BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
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Posted on April 3, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Eidetic memory refers to the ability to vividly recall images from memory after only a few instances of exposure, with high accuracy for a short time after exposure, without using a memory aid.
Photographic memory, though often used interchangeably with eidetic memory, implies the ability to recall extensive details, like entire pages of text, with high precision. Genuine photographic memory’s existence is debated and hasn’t been conclusively proven.
Posted on April 3, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Stocks looked like a very concerning EKG recently, fluctuating throughout as investors weighed today’s tariff announcement. The Newsmax meme stock kept on surging, stacking a 180% gain on top of Monday’s 735% spike to skyrocket over 900% since the conservative media outlet went public earlier this week.
U.S. stocks whipped through another dizzying day Wednesday in the final hours before President Donald Trump’s unveiling of the tariffs promised as part of his “Liberation Day,” which could drastically remake the global economy. The S&P 500 rose 0.7%, but only after careening between an earlier loss of 1.1% and a later gain of 1.1%. It’s had a pattern this week of opening with sharp drops only to finish the day higher.
The Dow Jones Industrial Average added 235 points, or 0.6%, and the NASDAQ composite climbed 0.9%. Both also veered from sharply lower in the morning to sharply higher in the afternoon before doubling back.
Mass layoffs at health agencies begin. The purge of thousands of Health and Human Services (HHS) employees announced last week by Secretary Robert F. Kennedy Jr. started yesterday, with senior leaders at the FDA, CDC, and other departments saying they had been pushed out. Among those removed were the FDA’s chief tobacco regulator, its top veterinarian, and medical officers in charge of new drug approvals.
f you like to use Zelle to send money to others, you need to find a new solution. On April 1st, the digital payment app shut down.
Visualize: How private equity tangled banks in a web of debt, from the Financial Times.
On March 15th, 2025, President Donald Trump signed a continuing resolution (CR) that avoided a government shutdown and funds the federal government for the rest of the fiscal year, i.e., through September 30th, 2025.
Perhaps more notable than what was included in the spending bill was what was once again excluded. While the COVID-era tele-health waivers were temporarily extended, Medicare physician payment rates were not addressed, meaning physicians will continue experiencing a 2.93% pay cut for 2025.
This Health Capital Topics article discusses the healthcare provisions included in and excluded from the CR, and the impacts on healthcare providers. (Read more…)
Posted on April 2, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
The CEO of a Texashealth insurance company was fired after admitting before a DOGE panel of state lawmakers that he hired private investigators to spy on customers and obtain sensitive details about their lives. Mark Sanders was dismissed from his duties as chief executive of Austin-based Superior HealthPlan after he testified before the Texas House Delivery of Government Efficiency Committee in a hearing on Medicaid procurement last week.
US stocks closed mixed on Tuesday as investors cautiously counted down to President Trump’s highly anticipated “Liberation Day” rollout of sweeping new reciprocal tariffs. The S&P 500 (^GSPC) rose about 0.4%, extending the gains the benchmark index secured on Monday, while the Dow Jones Industrial Average (^DJI) fell just below the flatline. The tech-heavy NASDAQ Composite (^IXIC) rebounded to close up around 0.9%.
Posted on April 1, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
US stocks rebounded Monday to cap a volatile month and quarter as trade-war worries mount in the run-up to President Trump’s tariff bonanza later in the week.
The tech-heavy NASDAQ Composite (^IXIC) closed down about 0.1%, while the S&P 500 (^GSPC) recuperated losses of as much as 1.7% to close up nearly 0.6%. The Dow Jones Industrial Average (^DJI) erased early morning losses to gain 1%, or about 400 points.
Markets wrapped up March on a woeful note after a rough month and quarter beset by Trump’s fast-evolving tariff policy. Last week was the fifth in six weeks that the NASDQ Composite and S&P 500 ended the week in the red. The benchmark index is down over 4.5% to start the year while the NASDAQ has lost over 10%, finishing with their worst quarters since 2022.
Some of the biggest-name megacaps have led the decline. NVIDIA (NVDA) fell Monday as it has neared a 20% loss so far this year, while TESLA (TSLA) has lost more than 35%.
Posted on March 30, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Negativity bias is not totally separate from pessimism bias, but it is subtly and importantly distinct. In fact, it works according to similar mechanics as the sunk cost fallacy in that it reflects our profound aversion to losing. We like to win, but we hate to lose even more.
And so, according to cognitive scientist Mackenzie Marcinko PhD, when we make a decision, we generally think in terms of outcomes—either positive or negative. The bias comes into play when we irrationally weigh the potential for a negative outcome as more important than that of a positive outcome.
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Pessimism bias on the other hand, is a cognitive bias that causes people to overestimate the likelihood of negative things and underestimate the likelihood of positive things, especially when it comes to assuming that future events will have a bad outcome.
For example, the pessimism bias could cause someone to believe that they’re going to fail an exam, even though they’re well-prepared and are likely to get a good grade.
According to colleague Dan Ariely PhD, The pessimism bias can distort people’s thinking, including your own, in a way that leads to irrational decision-making, as well as to various issues with your mental health and emotional well being.
Posted on March 29, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
DEFINITIONS
By Staff Reporters
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Paradoxes are broader concepts that may include statements, situations, or phenomena, revealing a truth through contradiction (e.g., “less is more”).
Oxymorons are combinations of two contradictory words to create a new meaning (e.g., “deafening silence”).
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Most people tend to confuse a paradox with an oxymoron, and it’s not hard to see why. Most oxymoron examples appear to be compressed version of a paradox, in which it is used to add a dramatic effect and to emphasize contrasting thoughts. Although they may seem greatly similar in form, there are slight differences that set them apart.
A paradox consists of a statement with opposing definitions, while an oxymoron combines two contradictory terms to form a new meaning. But because an oxymoron can play out with just two words, it is often used to describe a given object or idea imaginatively.
As for a paradox, the statement itself makes you question whether something is true or false. It appears to contradict the truth, but if given a closer look, the truth is there but is merely implied.
Posted on March 29, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
EDITOR-IN-CHIEF
By Dr. David Edward Marcinko; FACFAS MBA MEd
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NATIONAL PHYSICIANS WEEK
National Physicians Week sets out March 25-31 to honor the healers dedicated to the art of medicine. In 2017, National Physicians Week highlighted the shortage of physicians in the United States against a growing landscape of minorities joining the ranks.
#NationalPhysiciansWeek
“In hindsight, I am proud of what we have accomplished in a short period of time, including raising the recognition of our group and spotlighting the years of sacrifice by those in our profession to serve our patients. We are poised to initiate actionable efforts to engage and educate our physician community.”
Cite: Dr. Kimberly Funches Jackson, President
Today in 2025, let’s explore the invaluable contributions of physicians, celebrate their hard work during National Physicians Week, and highlight the essential role that locum doctors play in enhancing healthcare delivery.
A Week to Honor All Physicians
National Physicians Week is a celebration of the remarkable work that doctors do every single day. From diagnosing complex conditions to providing life-saving treatments, physicians dedicate themselves to improving the health and well-being of their patients. It’s a week for healthcare professionals, patients, and communities to come together and show appreciation for the doctors who make a difference in our lives.
Physicians work long hours, face immense pressure, and make critical decisions daily. Their contributions go beyond the walls of the hospital, as many are also involved in research, teaching, and community outreach.
So, this week, it’s important to acknowledge not only their professional expertise but also the compassion and resilience they exhibit in their work.
