust.

Addressing these challenges requires investment in training, mental health support, and technology infrastructure.

🌱 Importance of Resilience

Crisis management is not only about survival but about building resilience. Practices that learn from crises, adapt policies, and strengthen systems emerge stronger. For example, the COVID-19 pandemic accelerated telemedicine adoption, which continues to benefit patients today. Resilience ensures that medical practices can withstand future disruptions while continuing to deliver safe, effective care.

✅ Conclusion

Crisis management in medical practice is a vital competency that safeguards both patients and providers. By preparing for diverse scenarios, fostering strong leadership, and prioritizing communication, healthcare organizations can navigate crises with confidence. Ultimately, effective crisis management transforms challenges into opportunities for growth, innovation, and improved patient care.

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Filed under: "Ask-an-Advisor", "Doctors Only", Drugs and Pharma, Ethics, Glossary Terms, Management, Marcinko Associates | Tagged: crisis, crisis management, crisis management healthcare, crisis management meicine, david marcinko, digital marketing, health, healthcare, ICs, Incident Command System, public health, reputation management | Leave a comment »

PHYSICIAN PAYMENT: Direct Reimbursement Models

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

By Dr. David Edward Marcinko MBA MEd

BASIC DEFINITIONS

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

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

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

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

Key advantages of the direct reimbursement model include:

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

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

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

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

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

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Filed under: "Doctors Only", Ask a Doctor, Career Development, Funding Basics, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Insurance Matters, Managed Care, Marketing & Advertising | Tagged: ACOs, david marcinko, direct primary are, direct reimbursement payment, DO, doctors, DPC, DPM, health, healthcare, MD, mental health, physicians, value based csare, VBC | Leave a comment »

SINGULARITY: In Finance and Investing

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

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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

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

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

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

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

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

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

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

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

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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Filed under: "Doctors Only", Ask a Doctor, Drugs and Pharma, Ethics, finance, Investing, Portfolio Management, Research & Development, Touring with Marcinko | Tagged: AI, artificial intelligence, data privacy, david marcinko, diagnosis, Drugs, Ethics, finance, health, healthcare, Investing, medicine, precision medicine, singularity, Technology | Leave a comment »

BAD MONEY MOVES of Physicians!

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

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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

1. Impulse Spending

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

2. High‑Interest Debt

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

3. Ignoring Savings and Investments

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

4. Chasing Get‑Rich‑Quick Schemes

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

5. Overspending on Status

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

6. Neglecting Insurance

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

7. Failing to Budget

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

8. Ignoring Education and Skills

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

Conclusion

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

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Filed under: "Ask-an-Advisor", "Doctors Only", economics, Ethics, finance, Financial Planning, Insurance Matters, Investing, Marcinko Associates, Portfolio Management | Tagged: bad money moves, budgeting, CASH, david marcinko, DO, DPM, finance, insurance, interest rates, Investing, investments, MD, money, personal-finance, savings, spending, stocks, wealth manasgement | Leave a comment »

PUBLIC RELATIONS: In Medicine

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

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

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

1. Building Trust and Reputation

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

2. Health Education and Awareness

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

3. Crisis Communication

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

4. Advocacy and Community Engagement

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

5. Digital Transformation in Medical PR

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

6. Ethical Responsibility

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

Conclusion

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

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Understanding the Risks of Capitation in Healthcare

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

By A.I.

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The Pitfalls of Capitation in Medicine

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

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

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

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

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

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

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

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

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

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Filed under: "Doctors Only", Ask a Doctor, business, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Managed Care | Tagged: capitated medicine, capitation, DDS, DO, doctors, financia pitfalls, managedcare, MD, medical payment models, physicians | Leave a comment »

BAYLOR PLAN: Nursing Shift Payments

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

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

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

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

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

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

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

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

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

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Site-Neutral Payments Still a Long Ways Off

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

By Health Capital Consultants, LLC

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

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

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Understanding Parkinson’s Law: Importance vs Attention

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

The Attention a Problem Gets is Inverse to its’ Importance

Courtesy: http://www.CertifiedMedicalPlanner.org

By Dr. David Edward Marcinko MBA, MEd CMP

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

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

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

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

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

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

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

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

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

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

By Staff Reporters and Copilot A.I.

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

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

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

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

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

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

Modified: Dr. Neil Anand via Kevin MD

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MEDICAL PRACTICE MARKETING: Strategies for Success

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

By Dr. David Edward Marcinko MBA MEd

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

🎯 Understanding the Target Audience

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

🌐 Building a Strong Online Presence

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

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

🗣️ Leveraging Patient Reviews and Testimonials

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

📬 Utilizing Email and Content Marketing

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

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🤝 Community Engagement and Partnerships

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

📊 Measuring Success

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

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

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

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

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By Health Capital Consultants, LLC

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

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

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MONETARY VALUATION: Of the Medical Practice

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

By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

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

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

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

HEALTHCARE VALUATION: Terms and Definitions

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

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

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

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

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

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MEDICAL PRACTICE: Valuation Adjustments

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

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

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

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Safe Disposal: National Prescription Drug Take Back Day

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

PODCAST: National Prescription Drug Take Back Day

October 25, 2025

By Dr. David Edward Marcinko MBA MEd

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The National Prescription Drug Take Back Day aims to provide a safe, convenient, and responsible means of disposing of prescription drugs, while also educating the general public about the potential for abuse of medications.

Prescription Pill Bottles

PODCAST: https://www.bing.com/videos/search?q=dea+take+back+day&&view=detail&mid=0D5B986D9C5FD79B077B0D5B986D9C5FD79B077B&&FORM=VRDGAR

MORE DEA: https://takebackday.dea.gov/

Conclusion

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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

Ambulance DEM

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PPMC: Physician Practice Management Corporation

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

By Dr. David Edward Marcinko MBA MEd

DEFINED

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A physician practice management corporation (PPMC) is a business entity that provides non-clinical administrative and operational support to medical practices, allowing physicians to focus on patient care while the corporation handles the business side of healthcare.

Physician practice management corporations emerged in response to the increasing complexity of running a medical practice. As healthcare regulations, insurance requirements, and operational costs grew, many physicians found it challenging to manage both clinical responsibilities and business operations. PPMCs offer a solution by taking over the administrative burdens, enabling physicians to concentrate on delivering quality care.

At their core, PPMCs are responsible for a wide range of non-medical services. These include billing and coding, human resources, payroll, marketing, compliance, information technology, and financial management. By centralizing these functions, PPMCs can achieve economies of scale, reduce overhead costs, and improve operational efficiency for the practices they manage. This model is particularly attractive to small and mid-sized practices that may lack the resources to manage these functions independently.

PPMCs typically enter into long-term management agreements with physician groups. In some cases, they may purchase the non-clinical assets of a practice—such as equipment, office space, and administrative staff—while the physicians retain control over clinical decisions and patient care. This arrangement allows for a clear division between medical and business responsibilities, which is essential for maintaining compliance with healthcare regulations like the Stark Law and the Anti-Kickback Statute.

