DAILY UPDATE: Holiday Spending Economics with Mixed Stock Markets

By Staff Reporters

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SPONSOR: http://www.MarcinkoAssociates.com

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Shopping data reveals that Q4 isn’t as important as one might expect. For example, the holiday quarter in 2022 accounted for 26.8% of the year’s sales, just a hair over the 25% mark if sales were evenly spread across the year, per the US Census Bureau. Of course, some types of retailers depend on the holiday quarter far more than others. Discretionary retailers (which sell the things you want, but don’t need…aka gifts) rely on Q4 for up to 40% of their yearly sales, according to McKinsey. For department stores, clothing stores, and toy stores, the holiday season really is make-or-break. GameStop, for instance, recorded 37% of its annual revenue last year in the last three months of 2022.

But for other retailers, Q4 isn’t such a big deal. People apparently read throughout the year because book stores only depend on the fourth quarter for 27.4% of sales. People also need to eat food all year long: Q4 accounted for 26.3% of sales for grocery stores.

Meanwhile, gas stations, car dealerships, and building material companies perform worse in the holiday quarter than at other times of the year.

Here is where the major benchmarks ended:

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

The S&P 500 Index was 2.72 up points (0.1%) at 4,559.34, up 1% for the week; the Dow Jones Industrial Average®(DJI) was up 117.12 points (0.3%) at 35,390.15, up 1.3% for the week; the NASDAQ Composite was down 15.00 points (0.1%) at 14,250.85, up 0.9% for the week.

  • The 10-year Treasury note yield (TNX) was up about 5 basis points at 4.47%.
  • CBOE Volatility Index (VIX) was down 0.34 at 12.46.

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DAILY UPDATE: Nvidia Up, Zhao of Binance is Out and the Stock Index Win Streak Ends

By Staff Reporters

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How to Close Binance Account - Cryptalker

SPONSOR: http://www.MarcinkoAssociates.com

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Nvidia reported another quarter of record sales and gave a strong revenue outlook, pointing to red-hot demand for chips that underpin the artificial-intelligence boom. Huge investments in AI by tech giants from Microsoft to Amazon.com and by other large corporations have helped propel Nvidia’s sales to unprecedented levels in recent quarters.

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The chief executive of Binance, the largest global cryptocurrency exchange, plans to step down and plead guilty to violating criminal U.S. anti-money-laundering requirements, in a deal that may preserve the company’s ability to continue operating, according to people familiar with the matter. And, the U.S. Department of Justice has just brought criminal charges against Binance and its billionaire founder and CEO, Changpeng Zhao.

Here is where the major benchmarks ended:

The S&P 500 Index was down 9.19 points (0.2%) at 4,538.19; the Dow Jones Industrial Average® (DJI) was down 62.75 points (0.2%) at 35,088.29; the NASDAQ Composite was down 84.55 points (0.6%) at 14,199.98.

  • The 10-year Treasury note yield (TNX) was down about 2 basis points at 4.404%.
  • The CBOE Volatility Index® (VIX) was down 0.06 at 13.35.

Financial and technology shares were among the weakest sectors Tuesday, with the KBW Regional Banking Index (KRX) dropping 2.1%. Small-cap stocks also gave back some of a recent rally, as the Russell 2000® Index(RUT) fell 1.3% after touching a two-month high Monday. Health care, materials and utilities were among the few sectors to post gains.

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MARCINKO & Associates, Inc.

WHAT WE DO AND HOW WE ASSIST MEDICAL COLLEAGUES

Hard Business – Financial Advice AND Personal Lifestyle Coaching

http://www.MARCINKOASSOCIATES.com

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By Ann Miller RN MHA CMP™

At Marcinko & Associates our clients traditionally include physicians [MD, MBBS and DO], dentists [DDS and DMD], podiatrists [DPM], 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 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, etc].

Marcinko & Associates understands the complexity of financial and non-financial deal terms because we are also doctors. Our “hard” knowledge of your business comes from being actual healthcare facility owners, operators and medical practitioners [with additional professional licenses and expertise] enabling us to effectively analyze your business, take corrective measures and present your healthcare entity in the best possible and accurate light.

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But, if you’re looking at this website, chances are you are fed up, burned out, seeking practice management techniques or a better work-life balance. Or, you are looking for a new non-clinical career, thinking of finance, investing, retirement, or all of the above. Perhaps you are just looking to regain the joy and meaning in your medical or professional career? This is known as “soft” psychology, coaching, personal consulting or fraternal advice.

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Regardless, of your “soft” personal or “hard” corporate needs, our transparent Fees for Service [FFS] model is moderated for all colleagues based on the acuity and urgency of their engagements. Reduced rates and/or limited charity work may also be possible.

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CONTACT US TODAYTHRIVE TOMORROW!

Suite #5901 Wilbanks Drive

Norcross, Georgia USA 30092-1141

email: MarcinkoAdvisors@msn.com

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DAILY UPDATE: Inflation Down but Old Navy and the Gap are Up as Altman Goes to Microsoft

By Staff Reporters

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SPONSOR: http://www.MarcinkoAssociates.com

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News last week that inflation eased more than expected in October solidified the view that the Federal Reserve is done with its most aggressive rate-hike campaign in four decades. And that could be a boon for the stock market and your 401(k).

Over the last 10 rate hike cycles dating to 1974, the S&P 500 index rose an average 14.3% in the 12 months following the Fed’s final rate increase, according to an analysis by Ryan Detrick, chief market strategist at Carson Group.

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Stocks climbed to reach their third positive week in a row for the first time since summer, boosted by data showing inflation is on its way down. And, the Gap soared as the retailer reported strong sales last quarter at both Old Navy and its namesake stores.

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DAILY UPDATE: OpenAI’s Sam Altman Out – Maybe Not?

By Staff Reporters

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In a shocking move, the OpenAI’s board of directors pushed out CEO Sam Altman, one of the world’s most prominent tech executives. The company said that Altman “was not consistently candid in his communications with the board,” and thus the board lost its confidence in Altman’s ability to lead.

OpenAI, and Altman, became household names this year after the company’s ChatGPT chatbot sparked a frenzy around the field of generative artificial intelligence. OpenAI, which has received $13 billion in investment from Microsoft, is reportedly valued at $86 billion. CTO Mira Murati will keep the CEO seat warm for now.

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

Back In? https://arstechnica.com/information-technology/2023/11/breaking-sam-altman-reportedly-in-talks-for-potential-return-as-openai-ceo/

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DAILY UPDATE: The U.S. Stock Markets

By Staff Reporters

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SPONSOR: http://www.MarcinkoAssociates.com

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Here is where the major benchmarks ended on Friday:

  • The S&P 500 Index (SPX) was up 5.78 points (0.1%) at 4,514.02, up 2.2% for the week; the Dow Jones Industrial Average (DJI) was up 1.81 points at 34,947.28, up 1.9% for the week; the NASDAQ Composite was up 11.81 points (0.1%) at 14,125.48, up 2.4% for the week.
  • The 10-year Treasury note yield was down about 1 basis point at 4.439%.
  • CBOE’s Volatility Index (VIX) was down 0.54 at 13.78.

Retail shares were among Friday’s strongest sectors, helped by a nearly 30% surge by Gap (GPS) after the apparel company stronger-than-expected quarterly results. Energy companies were also higher thanks to a nearly 4% rise in WTI Crude Oil futures (/CL). Oil prices are still down 20% from a 2023 peak of more than $95 posted in late September.

In other markets, the U.S. dollar index dropped 1.8% for the week to touch its weakest level since September 1st, reflecting stepped-up expectations that interest rates have peaked.

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DAILY UPDATE: Mixed U.S. Stock Markets

By Staff Reporters

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SPONSOR: http://www.MarcinkoAssociates.com

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Over the course of the last few weeks, Cathie Wood of ARKK has been offloading the firm’s holdings in Roku, Inc. (NASDAQ:ROKU). Across all of her firm’s funds, Wood has sold stock in the streaming company totaling over $56 million. The move comes after Roku released its financials for q3. 