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: CONTACT: MarcinkoAdvisors@outlook.com
Posted on March 29, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Dr. Jay Bhattacharya is officially the new NIH director. The Senate voted to confirm the Stanford University professor’s appointment on March 26 in a 53–47 vote. Marty MakaryMD was also confirmed as FDA commissioner in the same hearing in a 56–44 vote. The appointments come as additional “healthcare disruptors,” alongside Robert F. Kennedy Jr.’s confirmation as HHS secretary and Mehmet Oz’s nomination as head of the Centers for Medicare and Medicaid Services. The nominees have faced backlash from the medical community following their controversial stances on topics like vaccinations and alternative medical practices.
The Dow Jones Industrial Average (^DJI) dropped more than 700 points or nearly 1.7%, while the benchmark S&P 500 (^GSPC) fell almost 2%. The NASDAQ Composite (^IXIC) dropped 2.7% as tech stocks led the declines.
As noted above, the major averages fell on Friday after the release of a hotter-than-expected Personal Consumption Expenditures index reading, which includes the Federal Reserve’s preferred inflation gauge of “core” PCE. The reading showed prices increased more than expected last month, rising 0.4% month over month and 2.8% year over year, continuing a stubborn plateau on the path to the Fed’s 2% target.
Visualize: How private equity tangled banks in a web of debt, from the Financial Times.
Avram Noam Chomsky is an American professor known for his traditional work in linguistics and political activism. Sometimes called “the father of modern linguistics”, Chomsky is also one of the founders of the field of cognitive science. He is a laureate professor of linguistics at the University of Arizona and an professor emeritus at MIT.
And so, modern linguists today approach their work with scientific rigor and perspective [STEM], although they use methods that were once thought to be solely an academic discipline of the humanities.
Contrary to this humanitarian belief, according to Professor Mackenzie Hope Marcinko PhD of the University of Delaware, linguistics is now multidisciplinary. It overlaps each of the human sciences including psychology, neurology, anthropology, and sociology. Linguists conduct formal studies of sound structure, grammar and meaning, but also investigate the history of language families, and research language acquisition.
Posted on March 28, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Dental care in America divides people into two camps: those who can afford regular preventive care and cleanings, and those who can’t.
These so-called dental deserts contribute to a deep disparity in overall health. People who live in these places are more likely to get tooth decay and develop severe health problems. They also spend more money on care, and more time seeking health assistance in an emergency.
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Stat: 25 million. That’s how many US residents live in areas without enough dentists, according to a recent Harvard University study.
A growing movement against fluoride is adding to the risk of tooth decay in these “dental deserts.” (NPR)
Posted on March 28, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Health and Human Services Secretary Robert F. Kennedy Jr. is expected to announce 10,000 employees will be cut, the Wall Street Journal reported today—the latest round of layoffs in the Trump administration’s push to slash the size of the federal workforce.
US stocks slid lower on Thursday after President Trump pushed ahead with hefty new tariffs on auto imports, stoking concerns about a potential full-on trade war and global economic harm. The S&P 500 (^GSPC) and the Dow Jones Industrial Average (^DJI) fell just over 0.3% on the heels of a losing day for the major gauges. The tech-heavy NASDAQ Composite (^IXIC) led the losses, falling more than 0.5%.
Posted on March 27, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
DEFINITION
By Staff Reporters
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Restaurant Reservation Scalping
The unauthorized online restaurant reservation market works like this.
Third-party platforms directly secure or encourage scalpers to secure reservations at popular restaurants without the restaurants’ permission, and then they facilitate the sale of those reservations for a hefty fee on their websites and smart phone apps.
These reservation scalpers often use bots to quickly secure the reservations online and take them off the market, so the average human customer can’t get access to that reservation without paying an unauthorized third party.
Posted on March 27, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Over the next decade, advances in artificial intelligence will mean that humans will no longer be needed “for most things” in the world, says Bill Gates. That’s what the Microsoft co-founder and billionaire philanthropist told comedian Jimmy Fallon during an interview on NBC’s “The Tonight Show” in February. At the moment, expertise remains “rare,” Gates explained, pointing to human specialists we still rely on in many fields, including “a great doctor” or “a great teacher.”
US stocks closed sharply loser Wednesday as President Trump prepared to unveil new tariffs on US auto imports. The benchmark S&P 500 (^GSPC) was down more than 1.1%, while the Dow Jones Industrial Average (^DJI) fell about 0.4%. The tech-heavy NASDAQ Composite (^IXIC) led the losses, sliding over 2%. Tech leaders Nvidia (NVDA) and Tesla (TSLA) both closed down more than 5%.
It’s a shocking fall for 23andMe that once boasted a $6 billion valuation in 2021—despite never making a profit. As of Friday, it was worth $50 million, and on Monday, shares for the consumer genetic testing pioneer fell 50% to 88 cents, Reuters reported.
Visualize: How private equity tangled banks in a web of debt, from the Financial Times.
Posted on March 26, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Donald Trump has officially dropped a stablecoin. It’s called USD1, and it’s pegged 1:1 with the US dollar, according to a statement from his family company World Liberty Financial Inc, (WLFI) today. The company says the token is fully backed by short-term US government treasuries, USD deposits, and other cash equivalents. Every token equals one dollar, no exceptions. WLFI says it built the whole thing to give people a stablecoin they don’t have to second guess.
US stocks rose for a third day in a row despite souring consumer confidence — and as investors weighed whether President Trump would temper his plans for upcoming tariffs.
The benchmark S&P 500 (^GSPC) rose more than 0.1%, while the Dow Jones Industrial Average (^DJI) ticked just above the flatline. The tech-heavy NASDAQ Composite (^IXIC) rose nearly 0.5%, bolstered by a more than 3% jump from Tesla (TSLA).
Posted on March 25, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Wikipedia and Staff Reporters
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Congestion pricing or congestion charges is a system of surcharging users of public goods that are subject to congestion through excess demand, such as through higher peak charges for use of bus services, electricity, railways, telephones, and road pricing to reduce traffic congestion; airlines and shipping companies may be charged higher fees for slots at airports and through canals at busy times. This pricing strategy regulates demand, making it possible to manage congestion without increasing supply.
According to the economic theory behind congestion pricing, the objective of this policy is to use the price mechanism to cover the social cost of an activity where users otherwise do not pay for the negative externalities they create (such as driving in a congested area during peak demand).
By setting a price on an over-consumed product, congestion pricing encourages the redistribution of the demand in space or in time, leading to more efficient outcomes.
Posted on March 25, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
US stocks closed near session highs on Monday as investors welcomed reports that the next wave of President Trump’s tariffs will be narrower than expected.
The S&P 500 (^GSPC) rose almost 1.8% on the heels of the broad benchmark snapping a four-week losing streak. The Dow Jones Industrial Average (^DJI) advanced 1.4%, while contracts on the tech-heavy NASDAQ Composite (^IXIC) led the gains, up 2.3%.
A hostile takeover happens when an entity takes control of a company without the knowledge and against the wishes of the company’s management. A hostile takeover is an acquisition strategy requiring that the entity acquire and control more than 50% of the voting shares issued by the company.
In mergers and acquisitions (M&A), a hostile takeover is the acquisition of a target company by an acquiring company that goes directly to the target company’s shareholders, either by making a tender offer or through a proxy vote.
