DAILY UPDATE: Happy “Festivus” with Drug Delays as the Stock Market Win Streak Continues

By Staff Reporters

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SPONSOR: http://www.MarcinkoAssociates.com

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Festivus is a secular holiday on December 23rd as an alternative to the pressures and commercialism of the Christmas Season. Originally created by author Daniel O’Keefe, Festivus entered popular culture after it was made the focus of the 1997 Seinfeld episode which O’Keefe’s son, Dan,co-wrote.

The non-commercial holiday’s celebration includes a Festivus dinner, an unadorned aluminum Festivus pole, practices such as the “airing of grievances” and “feats of strength”, and the labeling of easily explainable events as “Festivus miracles”. The TV episode refers to it as “a Festivus for the rest of us”.

It has been described both as a parody holiday festival and as a form of playful consumer resistance. Journalist Allen Salkin describes it as “the perfect secular theme for an all-inclusive December gathering”.

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(Bloomberg) — Drug-makers are slow-walking products to market to get around President Joe Biden’s plan to lower medication prices.

Companies from Roche Holding AG to biotech Alnylam Pharmaceuticals Inc. are among those delaying or evaluating therapies in light of the government’s new ability to negotiate for lower prices. Firms that normally try to sell drugs as soon as possible are suspending clinical trials and shifting timelines, while patient groups are demanding change. 

Here is where the major benchmarks ended:

Here’s where the major benchmarks ended:

  • The S&P 500 index was up 7.88 points (0.2%) at 4,754.63, up 0.8% for the week; the Dow Jones Industrial Average was down 18.38 points at 37,385.97, up 0.2% for the week; the NASDAQ Composite® (COMP) was up 29.11 points (0.2%) at 14,992.97, up 1.2% for the week.
  • The 10-year Treasury note yield (TNX) was up about 1 basis point at 3.901%.
  • The CBOEe® Volatility Index (VIX) was down 0.62 at 13.03.

Small-cap stocks continued a strong finish to the year. The Russell 2000® Index (RUT) rose 0.8% Friday to end at its highest level since April 2022 and rose 2.5% for the week, the small-cap benchmark’s sixth consecutive weekly gain. Regional banks and utilities were also among the strongest performers. In other markets, the U.S. Dollar Index (DXY) extended its recent slide and dropped to its weakest level since late July, reflecting ideas an outlook for lower interest rates may prompt investors to seek higher returns elsewhere.

Finally, with just four trading days left in 2023, the S&P 500 and other major equity benchmarks are poised to turn in a strong year that may more than make up for 2022’s losses. Through Friday, the S&P 500 was up nearly 24% for the year, after tumbling 19.4% in 2022. The Dow Jones Industrial Average and the NASDAQ Composite were up 13% and 43%, respectively, after losing 8.8% and 33% in 2022.

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HAPPY HOLIDAYS: A New Covid Virus Variant!

By Staff Reporters

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READ HERE: N.1 is the Covid variant that’s spiking just in time to disrupt the holidays.

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EtG – The Rosie Ruiz of Bent Science and Bad Medicine

BAD Medicine … and that is NOT “Good”

Langan MD[By Michael Lawrence Langan MD]

The original pitch to the medical boards for Etg  was done by ex-felon Greg Skipper who is one of the Federation of State Physician Health Program (FSPHP) “impaired physician” architect…

EtG: https://www.verywellmind.com/widely-used-etg-test-for-alcohol-unreliable-80212

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

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PODCAST: FFS MedicalPayment As a Public Health Threat?

FEE FOR SERVICE

By Eric Bricker MD

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PODCAST: US Primary Medical Care V. Other Industrialized Nations

By Eric Bricker MD

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SECTION 179 DEDUCTIONS: Physicians Avoiding IRS Tax Mistakes

By Staff Reporters

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DEFINITION: Section 179 of the U.S. IRS code is an immediate expense deduction that business owners can take for purchases of depreciating business equipment instead of capitalizing and depreciating the asset over a period of time. The Section 179 deduction can be taken if the piece of equipment is purchased or financed and the full amount of the purchase price is eligible for the deduction.

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

Not understanding parameters – Eligible property and annual limits

Medical practices may make mistakes by not fully understanding which types of property qualify for a Section 179 deduction. Section 179 is applicable only to assets used for business purposes. Failing to allocate assets properly can lead to improper deductions.

Eligible property for Section 179 may include:

  • Equipment, X-Ray, computers, fax machines, telephones, and other business property
  • Furniture and fixtures
  • Off-the-shelf-software that is used for business operations
  • Improvements to real-estate such as roofs, heating, ventilation, and air-conditioning.

Section 179 limits are updated annually, so it is important for doctors and practice owners to be aware of these limits and to plan accordingly.

Source: Natalie Westfall, Physicians Practice [12/4/23]

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“23andMe” Hacked & “Neuralink” Device Defective?

By Staff Reporters

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In a significant breach of privacy, hackers gained access to the DNA relatives data of 6.9 million users on 23andMe, posing serious questions about the security measures in place for our most personal data.

Meanwhile, Neuralink, the brain-computer interface company, faced disturbing reports about its clinical trials. Allegedly, up to a dozen monkeys suffered severe adverse effects, including brain swelling and partial paralysis, after being implanted with the Neuralink device.