Here is where the major benchmarks ended:

  • The S&P 500 Index was up 5.36 points (0.1%) at 4,508.24; the Dow Jones Industrial Average was down 45.74 points (0.1%) at 34,945.47; the NASDAQ Composite was up 9.84 points (0.1%) at 14,113.67.
  • The 10-year Treasury note yield (TNX) was uabout 9 basis points at 4.445%.
  • Cboe’s Volatility Index (VIX) was up 0.14 at 14.32.

Walmart’s commentary weighed on the retail sector. Energy was also a laggard, as crude oil futures fell 5% to a four-month low of less than $73 a barrel, in part because record U.S. crude production has boosted supply.

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DAILY UPDATE: Government Shutdown Averted as US Markets Extend their Gains

By Staff Reporters

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SPONSOR: http://www.MarcinkoAssociates.com

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Senate leaders voted Wednesday night in favor of the short-term government funding bill the House passed Tuesday night ahead of Friday’s shutdown deadline. House Speaker Mike Johnson pitched a two-step plan that he described as a “laddered CR” — or continuing resolution — that will keep the government funded at 2023 levels. The bill extends government funding until January 19th for the Veterans Affairs, Transportation, Housing and Urban Development and Energy departments, as well as for military construction. The rest of the government is funded until February 2nd, 2024.

Here is where the major benchmarks ended:

  • The S&P 500® Index (SPX) was up 7.18 points (0.2%) at 4,502.88; the Dow Jones Industrial Average was up 163.51 points (0.5%) at 34,991.21; the NASDAQ Composite was up 9.45 points (0.1%) at 14,103.84.
  • The 10-year Treasury note yield (TNX) was up about 10 basis points at 4.541%.
  • CBOE’s Volatility Index (VIX) was up 0.02 at 14.18.

Retail and financial shares were among Wednesday’s strongest performers. The KBW Regional Banking Index (KRX) rose 1.3% to a 2½-month high. Transportation and consumer staples were also higher. Energy shares were one of the few laggards as crude oil futures sank more than 2% after the Energy Department reported a larger-than-expected increase in U.S. crude inventories.

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DAILY UPDATE: US Economic Prognostications as Stock Markets Surge

By Staff Reporters

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SPONSOR: http://www.MarcinkoAssociates.com

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US Economic leaders are looking to the past for some inspiration on how to deal with the present—the only issue is, no one seems to be able to agree which past era they should be studying. But, predictions diverge, for example.

  1. Deutsche Bank believes the U.S. economy closely resembles the turbulent times of the 1970s, an outlook prompted by the war in Israel, oil shocks, and rampant inflation.
  2. Meanwhile economists at the White House say the inflationary period after World War II acts as a better guide because pent-up demand from the pandemic will eventually fade away.
  3. UBS disagrees with both, saying the 1990s more closely resembles the economic climate world leaders are currently attempting to navigate. A note from the UBS Chief Investment Office, led by Jason Draho, questioned whether the 2020s would act as “another roaring 20s” seen a century before. During this period, technological advances led to a rapid increase in productivity, while major industries like automotive, film and chemicals took off. The data suggests today’s economy has officially entered a new regime, UBS outlined: “A regime is defined by its growth, inflation, and rate attributes. These are all at their highest levels since prior to the global financial crisis (GFC).”

Here is where the major benchmarks ended:

  • The S&P 500 Index was up 84.15 points (1.9%) at 4,495.70; the Dow Jones Industrial Average (DJI) was up 489.83 points (1.4%) at 34,827.70; the NASDAQ Composite (COMP) was up 326.64 points (2.4%) at 14,094.38.
  • The 10-year Treasury note yield (TNX) was down about 18 basis points at 4.453%.
  • CBOE’s Volatility Index (VIX) was down 0.60 at 14.16.

The small-cap focused Russell 2000 Index (RUT), which has lagged large-cap benchmarks for most of the year, jumped more than 5% Tuesday. Small-caps are often seen as being more exposed to the economic cycle and had suffered because of concerns that high interest rates could push the economy into recession.

Other interest rate-sensitive sectors, such as real estate, materials, and utilities, also saw outsize gains.

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

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CAREER: Executive Physician Coaching

MARCINKO ASSOCIATES, Inc.

SPONSOR: http://www.MarcinkoAssociates.com

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Did you Know?

Experts estimate that it can cost more than $1 million to recruit and train a replacement for a doctor who leaves the profession because of burnout. But, as no broad calculation of burnout costs exists, Dr. Tait Shanafelt [Mayo Clinic researcher and Stanford Medicine’s first Chief Physician Wellness Officer] said Stanford, Harvard Business School, Mayo Clinic and the American Medical Association (AMA) are further cost estimating the issue. Nevertheless, Shanafelt and other researchers have shown that burnout erodes job performance, increases medical errors, and leads doctors to leave a profession they once loved.

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

Fortunately, we can help. From formal coaching to second career opinions, mentoring and advising, we can help with our remediation executive career programs. Regardless of what is happening in your life, it is wonderful to have a non-partial, confidential and informed career coach and sounding board on your side.

CITE: JAMA Internal Medicine [Effect of a Professional Coaching Intervention on the Well-Being and Distress of Physicians].

NCBI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6686971/

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CONTACT US: https://marcinkoassociates.com/process-what-we-do/

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DAILY UPDATE: World Kindness Day 2023

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World Kindness Day, an international holiday that was formed in 1998, to promote kindness throughout the world and is observed annually on November 13th as part of the World Kindness Movement. It is observed in many countries including the United States, Canada, Japan, Australia and the U.A.E. World Kindness Day presents us with the opportunity to reflect upon one of the most important and unifying human principles. On a day devoted to the positive potential of both large and small acts of kindness, try to promote and diffuse this crucial quality that brings people of every kind together. 

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And, stocks markets are on a roll with almost too many trophies to hand out. The NASDAQ had its best day since May on Friday, while the S&P 500 has gained for nine of the last 10 sessions, rising 7.2% in that period. Falling bond yields have investors thinking the market is poised for a rally to close out 2023.

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

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What is Financial CARRIED INTEREST?

A TAX LOOPHOLE?

BY DR. DAVID E. MARCINKO MBA CMP®

CMP logo

SPONSOR: http://www.CertifiedMedicalPlanner.org

Carried interest, or carry, in finance, is a share of the profits of an investment paid to the investment manager in excess of the amount that the manager contributes to the partnership, specifically in alternative investments (private equity and hedge funds).

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

In small businesses that are not blind pools, such as single property real estate, the investment manager often funds the business prior to the formation of the partnership. It is a performance fee, rewarding the manager for enhancing performance. The structure also takes advantage of favorable tax treatment in the United States.

However, critics of carried interest want it to be reclassified as ordinary income – not capital gains – to be taxed at the ordinary income tax rate. Private equity advocates argue that the increased tax will subdue the incentive to take the kind of risk that is necessary to invest in and manage companies to profitability.

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What is the carried interest tax loophole?

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TAXATION: https://www.taxpolicycenter.org/briefing-book/what-carried-interest-and-how-it-taxed

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FEES: Online Investment Platforms?

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DR. DAVID EDWARD MARCINKO MBA CMP

SPONSOR: http://www.MARCINKOASSOCIATES.com

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Regardless of the technology infra-structure, there are generally four types of fees that an online investment platforms charge:

  • Trading Fees: Any fixed charge attached to each trade that you make. This will typically be either a flat fee or what’s known as the “spread,” when your broker charges you based on the difference between the buying and the selling price of an asset.
  • Trading Commissions: This is when a broker will charge you for each trade you make based on a percentage of the volume or value of each trade.
  • Inactivity Fees: Any fees that the broker charges you for not trading, such as for keeping money in a brokerage account.
  • Non-Trading/Other Fees: Any form of fee for using this platform not covered above. For example, a brokerage might charge you for making deposits into your account, taking money out of it or signing up for additional services.
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Our iMBA e-Book Sales and Service

The Institute of Medical Business Advisors is a leading national scope provider of healthcare economics, finance, investing, managerial accounting, policy, management and business administration education and medical practice management textbooks, reports, hand-books, dictionaries, journals, white-papers, fair-market valuations [FMV] and legal advisory opinions using multi-platform and traditional seminars and channels of knowledge distribution. iMBA helps the nation’s financial, healthcare and education professionals make decisive improvements in their direction and performance by empowering them through unbiased information, consultants and proprietary tools, books, templates and B-school styled case models.A virtuous “win-win” situation for all concerned.

