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Effective Marketing: Using Loss Leaders in Financial Services

Posted on November 10, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd CMP™

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SPONSOR: http://www.CertifiedMedicalPlanner.org

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In the competitive world of financial services, attracting and retaining clients is a constant challenge. To stand out, many financial advisors employ strategic marketing tactics known as “loss leaders”—free or discounted services designed to showcase value and build trust. These offerings serve as entry points for potential clients, allowing advisors to demonstrate expertise and initiate long-term relationships.

One of the most common loss leaders is the free initial consultation. This no-obligation meeting gives prospective clients a chance to discuss their financial goals, ask questions, and get a feel for the advisor’s approach. For the advisor, it’s an opportunity to assess the client’s needs and present tailored solutions. While no revenue is generated from this meeting, it often leads to paid engagements once the client feels confident in the advisor’s capabilities.

Another popular tactic is offering a complimentary financial plan or portfolio review. These services provide tangible insights into a client’s current financial situation and suggest improvements. By delivering real value upfront, advisors build credibility and demonstrate their analytical skills. Clients who receive actionable advice are more likely to continue working with the advisor on a paid basis.

Educational content also plays a key role in loss leader strategy. Advisors frequently host free webinars, workshops, or seminars on topics like retirement planning, tax strategies, or investment basics. These events not only educate attendees but also position the advisor as a thought leader. Attendees often leave with a better understanding of their financial needs and a desire to seek personalized guidance.

In the digital realm, advisors may offer free tools and assessments on their websites. These include retirement readiness calculators, risk tolerance quizzes, and budgeting templates. Such tools engage users and provide personalized feedback, creating a natural segue into one-on-one consultations. Additionally, offering free newsletters or eBooks helps advisors stay top-of-mind while delivering ongoing value.

Some advisors go further by waiving fees for introductory services, such as account setup or the first few months of investment management. This lowers the barrier to entry and encourages hesitant clients to try the service. Once clients experience the benefits, they’re more likely to commit long-term.

Loss leaders are not limited to high-net-worth individuals. Advisors targeting younger or less affluent clients may offer free debt management plans or budgeting assistance. These services address immediate concerns and build loyalty among clients who may become more profitable as their financial situations improve.

Ultimately, loss leaders are about building relationships. By offering something of value without immediate compensation, financial advisors demonstrate their commitment to helping clients succeed. This fosters trust, encourages engagement, and often leads to lasting partnerships. In a field where reputation and reliability are paramount, loss leaders serve as powerful tools for growth and differentiation.

COMMENTS APPRECIATED

EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com -OR- http://www.MarcinkoAssociates.com

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Filed under: "Ask-an-Advisor", CMP Program, Ethics, finance, Financial Planning, Glossary Terms, Investing, mental health, Touring with Marcinko | Tagged: business, CMP, david marcinko, debt management, financial advisors, financial planners, free books, Free consultations, free services, free tools, health, insurance agents, loss-leaders, mental health, personal-growth, psychology | Leave a comment »

Understanding the Google Scholar Paradox in Research

Posted on November 9, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By A.I.

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Classic Definition: Scientific research depends on the referencing and citing of other research.

Modern Circumstance: The Google Scholar Paradox is that research which gets cited most often is whatever shows up in the top results of Google Scholar searches; regardless of its contribution to the field.

Paradox Example: The Google Scholar effect is a phenomenon when some medical and healthcare researchers pick and cite works appearing in the top results on Google Scholar regardless of their contribution to the citing publication.

Paradoxically they automatically assume these works’ credibility and believe that editors, reviewers, and readers expect to see these citations.

Courtesy: Morgan Housel

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Filed under: "Ask-an-Advisor", CMP Program, Ethics, Experts Invited, Glossary Terms, Information Technology, LifeStyle, mental health | Tagged: authors, citations, CMP, editors, google, google paradox, google scholar, google scholar effect, HIT, IT, mental health, Morgan Housel, paradox, publications, references, research, scholar paradox | Leave a comment »

INSURANCE AGENTS: Salary and Payment Mechanisms

Posted on November 7, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd CMP™ and Copilot A.I.

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Insurance agents are primarily paid through commissions, but may also earn salaries, bonuses, and fees depending on their employment model and the types of policies they sell.

Insurance agents play a vital role in helping individuals and businesses navigate the complex world of insurance. Their compensation structures vary widely, influenced by factors such as the type of insurance they sell, whether they work independently or for a company, and the specific agreements they have with insurers. Understanding how insurance agents are paid is essential for consumers who want to make informed decisions and for aspiring agents considering a career in the industry.

The most common form of compensation for insurance agents is commission-based pay. Agents earn a percentage of the premium paid by the customer when they successfully sell a policy. These commissions can vary depending on the type of insurance. For example, first-year commissions for auto and homeowners insurance typically range from 5% to 20%, while commercial property and casualty policies may offer 10% to 15%. Life insurance policies often provide higher initial commissions, sometimes exceeding 50% of the first-year premium, followed by smaller renewal commissions in subsequent years.

There are two main types of insurance agents: captive agents and independent agents. Captive agents work exclusively for one insurance company and usually receive a combination of salary and commissions. Their compensation may also include performance bonuses and incentives tied to sales targets. Independent agents, on the other hand, represent multiple insurers and rely more heavily on commissions. They have the flexibility to offer a wider range of products, but their income is directly tied to their ability to sell policies and maintain client relationships.

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In addition to commissions, some agents earn fees for services such as policy reviews, risk assessments, or consulting. These fees are more common in commercial insurance or financial planning contexts, where agents provide specialized expertise. However, fee-based compensation is less prevalent in personal lines of insurance like auto or home coverage.

Bonuses and incentives are another component of agent compensation. Insurance companies often reward agents for meeting sales quotas, retaining clients, or selling specific types of policies. These bonuses can significantly boost an agent’s income, but they may also create potential conflicts of interest if agents prioritize higher-paying products over client needs.

Some agents, particularly those employed by large firms or call centers, receive a fixed salary. This model provides stability but may limit earning potential compared to commission-based roles. Salaried agents may still receive performance bonuses or profit-sharing depending on company policy.

Ultimately, an insurance agent’s earnings depend on their business model, experience, and ability to build a loyal client base. While commissions remain the cornerstone of insurance compensation, the rise of fee-based services and hybrid models reflects a shift toward more transparent and client-focused practices.

Consumers should feel empowered to ask agents about their compensation structure to ensure they receive unbiased advice tailored to their needs.

COMMENTS APPRECIATED

EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com

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Filed under: "Advisors Only", "Ask-an-Advisor", CMP Program, Health Insurance, Insurance Matters, Marcinko Associates | Tagged: AI, bonus, business, captive agents, CMP, commissions, Copilot, david marcinko, fee for service, fixed salary, free agents, independent agents, insurance, insurance agents, insurance compensatioon, medicare | Leave a comment »

Understanding Paradoxes in Modern Medicine

Posted on November 1, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

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What is a Paradox?

A paradox is a figure of speech that can seem silly or contradictory in form, yet it can still be true, or at least make sense in the context given. This is sometimes used to illustrate thoughts or statements that differ from traditional ideas. So, instead of taking a given statement literally, an individual must comprehend it from a different perspective. Using paradoxes in speeches and writings can also add wit and humor to one’s work, which serves as the perfect device to grab a reader or a listener’s attention.

But paradoxes can be quite difficult to explain by definition alone, which is why it is best to refer to a few examples to further your understanding.

A good paradox example is in the famous television show House. Here, Dr. House is a rude, selfish, and narcissistic character who alienates everyone around him, even his own colleagues. However, he is also a brilliant doctor who is committed to saving lives. Regardless of his mean exterior, Dr. House is a moral and compassionate man who cares about his patients. The paradox here is how the character strives to save people’s lives despite his ruthless personality and behavior.

Modern health care appears to be rich in contradictions, and it is claimed to be paradoxical in a number of ways. In particular health care is held to be a paradox itself: it is supposed to do good; but is also accused of doing harm.

The expression “first do no harm,” which is a Latin phrase, is not part of the original or modern versions of the Hippocratic Oath, which was originally written in Greek (“primum non nocere,” the Latin translation from the original Greek.)
The Hippocratic Oath, written in the 5th century BCE, does contain language suggesting that the physician and his assistants should not cause physical or moral harm to a patient.
The first known published version of “do no harm” dates to medical texts from the mid-19th century, and is attributed to the 17th century English physician Thomas Sydenham.

Difference between Paradox and Oxymoron

Most people tend to confuse a paradox with an oxymoron, and it’s not hard to see why. Most oxymoron examples appear to be compressed version of a paradox, in which it is used to add a dramatic effect and to emphasize contrasting thoughts. Although they may seem greatly similar in form, there are slight differences that set them apart.

