BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
[Click on Image to Enlarge]
ME-P Free Advertising Consultation
The “Medical Executive-Post” is about connecting doctors, health care executives and modern consulting advisors. It’s about free-enterprise, business, practice, policy, personal financial planning and wealth building capitalism. We have an attitude that’s independent, outspoken, intelligent and so Next-Gen; often edgy, usually controversial. And, our consultants “got fly”, just like U. Read it! Write it! Post it! “Medical Executive-Post”. Call or email us for your FREE advertising and sales consultation TODAY [678.779.8597] Email: MarcinkoAdvisors@outlook.com
Medical & Surgical e-Consent Forms
ePodiatryConsentForms.com
iMBA Inc., OFFICES
Suite #5901 Wilbanks Drive, Norcross, Georgia, 30092 USA [1.678.779.8597]. Our location is real and we are now virtually enabled to assist new long distance clients and out-of-town colleagues.
ME-P Publishing
SEEKING INDUSTRY INFO PARTNERS?
If you want the opportunity to work with leading health care industry insiders, innovators and watchers, the “ME-P” may be right for you? We are unbiased and operate at the nexus of theoretical and applied R&D. Collaborate with us and you’ll put your brand in front of a smart & tightly focused demographic; one at the forefront of our emerging healthcare free marketplace of informed and professional “movers and shakers.” Our Ad Rate Card is available upon request [678-779-8597].
Posted on July 4, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Dr. David Edward Marcinko MBA MEd
***
Happy Fourth of July! It’s a good day to avoid the emergency department, so leave the fireworks shows to the pros—and perhaps use your extra hands to double-fist some BBQ instead.
Experts estimate that it can cost more than $1 million to recruit and train a replacement for a doctor who leaves the profession because of burnout. But, as no broad calculation of burnout costs exists, Dr. Tait Shanafelt [Mayo Clinic researcher and Stanford Medicine’s first Chief Physician Wellness Officer] said Stanford, Harvard Business School, Mayo Clinic and the American Medical Association (AMA) are further cost estimating the issue. Nevertheless, Shanafelt and other researchers have shown that burnout erodes job performance, increases medical errors, and leads doctors to leave a profession they once loved.
Fortunately, we can help. From formal coaching to second career opinions, mentoring and advising, we can help with our remediation executive career programs. Regardless of what is happening in your life, it is wonderful to have a non-partial, confidential and informed career coach and sounding board on your side.
CITE: JAMA Internal Medicine [Effect of a Professional Coaching Intervention on the Well-Being and Distress of Physicians].
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com
Assets under advisement refer to assets on which your firm provides advice or consultation but for which your firm does either does not have discretionary authority or does not arrange or effectuate the transaction. Such services would include financial planning or other consulting services where the assets are used for the informational purpose of gaining a full perspective of the client’s financial situation, but you are not actually placing the trade.
Assets under advisement could also be those which you monitor for a client on a non-discretionary basis, where you may make recommendations but where the client is the party responsible for arranging or effecting the purchase or sale. A common example of this AUM scenario is when an advisor reviews a participant’s 401(k) allocations. If the adviser does not have the authority or ability to effect changes in the portfolio, these assets are likely considered assets under advisement rather than regulatory assets under management.
Assets under advisement are permitted to be disclosed on Form ADV Part 2A as a separate asset figure from the assets under management. There is no requirement to disclose the assets under advisement figure, but some advisors opt to include the figure to give prospective clients a more complete picture of the firm’s responsibilities. If you choose to report your assets under advisement, be sure to make a clear distinction between this figure and your regulatory assets under management.
***
D. E. Marcinko & Associates Core Operating Values
9. We act with honesty, integrity and are always straightforward. 8. We strive to be innovative, creative, iconoclastic, and flexible. 7. We admit and learn from mistakes and don’t repeat them. 6. We work hard always as competitors are trying to catch up. 5. We treat others with dignity and respect. 4. We are the onus of consulting advice for the fiduciary well being of others. 3. We fight complacency as former success is in the past. 2. The best management styles are timeless, not timely. 1. Our clients are colleagues and always come first.
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com
Correlation measures the relationship between two investments–the higher the correlation, the more likely they are to move in the same direction for a given set of economic or market events. Correlation, in the finance and investment industries, is a statistic that measures the degree to which two securities move in relation to each other. Correlations are used in advanced portfolio management, computed as the correlation coefficient which has a value that must fall between -1.0 and +1.0.
So if two securities are highly positively correlated, they will move in the same direction the vast majority of the time. Negatively correlated investments do the opposite–as one security rises, the other falls, and vice versa. No correlation means there is no relationship between the movement of two securities–the performance of one security has no bearing on the performance of the other.
Correlation is an important concept for portfolio diversification--combining assets with low or negative correlations can improve risk-adjusted performance over time by providing a diversity of payouts under the same financial conditions.
Alternatively Weighted Exchange Traded Funds are designed to track an index that is constructed based on criteria other than market capitalization (the methodology used for most traditional indexes).
Instead, alternatively weighted indexes select and weight securities based on other factors, such as growth, valuation, and price momentum, among others. Examples include:
Invesco S&P 500 Equal Weight ETF (NYSEARCA: RSP)
SPDR Technology ETF (NYSEARCA: XNTK)
First Trust NYSE Arca Biotechnology Index Fund (NYSEARCA: FBT)
Amplify Online Retail ETF (NASDAQ: IBUY)
iShares MSCI USA Equal Weighted ETF (NYSEARCA: EUSA)
As many medical, dental and podiatric colleagues are aware, Environmental, Social and Governance (ESG) investing refers to a set of standards for a company’s behavior used by socially conscious investors to screen potential investments. Over the last decade, or so, I have seen many investors pursing this laudable aim.
Yet, more than 80% of private equity fund managers have now stepped away from at least one deal due to ESG concerns, according to the 2023 BDO Private Capital Survey. The reasons are complex, and point towards fund managers’ sentiment towards risk-reward in the current economic environment.
This retreat from ESG is due to backlash from conservatives who are critical of the idea that mutual fund managers should be considering any other factor but a company’s share holders in their investment decisions. Accusations of “Greenwashing” have also plagued many ESG funds, which is when an asset management firm charging higher fees or a specific thematic fund without actually delivering a unique investment strategic competitive advantage.
Greenwashing is the process of conveying a false impression or misleading information about how a company’s products are environmentally sound. Greenwashing involves making an unsubstantiated claim to deceive consumers and / or investors into believing that a company’s products are environmentally friendly or have a greater positive environmental impact than they actually do. Greenwashing may also occur when a company attempts to emphasize sustainable aspects of a product to overshadow the company’s involvement in environmentally damaging practices.
According to internationally known linguistics and cognitive science Professor,Mackenzie Hope Marcinko PhD of the University of Delaware, greenwashing is performed through the use of environmental imagery, misleading labels, cognitive biases and tendencies hiding tradeoffs. Greenwashing is also a play on the term “Whitewashing,” which means using false information to intentionally hide wrongdoing, errors or an unpleasant situation in an attempt to make it seem less bad than it really is.
To be sure, uncertainty around ESG regulations in the USA is leading financial deal makers to tread carefully. For example, Jim ClaytonMBA, aprivate equity advisor also from the University of Delaware recently stated:
“We’re a year past when the SEC said they were going to issue ESG reporting standards for public filers which has created more noise in the system.”
“People are nervous about what I would call ESG-intense exposed industries, in other words, those with “heavy carbon footprints”.
And, a federal judge in Texas said that American Airlines violated federal law by basing investment decisions for its employee retirement plan on environmental, social, and other non-financial factors. The ruling in January 2025 by US District Judge Reed O’Connor appeared to be the first of its kind amid growing backlash by conservatives to an uptick in socially-conscious investing. O’Connor said American had breached its legal duty to make investment decisions based solely on the financial interests of 401(k) plan beneficiaries by allowing BlackRock, its asset manager and a major shareholder, to focus on environmental, social and corporate governance (ESG) factors.
