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Value your money enough to fight for it
Posted on July 13, 2018 by Dr. David Edward Marcinko MBA MEd CMP™
US Health Spending Trends
Posted on July 13, 2018 by Dr. David Edward Marcinko MBA MEd CMP™
1966 – 2026
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Conclusion
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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements.
Book Marcinko: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/
Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.
DOCTORS:
“Insurance & Risk Management Strategies for Doctors” https://tinyurl.com/ydx9kd93
“Fiduciary Financial Planning for Physicians” https://tinyurl.com/y7f5pnox
“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8
HOSPITALS:
“Financial Management Strategies for Hospitals” https://tinyurl.com/yagu567d
“Operational Strategies for Clinics and Hospitals” https://tinyurl.com/y9avbrq5
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Breaking Healthcare Business News
Posted on June 29, 2018 by Dr. David Edward Marcinko MBA MEd CMP™
Breaking News and Updates
Atul Gawande Says His Goal Is Better Health Care for 1 Million Workers
Bloomberg, June 21, 2018
New Labor Rule Will be a Big Health Care Boon for Small Businesses
The Hill, June 20, 2018
The Benefits of Benefits: Why Employers Can’t Afford Inadequate Workplace Perks
Cision PRnewswire, June 19, 2018
Benefit Offerings Mature Along With the Millennials Employers Want to Hire
Bloomberg, June 14, 2018
Costs are Rising for Employer-Sponsored Insurance — Again
CBS News, June 13, 2018
Health Insurers Mount Major Defense of ‘Coverage at Work’
ThinkAdvisor, June 13, 2018
Fed Up With Rising Costs, Big U.S. Firms Dig Into Healthcare
Reuters via NY Times, June 11, 2018
Employers Urge Trump Administration to Pull Back on Obamacare Mandate
Modern Healthcare, June 1, 2018
A Health Plan with a la Carte Coverage
Star Tribune, May 25, 2018
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A Decade of Health Insurance Deductibles
Posted on June 18, 2018 by Dr. David Edward Marcinko MBA MEd CMP™
2006-2016
By KFF
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DOCTORS:
“Insurance and Risk Management Strategies for Doctors” https://tinyurl.com/ydx9kd93
“Fiduciary Financial Planning for Physicians” https://tinyurl.com/y7f5pnox
“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8
HOSPITALS:
“Financial Management Strategies for Hospitals” https://tinyurl.com/yagu567d
“Operational Strategies for Clinics and Hospitals” https://tinyurl.com/y9avbrq5
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Predictions in the Economy and Elections
Posted on June 13, 2018 by Dr. David Edward Marcinko MBA MEd CMP™
Be Wary of Predictions in Economy and Elections
By Rick Kahler CFP®
“I rarely have seen economic fundamentals as good as they are now.” I heard this observation from Greg Valliere, the chief global strategist at Horizon Investments, in a May 18 keynote address at the Spring Conference of the National Association of Personal Financial Advisors (NAPFA). With 3,100 members, NAPFA is the largest organization of fee-only financial planners in the US.
Valliere listed numerous positives for the economy, especially the very low unemployment rate, the tax cuts, the increase in government spending via the new budget, and the high corporate earnings. He saw as less positive the fact that we can’t seem to get our gross domestic product rate much over 2% when it needs to be around 3%. Also problematic are the anticipated rate increases by the Federal Reserve Bank and the growing protectionism that may cause the markets and economy to react poorly.
He noted that both Democrats and Republicans agree on two things: something must be done to address the unfair trade issues with China, and no one really wants a trade war that will cost jobs, increase prices, and probably send the economy into recession. They don’t agree on how to go about this. Despite the bluster, Valliere doesn’t see a comprehensive deal in the near future with China. Nor does he see a deal anytime soon to solve what he called the “disappointing” problems with the North American Free Trade Act (NAFTA). He added, “There is a chance Canadian relations will turn south in a hurry.”
As problematic as these issues are, the sleeper that may cause us economic troubles is the impact on our European trading partners caused by our new sanctions on Iran.
Regarding the Federal Reserve, Valliere observed that Janet Yellen left on a high note and was a good Fed chairman. However, noting that Trump is no respecter of the historical separation between the White House and the Federal Reserve Bank, he added, “I think there will be friction between Trump and Powel. Trump doesn’t want rates hiked so this new chairman will have to tiptoe.”
Valliere also ventured into prognosticating on the 2018 midterm elections. He thinks the Republicans will maintain control of the Senate and possibly gain 2 or 3 seats. His best guess is that the House will flip to the Democrats. They need a gain of 23 seats to gain control, and the midterm average is for the party in control to lose 25 seats. “The wild card is if by Labor Day the GDP is growing by 3% and unemployment is 3.5%. Then people may vote their pocketbook and give the Republicans another 2 years.”
He then wandered into the 2020 presidential election, saying, “I believe that Trump easily has the Republican nomination,” because Mitt Romney and John Kasich are no threat. He noted that “80% of Republicans love this guy. His support is rock solid. No one in the Republican Party takes out Trump.”
In the general election he doesn’t see a Democrat strong enough to defeat Trump. Neither does he see a credible third party candidate.
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Assessment
As much as I agree with Valliere’s take on the economy, and as convincing as he is on Trump’s chances of winning a second term, I am not making any bets on that. In 2016 I was sure Hillary Clinton would be our next president, and I put my money where my mouth was. Maybe this time I need to play the contrarian and put my money on Elizabeth Warren. The one sure bet I can rely on is that both the economy and politics are too complex to easily predict.
Conclusion
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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements.
Book Marcinko: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/
Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.
DOCTORS:
“Insurance & Risk Management Strategies for Doctors” https://tinyurl.com/ydx9kd93
“Fiduciary Financial Planning for Physicians” https://tinyurl.com/y7f5pnox
“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8
HOSPITALS:
“Financial Management Strategies for Hospitals” https://tinyurl.com/yagu567d
“Operational Strategies for Clinics and Hospitals” https://tinyurl.com/y9avbrq5
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What are Immortal HeLa Cells?
Posted on June 10, 2018 by Dr. David Edward Marcinko MBA MEd CMP™
On Henrietta Lacks
[By Dr. David Edward Marcinko MBA]
I am from Baltimore, Maryland and grew up playing stick ball in the parking lot of Johns Hopkins Hospital. I met more than a few medical luminaries and so I also know this legendary story. It is now passed on for your amazement!
What they are – How they work?
‘Immortal’ Cells
Journalist Rebecca Skloot’s new book investigates how a poor black tobacco farmer had a groundbreaking impact on modern medicine
https://en.wikipedia.org/wiki/HeLa
More: http://www.msn.com/en-us/news/us/henrietta-lacks-portrait-acquired-by-smithsonian-museums/ar-AAx5hQF
Conclusion
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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements.
Book Marcinko: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/
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Doctors Call for EHR Overhaul
Posted on June 7, 2018 by Dr. David Edward Marcinko MBA MEd CMP™
A New Research Study
By Stanford Medicine
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Conclusion
Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements.
Book Marcinko: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/
Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.
DOCTORS:
“Insurance & Risk Management Strategies for Doctors” https://tinyurl.com/ydx9kd93
“Fiduciary Financial Planning for Physicians” https://tinyurl.com/y7f5pnox
“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8
HOSPITALS:
“Financial Management Strategies for Hospitals” https://tinyurl.com/yagu567d
“Operational Strategies for Clinics and Hospitals” https://tinyurl.com/y9avbrq5
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Living U.S. World War II Veterans
Posted on May 28, 2018 by Dr. David Edward Marcinko MBA MEd CMP™
A Graph for the Period 1960-2016
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Conclusion
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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements.
Book Marcinko: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/
Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.
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Understanding the ME-P Knowledge Based Ranking Service
Posted on May 23, 2018 by Dr. David Edward Marcinko MBA MEd CMP™
About Our Professional User-Generated Ratings Interface
From the Contributing Editors
How We Work
The Medical Executive-Post is a professional ranking and educational rating system for the integrated industries, readers and contributors we serve.
We function as an open social utility that allows readers and users to submit and collectively evaluate the quality of blog posts, opinions and essays on any of more than 50 specific topics and related subject matters of collective interest.
Understanding Knowledge Based Ranking Services
Assessment
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.
Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos
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:
Health Dictionary Series: http://www.springerpub.com/Search/marcinko
Practice Management: http://www.springerpub.com/product/9780826105752
Physician Financial Planning: http://www.jbpub.com/catalog/0763745790
Medical Risk Management: http://www.jbpub.com/catalog/9780763733421
Hospitals: http://www.crcpress.com/product/isbn/9781439879900
Physician Advisors: www.CertifiedMedicalPlanner.org
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Filed under: Career Development, Experts Invited, iMBA, Inc., Marketing & Advertising | Tagged: ME-P, ranking services, rating services, www.MedicalExecutivePost.com | Leave a comment »
What are Lichtenberg figures?
Posted on May 20, 2018 by Dr. David Edward Marcinko MBA MEd CMP™
Shocking!
[By Staff reporters]
“Lichtenberg figures” are branching, tree-like patterns that are created by the passage of high voltage electrical discharges along the surface, or through, electrically insulating materials (dielectrics).
MORE: https://en.wikipedia.org/wiki/Georg_Christoph_Lichtenberg
The first Lichtenberg figures were actually 2-dimensional “dust figures” that formed when airborne dust settled on the surface of electrically-charged plates of resin in the laboratory of their discoverer, German physicist Georg Christoph Lichtenberg (1742-1799).
