The Top Ten Financial Scams in the USA

Posted on February 23, 2026 by Dr. David Edward Marcinko MBA MEd CMP™

Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Financial scams have become a defining challenge of the modern American economy. As technology evolves and financial systems grow more complex, scammers continually adapt, exploiting vulnerabilities in human psychology, digital infrastructure, and regulatory gaps. While the specific tactics shift over time, the underlying goal remains constant: to separate people from their money. Understanding the most prevalent and damaging scams is essential for building a more informed and resilient public. The following analysis explores ten of the most significant financial scams in the United States, examining how they operate and why they continue to succeed.

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1. Phishing and Identity Theft

Phishing remains one of the most widespread and effective financial scams in the country. It relies on deception rather than technical sophistication, tricking individuals into revealing sensitive information such as Social Security numbers, bank credentials, or credit card details. Scammers often impersonate trusted institutions—banks, government agencies, or major retailers—using emails, text messages, or fake websites. Once personal data is obtained, criminals can open fraudulent accounts, drain bank balances, or sell the information on illicit markets. The persistence of phishing stems from its simplicity and the sheer volume of attempts; even a tiny success rate yields substantial profit.

2. IRS and Government Impersonation Scams

Government impersonation scams exploit fear and authority. Fraudsters pose as IRS agents, Social Security officials, or law enforcement officers, claiming the victim owes money, faces arrest, or must verify personal information. These scams often target older adults, immigrants, or individuals unfamiliar with government procedures. The scammers’ aggressive tone and threats of legal consequences create a sense of urgency that overrides rational judgment. Despite widespread public warnings, these scams continue to thrive because they tap into deep-seated anxieties about government power and financial responsibility.

3. Investment and Ponzi Schemes

Investment scams, including Ponzi and pyramid schemes, have a long history in the United States. They promise high returns with little or no risk—an enticing proposition that often lures even financially savvy individuals. Ponzi schemes rely on using new investors’ money to pay earlier participants, creating the illusion of legitimate profit. Eventually, the scheme collapses when new investments dry up. These scams succeed because they exploit trust, often spreading through social networks, religious communities, or professional circles. The combination of social pressure and the allure of easy wealth makes them particularly destructive.

4. Romance Scams

Romance scams have surged with the rise of online dating platforms and social media. Scammers create fake personas, build emotional connections with victims, and eventually fabricate crises that require financial assistance. These scams are not only financially devastating but emotionally traumatic. Victims often feel ashamed, which can delay reporting and allow scammers to continue operating. The success of romance scams lies in their slow, deliberate manipulation; by the time money is requested, the victim may feel deeply bonded to someone who never existed.

5. Tech Support Scams

Tech support scams prey on individuals’ fear of losing access to their devices or data. Scammers pose as representatives from major technology companies, claiming the victim’s computer is infected or compromised. They persuade victims to grant remote access or pay for unnecessary services. Once inside the device, scammers may install malware, steal information, or lock the user out entirely. These scams often target older adults or those less comfortable with technology, but anyone can fall victim during a moment of panic.

6. Credit Repair and Debt Relief Scams

In a country where many people struggle with debt, credit repair and debt relief scams exploit financial vulnerability. Fraudulent companies promise to erase bad credit, negotiate with creditors, or eliminate debt entirely. They often charge high upfront fees and deliver little or nothing in return. Some even instruct clients to engage in illegal practices, such as creating new identities. These scams persist because they offer hope to people who feel overwhelmed by financial pressure, making them susceptible to unrealistic promises.

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7. Lottery and Sweepstakes Scams

Lottery scams typically begin with a message claiming the recipient has won a large prize. To collect it, the victim must pay taxes, processing fees, or insurance costs. Of course, no prize exists. These scams often target older adults, who may be more trusting or more likely to respond to unsolicited communication. The psychological hook is powerful: the idea of sudden wealth can cloud judgment, especially when the scammer uses official‑sounding language and fabricated documentation.

8. Business Email Compromise (BEC)

BEC scams are among the most financially damaging schemes affecting American businesses. Criminals infiltrate or spoof corporate email accounts to trick employees into wiring funds or revealing sensitive information. These scams often involve extensive research and social engineering, making them highly convincing. A scammer might impersonate a CEO requesting an urgent transfer or a vendor sending updated payment instructions. Because the communication appears legitimate and the transactions are often routine, victims may not realize anything is wrong until the money is gone.

9. Mortgage and Real Estate Scams

Real estate transactions involve large sums of money, making them prime targets for fraud. Scammers may pose as lenders offering unrealistic mortgage terms, title companies requesting wire transfers, or landlords advertising properties they do not own. In some cases, criminals steal the identities of property owners and attempt to sell homes without their knowledge. These scams exploit the complexity of real estate processes, where multiple parties and documents create opportunities for deception.

10. Cryptocurrency Scams

The rapid growth of cryptocurrency has created fertile ground for new forms of fraud. Scammers promote fake coins, fraudulent exchanges, or high‑yield investment programs. Some impersonate celebrities or financial influencers to lend credibility to their schemes. Because cryptocurrency transactions are irreversible and often anonymous, victims have little recourse once funds are transferred. The combination of technological novelty, speculative excitement, and limited regulation makes this one of the fastest‑growing categories of financial scams in the United States.

Conclusion

Financial scams in the United States are diverse, adaptive, and increasingly sophisticated. They exploit human emotions—fear, hope, trust, loneliness—as much as technological vulnerabilities. While law enforcement and regulatory agencies work to combat these schemes, public awareness remains the most powerful defense. Understanding how these scams operate empowers individuals to recognize warning signs, question suspicious requests, and protect themselves and their communities. As long as money and technology continue to evolve, scammers will follow, making vigilance an essential part of modern financial life.

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FLYNN: The I.Q. Effect

Posted on February 21, 2026 by Dr. David Edward Marcinko MBA MEd CMP™

Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.HealthDictionarySeries.org

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Understanding a Century of Rising IQ Scores

The Flynn Effect is one of the most intriguing and debated findings in the study of human intelligence. Named after political scientist James R. Flynn, who brought widespread attention to the phenomenon in the 1980s, it refers to the steady and substantial rise in average IQ scores across many countries throughout the twentieth century. Although intelligence tests are designed so that the average score remains 100, test publishers must periodically “renorm” them because people keep performing better than the previous generation. The scale of this rise is striking: in some nations, average scores have increased by roughly three points per decade. The Flynn Effect forces us to rethink what IQ tests measure, how societies change over time, and what “intelligence” even means.

At its core, the Flynn Effect highlights the dynamic relationship between human cognition and the environment. IQ tests do not measure intelligence in a vacuum; they measure how well individuals navigate the kinds of abstract, symbolic problems that modern societies increasingly demand. One of Flynn’s key insights was that the twentieth century brought a shift toward what he called “scientific spectacles”—a way of thinking that emphasizes classification, hypothetical reasoning, and abstraction. These cognitive habits are not innate; they are cultivated through schooling, technology, and daily life. As societies modernized, more people became accustomed to the mental tools that IQ tests reward.

Several explanations have been proposed to account for the rise in scores, and no single factor tells the whole story. One major contributor is improved education. Over the past century, schooling has become more widespread, more rigorous, and more focused on analytical reasoning. Children spend more years in school, encounter more complex curricula, and are exposed to problem‑solving tasks that mirror the structure of IQ test items. Even subtle changes—like the shift from rote memorization to conceptual understanding—can have a large cumulative effect on cognitive performance.

Another important factor is the transformation of everyday life. Modern work environments often require employees to manipulate symbols, operate technology, and adapt to rapidly changing tasks. Even leisure activities have become more cognitively demanding. Video games, digital interfaces, and information‑rich media encourage multitasking, spatial reasoning, and strategic thinking. These experiences may not directly teach the content of IQ tests, but they strengthen the underlying cognitive skills that such tests measure.

Nutrition has also been proposed as a contributor. Better prenatal care, reduced exposure to environmental toxins, and improved childhood nutrition can influence brain development. While nutrition alone cannot explain the full magnitude of the Flynn Effect, it likely plays a role, especially in countries that experienced dramatic improvements in public health during the twentieth century.

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Family size and parenting practices may also matter. Smaller families allow parents to invest more time and resources in each child. Parenting has become more child‑centered, with greater emphasis on verbal interaction, exploration, and educational enrichment. These shifts create environments that nurture the kinds of cognitive abilities reflected in IQ tests.

Despite the broad upward trend, the Flynn Effect is not uniform across all domains of intelligence. Gains tend to be largest on tests that measure fluid reasoning—abstract problem‑solving and pattern recognition—rather than crystallized knowledge such as vocabulary. This pattern supports the idea that environmental complexity, rather than simple memorization, drives the effect. It also suggests that IQ gains do not necessarily mean people are “smarter” in a general sense; instead, they may be better adapted to the cognitive demands of modern life.

In recent years, some countries have reported a slowing or even reversal of the Flynn Effect. This has sparked intense debate. Some argue that the earlier gains were driven by rapid modernization, and once societies reached a certain level of development, the effect naturally plateaued. Others point to changes in education, technology use, or immigration patterns. Still others suggest that the apparent decline may reflect changes in test design rather than real cognitive shifts. The truth is likely a mix of these factors, and the debate underscores how complex and multifaceted intelligence is.

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The Flynn Effect also raises philosophical questions. If IQ scores can rise so dramatically over a few generations, what does that say about the nature of intelligence? Are we measuring an innate trait, or a set of skills shaped by culture and environment? Flynn himself argued that intelligence is not a fixed quantity but a reflection of the cognitive tools that societies value and cultivate. In his view, rising IQ scores reveal not biological evolution but cultural evolution—a shift in how people think about the world.

Ultimately, the Flynn Effect challenges simplistic interpretations of IQ. It reminds us that human cognition is deeply intertwined with social, economic, and cultural forces. It shows that intelligence is not static but responsive to the world we build around ourselves. And it invites us to consider how future changes—technological, educational, or environmental—might continue to reshape the landscape of human thought.

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MILTON FRIEDMAN: Four Types of Money

Posted on February 21, 2026 by Dr. David Edward Marcinko MBA MEd CMP™

Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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Milton Friedman, one of the most influential economists of the twentieth century, devoted much of his work to understanding the nature of money and its role in the economy. Although he is best known for his advocacy of monetary policy rules and his critique of discretionary central banking, Friedman also offered a clear conceptual framework for understanding different forms of money. His discussion of the “four types of money” helps illuminate how money functions, how it evolves, and why its various forms matter for economic stability. These categories—commodity money, commodity‑backed money, fiat money, and fiduciary money—capture the historical progression of monetary systems and the institutional choices societies make in managing their currencies.