Ideally, an entity interested in acquiring a company should seek approval from the target company’s Board of Directors. The difference between a hostile and a friendly takeover is that, in a friendly takeover, the target company’s board of directors approve of the transaction and recommend shareholders vote in favor of the deal.
Defenses against a hostile takeover
These defense mechanisms can be preemptive or reactive, depending on how prepared the company is for the possibility of a hostile bid.
Poison pill is one of the most common defenses against a hostile takeover. Officially known as a “shareholder rights plan,” the poison pill allows existing shareholders to purchase additional shares at a discount, diluting the ownership interest of the acquiring company. The goal is to make it prohibitively expensive for the acquirer to complete the takeover.
A golden parachute is another defense strategy, which involves providing lucrative compensation packages (bonuses, severance pay, stock options, etc.) to key executives in the event they are terminated as a result of the takeover. This creates a financial disincentive for the acquiring company, as it would need to pay out these large sums upon completing the takeover.
In a Crown jewel defense, the target company sells or threatens to sell its most valuable assets—its “crown jewels”—if the takeover is completed. This reduces the attractiveness of the company to the acquirer, as the most desirable assets would no longer be part of the deal.
The Pac-Man defenses a more aggressive strategy in which the target company turns the tables by attempting to buy shares of the acquiring company, effectively launching a counter-takeover. While rare, this defense can deter hostile bids by making the takeover battle more costly and complex.
A White-Knight defense involves the target company seeking out a more favorable acquirer, or “white knight,” to make a friendly takeover bid. This allows the target company to avoid the hostile acquirer while still securing the benefits of a merger or acquisition.
The hostile takeover between Sanofi-Aventis and Genzyme Corp. occurred in 2010 when Sanofi, a French pharmaceutical company, wanted to buy Genzyme, a US biotech firm specializing in rare diseases. Genzyme resisted the offer, leading to conflict. Sanofi started a public campaign to pressure Genzyme’s shareholders into selling.
After months of negotiations, the two companies reached a deal in 2011. Sanofi agreed to pay $74 per share, with additional payments tied to Genzyme’s future performance, bringing the total deal value to around $20.1 billion. This acquisition allowed Sanofi to expand into the lucrative market for rare disease treatment.
The genetic testing company 23andMe went from biotech superstar to the brink of collapse. And, its most valuable asset might be its controversial customer DNA data trove.
Now, 23andMe filed for bankruptcy late Sunday night and announced the resignation of its chief executive officer Anne Wojcicki who is stepping down from her position but remains on the board of directors.
Wojcicki has so far tried unsuccessfully to rescue the business by buying it back and capping a precipitous fall for the DNA-testing company.
Posted on March 24, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Futures attached to the benchmark S&P 500 (ES=F) rose 0.6%, with NASDAQ 100 (NQ=F) futures up 0.7%. Futures tied to the Dow Jones Industrial Average (YM=F) advanced around 0.4%.
Posted on March 23, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
ByJ. Chris Miller JD
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Your personal and financial life is constantly changing. Significant changes always necessitate the need to review your life. However, a few key events trigger the need to review your estate plan. If any of the events below have occurred since you reviewed your estate plan, see a competent adviser to help you achieve your goals.
Birth of a child or grandchild.
Death of a spouse, beneficiary, guardian, trustee or personal representative.
Marriage of you or your children.
Divorce. (Review beneficiary designations and asset titling)
Move out of state. An estate is settled under the laws of the state in which the decedent resided. Certain provisions of a will that are valid in one state may not be in another.
Change in estate value. A large increase or decrease in the size of an estate may greatly affect some of the strategies that were implemented.
Changes in business. Starting, buying or selling a medical practice or other business has an impact on your estate. The addition or death of a business owner will cause a review.
Tax law changes. EGTRRA has dramatically changed the way we plan for estate taxes. It is important to note that only planning for estate taxes has been effected. Estate planning involves much more than just the motivation to reduce or eliminate taxes. Assuring that your family is financially taken care of, that children have the opportunity to go to college, that your debts are paid, that charitable desires are achieved, provisions for a needy child, proper selection of a guardian, the list goes on. Please do not use the new law as an excuse to not plan your estate.
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OVERHEARD IN THE FINANCIAL ADVISOR’S LOUNGE
From my perspective, estate planning is a team sport, and lawyers rely on financial advisers all the time to spot issues for clients. We do not share the opinion that non-lawyers are incapable of giving good advice.
The recent horrifying murder of UnitedHealthcare Group CEO Brian Thompson has called attention to the anger many Americans feel about our health care system. This tragedy has thrust the very real issue of health care costs back into the headlines.
One article on the topic, from Ken Alltucker for USA Today, offered seven reasons why Americans pay so much for health care with such poor results. When I saw the headline, I thought, “Finally, someone’s going to bring up the elephant in the room: taxes.”
The seven reasons included bloated administrative costs, lack of price transparency, overpaid specialists, higher prescription drug prices, and more. But I didn’t see a word about how, compared to other developed nations with “cheaper” health care, Americans pay far lower taxes. That omission feels like leaving a critical piece of the puzzle off the table.
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In reality, countries with universal health care are not pulling off some magic trick of efficiency. They are simply collecting the money differently—through significantly higher taxes. Americans, on the other hand, pay for health care more directly, through out-of-pocket costs and insurance premiums.
In a column last year, I did the math. Americans spend about 17.8% of GDP on health care, plus 27.7% of GDP in taxes. That’s a total of 45.5%. Now compare that to twelve European countries with universal health care. They spend a median of 11.5% of GDP on health care and collect 41.9% of GDP in taxes. Total? 53.4%. In other words, Americans are spending 7.9% less overall on healthcare and taxes combined.
The saving isn’t what it appears, though. A fair comparison of healthcare costs and taxes needs to account for the fact that universal healthcare systems cover 100% of their populations, while the U.S. system currently leaves about 8% uninsured. If you factor in the cost of covering our uninsured residents, the U.S. likely spends a comparable percentage of income on healthcare as European countries with universal systems.
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Our system is far from perfect. As the USA Todayarticle points out, administrative costs are bloated. Harvard’s David Cutler estimates up to 25% of our health spending goes toward paperwork, phone calls, and processing. Price transparency is practically nonexistent. The cost of a diagnostic test might vary from $300 to $3,000 depending on where you go. We pay much more for prescription drugs and many procedures than those same treatments cost in other developed nations. Another issue is the fee-for-service model that rewards doctors for ordering more tests and procedures, whether or not patients get better.
We can do better. Innovations like value-based care, where providers are paid for outcomes rather than procedures, could help shift the system toward real results. Greater price transparency would empower patients to make informed choices and force providers to compete. And addressing administrative inefficiencies could save billions.
Yet fixing the system requires being honest about trade-offs. If we want universal health care at European price rates, we need to accept European tax rates. That’s the part of the conversation that often gets left out. It’s easy to be angry at hospitals, insurance companies, and drug manufacturers—and yes, they all have plenty to answer for. But we also need to face the reality that we’ve chosen a system that prioritizes lower taxes over centralized health care.
Anger may have put the flaws in our health care system in the spotlight. Finding genuine solutions will require moving beyond expressions of anger and frustration. It will demand thoughtful discussions about what kind of health care system, as individuals and as a nation, that we want and how we are willing to fund it.
Posted on March 22, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
A CONTROVERSY?
