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    Dr. Marcinko is originally from Loyola University MD, Temple University in Philadelphia and the Milton S. Hershey Medical Center in PA; as well as Oglethorpe University and Emory University in Georgia, the Atlanta Hospital & Medical Center; Kellogg-Keller Graduate School of Business and Management in Chicago, and the Aachen City University Hospital, Koln-Germany. He became one of the most innovative global thought leaders in medical business entrepreneurship today by leveraging and adding value with strategies to grow revenues and EBITDA while reducing non-essential expenditures and improving dated operational in-efficiencies.

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    As a state licensed life, P&C and health insurance agent; and dual SEC registered investment advisor and representative, Marcinko was Founding Dean of the fiduciary and niche focused CERTIFIED MEDICAL PLANNER® chartered professional designation education program; as well as Chief Editor of the three print format HEALTH DICTIONARY SERIES® and online Wiki Project.

    Dr. David E. Marcinko’s professional memberships included: ASHE, AHIMA, ACHE, ACME, ACPE, MGMA, FMMA, FPA and HIMSS. He was a MSFT Beta tester, Google Scholar, “H” Index favorite and one of LinkedIn’s “Top Cited Voices”.

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On the PPMCs of Yester Year and Today

Over Heard in the Doctor’s Lounge

Courtesy: www.CertifiedMedicalPlanner.org

On the PPMCs of Yester Year and Today

PPMC = Physician Practice Management Corporation

LINK: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

Reflect on medical colleagues willing to securitize their practices a few years later, and cash out to Wall Street servitude for riches not rightly deserved. Where are firms such as MedPartners, Phycor, FPA, Coastal Healthcare, and a host of others, now?

ESSAY: https://medicalexecutivepost.com/2007/11/27/ppmc-redux/

A survey of the Cain Brothers Physician Practice Management Corporation Index of publicly traded PPMCs revealed a market capital loss of more than 99%, since inception.

UPDATE: https://www.beckershospitalreview.com/hospital-physician-relationships/physician-practice-management-a-new-chapter.html

QUERY: Would niche educated and physician-focused financial advisors [The Certified Medical Planner™ professional designation did not yet exist] have been able to avoid this calamity?


TODAY: https://healthcarefinancials.files.wordpress.com/2007/11/ppmc.pdf

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An Entrepreneurial Mindset Can Hinder Wealth Building

“Help Wanted: Entrepreneur”


You have probably never seen an ad like this, because entrepreneurs are not hired. They hire themselves. Merriam-Webster defines an entrepreneur as “a person who starts a business and is willing to risk loss in order to make money” or “one who organizes, manages, and assumes the risks of a business or enterprise.”

God bless entrepreneurs. Without them our world would look much different. We would probably still be living in caves, hunting with clubs, and eating raw meat. They create companies from scratch. In so doing, they create jobs and take significant monetary risks of a business failure.

They also stand to gain substantial rewards for success, but that success is far from guaranteed. Few people realize that most entrepreneurs fail in their attempts in business. According to Investopedia, 50% of all new businesses fail in 5 years, 66% in 10 years, and 75%  in 15 years.

Given those statistics, the entrepreneurs who succeed must be rich, right? A study by Career Explorer found that the average full-time salary of an entrepreneur is $43,240 a year. To put this into perspective, the average starting salary for a graduating four-year degree student at the South Dakota School of Mines and Technology is $63,354. Maybe there should be a song, “Mamas, don’t let your babies grow up to be entrepreneurs.”

My experience, however, is that it really doesn’t matter what Mama says. The entrepreneurial mindset is somewhat inextinguishable. While there have been some attempts at teaching entrepreneurial skills, it’s hard to teach grit, determination, and perseverance, coupled with a good dose of fantasy thinking and denial. It’s really hard to “tell” an entrepreneur anything.

Fittingly, entrepreneurs love to invest in their own companies. Investment advisors call such holdings “tangible” investments, ones you can see and touch. Tangible investments include start-up businesses, family-owned businesses, and all types of directly owned real estate. They are inherently non-diversified and illiquid. Typically, entrepreneurs have the vast portion of their net worth tied up in their businesses. It’s incredibly rare to find one with a stash of cash or any type of liquid portfolio or retirement plan.

Why? The entrepreneurial mindset. First, entrepreneurs don’t believe in traditional diversification. Why settle for earning an average of 5% a year when you can earn ten times that in your business? Never mind that the chance of losing it all is three to one. Most entrepreneurs firmly believe they are the one guaranteed to succeed even though the deck is stacked against them.