Friedman’s first category, commodity money, refers to money that has intrinsic value. Gold, silver, and other precious metals are the classic examples. In this system, the money itself is the valuable good; the coin is worth its weight in metal. Friedman appreciated the historical importance of commodity money because it emerged spontaneously in markets without central planning. People gravitated toward commodities that were durable, divisible, portable, and scarce. However, he also emphasized its limitations. Commodity money ties the money supply to the availability of the underlying resource, which can create instability. Gold discoveries can cause inflation, while shortages can cause deflation. For Friedman, the key issue was that commodity money makes the money supply dependent on mining rather than on the needs of the economy. This rigidity, he argued, is not ideal for modern economic systems that require flexibility and predictability.

The second type, commodity‑backed money, represents a transitional stage between pure commodity money and modern monetary systems. In this arrangement, paper notes or coins circulate, but they are redeemable for a fixed quantity of a commodity such as gold. The gold standard is the most famous example. Friedman acknowledged that commodity‑backed systems solved some of the practical problems of carrying and storing precious metals. They also introduced a degree of trust and institutional structure, since governments or banks promised convertibility. Yet Friedman was critical of the gold standard’s constraints. He argued that tying the money supply to gold reserves limited governments’ ability to respond to economic crises. The Great Depression, in his view, was worsened by the Federal Reserve’s failure to expand the money supply because it was constrained by gold convertibility. For Friedman, the gold standard was neither flexible enough nor stable enough to support a growing, complex economy.

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The third category, fiat money, is the system used by most modern economies. Fiat money has no intrinsic value and is not backed by a commodity. Its value comes from government decree and, more importantly, from public confidence. Friedman recognized that fiat money allows for a more adaptable money supply, which can be adjusted to meet the needs of the economy. However, he also believed that fiat money introduces significant risks. Without the discipline imposed by a commodity standard, governments may be tempted to expand the money supply excessively, leading to inflation. Friedman’s famous statement—“inflation is always and everywhere a monetary phenomenon”—reflects his belief that fiat money systems require strict rules to prevent abuse. He argued that central banks should follow predictable, rule‑based policies, such as increasing the money supply at a constant rate, to avoid the destabilizing effects of discretionary monetary decisions.

The fourth type, fiduciary money, is closely related to fiat money but emphasizes the role of trust and financial institutions. Fiduciary money includes bank deposits, checks, and other forms of money that exist primarily as accounting entries rather than physical currency. These forms of money rely on the confidence that banks will honor withdrawals and that the financial system will remain stable. Friedman viewed fiduciary money as an essential component of modern economies, but he also saw it as a source of vulnerability. Bank failures, credit contractions, and financial panics can all disrupt the supply of fiduciary money. His work with Anna Schwartz in A Monetary History of the United States highlighted how the collapse of the banking system during the Great Depression caused a severe contraction in the money supply, deepening the economic downturn. For Friedman, the lesson was clear: a stable monetary system requires not only sound government policy but also a well‑regulated and resilient banking sector.

Taken together, Friedman’s four types of money illustrate the evolution of monetary systems from tangible commodities to abstract financial instruments. Each type reflects a different balance between stability, flexibility, and trust. Commodity money offers intrinsic value but lacks adaptability. Commodity‑backed money introduces institutional structure but remains constrained by physical resources. Fiat money provides flexibility but requires disciplined policy to maintain stability. Fiduciary money expands the money supply through financial intermediation but depends on the health of the banking system.

Friedman’s analysis ultimately underscores his broader belief that the key to a stable economy is a predictable and well‑managed money supply. Regardless of the form money takes, he argued that economic stability depends on avoiding large swings in the quantity of money. His framework for understanding the four types of money remains relevant today, especially as new forms of digital and electronic money continue to emerge. By examining the strengths and weaknesses of each type, Friedman provided a foundation for thinking about how monetary systems can best support economic growth, stability, and public confidence.

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INTERNET PROTOCOL: Address Defined

Posted on February 20, 2026 by Dr. David Edward Marcinko MBA MEd CMP™

Dr. David Edward Marcinko; MBA MEd

SPONSOR: http://www.HealthDictionarySeries.org

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An Explanation of What an IP Address Is

An Internet Protocol (IP) address is a numerical identifier assigned to network interfaces participating in an IP‑based network. It functions as the cornerstone of packet‑switched communication, enabling devices to locate, identify, and exchange data across interconnected networks. At a technical level, an IP address encodes both host identity and network topology, allowing routers to forward packets efficiently through hierarchical addressing structures.

IP Address Structure and Protocol Versions

The two dominant versions of the Internet Protocol—IPv4 and IPv6—define the format and semantics of IP addressing.

IPv4, defined in RFC 791, uses a 32‑bit address space. These 32 bits are typically represented in dotted‑decimal notation, divided into four octets. The address space provides $2^{32}$ possible addresses, roughly 4.3 billion. IPv4 addresses are logically divided into network and host portions, historically using classful addressing (Classes A, B, C), though modern networks rely on Classless Inter‑Domain Routing (CIDR). CIDR allows arbitrary prefix lengths, expressed as a suffix such as /24, enabling more efficient allocation and route aggregation.

IPv6, defined in RFC 8200, expands the address space to 128 bits, represented in eight groups of hexadecimal values separated by colons. The enormous address space— $2^{128}$ possible addresses—supports hierarchical routing, stateless address autoconfiguration (SLAAC), and built‑in support for multicast and anycast addressing. IPv6 eliminates broadcast traffic entirely, replacing it with more efficient multicast mechanisms.

Address Types and Scopes

IP addresses can be categorized by scope and function:

Unicast: Identifies a single network interface. Most traffic on the internet is unicast.
Multicast: Identifies a group of interfaces; packets are delivered to all group members.
Broadcast (IPv4 only): Targets all hosts on a local network segment.
Anycast (primarily IPv6): Assigned to multiple interfaces; packets are routed to the nearest instance based on routing metrics.

Additionally, addresses can be public (globally routable) or private (RFC 1918 for IPv4, Unique Local Addresses for IPv6). Private addresses require Network Address Translation (NAT) to communicate with the public internet, a workaround that became essential due to IPv4 exhaustion.

Static vs. Dynamic Assignment

IP addresses may be assigned statically or dynamically:

Static addressing involves manual configuration and is common for servers, routers, and infrastructure requiring predictable reachability.
Dynamic addressing uses the Dynamic Host Configuration Protocol (DHCP). DHCP automates address assignment, lease renewal, and configuration of parameters such as default gateways and DNS servers.

In IPv6 networks, dynamic assignment may use DHCPv6 or SLAAC. SLAAC allows hosts to generate their own addresses using router advertisements and interface identifiers, reducing administrative overhead.

Routing and Packet Delivery

IP addresses are integral to routing—the process by which packets traverse networks. When a host sends a packet, it encapsulates data in an IP header containing source and destination addresses. Routers examine the destination address and consult their routing tables to determine the next hop. Routing protocols such as OSPF, BGP, and IS‑IS maintain these tables by exchanging topology information.

The hierarchical nature of IP addressing enables route aggregation, reducing the size of global routing tables. For example, a provider may advertise a single /16 prefix representing thousands of customer networks.

DNS and Address Resolution

Human‑readable domain names must be translated into IP addresses before communication can occur. The Domain Name System (DNS) performs this translation. When a user enters a URL, the system queries DNS resolvers, which return the corresponding A (IPv4) or AAAA (IPv6) records.

On local networks, the Address Resolution Protocol (ARP) maps IPv4 addresses to MAC addresses. IPv6 uses Neighbor Discovery Protocol (NDP) for similar functionality, leveraging ICMPv6 messages.

Security and Privacy Considerations

IP addresses reveal network topology and can expose approximate geographic location. Attackers may use them for reconnaissance, scanning, or targeted attacks. Techniques such as NAT, VPNs, and IPv6 privacy extensions help mitigate exposure by masking or rotating interface identifiers.

Conclusion

An IP address is far more than a simple identifier; it is a fundamental component of the Internet Protocol suite, enabling routing, addressing, and communication across global networks. Its structure, allocation mechanisms, and interaction with routing and resolution protocols form the backbone of modern digital infrastructure. As the internet continues to scale and diversify, the role of IP addressing—particularly IPv6—remains central to the performance, security, and scalability of global communication systems.

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The Net Investment Income Tax

Posted on February 20, 2026 by Dr. David Edward Marcinko MBA MEd CMP™

Dr. Gary Bode; MSA CPA CMP

Dr. David Edward Marcinko; MBA MEd CMP

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Purpose, Scope and Impact

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

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

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

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

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

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

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

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

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RISK MANAGEMENT: For Physicians

Posted on February 19, 2026 by Dr. David Edward Marcinko MBA MEd CMP™

Dr. David Edward Marcinko, MBA MEd

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Risk management has become an essential component of modern medical practice, shaping how physicians deliver care, communicate with patients, and navigate an increasingly complex healthcare environment. While medicine has always involved uncertainty, today’s physicians face heightened scrutiny, evolving regulations, and rising patient expectations. Effective risk management is not merely about avoiding lawsuits; it is about fostering safer clinical environments, strengthening trust, and supporting high‑quality care. When approached proactively, it becomes a framework that protects both patients and practitioners.

At its core, risk management begins with recognizing the areas where errors, misunderstandings, or system failures are most likely to occur. Clinical decision‑making is an obvious focal point. Physicians must constantly balance diagnostic possibilities, weigh treatment options, and consider potential complications. Even with strong clinical judgment, risks arise when information is incomplete, when symptoms are ambiguous, or when time pressures limit thorough evaluation. To mitigate these challenges, physicians increasingly rely on structured clinical protocols, decision‑support tools, and multidisciplinary collaboration. These strategies help reduce variability in care and ensure that critical steps are not overlooked.

Communication is another central pillar of risk management. Many malpractice claims stem not from clinical mistakes but from breakdowns in communication—unclear explanations, unmet expectations, or perceived dismissiveness. Physicians who take the time to listen carefully, explain diagnoses and treatment plans in accessible language, and invite questions create a foundation of trust that can prevent conflict later. Informed consent is a particularly important aspect of this process. When patients fully understand the benefits, risks, and alternatives of a proposed intervention, they are better equipped to make decisions and less likely to feel blindsided if complications arise. Clear documentation of these conversations further strengthens the physician’s position and ensures continuity of care.

Documentation itself is a powerful risk‑management tool. Accurate, timely, and thorough medical records serve multiple purposes: they guide clinical decision‑making, support communication among care teams, and provide a factual account of events if questions arise later. Physicians who document not only what they did but why they made certain decisions create a transparent narrative that reflects thoughtful, patient‑centered care. Conversely, incomplete or inconsistent records can create vulnerabilities, even when the care provided was appropriate.