Professor Lichtenberg first observed this in 1777, demonstrated the phenomenon to his physics students and peers, and reported his findings in his memoir (in Latin): De Nova Methodo Naturam Ac Motum Fluidi Electrici Investigandi (Göttinger Novi Commentarii, Göttingen, 1777). The English translation of the title is, “Concerning the New Method Of Investigating the Nature and Movement of Electric Fluid”.
MORE: http://www.capturedlightning.com/frames/lichtenbergs.html#What
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Assessment
I used to cover the ER back in the day, and actually saw a patient struck by lightening, thusly.
MORE: http://twistedsifter.com/2012/03/lichtenberg-figures-lightning-strike-scars/
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.
Book Marcinko: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/
Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.
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Dr. Marcinko Interviewed on the Physician Credit Crunch
Posted on May 6, 2018 by Dr. David Edward Marcinko MBA MEd CMP™
Financial Experts Share Tips on Obtaining Loans to Start or Expand a Medical Practice
By Michael Gibbons
Editor: ADVANCE Newsmagazines
Maybe you’re a young dermatologist or plastic surgeon who dreams of starting your own practice. Or maybe you’re an established professional but want to expand your palette of anti-aging services. Either way, you’ve probably made an unpleasant discovery: Banks are leery about lending today. Global recessions with seemingly no end in sight tend to give loan officers sticky fingers.
Dermatologists and Plastic Surgeons
We have it on good authority that dermatologists and plastic surgeons as a group are less affected by this problem than physicians in some other branches of medicine. Still, there’s no better time than now to absorb some sound advice on how to approach banks for loans—whether you’re a fresh-faced newcomer to the fresh-face business or a wrinkled veteran at eliminating wrinkles.
Start Small
There’s no soft-soaping it: Starting a healthy aging practice is much harder than expanding an existing practice, even in the flushest of times.
“For young dermatologists starting out, I recommend you start small,” advises Jerome Potozkin, MD, who offers facial rejuvenation, liposuction, body contouring and dermatological care through his practice in Walnut Creek, CA. “You can always expand. Keep your overhead low. Know what your credit score is and do everything you can to improve it. Pay your bills on time.”
Lasers aren’t cheap. Besides the initial acquisition costs, a service contract can cost $7,000 to $12,000 a year, according to Dr. Potozkin. “Don’t feel you have to buy every new laser under the sun,” he says. “In fact, renting rather than purchasing is an option many companies offer. When your volume is low you can rent and schedule laser days—although the pitfall there is you don’t have lasers available whenever patients come in.”
Also, young dermatologists “will probably have an easier time getting a loan if they go to a relatively underserved area, as opposed to an area that has a large number of dermatologists per capita,” says Dr. Potozkin, who began practicing 10 years ago. “There are two schools of thought on this: Go where you want to live to start a practice or go to where there’s a need and be instantly successful. I chose the former. It took me longer to get started but I’m very happy where I am.”
Patience, Prudence and Passion
Be patient, prudent, passionate—and start with a spare office and as little debt as possible, advises Dr. David E. Marcinko MBA, a financial advisor and Certified Medical Planner™. Marcinko, a health economist, is CEO of the Institute of Medical Business Advisors Inc., a national physician and medical practice consulting firm based in Norcross, GA www.MedicalBusinessAdvisors.com
“Patients are looking for passion from you, not lavish trappings,” Dr. Marcinko says. “When a banker or a loan officer sees $175,000 or more of debt they are loath to give a loan—and it’s hard to blame them. Purchase a home after you become a private practitioner. You need to be as close to debt-free as you can be.
Exit Strategy
“Another thing bankers want to know is, ‘If we give you a loan and you start a practice and it fails, how will we be paid back?’ They want an exit strategy.”
The good news is dermatology “remains a very lucrative specialty, and in most parts of the country they are in a shortage position, particularly with the aging population,” says Sandra McGraw, JD, MBA, principal and CEO of the Health Care Group, a financial and legal consulting firm based in Plymouth Meeting, PA., that advises the American Academy of Dermatology, among other groups.
“I would start with a realistic business plan for why you think this practice can succeed, in the specific location,” McGraw says. “How many patients do you expect to see? How will they know you are there and available? Remember that banks lend to all kinds of people, so keep your numbers realistic. Overestimating expenses is as bad as underestimating them. Then determine how you want the money—usually a fixed loan for a period of time and then a line of credit as you get your practice going and sometimes need the cash flow.”
Expanding a Practice
Established dermatologists should have an easier time getting loans to expand their practices. They have, one hopes, a track record of success and assets to put up as collateral.
Mid-career physicians “have cash flow, physician assets and equity to some degree in a house and personal assets,” Dr. Marcinko observes. “Banks can attach loans to personal assets and savings accounts. Ninety-nine percent of times you must sign a personal asset guarantee. Mid-lifers have assets young ones don’t, so mid-lifers aren’t quite the risk. They have businesses that have value and cash flow. Banks like cash flow.”
However, even veterans must do some homework before approaching a bank. “You still want to establish why you want the money and how the expansion will increase your income,” McGraw says.
Another tip: If the bank has loans out with reputable vendors, you might ask the loan officer to recommend them to you as potential contractors. “Sometimes keeping it local and supporting others with loans at the bank can be helpful,” she says.
Assessment
Dr. Marcinko adds, “Bankers today want you to come in with a well-reasoned, well-thought-out and well-written business plan. Give bankers a 30-second elevator speech on why you are different. It’s really important to ask yourself, ‘What can I offer the community as a doctor in my specialty that nobody else can?’ If you bill yourself as the first dermatologist to do laser surgery, that’s a perceived advantage. You purchased the equipment and learned to use it. But anyone can do that. If you can come up with something that nobody else has or can do, that’s how you’re successful in anything.”
Link: Dr. Marcinko Interview
Link: https://medicalexecutivepost.com/wp-content/uploads/2009/08/dr-marcinko-interview.pdf
Conclusion
And so, your thoughts and comments on this Medical Executive-Post are appreciated. Tell us what you think. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.
Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
Sponsors Welcomed
And, credible sponsors and like-minded advertisers are always welcomed.
Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise
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Filed under: "Doctors Only", Book Reviews, Career Development, CMP Program, Experts Invited, iMBA, Inc., Interviews, Managed Care, Practice Management, Practice Worth, Recommended Books, Research & Development | Tagged: ADVANCE Newsmagazines, bankers, business plan, certified medical planner, CMP, credit, credit crunch, david marcinko, dermatologists, Health Care Group, Jerome Potozkin, loans, MD, Michael Gibbons, plastic surgeons, Sandra McGraw, www.certifiedmedicalplanner.com, www.medicalbusinessadvisors.com | 2 Comments »
What up ‘Medical Virtualist’?
Posted on April 13, 2018 by Dr. David Edward Marcinko MBA MEd CMP™
Is the ‘medical virtualist’ specialty coming to a health system near you?
[By Staff Reporters]
The Journal of the American Medical Association not long ago published an online editorial by two physicians at NewYork-Presbyterian that called for the creation of a new medical specialty focused on virtual care.
Others expanded on this idea in a blog post last month on the Health Affairs website, calling for a “virtualist movement” that involves not just physician specialists but whole care teams devoted to virtual care. This virtual team would include nurses, pharmacists, medical social workers, psychologists, nutritionists and physical therapists.
MORE DIGITAL HEALTH: http://mhealth.amegroups.com/article/view/16494/16602
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http://www.HealthDictionarySeries.org
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Is Aetna Sucking Up after their Last Big Fiasco?
Posted on April 3, 2018 by Dr. David Edward Marcinko MBA MEd CMP™
On the New Aetna PBM Plan
[By Dr. David Marcinko MBA]
Aetna announced last week that they plan to directly apply negotiated pharmacy rebates to fully-insured member’s prescriptions at the time of purchase.
For details on how Aetna hopes this move will bring greater transparency to the drug supply chain, read more below.
The Screw Up!
CALIFORNIA LAUNCHES INVESTIGATION FOLLOWING STUNNING ADMISSION BY AETNA MEDICAL DIRECTOR
The Suck Up?
Aetna to Pass Pharmacy Savings Directly to Customers
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Leave FACEBOOK and Join the MEDICAL EXECUTIVE POST.com
Posted on March 27, 2018 by Dr. David Edward Marcinko MBA MEd CMP™
AN “OPEN LETTER” FROM THE PUBLISHER-IN-CHIEF
Niche Specificity is the Key to Future Social Media Action
By Dr. David Edward Marcinko MBA [Publisher-in-Chief]
My solution to Facebook dilution.
It was a no good, very bad week for Facebook.
WHY: It came to light that up to 50 million users had their data improperly accessed by data firm Cambridge Analytica. Ever since, the company has been under incredible scrutiny as its’ stock price is in free fall. In fact, CEO Mark Z. lost about ten billion dollars; at least on paper…Ouch! But, he is still worth about 65 billion dollars, so don’t worry — be happy for him!
The Critics
- Did you know that Elon Musk is joining a growing group of people in the tech industry who have taken aim at social media companies and Facebook in particular?
- Aaron Levie, CEO of cloud computing company Box, recently tweeted: “The days of arguing that (and acting like) tech companies are merely platforms and pipes are behind us.”
- Marc Benioff, CEO of business software company Salesforce, recently started equating social media to smoking cigarettes.
And now, this Medical Executive-Post is jumping on the alternate social media site bandwagon. Leave Facebook now!