By Staff Reporters
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DEFINITION
State medical boards are the agencies that license medical doctors, investigate complaints, discipline physicians who violate the medical practice act, and refer physicians for evaluation and rehabilitation when appropriate. The overriding mission of medical boards is to serve the public by protecting it from incompetent, unprofessional, and improperly trained physicians. Medical boards accomplish this by striving to ensure that only qualified physicians are licensed to practice medicine and that those physicians provide their patients with a high standard of care.
The right to practice medicine is a privilege granted by the state. Each state has laws and regulations that govern the practice of medicine and specify the responsibilities of the medical board in regulating that practice. These regulations are laid out in a state statute, usually called a medical practice act. State medical boards establish the standards for the profession through their interpretation and enforcement of this act.
Assembling a quality physician population to meet the needs of the public begins with licensure. During the process of evaluating applicants for medical licensure, state medical boards’ primary focus is on a physician’s qualifications, including undergraduate and graduate medical education, work history, and personal character.
Candidates for licensure also must successfully complete a rigorous examination designed to assess their ability to apply knowledge, concepts, and principles of health and disease that constitute the basis for safe and effective patient care.
The Federation of State Medical Boards of the United States, Inc., and the National Board of Medical Examiners (NBME) have collaborated to establish a single, 3-step examination for medical licensure in the United States, known as the United States Medical Licensing Examination (USMLE). The USMLE provides state medical boards with a common evaluation system for all licensure applicants. To assure the continued relevance of the exam, the NBME uses basic science and clinical faculty from the nation’s medical schools as well as practicing physicians, some of whom serve on state medical boards, to generate the examinations.
“… I am persuaded that licensure has reduced both the quantity and quality of medical practice…It has reduced the opportunities for people to become physicians, it has forced the public to pay more for less satisfactory service, and it has retarded technological development…I conclude that licensure should be eliminated as a requirement for the practice of medicine”
-Milton Friedman, Nobel prize-winning economist
“As a rule, regulation is acquired by the industry and is designed and operated primarily for its benefit”
-George J. Stigler Nobel Prize-winning economist
“Licensing has served to channel the development of health care services by granting an exclusive privilege and high status to practitioners relying on a particular approach to health care, a disease-oriented intrusive approach rather than a preventive approach….By granting a monopoly to a particular approach to health care, the licensing laws may serve to assure an ineffective health care system”
-Lori B. Andrews, Professor of Law, Chicago-Kent College
“Let us allow physicians, hospitals and schools to spring up where they’re needed, abolish the restrictive licensure laws, and simply invoke the laws against fraud to insure honesty among all providers of health care …That will make health care affordable for everyone”
Posted on March 21, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
Beware – Public Improvement Fees
Beware – Public Improvement Districts
By Staff Reporters
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A Public Improvement Fee (PIF) is a fee that developers may require their tenants to collect on sales transactions to pay for on-site improvements. The PIF is a fee and NOT a tax; therefore, it becomes a part of the overall cost of the sale/service and is subject to sales tax
Examples of these improvements include curbs and sidewalks, parking facilities, storm management system, sanitary sewer systems, road development (within the site) and outdoor public plazas.
Public Improvement Districts (PIDs) are a financing mechanism used to fund new developments and infrastructure improvements. PIDs are relatively easy to create and can be done by the local municipality. A majority of property owners within the district may petition a local government to create the district. Bonds can then be issued to fund a development or infrastructure improvements. Through an industry analysis and view of the current political environment, PIDs are certainly a beneficial mechanism to fund projects otherwise not feasible due to constraints on city budgets. Local elected officials will want PIDs monitored and only used in proper circumstances.
Posted on March 20, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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A medical zebra is rare a disease, one that is so rare that most doctors have not encountered a patient with that disease. Having only read about the disease in a textbook or in the case of many recently defined diseases, not at all. It is therefore difficult for medical doctors to diagnose these individuals.
The term originates from a popular saying among clinicians, “when you hear hoof-beats, think horses, not zebras”, meaning that when diagnosing a patient, one should first exclude the most common causes for a patients symptoms, before looking for rare causes. While this is a good idea in everyday practice, one must not forget to make the effort to go “zebra hunting” when the common causes don’t explain the full clinical picture. This is especially important with the current growth of genetics and personalized medicine.
Examples:
Sutton’s law – perform first the diagnostic test expected to be most useful
Occam’s razor – select from among competing hypotheses the one that makes the fewest new assumptions
Leonard’s law of physical findings – it is obvious or it is not there
Hickam’s dictum – “Patients can have as many diseases as they damn well please”
Samuel Gee – author of Medical lectures and aphorisms (1902)
James Alexander Lindsay – author of Medical axioms, aphorisms, and clinical memoranda (1924)
Maimonides – Commentary on the aphorisms of Hippocrates and Medical aphorisms of Moses (12th century)
Sagan standard – Extraordinary claims require extraordinary evidence
Twyman’s law – Any figure that looks interesting, or different, is usually wrong.
Now, a medical aphorisms is a pithy statement denoting a general truth. They have a special niche in medical discourse and writing. The use of aphorisms in medicine dates to ancient times and continues today.
Posted on March 20, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Stat: $1.2 billion. That’s how much San Diego-based Scripps Health plans to spend building a new hospital in San Marcos, California. (Becker’s Hospital Review)
Read: What WHO Director-General Tedros Adhanom Ghebreyesus said about USAID cuts. (Stat)
Pharm fresh: Check out in-depth strategies designed to help increase engagement between pharma reps and primary care clinicians. It’s all right here in Pri-Med’s research. Read the report.
Shares of Charles Schwab Corp. SCHW+1.51% rallied 1.51% to $78.73 Wednesday, on what proved to be an all-around favorable trading session for the stock market, with the S&P 500 IndexSPX+1.08% rising 1.08% to 5,675.29 and the Dow Jones Industrial AverageDJIA+0.92% rising 0.92% to 41,964.63.
SO – HOW MUCH IS A “FINANCIAL ADVISOR” REALLY WORTH?
This blog holds a rather uncomplimentary opinion of financial advisors, and the financial services and brokerage industry as a whole; deserved, or not? The entire site hints at this attitude as well, in favor of a going it alone or ME, Inc investing when possible. Nevertheless, it is reasonable to wonder how much boost in net-returns might an educated and informed, fee transparent and honest, fiduciary focused “financial advisor” add to a clients’ investment portfolio; all things being equal [ceteris paribus].
And, can it be quantified?
Well, according to Vanguard Brokerage Services®, perhaps as much as 3%? In a decade long paper from the Valley Forge, PA based mutual fund and ETF giant, Vanguard said financial advisors can generate returns through a framework focused on five wealth management principles:
• Being an effective behavioral coach: Helping clients maintain a long-term perspective and a disciplined approach is arguably one of the most important elements of financial advice. (Potential value added: up to 1.50%).
• Applying an asset location strategy: The allocation of assets between taxable and tax-advantaged accounts is one tool an advisor can employ that can add value each year. (Potential value added: from 0% to 0.75%).
• Employing cost-effective investments: This component of every advisor’s tool kit is based on simple math: Gross return less costs equals net return. (Potential value added: up to 0.45%).
• Maintaining the proper allocation through rebalancing: Over time, as investments produce various returns, a portfolio will likely drift from its target allocation. An advisor can add value by ensuring the portfolio’s risk/return characteristics stay consistent with a client’s preferences. (Potential value added: up to 0.35%).
• Implementing a spending strategy: As the retiree population grows, an advisor can help clients make important decisions about how to spend from their portfolios. (Potential value added: up to 0.70%).