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Another important dimension of risk management involves staying current with medical knowledge and regulatory requirements. Medicine evolves rapidly, and outdated practices can expose physicians to unnecessary risk. Continuing education, peer review, and participation in quality‑improvement initiatives help physicians maintain competence and identify areas for improvement. Regulatory compliance—whether related to privacy laws, prescribing rules, or reporting obligations—is equally critical. Violations, even unintentional ones, can lead to legal consequences and damage professional credibility.

Systems‑based risk management has also gained prominence. Many errors arise not from individual negligence but from flawed processes or communication gaps within healthcare organizations. Physicians who engage in system‑level improvements—such as refining hand off procedures, participating in morbidity and mortality reviews, or advocating for safer workflows—contribute to a culture of safety that benefits everyone. This collaborative approach recognizes that risk management is not solely the responsibility of individual clinicians but a shared commitment across the healthcare team.

Emotional intelligence plays a surprisingly influential role as well. When adverse events occur, patients and families often look to the physician for honesty, empathy, and reassurance. A compassionate response can de‑escalate tension and preserve the therapeutic relationship, even in difficult circumstances. Many institutions now encourage physicians to participate in disclosure training, which helps them navigate these conversations with clarity and sensitivity. Addressing the emotional impact on physicians themselves is equally important; burnout, fatigue, and stress can impair judgment and increase the likelihood of errors. Supporting physician well‑being is therefore an indirect but vital component of risk management.

Ultimately, effective risk management is not about practicing defensively or avoiding complex cases. It is about creating an environment where safety, transparency, and continuous improvement are woven into everyday practice. Physicians who embrace these principles are better equipped to navigate uncertainty, maintain strong patient relationships, and deliver care that aligns with both ethical and professional standards. In a healthcare landscape that continues to evolve, risk management remains a dynamic and indispensable part of responsible medical practice.

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Common Investing Contradictions

Posted on February 19, 2026 by Dr. David Edward Marcinko MBA MEd CMP™

Dr. David Edward Marcinko; MBA MEd CMP

Eugene Schmuckler; PhD MBA MEd CTS

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1. “Buy the dip” vs. “Don’t catch a falling knife”

A falling price is either a bargain or a warning sign — and you only know which after the fact.

2. “Time in the market beats timing the market” vs. “Price matters”

Long-term compounding is powerful, yet buying at the wrong valuation can cripple returns for decades.

3. “Diversify” vs. “Concentrate to build wealth”

Broad diversification protects you.
Concentration is how most fortunes are made.

4. “Be greedy when others are fearful” vs. “The trend is your friend”

Contrarianism says go against the crowd.
Trend-following says go with it.

5. “Past performance doesn’t predict future results” vs. “Winners tend to keep winning”

Momentum is real.
So is mean reversion.

6. “High risk, high reward” vs. “High risk often means high loss”

Risk can lead to outsized gains — or wipeouts.
The line between the two is rarely clear in real time.

7. “Cash is trash” vs. “Cash is king”

Holding cash hurts returns during bull markets.
Holding cash is priceless during crashes.

8. “Stay the course” vs. “Adapt to changing conditions”

Discipline matters.
So does flexibility when the world shifts.

9. “Buy what you know” vs. “Your circle of competence limits you”

Familiarity helps you understand a business.
But sticking only to what you know can leave you under-diversified or missing opportunities.

10. “Markets are efficient” vs. “Markets are driven by human emotion”

Prices often reflect all available information.
Until they don’t — and fear or euphoria takes over.

11. “Don’t try to beat the market” vs. “Someone has to beat the market”

Indexing works for most people.
But the market’s returns come from a minority of big winners — held by someone.

12. “Buy low, sell high” vs. “Low can go lower, high can go higher”

Value investors love bargains.
Momentum investors love strength.
Both can be right — and wrong.

13. “Patience pays” vs. “Opportunity cost is real”

Holding for decades can create massive wealth.
But holding the wrong thing for decades destroys it.

14. “Real estate always goes up” vs. “Real estate crashes happen”

Property is a long-term wealth builder.
Until leverage turns it into a liability.

15. “Follow expert advice” vs. “Experts disagree on everything”

Analysts, economists, and fund managers all have data.
They still reach opposite conclusions.

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PRIVATE EQUITY: In Podiatric Surgery

Posted on February 16, 2026 by Dr. David Edward Marcinko MBA MEd CMP™

Dr. David Edward Marcinko MBA MEd

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Why podiatry surgery volume matters so much?

Podiatry Management Service Organizations typically rely on three revenue pillars:

Office visits (high volume, low margin)
Ancillaries (DME, orthotics, imaging)
Surgery (low volume, high margin)

Surgery is the only pillar that reliably moves EBITDA in a meaningful way. Buyers know this, so they scrutinize surgical volume harder than anything else.

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🔍 What “surgery volume” really means in podiatry

It’s not just the number of cases. Buyers look at:

Case mix (forefoot vs. rearfoot vs. trauma)
Site of service (ASC vs. hospital vs. office)
Provider concentration (is one surgeon doing 40% of cases?)
Payer mix (Medicare vs. commercial)
Seasonality (podiatry has real seasonal swings)
Referral stability (orthopedics, PCPs, wound care centers)

If any of these look unstable, the MSO’s valuation drops fast.

🚧 What happens to surgery volume when an MSO misses its exit window

1. Surgeons become less motivated

When the exit stalls:

Equity feels less valuable
Surgeons may slow down elective cases
Some shift cases back to hospitals
Others reduce ASC utilization
A few may even explore leaving the MSO

This is one of the biggest hidden risks.

2. Case mix often deteriorates

High‑value cases (rearfoot, reconstructive, trauma) may decline, while:

Nail procedures
Callus debridements
Routine diabetic care

…take up more of the schedule. This drags down EBITDA even if total visit volume stays stable.

3. Referral patterns weaken

If the MSO is perceived as unstable:

Orthopedic groups may stop referring
PCPs may shift to independent podiatrists
Wound care centers may diversify referrals

Referral leakage is subtle but devastating.

4. ASC strategy becomes strained

Many podiatry MSOs depend on:

Owning ASCs
Leasing block time
Negotiating better payer rates

If surgery volume softens:

ASC utilization drops
Fixed costs become painful
Lenders get nervous
Buyers discount the valuation

ASC underperformance is one of the top reasons podiatry MSOs fail to exit.

5. Productivity gaps widen between providers

Podiatry MSOs often have:

A few high‑volume surgeons
Many low‑volume generalists

When the exit stalls:

High performers may feel under‑rewarded
Low performers may drag down averages
Buyers see concentration risk

If one surgeon leaves, the MSO’s EBITDA can collapse.

6. Compliance scrutiny increases

Surgical coding in podiatry is a known risk area. When an MSO can’t sell, buyers often dig deeper into:

Modifier usage
Global period billing
Site‑of‑service documentation
Medical necessity for certain procedures

If anything looks aggressive, the deal dies.

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🎯 The bottom line

Podiatry surgery volume is the core value driver of a podiatry MSO. When an MSO fails to sell at its vintage year, surgery volume usually:

Softens
Becomes more concentrated
Shifts toward lower‑margin cases
Shows referral instability
Raises compliance questions

Buyers interpret this as EBITDA fragility, which is why podiatry MSOs often end up in continuation funds or sell at discounted multiples.

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PRIVATE EQUITY: Role in Vascular Medical Care

Posted on February 15, 2026 by Dr. David Edward Marcinko MBA MEd CMP™

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“Role of Private Equity in Vascular Care,” authored by HCC’s Todd A. Zigrang and Jessica Bailey-Wheaton, as well as Bhagwan Satiani, MD, and Hiranya A. Rajasinghe, MD, was featured in the recent issue of the Journal of Vascular Surgery – Vascular Insights published by the Society of Vascular Surgery.

Read Here

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SECOND OPINIONS: Informed, Niche Focused and Fiduciary

Posted on February 4, 2026 by Dr. David Edward Marcinko MBA MEd CMP™

Sponsor: http://www.MarcinkoAssociates.com

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Finally … Fiduciary second opinions right here!

Telephonic or electronic advice for medical professionals that is:

Objective, affordable, medically focused and personalized
Rendered by a pre-screened financial consultant or medical management advisor
Offered on a pay-as-you-go basis, by phone or secure e-mail transmission

The iMBA Discussion Forum™ is a physician-to-advisor telephone or e-mail portal that connects independent financial professionals and medical management consultants, with doctors or healthcare executives desiring affordable and unbiased financial or business advice on an as-needed, pay-per-use basis.

Medical professionals and healthcare executives can now receive direct access to pre-screened iMBA professionals in the areas of Practice Enhancement, Investing, Financial Planning, Asset Allocation, Portfolio Management Taxes, Insurance, Mortgage and Lending, Practice Management, Information Technology, Human Resources and Employee Benefits. To assist our doctor / healthcare executive members, we can be contracted with per-minute or per-project fees, and contacted by client phone, email or secure instant messaging.

The iMBA Discussion Forum™ is designed to fill a growing need for medically focused financial or managerial advice that traditional consultants have not been able to serve. Most financial “consultants” either charge high sales commissions, or levy a percentage of fees for managing client assets. And, management consultants tend to extend their scope of engagement to tangential areas not originally needed, or wanted.

Typically, financial advisors also require clients to meet minimum asset level thresholds ($500,000 to $750,000, or more), or pay thousands of dollars in consulting fees to receive their services. These fee structures have created inherent conflicts of interest and significant barriers for an increasing number of time-compressed and economically constrained physicians or healthcare executives.

TOPICS: https://davidedwardmarcinko.com/coach/

Now, with the iMBA Discussion Forum™, all physicians and executive clients can receive unbiased financial advice, and objective business opinions, on their own terms, anytime-anywhere.

The iMBA Discussion Forum™ eliminates conflicts of interest by providing advice on a per-use basis, so you pay only for what you want and need. iMBA does not sell financial or business products. The result is a unique “no pressure”, and “no conflicts-of-interest experience.”

Get started with your consultation, now! Receive only the advice you need and pay for, from a medically focused and qualified doctor-advisor looking after your best interests.

Contact Us Now! How the iMBA Discussion Forum Works:

Contact Us
Request an iMBA Discussion Forum™ Conference Schedule
Pre-Pay a Small Retainer of $1,500
Receive Scheduled Advice via Conference Call or email transmission
Pay any Remainder

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We bill at the modest rate of $90 per quarter hour, or only $360 per hour.
A pre-paid minimum non-refundable retainer fee of $1,500 is required initially.
Pay any final invoice upon completion.
Total charges will always be known within a one-quarter hour increment.
Large or complex flat-fee engagements may be pre-arranged.
Clients remain in control, not consultants.
Collegiality and privacy is maintained.