PPMCs: https://medicalexecutivepost.com/2019/11/18/on-the-ppmcs-of-yester-year-and-today/

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One of the key advantages of working with a PPMC is access to capital and advanced infrastructure. PPMCs often invest in state-of-the-art electronic health record (EHR) systems, data analytics tools, and revenue cycle management platforms. These technologies can enhance patient care, streamline operations, and improve financial performance. Additionally, PPMCs may offer strategic guidance on practice expansion, mergers and acquisitions, and payer contract negotiations.

However, the relationship between physicians and PPMCs must be carefully managed. While PPMCs bring valuable expertise and resources, there is a risk that business priorities could overshadow clinical autonomy. To mitigate this, successful PPMCs prioritize physician engagement, transparent governance, and aligned incentives. They work collaboratively with physicians to ensure that business strategies support, rather than hinder, the delivery of high-quality care.

The physician practice management industry has evolved significantly over the past few decades. After a wave of failures in the 1990s due to overexpansion and misaligned incentives, modern PPMCs have adopted more sustainable and physician-centric models. Today, they play a crucial role in helping practices adapt to value-based care, population health management, and other emerging trends in healthcare delivery.

In conclusion, a physician practice management corporation serves as a strategic partner to medical practices, offering the business acumen and operational support needed to thrive in a complex healthcare environment. By offloading administrative tasks and providing access to advanced resources, PPMCs empower physicians to focus on what they do best—caring for patients—while ensuring the long-term success and sustainability of their practices.

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RE-IMAGINING RETIREMENT: A Path Forward for a Broke 65-Year-Old Doctor

Posted on October 22, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

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SPONSOR: http://www.MarcinkoAssociates.com

Turning 65 is often seen as the gateway to retirement—a time to slow down, reflect, and enjoy the fruits of decades of labor. But for some, including doctors who may have faced financial setbacks, poor planning, or unexpected life events, reaching this milestone without financial security can be deeply unsettling. The image of a broke 65-year-old doctor may seem paradoxical, given the profession’s reputation for high earnings. Yet, reality paints a more nuanced picture. Fortunately, even in the face of financial hardship, retirement is not a closed door—it’s a challenge that can be met with creativity, resilience, and strategic planning.

Understanding the Situation

Before exploring solutions, it’s important to understand how a physician might arrive at retirement age without adequate savings. Medical school debt, late career starts, divorce, health issues, poor investment decisions, or supporting family members can all contribute. Some doctors work in lower-paying specialties or underserved areas, sacrificing income for impact. Others may have lived beyond their means, assuming their high salary would always be enough. Regardless of the cause, the key is to shift focus from regret to action.

DOCTORS: https://medicalexecutivepost.com/2025/09/09/doctors-early-investing-needed-for-retirement/

Redefining Retirement

Traditional retirement—ceasing work entirely—is not the only option. For a broke 65-year-old doctor, retirement may mean transitioning to a less demanding role, reducing hours, or shifting to a new field. The goal is to create a sustainable lifestyle that balances income, purpose, and well-being.

Leveraging Medical Expertise

Even if full-time clinical practice is no longer viable, a physician’s knowledge remains valuable. Here are several ways to continue earning while easing into retirement:

Telemedicine: Remote consultations are in high demand, especially in primary care, psychiatry, and chronic disease management. Telemedicine offers flexibility, reduced overhead, and the ability to work from home.
Locum Tenens: Temporary assignments can fill staffing gaps in hospitals and clinics. These roles often pay well and allow for travel or seasonal work.
Medical Writing and Reviewing: Physicians can write for journals, websites, or pharmaceutical companies. Peer reviewing, editing, and content creation are viable options.
Teaching and Mentoring: Medical schools, nursing programs, and residency programs need experienced educators. Adjunct teaching or mentoring can be fulfilling and financially helpful.
Consulting: Doctors can advise healthcare startups, legal teams, or insurance companies. Their insights are valuable in product development, litigation, and policy.

Exploring Non-Clinical Opportunities

Some physicians may wish to pivot entirely. Transferable skills—critical thinking, communication, leadership—open doors in other industries:

Health Coaching or Life Coaching: With certification, doctors can guide clients in wellness, stress management, or career transitions.
Entrepreneurship: Starting a small business, such as a tutoring service, online course, or specialty clinic, can generate income and autonomy.
Real Estate or Investing: With careful planning, investing in rental properties or learning about the stock market can create passive income.

Maximizing Government and Community Resources

At 65, individuals become eligible for Medicare, which can significantly reduce healthcare costs. Additionally, Social Security benefits may be available, depending on work history. While delaying benefits until age 70 increases monthly payments, some may need to claim earlier to meet immediate needs.

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Other resources include:

Supplemental Security Income (SSI): For those with limited income and assets.
SNAP (food assistance) and LIHEAP (energy assistance): These programs help cover basic living expenses.
Community Organizations: Nonprofits and religious groups often provide support with housing, transportation, and social engagement.

Downsizing and Budgeting

Reducing expenses is a powerful way to stretch limited resources. Consider:

Relocating: Moving to a lower-cost area or state with favorable tax policies can reduce housing and living expenses.
Selling Assets: A large home, unused vehicle, or collectibles may be converted into cash.
Shared Housing: Living with family, roommates, or in co-housing communities can cut costs and reduce isolation.
Minimalist Living: Prioritizing needs over wants and embracing simplicity can lead to financial and emotional freedom.

Creating a realistic budget is essential. Track income and expenses, eliminate unnecessary costs, and prioritize essentials. Free budgeting tools and financial counseling services can help.

INVESTING: Rules of Thumb

Emotional and Mental Well-Being

Financial stress can take a toll on mental health. It’s important to cultivate resilience and maintain a sense of purpose. Strategies include:

Staying Active: Physical activity improves mood and health. Walking, yoga, or swimming are low-cost options.
Volunteering: Giving back can provide structure, community, and fulfillment.
Learning New Skills: Online courses, hobbies, or certifications can reignite passion and open new doors.
Building a Support Network: Friends, family, and peer groups offer emotional support and practical advice.

Planning for the Future

Even at 65, it’s not too late to plan. Consider:

Debt Management: Negotiate payment plans, consolidate loans, or seek professional help.
Estate Planning: Create a will, designate healthcare proxies, and organize important documents.
Insurance Review: Ensure adequate coverage for health, life, and long-term care.
Financial Advising: A fee-only advisor can help create a sustainable plan without selling products.

Embracing a New Chapter

Retirement is not a destination—it’s a transition. For a broke 65-year-old doctor, it may not look like the glossy brochures, but it can still be rich in meaning. By leveraging experience, reducing expenses, accessing resources, and nurturing well-being, retirement becomes a journey of reinvention.In many ways, doctors are uniquely equipped for this challenge. They’ve faced long hours, high stakes, and complex problems. That same grit and adaptability can guide them through financial hardship and into a fulfilling retirement.