Link: https://medicalexecutivepost.com/me-pr-a-new-feature/

The firm serves universities, medical, business, graduate and nursing schools; physicians, dentists, attorneys and legal societies – accountants, financial service providers, stock brokers, RIAs, wealth and hedge fund managers – emerging entities, hospitals, clinics, outpatient centers, CXOs and their BODs – the press, media and related academic entities.

Link: http://www.MarcinkoAssociates.com

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AT YOUR SERVICE

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CAREER: Physician Coaching and Executive Development

MARCINKO ASSOCIATES, Inc.

SPONSOR: http://www.MarcinkoAssociates.com

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Did you Know?

Experts estimate that it can cost more than $1 million to recruit and train a replacement for a doctor who leaves the profession because of burnout. But, as no broad calculation of burnout costs exists, Dr. Tait Shanafelt [Mayo Clinic researcher and Stanford Medicine’s first Chief Physician Wellness Officer] said Stanford, Harvard Business School, Mayo Clinic and the American Medical Association (AMA) are further cost estimating the issue. Nevertheless, Shanafelt and other researchers have shown that burnout erodes job performance, increases medical errors, and leads doctors to leave a profession they once loved.

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

Fortunately, we can help. From formal coaching to second career opinions, mentoring and advising, we can help with our remediation executive career programs. Regardless of what is happening in your life, it is wonderful to have a non-partial, confidential and informed career coach and sounding board on your side.

CITE: JAMA Internal Medicine [Effect of a Professional Coaching Intervention on the Well-Being and Distress of Physicians].

NCBI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6686971/

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CONTACT US: https://marcinkoassociates.com/process-what-we-do/

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DAILY UPDATE: Moody’s Down but Stocks Blast Off!

By Staff Reporters

Today is Veterans Day, when Americans honor all who have served our country in the armed forces. It’s celebrated on November 11th each year because on that morning in 1918 (at the 11th hour of the 11th day of the 11th month), the Allied nations and Germany signed an armistice that ended the fighting in World War I.

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SPONSOR: MarcinkoAssociates.com

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Moody’s credit rating agency downgraded its outlook on the US government from ‘stable’ to ‘negative’, citing the risks to the nation’s fiscal strength and the political polarization in Congress. The agency has maintained the US’s current top-grade AAA rating, but has raised the possibility that it may be cut in the future. While the move does not automatically mean it will downgrade America’s creditworthiness, it increases the chances. Even the prospect of a US downgrade could hurt Americans’ investment portfolios, make it even more expensive for them to borrow money, and make it more costly for the government to pay off its debts.

These effects would likely be even more painful if Moody’s does eventually downgrade the US debt. The nation’s diminished fiscal strength, undone by extreme partisanship in Washington, was a key driver of the action, according to a statement from Moody’s.

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YET: Here is where the major benchmarks ended on Friday:

  • The S&P 500 Index was up 67.89 points (1.6%) at 4,415.24, up 1.3% for the week; the Dow Jones Industrial Average was up 391.16 points (1.2%) at 34,283.10, up 0.7% for the week; the NASDAQ Composite was up 276.66 points (2.1%) at 13,798.11, up 2.4% for the week.
  • The 10-year Treasury note yield was down about 1 basis point at 4.622%.
  • CBOE’s Volatility Index (VIX) was down 0.11 at 14.20.

Nearly every market sector gained Friday, with semiconductors and other tech shares leading the pack. The Philadelphia Semiconductor Index (SOX) jumped more than 4% to its highest level in more than two months. Consumer discretionary and energy companies were also strong, the latter thanks to a nearly-2% gain in crude oil futures.

But small-caps continued to lag their bigger counterparts, with the Russell 2000 Index (RUT) rising 1.1% Friday, though it was still down 3.1% for the week.

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FINANCIAL PLANNING: Physician Niche Focused Fiduciaries

(“Informed Voice of a New Generation of Fiduciary Advisors for Healthcare”)

By Dr. David Edward Marcinko MBA CMP

http://www.MarcinkoAssociates.com

As fellow doctors, we understand better than most the more complex financial challenges physicians can face when it comes to their financial planning. Of course, most physicians ultimately make a good income, but it is the saving, asset and risk management tolerance and investing part that many of our colleagues’ struggle with. Far too often physicians receive terrible guidance, have no time to properly manage their own investments and set goals for that day when they no longer wish to practice medicine.

For the average doctor or healthcare professional, the feelings of pride and achievement at finally graduating are typically paired with the heavy burden of hundreds of thousands of dollars in student loan debt.

You dedicated countless hours to learning, studying, and training in your field. You missed birthdays and holidays, time with your families, and sacrificed vacations to provide compassionate and excellent care for your patients. Amidst all of that, there was no time to give your finances even a second thought.

Between undergraduate, medical school, and then internship and residency, most young physicians do not begin saving for retirement until late into their 20s, if not their 30s. You’ve missed an entire decade or more of allowing your money and investments to compound and work for you. When it comes to addressing your financial health and security, there’s no time to waste.

And you may be misled by unscrupulous “advisors”.

For example:

Question: Do you know the difference between a “Fee-Only” and a “Fee-Based financial advisor? Not knowing may cost you tens of thousands of dollars, or more, in excessive advisory fees.

MORE: https://marcinkoassociates.com/financial-planning/

Of course, all of this compound’s physician stress and burnout related issues, as well.

MORE: https://marcinkoassociates.com/process-what-we-do/

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On Merging Medical Practices

By David Edward Marcinko MBA CMP

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SPONSOR: http://www.MARCINKOASSOCIATES.com

Merging Medical Practices

There are only three possibilities if you want to go into practice for yourself; buy a practice; franchise a business, or start one. However, if you have an existing practice, merging it to form a larger entity can be a satisfying experience. The pace of practice mergers is accelerating, but it is often difficult to make an informed judgment about synergy. Mergers make sense only if the resulting value is more than additive to the original; not duplicative.

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

Unfortunately, far too many mergers fail to create, or actually destroy existing value. So, look for complimentary processes, personalities and ideas. In a merger of two existing practices, there is no substitute for personal interaction between employees and physician-management. This creates cross-pollination and new ideas in everything from service-lines and the patient production process, to marketing and finance, and to proprietary and intellectual rights. Most importantly, it allows
diversity of ideas.

And so, the following are questions to consider when contemplating a medical practice
merger:


 What are the risks of this transaction and how are they mitigated?
 Will talented employees be retained on both sides and can an exodus be
prevented?
 Are the specific liabilities of each practice known? Remember, the farther outside
your area of specialty or expertise, the greater the risk of being wrong.
 Will I appraise each practice independently, and correctly?
 Where will employee allegiance rest?
 What is the name, and logo, of the new entity? Who will be the CEO?

Vertical Integration: https://medicalexecutivepost.com/2023/04/14/integration-as-a-competitive-strategy-in-healthcare-reform/

More: https://medicalexecutivepost.com/2022/06/19/healthcare-mergers-acquisitions-2021-in-review/

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HEALTH INSURANCE COSTS: Employer Sponsored Shares Up

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SPONSOR: http://www.MarcinkoAssociates.com

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The average cost of a health insurance plan offered through an employer rose 7% this year, to $23,968 for family plans and $8,435 for individuals, according to a new survey from the private health foundation KFF.