CONTACT: Ann Miller; RN, MHA, CPHQ, CMP™

Email: MarcinkoAdvisors@outlook.com

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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: MarcinkoAdvisors@outlook.com

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QUANTUM MECHANICS: Unlocking the Secrets of the Microscopic Universe

Posted on January 25, 2026 by Dr. David Edward Marcinko MBA MEd CMP™

By Artificial Intelligence

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Quantum mechanics is a fundamental branch of physics that explores the behavior of matter and energy at the smallest scales—typically atomic and subatomic levels. Unlike classical physics, which deals with predictable and continuous phenomena, quantum mechanics reveals a world governed by probabilities, uncertainties, and strange dualities. It challenges our intuitive understanding of reality and has revolutionized both science and technology.

The origins of quantum mechanics trace back to the early 20th century, when classical theories failed to explain certain experimental results. Max Planck’s work on black-body radiation in 1900 introduced the idea that energy is quantized, meaning it comes in discrete packets called “quanta.” This concept laid the foundation for quantum theory. Soon after, Albert Einstein explained the photoelectric effect by proposing that light itself is made of particles—later called photons—further reinforcing the idea of quantization.

One of the most striking features of quantum mechanics is wave-particle duality. According to this principle, particles such as electrons and photons exhibit both wave-like and particle-like behavior depending on how they are observed. This duality was famously demonstrated in the double-slit experiment, where particles create an interference pattern typical of waves when not observed, but behave like particles when measured.

Another cornerstone of quantum mechanics is Heisenberg’s uncertainty principle, which states that certain pairs of physical properties—like position and momentum—cannot both be known precisely at the same time. This introduces a fundamental limit to measurement and implies that the act of observing a system can alter its state.

Quantum mechanics also introduces the concept of superposition, where particles can exist in multiple states simultaneously until measured. This idea is illustrated by Schrödinger’s cat thought experiment, in which a cat in a sealed box is both alive and dead until the box is opened and the cat is observed. Though metaphorical, this paradox highlights the non-intuitive nature of quantum systems.

Perhaps the most mysterious phenomenon in quantum mechanics is entanglement. When particles become entangled, their states are linked regardless of the distance between them. A change in one particle instantly affects the other, defying classical notions of locality. This “spooky action at a distance,” as Einstein called it, has been experimentally confirmed and is the basis for emerging technologies like quantum cryptography and quantum teleportation.

Quantum mechanics is not just theoretical—it has practical applications that shape our modern world. Technologies such as lasers, semiconductors, MRI machines, and atomic clocks all rely on quantum principles. Moreover, quantum computing promises to revolutionize information processing by using quantum bits (qubits) that can represent multiple states simultaneously, enabling calculations far beyond the reach of classical computers.

In conclusion, quantum mechanics is a profound and essential framework for understanding the universe at its most fundamental level. It challenges our perceptions, fuels technological innovation, and continues to inspire scientists and philosophers alike. As research advances, quantum mechanics may unlock even deeper mysteries of reality, reshaping our understanding of existence itself.

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GHOST JOBS & PHANTOM SCAMS: In Medicine and Finance

Posted on January 24, 2026 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters.

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A fake job or ghost job is a scam job posting for a non-existent or already filled position. A scam is a dishonest scheme to gain money or possessions from someone fraudulently, especially a complex or prolonged one.

Due to current economic conditions in 2025, there’s been a rise in scams related to job postings and financial relief offers, preying on people’s financial insecurities. Keep your wits about you and be wary of potential fraud in seemingly legitimate opportunities.

For example, an employer may post fake job opening listings for many reasons such as inflating statistics about their industries, protecting the company from discrimination lawsuits, fulfilling requirements by human-resources departments, identifying potentially promising recruits for future hiring, pacifying existing employees that the company is looking for extra help, or retaining desirable employees. They may also use this strategy to gather information regarding their competitors’ wages. And, there is a rising trend in employers promising remote work as “bait,” and it underscores the relative power of the employers in the job market.

GHOST NURSING: The 1982 Movie

A young woman nanny plagued with bad luck travels to Thailand to visit a friend. There, her friend suggests a visit to a sorcerer, which results in her adopting a child ghost/demon who begins to protect her, but matters soon go awry.

Impact on the Healthcare Field

This is not a 44 year old science-fiction movie. Medicine and the healthcare industry isn’t immune to the ghost job phantom trend. Some contingent labor or medical staffing agencies lack ethics and post jobs solely to bolster their database, without any intention of filling those roles. This deceptive practice misleads job seekers and wastes their time, further eroding trust in the hiring process.

If you are a nanny or caregiver, you may have your services listed on an online job site. While this is a great way to find work, it can also open you to ghost scams. One phone scam is to send you an offer of employment. The “employer” sends you a check, and asks you to send them some money to buy assistive care items needed for the job. However, the person you are talking to isn’t really interested in you. After you’ve sent the money, the check will bounce and the “employer” will ghost you and disappear. Not only do you not really have a job, you just sent money to a ghost scammer and will not be reimbursed.

Impact on the Finance Field

In finance, ghost jobs can appear for various reasons, such as companies wanting to gauge the labor market, fulfill internal posting policies, or maintain a pool of potential candidates. Consulting roles, including those in financial planning, have seen an increase in ghost jobs, with some firms keeping listings open despite slowing hiring activity. The IRS will never ghost call, but your bank might, which makes it harder to figure out if it’s the real deal; or a ghost scam. Plus, it makes sense that your bank would need to confirm your identity to protect your account. If your bank calls and asks you to confirm if transactions are legitimate, feel free to give a yes or no. But don’t give up any more information than that, says Adam Levin, founder of global identity protection and data risk services firm CyberScout and author of Swiped: How to Protect Yourself in a World Full of Scammers, Phishers, and Identity Thieves. Some scammers rattle off your credit card number and expiration date, then ask you to say your security code as confirmation, he says. Others will claim they froze your credit card because you might be a fraud victim, then ask for your Social Security number.

If someone claiming to be your accountant, insurance agent or financial advisor calls and says you have a computer problem with them, just say no and hang up. No one is ‘watching’ your computer for signs of a virus. And, those scammers won’t fix the problem—they’ll make it worse by installing malware or stealing your account information or even money.

Promoters of cryptocurrency and other investments use complex schemes, often enhanced through deepfake videos or AI-manipulated audio, to lend credibility. According to the FBI’s Internet Crime Complaint Center (IC3), victims reported an estimated $3.9 billion in losses from investment fraud in 2024. Promises of “guaranteed returns” or requests for money transfers via crypto wallets are warning signs.

Many targets lack experience in crypto markets, amplifying risk. Do thorough research, consult official resources (like SEC.gov), and use licensed platforms if investing. Treat “sure thing” tips and unsolicited offers as red flags.

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The Medical Executive-Post is a news and information aggregator and social media professional network for medical and financial service professionals. Feel free to submit education content to the site as well as links, text posts, images, opinions and videos which are then voted up or down by other members. Comments and dialog are especially welcomed. Daily posts are organized by subject. ME-P administrators moderate the activity. Moderation may also conducted by community-specific moderators who are unpaid volunteers.

EDUCATION: Books

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HOBSON’S CHOICE: The Illusion of Free Choice

Posted on January 16, 2026 by Dr. David Edward Marcinko MBA MEd CMP™

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By Dr. David Edward Marcinko MBA MEd

The phrase “Hobson’s choice” refers to a situation where a person is offered only one option disguised as a free choice. It’s the classic “take it or leave it” scenario—where declining the offer results in no alternative, making the choice effectively compulsory. Though it may sound paradoxical, Hobson’s choice is a powerful concept that reveals much about human decision-making, power dynamics, and the illusion of autonomy.

The term originates from Thomas Hobson, a 16th-century livery stable owner in Cambridge, England. Hobson rented horses to university students and townsfolk, but to prevent his best horses from being overused, he implemented a strict rotation system. Customers could only take the horse nearest the stable door—or none at all. While it appeared that Hobson was offering a choice, in reality, there was no real alternative. This practice became so well-known that “Hobson’s choice” entered the English lexicon as a metaphor for constrained decision-making.

In modern contexts, Hobson’s choice appears in various forms. In business, a company might present a single product or service as if it were part of a broader selection. In politics, voters may feel they are choosing between candidates, but if all options represent similar policies or ideologies, the choice is superficial. Even in personal relationships or workplace settings, individuals may be given decisions that seem voluntary but are shaped by pressure, necessity, or lack of alternatives.

Philosophically, Hobson’s choice challenges the notion of free will. It forces us to ask: Is a decision truly free if the consequences of refusal are unacceptable? This dilemma is particularly relevant in ethical debates, such as informed consent in medicine or coercion in legal contracts. When someone is pressured to accept terms under duress or limited options, the legitimacy of their consent becomes questionable.

Moreover, Hobson’s choice is often used rhetorically to justify decisions that limit others’ autonomy. For example, a government might present a controversial policy as the only viable solution to a crisis, framing dissent as irresponsible. In such cases, the illusion of choice masks the exercise of power and control.

Despite its negative connotations, Hobson’s choice can also serve as a tool for efficiency and fairness. Hobson’s original intent was to protect his horses and ensure equal access for all customers. In systems where resources are limited, offering a single standardized option may prevent exploitation or favoritism.

In conclusion, Hobson’s choice is more than a historical anecdote—it’s a lens through which we can examine the boundaries of freedom, the ethics of decision-making, and the subtle ways power operates in everyday life. Whether in politics, business, or personal relationships, recognizing Hobson’s choice helps us navigate the complex terrain between autonomy and constraint.

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

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PASSIVE-AGGRESSIVE: Patients

Posted on January 6, 2026 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

Professor Eugene Schmuckler PhD MBA MEd CTS

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Navigating the Challenges of Passive-Aggressive Patients in Healthcare

In the complex landscape of healthcare, effective communication between providers and patients is essential for accurate diagnosis, treatment adherence, and overall patient satisfaction. However, passive-aggressive behavior—characterized by indirect resistance, subtle obstruction, and veiled hostility—can significantly hinder this process. Passive-aggressive patients present unique challenges that require emotional intelligence, patience, and strategic communication skills from healthcare professionals.

Passive-aggressive behavior often stems from underlying feelings of fear, resentment, or a perceived lack of control. Patients may feel overwhelmed by their diagnosis, skeptical of medical advice, or frustrated by systemic issues such as long wait times or insurance complications. Rather than expressing these concerns openly, they may resort to behaviors such as missed appointments, vague complaints, sarcasm, or noncompliance with treatment plans. These actions, though subtle, can disrupt care continuity and erode trust between patient and provider.

