BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
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Posted on March 4, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
Electronic Data Gathering, Analysis, and Retrieval
By Staff Reporters
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EDGAR (Electronic Data Gathering, Analysis, and Retrieval) is an internal database system operated by the U.S. Securities and Exchange Commission (SEC) that performs automated collection, validation, indexing, and accepted forwarding of submissions by companies and others who are required by law to file forms with the SEC. The database contains a wealth of information about the commission and the securities industry which is freely available to the public via the Internet.
In September 2017, SEC Chairman Jay Clayton revealed the database had been hacked and that companies’ data may have been used by criminals for insider trading.
Marketability and liquidity are two concepts that are interrelated but often confused by the medical professional. Marketability deals with the speed at which an asset can be turned into cash. Liquidity, on the other hand, deals with an asset that can be turned to cash without a significant loss of value. A physician’s practice may still be good investment, but is it not particularly marketable or liquid. A common stock traded on the New York Stock Exchange can be easily sold for its quoted fair market value.
[B] The Time Value of Money
To the young physician starting a career, the time value of money is not a primary concern. It involves spending dollars in the future compared with spending today. Paying off high student loans while earning a relatively low salary leaves barely enough for present personal consumption. In the past, the rationale to spend today, forsaking the future, was not only a function of necessity but stemmed from the probability that future income would grow appreciably higher. Today, this is no longer a given for medical professionals.
In the simplest terms, a dollar today is worth more than a dollar tomorrow. The supply and demand for a dollar today to be paid back in the future is what determines interest rates. This calls for an understanding of the concepts of present and future value.
Present value is what you have today. So a dollar is a worth a dollar.Future value is what that dollar will grow to when compounded at a given interest rate. If you started with 100 dollars and earned 10 percent for five years, you would end up with 161 dollars.
Year Paying Interest Ending Interest
Amount of Factor Amount (annual)
1 $ 100 1.10 $ 110.00 $ 10.00
2 110 1.10 121.00 11.00
3 121 1.10 133.10 12.10
4 133.10 1.10 146.41 13.31
5 146.41 1.10 161.05 14.64
$ 61.05
Whenever you do not have a financial calculator, such as a Hewlett-Packard 12-C, Texas Instruments BA III plus, apps, SAAS, or computer spreadsheet or handy, you can figure future value with this formula.
FV = PV (1 + i)^N
FV is future value and PV is present value. The periodic interest rate is represented by the i. The number of periods being compounded is the n. The N means to the power of some number. In the example above, the equation would appear as follows:
FV = $100(1+.1)^2
FV = $100(1.21)
FV = $121
N
Likewise, the formula for present value is: PV = amount / (1 + i )
Other time value of money concepts, easily determined with a calculator, or interest table include the future value of multiple (equal) cash flows (ordinary annuity); conversion to an annuity due; the present value of multiple (equal) cash flows (ordinary annuity); and the conversion to an annuity due.
Example: Determining a Funding Amount
Dr. Smith has a daughter who plays the piano very well. He wishes to accumulate funds for his daughter Mackenzie’s advanced music education. He estimates that she will need $6,000 per year in today’s dollars, and will start school at age 18. She is 10 years old now. Costs are expected to increase 6 percent annually. Dr. Smith and his financial advisor believe that he can earn 9 percent after tax on his funds. How much is required?
Step # 1: Determine the future value of $6,000, 8 years from now. Or, what will Mackenzie’s first-year piano school cost, considering inflation?
Using a financial calculator, such as the HP 12-C: @ 8n (years), 6i (interest rate); $ 6,000 PV; the future value is $9,563
Step # 2: Next, determine the lump sum necessary to provide the above amount at the start of each year (present value annuity due).
Again, using the HP12-C @ $9,563 PMT; g7 (PVAD); 4 N; 1.09/1.06 i; the present value is $36, 702.
Step # 3: Compute the annual savings required at the end of each year (ordinary annuity) to provide the lump sum needed at age 18.
Finally, calculate with the HP 12-C @ g8 (ordinary annuity); $ 36,702 FV; 8N; 9i, and solve for PMT = $ 3,328.
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
Posted on March 3, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Suppose, as a medical or nursing school student, or new practitioner, you want to invest in a company, but its stock price may be higher than what you want, or can afford, to pay.
Instead of buying a whole share of stock, you can buy a fractional share, which is a “slice” of stock that represents a partial share, for very little money (ie., $5 at Charles Schwab).
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Example: If a company’s stock is selling at $1,000 a share and you were buying $200 worth of it, you would own 0.2 (20%) of a share. With stock slices, investing has never been more accessible.
In 1972, Nobel Laureate Kenneth J. Arrow, PhD shocked academe’ by identifying health economics as a separate and distinct field. Yet, the seemingly disparate insurance, tax, risk management and financial planning principles that he also studied are just now becoming transparent to some medical professionals and their financial advisors. Despite the fact that a basic, but hardly promoted premise of this new wave financial planning era, is imprecision.
Nevertheless, to informed cognoscenti like Certified Medical Planners™, the principles served as predecessors to the modern physician-focused financial advisory niche sector. In 2004, Arrow was selected as one of eight recipients of the National Medal of Science for his innovative views.
And now, as a long bull market may be over, and if the current “new-normal” prevails – meaning a 4.5% real annualized rate of return on equities and a 1.5% real rate on bonds – wealth accumulation for all may be reduced.
An Imprecise Science
There is a major variable, dominant in any marketplace that pushes an economy in a forward direction. It is called consumerism. This became apparent while waiting in a doctor’s office one recent afternoon.
Scenario:
The front office receptionist, who appeared to be about 21 years old, was breaking for lunch and her replacement, who appeared not much older, came over to assist. Realizing the propensity for a long wait, one was taken by the size of waiting room and the number of patients coming in and out of the office. [Americans consume healthcare and a lot of it]. There was another notable peculiarity. The sample prescription bags being carried out the door were no match for the bags under everyone’s eyes, including the doctor’s. The office staff was probably working overtime, if not two jobs, and the doctor was working harder and faster in a managed care system.