The jump—the highest since 2011—was driven by inflation, as well as higher wages for healthcare workers and hospital system mergers, health policy experts say. Here’s what it means for employers and the 150+ million Americans who get insurance through work:

  • The increase amounted to ~$500 more out of pocket for family plan-holders, and $75 more for solo riders—further squeezing consumer spending power, which is already constrained by wages that haven’t caught up to high inflation.
  • Employers often bear the brunt of increased health spending because, in the interest of staying competitive, they’re wary of offloading too much of the rising costs onto their workers. That’s likely why deductibles haven’t grown much in the past five years.

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

But things might get worse: 1 in 4 companies surveyed by KFF said they plan to increase employees’ premium contributions in the next two years

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DR. NATHANIEL POTTER: Rest in Peace [R.I.P]

By Dr. David Edward Marcinko MBA

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READ HERE: https://medicalexecutivepost.com/2009/08/27/off-road-touring-with-dr-marcinko-part-vi/

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M&As: A New Guidelines Draft

By Staff Reporters

http://www.MARCINKOASSOCIATES.com

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Last month, the FTC and DOJ jointly released a draft of new guidelines they will use to evaluate potential mergers and acquisitions (M&As).

The guidelines include 13 principles the agencies will follow when scrutinizing deals. The principles stipulate that mergers may not “entrench or extend a dominant position,” eliminate competition between firms, increase concentration in an already concentrated market, or prevent new players from entering a market. The guidelines will be finalized following a 60-day public comment period.

The proposed rules reflect a return to pre-2010 guidelines on concentration, the Wall Street Journal reported, noting that they’d apply to deals that resulted in firms having a market share of 30% or more. The new guidance may give the FTC and DOJ, which have filed numerous antitrust actions, more leeway to go after deals.

PHYSICIAN ENTREPRENEURS: https://marcinkoassociates.com/welcome-medical-colleagues/

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D.E. MARCINKO & Associates, Inc.

WHAT WE DO AND HOW WE ASSIST MEDICAL COLLEAGUES

Hard Business Advice AND Personal Lifestyle Coaching

http://www.MARCINKOASSOCIATES.com

By Ann Miller RN MHA CMP™

At D.E. Marcinko & Associates our clients traditionally include physicians [MD, MBBS and DO], dentists [DDS and DMD], podiatrists [DPM], 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 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, etc].

D.E. Marcinko & Associates understands the complexity of financial and non-financial deal terms because we are also doctors. Our “hard” knowledge of your business comes from being actual healthcare facility owners, operators and medical practitioners [with additional professional licenses and expertise] enabling us to effectively analyze your business, take corrective measures and present your healthcare entity in the best possible and accurate light.

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But, if you’re looking at this website, chances are you are fed up, burned out, seeking practice management techniques or a better work-life balance. Or, you are looking for a new non-clinical career, thinking of finance, investing, retirement, or all of the above. Perhaps you are just looking to regain the joy and meaning in your medical or professional career? This is known as “soft” psychology, coaching, personal consulting or fraternal advice.

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Regardless, of your “soft” personal or “hard” corporate needs, our transparent Fees for Service [FFS] model is moderated for all colleagues based on the acuity and urgency of their engagements. Reduced rates and/or limited charity work may also be possible.

***

CONTACT US TODAYTHRIVE TOMORROW!

Suite #5901 Wilbanks Drive

Norcross, Georgia USA 30092-1141

email: MarcinkoAdvisors@msn.com

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RETAIN A PHYSICIAN COACH: “From Chaos to Calm” in 2024?

SPONSOR: http://www.MARCINKOASSOCIATES.com

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“FROM CHAOS-TO-CALM”

If you’re looking at this tab, chances are you are fed up, burned out, seeking better work-life balance, looking for a new non-clinical career, thinking of retirement, or all of the above. Perhaps you are just looking to regain the joy and meaning in your medical career.

No worries! You may have come to the right place.

LEARN MORE: https://medicalexecutivepost.com/2022/10/24/personal-coaching-dr-marcinko-at-your-service/

THANK YOU

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NET WORTH: Average by Age

By Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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The average net worth of someone younger than 35 years old is $76,300, as of 2019. From there, average net worth steadily rises within each age bracket. Between 35 to 44, the average net worth is $436,200, while between 45 to 54 that number increases to $833,200. Average net worth cracks the $1 million mark between 55 to 64, reaching $1,175,900.

Average net worth again rises for those ages 65 to 74, to $1,217,700, before falling to $977,600 for someone over age 75.

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

The median net worth within every single age bracket, however, is lower than the average net worth.

MARCINKO & ASSOCIATES: http://www.MarcinkoAssociates.com

PHYSICIAN NET WORTH: https://medicalexecutivepost.com/2023/09/27/physician-assets-liabilities-and-personal-net-worth/

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COMMENTS APPRECIATED

Thank You

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Our iMBA e-Book Sales and Service

The Institute of Medical Business Advisors is a leading national scope provider of healthcare economics, finance, investing, managerial accounting, policy, management and business administration education and medical practice management textbooks, reports, hand-books, dictionaries, journals, white-papers, fair-market valuations [FMV] and legal advisory opinions using multi-platform and traditional seminars and channels of knowledge distribution. iMBA helps the nation’s financial, healthcare and education professionals make decisive improvements in their direction and performance by empowering them through unbiased information, consultants and proprietary tools, books, templates and B-school styled case models.A virtuous “win-win” situation for all concerned.

Link: https://medicalexecutivepost.com/me-pr-a-new-feature/

The firm serves universities, medical, business, graduate and nursing schools; physicians, dentists, attorneys and legal societies – accountants, financial service providers, stock brokers, RIAs, wealth and hedge fund managers – emerging entities, hospitals, clinics, outpatient centers, CXOs and their BODs – the press, media and related academic entities.

Link: http://www.MarcinkoAssociates.com

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AT YOUR SERVICE

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CAREER: Physician Coaching and Development

MARCINKO ASSOCIATES, Inc.

SPONSOR: http://www.MarcinkoAssociates.com

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Did you Know?

Experts estimate that it can cost more than $1 million to recruit and train a replacement for a doctor who leaves the profession because of burnout. But, as no broad calculation of burnout costs exists, Dr. Tait Shanafelt [Mayo Clinic researcher and Stanford Medicine’s first Chief Physician Wellness Officer] said Stanford, Harvard Business School, Mayo Clinic and the American Medical Association (AMA) are further cost estimating the issue. Nevertheless, Shanafelt and other researchers have shown that burnout erodes job performance, increases medical errors, and leads doctors to leave a profession they once loved.

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

Fortunately, we can help. From formal coaching to second career opinions, mentoring and advising, we can help with our remediation executive career programs. Regardless of what is happening in your life, it is wonderful to have a non-partial, confidential and informed career coach and sounding board on your side.

CITE: JAMA Internal Medicine [Effect of a Professional Coaching Intervention on the Well-Being and Distress of Physicians].

NCBI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6686971/

THANK YOU

CONTACT US: https://marcinkoassociates.com/process-what-we-do/

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What is GAAP?

HOW IT WORKS

By Dr. David E. Marcinko MBA CMP®

http://www.MarcinkoAssociates.com

CMP logo

SPONSOR: http://www.CertifiedMedicalPlanner.org

Generally Accepted Accounting Principles

As a new physician investor, it’s important to know the distinctions between like measurements because the market allows firms to advertise their numbers in ways not otherwise regulated. Often companies will publicize their numbers using either GAAP or non-GAAP measures. GAAP, or generally accepted accounting principles, outlines rules and conventions for reporting financial information. It is a means to standardize financial statements and ensure consistency in reporting.

When a company publicizes its earnings and includes non-GAAP figures, it means it wants to provide investors with an arguably more accurate depiction of the company’s health (for instance, by removing one-time items to smooth out earnings). However, the further a company deviates from GAAP standards, the more room is allocated for some creative accounting and manipulation.

When looking at a company that is publishing non-GAAP numbers, new physician investors should be wary of these pro forma statements, because they may differ greatly from what GAAP deems acceptable.

