ABOUT: “Turn-it-In”

By Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Turnitin (stylized as turnitin) is an Internet-based plagiarism detection service run by the American company Turnitin, LLC, a subsidiary of Advance Publications.

LINK: http://www.TurnItIn.com

Founded in 1998, it sells its licenses to universities and high schools who then use the software as a service (SaaS) website to check submitted documents against its database and the content of other websites with the aim of identifying plagiarism. Results can identify similarities with existing sources and can also be used in formative assessment to help students learn to avoid plagiarism and improve their writing.

Students may be required to submit work to Turnitin as a requirement of taking a certain course or class. The software has been a source of controversy, with some students refusing to submit, arguing that requiring submission implies a presumption of guilt. Some critics have alleged that use of this proprietary software violates educational privacy as well as international intellectual-property laws, and exploits students’ works for commercial purposes by permanently storing them in Turnitin’s privately held database.

ChatGPT: https://medicalexecutivepost.com/2023/01/17/chatgpt-a-microsoft-start-up-venture/

Turnitin, LLC also runs the informational website plagiarism.org and offers a similar plagiarism-detection service for newspaper editors and book and magazine publishers called iThenticate. Other tools included with the Turnitin suite are GradeMark (online grading and corrective feedback) and PeerMark (student peer-review service).

NOTE: According to Wikipedia, in March 2019, Advance Publications acquired private Turnitin, LLC for US$1.75 billion.

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PODCAST: Hospital Financial Cross – Subsidization

By Eric Bricker MD

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Hospital Profit Margin from Employers = 57%

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Recession OR Not … You Decide?

A ME-P Reader Opinion Poll

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DEFINITION: NBER defines a recession as “a significant decline in economic activity that is spread across the economy and that lasts more than a few months.” That definition encompasses a range of economic factor but is based on three main criteria: The depth, diffusion and duration of a downturn.

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

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Former Federal Reserve Chair Alan Greenspan recently said a US recession is the “most likely outcome” in 2023 as the central bank tightens monetary policy to curb inflation. 

So – Tell Us What You Think.

FELL FREE TO PONTIFICATE

LEAVE A COMMENT BELOW

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CENTENE CORPORATION: Medicaid Over-Billing?

By Staff Reporters

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Centene Corporation showers politicians with millions as it courts contracts and settles over-billing allegations by Samantha Young, Andy Miller, and Rebecca Grapevine (Kaiser Health News)

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Somehow KHN made Medicaid over-billing sound sexy.

This deep dive into Centene, “the nation’s largest private managed-care provider for Medicaid,” shows how the company has maintained good relationships with politicians as it looked to keep its market share and settle over-billing allegations.

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

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PODCAST: https://medicalexecutivepost.com/2021/11/12/podcast-centene-giant-medicaid-hmo/

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FACEBOOK & GOOGLE: A “Duopoly” in Decline?

By Staff Reporters

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Facebook and Google appear to be an empire in decline.

Considered for years to be a “duopoly” over the advertising industry, they are on track to account for only 48.4% of US ad revenues this year. It’s the first time their market share has fallen below 50% since 2014, per Insider Intelligence.

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

And, some suggest TikTok, Apple, Amazon, and Microsoft are slowly and successfully clawing away business from the duopoly.

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DIGITAL SECURITY and the American Dental Association [ADA]

By Darrell K. Pruitt DDS

Digital security and the ADA

I wrote the following letter four years ago today. Neither The Digital Dental Record nor its sponsor, The American Dental Association, responded. In fact, a few years later, The Digital Dental Record was predictably hacked and more than 500 dentists, including many ADA members, were victims of a breach of the ADA’s favored digital record system. The ADA is still silent, but they did however, terminate their business relationship with The Digital Dental Record.

Dear The Digital Dental Record,

Thanks for your response on Linkedin to my concerns about the security of EHRs compared to paper. To be honest with you, I’m pleasantly surprised. Contrary to the norm of what I consider an open and free market, very few vendors in the dental IT industry seem willing to openly discuss the dangers or cost of software they hope to sell to dentists – who obviously don’t ask the right questions. That is why I respectfully decline your offer of a private telephone conversation.

You know my name is Darrell Pruitt because it heads my post. I never hide it. Whoever you are, you should probably show potential customers the respect of accountability through transparency. After all, The Digital Dental Record is the only EHR system endorsed by the ADA. I hope that still stands for something of value.    

If you have any non-anecdotal evidence on which you base your bold claim that DDS Safe R2 is more secure than paper dental records, please share it. I’ll be transparent:  Nobody believes you. Then again, maybe “Luddites” who question the security of digital records are simply wrong. Here’s your chance to show the nation why the ADA chose to endorse The Digital Dental Record above all other electronic dental record systems.

D. Kellus Pruitt DDS

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Musings on a Famous Portfolio Asset Allocation Study

Some Critics Claim Brinson, Hood, and Beebower Conclusions Wrong

[By Dr. David Edward Marcinko MBA CMP™]

http://www.CertifiedMedicalPlanner.org

[Publisher-in-Chief]

Frequently, we hear the axiom that asset allocation is the most important investment decision, explaining 93.6% of portfolio returns. The presumption has been that once the risk tolerance and time horizon have been established, investing is simply a matter of implementing a fixed mix of stocks, bonds, and cash using mutual funds selected for this purpose. This axiom is based on a famous study by Brinson, Hood, and Beebower (BHB) published in the Financial Analysts Journal in July/August 1986. It is the stuff of most modern business school and graduate students in economics and finance.

Enter the Critics

One critic claims that BHB’s conclusions and the interpretation of their conclusions are wrong, stating that because of several methodological problems, BHB needed to make certain assumptions for their analysis to go forward. They assumed that the average asset-class weights for the 10-year period studied are the same as the actual normal policy weights; that investments in foreign stocks, real estate, private placements, and venture capital can be proxied by a mix of stocks, bonds, and cash; and that the benchmarks for stocks, bonds, and cash against which fund performance was measured are appropriate. The author believes that each of these assumptions can lead to a faulty measurement of success or failure at market timing and stock selection.

The Jahnke Study

William Jahnke claims that BHB erred in their focus on explaining the variation of quarterly portfolio returns rather than portfolio returns over the 10-year period studied. According to the study, asset allocation policy explains only a small fraction of the range of 10-year portfolio returns earned by the pension funds reported in the study. The author concluded that this discrepancy is caused by the effect of compounding returns. He adds that BHB were wrong to use variance of quarterly returns rather than the standard deviation. Use of standard deviation would reduce the often cited 93.6% to about 79%. Moreover, BHB did not consider the cost of investing, such as operating expenses, management fees, brokerage commissions, and other trading costs, which are more significant for individual investors than for the pension plans studied. Jahnke claims that excessive costs can reduce wealth accumulation by 50%.