Assessment
Why? So they all could afford to buy and voraciously consume for their children and themselves. Americans indeed work longer hours than any other industrialized nation.
Conclusion
Finally, as women medical professionals entered the workforce in unprecedented numbers, the stock markets reached an all time high in 2025, even as money was spent at a feverish pace as the Federal Reserve pumped out money in inflammatory fashion.
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: CONTACT: MarcinkoAdvisors@outlook.com
Posted on February 26, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
BREAKING NEWS
By Staff Reporters
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WASHINGTON, Feb 25 (Reuters) – U.S. President Donald Trump signed an executive order on Tuesday aiming to improve price transparency on healthcare costs by directing federal agencies to strictly enforce a 2019 order he signed during his first term.
The order directs the Departments of the Treasury, Labor, and Health and Human Services to within 90 days come up with a framework to enforce Trump’s 2019 executive order forcing health insurers and hospitals to disclose healthcare cost details.
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This includes requiring the disclosure of actual prices not estimates, update existing guidance or proposing new regulations that ensure price information is standardized, and updating or issuing enforcement policies that guarantee compliance.
“You’re not allowed to even talk about it when you’re going to a hospital or see a doctor. And this allows you to go out and talk about it,” Trump told reporters as he signed the order. “It’s been unpopular in some circles because people make less money, but it’s great for the patient.”
Posted on February 26, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
AMERICAN DENTAL ASSOCIATION
By ADA and Staff Reporters
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Every day should be about children’s dental health
This is the message behind the ADA’s National Children’s Dental Health Month resources for 2025. Observed nationally each February, the recognition brings together thousands of dedicated professionals, health care providers and educators to promote the benefits of good oral health to children, their caregivers, teachers and many others.
The ADA is offering new materials to celebrate and promote the importance of children’s dental health, not only during the month of February, but all year.
Posters and flyers emphasizing the importance of brushing are available for free download in two kid-friendly, topical designs and two sizes, 8.5″x11″ and 11″x17″. Matching coloring sheets are offered in 8.5″x11″. All materials have instructions for proper brushing and are available in English and Spanish from ADA.org/NCDHM.
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In addition, the ADA’s 2025 Brushing Calendar is available for free download. This 12-month calendar is valuable year-round for promoting healthy behaviors like brushing twice a day with a fluoride toothpaste to help prevent dental disease. Kids can track their daily brushing and flossing routines and exercise their creativity by coloring the calendar image for each month.
Another tool, the NCDHM Program Planning Guide, provides resources for program coordinators, dental societies, teachers and parents to promote the benefits of good oral health to children. The guide includes easy-to-do activities, program planning tips, a sample NCDHM proclamation and more.
“The sooner children understand the value of good oral health habits, the more likely they are to continue these habits well into adulthood,” said ADA President Brett Kessler, D.D.S. “The ADA is proud that NCDHM will once again equip some of the most influential figures in kids’ lives — like parents, educators and health care providers — to help set our nation’s kids on the path to a lifetime of healthy smiles and healthier lives.”
National Children’s Dental Health Month observances began with a one-day event in Cleveland and a one-week celebration in Akron, Ohio, in February 1941. Since then, the concept has evolved into a nationwide program.
The ADA held the first national observance of Children’s Dental Health Day on February 8th, 1949. The one-day event became a week long event in 1955, and in 1981 the program was extended to a month long celebration known today as National Children’s Dental Health Month.
Posted on February 23, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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ORIGINAL: May 2021 | Matt Cohlmia
As the future of healthcare becomes digitized, the threat of disruption to health systems has never been greater. Despite their best intentions, the flood of new competitors and ever-proliferating modalities of care each compete for patient attention, creating the potential for a fragmented, confusing, and impersonal patient experience. At the same time, health systems possess the breadth of care, the access to data, and the patient trust to become their community’s preferred partner in care.
But to achieve success, they must leverage these resources to create easy to navigate and personalized experiences for their patients, and for the first time ever, those are within reach.
9. We act with honesty, integrity and are always straightforward. 8. We strive to be innovative, creative, iconoclastic, and flexible. 7. We admit and learn from mistakes and don’t repeat them. 6. We work hard always as competitors are trying to catch up. 5. We treat others with dignity and respect. 4. We are the onus of consulting advice for the well being of others. 3. We fight complacency as former success is in the past. 2. The best management styles are timeless, not timely. 1. Our clients are colleagues and always come first.
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
Satisficing is a business decision-making strategy or cognitive heuristic that entails searching through the available alternatives until an acceptability threshold is met.
The term economic satisficing, a portmanteau of satisfy and suffice, was introduced by Herbert A. Simon in 1956, although the concept was first posited in his 1947 book Administrative Behavior. Simon used satisficing to explain the behavior of decision makers under circumstances in which an optimal solution cannot be determined. He maintained that many natural problems are characterized by computational intractability or a lack of information, both of which preclude the use of mathematical optimization procedures.
He observed in his Nobel Prize in Economics speech that “decision makers can satisfice either by finding optimum solutions for a simplified world, or by finding satisfactory solutions for a more realistic world. Neither approach, in general, dominates the other, and both have continued to co-exist in the world of management science”.
“Satisficing” – a made-up word created by combining satisfactory and sufficient – indicates something good, but not great. Like the Canadian single-payer health system, like Medicare-for-All.
Posted on February 21, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Dan Ariely PhD
THE IRRATIONAL ECONOMIST
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Of course you don’t need a human financial advisor … until you do. Today, we’ve had unfettered internet access to a wide range of investments, opinions and models for at least two decades. So, why the bravado to go it alone; fifteen positive years for equities, since 2009! Yet, the DJIA, S&P 500 and NASDAQ just plunged and plummeted today!
The financial advisor’s role is to remove the human element and emotion from investing decisions for something as personal as your wealth. Emotion drives the retail investor to sell low (fear) and buy high (greed). This is the reason why the average equity returns for retail investors is less than half of the S&P 500’s returns.
No, of course you don’t need a human financial advisor … until you do.