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

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The Core GAAP Principles

GAAP is set forth in 10 primary principles, as follows:

  1. Principle of consistency: This principle ensures that consistent standards are followed in financial reporting from period to period.
  2. Principle of permanent methods: Closely related to the previous principle is that of consistent procedures and practices being applied in accounting and financial reporting to allow comparison.
  3. Principle of non-compensation: This principle states that all aspects of an organization’s performance, whether positive or negative, are to be reported. In other words, it should not compensate (offset) a debt with an asset.
  4. Principle of prudence: All reporting of financial data is to be factual, reasonable, and not speculative.
  5. Principle of regularity: This principle means that all accountants are to consistently abide by the GAAP.
  6. Principle of sincerity: Accountants should perform and report with basic honesty and accuracy.
  7. Principle of good faith: Similar to the previous principle, this principle asserts that anyone involved in financial reporting is expected to be acting honestly and in good faith.
  8. Principle of materiality: All financial reporting should clearly disclose the organization’s genuine financial position.
  9. Principle of continuity: This principle states that all asset valuations in financial reporting are based on the assumption that the business or other entity will continue to operate going forward.
  10. Principle of periodicity: This principle refers to entities abiding by commonly accepted financial reporting periods, such as quarterly or annually.

Thank You

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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

YOUR COMMENTS ARE APPRECIATED

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

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HOSPITALS: 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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MEDICARE ADVANTAGE PLANS: Part C Plans Down AS Cigna Pays Up?

Hospitals are Dropping Medicare Advantage [Part C] Plans – Left and Right

By Dr. David Edward Marcinko MBA

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Hospitals Say Bye-Bye?

Medicare Advantage provides health coverage to more than half of the nation’s seniors, but a growing number of hospitals and health systems nationwide are pushing back and dropping the private plans altogether. Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers. Some systems have noted that most MA carriers have faced allegations of billing fraud from the federal government and are being probed by lawmakers over their high denial rates.

“It’s become a game of delay, deny and not pay,” Chris Van Gorder, president and CEO of San Diego-based Scripps Health, told Becker’s. “Providers are going to have to get out of full-risk capitation because it just doesn’t work — we’re the bottom of the food chain, and the food chain is not being fed.” Van Gorder said the health system is facing a loss of $75 million this year on the MA contracts, which will end December 31st for patients covered by UnitedHealthcare, Anthem Blue Cross, Blue Shield of California, Centene’s Health Net and a few more smaller carriers.

Source: Becker’s Hospital Review [9/27/23]

COMMENTS APPRECIATED

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Cigna to Pay $172M Over Alleged Medicare Advantage Fraud

The Cigna Group will pay $172.3 million to resolve allegations that it violated the False Claims Act by submitting incorrect Medicare Advantage patient data to CMS to receive higher payments from the agency. The U.S. Attorney’s Office for the Eastern District of Pennsylvania alleged Sept. 30 that Cigna also falsely certified that the submitted data was accurate, failed to withdraw the “untruthful” data, and did not repay CMS.

Cigna will use $135.3 million from the settlement to resolve the allegations from the Justice Department. The remaining $37 million will resolve allegations related to unsupported diagnoses for Medicare Advantage enrollees that received in-home services from Cigna. As part of the settlement, Cigna has entered into a five-year accountability and auditing agreement with HHS’ Office of Inspector General, which will require company executives and board members to certify Cigna’s compliance moving forward. The payer must also conduct annual risk assessments and submit to independent risk adjustment audits.

Source: Jakob Emerson, Becker’s Payer Issues [10/2/23]

Thank You

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What’s in a Medical Practice Professional Name?

NAMING YOUR MEDICAL PRACTICE

By Dr. David Edward Marcinko MBA CMP

SPONSOR: http://www.MARCINKOASSOCIATES.com

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A medical practice name should be easy to say, hear, spell, and remember-unlike prescription drugs. It should be appealing and resonate with your target patient base. Here are some common naming methods for small to medical medical practices use.

We, and most experts, recommend against naming a new medical practice with your own name because it limits future growth and you may lose the benefits that a more descriptive name would bring. Your business name will likely be incorporated using your practice’s name, although larger (multi-specialty group) practices may use a more general name for the entire enterprise; and then having multiple “dba’s” (”Doing Business As”) for the individual practices under the umbrella.

It is important to discuss these options with an attorney if you believe this arrangement has advantage; others find it confusing. Usually, your medical specialty can be used as a base-name, and then some
descriptor to differentiate it from local competing practices. Selecting a name like “The Medical Allegiance Partners” does not indicate that medicine is your service. On the other hand, naming your practice “Dental Associates of Your Town” won’t be helpful to patients looking for you in the yellow pages, or internet search engines, and finding your practice listed just before “Your Town Dental Partners”. It is therefore good to be cognizant of your competitors’ names when choosing your own.

MORE: https://medicalexecutivepost.com/2022/12/07/how-to-name-your-new-medical-practice/

And, you should select a name that will hopefully grow with you into a larger enterprise.

For example: You are a solo doctor, but are pretty sure you’ll take on one or more partners in the future? Then besides not naming your practice after yourself, you may choose to add “Group” or “Partners” to your name initially even if you’re the only doctor.

Moreover, is there any possibility you’ll open a second office in another town? Naming your medical practice something like the ”Apple Street Internal Medicine Group” may not make sense when your second office is opened on Main Street in a nearby city, in a few years.

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COMMENTS APPRECIATED

Thank You

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RETAIN A PHYSICIAN COACH: “From Chaos to Calm” in 2023?

By Ann Miller RN MHA

SPONSOR: http://www.MARCINKOASSOCIATES.com

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“FROM CHAOS-TO-CALM”

If you’re looking at this tab, chances are you are fed up, burned out, seeking better work-life balance, looking for a new non-clinical career, thinking of retirement, or all of the above. Perhaps you are just looking to regain the joy and meaning in your medical career.

No worries! You may have come to the right place.

LEARN MORE: https://medicalexecutivepost.com/2022/10/24/personal-coaching-dr-marcinko-at-your-service/

THANK YOU

***

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Physician Assets, Liabilities and Personal Net Worth

How are Assets and Liabilities Related to Doctor Net Worth?

cropped-dem

Dr. David E. Marcinko MBA  

Before the relationship among financial assets, liabilities and net worth can be examined, some based definitions must be understood. 

LINK: http://www.CertifiedMedicalPlanner.org

[A] Short-Term Assets

Short-term goals (less than 12 months) require liquidity or short-term assets. These assets include cash, checking and saving accounts, certificates of deposit, and money market accounts. These accounts have two things in common. The principal is guaranteed from risk of loss, and pay a very low interest rate.  As an investment, they are considered substandard and one would only keep what is actually needed for liquidity purposes in these accounts.           

[B] Long-Term Assets

Longer-term assets (more than 12 months) include real estate, mutual funds, retirement plans, stocks, and life insurance cash value policies. Bonds may also be an appropriate long-term investment asset for a number of reasons, for example, if you are seeking a regular and reliable stream of income or if you have no immediate need for the amount of the principal invested. Bonds also can be used to diversify your portfolio and reducing the overall risk that is inherent in stock investments. 

[C] Short-Term Liabilities

Short-term liabilities (less than 12 months) include credit card debt, utility bills, and auto loans or leasing. When a young doctor leaves residency and starts practice, the foremost concern is student debt. This is an unsecured debt that is not backed by any collateral, except a promise to pay. There are recourses that an unsecured creditor can take to recoup the bad debt. Usually, if the unsecured creditor is successful obtaining a judgment, it can force wages to be garnished, and the Department of Education can withhold up to ten percent of a wages without first initiating a lawsuit, if in default.  It is also probable that young medical professionals have been holding at least one credit card since their sophomore year in college.  Credit card companies consider college student the most lucrative target market and medical students hold their first card for an average of fifteen years. There are several other types of other unsecured debt, including department store cards, professional fees, medical and dental bills, alimony, child support, rent; utility bills, personal loans from relatives, and health club dues, to name a few.  

