MEMORIAL DAY: Weekend Origination Thoughts 2024

“Decoration Day”

By Dr. David E. Marcinko MBA MEd CMP

”Memorial Day (Decoration Day) is a federal holiday in the United States for honoring and mourning the military personnel who died while serving in the United States Armed Forces.

The holiday is now observed on the last Monday of May, having been observed on May 30th from 1868 to 1970.

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METAVERSE MEDICINE: Doctor, Patient Avatars Ahead?

By WebMD

In what some are calling the next iteration of the internet, the metaverse is an unfamiliar digital world where you could be an avatar navigating computer-generated places and interacting with others in real time. In this space, the constraints of our physical, bricks and mortar world and travel habits fade. And new opportunities and challenges emerge.

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READ HERE: https://www.webmd.com/a-to-z-guides/news/20220812/metaverse-medicine-doctor-patient-avatars-ahead

Cite: https://www.amazon.com/Dictionary-Health-Information-Technology-Security/dp/0826149952/ref=sr_1_5?ie=UTF8&s=books&qid=1254413315&sr=1-5

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DAILY UPDATE: Top Causes of Death, Narcan Saves Lives but Scientific Research Fraudulent as DJIA Tops 40,000

MEDICAL EXECUTIVE-POST TODAY’S NEWSLETTER BRIEFING

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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily

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Walgreens has released its own brand of naloxone, a medication that reverses the effects of an opioid overdose. Available online now, Walgreens Brand Naloxone HCl Nasal Spray comes with two doses for $34.99, about $10 cheaper than the name-brand version, Narcan. The over-the-counter medication will also be available in stores by the end of May in the pain aisle, according to a press release, making the life-saving nasal spray more accessible.

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Here’s where the major benchmarks ended:

  • The S&P 500 index rose 6.17 points (0.1%) to 5,303.27, up 1.5% for the week; the Dow Jones Industrial Average gained 134.21 points (0.3%) to 40,003.59, up 1.2% for the week; the NASDAQ Composite® ($COMP) lost 12.35 points (0.1%) to 16,685.97, up 2.1% for the week.
  • The 10-year Treasury note yield (TNX) rose more than 4 basis points to 4.42%, down about 8 basis points for the week.
  • The CBOE Volatility Index® (VIX) fell 0.43 to 11.99.

Among major companies, Nvidia (NVDA) dropped 2% Friday but still posted a 2.9% advance for the week ahead of the semiconductor leader’s quarterly earnings Wednesday. Among sectors, energy shares led gainers behind a 1% jump in WTI Crude Oil (/CL) futures. The small-cap Russell 2000® Index (RUT) ended little changed but still gained 1.7% for the week.

CITE: https://www.r2library.com/Resource

Fraudulent research papers have cost scientific journal publishers millions in lost revenue. (the Wall Street Journal)

CITE: https://tinyurl.com/2h47urt5

The 10 Top Causes of Adult Death in the U.S.A.

1.  Heart disease 267.2* 2.  Cancer 142.3 3.  Unintentional injuries 64.0 4.  COVID-19 44.5 5.  Stroke 39.5 6.  Chronic lower respiratory disease 34.3 7.  Alzheimer disease 28.9 8.  Diabetes 24.1  9   Kidney disease 13.8 10. Chronic liver disease and cirrhosis 13.8 Deaths per 100,000 population.

Source: Jeffrey Bendix, Medical Economics [5/15/24]

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PHYSICIANS BEWARE: Traditional Financial Planning “Rules of Thumb”

DOCTORS AND MEDICAL PROFESSIONALS BEWARE?

We ARE Different!

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By Dr. David E. Marcinko MBA CMP®

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  • While financial planning rules of thumbs are useful to people as general guidelines, they may be too oversimplified in many situations, leading to underestimating or overestimating an individual’s needs. This may be especially true for physicians and many medical professionals. Rules of thumb do not account for specific circumstances or factors occurring at a particular time, or that could change over time, which should be considered for making sound financial decisions.
  • Great Health Industry Resignation: https://medicalexecutivepost.com/2021/12/12/healthcare-industry-hit-with-the-great-resignation-retirement/

For example, in a tight job market, an emergency fund amounting to six months of household expenses does not consider the possibility of extended unemployment. I’ve always suggested 2-3 years for doctors. Venture capitalist lay-offs of physicians during the pandemic confirm this often criticized benchmark opinion of mine.

As another example, buying life insurance based on a multiple of income does not account for the specific needs of the surviving family, which include a mortgage, the need for college funding and an extended survivor income for a non-working spouse. Again a huge home mortgage, or several children or dependents, may be the financial bane of physician colleagues and life insurance.

CITE: https://www.r2library.com/Resource/Title/082610254

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EXAMPLES: Old/New Rules

  • A home purchase should cost less than an amount equal to two and a half years of your annual income. I think physicians in practice for 3-5 years might go up to 3.5X annual income; ceteras paribus.
  • Save at least 10-15% of your take-home income for retirement. Seek to save 20% or more.
  • Have at least five times your gross salary in life insurance death benefit. Consider 10X this amount in term insurance if young, and/or with several children or other special circumstances.
  • Pay off your highest-interest credit cards first. Agreed.
  • The stock market has a long-term average return of 10%. Agreed, but appreciated risk adjusted rates of return..
  • You should have an emergency fund equal to six months’ worth of household expenses. Doctors should seek 2-3 years.
  • Your age represents the percentage of bonds you should have in your portfolio. Risk tolerance and assets may be more vital.
  • Your age subtracted from 100 represents the percentage of stocks you should have in your portfolio. Risk tolerance and assets may still be more vital.
  • A balanced portfolio is 60% stocks, 40% bonds. With historic low interest rates, cash may be a more flexible alternative than bonds; also avoid most bond mutual funds as they usually never mature.

There are also rules of thumb for determining how much net worth you will need to retire comfortably at a normal retirement age. Here is the calculation that Investopedia uses to determine your net worth:

Compensation in the Physician Specialties: Mostly Stable - NEJM  CareerCenter Resources

RULES 72, 78 and 115: https://medicalexecutivepost.com/2022/01/30/the-rules-of-72-78-and-115/

INVITATION: https://medicalexecutivepost.com/2021/05/08/invite-dr-marcinko-to-your-next-big-event/

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Physician Electronic-Mail Bills

MY CHART”

By AMANDA SEITZ

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E-Mailing your Physician may Cost You like Your Attorneys!

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WASHINGTON (AP) — The next time you message your doctor to ask about a pesky cough or an itchy rash, you may want to check your bank account first — you could get a bill for the question.

Hospital systems around the country are rolling out fees for some messages that patients send to physicians, who they say are spending an increasing amount of time poring over online queries, some so complex that they require the level of medical expertise normally dispensed during an office visit. Patient advocates, however, worry these new fees may deter people from reaching out to their doctor and that they add another layer of complexity to the U.S. health care system’s already opaque billing process.

“This is a barrier that denies access and will result in hesitancy or fear to communicate and potentially harm patients with lower quality of care and outcomes at a much higher cost,” said Cynthia Fisher, the founder of Patient Rights Advocate, a Massachusetts-based nonprofit that pushes for hospital price transparency.

CITE: https://www.r2library.com/Resource/Title/082610254

The explosion of telehealth over the last three years — driven by the COVID-19 outbreak and relaxed federal regulations for online care — prompted many doctors to adopt more robust telecommunication with their patients. Consultations that once happened in an office were converted to computer or smart phone visits. And health care systems invited patients to use new online portals to message their doctors with a question at any time, American Medical Association president Jack Resneck Jr. told The Associated Press.