Note: (“The Asset Allocation Hoax,” William W. Jahnke, Journal of Financial Planning, February 1997, Institute of Certified Financial Planners [303] 759-4900).

Assessment

Finally, the author takes issue with establishing long-term fixed asset class weights. Asset allocation should be a dynamic process. Higher equity return expectations should in turn produce larger equity allocations, other things being equal.

Certified Medical Planner

Conclusion

Are doctors different than the average investor noted in this essay?

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.

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Product Details

  Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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PODCAST: Never Pay Your First Medical Bill?

Marshall Allen Has a New Healthcare Book Out Called Never Pay the First Bill.”

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PODCAST: Healthcare is Great for People with Medicare.

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Greater than 90% of Medicare Beneficiaries Are Satisfied with Their Care

By Eric Bricker MD

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CITE: https://www.r2library.com/Resource/Title/0826102549

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ORGANIZATIONS: https://www.amazon.com/Financial-Management-Strategies-Healthcare-Organizations/dp/1466558733/ref=sr_1_3?ie=UTF8&qid=1380743521&sr=8-3&keywords=david+marcinko

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PODCAST: Hospital Debt and Tax Exempt Bonds

By Eric Bricker MD

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

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HOUSING MARKET: Worse Than You Think?

By Vitaliy N. Katsenelson CFA

REALLY!

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READ: https://contrarianedge.com/the-housing-market-is-worse-than-you-think/

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My Pragmatic Philosophy of Education

It is NOT the Boyer Model

[By Dr. David E. Marcinko MBA]

The Boyer Model of Education and Scholarship

OK – I may subscribe to the Boyer Model but with several specific personal variations which I will keep propriety and not disclose here. But, I will discuss my teaching pragmatism, below.

Definition

Boyer’s Model of scholarship and education is an academic model advocating expansion of the traditional definition of scholarship and research into four types of scholarship. It was introduced in 1990 by Ernest Boyer.

According to Boyer, traditional research, or the scholarship of discovery, had been the center of academic life and crucial to an institution’s advancement but it needed to be broadened and made more flexible to include not only the new social and environmental challenges beyond the campus but also the reality of contemporary life.

His vision was to change the research mission of universities by introducing the idea that scholarship needed to be redefined.

MORE: https://en.wikipedia.org/wiki/Boyer%27s_model_of_scholarship

ME: Dr. Marcinko Teaching Philosophy

ENTER MY PRAGMATISM

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DEAN: Dean 3.0 Philosophy

Assessment

So, what do you think?

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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MEDIA / INTERVIEW REQUESTS

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BLOGGING / VLOGGING / CROSS AND RE-POSTS

Yes. We’re looking for writers & cross-posts.

Send them to us: MarcinkoAdvisors@msn.com

WHAT WE’RE LOOKING FOR

Op-eds. Cross and Re-Posts, Links and Columns. Great ideas for improving physician focused financial planning, health insurance, economics and the financial ecosystem; etc. Pitches for healthcare-focused startups and business. Write-ups of original research. Reviews of new health care products, DME and AI. Data driven analysis of health care trends. Policy proposals; etc.

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On Elon Musk’s Twitter Purchase

A Guest Column by Ryan Bernier

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What the Skeptics and Naysayers Miss about Elon Musk’s Twitter Purchase

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EDITOR’S NOTE: I first Met Richard Helppie when I was in business school. He was the CEO of Superior Consultant at the time and very gracious to me with with his advice. Today he is a respected philanthropist and publisher of The Common Bridge. -David E. Marcinko

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What is E-Learning?

What it is – How it works?

[By Staff Reporters]

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Live Interactive iMBA Education

Electronic Classes can require intense interaction between live faculty members and adult-learners, often more so than in many traditional on-ground courses; and most automated Computer Based Training (CBT) programs.

Students [adult learners] are typically expected to log-in and contribute three to five times each week. With this frequency of interaction, students and faculty all get to know one another, well. There are few opportunities for passivity.

In fact, in the iMBA CERTIFIED MEDICAL PLANNER™ program, students tend to interact with instructors much more than in traditional settings; thus promoting future peer-based discussions and real world applications.

Moreover, in the electronic iMBA classroom, everyone must write; particularly for the R&D loaded CERTIFIED MEDICAL PLANNER™ program. All assignments are typed, creating a permanent record of each person’s contribution. Faculty members find this promotes careful, reflective submissions from most students.

Additionally, instructors can easily monitor student progress and communicate with those who need help, or who have trouble keeping up. This is usually done privately by e-mail, fax or phone after certain online expectations have been clarified.

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More:

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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CMP Logo

Become a CMP

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CRYPTO.com and Celebrity Endorsements?

AFFINITY MARKETING!

Physicians and All Investors Beware!

By Staff Reporters

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Celebrity Matt Damon’s infamous “fortune favors the brave” Crypto.com commercial premiered one year ago today, and its timing couldn’t have been worse. Had you been inspired to buy $1,000 worth of bitcoin on that day (the token was then worth $60,608, near its peak price) you would have just ~$340 now.

Fortune isn’t exactly what’s favored Crypto.com in the year since the ad debuted. The price of bitcoin has plunged ~70%, the company reportedly slashed about 40% of its workforce this summer, and the YouTube version of the Damon commercial has been set to private.

Today, the coin has been pretty stable since mid-June, 2022 and hovering at around $20,000.

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STABLECOINS: Altering the US Banking System?

By Staff Reporters

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DEFINITION: Stablecoins are cryptocurrencies where the price is designed to be pegged to a reference asset. The reference asset may be fiat money, exchange-traded commodities, or a cryptocurrency.

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

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In fact, Stablecoins could have such a profound effect on the established banking system that U.S. regulators need to require that the digital tokens fit in without disrupting it, said Martin Gruenberg, the acting chairman of the Federal Deposit Insurance Corp. (FDIC). His remarks were delivered at a Brookings Institution event recently.

Gruenberg’s agency is among the U.S. banking watchdogs that will have significant influence over how stablecoins are regulated, and the FDIC has also had to weigh in with recent sanctions against firms – such as FTX US – that have made claims misrepresenting how FDIC deposit insurance backstops their operations. As U.S. banks have increasingly sought to offer crypto services, including maintaining custody of customer’s digital assets, Gruenberg said that his agency has been cautious about allowing regulated lenders to engage.

