BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
[Click on Image to Enlarge]
ME-P Free Advertising Consultation
The “Medical Executive-Post” is about connecting doctors, health care executives and modern consulting advisors. It’s about free-enterprise, business, practice, policy, personal financial planning and wealth building capitalism. We have an attitude that’s independent, outspoken, intelligent and so Next-Gen; often edgy, usually controversial. And, our consultants “got fly”, just like U. Read it! Write it! Post it! “Medical Executive-Post”. Call or email us for your FREE advertising and sales consultation TODAY [678.779.8597] Email: MarcinkoAdvisors@outlook.com
Medical & Surgical e-Consent Forms
ePodiatryConsentForms.com
iMBA Inc., OFFICES
Suite #5901 Wilbanks Drive, Norcross, Georgia, 30092 USA [1.678.779.8597]. Our location is real and we are now virtually enabled to assist new long distance clients and out-of-town colleagues.
ME-P Publishing
SEEKING INDUSTRY INFO PARTNERS?
If you want the opportunity to work with leading health care industry insiders, innovators and watchers, the “ME-P” may be right for you? We are unbiased and operate at the nexus of theoretical and applied R&D. Collaborate with us and you’ll put your brand in front of a smart & tightly focused demographic; one at the forefront of our emerging healthcare free marketplace of informed and professional “movers and shakers.” Our Ad Rate Card is available upon request [678-779-8597].
A Junk Rally is a general trend of out performance by companies that tend to score poorly along several dimensions, such as price-to-earnings (P/E) ratios, return on assets (ROA), balance sheet strength, levels of debt and volatility.
Posted on January 10, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
***
***
Definition of the Paradox of Competition
The Paradox of Competition refers to the complex and often counterintuitive effects competitive behaviors can have within markets and industries. Generally, competition is seen as a positive force that drives innovation, lowers prices, and improves quality and choice for consumers. However, the paradox lies in the fact that intense competition can sometimes lead to negative outcomes, such as diminished profitability for companies, reduced incentives to innovate, and the potential for a race to the bottom in terms of quality and sustainability.
According to colleague Dan Ariely PhD, understanding the nuances of the Paradox of Competition reveals the complexity of market dynamics and the importance of strategic, informed approaches to competition, both from businesses and regulators.
This paradox challenges the conventional wisdom that competition is universally beneficial, highlighting the need for a more nuanced view of how competitive forces shape markets and societies.
Posted on January 5, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
***
***
Morality Priming refers to subtle reminders of ethical principles that can make us behave more responsibly. It’s like an internal nudge that brings our conscience to the surface.
And, according to colleague Dan Ariely PhD, by focusing on moral standards, people are often encouraged to act more honestly, even in small, everyday decisions.
Posted on January 3, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
***
***
Outcome bias is judging a decision based on its result rather than the quality of the decision at the time it was made.
It’s like saying a bad poker play was smart because you won the hand. Or, a bad stock picker or financial advisor was good because the price went up!
According to psychologist and colleague Dan Ariely PhD, this bias ignores the process and focuses solely on the outcome. It’s why we celebrate lucky breaks and criticize thoughtful risks that didn’t pan out.
So, the next time you’re evaluating a decision, focus on the reasoning behind it, not just the end result.
Posted on December 31, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
***
***
The Li Keqiang Index was created in 2010 by The Economist and measure’s China’s economy using three indicators: railway cargo volume, electricity consumption and bank loans.
The index is seen as an alternative to official gross domestic product numbers released by the Chinese government.
Posted on December 29, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
BREAKING NEWS!
Former President Jimmy Carter has died at the age of 100.
The 39th president of the United States was a Georgia peanut farmer who sought to restore trust in government when he assumed the presidency in 1977 and then built a reputation for tireless work as a humanitarian.
Nominal yield, for most bonds and other fixed-income securities, is simply the yield you see listed online or in newspapers. Most nominal fixed-income yields include some extra yield, an “inflation premium,” that is typically priced/added into the yields to help offset the effects of inflation.
Real yields, such as those for TIPS, don’t have the inflation premium. As a result, nominal yields are typically higher than TIPS yields and other real yields.
Posted on December 23, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Dr. David Edward Marcinko MBA
[CEO – iMBA Inc]
To Our ME-P Subscribers, iMBA Inc., Clients and Friends
As we look forward to sharing the holidays with family and friends, we also remember those less fortunate.
And, as has been our practice in recent years, rather than sending holiday greeting cards, the iMBA Inc will provide support to several charities dedicated to helping those in need.
We hope this gesture provides happier holidays for others and serves to express our gratitude to you, in the spirit of the season, for your continued support and loyalty to this ME-P.
Happy New Year 2024
We also extend our hope that the New Year 2022 brings you and your loved ones good health, happiness and a world that comes to know peace and understanding.
***
***
Channel Surfing the ME-P
Have you visited our other topic channels? Established to facilitate idea exchange and link our community together, the value of these topics is dependent upon your input. Please take a minute to visit. And, to prevent that annoying spam, we ask that you register. It is fast, free and secure.