Even the State of Florida pulled $2 billion from the investment management firm BlackRock in the largest divestment ever made. Florida Governor Ron DeSantis claimed that by taking ESG standards into account when making investment decisions, the firm isn’t prioritizing the financial bottom line for Floridians.
Assessment
But, for a few years at least, things were indeed good. In 2020 and 2021, ESG funds outperformed the market by ~4.3%.
Conclusion
So, always remember [caveat emptor]: let the buyer beware!
2. Marcinko, DE; Comprehensive Financial Planning Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™] Productivity Press, New York, 2017
3. Marcinko, DE: Dictionary of Health Economics and Finance. Springer Publishing Company, NY 2006.
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com
Life planning and behavioral finance as proposed for physicians and integrated by the Institute of Medical Business Advisors Inc., is unique in that it emanates from a holistic union of personal financial planning, human physiology and medical practice management, solely for the healthcare space. Unlike pure life planning, pure financial planning, or pure management theory, it is both a quantitative and qualitative “hard and soft” science, with an ambitious economic, psychological and managerial niche value proposition never before proposed and codified, while still representing an evolving philosophy. Its’ first-mover practitioners are called Certified Medical Planners™.
Financial Life Planning is an approach to financial planning that places the history, transitions, goals, and principles of the client at the center of the planning process. For the financial advisor or planner, the life of the client becomes the axis around which financial planning develops and evolves.
Financial Life Planning is about coming to the right answers by asking the right questions. This involves broadening the conversation beyond investment selection and asset management to exploring life issues as they relate to money.
Financial Life Planning is a process that helps advisors move their practice from financial transaction thinking, to life transition thinking. The first step is aimed to help clients “see” the connection between their financial lives and the challenges and opportunities inherent in each life transition.
But, for informed physicians, life planning’s quasi-professional and informal approach to the largely isolate disciplines of financial planning and medical practice management is inadequate. Today’s practice environment is incredibly complex, as compressed economic stress from HMOs managed care, financial insecurity from insurance companies, ACOs and VBC, Washington DC and Wall Street; liability fears from attorneys, criminal scrutiny from government agencies, and IT mischief from malicious electronic medical record [eMR] hackers. And economic bench marking from hospital employers; lost confidence from patients; and the Patient Protection and Affordable Care Act [PP-ACA] more than a decade ago. All promote “burnout” and converge to inspire a robust new financial planning approach for physicians and most all medical professionals.
The iMBA Inc., approach to financial planning, as championed by the Certified Medical Planner™ professional certification designation program, integrates the traditional concepts of financial life planning, with the increasing complex business concepts of medical practice management. The former topics are presented in this textbook, the later in our recent companion text: The Business of Medical Practice [Transformational Health 2.0 Skills for Doctors].
***
***
For example, views of medical practice, personal lifestyle, investing and retirement, both what they are and how they may look in the future, are rapidly changing as the retail mentality of medicine is replaced with a wholesale and governmental philosophy. Or, how views on maximizing current practice income might be more profitably sacrificed for the potential of greater wealth upon eventual practice sale and disposition.
Or, how the ultimate fear represented by Yale University economist Robert J. Shiller, in The New Financial Order: Risk in the 21st Century, warns that the risk for choosing the wrong profession or specialty, might render physicians obsolete by technological changes, managed care systems or fiscally unsound demographics. OR, if a medical degree is even needed for future physicians?
Say, what medical license?
Dr. Shirley Svorny, chair of the economics department at California State University, Northridge, holds a PhD in economics from UCLA. She is an expert on the regulation of health care professionals who participated in health policy summits organized by Cato and the Texas Public Policy Foundation. She argues that medical licensure not only fails to protect patients from incompetent physicians, but, by raising barriers to entry, makes health care more expensive and less accessible. Institutional oversight and a sophisticated network of private accrediting and certification organizations, all motivated by the need to protect reputations and avoid legal liability, offer whatever consumer protections exist today.
Yet, the opportunity to revise the future at any age through personal re-engineering, exists for all of us, and allows a joint exploration of the meaning and purpose in life. To allow this deeper and more realistic approach, the informed transformation advisor and the doctor client, must build relationships based on trust, greater self-knowledge and true medical business management and personal financial planning acumen.
[A] The iMBA Philosophy
As you read this ME-P website, we hope you will embrace the opportunity to receive the focused and best thinking of some very smart people. Hopefully, along the way you will self-saturate with concrete information that proves valuable in your own medical practice and personal money journey. Maybe, you will even learn something that is so valuable and so powerful, that future reflection will reveal it to be of critical importance to your life. The contributing authors certainly hope so.
At the Institute of Medical Business Advisors, and thru the Certified Medical Planner™ program, we suggest that such an epiphany can be realized only if you have extraordinary clarity regarding your personal, economic and [financial advisory or medical] practice goals, your money, and your relationship with it. Money is, after only, no more or less than what we make of it.
Ultimately, your relationship with it, and to others, is the most important component of how well it will serve you.
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: CONTACT: MarcinkoAdvisors@outlook.com
Financial Advisors and Financial Planners Usually Aren’t Millionaires
According to the most recent data from the Bureau of Labor Statistics (BLS), financial advisors had a median annual salary of $99,580 in 2023, which is significantly higher than the national average of $65,470. Of course, salaries of financial advisors can differ significantly by their location and level of expertise. The client’s profile may also have an impact on their compensation. But, many are not rich.
This is unfortunate. Financial advisors and Financial planners don’t rank among the millionaire professions in Thomas J. Stanley and William D. Danko’s book The Millionaire Next Door. Many work as salaried employees rather than entrepreneurs, lacking the scalable income potential of business owners who reinvest profits.
Stanley and Danko also stressed frugality, a challenge for advisors pressured to flaunt success—think luxury cars or upscale offices—making them “income-statement affluent” rather than “balance-sheet affluent.”
The truth is that a Financial Advisors’ success isn’t measured in client returns. Instead it is measured in their ability to gather assets and retain clients. In other words; Financial Advisors do not need to be good with money.
Financial Advisors need to be good with marketing, advertising, sales and people.
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com
Virtual chronic care provider Omada Health has filed to go public in the United States, the latest in a string of healthcare listings expected this year. Omada did not disclose the details as to how much it plans to raise from its IPO.
The San Francisco, California-based company, which last raised $192 million in a Series E funding round in 2022, reported a 38% increase in revenue to $169.8 million for 2024, according to its IPO paperwork. For the first quarter of 2025, the company posted a 56.6% year-on-year jump in revenue to $55 million. Omada has applied to list its common stock on the NASDAQ under the symbol “OMDA”.
Healthcare IPOs on U.S. exchanges have fetched $7.1 billion in 2024, compared with $2.8 billion a year earlier, according to data compiled by LSEG.
Posted on May 4, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Health Capital Consultants LLC
***
***
During the first 90 days of the Republican Party’s government trifecta (controlling the White House, Senate, and House of Representatives), both the Trump Administration and Congress have laid the groundwork for seismic change to the U.S. healthcare industry.
In an attempt to track the latest actions of the federal government’s legislative and executive branches affecting the healthcare industry since the first installment in our February issue, this Health Capital Topics article summarizes recent events in Washington and the impact of these changes on providers and patients. (Read more…)
Posted on May 4, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
BREAKING NEWS
By Staff Reporters
***
***
According to the Washington Post, legendary investor Warren Buffett said Saturday that he plans to step down from his role leading Berkshire Hathaway. Warren, 94, serves as the conglomerate’s chairman and chief executive. He said Saturday that he will recommend to the Berkshire Hathaway board that Greg Abel become CEO at the end of 2025.
“I think the time has arrived where Greg should become the chief executive officer of the company at year end,” Buffett said at Berkshire Hathaway’s annual meeting in Omaha.
Abel is chairman and CEO of Berkshire Hathaway Energy. Buffett has previously signaled that Abel would be in line to succeed him as CEO.