“When people figured out this is cool and could improve care, you saw hospitals and practice groups saying to patients, welcome to your portal … you can ping your physician with questions if you want,” Resneck said. “We found ourselves as physicians getting dozens and dozens of these a day and not having time built in to do that work.”

The charges vary for each patient and hospital system, with messages costing as little as $3 for Medicare patients to as much $160 for the uninsured. In some cases, the final bill depends on how much time the doctor spends responding.

READ HERE: https://my.clevelandclinic.org/online-services/mychart/messaging#msdynttrid=bAU8cKe-602S6wFIwSYop1KQswRcT2b2F5mRJ-92OEc

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VENTURE CAPITAL: Women’s Health Start-Ups

By Staff Reporters

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Women’s health startups are still closing multi million-dollar funding deals despite a challenging venture capital (VC) landscape in which VC dollars are on track to fall by 73% this year compared to last.

CITE: https://www.r2library.com/Resource

For example, in the last year, virtual maternity care program Pomelo Care raised $33 million in seed and Series A rounds led by Andreessen Horowitz; Caraway Health, a digital mental, physical, and reproductive health services platform, raised almost $17 million in a Series A round led by Maveron and GV (formerly Google Ventures); and Intrinsic, which acquires brands that make women’s health products, announced a $15 million equity fund raise (which is when a company raises money by selling its shares).

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PODCAST: RIP James Simons [Renaissance Technologies]

HEDGE FUND

By Staff Reporters

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“I did a lot of math. I made a lot of money, and I gave almost all of it away. That’s the story of my life.”

There are longer versions of the life story of Jim Simons, the legendary mathematician, quantitative investing pioneer, and philanthropist who just died at age 86, but his summary is pretty good.

In 1978, Simons started what would become his wildly successful hedge fund, Renaissance Technologies, where he used his mathematical savvy to deliver a performance that outpaced Warren Buffett and George Soros. Its signature fund averaged 66% annual returns.

With his wife, Marilyn Simons, he also started the Simons Foundation, which gave billions to causes they cared about—including, most recently, the Dublin–New York portals.

PODCAST: https://www.youtube.com/watch?v=QNznD9hMEh0

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The M1 and M2 Money Supply

By Staff Reporters

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DEFINITION: In macro-economics, the money supply (or money stock) refers to the total volume of currency held by the public at a particular point in time. There are several ways to define “money”, but standard measures usually include currency in circulation (i.e. physical cash) and demand deposits (depositors’ easily accessed assets on the books of financial institutions . The Central Bank [FOMC] of a country may use a definition of what constitutes legal tender for its purposes.

CITE: https://www.r2library.com/Resource

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Though there are a few variations of money supply, most economists tend to focus on M1 and M2. The former takes into account cash and coins in circulation, as well as demand deposits in checking accounts and traveler’s checks. In other words, money that’s either in your hand or can be accessed very easily.

Meanwhile, M2 accounts for everything in M1 and adds savings accounts, money market funds, and certificates of deposit (CDs) below $100,000. It’s money you have access to, but it takes a little extra effort to put this capital to work. It’s M2 money supply that’s raising eyebrows on Wall Street and making history.

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What’s of interest is what’s happened to M2 money supply over the trailing year. Following a peak of $21.7 trillion in July 2022, M2 has fallen to a fresh reading of $20.81 trillion, as of May 2023. Although the May reading was higher than April and broke a nine-month downtrend, we’ve still witnessed a 4.1% aggregate drop in M2 from its all-time high. 

Considering that M2 enjoyed a historic expansion during the pandemic, it’s certainly possible that a 4.1% decline can be shrugged off as nothing more than money supply reverting back to the mean. But history suggests otherwise.

Though history rarely repeats itself on Wall Street, it often rhymes. We haven’t seen a meaningful year-over-year decline in M2 money supply since the Great Depression in 1933.

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And so, based on what we’re seeing from M2 money supply, commercial bank lending, and domestic banks tightening their lending standards for C&I loans, the ingredients for a U.S. recession are most definitely there. Stock losses have, historically, been most pronounced in the months that follow the official declaration of a recession by the eight-economist panel of the National Bureau of Economic Research.

However, Wall Street’s performance is largely dependent on your investment time frame. If you’re patient, these and other potentially worrisome money metrics represent nothing more than temporary white noise.

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DAILY UPDATE: Sleep, Starbucks and Cell Phone Education

MEDICAL EXECUTIVE-POST TODAY’S NEWSLETTER BRIEFING

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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily

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SPONSORED BY: Marcinko & Associates, Inc.

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Happy Cinco de Mayo 2024

Starbucks – The coffee company known for consistently outperforming itself reported less-than-spectacular earnings this week, sending its stock plunging 12% on Tuesday evening last week on the news—nearly as much as when the company shut all its doors during Covid 19. For the first time since 2020, US same-store sales declined, falling 3% alongside a 7% decrease in foot traffic. Meanwhile, revenue fell 1.8% to $8.56 billion as sales in China—the chain’s second-biggest market—declined 11%, and Starbucks lowered its sales outlook for the year.

CITE: https://www.r2library.com/Resource

Educators have long pushed back against distraction machines (aka phones), with 77% of schools banning them in the classroom as of 2020, according to a National Center for Education Statistics survey. School time still overlaps with screen time: 97% of students are on their phones during school hours, according to a study by Common Sense Media, a nonprofit that informs parents about technology. While much of students’ phone use might be at lunch or recess, teachers complain that kids aren’t waiting for the bell to take a discreet peek at their screens.

CITE: https://tinyurl.com/2h47urt5

Creatine may counteract sleep deprivation. The dietary supplement all over your Instagram feed might one day help workers who have to do a lot on small amounts of sleep, like ER staff, first responders, and anyone sharing a house with a baby.

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THE CARTOON: Shrink

Cartoons on Topics in Psychiatry and Medicine

http://www.TheCartoonShrink.com

By Staff Reporters

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Emily Watters, M.D. is an adult psychiatrist. She lives and practices in the bay area. She works in both community psychiatry and in private practice. She loves to teach, especially through sketches and comics.

Questions contribute to understanding and you are welcome to reach out to her at: thecartoonshrink@gmail.com

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National Supply Chain Management Day: Health Care “White Paper”

By Staff Reporters

Dr. David Edward Marcinko MBA MEd CMP

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National Supply Chain Management Day is celebrated on April 29th every year to mark the binding importance of the global supply chain in the everyday lives of people. National Supply Chain Day brings all stakeholders together to share recent developments in the field. Introduced in 2020 by a Georgia-based packaging outlet, this holiday aims to raise awareness about the way a supply chain affects all of us, and how we can be better partners and benefactors of the global supply chain management system.

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One of the most iconic symbols of the COVID economy was the epic backlog of container ships waiting to dock at the ports of Los Angeles and Long Beach. At one point this year, that backup was longer than the line at Trader Joe’s on a Saturday, stretching 109 ships deep and almost 60 miles from the coast.

But now, the shipping situation is almost back to normal. As of last week, the number of ships waiting to drop off their goods stood at just four, according to the WSJ. Plus, the cost of sending a 40-foot container from Shanghai to LA has plummeted from its peak of more than $12,000 to almost $2,000, nearing its pre-COVID average.