Source: Financial Advisor Magazine, page 20, April 2014.
Assessment
However, Vanguard notes that while it’s possible all of these principles could add up to 3% in net returns for clients, it’s more likely to be an intermittent number than an annual one because some of the best opportunities to add value happen during extreme market lows and highs when angst or giddiness [fear and greed] can cause investors to bail on their well-thought-out investment plans.
And, is the study applicable to doctors and allied healthcare providers? Doe Vanguard have a vested interest in the topic. What about fee based versus fee-only financial advice?
Conclusion
Finally, recognize the plethora of other financial planning life-cycle topics addressed in this ME-P were not included in the Vanguard investment portfolio-only study a decade ago.
And what about today with contemporaneous internet advising, chat-rooms, linkedin, robo-advisors, reddit and the like?
Posted on March 18, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
A group of current and former employees of JPMorgan Chase (NYSE:JPM) has filed a lawsuit alleging that the company, through its prescription drug plan run by CVS Health (NYSE:CVS), overpaid for medicines, resulting in higher expenses for its workers, according to Bloomberg News.
The S&P 500 (^GSPC) gained about 0.6% to rebound for a second day in row, while the Dow Jones Industrial Average (^DJI) gained more than 350 points, or more than 0.8%. The tech-heavy NASDAQ Composite (^IXIC) rose 0.3% as “Magnificent 7” stocks, including Nvidia (NVDA) and Tesla (TSLA), faltered.
Posted on March 17, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
The Power of Attorney Mistake That Could Cost You Everything
By Rick Kahler CFP®
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Recently, reading a training manual on elder abuse, I was reminded of a financial risk that is often overlooked. One of the fastest and easiest ways to unravel your financial security is to have the wrong person gain control of your money.
The example in the manual mirrored a heartbreaking situation I once experienced with a long-term client. As her mental and physical health declined, this single woman moved into assisted living. Her newly designated power of attorney, a relative from out of town, took control of her financial affairs.
Almost immediately, without consulting us, the relative began making large withdrawals, closed her accounts, and transferred funds elsewhere. They challenged the financial plan, investments, and strategies we had established to safeguard the client’s financial security and provide for her long-term care. Even though their actions threatened the client’s wellbeing, we were powerless to stop them. Our only recourse was to report the behavior to the authorities.
This heartbreaking and frustrating experience underscored just how critical it is to be mindful when executing a Power of Attorney. Besides designating someone you trust, it is wise to build in safeguards to prevent even a well-meaning relative from inadvertently derailing a carefully constructed financial plan.
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One such safeguard is to include a financial advisor in your POA—as long as that person is a fee-only, fiduciary advisor with an obligation to act in your best interests. In many cases, advisors are hesitant to suggest this option because they are sensitive to the potential conflict of interest and do not want to appear self-serving. An unfortunate reality is that you should be cautious if an advisor, particularly one who sells products on commission, seems eager to be added to your POA.
Including your financial advisor in your POA does not mean you designate them as your agent to manage your affairs. Instead, you include a clause naming them as the professional of record you want your designated agent to continue working with. This creates continuity and accountability. It prevents your agent from replacing your advisor with someone who may be unfamiliar with your needs and goals, unqualified, or untrustworthy.
Your advisor might also recommend adding a secondary safeguard, such as naming an attorney or accountant to oversee the selection of a successor advisor in case your current advisor is unable to continue. This additional layer of protection ensures that the financial professionals guiding your portfolio remain aligned with your best interests. Taking these extra steps can save you—and your loved ones—from significant financial stress down the road.
Including safeguards in your POA is not about mistrusting your loved ones, but about equipping them with the right resources and support to act in your best interest. Financial management is complex, and it requires expertise that most people, even those with the best intentions, may not possess.
One of the hardest parts about planning for diminished financial capacity is the emotional aspect. No one likes to imagine a time when they might not be able to manage their own money. But in reality, taking steps now to protect your financial future is the ultimate act of control. It can help ensure that your wishes are respected and the financial foundation you’ve worked so hard to build remains intact.
Remember, too, that avoiding conversations often increases financial vulnerability. If you don’t have a POA or aren’t comfortable with what you do have, now is the time to bring it up with your advisor, attorney, or a trusted family member. These safeguards are about protecting yourself. They also support those you will rely on to care for you and your financial legacy,
Posted on March 16, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
DOCTOR PODIATRIC MEDICINE
By Staff Reporters
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Background: Survey research is common practice in podiatry literature and many other health-related fields. An important component of the reporting of survey results is the provision of sufficient information to permit readers to understand the validity and representativeness of the results presented. However, the quality of survey reporting measures in the body of podiatry literature has not been systematically reviewed.
Objective: To examine the reporting of response rates and nonresponse bias within survey research articles published in the podiatric literature in order to provide a foundation with regard to the development of appropriate research reporting standards within the profession.
Methods: This study reports on a secondary analysis of survey research published in the Journal of the American Podiatric Medical Association, the Foot, and the Journal of Foot and Ankle Research. 98 surveys published from 2000 to 2018 were reviewed and data abstracted regarding the report of response rates and non-response bias.
Results: 67 surveys (68.4%) report a response rate while only 36 articles (36.7%) mention non-response bias in any capacity.
Conclusions: The findings suggest that there is room for improvement in the quality of reporting response rates and nonresponse in the body of podiatric literature involving survey research. Both nonresponse and response rate should be reported to assess survey quality. This is particularly problematic for studies that contribute to best practices.
Health actuaries analyze potential risks, profits and trends that will affect their employers, which are often in the health insurance, government health services and medical provider industries. They advise companies on issuing policies to consumers based on risks, calculated premiums and upcoming changes in health-care costs.
It’s common for an actuary to have a bachelor’s degree or higher in actuary studies, mathematics or statistics. Coursework on medical terminology and hierarchy of the medical field is also beneficial. In addition to academic education, certification is also necessary to reach “professional status,” which is required by most employers.
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The professional organization, Society of Actuaries, certifies actuaries in the health and medical field. Their statistical work is commonly done with predictive tables, probability tables and life tables that are created on customized statistical analysis software such as Stata or XLSTAT.
The actuary field as a whole is growing faster than other fields, according to the Bureau of Labor Statistics [BLS]. In 2020, it expanded by 27 percent. The average annual salary for an actuary in 2010 was $87,650. More specifically, in the health insurance field, the salary was slightly higher at $91,000.
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: CONTACT: MarcinkoAdvisors@outlook.com
Posted on March 16, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
DEFINITION
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According to Wikipedia, a tontine (/ˈtɒntaɪn, -iːn, ˌtɒnˈtiːn/) is an investment linked to a living person which provides an income for as long as that person is alive. Such schemes originated as plans for governments to raise capital in the 17th century and became relatively widespread in the 18th and 19th centuries.
Tontines enable subscribers to share the risk of living a long life by combining features of a group annuity with a kind of mortality lottery. Each subscriber pays a sum into a trust and thereafter receives a periodical payout. As members die, their payout entitlements devolve to the other participants, and so the value of each continuing payout increases. On the death of the final member, the trust scheme is usually wound up.
Tontines are still common in France. They can be issued by European insurers under the Directive 2002/83/EC of the European Parliament. The Pan-European Pension Regulation passed by the European Commission in 2019 also contains provisions that specifically permit next-generation pension products that abide by the “tontine principle” to be offered in the 27 EU member states.