Posted on February 18, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
DEFINITION
By Staff Reporters
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Variable Universal Life Insurance: Permanent life insurance that allows the policyholder to vary the amount and timing of premiums and, by extension, the death benefit. Universal life insurance policies accumulate cash value which grows tax deferred. Within certain limits, policyholders can direct how this cash value will be allocated among sub-accounts offered within the policy.
Several factors will affect the cost and availability of life insurance, including age, health, and the type and amount of insurance purchased. Life insurance policies have expenses, including mortality and other charges. If a policy is surrendered prematurely, the policyholder also may pay surrender charges and have income tax implications. You should consider determining whether you are insurable before implementing a strategy involving life insurance.
Any guarantees associated with a policy are dependent on the ability of the issuing insurance company to continue making claim payments.
Posted on February 17, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MSFT-HUG Update
By Dr. David Edward Marcinko; MBA MEd
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MSHUG: Microsoft Healthcare Users Group (MS-HUG) unified with the Healthcare Information and Management Systems Society (HIMSS) as part of the HIMSS Users Group Alliance Program in October 2003.
Today, the unification strengthens the commitment of HIMSS and MS-HUG to better serve their members and the industry through a shared strategic vision to provide leadership and healthcare information technology solutions that improve the delivery of patient care.
Posted on February 17, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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U.S. Stock Markets will be closed for Presidents Day. But crypto trading takes no days off.
The Presidents Day holiday was originally intended to celebrate the birthday of the first President George Washington on February 22nd, according to the Library of Congress. The holiday is still formally designated as Washington’s Birthday by the Office of Personnel Management. Washington’s birthday was an informal holiday during the country’s early existence and President Rutherford B. Hayes formalized the holiday in 1879, according to History.com. The holiday’s proximity to the birthday of President Abraham Lincoln on February 12th caused the general public to link the two and later expand the celebration to all presidents.
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Berkshire Hathaway, the investment conglomerate led by Warren Buffett, reduced its holdings in two US banks. Bank of America (BoA) and Citigroup shares were sold in the final quarter of 2024. The move, disclosed in a regulatory filing last Friday, comes as Buffett continues to trim Berkshire’s stock portfolio, favoring safer investments such as US Treasury bills.
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Wall Street just dumped nearly every dollar of the $12.5 billion in loans that helped Elon Musk buy Twitter—now called X—in 2022. A group of seven major banks, led by Morgan Stanley, offloaded $4.74 billion of the debt last Friday, selling more than their planned $3 billion as investors flooded in with $12 billion in orders, according to a report from the Financial Times.
Posted on February 12, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Blue Cross Blue Shield will soon begin paying out $2.67 billion to customers follow a years-long lawsuit alleging that the health insurance giant broke antitrust laws. The litigation began in 2013, when a class-action lawsuit was filed against more than 35 Blue Cross Blue Shield health insurance plans. The lawsuit claims the company broke antitrust laws by limiting market competition, resulting in increased premiums and reduced options for customers.
US stocks closed mixed on Tuesday as investors assessed more tariff policy shifts from President Donald Trump and looked ahead to upcoming inflation data.
Traders also digested the start of Federal Chair Jerome Powell’s two-day testimony in Congress. In his opening remarks, Powell told lawmakers the Fed is not in a rush to adjust interest rates and reiterated the central bank’s stance of not commenting on trade policy.
The Dow Jones Industrial Average (^DJI) edged around 0.3% higher, while the benchmark S&P 500 (^GSPC) closed just above the flatline. The tech-heavy NASDAQ Composite (^IXIC) pulled back about 0.4%.
Posted on February 10, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
EVIDENCE BASED DENTISTRY
By Staff Reporters
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Evidence Based Dentistry?
Despite the high praise for evidence-based dentistry, there are a number of limitation and criticism that has been given to the process. Chambers DW provides quite a bit of criticism, as well as a number of limitations that evidence-based dentistry provides. In no particular order of importance, a number of mentioned objections towards this format are:
Evidence-based dentistry is too clumsy due to the concept being poorly defined
The implementation of evidence-based dentistry has been distorted by too heavy of an emphasis of computerized searches for research findings that meet the standards of academics
Although EBD advocates enjoy sharing anecdotal accounts of mistakes others have made, faulting others is not proof that one’s own position is correct
There is no systematic, high-quality evidence that EBD is effective
Patient and practitioner values are the shortest leg of the stool. As they are so little recognized, their integration in EBD is problematic and ethical tensions exist where paternalism privileges science over patient’s self-determined best interests.
Although dentists, dental hygienists, and dental assistants may not formally recite the Hippocratic Oath, its principles undeniably apply in their practice, particularly in the high-stakes context of emergency medical care.
By embodying these principles, dental professionals not only fulfill their commitment to ethical patient care but also ensure the safety and well-being of those they serve.
Posted on February 7, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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The Pygmalion Effect, also known as the Rosenthal Effect, is a fascinating psychological phenomenon where higher expectations lead to an increase in performance. This concept originated from a study conducted by Robert Rosenthal and Lenore Jacobson in the 1960s. They discovered that when teachers were led to believe that certain students were expected to perform better academically, those students indeed showed significant improvement.
Here’s a brief overview of how the Pygmalion Effect works:
Expectation Setting: When someone in a position of authority (like a teacher or manager) has high expectations for an individual, they often communicate these expectations through subtle cues.
Behavioral Changes: The individual receiving these cues tends to internalize the expectations and changes their behavior accordingly. They might become more motivated, put in more effort, and show greater persistence.
Performance Improvement: As a result of these behavioral changes, the individual’s performance improves, thereby fulfilling the initial high expectations.
This effect highlights the power of positive reinforcement and belief in someone’s potential. It underscores the importance of fostering a supportive and encouraging environment, whether in educational settings, workplaces, or personal relationships.
If you’re interested in applying the Pygmalion Effect in your life, consider these tips:
Set High, Yet Realistic Expectations: Believe in the potential of those around you and communicate your confidence in their abilities.
Provide Support and Resources: Ensure that individuals have the tools and support they need to meet these expectations.
Offer Positive Feedback: Regularly acknowledge and celebrate progress and achievements to reinforce positive behavior.