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Here’s How to manipulate Facebook instead of it Manipulating You
Social media platforms know a lot about us—but that doesn’t mean we can’t have our own ways of fighting back.
So, try these six tricks to take back control of your digital life. https://tinyurl.com/y888s8m5
Intellectual Riches … thru Niches
As Facebook became ever-more generalized, it also became less powerful, less informed, less important and therefore less credible; writ large. All opinions are not informed opinions
“When you try to be all things to every one – you became nothing to no one”
But smaller, niche alternatives like this Medical Executive-Post can provide new ways for us to interact with other smart, like-minded and informed people online.
Re-Enter the Medical Executive-Post of iMBA, Inc.
This Medical Executive-Post is sponsored by the Institute of Medical Business Advisors Inc., of Atlanta, Georgia; which was founded in 2006 as a leading national scope provider of healthcare administration education and medical practice management reports, books, dictionaries, journals, white-papers, fair-market valuations [FMV] and economic advisory opinions using multi-platform and traditional seminars and channels of knowledge distribution.
iMBA helps the nation’s medical, healthcare and education professionals make decisive improvements in their direction and performance by empowering them through unbiased information, consultants and proprietary tools, books, templates and B-school styled case models.
We serve universities, medical, business, graduate and nursing schools; physicians, dentists and legal societies; accountants, financial service providers, wealth and hedge fund managers; emerging entities, hospitals, clinics, outpatient centers, CXOs and their BODs – the press, media and related organizations.
My Idea
For the solution to Facebook dilution, my idea is not new or radical; but it is simple. Join the Medical Executive Post. It is time.
To achieve a better and more niche focused professional social site, we need to be much more concentrated and serious about all vital topics in the healthcare industrial complex – which is an ecosystem projected to become 20% of domestic GDP; very soon.
Thus, this academic niche is not so small; but we are indeed highly educated, powerful and can become very influential and very actionable; more so than the general Facebook populace hoi polloi.
Remember, Pareto’s 80/20 Law and the trivial many versus vital few. Show us your vitality.
More Reasons to Join Us – Today!
- Why I Won’t Leave Facebook – NO MATTER WHAT!
- Why Subscribe to the ME-P?
- Why Post Your e-Content or Print Publish with Us?
- Contribute to the ME-P
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.
Contact: MarcinkoAdvisors@msn.com
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WHY MEDICAL TREATMENT COSTS ARE BECOMING EXPENSIVE [25 Factors]
Posted on March 11, 2018 by Dr. David Edward Marcinko MBA MEd CMP™
Are Doctors Responsible?
By Dr. Pankaj Kumar
Namaste!
The following features have led to increasing dependence on investors in the medical field which then has to run along the lines of an industry to ensure its financial viability.
For example:
1. Newer technology and rapid advances in newer innovations in medical fields for improvement in diagnostic and newer treatment modalities: If a hospital or doctor does not upgrade, it will be regarded as having obsolete technology. Most of these medical technologies are extremely expensive and owned and marketed by big multinational companies who sell them. Since cost involved is very high, there can be various types of deals involved between middlemen involved in selling and buying the equipment and technologies. Doctors are the end users of these technologies, but not part of business process. They are actually the consumers and users for these technologies.
2. Expensive real estate: A self made doctor at the start or even during his life time, does not have the kind of finances to build a hospital which needs a large parcel of land with commercial location. Therefore there is a need for big investment or investor to pitch in and invest funds. And if they invest, obviously they would look for some returns.
3. Equipping the Hospital: Building of hospital with the infrastructure and equipping it well needs lot of money and investment which only an investor can provide. Same is true for maintenance of equipment, bills, insurances, AMC etc.
4. Staffing of Hospital: A hospital needs lot of skilled human resources, health care being a highly labour intensive industry. Doctors , nurses, technicians, para medical, administrative and clerical staff is required. Employment of non medical in hospital industry too has been increasing because of various regulatory requirements and complex processes other than just treating patients.
5. High regulatory requirements: globally the requirements of regulatory authorities have been sky rocketing and it requires a lot of manpower to maintain such data. Getting accreditation etc are processes which requires manpower, time, and a legal team. All these legal requirements are expensive.
6. Consumer protection act: This single important factor can increase the cost of healthcare for the patient. As doctors are increasingly scared of being dragged to court, they are always on backfoot and are forced to do defensive practice. Investigations are required for documentation. Patient and courts will ask for proof and goes by documentation. Medical problems are very complex and sometimes it is difficult to judge the future course of disease or decisions for surgery, or how patient will behave before or after surgery. A doctor, thus, will always try to play safe legally in present scenarios. Because everything he does will be scrutinized later, with retrospective wisdom, by courts. And since doctors manage so many patients everyday, they never know which one will harass and deceive them later. Mistrust has increased to such an extent that patient relatives do not understand even if things are told in good faith and in patient’s interest. Summarily doctors have to safeguard themselves from treatment as well as legal and documentation hassles.
7. Expensive legal services: Every case that goes to court involves lawyers and their expensive fees. Most of the time even though the doctors may be right, he has to defend himself with the help of lawyers. Law industry has been benefitted enormously because of consumer protection act at the cost of doctors. Increasing mistrust and unhappiness in patient’s mind definitely does not help patients and doctors. Strangely doctor’s fee are quite low but lawyers charges them astronomical amounts, which are beyond any logic.
8. Increased expectation of patients: People want exceptional care, best in the world with best technology, that also at a price less than even a meal in restaurant, and then they want a quick relief!! This is an expectation almost impossible to fulfil. Even government hospitals, which are funded by taxayer’s money find it difficult to provide free treatment with quality.
9. Large claims given by courts: in a country where people fight with their parents, brothers and sisters for money and property, it will be naive to think that idea of making money from doctor does not exist. With court compensations going into crores, doctors can sense many times that some patient relatives try to use the opportunity. They have nothing at stake so they try to make some noise on social media and harass the doctor in court or on social platforms. Even for patients, who had poor prognosis at the very onset of treatment, relatives can create problems. Doctors have no protection from these nuisanse. All these factors further enhance insecurity in doctor’s mind.
10. Expensive and time consuming medical education, on sale: Although an open secret , as reported routinely in news, medical seats are big business. Each private medical college seat sells for huge money. Such doctors, who have purchased seats have already behaved as investors. Once these doctors are in practice, they will try to recover the investment. This can obviously push up the health care costs not to mention vitiation of the medical fraternity.
11. Requirement for maintaining huge data and audits: to maintain standards, to have accreditations, for medicolegal issues , large data storage, audits and surveillance is required. These systems also need new systems and manpower.
12. Employment of large numbers of non-medical personnel: earlier management work was handled by doctors. All senior doctors were given small and differnet departments of administrative work at very little or no extra cost. But now for all these works separate administrators are appointed. Now a days ratio of doctors to nondoctors is higher as compared to previous years. Increased regulatory and and insurance system needs more non- medical staff. But productivity of hospital still remains by doctor-patient interaction. This change in arrangement in Hospitals has caused increase in costs and hence pushed the health care expenses. Advantages and disadvangages of these changes in arrangement will be known with time in future.
13. Non regulation of businesses associated with large health care industry: for example pharma industry, suppliers , biomedical, equipments, consumables. Such individuals, although play important part in medicine, cost, sale and purchase, but are largely unregulated. Unlike doctors, who are regulated by multiple governing bodies. But doctors are often perceived as culprits for these costs escalation.
14. Increasing extinction of Single doctor and small setups: for them it will be difficult to keep pace with newer technology and buying expansive equipments. It will be difficult for them to manage requirements of new medical system, legal problems . At the most they will continue to provide cheap medical services, but for only common and simple ailments. It will be difficult to manage serious patients and sick and complex patients in view of high public expectations . These set ups are under severe security threat and pressure because of non – acceptance of even genuinine complications of treatment. As legal requirements increase, these systems will become unviable and option of common public for cheaper, friendly services may become extinct. So it will decrease the easy and sometimes last option of doctors to settle with a small set up. Chances of them to work for investors and insurance companies will increase, and they will be cheap labour for industry.
15. Medical and health Insurance becoming indispensible: Insurance companies are every where. They sell policies to patients , as well as doctors. In fact, they are positioned between doctor and patients. They make money from both sides. Obviously more expensive the treatment, more dependence on insurance. Therefore a cycle has been set up. Increase in insurance cost will push health care more expensive and a vicious cycle is set up. One should not be surprised, if in future treatment to a large extent will be dictated by insurance companies.
16. Conversion to a industry: Because of above reasons Medical and health care has become an industry and needs investors. So as it is business proposition. Funded by investors and run on commercial principles, the doctors are being slowly reduced to skilled labour, alienated from the core.
17. Aging, multiple diseases: as life expectancy is increasing, it is leading to multiple diseases and more complex diseases and new expensive treatments. In this changed scenario and all people want to prolong life as much as possible. Cost of prolonging life with multiple problems is quite high. It consumes more medication and resouces and hence consequently pushes up the cost of medical treatment.
18. Evolution of complex infections: Advent of antibiotics and germ theory was thought to be game changer in medical history. But because bacteria proved to be smarter than humans and acquired resistant. New and expensive antibiotics have been gradually being rendered useless. Need for more antibiotics is causing treatment to be costlier.
19. Evolution of advanced treatment: Invention of Expensive and new diagnostic techniques along with highly technical treatments by industry is not without added cost. Although it may be useful in certain patients, but how much it will help overall in masses, for general treatment, as it increases the cost of overall treatment.
