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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
By A.I.
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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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Filed under: "Ask-an-Advisor", CMP Program, Ethics, Experts Invited, Glossary Terms, Information Technology, LifeStyle, mental health | Tagged: authors, citations, CMP, editors, google, google paradox, google scholar, google scholar effect, HIT, IT, mental health, Morgan Housel, paradox, publications, references, research, scholar paradox | Leave a comment »
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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Filed under: "Doctors Only", Ask a Doctor, Drugs and Pharma, Experts Invited, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance | Tagged: ambulatory surgery center, ASC, ASCs, Health Affasirs, Health Capital Topics, HOPDs, hospital outpatient departments, hospitals, Jessica Bailey-Wheaton, TODD A. ZIGRANG | Leave a comment »
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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Filed under: "Doctors Only", Career Development, Ethics, Experts Invited, Glossary Terms, Health Economics, Information Technology | Tagged: AI, AI Medicine, artificial intelligence, cobra effect, cobras, Goodhart's Law, Goodharts Law Medicine, KevinMD, leadership, Neil Anand, Technology | Leave a comment »
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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Filed under: Accounting, Experts Invited, Funding Basics, Glossary Terms, Investing, LifeStyle, mental health | Tagged: capacity constraints, Dan Ariely PhD, economics, edgeworth box, Edgeworth paradox, Frances Edgeworth, life, mental health, monopoly theory, paradox, philosophy | Leave a comment »
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.
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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
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Contact: MarcinkoAdvisors@outlook.com
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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 »
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 »
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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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
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Filed under: Experts Invited, Insurance Matters, Risk Management | Tagged: cash value insurance, Jeffrey H. Rattiner, Whole life Insurance | 5 Comments »
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 »
PODCAST: National Prescription Drug Take Back Day
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
MORE DEA: https://takebackday.dea.gov/
Conclusion
Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
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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 »
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).
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 »
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:
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.
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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 »
By Brian J. Knabe MD, Certified Medical Planner
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:
The practicing physician should seek the advice of professionals with expertise in these areas. Every practice should have an experienced attorney on retainer. It is very important to seek advice from fiduciaries – experts who have no conflicts of interest and who can therefore act in the best interest of the client. A Certified Medical Planner is such a fiduciary with training and expertise in these areas.
http://www.CertifiedMedicalPlanner.org
It can be particularly challenging to find an insurance advisor with no conflicts of interest, as this industry is built upon product sales and commissions. One such insurance advisor is Scott Witt, a fee-only insurance advisor with Witt Actuarial Services (www.wittactuarialservices.com).
Others can be found with an internet search for “fee only insurance advisor”.
Conclusion
Your comments on this ME-P are appreciated. How do you select an advisor? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
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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 »
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.
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.
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.
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.
Here are the three most popular Micro-Certification course from the Institute of Medical Business Advisors, Inc:
Other Topics include: economics, finance, investing, marketing, advertising, sales, start-ups, business plan creation, financial planning and entrepreneurship, etc.
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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Filed under: "Advisors Only", "Ask-an-Advisor", Book Reviews, Career Development, CMP Program, Experts Invited, Financial Planning, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Information Technology, Investing, Op-Editorials, Touring with Marcinko | Tagged: accountants, certifications, certified medical planner, CMP, financial advisors, financial planners, investment advisors, Marcinko, micro, micro-certifications, micro-credentials | Leave a comment »
By Staff Reporters
Is the Doctor – In?
SPONSOR: http://www.CertifiedMedicalPlanner.org
INFO-GRAPHIC
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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:
The second category, Applied (also referred to as Professional) includes, among others:
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:
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.
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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Filed under: "Doctors Only", Career Development, CMP Program, Experts Invited, Glossary Terms, iMBA, Inc., Op-Editorials, Professional Liability, Quality Initiatives | Tagged: American Psychological Association, AP, APA, Associated Press, CMP, DBA, DCS, DDS, DMA, DMD, DNP, DNSc, DO, doctor, DPM, DSc, EdD, education, EngD, higher-education, JD, MD, MEd, news, OD, PhD, Psy.D, research, ThD, UAGC | Leave a comment »
By Dr. David Edward Marcinko MBA MEd
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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.
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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Filed under: "Doctors Only", Ask a Doctor, Ethics, Experts Invited, Funding Basics, Glossary Terms, Managed Care, Marcinko Associates, Risk Management | Tagged: AMA, cancellation fees, DDS, DO, DPM, Marcinko, MD, medical ethics, medical office, medical office cancellation fees, no show fees | Leave a comment »
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.
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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There are six main critical thinking skills you can develop to successfully analyze facts and situations and come up with logical conclusions:
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.
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.
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.
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.
The ability to correctly analyze a problem and work on implementing a solution is another valuable skill.
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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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.
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.
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.
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.
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: "Advisors Only", "Ask-an-Advisor", Career Development, CMP Program, Experts Invited, Financial Planning, Investing, Managed Care, Marcinko Associates, Marketing & Advertising, Op-Editorials, Sponsors | Tagged: CFPs, creative thinking, critical thinking skills, decision-making, education, FAs, financial advisors, financial planners, FPs, indeed, learning, life, Marcinko, problems, questions, RIA, thinking, what, when, why | Leave a comment »
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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.