Questionable practices by U.S. life insurers in 1906 led to the Armstrong Investigation in the United States restricting some forms of tontines. Nevertheless, in March 2017, The New York Times reported that tontines were getting fresh consideration as a way for people to get steady retirement income.
In the United States, the difference between a Ph.D and a Sc.D is that the former is awarded to most, if not all, disciplines, while a Sc.D is awarded to science or STEM (science, technology, engineering, mathematics) disciplines.
This means that, in the United States at least, a Ph.D and a Sc.D are equal to one another in terms of telling people about an individual’s mastery of a particular skill, training, and prestige. A Ph.D holder and a Sc.D holder are viewed as peers and equals by most, if not all, American universities.
Meanwhile in Europe, according to Emily Summer, the difference between a Ph.D and a Sc.D is that the former is awarded at the start of an academic career, while the Sc.D is awarded much later, after the individual has built up an impressive body of work.
Posted on March 15, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
DEFINITION
By Staff Reporters and FTC
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Surveillance pricing is a broad term to describe the practice of linking pricing to individualized consumer data.
Companies employing it might use algorithms, personal information, and AI to set a price for their goods based on everything from where you live to your age to your browsing or credit history. The practice, sometimes called dynamic pricing or personalized pricing, is growing increasingly common, but isn’t completely new.
In 2012, the travel website Orbitz began directing people on Macs to higher hotels after realizing they often had more purchasing power. It stopped the practice after the Wall Street Journalreported on it.
Is surveillance pricing the same thing as surge pricing?Yes and no.
You might know about surge pricing from the last time you tried to call an Uber during a rainstorm. As demand skyrockets for a ride share, so does the price. This is one kind of surveillance pricing, but what the FTC is targeting appears more specific. The FTC said its probe concerns “when the pricing is based on surveillance of an individual’s personal characteristics and behavior.”
Is surveillance pricing bad?
The FTC opened its probe into companies using surveillance pricing because it’s worried about the risks it might pose to consumers
“Firms that harvest Americans’ personal data can put people’s privacy at risk. Now firms could be exploiting this vast trove of personal information to charge people higher prices,” FTC Chair Lina M. Khan said in a statement. “Americans deserve to know whether businesses are using detailed consumer data to deploy surveillance pricing, and the FTC’s inquiry will shed light on this shadowy ecosystem of pricing middlemen.”
The FTC is looking into four major areas of the practice: types of products being offered, data collection, customer and sales information, and impacts on consumers and prices.
Many Americans, it fears, don’t know when their data is being harvested and how it is affecting what they pay. “Consumers may now be subjected to surveillance pricing when they shop for anything, big or small, online or in person: a house, a car, even their weekly groceries,” the FTC said.
The FTC sent the orders for more information to Accenture, Bloomreach, Chase, Mastercard, McKinsey & Co., Pros, Revionics, and Task.
“Advancements in machine learning make it cheaper for these systems to collect and process large volumes of personal data, which can open the door for price changes based on information like your precise location, your shopping habits, or your web browsing history,” the FTC wrote.
According to Patricia Salber MD [personal communication], there are a number of reasons why direct patient access to laboratory medical results is a good idea:
Between 8 and 26% of abnormal test results, including those suspicious for cancer, are not followed up in a timely manner. Direct access could help reduce the number of times this occurs
Self-management, particularly of chronic illness has known benefits. Just like the QS people, many folks with chronic illness obtain and manage to self-acquired lab results every day via gluco-meters, home pulmonary function tests, blood pressure measurements, and so forth. Direct access to laboratory-acquired data, one could argue is a continuation of that personal responsibility
Patients want to be notified about their results in what they perceive as a timely fashion. In one study, patients who received direct notification of their bone density tests results were more likely to perceive they had timely notification compared to usual care even though there was no measurable effect on actual treatment received after three months
Being more responsible for test results could encourage consumers to try to learn more about the meaning of the test results, conceivably increasing their health literacy.
But, the arguments against direct access discussed include the following:
Patients prefer their physicians contact them directly when they have abnormal test results, although the major studies published in 2005 and 2009, preceded the extraordinary use of the internet to access health information that exists today.
There is concern over whether patients will know what to do when they receive the results – will they make erroneous interpretations or fail to contact their docs? This could be, but the intent of the proposed rule is shared access to the results. We suspect if the rule become law, docs will develop better notification mechanisms so that they reach the patient before the patient directly accesses the results or lab companies will design better lab test notifications with easy-to-understand interpretations or a whole new industry will appear that can provide instantly available individualized lab interpretation…or maybe all three of these would happen and that would be a very good thing.
Unknown impact of dual notification (doctors and patients) of lab test results on physician behavior…would docs simply shift responsibility for initiating follow-up care from themselves to their patients?
Would direct access of life-changing lab tests, such as HIV or malignancy, lead to unnecessary patient anxiety – or worse? (Conversely, is there less anxiety, desperation, or suicidal ideation if the bad news is delivered face to face?
Individuals likely may contact their physicians immediately after getting the lab results asking for a telephonic or face-to-face interpretation … it is not known how this would impact physician workload and/or potential for reimbursement [personal communication, Richard Hudson DO, Atlanta, GA].
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: CONTACT: MarcinkoAdvisors@outlook.com
Posted on March 15, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
At least eight agencies are investigating a recent fire at a Bayer executive’s New Jersey home as a possible arson, authorities said. The fire happened around 7:30 a.m. March 4th “at an occupied residence on East Lane in Madison,” the Morris County Prosecutor’s Office told CNN yesterday.
US stocks bounced back sharply on Friday to cap a volatile week on Wall Street as the risk of a government shutdown eased while investors stayed on watch for the next move in an escalating trade war. The S&P 500 (^GSPC) climbed more than 2.1% after the benchmark index sank on Thursday to close in correction territory. The NASDAQ Composite (^IXIC) jumped over 2.6% as tech stocks soared. The Dow Jones Industrial Average (^DJI) moved up more than 600 points, or 1.6%.
Yesterday March 14th was Pi Day! (Yes, the mathematical constant, although we fully support celebrating with actual pie.) Put simply, Pi—aka π—is the ratio of a circle’s circumference to its diameter. It also sneaks its way into medicine. For one, it’s part of Poiseuille’s Law, an equation that helps explain how fluid flows through tubes, including arteries and IV lines. So, whether you’re crunching numbers or crunching on a slice, Pi is definitely worth celebrating
And, today is the Ides of March!
Visualize: How private equity tangled banks in a web of debt, from the Financial Times.
Posted on March 14, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
Over Heard in the Doctor’s Lounge
By Staff Reporters
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Statistics is a discipline that deals with data, facts, and figures from which meaningful information is inferred. It involves gathering, summarizing, and analyzing data to understand trends and patterns. Statistics can be divided into two main types: descriptive statistics, which summarize data, and inferential statistics, which make predictions or inferences about a population based on a sample
But, reading statistical income information can be full of pitfalls. One needs to look at the mean and median. Both give useful information. By comparing the two, one can ascertain if there are outliers that affect the results.
Example:
If a sample of 10 physicians has one earning $1,000,000 and the other nine earning $100,000, the average (mean) income is $190,000; but the median income is $100,000.
Just using this information alone, one can tell there are some outliers that could affect the results.
–Dr. Edmond F. Mertzenich, DPM MBA [Rockford, IL]
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Example:
“Lies, damned lies, and statistics” is a phrase describing the persuasive power of statistics to bolster weak arguments, “one of the best, and best-known” critiques of applied statistics. It is also sometimes colloquially used to doubt statistics used to prove an opponent’s point.