***
UPDATE: Berkshire Hathaway (NYSE:BRK.A)(NYSE:BRK.B) on Saturday reported its worst drop in quarterly operating earnings since 2020, and noted “considerable uncertainty” around international trade policies and tariffs.
The sprawling conglomerate’s Q1 operating earnings slipped 14.1% Y/Y to $9.64B. This was the steepest fall in operating earnings since a 32.1% decrease logged in the third quarter of 2020
Posted on April 23, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
***
***
Classic Definition: Suppose someone tells you “I am lying.” If what he/she tells you is true, then he/she is lying, in which case what he/she tells you are false. On the other hand, if what he/she tells you is false, then he/she is not lying, in which case what he/she tells you is true.
Modern Circumstance: In short: if “I am lying” is true then it is false, and if it is false then it is true.
Paradox Example: The paradox arises for any sentence that says or implies of itself that it is false (the simplest example being “This sentence is false”). It is attributed to the ancient Greek seer Epimenides (fl. c. 6th century BCE), an inhabitant of Crete, who famously declared that “All Cretans are liars” (consider what follows if the declaration is true). The paradox is important in part because it creates severe difficulties for logically rigorous theories of truth; it was not adequately addressed (which is not to say solved) until the 20th century.
Paradox Example: Doctors lie because, as caretakers, our role isto improve the lives of their patients. Re-assuring patients during some of the most difficult times of their lives counts as improving their well being! This is an acceptable practice because it does not cause harm.
Paradox Example: Cultural differences may make a lie of omission or the practice of withholding information from the patient, prudent. For instance, some cultures and religions dictate that the husband or head male family members make all medical decisions for women.
Paradox Example: Many physicians don’t report “near misses” to their patients. But, concealing serious medical errors is something we recommend against.
COMMENTS APPRECIATED
The Medical Executive-Post is a news and information aggregator and social media professional network for medical and financial service professionals.
Feel free to submit education content to the site as well as links, text posts, images, opinions and videos which are then voted up or down by other members. Comments and dialog are especially welcomed.
Daily posts are organized by subject. ME-P administrators moderate the activity. Moderation may also conducted by community-specific moderators who are unpaid volunteers.
An annuity is a contract between you and an insurance company. When you purchase an annuity, you make a lump-sum contribution or a series of contributions, generally each month. In return, the insurance company makes periodic payments to you beginning immediately or at a pre-determined date in the future. These periodic payments may last for a finite period, such as 20 years, or an indefinite period, such as until both you and your spouse are deceased. Annuities may also include a death benefit that will pay your beneficiary a specified minimum amount, such as the total amount of your contributions.
The growth of earnings in your annuity is typically tax-deferred; this could be beneficial as you may be in a lower tax bracket when you begin taking distributions from the annuity.
Warning: A word of caution: Annuities are intended as long-term investments. If you withdraw your money early from an annuity, you may pay substantial surrender charges to the insurance company as well as tax penalties to the IRS and state.
***
***
There are three basic types of annuities — fixed, indexed, and variable
1. With a fixed annuity, the insurance company agrees to pay you no less than a specified (fixed) rate of interest during the time that your account is growing. The insurance company also agrees that the periodic payments will be a specified (fixed) amount per dollar in your account.
2. With an indexed annuity, your return is based on changes in an index, such as the S&P. Indexed annuity contracts also state that the contract value will be no less than a specified minimum, regardless of index performance.
3. A variable annuity allows you to choose from among a range of different investment options, typically mutual funds. The rate of return and the amount of the periodic payments you eventually receive will vary depending on the performance of the investment options you select.
The Medical Executive-Post is a news and information aggregator and social media professional network for medical and financial service professionals.
Feel free to submit education content to the site as well as links, text posts, images, opinions and videos which are then voted up or down by other members. Comments and dialog are especially welcomed.
Daily posts are organized by subject. ME-P administrators moderate the activity. Moderation may also conducted by community-specific moderators who are unpaid volunteers.
Posted on April 20, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
***
***
According to colleague Dan Ariely PhD, Bereavement Sex is one of those coping mechanisms that sounds strange but makes sense when you think about it. In the face of loss, our brains crave connection and comfort.
Engaging in sex after a significant loss can be a way to feel alive and regain a sense of control. It’s a testament to our complex emotional wiring, where grief and intimacy intertwine.
Posted on April 7, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
***
***
Initial Public Offering Defined
IPO stands for initial public offering. It is when a company takes a portion of their shares and makes them available for the general public to buy on the open market. It is a way for the company to raise money by selling those shares to the general public. You can usually access shares from an IPO by working directly with an investment bank.
Paused IPOs
Private companies StubHub and Klarna each paused their imminent plans to go public.
Klarna, which was set to IPO on this Monday, was expected to jump-start the frozen IPO market this year with an expected ~$15 billion valuation.
StubHub, meanwhile, reportedly wants to wait for the market to calm down before resuming its plans to go public.
A hedge fund is a limited partnership of private investors whose money is pooled and managed by professional fund managers. These managers use a wide range of strategies, including leverage (borrowed money) and the trading of nontraditional assets, to earn above-average investment returns. A hedge fund investment is often considered a risky, alternative investment choice and usually requires a high minimum investment or net worth. Hedge funds typically target wealthy investors.
***
The Hedge Fund manager I am considering is a Registered Investment Adviser [RIA]
QUESTION: What is a Registered Investment Advisor?
If the fund manager is an entity, then any individual you deal with will be a registered investment adviser representative. If the fund manager is an individual, then that individual is a registered investment adviser. In either case, the designation implies several steps have been taken.
In order to become a registered investment adviser, an individual must register for and pass the Series 65 Uniform Investment Adviser Law Exam, a three-hour, 130-question computer-based exam administered by the North American Securities Administrators Association. Topics covered include economics and analysis, investment vehicles, investment recommendations and strategies, and ethics and legal guidelines. A passing score is 70 percent or higher.
Once an individual has passed the Series 65, he or she must then apply via Form ADV to become a registered investment adviser. This application is made to either a state authority or to the SEC, depending on the adviser’s assets under management. If assets under management exceed $30 million, then the adviser must register with the SEC.
Form ADV consists of two parts. Part I provides general information to the regulatory authority. Part II is designed to be distributed to potential clients, and includes disclosure of a decent amount of information about the adviser. If the manager is a registered investment adviser, then you should expect to receive as part of the offering documentation either a current copy of Part II of the adviser’s Form ADV or a brochure that contains all the current information in Part II of Form ADV.
In addition to filing Form ADV and paying a small fee, the registered investment adviser becomes subject to extra administrative/regulatory burden as well as capital adequacy requirements that state the Adviser must maintain certain net worth levels.
By and large, because of the extra administrative burden as well as restrictions on certain activities, hedge fund managers attempt to avoid registering as investment advisers. Whether such managers can or cannot avoid such registration is largely dependent upon the state in which the manager operates. In California, for instance, hedge fund managers must register as investment advisers. In New York, such registration is not necessary. Not surprisingly, hedge fund managers located in California are rare, while they are quite plentiful in New York.
Posted on April 2, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Ann Miller RN MHA CPHQ CMP™
***
***
Finally … Fiduciary second investing and financial planning opinions right here!
Telephonic or electronic advice for medical professionals that is:
Objective, affordable, medically focused and financially personalized
Rendered by a pre-screened financial consultant for doctors and medical professionals
Offered on a pay-as-you-go basis, by phone or secure e-mail transmission
The iMBA Discussion Forum™ is a physician-to-financial advisor telephone or e-mail portal that connects independent financial professionals to doctors, nurses or healthcare executives desiring affordable and unbiased financial planning advice.
Medical professionals and healthcare executives can now receive direct access to pre-screened iMBA professionals in the areas of Investing, Financial Planning, Asset Allocation, Portfolio Management, Insurance, Mortgage and Lending, Human Resources, Retirement Planning and Employee Benefits. To assist our medical professional and healthcare executive members, we can be contracted with per-minute or per-project fees, and contacted by client phone, email or secure instant messaging.