Remember, the Pygmalion Effect is a powerful reminder that our beliefs and expectations can significantly influence the outcomes we see in others.
Posted on February 6, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Cognitive bias is a pattern of thinking in humans that, although flawed, is repeated mindlessly, sometimes resulting in irrational behavior and decisions. Dental personnel need to understand how cognitive biases impact both their patients and their team members. Left unchecked, these automatic associations can cause grave mistakes and injuries, and result in real harm.
This course is designed to help dental team members recognize their own biases and see the need to introspect and self-regulate to change them.
Posted on February 5, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
DEFINITION
By Staff Reporters ***
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Naturopathic Doctors are educated and trained in accredited naturopathic medical colleges. They diagnose, prevent, and treat acute and chronic illness to restore and establish optimal health by supporting the person’s inherent self-healing process.
Rather than just suppressing symptoms, naturopathic doctors work to identify underlying causes of illness, and develop personalized treatment plans to address them. Their Therapeutic Order™, identifies the natural order in which all therapies should be applied to provide the greatest benefit with the least potential for damage.
Posted on February 4, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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According to Wikipedia, the Flexner Report was a book-length landmark report of medical education in the United States and Canada, written by Abraham Flexner and published in 1910 under the aegis of the Carnegie Foundation. Flexner not only described the state of medical education in North America, but he also gave detailed descriptions of the medical schools that were operating at the time. He provided both criticisms and recommendations for improvements of medical education in the United States.
Many aspects of the present-day American medical profession stem from the Flexner Report and its aftermath. While it had many positive impacts on American medical education, the Flexner report has been criticized for introducing policies that encouraged systemic racism and sexism.
The Report, also called Carnegie Foundation Bulletin Number Four, called on American medical schools to enact higher admission and graduation standards, and to adhere strictly to the protocols of mainstream science principles in their teaching and research. The report talked about the need for revamping and centralizing medical institutions. Many American medical schools fell short of the standard advocated in the Flexner Report and, subsequent to its publication, nearly half of such schools merged or were closed outright.
Colleges for the education of the various forms of alternative medicine, such as electro-therapy were closed. Homeopathy, traditional osteopathy, eclectic medicine, and physiomedicalism (botanical therapies that had not been tested scientifically) were derided.
The Report also concluded that there were too many medical schools in the United States, and that too many doctors were being trained. A repercussion of the Flexner Report, resulting from the closure or consolidation of university training, was the closure of all but two black medical schools and the reversion of American universities to male-only admittance programs to accommodate a smaller admission pool.
In Chapter 11, Flexner stressed that the success of medical education reform and the professionalization of medicine relied heavily on the effective legal and ethical functioning of state medical boards. However, he noted that these boards were failing in their mission, stalling progress and allowing substandard medical practices to continue, thereby jeopardizing public health. This problem persists as a significant issue in the current practice of medicine in the United States.
Posted on February 4, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Just moments after he was appointed by President Donald Trump to be the new acting director of the Consumer Financial Protections Bureau, Treasury Secretary Scott Bessent moved to halt the agency’s work investigating financial abuses and regulating deceptive banking practices impacting American consumers, according to a memo sent to employees and obtained by Scripps News.
This year is expected to be busy with healthcare mergers and acquisitions (M&A).Consulting company PwC reported that annual healthcare deals shot up 70% through November 15th compared to pre-Covid trends, and projected the trend will continue into 2025.
US stocks fell on Monday in reaction to the Trump administration’s scheduled tariff rollout against Canada and China, though the major averages pared heavier losses after President Donald Trump said the US would delay duties on Mexican imports by a month.
The tech-heavy NASDAQ Composite (^IXIC) closed down 1.2%, recouping a chunk of its earlier losses. Meanwhile, the S&P 500 (^GSPC) fell roughly 0.7%, and the Dow Jones Industrial Average (^DJI) fell 0.3%.
Book Dr. David E. MarcinkoMBA MEd CMPfor your Next Medical, Pharma or Financial Services Seminar orPersonal and Corporate Coaching Sessions
Dr. Marcinko enjoys personal coaching and public speaking and gives as many talks each year as possible, at a variety of medical society and financial services conferences around the country and world. These have included lectures and visiting professorships at major academic centers, keynote lectures for hospitals, economic seminars and health systems, keynote lectures at city and statewide financial coalitions, and annual keynote lectures for a variety of internal yearly meetings.
His talks tend to be engaging, iconoclastic, and humorous. His most popular presentations include a diverse variety of topics and typically include those in all iMBA, Inc’s textbooks, handbooks, white-papers and most topics covered on this blog.
A certified financial planner (CFP®) helps individuals plan their financial futures. CFPs are not focused only on investments; they help their clients achieve specific long-term financial goals, such as saving for retirement, buying a house, or starting a college fund for their children.
To become a CFP®, a person must complete a course of study and then pass a two-part examination. The exam covers wealth management, tax palnning, insurance, retirement planning, estate planning, and other basic personal finance topics. These topics are all important for someone seeking to help clients achieve financial goals.
Chartered Financial Analyst (CFA)
A CFA, on the other hand, conducts investing in larger settings, normally for large investment firms on both the buy side and the sell side, mutual funds or hedge funds. CFAs can also provide internal financial analysis for corporations that are not in the investment industry. While a CFP® focuses on wealth management and planning for individual clients, a CFA focuses on wealth management for a corporation.
To become a CFA, a person must complete a rigorous course of study and pass three examinations over the course of two or more years. In addition, the candidate must adhere to a strict code of ethics and have four years of work experience in an investment decision-making setting.
Generative artificial intelligence (AI) is the utilization of algorithms to create content—such as text, code, imagery, videos, and even simulations—in mere seconds. The goal of AI in general is to mimic the intelligence of humans to perform tasks. “Generative” AI aims to learn from data without the assistance of humans. While today’s generative AI bots are not yet prepared for widespread utilization in patient care settings, AI is garnering significant interest in the healthcare industry as providers begin to test its capabilities in clinics and offices.
This article reviews the role that generative AI is beginning to play in the U.S. healthcare system, the potential of AI in healthcare, and concerns related to the technology.