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
OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
Choice Overload is the difficulty in making a decision when faced with too many options. It’s like standing in front of an ice cream counter with 31 flavors and feeling paralyzed.
Among personal decision-makers, a prevention focus is activated and people are more satisfied with their choices after choosing among few options compared to many options, i.e. choice overload. However, individuals can also experience a reverse choice overload effect when acting as proxy decision-maker, too.
It is widely accepted that having more choices is inherently positive. When there are more available options from which to choose, an individual is more likely to be able to select the particular option that is the best fit and most likely to satisfy them. Choice is typically thought to be related to personal freedom and enhanced well-being.
Therefore, according to colleague Neal Baum MD, for most individuals the ultimate goal is to constantly maximize their choices in life to increase their overall satisfaction and well-being. The decision-making process, however, is a complex cognitive task that does not always lead to positive outcomes.
Thus, while having options is generally good, too many choices can lead to anxiety and decision fatigue. This is why curated selections and recommendations are so popular – they simplify the decision-making process’ according to another colleague Dan Ariely PhD.
So, when you’re overwhelmed by choices, narrow them down to a manageable number and make your decision easier.
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!
The breakeven inflation rate is the difference between the nominal yield (usually the market yield, which includes an inflation premium) on a fixed-income investment and the real yield (with no inflation premium) on an inflation-linked investment of similar maturity and credit quality.
So, if inflation averages more than the breakeven rate, the inflation-linked investment will outperform the investment with the nominal yield.
Conversely, if inflation averages below the breakeven rate, the investment with the nominal yield will outperform the inflation-linked investment.
Breakeven inflation rates are also considered useful measures of inflation expectations—higher breakeven rates represent higher inflation expectations (and higher relative prices for inflation-linked investments), while lower breakeven rates represent lower inflation expectations (and lower relative prices for inflation-linked investments).
Therefore, ideally, investors want to purchase inflation-linked investments when breakeven rates are relatively low because that’s typically when prices are also relatively low.
Commodities: Commodities are raw materials or primary agricultural products that can be bought or sold on an exchange or market. Examples include grains such as corn, foods such as coffee, and metals such as copper.
Commodity Futures: Agreements to buy or sell a specific amount of a commodity or financial instrument at a particular price on a stipulated future date related to basic raw materials such as precious metals and natural resources.
Commodity Intensity: Commodity intensity refers to commodity usage per unit of economic growth. An emerging, more manufacturing-based economy will usually be more commodity intensive in terms of its growth than will a more developed, service-oriented economy.
The Rule of 20 is a dimensionless number that adds the current 12-month trailing Price to Earnings Ratio to the annual change in an index of the annual consumer inflation rate. A reading below 20, while a market is trending lower, means that we could be near a bottom.
In the United States, the most common index used is the broad-based S&P 500, and CPI-U is used as a proxy for inflation.
The Rule of 20 is purportedly a rule from Peter Lynch. In chapter 39 of Graham and Dodd’s seminal Security Analysis, they mention: “We would suggest that about 20 times average earnings is as high a price as can be paid in an investment purchase of a common stock” … with no mention of inflation.
Lynch’s formulation attempts to factor the ‘gravity’ of interest rates into the fair value of a stock. And, as you can see, the measure has fluctuated quite a bit. However, it has returned to roughly the 20 level repeatedly.
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.
Collateralized Mortgage Obligations (CMOs) are a form of securitized debt derived from mortgage-backed securities. It’s a form of derivative security. Like most MBS pass-through securities, CMOs are typically backed by pools of residential mortgages and their payments. But not all investors want to receive the monthly payments of principal and interest that “plain vanilla” MBS pass-throughs offer–some prefer just the principal, some prefer just the interest, or some want payments with other particular/special characteristics.
For them, the cash flows from MBS can be pooled and structured into many classes of CMOs with different maturities and payment schedules, creating securities with very specific characteristics and behaviors. These characteristics and behaviors can vary widely. Some CMOs can offer less risk than “plain-vanilla” MBS, or can help offset other forms of risk in a diversified portfolio, but others can be much more volatile.
CMOs typically have two or more bond classes, called tranches. Each tranche has its own expected maturity and cash flow pattern. The unique cash flow patterns of each CMO tranche allow investors to tailor their mortgage exposure to meet a range of investment objectives, since different classes can have different risk/return characteristics.
Swaps (a.k.a. swap agreements) are two-party contracts entered into primarily by institutional investors for periods ranging from a few weeks to more than one year.
In a standard “swap” transaction, two parties agree to exchange the returns (or differentials in rates of return) earned or realized on particular predetermined investments or instruments. The gross returns to be exchanged or “swapped” between the parties are generally calculated with respect to a “notional amount,” i.e., the return on or increase in value of a particular dollar amount invested at a particular interest rate, in a particular foreign currency, or in a “basket” of securities representing a particular index.