Posted on March 14, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
An executive for insurance giant State Farm was fired this week after he was recorded on an undercover video making comments about the insurer’s premium increases in response to Southern California wildfires. Haden Kirkpatrick, who worked as State Farm’s vice president for innovation and venture capital, was surreptitiously recorded on a video published by O’Keefe Media Group. The Los Angeles Times reported that he claims he was fired over the recording.
US stocks fell on Thursday, with the S&P 500 (^GSPC) officially entering into correction territory, as economic concerns grew and investors digested the latest inflation data, President Trump’s trade offensive, and a looming US government shutdown.
The S&P 500 (^GSPC) dropped 1.4% to officially enter a correction, as it is now more than 10% off its February record high. The tech-heavy NASDAQ Composite (^IXIC), which itself entered into a correction last week, shed nearly 2% on the heels of a rebound for both gauges. The Dow Jones Industrial Average (^DJI) slid 1.3%, or nearly 550 points.
Posted on March 13, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Wikipedia suggests that Rhetoric is the art of persuasion . It is one of the three ancient arts of discourse (trivium) along with grammar and logic/dialectic.
As an academic discipline within the humanities, rhetoric aims to study the techniques that speakers or writers use to inform, persuade, and motivate their audiences.
And, according to Professor Mackenzie Hope Marcinko PhD, rhetoric also provides heuristics for understanding, discovering, and developing arguments for particular situations.
Posted on March 13, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
BEHAVIORAL ECONOMICS
By Staff Reporters
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Prospect theory is a psychological and behavioral economics theory developed by Daniel Kahneman and Amos Tversky in 1979. It explains how people make decisions when faced with alternatives involving risk, probability, and uncertainty. According to this theory, decisions are influenced by perceived losses or gains.
Example:
Amanda, a DO client, was just informed by her financial advisor that she needed to re-launch her 403-b retirement plan. Since she was leery about investing, she quietly wondered why she couldn’t DIY. Little does her FA know that she doesn’t intend to follow his advice, anyway! So, what went wrong?
The answer may be that her advisor didn’t deploy a behavioral economics framework to support her decision-making. One such framework is the “prospect theory” model that boils client decision-making into a “three step heuristic.”
Prospect theory makes the unspoken biases that we all have more explicit. By identifying all the background assumptions and preferences that clients [patients] bring to the office, decision-making can be crafted so that everyone [family, doctor and patient] or [FA, client and spouse] is on the same page. Briefly, the three steps are:
1. Simplify choices by focusing on the key differences between investment [treatment] options such as stock, bonds, cash, and index funds.
2. Understanding that clients [patients] prefer greater certainty when it comes to pursuing financial [health] gains and are willing to accept uncertainty when trying to avoid a loss [illness].
3. Cognitive processes lead clients and patients to overestimate the value of their choices thanks to survivor bias, cognitive dissonance, appeals to authority and hindsight biases.
Assessment
Much like healthcare today, the current mass-customized approaches to the financial services industry falls short of recognizing more personalized advisory approaches like prospect theory and assisted client-centered investment decision-making.
Posted on March 13, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Stock markets mostly rose Wednesday on both sides of the Atlantic as investors shrugged off Washington’s latest tariffs to focus on cooling US inflation and a Ukraine ceasefire plan.
Markets have worried that the tariffs could spark a surge in US inflation and drive a stake into the chances that the Federal Reserve cuts interest rates further. But government data released Wednesday showed US consumer inflation had slowed slightly to 2.8 percent in February — the first full month of Trump’s White House return.
That was slightly better than analysts expected. Core inflation, which excludes volatile food and energy prices, dipped to an annual rate of 3.1 percent. “The inflation data are a bright spot in the Federal Reserve’s battle against rising prices. They reinforce the expectation of three rate cuts later in 2025,” said Jochen Stanzl, chief market analyst at CMC Markets.
“Sentiment on Wall Street is so negative that these positive inflation figures could spark a broader recovery in stock prices,” he added.
Wall Street’s main stock indices mostly closed higher with the tech-heavy NASDAQ Composite rising 1.2 percent. But the Dow dipped into the red, losing 0.2 percent.
Some Stupid Things Financial Advisors Say to Physician Clients
A few years ago and just for giggles, colleague Lon Jefferies MBA CFP® and I collected a list of dumb-stupid things said by some Financial Advisors to their doctor, dentist, nurse and and other medical professional clients, along with some recommended under-breath rejoinders:
“They don’t have any debt except for a mortgage and student loans.” OK. And I’m vegan except for bacon-wrapped steak.
“Earnings were positive before one-time charges.” This is Wall Street’s equivalent of, “Other than that Mrs. Lincoln; how was the play?”
“Earnings missed estimates.” No. Earnings don’t miss estimates; estimates miss earnings. No one ever says “the weather missed estimates.” They blame the weatherman for getting it wrong. Finance is the only industry where people blame their poor forecasting skills on reality.
“Earnings met expectations, but analysts were looking for a beat.” If you’re expecting earnings to beat expectations, you don’t know what the word “expectations” means.
“It’s a Ponzi scheme.” The number of things called Ponzi schemes that are actually Ponzi schemes rounds to zero. It’s become a synonym for “thing I disagree with.”
“The [thing not going perfectly] crisis.” Boy who cried wolf, meet analyst who called crisis.
“He predicted the market crash in 2008.” He also predicted a crash in 2006, 2004, 2003, 2001, 1998, 1997, 1995, 1992, 1989, 1984, 1971…
“More buyers than sellers.” This is the equivalent of saying someone has more mothers than fathers. There’s one buyer and one seller for every trade. Every single one.
“Stocks suffer their biggest drop since September.” You know September was only six weeks ago, right?
“We’re cautiously optimistic.” You’re also an oxymoron.
[Guy on TV]: “It’s time to [buy/sell] stocks.” Who is this advice for? A 20-year-old with 60 years of investing in front of him, or a 82-year-old widow who needs money for a nursing home? Doesn’t that make a difference?
“We’re neutral on this stock.” Stop it. You don’t deserve a paycheck for that.
“There’s minimal downside on this stock.” Some lessons have to be learned the hard way.
“We’re trying to maximize returns and minimize risks.” Unlike everyone else, who are just dying to set their money ablaze!
“Shares fell after the company lowered guidance.” Guys, they just proved their guidance can be wrong. Why are you taking this new one seriously?
“Our bullish case is conservative.” Then it’s not a bullish case. It’s a conservative case. Those words mean opposite things.
“We look where others don’t.” This is said by so many investors that it has to be untrue most of the time.
“Is [X] the next black swan?” Nassim Taleb’s blood pressure rises every time someone says this. You can’t predict black swans. That’s what makes them dangerous.
“We’re waiting for more certainty.” Good call. Like in 1929, 1999 and 2007, when everyone knew exactly what the future looked like. Can’t wait!
“The Dow is down 50 points as investors react to news of [X].” Stop it – you’re just making stuff up. “Stocks are down and no one knows why” is the only honest headline in this category.
“Investment guru [insert name] says stocks are [insert forecast].” Go to Morningstar.com. Look up that guru’s track record against their benchmark. More often than not, their career performance lags an index fund. Stop calling them gurus.
“We’re constructive on the market.” I have no idea what that means. I don’t think you do, either.