A hedge fund is a limited partnership of private investors whose money is pooled and managed by professional fund managers. These managers use a wide range of strategies, including leverage (borrowed money) and the trading of nontraditional assets, to earn above-average investment returns. A hedge fund investment is often considered a risky, alternative investment choice and usually requires a high minimum investment or net worth. Hedge funds typically target wealthy investors.
QUESTION:Can I invest my Individual Retirement Account [IRA] in a Hedge Fund?
This is up to the manager, but there is no legal restriction on a hedge fund accepting individual retirement account (IRA) assets. IRA accounts are not well suited for funds that make extensive use of leverage, however. In such cases, the fund is likely to generate significant amounts of unrelated business taxable income (UBTI) – profits of the fund attributable to the use of leverage. The holder of an IRA account must pay taxes on UBTI, even if the UBTI was generated in an IRA account.
But, today’s hedge funds may or may not use leverage. Many hedge funds are not hedged at all, but rather are just specialized versions of regular long stock portfolios. If such funds do not use much leverage, IRA investors will not encounter much difficulty with UBTI and should not hesitate in considering these funds.
In considering whether to accept IRA money, hedge fund managers must consider several factors. If the only type of retirement money accepted by the hedge funds is IRA money, then the manager has no limit on how much retirement money the fund can accept. If, however, there are other types of retirement money invested in the fund, such as pension funds, IRA money will be counted towards a total of 25 percent of fund assets that can be invested in retirement accounts before the fund becomes subject to the Employment Retirement Income Security Act of 1974 (ERISA). Funds subject to ERISA regulations face a heavy administrative burden and more restrictions than most fund managers like.
Finally, IRA distributions from a hedge fund are subject to the standard 20 percent withholding unless the funds are directly rolled over to other qualified plans.
Suppose that in a new Accountable Care Organization [ACO] contract, a certain medical practice was awarded a new global payment or capitation styled contract that increased revenues by $100,000 for the next fiscal year. The practice had a gross margin of 35% that was not expected to change because of the new business. However, $10,000 was added to medical overhead expenses for another assistant and all Account’s Receivable (AR) are paid at the end of the year, upon completion of the contract.
Cost of Medical Services Provided (COMSP):
The Costs of Medical Services Provided (COMSP) for the ACO business contract represents the amount of money needed to service the patients provided by the contract. Since gross margin is 35% of revenues, the COMSP is 65% or $65,000. Adding the extra overhead results in $75,000 of new spending money (cash flow) needed to treat the patients. Therefore, divide the $75,000 total by the number of days the contract extends (one year) and realize the new contract requires about $ 205.50 per day of free cash flows.
Assumptions
Financial cash flow forecasting from operating activities allows a reasonable projection of future cash needs and enables the doctor to err on the side of fiscal prudence. It is an inexact science, by definition, and entails the following assumptions:
All income tax, salaries and Accounts Payable (AP) are paid at once.
Durable medical equipment inventory and pre-paid advertising remain constant.
Gains/losses on sale of equipment and depreciation expenses remain stable.
Gross margins remain constant.
The office is efficient so major new marginal costs will not be incurred.
***
***
Physician Reactions:
Since many physicians are still not entirely comfortable with global reimbursement, fixed payments, capitation or ACO reimbursement contracts; practices may be loath to turn away short-term business in the ACA era. Physician-executives must then determine other methods to generate the additional cash, which include the following general suggestions:
1. Extend Account’s Payable
Discuss your cash flow difficulties with vendors and emphasize their short-term nature. A doctor and her practice still has considerable cache’ value, especially in local communities, and many vendors are willing to work them to retain their business
2. Reduce Accounts Receivable
According to most cost surveys, about 30% of multi-specialty group’s accounts receivable (ARs) are unpaid at 120 days. In addition, multi-specialty groups are able to collect on only about 69% of charges. The rest was written off as bad debt expenses or as a result of discounted payments from Medicare and other managed care companies. In a study by Wisconsin based Zimmerman and Associates, the percentages of ARs unpaid at more than 90 days is now at an all time high of more than 40%. Therefore, multi-specialty groups should aim to keep the percentage of ARs unpaid for more than 120 days, down to less than 20% of the total practice. The safest place to be for a single specialty physician is probably in the 30-35% range as anything over that is just not affordable.
The slowest paid specialties (ARs greater than 120 days) are: multi-specialty group practices; family practices; cardiology groups; anesthesiology groups; and gastroenterologists, respectively. So work hard to get your money, faster. Factoring, or selling the ARs to a third party for an immediate discounted amount is not usually recommended.
3. Borrow with Short-Term Bridge Loans
Obtain a line of credit from your local bank, credit union or other private sources, if possible in an economically constrained environment. Beware the time value of money, personal loan guarantees, and onerous usury rates. Also, beware that lenders can reduce or eliminate credit lines to a medical practice, often at the most inopportune time.
4. Cut Expenses
While this is often possible, it has to be done without demoralizing the practice’s staff.
5. Reduce Supply Inventories
If prudently possible; remember things like minimal shipping fees, loss of revenue if you run short, etc.
6. Taxes
Do not stop paying withholding taxes in favor of cash flow because it is illegal.
Hyper-Growth Model:
Now, let us again suppose that the practice has attracted nine more similar medical contracts. If we multiple the above example tenfold, the serious nature of potential cash flow problem becomes apparent. In other words, the practice has increased revenues to one million dollars, with the same 35% margin, 65% COMSP and $100,000 increase in operating overhead expenses.
Using identical mathematical calculations, we determine that $750,000 / 365days equals $2,055.00 per day of needed new free cash flows! Hence, indiscriminate growth without careful contract evaluation and cash flow analysis is a prescription for potential financial disaster.
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: CONTACT: MarcinkoAdvisors@outlook.com
Posted on March 30, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
***
***
Negativity bias is not totally separate from pessimism bias, but it is subtly and importantly distinct. In fact, it works according to similar mechanics as the sunk cost fallacy in that it reflects our profound aversion to losing. We like to win, but we hate to lose even more.
And so, according to cognitive scientist Mackenzie Marcinko PhD, when we make a decision, we generally think in terms of outcomes—either positive or negative. The bias comes into play when we irrationally weigh the potential for a negative outcome as more important than that of a positive outcome.
***
***
Pessimism bias on the other hand, is a cognitive bias that causes people to overestimate the likelihood of negative things and underestimate the likelihood of positive things, especially when it comes to assuming that future events will have a bad outcome.
For example, the pessimism bias could cause someone to believe that they’re going to fail an exam, even though they’re well-prepared and are likely to get a good grade.
According to colleague Dan Ariely PhD, The pessimism bias can distort people’s thinking, including your own, in a way that leads to irrational decision-making, as well as to various issues with your mental health and emotional well being.
Both median and average family net worth surged between 2019 and 2022, according to the U.S. Federal Reserve. Average net worth increased by 23% to $1,063,700, the Fed reported in October 2023, the most recent year it published the data. Median net worth, on the other hand, rose 37% over that same period to $192,900.
You might wonder why the average and median net worth figures are so different. That’s because when you take the average of something, you add together every value in a data set and then divide that figure by the number of individual values.
When calculating a median, you simply look at the middle figure within a data set. That said, an average figure can be significantly higher or lower than a median figure if there are extreme outliers – meaning a group of people with significantly more net worth than the rest of the group can bring the average higher.
Average Net Worth by Age
The average net worth of someone younger than 35 years old is $183,500, as of 2022. From there, average net worth steadily rises within each age bracket. Between 35 to 44, the average net worth is $549,600, while between 45 and 54, that number increases to $975,800. Average net worth surges above the $1 million mark between 55 to 64, reaching $1,566,900.
Average net worth again rises for those ages 65 to 74, to $1,794,600, before falling to $1,624,100 for the 75 and older group. The median net worth within every single age bracket, however, is much lower than the average net worth.