20. Increasing need for heightened security: It is not uncommon to have mobs causing physical harms to medical workers and damaging hospital properties. These incidents have caused increased need for security for the premises and adding to the cost.
21. Complex interplay of various industries eg pharma industry and consumable industry: large number of consumables pharmaceuticals, sutures, surgical instruments, IT industry, drugs, implants, medical supplies are required. These industries supply their items on a price commanded by them and there is complex interplay of various industries.
22. Non uniform and variable care and cost: each city has multiple hospitals. Care and cost varies in every set up. Even all government set ups are not uniform in facilities and cost. Private setups vary in cost and care, to the extent of maximum possible variations. All this non-uniformity has created confusion in the mind of patients and variation in financial issues.
23. Poor public health care facilities: due to less expenditure on health care, government health care facilities have been under developed. Less investment by government has given way to private health care to flourish.
24: Conversion to a industry model and entry of investors: all the above investments are very expensive. Doctors usually do not have that much money to invest. Therefore Investors and financers have become indispensible part of health. once investor invests money, it will be driven on business principles.
25. Future course: I do not see in future that this arrangement is going to change , rather it will be strengthened more and more and quality care will become more costly. Doctors will be totally alienated from financial and business aspect, because industry will not be sustainable without an investor.
Assessment
As we look at reasons above, doctors are no where in the financial picture and to be blamed for increase in overall health cost. But, since only doctors are visible part of industry, who treat and interact with patients, often they are blamed for the cost. They have actually being alienated from financial aspect, barring small percentage of doctors, who are financially literate. Consequently, the doctors who will be unable to entrench themselves in the business milieu will be unfit in future and hence extinct.
Conclusion
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Contact: MarcinkoAdvisors@msn.com
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8
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How Amazon could lose its health-care bid
Posted on March 7, 2018 by Dr. David Edward Marcinko MBA MEd CMP™
While drug distributor stocks win
By Vitaliy Katsenelson CFA
Amazon.com has been one of the most innovative and disruptive companies of this century, with incredible success in areas that lie outside of what has been historically perceived as its core business (book selling).
Thus every announcement or speculation that Amazon will enter into a particular industry sends stocks of that industry into a tailspin. Investors sell first and ask questions later. When Amazon announced its purchase of Whole Foods, grocery stores declined as much as 30%. Even Tesco separated by an ocean from Whole Foods, was down on that news.
A big part of Amazon’s success has come from not being taken seriously by its competition. Amazon was able to create a huge lead in AWS (Amazon Web Services) because the competition (Alphabet and Microsoft did not give Amazon enough respect. Competitors thought, “what does a book seller know about the cloud?” Well, according to Amazon CEO Jeff Bezos, such thinking gave Amazon a much bigger lead over its rivals. Today, everyone takes Amazon seriously. Indeed, fear of Amazon is reaching paranoia levels.
McKesson
McKesson shares, for example, took a 20% dive during the fourth quarter of 2017 on speculation that Amazon would start distributing pharmaceuticals in the U.S. As McKesson shareholders, my firm took this speculation seriously, but upon further investigation, it became evident that such concerns were overblown. After the market cooled off from fourth-quarter worry about Amazon, McKesson shares recovered.
Then in late January, news that Amazon, JPMorgan Chase, and Berkshire Hathaway will join forces to drive down U.S. health-care costs hit health-care sector stocks, including McKesson.
How big of a punch could this be? McKesson is the largest distributor of pharmaceuticals in the U.S. Its 2018 sales are on track to exceed $210 billion. It is important to point out that McKesson is not a retailer but a distributor. It is one of three railroads for drugs in the U.S. McKesson distributes drugs to thousands of independent pharmacies, as well as giants like CVS Health, Rite Aid and Walmart McKesson operates two distinct distribution businesses: branded and generics. Though these businesses may look similar on the surface, the economic models of branded and generic businesses are quite different.
In the distribution of branded drugs (about 70% of McKesson’s revenue and 30% of profits) McKesson has a fee-for-service model. Pharmaceutical companies want to be involved in high-value activities: chiefly, inventing and manufacturing drugs. Getting drugs to thousands of pharmacies on a timely basis and collecting accounts receivable is not the business they want to be in. They don’t have the scale and distribution know-how of McKesson, Cardinal Health, and AmerisourceBergen — that collectively control 90% of drug distribution in the U.S. Thus the likes Pfizer and Bristol-Meyers Squibb pay drug distributors a small “fee for service,” and pharmaceutical companies (not distributors) negotiate prices with pharmacies.
More than 90% of McKesson’s profit in this segment is driven by volume, while just 10% is linked to changes in drug prices. Pfizer, for instance, despite its might, would still have higher distribution costs than McKesson because it doesn’t have McKesson’s scale and focus on distribution efficiency. So Pfizer is happy to pay McKesson this service fee and not think about drug distribution.
In its generic drug distribution business (about 30% of sales, 70% of earnings), McKesson uses its enormous buying power to buy drugs at low prices from generics manufacturers and sell at higher prices to pharmacies. Since it can source the same drug from various manufacturers, it leverages better prices from the likes of Mylan and Teva Pharmaceuticals Industries. Drug distributors are a significant deflationary force in generic pricing — good for consumers, not great for Teva or Mylan.
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Moats
So McKesson has a wide protective moat, which includes the distinct possibility that Amazon’s adventure into drug distribution could lead to miserable failure. Here’s why:
1. Amazon cannot match McKesson’s buying power or negotiating power when it comes to generics. Current Amazon sales of pharmaceuticals are somewhere between zero and slightly above zero. McKesson’s sales are pushing $210 billion, about $65 billion of which comes from generics. Walmart is the fourth-largest pharmacy in the U.S., with sales of $20 billion. It had distributed drugs, but in 2016 it signed a distribution deal with McKesson. Walmart realized it could get better prices for generics through McKesson. Amazon, with near-zero sales, doesn’t stand a chance.
2. Amazon has no structural advantage. In the fight against Barnes & Noble and Best Buy, Amazon could charge lower prices than brick-and-mortar retailers because it had a structural advantage — it did not own stores and have all the extra costs associated with them. On one of his conference calls, McKesson CEO John Hammergren said his company was Amazon before Amazon was Amazon. Indeed. McKesson has highly specialized warehouses designed to distribute drugs. It can get any drug to any pharmacy in the U.S. within hours.
3. McKesson’s pretax margins are just 1.7%. If Amazon is looking to cut fat in the pharmaceutical industry, this is not where the fat is.
4. Distributing and selling drugs is not like selling or distributing most anything else. First, some drugs require refrigeration and others are controlled substances. Distributing them puts an extra regulatory (and self-policing) burden on distributors. McKesson has paid fines and recently received plenty of negative publicity from “60 Minutes” for distributing opioid pain medications to legal pharmacies who illegally sold the medicine on the black market.
Next, unlike in almost any other industry, pharma consumers are price-insensitive. If you are on Medicare, Medicaid, or a copay/low-deductible private insurance plan, you really don’t care if you are paying the lowest price because you don’t see the price (other than for copay). For this group of drug consumers, which constitutes the bulk of the U.S. population, lower drug prices are not an incentive to switch.
Moreover, let’s say Amazon starts an online pharmacy and self-distributes. Internet-savvy millennials are not the ones consuming most of the drugs in the U.S. Their parents and grandparents are. This demographic still has brick-and-mortar habits that are less likely to be broken anytime soon. Also, major pharmacies already have mail-order operations. It would be logical for Amazon to try to get into the almost-trillion-dollar pharma business, but its success here will be limited, and it will take decades to gain a meaningful market share
5. Suppose Amazon opens an online pharmacy and succeeds. It would probably take five to 10 years to reach sales of, let’s say, $10 billion (half of Walmart’s current drug sales). Let’s assume that Amazon self-distributes and will not use McKesson, or that it decides to employ the services of Cardinal Health. This would steal less than a year of current growth from McKesson, in five to 10 years.
Put simply, the laws of economics still apply — even to Amazon. Drug distributors are strong financially and have great scale and a tremendous purchasing-power advantage. Distributors’ stocks may take a dive but their business will be fine in the long run. The only competitive advantage Amazon has against drug distributors is that Wall Street completely ignores its profitability and focuses only on revenue growth.
McKesson is one of the U.S. stock market’s most interesting investments. Its business is future-proof. The demand for its product is not cyclical and is likely to continue to grow as the U.S. population ages. Higher or lower interest rates, recession or no recession, inflation or deflation, McKesson’s earnings power will continue to march ahead for a long time.
McKesson has a conservative balance sheet; it can pay off its debt in less than two years. McKesson pays a lower dividend than its competitors, but it has purchased a third of its shares over the last decade. Expected earnings of about $13 a share this year could grow to $15 in 2019. At a conservative 15 times earnings, McKesson is worth about $225 a share.
Assessment
However, McKesson has spun off its technology business into Change Healthcare, which could go public in 2019. McKesson owns 70% of Change Healthcare, and my firm estimates McKesson’s interest is worth about $25-$30 a share. Thus, a conservative estimate of McKesson’s value is about $250.
Conclusion
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***
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Growth of Physicians and Administrators [1970-2009]
Posted on February 28, 2018 by Dr. David Edward Marcinko MBA MEd CMP™
And Waste – Need We Say More?