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HEALTH: Public V. Population

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

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.CertifiedMedicalPlanner.org

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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.

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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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SOCIALIZED MEDICINE: Can it Save Healthcare in the USA

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

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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Can Socialized Medicine Save U.S. Healthcare?

The U.S. healthcare system is often criticized for its high costs, unequal access, and inconsistent outcomes. With nearly 30 million Americans uninsured and many more underinsured, the question arises: could socialized medicine be the solution to these systemic issues?

Socialized medicine refers to a system where the government owns and operates healthcare facilities and employs medical professionals, funded primarily through taxation. While the term is often used pejoratively in American discourse, countries like the United Kingdom and Sweden have long embraced such models. These systems guarantee universal access to healthcare, regardless of income or employment status.

One of the strongest arguments in favor of socialized medicine is its potential to reduce overall healthcare costs. In the U.S., administrative expenses, profit margins, and fragmented billing systems contribute to exorbitant prices. A centralized system could streamline operations, negotiate better drug prices, and eliminate the need for private insurance middlemen. Countries with socialized systems typically spend less per capita on healthcare while achieving comparable or better health outcomes.

Moreover, socialized medicine could address the issue of healthcare access. In the current U.S. model, losing a job often means losing health insurance. Even with the Affordable Care Act, many Americans face high premiums and deductibles. A government-run system would ensure that healthcare is a right, not a privilege, and that no one is denied care due to financial constraints.

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However, critics argue that socialized medicine could lead to longer wait times, reduced innovation, and lower quality of care. They point to examples in Canada and the U.K. where patients sometimes wait weeks or months for non-emergency procedures. Additionally, skeptics fear that government control could stifle competition and reduce incentives for medical advancement.

Yet, these concerns may be overstated. Many countries with socialized systems still foster innovation through public-private partnerships and maintain high standards of care. France, for example, combines universal coverage with private providers and consistently ranks among the top healthcare systems globally.

Transitioning to socialized medicine in the U.S. would be a monumental task, requiring political will, public support, and a reimagining of healthcare financing. It would disrupt entrenched interests, including insurance companies and pharmaceutical firms. But if the goal is to create a more equitable, efficient, and humane system, socialized medicine deserves serious consideration.

In conclusion, while not a panacea, socialized medicine offers a compelling framework for addressing the deep-rooted problems in U.S. healthcare. By prioritizing access, affordability, and public health over profit, it could pave the way for a healthier and more just society.

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EDUCATION: Books

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Understanding 4 Key Financial Psychological Biases

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

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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

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

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

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

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

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

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

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

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

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

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

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Filed under: "Ask-an-Advisor", "Doctors Only", Accounting, Alternative Investments, Career Development, Ethics, Glossary Terms, Investing, Marcinko Associates | Tagged: biases, Cognitive Biases, finance, Flash Crash, herd mentality, Investing, investment, loss aversion, Marcinko, mental accounting, over confident investing, real estate, real-estate, S&P 500 | Leave a comment »

Understanding Doctorate Degrees: A Clear Guide

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

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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Understanding Medical Office Cancellation Fees

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

By Dr. David Edward Marcinko MBA MEd

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Can a physician medical provider charge an office cancellation fee?

According to the American Medical Association’s Code of Medical Ethics, physicians can charge fees for “missed appointments or appointments not cancelled in advance in keeping with the published policy of the practice”, and they should “clearly notify patients in advance of fees charge” (Opinion 11.3. 2) [28].

And so, if you miss a doctor’s appointment these days, you could get hit with a “no-show” fee of up to $150 — or more for some specialties.

Is it legal for an insurance company to charge a cancellation fee?

These practices are typically legal. They help businesses ensure they can recoup the lost revenue due to no-shows or last-minute cancellations.

Cancellation fees are permitted, but seldom collected absent unusual circumstances, such as a great deal of work having been provided.

QUESTION: As a doctor [MD, DO, DPM or DDS], do you charge an office cancellation fee? If so, how much is it?

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Understanding Investment Fees: A Guide for Physicians

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

SPONSOR: http://www.MarcinkoAssociates.com

By Dr. David Edward Marcinko MBA MEd CMP™

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MEDICAL COLLEAGUES BEWARE!

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

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

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

EDUCATION: Books

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

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NOBEL PRIZE WINNERS: Medicine 2025

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

By A. I.

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A trio of scientists — two of them American and one Japanese — have won the Nobel Prize in Medicine for their discoveries concerning peripheral immune tolerance, a mechanism by which the body helps prevent itself from attacking its own tissues instead of foreign invaders.

Mary E. Brunkow, Fred Ramsdell and Shimon Sakaguchi will share the prize for discoveries that “launched the field of peripheral tolerance, spurring the development of medical treatments for cancer and autoimmune diseases,” the Nobel Assembly said in a news release. The trio will now share the prize money of 11 million Swedish kronor (nearly $1.2 million).

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VARIABLE ANNUITIES: Retired Physicians Beware!

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

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

SPONSOR: http://www.CertifiedMedicalPlanner.org

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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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Financial Planning for Physicians: Achieve Your Goals

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

By: http://www.MarcinkoAssociates.com

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

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

We assess, plan, and opine for your success

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

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

We take a deep dive into your financial retirement plans

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

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

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

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

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

EDUCATION: Books

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

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Fiduciary Financial Colleagues Advising Medical Colleagues … in Turbulent Times!

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Overcoming Financial Psychological Traps

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

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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Psychological Traps

As human beings, our brains are booby-trapped with psychological barriers that stand between making smart financial decisions and making dumb ones. The good news is that once you realize your own mental weaknesses, it’s not impossible to overcome them.

PARADOX: https://medicalexecutivepost.com/2025/01/05/maurice-allais-behavioral-finance-paradox/

In fact, Mandi Woodruff, a financial reporter whose work has appeared in Yahoo! Finance, Daily Finance, The Wall Street Journal, The Fiscal Times and the Financial Times among others; related the following mind-traps in a September 2013 essay for the finance vertical Business Insider; as these impediments are now entering the lay-public zeitgeist:

Anchoring happens when we place too much emphasis on the first piece of information we receive regarding a given subject. For instance, 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 advice, even though the guideline provided may cause us to spend more than we can afford.
Myopia makes it hard for us to imagine what our lives might be like in the future. For example, because we are young, healthy, and in our prime earning years now, it may be hard for us to picture what life will be like when our health depletes and we know longer have the earnings necessary to support our standard of living. This short-sightedness makes it hard to save adequately when we are young, when saving does the most good.
Gambler’s fallacy occurs when we subconsciously believe we can use past events to predict the future. It is common for the hottest sector during one calendar year to attract the most investors the following year. Of course, just because an investment did well last year doesn’t mean it will continue to do well this year. In fact, it is more likely to lag the market.
Avoidance is simply procrastination. Even though you may only have the opportunity to adjust your health care plan through your employer once per year, researching alternative health plans is too much work and too boring for us to get around to it. Consequently, we stick with a plan that may not be best for us.
Loss aversion affected many investors during the stock market crash of 2008. During the crash, many people decided they couldn’t afford to lose more and sold their investments. Of course, this caused the investors to sell at market troughs and miss the quick, dramatic recovery.
Overconfident investing happens when we believe we can out-smart other investors via market timing or through quick, frequent trading. Data convincingly shows that people who trade most often under perform the market by a significant margin over time.
Mental accounting takes place when we assign different values to money depending on where we get it from. For instance, even though we may have an aggressive saving goal for the year, it is likely easier for us to save money that we worked for than money that was given to us as a gift.
Herd mentality makes it very hard for humans to not take action when everyone around us does. For example, we may hear stories of people making significant profits buying, fixing up, and flipping homes and have the desire to get in on the action, even though we have no experience in real estate.

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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Filed under: "Ask-an-Advisor", "Doctors Only", Ethics, Experts Invited, Financial Advisor Listings, Glossary Terms, Investing, mental health | Tagged: Anchoring, aversion, avoidance, behavioral finance, finance, gambler, herd, Investing, Mandi Woodruff, Marcinko, mental health, mind traps, myopia, over confidence, personal-finance, psychiatry, psychology, psychology traps, stock market, WSJ, Yahoo | Leave a comment »

The Importance of Public Relations in Healthcare

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

By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

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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

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 [3^rd 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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Essential Health Dictionary Series for Professionals

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

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HEALTH DICTIONARY SERIES

VISIT: https://healthdictionaryseries.wordpress.com/

By Ann Miller RN MHA

[An Internet WIKI CROWD-SOURCED Curation Project]*

To keep up with the ever-changing healthcare industrial complex, we must learn new definitions and re-learn old terminology in order to correctly apply it to practice. By aggregating the most up-to-date abbreviations, acronyms, definitions and terms, the Health Dictionary Series offers a wealth of information to help understand the ever-changing terms-of-art in healthcare today.

Each 10,000 item handbook is essential for doctors, nurses, benefits managers and insurance agents, CPAs, and administrators; as well as graduate and under graduate students and professors. Our goal to for each dictionary to be designated as a Doody’s Core Title.

Dictionary of Health Insurance and Managed Care

With more than 8,000 definitions, 4,000 abbreviations and acronyms, and a 3,000 item oeuvre of resources, readings, and nomenclature derivatives, this dictionary covers the Medicare, managed care and Medicaid, private insurance, Veteran’s Administration and PP-ACA language of the entire health and long-term care insurance sector.

Dictionary of Health Economics and Finance

Health economics and finance is an integral component of the health care industrial complex. Its language is a diverse and broad-based concept covering many other industries: accounting, mathematics, the actuarial sciences, stochastics and statistics, salary reimbursements, physician payments, compensation and forecasting are all commingled arenas.

Dictionary of Health Information Technology Security

There is a myth that all healthcare stakeholders understand the meaning of information technology jargon. In truth, the vernacular of contemporary systems is unique, and often misused or misunderstood. Moreover, emerging Heath Information Technology (HIT) thru the HITECG initiatives; in the guise of terms, definitions, acronyms, abbreviations and standards; often puts the non-expert in a position of maximum uncertainty and minimum productivity.

*NOTE: A wiki website allows users to add or update content using their browser thru a hosted server created by the collaborative effort of site visitors. The Hawaiian term “wiki wiki” means “super fast.”

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Filed under: "Doctors Only", Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Information Technology, Touring with Marcinko | Tagged: health dictionary series, Health Economics, health finance, Health I.T., Health Insurance, HIT, Marcinko | Leave a comment »

Financial Self-Discovery for Medical Professionals

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

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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DOCTORS: Early Investing Needed for Retirement

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

NEW FINANCIAL STRATEGIES?

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

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SPONSOR: http://www.CertifiedMedicalPlanner.org

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Starting early is key to saving for retirement

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

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

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

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

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

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

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

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

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

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PHYSICIAN BANKRUPTCY: Six Total Types to Know!

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

By A.I. and Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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According to Medical Economics, there were 10 clinic and physician practices filing bankruptcy in 2024, making it the highest level of the last six years, according to a new analysis of cases with liabilities of at least $10 million.

Meanwhile, the Steward Health Care System bankruptcy, which was based in Massachusetts but making headlines across the nation, has become “the largest hospital sector bankruptcy by far in the last 30 years,” according to a new analysis by Gibbins Advisors, based in Nashville, Tennessee.

Health care bankruptcy filings totaled 57 last year, down from 79 in 2023, said “Healthcare Restructuring: Trends and Outlook.” The report analyzed Chapter 11 health care bankruptcy cases with liabilities of at least $10 million, since 2019.

Last year’s total was down 28% from 2023’s peak, but greater than the 2019 to 2022 average of 42 filings a year, the report said.

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

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Bankruptcy, often considered a last financial resort, is a legal process that can help alleviate outstanding debts for individuals and businesses. Reasons to file for bankruptcy can include divorce, job loss, exorbitant medical bills or credit card debt.

There are several types of bankruptcy — six, as a matter of fact. The two most common types of bankruptcy for individuals are Chapter 7 and Chapter 13.

But there are four other types as well: Chapter 9, Chapter 11, Chapter 12 and Chapter 15. And, the type of bankruptcy filed depends on the situation.

Regardless of which type, the process is typically the same: You’ll usually retain an attorney and make your case before a judge, who will then erase some debts or set up a repayment plan.

Also note that an eligibility requirement — for all bankruptcy chapters — is that you must undergo credit counseling within the 180 days before filing.

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

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PHYSICIANS: Alimony V. Palimony

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

By A.I. and Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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What is Alimony

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

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

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

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

What is Palimony

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

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

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

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

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PHYSICIAN BURNOUT: Causes and Conclusions

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

By Dr. David Edward Marcinko; MBA MEd

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Healthcare comes with its share of mental challenges, especially considering that clinicians often care for patients when they’re in difficult and sometimes tragic situations. New research shows that even the path to getting into the workforce can be a challenge, with some physicians burning out before they make it to graduation.

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American medicine is undergoing vast changes, placing the status of physicians in the medical industrial complex at great risk. Most physicians feel overwhelmed by increasing bureaucratic mandates from insurers, hospitals, and government. At the same time, physicians are the front line employees of healthcare and assume the majority of the risk for patient care. This has left many in the profession with increasing disillusionment.