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Filed under: "Ask-an-Advisor", Experts Invited, Financial Planning, Funding Basics, Glossary Terms, Health Economics | Tagged: Austrian Economics, economics, fed, Federal Reserve, FOMC, interest rates, Jeff Deist, Keynes, Keynesian Economics, Keynesian versus Austrian Economics | 1 Comment »
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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
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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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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Filed under: "Ask-an-Advisor", Experts Invited, Glossary Terms, Health Economics, Health Insurance | Tagged: david marcinko, Fierce Healthcare, medicare, Medicare Advantage, Medicare Part C, PPO, Tim Noel, UnitedHealthcare | Leave a comment »
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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Filed under: "Ask-an-Advisor", CMP Program, Experts Invited, Financial Planning, Funding Basics, Glossary Terms, Investing, Marcinko Associates, Portfolio Management | Tagged: Alternative Investments, CMP, Health Insurance, hedge funds, life insurance, Marcinko, master feeder, Mike Burry MD, mutual fund, nifty, personal-finance, retirement, suiability, UBTI, unrelated business taxable income | Leave a comment »
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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Filed under: "Ask-an-Advisor", Experts Invited, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy | Tagged: congress, GAO, GAO report, Government Accountability Office, Health Capital Consultants, Physician Consolidation | Leave a comment »
By A.I. and Dr. David Edward Marcinko MBA MEd CMP™
SPONSOR: http://www.CertifiedMedicalPlanner.org
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After a lifetime of hard work practicing medicine and saving, you’re at the retirement finish line. Instead of a paycheck, you’re relying on your nest egg and investment income to cover the bills. Picking the right investments is even more important, as you won’t have much chance to recover as a retired MD, DO, DPM or DDS.
“You made it to the top of the mountain through a systematic approach and are trying to make your way down safely,” says retirement planner John Gillet John Gillet in Hollywood, Fla. “Why throw all caution to the wind and try something different now?”
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Definitions
An annuity is an insurance contract designed to grow your money and then repay it as income. There are different versions. An immediate annuity turns your lump sum into future guaranteed income payments, like your own personal pension. They are simple to understand with no or small fees.
Fixed annuities pay a guaranteed interest rate over a set period to grow your money, like 5% a year for five years. These options could make sense as part of a retirement plan.
A variable annuity, on the other hand, invests your savings in mutual funds. While you can buy riders that guarantee a minimum income, you’ll be paying very much for it. “All in, the annual fees can be 3% or more of your balance,” says Jeff Bailey, an advisor from Nashville. “That’s a huge withdrawal rate from your portfolio versus investing on your own.”
The variable annuity will lock up your money for years. If you cancel early, you owe a surrender charge that could start at 7% or more of your annuity balance before gradually going down as time goes by. “Clients believe they can walk away with their contract value, but that’s often not true,” says Bailey.
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SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com -OR- http://www.MarcinkoAssociates.com
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Filed under: "Ask-an-Advisor", "Doctors Only", CMP Program, Ethics, Experts Invited, Funding Basics, Glossary Terms, Insurance Matters, Investing, Marcinko Associates, Portfolio Management | Tagged: annuities, beware annuities, beware physicians, CMP, david marcinko, DDS, DO, finance, fixed annuities, Gillet John, Jeff Bailey, MD, Mutual Funds, retired doctors, retired physicians, retirement, retirement planning, variable annuities | Leave a comment »
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 »
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):
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.
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
Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
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Filed under: "Ask-an-Advisor", Experts Invited, Investing, Portfolio Management | Tagged: asset allocation, certified medical planner, CFP, CMP, Investing, Lon Jefferies MBA CFP® | Leave a comment »
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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Filed under: "Ask-an-Advisor", Events-Planner, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance | Tagged: Government Shutdown, Health Capital Consultants LLC, healthcare policy, Jessica Bailey-Wheaton, shutdown, TODD A. ZIGRANG | Leave a comment »
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:
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:
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:
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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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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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:
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 »
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:
Conclusion
Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@outlook.com
OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
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Filed under: CMP Program, curated experts,, Experts Invited, Financial Planning, Funding Basics, Investing, Portfolio Management | Tagged: alpha, Amita Patel, beta, certified medical planner, CMP, DFA, Dimensional Fund Advisors, FutureMetrics, marcinko., Roger Ibbotson, ROI, Wayne Firebaugh | 1 Comment »
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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Filed under: Ask a Doctor, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Op-Editorials | Tagged: APMA, DO, do education, doctor education, DPM, dpm education, MD, md education, medical education osteopathic education, osteopath, osteopathic education, physician, podiatrist, podiatry | Leave a comment »
By Dr. David Edward Marcinko; MBA MEd CMP™
PHYSICIAN COACHING: https://marcinkoassociates.com/process-what-we-do/
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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
Cultural heritage
Family
Your parents
Please do your best to answer the same questions regarding your life or business partner(s) and their parents.
Childhood: Revisited
If not, please describe your thoughts and feelings about that.
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Same questions, as a teenager, young adult, older adult.