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Problem #1
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Conclusion
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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
- PRACTICES: www.BusinessofMedicalPractice.com
- HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
- CLINICS: http://www.crcpress.com/product/isbn/9781439879900
- ADVISORS: www.CertifiedMedicalPlanner.org
- FINANCE: Financial Planning for Physicians and Advisors
- INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
- Dictionary of Health Economics and Finance
- Dictionary of Health Information Technology and Security
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A Path to Faster Growth for Healthcare Companies
Posted on February 23, 2018 by Dr. David Edward Marcinko MBA MEd CMP™
A Path to Faster Growth for Healthcare Companies
[A Bain Brief]
Many healthcare manufacturers view growth as a top priority, but the complexity that comes with growth creates a serious drag on performance.
Reducing all five types of complexity helps build a healthier, more resilient business.
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http://www.bain.com/publications/articles/a-path-to-faster-growth-for-healthcare-companies.aspx
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Insurers Can Break the Gordian Knot of Commoditization
Posted on February 22, 2018 by Dr. David Edward Marcinko MBA MEd CMP™
How Insurers Can Break the Gordian Knot of Commoditization
[A Bain Infographic]
Insurance companies don’t have much contact with customers, making it hard to build loyalty.
But, this Bain research shows how insurers can build loyalty by focusing on ecosystem services.
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***http://www.bain.com/publications/articles/insurance-loyalty-2017-infographic.aspx
***
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CALIFORNIA LAUNCHES INVESTIGATION FOLLOWING STUNNING ADMISSION BY AETNA MEDICAL DIRECTOR
Posted on February 12, 2018 by Dr. David Edward Marcinko MBA MEd CMP™
A CNN Exclusive
(CNN) California’s insurance commissioner has launched an investigation into Aetna after learning a former medical director for the insurer admitted under oath he never looked at patients’ records when deciding whether to approve or deny care.
California Insurance Commissioner Dave Jones expressed outrage after CNN showed him a transcript of the testimony and said his office is looking into how widespread the practice is within Aetna.
http://www.cnn.com/2018/02/11/health/aetna-california-investigation/index.html
Conclusion
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Contact: MarcinkoAdvisors@msn.com
***
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Hospital Inpatient Spending and Utilization
Posted on February 3, 2018 by Dr. David Edward Marcinko MBA MEd CMP™
For 2012 – 2016
By http://www.MCOL. com
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Conclusion
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2018 Markets Update Video
Posted on January 17, 2018 by Dr. David Edward Marcinko MBA MEd CMP™
The Business Cycle
As part of Merk’s in-house research meetings, they are studying a variety of charts that might affect the markets, ranging from charts on the economy, equities, fixed income, currencies, and commodities.
So, they now share with us an update on select charts on the business cycle and why they might matter when thinking about the markets in 2018.
Please view: The Business Cycle
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Continued focus on improving EHRs (or is it CHRs?)
Posted on January 8, 2018 by Dr. David Edward Marcinko MBA MEd CMP™
From EHR to CHR
By Dr. David Edward Marcinko MBA
http://www.CertifiedMedicalPlanner.org
I read this curated article and decided to send it right out to our ME-P readers for comment [EHR = CHR].
Nothing more needs to be said, on my part. Is this mere definitional obfuscation for flawed technology? http://www.HealthDictionarySeries.org
So, what do you think?
http://www.healthcareitnews.com/news/epic-ceo-judy-faulkner-standing-behind-switch-ehrs-chrs
Assessment
A rose by any other name still smells sweet. But, does not an onion stink?
Conclusion
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Health Plan Provider Data Quality Confidence
Posted on December 21, 2017 by Dr. David Edward Marcinko MBA MEd CMP™
For 2016
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Conclusion
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Healthcare Spending Distribution
Posted on December 17, 2017 by Dr. David Edward Marcinko MBA MEd CMP™
For FY 2016
By MCOL.com
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Conclusion
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The “CLOUD” Could Get Expensive for Health Care
Posted on December 15, 2017 by Dr. David Edward Marcinko MBA MEd CMP™
AND … DOCTORS
By Darrell K. Pruitt DDS
Without net-neutrality, cloud-based practice management (which is already more expensive than office-based) could cost even more.
The Impactful Industries
“4 industries that could be impacted by net neutrality – With a historic net neutrality vote set to take place tomorrow, people across the United States are rightly concerned about the future of the internet. Visions of price-tiered online spaces dancing in their heads, constituents all over the country are reaching out to their elected officials in a likely doomed effort to forestall what many see as the inevitable destruction of our mostly level digital playing field.” Healthcare is one of the four.
– Jack Morse for Mashable
[December 13, 2017]
http://mashable.com/2017/12/13/net-neutrality-impacts/#rypwq_M6Gmqi
Morse Speaks:
In addition to just being a pain in the ass, the repeal of net neutrality could do real harm to your health. That’s because the modern medical field has come to depend on that aforementioned free and open internet — something very much at odds with Federal Communications Commission chairman Ajit Pai’s plans.
These days, electronic health records are often kept in the cloud, and fast and reliable access to this data is vital to patient care. What’s more, telemedicine — remotely providing healthcare via some form of telecommunication — is super data heavy. Whether that’s remotely analyzing X-rays, or a rural patient connecting with a doctor in a far-off city, this stuff takes a lot of bandwidth.
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Assessment
Will your small-town hospital be able to compete with the Facebooks of the world when it comes to buying a piece of bandwidth pie? Unfortunately, we may soon have to find out.
Conclusion
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U.S. Childhood Obesity Growth Projection Trends
Posted on December 13, 2017 by Dr. David Edward Marcinko MBA MEd CMP™
The trend is NOT our friend!
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Conclusion
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About Medical Alert Tattoos
Posted on December 12, 2017 by Dr. David Edward Marcinko MBA MEd CMP™
It’s all about the …. INK!
[By staff reporters]
A medical alert tattoo is quite different from a scar tattoo. People dealing with a serious medical condition, such as diabetes can have a tattoo showing that they are a diabetic, thus meaning a higher likelihood of getting help should they fall under attack and not be able to communicate their problem verbally.
Alert medical tattoos offer a permanent solution as compared to medical alert bracelets. Bracelets have been known to break, and that not only means waiting for a new bracelet, but usually having to spend more money to get a replacement as well. With the consent of their parents, these medical tattoos have even been known to be a solution for children dealing with these kinds of diseases.
People experiencing allergies that can lead to major complications may also consider medical alert tattoos. People who have a penicillin or peanut allergy for example, can benefit from this type of tattoo in the event they eat something that has peanuts in it without their knowledge. This can result in something called anaphylaxis, which is a condition that requires immediate attention and treatment.
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MORE: Medical tattoos: http://www.freetattoodesigns.org/medical-tattoos.html
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.
Book Marcinko: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/
Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.
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The Marine Corp Anniversary
Posted on November 11, 2017 by Dr. David Edward Marcinko MBA MEd CMP™
Happy Birthday!
By Dr. David Marcinko MBA
Yesterday, (Nov 10th) in 1775 the Marine Corp was established in a small tavern in Philadelphia to provide protection for our fleets. The Corp is steeped in history; history that I am proud of and thankful for as an American. We are far from a perfect nation, but we should ALL be proud and thankful for the blessing that is our country.
We live free by NEVER “taking a knee.”
This was from the Commandant of the Marine Corp (his address to all Marines yesterday):
Seventy-Five years ago today, after months of fighting at Henderson Field and along Edson’s Ridge, Marines on Guadalcanal spent the night of 10 November 1942 planning and preparing. Although the Battle of Guadalcanal would continue for three more months, the plans laid on our Corps’ most sacred day became integral to the amphibious campaigns that followed. Success at Guadalcanal proved to be the turning point that ultimately paved the way for Allied victory in the Pacific. Those warriors defended their positions in brutal conditions against a formidable enemy – and triumphed. Through every major conflict our Nation has seen since the Revolution, Marines performed their duty with utmost courage, devotion, and raw determination. Their valiant deeds in the face of overwhelming challenges give us confidence and inspire us to meet the trials of today. As we pause to celebrate the birth of our Corps this year, we honor the legacy that was passed down to us and we recommit ourselves to carrying those traditions into the future.
This November 10th marks 242 years of warfighting excellence. At places like Trenton, Tripoli, Chapultepec, Belleau Wood, Guadalcanal, Chosin, Khe Sanh, Fallujah, Sangin, and so many others, Marines have fought with an inner spirit – a spirit that bonds us, binds us together as a cohesive team. It’s that intangible spirit that has formed the foundation of our warfighting reputation for the past 242 years. Now it’s our responsibility to ensure we honor and carry on that legacy. The American people expect a Corps of men and women who are committed, selfless, willing to sacrifice, who epitomize honor, courage, commitment, virtue, and character. We owe our Nation and our predecessors no less.
Today, as we celebrate our 242nd birthday, we must remember who we are, where we came from, and why we’re here. We must remember the past, honor those who are no longer with us, focus on today’s battles, and get ready for tomorrow. We can and will prevail as we always have, in any clime and place. But we must prevail together, united by the unyielding spirit in each of us that makes our Corps unique – that willingness to put our Corps and fellow Marines ahead of ourselves. Victory in battle comes through the integrated efforts of many – teamwork. We value the sacrifices and contributions of every Marine and Sailor, as well as our family members without whose support we would not be able to accomplish our mission. And we remain committed to being our Nation’s Expeditionary Force in Readiness that sets the standard for honor, discipline, and courage. I am proud of each and every one of you. Happy Birthday, Marines!