The fact that goods are once again flowing smoothly through US ports is a hopeful sign that inflation, which was instigated in part by supply chain snarls, could start to abate.

CITE: https://www.r2library.com/Resource/Title/082610254

READ MORE: https://medicalexecutivepost.com/2011/06/09/supply-chain-management-in-healthcare

WHITE PAPER: https://medicalexecutivepost.com/wp-content/uploads/2011/06/scm-dr.-dem-sample.pdf

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EARTH DAY: Celebrate 2024!

CELEBRATE AND PREPARE

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Earth Day is an annual event on April 22nd to demonstrate support for environmental protection.

First held on April 22, 1970, it now includes a wide range of events coordinated globally by EARTHDAY.ORG (formerly Earth Day Network) including 1 billion people in more than 193 countries.[ The official theme for 2024 is “Planet vs. Plastics.” 2025 will be the 55th anniversary of Earth Day.

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16th NATIONAL: Healthcare Decision Day 2024

By Staff Reporters

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National Healthcare Decisions Day (NHDD) is an annual initiative celebrated on April 16th. Its purpose is to inspire, educate, and empower the public and healthcare providers about the importance of advance care planningNHDD encourages individuals to express their wishes regarding healthcare, and it emphasizes that providers and facilities should respect those wishes, whatever they may be.

Here are some key points about NHDD:

Let’s continue spreading awareness about advance care planning and making informed decisions about our health and well-being.

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Invite Dr. Marcinko to Speak at your Next Seminar, Webcast or Big Event in 2024?

Invite Dr. Marcinko

The Choice is Up to You

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Colleagues know that I enjoy personal coaching and public speaking and give as many talks each year as possible, at a variety of medical society and financial services conferences around the country and world.

These include lectures and visiting professorships at major academic centers, keynote lectures for hospitals, economic seminars and health systems, keynote lectures at city and statewide financial coalitions, and annual keynote lectures for a variety of internal yearly meetings.

 Topics Link: imba-inc-firm-services

My Fond Farewell to Tuskegee University

And so, we appreciate your consideration.

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DOCTORS FEELING WEALTHY: How Much is [Really] Enough?

By Staff Reporters

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What does wealth mean to you?

In a recent survey by Edelman Financial Engines, 57% of respondents said they’d feel wealthy if they had $1 million in the bank. But for many people, like doctors, that may not be enough.

Among those with $500,000 and $3 million in assets, 53% said it would take over $3 million in the bank for them to feel wealthy, and 33% said it would take over $5 million. Given that these are amounts some people will never even come close to amassing in their lifetimes, it may be hard to wrap your head around these answers.

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DAILY UPDATE: March Round-Up as Stocks End their Best First Quarter in Five Years

By Staff Reporters

APRIL FOOL’S DAY

April Fools’ Day customs date back to at least Renaissance Europe, but it’s likely the tradition originated long before then. Some historians have linked April Fools’ Day to the ancient Roman festival of “Hilaria,” where at the end of March, people would come together to commemorate the resurrection of the god Attis. It was a celebration of renewal in which revelers would dress up in disguises and imitate others.

It’s also possible that the medieval celebration of the Feast of Fools, where a mock bishop or pope was elected and church customs were parodied, could have inspired the day.

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Stocks had their best Q1 in five years. The S&P 500 ended Thursday—the last trading day of the quarter—up by more than 10%, marking its best start to a year since 2019.

The AI craze, record corporate profits, and optimism around cooling inflation are all contributing to the stock boom. The economy got more good news yesterday when the Stocks had their best Q1 in five years reported that several key gauges, including GDP and consumer spending, grew in Q4 of last year.

And, that’s not all: Home sales bounced back after a January slump, jobless claims fell, and advertisers raised their full-year forecast. Consumer sentiment is now at its highest level since 2021.

CITE: https://www.r2library.com/Resource

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SPRING: Automobile Detailing Tips for Neurotic Docs

Use a Pro -or- DIY? By Dr. David E. Marcinko MBADr. David E. Marcinko MBA

It’s never a source of pride stepping out of a dirty car or truck, especially for image conscious doctors. But, keeping your vehicle looking like new, for the doctor’s parking lot, is tough work. Sure, you may take it through the drive-thru car wash every now and then, but that isn’t the deep cleaning that your car deserves.

All in the Details

Detailing, on the other hand, is promised to give your beloved vehicle that ‘new-car’ feeling all over again. It isn’t easy work, but the results are amazing. While you could detail your car at home, is it really worth it? Let’s take a look at why letting the pros detail your vehicle is the way to go – or – not!

Working at the Car Wash

When you wash your vehicle at a drive-thru car wash, you may be doing more harm than good. If the car wash has brushes or pieces of cloth that scrub your vehicle as it goes through, these components can easily scratch your car’s finish. All of the bits of dirt from cars before can be trapped in the cloth   and brushes, and as they scrub your vehicle, they act as sandpaper, permanently marring your paint.

One step better is hand washing your car at home, but even then, you must be careful to not just become a humanized version of the car wash. Using two buckets is a good start, with one bucket being a rinse bucket to remove the dirt from your sponge, and the other containing the soap.

car

SOAP Suds – Not SOAP Notes

Also, be careful of the type of soaps and car care products being used. The interior and exterior cleaners found at the local parts store are often of decent quality, but they aren’t always the best, and they must be used properly. Even then, for a normal car owner, detailing a car can become an all-day task, sometimes with less than perfect results.

Don’t forget to use a clay bar or brick followed by your favorite Carnuba wax, too.

XJ-V8-LWB

Jaguar front seat

My Jaguar's engine after a steam

The Pros

So, why should you let the pros handle your detailing needs? They should know exactly what specialty products are right for your vehicle to get the perfect results every time. And, they know the techniques that will yield showroom-finish results while you don’t have to even touch your car.

And, while you won’t want to clean out all the dried soda, coffee stains, or leftover cheeseburger wrappers from under your seat, they will gladly do it for you – for a price.

Imagine

Just picture getting into a blindingly shiny, clean vehicle with an interior that looks equally as pristine. No more purchasing all kinds of car care products that don’t deliver results. No more spending hours in the driveway getting soaked and frustrated. No more wasted time. Pros know what it takes to detail your vehicle to concourse standards.

But then, it is just a job for them. It is a labor of love for me. Am I neurotic or compulsive?

More:

Assessment

My near showroom and mint conditioned 2000 Jaguar XJ-V8-L is a full-size luxury sedan, offers sporting drive characteristics, mixed with a classic style and interior comfort. It was available in multiple trims which all came very well equipped with upscale amenities.

And, this extended wheelbase version offers much more rear seat leg room for long and winding Georgia road trips. The standard steel engine [not nikasil] in this XJ is a 4.0L V8 which produces 290 hp. The upper and lower timing chain tensioners are original, second generation metal, not plastic.

There is also a supercharged version of this vehicle which bumps output to an impressive 370 hp. Even with all of its power and weight, my XJ-8-L is still rated at over 20 mpg on the highway. Ammenities and upgrades include a mobile phone, Magellan GPS, LoJack theft recovery system, CD and MP-3 players, with internal and external cable antenna for satellite radio.

What a Cat? She is my third favorite female after my intelligent and beautiful wife, and smart and lovely daughter.

Conclusion

Are you a DIYer, like me? Nothing says you care more than doing it yourself.