Credit
Adulthood
Why did you choose your personal path?
a) Would you do it again?
b) Describe your feelings about credit.
Adult attitudes
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 »
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.
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 »
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!
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com
REFERENCES:
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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 »
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
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/
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.
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.
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.
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:
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SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com -OR- http://www.MarcinkoAssociates.com
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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 »
By Staff Reporters
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The verification of the identity of an individual, system, machine, or any other unique entity
The process of allowing access to specific areas of a system based on the role and needs of the user
A document that defines the purposes and responsibilities of the oversight committee
The current and prospective risk to earnings or capital arising from violations of or nonconformance with laws, rules, regulations, prescribed practices, internal policies and procedures, or ethical standards
A high-level review and analysis of controls relating to a process; should encompass both current and missing controls
Methods that preserve the integrity of important information, meet operational or financial targets, and/or communicate management policies (See also: Key Control, Secondary Control, Tertiary Control)
Defines an organization’s approach to and method of enterprise risk management
Processes and structures implemented to communicate, manage, and monitor organizational activities
The influence and effect of a risk
Risk that is inherent to a process, taking into consideration the likelihood and impact of a risk
A primary control that is essential for a business process; typically takes place during the process it applies to
Measurements that are important for organizations to monitor for potential issues; examples include key performance indicators (KPIs) and key risk indicators (KRIs)
A measurement with a defined set of goals and tolerances that gauges the performance of an important business activity
A proactive measurement for future and emerging risks that indicates the possibility of an event that adversely affects business activities
The probability of a risk occurring
The necessary steps, or action items, to reduce the likelihood and/or impact of a potential risk
1) The risk arising from the execution of an organization’s business processes;
2) The risk of loss resulting from failed or inadequate internal processes, systems, people, or other entities
The risk to earning or capital arising from adverse changes in portfolio values
1) The principle elements of essential business functions within work groups or business units;
2) A set of tasks completed by business continuity plan owners within a department
The current and prospective risk to earnings or capital arising from negative public opinion or perception
Risk remaining after considering the existing control environment
A potential event or action that would have an adverse effect on the organization
A statement that broadly considers the risk levels that management deems acceptable
The prioritization of potential business disruptions based on the impact and likelihood of occurrence; includes an analysis of threats based on the impact to the organization, its customers, and financial markets
A metric that sets the acceptable level of variation around organizational objectives and provides assurance that the organization remains within its risk appetite
An important control that typically takes place after the process it applies to (i.e., reporting or ongoing monitoring)
The current and prospective risk to earnings or capital raising from adverse business decisions, improperly implemented decisions, or lack of responsiveness to industry changes
A non-essential control that can still be applied effectively to a business process
The time it takes a risk event to manifest itself
An entity’s susceptibility to a risk event as determined by the entity’s preparedness, agility, and adaptability
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Filed under: "Advisors Only", "Ask-an-Advisor", Career Development, Experts Invited, Glossary Terms, Risk Management | Tagged: business, glossary risk management, leadership, project-management, risk, Risk Management, risk management terms | Leave a comment »
NIST, A.I. and Staff Reporters
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SPONSOR: http://www.CertifiedMedicalPlanner.org
A computer that could break the encryption that safeguards your private information on the internet. A machine that can design powerful new drugs by precisely simulating the behavior of individual molecules. A device that optimizes complex supply chains to help companies get the parts they need and assemble them in the most efficient way possible.
These are all examples of how an emerging technology — the quantum computer — could change our world.
These computers work by harnessing quantum physics — the strange, often counterintuitive laws that govern the universe at its smallest scales and coldest temperatures. Today’s quantum computers are rudimentary and error-prone. But if more advanced and robust versions can be made, they have the potential to rapidly crunch through certain problems that would take current computers years. That’s why governments, companies and research labs around the world are working feverishly toward this goal.
Quantum computers will not replace our familiar “classical” computers. Rather, the two types of machines could work together to solve problems that stymie classical computers, potentially supercharging scientific research in fields such as materials and drug discovery, giving a boost to industry and upending cybersecurity as we know it.
So, let’s explore how quantum computers work.
MORE: https://www.nist.gov/quantum-information-science/quantum-computing-explained
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Filed under: CMP Program, Drugs and Pharma, Ethics, Experts Invited, Information Technology | Tagged: CMP, computers, Cyber Security, Drugs, internet, molecules, NIST, PC, PCs, personal computer, physics, quantum computers | Leave a comment »
By Dr. David Edward Marcinko MBA MEd CMP™
SPONSOR: http://www.CertifiedMedicalPlanner.org
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A paradox is a statement or situation that seems contradictory but actually makes sense when you think about it more deeply. It challenges logic and often reveals a hidden truth.
FLEXIBLY DOGMATIC PARADOX
The Flexibly Dogmatic Paradox suggests that no matter how sensible your financial planning, investing or wealth management process is there will be uncomfortably long periods when it looks broken. And process is the best way of ensuring you keep standing for something because if you don’t stand for something, you’ll fall for anything. This is why, when assessing an investment fund, focus 50% on the manager’s character and 50% on their process. Everything else is detail. There are few guarantees in investing, but the fact that markets will batter you emotionally is one of them.