***
***
Physicians [MD/DO]Net Worth by Specialty
A 2023 Medscape report shows the top 10 specialties with the most survey respondents saying they are worth more than $5 million.
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: CONTACT: MarcinkoAdvisors@outlook.com
*** Several years ago we noted that far too many mid-career, mature and physician clients using traditional stock brokers, management consultants and “financial advisors”, seemed to be less successful than those who went it alone. These Do-it-Yourselfers [DIYs] had setbacks and made mistakes, for sure. But, the ME Inc,. doctors seemed to learn from their mistakes and did not incur the high management and service fees demanded from general or retail one-size-fits-all “advisors.”
In fact, an informal inverse related relationship was noted, and dubbed the “Doctor Effect.” In other words, the more consultants an individual doctor retained; the less well they did in all disciplines of the financial planning, professional portfolio and investing continuum.
Of course, the reason for this discrepancy eluded many of them as Wall Street brokerages and wire-houses flooded the media with messages, infomercials, print, radio, TV, texts, tweets, and internet ads to the contrary. Rather than self-learn the basics, the prevailing sentiment seemed to purse the holy grail of finding the “perfect financial advisor.” This realization was a confirmation of the industry culture which seemed to be: Bread for the advisor – Crumbs for the client!
And so, we at the the Institute of Medical Business Advisors Inc. (iMBA), and this Medical Executive-Post, formed a cadre’ of technology focused and highly educated doctors, financial advisors, attorneys, accountants, psychologists and educational visionaries who decided there must be a better way for their healthcare colleagues to receive financial planning advice, products and related management services within a culture of fiduciary responsibility.
We trust you agree with this ME Inc philosophy as illustrated in this free white paper available upon request.
PROFESSIONAL PORTFOLIO CONSTRUCTION [Investing Assets and their Management] Subscribe, Read, Like and Refer
Email whiote paper request here:MarcinkoAdvisors@outlook.com
Posted on March 16, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Vitaliy Katsenelson CFA
***
***
Today, I’m going to share stories about my best and worst investment decisions. But don’t worry, this isn’t just a brag-and-cringe session about making or losing money. These stories are about the valuable lessons learned, and how these adventures in investing helped shape my current approach.
The Best Investment Decision
In investing, you don’t get extra points for creativity or difficulty. A million dollars earned while you are smiling buys as many potatoes as a million dollars that cost you your marriage and hair.
However, from a personal, creative satisfaction perspective, our investment in Uber was one of our best. That’s not to say that it has been the most successful decision from a financial perspective, at least not yet.
Uber doesn’t fit into the traditional value stock category. Until 2023, the third year of our ownership, it never made money. It was a stock everyone hated. After we bought it, I had clients reach out to me asking if I had been kidnapped and someone else was making these purchases of Uber.
We bought more shares very opportunistically during and after the pandemic. I wrote a long research report on it, which you can read here.
On one hand, Uber’s switchboard is a digital business, but the company also has a physical presence in thousands of cities, which incurs costs (the analog side of the business). Additionally, the availability of cheap money caused the ride-share market to go crazy and act rationally irrational, as competitors jostled in a land grab.
My thesis consisted of several insights:
Unlike traditional-tech, digital-only companies, Uber is a hybrid, both digital and analog. Thus, its cost structure is much higher than that of other companies. This, in part, explains the higher losses.
It has a strong brand; its name has become a verb.
The rideshare market is inevitable and will only continue to grow. Uber is not just in competition with taxis, second cars, or seldomly used cars; it is also in competition with the favors we ask of friends and relatives, such as dropping us off at the mechanic or picking us up from the doctor’s office.
Uber has global scale, which its competitors lack, allowing it to spread R&D across more markets.
As its revenue grows, each incremental dollar comes with a very high margin, which directly drops to the bottom line. Therefore, at some point, its earnings will explode to the upside as fixed costs stop growing, allowing it to scale.
The Uber story is not over; we still own the stock. I don’t want to do a celebratory dance. But this idea came with a lot of creative satisfaction. There is another point of pride here. Despite our very tumultuous ownership of this stock, we remained rational (I have written about that here). We bought more when it became extremely undervalued, and I would be lying if I said that was psychologically easy – it was not, but we followed our research and process.
The Worst Investment Decision
My worst investments that resulted in losses had several things in common: They were low-quality companies; their financials were complex and not transparent (for instance, one-time items were labeled as “one-time” every quarter); and they had questionable management.
However, they were all considered “cheap”… until they were not. Now, I hope you see why I am dogmatic about quality.
However.
When you are wrong on an investment and you lose money, the most you can lose is 100%. I have learned a lot from those. But they were not my worst investments. Those were the ones where I left 300–400% on the table when I sold too soon. Let me detail two examples.
EA – Electronic Arts
We bought EA in the early 2010s. I wrote about it – you can read my investment case for it here. To sum up, games were moving from being sold in stores to being digital downloads, which would lead to higher margins (don’t have to pay for packaging and Best Buy to sell them). The market for games was exploding, as every adult and teenager had a gaming device in their hands – a smartphone. The market for video games was going to be much larger. EA was the largest player in that space, with great franchises.
The following two years of ownership were very painful. EA had a few big game flops, and the market did not care about improving fundamentals. The stock kept declining. We continued to buy more. Every time we bought more shares, the stock fell further. Fast-forward a year or two. The stock doubled from our original purchase, but I was mentally exhausted. I did a celebratory dance and sold the stock. The stock then went up another 4x within a few years after we sold it. It went up for the right reasons – its earnings exploded to the upside, in line with my original thesis.
The sale was a mistake, not because the price went up but because I let frustration over the stock-price decline (volatility) get to me. Investing is a mental game. I learned from this adventure that it is important to zoom out and not obsess over individual stocks in the portfolio. This is why we have a portfolio. It was a very costly but educational mistake. Our ownership of Uber was not a walk in the park, either – just look at the stock price over the last few years. But I had learned my lesson from EA and was able to do the analysis, update our model, and zoom out.
In investing, there is a big difference between intellectual and tactile knowledge. I am going to go PG-13 on you for a second and quote the irascible Charlie Munger: “Learning about investing through a model portfolio is like learning about sex through romantic novels.” A big part of investing is observing yourself as an investor – your thoughts and emotions as you ride the actual rollercoaster of owning a stock.
I also made an important modification to our process.
We always value every company in the portfolio on earnings (free cash flows) at least four years out. Why four years? Three seems too short. There is no magic in this number, other than it being longer than most analyst estimates. We do this for all stocks in the portfolio, and then the total return for each is calculated and annualized. If a company has strong growth potential, it may appear to be expensive based on current earnings; but in reality, it may actually be cheap based on earnings projected four years from now.
On the other side of the spectrum, a company that has no growth or dividends may seem “cheap” based on its current earnings multiple, but this cheapness may quickly dissipate once a total return is calculated using future earnings. Time is on the side of growing businesses and the enemy of the ones that stand still. Therefore, a non-growing or slow-growing business needs a much greater discount (margin of safety) to secure a spot in our portfolio.
I want to stress another point. We sometimes sell a stock and then it goes higher. If we sold it for the right fundamental reasons, this doesn’t bother me. There is very little to learn.
Twilio
I’ll give you another crazy example. We bought Twilio at $25 in 2017 or so. Our thesis was that they had built the largest digital telecommunications network, which gave them a brief competitive advantage. They were also spending 5x more on R&D than competitors to build applications around this network, which would give them long-term advantages.
The stock price went up to $60 in a few months without anything significantly changing, so we sold a third of our position. Then it went up to $90, and we sold some more. To our disbelief, we sold the rest at around $120, a bit before the pandemic.
During the pandemic, Twilio’s price hit $400. I had zero regret about not holding on to the shares. Absolutely none. Twilio’s profitability did not match the stock market’s opinion of its price. Twilio’s stock price was as crazy to me at $250 as it was at $300 or $400. After reviewing our models, we concluded that even $120 was at the extreme end of our optimistic assumptions. Fast-forward to today, where the stock is at $60 or so. We are currently sharpening our pencils, but we have not bought the stock – yet.