One of the most difficult aspects of managing passive-aggressive patients is identifying the behavior early. Unlike overt aggression, passive-aggression is cloaked in ambiguity. A patient might nod in agreement during a consultation but later ignore medical instructions. They may offer compliments laced with sarcasm or express dissatisfaction through third parties rather than directly. These indirect signals can leave providers confused and uncertain about the patient’s true feelings or intentions.

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Addressing passive-aggressive behavior requires a nuanced approach. First, providers must cultivate a nonjudgmental environment where patients feel safe expressing concerns. Active listening, empathy, and validation can encourage more direct communication. For example, acknowledging a patient’s frustration with wait times or side effects can open the door to honest dialogue. Providers should also be mindful of their own reactions, avoiding defensiveness or dismissiveness, which can exacerbate the behavior.

Setting clear boundaries and expectations is another key strategy. Passive-aggressive patients often test limits subtly, so it’s important to reinforce the importance of mutual respect and accountability. Documenting interactions, treatment plans, and patient responses can help track patterns and ensure consistency. In some cases, involving mental health professionals may be beneficial, especially if the behavior is rooted in deeper psychological issues.

Ultimately, the goal is to transform passive-aggressive dynamics into constructive partnerships. This requires time, effort, and a willingness to engage with patients beyond surface-level interactions. When successful, it can lead to improved outcomes, greater patient satisfaction, and a more harmonious clinical environment.

In conclusion, passive-aggressive patients pose a unique challenge in healthcare, but they also offer an opportunity for providers to refine their communication skills and deepen their understanding of patient psychology. By fostering openness, setting boundaries, and responding with empathy, healthcare professionals can navigate these interactions effectively and promote better health outcomes for all.

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PARADOX: Cold Weather Flu & Sickness

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

Filed under: Ask a Doctor, Drugs and Pharma, Experts Invited, Glossary Terms, Health Economics, Health Insurance, Healthcare Finance | Tagged: cold, corona virus, flu, flu virus, food, health, Laura Goeggel, NEJM, paradox, patients, rhinovirus, Technology, travel, virus | Comments Off on PARADOX: Cold Weather Flu & Sickness

Understanding the Google Scholar Paradox in Research

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

By A.I.

SPONSOR: http://www.CertifiedMedicalPlanner.org

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

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

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

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

Courtesy: Morgan Housel

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Site-Neutral Payments Still a Long Ways Off

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

By Health Capital Consultants, LLC

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

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

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

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

By Staff Reporters and Copilot A.I.

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

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

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

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

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

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

Modified: Dr. Neil Anand via Kevin MD

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Understanding the Edgeworth Paradox in Economics

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

By Staff Reporters

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Irish economist Frances Edgeworth put forward the Edgeworth Paradox in his paper “The Pure Theory of Monopoly”, published in 1897.

It describes a situation in which two players cannot reach a state of equilibrium with pure strategies, i.e. each charging a stable price. A fact of the Edgeworth Paradox is that in some cases, even if the direct price impact is negative and exceeds the conditions, an increase in cost proportional to the quantity of an item provided may cause a decrease in all optimal prices. Due to the limited production capacity of enterprises in reality, if only one enterprise’s total production capacity can be supplied cannot meet social demand, another enterprise can charge a price that exceeds the marginal cost for the residual social need.

And so, according to colleague Dan Ariely PhD, the Edgeworth Paradox suggests that with capacity constraints, there may not be an equilibrium.

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The Hidden Risk of Trusting Friends in Finance

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

Here’s a risk to your financial health that may surprise you!

Rick Kahler MS CFP

By Rick Kahler CFP™

There are two reasons for this.

First, we tend to trust and rely on people we know.

Second, research finds that humans have a deep-seated desire to meet the needs of others, so “helping” a relative or friend get started in their financial sales career is just human nature. Unfortunately, brokerage and insurance companies know this. They train their new agents that the easiest sales to make when getting started are to relatives and friends.

Any time I find an ill-advised financial product a client has purchased from a relative or friend, I cringe, anticipating the client’s resistance to canceling it. Regardless of how bad the advice was or how outrageous the fees of an investment product may be, the deeper the relationship the more difficulty there will be in changing course.

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Here’s a typical example

Jim and Sofia, two young professionals, married at around the same time Jim’s uncle went to work for a financial services company. The uncle sold Jim a $250,000 Variable Universal Life (VUL) policy with a $500 monthly premium. Jim and Sofia were happy, thinking they had made a prudent choice to start saving for retirement and help out a relative at the same time.

When Sofia became pregnant, the couple decided to engage a fee-only financial planner. She found they were under insured to provide for a family and also that the VUL policy was incredibly expensive and ill-advised for their needs. She recommended canceling the VUL policy with its $500 monthly premium, instead paying $300 monthly for two $1 million term life insurance policies and putting $200 a month into a tax-free Roth IRA.

Sofia and Jim told this to their uncle, who was “shocked” at the planner’s “poor advice.”

He contended that any competent financial planner would know a person needs permanent insurance as a foundation to “raise their child in the case of a premature death, fund their retirement, pay estate taxes and just like a Roth, it is tax free.”
Sadly, the uncle was unwilling to admit that $250,000 of insurance wouldn’t be enough to raise their child, fund their retirement, and pay estate taxes; nor was it truly tax free. He also didn’t mention that he had a vested interest in their keeping the policy. While he probably earned 55% to 100% of the first year’s commission, it is common practice that an agent will also receive 10-15% of the annual premium from years 2-10.

***

Sofia and Jim agreed with the financial planner’s recommendation. They could see the sense in having $1 million of insurance on each of them instead of $250,000 on just Jim for almost half the price, plus the tax-free growth of $200 a month in the Roth IRA.

Yet they didn’t follow the planner’s advice, because they didn’t want to upset their uncle. They chose to weaken their financial health, plus risk the well-being of their family if one of them died prematurely, in order to enrich their uncle for fear of offending him.

This happens more frequently than you would think. And it isn’t limited to life insurance. I’ve seen clients invest in a variety of “opportunities,” based on advice from a family member, that were not in their best interest.

Assessment

Next time a friend or family member offers to sell you a financial product or give you some great advice, you may want to do yourself a favor and decline. If you really want to help them out, invite them over for dinner.

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

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

Contact: MarcinkoAdvisors@outlook.com

***

Filed under: "Ask-an-Advisor", Experts Invited, Financial Planning, Insurance Matters, Investing | Tagged: financial advice, Financial Planning, insurance, Investing, investments, Rick Kahler CFP®, Variable Universal Life, vul | Leave a comment »

Rethinking Productivity in Wealth Management

Posted on October 31, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Vitaliy Katsenelsen CFA

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One of the biggest hazards of being a professional money manager is that you are expected to behave in a certain way.

One of the biggest hazards of being a professional money manager is that you are expected to behave in a certain way: You have to come to the office every day, work long hours, slog through countless emails, be on top of your portfolio (that is, check performance of your securities minute by minute), watch business TV and consume news continuously, and dress well and conservatively, wearing a rope around the only part of your body that lets air get to your brain. Our colleagues judge us on how early we arrive at work and how late we stay. We do these things because society expects us to, not because they make us better investors or do any good for our clients.

Somehow we let the mindless, Henry Ford–assembly-line, 8:00 a.m. to 5:00 p.m., widgets-per-hour mentality dictate how we conduct our business thinking. Though car production benefits from rigid rules, uniforms, automation and strict working hours, in investing — the business of thinking — the assembly-line culture is counterproductive. Our clients and employers would be better off if we designed our workdays to let us perform our best.

Investing is not an idea-per-hour profession; it more likely results in a few ideas per year. A traditional, structured working environment creates pressure to produce an output — an idea, even a forced idea. Warren Buffett once said at a Berkshire Hathaway annual meeting: “We don’t get paid for activity; we get paid for being right. As to how long we’ll wait, we’ll wait indefinitely.”

How you get ideas is up to you. I am not a professional writer, but as a professional money manager, I learn and think best through writing. I put on my headphones, turn on opera and stare at my computer screen for hours, pecking away at the keyboard — that is how I think. You may do better by walking in the park or sitting with your legs up on the desk, staring at the ceiling.

I do my best thinking in the morning. At 3:00 in the afternoon, my brain shuts off; that is when I read my emails. We are all different. My best friend is a brunch person; he needs to consume six cups of coffee in the morning just to get his brain going. To be most productive, he shouldn’t go to work before 11:00 a.m.

And then there’s the business news. Serious business news that lacked sensationalism, and thus ratings, has been replaced by a new genre: business entertainment (of course, investors did not get the memo). These shows do a terrific job of filling our need to have explanations for everything, even random events that require no explanation (like daily stock movements). Most information on the business entertainment channels — Bloomberg Television, CNBC, Fox Business — has as much value for investors as daily weather forecasts have for travelers who don’t intend to go anywhere for a year.

Yet many managers have CNBC, Fox or Bloomberg TV/Internet streaming on while they work.

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Filed under: "Advisors Only", "Ask-an-Advisor", Experts Invited, Financial Planning, Information Technology, Portfolio Management | Tagged: assets, Bloomberg, CASH, CNBC, factory workers, financial advisors, Financial Planning, Fox, investment advisor, investments, money, Money Managers, Portfolio Management, profit, trade, Vitaliy Katsenelson CFA, wealth manager, wealth managers | Leave a comment »

Understanding Whole Life Insurance for Medical Professionals

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

Insurance Basics for Medical Professionals

By Jeffrey H. Rattiner, CPA, CFP®, MBA via iMBA, Inc.

After determining the need for insurance and the amount to purchase, the doctor-client and financial planner’s next task is to match those needs to the client’s objectives to determine what type of policy the client should purchase. The life insurance industry features more products today than ever before. One reason for this change is that, clearly, the insurance industry has expanded its product base to become more competitive. Another reason is that clients’ needs are constantly changing and the insurance companies must keep up with those needs or run the risk of having funds withdrawn from their companies. New and different types of life insurance products are here to stay. Since life insurance represents a significant part of a client’s risk-management program, planners have to be versed in the specifics of the varied product base.

Term Insurance Alternative

Whole life insurance was introduced as an alternative to term insurance. Whole life is often called cash value insurance or permanent insurance to distinguish it from term insurance. The cash value in whole life insurance arises because of the level premium system and the need to account for prepaid premiums. Whole life insurance offers permanent protection at a level premium for the entire lifetime of the insured. Premiums remain fixed and are paid throughout the insured’s entire lifetime. The premium level can remain constant throughout the life of the policy because premiums are higher during the early years. The excess charge in the early years makes it possible to build up a reserve, which will be needed, together with interest earned, to keep premiums level throughout the life of the policy. Older clients then pay the same premium in later years as they did when they were younger.