FINANCIAL PARADOX: https://medicalexecutivepost.com/2025/07/27/paradox-of-financial-health/
Example: During volatile times, the temptation to abandon the process is strong. But that’s why it’s there. Process is what forces one fund manager to keep buying unbroken companies when everyone else thinks they’re bust, and another to keep faith with a top-quality company when the mob says it’s too expensive The best fund managers dogmatically stick to their process when it’s out of favor. Then, when it returns to favor, the elastic pings back: they recapture lost ground surprisingly fast. However, every rule has an exception. And spotting the exceptions to their process is something the true greats have a knack for buying and selling.
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Example: In 2007, US value manager Bill Miller had the makings of an investment legend, but the financial crisis wrecked all that. His process told him to double down into falling share prices, which had worked well for years. But it doesn’t work if the companies go bust, which many of his financial stocks did in 2008.
ADVISORS PARADOX: https://medicalexecutivepost.com/2025/06/20/paradoxical-contradictions-all-financial-advisors-must-know-to-win-clients/
Conclusion
The fact is that no matter how good it is, a process operated without human judgment is just an algorithm. The best fund managers and financial prospectors and sales men/women know this.
They stick dogmatically to their process but somehow remain flexible enough to spot the occasions when it’s about to drive them into a brick wall.
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SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com -OR- http://www.MarcinkoAssociates.com
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Filed under: CMP Program, Ethics, Experts Invited, finance, Financial Planning, Glossary Terms, Marcinko Associates, mental health, Portfolio Management | Tagged: bill miller, brain, budgeting, CMP, dogmatic, dogmatic paradox, finance, financial planniing, flexibility paradox, flexible, Investing, investing paradox, marcinko david, mental health, money, paradox, personal-finance, US value, wealth management | Leave a comment »
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By Dr. David Edward Marcinko MBA MEd CMP™
SPONSOR: http://www.CertifiedMedicalPlanner.org
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DEFINITION
Capitation is a type of healthcare payment system in which a physician or hospital is paid a fixed amount of money per patient for a prescribed period by an insurer or physician association. The cost is based on the expected healthcare utilization costs for a group of patients for that year.
With capitation, the physician—otherwise known as the primary care physician— is paid a set amount for each enrolled patient whether a patient seeks care or not. The PCP is usually contracted with an HMO whose role it is to recruit patients.
ACOs: https://medicalexecutivepost.com/2024/12/01/record-breaking-savings-for-acos-in-2023/
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CAPITATION REIMBURSEMENT HISTORY
According to Richard Eskow, CEO of Health Knowledge Systems of Los Angeles, capitated medical reimbursement has been used in one form or another, in every attempt at healthcare reform since the Norman Conquest. Some even say an earlier variant existed in ancient China [personal communication].
Initially, when Henry I assumed the throne of the newly combined kingdoms of England and Normandy, he initiated a sweeping set of healthcare reforms. Historical documents, though muddled, indicate that soon thereafter at least one “physician,” John of Essex, received a flat payment honorarium of one penny per day for his efforts. Historian Edward J. Kealey opined that sum was roughly equal to that paid to a foot-soldier or a blind person. Clearer historical evidence suggests that American doctors in the mid-19th century were receiving capitation-like payments. No less an authoritative figure than Mark Twain, in fact, is on record as saying that during his boyhood in Hannibal, MO his parents paid the local doctor $25/year for taking care of the entire family regardless of their state of health.
Later, Sidney Garfield MD [1905-1984] is noted as one of the great under-appreciated geniuses of 20th century American medicine stood in the shadow cast by his more celebrated partner, Henry J. Kaiser. Garfield was not the first physician to embrace the notion of prepayment capitation, nor was he the first to understand that physicians working together in multi-specialty groups could, through collaboration and continuity of care, outperform their solo practice colleagues in almost every measure of quality and efficiency. The Mayo brothers, of course, had prior claim to that distinction. What Garfield did, was marry prepayment to group practice, providing aligned financial incentives across every physician and specialty in his medical group, as well as a culture of group accountability for the care of every member of the affiliated health plan. He called it “the new economics of medicine,” and at its heart was a fundamentally new paradigm of care that emphasized – prevention before treatment – and health before sickness. Under his model: the fewer the sick – the greater the remuneration. And: the less serious the illness, the better off the patient and the doctors.
VBC: https://medicalexecutivepost.com/2018/12/07/the-state-of-value-based-care-vbc/
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Such ideas were heresy to the reigning fee-for-service, solo practice, ideologues of the mainstream medical establishment of the 1940s and ‘50s, of course. Throughout the period, Garfield and his group physicians were routinely castigated by leaders of the AMA and county medical associations as socialistic and unethical. The local medical associations in Garfield’s expanding service areas – the San Francisco Bay Area, Los Angeles, and Portland, Oregon – blocked group practice physicians from association membership, effectively shutting them out of local hospitals, denying them patient referrals or specialty society accreditation. Twice in the 1940s, formal medical association charges were brought against Garfield personally, at one time temporarily succeeding in suspending his license to practice medicine.