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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DAILY UPDATE: Good Friday’s Impressive First Quarter Stock Market Returns

By Staff Reporters

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The stock market will be closed Friday, March 29th, for Good Friday. While Good Friday is a stock market holiday, it is not a federal holiday. As a result, the February Personal Consumption and Expenditures (PCE) Price Index will be released this Friday morning.

Yesterday, on the final trading session of March and the first quarter, the returns for major stock indexes are impressive, with the Dow Jones Industrial Average up 5% this quarter or 2,000 points and the S&P 500 and the tech-heavy NASDAQ up 11% apiece. Stock superlatives for 2024’s opening stretch are numerous, including each of the three indexes setting respective all-time highs and the benchmark S&P heading toward its best first-quarter return since 2019 and its second consecutive quarter of double-digit percentage gains since 2011-12.

CITE: https://www.r2library.com/Resource

Here’s where the major benchmarks ended Thursday:

  • The S&P 500 index added 5.86 points (0.1%) to 5,254.35, up 0.4% for the week; the Dow Jones Industrial Average climbed 47.29 points (0.1%) to 39,807.37, up 0.8% for the week; the NASDAQ Composite lost 20.06 points (0.1%) to 16,379.46, down 0.3% for the week. 
  • The 10-year Treasury note yield rose one basis point to just under 4.21%.
  • The CBOE Volatility Index® (VIX) rose 0.22 to 13.00.

For the month, the S&P 500 index gained 3.1%, the Dow Jones Industrial Average rose 2.1%, and the NASDAQ Composite added 1.8%. For the quarter, the three indexes rose 10.3%, 5.6%, and 9.2%, respectively.

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A Brief Historical Review of Behavioral Finance and Economics

By Related Influential Thought-Leaders

  • Dr. Brad Klontz CSAC CFP®
  • Dr. Ted Klontz PsyD
  • Dr. Eugene Schmuckler MBA MEd CTS
  • Dr. Kenneth Shubin-Stein FACP CFA
  • Dr. David Edward Marcinko MEd MBA CMP™

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doctor

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James O. Prochaska PhD, Professor of Psychology and Director of the Cancer Prevention Research Center at the University of Rhode Island, developed the Trans-Theoretic Model of Behavior Change [TTM] which has been evolving since in 1977. Nominated as one of the five most influential authors in Psychology, by the Institute for Scientific Information and the American Psychological Society, Dr. Prochaska is author of more than 300 papers on behavior change for health promotion and disease prevention.

TTM Stages of Change

In his Trans-Theoretical Model, behavior change is a “process involving progress through a series of these stages:

  • Pre-Contemplation (Not Ready) – “People are not intending to take action in the foreseeable future, and can be unaware that their behavior is problematic”
  • Contemplation (Getting Ready) – “People are beginning to recognize that their behavior is problematic, and start to look at the pros and cons of their continued actions”
  • Preparation (Ready) – “People are intending to take action in the immediate future, and may begin taking small steps toward behavior change”
  • Action – “People have made specific overt modifications in changing their problem behavior or in acquiring new healthy behaviors”
  • Maintenance – “People have been able to sustain action for a while and are working to prevent relapse”
  • Termination – “Individuals have zero temptation and they are sure they will not return to their old unhealthy habit as a way of coping”

Relapse

In addition, researchers conceptualized “relapse” (recycling) which is not a stage in itself but rather the “return from Action or Maintenance to an earlier stage.” In medical care, these stages of behavior change have applicability to anti-hypertension and lipid lowering medication use, as well as depression prevention, weight control and smoking cessation.

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Psychology

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Uniting Psychology and Financial Behavior

More recently, validating the emerging alliance between psychology (human behavior) and finance (economics) are two Americans who won the Royal Swedish Academy of Science’s 2002 Nobel Memorial Prize in Economic Science. Their research was nothing short of an explanation for the idiosyncrasies incumbent in human financial decision-making outcomes.

Enter Kahneman and Smith

Daniel Kahneman, PhD, professor of psychology at Princeton University, and Vernon L. Smith, PhD, professor of economics at George Mason University in Fairfax, Va., shared the prize for work that provided insight on everything from stock market bubbles, to regulating utilities, and countless other economic activities. In several cases, the winners tried to explain apparent financial paradoxes.

For example, Professor Kahneman made the economically puzzling discovery that most of his subjects would make a 20-minute trip to buy a calculator for $10 instead of $15, but would not make the same trip to buy a jacket for $120 instead of $125, saving the same $5.

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in vitro and in-vivo Economics

Initially, in the 1960’s, Smith set out to demonstrate how economic theory worked in the laboratory (in vitro), while Kahneman was more interested in the ways economic theory mis-predicted people in real-life (in-vivo). He tested the limits of standard economic choice theory in predicting the actions of real people, and his work formalized laboratory techniques for studying economic decision making, with a focus on trading and bargaining.

Later, Smith and Kahneman together were among the first economists to make experimental data a cornerstone of academic output. Their studies included people playing games of cooperation and trust, and simulating different types of markets in a laboratory setting. Their theories assumed that individuals make decisions systematically, based on preferences and available information, in a way that changes little over time, or in different contexts.

University of Chicago

By the late 1970’s, Richard H. Thaler, PhD, an economist at the University of Chicago also began to perform behavioral experiments further suggesting irrational wrinkles in standard financial theory and behavior, enhancing the still embryonic but increasingly popular theories of Kahneman and Smith.

Laboratory

Other economists’ laboratory experiments used ideas about competitive interactions pioneered by game theorists like John Forbes Nash Jr., PhD, who shared the Nobel in 1994, as points of reference.

Assessment

But, Kahneman and Smith often concentrated on cases where people’s actions departed from the systematic, rational strategies that Nash envisioned. Psychologically, this was all a precursor to the informal concept of life or holistic financial planning. Kahneman was awarded the Medal of Freedom, by President Barack Obama, on November 20, 2013.

READ: Behavioral Economics and Psychology DEM

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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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners(TM)

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RIP: Daniel Kahneman PHD

NOBEL PRIZE WINNER AND FATHER OF BEHAVIORAL ECONOMICS

By Staff Reporters

DEFINITION: According to Wikipedia, behavioral economics is the study of the psychological, cognitive, emotional, cultural and social factors involved in the decisions of individuals or institutions, and how these decisions deviate from those implied by classical economic theory.

Behavioral economics is primarily concerned with the bounds of rationality of economic agents. Behavioral models typically integrate insights from psychology, neuroscience and microeconomic theory. The study of behavioral economics includes how market decisions are made and the mechanisms that drive public opinion.

Behavioral economics began as a distinct field of study in the 1970s and ’80s, but can be traced back to 18th-century economists, such as Adam Smith, who deliberated how the economic behavior of individuals could be influenced by their desires.

The status of behavioral economics as a subfield of economics is a fairly recent development; the breakthroughs that laid the foundation for it were published through the last three decades of the 20th century. Behavioral economics is still growing as a field, being used increasingly in research and in teaching.

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Daniel Kahneman PhD, the father of behavioral economics, died yesterday at age 90 years old. He’s best known for applying psychology to economics and uncovering biases and mental shortcuts that make people act irrationally, as he chronicled in his best-selling book Thinking, Fast and Slow.

Kahneman, along with his long-time collaborator and friend Amos Tversky PhD, developed “prospect theory,” or loss-aversion theory, which earned him the Nobel Prize in Economics in 2002 (which he shared with fellow economist Vernon Smith). The idea is that people value losses and gains differently, so we feel more bad about losing $100 than we feel good about making the same amount. He applied this theory to investors, who had previously been considered rational decision-makers. It shows up elsewhere, too—for example, golfers putt better when they’re facing the loss of a stroke than when they might gain one.