[D] Long-Term Liabilities

A secured debt, on the other hand, is debt that is pledged by a specific property. This is a collateralized loan. Generally, the purchased item is pledged with the proceeds of the loan. This would include long-term liabilities (more than 12 months) such as a mortgage, home equity loan, or a car loan. Although the creditor has the ability to take possession of your property in order to recover a bad debt, it is done very rarely. A creditor is more interested in recovering money. Sometimes, when borrowing money, there may be a requirement to pledge assets that are owned prior to the loan.  

For example, a personal loan from a finance company requires that you pledge all personal property such as your car, furniture, and equipment.  The same property may become subject to a judicial lien if you are sued and a judgment is made against you. In this case, you would not be able to sell or pledge these assets until the judgment is satisfied.

A common example of a lien would be from unpaid federal, state or local taxes. Doctors can be found personally liable for unpaid payroll taxes of employees in their professional corporations.  Be aware that some assets and liabilities defy short or long-term definition. When this happens, simply be consistent in your comparison of financial statements, over time. 

[E] Personal Physician Net Worth

Once the value of all personal assets and liabilities is known, net worth can be determined with the following formula: Net worth = assets minus liabilities. Obviously, higher is better.  In The Millionaire Next Door, Thomas H. Stanley, PhD, and William H. Danko give the following benchmark for net worth accumulation. Although conservative for physicians of a past generation, it may be more applicable in the future because of current managed care environment.

Here is the guide: Multiple your age by your annual pre-tax income from all sources – except inheritances – and divide by ten. 

Real-Life Medical Example: As an HMO pediatrician, Dr. Curtis earned $ 60,000 last year. So, if she is 35, her net worth should be at least $ 210,000.

How do you get to that point? In a word, consume less, save more and watch the student loans. Stanley and Danko found that the typical millionaire set aside 15 percent of earned income annually and has enough invested to survive 10 years, at current income levels if he stopped working.  Now, if Dr. Curtis lost her job tomorrow, how long could she pay herself the same salary? 

[F] Common Liability Management Mistakes

 A common liability management mistake is not recognizing when you are heading for trouble. If doctors are paying only the minimum payments on credit card debt, while continuing to charge purchases at a rate faster than the pay-down, trouble is brewing. If you don’t categorize your debt, you could find yourself paying down non-priority debt while ignoring priority debt.

A priority debt is one that is essential or subject to serious consequences, if not paid. Examples include rent, mortgage payments, utility bills, child support, car payments, unpaid taxes, and other secured debt. If in one month, a doctor had to choose between paying his accounting bill or his rent, it would be essential to pay the rent. 

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

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners(TM)Invite Dr. Marcinko

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On Merging Medical Practices

By David Edward Marcinko MBA CMP

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SPONSOR: http://www.MARCINKOASSOCIATES.com

Merging Medical Practices

There are only three possibilities if you want to go into practice for yourself; buy a practice; franchise a business, or start one. However, if you have an existing practice, merging it to form a larger entity can be a satisfying experience. The pace of practice mergers is accelerating, but it is often difficult to make an informed judgment about synergy. Mergers make sense only if the resulting value is more than additive to the original; not duplicative.

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

Unfortunately, far too many mergers fail to create, or actually destroy existing value. So, look for complimentary processes, personalities and ideas. In a merger of two existing practices, there is no substitute for personal interaction between employees and physician-management. This creates cross-pollination and new ideas in everything from service-lines and the patient production process, to marketing and finance, and to proprietary and intellectual rights. Most importantly, it allows
diversity of ideas.

And so, the following are questions to consider when contemplating a medical practice
merger:


 What are the risks of this transaction and how are they mitigated?
 Will talented employees be retained on both sides and can an exodus be
prevented?
 Are the specific liabilities of each practice known? Remember, the farther outside
your area of specialty or expertise, the greater the risk of being wrong.
 Will I appraise each practice independently, and correctly?
 Where will employee allegiance rest?
 What is the name, and logo, of the new entity? Who will be the CEO?

Vertical Integration: https://medicalexecutivepost.com/2023/04/14/integration-as-a-competitive-strategy-in-healthcare-reform/

More: https://medicalexecutivepost.com/2022/06/19/healthcare-mergers-acquisitions-2021-in-review/

COMMENTS APPRECIATED

Thank You

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CERTIFIED MEDICAL PLANNER™: Helping Physicians Financially Thrive to Avoid the “Doctor Effect”

By Dr. David Edward Marcinko, MBA CMP

CEO: D.E. Marcinko & Associates, Inc.

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SPONSOR: http://www.CERTIFIEDMEDICALPLANNER.org

BEWARE MEDICAL PRACTITIONERS

Several years ago a group of highly trusted and deeply experienced financial services professionals and estate planners noted that far too many of their mature physician clients, using traditional stock brokers, management consultants and financial advisors, seemed to be less successful than those who went it alone. These Do-it-Yourselfers [DIYs] had setbacks and made mistakes, for sure. But, the ME Inc doctors seemed to learn from their mistakes and did not incur the high management and service fees demanded from general or retail one-size-fits-all “advisors.”

In fact, an informal inverse relationship was noted, and dubbed the “Doctor Effect.” In others words, the more consultants an individual doctor retained; the less well they did in all disciplines of the financial planning and medical practice management, continuum.

Of course, the reason for this discrepancy eluded many of them as Wall Street brokerages and wire-houses flooded the media with messages, infomercials, print, radio, TV, texts, tweets, and internet ads to the contrary. Rather than self-learn the basics, the prevailing sentiment seemed to purse the holy grail of finding the “perfect financial advisor.” This realization was a confirmation of the industry culture which seemed to be: Bread for the advisor – Crumbs for the client!

And so, at D.E. Marcinko & Associates, our informed cadre’ of technology focused and highly educated doctors, nurses, financial advisors, attorneys, accountants, psychologists and educational visionaries decided there must be a better way for healthcare colleagues to receive financial planning advice, products and related management services within a culture of fiduciary responsibility.

We trust you agree with this ME Inc, and Certified Medical Planner™ consulting philosophy, as illustrated  on our website.

WEBSITE: http://www.MARCINKOASSOCIATES.com

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RISK MANAGEMENT FOR PHYSICIANS

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

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FAIR MARKET VALUATION DETERMINATION [FMV]

MEDICAL PRACTICE OR AMBULATORY SURGERY CENTER

D.E. MARCINKO ASSOCIATES, Inc.

http://www.MARCINKOASSOCIATES.com

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FAIR MARKET VALUATION DETERMINATION

There are a Myriad of Reasons for Obtaining a Medical Practice Valuation and Appraisal Engagement:

  • Outright selling-buying
  • Partnership and Associate buy-in / buy-out
  • Mergers and Acquisitions
  • Organic growth tracking
  • Hospital integrations
  • Private and public reporting
  • Financing and Venture Capital
  • Estate and tax planning

MORE: https://marcinkoassociates.com/fmv-appraisals/

Our Capability

We have the ability to provide extensive analysis of value components in healthcare practices and provide appraisals based on business, economic, and market conditions. This involves detailed examination of financials and clinical data in the context of numerous factors including medical specialty, physician supply and demand, payer mix, regulatory environment, regional dynamics, and risk premium.

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

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

THANK YOU

***

MARCINKO & Associates, Inc.

WHAT WE DO AND HOW WE ASSIST MEDICAL COLLEAGUES

Hard Business Advice AND Personal Lifestyle Coaching

http://www.MARCINKOASSOCIATES.com

By Ann Miller RN MHA CMP™

At Marcinko & Associates our clients traditionally include physicians [MD, MBBS and DO], dentists [DDS and DMD], podiatrists [DPM], 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 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, etc].

Marcinko & Associates understands the complexity of financial and non-financial deal terms because we are also doctors. Our “hard” knowledge of your business comes from being actual healthcare facility owners, operators and medical practitioners [with additional professional licenses and expertise] enabling us to effectively analyze your business, take corrective measures and present your healthcare entity in the best possible and accurate light.

***

But, if you’re looking at this website, chances are you are fed up, burned out, seeking practice management techniques or a better work-life balance. Or, you are looking for a new non-clinical career, thinking of finance, investing, retirement, or all of the above. Perhaps you are just looking to regain the joy and meaning in your medical or professional career? This is known as “soft” psychology, coaching, personal consulting or fraternal advice.