Neuralink Corp. is an American company that is developing brain computer interfaces (BCIs) as of 2022. Founded by Elon Musk and a team of seven scientists and engineers, Neuralink was launched in 2016 and was first publicly reported in March 2017.

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DEAR COLLEAGUES: Are You a Financial Advisor’s “Customer” or “Client”?

By Dr. David Edward Marcinko MBA CMP

SPONSOR: http://www.MarcinkoAssociates.com

First – a little “insider expert” background on the confusion. It exists largely because of the influence that large financial institutions (who earn revenue through the sale of financial products) have on legislators.

The Investment Advisors Act of 1940 requires that anyone giving investment advice must be acting in a fiduciary capacity. The intent was to separate the financial salespeople, who had significant conflicts of interest, from the investment advisors, who had few to none. If you know very little about financial products, would you rather be educated as the customer of a commissioned salesperson or the client of a fee-for-service advisor? Hands down, you’d want the fee-for-service advisor.

Of course, the financial institutions selling products understood this. They were able to influence the drafting of the 1940 Investment Advisors Act, to exclude “any broker or dealer whose performance of such [advisory] services is solely incidental to the conduct of his business as a broker or dealer.” So if salespeople just happen to give some financial advice that is “incidental” to the sale of a product, they and their companies are not held to the fiduciary standard. Our U.S. Congress allows financial companies to advertise as if they are fiduciaries while their sales forces are not held to a fiduciary standard.

Now, according to Rick Kahler CFP®, the same conflict arises in some professional designations, like the Certified Financial Planner® designation conferred by the CFP® Board. The designation initially certified the completion of training in financial planning. In 2008 the Board added a fiduciary requirement to the designation.

However, CFP®’s are only held to a fiduciary requirement when they are doing what the CFP® Board defines as financial planning. If a CFP® professional is giving advice to a client, the fiduciary standard applies. Yet the same professional can sell the same client an annuity with high fees and high commissions, even if the product may not be in the client’s best interest, as long as no “financial planning” is part of the transaction. The result is significant confusion for consumers.

The bottom line is this: when you look for financial advice or financial products, don’t assume the advisor is looking out for you. It’s your responsibility to find out whether any financial professional owes you a fiduciary duty.

So, I suggest you ask directly, “Am I a customer or a client?” The answer is almost always “a client,” as most financial services salespeople honestly don’t know the difference. After you explain that difference, ask them to verify their fiduciary duty in writing. That five-minute solution may have a lasting impact on your financial well-being.

Better yet, consider speaking to your fiduciary focused and fee-only Certified Medical Planner® professional colleagues at D.E. Marcinko & Associates.

“By Doctors – For Doctors”

CMP: http://www.CertifiedMedicalPlanner.org***

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PODCAST: Health Insurance is Sold; NOT Bought

BUILD A HEALTHCARE SALES MACHINE

By Eric Bricker MD

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PHYSICIANS: Leaving Medical Practice

By Staff Reporters

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QUESTION: Why are doctors leaving their practices?

For many it’s about demographics. Just like the rest of us, doctors are aging too. Already the average physician age is about 53 years old. The Association of American Medical Colleges reports that about half of doctors are over the age of 55. Over the next decade, an estimated 40% of physicians will be over 65 years old. This means more than two of every five active physicians will reach age 65 within the next 10 years.

Moreover, compared with their boomer colleagues who were more likely to work past retirement, a robust 60% of younger Generation X doctors are reporting that they plan to retire by age 60.

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Doctors cite poor quality of life and stress as reasons for their early departure. The pandemic certainly crushed many providers and has led to burnout. Generation X physicians in their 40s and early 50s were more likely than boomers to report that their current work life was not making the grade. In short, 43% of middle-aged doctors, compared with 31% of doctors over age 55, were reporting lower levels of professional fulfillment. Moreover, 47% of mostly Gen X doctors indicated dissatisfaction with their level of personal fulfillment compared with 36% of practicing boomer physicians.

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FTC Lawsuit Targets Private Equity & U.S. Anesthesia Partners

By Health Capital Consultants, LLC

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FTC Lawsuit Targets Private Equity

On September 21, 2023, the Federal Trade Commission (FTC) sued U.S. Anesthesia Partners (USAP), a Texas-based anesthesia provider, and Welsh, Carson, Anderson & Stowe (Welch Carson), a private equity firm. The FTC alleged that the two companies executed an anti-competitive scheme for multiple years to consolidate anesthesiology practices in Texas, boost their profits, and drive up the price of anesthesia services rendered to patients.

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

This Health Capital Topics article will discuss the lawsuit and how it appears to fit in with the FTC’s recent moves to crack down on anti-competitive actions in healthcare. (Read more…)

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TELE-HEALTH: The “Smile Direct Club” Frowns

By Staff Reporters

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7.2 The Skull – Anatomy and Physiology

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SmileDirectClub is the latest casualty of what some have dubbed a startup Mass Extinction Event.

The telehealth company that attempted to revolutionize traditional orthodontics just announced that it was winding down operations less than three months after it filed for Chapter 11 bankruptcy. At its peak, SmileDirectClub was valued at $8.9 billion and had raised $427 million as a private company before going public in 2019.