Two other biases he identified include:

  • The “peak-end rule” that people remember an experience primarily based on how they felt at its most intense moment and the final part of it. It’s why you consider a whole vacation good if the last day was good—or the opposite.
  • The conjunction fallacy where people erroneously think the probability of two things being true is more likely than just one thing, which the famous “Linda the Bank Teller” problem illustrates.

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CRM: Patient Relations Management and Concierge Medicine

Characteristics of a Retainer or Cash-Based Practice

By DeeVee Devarakonda; MBA [Former CMO of Quaero, Inc]

By Dr. David Edward Marcinko; MBA http://www.CertifiedMedicalPlanner.org

Calendar Calculator

A young concierge medical practice is a business with challenges in these Customer [Patient] Relationship Management’s [CRM] areas that are critical for success.

Areas of Most Challenge

Maturity of Processes:

Processes are often associated with bureaucracy or stuffy hierarchical healthcare systems that are anathema to emerging concierge medical practices. At small practices, doctors are often owners who fiercely pride themselves on flat structures, autonomy and flexibility. However, processes are imperative to conduct a streamlined practice that can be woven around a CM culture that still ensures practice business is conducted in a systematic manner.

Organization Structure:

Young concierge medical practices have challenges managing growth while grappling to incorporate an organization structure that promotes the elite private practice culture.

Multi-tasking, rapidly growing work places:

Young CM practices are often characterized by employees who multi-task and assume several roles to make their resources stretch farther. Especially in the current healthcare reform climate, young practice employees take up a broader set of responsibilities. In addition, as young private CM practices grow, they may become anguished with a growing office workplace that may not be equipped with an evolving infrastructure to cope. They have a fierce need to carefully control growth with tightly managed resources.

Changing business needs and strategy:

In an era after the golden age of traditional medicine, profitability is critical for emerging concierge practices. It is imperative to be nimble and change marketing strategies as socio-political and competitive climates dictate. A good C[P] RM system is tightly integrated, but loosely coupled, to allow CM practices to communicate appropriately with patients.

Little room for Slack:

Small concierge medical practices do not have as much established name-brand equity as larger, established practices of any model type, and patients are less willing to tolerate mistakes. Concierge practices have to run a much tighter ship and build impeccable patient experiences.

Fierce Competition:

The cash or retainer medicine landscape today looks very different from just five years ago. Competition is becoming fierce and practices are fighting for mindshare and patients. Young practices are competing with older concierge practices – large traditional practices, micro-practices, behemoth healthcare systems, enterprise-wide medical corporations and every other practice model in-between – to attract and retain patients with private resources.

Assessment

The above characteristics form the basis of a compelling strategy to embrace C[P]RM and streamline patient relationships and cash revenue opportunities. Concierge practices still need to build scalable marketing programs that can easily ramp up and down effortlessly as needs and economic environments demand. But, they do need to establish marketing metrics and processes that can demonstrate the Return on Investment (ROI) on their CRM, and marketing programs, and for getting critical cash-paying patient buy-in.

Related link: https://healthcarefinancials.wordpress.com/2009/04/28/defining-and-understanding-%e2%80%9cboutique-medicine%e2%80%9d/

MORE: https://medicalexecutivepost.com/2009/10/30/return-on-investment-calculations-for-concierge-medical-practice-marketing-initiatives/

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PHYSICIANS: www.MedicalBusinessAdvisors.com
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HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com

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WHAT IS THE “LUXURY PRODUCT” ECONOMIC PARADOX?

WHAT IS THE “LUXURY PRODUCT” ECONOMIC PARADOX?

By Dr. David Edward Marcinko MBA

Courtesy: http://www.CertifiedMedicalPlanner.org

The more expensive something is – the less likely you are to use it. This relationship between price and product utility is graphed as an “inverted U.”

CITE: https://www.r2library.com/Resource/Title/082610254

So, super car Ferraris sit in garages; but Fords get driven.

ESSAY: https://medicalexecutivepost.com/2014/01/08/the-jaguar-touring-sedan-one-of-the-finest-luxury-cars-built-yesterday/

My own Jaguar touring sedan illustrates this paradox.

dem-jag

ESSAY: https://medicalexecutivepost.com/2018/09/02/my-jaguar-mechanic-vs-doctor-story/

This theory may even be valid for services; as well as products?

THINK: Plastic and cosmetic surgery?

Assessment: Your thoughts and comments are appreciated.

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Product DetailsProduct DetailsProduct Details

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DAILY UPDATE: Senior Care Facility Bankruptcies Up with Recession Life Spans?

By Staff Reporters

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Financial hardship has led dozens of operators of senior facilities to file for bankruptcy over the past three years, with 13 companies filing petitions in 2021, 12 debtors filing in 2022 and 15 more in 2023, according to Gibbins Advisors.

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Notable Chapter 11 filings over the past year have included Evangelical Retirement Homes of Greater Chicago, which filed Chapter 11 in the U.S. Bankruptcy Court for the Northern District of Illinois in June 2023 to sell its assets at auction. Also, Windsor Terrace Health, an operator of 32 nursing homes in California and three in Arizona, filed its petition in the U.S. Bankruptcy Court for the Central District of California in August 2023 listing $1 million to $10 million in assets and liabilities and unable to pay its debts.

CITE: https://www.r2library.com/Resource/Title/082610254

More recently, Magnolia Senior Living, an operator of four facilities in Georgia, filed for Chapter 11 protection on March. 19 in the U.S. Bankruptcy Court for the Northern District of Georgia.

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The Great Recession of 2008 had a lot of downsides: People lost homes, jobs, and retirement savings, had their careers derailed, and were forced to learn what the heck synthetic collateralized debt obligations are. But according to recent research, it also made people in the US live longer.

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Happy SAINT URHO’S Day 2024

Happy Saint Urho’s Day on March 16th!

[By Staff reporters]

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Saint Urho is a fictional saint of Finland, created and elaborated by Finnish Americans.

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Finnish Americans comprise Americans with ancestral roots from Finland or Finnish people who emigrated to and reside in the United States. The Finnish American population numbered about 600,000 in the 1950s. To celebrate their heritage and pre-empted and extend celebrations of St. Patrick’s Day the day before.

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NOTE: Blue grapes denoted Finnish wine. Just as a green 4-leaf clover represented “good luck” on St. Patrick’s Day.

MORE: https://en.wikipedia.org/wiki/Saint_Urho

Assessment: Your thoughts and comments are appreciated.

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What is ZENO’S Paradox?

By Staff Reporters

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Zeno of Elea was a pre-Socratic Greek philosopher of Magna Graecia and a member of the Eleatic School founded by Parmenides. Aristotle called him the inventor of the dialectic. He is best known for his paradoxes, which Bertrand Russell described as “immeasurably subtle and profound”

Now, Zeno’s paradoxes are a set of philosophical problems generally thought to have been devised to support Parmenides’ doctrine that contrary to the evidence of one’s senses, the belief in plurality and change is mistaken, and in particular that motion is nothing but an illusion.

CITE: https://www.r2library.com/Resource/Title/082610254

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Can you solve Zeno's paradox? - Brain Teaser - YouTube

READ: https://en.wikipedia.org/wiki/Zeno%27s_paradoxes

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DAILY UPDATE: Boeing Down as Stocks End Mixed

By Staff Reporters

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Stocks were mixed yesterday as investors looked ahead to what today’s government inflation data will bring. Boeing took a dive and the stock is down 24% this year.