A paradox consists of a statement with opposing definitions, while an oxymoron combines two contradictory terms to form a new meaning. But because an oxymoron can play out with just two words, it is often used to describe a given object or idea imaginatively. As for a paradox, the statement itself makes you question whether something is true or false. It appears to contradict the truth, but if given a closer look, the truth is there but is merely implied.

The Paradox in Medicine and Health Care

Dr. Bernard Brom [Editor: SA Journal of Natural Medicine] suggests modem medicine is riddled with paradoxes. Most doctors live with these paradoxes without being aware of the conflict of interest that these paradoxes represent. Intrinsic to a general understanding of science is the idea that science frees us from misunderstanding and guides us towards clear decision making.

Most veteran doctors with experience know that medical science still does not give definitive answers, that each individual is unique, that one can never be sure how a patient will respond to a particular drug, or what the outcome of a particular operation will be. Human beings are not machines and therefore do not respond according to Newtonian logic, and therefore a paradox in medicine is not surprising. Medicine is an art which uses scientific techniques and approaches. It is, however, important to face these paradoxes. It is both humbling and enlightening, enriching those who consider the implications deeply enough.

The Compensation versus Value Paradox

Regardless of specialty, degree designation or delivery model, private practice physician salary is traditionally inversely related to independent medical practice business value.

SALARY: https://medicalexecutivepost.com/2024/07/21/medicare-doctor-salary-rates-would-cut-pay-3/

In other words, the more a doctor takes home in compensation from his practice, the less ownership in a private practice is worth, and vice versa.

VALUE: https://medicalexecutivepost.com/2008/01/11/how-to-maximize-medical-practice-value/

Higher doctor salary equals lower practice appraisal value.

BROKE DOCTORS: https://medicalexecutivepost.com/2025/08/02/doctors-going-broke-and-living-paycheck-to-paycheck/

This is the difference between a short-term and long-term compensation strategy.

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EDUCATION: Books

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MONETARY VALUATION: Of the Medical Practice

Posted on October 27, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Valuing a medical practice involves assessing its financial performance, assets, and intangible factors like goodwill and patient loyalty to determine its fair market worth.

Determining the value of a medical practice is a nuanced process that blends financial analysis with strategic insight. Whether you’re preparing to sell, merge, or bring in a partner, understanding how to value your practice ensures informed decision-making and fair negotiations.

There are several recognized methods for valuing a medical practice, each suited to different scenarios. The most common include the income approach, market approach, asset-based approach, and the rule-of-thumb method.

HEALTHCARE VALUATION: Terms and Definitions

The income approach focuses on the practice’s ability to generate future earnings. This method involves analyzing historical financial statements, projecting future cash flows, and discounting them to present value using a risk-adjusted rate. It’s particularly useful when the practice has stable revenue and predictable expenses. Key metrics include net income, physician productivity, and reimbursement rates.

The market approach compares the practice to similar ones that have recently sold. It relies on data from comparable transactions, adjusted for differences in size, specialty, location, and profitability. This method is ideal when reliable market data is available, though such data can be scarce for niche specialties or rural practices.

The asset-based approach calculates the value of tangible and intangible assets. Tangible assets include medical equipment, office furniture, and real estate. Intangible assets—like patient records, brand reputation, and goodwill—are harder to quantify but can significantly impact value. Goodwill, for instance, reflects the practice’s reputation, patient loyalty, and referral networks.

The rule-of-thumb method uses industry benchmarks, such as a multiple of annual revenue or earnings. For example, a general practice might be valued at 60–80% of annual gross revenue. While quick and easy, this method oversimplifies and may not reflect the unique strengths or weaknesses of a specific practice.https:/https://medicalexecutivepost.com/2025/03/17/medial-practice-valuation-adjustments//medicalexecutivepost.com/2025/03/17/medial-practice-valuation-adjustments/

Beyond these methods, several qualitative factors influence valuation. These include the size and diversity of the patient base, the practice’s specialty, use of technology (like EHR systems or telemedicine), and whether key physicians will remain post-sale. A practice heavily reliant on one provider may be less valuable than one with a strong team and succession plan.

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MEDICAL PRACTICE: Valuation Adjustments

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Timing also matters. Economic conditions, regulatory changes, and shifts in healthcare reimbursement can affect practice value. Tax implications and deal structure—such as asset sale vs. stock sale—should also be considered during negotiations.

Ultimately, valuing a medical practice is both art and science. Engaging a professional appraiser or valuation expert can help ensure accuracy and objectivity. They bring experience, access to market data, and the ability to tailor valuation methods to your specific situation.

In summary, a comprehensive valuation considers financial performance, assets, market trends, and intangible factors. By understanding these elements, practice owners can make strategic decisions that reflect the true worth of their medical enterprise.

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EDUCATION: Books

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Filed under: "Ask-an-Advisor", "Doctors Only", CMP Program, finance, Funding Basics, Glossary Terms, Health Economics, Marcinko Associates, Practice Management | Tagged: asset based approach, CMP, david marcinko, healthcare, income approach, market approach, medical practice, medical practice value, rule thumb, stocks, Technology, valuation | Leave a comment »

HEALTH: Public V. Population

Posted on October 21, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Population health and public health are two interrelated disciplines that strive to enhance the health outcomes of communities. While they share a common mission—to reduce health disparities and promote wellness—their approaches, target populations, and operational frameworks differ significantly.

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Public health is traditionally defined as the science and art of preventing disease, prolonging life, and promoting health through organized efforts and informed choices of society, organizations, public and private sectors, communities, and individuals. It focuses on the health of the general population and emphasizes broad interventions such as vaccination programs, sanitation, health education, and policy advocacy. Public health professionals often work in government agencies, nonprofit organizations, and academic institutions to implement community-wide initiatives that prevent disease and promote healthy behaviors.

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In contrast, population health takes a more targeted approach. It refers to the health outcomes of a specific group of individuals, including the distribution of such outcomes within the group. This field is particularly concerned with the social determinants of health—factors like income, education, environment, and access to care—that influence health disparities. Population health strategies often involve data-driven interventions tailored to the needs of defined groups, such as rural communities, ethnic minorities, or patients with chronic conditions.

One key distinction lies in scope and granularity. Public health initiatives are typically designed for the entire population, aiming to create systemic change. For example, anti-smoking campaigns or water fluoridation programs benefit everyone regardless of individual risk. Population health, however, might focus on reducing diabetes rates among Hispanic adults in a specific urban area, using targeted outreach and culturally sensitive care models.

Another difference is in data utilization. Population health relies heavily on health informatics and analytics to identify trends, allocate resources, and evaluate outcomes. This evidence-based approach supports precision in addressing health inequities. Public health also uses data, but often at a broader level to guide policy and monitor general health indicators like life expectancy or disease prevalence.

Despite these differences, the two fields are complementary. Public health lays the foundation for healthy societies through preventive infrastructure, while population health builds on this by addressing nuanced needs within subgroups. Together, they form a holistic framework for improving health outcomes across diverse communities.

In today’s healthcare landscape, the integration of public and population health is increasingly vital. The COVID-19 pandemic underscored the importance of both approaches: public health measures like mask mandates and vaccination campaigns were essential, while population health efforts ensured vulnerable groups received targeted support.

In conclusion, while public health and population health differ in focus and methodology, they are united by a shared goal: to foster healthier communities. Understanding their distinctions enables more effective collaboration and innovation in health policy, care delivery, and community engagement.

COMMENTS APPRECIATED

EDUCATION: Books

SPEAKING: ME-P Editor Dr. David Edward Marcinko MBA MEd will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com -OR- http://www.MarcinkoAssociates.com

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Filed under: "Doctors Only", Ask a Doctor, CMP Program, economics, finance, Health Insurance, Healthcare Finance, Information Technology, Marcinko Associates, mental health | Tagged: CMP, covid, david marcinko, health, HIT, IT, mental health, Population Health, public health, self-improvement | Leave a comment »

Essential Investing Tips for New Physicians

Posted on October 21, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

HOW TO COMMENCE THE FINE ART OF MONEY

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By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

Investing may seem complicated, but today there are many ways for the newly minted physician [MD, DO, DPM, DMD or DDS] to begin, even with minimal knowledge and only a small amount to invest. Starting as soon as possible will help you get closer to the retirement you deserve.

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Why is investing important?

Investing often feels like a luxury reserved for the already wealthy physician. Many of us find it difficult to think about investing for the future when there are so many things we need that money for right now; medical school loans, auto, home and children; etc. But, at some point, we’re going to want to stop working and enjoy retirement. And simply put, retirement is expensive.

Most calculations advise that you aim for enough savings to give you 70% to 80% of your pre-retirement income for 20 years or more. Depending on your goals for retirement, that means you could need between $500,000 and $1 million in savings by the time you retire. That may not sound attainable, but with the power of compounding growth, it’s not as hard to achieve as you think. The key is starting as soon as possible and making smart choices.