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

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PODCAST: Physician Performance Reviews

By Eric Bricker MD

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WHY: Your Medical Internet Marketing Campaign Still Isn’t Effective?

THE THREE VITAL ELEMENTS

SPONSOR: http://www.MarcinkoAssociates.com

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A strong online presence is crucial for any medical or healthcare businesses, but many are struggling to figure out where to invest their marketing dollars. It is important to diversify marketing efforts and not rely solely on one channel, as changes in the industry are inevitable. Search marketing, direct marketing, and social media are three key components that healthcare organizations should incorporate in their marketing campaigns.

  1. Search marketing has evolved over the years with changes in Google’s algorithms and the saturation of the market, requiring a focus on quality content and the expertise of an expert.
  2. Direct marketing is becoming more popular, with lead generation companies and email marketing being effective and budget-friendly tactics. Social media is constantly evolving and increasing in price, with networks like Facebook and Twitter pushing paid advertisements.
  3. While social media should not be the focal point of a healthcare organization’s marketing campaign, it is an integral component that can contribute to search engine rankings.

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Overall, a well-rounded marketing strategy that incorporates these three elements is crucial for success. A strong online presence is crucial for healthcare businesses, and diversifying marketing efforts across search marketing, direct marketing, and social media is important for success. Search marketing has changed with Google’s algorithms and increased ad costs, while direct marketing and social media have become more popular. Social media also affects search engine rankings.

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DAILY UPDATE: Economy Modest, Sickle Cell CRISPR Therapy Approved and Stock Markets Rise

By Staff Reporters

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SPONSOR: http://www.MarcinkoAssociates.com

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According to the Organization for Economic Cooperation and Development’s November economic outlook report, global growth is on track to stay modest this year and into 2024. And, while gross domestic product growth has been stronger than anticipated in 2023 so far, it’s now “moderating on the back of tighter financial conditions, weak trade growth and lower business and consumer confidence,” the report’s authors noted. The OECD anticipates global GDP growth of 2.9% in 2023, and a dip to 2.7% in 2024. 2025 looks better, with predicted global growth of 3%.

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The Food and Drug Administration on Friday approved a powerful treatment for sickle cell disease, a devastating illness that affects more than 100,000 Americans, the majority of whom are Black. The therapy, called Casgevy, from Vertex Pharmaceuticals and CRISPR Therapeutics, is the first medicine to be approved in the United States.

CRISPR: https://medicalexecutivepost.com/2022/08/06/crispr-play-by-play-of-an-experiment/

Here is where the major benchmarks ended:

The S&P 500® Index (SPX) was up 0.41% at 4,604.46, up marginally for the week; the Dow Jones Industrial Average (DJI) was up 130 points (0.36%) at 36,247.87, up marginally for the week; the NASDAQ Composite® (COMP) was up 63.98 points (0.45%) at 14,403.97, up 0.7% for the week.The 10-year Treasury note yield (TNX) was up 10 basis points at 4.235%. The CBOE Volatility Index (VIX) was down 5.44% at 12.35.

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

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CAREER: Physician Coaching and Development in 2024

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.

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

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/

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COACH: https://marcinkoassociates.com/process-what-we-do/

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CVS PHARMACY: Rx Drug Price Overhaul

By Staff Reporters

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CVS is overhauling how it prices prescription drugs

In a recent announcement, the company CVS promised that its new model would be more transparent than the current setup, which prices drugs based on complex reimbursement formulas that can make the costs of prescriptions confusing for consumers.

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

The new model, called CVS CostVantage, is based on a simple equation: Drugs will cost what CVS paid for them, plus a limited markup and a flat fee to cover the services of fulfilling the prescriptions. That’s similar to a plan proposed by billionaire Mark Cuban, founder of Cost Plus Drugs, to bring accountability to drug pricing in the US.

MORE: https://medicalexecutivepost.com/2022/06/23/mark-cubans-cost-plus-drugs-com/

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MEDICARE [dis] ADVANTAGE Plans?

By Staff Reporters

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Leading hospital trade groups are accusing some Medicare Advantage plans, including giant UnitedHealthcare, of flaunting coverage requirements recently codified by CMS. The American Hospital Association is now petitioning the Biden administration to crack down.


However … the Medicare Advantage market is booming but investment in cancer care continues to lag.

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MPFS Final Rule Cuts Physician Payments

Medicare Physician Fee Schedule

By Health Capital Consultants

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DEFINITION: The Centers for Medicare and Medicaid Services (CMS) uses the Medicare Physician Fee Schedule (MPFS) to reimburse physician services. The MPFS is funded by Part B and is composed of resource costs associated with physician work, practice expense and professional liability insurance.

Under the MPFS, each of these three elements is assigned a Relative Value Unit (RVU) for each Current Procedural Terminology (CPT®) code. These RVUs are then adjusted based on the Geographical Practice Cost Index associated with various geographic areas for different medical costs and wage differentials. The conversion factor is the national dollar amount that is multiplied by the total geographically adjusted RVU to determine the Medicare-allowed payment amount for a particular physician service.