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PODCAST: Hospital Insurance Contracting [Prices]

Percent-of-Charge Discounts”

By Eric Bricker MD

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ELON MUSK’S TWITTER FOR DOCTORS: Same, Change, Grow or Die?

By Staff Reporters

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NEWS FLASH!

Elon Musk, the richest person on the planet, is the CEO of the world’s most valuable automaker TESLA, heads up a $125 billion aerospace giant, and as of yesterday, is the owner of a social media company Twitter.

According to multiple reports, Musk closed the $44 billion deal last night, less than 24 hours before today’s 5pm ET deadline. He began his reign as “Chief Twit” by firing at least four executives, including CEO Parag Agrawal (who was reportedly escorted out of Twitter’s SF headquarters). Later today, Musk is expected to address anxious employees, who might be worried they’ll face the same fate as their former leader. Historically:

  • Musk acquired a large stake in Twitter and later signed a deal to buy all of it.
  • Then he tried to back out, citing bot issues, but Twitter sued him to enforce the agreement.
  • Musk blinked weeks ahead of a trial, and said he would buy Twitter.

Now What?

So begins Musk’s attempt to, in his words, “help humanity” by trying to turn Twitter into a “common digital town square.”

We know that Musk has ultra-ambitious goals for the company: 5x Twitter’s revenue by 2028, supercharge the subscriptions business, and turn Twitter into a super app called “X.” But murkier is the path he intends to take to get there, and he’s already sending mixed signals about his intentions. And what about doctors and the healthcare industrial complex? Will it remain the same or change?

History

Back in early 2014 the first list of the “Top 100 Twitter Accounts For Healthcare Professionals To Follow” was born. Then, the biggest social media-related question to hurdle wasn’t, “Who should I be following on social media?” but rather, “Should I even be on social media at all?”

Many years later, it’s safe to say that social media has firmly established itself in the healthcare industry. By finding healthcare Twitter accounts that are related to your specialty, you can have access to the best information and always remain within the loop.

Top 100 Healthcare Twitter Accounts T...

But, with the Elon Musk takeover of Twitter, the medicine and healthcare accounts available may change, remain static or grow, and finding the most valuable medical accounts to follow has become more challenging than ever.

Today

Today, the question truly is, “Who should I be following?” Thankfully, you have been covered since 2020.

HERE: https://emedcert.com/blog/top-healthcare-twitter-accounts-to-follow

Now, colleagues should follow the rest of the Musk story in 2022 and beyond.

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PODCAST: Nine [9] Ways to Pay Doctors

“Behavioral Economic Strategies”

By Eric Bricker MD

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As Published in the Annals of Internal Medicine by an All-Star Cast of Researchers:

1) Limitations of Information
2) Inertia/Status Quo Bias
3) Choice Overload
4) Immediacy
5) Loss Aversion
6) Relative Social Ranking
7) Threshold Effect
8) Limits of Willpower
9) Mental Accounting

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META: “Needs to Get its Mojo Back”

By Staff Reporters

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Quote: “Meta needs to get its mojo back.”

With Meta’s share price down more than 60% this year, investors are losing patience with Mark Zuckerberg’s big bet on the metaverse.

Altimeter Capital CEO Brad Gerstner, whose firm has more than 2 million shares in the company, wrote an open letter yesterday urging Meta to cut headcount expenses by 20% and keep metaverse spending under $5 billion per year to become a “more productive, and more focused company.”

We’ll see how Meta feels about its own mojo when it reports earnings tomorrow.

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FOMC: Treasuries the Next Financial Crisis?

By Staff Reporters

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For months, traders, academics, and other analysts have fretted that the $23.7 trillion Treasury market might be the source of the next financial crisis. Then last week, U.S. Treasury Secretary Janet Yellen acknowledged concerns about a potential breakdown in the trading of government debt and expressed worry about “a loss of adequate liquidity in the market.” Now, strategists at BofA Securities have identified a list of reasons why U.S. government bonds are exposed to the risk of “large scale forced selling or an external surprise” at a time when the bond market is in need of a reliable group of big buyers.

“We believe the UST market is fragile and potentially one shock away from functioning challenges” arising from either “large scale forced selling or an external surprise,” said BofA strategists Mark Cabana, Ralph Axel and Adarsh Sinha. “A UST breakdown is not our base case, but it is a building tail risk.”

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ELON MUSK: Thinks Twitter Can Run at 25% Workforce

By Staff Reporters

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According to the Washington Post, Elon Musk told potential investors for his Twitter purchase that he would thin the company’s 7,500-person workforce by 75%, leaving less than 2,000 employees to protect against security threats and solve the bot problem.

But even if the deal didn’t go through, Twitter was probably headed for layoffs. Current management said they needed to cut payroll by nearly $800 million by the end of 2023. Musk’s acquisition of Twitter is expected to close by next week.

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FINANCE: https://www.routledge.com/Comprehensive-Financial-Planning-Strategies-for-Doctors-and-Advisors-Best/Marcinko-Hetico/p/book/9781482240283

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ELON MUSK: On Tesla Shares

By Staff Reporters

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Elon Musk gets good news and bad news

Tesla just reported its highest ever quarterly revenue of $21.5 billion. But that still fell short of analyst expectations, so shares fell about 5% after the announcement.

And, although Tesla stock has declined around 37% since the beginning of the year, Musk remained optimistic, saying he can see a future where the company ends up “worth more than Apple and Saudi Aramco combined.”

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FINANCE: https://www.amazon.com/Comprehensive-Financial-Planning-Strategies-Advisors/dp/1482240289/ref=sr_1_1?ie=UTF8&qid=1418580820&sr=8-1&keywords=david+marcinko

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Dr. Dave Marcinko at YOUR Service in 2022

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Book Marcinko for your Next Financial Planning Seminar, Meeting or Medical Business Event 

By Ann Miller RN MHA

Professor and physician executive David Edward Marcinko MBBS DPM MBA MEd BSc CMP® is originally from Loyola University MD, Temple University in Philadelphia and the Milton S. Hershey Medical Center in PA; Oglethorpe University, and Atlanta Hospital & Medical Center in GA; and the Aachen City University Hospital, Koln-Germany. He is one of the most innovative global thought leaders in health care business and entrepreneurship today.

Dr. Marcinko is a multi-degreed educator, board certified physician, surgical fellow, hospital medical staff President, Chief Education Officer and philanthropist with more than 400 published papers; 5,150 op-ed pieces and over 125+ international presentations to his credit; including the top 10 biggest pharmaceutical companies and financial services firms in the nation. He is also a best-selling Amazon author with 30 published text books in four languages [National Institute of Health, Library of Congress and Library of Medicine].