Selling EA was a mistake; selling Twilio was not.
***
Key takeaways
My “best investment decision” with Uber wasn’t just about financial gains, but the creative satisfaction it brought. It taught me the value of sticking to our research and process, even when it’s psychologically challenging.
The worst investments often share common traits: low-quality companies, complex financials, questionable management, and the illusion of being “cheap.” This reinforces my dogmatic stance on prioritizing quality.
Sometimes, the costliest mistakes aren’t the ones where you lose money, but those where you leave significant gains on the table by selling too soon. My experience with EA taught me this lesson the hard way.
There’s a crucial difference between intellectual and tactile knowledge in investing. Actually owning stocks and experiencing the emotional roller coaster is invaluable for developing as an investor.
Selling a stock that later increases in value isn’t always a mistake if the decision was based on sound fundamental reasons. My experience with Twilio illustrates this point – sometimes it’s right to sell even if the price continues to climb.
NOTE:Please read the following important disclosure here.
In the United States, the difference between a Ph.D and a Sc.D is that the former is awarded to most, if not all, disciplines, while a Sc.D is awarded to science or STEM (science, technology, engineering, mathematics) disciplines.
This means that, in the United States at least, a Ph.D and a Sc.D are equal to one another in terms of telling people about an individual’s mastery of a particular skill, training, and prestige. A Ph.D holder and a Sc.D holder are viewed as peers and equals by most, if not all, American universities.
Meanwhile in Europe, according to Emily Summer, the difference between a Ph.D and a Sc.D is that the former is awarded at the start of an academic career, while the Sc.D is awarded much later, after the individual has built up an impressive body of work.
Posted on March 7, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
***
***
Base-Erosion Anti-Abuse Tax (BEAT): The 2017 tax reforms moved the U.S. from a worldwide taxation system to a quasi-territorial system, so foreign earnings are no longer included in a company’s domestic tax base.
To discourage companies operating in the U.S. from avoiding tax liability by shifting profits out of the country, Congress imposed a 10% minimum tax called Base-Erosion Anti-Abuse Tax (BEAT). The BEAT rate will increase from 10% to 12.5% in 2026.
As in the case of Declinism, to better understand the Forer effect (commonly known as the Barnum Effect), it’s helpful to acknowledge that people like their world to make sense. If it didn’t, we would have no pre-existing routine to fall back on and we’d have to think harder to contextualise new information.
Note: Phineas Taylor Barnum (July 5, 1810 – April 7, 1891) was an American showman, businessman, and politician remembered for promoting celebrated hoaxes and founding with Jim Bailey the Ringling Bros. and Barnum & Bailey Circus. He was also an author, publisher, and philanthropist although he said of himself: “I am a showman by profession … and all the gilding shall make nothing else of me.” According to Barnum’s critics, his personal aim was “to put money in his own coffers”. According to Wikipedia, the adage “there’s a sucker born every minute” has frequently been attributed to him, although no evidence exists that he had coined the phrase
With that, if there are gaps in our thinking of how we understand things, we will try to fill those gaps in with what we intuitively think makes sense, subsequently reinforcing our existing schema(s). As our minds make such connections to consolidate our own personal understanding of the world, it is easy to see how people can tend to process vague information and interpret it in a manner that makes it seem personal and specific to them. Given our egocentric nature (along with our desire for nice, neat little packages and patterns), when we process vague information, we hold on to what we deem meaningful to us and discard what is not. Simply, we better process information we think is specifically tailored to us, regardless of ambiguity.
More specifically, according to colleague Dan Ariely PhD, the Forer effect refers to the tendency for people to accept vague and general personality descriptions as uniquely applicable to themselves without realizing that the same description could be applied to just about everyone else (Forer, 1949). For example, when people read their horoscope, even vague, general information can seem like it’s advising something relevant and specific to them.
Remember, we make thousands of decisions every day, some more important than others. Make sure that the ones that do matter are not made based on bias, but rather on reflective judgment and critical thinking.
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com
If the definition of a security is title to a stream of cash flows, then the dividends a company is expected to pay to equity shareholders on a periodic basis (e.g., quarterly) are a clear source of return for an investor. A dividend is simply a distribution of (some portion of) the company’s earnings to equity shareholders. Like a bond yield, a stock’s dividend yield can be used to measure the income return on the stock.
To determine a stock’s dividend yield, the trailing year’s dividends per share paid are divided by the current stock price. However, a key difference between a dividend yield and a bond yield is the level of certainty that can be assumed regarding future payments, since a bond’s coupon is generally predetermined and its payment is expected to be senior to the payment of dividends.
After a company has determined that it has earned a profit, management has to decide what to do with those profits. One choice is to distribute the earnings to shareholders in the form of dividends, while another option is to reinvest the profits in the company. A company’s management may determine that the shareholders interest is best served by using the earnings to pursue growth opportunities (e.g., capital expansion, research & development, etc.) at the corporate level. Thus, when management believes that its investment opportunities are likely to produce a higher return than what investors’ could generate with their dividends or that reinvestment is needed to maintain its financial strength, the company will retain the earnings.
One of the biggest myths in investing is capital appreciation accounts for the largest part of investors’ gains. Dividends, or cash payments to shareholders, actually account for a substantial part of an equity investor’s total return. In fact since 1926, dividends have accounted for more than 40% of the total return of the S&P 500 stock index. In the last decade (2000-2009), the S&P 500’s total return of -9% would have been a heftier loss of -24% had it not been for the 15% contribution from dividends.
History has shown that dividends have been a powerful source of total return in a diversified investment portfolio, especially during periods of market turbulence. In examining the prior eight decades of stock market performance, dividends often account for more than 2/3 of the total return (1930s, 1940s, 1970s, & 2000s). If an investor avoided dividend paying stocks during these elongated time periods, most of the total gains would be lost.
***
DIVIDEND CONTRIBUTION OF S&P 500 RETURN BY DECADE
S&P 500
Cumulative
Dividends
Average
Price %
Dividend
Total
% of Total
Payout
Years
Change
Contribution*
Return
Return
Ratio**
1930s
-41.9%
56.0%
14.1%
>100%
90.1%
1940s
34.8%
100.3%
135.0%
74.3%
59.4%
1950s
256.7%
180.0%
436.7%
41.2%
54.6%
1960s
53.7%
54.2%
107.9%
50.2%
56.0%
1970s
17.2%
59.1%
76.4%
77.4%
45.5%
1980s
227.4%
143.1%
370.5%
38.6%
48.6%
1990s
315.7%
117.1%
432.8%
27.0%
47.6%
2000s
-24.1%
15.0%
-9.1%
>100%
35.3%
2010s
27.9%
8.4%
36.3%
23.1%
28.4%
as of 12/31/12
Source: Strategas
During those decades such as the 2000s where the stock market struggled to advance, dividends were a significant element for investor survival. This is not only due to the dividends alone, but also the risk element of stocks that pay dividends. Dividend stocks have historically provided lower overall volatility and stronger downside protection when markets decline. Since 1927, dividend stocks have consistently held up better than the broader market during downturns. You can measure downside risk through a statistic known as downside capture ratio.
Downside capture ratio is a statistical measure of overall performance in a down stock market. An investment category, or investment manager, who has a down-market ratio less than 100 has outperformed the index during a falling stock market.
For example, a down-market capture ratio of 80 indicates that the portfolio measure declined only 80% as much as the index during the period. The downside capture ratio of high-dividend-yielding stocks, since 1927, has been 81% or lower over various long-term periods. Put a better way, during months that the S&P 500 stock index fell, dividend stocks declined by nearly 19% less than the broader market.