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) fell 5.75 points (0.1%) to 5,117.94; the Dow Jones Industrial Average® ($DJI) gained 46.97 points (0.1%) to 38,769.66; the NASDAQ Composite® (COMP) declined 65.84 points (0.4%) to 16,019.27.
  • The 10-year Treasury note yield (TNX) was up almost 1 basis point to 4.096%.
  • The CBOE Volatility Index® (VIX) rose 0.45 to 15.19. 

Chip maker weakness sent the Philadelphia Semiconductor Index (SOX) down 1.36% Monday following a 3.5% drop Friday, when the benchmark initially set a record intra-day high above 5,217. The index is still up 17% this year.

Other sectors outside of tech extended recent strength, including the Dow Jones Utility Index ($DJU), which gained for the fourth straight day and ended at its highest level since February 1. The S&P Energy Index ($SP500#10) reached its highest level since late October, while the S&P 500 Materials Index ($SP500#15) advanced over 1% to its highest post in nearly two years.

CITE: https://www.r2library.com/Resource

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DAILY UPDATE: UnitedHealth Group and Fidelity Investments Suffer Ransomware Attacks as Stock Markets Crash

By Staff Reporters

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According to Fidelity, in documents filed with the Maine attorney general’s office, miscreants “likely acquired” information about 28,268 people’s life insurance policies after infiltrating Infosys.

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Criminals have probably stolen nearly 30,000 Fidelity Investments Life Insurance customers’ personal and financial information — including bank account and routing numbers, credit card numbers and security or access codes — after breaking into Infosys’ IT systems.

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Healthcare providers across the United States are struggling to get paid following the week-long ransomware outage at a key tech unit of UnitedHealth Group, with some smaller medical providers saying they are already running low on cash.

And, the nation’s health-care system continues to reel from a cyberattack that has crippled payments for tens of thousands of organizations as Daniel Gilbert writes in The Post.

CITE: https://www.r2library.com/Resource

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) dropped 52.30 points (1.0%) to 5,078.65; the Dow Jones Industrial Average decreased 404.64 points (1.0%) to 38,585.19; the NASDAQ Composite fell 267.92 points (1.7%) to 15,939.59.
  • The 10-year Treasury note yield (TNX) fell about 8 basis points to 4.137%.
  • The CBOE Volatility Index® (VIX) rose 0.97 to 14.46.

With chip makers under pressure, the Philadelphia Semiconductor Index (SOX) fell 2.1%, reversing part of a recent surge to a record high. Consumer discretionary and real estate shares also ranked among the weakest performers Tuesday. Banks were one of the few industries to buck the broader weakness, perhaps supported by further declines in Treasury yields. The 10-year Treasury note yield (TNX) almost fell to a four-week low near 4.11%. The KBW Regional Banking Index (KRX) jumped 4.3%. 

In other markets, bitcoin plunged almost 10% after climbing earlier Tuesday to a record above $69,000. The cryptocurrency had rallied as much as 36% over the last week of February. 

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DAILY UPDATE: Inflation and “Bumble” Down as Stock Markets Rise and UHC Hackers ID’d

By Staff Reporters

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The Bumble dating app said this week that it plans to lay off 30% of its staff (about 350 employees) after a Q4 earnings report highlighted that profits are ghosting the company and Gen Z considers dating apps a turnoff. Bumble CEO Lidiane Jones, who took over in November when founder Whitney Wolfe Herd stepped down, said the cuts would save the company around $55 million. The company plans to invest in relaunching the app next quarter with new safety and AI features to entice all those looking for love.

CITE: https://www.r2library.com/Resource

Here’s where the major benchmarks ended:

  • The S&P 500 index rose 26.51 points (0.5%) to 5,096.27, up 5.2% for the month; the Dow Jones Industrial Average® (DJI) added 47.37 points (0.1%) to 38,996.39, up 2.2% for the month; the NASDAQ Composite gained 144.18 points (0.9%) to 16,091.92, up 6.1% for the month.
  • The 10-year Treasury note yield (TNX) fell about 3 basis points to 4.244%.
  • The CBOE Volatility Index® (VIX) dropped 0.44 to 13.40.

Chipmaker shares were among the strongest performers Thursday, helping lift the Philadelphia Semiconductor Index (SOX) 2.7% to a record high close. Banks and food and beverage industries were also firm. Small-cap stocks also extended a recent upswing. The Russell 2000® Index (RUT) erased much of an initial surge to a 22-month high but still finished with a 0.7% advance, gaining 5.5% for the month.

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Hackers that allegedly caused the UnitedHealth Group cyberattack reportedly posted on the dark web that they stole personal data and the records of “millions” of patients.

In a now-deleted post, the Blackcat ransomware group – also known as ALPHV or Noberus – said it stole several terabytes of data from UnitedHealth, which includes medical insurance and health data, Reuters reported, citing screenshots of the post.

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DAILY UPDATE: Down Down Third Day

By Staff Reporters

HAPPY LEAP YEAR DAY

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Stocks fell yesterday, while bitcoin almost touched an all-time high after surging 20% in five days as its halving approaches. UnitedHealth dipped on reports that antitrust regulators are investigating the massive insurer.

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Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) fell 8.42 points (0.2%) to 5,069.76; the Dow Jones Industrial Average lost 23.39 points (0.1%) to 38,949.02; the NASDAQ Composite® (COMP) declined 87.56 points (0.6%) to 15,947.74.
  • The 10-year Treasury note yield (TNX) fell about 5 basis points to 4.264%.
  • The CBOE Volatility Index® (VIX) rose 0.39 to 13.82.

Regional banks and semiconductors were among the weakest performers Wednesday, and communications services and health care shares were also soft. Real estate shares bucked the weakness in many sectors to post firm gains. Food and beverage and consumer discretionary sectors also firmed. In other markets, WTI crude oil (/CL) futures rose to a three-month high at $79.62 per barrel before ending lower after the Energy Information Administration reported a rise in U.S. inventories.

CITE: https://www.r2library.com/Resource

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DAILY UPDATE: Consumer Spending Down While CVS Earnings Up

By Staff Reporters

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To See What’s Next For Consumer Spending, Take a Closer Look at High ...
  • Stat: 0.8%. That’s how much consumer spending fell in January 204—a much bigger dip than expected (CNBC).

CITE: https://www.r2library.com/Resource

CVS reported strong results for its healthcare segment in 2023, showing a 10.2% increase in revenue compared to the prior year. Still, executives lowered the segment’s 2024 guidance in anticipation of rising medical costs, according to earnings released this month.

Finally, the US stock market reopens today after the long weekend, and everyone’s still talking about the Magnificent Seven. That’s because, according to a new report from Deutsche Bank, profits at these seven tech giants are greater than the profits of all publicly traded companies in nearly every G20 country. And in terms of market value, they’d be the second-largest national stock exchange in the world. Goldman Sachs sees this party lasting all night: It raised its 2024 target for the S&P 500 for the second time.

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META: Stock Up!

By Staff Reporters

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2022 was a rough year for Meta. Inflation and high interest rates dinged the company, and Apple made changes to its operating system that made it harder for brands to target customers, and rival TikTok kept on growing. Meta’s stock price fell more than 60%.