Dr. Marcinko is past Editor-in-Chief of the prestigious “Journal of Health Care Finance”, and a former Certified Financial Planner®, who was named “Health Economist of the Year” in 2001. He is a Federal and State court approved expert witness featured in hundreds of peer reviewed medical, business, management and trade publications [AMA, ADA, APMA, AAOS, Physicians Practice, Investment Advisor, Physician’s Money Digest and MD News].

As a licensed insurance agent, RIA and SEC registered endowment fund manager, Dr. Marcinko is Founding Dean of the fiduciary focused CERTIFIED MEDICAL PLANNER® chartered designation education program; as well as Chief Editor of the HEALTH DICTIONARY SERIES® Wiki Project. His professional memberships include: ASHE, AHIMA, ACHE, ACME, ACPE, MGMA, FMMA and HIMSS.

Dr. Marcinko is a MSFT Beta tester, Google Scholar, “H” Index favorite and one of LinkedIn’s “Top Cited Voices”.

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FEDERAL RESERVE: Keeps Buying Mortgages

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The Federal Reserve Keeps Buying Mortgages

Alex J. Pollock

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The Federal Reserve now owns $2.6 trillion in mortgages. That means about 24 percent of all outstanding residential mortgages in this whole big country reside in the central bank.

READ: https://mises.org/wire/federal-reserve-keeps-buying-mortgages

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PODCAST: Dental Insurance Doesn’t Exist?

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Don’t be Fooled?

By D. Kellus Pruitt DDS

1-darrellpruittDowney, California dentist John McCallister DDS has produced a splendid video which blows apart myths which keep dental “insurance” companies in business.

The more appropriately called, “discount dentistry brokers” – who casually hide dentists’ concerns – simply cannot survive transparency.

The Video: http://www.youtube.com/watch?v=PPo4XsYhHPk&feature=youtu.be

Quality?

Let’s face it. Purchasing rushed dental work which Delta Dental discounts more than 30% – or even faster dentistry that is discounted up to 65% by Brighter.com – will always be a foolish investment in one’s health simply because managed care dentistry has NO QUALITY CONTROL.

What’s more, neither Steve Olson, CEO of Delta, nor Brighter.com CEO Jake Winebaum can ever be held accountable for the shoddy work they sell.

Share the Cartoon

The Hippocratic thing to do, Doc, is to share Dr. McCallister’s cartoon with everyone.

As for me, I especially look forward to publicly taunting Delta Dental Insurance Company through @DeltaDentalins on Twitter, as well as CEO Jake Winebaum via @Brighter.com.

Jake blocked me from following @Brighter.com years ago after I asked him about Brighter.com’s quality control measures (There are none. Isn’t that right, Jake?)

Assessment

I pick on Delta Dental and Brighter.com not just because they are unresponsive to dentists’ concerns, but Steve Olsen and Jake Winebaum run the two most harmful examples of sleazy discount dentistry businesses.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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TWO SKILLS: Physician Programmers Need to Know

By Joel Comm

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Machine Learning

The global machine learning market was valued at $15.44 billion in 2021, and it is expected to grow to $209 billion by 2029. Machine Learning is a technology that has grown in popularity over the past years, especially driven by the success of companies like Google in the field of AI.

This success is also in big part due to the technology becoming more accessible to the masses. Take OpenAI’s AI image generator, DALL-E, as an example: Since DALL-E Mini went public, it has been given uses ranging from making memes to artwork worth the attention of The New Yorker.

Gone are the days in which machine learning was only accessible to researchers in top-notch institutions. Today, machine learning can be mastered all around the globe in official institutions, online education platforms, and even via comics.

Web3 / Blockchain Development

Whether you are invested in crypto and NFTs or not, the Metaverse is being built, and it promises to turn centralized, corporate-controlled Web2 on its head. The world of computer users–that’s pretty much all of us–has, for years, grown increasingly frustrated by having to operate under the oversight of a few monoliths.

The promise of Web3 is community–not corporation–first.

Innovators in the space like Proof of Learn are developing easily accessible educational platforms where Web2 pros and the tech-interested can learn to code in Web3, in a learn and earn model. The company’s first project is a lore-rich online academy called Metacrafters.io, drawing in gamers and developers, and attracting some serious backing from leading VCs and crypto investors. Fellow industry leaders, such as Solana, Flow, Avalanche, and Polygon Foundations, recently gave $4.5 million in grant funding to support Metacrafters’ mission of upskilling Web2 developers. This grant helps fund their learn and earn protocol, so you get to take courses in a game world and get paid for it.

Metacrafters.io might be one with this learn and earn model teaching coding skills, but it is in line to inspire more of its kind. Look around at the landscape of Web3 education and get cracking, because the Metaverse will be here sooner than expected, and developers will be the major players in it.

HIT: 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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RELATED: 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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PODCAST: Hospital CFOs Found Doctors Drive $1.56 Million / Doctor / Year by Ordering Tests and Performing Procedures!

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By Eric Bricker MD

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AMA ECONOMICS: https://medicalexecutivepost.com/2022/08/01/ama-to-teach-medical-students-about-health-economics/

Health Economics: https://medicalexecutivepost.com/2022/07/31/podcast-history-applied-to-health-economics/

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

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A Fiduciary Comes with Responsibilities to the Client

By Stephen Kelley, CSA

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As a Registered Investment Adviser (RIA) with a Series #65 securities license, we hold a fiduciary duty to you. This means that we are legally bound to put your interests above those of anyone else, including ourselves.

Now you might reasonably think that anyone offering financial advice or services to clients is required to be a fiduciary. Sadly, if you thought that, you’d be wrong. Some estimates claim that only 15 percent of advisors have a fiduciary duty to their clients. The Paladin Registry puts the number even lower, estimating that just one in 12 (8.3 percent) advisors have a fiduciary responsibility.

For the most part, stockbrokers (also called “Registered Representatives,” “Account Executives,” “Financial Advisors,” or “Wealth Managers”) are not fiduciaries, even though they are allowed to portray themselves as full-service investment advisors. If your stockbroker/registered representative/account executive/financial advisor/wealth manager holds a series seven [#7] securities license, then it’s probable that they aren’t a fiduciary.

This was made amply clear in the movie, “The Wolf of Wall Street,” a biopic about Jordan Belfort, a stockbroker who made his fortune selling junk stocks and bonds to middle-class investors: in other words, by cheating them. Much of it was perfectly legal. The SEC went after Belfort’s company, Stratton Oakmont, for nearly a decade before it was able to shut it down. The point being that even in the face of egregious wrongdoing, theft, fraud and a virtual sea of drugs and blatant hedonism, the securities laws in this country are so loose that it took billions in theft and a decade of suspected and known fraud to step in and stop the abuse. And this movie was based on a true story.