INVESTMENT TYPES: https://medicalexecutivepost.com/2025/08/26/

When should you start investing?

The short answer is “now,” no matter what your age. Due to the way the gains in investments can compound, the earlier you start the better. Money invested in your 20s could very easily grow over 20 times before you retire, without you having to do much.That is powerful. Even if you’re in your 50s or older, you can still make significant progress toward meeting your goals in retirement.

How much should you invest per month?

Most financial experts say you should invest 10% to 15% of your annual income for retirement. That’s the goal, but you don’t have to get there immediately. Whatever you can start investing today is going to help you down the road.

So, if 10% to 15% is too much right now, start small and build toward that goal over time. You can actually start investing with $5 if you want. And you should. Some investment products require a minimum investment, but there are plenty that don’t, and a lot of online brokerage accounts can be started for free.

BROKE DOCTORS: https://medicalexecutivepost.com/2025/08/02/doctors-going-broke-and-living-paycheck-to-paycheck/

Good beginner investments.

The best investments for you are going to depend on your age, goals, and strategy. The important thing is to get started. You’ll learn as you go. If you have questions, a dedicated DIYer or investment advisor can help give you the guidance and options you need.

ALTERNATIVE INVESTMENTS: https://medicalexecutivepost.com/2022/06/06/risk-aversion-and-investment-alternatives/

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EDUCATION: Books

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Filed under: "Ask-an-Advisor", Ask a Doctor, finance, Financial Planning, Funding Basics, Investing, Marcinko Associates, Portfolio Management | Tagged: budgeting, CMP, DDS, DO, DPM, finance, Investing, Marcinko, MD, money art, personal-finance, physician investing, retirement, young doctors, young physicians | Leave a comment »

Unlock Your Career with Micro-Certifications

Posted on October 19, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

Micro-Credentials on the Rise

KNOWLEDGE RICHES IN SPECIALTY NICHES

DR. DAVID EDWARD MARCINKO MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Do you ever wish you could acquire specific information for your career activities without having to complete a university Master’s Degree or finish our entire Certified Medical Planner™ professional designation program? Well, Micro-Certifications from the Institute of Medical Business Advisors, Inc., might be the answer. Read on to learn how our three Micro-Certifications offer new opportunities for professional growth in the medical practice, business management, health economics and financial planning, investing and advisory space for physicians, nurses and healthcare professionals.

Micro-Certification Basics

Stock-Brokers, Financial Advisors, Investment Advisors, Accountants, Consultants, Financial Analyists and Financial Planners need to enhance their knowledge skills to better serve the changing and challenging healthcare professional ecosystem. But, it can be difficult to learn and demonstrate mastery of these new skills to employers, clients, physicians or medical prospects. This makes professional advancement difficult. That’s where Micro-Certification and Micro-Credentialing enters the online educational space. It is the process of earning a Micro-Certification, which is like a mini-degree or mini-credential, in a very specific topical area.

Micro-Certification Requirements

Once you’ve completed all of the requirements for our Micro-Certification, you will be awarded proof that you’ve earned it. This might take the form of a paper or digital certificate, which may be a hard document or electronic image, transcript, file, or other official evidence that you’ve completed the necessary work.

Uses of Micro-Certifications

Micro-Certifications may be used to demonstrate to physicians prospective medical clients that you’ve mastered a certain knowledge set. Because of this, Micro-Certifications are useful for those financial service professionals seeking medical clients, employment or career advancement opportunities.

Examples of iMBA, Inc., Micro-Certifications

Here are the three most popular Micro-Certification course from the Institute of Medical Business Advisors, Inc:

1. Health Insurance and Managed Care: To keep up with the ever-changing field of health care physician advice, you must learn new medical practice business models in order to attract and assist physicians and nurse clients. By bringing together the most up-to-date business and medical prctice models [Medicare, Medicaid, PP-ACA, POSs, EPOs, HMOs, PPOs, IPA’s, PPMCs, Accountable Care Organizations, Concierge Medicine, Value Based Care, Physician Pay-for-Performance Initiatives, Hospitalists, Retail and Whole-Sale Medicine, Health Savings Accounts and Medical Unions, etc], this iMBA Inc., Mini-Certification offers a wealth of essential information that will help you understand the ever-changing practices in the next generation of health insurance and managed medical care.
2. Health Economics and Finance: Medical economics, finance, managerial and cost accounting is an integral component of the health care industrial complex. It is broad-based and covers many other industries: insurance, mathematics and statistics, public and population health, provider recruitment and retention, health policy, forecasting, aging and long-term care, and Venture Capital are all commingled arenas. It is essential knowledge that all financial services professionals seeking to serve in the healthcare advisory niche space should possess.
3. Health Information Technology and Security: There is a myth that all physician focused financial advisors understand Health Information Technology [HIT]. In truth, it is often economically misused or financially misunderstood. Moreover, an emerging national HIT architecture often puts the financial advisor or financial planner in a position of maximum uncertainty and minimum productivity regarding issues like: Electronic Medical Records [EMRs] or Electronic Health Records [EHRs], mobile health, tele-health or tele-medicine, Artificial Intelligence [AI], benefits managers and human resource professionals.

Other Topics include: economics, finance, investing, marketing, advertising, sales, start-ups, business plan creation, financial planning and entrepreneurship, etc.

How to Start Learning and Earning Recognition for Your Knowledge

Now that you’re familiar with Micro-Credentialing, you might consider earning a Micro-Certification with us. We offer 3 official Micro-Certificates by completing a one month online course, with a live instructor consisting of twelve asynchronous lessons/online classes [3/wk X 4/weeks = 12 classes]. The earned official completion certificate can be used to demonstrate mastery of a specific skill set and shared with current or future employers, current clients or medical niche financial advisory prospects.

Mini-Certification Tuition, Books and Related Fees

The tuition for each Mini-Certification live online course is $1,250 with the purchase of one required dictionary handbook. Other additional guides, white-papers, videos, files and e-content are all supplied without charge. Alternative courses may be developed in the future subject to demand and may change without notice.

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Contact: For more information, or to speak with an academic representative, please contact Ann Miller RN MHA CMP™ at Email: MarcinkoAdvisors@msn.com [24/7].

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Filed under: "Advisors Only", "Ask-an-Advisor", Book Reviews, Career Development, CMP Program, Experts Invited, Financial Planning, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Information Technology, Investing, Op-Editorials, Touring with Marcinko | Tagged: accountants, certifications, certified medical planner, CMP, financial advisors, financial planners, investment advisors, Marcinko, micro, micro-certifications, micro-credentials | Leave a comment »

DENTISTRY: Stress, Burnout, Divorce and Practice Turmoil

Posted on October 19, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters and A.I.

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Dentistry is often perceived as a stable and rewarding profession, yet beneath the surface lies a troubling reality: dentists face disproportionately high levels of stress, burnout, divorce, practice turmoil, and even suicide. These issues stem from a complex interplay of emotional, financial, and professional pressures that uniquely affect dental practitioners.

Emotional and Psychological Strain

Dentists frequently operate in high-stakes environments where precision is paramount. The pressure to deliver flawless results while managing patient anxiety and discomfort can be overwhelming. Many patients fear dental procedures, and this fear often manifests as hostility or distrust, placing emotional strain on the dentist. Over time, the cumulative effect of these interactions can lead to compassion fatigue and emotional exhaustion.

The Amazing Future of Dentistry and Oral Health

Isolation and Professional Loneliness

Unlike other medical professionals who often work in collaborative hospital settings, dentists typically operate in solo or small group practices. This isolation can limit opportunities for peer support and professional camaraderie. Without a strong support network, dentists may struggle to process the emotional toll of their work, increasing their vulnerability to depression and burnout.

Financial and Business Pressures

Running a dental practice involves more than clinical expertise—it requires business acumen. Dentists must manage overhead costs, staff salaries, insurance reimbursements, and patient billing. The financial burden of student loans, often exceeding six figures, adds to the stress. Economic downturns or shifts in healthcare policy can destabilize practices, leading to turmoil and uncertainty.

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Work-Life Imbalance and Marital Strain

The demanding nature of dentistry often spills into personal life. Long hours, administrative responsibilities, and the emotional weight of patient care can leave little time or energy for family. This imbalance contributes to high divorce rates among dentists. The stress of maintaining a successful practice while nurturing personal relationships can become untenable, especially without adequate coping mechanisms.

Burnout and Suicide Risk

Burnout in dentistry is alarmingly common. A study by the American Dental Association found that 84% of dentists report experiencing burnout at some point in their careers.

Breaking the Cycle

METAVERSE: Dentistry and Dental Education

Addressing these challenges requires systemic change. Mental health support, peer mentorship, and business education should be integrated into dental training. Encouraging open conversations about stress and providing resources for emotional well-being can help reduce stigma and promote resilience.