(“Informed Voice of a New Generation of Fiduciary Advisors for Healthcare”)
For most lay folks, personal financial planning typically involves creating a personal budget, planning for taxes, setting up a savings account and developing a debt management, retirement and insurance recovery plan. Medicare, Social Security and Required Minimal Distribution [RMD] analysis is typical for lay retirement. Of course, we can assist in all of these activities, but lay individuals can also create and establish their own financial plan to reach short and long-term savings and investment goals.
But, as fellow doctors, we understand better than most the more complex financial challenges doctors can face when it comes to their financial planning. Of course, most physicians ultimately make a good income, but it is the saving, asset and risk management tolerance and investing part that many of our colleagues’ struggle with. Far too often physicians receive terrible guidance, have no time to properly manage their own investments and set goals for that day when they no longer wish to practice medicine.
For the average doctor or healthcare professional, the feelings of pride and achievement at finally graduating are typically paired with the heavy burden of hundreds of thousands of dollars in student loan debt.
You dedicated countless hours to learning, studying, and training in your field. You missed birthdays and holidays, time with your families, and sacrificed vacations to provide compassionate and excellent care for your patients. Amidst all of that, there was no time to give your finances even a second thought.
Between undergraduate, medical school, and then internship and residency, most young physicians do not begin saving for retirement until late into their 20s, if not their 30s. You’ve missed an entire decade or more of allowing your money and investments to compound and work for you. When it comes to addressing your financial health and security, there’s no time to waste.
Posted on February 1, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
US stocks lost ground on Friday after the White House said tariffs against Mexico, Canada, and China will take effect on Saturday, reigniting fears of a coming trade war with the nation’s closest trading partners. White House Press Secretary Karoline Leavitt said the president would impose 25% tariffs on goods from Mexico and Canada, as well as a 10% tariff on goods from China.
All three major gauges fell into the red Friday. The S&P 500 (^GSPC) lost 0.5% at the closing bell, while the Dow Jones Industrial Average (^DJI) shed 0.8%. The tech-heavy NASDAQ Composite (^IXIC) gave up 0.3%, reversing earlier gains.
The dramatic tariff news pushed aside more optimistic updates from earlier in the day, which had buoyed stocks. Solid earnings from Apple (AAPL) and an inflation reading that matched expectations lifted market sentiment for much of the day.
Finally, the S&P and the Nasdaq posted losses for the week of 1% and 1.6%, respectively. The Dow, meanwhile, recorded a weekly gain of 0.3%.
Posted on January 31, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Health Capital Consultants, LLC
In the first days of his second (nonconsecutive) presidential term, Donald Trump and his administration took a number of actions that will affect the healthcare industry in the near- and long-term. Further, the Trump Administration is reportedly poised to take a number of additional actions to pause, end, or otherwise change Biden-era initiatives.
Meanwhile, President Trump’s cabinet pick for the Department of Health & Human Services (HHS) hangs in the balance. This Health Capital Topics article reviews the new administration’s actions impacting the healthcare industry as of the date of publication. (Read more...)
Posted on January 22, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Stocks ended firmly higher on Tuesday, with the S&P 500 rising 0.88% and reclaiming the 6,000 point mark amid a pullback in Treasury yields and optimism over Donald Trump’s focus on deregulation, focused tariff strategies and the prospect of solid corporate earnings into the fourth quarter reporting season.
Tech stocks are likely to pace early gains in the Wednesday session, however, following the unveiling of a new AI joint venture called ‘Stargate’ that will include an initial $100 billion investment from SoftBank, Oracle Corp. (ORCL) and OpenAI.
Executive Order 14009, titled “Strengthening Medicaid and the Affordable Care Act,” includes several key components designed to increase access to affordable health care and reduce the number of uninsured Americans:
Reversal of Trump administration policies: The order sought to undo measures that limited ACA provisions or made healthcare less accessible.
Longer enrollment periods: The order encouraged states to lengthen enrollment periods and provided additional federal support. As a result, many states extended their enrollment windows to ensure broader access to affordable healthcare.
Restoration of pre-existing condition protections: Reaffirmed protections for individuals with pre-existing conditions and reinforced nondiscrimination policies in healthcare.
Immediate review of agency actions: The order directed various executive departments and agencies to review existing regulations, orders, and policies to ensure they align with the goal of strengthening Medicaid and the ACA.
xecutive Order 14070, titled “Continuing To Strengthen Americans’ Access to Affordable, Quality Health Coverage,” aimed to maintain and enhance Medicaid and the ACA. Key components included:
Enhanced marketplace subsidies: The order highlights the positive impact of the American Rescue Plan Act on access to coverage, including enhanced marketplace subsidies.
Extended postpartum Medicaid coverage: It provides options for states to extend postpartum Medicaid coverage.
New incentives for Medicaid expansion: The order includes new incentives for states to expand their Medicaid programs.
Posted on January 20, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
BREAKING NEWS
By Staff Reporters
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WASHINGTON: 8:15 am: The President Joe Biden administration just preemptively pardoned Anthony Fauci, MD.
“Our nation relies on dedicated, selfless public servants every day. They are the lifeblood of our democracy,” Biden said in a statement just hours before President-elect Donald Trump is sworn into office.
“The issuance of these pardons should not be mistaken as an acknowledgment that any individual engaged in any wrongdoing, nor should acceptance be misconstrued as an admission of guilt for any offense,” Biden said in a statement.
Posted on January 18, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
WASHINGTON — The US Supreme Court on Friday delivered a blow to TikTok by upholding a law that could potentially lead to the video-sharing social media platform being banned in the United States. The justices in an unsigned opinion with no dissents rejected a free speech challenge filed by the company, meaning the law is set to go into effect on Sunday as planned. The bipartisan law requires China-based TikTok owner ByteDance to divest itself of the company by Sunday, the day before President-elect Donald Trump is to take office. If no sale takes place, the platform used by millions of Americans will in theory be banned.