That’s why a fiduciary duty is so important to a client. Being a fiduciary is a legal distinction. A Registered Investment Advisor (RIA) or Investment Advisor Representative (IAR) who holds a Series #65 securities license, subject to the Investment Advisers Act of 1940, is a fiduciary. The legal investment advising standards that govern a non-fiduciary stockbroker and a fiduciary Registered Investment Advisor are very different.

A Registered Investment Advisor is legally required to follow the “trust” standard — the highest known in law — which requires it to place the interests of its clients ahead of its own and fulfill critical fiduciary duties of trust and confidence. Under the fiduciary trust standard, a Registered Investment Advisor must provide its “best advice” to a client. A non-fiduciary stockbroker (like the coveted Series #7 of “The Wolf of Wall Street”) follows only the “suitability” standard, which doesn’t require a stockbroker to place the interests of his clients ahead of its own. Under the non-fiduciary suitability standard, a stockbroker need provide only “suitable advice” to his clients — even if the stockbroker knows that the advice is not the best advice for the client.

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The table below helps summarize which professionals are fiduciaries.

Type of ProfessionalAre They A Fiduciary?
PhysicianYes
LawyerYES/Maybe
CPANo
Trust OfficerYes
Stock BrokerNo
Insurance AgentNo
Registered RepresentativeNo
CFP PractitionerMaybe
Financial PlannerMaybe
Registered Investment AdviserYes
NAFPA-Registered Financial AdvisorYes

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MORE: https://medicalexecutivepost.com/2022/05/21/an-interview-with-bennett-aikin-aif/

RELATED: https://www.kitces.com/blog/the-4-different-types-of-financial-advisor-fiduciaries/

CFPs: https://medicalexecutivepost.com/2016/11/18/why-we-cannot-assume-cfp-equals-fiduciary/

INVESTING: https://www.routledge.com/Comprehensive-Financial-Planning-Strategies-for-Doctors-and-Advisors-Best/Marcinko-Hetico/p/book/9781482240283

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Future Trends Help Choose The Most Fitting Medical Specialty

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By Bertalan Meskó, MD PhD

I hope you will find the newsletter useful!
Best regards,
Berci Meskó, MD
The Medical Futurist

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READ HERE: https://medicalfuturist.com/future-trends-help-you-choose-the-most-fitting-medical-specialty/?mc_cid=becfbe85ae&mc_eid=40fee31c25

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UPDATE: Recession, Goldman Sachs, and Tesla

By Staff Reporters

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The director of the nonpartisan Congressional Budget Office [CBO] added his voice Thursday to those economists who say it’s unclear if the economy has hit a downturn, despite posting two straight quarterly drops in growth. “The U.S. economy shows signs of slowing, but whether the economy is currently in a recession is difficult to say,” wrote CBO Director Phillip Swagel in a letter to Sen. Lindsey Graham (R-S.C.). “It is possible that, in retrospect, it will become apparent that the economy moved into recession sometime this year. However, that is not clear from data that were available at the beginning of August,” Swagel added.

Goldman Sachs said its credit card unit is under investigation by the Consumer Financial Protection Bureau, a federal agency tasked with protecting Americans from financial abuse. In a securities filing, Goldman said the CFPB is examining a number of the company’s credit card account management practices, including refunds, resolving billing errors, advertisements and reporting to credit bureaus. And, in a statement to CBS MoneyWatch, Goldman said the bank “is cooperating with the CFPB on this matter.”

Finally, shares of electric vehicle maker Tesla rallied in after-hours trading as the company won shareholder approval for a 3:1 stock split, the second such move in two years, as the world’s most valuable automaker looks to make its stock more affordable.

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FINANCIAL PLANNING: https://www.routledge.com/Comprehensive-Financial-Planning-Strategies-for-Doctors-and-Advisors-Best/Marcinko-Hetico/p/book/9781482240283

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MEDICARE ADVANTAGE PLANS: TV Ads are Deceiving?

By Dr. Keith L. Gurnick, DPM

[Los Angeles, CA via PM Online]

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Paid spokespersons consisting exclusively of older celebrities, including William Shatner, George Forman, Joe Namath, and Jimmie “J.J.” Walker read similar, if not exact, scripts in an attempt to induce the elderly to phone and check their “zip code” to see if they are eligible. I can’t figure out what the zip code has to do with anything, but maybe someone can help me to understand this fish hook?

As of November 2021, 42% of all Medicare eligible patients are enrolled in Medicare Advantage plans. Does the viewing public not wonder why there is never any mention at all during these commercials that changing to a Medicare Advantage plan means switching their traditional Medicare over to an HMO, and that most likely they will lose their network of doctors and possibly hospitals as well? 

Why don’t they just tell the truth?

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

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PODCAST: Why AMAZON CARE Will Fail?

BY Eric Bricker MD

Employee AGE AND Demographics

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Healthcare Costs (Per Person Per Year) by Age:
Less than 18: $3,628
19 – 44: $4,422
45-64: $8,370
65+: $18,424

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Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors : Best Practices from Leading Consultants and Certified Medical Planners™ book cover

ORDER: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

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UPDATE: President Biden, Domestic Markets, IRS Tax Filing Service, Polio and Paul Krugman’s “Sorry”

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By Staff Reporters

President Biden tested positive for the coronavirus, raising health concerns for the 79-year-old president and underscoring how the virus remains a persistent, if muted, threat in a country trying to put the pandemic in the past.

U.S. IndicesChangeClose
Dow Jones+162.0632036.90
NASDAQ+161.9612059.61
S&P500+39.053998.95
SCHWAB1000+129.5013230.70

Senator Elizabeth Warren along with 22 more Democratic lawmakers are pushing the IRS to create its own free tax filing service. The bill also aims to allow eligible taxpayers to choose a “return-free option,” providing a pre-populated filing. “The average American spends 13 hours and $240 every year to file their taxes — that’s too much time and too much money,” Warren said in a press release. But some tax professionals say it’s not a realistic plan for the overburdened agency.