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

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MPFS Final Rule Cuts Physician Payments

On November 2nd, 2023, the Centers for Medicare & Medicaid Services (CMS) released its finalized Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2024. While the finalized fee schedule cuts payments to physicians, there are a number of other (more positive) provisions in the final rule.

This Health Capital Topics article explores the various changes and updates included in the MPFS final rule. (Read more…)

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HEALTHCARE Innovation and Practice Management on the Move

By Staff Reporters

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Online therapy company Talkspace will provide free virtual mental health services to more than 400,000 adolescents and teens in New York City after inking a deal with the city. The new program, dubbed TeenSpace, will connect teens to a licensed therapist through phone, video and text.

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The Patient-Centered Outcomes Research Institute (PCORI) has announced funding awards of $80.5 million to support four new studies focused on disparities in maternal health. They will take into account clinical and social factors that contribute to inequities and will compare interventions in various settings.


And … Ayble Health, a digital health platform for patients with chronic gastrointestinal conditions, is working with the Mayo Clinic Complex Care Program to offer a hybrid care model that matches patients with the appropriate virtual and in-person care based on acuity and need.

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“BREAKING NEWS” Cigna and Humana to Merge?

By Staff Reporters

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Cigna and Humana are in talks for a combination that would create a new powerhouse in the health-insurance industry. The companies are discussing a stock-and-cash deal that could be finalized by the end of the year, assuming the talks don’t fall apart.

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A combination of the managed-care providers would be huge, given Cigna’s market value Wednesday morning of about $83 billion and Humana’s of roughly $62 billion.

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Cigna and Humana previously explored merging in 2015, but Humana instead struck a deal with another rival, Aetna, that was blocked by a judge on antitrust grounds, leaving Aetna to be scooped up by CVS in 2018. Another deal that would have combined Cigna with Anthem, now known as Elevance Health, also died after an adverse antitrust ruling.

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

Editor’s Note: Medicare Advantage plans are pretty popular with both lawmakers and ordinary Americans — they now enroll about 31 million people, representing just over half of everyone in Medicare, by KFF’s count. Across the country, doctors are grumbling about claim denials and onerous pre-approval requirements by Medicare Advantage plans. Some hospitals and physician practices are so fed up they’re refusing to accept the plans — even big ones like those offered by United Healthcare, Cigna and Humana.

“The insurance companies running the Medicare Advantage plans are pushing physicians and hospitals to the edge,” said Chip Kahn, president and CEO of the Federation of American Hospitals, which represents the for-profit hospital sector.

And, just last week, the industry’s largest lobbying group, the American Hospital Association, fired off a letter to the Centers for Medicare and Medicaid Services warning that some insurers seem intent on circumventing new rules put in place by the Biden administration aimed at reining in some prior authorization and claim denials.

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MARCINKO & Associates, Inc.

WHAT WE DO AND HOW WE ASSIST MEDICAL COLLEAGUES

Hard Business Advice AND Personal Lifestyle Coaching

http://www.MARCINKOASSOCIATES.com

By Ann Miller RN MHA CMP™

At Marcinko & Associates our clients traditionally include physicians [MD, MBBS and DO], dentists [DDS and DMD], podiatrists [DPM], Registered Nurses [RNs], Certified Registered Nurse Anesthetists [CRNA], Physician Assistants [PA] and Nurse Practitioners [NP]. A growing cohort of clients include medical technologists, physical, speech and occupational therapists, etc.

The above are naturally segregated into three career tranches: 1. New practitioners, 2] Mid-Career practitioners and 3] Mature practitioners. We serve them all and are fully prepared for any special needs situation that may arise in any tranche [death, divorce, adverse risk event and/or bankruptcy, etc].

Marcinko & Associates understands the complexity of financial and non-financial deal terms because we are also doctors. Our “hard” knowledge of your business comes from being actual healthcare facility owners, operators and medical practitioners [with additional professional licenses and expertise] enabling us to effectively analyze your business, take corrective measures and present your healthcare entity in the best possible and accurate light.

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But, if you’re looking at this website, chances are you are fed up, burned out, seeking practice management techniques or a better work-life balance. Or, you are looking for a new non-clinical career, thinking of finance, investing, retirement, or all of the above. Perhaps you are just looking to regain the joy and meaning in your medical or professional career? This is known as “soft” psychology, coaching, personal consulting or fraternal advice.

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Regardless, of your “soft” personal or “hard” corporate needs, our transparent Fees for Service [FFS] model is moderated for all colleagues based on the acuity and urgency of their engagements. Reduced rates and/or limited charity work may also be possible.

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http://www.DavidEdwardMarcinko.com

CONTACT US TODAYTHRIVE TOMORROW!

Suite #5901 Wilbanks Drive

Norcross, Georgia USA 30092-1141

email: MarcinkoAdvisors@msn.com

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NURSING: Emerging Trends and Innovation

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MARCINKO & Associates, Inc.

WHAT WE DO AND HOW WE ASSIST MEDICAL COLLEAGUES

Hard Business – Financial Advice AND Personal Lifestyle Coaching

http://www.MARCINKOASSOCIATES.com

***

By Ann Miller RN MHA CMP™

At Marcinko & Associates our clients traditionally include physicians [MD, MBBS and DO], dentists [DDS and DMD], podiatrists [DPM], Registered Nurses [RNs], Certified Registered Nurse Anesthetists [CRNA], Physician Assistants [PA] and Nurse Practitioners [NP]. A growing cohort of clients include medical technologists, physical, speech and occupational therapists, etc.