Of course, capitation payments made a comeback in the first cost-cutting managed care era of the 1980-90s because fee-for-service medicine created perverse incentives for physicians by paying more for treating illnesses and injuries than it does for preventing them — or even for diagnosing them early and reducing the need for intensive treatment later. Nevertheless, the modern managed care industry’s experience with capitation wasn’t initially a good one. The 1980-90s saw a number of HMOs attempt to put independent physicians, especially primary care doctors, into a capitation reimbursement model. The result was often negative for patients, who found that their doctors were far less willing to see them — and saw them for briefer visits — when they were receiving no additional income for their effort. Attempts were also made to aggregate various types of health providers — including hospitals and physicians in multiple specialties — into “capitation groups” that were collectively responsible for delivering care to a defined patient group. These included healthcare facilities and medical providers of all types: physicians, osteopaths, podiatrists, dentists, optometrists, pharmacies, physical therapists, hospitals and skilled nursing homes, etc.
However, the healthcare industry isn’t collective by nature, and these efforts tended to be too complicated to succeed. One lesson that these experiments taught is that provider behavior is difficult to change unless the relationship between that behavior and its consequences is fairly direct and easy to understand.
Today, the concept of prepayment and medical capitation is to uncouple compensation from the actual number of patients seen, or treatments and interventions performed. This is akin to a fixed price restaurant menu, as opposed to an àla carte eatery.
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SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com -OR- http://www.MarcinkoAssociates.com
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Filed under: Ask a Doctor, Career Development, CMP Program, curated experts,, economics, Ethics, Experts Invited, finance, Glossary Terms, Health Economics, Health Law & Policy, Healthcare Finance, Marcinko Associates | Tagged: AMA, capitation, capitation economics, CMP, david marcinko, DDS, DMD, DO, doctor compensation, DPM, exchange-server, Health Economics, Health Insurance, HMO, Managed Care, MD, PCP, physician compensation, powershell, primary care provider, Richard Eskow, RN, Sidney Garfield, system-center | Leave a comment »
By Dr. David Edward Marcinko MBA MEd
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BREAKING NEWS
Law enforcement officials in Utah released a video of the suspected shooter in the assassination of Turning Point USA co-founder and CEO Charlie Kirk, saying that the person wore Converse tennis shoes and left a hand print and a shoe print at the scene.
The suspect in Charlie Kirk’s assassination has been identified as Tyler Robinson, a 22-year-old Utah resident. Law enforcement sources told the Daily Mail that Robinson was taken into custody as the alleged assassin who killed Kirk at a rally at Utah Valley University on Wednesday.
PODIATRY EDUCATION: https://medicalexecutivepost.com/2025/09/11/education-md-do-and-dpm/
Forensic Podiatry on TV
Before today, forensic podiatry has even made it into the public zeitgeist with the hit TV show “Bones” which premiered on September 13, 2005, and concluded on March 28, 2017, airing for 246 episodes over 12 seasons. The show was based on forensic anthropology and forensic archaeology, with each episode focusing on the mystery behind human body remains brought in for examination and identification.
PODIATRY TYPES: https://medicalexecutivepost.com/2025/07/28/podiatrist-types-specialization-and-salary/
In one show, eight pairs of dismembered feet washed ashore after a flood on the U.S.-Canada border, but things didn’t add up when only seven pairs of feet were identified as research corpses from a nearby university body farm.
When the fictional Canadian forensic podiatrist Dr. Douglas Filmore took the remains back to Canada, he had to form a jurisdictional alliance with the United States to match the pairs of feet and identify the victims. A rare and expensive pair of sneakers led the team to the victim’s murderer.
In 2016, an actual forensic podiatry club was started at the Barry University School of Podiatric Medicine. And, a formal class covering aspects of forensic podiatry is held at the New York College of Podiatric Medicine. Students exit the class with an in depth knowledge of forensic podiatry and other legal knowledge applicable to current cases.
More expertly, real-life colleague Michael Steven Nirenberg DPM actually testified in the murder trial of defendants Kailie Brackett and Donnell Dana with the state calling three witnesses to testify, including the podiatrist who claimed Brackett’s footprints match the ones found in blood at the apartment of the victim, Kimberly Neptune. The forensic podiatrist focused on the footprints discovered at Neptune’s apartment, using prints and images of the defendant’s feet taken by law enforcement. After study, he claimed the prints at the scene bore a resemblance to Kailie Brackett’s in the width of the foot. The defense questioned the field of forensic podiatry and pressed Dr. Nirenberg on whether the measurements would be altered depending on how thick the sock covering the foot was woven.
Dr. Nirenberg was also interviewed on National Public Radio’s Morning Edition on April 14th 2023 about the gait of the bombing suspect associated with the capital riot on Wednesday January 6th, 2021. Dr. Nirenberg is president of the American Society of Forensic Podiatry and co-editor of the textbook: “Forensic Gait Analysis: Principles and Practice”. The bombing suspect had placed bombs at the DNC and RNC headquarters in Washington, DC on the night before. NPR asked Dr. Nirenberg to comment on the features of the person’s gait.