A case of polio has been identified in an un-vaccinated adult in Rockland County, according to a news release from the New York State Department of Health. The agency confirmed that the infection was transmitted from someone who received the oral polio vaccine, which has not been administered in the United States since 2000. Officials believe the virus may have originated outside the United States, where the oral vaccine is still administered.

he New York Times opinion columnist Paul Krugman published a mea culpa in column form flat out admitting he was wrong for thinking inflation wouldn’t be that bad. In his piece, titled, “I Was Wrong About Inflation,” the economics professor noted that he was on “Team Relaxed” when it came to fears of inflation and acknowledged that was a “very bad call.” Krugman began by recounting the “intense debate among economists about the likely consequences of the American Rescue Plan, the $1.9 trillion package enacted by a new Democratic president and a (barely) Democratic Congress.” He mentioned how he originally didn’t see the massive government spending bill as that dangerous for the economy. “Some warned that the package would be dangerously inflationary; others were fairly relaxed. I was Team Relaxed. As it turned out, of course, that was a very bad call,” he confessed.

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

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My Conversation with an Anonymous Cigna Representative

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Cigna, do you even have a clue that dentists don’t like you?

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By Darrell K. Pruitt DDS

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Hi Dr. Pruitt,

I’m truly sorry for any negative experience you’ve encountered with us. Is there a claim, benefit, or authorization concern I can help with? Please email me at LetUsHelpU@cigna.com. I’d like an opportunity to assist.

At a time when interest rates are surging, and just when I request an increase, CIGNA REDUCED MY REIMBURSEMENTS! Never again will I do business with you, and will discourage other dentists from falling into your trap …. And that is why dentists don’t like #TeamCigna. 

What is your name, anyway. You know mine. Perhaps Linkedin’s transparency makes it a poor choice for marketing Cigna.

As if things could get no worse between Cigna and dentists, you censored my response!

NOTE: Cigna representatives prefer to remain anonymous for reasons of accountability.

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BUSINESS MEDICINE: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko

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

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PODCAST: Why We Still Need to Celebrate Independence Day?

By Richard Helppie

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EDITOR’S NOTE: I first Met Rich Helppie when I was in business school. He was the CEO of Superior Consultant at the time. Today he is a respected philanthropist and publisher of The Common Bridge. This is a much-requested replaying of Rich’s 2021 podcast honoring of Independence Day.  He takes some time to reflect on why we still should celebrate our nation’s birthday even though our history has been imperfect. -David E. Marcinko

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PODCAST: https://thecommonbridge.substack.com/p/independence-day?utm_source=substack&utm_medium=email#play

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PODCASTS: 36 Blue Cross / Blue Shield Organizations Explained

By Eric Bricker MD

By Laurence Baker MD

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A Doctor – Economist’s Solution for Health Reform

My Laundry Wish List for all US Healthcare Stakeholders

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]Fox News

As President Obama spoke, prodded and cajoled for Congress to pass HR 3200-3400 in 2008, I believe that for any healthcare reform effort to work successfully for the American people – for the long term – we need to consider the following in no particular prioritized order:

  • Insurance portability uncoupled from patient employment
  • Health insurance regional exchanges with inter-state purchase competition
  • Doctor, drug, DME and hospital pricing and payment transparency for HSAs, and all of us
  • Modifying or eliminating AMA owned CPT Codes®; a huge money maker for them
  • Abandoning ala’ carte medicine for values-based outcomes
  • Reduce JCAHO influence; encourage competition from Norwegian Det Norske Veritas [DNV]
  • Reduce big-pharma influence thru-out the entire medical education, career and care pipeline
  • End DTC advertising from big-pharma
  • Promote wholesale drug purchase competition, MC bidding and generic drugs
  • Encourage evidence-based medicine, not expert-based medicine
  • Less pay for medical specialists with a  re-evaluation of the hospitalist concept
  • Advance the dying art of physical diagnosis, teach and embrace Paretto’s 80/20 rule for clinic issues
  • Reduce lab test, diagnostic imaging and testing
  • Encourage private 24/7/365 medical offices and clinics; and on-site and retail clinics
  • Abandon P4P, medical homes and disease management ideas
  • Give more economic skin-in-game to patients relative to health benchmarks
  • Concretize the “never-event” prohibitions and include a list of patient health responsibilities
  • More pay for primary care docs and internists
  • Adopt digital records and cloud computing for patients
  • Phase in true eHRs incrementally; and abandon CCHIT for open source SaaS
  • Promote Health 2.0 social media.
  • Augmented scope of practice, numbers and pay for NPs and DNPs, etc
  • Reduce pay for CRNAs and increase it for staff RNs
  • Develop step down triage and treatment units to reduce the number of full service ERs
  • Increase medical, osteopathic, dental, optometric and podiatric medical school classes
  • Increased practice scope for dentists, podiatrists and optometrists
  • Make some sort of catastrophic HI mandatory, much like auto insurance for all
  • End pre-existing conditon health insurance contract clauses
  • More choice  and end of life control for the terminally ill patient
  • Increase marketplace competition with fewer political and financial “externalities”.
  • Teach basic healthcare topics in school and encourage physical exercise
  • Health and insurance education should be, but is not, the “answer” for Americans
  • Protect borders and discourage undocumented illegals
  • Adopt medical malpractice tort reform
  • Make all stakeholders fiduciaries
  • No public “option” unless you like food stamps, Section 8 housing, public transportation and schools
  • Budget deficit neutrality
  • Slow down!

Assessment

Recently, while in the Baltimore/Washing area, I was asked by several reporters to opine on the healthcare debate; which I did so freely having never been known as the shy type. And, regular readers will note that many of these items have been used as posts or comments on this ME-P. Unfortunately, my “laundry list” interview was pre-empted by two local but boisterous town-hall meetings with respective passionate politicians. It was redacted no doubt, but never broadcast. Thus, I missed the potential for my “five minutes” of fame. C’est la vive!

Conclusion

There you have it; direct and straight forward. And so, your thoughts and comments on this Medical Executive-Post are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

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Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

THANK YOU

IMHO @TeamCigna Should Treat their Dentists Better!

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By Darrell Pruitt DDS

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“How Is The Market Feeling About Cigna?” Spoiler – According to Benzinga insights, the market is not optimistic about Cigna’s future. Neither am I. But then, I’m only their clients’ dentist.

Link: https://www.benzinga.com/short-sellers/22/06/27888029/how-is-the-market-feeling-about-cigna

Tomorrow is my last day as a Cigna Preferred Provider .. Never Again!

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ENTREPRENEURIAL MANAGEMENT EFFICIENCY: “Slowly I Turned … Step by Step … Inch by Inch”

By Staff Writers

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Venture capitalists who are in a rut should stop talking about how hard it is to raise a $100 million fund. Instead, raise a $5 million fund.

Rather, they should stop trying to invest $5 million at a time (with an 18-month window before going public). A better strategy is to start doing smaller investments with longer time horizons.

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

Just like chili, low and slow is the way to maximum flavor.

READ: https://tinyurl.com/2ewwvz2c

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The Next Big [Investment] Thing?

Or, NOT!