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Semper Fidelis
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Fighting Healthcare Fraud?
Posted on October 29, 2017 by Dr. David Edward Marcinko MBA MEd CMP™
Turning Data into Intelligence
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Conclusion
Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, urls and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements.
Contact: MarcinkoAdvisors@msn.com
Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, I.T, business and policy management ecosystem.
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CONSENSUAL AMOROUS RELATIONSHIPS IN MEDICINE?
Posted on October 26, 2017 by Dr. David Edward Marcinko MBA MEd CMP™
NON-CONSENSUAL AMOROUS RELATIONSHIPS DEFINED
By Vicki L. Buba JD
By Dr. David Edward Marcinko MBA CMP™
http://www.CertifiedMedicalPlanner.org
An “Amorous Relationship” is defined as a consensual romantic, sexual or dating relationship. This definition excludes marital unions. The term also encompasses those relationships in which amorous or romantic feelings exist without physical intimacy and which, when acted upon by the faculty or staff member, exceed the reasonable boundaries of what a person of ordinary sensibilities would believe to be a collegial or professional relationship. The faculty/student and supervisor/employee relationship should not be jeopardized by question of favoritism or fairness in professional judgment.
Furthermore, whether the consent by a student or employee in such relationship is indeed voluntary is suspect due to the imbalance of power and authority between the parties. All members of the healthcare entity should be aware that initial consent to a romantic relationship does not preclude the potential for charges of conflict of interest, or for charges of sexual harassment arising from the conflict of interest, particularly when students and employees not involved in the relationship claim they have been disadvantaged by the relationship. A faculty, staff member or graduate assistant who enters into an “Amorous Relationship” with a student under his or her supervision, or a supervisor who enters into an “Amorous Relationship” with an employee under his or her supervision, must realize that if a charge of sexual harassment is subsequently lodged, it will be exceedingly difficult to prove blamelessness on grounds of mutual consent. This policy is superseded by the laws governing inability to consent based on age.
HANDLING ROMANTIC PATIENT ADVANCES
While physicians vary in their approaches to managing flirtatious patients, many agree that nipping the behavior in the bud is critical to maintaining professionalism and upholding ethical standards. “It’s flattering to have a flirtatious patient,” said Dr. William P. Scherer MS, Professor of Radiology at the Barry University School of Medicine, Boca Raton, Florida. “But, we have an obligation to protect the integrity of our medical profession, and to our marital contracts and spousal relationships and family, and to act professionally at all times” [personal communication].
Dr. Scherer finds it helpful to put some professional distance between himself and a flirtatious patient. “I have no problem saying to a patient: I appreciate what interests you may have, but I have to draw the line to take proper professional care of you, instead.”
And a good way to derails flirtatious behavior from patients is by deflecting their unwelcome comments. “And, you can’t act sheepish about it.” When a patient’s remark crosses the line from complimentary to something uncomfortable, the doctor may either curtly laugh it off or ignore it. “I don’t acknowledge the statement and immediately move the conversation into something clinical in order to put the rest of the visit in a serious tone.”
On the other hand, Dr. Barbara S. Schlefman MS, a fitness trainer and retired podiatrist, instructed her nurses to have another staffer accompany them into an examination room when a patient is known for being flirtatious was waiting to be seen; and to leave the door open [personal communication].
Likewise, other physicians use a “more is merrier” approach for themselves and their staff as a defense against flirtatious behavior. This is a problem that can be avoided by having physicians never see patients alone. So, as Dr. Schlefman advised, be sure to always a nurse or medical assistant in the room with the physician, even if you have to see somebody in the office on call after hours. And, be sure to have a call schedule for the nursing and medical assistant staff that includes patients of both genders, regardless of physician gender, since flirtatious behavior can be same-sex flirtatious behavior. Fortunately, adjunct or visiting clinical professors, or doctors on a medical school clinical teaching staff, rarely have patient encounters without a medical student, intern, resident fellow or nurse in the room during examinations.
Recognize the Signs
While it’s important that physicians don’t act on a flirtatious patient’s advances, it’s equally critical to recognize subtle flirtatious signs from a patient; according to Donna Petrozzello MD, an otolaryngologist at the California Sinus Centers.
A patient that maintains unusually long eye contact with their doctor, or engages in talk not related to their visit, or makes a habit of touching the physicians when not medically necessary may be flirting. Additionally, doctors can protect themselves when performing some common procedures that put the physician in close proximity to a patient’s face, breasts, genitals, legs and even feet. That closeness could turn a clinical exam into a flirtatious event. Wearing a mask to perform each of these local or regional examinations is not only for the purposes of infection control but gives the added benefit of establishing some personal space and protection, to avoid any potential misunderstanding. For example, auscultating lungs through a shirt, not underneath, is a good idea with this type of exam on a young woman patient.
[Two icons of romantic relationships]
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On Investing Risk Tolerance
Posted on October 24, 2017 by Dr. David Edward Marcinko MBA MEd CMP™
Determining Risk Tolerance
By Rick Kahler CFP®
If you are new to investing, or if you aren’t sure how much risk you are taking in your current portfolio, it may be helpful to spend a little time to determine your risk tolerance.
A good place to start is by taking a few risk tolerance surveys. A variety of free assessments are available online; three examples are at Vanguard, Schwab, and Morningstar.
Examples:
I like surveys that express your risk in terms of downside volatility, or how much loss you could tolerate. Most will express the downside in terms of how far your portfolio would have to go down over a 12-month period before you would jump out.
Unless you only look at your portfolio once a year (which I highly recommend), you most likely won’t tend to think of a decline in your investments as being over a 12-month period. Because we all “anchor” on the highest value, it’s more typical to compare a portfolio’s peak value to its lowest point. You may want to ask yourself how far would the markets need to drop from their highs before you would want to get out “before it’s all gone.” It’s important to understand that the peak to trough drop will usually be much higher than the annual drop. For example, in 2008-2009 the peak to bottom drop in some portfolios was 40% when the 12-month drop was closer to 20%.
What is the right number for you?
So, as the Sleep Number bed commercials ask, what is the right number for you?
If your 12-month tolerance is a 15% drop, you will need to be in a very conservative portfolio, perhaps something like an allocation of 25% in equities and 75% in fixed income investments like bonds. If your tolerance is 25%, a 50/50 allocation may fit. For a tolerance of 35%, maybe a 75/25 allocation will be comfortable.
Don’t take these numbers as gospel. There are many, many variables that will determine what is right for you. I use these simply to give you a context that the less of a drop you can stomach in your portfolio before selling out, the lower your allocation needs to be to equities and the higher your allocation needs to be to fixed income.
If your answer to the question of how much risk you are taking in your investment portfolio is, “I have no clue,” now is the perfect time to get a clue. Why? We are in the ninth year of a bull market in stocks, the third longest in history. Also, 22 out of 23 of the last bear markets bottomed in the first two years of the Presidential cycle.
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If you find yourself taking too much risk in your portfolio, lighten up on equities and increase your allocation to bonds. Lightening up doesn’t mean selling out of equities. It may mean shifting a 70/30 allocation to a 60/40 or a 50/50. Maybe it means adding some asset classes or investment strategies that do well when stocks drop. Sometimes a slight tweak can do a great deal to keep you in the market when the economy looks to be in a death spiral.
The time to do that tweaking is before the stock market crashes (goes into a bear market), not after. As the six months from September 2008 to February 2009 reminded us, bear markets develop very quickly.
Assessment
The important thing is to take action today to become aware of the risk that is in your portfolio and assess whether you need to make a change.
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
Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, I.T, business and policy management ecosystem.
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Take the Physician-Focused FINANCIAL PLAN “Challenge”
Posted on October 21, 2017 by Dr. David Edward Marcinko MBA MEd CMP™
Do You Have “What it Takes”?
By Professor David E. Marcinko MBBS DPM MBA MEd CMP®
Institute of Medical Business Advisors, Inc.
www.CertifiedMedicalPlanner.org
My History
More than 15 years ago I crafted a comprehensive holistic financial plan for a young doctor colleague who was born in 1959. In fact, he was not even a medical student at the time; so “canned off-the-shelf plans”, computer generated software or generic spread sheets were not a viable creation option. It was all a granular, detailed, specific and cognitive work-product. Today, he is a board-certified internist.
So, in 2017, it is right and just to take a look back and see how well, or poorly, we’ve fared.
Now, I appreciate more than most how financial planning is a “process”; and not an isolated event. Yet, all sorts of “advisors” and “consultants” create and charge hefty fees for same, and on-going monitoring, every day.
The ME-P Challenge
Nevertheless, I challenge all you mid-career or senior financial planners /advisors to this competition; regardless of degree, certification or designation.
“Show me your financial plan” – AND – “I’ll show you my financial plan”
Here Comes the Judge
Then, our community of ME-P readers, subscribers, visitors and “judges” will decide the winner.
The contest is open to any financial advisor, planner, consultant, wealth manager, CFP®, CFA, insurance agent, CPA or CLU, ChFC, or stock-broker, etc., who is not afraid of transparency in his or her work product and purported expertise.
Of Financial Certifications and Designations
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[Creating and Evaluating a physician focused financial plan]
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Assessment
So, just send in a copy of any “blinded” physician-focused financial plan that is about 15 years old. We will post for all to see and review …. warts and all … including my own; three part mega-plan!
The winner will receive bragging rights, academic swagger, and expert promotion to our entire ME-P ecosystem and network of medical, business, law and graduate school communities; as well as physicians, nurses, healthcare executives and allied health care professionals.