By acknowledging the hidden struggles of dentistry, the profession can move toward a healthier, more sustainable future.

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Filed under: Ask a Doctor, Career Development, CMP Program, Ethics, Health Economics, Practice Management | Tagged: ADA, American Dental Association, CMP, DDS, demtal suicide, dental burn out, dental stress, disabled, DMD, health-wellness, nursing homes | Leave a comment »

Understanding Doctorate Degrees: A Clear Guide

Posted on October 18, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

Is the Doctor – In?

SPONSOR: http://www.CertifiedMedicalPlanner.org

INFO-GRAPHIC

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What Is a Doctorate Degree?

Doctorate, or doctoral, is an umbrella term for many degrees — PhD among them — at the height of the academic ladder. Doctorate degrees fall under two categories, and here is where the confusion often lies.

The first category, Research (also referred to as Academic) includes, among others:

Doctor of Philosophy (PhD)
Doctor of Business Administration (DBA)
Doctor of Education (EdD)
Doctor of Theology (ThD)

The second category, Applied (also referred to as Professional) includes, among others:

Doctor of Medicine (MD)
Doctor of Podiatric Medicine (DPM)
Doctor Of Osteopathic Medicine (DO)
Doctor of Dental Surgery (DDS)
Doctor of Optometry (OD)
Doctor of Psychology (PsyD)
Juris Doctor (JD)

As you can see, applied doctorates are generally paired with very specific careers – medical doctors, podiatrists, dentists, optometrists, psychologists, and law professionals.

When it comes to outlining the differences between a PhD and doctorate, the real question should be, “What is the difference between a PhD and an applied doctorate?” The answer, again, can be found in the program outcomes. The online Doctor of Psychology at UAGC, for example, lists outcomes that are heavily focused on the ability to put theory into practice in a professional setting. For example:

Apply best practices in the field regarding professional values, ethics, attitudes, and behaviors
Exhibit culturally diverse standards in working professionally with individuals, groups, and communities who represent various cultural and personal backgrounds
Utilize a comprehensive psychology knowledge base grounded in theoretical models, evidence-based methods, and research in the discipline
Integrate leadership skills appropriate in the field of psychology
Critically evaluate applied psychology research methods, trends, and concepts

Bottom line: As the PhD is more academic, research-focused, and heavy on theory, an applied doctorate degree is intended to master a subject in both theory and practice.

Can a PhD Be Called a Doctor?

The debate over whether a PhD graduate should be called a doctor has existed for decades, and if you’re a member of this exclusive club, you’ll no doubt hear both sides of the argument during your lifetime. After all, if a PhD is a doctor, can a person with a doctoral degree in music – the Doctor of Musical Arts (DMA) – be called a doctor as well?

Those in favor argue that having “Dr.” attached to your name indicates that you are an expert and should be held in higher regard. For some, the debate is at the heart of modern gender disparity. For example, on social media and in some academic circles, there is an argument that female PhD holders should use the “Dr.” title in order to reject the notion that women are less worthy of adding the title to their name once they have earned a doctoral degree.

The American Psychological Association has, for years, challenged the Associated Press (AP) and other news outlets to broaden its use of “Dr.” beyond those that practice medicine – MDs, podiatrists, dentists, etc. – in its reporting. However, the organization was rebuked, as the AP argued that, “It comes down to a basic distinction. Psychologists earn PhDs, and AP style allows the ‘Dr.’ title only for those with medical degrees.”

The AP has, thus far, refused to change their style guide when it comes to the “doctor question.”

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FINANCIAL PLANNERS: Part Time Employment Difficulties

Posted on October 18, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Why It Is Difficult to Be a Part-Time Financial Planner Today

In theory, part-time financial planning offers flexibility and work-life balance, making it an attractive option for professionals seeking reduced hours. However, in practice, the role of a financial planner has evolved into a demanding, full-time commitment. The complexity of financial markets, client expectations, regulatory requirements, and technological advancements make part-time financial planning increasingly difficult to sustain.

One of the primary challenges is client relationship management. Financial planning is deeply personal and trust-based. Clients expect consistent communication, timely updates, and proactive advice. A part-time planner may struggle to maintain the same level of responsiveness as full-time counterparts, especially during volatile market conditions or life-changing events like retirement, divorce, or inheritance. Delayed responses or limited availability can erode client confidence and damage long-term relationships.

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Another obstacle is the rapid pace of financial change. Tax laws, investment products, insurance regulations, and retirement planning strategies are constantly evolving. Staying current requires ongoing education, certifications, and industry engagement. For part-time planners, keeping up with these changes while managing clients and administrative tasks can be overwhelming. Falling behind risks offering outdated or suboptimal advice, which could lead to compliance issues or client dissatisfaction.

Regulatory compliance adds another layer of complexity. Financial planners must adhere to strict standards set by organizations like FINRA, the SEC, and state regulators. These include documentation, disclosures, fiduciary responsibilities, and continuing education. Compliance is non-negotiable and time-consuming, regardless of hours worked. Part-time planners face the same scrutiny and liability as full-time professionals, but with fewer hours to manage the workload.

Technology, while a powerful tool, also presents challenges. Clients increasingly expect digital access to their portfolios, real-time updates, and virtual meetings. Managing these platforms requires technical proficiency and regular maintenance. Part-time planners may find it difficult to keep systems updated, troubleshoot issues, or provide tech support, especially if they lack dedicated staff.

Business development is another hurdle. Building and maintaining a client base requires networking, marketing, and referrals. Part-time planners often have limited time to attend events, follow up with leads, or cultivate relationships. This can hinder growth and make it difficult to compete with full-time advisors who are more visible and accessible.

Finally, there’s the issue of income and scalability. Many financial planners earn through commissions, assets under management (AUM), or fee-based models. Part-time work often means fewer clients and lower revenue, which can make it hard to justify the costs of licensing, insurance, software, and office space. Without scale, profitability becomes a challenge.

In conclusion, while the idea of part-time financial planning may seem appealing, the realities of the profession make it difficult to execute effectively. The demands of client care, compliance, education, and business development require consistent attention and availability. Unless the industry adapts to support flexible models, part-time financial planners will continue to face significant barriers to success.

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Understanding Investment Fees: A Guide for Physicians

Posted on October 14, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.MarcinkoAssociates.com

By Dr. David Edward Marcinko MBA MEd CMP™

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MEDICAL COLLEAGUES BEWARE!

Investment fees still matter for physicians and all of us, despite dropping dramatically over the past several decades due to computer automation, algorithms and artificial intelligence, etc. And, they can make a big difference to your financial health. So, before buying any investment thru a financial advisor, planner, manager, stock broker, etc., it’s vital to understand these two often confusing costs.

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Fee Only: Paid directly by clients for their services and can’t receive other sources of compensation, such as payments from fund providers. Act as a fiduciary, meaning they are obligated to put their clients’ interests first

Fee Based: Paid by clients but also via other sources, such as commissions from financial products that clients purchase. Brokers and dealers (registered representatives) are simply required to sell products that are “suitable” for their clients. Not a fiduciary.

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ACUTE CARE MEDICINE: Defined

Posted on October 12, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By A.I. and Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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ACUTE CARE MEDICINE

Classic: Acute care is a branch of secondary health care where a patient receives active but short-term treatment for a severe injury or episode of illness, an urgent medical condition, or during recovery from surgery. In medical terms, care for acute health conditions is the opposite from chronic care, or longer term care.

Modern: Acute care is active, short-term treatment for a severe injury or episode related to illness, an urgent medical condition or recovery from surgery.

HOSPITAL: https://medicalexecutivepost.com/2008/12/08/the-acute-care-inpatient-hospital/

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Examples: The following are considered acute care facilities:

Hospital (General Acute Care as well as Psychiatric, Specialized and Rehabilitation Hospitals; and Long Term Acute Care or LTAC)
Ambulatory Care Facility.
Home Health Agency.
End Stage Renal Disease Facility (dialysis center)
Hospice.

EMERGENT CARE: https://medicalexecutivepost.com/2025/05/03/medicine-emergent-care/

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Understanding Hedge Funds: A Comprehensive Guide

Posted on October 5, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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SPONSOR: http://www.MarcinkoAssociates.com

QUESTION: What is a Hedge Fund?

A hedge fund is a limited partnership of private investors whose money is pooled and managed by professional fund managers. These managers use a wide range of strategies, including leverage (borrowed money) and the trading of nontraditional assets, to earn above-average investment returns. A hedge fund investment is often considered a risky, alternative investment choice and usually requires a high minimum investment or net worth. Hedge funds typically target wealthy investors.