Forms of swap agreements include interestrate swaps (under which fixed- or floating-rate interest payments on a specific principal amount are exchanged) and total return swaps (under which one party agrees to pay the other the total return of a defined underlying asset in exchange for fee payments).
In addition, credit default swaps enable an investor to buy/sell protection against a credit event of a specific issuer. The seller of credit protection against a security or basket of securities receives an up-front or periodic payment to compensate against potential default(s).
Two years ago, prior to the 2022 election, mental health experts alerted the medical world to their version of an assessment scale for yet another new condition – “doomscrolling.”
As defined by the National Library of Medicine in the article, “Constant exposure to negative news on social media and news feeds could take the form of ‘doomscrolling’ which is commonly defined as a habit of scrolling through social media and news feeds where users obsessively seek for depressing and negative information.”
And so, formally Doomscrolling or doomsurfing is the act of spending an excessive amount of time reading large quantities of news, particularly negative news, on the web and social media. Doomscrolling can also be defined as the excessive consumption of short-form videos or social media content for an excessive period of time without stopping. The concept was coined around 2020, particularly in the context of the COVID pandemic.
Surveys and studies suggest doomscrolling is predominant among youth. It can be considered a form of internet addiction disorder. In 2019, a study by the National Academy of Sciences found that it can be linked to a decline in mental and physical health. Numerous reasons for doomscrolling have been cited, including negativity bias and FOMO [fear of missing out], and attempts at gaining control over uncertainty.
QUERY: What about the roaring stock market, post the 2024 presidential election. Fundamental analysis or FOMO?
Market Capitalization: Market capitalization is the market value of all the equity of a company’s common and preferred shares. It is usually estimated by multiplying the stock price by the number of shares for each share class and summing the results.
Market Depth: The degree to which a market can execute large market orders without impacting the price of a security. For example, a “deep” market for a stock will have a sufficient number of both bid and ask orders to keep a big order from significantly moving the security’s price.
Market Maker: A market maker exists to “create a market” for specific company securities by being willing to buy and sell those securities at a specified displayed price and quantity to broker-dealer firms that are members of the exchange. These firms help keep financial markets liquid by making it easier for investors to buy and sell securities–they ensure that there is always someone to buy and sell to at the time of trade.
Market Neutral: Equity market neutral strategies seek to eliminate the risks of the equity market by holding up to 100% of net assets in long equity positions and up to 100% of net assets in short equity positions. These strategies attempt to exploit differences in stock prices by being long and short in stocks within the same sector, industry, market capitalization, etc. If successful, these strategies should generate returns independent of the equity market. Equity market neutral portfolios have two key sources of return:
the Treasury Bill return (the interest on proceeds from short sales held in cash as collateral)
the difference (the “spread”) between the return on the long positions and the return on the short positions. Stock picking, rather than broad market moves, should drive most of a market-neutral strategy’s total return (save for any return from the 100% cash position).
It’s important to point out that here is the risk of theoretical unlimited amount of loss with short selling, (i.e. the price of the short-sold stocks increases; the long position can only go down to $0).
Market Order: An order placed with a bank or brokerage firm to immediately buy or sell a security at the best available current price. May also be referred to as an “unrestricted order.”
Posted on December 7, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
***
***
The Shadow Self is like the dark twin you never knew you had. It’s the part of your personality that lurks in the background, hiding your less-than-perfect traits. Think of it as the villain in your personal movie, full of suppressed desires and impulses.
According to colleague Dan Ariely PhD, acknowledging your shadow self can be a bit like therapy – uncomfortable but ultimately enlightening.
So, embrace your inner Darth Vader, and you might just find a better balance between light and dark.
Municipal Securities (munis): Debt securities typically issued by or on behalf of U.S. state and local governments, their agencies or authorities to raise money for a variety of public purposes, including financing for state and local governments as well as financing for specific projects and public facilities. In addition to their specific set of issuers, the defining characteristic of munis is their tax status. The interest income earned on most munis is exempt from federal income taxes. Interest payments are also generally exempt from state taxes if the bond owner resides within the state that issued the security. The same rule applies to local taxes.
Another interesting characteristic of munis: Individuals, rather than institutions, make up the largest investor base. In part because of these characteristics, munis tend to have certain performance attributes, including higher after-tax returns than other fixed income securities of comparable maturity and credit quality and low volatility relative to other fixed-income sectors.
The two main types of munis are general obligation bonds (GOs) and revenue bonds. GOs are munis secured by the full faith and credit of the issuer and usually supported by the issuer’s taxing power. Revenue bonds are secured by the charges tied to the use of the facilities financed by the bonds.
Municipal Yield Curve: The yield curve that illustrates the yields of a certain type of municipal security at its various maturities.
Municipal Yield Ratio: A yield ratio most often used to determine the relative value of municipal securities compared with U.S. Treasury securities. The ratio consists of the yield of a municipal security of a certain maturity divided by the yield of a U.S. Treasury security of the same maturity.
Posted on December 6, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
BREAKING NEWS!