***

Regardless, of your “soft” personal or “hard” corporate needs, our transparent Fees for Service [FFS] model is moderated for all colleagues based on the acuity and urgency of their engagements. Reduced rates and/or limited charity work may also be possible.

***

http://www.DavidEdwardMarcinko.com

CONTACT US TODAYTHRIVE TOMORROW!

Suite #5901 Wilbanks Drive

Norcross, Georgia USA 30092-1141

email: MarcinkoAdvisors@msn.com

***

***

OPEN LETTER: MARCINKO Associates, Inc.

MISSION & PHYSICIAN COACHING STATEMENT

Open Letter from the CEO

Dr. David Edward Marcinko MBA CMP™

http://www.MarcinkoAssociates.com

ALL MEDICAL AND HEALTHCARE COLLEAGUES

Did you know that at MARCINKO & Associates, all medical colleagues throughout the United States may contact us when they are considering the sale, purchase, strategic operating improvement, merger, acquisition and/or other financial business or related personal financial planning transaction?

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

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Our difference is “hard” knowledge and insider financial guidance that helps medical colleagues, nurses, private practitioners, clinics, ambulatory surgery, radiology and outpatient wound care centers realize their ultimate economic goals. This typically includes managerial and cost accounting, financial ratio analysis, fair market valuation business appraisals, business plan creation and personal financial planning.

MORE: https://marcinkoassociates.com/fmv-appraisals/

Our “expert witness” business litigation support service and divorce mediation, arbitration, asset division, settlement and second opinion offerings are always available, as well.

MORE: https://marcinkoassociates.com/expert-witness/

And, our “soft” skill professional career guidance and mentoring center includes executive coaching, consulting and mentoring advisory programs for stressed, conflicted or burned-out physicians and medical practitioners.

Our DIY BOOKS:

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Most importantly, our professional fees are reasonable and always transparent.

MARCINKO & Associates also serves universities, medical, business, graduate and nursing schools; physicians, dentists, podiatrists, optometrists and legal societies. This includes accountants, financial service providers, wealth and hedge fund managers, emerging entities, hospitals, CEOs and their BODs, the press, media and related organizations.

MORE: https://marcinkoassociates.com/speaking-seminars/

Contact us for an educational white-paper on most any topic.

MORE: https://marcinkoassociates.com/case-studies/

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Now, please review our website to learn more.

And, always retain us when needed.

How May We Serve You?

DAVID EDWARD MARCINKO

email: MarcinkoAdvisors@msn.com

© Copyright: Institute of Medical Business Advisors, Inc. All rights reserved, USA. Present to 2024.

FAIR MARKET VALUATION DETERMINATION [FMV]

MEDICAL PRACTICE OR AMBULATORY SURGERY CENTER

D.E. MARCINKO ASSOCIATES, Inc.

http://www.MARCINKOASSOCIATES.com

***

FAIR MARKET VALUATION DETERMINATION

There are a Myriad of Reasons for Obtaining a Medical Practice Valuation and Appraisal Engagement:

  • Outright selling-buying
  • Partnership and Associate buy-in / buy-out
  • Mergers and Acquisitions
  • Organic growth tracking
  • Hospital integrations
  • Private and public reporting
  • Financing and Venture Capital
  • Estate and tax planning

MORE: https://marcinkoassociates.com/fmv-appraisals/

Our Capability

We have the ability to provide extensive analysis of value components in healthcare practices and provide appraisals based on business, economic, and market conditions. This involves detailed examination of financials and clinical data in the context of numerous factors including medical specialty, physician supply and demand, payer mix, regulatory environment, regional dynamics, and risk premium.

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

***

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

THANK YOU

***

D.E. MARCINKO & Associates, Inc.

WHAT WE DO AND HOW WE ASSIST MEDICAL COLLEAGUES

Hard Business Advice AND Personal Lifestyle Coaching

http://www.MARCINKOASSOCIATES.com

By Ann Miller RN MHA CMP™

At D.E. Marcinko & Associates our clients traditionally include physicians [MD, MBBS and DO], dentists [DDS and DMD], podiatrists [DPM], 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 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, etc].

D.E. Marcinko & Associates understands the complexity of financial and non-financial deal terms because we are also doctors. Our “hard” knowledge of your business comes from being actual healthcare facility owners, operators and medical practitioners [with additional professional licenses and expertise] enabling us to effectively analyze your business, take corrective measures and present your healthcare entity in the best possible and accurate light.

***

But, if you’re looking at this website, chances are you are fed up, burned out, seeking practice management techniques or a better work-life balance. Or, you are looking for a new non-clinical career, thinking of finance, investing, retirement, or all of the above. Perhaps you are just looking to regain the joy and meaning in your medical or professional career? This is known as “soft” psychology, coaching, personal consulting or fraternal advice.

***

Regardless, of your “soft” personal or “hard” corporate needs, our transparent Fees for Service [FFS] model is moderated for all colleagues based on the acuity and urgency of their engagements. Reduced rates and/or limited charity work may also be possible.

***

http://www.DavidEdwardMarcinko.com

CONTACT US TODAYTHRIVE TOMORROW!

Suite #5901 Wilbanks Drive

Norcross, Georgia USA 30092-1141

email: MarcinkoAdvisors@msn.com

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IPOs: More Caution Ahead

By Staff Reporters

http://www.MARCINKOASSOCIATES.com

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From 2020 to 2021, when VC money was cheap and tech IPOs were hot, the tech companies that went public via IPO were mostly growth-focused unicorns that had yet to see any profits. But Instacart, which has turned a profit for the last five quarters, is something different.

Chip design company Arm, which debuted last week in the year’s biggest IPO, was the first venture-capital-backed startup to go public in the US since December 2021. It may have broken the ice, but Instacart is the next big test.

However, being profitable and being valuable aren’t the same thing. In 2020, investors valued Instacart at $39 billion, its highest valuation and roughly $29 billion more than what it’s expected to be worth to investors today.

  • Late-stage investors in Instacart, such as Fidelity and T. Rowe Price, stand to lose 40% or more.
  • Sequoia Capital—Instacart’s largest external shareholder—was also one of its earliest. Its initial $8 million investment in 2013 is worth $1 billion today, but its later investment of $50 million in 2021 has shrunk to $12 million.

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COMMENTS APPRECIATED

Thank You

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D.E. MARCINKO & Associates, Inc.

WHAT WE DO AND HOW WE ASSIST MEDICAL COLLEAGUES

Hard Business Advice AND Personal Lifestyle Coaching

http://www.MARCINKOASSOCIATES.com

By Ann Miller RN MHA CMP™

At D.E. Marcinko & Associates our clients traditionally include physicians [MD, MBBS and DO], dentists [DDS and DMD], podiatrists [DPM], 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 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, etc].

D.E. Marcinko & Associates understands the complexity of financial and non-financial deal terms because we are also doctors. Our “hard” knowledge of your business comes from being actual healthcare facility owners, operators and medical practitioners [with additional professional licenses and expertise] enabling us to effectively analyze your business, take corrective measures and present your healthcare entity in the best possible and accurate light.

***

But, if you’re looking at this website, chances are you are fed up, burned out, seeking practice management techniques or a better work-life balance. Or, you are looking for a new non-clinical career, thinking of finance, investing, retirement, or all of the above. Perhaps you are just looking to regain the joy and meaning in your medical or professional career? This is known as “soft” psychology, coaching, personal consulting or fraternal advice.

***

Regardless, of your “soft” personal or “hard” corporate needs, our transparent Fees for Service [FFS] model is moderated for all colleagues based on the acuity and urgency of their engagements. Reduced rates and/or limited charity work may also be possible.

***

http://www.DavidEdwardMarcinko.com

CONTACT US TODAYTHRIVE TOMORROW!