Samantha Meltzer-Brody a psychiatrist and director of, Taking Care of Our Own, University of North Carolina, Chapel Hill, NC states it best:

“Daily, I am contacted by good doctors who are struggling with symptoms of burnout syndrome and who have become overwhelmed by the challenges of attempting to practice medicine in today’s health care environment. As a psychiatrist who runs a program to address and treat these distressed doctors, I am troubled by the ever-growing number of calls I receive.”

What causes physician burnout?

The “Big 4” factors known to contribute to stress and burnout include:

Time pressure, especially in patient visits or documentation
Lack of control over work environment
Chaotic, fast-paced workplaces
Culture of the organization, specifically a culture that does not emphasize communication, cohesion, trust, and alignment of values between clinicians and their leaders

In addition to burnout rates, these factors can be assessed to help direct interventions toward those drivers that are most likely to be contributing to burnout at your organization.

OK BURNOUT: https://medicalexecutivepost.com/2022/08/30/u-s-hospitals-feeling-the-pain-of-physician-burnout/

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The burned-out physician is exhausted — mentally and physically — and often no longer able to find empathy or connection with patients. The question of how to escape from what has become a highly unpleasant situation becomes a frequent one. Given the high demands of the profession and serious consequences of mistakes, the burned-out doctor is a potentially impaired one. And the impaired physician is not able to maintain the unflappable, perpetually cool under fire, always objective, professional and yet compassionate demeanor that is expected by society. Worst of all, the impaired physician is at great risk for developing depression, suicidal ideation, or a serious addiction.

The doctors who contact me report feeling beaten down by an increasingly hostile work environment. They say that they don’t have time to take care of patients the way they envisioned when they decided to apply to medical school. Many describe feeling betrayed by a system that they say seems focused on achieving the bottom line with little regard for the impact on both doctors and patients.

Most of these doctors report spending a significant amount of their time dealing with the electronic medical record and documentation. The ratio of time spent on doctor-patient

interactions compared to physician-computer ones appears so horribly skewed that it has reached the point of complete dysmorphia. These good physicians call me when they feel like they can’t continue any longer in the profession. They want to quit medicine. They report a loss of joy and meaning in their work. They describe the toll that the profession has had on their mental health, physical health, and personal lives. And most wrenchingly, they don’t see an end.

What can we do? There are no easy answers to the complex issues that threaten our profession. “The Taking Care of Our Own Program…has had an over 200% rate of growth in the first year, reflecting the enormous need…”

PHYSICIAN COACHING: https://medicalexecutivepost.com/coach/

Assessment

Burned out physicians will eventually be labeled as disruptive, impaired, an outlier or arrogant. There’s a reason it’s difficult and extremely expensive for physicians to find disability insurance; psychiatric claims. Burnout leads to depression, anxiety, PTSD, suicide, divorce, drug abuse, surly behaviors and interactions, etc. It’s nothing new; it’s been occurring for a long time. Go without routine sleep, eat erratically, work long hours, operate under constantly stressful situations and have no time for your family or self and most individuals will de-compensate physically and psychologically within weeks.

Conclusion

Physicians operate within these parameters year after year.

How are they to remain healthy, functional humans? They can’t. Even a superhero couldn’t, yet physicians are expected to endure and thrive under such conditions.

If a physician makes a single mistake, or snaps just one day, their entire career is on the line.

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PHYSICIANS: Why Salary is Down?

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

MEDICAL PROVIDER PAYMENTS LOWERED

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Statistic: $2.8+ billion dollars

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

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PHYSICIAN DIVORCE: “Buyer’s Settlement Remorse”

Posted on August 24, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

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

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Introduction

It is normal for physician litigants to develop a case of “buyer’s remorse” after any mediation or divorce settlement. They may feel disappointed after entering into a settlement agreement or feel that they received a bad deal.

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

Mediation: Some advantages of divorce mediation over divorce litigation include:

◊ Mediation is generally faster and less costly.

◊ Mediation is voluntary, private and confidential.

◊ Mediation facilitates creative and realistic solutions.

◊ Mediation allows parties to control their agreements.

◊ Mediation eliminates a win-lose atmosphere and result.

◊ Mediation provides a forum for addressing future disputes.

◊ Mediation fosters communication and helps mend relationships.

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Settlement

And so, in a vast majority of cases, mediation and settlement is probably a good deal. In fact, it is probably a great deal because you are receiving something without having to risk losing. Remember, trial can be a crap-shoot, and nothing is worse than losing it all at the time of trial.

Bench trial verdict by a trial judge.
Jury trial verdict by your “peers.”

Instead, you entered into a settlement agreement and now your divorce case is over.

But beware since trying to get out of a settlement agreement reached at mediation or settlement is virtually impossible.

Why? Well, there is a strong interest by the court to enforce mediation and settlement agreements. The court wants your divorce case to be over and off its docket. There are a few very narrow exceptions; for example, if one party was truly coerced because someone held a gun to their head. But that rarely happens, and it certainly doesn’t happen to most doctors or dentists.

MEDIATION: https://medicalexecutivepost.com/2024/09/15/financially-egalitarian-dating-marriages-and-divorce-mediation-for-doctors/

Re-litigate?

Of course, you can fight against your mediation or settlement agreement if you like, but you won’t get too far. There’s an old adage in the law that a bad settlement is better than a great trial. That’s because no one knows how a judge or jury will rule come time of trial.

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This buyers remorse phenomenon also isn’t uncommon among people who receive sudden wealth, whether through divorce settlements, inheritances, lottery winnings, or other windfalls.

Assessment

Financial advisors often see clients struggle with “sudden wealth syndrome”—the inability to properly manage a large sum of money they’re not accustomed to having.

Common mistakes include:

Lifestyle inflation without sustainable income to support it.
Poor investment decisions or lack of investment planning.
Emotional spending following traumatic life events like divorce.
Failure to set aside money for taxes on the settlement.
Not creating a long-term financial plan for the money.

So, do not let these mistakes happen to you!

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PHYSICIAN GENDER FINANCIAL DIFFERENCES: In Marriage and Divorce

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

By Dr. David Edward Marcinko MBA MEd

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SPONSOR: http://www.MarcinkoAssociates.com

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

But, this is changing over time.

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

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

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

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

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BENEFICIARY DESIGNATIONS: Top 10 Tips for Medical Professionals

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

[1] Penguin USA (paper), 1999.

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PHYSICIAN DIVORCE: Within the Medical Profession

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

By Dr. David Edward Marcinko MBA MEd

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SPONSOR: http://www.MarcinkoAssociates.com

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DIVORCE WITHIN THE MEDICAL PROFESSION

A Johns Hopkins University study, by Michael J. Klag MD in 1997, found that physicians in some specialties — chiefly psychiatry and surgery — are at higher risk for divorce than their medical brethren in other fields. But, the results did not support the common view that job-related anxiety and depression are linked to marital breakup. Alerting medical students to the risks of divorce in some specialties may influence their career choices and strengthen their marriages whatever field they choose. The study, supported by the National Institutes of Health [NIH], was published in the March 13th issue of The New England Journal of Medicine. Results also strongly suggested that the high divorce risk in some specialties may result from the inherent demands of the job as well as the emotional experiences of physicians who enter those fields.