Cash Value

The cash value of a whole life policy serves a variety of purposes:

• It can be used for collateral for an insurance company loan.

• If the insured decides to terminate the policy, he or she can elect to receive the policy’s cash value at that time.

• The cash value balance can be remitted to the insurance company to purchase a reduced paid-up insurance policy. This will provide coverage until the funds are insufficient to pay the premiums. This cancellation feature is also referred to as a non-forfeiture value.

• If the policy is not canceled, the accumulated cash value becomes part of the death benefit paid upon the insured’s death (which makes this type of policy similar to a decreasing term policy). It can reduce cash flow by taking some of the investment results out of the contract either through dividends or through policy loans.

General Accounts

With a whole life policy, the insured does not control the investment vehicle. Policies are invested in the insurance company’s general account through the purchase of long-term bonds and mortgages. As a result, during a period of decreasing interest rates, whole life products can be expected to produce superior results since rates can be locked in when interest rates in general are higher. In contrast, rates in an increasing environment are locked in to their portfolios until maturity. There is no flexibility within a whole life policy. Premium payments, type of investment vehicle, and change in death benefit are all fixed. The safety of cash value is high, but the potential rate of return is low to moderate. If interest rates are rising, the price of the policy is declining, and you may want to suggest replacing the policy. (See Planning Issue 10.)

If the premiums paid to the insurance company turn out to be more than the company needs because expenses are lower than expected, the company’s portfolio investment return will be larger than the company expected. As a result, the company will then return some of the excess premium to the policyholder as a dividend or excess interest. Life insurance dividends are not taxable as income because they represent an excess of premium.

Premium Payments

The premium consists of mortality charge, policy expense, and a cash value. When the insured reaches 100 years of age, the policy endows with the face amount of the policy collectible by the insured. Since mortality tables end at age 100, the insurer considers the client dead and pays the face amount of the policy.

Whole life policies are packaged in a variety of ways. One policy, a limited-pay whole life policy, is a whole life policy with a death benefit continuing through age 100. The only difference between this and the traditional whole life policy is that premiums are paid only for a specified period, for example, seven years. In other words, the policyholder prepays the policy. A policy is considered to be fully paid up when the cash value of the basic contract plus the value of the dividend additions or deposits equals the net single premium for the policy in question at the insured’s attained age. The premium-paying period influences the cash value buildup in the policy. This is accomplished by using part of the investment return or dividends from long-term bonds and mortgages to pay the mortality and the expense charges on the policy for the rest of the policyholder’s life.

Advantages and DisAdvantages

Advantages of a whole life policy include lifetime coverage for the insured, a forced savings element, loan privileges, and a variety of premium payment plans. Over time, the cost is lower than term, the rate of return if the policy is kept until death is quite reasonable, and the policy will do a better job than universal life in keeping up with inflation. Disadvantages include a higher cost of death protection, a low rate of return, lack of flexibility, and incompatibility with inflation.

Assessment

Whole life policies are most appropriate for people who want or need a forced savings arrangement and for people who want lifetime coverage. As interest rates increased during the late 1970s, the returns received from insurance companies on long-term bonds and mortgage portfolios of whole life portfolios declined. As a result, in order to prevent policyholders from borrowing their cash reserves and investing these funds in other financial products, the insurance industry offered the following incentives:

• Existing policyholders were given the option to have their policies upgraded to reflect current market rates. Policies were upgraded through higher interest rates on cash values and higher future dividends and rates on policy loans.

• New types of policies were introduced—such as universal life, which tied cash value to short-term money market rates.

• Variable life insurance and universal variable life insurance were introduced, which segregated policy assets into a separate account.

Conclusion

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Filed under: Experts Invited, Insurance Matters, Risk Management | Tagged: cash value insurance, Jeffrey H. Rattiner, Whole life Insurance | 5 Comments »

Transform Your Financial Insights into Lasting Change

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

Turn Financial A-Ha Moments Into Lasting Change With Memory Re-Consolidation

By Rick Kahler MSFS CFP™

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Have you ever had a light bulb moment about money?

Maybe you leave a workshop, a therapy session, or a conversation with a financial advisor, feeling as if you have finally cracked the code. You understand why you keep overspending. You see the pattern that keeps you procrastinating about saving and investing. You feel the reason you panic about money, even when you know you are okay. In that moment, it all seems so clear.

Yet a week later, you are right back at it. Swiping the credit card. Avoiding the budget. Losing sleep over the same worries you thought you had just solved. What happened to that breakthrough? Why did it not last?

BRAIN ANCHORING: https://medicalexecutivepost.com/2024/10/22/anchoring-initial-mental-brain-trickery/

I’ve experienced this myself, more times than I’d like to admit. Recently, I found a book that explains why: Unlocking the Emotional Brain by Bruce Ecker, Robin Ticic, and Laurel Hulley. The authors explain that lasting change happens through something called “memory re-consolidation.” It is the brain’s way of updating emotional patterns we have carried for years—often since childhood.

Most of us have old money stories tucked away in our emotional memory. Suppose, for example, as a child you were scolded for asking a neighbor how much money they earned. This and other similar experiences that left you feeling shamed or dismissed taught you that it was rude to talk about money.

Such early experiences are filed away as emotional truths. They shape what feels true, even years later as an adult, whether or not that “truth” is still relevant.

NEUROLINK: https://medicalexecutivepost.com/2023/03/07/neurolink-brain-chips-rejected-by-the-fda/

As an adult, you may have come to understand that talking about money is often essential for your emotional and financial well being. But when the moment comes to have a money conversation, your body still freezes up. That is not weakness. That is your brain pulling up the old file.

Here is where memory re-consolidation comes in. The brain does not update the file just because you think new thoughts. It updates when you have a new experience that feels different. Maybe someone listens without judgment, or you realize you are talking about money and still feel safe. That emotional mismatch tells the brain, “Maybe this file is not true anymore.”

But the update is not finished. To make the change stick, you have to hold both the old belief and the new experience together for a little while. It is like showing your brain two pictures: here is how it used to feel, and here is how it feels now. That moment of holding both is when the rewrite happens.

Even more interesting, the brain keeps the file open for several hours after the shift. What you do in that window can help the change settle in—or not. If you rush back into busyness or distractions, you might accidentally let the old version save itself again.

BRAIN HEALTH: https://medicalexecutivepost.com/2025/02/19/brain-health-bilingualism/

So what can we do to give those shifts a better chance of sticking? I have noticed that insights gained during a retreat or workshop, with ample time to focus and reflect, are more likely to last. Even in our everyday lives, we can slow down, even for a few minutes, to write about what we felt, check in with our bodies, or talk with someone who supports us. We can protect a little bit of quiet space before diving back into the noise.

The next time you have a money breakthrough, try giving yourself that space. Consciously notice both the old belief and the new experience. Give the re-consolidation time to settle in.

Then, the next time your brain pulls up that old money story, you’ll have access to the updated, more accurate version.

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Filed under: "Ask-an-Advisor", Ethics, Experts Invited, Financial Planning, Investing, mental health, Op-Editorials, Portfolio Management | Tagged: A-HA moment, brain, brain anchoring, brain health, Bruce Ecker, CFP, emotional brain, Ethics, financial advisor, light bulb moment, Lurel Hulley, mental health, money, money stories, neurolink, old money, rick kahler, Robin Ticic | Leave a comment »

Safe Disposal: National Prescription Drug Take Back Day

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

PODCAST: National Prescription Drug Take Back Day

October 25, 2025

By Dr. David Edward Marcinko MBA MEd

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

Prescription Pill Bottles

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

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

Conclusion

Ambulance DEM

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Filed under: "Doctors Only", Drugs and Pharma, Ethics, Experts Invited, LifeStyle, Touring with Marcinko, Videos | Tagged: "Illegal" Drugs, david marcinko, DEA, drug take back day, Marcinko, National Prescription Drug Take-Back Day, october, Rx | 1 Comment »

Understanding Polymaths, Savants, and Geniuses

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

By Staff Reporters

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What’s a polymath?

The definition of “polymath” is the subject of debate. The term has its roots in Ancient Greek and was first used in the early 17th Century to mean a person with “many learnings”, but there is no easy way to decide how advanced those learnings must be and in how many disciplines. Most researchers argue that to be a true polymath you need some kind of formal acclaim in at least two apparently unrelated domains. And, one of the most detailed examinations of the subject comes from Waqas Ahmed in his book The Polymath, published earlier this year.

Now, despite his many achievements, Ahmed does not identify as a polymath. “It is too esteemed an accolade for me to refer to myself as one,” he said. When examining the lives of historical polymaths, he only considered those who had made significant contributions to at least three fields, such as Leonardo da Vinci (the artist, inventor and anatomist), Johann Wolfgang von Goethe (the great writer who also studied botany, physics and mineralogy) and Florence Nightingale (who, besides founding modern nursing, was also an accomplished statistician and theologian).

What is a savant?

Savant syndrome is an exceedingly rare condition in which individuals with a developmental disorder or an intellectual disability possess extraordinary talents, knowledge, or abilities in a specific area. Savant syndrome may be congenital at birth or acquired later in life and is commonly associated with autism spectrum disorder (ASD). It may also coexist alongside other conditions, such as brain injuries . Individuals with savant syndrome were historically referred to with the term “idiot savant,” but negative connotations of the term “idiot” resulted in its abandonment and is now solely termed “savant.”

Famous individuals with savant syndrome include Kim Peek, who was able to calculate dates for any event hundreds of years into the past or future and inspired the movie the Rain Man. Stephen Wiltshire was mute and communicated through drawings of detailed city landscapes. Approximately 10% of individuals with autistic disorder have savant abilities. Less than 1% of the non-autistic population have savant syndrome. Therefore, not all savants have ASD, and not all persons with autismare savants.

What is a genius?

There is no scientifically precise definition of genius. When used to refer to the characteristic, genius is associated with talent but several authors systematically distinguish these terms. Walter Isaacson, biographer of many well-known geniuses, explains that although high intelligence may be a prerequisite, the most common trait that actually defines a genius may be the extraordinary ability to apply creativity and imaginative thinking to almost any situation.

The plural form of genius can be either geniuses or genii, pronounced [ jee-nee-ahy ], depending on the intended meaning of the word. Geniuses is much more commonly used. The plural forms of several other singular words that end in -us are also formed in this way, such as virus/viruses, callus/calluses, and status/statuses. Irregular plurals that are formed like genii, such as radius/radii or cactus/cacti, derive directly from their original pluralization in Latin. However, the standard English plural -es is often also acceptable for these terms, as in radiuses and cactuses.

Who is Mensa material?