***
***
The internet web page listing the corporate leadership team behind Anthem Blue Cross Blue Shield (BCBS), one of America’s biggest health insurers, has disappeared from the company’s website.
The disappearance of the page listing the provider’s 25 highest-ranking employees was highlighted in a post shared to the r/antiwork subreddit on Reddit by the user u/wendysdriv
Posted on December 5, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
LTC
By Anonymous Insurance Agent
***
***
Some retired people live on a fixed income and many of them live right on the edge of their financial capability. At some time in their life, they may have to make a choice regarding many purchases. In this case, we will illustrate “choice” using a couple’s purchase of Long-Term-Care Insurance [LTCI].
Of course, economics is the study of choice; wants, needs and scarcity, etc. In our case, if they decide to make the purchase they commit to a lifetime of premium payments. The financial tradeoff is this; if they make the commitment to purchase LTCI, they must give up something else.
Example: In order to maintain a monthly premium of $100 ($1,200per year), an elderly patient, retired layman or couple must essentially relegate about $30,000 of financial assets to generate the $100 necessary to make an average premium payment (assumes a 7% rate of return with 4% withdrawal rate) or [4% X $30,000 = $1,200 year]. Thus, if the monthly premium cost is $500 per month, the elder must give up the use of $150,000 of retirement asset just to generate enough cash flow to pay for the LTC insurance.
The married elder couple has to make the decision among lifestyle (dinners, vacations, gifts to children, prescription drugs, medical care or food and shelter) versus paying an insurance premium to provide for nursing home coverage for a need, which may be very real, but will not occur until sometime in the ambiguous future.
And so, when faced with such a tough economics, neither of which delivers peace of mind or a respectable solution; many will simply decide that, in either case, they may already end up impoverished.
Thus, many will often opt for the better lifestyle now … while they can enjoy it … together.
Posted on December 5, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
Beneficial Ownership Information
By Staff Reporters
***
***
Small business owners face severe penalties if they don’t report to the federal government by year’s end. And, thousands of businesses may not realize they are subject to a new reporting process mandated under the Corporate Transparency Act, which went into effect in January 2024. Even lawyers, doctors, financial advisors and accountants are affected; along with “mom and pop”business owners.
For most eligible businesses, the filing deadline is Jan. 1, 2025, according to the U.S. Chamber of Commerce. “Those who fail to file by this deadline — or fail to update this information if needed — could face up to two years imprisonment and fines up to $10,000, in addition to civil penalties of up to $591 per day,” the U.S. Chamber of Commerce website reads.
The law was created “to combat illicit activity including tax fraud, money laundering and financing for terrorism by capturing more ownership information for specific U.S. businesses operating in or accessing the country’s market,” the chamber website explained.
Posted on December 4, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Health Capital Consultants, LLC
***
***
On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) released its finalized Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2025, aiming “to strengthen primary care, expand access to preventive services, and further access to whole-person care.” While the finalized fee schedule cuts payments to physicians, Congress is considering legislation to override the cut.
This Health Capital Topics article discusses the provisions contained in the MPFS final rule, as well as the proposed “doc fix” legislation. (Read more…)
Real Bond Yield: For most bonds and other fixed-income securities, real yield is simply the yield you see listed online or in newspapers minus the premium added to help counteract the effects of inflation. Most “nominal” fixed-income yields include an “inflation premium” that is typically priced into the yields to help offset the effects of inflation.
Real yields, such as those for TIPS, don’t have the inflation premium. As a result, TIPS yields and other real yields are typically lower than most nominal yields
Negative Bond Yield: In a normal bond market environment, bond yields are positive, and bond issuers (including governments) make interest payments to investors who lend them money.
In an abnormal, or negative-yield environment, investors essentially pay the bond issuer to hold their money.
Posted on December 2, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
BEWARE THE PSYCHOLOGY OF HOLIDAY SHOPPING!
[Online -OR- Onground]
By Staff Reporters
***
***
Power of Free
Who doesn’t love free stuff? The word “free” is like a magic spell that makes our rational minds go on vacation.
According to colleague Dan Ariely PhD, the power of free compels us to grab things we don’t need and make questionable choices. Why buy one and get one free when you can get two for the price of one? It’s the same deal, but free feels better.
IOW: Like other heuristics, the Power of Free is a mental shortcut that allows us to bypass rational thought and save effort to make quick decisions. Studies of the Power of Free have shown it to be closely linked to the Affect Heuristic. Specifically, it is linked to emotional and social thinking rather than transactional thinking. People become influenced by emotion and obligated to socially acceptable behaviors.
For example, say, a yoga studio charges extra to use their mats. This leads more people to pay the fee and use their mats for convenience. Then, say, the same yoga studio removed the extra fee more people would bring their mats from home instead of feeling guilty about borrowing one for class.
Removing a dollar value increases its inherent value and makes it more desirable. The type of product matters too. People are more likely to opt for a free product that is fun rather than functional. This is because emotion is more powerful than rational thinking under the influence of the Power of Free.