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Additionally, Nirenberg was interviewed by Nancy Grace on her TV show Crime Stories. Grace interviewed Nirenberg about his forensic podiatry work in helping to solve the murder of a mother of 3 who was killed in a church. The case remains unsolved. The episode, “Fitness-Mom Missy Bevers Bludgeoned Dead in Creekside Church” aired June 6th, 2024 and is available online at Merit+ TV.
And, Netflix’s 2023 docu-series, “Till Murder Do Us Part”, recounts the killings of Derek and Nancy Haysom by including a series of interviews with a cast of real people. The four-part docu-series revolves around the unpacking of how a wealthy couple was murdered in Virginia in 1985. It also focuses on how the suspects, Elizabeth Haysom, and her boyfriend, Jens Soehring, betrayed each other during the trial. Dr. Sarah Reel DPM was the forensic podiatrist who was involved with Jens’ and Elizabeth’s footprint examination. Dr. Reel pointed out that, statistically, there was no difference “between a bare footprint and a socked footprint.” The doctor suggested that Jens’ reference footprint matched closely with the crime scene footprint.
Cite: Aeron Mer Eclarinal, The Direct [11/9/23]
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SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com -OR- http://www.MarcinkoAssociates.com
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Filed under: Ask a Doctor, Career Development, Ethics, Experts Invited, Glossary Terms, Health Economics, Health Insurance, Healthcare Finance, Practice Management, Professional Liability | Tagged: "BONES", Barry University Forensics, charlie Kirk, daily mail, david marcinko, DDS, DNC, DO, DPM, foot prints, forensic podiatry, Haysom, MD, Michael Steven Nirenberg DPM, Nancy Grace, physicians, podiatric physician, podiatrist, podiatry, S&P 500, Sarah Reel DPM, turning point USA, tyler robinson | Leave a comment »
By Dr. David Edward Marcinko MBA MEd CMP™
SPONSOR: http://www.MarcinkoAssociates.com
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Here are some of the most common risks associated with fixed income securities.
The market value of the securities will be inversely affected by movements in interest rates. When rates rise, market prices of existing debt securities fall as these securities become less attractive to investors when compared to higher coupon new issues. As prices decline, bonds become cheaper so the overall return, when taking into account the discount, can compete with newly issued bonds at higher yields. When interest rates fall, market prices on existing fixed income securities tend to rise because these bonds become more attractive when compared to the newly issued bonds priced at lower rates.
Investors who need access to their principal prior to maturity have to rely on the secondary market to sell their securities. The price received may be more or less than the original purchase price and may depend, in general, on the level of interest rates, time to term, credit quality of the issuer and liquidity.
Among other reasons, prices may also be affected by current market conditions, or by the size of the trade (prices may be different for 10 bonds versus 1,000 bonds), etc. It is important to note that selling a security prior to maturity may affect actual yield received, which may be different than the yield at which the bond was originally purchased. This is because the initially quoted yield assumed holding the bond to term. As mentioned above, there is an inverse relationship between interest rates and bond prices. Therefore, when interest rates decline, bond prices increase, and when interest rates increase, bond prices decline.
Generally, longer maturity bonds will be more sensitive to interest rate changes. Dollar for dollar, a long-term bond should go up or down in value more than a short-term bond for the same change in yield. Price risk can be determined through a statistic called duration, which is featured at the end of the fixed income section.
REVENUE BONDS: https://medicalexecutivepost.com/2024/12/20/bonds-revenue/
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Liquidity risk is the risk that an investor will be unable to sell securities due to a lack of demand from potential buyers, sell them at a substantial loss and/or incur substantial transaction costs in the sale process. Broker/dealers, although not obligated to do so, may provide secondary markets.
Downward trends in interest rates also create reinvestment risk, or the risk that the income and/or principal repayments will have to be invested at lower rates. Reinvestment risk is an important consideration for investors in callable securities. Some bonds may be issued with a call feature that allows the issuer to call, or repay, bonds prior to maturity. This generally happens if the market rates fall low enough for the issuer to save money by repaying existing higher coupon bonds and issuing new ones at lower rates. Investors will stop receiving the coupon payments if the bonds are called. Generally, callable fixed income securities will not appreciate in value as much as comparable non-callable securities.
ZERO COUPON BONDS: https://medicalexecutivepost.com/2024/11/12/bonds-zero-coupon/
Similar to call risk, prepayment risk is the risk that the issuer may repay bonds prior to maturity. This type of risk is generally associated with mortgage-backed securities. Homeowners tend to prepay their mortgages at times that are advantageous to their needs, which may be in conflict with the holders of the mortgage-backed securities. If the bonds are repaid early, investors face the risk of reinvesting at lower rates.
Fixed income investors often focus on the real rate of return, or the actual return minus the rate of inflation. Rising inflation has a negative impact on real rates of return because inflation reduces the purchasing power of the investment income and principal.
GENERAL OBLIGATION BONDS: https://medicalexecutivepost.com/2022/03/24/general-obligation-and-revenue-bonds/
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Filed under: "Ask-an-Advisor", Experts Invited, finance, Financial Planning, Investing, Marcinko Associates, Portfolio Management | Tagged: bond risks, bonds, finance, fixed income risks, interest rate risks, Investing, liquidity risk, Marcinko, personal-finance, prepayment risks, price risks, purchasing power risk, reinvetment risks, stocks | Leave a comment »
By Dr. David Edward Marcinko MBA MEd CMP™
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SPONSOR: http://www.MarcinkoAssociates.com
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Read more about stock manipulation.