MANAGERS: https://medicalexecutivepost.com/2025/05/23/hedge-fund-hiring-separate-managers/

The hedge fund manager I am considering also runs an offshore fund under a “master feeder” arrangement.

A PHYSICIAN’S QUESTION: What does this mean? In which fund should I invest?

The master feeder arrangement is a two-tiered investment structure whereby investors invest in the feeder fund. The feeder fund in turn invests in the master fund. The master fund is therefore the one that is actually investing in securities. There may be multiple feeder funds under one master fund. Feeder funds under the same master can differ drastically in terms of fees charged, minimums required, types of investors, and many other features – but the investment style will be the same because only the master actually invests in the market.

A master feeder structure is a very popular arrangement because it allows a portfolio manager to pool both onshore and offshore assets into one investment vehicle (the master fund) that allocates gains and losses in an asset-based, proportional manner back to the onshore and offshore investors. All investors, both offshore and onshore, get the same return. In this manner, the portfolio manager, despite offering more than one fund with different characteristics to different populations, is not faced with the dilemma of which fund to favor with the best investment ideas.

PENSION PLANS: https://medicalexecutivepost.com/2025/05/18/medical-practice-pension-plan-hedge-fund-difficulties/

A manager may offer an offshore fund because there is demand for that manager’s skill either abroad, where investors may wish to preserve anonymity, or more commonly where investors simply do not wish to become entangled with the United States tax code. American citizens should generally avoid the offshore fund, since American citizens are taxed on their allocated share of offshore corporation profits whether or not a distribution occurs. Therefore, there is no benefit for most American taxpayers investing in an offshore fund.

Tax-exempt institutions, such as medical foundations, in the United States may have reason to consider an offshore hedge fund, however. Domestic tax-exempt organizations are generally not subject to unrelated business taxable income (UBTI) – the portion of hedge fund income that comes about as a result of the use of leverage – when investing with an offshore corporation. If the same tax-exempt organization were to invest in a domestic fund, and if UBTI was generated, then the organization would have to pay taxes on that UBTI. Most domestic hedge funds generate UBTI.

FEES: https://medicalexecutivepost.com/2025/04/05/hedge-fund-wrap-fees/

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VARIABLE ANNUITIES: Retired Physicians Beware!

Posted on October 4, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By A.I. and Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

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After a lifetime of hard work practicing medicine and saving, you’re at the retirement finish line. Instead of a paycheck, you’re relying on your nest egg and investment income to cover the bills. Picking the right investments is even more important, as you won’t have much chance to recover as a retired MD, DO, DPM or DDS.

“You made it to the top of the mountain through a systematic approach and are trying to make your way down safely,” says retirement planner John Gillet John Gillet in Hollywood, Fla. “Why throw all caution to the wind and try something different now?”

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Definitions

An annuity is an insurance contract designed to grow your money and then repay it as income. There are different versions. An immediate annuity turns your lump sum into future guaranteed income payments, like your own personal pension. They are simple to understand with no or small fees.

Fixed annuities pay a guaranteed interest rate over a set period to grow your money, like 5% a year for five years. These options could make sense as part of a retirement plan.

A variable annuity, on the other hand, invests your savings in mutual funds. While you can buy riders that guarantee a minimum income, you’ll be paying very much for it. “All in, the annual fees can be 3% or more of your balance,” says Jeff Bailey, an advisor from Nashville. “That’s a huge withdrawal rate from your portfolio versus investing on your own.”

The variable annuity will lock up your money for years. If you cancel early, you owe a surrender charge that could start at 7% or more of your annuity balance before gradually going down as time goes by. “Clients believe they can walk away with their contract value, but that’s often not true,” says Bailey.

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Understanding Asset Allocation for Investment Success

Posted on October 3, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

Delving Deeper into Asset Allocation

SPONSOR: http://www.CERTIFIEDMEDICALPLANNER.org

By Lon Jefferies MBA CFP® CMP®

Asset allocation is one of the key factors contributing to long-term investment success.

When designing a portfolio that represents their risk tolerance, investors should be aware that a portfolio that is 50% stocks is likely to obtain approximately half of the gain when the market advances but suffer only half the loss when the market declines.

This general principle frequently holds true over extended investing cycles, but can waiver during shorter holding periods.

Case Model

For example, a fairly typical physician client of mine who has a 50% stock, 50% bond portfolio has obtained a return of 4.62% over the last 12 months, while the S&P 500 has obtained a return of 14.31% over the same time period (as of 10/30/14).

An investor expecting to obtain half the return of the index would anticipate a return of 7.15%, and by this measuring stick, has underperformed the market by over 2.50% during the last year.

What caused this differential?

Answer

The issue resides in how we define “the market.” In this example, we use the S&P 500 index as a measure for how the market as a whole is performing. As you may know, the S&P 500 (and the Dow Jones Industrial Average, for that matter) consists solely of large company U.S. stocks.

Of course, a diversified portfolio owns a mixture of large, mid, and small cap U.S. stocks, as well as international and emerging market equities. Consequently, comparing the performance of a basket of only large cap stocks to the performance of a diversified portfolio made up of a variety of different asset classes isn’t an apples-to-apples comparison.

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Frequently, the diversified portfolio will outperform the non-diversified large cap index because several of the components of the diversified portfolio will obtain higher returns than those achieved by large cap holdings.

However, the past 12 months has been a case where a diversified portfolio underperformed the large cap index because large cap stocks were the best performing asset class over the time period. In fact, over the last twelve months, there has been a direct correlation between company size and stock performance (as of 10/30/14):

Large Cap Stocks (S&P 500): 14.92%
Mid Cap Stocks (Russell Mid Cap): 11.08%
Small Cap Stocks (Russell 2000): 4.45%
International Stocks (Dow Jones Developed Markets): -1.05%
Emerging Market Stocks (iShares MSCI Emerging Markets): -1.04%

Since large cap stocks were the best performing element of a diversified portfolio over the last 12 months, in retrospect, an investor would have obtained a superior return by owning only large cap stocks during the period as opposed to owning a diversified mix of different equities. Does this mean owning only large cap stocks rather than a diversified portfolio is the best investment approach going forward? Of course not.

Year after year, we don’t know which asset category will provide the best return and a diversified portfolio ensures we have exposure to each year’s big winner. Additionally, although large caps were this year’s winner, they could easily be next year’s big loser, and a diversified portfolio ensures we don’t have all our investment eggs in one basket.

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

Assessment

Don’t be overly concerned if your diversified portfolio is underperforming a non-diversified benchmark over a short period of time. As always, long-term results should be more heavily weighted than short-term swings, and having a diversified portfolio is likely to maximize the probability of coming out ahead over an extended period.

Conclusion

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Understanding Pre-Payment Health Plans

Posted on October 2, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Classic: A pre-payment plan refers to health insurance plans that provide medical or hospital benefits in service rather than dollars, such as the plans offered by various Health Maintenance Organizations. A method providing in advance for the cost of predetermined benefits for a population group, through regular periodic payments in the form of premiums, dues, or contributions including those contributions that are made to a health and welfare fund by employers on behalf of their employees!

Modern: A Prepaid Group Practice Plan specifies health services are rendered by participating physicians to an enrolled group of persons, with a fixed periodic payment made in advance by (or on behalf of) each person or family. If a health insurance carrier is involved, a contract to pay in advance for the full range of health services to which the insured is entitled under the terms of the health insurance contract.

Examples:

Pre-Paid Hospital Service Plan: The common name for a health maintenance organization (HMO), a plan that provides comprehensive health care to its members, who pay a flat annual fee for services.
Pre-Paid Premium: An insurance or other premium payment paid prior to the due date. In insurance, payment by the insured of future premiums, through paying the present (discounted) value of the future premiums or having interest paid on the deposit.
Pre-Paid Prescription Plan: A drug reimbursement plan that is paid in advance.

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Understanding Hobson’s Choice in Healthcare

Posted on September 28, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd CMP™

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Hobson’s Choice in Medicine

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Hobson’s choice is a free choice in which only one thing is actually offered. The term is often used to describe an illusion that choices are available. The best known example is “I’ll give you a choice: Take it or leave it”, wherein “leaving it” is strongly undesirable.

The phrase is said to have originated with Thomas Hobson (1544–1631), a livery stable owner in Cambridge, England, who offered customers the choice of either taking the horse in the stall nearest to the door or taking none at all.

A CASE MODEL

Half of Physicians Plan to Change Career Paths

The Physicians Foundation recently conducted a survey on physician practice patterns and perspectives. Here are some key findings from the report:

• 31% of physicians identify as independent practice owners or partners.
• Almost half (47%) of physicians plan to change career paths.
• 78% of physicians sometimes, often or always experience feelings of burnout.
• Nearly a quarter of physician time is spent on non-clinical paperwork.

This result is not a good Hobson’s Choice in Medicine.