In another example, people are more likely to say “yes” to a free piece of cake or sample size of perfume than furniture polish or a bag of white flour.
So, next time you find yourself going to a free financial planning or retirement seminar with free dinner, or a free medical screening test, or free stock market portfolio review, just blame it on the irresistible and irrational power of free.
Posted on December 1, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
AUSTRIAN SCHOOL OF ECONOMICS
By Staff Reporters
***
***
A Paradox is a logicalself-contradictory statement or a statement that runs contrary to one’s expectation. It is a statement that, despite apparently valid reasoning from true or apparently true premises, leads to a seemingly self-contradictory or a logically unacceptable conclusion. A paradox usually involves contradictory-yet-interrelated elements that exist simultaneously and persist over time. They result in “persistent contradiction between interdependent elements” leading to a lasting “unity of opposites”.
Here are five economic paradoxes from the Austrian School of Economics.
***
Prosperity: Why do generations that significantly improve the economic climate seem to generally rear a successor generation that consumes rather than produces?
Thrift: If everyone saves more money during times of recession, then aggregate demand will fall and will in turn lower total savings in the population.
Toil: If everyone tries to work during times of recession, lower wages will reduce prices, leading to more deflationary expectations, leading to further thrift, reducing demand and thereby reducing employment.
Value: [also known as Diamond-Water Paradox]: Water is more useful than diamonds, yet is a lot cheaper.
Productivity: [also known as Solow Computer Paradox]: Worker productivity may go down, despite technological improvements.
Note: The Austrian School of Economics promotes an economic and social thinking that is not trapped in unrealistic, mostly mathematical models. It does not see the economy as an object of state political regulation and central, almost engineering-like control. Rather, its analysis focuses on autonomous entrepreneurial action and the free interaction of individuals in the marketplace, which eludes both the logic of differential equations, and centrally planned political control.
“Paradox of Medical Progress” is a language of medicine is loaded with misnomers, inaccuracies, and ambiguities, and is in need of reform.
Paradoxes on the other hand, deserve a different kind of attention. These seeming self-contradictions are set apart from other inconsistencies because of the truths they tell. The veracity of a paradox is at once appealing and vexing. Anyone who has tried to suppress a thought knows that trying not to think of white polar bears is a sure way to think of white polar bears!
The comic impact of a paradox was even famously explored in Joseph Heller’s Catch 22 and in Groucho Marx’s reluctance to be a member of any club that would accept him. However, the provocative nature of a paradox is its capacity to express familiar wisdom and this is particularly evident in medical science.
The more we learn, the more we learn how much we still have to learn; whereas, “what gets us into trouble is not what we don’t know, it’s what we know for sure that just ain’t so.”
On the significance of the knowledge paradox in biology, Lewis Thomas regarded ignorance as the only scientific truth of which he was confident, and discovering “the depth and scope of ignorance” as the greatest contribution of modern science.
Basis Points are used in financial literature to express values that are carried out to two decimal places (hundredths of a percentage point), particularly ratios, such as yields, fees, and returns. Basis points describe values that are typically on the right side of the decimal point–one basis point equals one one-hundredth of a percentage point (0.01%). So 25 basis points equals 0.25%, and 50 basis points equals 0.50%.
Only when basis points equal or exceed 100 does the value move to the left of the decimal point–100 basis points equals 1.00%, 500 basis points equals 5.00%, etc.
Bid/Ask Spread (also known as bid/offer spread) is the difference between the National Best Bid and the National Best Offer, which represents the implied cost to trade a security.
As compensation for the risk taken, the market maker (or dealer) earns the bid/offer spread in exchange for facilitating the trade. Wider spreads generally indicate higher costs associated with trading the underlying assets in the ETF, hedging costs, inventory management costs, and general market risk.
The www.MedicalBusinessAdvisors.com is focused solely on appraising medical practices, surgery centers [ASCs], medicine, podiatry, optometry and allied healthcare businesses.
Working with our affiliated partners, like the ME-P and others, we are also available for behemoth multi-specialty medical practices, major clinics, hospitals, related healthcare organizations and networks, and PHOs, etc.
We are backed by the expertise of dedicated appraisers and valuation analysts who are trained by the foremost organizations in our industry www.CertifiedMedicalPlanner.org
Practice owners, attorneys and accountants retain us for projects including, but not limited to the following:.
There are a Myriad of Reasons for Obtaining a Medical Practice Valuation and Appraisal Engagement
Outright selling-buying
Partnership and Associate buy-in / buy-out
Mergers and Acquisitions
Organic growth tracking
Hospital integrations
Private and public reporting
Financing and Venture Capital
Estate and tax planning
Our Capability
We have the ability to provide extensive analysis of value components in healthcare practices and provide appraisals based on business, economic, and market conditions. This involves detailed examination of financials and clinical data in the context of numerous factors including medical specialty, physician supply and demand, payer mix, regulatory environment, regional dynamics, and risk premium.