But the company saw a dramatic turnaround of its fortunes in 2023. Its full-year net income rose 69% over 2022 to $39.1 billion. Its diluted earnings per share went from $8.59 to $14.87, a 73% YoY jump. Q4 2023 was especially good for Meta: Its net income more than tripled and its revenue rose 25%.

And for the first time, the company gave out cash dividends to investors. Technology analyst Ben Barringer described the move to CNBC as a “symbolic moment” that showed Meta viewed itself as a “mature, grown-up business.”

Meta’s success, though, required paring down. It reduced operating expenses in 2023 by laying off some 20,000 people, slashing its headcount by 22%. It spent $2.5 billion on “facilities consolidation,” or reducing its office footprint. The changes were part of a plan to make the company “leaner” so it would be better able to weather volatility over the next five to 10 years, CEO Mark Zuckerberg said.

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AMERICAN DREAM: Now Costs $3.4 Million?

By Staff Reporters

SPONSOR: http://www.MARCINKOASSOCIATES.com

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The classic “American Dream” including two kids, a house, and car now costs more than most folks make in a lifetime. According to Investopedia.

READ HERE: https://www.investopedia.com/the-american-dream-now-costs-over-usd3-million-8409951

PHYSICIAN SPECIFIC ASSISTANCE AND RESOURCES: https://marcinkoassociates.com/financial-planning/

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SNAP: Employee Staff Layoffs

By Staff Reporters

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According to Wikipedia, Snapchat is an American multimedia instant messaging app and service developed by Snap Inc., originally Snapchat Inc. One of the principal features of Snapchat is that pictures and messages are usually only available for a short time before they become inaccessible to their recipients. The app has evolved from originally focusing on person-to-person photo sharing to presently featuring users’ “Stories” of 24 hours of chronological content, along with “Discover”, letting brands show ad-supported short-form content. It also allows users to store photos in a password-protected area called “my eyes only”. It has also reportedly incorporated limited use of end-to-end encryption, with plans to broaden its use in the future.

Snapchat was created by Evan Spiegel, Bobby Murphy, and Reggie Brown, former students at Stanford University. It is known for representing a mobile-first direction for social media, and places significant emphasis on users interacting with virtual stickers and augmented reality objects. In July 2021, Snapchat had 293 million daily active users, a 23% growth over a year. On average more than four billion Snaps are sent each day. Snapchat is popular among the younger generations, particularly those below the age of 16, leading to many privacy concerns for parents.

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So yesterday, Snap laid off 10% of its staff. The job cuts, which amount to roughly 540 people, are Snap’s largest since 2022. Ad revenue at the social media giant has slowed since Apple changed its privacy policy, making it harder for advertisers to access user data.

Meta also suffered from the changes but has rebounded after the company laid off thousands of workers as part of CEO Mark Zuckerberg’s “year of efficiency.” Snap’s layoffs prolong a ghastly start to 2024 for the tech industry, which has endured 32-K job cuts already this year, as per the Layoffs.

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INVITE: Dr. Marcinko to Speak at your Next Big Event in 2024?

Invite Dr. Marcinko

The Choice is Up to You

http://www.MARCINKOASSOCIATES.com

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Colleagues know that I enjoy personal coaching and public speaking and give as many talks each year as possible, at a variety of medical society and financial services conferences around the country and world.

These include lectures and visiting professorships at major academic centers, keynote lectures for hospitals, economic seminars and health systems, keynote lectures at city and statewide financial coalitions, and annual keynote lectures for a variety of internal yearly meetings.

 Topics Link: imba-inc-firm-services

My Fond Farewell to Tuskegee University

And so, we appreciate your consideration.

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JANUARY: Doctors Beware Divorce Month

OVERHEARD IN THE ADVISOR’S LOUNGE
[January is Divorce Month]

SPONSOR: http://www.MARCINKOASSOCIATES.com

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January is nick-named the “divorce month” because of an uptick in activity for divorce lawyers after the New Year. Yet, January to April 15th is also a very low period in terms of people inquiring about divorce mediation. The reason is that couples generally want to know where they stand financially before pursuing divorce.

CITE: https://www.r2library.com/Resource

And, with the economy improving in 2024, people may be less inclined to wait. While anecdotal evidence abounds, hard figures are more elusive. An analysis of national divorce filings between 2008 and 2011 by legal information website FindLaw.com found a spike in January and a gradual rise until a peak in late March.

Mediation: https://medicalexecutivepost.com/2023/08/12/a-step-wise-approach-to-the-divorce-mediation-process-for-doctors/

UPDATE 2024: The exclusivity of marriage in the contemporary era has dire, compounding consequences across generations. As researchers Shelly Lundberg, Robert A. Pollak and Jenna Stearns document, in 1960, people with and without college degrees married and formed families in a similar manner, but today, just 11% of childbirths for those with college degrees are non-marital, while 58% of childbirths for those without are. This cleavage makes possible what the Brookings Institution’s Melissa Kearney describes as “two-parent privilege,” an emerging phenomenon through which well-off couples transmit educational and economic advantages to their children. Viewed from this angle, it should not surprise us that many Americans think the rich are galloping ever further ahead.

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ENTREPRENEURS: Physicians and Medical Professionals

By Dr. David Edward Marcinko MBA

SPONSOR: http://www.MARCINKOASSOCIATES.com

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SERVING ALL PHYSICIANS AND HEALTHCARE PROVIDERS

At D.E. Marcinko & Associates our clients traditionally are medical entrepreneurs that include physicians [MD, MBBS, DPM and DO], dentists [DDS and DMD], Registered Nurses [RNs], Certified Registered Nurse Anesthetists [CRNA], Physician Assistants [PA] and Nurse Practitioners [NP]. A growing cohort of clients include medical technologists, physical, speech and occupational therapists, etc.

The above healthcare providers are naturally segregated into three career tranches: 1. New practitioners, 2] Mid-Career practitioners and 3] Mature practitioners. We serve them all and are fully prepared for any special needs situation that may arise in any tranche [death, divorce, adverse risk event and/or bankruptcy, reorganization, etc].

At D. E. Marcinko & Associates, our colleagues are located throughout the United States. They are considering the sale, purchase, strategic or operational improvement, merger, acquisition and/or other business or personal financial planning transaction. Our guidance helps doctors, nurses, practices, clinics, ambulatory surgery centers, outpatient wound care facilities realize their ultimate goals.

We can do it all for you, or educate and guide do it yourself colleagues to reach the best possible outcomes.

READ MORE: https://marcinkoassociates.com/welcome-medical-colleagues/

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PODCAST: Hospital Medicare Break-Even Plans

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By Eric Bricker MD

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What is MEDICAL AID [Assistance] in DYING?

MAiD

By Staff Reporters

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Medical Assistance in Dying (MAiD) by Pam Dominguez

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Medical Aid in Dying [MAiD] is an end-of-life option for people who are terminally ill. Terminally ill means you have an illness, disease, or health condition that, according to doctors, you will likely die from within 6 months. If you’re eligible for MAiD, you can ask a doctor who participates in MAiD to prescribe life-ending medications. You can take these medications at a time of your choosing.

Medical Aid in Dying (MAID) is legal in eleven jurisdictions in the United States: California, Colorado, District of Columbia, Hawaii, Maine, Montana, New Jersey, New Mexico, Oregon, Vermont, and Washington.

But, only patients can make a request for MAiD. Family members, caregivers, and health care agents cannot request MAiD for a patient.