BENEFICIARY DESIGNATIONS: Top 10 Tips for Medical Professionals

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Divorce Prone Medical Specialties*

For example, the Hopkins team assessed the specialty choices, marriage histories, psychological characteristics, and other career and personal factors of 1,118 physicians who graduated from The Johns Hopkins University School of Medicine from 1948 through 1964. Over 30 years of follow-up, the divorce rate was 51 percent for psychiatrists, 33 percent for surgeons, 24 percent for internists, 22 percent for pediatricians and pathologists, and 31 percent for other specialties. The overall divorce rate was 29 percent after three decades of follow-up and 32 percent after nearly four decades of follow-up.

Physicians who married before medical school graduation had a higher divorce rate than those who waited until after graduation (33 percent versus 23 percent). The year of first marriage was linked with divorce rates: 11 percent for marriages before 1953, 17 percent for those from 1953 to 1957, 24 percent for those from 1958 to 1962 and 21 percent for those after 1962. Those who had a parent die before medical school graduation had a lower divorce rate.

Female physicians had a higher divorce rate (37 percent) than their male colleagues (28 percent). Physicians who were members of an academic honor society in medical school had a lower divorce rate, although there was no difference in divorce rates according to class rank. Religious affiliation, being an only child, having a parent who was a physician and having a divorced parent were not associated with divorce rates. Physicians who reported themselves to be less emotionally close to their parents and who expressed more anger under stress also had a significantly higher divorce rate, but anxiety and depression levels were not associated with divorce rates.

MEDIATION: https://medicalexecutivepost.com/2024/09/15/financially-egalitarian-dating-marriages-and-divorce-mediation-for-doctors/

*Cite: Co-authors of the study, which was part of the Johns Hopkins Precursors Study, an ongoing, prospective study of physicians from the Hopkins medical school graduating classes of 1948 through 1964, were lead author Bruce L. Rollman, M.D., Lucy A. Mead, Sc.M., and Nae-Yuh Wang, M.S.

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The Painful Truth

In their article “The Painful Truth: Physicians Are Not Invincible” [1] Miller and McGowen state that divorce rates among physicians have been reported to be 10% to 20% higher than those in the general population. They explain that for many years in pre-med college, medical school, and residency, physicians focus on getting through the next hurdle. They may postpone the pleasures of life that others enjoy. Compulsive traits that allow them to postpone enjoyment may have the unwanted consequence of leading to more distant relationships., thus placing strain on intimate relationships.

A 2002 study looking at dual physician marriages found they have a relatively low divorce rate of 11%. “They’re a happily married cohort,” says Dr Wayne Sotile of the Sotile Cetner for Resilience (www.sotile.com). “They’re more compassionate about the passion for the career — they understand the calling because they share it.”

A study published in The New England Journal of Medicine in 1997 with Bruce L. Rollman as the lead researcher [2] found that physicians in some specialties — chiefly psychiatry and surgery — are at higher risk for divorce than their medical brethren in other fields. Alerting medical students to the risks of divorce in some specialties may influence their career choices and strengthen their marriages whatever field they choose.

The study suggested that the high divorce risk in some specialties may result from the inherent demands of the job as well as the emotional experiences of physicians who enter those fields. The divorce rate was 51 percent for psychiatrists, 33 percent for surgeons, 24 percent for internists, 22 percent for pediatricians and pathologists, and 31 percent for other specialties.

The overall divorce rate was 29 percent after three decades of follow-up and 32 percent after nearly four decades of follow-up. Physicians who married before medical school graduation had a higher divorce rate than those who waited until after graduation (33 percent versus 23 percent). Female physicians had a higher divorce rate (37 percent) than their male colleagues (28 percent).

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References:

Miller, M. N., McGowen, R., 2000, “The painful truth: Physicians are not invincible,” Southern Medical Journal, 93: 966-973.
Rollman BL, Mead LA, Wan NY, Klag MJ. Medical specialty and the incidence of divorce. N Engl J Med. 1997;336:800–3

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EMOTIONAL INTELLIGENCE & ORGANIZATIONAL BEHAVIOR: Economic Risk Management Classification for Medical Professionals

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

BY DR. DAVID EDWARD MARCINKO, MBA MEd CMP®

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SPONSOR: http://www.MarcinkoAssociates.com

ORGANIZATIONAL BEHAVIOR AND CLASSIFICATION OF RISKS

DEFINITION EMOTIONAL INTELLIGENCE: Emotional intelligence [EI] refers to the ability to identify and manage one’s own emotions, as well as the emotions of others. Emotional intelligence is generally said to include a few skills: namely emotional awareness, or the ability to identify and name one’s own emotions; the ability to harness those emotions and apply them to tasks like thinking and problem solving; and the ability to manage emotions, which includes both regulating one’s own emotions when necessary and helping others to do the same.

DEFINITIONAL ORGANIZATIONAL BEHAVIOR: Organizational behavior (OB) is the study of how individuals, groups, and organizations interact and influence one another. Though it is largely used within the field of business management as means to understand–and more effectively manage–groups of people. The reason businesses look to OB is because it can help organizations increase employee performance, while also creating a positive working environment.

CITE: Eugene Schmuckler; PhD MBA MEd CTS®

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And so, as we review the concept of Emotional Intelligence and Organizational Behavior, it is possible to set up five EI/OB risk classes, based on the economic consequences of the occurrence of specific individual risks:

1. Prevented risks: Risks whose cost of occurrence is higher than their cost of management and whose occurrence may invoke additional legal sanctions. This class would include intentional torts and injuries caused by gross negligence.

2. Normally prevented risks: Risks whose cost of occurrence is greater than the cost of their management but whose occurrence will be considered only as negligent. This class includes most negligent injuries
and most types of product liability actions.

3. Managed risks: Risks whose cost of occurrence is only slightly greater than their cost of management. The plaintiff usually has the burden of showing that the defendant owed the plaintiff a special duty to recover for one of these risks.

4. Un-Prevented risks: Risks whose cost of occurrence is less than their cost of management. The classic example of this class is the cost of railroad crossing barriers compared to the cost of people being hit by
trains.

5. Un-Preventable risks: Risks whose occurrence is unmanageable. The assignment of a risk to one of these classes is a major problem in medical and healthcare quality control, because the class of a risk determines how much effort must be expended to prevent the risk. The misclassification of a prevented or normally prevented risk as a managed or un-prevented risk can result in large financial losses.

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For example: A medical clinic that does not update obsolete equipment, such as inaccurate oxygen monitors, would be liable for any injuries attributable to the obsolete equipment. The classifications of risk must be reviewed periodically to determine if the cost of the risk-taking behavior has changed, thereby altering the classification.