Assessment
Our methods and approaches adhere to accepted standards of healthcare practice appraisal and utilize direct market data to reach justifiable conclusions. These are documented in a comprehensive report which is tailored to meet the need of the specific engagement.
SAMPLE ENGAGEMENTS: See partial engagement list below.
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
OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
Prepayment risk is typically used in reference to mortgage-backed securities. It refers to the risk that mortgage refinancing activity might increase when market interest rates decline, which is generally not favorable for MBS investors.
For example, when homeowners refinance their mortgages, MBS investors are “prepaid,” shortening the life of their investments and forcing investors to reinvest the proceeds under lower interest rate conditions than what were most likely prevailing at the time of the original MBS investment.
Price adjustments for prepayment risk are one factor that helps explain why MBS, despite their generally high credit quality, have higher yields than comparable-maturity Treasury securities.
Posted on November 22, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
***
***
A “Tipping point” has slightly varied meanings depending upon the field of study, but is frequently defined as a series of small changes in an evolutionary process that ultimately lead to a significant change or point beyond which new circumstances and conditions obtain.
For example, the point at which emerging economies go from being a long-time source of deflation to a source of inflation can be said to be an inflationary tipping point.
***
The Tipping Point: How Little Things Can Make a Big Difference is the debut book by Malcolm Gladwell, first published by Litttle, Brown in 2000. Gladwell defines a tipping point as “the moment of critical mass, the threshold, the boiling point.” The book seeks to explain and describe the “mysterious” sociological changes that mark everyday life. As Gladwell stated: “Ideas and products and messages and behaviors spread like viruses do.”
Examples of such changes in his book include the rise in popularity and sales of Hush Puppies shoes in the mid-1990s and the steep drop in New York City‘s crime rate after 1990.
Posted on November 21, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
***
***
Active investment management strategies are the opposite of passive investment strategies. Active portfolio managers regularly take investment positions that clearly differ from those of the portfolio’s performance benchmark, with the objective of outperforming the benchmark over time.
In addition to the upside potential of outperforming the benchmark, there’s also the downside possibility of under performing the benchmark. In an efficient market, there should be roughly the same magnitude of out performers and under performers for any given benchmark. But, markets are not always efficient.
Active non-transparent investment management strategies are Exchange Traded Funds that are actively managed by a portfolio manager or team of managers without daily disclosure of portfolio holdings. Active transparent strategies are daily disclosures of portfolio holdings as an attribute of traditional index-based Exchange Traded Funds (ETFs). Active transparent exchange traded funds are actively managed by a portfolio manager or team of managers. As with index-based ETFs, their portfolio holdings are disclosed daily.
NOTE: Absolute return as an investment vehicle seeks to make positive returns by employing investment management techniques that differ from traditional mutual funds. Absolute return investment techniques include using short selling, futures, options, derivatives, arbitrage, leverage and unconventional assets.
Posted on November 21, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
***
***
The Grossman-Stiglitz Paradox was introduced by Sanford J. Grossman and Joseph Stiglitz in a joint publication in American Economic Review in 1980 that argues perfectly informationally efficient markets are an impossibility since, if prices perfectly reflected available information, there is no profit to gathering information, in which case there would be little reason to trade and markets would eventually collapse.
IOW: According to colleague Eugene Schmuckler PhD MBA CTS, the Grossman-Stiglitz paradox is the inability to recoup the cost of obtaining market information and thus implies that efficient markets cannot exist.
Posted on November 20, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
***
***
Ever notice how memories change over time? That’s retrospective framing.
According to Dan Ariely PhD, our brains are like movie editors, constantly tweaking the past to fit our current narrative. Recall that terrible vacation where everything went wrong? Fast forward and now it’s a hilarious adventure. This mental editing helps us make sense of our lives and learn from our experiences.
So, just remember, the past is a story we keep rewriting, and sometimes those edits can be more fiction than fact
Classic Definition: A comprehensive review of a physician, clinic, facility, medical provider or hospital’s charges to ensure Medicare billing compliance through complete and accurate HCPCS/CPT and UB-92 revenue code assignments for all items including supplies and pharmaceuticals. The charge master captures the costs of each procedure, service, supply, prescription drug, and diagnostic test provided at the hospital, as well as any fees associated with services, such as equipment fees and room charges
Modern Circumstance: A charge master quizlet (charge description master [CDM]) document that contains a computer-generated list of procedures, services, and supplies with charges for each. Charge master rates are essentially the health care market equivalent of Manufacturer’s Suggested Retail Price (MSRP) in the car buying market. Poor charge master maintenance can lead to overpayments or underpayments. It can also lead to claim rejections from insurance companies, poor patient experience, or compliance violations.
Paradox Examples:
Superbills: An encounter form that is the financial record source document used by healthcare providers and other personnel to record treated diagnoses and services rendered to the patient during the current encounter. It is also called a superbill.