Suite #5901 Wilbanks Drive

Norcross, Georgia USA 30092-1141

email: MarcinkoAdvisors@msn.com

***

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The HEALTH DICTIONARY SERIES

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HEALTH DICTIONARY SERIES

By Ann Miller RN MHA

[An Internet WIKI CROWD-SOURCED Curation Project]*

To keep up with the ever-changing healthcare industrial complex, we must learn new definitions and re-learn old terminology in order to correctly apply it to practice. By aggregating the most up-to-date abbreviations, acronyms, definitions and terms, the Health Dictionary Series offers a wealth of information to help understand the ever-changing terms-of-art in healthcare today.

Each 10,000 item handbook is essential for doctors, nurses, benefits managers and insurance agents, CPAs, and administrators; as well as graduate and under graduate students and professors. Our goal to for each dictionary to be designated as a Doody’s Core Title. 

Dictionary of Health Insurance and Managed Care

With more than 8,000 definitions, 4,000 abbreviations and acronyms, and a 3,000 item oeuvre of resources, readings, and nomenclature derivatives, this dictionary covers the Medicare, managed care and Medicaid, private insurance, Veteran’s Administration and PP-ACA language of the entire health and long-term care insurance sector.

Product DetailsProduct DetailsProduct Details

Dictionary of Health Economics and Finance

Health economics and finance is an integral component of the health care industrial complex. Its language is a diverse and broad-based concept covering many other industries: accounting, mathematics, the actuarial sciences, stochastics and statistics, salary reimbursements, physician payments, compensation and forecasting are all commingled arenas.

Product DetailsProduct DetailsProduct Detailsm

 Dictionary of Health Information Technology Security

There is a myth that all healthcare stakeholders understand the meaning of information technology jargon. In truth, the vernacular of contemporary systems is unique, and often misused or misunderstood. Moreover, emerging Heath Information Technology (HIT) thru the HITECG initiatives; in the guise of terms, definitions, acronyms, abbreviations and standards; often puts the non-expert in a position of maximum uncertainty and minimum productivity.

Product DetailsProduct DetailsProduct Details

 *NOTE: A wiki website allows users to add or update content using their browser thru a hosted server created by the collaborative effort of site visitors. The Hawaiian term “wiki wiki” means “super fast.”

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OPEN LETTER: MARCINKO Associates, Inc.

MISSION STATEMENT

Open Letter from the CEO

Dr. David Edward Marcinko MBA CMP™

http://www.MarcinkoAssociates.com

ALL MEDICAL AND HEALTHCARE COLLEAGUES

Did you know that at MARCINKO & Associates, all medical colleagues throughout the United States may contact us when they are considering the sale, purchase, strategic operating improvement, merger, acquisition and/or other financial business or related personal financial planning transaction?

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

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Our difference is “hard” knowledge and insider financial guidance that helps medical colleagues, nurses, private practitioners, clinics, ambulatory surgery, radiology and outpatient wound care centers realize their ultimate economic goals. This typically includes managerial and cost accounting, financial ratio analysis, fair market valuation business appraisals, business plan creation and personal financial planning.

MORE: https://marcinkoassociates.com/fmv-appraisals/

Our “expert witness” business litigation support service and divorce mediation, arbitration, asset division, settlement and second opinion offerings are always available, as well.

MORE: https://marcinkoassociates.com/expert-witness/

And, our “soft” skill professional career guidance and mentoring center includes executive coaching, consulting and mentoring advisory programs for stressed, conflicted or burned-out physicians and medical practitioners.

Most importantly, our professional fees are reasonable and always transparent.

MARCINKO & Associates also serves universities, medical, business, graduate and nursing schools; physicians, dentists, podiatrists, optometrists and legal societies. This includes accountants, financial service providers, wealth and hedge fund managers, emerging entities, hospitals, CEOs and their BODs, the press, media and related organizations.

MORE: https://marcinkoassociates.com/speaking-seminars/

Contact us for an educational white-paper on most any topic.

MORE: https://marcinkoassociates.com/case-studies/

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Now, please review our website to learn more.

And, always retain us when needed.

How May We Serve You?

DAVID EDWARD MARCINKO

email: MarcinkoAdvisors@msn.com

© Copyright: Institute of Medical Business Advisors, Inc. All rights reserved, USA. Present to 2024.

What is Financial CARRIED INTEREST?

A TAX LOOPHOLE?

BY DR. DAVID E. MARCINKO MBA CMP®

CMP logo

SPONSOR: http://www.CertifiedMedicalPlanner.org

Carried interest, or carry, in finance, is a share of the profits of an investment paid to the investment manager in excess of the amount that the manager contributes to the partnership, specifically in alternative investments (private equity and hedge funds).

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

In small businesses that are not blind pools, such as single property real estate, the investment manager often funds the business prior to the formation of the partnership. It is a performance fee, rewarding the manager for enhancing performance. The structure also takes advantage of favorable tax treatment in the United States.

However, critics of carried interest want it to be reclassified as ordinary income – not capital gains – to be taxed at the ordinary income tax rate. Private equity advocates argue that the increased tax will subdue the incentive to take the kind of risk that is necessary to invest in and manage companies to profitability.

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What is the carried interest tax loophole?

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TAXATION: https://www.taxpolicycenter.org/briefing-book/what-carried-interest-and-how-it-taxed

YOUR COMMENTS ARE APPRECIATED.

***

ORDER: 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

Thank You

***

MARCINKO & Associates, Inc.

WHAT WE DO AND HOW WE ASSIST MEDICAL COLLEAGUES

Hard Business Advice AND Personal Lifestyle Coaching

http://www.MARCINKOASSOCIATES.com

By Ann Miller RN MHA CMP™

At Marcinko & Associates our clients traditionally include physicians [MD, MBBS and DO], dentists [DDS and DMD], podiatrists [DPM], 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 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, etc].

Marcinko & Associates understands the complexity of financial and non-financial deal terms because we are also doctors. Our “hard” knowledge of your business comes from being actual healthcare facility owners, operators and medical practitioners [with additional professional licenses and expertise] enabling us to effectively analyze your business, take corrective measures and present your healthcare entity in the best possible and accurate light.

***

But, if you’re looking at this website, chances are you are fed up, burned out, seeking practice management techniques or a better work-life balance. Or, you are looking for a new non-clinical career, thinking of finance, investing, retirement, or all of the above. Perhaps you are just looking to regain the joy and meaning in your medical or professional career? This is known as “soft” psychology, coaching, personal consulting or fraternal advice.

***

Regardless, of your “soft” personal or “hard” corporate needs, our transparent Fees for Service [FFS] model is moderated for all colleagues based on the acuity and urgency of their engagements. Reduced rates and/or limited charity work may also be possible.

***

http://www.DavidEdwardMarcinko.com

CONTACT US TODAYTHRIVE TOMORROW!

Suite #5901 Wilbanks Drive

Norcross, Georgia USA 30092-1141

email: MarcinkoAdvisors@msn.com

***

***

CAREER: Physician Coaching and Development

MARCINKO ASSOCIATES, Inc.

SPONSOR: http://www.MarcinkoAssociates.com

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Did you Know?

Experts estimate that it can cost more than $1 million to recruit and train a replacement for a doctor who leaves the profession because of burnout. But, as no broad calculation of burnout costs exists, Dr. Tait Shanafelt [Mayo Clinic researcher and Stanford Medicine’s first Chief Physician Wellness Officer] said Stanford, Harvard Business School, Mayo Clinic and the American Medical Association (AMA) are further cost estimating the issue. Nevertheless, Shanafelt and other researchers have shown that burnout erodes job performance, increases medical errors, and leads doctors to leave a profession they once loved.

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

Fortunately, we can help. From formal coaching to second career opinions, mentoring and advising, we can help with our remediation executive career programs. Regardless of what is happening in your life, it is wonderful to have a non-partial, confidential and informed career coach and sounding board on your side.

CITE: JAMA Internal Medicine [Effect of a Professional Coaching Intervention on the Well-Being and Distress of Physicians].

NCBI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6686971/

THANK YOU

CONTACT US: https://marcinkoassociates.com/process-what-we-do/

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