For further details about other common securities violations, see our Securities Law Primer.
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SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com -OR- http://www.MarcinkoAssociates.com
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Filed under: "Ask-an-Advisor", CMP Program, Ethics, Experts Invited, finance, Glossary Terms, Investing, Marcinko Associates, Portfolio Management | Tagged: Apple, bear raids, CMP, david marcinko, economy, google, internet, layering, matched order, paintibg the tape, ponzi scheme, pump and dump, SEC, spoofing, stock manipulation, stock market manipulation, Venture Capital, wash trading | Leave a comment »
NEW FINANCIAL STRATEGIES?
By A.I. and Dr. David Edward Marcinko; MBA MEd CMP™
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SPONSOR: http://www.CertifiedMedicalPlanner.org
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Although 97% of people aren’t yet millionaires, many could eventually meet that target if they start investing sooner rather than later; especially doctors [MD, DO, DPM, DDS or DMD].
BROKE DOCTORS: https://medicalexecutivepost.com/2025/08/02/doctors-going-broke-and-living-paycheck-to-paycheck/
A 20-year-old, for instance, needs to invest just $330 a month into an asset class that delivers a 7% to 8% annual return to reach $1.26 million by the time s/he turns 65 years old. The luxury of time significantly boosts your chances of becoming a millionaire.
This doesn’t mean it’s too late for middle-aged savers to reach that millionaire milestone, but it will take a significantly greater investment. If a 50-year-old doctor hasn’t started saving for retirement, s/he would need to invest $3,958 a month at a steady 7% return to reach $1.26 million by retirement.
MONEY ADDICTION: https://medicalexecutivepost.com/2025/08/07/moiney-addicted-physicians-the-investing-and-trading-personality-of-doctors/
However, according to one Goldman Sachs report, investors could expect the S&P 500 to deliver just 3% annualized nominal returns over the next 10 years.
After an average 13% yearly return for the past decade, a new strategy outside of the stock market may be needed for that level of outsized gain, especially if you’re late to investing.
RETIREMENT VISION: https://medicalexecutivepost.com/2025/08/04/physicians-determine-your-retirement-vision/
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SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com -OR- http://www.MarcinkoAssociates.com
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Filed under: "Doctors Only", Accounting, Alternative Investments, business, Career Development, CMP Program, Experts Invited, finance, iMBA, Inc., Information Technology, Investing, Marcinko Associates, Portfolio Management | Tagged: books, broke doctors, CMP, david marcinko, DDS, DJIA, DMD, DO, DOW, DPM, finance, Goldman Sachs, HIT, Investing, IT, portfolios, retirement vision, S&P 500 | Leave a comment »
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Filed under: "Ask-an-Advisor", Accounting, Career Development, Experts Invited, Funding Basics, Investing, Portfolio Management | Tagged: capital, CASH, Entrepreneurs, Investing, investors, money, newton, pitching angels, start up capital, start-ups, VC, Venture Capital | Leave a comment »
By A.I. and Staff Reporters
SPONSOR: http://www.CertifiedMedicalPlanner.org
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According to Medical Economics, there were 10 clinic and physician practices filing bankruptcy in 2024, making it the highest level of the last six years, according to a new analysis of cases with liabilities of at least $10 million.
Meanwhile, the Steward Health Care System bankruptcy, which was based in Massachusetts but making headlines across the nation, has become “the largest hospital sector bankruptcy by far in the last 30 years,” according to a new analysis by Gibbins Advisors, based in Nashville, Tennessee.
Health care bankruptcy filings totaled 57 last year, down from 79 in 2023, said “Healthcare Restructuring: Trends and Outlook.” The report analyzed Chapter 11 health care bankruptcy cases with liabilities of at least $10 million, since 2019.
Last year’s total was down 28% from 2023’s peak, but greater than the 2019 to 2022 average of 42 filings a year, the report said.
BROKE DOCTORS: https://medicalexecutivepost.com/2025/08/02/doctors-going-broke-and-living-paycheck-to-paycheck/
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Bankruptcy, often considered a last financial resort, is a legal process that can help alleviate outstanding debts for individuals and businesses. Reasons to file for bankruptcy can include divorce, job loss, exorbitant medical bills or credit card debt.
There are several types of bankruptcy — six, as a matter of fact. The two most common types of bankruptcy for individuals are Chapter 7 and Chapter 13.
But there are four other types as well: Chapter 9, Chapter 11, Chapter 12 and Chapter 15. And, the type of bankruptcy filed depends on the situation.
Regardless of which type, the process is typically the same: You’ll usually retain an attorney and make your case before a judge, who will then erase some debts or set up a repayment plan.
Also note that an eligibility requirement — for all bankruptcy chapters — is that you must undergo credit counseling within the 180 days before filing.