Payment rates: Almost no one actually pays the publicized charge master rates. The vast majority of health care consumers are represented by a payer of some kind, such as a commercial health insurance company, Medicaid, or Medicare. Commercial insurers negotiate the actual prices they pay during the process of contracting with providers. Medicare and Medicaid establish their own payment levels independent of hospitals’ charge master lists – Medicare through the federal government and Medicaid through state governments.
Cash pay: The sad irony of the charge master is that the uninsured are the most likely to be billed charge master rates because they are not represented by a third-party payer.
Problematic features: Other items also impede the ability of payers to have a comprehensive and accurate understanding of hospitals’ financial positions. For example, nonprofit hospitals are required to report charity care, bad debt expenses, community benefit initiatives, and uncompensated care. When these expenses are reported at the charge master level, expenses can be paradoxically overstated, potentially making a hospital’s financial position look worse than it actually is.
A trader can gain by throwing away some of his/her initial endowment.
SAMPLE: There is an economy with two commodities (x and y) and two traders (e.g. Alice and Bob).
In one situation, the initial endowments are (20,0) and (0,10), i.e, Alice has twenty units of commodity x and Bob has ten units of commodity y. Then, the market opens for trade. In equilibrium, Alice’s bundle is (4,2), i.e, she has four units of x and two units of y.
In the second situation, Alice decides to discard half of her initial endowment – she throws away 10 units of commodity x. Then, the market opens for trade. In equilibrium, Alice’s bundle is (5,5) – she has more of every commodity than in the first situation.
The “throw away paradox” was first described by Robert J. Aumann and B. Peleg as a note on a similar paradox by David Gale.
Volatility indexes are forward-looking measures of the market’s expectations of volatility (or how much a stock index’s price moves). The CBOE manages and publishes three of the most widely used volatility indexes based on three major stock indexes:
The VIX Index tracks the expected 30-day future volatility of the S&P 500 Index.
The VXN Index tracks the expected 30-day future volatility of the NASDAQ-100 Index.
The VXD Index tracks the expected 30-day future volatility of the Dow Jones Industrial Average Index.
A Stop order, also known as a “stop-loss order,” a stop order is an order placed with a bank or brokerage firm to either buy or sell a security after it reaches a specified price. Once the price is reached, the stop order becomes a market order, meaning there is no guarantee that an order will be completely filled at the specified stop price.
A Stop-limit order is order placed with a bank or brokerage firm to buy or sell a fixed amount of an investment after it reaches a specified or better price, combining the features of a stop order and a limit order.
A stop-limit order requires investors to set two price points: the first initiates the stop (the order to buy or sell) and the second sets the limit, or price beyond which the investor would not like to buy or sell. The investor also sets a time frame for which the order is valid before being cancelled. If the investor’s price cannot be met during the specified time frame, the order will be cancelled.
Posted on November 17, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Dr. David Edward Marcinko MBA MEd
***
***
The number of people living with Alzheimer’s disease is growing. The ripple effect is straining families, communities, and the healthcare system, yet talking about the disease on a personal level can be difficult.
November is Alzheimer’s Awareness Month because it can happen in any family, and because it’s worth talking about the challenges of living with or caring for someone with this disease.
You may notice splashes of teal and purple sprouting up this November, as both colors are associated with Alzheimer’s awareness. Teal is the color of the Alzheimer’s Foundation of America, chosen for its calming effect. Purple is the signature color of the Alzheimer’s Foundation, which stands for strength in the fight against Alzheimer’s disease.
Posted on November 16, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
***
***
Patternicity is our brain’s tendency to find patterns in random data. It’s why we see faces in clouds or think the stock market follows our horoscope. According to colleague Dan Ariely PhD, this quirk helped our ancestors survive by recognizing predator shapes in the bushes, but in modern times, it can lead us astray. Our brains love making connections, sometimes too much, seeing patterns where none exist.
So, when you’re convinced that your lucky socks influence your team’s performance, remind yourself: it’s just your brain’s patternicity at work.
Now, “Apophenia is the general term for the human tendency to see patterns in meaningless data that may involve visual, auditory, or other senses,” according to Dr. Harold Hong, a psychiatrist from Raleigh, North Carolina. He points out that pareidolia is a specific form of apophenia that refers to seeing visual patterns in random or ambiguous visual stimuli, such as seeing a face in the clouds.
Apophenia and pareidolia are common occurrences, says Hong, and challenges often only present when someone becomes fixated on specific patterns or details that others perceive as random. “While both phenomena are natural human tendencies, they can become concerning if someone starts to fixate on specific patterns excessively,” he says, noting that apophenia may be prevalent in certain mental health conditions, such as obsessive-compulsive disorder (OCD).
Posted on November 15, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
***
***
The Fight or Flight Response is our built-in alarm system, ready to spring into action at the first sign of danger. Whether it’s a charging lion or an impending deadline, our bodies react the same way – heart racing, adrenaline pumping, ready to fight or flee. This ancient survival mechanism is great for escaping predators but less helpful when dealing with modern stressors.
So, the next time you feel your heart racing over a tough email or stock market loss, remember: it’s just your caveman brain doing its thing.