Legendary short seller Nate Andersonannounced this week that he is shutting down his firm, Hindenburg Research, due to extreme job stress. With only 11 employees, Anderson took gargantuan swings at companies—and their billionaire leaders. Hindenburg published deeply researched reports about companies it believed were overvalued and rife with corruption. It got its big break when it shorted electric truck-maker Nikola in 2020, calling the company an “intricate fraud.” Regulators took note, and it led to three fraud convictions for Nikola founder Trevor Milton.
US stocks jumped on Friday amid a tech stock revival as investors assessed a week of key data and earnings reports alongside potential policy shifts under a Trump administration.
The Dow Jones Industrial Average (^DJI) gained 0.8% while the S&P 500 (^GSPC) rose 1%, coming off a losing day for the major gauges. The tech-heavy NASDAQ Composite (^IXIC) put on 1.5% as Nvidia (NVDA) and Tesla (TSLA) shares nudged back into the green.
The US Department of Justice (DOJ) filed a lawsuit against Walgreens (WBA), one of the nation’s largest pharmacy chains, alleging widespread prescription drug practice violations. According to the DOJ, Walgreens improperly dispensed millions of prescriptions from August 2012 to the present day that either lacked “legitimate medical purpose” or were otherwise invalid.
Posted on January 16, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
The U.S. Department of Labor reported a 0.4% increase in the monthly CPI after seasonal adjustment, overshooting the forecast of 0.3% and the previous value of 0.3%. On an annual basis, inflation climbed to 2.9%, up from 2.7% in November, the highest rate since July 2024.
US stocks ripped higher on Wednesday as high hopes for bank earnings paid off and a crucial consumer inflation update showed key prices increased less than expected in December.
The benchmark S&P 500 (^GSPC) popped more than 1.8%, while the Dow Jones Industrial Average (^DJI) rose more than 1.6%, or over 700 points. Meanwhile, the tech-heavy NASDAQ Composite (^IXIC) soared 2.5%.
Stocks took a leg higher after the Consumer Price Index (CPI) showed progress toward the Fed’s 2% inflation target in December. Prices climbed 0.2% month-on-month on a “core” basis, which strips out the more volatile costs of food and gas, an easing from November’s 0.3% gain. Over last year, core CPI rose 3.2%.
Capital One is being sued by the US government’s consumer watchdog agency for “cheating millions of consumers” and not paying more than $2 billion in interest to holders of its high-interest savings accounts.
As of January 1st 2025, beneficiaries enrolled in Part D prescription drug plans will have their out-of-pocket spending capped at $2,000 for the year. This new policy was part of President Joe Biden’s 2022 Inflation Reduction Act (IRA), which included other drug pricing measures such as capping the cost of insulin at $35 per month for seniors.
But only a small share of Medicare enrollees will benefit from the cap, according to an analysis from nonprofit organization AARP’s Public Policy Institute, as most don’t spend more than $2,000 annually on their medications after hitting their deductible (which is up to $590 for standard plans in 2025). Beneficiaries spent an average of $400 to $500 per year as of 2022, the Hill reported, citing data from the US Department of Health and Human Services (HHS).
Did you know that at MARCINKO & Associates, all medical colleagues throughout the United States may contact us when they are considering the sale, purchase, strategic operating improvement, merger, acquisition and/or other financial business or related personal financial planning transaction?
Our difference is “hard” knowledge and insider financial guidance that helps medical colleagues, nurses, private practitioners, clinics, ambulatory surgery, radiology and outpatient wound care centers realize their ultimate economic goals. This typically includes managerial and cost accounting, financial ratio analysis, fair market valuation business appraisals, business plan creation and personal financial planning.
Our “expert witness” business litigation support service and divorce mediation, arbitration, asset division, settlement and second opinion offerings are always available, as well.
And, our “soft” skill professional career guidance and mentoring center includes executive coaching, consulting and mentoring advisory programs for stressed, conflicted or burned-out physicians and medical practitioners.
Most importantly, our professional fees are reasonable and always transparent.
MARCINKO & Associates also serves universities, medical, business, graduate and nursing schools; physicians, dentists, podiatrists, optometrists and legal societies. This includes accountants, financial service providers, wealth and hedge fund managers, emerging entities, hospitals, CEOs and their BODs, the press, media and related organizations.
Posted on January 8, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
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Three UnitedHealth-owned insurance companies must pay over $165 million for misleading thousands of customers in Massachusetts into paying for additional health insurance, a state judge has ruled.
Nvidia stock (NVDA) tumbled more than 6% Tuesday, a day after shares closed at a record high in anticipation of CEO Jensen Huang’s keynote at the tech industry’s annual CES trade show in Las Vegas.
The Biden administration’s Consumer Financial Protection Bureau (CFPB) issued a new rule Tuesday that will hide an estimated $49 billion in medical debt from credit reports. The rule, which is slated to affect 15 million Americans, prohibits the inclusion of medical bills on credit reports and bars creditors from using medical information in making lending decisions. The policy specifically targets national credit-reporting companies Equifax, Experian and Transunion, which provide detailed evaluations of consumer finances to banks, employers and landlords.
Posted on January 4, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Nvidia stock (NVDA) led gains among the “Magnificent Seven” tech stocks to start the new year after a group-wide sell-off in the last days of 2024. Shares of the AI chip-maker rose 4.5% Friday after gaining roughly 3% the prior day.
Quote: “If your credit card gets compromised, your bank will alert you, cancel it and send you get a new one. But your medical records have a long lifespan. They can be misused without detection for long periods of time, because it’s harder to identify malicious activity. That makes them very valuable.”—Geetha Thamilarasu, associate professor at the University of Washington Bothell, on why hackers want healthcare information (the Wall Street Journal)
That upswing followed a 4% dip between Christmas Eve and New Year’s Eve as megacap tech stocks dropped across the board in the absence of a “Santa Claus” rally, where the stock market typically enjoys a surge between December 24th and January 2nd. Tesla (TSLA) stock plunged nearly 13% over that time frame, while Amazon (AMZN) and Microsoft (MSFT) dropped more than 4%. Meanwhile, Meta (META) and Google (GOOG) fell just under 4%, and Apple (AAPL) dropped 3%.