Cite: The Physicians Foundation, September 2018

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SERIES #65 EXAM: Uniform Investment Adviser Law

Posted on September 28, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By A.I. and FINRA

SPONSOR: http://www.CertifiedMedicalPlanner.org

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The Series 65 exam — the NASAA Investment Advisers Law Examination — is a North American Securities Administrators Association (NASAA) exam administered by FINRA.

The exam consists of 130 scored questions and 10 unscored questions. Candidates have 180 minutes to complete the exam. In order for a candidate to pass the Series 65 exam, they must correctly answer at least 92 of the 130 scored questions.

PHYSICIAN NET WORTH: Versus Average Family

The Series 65 exam will only be available online for candidates who require a testing accommodation.

For additional information about this exam, including the content outline, please visit the exams page on the NASAA website.

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PARADOX : Government Health Information is Trusted?

Posted on September 27, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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A paradox is a statement that appears at first to be contradictory, but upon reflection then makes sense. This literary device is commonly used to engage a reader to discover an underlying logic in a seemingly self-contradictory statement or phrase. As a result, paradox allows readers to understand concepts in a different and even non-traditional

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GOVERNMENT HEALTH INFORMATION IS TRUSTED?

Classic Definition: Despite the PP-ACA, there is ambivalence about the role of the US Government as a source of quality healthcare information.

Modern Circumstance: Of brands presented to respondents in a Consumer Reports (50 percent), and AARP (37 percent) survey, they outpolled the “US Government Healthcare Quality Reporting Website” (36 percent) and Medicare Website (32 percent).

Paradox Example: The focus groups expressed “mixed reactions and raised doubts about government involvement in quality ratings information. At least one participant in each group expressed skepticism about trusting ‘the government’ to compile information.”

Younger consumers especially questioned the relevance of Medicare measures to the non-elderly population. Yet participants gravitated to “.gov” websites over “.org” websites as a more authoritative source.

CITE: Williams, Jason: Health Affairs, December 28, 2016

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The Economy, Stocks and Commodities

Posted on September 27, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By. A.I. and Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Economy: Headline PCE rose from 2.6% on an annual basis in July to 2.7% in August, while core PCE stayed flat at 2.9%—all in line with analyst expectations.
Stocks: Solid inflation numbers helped equities arrest their recent selloff and offset the latest batch of tariffs. However, all three major indexes still ended the week lower than where they started.
Commodities: Oil climbed as Ukrainian drones continue to strike Russian energy infrastructure. Meanwhile, gold hit another all-time high, and rose above $3,800 for the first time ever at one point today.

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Understanding Alpha: Non-Systematic ROI Explained

Posted on September 26, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

Understanding Non-Systematic Return on Investment

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[By Dr. David Edward Marcinko MBA MEd CMP™ ]

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According to Wayne Firebaugh CPA, CFP®, CMP™ alpha measures non-systematic return on investment [ROI], or the return that cannot be attributed to the market.

It shows the difference between a fund’s actual return and its expected performance given the level of systematic (or market) risk (as measured by beta).

Example

For example, a fund with a beta of 1.2 in a market that returns 10% would be expected to earn 12%. If, in fact, the fund earns a return of 14%, it then has an alpha of 2 which would suggest that the manager has added value. Conversely, a return below that expected given the fund’s beta would suggest that the manager diminished value.

In a truly efficient market, no manager should be able to consistently generate positive alpha. In such a market, the endowment manager would likely employ a passive strategy that seeks to replicate index returns. Although there is substantial evidence of efficient domestic markets, there is also evidence to suggest that certain managers do repeat their positive alpha performance.

In fact, a 2002 study by Roger Ibbotson and Amita Patel found that “the phenomenon of persistence does exist in domestic equity funds.” The same study suggested that 65% of mutual funds with the highest style-adjusted alpha repeated with positive alpha performances in the following year.

More Research

Additional research suggests that active management can add value and achieve positive alpha in concentrated portfolios.

A pre 2008 crash study of actively managed mutual funds found that “on average, higher industry concentration improves the performance of the funds. The most concentrated funds generate, after adjusting for risk … the highest performance. They yield an average abnormal return [alpha] of 2.56% per year before deducting expenses and 1.12% per year after deducting expenses.”

FutureMetrics

FutureMetrics, a pension plan consulting firm, calculated that in 2006 the median pension fund achieved record alpha of 3.7% compared to a 60/40 benchmark portfolio, the best since the firm began calculating return data in 1988. Over longer periods of time, an endowment manager’s ability to achieve positive alpha for their entire portfolio is more hotly debated. Dimensional Fund Advisors, a mutual fund firm specializing in a unique form of passive management, compiled FutureMetrics data on 192 pension funds for the period of 1988 through 2005.

Their research showed that over this period of time approximately 75% of the pension funds underperformed the 60/40 benchmark. The end result is that many endowments will use a combination of active and passive management approaches with respect to some portion of the domestic equity segment of their allocation.

Assessment

One approach is known as the “core and satellite” method in which a “core” investment into a passive index is used to capture the broader market’s performance while concentrated satellite positions are taken in an attempt to “capture” alpha. Since other asset classes such as private equity, foreign equity, and real assets are often viewed to be less efficient, the endowment manager will typically use active management to obtain positive alpha from these segments.

Notes:

Ibbotson, R.G. and Patel, A.K. Do Winners Repeat with Style? Summary of Findings – Ibbotson & Associates, Chicago (February 2002).
Kacperczyk, M.T., Sialm, C., and Lu Zheng. On Industry Concentration of Actively Managed Equity Mutual Funds. University of Michigan Business School. (November 2002).
2007 Annual US Corporate Pension Plan Best and Worst Investment Performance Report. FutureMetrics, April 20, 2007.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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The Importance of Public Relations in Healthcare

Posted on September 26, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Public Relations [PR] is differentiated than advertising in that an advertiser pays for and has control over the message. It differs from personal selling in that the message is non-personal, i.e., not directed to a particular individual patient. We pay for advertising but pray for public relations. Public relations are not controllable but it is free; advertising is not free. PR suggests that “good news or bad news”; just spell the doctors name correctly

Change Management is the discipline that guides how we prepare, equip and support individuals to successfully adopt to change in order to drive organizational success and outcomes.

For example, a senior doctor may retire, become ill, or a junior associate might become a practice partner. How will patients be affected?

Crisis Management is the precautions and identification of threats to an organization and its stakeholders, and the methods used by the organization to deal with these threats.

For example, recall in 1982, that Tylenol™ commanded 35 percent of the over-the-counter analgesic market in America and it represented nearly 17 percent of Johnson & Johnson’s profits. But, when seven people died from consuming the tainted drug, a national panic ensued. Moreover, Americans started to question the safety of all over-the-counter medications.

Fortunately, J&J commenced the proto-typical positive crisis response in the following way:

J&J acted quickly, with complete candidness about what happened and within hours of learning of the deaths, J&J installed toll-free numbers for consumers, sent alerts to healthcare providers nationwide, and stopped advertising the product. J&J recalled 31 million bottles of Tylenol™ capsules and offered replacement products free of charge. J&J did not wait for evidence to see whether the contamination might be more widespread.

J&J’s leadership was in the lead and seemed in full control throughout the crisis. The chairman was admired for his leadership to pull Tylenol™ capsules off the market and his forthrightness in dealing with the media. The Tylenol™ crisis led the news every night on every station for six weeks.

J&J placed consumers first. J&J spent more than $100 million for the recall and re-launch of Tylenol™. The stock which had been trading near a 52-week high just before the tragedy, dropped for a time, but recovered to its highs only two months later.

J&J accepted responsibility. The disaster could have been described in many different ways: as an assault on the company, as a problem somewhere in the process of getting Tylenol™ from J&J factories to retail stores, or as the acts of a crazed criminal. Yet, the company accepted full responsibility.

J&J sought to ensure that measures were taken to prevent a recurrence of the problem. J&J introduced tamper-proof packaging that would make it much more difficult for a similar incident to occur in the future.

J&J presented itself prepared to handle the short-term damage in the name of consumer safety. Within a year of the disaster, J&J’s share of the analgesic market, which had fallen to 7 percent from 37 percent following the poisoning, had climbed back to 30 percent.

This wildly successful response in now the stuff of graduate and business school case models for excellence in teaching!

PRM stands for Patient Relationship Management, which is a system for managing all interactions with current and potential patients, families, friends, referring physicians, clinics and hospitals. The goal is simple: improve relationships to grow your medical practice. PRM technology helps medical practices and clinics stay connected to patients, streamline processes, and improve profitability.

When people talk about PRM, they’re usually referring to a PRM system: software that helps track each interaction with a patient or elated others. That can include practice sales calls, treatment or service plans, marketing e-mails, website, social media and more. PRM tools can unify patient and practice data from many sources and even use Artificial Intelligence [AI] to help better manage relationships across the entire doctor– patient lifecycle – spanning departments described elsewhere in the Marketing, Advertising and Sales ME-Ps.