***
DOWNSIDE AND UPSIDE CAPTURE RATIOS OF HIGH DIVIDEND STOCKS – 1927 TO 2011
SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: CONTACT: MarcinkoAdvisors@outlook.com
Posted on February 19, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
***
***
Optometry Doctor [OD]: An optometrist has an Optometry Doctor (OD) degree and can assess overall eye health and the quality of a person’s vision through a comprehensive examination. They diagnose and treat many eye disorders that do not require surgery or further specialized care. An optometrist can also identify symptoms of other health conditions that may affect the eyes, such as diabetes. Some also specialize in a field like pediatric care.
Optometrists [OD] and ophthalmologists [MD/DO] are both eye doctors, but they have different types of training and areas of expertise. If you need an eye exam—and think you may need glasses or contact lenses—an optometrist is a good first choice. To become an optometrist, a person needs to complete four years of additional education after a bachelor’s degree. Sometimes they complete a residency as well.
Now, ODs are licensed doctors and can prescribe medication. However, optometrists have a defined scope of practice that that revolves largely around the eyes. Optometrists can not prescribe all the same medications that your family doctor or ophthalmologist can.
So, if your eye issue requires surgery, or for specific conditions related to your eyes or overall health, you’ll want to visit an ophthalmologist [MD/DO].
On average, an optometrist in the U.S. makes about $131,860 per year, according to 2023 statistics.
Posted on February 16, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
***
INFLUENCERS
Reach Industry Pros, Executives and Decision-Makers with Ease!
Thank you for your interest in advertising on, or sponsoring the ME-P, the web’s only site integrating medical practice management with personal financial planning for all industry professionals.
Why should your company sponsor or advertise on the ME-P?
• Reader loyalty. Not only does the ME-P receive a mind-boggling number of page views and visits each month, its readers are loyal. • Reader stature. ME-P readers are experienced industry pros, executives and decision-makers. • Selective advertising. The ME-P is a free read that’s off the radar of the big-ad companies. Your ad here stands out as personal and different. • Supporting the ME-P makes a big difference and costs only a fraction of other online publications with far fewer readers. • Cost. CPM is reasonable and low compared to other sites.
E-mail us for a full packet, but give a look to these results from the ME-P’s annual reader survey:
* 89% of readers said the ME-P influences their perception of products and companies * 34% said that ME-P sponsorship alone give them a higher interest or appreciation for those companies * 754% said the ME-P has some, a good bit, or a lot of industry influence
Contact me and I’ll e-mail you a rate card. Your support makes a difference!
Posted on February 9, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
ACADEMIC DEFINITIONS
By Staff Reporters
***
***
What Is a PhD?
A PhD is a doctorate degree and is the highest postgraduate qualification awarded by universities. It involves undertaking original research in a narrow subject field and typically takes 4 years to complete.
A PhD in Business Administration provides an individual with a specialized and research-based background for a topic in the business management field. This is one of the key reasons it’s sought after by those who wish to work in business-related academia or research.
What Is a DBA?
A Doctor of Business Administration (DBA) is a business-orientated professional doctorate. Like a PhD, it is the highest-level postgraduate qualification which you can obtain from a university.
The degree program focuses on providing practical and innovative business management knowledge which can apply to any workplace. DBAs are designed for experienced practitioners such as senior managers, consultants and entrepreneurs who want to further their practical abilities.
This form of doctorate was first introduced as a way of allowing a distinction to be made between experienced practitioners and expert practitioners. The doctorate is an equal alternative to a traditional PhD and is an advanced follow-up for a Master’s in Business Administration (MBA).
Is a DBA and PhD Equivalent?
A Doctor of Business Administration (DBA) is equivalent to a Doctor of Philosophy (PhD); however, there are fundamental differences between these two doctoral degrees. These differences are nearly always at the center of DBA vs PhD discussions, and they stem from the intended career path of the student following their degree.
A PhD focuses on the ‘theory’ underpinning business management, whereas a DBA focuses on the ‘practical’ concepts. Those who complete a PhD in business management usually do so as they wish to pursue a career in research or academia. Those who complete a DBA do so as they want to pursue a more advanced role in the business industry or within their organization.
Fund managers Tom Bailard, Larry Biehl and Ron Kaiser identified five types of investors, each type characterized by their investment preferences and actions. These 5 types are: Individualists, Adventurers, Celebrities, Guardians and Straight Arrows. Key to the different categories is their different attitude to seeking professional financial advice. Defined below:
Individualists have faith in their own investment abilities so do not approach a financial adviser. But they are also cautious.
Adventurers are what may be called high rollers, in that they like big bets, tend not to diversify and are happy to put all their eggs in one basket. They, too, are unlikely to seek financial advice.
Celebrities tend to follow the crowd in investment terms but are aware of their lack of expertise so frequently consult advisers.
Guardians are fearful of losing money, thus prefer rock-solid investments such as government bonds. They, too, are likely to seek professional investment advice.
Straight Arrows exhibit some of the characteristics of individualists and some of adventurers.
Posted on February 5, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
DEFINITION
By Staff Reporters ***
***
Naturopathic Doctors are educated and trained in accredited naturopathic medical colleges. They diagnose, prevent, and treat acute and chronic illness to restore and establish optimal health by supporting the person’s inherent self-healing process.
Rather than just suppressing symptoms, naturopathic doctors work to identify underlying causes of illness, and develop personalized treatment plans to address them. Their Therapeutic Order™, identifies the natural order in which all therapies should be applied to provide the greatest benefit with the least potential for damage.
Posted on January 31, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Health Capital Consultants, LLC
In the first days of his second (nonconsecutive) presidential term, Donald Trump and his administration took a number of actions that will affect the healthcare industry in the near- and long-term. Further, the Trump Administration is reportedly poised to take a number of additional actions to pause, end, or otherwise change Biden-era initiatives.
Meanwhile, President Trump’s cabinet pick for the Department of Health & Human Services (HHS) hangs in the balance. This Health Capital Topics article reviews the new administration’s actions impacting the healthcare industry as of the date of publication. (Read more...)
Posted on January 28, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
***
***
Capital is not flowing from developed countries to developing countries despite the fact that developing countries have lower levels of capital per worker, and therefore higher returns to capital.
Classical economic theory predicts that capital should flow from rich countries to poor countries, due to the effect of diminishing returns of capital. Poor countries have lower levels of capital per worker – which explains, in part, why they are poor. In poor countries, the scarcity of capital relative to labor should mean that the returns related to the infusion of capital are higher than in developed countries.
In response, savers in rich countries should look at poor countries as profitable places in which to invest. In reality, things do not seem to work that way. Surprisingly little capital flows from rich countries to poor countries.
This puzzle, famously discussed in a paper by Robert Lucas in 1990, is often referred to as the “Lucas Paradox”.
Posted on January 26, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
***
***
Cognitive Dissonance is the discomfort experienced when holding conflicting cognitions, like believing in healthy eating while munching on a doghnut. It’s a mental tug-of-war that makes us squirm.
To reduce this discomfort according to colleague Dan Ariely PhD, we often change our beliefs or behaviors to align them. This is why smokers might downplay the health risks of smoking. Understanding cognitive dissonance helps us recognize these mental gymnastics and strive for consistency in our beliefs and actions.
So, next time you feel that mental itch, it’s cognitive dissonance asking for some resolution.
Posted on January 24, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
***
***
Nash equilibrium, in game theory, is an outcome in a noncooperative game for two or more players in which no player’s expected outcome can be improved by changing one’s own strategy.
The Nash equilibrium is a key concept in game theory, in which it defines the solution of N-player non-cooperative games. It is named for American mathematician John Nash, who was awarded the 1994 Nobel Prize for Economics for his contributions to game theory.
MBA is the common abbreviation for a Master of Business Administration degree, and recipients typically stop attending school after receiving it.
However, those who are interested in conducting business research may decide to pursue a doctorate in business or management. Such students can earn a Ph.D. or a Doctor of Business Administration degree, commonly known as a DBA.
What ‘MSHA’ Stands For?