The above are naturally segregated into three career tranches: 1. New practitioners, 2] Mid-Career practitioners and 3] Mature practitioners. We serve them all and are fully prepared for any special needs situation that may arise in any tranche [death, divorce, adverse risk event and/or bankruptcy, etc].

Marcinko & Associates understands the complexity of financial and non-financial deal terms because we are also doctors. Our “hard” knowledge of your business comes from being actual healthcare facility owners, operators and medical practitioners [with additional professional licenses and expertise] enabling us to effectively analyze your business, take corrective measures and present your healthcare entity in the best possible and accurate light.

***

But, if you’re looking at this website, chances are you are fed up, burned out, seeking practice management techniques or a better work-life balance. Or, you are looking for a new non-clinical career, thinking of finance, investing, retirement, or all of the above. Perhaps you are just looking to regain the joy and meaning in your medical or professional career? This is known as “soft” psychology, coaching, personal consulting or fraternal advice.

***

Regardless, of your “soft” personal or “hard” corporate needs, our transparent Fees for Service [FFS] model is moderated for all colleagues based on the acuity and urgency of their engagements. Reduced rates and/or limited charity work may also be possible.

***

***

CONTACT US TODAYTHRIVE TOMORROW!

Suite #5901 Wilbanks Drive

Norcross, Georgia USA 30092-1141

email: MarcinkoAdvisors@msn.com

***

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HEALTH FRAUD: Abuse Control Program Annual Report

By Staff Reporters

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Healthcare Fraud and Abuse Control Program Annual Report Released

In Fiscal Year (FY) 2022, the Department of Justice (DOJ) opened more than 809 new criminal healthcare fraud investigations. Federal prosecutors filed criminal charges in over 419 cases involving at least 680 defendants. More than 477 defendants were convicted of healthcare fraud related crimes during the year. Also, in FY 2022, DOJ opened more than 774 new civil healthcare fraud investigations and had over 1,288 civil healthcare fraud matters pending at the end of the fiscal year. 

Federal Bureau of Investigation (FBI) investigative efforts resulted in over 499 operational disruptions of criminal fraud organizations and the dismantlement of the criminal hierarchy of more than 132 healthcare fraud criminal enterprises. In FY 2022, investigations conducted by HHS’s Office of Inspector General (HHS-OIG) resulted in 661 criminal actions against individuals or entities that engaged in crimes related to Medicare and Medicaid, and 726 civil actions, which include false claims, unjust-enrichment lawsuits filed in Federal district court, and civil monetary penalty (CMP) settlements. HHS-OIG excluded 2,332 individuals and entities from participation in Medicare, Medicaid, and other Federal healthcare programs.

Source: U.S. Department of Health and Human Services and U.S. Department of Justice

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NATIONAL: Nurse Practitioner Week

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Nurse Practitioner Week takes place annually in the second week of November to recognize these incredible healthcare providers and raise awareness of the powerful role they play in ensuring general health and well-being.

Can you believe that the nurse practitioner profession has been in existence for 56 years now? Nurse practitioners are highly educated and trained medical professionals who are almost like doctors. In addition to their fundamental roles as registered nurses, they can provide primary care, counseling, diagnosis, offer health education, and write prescriptions.

Want to become a nurse? Here are some nursing scholarships to help you.

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PODCAST: How PBMs Work -OR- Don’t Work?

PRIOR AUTHORIZATION

By Eric Bricker MD

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CAREER: Executive Physician Coaching

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.

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

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/

***

CAREER: Physician Coaching and Executive Development

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.

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

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/

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

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DAILY UPDATE: A New NIH Director and a Home Loan Bank System Update as the Stock Markets Ascend Again

By Staff Reporters

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The Senate on Tuesday confirmed Dr. Monica M. Bertagnolli, a cancer surgeon who currently leads the National Cancer Institute, as the next director of the National Institutes of Health, overriding the objections of Senator Bernie Sanders of Vermont, the chairman of the Senate health committee.

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The U.S. regulator charged with overseeing the Federal Home Loan Bank system said in a report on Tuesday the system is overdue for an update in terms of its structure and operation. The Federal Housing Finance Agency emphasized in the report there needs to be a clearer distinction between the purpose of those banks, which is to aid liquidity needs at banks in a bid to facilitate mortgage lending, with the Federal Reserve, which should serve as a source of emergency liquidity for banks.

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

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Here is where the major stock market benchmarks ended:

  • The S&P 500 Index was up 12.40 points (0.3%) at 4,378.38; the Dow Jones Industrial Average was up 56.74 points (0.2%) at 34,152.60; the NASDAQ Composite (COMP) was up 121.08 points (0.9%) at 13,639.86.
  • The 10-year Treasury note yield (TNX) was down about 9 basis points at 4.571%.
  • CBOE’s Volatility Index (VIX) was down 0.08 at 14.81.

The small-cap-focused Russell 2000 Index (RUT) fell a second day, reflecting concerns about the economy tipping over into recession.