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For example: A small hospital in a rural area would not be expected to have the sophisticated equipment as a major hospital in a city. If an accident victim is brought into the rural facility, the hospital’s duty may be to transfer the patient to a better-equipped facility. The patient will face the risk of dying because of the delay in treatment, but the risk of insufficient treatments outweighs the risk of transfer. If the same victim were brought into a hospital in a major metropolitan center, the duty would be to treat the patient without a transfer. The risk of transfer has not changed, but the risk of insufficient treatment has disappeared.

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Stocks, the FOMC and Trade Deals

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

SPONSOR: http://www.CertifiedMedicalPlanner.org

By A.I.

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Stocks: The multi-day rally wavered this afternoon as investors turned their attention to big tech earnings tomorrow. The S&P 500 closed at a record high, while the NASDAQ finally broke its hot streak.
FOMC: Treasury Secretary Scott Bessent sees no reason for Jerome Powell to step down, while President Trump tempered his outrage against the Fed chair. Instead, well-known economist Mohamed El-Erian took up the gauntlet.
Trade: Bessent said China may get an extension to make a true trade deal, while promising a “rash of trade deals” in the coming days. Speaking of, Trump declared the US has made a deal with the Philippines capping import levies at 19%.

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Filed under: "Doctors Only", Alternative Investments, CMP Program, finance, Financial Planning, Funding Basics, Investing, Portfolio Management, Risk Management | Tagged: Bessent, China, deals, DJIA, DOW, El-Erian, NASDAQ, Powell, S&P 500, stocks, trade, Trump, US | Leave a comment »

DOCTORS AND LAWYERS: Often Aren’t Millionaires

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

Filed under: "Ask-an-Advisor", "Doctors Only", Ask a Doctor, Experts Invited, Financial Planning, Funding Basics, Investing, Marcinko Associates, Portfolio Management | Tagged: attorneys, books, DDS, dentist, DMD, DO, doctors, DPM, lawyers, Marcinko, MD, medicare, Millionaires, news, photos, physicians, podiatrist, poor attorneys, poor doctors, portfolio managers, rich attorneys, rich dentists, rich doctors, Technology | Comments Off on DOCTORS AND LAWYERS: Often Aren’t Millionaires

DOCTOR BRANDING STRATEGIES: Exploring 9 [NINE] Different Types

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

By A.I.

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Medical doctors, dentists, and podiatrists have to undergo extensive training before they can practice medicine independently. Once they receive training, there are opportunities to increase pay and prestige in the medical field through a series of promotions. As a doctor, how much training, experience and skills you have can determine your ability to move upward in these levels. But, personal branding strategies may even be more vital in today’s social media age?

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Physician, medical and healthcare branding is more than just the creation of logos, taglines, or specific brand messaging. It’s about creating a meaningful connection between your mission, vision and values and the people served – from patients and their families to local and global communities.

While there are many different types of branding strategies in marketing science, they all share key elements that serve as the foundation for the strategy. These 9 elements for all physicians and medical professionals include the following:

Brand purpose: The reason the physician is in practice and what he/she is trying to achieve.
Brand vision: The ideas and goals behind the dentist which serve as inspiration for practice growth.
Brand values: The osteopaths beliefs and what they stand for.
Target audience: The demographic(s) and patient targets that the podiatrist is aiming to reach.
Market analysis: An analysis of the marketplace that identifies gaps where the chiropractor has an opportunity to position him/her self based on a unique value proposition.
Awareness goals: The initiatives the doctor will take in order to reach a target market patient demographic.
Brand personality: The human-like attributes of the physician that will help build relationships with patients, consumers and other physicians and practitioners.
Brand voice: The language and tone the doctor uses to communicate with patients, physicians and consumers.
Brand tagline: A memorable slogan that sums up the physician and their medical offering in a few choice words.

And so, physician branding is the development of a easily recognizable identity for a medical practice, clinic or healthcare organization that helps to shape perception by current and prospective patients and the wider world.

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Filed under: "Ask-an-Advisor", "Doctors Only", Career Development, Glossary Terms, LifeStyle, Managed Care, Marketing & Advertising, Practice Management | Tagged: advertising, branding, brands, business, DDS, digital marketing, DO, doctors, DPM, marketing, MD, physicians, PR, promotions, public relatiions, sales, seo, slogans, tagline | Leave a comment »

BRANDS & BRAND MANAGEMENT: Defined and Explored for Doctors and Advisors

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

By A.I.

SPONSOR: http://www.CertifiedMedicalPlanner.org

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What Is a Marketing Brand

A brand is a name, term, design, symbol or any other feature that distinguishes one seller’s goods or service from those of other sellers. Brands are used in business, marketing and advertising for recognition and, importantly, to create and store value as brand equity for the object identified, to the benefit of the brand’s clients, patients, customers, its owners and shareholders. Brand names are sometimes distinguished from generic or store brands.

BRANDING: https://medicalexecutivepost.com/2023/02/02/podcast-personal-branding-for-doctors/

What is Brand Management?

Brand management, also known as Marketing, is responsible for the overall management of a brand. This includes everything from product or service development and marketing to advertising and public relations. All of these aspects work together to create a particular image or reputation for a brand. The goal of brand management is to create a robust and positive reputation for a brand that will result in increased sales and market share.This process helps companies create a unique identity for their products or services in the marketplace. A successful brand management strategy can build client, patient and customer loyalty .

BRANDS: https://medicalexecutivepost.com/2021/06/03/physician-branding-post-pandemic/

Branding is essential for financial advisors, doctors and businesses because it involves creating a unique identity for a company’s products, offerings and services. It can also help build customer, client and patient loyalty and emotionally connect with the practitioner. Branding can be complex, but it is essential to understand the basics before starting a brand strategy.

Thus, doctors, podiatrists, dentists, CPAs, insurance agents, financial advisors and their practices need to understand the different aspects of branding and brand management to create a strong brand identity.

SELF BRANDING: https://medicalexecutivepost.com/wp-content/uploads/2011/03/leadership-self-branding-marcinko.pdf

EDUCATION: Books

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Filed under: "Advisors Only", "Ask-an-Advisor", "Doctors Only", Ask a Doctor, Career Development, CMP Program, Glossary Terms, Insurance Matters, LifeStyle, Marketing & Advertising, Media Mentions and PR, mental health | Tagged: advertising, agents, books, brand management, branding, brands, Change, CMP, CPA, DC, DMD, DO, inspiration, insurance agents, marketing, MD, mental health, mrcinko, PR, product development, public relations, sales | Leave a comment »

DOCTORS: Marketing, Advertising & Sales

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

Filed under: "Doctors Only", Ask a Doctor, Career Development, CMP Program, Glossary Terms, Managed Care, Marcinko Associates, Practice Management, Touring with Marcinko | Tagged: advertising, business, CMP, competitive advantage, content-marketing, digital marketing, Marcinko, marketing, MAs, moat, PR, promotions, public relations, sales, SCA, social media | Comments Off on DOCTORS: Marketing, Advertising & Sales

PHYSICIANS ONLY: Career Coaching and Development

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

MARCINKO ASSOCIATES, Inc.