Even with its December decline, Nvidia shares still ended 2024 up more than 150%. Wall Street analysts have remained bullish on the stock, estimating shares will rise to roughly $173 over the next year from their current level of $138, according to Yahoo Finance data.
Posted on January 2, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Anthem Blue Cross and Scripps Health will part ways impacting thousands of patients.
Scripps Health and Anthem Blue Cross officially just parted ways on January 1st, 2025, leaving about 125,000 patients uncertain of what their healthcare and insurance will look like in 2025.
Posted on December 28, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
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US stocks closed the holiday week on a downbeat note as Wall Street slogged to the finish of a largely triumphant year.
The S&P 500 (^GSPC) lost 1.1%, while the tech-heavy NASDAQ Composite (^IXIC) shed 1.5% Friday at the close. The Dow Jones Industrial Average (^DJI) gave up 0.8%. Meanwhile, the 10-year Treasury yield (^TNX) hovered near seven-month highs around 4.6%.
After stacking impressive gains this year, some of the biggest names in tech lost ground as investors took profits, rebalance portfolios, or reassessed their lofty valuations. Tesla (TSLA) lost 5%. Nvidia (NVDA) gave up c2%, while Amazon (AMZN) decreased by 1%.
Wall Street has just three trading days remaining in a 2024 full of big gains, but markets have been unable to mount a “Santa Claus” rally into the end of the year.
Posted on December 27, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Absent Congressional action, beginning January 1sy, 2025, the statutory limitations that were in place for Medicare telehealth services prior to the COVID-19 PHE will retake effect for most telehealth services.
This means most telehealth visits will not be covered by Medicare in 2025, unless Congress acts by the end of December 2024.
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(Reuters) -The Dow Jones Industrial Average closed fractionally higher on Thursday, stretching its winning streak to five sessions despite light trading volumes and rising U.S. Treasury yields weighing on some of the dominant technology megacaps.
While the NASDAQ Composite and the S&P 500 were broadly unchanged, the indexes both finished slightly in negative territory. This snapped the NASDAQ’s four-session run of higher closes, and ended the S&P 500’s own run at three sessions.
On a day of few catalysts, investors responded to yields on U.S. government bonds inching higher, including the yield on the benchmark 10-year Treasury note hitting its highest since early May at 4.64% earlier in the session. And, a strong auction of seven-year notes early in the afternoon though helped yields come off slightly, with the 10-year note at 4.58% in late-afternoon trade.
Higher yields are traditionally seen as negative for growth stocks, as it raises the cost of their borrowing to fund expansion. With markets increasingly dominated by the megacap technology stocks known as the Magnificent Seven, crimping their performance – especially in lieu of other market catalysts – will put downward pressure on benchmark indexes.
The S&P 500 slipped 2.45 points, or 0.04%, to 6,037.59 points, while the NASDAQ Composite lost 10.77 points, or 0.05%, to 20,020.36. The Dow Jones Industrial Average rose 28.77 points, or 0.07%, to 43,325.80.
Six of the megacaps fell, with Tesla leading decliners with a 1.8% fall. The outlier was Apple, rising 0.3% and continuing to edge closer to becoming the first company in the world to hit a market value of $4 trillion.
Posted on December 26, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
DEFINITION
By Staff Reporters
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Bernard Mandeville’s Paradox represent actions that may be vicious to individuals may also benefit society as a whole.
Mandeville’s Paradox challenges traditional moral and economic assumptions about selfishness and virtue. It suggests that economic systems can thrive on individual self-interest, a concept that has influenced modern economic thought, particularly in the development of free-market ideologies.
Understanding this paradox is crucial for economists, policymakers, and philosophers as it complicates the evaluation of behaviors and policies based solely on their perceived moral qualities. It invites a complex analysis of how individual actions, regardless of their intentions, contribute to the broader welfare of society.
Posted on December 21, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Metzler’s Paradox is the imposition of a tariff [tax] on imports that may reduce the relative internal price of that good.
It was proposed by Lloyd Metzler PhD in 1949 upon examination of tariffs within the Heckscher-Ohlin Model. The paradox has roughly the same status as immiserizing growth and a transfer that makes the recipient worse off.
Posted on December 21, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Ann Miller RN MHACMP™
INTRODUCING OUR NEXT GENERATION e-BOOK LIBRARYFROM iMBA, Inc.
An e-book is an electronic or digital book that can be read on a computer or a handheld device.
Our new e-books consists of text, images, and are fixed to a specific spot on the page.
And, our e-books are a data files similar in content and structure to a word-processing document that comes in a PDF format. To use our e-books, you need to purchase and download it to a device that has a .pdf file reader app, such as ADOBE® or similar on a smartphone, tablet or computer. A PDF, also known as a portable document format, is the format most people are familiar with and used in our e-books. PDFs are known for their ease of use and ability to hold custom layouts. They are the most commonly used e-Book formats, especially by professionals and adult-learners.
You can then access the e-book and read it, or highlight pages and even take side notes.
e-Books Save Money
With no manufacturing, printing, binding or shipping costs, e-Books are cheaper than traditional hard or paper back books.The price of each specialized and highly niche focused e-Book [50-100 pages] is only $25, whereas similar paperback printed books of this type generally cost $145, or more!
Posted on December 20, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
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Gallup’s annual Health and Healthcare poll released on December 6th found that the US adult rating of healthcare quality is the lowest it’s been since 2001, with 54% of respondents saying they believe the healthcare system has “major problems” and 16% saying it’s in a “state of crisis.” In 2001, 53% viewed healthcare positively.
US stocks closed little changed as a rebound from the previous day’s sell-off flopped with a hawkish outlook from the Federal Reserve on its path for interest rates looming over markets.
The Dow Jones Industrial Average (^DJI) ended a 10-day losing streak, its longest in 50 years, as it closed just above the flat line on Thursday. Meanwhile, the S&P 500 (^GSPC) and tech-heavy NASDAQ Composite (^IXIC) both fell about 0.1%.
The 10-year Treasury yield (^TNX) continued its trek higher on Thursday, rising roughly seven basis points to hit 4.57% for its highest levels since May.