Second is that since 75% of businesses ultimately fail, most entrepreneurs are losing, not making, money. They are perennially cash-poor and need every dollar they can find to fund their negative cash flows. Even those who are making money rarely have any liquid investments because entrepreneurs are always looking for new ventures, which of course, need funding.

One of the most difficult tasks I face is persuading a successful entrepreneur to take some hard-earned “chips” off the table and sock away a low-risk, diversified nest egg to assure a comfortable retirement. The only ones I’ve convinced to do that were older entrepreneurs who had owned their companies for well over 15 years and were under five years from retirement. All the younger entrepreneurs to whom I have given that advice have refused the notion. All have eventually lost 75% to 90% of their net worth and, sadly, the opportunity to secure their future.

The entrepreneurial mindset of determination and perseverance can bring significant financial rewards. Expanding that mindset to include a broader, more diversified view of investing for the future can turn those rewards into long-term financial independence.

Assessment: Your thoughts are appreciated.


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On David Ricardo and “Derived-Demand” Health Economics in Medicine?

On Ricardian Derived Demand – Does it Even Exist?

Courtesy: www.CertifiedMedicalPlanner.org

What it is – How it works

In economics, derived demand is demand for a factor of production or intermediate good that occurs as a result of the demand for another intermediate or final good. In essence, the demand for one is dependent on that whose demand its’ demand is derived from www.HealthDictionarySeries.org


For example, if the demand for a good such as cars increases, then this leads to an increase in the demand for iron ore.


For example, if the demand for a good such as wheat increases, then this leads to an increase in the demand for labor.


So, what about medicine? Saurabh Jha gives us some insight right here!

ESSAY: http://thehealthcareblog.com/blog/2018/08/30/is-medical-imaging-a-ricardian-derived-demand/

RELATED: big data

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The Cost of Business Embezzlement

Nothing Typical

By Rick Kahler CFP

As a fan of our local ECHL hockey team, the Rapid City Rush, I was sorry to learn recently that the team’s new owners had uncovered evidence of some $500,000 worth of embezzlement over the past several years.

Other embezzlement arrests or convictions in our area in 2019 have included a priest, an accountant for a nonprofit, a former chief of a volunteer fire department, and a former secretary of a tribal office. Amounts stolen ranged from $9,100 to $250,000.

Few things strike more fear and disbelief into the heart of an employer than learning a trusted employee has embezzled thousands of dollars. Employers that have gone through this tell me their feelings range from disbelief, violation, anger both at the employee and at themselves, sadness, and fear over the loss of capital and ensuing financial problems the embezzlement often causes.

The study

According to the 2018 Hiscox Embezzlement Study, most instances of embezzlement are serious, long-term crimes. The average case lasted over two years, and the average loss was $357,650. The vast majority of cases involved more than one person. Nearly a third of employee theft cases persisted for more than five years. The average loss for cases that continued for five years or more was $2.2 million and for cases lasting 10 years or more was $5.4 million.

The study found that there is no “typical” embezzler. However, it did find that the median age of embezzlers is 48, slightly more women than men commit this type of crime, and embezzlers’ most common job functions are finance and accounting.

Embezzlers may target organizations of all sizes and types. Four of the five local cases I cited were non-profits. Large organizations experience fewer instances of embezzlement than small and mid-sized organizations. According to the study, financial services continues to account for the highest number of cases of employee theft of any industry examined.

Many business owners, executive directors, and board members blame themselves for allowing theft to happen under their watch, but in all fairness the warning signs are often subtle.

Hiscox has identified five common characteristics to watch for:

 Intelligence and curiosity: Embezzlers are often eager to know how everything in the office works. Once they learn the processes, they manipulate them for their own gain.

• Extravagance: Watch for employees who are living a lifestyle that is out of proportion to their salary.

 Egotistical risk-taking. Embezzlers often break rules, from traffic laws to company policies to social norms, both at work and in their personal lives.

 Diligence and ambition. Embezzlers may work long hours or refuse to take time off—not out of dedication to the job but in an attempt to avoid being caught.

• Disgruntlement. Employees who feel they are being treated unfairly may be tempted to get even by stealing.

In my experience, most people are honest and trustworthy. But there are some whose past trauma contributes to a pattern of poor financial decisions and behaviors. Embezzlement, which to some degree can be a crime of opportunity, might even seem to be a way to avoid the consequences of previous poor money choices.

The study noted that more than half of the organizations recovered less than a third of what was taken. It also pointed out that embezzlement costs companies far more than money. Business partners may be lost. The damage to an organization’s reputation results in lost customers or donors and difficulty attracting new ones. It can take years to recover. Yet three-quarters of respondents said their current employers did not have insurance to cover embezzlement losses.

Assessment: Embezzlement is a serious crime with serious consequences.


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