SPONSOR: http://www.MarcinkoAssociates.com

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Did you Know?

Experts estimate that it can cost more than $1 million to recruit and train a replacement for a doctor who leaves the profession because of burnout. But, as no broad calculation of burnout costs exists, Dr. Tait Shanafelt [Mayo Clinic researcher and Stanford Medicine’s first Chief Physician Wellness Officer] said Stanford, Harvard Business School, Mayo Clinic and the American Medical Association (AMA) are further cost estimating the issue. Nevertheless, Shanafelt and other researchers have shown that burnout erodes job performance, increases medical errors, and leads doctors to leave a profession they once loved.

Fortunately, we can help. From formal coaching to second career opinions, mentoring and advising, we can help with our remediation executive career programs. Regardless of what is happening in your life, it is wonderful to have a non-partial, confidential and informed career coach and sounding board on your side.

CITE: JAMA Internal Medicine [Effect of a Professional Coaching Intervention on the Well-Being and Distress of Physicians].

NCBI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6686971/

THANK YOU

CONTACT US: https://marcinkoassociates.com/process-what-we-do/

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EDUCATION: Books

Filed under: "Advisors Only", "Doctors Only", Career Development, Ethics, iMBA, Inc., LifeStyle, Marketing & Advertising, mental health, Op-Editorials, Quality Initiatives, Sponsors, Touring with Marcinko | Tagged: advise, advising, career advice, career advising, career coach, career coaching, coach, coaching, Marcinko, Marcinko Associates, Marcinko coaching, mentor, mentoring | Leave a comment »

ASSETS UNDER ADVISEMENT: Doctors Only

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

By Dr. David Edward Marcinko; MBA MEd CMP™

A.U.A IS ALL WE DO!

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SPONSOR: http://www.MarcinkoAssociates.com

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

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

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

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D. E. Marcinko & Associates Core Operating Values

9. We act with honesty, integrity and are always straightforward.
8. We strive to be innovative, creative, iconoclastic, and flexible.
7. We admit and learn from mistakes and don’t repeat them.
6. We work hard always as competitors are trying to catch up.
5. We treat others with dignity and respect.
4. We are the onus of consulting advice for the fiduciary well being of others.
3. We fight complacency as former success is in the past.
2. The best management styles are timeless, not timely.
1. Our clients are colleagues and always come first.

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EDUCATION: Books

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Filed under: "Ask-an-Advisor", "Doctors Only", Ask a Doctor, CMP Program, Ethics, Financial Planning, Funding Basics, Glossary Terms, Health Economics, iMBA, Inc., Marcinko Associates | Tagged: assets under advisement, AUA, AUM, CMP, fiduciary, Marcinko, news, Technology | Leave a comment »

FINANCIAL COACHING: For Physicians!

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

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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DEAR COLLEAGUES

If you are just starting out managing your finances and don’t know where to begin, a financial coach may be a good option for you. They are helpful for someone who wants to become proficient in the basics of finance, from learning how to budget or save money to building an emergency fund or creating a plan for paying off debt. If you have short-term money goals, like saving for a big purchase or just practicing better money habits, a financial coach can help you reach them by working with you to create a plan and holding you accountable. Even more for physicians and most all medical professionals.

Pros and Cons of Working with a Financial Coach
A financial coach can have a positive impact on your financial well–being and your life in a number of ways:

Financial coaches see the bigger picture of how you relate to money. They can help you develop better habits, resulting in positive personal growth.
By providing education and encouragement, they can reduce financial stress, confusion, and what it is about money that overwhelms you.
Through accountability and support, they can help you accomplish your goals and help you feel more confident in your finances.
Available 24/7/365.
Modest fees.

At you service.
Dr. David Edward Marcinko MBA MEd CMP

CONTACT: MarcinkoAdvisors@outlook.com

LINK: https://medicalexecutivepost.com/2025/01/23/personal-coaching-dr-marcinko-at-your-service/

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Filed under: "Advisors Only", "Doctors Only", Career Development, Experts Invited, Financial Planning, Health Economics, Healthcare Finance, LifeStyle | Tagged: finance, financial advisor, financial coach, financial coaching, financial consultant, Financial Planning, Investing, Marcinko, personal-finance | Leave a comment »

NEW AMA PRESIDENT: Robert Mukkamala MD

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

By Staff Reporters

NEWS UPDATE!

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On June 10th, Bobby Mukkamala was inaugurated as the 180th president of the American Medical Association (AMA).

An otolaryngologist from Flint, Michigan, Mukkamal chairs the organization’s substance use and pain care task force, won the AMA Foundation’s Excellence in Medicine Leadership Award last June, and served on the AMA board of trustees in 2017 and 2021.

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EDUCATION: Books

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Filed under: "Doctors Only", Ask a Doctor, Breaking News, Career Development, Health Economics, Health Insurance, Health Law & Policy | Tagged: AMA, american medical association, doctor, ears, ENT, eyes, GI, gut, MD, nose, otolaryngologis, physician, Robert Mukkamala, throat | Leave a comment »

Subscribe MEDICAL EXECUTIVE-POST?

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CERTIFIED MEDICAL PLANNER® program

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OIG Fraud Warnings

⚠️ Cons of Compounding Pharmacies

1. Quality and Safety Concerns

2. Limited Regulation

3. Insurance and Cost Issues

4. Availability and Accessibility

5. Evidence and Efficacy

6. Risk of Errors

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Shaping Well-being Beyond Medicine

Economic Stability

Education

Neighborhood and Physical Environment

Healthcare Access and Quality

Social and Community Context

Conclusion

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Crisis Management in Medical Practice

🌐 Nature of Crises in Healthcare

🔑 Principles of Crisis Management

⚙️ Crisis Management Frameworks

💡 Challenges in Crisis Management

🌱 Importance of Resilience

✅ Conclusion

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1. Impulse Spending

2. High‑Interest Debt

3. Ignoring Savings and Investments

4. Chasing Get‑Rich‑Quick Schemes

5. Overspending on Status

6. Neglecting Insurance

7. Failing to Budget

8. Ignoring Education and Skills

Conclusion

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1. Building Trust and Reputation

2. Health Education and Awareness

3. Crisis Communication

4. Advocacy and Community Engagement

5. Digital Transformation in Medical PR

6. Ethical Responsibility

Conclusion

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The Attention a Problem Gets is Inverse to its’ Importance

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🎯 Understanding the Target Audience

🌐 Building a Strong Online Presence

🗣️ Leveraging Patient Reviews and Testimonials

📬 Utilizing Email and Content Marketing

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📊 Measuring Success

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October 25, 2025

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