Energy stocks fell as WTI crude oil futures tumbled more than 4% to a 3½-month low on concerns about softening demand from China.

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HEALTHCARE: Business News

By Staff Reporters

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House Democrats want CMS to better monitor Medicare Advantage plans’ use of AI tools to ensure they don’t allow an unusually high level of restrictive and repeated denials.


Kaiser Permanente continues to rebound from a rough 2022 and pulled in $239 million in net income in Q3. That marks a dramatic turnaround from the $1.5 billion net loss the integrated system had seen a year prior.

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


And … during the Milken Institute’s Future of Health Summit Monday, former HHS Secretary Alex Azar and current department chief Xavier Becerra sparred over the Biden administration’s approach to negotiating Medicare drug prices.

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Finally, family physicians utilizing value-based payment (VBP) models reported burnout relief in a study from EHR company Elation Health and the American Academy of Family Physicians. Burnout among providers decreased once practices passed a threshold of 75% financial investment in VBP models.

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PROPOSED CHANGES: Medicare Advantage

JUST ANNOUNCED

By Staff Reporters

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The Biden administration wants to make changes to private Medicare insurance plans that officials say will help seniors find plans that best suit their needs, promote access to behavioral health care and increase use of extra benefits such as fitness and dental plans.

PART C FRAUD: https://medicalexecutivepost.com/2023/10/24/podcast-medicare-advantage-part-c-fraud/

MEDICARE ADVANTAGE ALLEGATIONS: https://medicalexecutivepost.com/2022/09/06/medicare-part-c-advantage-plan-allegations-investigations/

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CASE MODELS: Healthcare Business Entities

MARCINKO ASSOCIATES, Inc.

SPONSOR: http://www.MarcinkoAssociates.com

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The Marcinko & Associates case study and white-paper compendium is a teaching vehicle that presents potential clients with a critical management issue that serves as a spring board to lively debate in which participants present and defend their analysis and prescriptions. The average case is 2 to 100 pages long (prose, tables, graphs, charts, spread sheets and figures, etc).

CASE MODEL Sample Privatization: https://tinyurl.com/3af5nf7s

ORDER: https://marcinkoassociates.com/case-studies/

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On Merging Medical Practices

By David Edward Marcinko MBA CMP

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SPONSOR: http://www.MARCINKOASSOCIATES.com

Merging Medical Practices

There are only three possibilities if you want to go into practice for yourself; buy a practice; franchise a business, or start one. However, if you have an existing practice, merging it to form a larger entity can be a satisfying experience. The pace of practice mergers is accelerating, but it is often difficult to make an informed judgment about synergy. Mergers make sense only if the resulting value is more than additive to the original; not duplicative.

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

Unfortunately, far too many mergers fail to create, or actually destroy existing value. So, look for complimentary processes, personalities and ideas. In a merger of two existing practices, there is no substitute for personal interaction between employees and physician-management. This creates cross-pollination and new ideas in everything from service-lines and the patient production process, to marketing and finance, and to proprietary and intellectual rights. Most importantly, it allows
diversity of ideas.

And so, the following are questions to consider when contemplating a medical practice
merger:


 What are the risks of this transaction and how are they mitigated?
 Will talented employees be retained on both sides and can an exodus be
prevented?
 Are the specific liabilities of each practice known? Remember, the farther outside
your area of specialty or expertise, the greater the risk of being wrong.
 Will I appraise each practice independently, and correctly?
 Where will employee allegiance rest?
 What is the name, and logo, of the new entity? Who will be the CEO?

Vertical Integration: https://medicalexecutivepost.com/2023/04/14/integration-as-a-competitive-strategy-in-healthcare-reform/

More: https://medicalexecutivepost.com/2022/06/19/healthcare-mergers-acquisitions-2021-in-review/

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PEPFAR’s Uncertain Future for AIDS Relief

By Staff Reporters

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An impactful government program is facing an uncertain future. PEPFAR—an acronym for the President’s Emergency Plan for AIDS Relief—was created by former President George W. Bush in 2003 and is credited with saving 25 million lives around the world. Through the program, the US government has invested more than $100 billion in treatment for HIV-AIDS and related illnesses by providing training, medical infrastructure, and antiretroviral drugs. PEPFAR remains the largest commitment by a country to confront a single disease, according to KFF.

Since its inception, PEPFAR has been renewed every five years with bipartisan support. But that wasn’t the case in 2023, as lawmakers let the program expire at the end of September.

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

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CUSTOMIZABLE e-PODIATRY CONSENT FORMS Now Available for 2024

electronically CUSTOMIZABLE FOR EVERY SURGEON

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http://www.ePodiatryConsentForms.com

CUSTOMIZABLE CMS & AGENCY FOR HEALTHCARE RESEARCH AND QUALITY STYLED PROTOCOLS, CHECKLISTS AND TEMPLATES

.… Specifically for Podiatrists ….   

e-Podiatry Consent Forms™ is an innovative new suite of software programs from the Institute of Medical Business Advisors [iMBA, Inc]. Our products solve your informed consent problems and enhance the education, discussion and documentation of the informed consent process for all podiatrists performing foot, ankle and leg reconstructive surgical procedures.