DOCTORS: https://medicalexecutivepost.com/2025/07/17/doctors-and-lawyers-often-arent-millionaires/
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Filed under: "Ask-an-Advisor", "Doctors Only", Career Development, CMP Program, economics, Experts Invited, finance, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Insurance Matters | Tagged: assets, bankruptcy, california, Chapter 11, Chapter 7, CMP, credit counseling, DMD, DPM, Gibbins Advisors, liabilities, MD, Media, medical, Medical Exonomics, Physician bankruptcy, software, Steward Health Care | Leave a comment »
By Health Capital Consultants, LLC
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A recent study of hospital physician acquisition and employment found that such acquisitions decrease competition and raise prices. A National Bureau of Economic Research (NBER) working paper, released in July 2025, “empirically analyze[d] the effects of mergers between complementary firms on competition and pricing,” and found hospital prices increased by an average of 3.3%, while physician prices increased by an average of 15.1%.
This Health Capital Topics article reviews the study’s findings and implications for the healthcare industry. (Read more…)
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Filed under: "Ask-an-Advisor", economics, Experts Invited, finance, Funding Basics, Health Economics, Health Insurance, Healthcare Finance, Investing, Practice Worth | Tagged: DO, Health Capital Consultants, hospital acquisitioons, Jessica Bailey-Wheaton, MD, National Bureau of Economic Research, NBER, physician practices, TODD A. ZIGRANG | Leave a comment »
U.S. Department for Health & Human Services & Centers for Medicare & Medicaid Services
By Health Capital Consultants, LLC
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On August 21, 2025, the U.S. Department for Health & Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) announced the formation of a new Healthcare Advisory Committee.
The Committee is expected to be comprised of a group of experts who will make strategic recommendations to HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Dr. Mehmet Oz.
This Health Capital Topics article discusses this announcement and potential implications on the healthcare industry. (Read more…)
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Filed under: "Ask-an-Advisor", Experts Invited, Health Economics, Health Law & Policy, Healthcare Finance, Op-Editorials | Tagged: CMS, Health Capital Consultants, Healthcare Advisory Committee., HHS, Jessica Bailey-Wheaton, Mehmet Oz, Robert Kennedy, TODD A. ZIGRANG | Leave a comment »
Medicare Inpatient Prospective Payment System
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By Health Capital Consultants, LLC
On July 31, 2025, the Centers for Medicare & Medicaid Services (CMS) released its finalized payment and policy updates for the Medicare Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) for fiscal year (FY) 2026.
The final rule authorized Medicare inpatient reimbursement increases for 2026 and moved forward with improvements to quality measurement, and provided more information on a new value-based payment model.
This Health Capital Topics article will discuss the IPPS final rule and stakeholder reactions. (Read more…)
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Filed under: "Ask-an-Advisor", Ethics, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance | Tagged: Centers for Medicare & Medicaid Services, CMS, Health Capital Consultants LLC, IPPS, Jessica Bailey-Wheaton, Long-Term Care Hospital, LTCH, Medicare Inpatient Prospective Payment System, TODD A. ZIGRANG | Leave a comment »
By A.I. and Staff Reporters
SPONSOR: http://www.CertifiedMedicalPlanner.org
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According to Hello Divorce, alimony, often referred to as spousal support, is a court-ordered payment from one spouse to the other following a divorce or legal separation. Its existence is tied to the legal status of marriage. The underlying principle is that both spouses contributed to the marital standard of living, and the dissolution of the marriage should not cause an inequitable economic outcome for the lower-earning spouse. This support is not intended as a punishment but as a means of mitigating the financial impact of divorce.
The purpose of alimony can vary. In some cases, it is rehabilitative, providing temporary support while one spouse obtains education or job training to become self-sufficient. For longer marriages, it might serve to help maintain the standard of living established during the partnership. Alimony is a legal tool derived from family law statutes to address the financial interdependence created by marriage.
DIVORCE: https://medicalexecutivepost.com/2025/08/14/physician-divorce-within-the-medical-profession/
Note: The federal tax treatment for alimony changed with the Tax Cuts and Jobs Act of 2017. For any divorce or separation agreement executed after December 31st, 2018, alimony payments are no longer tax-deductible for the person paying them. The recipient of the support does not report the payments as taxable income. This change is permanent and does not expire with other provisions of the act.
According to Wikipedia, Palimony refers to financial support that may be awarded after an unmarried couple separates. Unlike alimony, palimony is not rooted in family law but is a concept derived from contract law. An award depends on the existence of an agreement between the partners. This agreement can be a formal written contract or an oral or implied agreement for support in exchange for services, such as managing the household.
The legal basis for palimony was established by the 1976 California Supreme Court case, Marvin v. Marvin. In that case, the court ruled that unmarried cohabitants could make enforceable contracts for support, as long as the agreement was not based on sexual services. Because it is a contract claim, a palimony case is pursued in civil court, not family court. Palimony is not available in all states and is only recognized in a minority of jurisdictions.
Note: The tax implications of palimony are less defined than alimony because the IRS does not have a specific rule for it. How palimony is treated depends on the nature of the underlying claim. If the payments are a settlement for services rendered, they may be considered taxable income to the recipient. If the payments are characterized as a gift, they are not considered taxable income for the recipient.
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