Master of Health Administration (MHA) and Master of Science in Health Administration (MSHA) are largely equivalent designations for degree programs that focus primarily on leadership and management of hospitals, healthcare organizations, and businesses that operate in the healthcare sector.
In contrast, an MBA in Health Administration is a Master of Business Administration degree program with a concentration, track, or specialization that provides students with several courses in topics specific to healthcare management and administration. Most of the coursework in an MBA program is devoted to general training in business functions, such as accounting, finance, logistics, marketing, personnel and project management.
MHA and MHSA programs devote all or most of their curriculum to studying the healthcare system, healthcare policy, and the application of business principles in the field of healthcare. MBA in Healthcare Administration programs devote only a portion of their curricula to topics specific to the healthcare sector.
MBBS Degree [Bachelor of Medicine, Bachelor of Surgery]
The MBBS is usually a five-year undergraduate degree that medical students complete when they want to become doctors. However, some programs take six years to complete because the institution expects you to earn a Bachelor of Science (BSc) in your training.
By the time a student applies to a medical program, they have likely taken several foundational science courses as part of their high school (or secondary) education. For example, medical applicants in the United Kingdom are often expected to show high scores on their General Certificate of Secondary Education (GCSE) and A-levels.
Earning an MBBS means that students are certified to care for patients as junior physicians without specialized training. Graduates are expected to complete two years of additional training, which rotates them through different specialties. Once they identify a specialty they like, they can apply for additional training, which can take anywhere between three and eight years.
MD Degree [Doctor of Medicine]
The acronym “MD” stands for the Latin term “Medicinae Doctor,” which translates to “Doctor of Medicine” in English.
It refers to the title that students from the United States of America obtain after finishing medical school. Some countries consider the “MD” title a postgraduate doctoral degree that MBBS graduates can obtain with additional years of training.
The CPA and CMA designations cater to distinct professional focuses within the accounting and finance fields. A CPA is often seen as the gold standard for public accounting, emphasizing auditing, tax, and regulatory compliance. This certification is highly regarded for roles that require a deep understanding of financial reporting and external auditing. CPAs are frequently employed by public accounting firms, government agencies, and corporations that need to ensure their financial statements adhere to strict regulatory standards.
On the other hand, the CMA designation is tailored for professionals who aim to excel in management accounting and strategic financial management. CMAs are trained to analyze financial data to inform business decisions, focusing on internal processes and performance management. This makes the CMA particularly valuable for roles in corporate finance, strategic planning, and management consulting. Companies looking to optimize their internal financial operations and drive business strategy often seek out CMAs for their expertise in cost management, budgeting, and financial analysis.
The educational and experiential requirements for these certifications also differ. To become a CPA, candidates typically need to complete 150 semester hours of college education, which often includes a bachelor’s degree in accounting or a related field. Additionally, CPAs must pass the Uniform CPA Examination and meet specific state licensing requirements, which usually include a certain amount of professional experience.
In contrast, the CMA certification requires a bachelor’s degree in any discipline, two years of relevant work experience, and passing the two-part CMA exam. This flexibility in educational background can make the CMA more accessible to a broader range of professionals.
The Bloomberg U.S. Universal Index represents the union of the U.S. Aggregate Index, U.S. Corporate High Yield Index, Investment Grade 144A Index, Eurodollar Index, U.S. Emerging Markets Index, and the non-ERISA eligible portion of the CMBS Index.
The index covers USD-denominated, taxable bonds that are rated either investment grade or high-yield. Some Bloomberg U.S. Universal Index constituents may be eligible for one or more of its contributing sub-components that are not mutually exclusive. These securities are not double-counted in the index.
The Bloomberg U.S. Universal Index was created on January 1st, 1999, with index history back-filled to January 1st, 1990.
A Junk Rally is a general trend of out performance by companies that tend to score poorly along several dimensions, such as price-to-earnings (P/E) ratios, return on assets (ROA), balance sheet strength, levels of debt and volatility.
Posted on January 10, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
***
***
Definition of the Paradox of Competition
The Paradox of Competition refers to the complex and often counterintuitive effects competitive behaviors can have within markets and industries. Generally, competition is seen as a positive force that drives innovation, lowers prices, and improves quality and choice for consumers. However, the paradox lies in the fact that intense competition can sometimes lead to negative outcomes, such as diminished profitability for companies, reduced incentives to innovate, and the potential for a race to the bottom in terms of quality and sustainability.
According to colleague Dan Ariely PhD, understanding the nuances of the Paradox of Competition reveals the complexity of market dynamics and the importance of strategic, informed approaches to competition, both from businesses and regulators.
This paradox challenges the conventional wisdom that competition is universally beneficial, highlighting the need for a more nuanced view of how competitive forces shape markets and societies.
Posted on January 5, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
***
***
Morality Priming refers to subtle reminders of ethical principles that can make us behave more responsibly. It’s like an internal nudge that brings our conscience to the surface.
And, according to colleague Dan Ariely PhD, by focusing on moral standards, people are often encouraged to act more honestly, even in small, everyday decisions.
Posted on January 3, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
***
***
Outcome bias is judging a decision based on its result rather than the quality of the decision at the time it was made.
It’s like saying a bad poker play was smart because you won the hand. Or, a bad stock picker or financial advisor was good because the price went up!
According to psychologist and colleague Dan Ariely PhD, this bias ignores the process and focuses solely on the outcome. It’s why we celebrate lucky breaks and criticize thoughtful risks that didn’t pan out.
So, the next time you’re evaluating a decision, focus on the reasoning behind it, not just the end result.
Posted on December 31, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
***
***
The Li Keqiang Index was created in 2010 by The Economist and measure’s China’s economy using three indicators: railway cargo volume, electricity consumption and bank loans.
The index is seen as an alternative to official gross domestic product numbers released by the Chinese government.
Posted on December 29, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
BREAKING NEWS!
Former President Jimmy Carter has died at the age of 100.
The 39th president of the United States was a Georgia peanut farmer who sought to restore trust in government when he assumed the presidency in 1977 and then built a reputation for tireless work as a humanitarian.
Nominal yield, for most bonds and other fixed-income securities, is simply the yield you see listed online or in newspapers. Most nominal fixed-income yields include some extra yield, an “inflation premium,” that is typically priced/added into the yields to help offset the effects of inflation.
Real yields, such as those for TIPS, don’t have the inflation premium. As a result, nominal yields are typically higher than TIPS yields and other real yields.
Posted on December 23, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Dr. David Edward Marcinko MBA
[CEO – iMBA Inc]
To Our ME-P Subscribers, iMBA Inc., Clients and Friends
As we look forward to sharing the holidays with family and friends, we also remember those less fortunate.
And, as has been our practice in recent years, rather than sending holiday greeting cards, the iMBA Inc will provide support to several charities dedicated to helping those in need.
We hope this gesture provides happier holidays for others and serves to express our gratitude to you, in the spirit of the season, for your continued support and loyalty to this ME-P.
Happy New Year 2024
We also extend our hope that the New Year 2022 brings you and your loved ones good health, happiness and a world that comes to know peace and understanding.
***
***
Channel Surfing the ME-P
Have you visited our other topic channels? Established to facilitate idea exchange and link our community together, the value of these topics is dependent upon your input. Please take a minute to visit. And, to prevent that annoying spam, we ask that you register. It is fast, free and secure.
Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
Support our online development, and advance our onground research initiatives in free market economics, as we seek to showcase the brightest Next-Gen minds.
THE ME-P DISCLAIMER: Posts, comments and opinions do not necessarily represent iMBA, Inc., but become our property after submission. Copyright © 2006 to-date. iMBA, Inc allows colleges, universities, medical and financial professionals and related clinics, hospitals and non-profit healthcare organizations to distribute our proprietary essays, photos, videos, audios and other documents; etc. However, please review copyright and usage information for each individual asset before submission to us, and/or placement on your publication or web site. Attestation references, citations and/or back-links are required. All other assets are property of the individual copyright holder.
The Leading Business Education Network for Doctors, Financial Advisors and Health Industry Consultants 