By Rick Kahler CFP®

How do you spot the investment opportunity that will become the next Apple, Facebook, or Microsoft? Certainly they are out there. Someone is going to discover them and be set for life, so why shouldn’t it be you?

Here’s why it shouldn’t

As with all Registered Investment Advisors, the amount of money I manage for clients is publicly disclosed information that anyone with an Internet connection can find.

Because of that, I am seen as the gatekeeper of a source of funding for every under funded business opportunity that is sure to become the next Apple. I get to see a lot of proposals. Many have promise at first glance. But the promise usually fades the more I dig into the proposal, ask questions, and do the math.

After hours and hours of investigation, every few years I see that one proposal that looks really good. One that calls to me to invest, that really has the promise of being a winner. When all the stars and the planets align, I know I now have a 90% chance of not making a dime on the venture.

That’s why I have learned to save my time and my money when I am approached with “the next big thing.” I just don’t have time to investigate every project and cull hundreds of opportunities down to the one that has a 10% chance of succeeding. I see it as looking for the proverbial needle in the haystack. Certainly, there’s a needle in there somewhere. But examining every piece of hay in order to find it has a significant monetary cost.

To succeed, I would need a lot of time, even more money, and exponentially more intuition and intellect. Not to mention a fair amount of luck. The probability that I will go bankrupt before I ever find the needle is staggering.

Most of the “next big things” are discovered by driven entrepreneurs who bank everything they have on an idea and find the financing to shoestring it together. It usually isn’t the armchair investor who cashes in.

My experience

Over my 40 years of real estate and investment experience, I have seen people lose millions investing in lumber mills, emu farms, highly leveraged real estate, futures contracts, day trading, restaurants, multi-level-marketing companies, rare earth minerals, Iraqi currency, and the newest ones—marijuana farms and crypto-currencies.

As a result, for my money and the money of my clients, I’ll play the odds for success by saying “no” to every opportunity that comes across my desk. I don’t take the time to investigate them. I don’t read the offering circulars. I don’t attend presentations. The answer is “no” to the great odds of losing my money and “yes” to the staggering odds of keeping money growing conservatively for me and for my clients.

What do I say “yes” to? I say yes to investing in mutual funds that own or loan money to 12,000 successful companies around the globe and thousands of real estate properties. I say yes to well-diversified portfolios. I say yes to proven investment strategies with 25-year track records. I say yes to having enough cash reserves to fund two to five years of retirement income.

Boring

I know, it’s not very sexy, is it? In fact, the way I invest my money and the money of those who have entrusted their investments to me is downright boring.

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https://www.crcpress.com/Comprehensive-Financial-Planning-Strategies-for-Doctors-and-Advisors-Best/Marcinko-Hetico/p/book/9781482240283

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Assessment

So here is my hot tip when it comes to finding investment opportunities to secure your future: forget about the “next big thing.” Instead, stay with the “next boring thing.” The odds are overwhelming that this will make you a long-term winner.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements.

Book Marcinko: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.

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What is Techno SCAM-BAITING?

BY ANONYMOUS

SPONSOR: http://www.CertifiedMedicalPlanner.org

CMP logo

Scam-Baiting Behind the Scenes

The most basic form of scambaiting sets out to waste a scammer’s time. At a minimum, scambaiters attempt to make scammers answer countless questions or perform pointless and random tasks. By keeping a scammer busy, scambaiters claim they’re preventing the scammer from defrauding a real victim.

Scambaiting may also be conducted with a specific purpose in mind. Sometimes scambaiters attempt to obtain an offender’s bank account information, for instance, which they then report to a financial institution. But there are other, less benevolent motives in the scambaiting community.

Thousands of scambaiters are organised on the 419eater forum, which describes itself as the “largest scambaiting community on earth”, with over 1.7 million forum threads. The forum was first established in 2003 to tackle the growing issue of 419 emails – a scam that promises people huge sums of cash in return for a small upfront fee.

419eater provides a particularly interesting case study because members are incentivised and rewarded for their scambaits through a unique system of icons, regarded as trophies, that they can obtain in their profile’s signature lines.

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Romance Scam : Find Out How We Uncovered This Chinese Scam

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MORE: https://www.theguardian.com/technology/2021/oct/03/who-scams-the-scammers-meet-the-amateur-scambaiters-taking-on-the-crooks?utm_source=pocket-newtab

Healthcare: https://www.scamwatch.gov.au/types-of-scams/buying-or-selling/health-medical-products

Medical Insurance: https://www.reddit.com/r/scambait/comments/jsgffx/just_got_a_scam_call_to_sign_me_up_for_bogus/

YOUR COMMENTS ARE APPRECIATED.

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THANK YOU

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SUPREME COURT: Rules Against HHS Drug Pricing [340-B] Program

By Health Capital Consultants, LLC

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U.S. Supreme Court Rules Against HHS in 340B Case

On June 15, 2022, the U.S. Supreme Court released its decision regarding the cuts made by the Department of Health and Human Services (HHS) to the 340B Drug Pricing Program, finding that HHS acted outside its statutory authority in changing reimbursement rates for one group of hospitals without first surveying them on their costs.

The 340B Drug Pricing Program allows hospitals and clinics that treat low-income, medically underserved patients to purchase certain “specified covered outpatient drugs” at discounted prices. (Read more…)

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COMMENTS APPRECIATED

Thank You

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Professor VERSUS Entrepreneur

Teaching / Educating

Bill Hennessey, M.D.

Bill Hennessey, M.D.

As a teacher educating is your job. It’s what you enjoy. There’s a fairly lax time schedule and resources are already built in the equation. Little accountability because the ultimate burden and measure of success is placed on the student to pass a test. If they don’t do well, it’s the student not directly the teacher who pays the price.

Now, I work with first year students who don’t know what a red blood cell looks like (biconcave disc, you thought I forgot, didn’t you) all the way to a chief resident who can probably do some surgeries better than me. It’s my job to take that first year student and turn them into a chief resident.

As an entrepreneur with limited resources, time, and energy, you don’t have the luxury to continuously teach, develop, and convince. You need people who simply get it especially in strategic positions. You don’t have the luxury of time or resources. You also are directly accountable if they don’t understand because you have a burn rate that probably just got worse. So how much “oxygen” do you allocate when trying to build your team?

Different story for Apple, Boeing and others that can create academies and educational tracks to teach and develop internally.

ASSESSMENT: Your thoughts are appreciated.

Product Details

ENCORE: How to Interview an Investment Portfolio Manager?

Selection Criteria Critical for Physicians

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief and former certified financial plannerdem2]

Recently in the Atlanta area, two high-profile financial advisors and portfolio investment managers have been charged with client embezzlement, malfeasance, and more!