An informed sought-after and lucrative sector – indeed!
IOW: Free publicity and positive “new-wave” PR – PRICELESS!
Of course, as an educator and professor of health economics and finance, we are pleased to present you with the deep medical business knowledge and detailed financial,managerial and accounting techniques used, with some real-life “tips and pearls” developed over the last two decades of R&D, right here:
MORE: Comprehensive Financial Planning Strategies for Doctors …[Best Practices from Leading Consultants and Certified Medical Planners™]
MORE: Risk Management Liability Insurance, and Asset Protection Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™]
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:
- PRACTICES: www.BusinessofMedicalPractice.com
- HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
- CLINICS: http://www.crcpress.com/product/isbn/9781439879900
- ADVISORS: www.CertifiedMedicalPlanner.org
- FINANCE: Financial Planning for Physicians and Advisors
- INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
- Dictionary of Health Economics and Finance
- Dictionary of Health Information Technology and Security
- Dictionary of Health Insurance and Managed Care
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PART 1: My Sample Financial Plan I [Data gathering, goals and objectives]
PART 2: My Sample Financial Plan II [Data Analytics, Creation and Crafting]
PART 3: Request here: MarcinkoAdvisors@msn.com [Stress Testing and Completion]
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Can blockchains set the Web free?
Posted on September 27, 2017 by Dr. David Edward Marcinko MBA MEd CMP™
Really!
By MIT Technology News
Growing numbers of technologists want to reinvent the Web, to counter dominance of firms like Facebook and Google. They say the tech inside digital currencies could transform the way we share data.
Our own Mike Orcutt wonders if they’re right |
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Conclusion
Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, urls and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
- PRACTICES: www.BusinessofMedicalPractice.com
- HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
- CLINICS: http://www.crcpress.com/product/isbn/9781439879900
- ADVISORS: www.CertifiedMedicalPlanner.org
- FINANCE: Financial Planning for Physicians and Advisors
- INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
- Dictionary of Health Economics and Finance
- Dictionary of Health Information Technology and Security
- Dictionary of Health Insurance and Managed Care
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Non-Profit CEO Compensation Update
Posted on September 13, 2017 by Dr. David Edward Marcinko MBA MEd CMP™
Percentage contribution amounts
By Snopes
NOTE: Not independently verified by us. Continue reading
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What the heck is an Initial Coin Offering anyway?
Posted on September 11, 2017 by Dr. David Edward Marcinko MBA MEd CMP™
Wither the I.C.O.
| By MIT Technology Review |
| You may have heard a buzz surrounding the new fundraising tool known as an ICO, which is how many new blockchain startups are raising cash.
But for those of you who are too embarrassed to ask, let us tell you what they’re all about. |
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:
- PRACTICES: www.BusinessofMedicalPractice.com
- HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
- CLINICS: http://www.crcpress.com/product/isbn/9781439879900
- ADVISORS: www.CertifiedMedicalPlanner.org
- FINANCE: Financial Planning for Physicians and Advisors
- INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
- Dictionary of Health Economics and Finance
- Dictionary of Health Information Technology and Security
- Dictionary of Health Insurance and Managed Care
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On Social Determinants Of Heath [SDOH]
Posted on September 9, 2017 by Dr. David Edward Marcinko MBA MEd CMP™
Eight Data Sources from the CDC
| 1. | Chronic Disease Indicators – https://www.cdc.gov/cdi/index.html |
| 2. | Community Health Status Indicators (CHSI 2015) –http://wwwn.cdc.gov/CommunityHealth/ |
| 3. | Health Indicators Warehouse – http://www.healthindicators.gov/ |
| 4. | Interactive Atlas of Heart Disease and Stroke – http://nccd.cdc.gov/dhdspatlas/ |
| 5. | National Center for HIV/AIDS, Viral Hepatitis, STD, & TB Prevention Atlas – https://www.cdc.gov/nchhstp/atlas/index.htm |
| 6. | National Environmental Public Health Tracking Network – http://ephtracking.cdc.gov/showHome.action |
| 7. | The Social Vulnerability Index – http://svi.cdc.gov/ |
| 8. | Vulnerable Populations Footprint Tool – http://www.communitycommons.org/chna/ |
MORE: https://www.goinvo.com/vision/determinants-of-health/
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:
- PRACTICES: www.BusinessofMedicalPractice.com
- HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
- CLINICS: http://www.crcpress.com/product/isbn/9781439879900
- ADVISORS: www.CertifiedMedicalPlanner.org
- FINANCE: Financial Planning for Physicians and Advisors
- INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
- Dictionary of Health Economics and Finance
- Dictionary of Health Information Technology and Security
- Dictionary of Health Insurance and Managed Care
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Are you ready to secure patient data?
Posted on September 7, 2017 by Dr. David Edward Marcinko MBA MEd CMP™
The Challenge of Managing Member Identities
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Conclusion
Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, urls and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
- PRACTICES: www.BusinessofMedicalPractice.com
- HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
- CLINICS: http://www.crcpress.com/product/isbn/9781439879900
- ADVISORS: www.CertifiedMedicalPlanner.org
- FINANCE: Financial Planning for Physicians and Advisors
- INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
- Dictionary of Health Economics and Finance
- Dictionary of Health Information Technology and Security
- Dictionary of Health Insurance and Managed Care
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WEGO Health Nominates the ME-P as “Best- in-Show” Blog
Posted on September 1, 2017 by Dr. David Edward Marcinko MBA MEd CMP™
WEGO Nomination 2017
By the WEGO Health Team
Dear Dr. David Edward Marcinko MBA,
Congratulations on your nominations for a WEGO health activist award.
We wanted to let you know that you’ve been nominated for the WEGO health activist award –
This nomination will appear on your nominee profile – feel free to update your personal bio if needed and share this new achievement with your family, friends, patients, students and clients community.
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Assessment
And, your ME-P readers, visitors and subscribers can view your entire profile; here.
Congratulations!
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:
- PRACTICES: www.BusinessofMedicalPractice.com
- HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
- CLINICS: http://www.crcpress.com/product/isbn/9781439879900
- ADVISORS: www.CertifiedMedicalPlanner.org
- FINANCE: Financial Planning for Physicians and Advisors
- INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
- Dictionary of Health Economics and Finance
- Dictionary of Health Information Technology and Security
- Dictionary of Health Insurance and Managed Care
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VOTE: Dr. David E. Marcinko WEGO HEALTH AWARDS 2017
Posted on August 26, 2017 by Dr. David Edward Marcinko MBA MEd CMP™
By Ann Miller RN MHA
[Executive Director for the Institute of Medical Business Advisors, Inc]
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Dr. David Edward Marcinko MBA MEd CMP®
[Abbreviated Biography]
Distinguished Professor, Endowed Chairman and Wall Street physician executive Dr. David Edward Marcinko MBBS DPM MBA MEd BSc CPHQ® CMP® is originally from Loyola University MD, Temple University in Philadelphia and the Milton S. Hershey Medical Center in PA; Oglethorpe University, and Atlanta Hospital & Medical Center in GA; and Aachen City University Hospital, Koln-Germany. He is one of the most innovative global thought leaders in health care business and entrepreneurship today.
Dr. Marcinko is a board certified physician, surgical fellow, hospital medical staff Vice President, public and population health advocate, and Chief Executive & Education Officer with more than 400 published papers; 5,150 op-ed pieces and over 135+ domestic/international presentations to his credit; including the top 10 biggest pharmaceutical companies and financial services firms in the nation. He is also a best-selling Amazon author with 30 published text books in four languages [National Institute of Health, Library of Congress and Library of Medicine.
Dr. Marcinko is a Managerial Healthcare Accountant and past Editor-in-Chief of the respected quarterly print “Journal of Health Care Finance“, and a former Certified Financial Planner® who was named “Health Economist of the Year” in 2010, by PM magazine. He is a Federal and State court approved expert witness featured in hundreds of peer reviewed medical, business, management and trade publications [AMA, ADA, APMA, AAOS, Physicians Practice, Investment Advisor, Physician’s Money Digest and MD News]. As a licensed insurance agent, RIA and SEC registered affiliate, Dr. Marcinko is Founding Dean of the fiduciary focused CERTIFIED MEDICAL PLANNER® chartered designation education program: http://www.CertifiedMedicalPlanner.org
He is also the Editor-in-Chief of the print, and online, HEALTH DICTIONARY SERIES® WIKE project: http://www.HealthDictionarySeries.org AND co-founder of the board certification, re-certification and state licensure education, preparation & Computer Based Testing [CBT] firm, FARC, Inc: http://PodiatryPrep.org
Dr. Marcinko’s professional memberships include: ASHE, AHIMA, ACHE, ACME, ACPE, MGMA, FMMA and HIMSS. Dr. Marcinko is a MSFT Beta tester, Google Scholar, “H” Index favorite and one of LinkedIn’s “Top Cited Voices”.
Presently, Professor Marcinko is “ex-officio”, and R&D Scholar-on-Sabbatical, for iMBA, Inc. His current grant-funded book, and WIKI styled cloud sourced project-in-progress in public health economics, is: http://www.HobsonsChoiceMedicine.com
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Click Here to Endorse
THANK YOU!
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On Veterinary Physicians
Posted on August 24, 2017 by Dr. David Edward Marcinko MBA MEd CMP™
“Want a kitten? It’s free”
This is an offer I would turn down in a heartbeat. My lack of enthusiasm for cats would far outweigh my frugal appreciation of getting something for nothing.