Mensa members range in age from 2 to 106. They include engineers, homemakers, teachers, actors, athletes, students, and CEOs, and they share only one trait — high intelligence. To qualify for Mensa, they scored in the top 2 percent of the general population on an accepted standardized intelligence test.

Note: These descriptions are presented with some thanks to Chat GPT.

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Filed under: Book Reviews, Ethics, Experts Invited, Glossary Terms, LifeStyle, mental health | Tagged: ASD, autism, autistic, ChatGPT, genius, IQ, kim peek, knowledge, mensa, mental health, neurodiversity, polymath, savant, smart, stephen wiltshire, Walter Isaacson, Waqas Ahmed, wisdom, wise | Leave a comment »

Mastering the 20/4/10 Car Buying Rule

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

20/4/10 RULE

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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An automobile is one of the biggest purchases after a home; for many physicians and most all of us. But, unlike the typical home, it is usually a depreciating asset – today morning you purchase a car for X-amount of dollars and by the evening it will be worth less. After 5 years it will not be even half-value but still, many folks keep buying cars regularly – buy at 10, sell at 4 & lose 6 (repeat the cycle).

So, here are few financial rules of thumb that you can follow:

The value of a car should not be more than 50% of the annual income of the owner.
Purchase a used car or buy a new & use it for 10 years.
While buying a car with a loan stick to Rule 20/4/10 – Minimum 20% down payment, loan tenure not more than 4 years & EMI should not be higher than 10% of your income.

Note: Equated Monthly Installment [EMI]

Caution: The phrase rule of thumb refers to an approximate method for doing something, based on practical experience rather than theory. This usage of the phrase can be traced back to the 17th century and has been associated with various trades where quantities were measured by comparison to the width or length of a human adult thumb.

EDUCATION: Books

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Filed under: "Ask-an-Advisor", Experts Invited, Financial Planning, Funding Basics, Glossary Terms, Marcinko Associates | Tagged: automobile buying, automobile purchase, car buying, car purchase, EMI, Equated Monthly Installment, Marcinko | Leave a comment »

Critical Risk Management for Physicians Today

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

More Difficult than Ever Before

By Brian J. Knabe MD, Certified Medical Planner

www.SavantCapital.com

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

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

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

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

http://www.CertifiedMedicalPlanner.org

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

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

Conclusion

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

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Filed under: CMP Program, Experts Invited, Op-Editorials, Practice Management, Risk Management | Tagged: brian knabe, CMS, DOJ, financial advisors, FTC, HHS, HIPAA, insurance agents, Marcinko, medicare, Medicare compliance, National Association of Personal Financial Advisors, OSHA, RICO, www.certifiedmedicalplanner.com | Leave a comment »

Unlock Your Career with Micro-Certifications

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

Micro-Credentials on the Rise

KNOWLEDGE RICHES IN SPECIALTY NICHES

DR. DAVID EDWARD MARCINKO MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

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***

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

Micro-Certification Basics

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

Micro-Certification Requirements

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

Uses of Micro-Certifications

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

Examples of iMBA, Inc., Micro-Certifications

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

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

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

How to Start Learning and Earning Recognition for Your Knowledge

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

Mini-Certification Tuition, Books and Related Fees

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

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

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Understanding Doctorate Degrees: A Clear Guide

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

By Staff Reporters

Is the Doctor – In?

SPONSOR: http://www.CertifiedMedicalPlanner.org

INFO-GRAPHIC

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What Is a Doctorate Degree?

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

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

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

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

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

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

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

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

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

Can a PhD Be Called a Doctor?

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

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

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

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

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Understanding Medical Office Cancellation Fees

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

By Dr. David Edward Marcinko MBA MEd

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Can a physician medical provider charge an office cancellation fee?

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

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

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

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

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

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

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Essential Critical Thinking Skills for Financial Advisors

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

FOR ETHICAL PHYSICIAN CLIENT ACQUISITION SUCCESS

By Dr. David Edward Marcinko; MBA MEd CMP™

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SPONSOR: http://www.CertifiedMedicalPlanner.org

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

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

What is critical thinking?

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

Why do employers value critical thinking?

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

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Six main types of critical thinking skills

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

1. Analytical thinking

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

2. Good communication

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

3. Creative thinking

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

4. Open-mindedness

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

5. Ability to solve problems

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

6. Asking thoughtful questions:

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

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* Open-ended questions

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

* Outcome-based questions

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

Reflective questions

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

* Structural questions

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

CONCLUSION

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

EDUCATION: Books

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

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Austrian vs Keynesian Economics Explained

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

Austrian Economics vs. Keynesian Economics in One Simple Chart

Courtesy of Jeff Deist

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Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

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Understanding Workplace Violence: Types and Impact

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

Filed under: Experts Invited, Marcinko Associates, mental health, Risk Management, Touring with Marcinko | Tagged: abuse, Marcinko, medical workplace violence, mental health, news, psychology, Relationships, schmuckler, trauma, violence, violence medical, workplace | Comments Off on Understanding Workplace Violence: Types and Impact

UnitedHealthcare CEO Reveals $6.5 Billion Medical Cost Spike

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

By Fierce Healthcare [7/29/25]

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UnitedHealthcare CEO Tim Noel offered investors a deeper look at the medical cost spike that’s plaguing the insurance giant’s finances. He said during the company’s earnings call that pricing assumptions set by the company “were well short of actual medical costs” for 2025. UHC’s current outlook, he said, instead reflects an additional $6.5 billion in medical costs, with more than half, or about $3.6 billion, coming from its Medicare plans.

Noel said that in Medicare Advantage specifically, the team is looking to adjust pricing and benefit designs to account for the cost pressures, which they anticipate will stretch into much of 2026.

It has also decided to exit certain markets largely with plans that are more loosely designed, such as PPOs, in a move that will impact 600,000 beneficiaries.

Source: Paige Minemyer, Fierce Healthcare [7/29/25]

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Understanding Hedge Funds: A Comprehensive Guide

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

By Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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SPONSOR: http://www.MarcinkoAssociates.com

QUESTION: What is a Hedge Fund?

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

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

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

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

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

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

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

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

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

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

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GAO RREPORT: Rising Physician Consolidation Increases Prices

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

By Health Capital Consultants, LLC

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On September 22, 2025, the Government Accountability Office (GAO) released a report estimating “the Extent and Effects of Physician Consolidation.” The GAO, the non-partisan audit, evaluation, and investigative arm of Congress, undertook the analysis of physician consolidation in response to lawmakers’ request.

This Health Capital Topics article reviews the GAO report and stakeholder reactions. (Read more…)

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VARIABLE ANNUITIES: Retired Physicians Beware!

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

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

SPONSOR: http://www.CertifiedMedicalPlanner.org

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

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

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Definitions

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

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

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

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

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Why You Shouldn’t Trust Your Financial Advisor’s Awards

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

OVERHEARD IN THE DOCTOR’S LOUNGE

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By D. Kellus Pruitt DDS

According to money journalists Max Tailwagger and Allan Roth of MoneyWatch, the trade publication Medical Economics Magazine [“advertising supplement”] nearly listed a dog on its’ 2013 list of Best Financial Advisors for Doctors. Indeed, being listed as a top financial advisor in this publication would enhance any advisor’s credibility as well as reach a high income readership.

For example, several advisors in the Financial Planning Association, mentions this prestigious award year after year. And, the NAPFA organization of fee-only financial planners has issued press releases when member advisors make this annual list. In fact, in 2008, it touted that 52/150 listed FAs were NAPFA members.

Yet, the dog is well known in the financial advisory world, having allegedly received a plaque as one of 2009 America’s Top Financial Planners by the Consumers’ Research Council of America, and has appeared in several books including Pound Foolish and Money for Life. The fee for Maxwell Tailwagger CFP® [a five year old Dachshund] was reported to be $750 with $1,000 for a bold listing. Colorado Securities Commissioner Fred Joseph is reported to have said, “Once again, Max is gaining national notoriety for his astute, and almost superhuman, abilities in the financial arena.”

The only two qualifications for the listing were to pay the fee and not have a complaint against them. In 2009, James Putman, then the NAPFA chairman who touted his own Medical Economics award, was charged by the SEC for securities fraud. NAPFA spokesperson Laura Fisher allegedly opined that “NAPFA no longer promotes the Medical Economics Top Advisors for Doctors list. We felt promoting a list that included stock-brokers was inconsistent with NAPFA’s mission to advance the fee-only profession.” When an advisor name drops an honor to you, congratulate him and then ask how s/he achieved the award. Ask how many nominees versus award recipients there were. What were the criteria for selection and how were they nominated. Ask if they had to pay for the honor, and go online to check out the organization.

Then ask yourself this question: If your financial advisor is buying credibility, do you really want to trust your financial future to him or her?

Source: http://www.cbsnews.com/news/dog-nearly-fetches-prestigious-financial-advisor-honor/

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Filed under: "Ask-an-Advisor", Accounting, Ethics, Experts Invited, Financial Planning, Healthcare Finance, Investing, Pruitt's Platform | Tagged: Allan Roth, D. Kellus Pruitt, Darrell Pruitt, Darrell Pruitt DDS, DDS, dog, dogs, financial advisors, financial advisors doctors, financial future, Fred Joseph, Laura Fisher, Max Tailwagger, Medical Economics, MoneyWatch, NAPFA, photography, travel | Leave a comment »

Understanding Asset Allocation for Investment Success

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

Delving Deeper into Asset Allocation

SPONSOR: http://www.CERTIFIEDMEDICALPLANNER.org

By Lon Jefferies MBA CFP® CMP®

Asset allocation is one of the key factors contributing to long-term investment success.

When designing a portfolio that represents their risk tolerance, investors should be aware that a portfolio that is 50% stocks is likely to obtain approximately half of the gain when the market advances but suffer only half the loss when the market declines.

This general principle frequently holds true over extended investing cycles, but can waiver during shorter holding periods.

Case Model

For example, a fairly typical physician client of mine who has a 50% stock, 50% bond portfolio has obtained a return of 4.62% over the last 12 months, while the S&P 500 has obtained a return of 14.31% over the same time period (as of 10/30/14).

An investor expecting to obtain half the return of the index would anticipate a return of 7.15%, and by this measuring stick, has underperformed the market by over 2.50% during the last year.

What caused this differential?

Answer

The issue resides in how we define “the market.” In this example, we use the S&P 500 index as a measure for how the market as a whole is performing. As you may know, the S&P 500 (and the Dow Jones Industrial Average, for that matter) consists solely of large company U.S. stocks.

Of course, a diversified portfolio owns a mixture of large, mid, and small cap U.S. stocks, as well as international and emerging market equities. Consequently, comparing the performance of a basket of only large cap stocks to the performance of a diversified portfolio made up of a variety of different asset classes isn’t an apples-to-apples comparison.