THE PROBLEM

All podiatrists are being pressured by the Centers for Medicare and Medicaid Services [CMS], the Joint Commission on Accreditation of Healthcare Organizations [JCAHO], liability carriers and private insurance payers to make their consent process more patient-friendly, informed and easily understood. And, the pressure to standardize and comply is great.

Most recently, based on the need to make healthcare even safer, the Agency for Healthcare Research and Quality (AHRQ) undertook a major study to identify patient safety issues and develop recommendations for “best practices”.

The AHRQ Evidence Report

The AHRQ report identified the challenge of addressing shortcomings such as missed, incomplete or not fully comprehended informed consent, as a significant patient safety issue and opportunity for improvement.

The authors of the AHRQ report hypothesized that better informed patients:

“are less likely to experience errors by acting as another layer of protection.”

And, the AHRQ study ranked a “more interactive informed consent process” among the top 11 practices supporting more widespread implementation; especially for surgical consent forms.

THE SOLUTION

Why Us: https://epodiatryconsentforms.com/why-us/

One answer to the modern risk-management problem of “informed consent interactivity” may be e-Podiatry Consent Forms™  We license two core interactive surgical products, and a reference library, with related concepts and products in development:

  • Forefoot, Mid-Foot and Simple Rear-Foot Version
  • Complex Rear-Foot, Ankle and Lower Leg Version
  • Comprehensive content library for extreme customization.

Each e-Podiatry Consent Forms™ CD-ROM [secure email delivery is now available] is increasingly trusted as the simple solution to standardized communications across the entire office-enterprise; from managing-risk, informing-patients and complying with modern regulatory requirements through enhanced patient-centric informed consent encounters.

Thus, by improving the consistency, details, documentation and effectiveness of the informed consent process, e-Podiatry Consent Forms™ equips all podiatric surgeons with the tools needed to augment quality standards, reduce litigation potential and improve patient outcomes and safety.

http://www.ePodiatryConsentForms.com

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ORDER NOW: http://www.ePodiatryConsentForms.com

Phone: 770-448-0769

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PODCAST: The Elon Musk Algorithm Applied to Healthcare

By Eric Bricker MD

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President Bidens Executive Order on Artificial Intelligence

By Staff Reporters

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Biden will issue sweeping executive order on A.I. Today

The Biden administration just released an executive order today to regulate AI technology. The directive aims to leverage the government’s role as a leading technology customer by requiring advanced AI models to undergo assessments before they can be used by federal employees. It would also ease barriers to immigration for highly skilled workers in an attempt to boost the US’ technological edge.

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MORE Fierce Healthcare NEWS

The Biden administration has proposed a new rule refining several aspects of the healthcare services billing process in response to criticisms levied from all sides of the industry.


The federal government is rolling back a pandemic-era waiver that lowered the bar for 340B hospitals to dispense discounted drugs across some outpatient clinics. Hospitals argue the decision will “stifle” future efforts to expand access to under served communities.


And … Amazon Pharmacy is focused on making it faster and more convenient for patients to get prescription medications. The company’s moves come as brick-and-mortar drugstores are limiting pharmacy hours and even closing locations.

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CASE MODELS: Healthcare Business Entities

MARCINKO ASSOCIATES, Inc.

SPONSOR: http://www.MarcinkoAssociates.com

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***

The Marcinko & Associates case study and white-paper compendium is a teaching vehicle that presents potential clients with a critical management issue that serves as a spring board to lively debate in which participants present and defend their analysis and prescriptions. The average case is 2 to 100 pages long (prose, tables, graphs, charts, spread sheets and figures, etc).

CASE MODEL Sample Privatization: https://tinyurl.com/3af5nf7s

ORDER: https://marcinkoassociates.com/case-studies/

THANK YOU

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M&As: In Healthcare

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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Hospital and health system deal activity is finally starting to rebound following a pandemic-era plunge, according to consulting firm Kaufman Hall, but hospitals are increasingly citing “financial distress” as the reason behind the deals.

In more than a third of the 18 hospitals and health systems deals made in Q3 2023—including mergers and acquisitions (M&A) and partnerships—at least one party cited financial distress as the impetus for the transaction. That figure is “well above historical benchmarks,” according to the firm.

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

“Hospitals and health systems have been under extreme financial pressure since 2022, when median operating margins remained in negative territory for the full year,” Kaufmann Hall analysts wrote in an October 12 report. “These challenges are reflected in the 39% percent of announced transactions in Q3 in which a party has cited, or publicly available information has enabled Kaufman Hall to infer, an element of financial distress as a transaction driver.”

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PODIATRY PREP: Pass All Your Board Certification Examinations

Celebrating 30 Years of Your Success!

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Pass ALL the Certification Boards!

By: http://www.PodiatryPrep.org

The Foot and Ankle Research Consortium, Inc. (FARC) is the leading publisher of Podiatric educational software. Since 1992, we have been producing the most effective and innovative method of preparing for ALL the Podiatry Board Examinations.

CURIOUS STUDY: Hallux Valgus Met I

SCARF: scarf osteotomy

This includes: The American Board of Podiatric Surgery, The American Board Of Podiatric Orthopedics and Primary Podiatric Medicine, the American Podiatric Medical Specialties Board, ABLES and the PMLexis. (Now includes the latest information for all Board Re-Certifications).