The first was Kirk Wright, a Harvard-educated fund manager who was convicted last week in a fraud scheme that bilked investors out of tens of millions of dollars.  He later hanged himself, according to the Fulton County Georgia medical examiner’s office.  A federal jury convicted Wright last week on all 47 counts of mail fraud, securities fraud and money laundering stemming from a scam run through his firm, International Management Associates. High-profile clients included sports-stars, celebrities and several well-known local physicians.

The second, Frederick J. Barton, received a Securities and Exchange Commission (SEC) civil action letter on June 3rd, 2008. Barton, formerly a registered representative of a national, registered broker-dealer and two entities he controlled: TwinSpan Capital Management, LLC (TwinSpan), an investment adviser formerly registered with the Commission, and Barton Asset Management, LLC (Barton Asset Management). The Commission alleges that, between 1999 and 2007, Barton, acting individually or through TwinSpan or Barton Asset Management, engaged in three separate securities frauds-including one involving a patient suffering from Alzheimer’s disease-and through his misconduct obtained over $3 million in ill-gotten gains. The Commission further alleges that he then spent his ill-gotten gains, among other things, to send his children to an exclusive private school, fund his own investment portfolio, and service his credit card debts. 

Manager Selection

So, how can the medical professional reduce the potential for similar behavior from his/her portfolio manager?

The first way is to skip the middle-man and “do-it-yourself.” But, doctors are sometimes hard-pressed to following this directive because of time constraints, knowledge paucity, fear/greed and/or disinterest; among other reasons.

The second way, of course, is to outsource the task by hiring a financial advisor. But, how do you find a financial advisor (easy), and more importantly, how do you discern a good fit (personally and professionally)? Still, there is no guarantee of honesty or capability.

But, your odds can be improved with insider knowledge of the financial services industry; a common-theme of the ME-P. And so, the following checklist may be a good place to start the selection, or triage process.  

SAMPLE: Engagement Letter

Mr. Joseph H. Sample

Vice President

Medical Capital Management of Nevada, LLC

RE: Letter to Request Pre-Interview Information from Portfolio Manager

Dear [Mr. Name]:

Thank you for agreeing to meet with us on [date, time] in our office. We are in the process of interviewing several portfolio investment managers.

So that we may obtain consistent information in our evaluation, we would appreciate the coverage of specific areas during your presentation. We are particularly interested in information regarding your approach to investment management in the following areas:

Investment philosophy and approach

• Describe your management style and any changes you have made over the past decade.

• Describe your investment decision-making process.

• Do you make the decisions or do you rely on others, and if so, who?

• Describe your sources of research.

• What contact, if any, do you have with the management of companies in which you invest?

• Briefly describe the sell disciplines employed by you and your firm.

• Describe whether/how you use top-down or bottom-up approaches to investment selection.

• Are you value or growth orientated; hedged or not; domestic or international?

Track record

• Please supply performance data by 5, 10 and 15-year intervals.

• Please supply performance records compared to benchmarks you feel appropriate.

• If balanced management, please provide performance data by asset class.

• Provide MPT or APT statistics such as beta, alpha, standard deviations, etc.

• What are your cash holdings; fully invested or selectively invested at various times?

• Turnover history and number of securities, industries and sectors; are guidelines in place?

• Typical portfolio percentage of largest ten positions.

Firm/advisor background

Please provide us with information regarding your background, including general information about the organization. In particular, please cover:

• The stability of ownership, managers, analysts or others directly involved in management.

• Who makes the investment decisions and how the firm dictates policy to managers?

• A description of expenses, including management fees, commissions, and other expenses.

• A detailed description of the growth of money under management over the past ten years.

• Please discuss the flexibility in design and management of a client’s portfolio by managers.

• If your firm is multidisciplined, what are your areas of expertise?

• Who is the custodian of securities? Does the firm have insurance?

Manager background

Please provide the resume(s) of the manager(s) as well as information about the manager’s style and consistency. Additional items of interest include:

• The manager’s record with other firms, if employed less than ten years.

• How the manager does research, including use of analysts and outside research?

• Regarding the decision process, what steps does the manager actually take?

• Manager’s ownership status in the firm?

• History of asset growth under the specific manager.

• Examples of past successes and failures on investment decisions.

Statistics

Please provide the following statistical information:

• Price/earnings ratios compared to market

• Price/book ratios compared to market

• Average earnings growth data

• Average market cap of companies in portfolio

• Average dividend yield information

• Average maturity and/or duration of fixed-income portfolios (and how this is managed)

• Average credit rating of fixed-income portfolios

• Where short-term funds are invested

Communication

• How often do you provide portfolio and performance reports?

• How do you compare performance to the market? What benchmarks do you use?

• Who will meet with us (and how often)?

• Who is the primary and secondary contact?

• Does the firm provide investment newsletters or promotional literature, with sample?

• Is the portfolio manager(s) available to meet or discuss issues with the client or advisor?

Compliance

• Are you a fiduciary? Will you sign-off as same?

• Are you a stoke-broker or registered representative?

• What securities licenses do you hold?

• Are you independent?

• Who is your broker-dealer?

• Who is your custodian and clearinghouse?

• Are you a RIA or RIA representative?

• May we please see you ADV Parts I, II, III

• May we review a sample investment policy statement?

• May we see your CRD report?

• Must we sign an arbitration clause?

• What educational degrees have earned?

• What financial/securities designation do you hold?

• What peer-reviewed or non-peered reviewed material have you published, and where? 

• What medical specificity do you possess?

• Do you hold the AIF® and/or AIFA® designations, and adhere to its code-of-ethics?

• Are you a [CMP] Certified Medical Planner™?

• Are you a [CFP] Certified Financial Planner™ with health economics knowledge?

• How do/can you demonstrate you specific knowledge on the heath care space?

Thank you.

Dr. Michael B. Sample; MD/DO

Managing Partner – Medical Associates of Nevada, PC  

Assessment

Some financial advisors, insurance agents, portfolio and wealth managers speak of “prospecting”, “hunting” or “screening” clients. In fact, potential doctor-clients are often, not-so-charmingly called, “prospects”.

Don’t you think it’s about time that the “tables-are-turned” by informed medical professionals, as the “hunted-becomes-the-hunter”, by the informed physician? Triage well, and always remember; caveat emptor and vendor emptor!

What other criteria should be included in this engagement letter, or personal interview itself? What has been your experience with portfolio manager selection? How do you select same, and what has been your success rate? Why don’t you do-it-yourself? Please comment and opine.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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