EDUCATION: Books

References:

1. Purcarea, Victor: The impact of marketing strategies in healthcare systems. J. Med Life. 2019 Apr-Jun;12(2):93–96. doi: 10.25122/jml-2019-1003

READINGS:

Marcinko, DE and Hetico, HR: The Business of Medical Practice [3^rd Edition]. Springer Publishing, New York, 2010.

Marcinko, DE and Hetico, HR: Hospitals & Healthcare Organizations [Management Strategies, Operational Techniques, Tools, Templates and Case Studies]. Productivity Press, New York, 2012.

Marcinko, DE and Hetico, HR: Financial Management Strategies for Hospitals and Healthcare Organizations [Tools, Techniques, Checklists and Case Studies]. Productivity Press, New York, 2012.

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Understanding Investment Apps: A Guide for Beginners

Posted on September 25, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

DEFINITIONS

By Dr. David Edward Marcinko MBA MEd CMP™

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SPONSOR: http://www.CertifiedMedicalPlanner.org

An app, which is short for “application,” is a type of software that can be installed and run on a computer, tablet, smartphone or other electronic devices. An app most frequently refers to a mobile application or a piece of software that is installed and used on a computer. Most apps have a specific and narrow function.

BROKE DOCTORS: https://medicalexecutivepost.com/2025/08/02/doctors-going-broke-and-living-paycheck-to-paycheck/

Robo-Advisors

An easy and fairly cheap way for novices to get into investing is to use a robo-advisor. Basically, the funds you contribute will be invested by an algorithm based upon your goals, which are usually determined by taking a survey. This helps keep fees low; the algorithm doesn’t rely on a human expert to make trades, and you don’t have to spend significant amounts of time researching your investments. While this is a good way to start, it may not be the best option in the long run.

Online Brokerage or Investment Apps

More options are becoming available all the time, and they have opened trading to a much larger percentage of the population. That is a great thing, but it’s important to remember that “easier to invest” doesn’t necessarily mean it’s easy to invest well.

Be wary of apps that “gamify” trading and encourage risky choices. Keep in mind that trusted names offer more security, so do your research when you are selecting a platform.

POOR DOCTORS: https://medicalexecutivepost.com/2024/04/04/why-physicians-do-not-get-rich/

Investing should be taken seriously, and we encourage you to have a good working relationship with a human financial services professional.

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Financial Self-Discovery for Medical Professionals

Posted on September 25, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko; MBA MEd CMP™

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

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SPONSOR: http://www.CertifiedMedicalPlanner.org

A Financial Self Discovery Questionnaire for Medical Professionals

For understanding your relationship with money, it is important to be aware of yourself in the contexts of culture, family, value systems and experience. These questions will help you. This is a process of self-discovery. To fully benefit from this exploration, please address them in writing. You will simply not get the full value from it if you just breeze through and give mental answers. While it is recommended that you first answer these questions by yourself, many people relate that they have enjoyed the experience of sharing them with others who are important to them.

As you answer these questions, be conscious of your feelings, actually describing them in writing as part of your process.

Childhood

What is your first memory of money?
What is your happiest moment with Money? Your most unhappy?
Name the miscellaneous money messages you received as a child.
How were you confronted with the knowledge of differing economic circumstances among people, that there were people “richer” than you and people “poorer” than you?

Cultural heritage

What is your cultural heritage and how has it interfaced with money?
To the best of your knowledge, how has it been impacted by the money forces? Be specific.
To the best of your knowledge, does this circumstance have any motive related to Money?
Speculate about the manners in which your forebears’ money decisions continue to affect you today?

Family

How is/was the subject of money addressed by your church or the religious traditions of your forebears?
What happened to your parents or grandparents during the Depression?
How did your family communicate about money?
How? Be as specific as you can be, but remember that we are more concerned about impacts upon you than historical veracity.
When did your family migrate to America (or its current location)?
What else do you know about your family’s economic circumstances historically?

Your parents

How did your mother and father address money?
How did they differ in their money attitudes?
How did they address money in their relationship?
Did they argue or maintain strict silence?
How do you feel about that today?

Please do your best to answer the same questions regarding your life or business partner(s) and their parents.

Childhood: Revisited

How did you relate to money as a child? Did you feel “poor” or “rich”?
Relatively? Or, absolutely? Why?
Were you anxious about money?
Did you receive an allowance? If so, describe amounts and responsibilities.
Did you have household responsibilities?
Did you get paid regardless of performance?
Did you work for money?

If not, please describe your thoughts and feelings about that.

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Same questions, as a teenager, young adult, older adult.

Credit

When did you first acquire something on credit?
When did you first acquire a credit card?
What did it represent to you when you first held it in your hands?
Describe your feelings about credit.
Do you have trouble living within your means?
Do you have debt?

Adulthood

Have your attitudes shifted during your adult life? Describe.

Why did you choose your personal path?
a) Would you do it again?
b) Describe your feelings about credit.

Adult attitudes

Are you money motivated?
If so, please explain why? If not, why not?
How do you feel about your present financial situation?
Are you financially fearful or resentful? How do you feel about that?
Will you inherit money? How does that make you feel?
If you are well off today, how do you feel about the money situations of others?
If you feel poor, same question.
How do you feel about begging? Welfare?
If you are well off today, why are you working?
Do you worry about your financial future?
Are you generous or stingy? Do you treat? Do you tip?
Do you give more than you receive or the reverse? Would others agree?
Could you ask a close relative for a business loan? For rent/grocery money?
Could you subsidize a non-related friend? How would you feel if that friend bought something you deemed frivolous?
Do you judge others by how you perceive they deal with their Money?
Do you feel guilty about your prosperity?
Are your siblings prosperous?
What part does money play in your spiritual life?
Do you “live” your Money values?

Conclusion

There may be other questions that would be useful to you. Others may occur to you as you progress in your life’s journey. The point is to know your personal money issues and their ramifications for your life, work, and personal mission.

This will be a “work-in-process” with answers both complex and incomplete. Don’t worry.

Just incorporate fine-tuning into your life’s process.

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Filed under: "Doctors Only", Career Development, CMP Program, Ethics, Experts Invited, Financial Planning, Funding Basics, Glossary Terms, Health Economics, Investing, mental health, Portfolio Management, Touring with Marcinko | Tagged: behavioral finance, budgeting, business, certified medical planner, CMP, credit, credit cards, DDS, debit, DO, doctors, DPM, economics, employment, finance, great depression, grocery money, Marcinko, MD, mental health, money, money scripts, money values, nurses, personal-finance, physician coaching, physicians, poor, psychology of money, rent, richer, self discovery, work | Leave a comment »

SERIES #6 EXAM: Investment Company and Variable Contracts Products Representative

Posted on September 25, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By A.I.and Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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The Series 6 exam — the Investment Company and Variable Contracts Products Representative Qualification Examination (IR) — assesses the competency of an entry-level representative to perform their job as an investment company and variable contracts products representative.

The exam measures the degree to which each candidate possesses the knowledge needed to perform the critical functions of an investment company and variable contract products representative, including sales of mutual funds and variable annuities.

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PHYSICIAN NET WORTH: Versus Average Family

Candidates must pass the Securities Industry Essentials (SIE) exam and the Series 6 exam to obtain the Investment Company and Variable Contracts Products registration.

For more information about the SIE and Series 6 exams, refer to FINRA Rule 1210 and FINRA Rule 1220(b)(7).

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EDUCATION: Books

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3 Behavioral Biases Hurting Your Finances

Posted on September 23, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

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The study of behavioral economics has revealed much about how different biases can affect our finances—often for the worse.

Take loss aversion: Because we feel a financial setback more acutely than a commensurate gain, we often cling to failed investments to avoid realizing the loss. Another potential hazard is present bias, or the tendency to prefer instant gratification over long-term reward, even if the latter gain is greater.

When it comes to money, sometimes it’s difficult to make rational decisions. Here, are three behavioral financial biases that could be impeding financial goals.

ANCHORING BIAS

Anchoring Bias happens when we place too much emphasis on the first piece of information we receive regarding a given subject. Anchoring is the mental trick your brain plays when it latches onto the first piece of information it gets, no matter how irrelevant. You might know this as a ‘first impression’ when someone relies on their own first idea of a person or situation.

Example: When shopping for a wedding ring a salesman might tell us to spend three months’ salary. After hearing this, we may feel like we are doing something wrong if we stray from this financial advice, even though the guideline provided may cause us to spend more than we can afford.

Example: Imagine you’re buying a car, and the salesperson starts with a high price. That number sticks in your mind and influences all your subsequent negotiations. Anchoring can skew our decisions and perceptions, making us think the first offer is more important than it is. Or, subsequent offers lower than they really are.