Posted on December 19, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Survivor’s Guilt is the feeling of guilt experienced by those who have survived a tragedy when others did not. It’s like winning a lottery you didn’t want to enter. This emotional response can be overwhelming, as survivors question why they lived while others didn’t. It’s a mix of empathy, remorse, and a search for meaning in the randomness of survival.
According to colleague Dan Ariely PhD, If you or someone you know is dealing with survivor’s guilt, remember: it’s a natural reaction, and seeking support can help navigate these complex feelings.
Posted on December 19, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Demographic-Economics Paradox Definition: A nations or sub-populations with higher GDP per capita are observed to have fewer children, even though a richer population can support more children. Dr. Herwig Birg has called this inverse relationship between income and fertility a “demo-economic paradox”.
Why? Evolutionary biology predicts that more successful individuals (and by analogy countries) should seek to develop optimum conditions for their life and reproduction.
However, in the last half of the 20th century it has become clear that the economic success of developed countries is being counterbalanced by a demographic failure, a sub-replacement fertility that may prove destructive for their future economies and societies.
Posted on December 19, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
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Stat: 23,000. That’s about how many Connecticut residents will get at least part of their medical debt eliminated, thanks to a state partnership with nonprofit organization Undue Medical Debt. (NBC Connecticut)
The stock market plunged on Wednesday after the Federal Reserve scaled back its expectations for interest rate cuts next year.
The Dow Jones Industrial Average fell about 1,100 points, or 2.5%, the largest drop for the index since August. The dip marked the 10th consecutive day of losses for the Dow, its longest losing streak since 1974.
The S&P 500 fell nearly 3%, while the tech-heavy NASDAQ plummeted about 3.5%.
Native American patients are reportedly often billed for healthcare services the government is supposed to pay for, according to an investigation. (KFF Health News)
Visualize: How private equity tangled banks in a web of debt, from the Financial Times.
Posted on December 18, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
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Stat: 97%. That’s how many healthcare leaders think A.I. will become important in healthcare over the next five years.
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Pharmacy benefit managers (PBMs) are once again under pressure from federal leaders. A group of Democratic and Republican congresspeople proposed legislation that would attempt to prevent pharmacies from also owning PBMs. The three largest PBMs—CVS Health’s Caremark, Cigna’s Express Scripts, and UnitedHealth Group’s Optum Rx—currently operate pharmacies and administer more than 80% of the prescriptions in the US, and officials have linked this practice to drug price increases.
US stocks fell across the board on Tuesday, with the Dow logging its biggest losing streak in 46 years. The Dow Jones Industrial Average (^DJI) finished the session down roughly 0.6%, registering its ninth straight day of losses. The last 9-day losing streak for the Dow was Feb. 1978. Prior to that, the index suffered an 11-day losing streak in 1974 and another in 1971.
The other major indexes dropped in tandem on Tuesday, with the benchmark S&P 500 (^GSPC) falling around 0.4% and the NASDAQ Composite (^IXIC) losing about 0.3% after the tech-heavy index closed at a record high on Monday.
The Information Ratio (IR) is a risk-adjusted rate of return measure for comparing the performance of active investment managers over time. Its purpose is to help determine how much return an active portfolio manager has added per unit of active management risk.
Think of IR as a Sharpe Ratiofor active investment management; the IR is more focused than the Sharpe Ratio. Starting with the Sharpe Ratio’s formula, if we replace the excess return in the numerator with a portfolio’s active return (the average annualized return of an actively managed portfolio minus the average annualized return of the portfolio’s benchmark over a given period, adjusted for the portfolio’s market risk exposure), and you replace the Sharpe Ratio’s standard deviation of excess returns in the denominator with the standard deviation of a portfolio’s active returns over the period, you have the IR.
While the Sharpe Ratio expresses the amount of excess return per unit of overall risk, the IR computes only the active management-driven (alpha) returns per unit of alpha-driven risk. And while the Sharpe Ratio’s excess returns are calculated with regard to what is considered to be a relatively risk-free asset, such as a U.S. Treasury bill, the IR’s active returns are calculated with regard to each portfolio’s specific market benchmark.
The higher the IR, the better. The IR should be measured over a meaningful period of time, typically at least three to five years. The IR is not perfect–it can be influenced by external factors such as changes in market volatility. The standard deviation of active returns in the IR’s denominator is called tracking error. Tracking error will tend to increase in volatile markets for even the best active managers.
Posted on December 13, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
FRIDAY 13th = Triskaidekaphobia
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
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The Dow Jones Industrial Average (^DJI) was down and the S&P 500 (^GSPC) were both about 0.5%. The tech-heavy NASDAQ Composite (^IXIC) fell roughly 0.6% while shares of Apple (AAPL) rallied less than 1% to close at a record high.
In bonds, the 10-year Treasury yield (^TNX) added 5 basis points to hit 4.32%, its highest closing level since November 22nd.
On a day where President-elect Donald Trump rang the opening bell at the New York Stock Exchange, Wall Street failed to build on a furious rally that has picked up steam after his election win. In focus was fresh inflation data, which helped cast doubt on investor confidence for the path of interest rates ahead.
Incentives: It is broadly accepted that incenting someone to do something is effective, whether it be paying office staff a commissions to sell more healthcare products, or giving bonuses to office employees if they work efficiently to see more HMO patients. Some experts even suggest there are five specific components1 that should be built into an overall physician incentive program:
Appropriate financial incentives.
Managed-care efficiency incentives.
Group citizenship.
Patient satisfaction.
Group profitability.
What is not well understood is that the incentives cause a sub-conscious distortion of decision-making ability in the incented person. This distortion causes the affected person – whether it is yourself or someone else – to truly believe in a certain decision, even if it is the wrong choice when viewed objectively. Service professionals, including financial advisors and lawyers, are affected by this bias, and it causes them to honestly offer recommendations that may be inappropriate, and that they would recognize as being inappropriate if they did not have this bias.
According to colleague Dan Ariely PhD, the existence of this bias makes it important for each one of us to examine our incentive biases and take extra care when advising physician clients, or to make sure we are appropriately considering non-incented alternatives.
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