“[Noun] [verb] bubble.” (That’s a sarcastic observation from investor Eddy Elfenbein.)
“Investors are fleeing the market.” Every stock is owned by someone all the time.
“We expect more volatility.” There has never been a time when this was not the case. Let me guess, you also expect more winters?
“This is a strong buy.” What do I do with this? Click the mouse harder when placing the order in my brokerage account?
“He was tired of throwing his money away renting, so he bought a house.” He knows a mortgage is renting money from a bank, right?
“This is a cyclical bull market in a secular bear.” Vapid nonsense.
“Will Obamacare ruin the economy?” No. And get a grip.
So, don’t let these aphorisms blind you to the critical thinking skills you learned in college, honed in medical school and apply every day in life.
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: CONTACT: MarcinkoAdvisors@outlook.com
Posted on March 11, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Inattentional Blindness: Is a psychological phenomenon where individuals fail to notice unexpected stimuli in their visual field when their attention is focused on a specific task or object.
This occurs because the brain prioritizes processing information relevant to the task at hand, leading to a temporary inability to perceive other, potentially significant details in the environment. Experiments, such as the famous “invisible gorilla” study, illustrate how people can completely miss prominent objects or events when their attention is directed elsewhere.
And, according to colleague Dan Ariely PhD, inattentional blindness highlights the limitations of human perception and attention, emphasizing that what we see is often influenced by where we focus our cognitive resources.
Posted on March 11, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
US stocks plunged on Monday as investors processed growing concerns about the health of the US economy after President Trump and his top economic officials acknowledged the possibility of a potential rough patch.
The Dow Jones Industrial Average (^DJI) fell nearly 900 points, or over 2%, while the benchmark S&P 500 (^GSPC) dropped around 2.7% after the index posted its worst week since September. The tech-heavy NASDAQ Composite (^IXIC) fell 4% in its worst day since 2022, as the “Magnificent Seven” stocks led the sell-off. Tesla’s (TSLA) rout continued, plunging 15% and officially wiping out the gains it had made in the wake of Trump’s election win. Nvidia (NVDA), Apple (AAPL), Google parent Alphabet (GOOG), and Meta (META) all each lost more than 4%.
Key inflation data includes the Consumer Price Index (CPI) and Producer Price Index (PPI) on Wednesday and Thursday could help set the tone, though economic growth concerns seem to have replaced inflation as the prime concern. The S&P 500 index (SPX) dropped more than 3% last week, the worst performance since September.
However, the U.S. economy “is in a good place” despite recent policy uncertainty, Federal Reserve Chairman Jerome Powell said Friday. He sees no need to hurry rate cuts until there’s more policy clarity, Bloomberg reported. Stocks rallied on Powell’s words late Friday, but Monday’s early action indicates that rallies continue being sold, and the Cboe Volatility Index (VIX) rose above 26 as investors piled into risk-off assets like bonds. The 200-day moving average of 5,734 for the SPX remains a key technical support area, and the SPX was on pace to open below that Monday, now more than 6% off of all-time highs but not yet in –10% correction territory.
During the January 2025 J.P. Morgan Healthcare Conference, Teladoc’s executives announced the company has partnered with Amazon Health Services, joining its Health Benefits Connector program. The program was rolled out in January 2024 and connects Amazon customers with virtual care benefits covered by their insurance plan or employer; if eligible, customers are able to apply to join the program(s).
Teladoc is the fifth company to join Amazon’s Health Benefits Connector program (formerly known as Health Conditions Programs), along with digital physical therapy company Hinge Health; chronic condition management company Omada; online therapy and mental health firm Rula; and behavioral healthcare provider Talkspace. (Read more…)
Posted on March 9, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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A Morton’s fork is a type of false dilemma in which contradictory observations lead to the same conclusion.
Morton’s Fork:Claims its origin from John Morton, the Archbishop of Canterbury, a public policymaker who used convoluted and contradictory logic to establish tax laws in the mid-15th century.
He contended that whoever lived humbly must be saving much money and hence would be able to pay higher taxes; and those that lived lavish lives were obviously rich, so they could also pay higher taxes.
In other words: a Hobsons Choice between two equally unpleasant alternatives.
Posted on March 8, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
AGREE or DISAGREE?
By Staff Reporters
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US Treasury Secretary Scott Bessent made waves yesterday with his comment that the American economy is facing a “detox period.”
Should we be seeing that this economy that we inherited [is] starting to roll a bit? Sure. And look, there’s going to be a natural adjustment as we move away from public spending to private spending. The market and the economy have just become hooked, and we’ve become addicted to this government spending, and there’s going to be a detox period. There’s going to be a detox” .
Bessent, a former hedge-fund manager, said during a CNBC interview.
“Employment should be from private companies, not from government. And I’m confident, if we have the right policies, it will be a very smooth transition.”
Bessent said, in an apparent reference to the layoffs of federal workers executed in large part by the entity known as the Department of Government Efficiency, which is run by Trump adviser Elon Musk.
Posted on March 8, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Walgreens Boots Alliance says it has agreed to be acquired by private equity firm Sycamore Partners as the struggling retailer looks to turn itself around after years of losing money. Walgreens said Thursday that Sycamore will pay $11.45 per share, giving the deal an equity value just under $10 billion. Shareholders could eventually receive up to an
Posted on March 7, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
US stocks tanked to session lows on Thursday after more tariff whiplash from the Trump administration.
The Dow Jones Industrial Average (^DJI) fell 1%, or over 400 points, while the S&P 500 (^GSPC) dropped nearly 2%. The tech-heavy NASDAQ Composite (^IXIC) plummeted more than 2.6%. The Nasdaq is now more than 10% off its December record high and officially entered into correction territory.
Trade-war uncertainty has persisted as investors weighed how far President Donald Trump would be willing to negotiate on tariffs. On Thursday, Trump said he would pause tariffs on some Mexican goods, and the White House later said the delay also includes goods from Canada.
Posted on March 6, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Endometriosis Awareness Week, which brings attention to the chronic disease that affects about 10% of reproductive-age patients with uteruses worldwide. There’s still no known cure, due in part to research being underfunded—in 2022, the NIH allocated just $16 million, or $2 per patient, to endometriosis research, according to a 2024 study.
After sliding earlier in the session, the tech-heavy NASDAQ Composite (^IXIC) led the gains, rising more than 1.4%. Meanwhile, the Dow Jones Industrial Average (^DJI) and the S&P 500 (^GSPC) rose roughly 1.1%.
Stocks lifted higher after the White House delayed by one month auto tariffs that could significantly impact US automakers Ford (F), GM (GM), and Stellantis (STLA). Shares of all three automakers were at least 5% higher.
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STUPID COMMENTS: Financial Advisors Say to Physician Clients
BY DR. DAVID EDWARD MARCINKO; MBA MEd CMP®
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SPONSOR: http://www.MarcinkoAssociates.com
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Some Stupid Things Financial Advisors Say to Physician Clients
A few years ago and just for giggles, colleague Lon Jefferies MBA CFP® and I collected a list of dumb-stupid things said by some Financial Advisors to their doctor, dentist, nurse and and other medical professional clients, along with some recommended under-breath rejoinders:
So, don’t let these aphorisms blind you to the critical thinking skills you learned in college, honed in medical school and apply every day in life.
COMMENTS APPRECIATED
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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 a RFP for speaking engagements: CONTACT: MarcinkoAdvisors@outlook.com
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