Even the most ardent cat lover, though, would be wise to think twice before accepting a free kitten. Just as there is no such thing as a free lunch, there is absolutely no such thing as a free pet. I don’t care how “free” the initial cost of any pet is, there will be a cost to owning it. For most pets, the expense of ongoing maintenance is so substantial that the initial cost of the pet becomes insignificant.
A Story
My family once inherited a “free” pet, Sammy the Salamander. He lived the life of Riley for the next 7 years, with a continuous supply of fresh crickets, water, and mulch. At $2 a week, our total cost over his lifetime was $700. Fortunately, he passed peacefully under his rock, so there were no vet costs.
I once had a retired client, with an annual income of $60,000, who opted for medical intervention when her 12-year-old cat was diagnosed with cancer. Her vet bill for surgery and medication came to $12,000. The cat died shortly afterward, but the blow to her standard of living lasted for years while she paid off the debt. I don’t know how much, if anything, she paid for the cat originally. What I can tell you is the initial cost of the cat paled in comparison to its life-long upkeep.
Vet bills can end up to be a significant cost for any pet. According to a July 2017 survey of 1,000 pet owners by Ask.Vet, 40% of pet owners spend more than $500 a year at the vet. The site suggest one reason is that pet owners often ignore their pet’s wellness until a crisis materializes. Maybe annual physicals are as important for pets as they are for people. Of course, in this regard, many people don’t take any better care of themselves than they do of their pets.
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Survey
According to a second survey of 500 dog and/or cat owners by LendEDU, dogs cost their owners an estimated total of just over $2,000 per year while cats averaged just over $1,000. Those who owned only dogs said they would spend over $10,000 to save a dog with a life-threatening condition. Cat-only people were willing to spend about $3,500. Those with both dogs and cats would spend over $10,000 for either one.
Ironically, the Ask.Vet survey found that the highest vet bills come from the smallest pets, with a gerbil being the most expensive. Eighty percent of gerbil owners surveyed spent more than $500 a year on vet bills. Mouse owners were close behind at 79%. Rounding out the top ten were alpacas (75%), goats (72%), chinchillas (70%), sheep (67%), hedgehogs (67%), guinea pigs (64%), pot-bellied pigs (63%), and finally frogs (60%).
Frogs, really? Who would spend $500 a year on vet bills for a frog? I guess the same person that would spend $500 on a gerbil.
I was surprised that the top ten list didn’t include some of the most common pets like dogs, cats, and horses. The survey found that the five pets with the lowest vet bills, in order from top to bottom, were dogs, cats, fish, birds, and turtles.
Assessment
I think the message here is clear. Before you take on any kind of pet, consider whether you can afford the care it will need. And if someone offers you a free gerbil or a free turtle, go for the turtle.
Editor’s Note: This is the first ME-P on the topic. Continue reading
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SoftBank’s big plan for a smarter internet is brilliant
Posted on August 22, 2017 by Dr. David Edward Marcinko MBA MEd CMP™
Enter the Singularity of A.I.
[By Vitaliy Katsenelson CFA]
Masayoshi Son doesn’t do anything small nor does he do things in a simple way.
SoftBank’s big plan for a smarter internet is brilliant
Conclusion
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- Dictionary of Health Economics and Finance
- Dictionary of Health Information Technology and Security
- Dictionary of Health Insurance and Managed Care
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On Mental Health Gender and Racial Disparities
Posted on August 11, 2017 by Dr. David Edward Marcinko MBA MEd CMP™
USA Adults in 2015
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Conclusion
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- FINANCE: Financial Planning for Physicians and Advisors
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- Dictionary of Health Economics and Finance
- Dictionary of Health Information Technology and Security
- Dictionary of Health Insurance and Managed Care
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Royal College of General Practitioners Recommends: “Comprehensive Financial Planning Strategies for Doctors and Advisors”
Posted on August 9, 2017 by Dr. David Edward Marcinko MBA MEd CMP™
Comprehensive Financial Planning Strategies for Doctors and Advisors
RECOMMENDATION
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Drawing on the expertise of multi-degreed doctors, and multi-certified financial advisors, Comprehensive Financial Planning Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™] will shape the industry landscape for the next generation as the current ecosystem strives to keep pace.
Traditional generic products and sales-driven advice will yield to a new breed of deeply informed financial advisor or Certified Medical Planner™.
The profession is set to be transformed by “cognitive-disruptors” that will significantly impact the $2.8 trillion healthcare marketplace for those financial consultants serving this challenging sector. There will be winners and losers.
The text, which contains 24 chapters and champions healthcare providers while informing financial advisors, is divided into four sections compete with glossary of terms, Certified Medical Planner™ curriculum content, and related information sources.
http://www.CertifiedMedicalPlanner.org
1. For ALL medical providers and financial industry practitioners
2. For NEW medical providers and financial industry practitioners
3. For MID-CAREER medical providers and financial industry practitioners
4. For MATURE medical providers and financial industry practitioners
Using an engaging style, the book is filled with authoritative guidance and healthcare-centered discussions, providing the tools and techniques to create a personalized financial plan using professional advice.
Comprehensive coverage includes topics likes behavioral finance, modern portfolio theory, the capital asset pricing model, and arbitrage pricing theory; as well as insider insights on commercial real estate; high frequency trading platforms and robo-advisors; the Patriot and Sarbanes–Oxley Acts; hospital endowment fund management, ethical wills, giving, and legacy planning; and divorce and other special situations.
The result is a codified “must-have” book, for all health industry participants, and those seeking advice from the growing cadre of financial consultants and Certified Medical Planners™ who seek to “do well by doing good,” dispensing granular physician-centric financial advice:
Omnia pro medicus-clientis
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DR. DAVID EDWARD MARCINKO MBA CMP™
ISBN Number: 9781482240283
Number of pages: 744
Publisher: CRC Press
AWARDS
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Hospital Re-Admissions Trends
Posted on July 27, 2017 by Dr. David Edward Marcinko MBA MEd CMP™
For Medicare
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Conclusion
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- FINANCE: Financial Planning for Physicians and Advisors
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- Dictionary of Health Economics and Finance
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- Dictionary of Health Insurance and Managed Care
***
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Why Aren’t Google and Apple Saving Healthcare?
Posted on July 23, 2017 by Dr. David Edward Marcinko MBA MEd CMP™
Why Aren’t Google and Apple Saving Healthcare?
By Bertalan Meskó, MD PhD
The introduction of artificial intelligence, robotics, social media, various sensors and wearables in medicine could save millions of lives and reduce costs at the same time.
There is one question, however, which needs to be answered. Who can and should provide these new technologies for the advancement of humanity?
Tech companies could change healthcare with their knowledge about disruption and could lead the way to medical innovation.
Why isn’t that happening already?
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Why Aren’t Google And Apple Saving Healthcare?
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Conclusion
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- Dictionary of Health Economics and Finance
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- Dictionary of Health Insurance and Managed Care
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Medical “Chartless future for everyone closer than you think”
Posted on June 25, 2017 by Dr. David Edward Marcinko MBA MEd CMP™
2015 … Really?
By Darrell K. Pruitt DDS
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“By 2015, health care is scheduled to be chartless. The federal National Health Information Infrastructure (NHII) is already formulating the parameters for this future. Chartless records are not a choice. The year 2015 is less than seven years away. We have seen hospitals, physicians’ offices, and other health-care providers moving in this direction.
In dentistry, only about 25% of practices are using computers chairside and only 1% is chartless. The American Dental Association is taking a proactive role in NHII. Individual dentists must also take part in the coming changes or once again be victims to others’ choices.”
-Patti DiGangi, RDH, BS
[Dental Economics, 2009]
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Conclusion
Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
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- FINANCE: Financial Planning for Physicians and Advisors
- INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
- Dictionary of Health Economics and Finance
- Dictionary of Health Information Technology and Security
- Dictionary of Health Insurance and Managed Care
***
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The Computers are now Ruling Wall Street
Posted on June 17, 2017 by Dr. David Edward Marcinko MBA MEd CMP™
The computers are now ruling Wall Street
By MIT Technology Review
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Over the past five years, human hedge fund managers have averaged 4.3 percent returns.
Funds that rely on algorithms to pick stocks, on the other hand—so-called quant-focused funds—have brought in 5.1 percent
Assessment: So, what gives?
More: The Massacre of Hedge Fund Business
Conclusion
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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
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- Dictionary of Health Economics and Finance
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Bitcoin’s Value is Soaring!
Posted on June 7, 2017 by Dr. David Edward Marcinko MBA MEd CMP™
But don’t let that distract you!
[By MIT Technology Review]
Even as it and other cryptocurrencies skyrocket in price, their potential for remaking the world of finance lies outside their dollar value.
An interesting piece in The Information lays out how blockchain, the technology that underpins cryptocurrencies, will change the world of equity trading (paywall).
But even that is just the beginning—the speakers at our Business of Blockchain conference last month got into the topic in great detail.
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You can check out all of the videos here |
| Understanding Currencies & Bitcoins |
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What is the Best Stock Valuation Ratio?
Posted on May 30, 2017 by Dr. David Edward Marcinko MBA MEd CMP™
On Value Investing
By Michael at: https://valuestockgeek.com
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What is the Best Stock Valuation Ratio?
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:
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- Dictionary of Health Economics and Finance
- Dictionary of Health Information Technology and Security
- Dictionary of Health Insurance and Managed Care
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