READ: http://tinyurl.com/yes7wbzm

NOTE: If you are struggling with thoughts of suicide or worried about a friend or loved one, call or text the Suicide & Crisis Lifeline at 988 for free, confidential emotional support 24 hours a day, seven days a week.

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DAILY UPDATE: Mobile Payment Fraud Up as Economy Grows and Stock Markets Extend Gains

By Staff Reporters

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Alarmed by a surge in fraud draining bank accounts through popular mobile payment apps like Venmo, Cash App and Zelle, Manhattan District Attorney Alvin Bragg, Jr., has sent scathing letters to the CEOs of each company, demanding immediate action to protect consumers.

In the letters, Bragg described the crimes as involving an unauthorized user gaining access to unlocked devices, then stealing significant sums of money from bank accounts by making purchases with the mobile payment apps and using financial information from them to open new accounts.

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And, the U.S. economy expanded at a 3.3% annualized pace in the final quarter of 2023, the Commerce Department said on Thursday.

Why it matters: It’s much stronger growth than economists expected and caps a year of economic resilience as the nation avoided a projected recession.

Here’s where the major benchmarks ended:

  • The S&P 500 index rose3.95 points (0.1%) to 4,868.55; the Dow Jones Industrial Average® (DJI) lost 99.06 points (0.3%) to 37,806.39; the NASDAQ Composite gained 55.97 points (0.4%) to 15,481.92.
  • The 10-year Treasury note yield (TNX) increased about 4 basis points to 4.18%.
  • The CBOE Volatility Index® (VIX) rose 0.59 to 13.14.

Tech-related strength helped boost the NASDAQ-100® (NXD), which includes the NASDAQ’s largest non-financial companies, by 0.6% to a record close. Energy shares were also strong behind continued gains in WTI Crude Oil (/CL) futures, which rose 1.4% and settled near a two-month -high after the Energy Information Administration reported a 7.5% drop in U.S. oil production last week, reflecting disruptions from winter storms. Small-cap shares lagged as the Russell 2000® Index (RUT) fell 0.7%.

CITE: https://www.r2library.com/Resource

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BUYING: Home Economics

By Staff Reporters

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A report released last month by the National Association of Realtors (NAR) confirms what many Americans suspect: home affordability is down. Due to rising interest rates and low inventory, NAR found that the average income of a home buyer between July 2022 and June 2023 was $107,000, up from $88,000 the year prior—one of the highest levels since NAR started tracking in 1981.

But the housing market continues to churn. The organization found…

  • More and more home buyers are single women. The share of single women buying homes is almost double that of men. They’re also slightly older—a single woman buying her first home is 38 on average, while a single man is 33 years old.
  • Buyers are older. The average first-time home buyer is 35, up from 29 in the 1980s, but it’s older people who are buying up the three-bedrooms after selling their starter homes: NAR found that the median age of a repeat home buyer last year was 58. In 1981, it was 36 years old.

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HELPING DOCTORS ACHIEVE: New Year Resolutions

COACHING AND MENTORING

Physician Goal Setting [Business V. Personal Approach] in 2024

By Marcinko Associates, Inc.

SPONSOR: http://www.MarcinkoAssociates.com
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CORPORATE APPROACH

The year-end physician, nurse and/or medical employee reviews in general aren’t very effective at motivating employees in ACOs, and VBC organizations, etc.

And, according to a Gallup [non-medical worker] poll, only 14% of employees “strongly agreed” that a performance review inspired them to improve. But in recent years, some workplaces have changed how they conduct performance reviews—or abandoned them altogether especially in technology.

  • A decade ago, Microsoft disbanded its version of stack ranking, the practice pioneered by General Electric CEO Jack Welch in the 1980s in which the company would rank every employee. Experts say it hurts morale and can create a toxic work culture.
  • Netflix has around 10,000 employees but has eschewed the year-end review for informal conversations during the year.
  • Google revamped its system last May by reducing performance reviews from twice to once a year.
  • Apple dropped performance reviews completely.

Healthcare business and corporate employees want feedback, even physicians, but it has to be useful.

PERSONAL APPROACH

Now that you’ve set your personal goals on your landmark date (New Year 2024), how you pursue it will go a long way toward whether you achieve it. There are generally two ways to tackle the goals you’ve set for yourself—and one yields more success than the other.

  • Avoidance goals: While this works well when it comes to your ex-medical partner or spouse, it’s not how you want to attack resolutions. Avoidance goals include “stop eating sweets” or “watch less TV.”
  • Approach goals: Instead of avoiding a behavior, you create a new one. Your goals would be “eating more vegetables” or “reading more books” to replace the habits you want to shake.

And, a recent study found that approach goals are more likely to be accomplished (59%) than avoidance goals (47%) across a wide range of potential resolutions. Good luck with that!

WE CAN HELP.

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PHYSICIAN COACHING: https://marcinkoassociates.com/process-what-we-do/

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HAPPY NEW YEAR: From All of Us at the ME-P

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www.CERTIFIEDMEDICALPLANNER.org

www.MARCINKOASSOCIATES.com

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EDUCATION: https://marcinkoassociates.com/textbooks-academic-catalog/

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 From us all to you and yours.
Here’s to making a difference and paying it forward today, in 2024, and beyond. 

THANK YOU

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DEFLATION: Another Holiday Surprise?

By Staff Reporters

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Deflation could be arriving this holiday season. Walmart CEO Doug McMillon recently said deflation may be on the horizon, citing a decline in the prices of grocery items such as chicken and eggs. McMillion said that although some items like beef remain expensive, he expects prices on other staples to come down in the coming months.

CITE: https://www.r2library.com/Resource/Title/082610254

It’s the latest welcome news for everyone feeling the squeeze from inflation and rising interest rates.

  • Target Chief Growth Officer Christina Hennington said earlier this week that the average price of basics fell three percentage points between Q2 and Q3.
  • JCPenney announced last month that it planned to keep prices for Black Friday the same or lower than last year.

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HEALTHCARE: Spending Grew in 2022

By Health Capital Consultants, LLC

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On December 13, 2023, the Centers for Medicare & Medicaid Services (CMS) released its annual report on healthcare spending in the U.S., highlighting the growth in private insurance and Medicaid spending in 2022, which was offset by the declines in supplemental federal funding as a result of the COVID-19 pandemic.

CITE: https://www.r2library.com/Resource/Title/082610254

This Health Capital Topics article reviews the notable healthcare spending findings in CMS’s report. (Read more…) 

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HOLIDAY BONUS: Wall Street is Down

By Staff Reporters

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For the second straight year, Wall Street bankers should prepare for smaller bonuses this holiday season, according to a report from consulting firm Johnson Associates. Cash bonuses for investment bankers in particular could shrivel up to 25% compared to 2022. Now, bonuses often account for a huge share of bankers’ total compensation. In some cases, they can be double their salary. That adds up to tens of billions of dollars in Wall Street’s bonus pot, which hit an all-time high in 2021.

But two years later, the economy looks a lot different.

For example, IPOs have slowed, interest rates are up, and we’re down a few banks. Investment bankers aren’t the only ones feeling the effects:

  • Regional bankers are likely to see bonuses fall 10%–20%.
  • Workers in asset management and sales could get 5%–10% less this year.
  • The only groups expected to receive bonus bumps this year are wealth managers and retail or commercial bankers at major global banks. Goldman Sachs is also reportedly considering bigger (but still unspecified) bonuses to keep top traders.

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MERRY CHRISTMAS

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