CONTENTS: https://podiatryprep.org/compatibility-test/

Customization and private  tutoring services also available.

FAN CLUB: https://podiatryprep.org/podiatryprep-fan-club/

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PURCHASE – PREPARE – PASS®

ORDER HERE: https://podiatryprep.org/order-form/

GOOD LUCK!

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BUSINESS: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko

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RUDE PATIENTS: To Laboring Physicians?

By Staff Reporters

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A spike in rude behavior emerged as one of the pandemic’s many societal consequences and has not receded alongside the public health crisis. The uptick in poor behavior is likely driven by increased stress and isolation from society, The Atlantic’s Olga Khazan reported in 2022. In many cases, these stressors mean people are easily set off when encountering innocuous requests, Keith Humphreys, PhD, a psychiatry professor at Stanford University, told The Atlantic

The trend has hit healthcare hard. Hospitals and health systems nationwide have reported an uptick in disrespectful, discriminatory, or violent behaviors from patients since the pandemic. Nearly 24 percent of physicians reported experiencing workplace mistreatment in 2020, including verbal mistreatment or abuse, according to a study published in JAMA Network Open. 

Source: Mackenzie Bean, Becker’s Hospital Review

MORE: https://medicalexecutivepost.com/2023/08/07/medical-workplace-violence-prevention-guidelines/

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AMAZON in Healthcare

By The Medical Futurist

Amazon In Healthcare: Disruption, Data Nightmares And Digital Health Dreams

Amazon’s healthcare ventures present a double-edged sword. On one hand, there’s undeniable promise, but the flip side paints a cautionary tale.

READ: https://tinyurl.com/ydtbvahx

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WEIGHT LOSS DRUGS FOR KIDS: Stocks for Adults?

By Staff Reporters

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The already booming market for weight loss treatments like Ozempic might get even bigger as drug companies seek to make them available for children. The CDC estimates that ~20% of kids 6+ in the US have obesity, and manufacturers are working to make their weight loss drugs available for that age group.

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

According to Bloomberg, Novo Nordisk is testing its Saxenda in kids as young as six, and Eli Lilly is getting ready for similar trials of Mounjaro. That could give the companies lifelong customers since the drugs only keep weight off as long as people take them—and Goldman Sachs’s recent estimate that the drug category would make $100 billion by 2030 didn’t even take sales to children into account.

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D.E. MARCINKO & Associates, Inc.

WHAT WE DO AND HOW WE ASSIST MEDICAL COLLEAGUES

Hard Business Advice AND Personal Lifestyle Coaching

http://www.MARCINKOASSOCIATES.com

By Ann Miller RN MHA CMP™

At D.E. Marcinko & Associates our clients traditionally include physicians [MD, MBBS and DO], dentists [DDS and DMD], podiatrists [DPM], Registered Nurses [RNs], Certified Registered Nurse Anesthetists [CRNA], Physician Assistants [PA] and Nurse Practitioners [NP]. A growing cohort of clients include medical technologists, physical, speech and occupational therapists, etc.

The above are naturally segregated into three career tranches: 1. New practitioners, 2] Mid-Career practitioners and 3] Mature practitioners. We serve them all and are fully prepared for any special needs situation that may arise in any tranche [death, divorce, adverse risk event and/or bankruptcy, etc].

D.E. Marcinko & Associates understands the complexity of financial and non-financial deal terms because we are also doctors. Our “hard” knowledge of your business comes from being actual healthcare facility owners, operators and medical practitioners [with additional professional licenses and expertise] enabling us to effectively analyze your business, take corrective measures and present your healthcare entity in the best possible and accurate light.

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But, if you’re looking at this website, chances are you are fed up, burned out, seeking practice management techniques or a better work-life balance. Or, you are looking for a new non-clinical career, thinking of finance, investing, retirement, or all of the above. Perhaps you are just looking to regain the joy and meaning in your medical or professional career? This is known as “soft” psychology, coaching, personal consulting or fraternal advice.

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Regardless, of your “soft” personal or “hard” corporate needs, our transparent Fees for Service [FFS] model is moderated for all colleagues based on the acuity and urgency of their engagements. Reduced rates and/or limited charity work may also be possible.

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CONTACT US TODAYTHRIVE TOMORROW!

Suite #5901 Wilbanks Drive

Norcross, Georgia USA 30092-1141

email: MarcinkoAdvisors@msn.com

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PODCAST: Health Insurance Dis-Intermediation

By Eric Bricker MD

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RETAIN A PHYSICIAN COACH: “From Chaos to Calm” in 2024?

SPONSOR: http://www.MARCINKOASSOCIATES.com

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“FROM CHAOS-TO-CALM”

If you’re looking at this tab, chances are you are fed up, burned out, seeking better work-life balance, looking for a new non-clinical career, thinking of retirement, or all of the above. Perhaps you are just looking to regain the joy and meaning in your medical career.

No worries! You may have come to the right place.

LEARN MORE: https://medicalexecutivepost.com/2022/10/24/personal-coaching-dr-marcinko-at-your-service/

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PODCAST: Why Hospitals Cry “Poor”

By Eric Bricker MD

“Cross Subsidization”

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