Social Proof is a subtle but powerful reality that having others agree with a decision one makes, gives that person more conviction in the decision, and having others disagree decreases one’s confidence in that decision.
This bias is even more exaggerated when the other parties providing the validating/questioning opinions are perceived to be experts in a relevant field, or are authority figures, like doctors, attorneys, financial advisors, teachers and/or people on television. In many ways, the short term moves in the stock market are the ultimate expression of social proof – the price of a stock one owns going up is proof that a lot of other people agree with the decision to buy, and a dropping stock price means a stock should be sold.
According to colleague Dan Ariely PhD, when these stressors become extreme, it is of paramount importance that all participants in the financial planning and investing process have a clear understanding of what the long-term goals are, and what processes are in place to monitor the progress towards these goals.
Without these mechanisms it is very hard to resist the enormous pressure to follow the crowd; think social media and related influences.
Convertible securities are those that can be converted at the investor’s choice into other investments, normally into shares of the issuer’s underlying common stock. Convertibles are typically issued as bonds or preferred stock.
Convertible bonds, which provide an ongoing stream of income, can be converted into a preset number of shares of the company’s common stock and have a maturity date. Unlike common stock, which pays a variable dividend depending on a corporation’s earnings, convertible preferred stock pays a fixed quarterly dividend. It can be converted into common stock at any time, but often are perpetual.
Corporate securities (corporate bonds and notes) are debt instruments issued by corporations, as distinct from those issued by governments, government agencies, or municipalities.
Corporate securities typically have the following features: 1) they are taxable, 2) they tend to have more credit (default) risk than government or municipal securities, so they tend to have higher yields than comparable-maturity securities in those sectors; and 3) they are traded on major exchanges, with prices published in newspapers.
Posted on November 14, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
***
***
November is Lung Cancer Awareness Month, which according to the CDC, is the third most common cancer in the US. There are about one in five lung cancer deaths each year across the country, and November is dedicated to increasing screening, reducing smoking, and finding new treatments.
Equity market neutral strategies seek to eliminate the risks of the equity market by holding up to 100% of net assets in long equity positions and up to 100% of net assets in short equity positions. These strategies attempt to exploit differences in stock prices by being long and short in stocks within the same sector, industry, market capitalization, etc. If successful, these strategies should generate returns independent of the equity market.
Equity market neutral portfolios have two key sources of return: 1) the Treasury Bill return (the interest on proceeds from short sales held in cash as collateral), and 2) the difference (the “spread”) between the return on the long positions and the return on the short positions. Stock picking, rather than broad market moves, should drive most of a market-neutral strategy’s total return (save for any return from the 100% cash position).
Extended Equity Strategies attempt to provide better returns than possible with long-only investments
An example of an extended equity strategy is a 130/30 portfolio, which gets its designation from taking a 130% long position and a 30% short position. In practice, this would mean $100mm invested in stocks that are viewed as attractive.
Next, the manager would borrow and sell short $30mm of unattractive stocks. Then the manager uses the proceeds from the short sale to buy an additional $30mm of attractive stocks. This results in a portfolio that has 130% long and 30% short exposure to stocks, or “extended” exposure to equities relative to a long-only, 100% stock portfolio.
Note: It’s important to point out that here is the risk of theoretical unlimited amount of loss with short selling, (i.e. the price of the short-sold stocks increases; the long position can only go down to $0).
Classic Definition: A doctor announces to her hospitalized patient that there will be a painful medical test sometime during the following week. The patient begins to speculate about when it might occur, until another patient announces that there is no reason to worry because a medical surprise test is impossible.
The test cannot be given on Friday, because by the end of the day on Thursday we would know that the test must be given the next day. Nor can the test be given on Thursday, because, given that we know that the test cannot be given on Friday, by the end of the day on Wednesday we would know that the test must be given the next day. And likewise for Wednesday, Tuesday, and Monday!
Modern Circumstance: The patient spends a restful weekend not worrying about the test, yet is very surprised when it is given on Wednesday. How could this happen?
Paradox Example: There are various versions of this paradox; one of them, called the Hangman, concerns a condemned prisoner who is clever but ultimately overconfident. The implications of the paradox are as yet unclear, and there is virtually no agreement about how it should be solved.
Support our online development, and advance our onground research initiatives in free market economics, as we seek to showcase the brightest Next-Gen minds.
THE ME-P DISCLAIMER: Posts, comments and opinions do not necessarily represent iMBA, Inc., but become our property after submission. Copyright © 2006 to-date. iMBA, Inc allows colleges, universities, medical and financial professionals and related clinics, hospitals and non-profit healthcare organizations to distribute our proprietary essays, photos, videos, audios and other documents; etc. However, please review copyright and usage information for each individual asset before submission to us, and/or placement on your publication or web site. Attestation references, citations and/or back-links are required. All other assets are property of the individual copyright holder.
The Leading Business Education Network for Doctors, Financial Advisors and Health Industry Consultants 