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Frequently, the diversified portfolio will outperform the non-diversified large cap index because several of the components of the diversified portfolio will obtain higher returns than those achieved by large cap holdings.

However, the past 12 months has been a case where a diversified portfolio underperformed the large cap index because large cap stocks were the best performing asset class over the time period. In fact, over the last twelve months, there has been a direct correlation between company size and stock performance (as of 10/30/14):

Large Cap Stocks (S&P 500): 14.92%
Mid Cap Stocks (Russell Mid Cap): 11.08%
Small Cap Stocks (Russell 2000): 4.45%
International Stocks (Dow Jones Developed Markets): -1.05%
Emerging Market Stocks (iShares MSCI Emerging Markets): -1.04%

Since large cap stocks were the best performing element of a diversified portfolio over the last 12 months, in retrospect, an investor would have obtained a superior return by owning only large cap stocks during the period as opposed to owning a diversified mix of different equities. Does this mean owning only large cap stocks rather than a diversified portfolio is the best investment approach going forward? Of course not.

Year after year, we don’t know which asset category will provide the best return and a diversified portfolio ensures we have exposure to each year’s big winner. Additionally, although large caps were this year’s winner, they could easily be next year’s big loser, and a diversified portfolio ensures we don’t have all our investment eggs in one basket.

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

Assessment

Don’t be overly concerned if your diversified portfolio is underperforming a non-diversified benchmark over a short period of time. As always, long-term results should be more heavily weighted than short-term swings, and having a diversified portfolio is likely to maximize the probability of coming out ahead over an extended period.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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SHUTDOWN: Healthcare Policy Disputes Threaten Government Shutdown: SHUTDOWN

Posted on October 1, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

BREAKING NEWS!

UNITED STATES GOVERNMENT SHUTS DOWN

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By Health Capital Consultants, LLC

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With hours to go until the midnight deadline on September 30th, 2025 to fund the government, lawmakers appear deadlocked over whether certain healthcare provisions should be included in the temporary funding bill.

Should this deadlock continue, the federal government will shut down beginning today October 1st and remain shut down until that deadlock is resolved.

This Health Capital Topics article provides an update on the developing saga. (Read more…)

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Financial Planning for Physicians: Achieve Your Goals

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

By: http://www.MarcinkoAssociates.com

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

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

We assess, plan, and opine for your success

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

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

We take a deep dive into your financial retirement plans

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

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

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

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

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

EDUCATION: Books

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

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Fiduciary Financial Colleagues Advising Medical Colleagues … in Turbulent Times!

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Unlocking the Power of Compounding in Investments

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

SPONSOR: http://www.MarcinkoAssociates.com

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Time is both our ally and our enemy?

In the case of financial investments, compounding interest relies on time to reveal its true magic.

Here’s how: a young investor can invest less money over a longer period of time than an older investor who invests more money over a shorter period and ends up with more in the end. Compounding returns grow exponentially, making time more than an ally – but a force of the universe driving growth.

Time is certainly our ally in investing, but according to ME-P Editor Dr. David Edward Marcinko MBA MEd, you’ll kick yourself wishing you had invested earlier when you witness compounding after a few years (or a decade).

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Overcoming Financial Psychological Traps

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

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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Psychological Traps

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

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

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

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

EDUCATION: Books

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

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

Understanding Alpha: Non-Systematic ROI Explained

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

Understanding Non-Systematic Return on Investment

www.CertifiedMedicalPlanner.org

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

https://marcinkoassociates.com

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

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

Example

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

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

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

More Research

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

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

FutureMetrics

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

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

Assessment

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

Notes:

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

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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Understanding Different Medical Degrees: MD, DO, and DPM

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

Doctor of Medicine

Doctor of Osteopathic Medicine

Doctor of Podiatric Medicine

By Staff Reporters and APMA

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APMA INFOGRAPHIC: https://www.apma.org/apmamain/document-server/?cfp=/apmamain/assets/file/public/about/physician-education-comparison-fact-sheet.pdf

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EDUCATION: Books

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Financial Self-Discovery for Medical Professionals

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

By Dr. David Edward Marcinko; MBA MEd CMP™

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

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SPONSOR: http://www.CertifiedMedicalPlanner.org

A Financial Self Discovery Questionnaire for Medical Professionals

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

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

Childhood

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

Cultural heritage

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

Family

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

Your parents

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

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

Childhood: Revisited

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

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

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

Credit

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

Adulthood

Have your attitudes shifted during your adult life? Describe.

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

Adult attitudes

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

Conclusion

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

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

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

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Filed under: "Doctors Only", Career Development, CMP Program, Ethics, Experts Invited, Financial Planning, Funding Basics, Glossary Terms, Health Economics, Investing, mental health, Portfolio Management, Touring with Marcinko | Tagged: behavioral finance, budgeting, business, certified medical planner, CMP, credit, credit cards, DDS, debit, DO, doctors, DPM, economics, employment, finance, great depression, grocery money, Marcinko, MD, mental health, money, money scripts, money values, nurses, personal-finance, physician coaching, physicians, poor, psychology of money, rent, richer, self discovery, work | Leave a comment »

VALUE STOCKS: Discovering Under Priced Investment Gems

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

BY DR. DAVID EDWARD MARCINKO; MBA MEd CMP™

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SPONSOR: http://www.MarcinkoAssociates.com

Value Stocks – Looking for Bargains!

The bargain-hunting value style is looking for shares that are under priced in relation to the company’s future potential. A physician value investor will invest in a company in the expectation that its shares will increase in value over time. Value investing is based essentially on quantitative criteria; asset values, cash flow, and discounted future earnings. The key properties of value shares are low Price/Earnings, Price/Sales ratios, and normally higher dividend yields.

On observing a company’s earnings growth, a value manager will decide whether to buy shares based on the company’s consistency or recovery prospects.

The key research questions are: 1) Does the current P/E ratio warrant an investment in a slow growth company or, 2) Is the company a higher growth candidate that has dropped in price due to a temporary problem. If this is the case, will the company’s earnings growth recover, and if so, when? The key to value investing is to find bargain shares (priced low historically or for temporary and/or irrational reasons), avoiding shares that are merely cheap (priced low because the company is failing).

The buying opportunity is identified when a company undergoing some immediate problems is perceived to have good chances of recovery in the medium to long term. If there is a loss in market confidence in the company, the share price may fall, and the value investor can step in. Once the share price has achieved a suitable value, reflecting the predicted turnaround in company performance, the shareholding is sold, realizing a capital gain.

And, a potential risk in value investing is that the company may not turn around, in which case the share price may stay static or fall.

EDUCATION: Books

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

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Filed under: "Ask-an-Advisor", Experts Invited, Financial Planning, Glossary Terms, Investing | Tagged: bargain stocks, bargain value stocks, finance, Investing, Marcinko, physicians value investing, stock market, stocks, value investing | Leave a comment »

3 Behavioral Biases Hurting Your Finances

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

By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

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

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

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

ANCHORING BIAS

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

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

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

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

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

HERD MENTALITY BIAS

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

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

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

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

OVERCONFIDENT INVESTING BIAS

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

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

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

ASSESSMENT

Finally, questions remain after consuming this cognitive bias review.

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

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

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

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

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

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

CONCLUSION

Remember, it is far more useful to listen to client beliefs, fears and goals, and to suggest options and offer encouragement to help them discover their own path toward financial well-being. Then, incentivize them with knowledge of the above psychological biases to your mutual success!

EDUCATION: Books

REFERENCES:

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

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Filed under: Ask a Doctor, Career Development, CMP Program, economics, Experts Invited, finance, Funding Basics, Glossary Terms, Investing, mental health, Portfolio Management | Tagged: anchoring bias, behavioral economics, bias, CMP, economics, finance, financial advisors, herd bias, Investing, loss aversion, Marcinko, mental health, overconfidency, overconfident bias, personal-finance, present bias, psychology | Leave a comment »

Why Many Doctors Struggle Financially: 5 Key Reasons

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

By A.I. and Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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

1 | Believing They Are Universally Smart

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

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

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

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

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

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

2 | Overspending Too Soon

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

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

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

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

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

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

3 | Decreasing Salaries

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

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

4 | Increasing Costs of Private Practice

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

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

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

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

5 | Tuition Debt

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

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

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

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

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

THE FINANCIAL FIX

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

Place a portion of your salary (15-20% or more) into a savings account, and another portion (10-20% or more) into wise investments [stocks, bonds, mutual funds, and/or ETFs].

Pay off your bills each month, and then use leftover spending money to purchase fun things like vacations and fancy dinners, within your means. Shop sales, buy used clothes, and use credit card points for travel.

Hire an excellent tax professional and meet with an investment advisor once or twice a year about your investment status and strategy. http://www.MarcinkoAssociates.com

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Filed under: "Ask-an-Advisor", Accounting, Ask a Doctor, Career Development, CMP Program, economics, Experts Invited, finance, Financial Planning, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Investing, Marcinko Associates, Taxation | Tagged: broke physicians, CMP, DDS, DO, doctor, doctor debt, DPM, EMRs, health, healthcare, HIPAA, Marcinko, MD, medical school, medical school debt, medicine, physician debt, physicians | Leave a comment »

PALACE FALLACY: Memory Loss

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

SPONSOR: http://www.CertifiedMedicalPlanner.org

By Staff Reporters and A.I.

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

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

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

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

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Filed under: Ask a Doctor, CMP Program, Experts Invited, Glossary Terms, LifeStyle, mental health, Risk Management | Tagged: auditory learner, auditory person, CMP, education, learner, learning myths, memory loss, mental, mental health, palace fallacy, teaching, visual learner, visual perso, what is memory loss?, what is pallace fallacy | Leave a comment »

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1. “Buy the dip” vs. “Don’t catch a falling knife”

2. “Time in the market beats timing the market” vs. “Price matters”

3. “Diversify” vs. “Concentrate to build wealth”

4. “Be greedy when others are fearful” vs. “The trend is your friend”

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6. “High risk, high reward” vs. “High risk often means high loss”

7. “Cash is trash” vs. “Cash is king”

8. “Stay the course” vs. “Adapt to changing conditions”

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10. “Markets are efficient” vs. “Markets are driven by human emotion”

11. “Don’t try to beat the market” vs. “Someone has to beat the market”

12. “Buy low, sell high” vs. “Low can go lower, high can go higher”

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Why podiatry surgery volume matters so much?

🔍 What “surgery volume” really means in podiatry

🚧 What happens to surgery volume when an MSO misses its exit window

1. Surgeons become less motivated

2. Case mix often deteriorates

3. Referral patterns weaken

4. ASC strategy becomes strained

5. Productivity gaps widen between providers

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