Example: Imagine an investor named Jane who purchased 100 shares of XYZ Corporation at $100 per share several years ago. Over time, the stock price declined to $60 per share. Jane is anchored to her initial price of $100 and is reluctant to sell at a loss because she keeps hoping the stock will return to her original purchase price. She continues to hold onto the stock, even as it declines, due to her anchoring bias. Eventually, the stock price drops to $40 per share, resulting in significant losses for Jane.

In this example, Jane’s nchoring bias to the original purchase price of $100 prevents her from rationalizing to sell the stock and cut her losses, even though market conditions have changed. So, the next time you’re haggling for your self, a potential customer or client, or making another big financial decision, be aware of that initial anchor dragging you down.

HERD MENTALITY BIAS

Herd Mentality Bias makes it very hard for humans to not take action when everyone around us does.

Example: We may hear stories of people making significant monetary profits buying, fixing up, and flipping homes and have the desire to get in on the action, even though we have no experience in real estate.

Example: During the dotcom bubble of the late 1990’s many investors exhibited a herd mentality. As technology stocks soared to astronomical valuations, investors rushed to buy these stocks driven by the fear of missing out on the gains others were enjoying. Even though some of these stocks had questionable fundamentals, the herd mentality led investors to follow the crowd.

In this example, the herd mentality contributed to the overvaluation of technology stocks. Eventually, it led to the dot-com bubble’s burst, causing significant losses for those who had unthinkingly followed the crowd without conducting proper research or analysis.

OVERCONFIDENT INVESTING BIAS

Overconfident Investing Bias happens when we believe we can out-smart other investors via market timing or through quick, frequent trading. This causes the results of a study to be unreliable and hard to reproduce in other research settings.

Example: Data convincingly shows that people and financial planners/advisors and wealth managers who trade most often under-perform the market by a significant margin over time. Active traders lose money.

Example: Overconfidence Investing Bias moreover leads to: (1) excessive trading (which in turn results in lower returns due to costs incurred), (2) underestimation of risk (portfolios of decreasing risk were found for single men, married men, married women, and single women), (3) illusion of knowledge (you can get a lot more data nowadays on the internet) and (4) illusion of control (on-line trading).

ASSESSMENT

Finally, questions remain after consuming this cognitive bias review.

Question: Can behavioral cognitive biases be eliminated by financial advisors in prospecting and client sales endeavors?

A: Indeed they can significantly reduce their impact by appreciating and understanding the above and following a disciplined and rational decision-making sales process.

Question: What is the role of financial advisors in helping clients and prospects address behavioral biases?

A: Financial advisors can provide an objective perspective and help investors recognize and address their biases. They can assist in creating well-structured investment and financial plans, setting realistic goals, and offering guidance to ensure investment decisions align with long-term objectives.

Question: How important is self-discipline in overcoming behavioral biases?

A; Self-discipline is crucial in overcoming behavioral biases. It helps investors and advisors adhere to their investment plans, avoid impulsive decisions, and stay focused on long-term goals reducing the influence of emotional and cognitive biases.

CONCLUSION

Remember, it is far more useful to listen to client beliefs, fears and goals, and to suggest options and offer encouragement to help them discover their own path toward financial well-being. Then, incentivize them with knowledge of the above psychological biases to your mutual success!

EDUCATION: Books

REFERENCES:

Marcinko, DE; Dictionary of Health Insurance and Managed Care. Springer Publishing Company, New York, 2007.
Marcinko, DE: Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™. Productivity Press, NY, 2016.
Marcinko, DE: Risk Management, Liability and Insurance Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™. Productivity Press, NY, 2017.
Nofsinger, JR: The Psychology of Investing. Rutledge Publishing, 2022
Winters, Scott: The 10X Financial Advisor: Your Blueprint for Massive and Sustainable Growth. Absolute Author Publishing House, 2020.
Woodruff, Mandy: https://www.mandimoney.com

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Why Many Doctors Struggle Financially: 5 Key Reasons

Posted on September 23, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By A.I. and Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Despite their high salaries, not all doctors are wealthy, and some live paycheck to paycheck. Here are 5 reasons why many doctors today are broke, according to https://medschoolinsiders.com

1 | Believing They Are Universally Smart

The first reason so many doctors are broke is that many doctors believe they are universally smart. While most doctors have deep specialized knowledge, there’s a big difference between being smart in your profession and being smart with money. A physician’s schooling is quite thorough when it comes to the human body, but med school doesn’t include a prerequisite class on how to handle finances.

MORE: https://medicalexecutivepost.com/2022/11/18/what-is-the-dunning-kruger-effect/

Graduating medical school is a major feat and certainly demonstrates superior work ethic and cognitive abilities. But many new doctors believe these accomplishments transcend all aspects of life. If you’re smart enough to earn an MD, you’re certainly smart enough to handle your finances, but only once you properly and intentionally educate yourself.

The truth is doctors, especially traditional graduates, haven’t had an opportunity to manage large sums of money until they become fully trained attending physicians and start pulling in low to mid six figures in income. Prior to that, there was very little of it to manage.

Far too many aspiring doctors, and students in general, don’t take the time to learn financial basics, in part because it’s uncomfortable and seems like something they can figure out “later”, whenever that may be. Their poor spending habits and lack of investment knowledge carry over into their careers, causing many to make irresponsible decisions.

MORE: https://medicalexecutivepost.com/2025/07/17/doctors-and-lawyers-often-arent-millionaires/

2 | Overspending Too Soon

The second factor is overspending too soon, and this comes up at two points in training.

First, it’s natural to want to start spending more as soon as you get into residency and start making a little more money. After all, you’ve been a broke student for 8 or more years, and now you’re finally making a reasonable and reliable wage. But that’s where young doctors get into trouble. Residency pays, but not nearly as much as you will be making once you become an attending physician. The average resident makes about $60K a year, and if you begin spending all of that money right away, thinking you’ll handle your loans once you become an attending, you delay paying off your medical school debt, which means the compounding effect through your student loan interest rate works against you.

Now that $250,000 in student loans has ballooned to over $350,000 by the time you finish residency. The compounding effect, which can be one of your greatest allies in your financial life, becomes an equally powerful enemy when working against you through debt. But of course, pinching pennies is easier said than done, especially when you’re in residency and are surrounded by peers in different professions. They’ve been earning good money much longer than you have, and they can afford more luxurious lifestyles.

They may not be worried about indulging in fine dining or how much a hotel costs when traveling. Students in college and medical school are often confident they will resist the temptations, but the desire to keep up with your friends and family can be difficult to ignore, which causes many to overspend before they technically have the money to do so.

The same is true of attending physicians. As soon as those six-figure salaries come rolling in, many physicians go overboard with spending, trying to make up for lost time and to treat yourself.

Now, we are not suggesting you shouldn’t reward yourself for completing residency, but that reward shouldn’t be a Lamborghini. It’s best to continue living like a resident in your first few years after becoming an attending to pay off loans, put a down payment on a home, and get your financial foundation built before loosening the purse strings.

3 | Decreasing Salaries

Third, doctors continue to make less money than they did before. And this includes nearly all 44 medical specialties. For example, while physician compensation technically rose from $343k to $391k between 2017 and 2022, this rise does not keep up with inflation. The real average compensation in 2022 was less than $325k—a $20k decrease in purchasing power in only six years.

For doctors who are already spending to the limits of their salaries with huge mortgages, car payments, business costs, and other luxuries, a decreased salary can have a huge impact. You might be able to cut back by going on fewer vacations or eating out less frequently, but many accrued costs are locked in, such as a mortgage payment, car loan, or leased rental space for your practice.

4 | Increasing Costs of Private Practice

In the past, running a private practice was much simpler, but recent stricter guidelines and regulations have made it difficult for solo practices to keep up. While regulations like the Health Insurance Privacy and Portability Act, or HIPAA, and mandatory Electronic Medical Records, or EMRs, are necessary to protect patients, they make costs higher for physicians who run their own private practice. These physicians need to spend their own money to set up and maintain EMRs as well as invest in security to ensure patient data is protected.

With the steep rise of inflation we’ve seen over the past couple of years, everything is more expensive, which means costs, such as business space, equipment, and even office supplies, have gone up for private practice physicians while salaries have not. 2013 to 2020 saw an annual inflation rate of anywhere from 0.7% to 2.3%. This skyrocketed to an annual inflation rate of 7.0% in 2021 and another 6.5% in 2022. In fact, the cost of running a private practice has increased by almost 40% between 2001 and 2021.

These increased costs are exacerbated by another problem plaguing private practices; decreased reimbursement. While costs increased by almost 40%, Medicare reimbursement only increased by 11%. When doctors see patients who are insured, the insurance companies pay the physicians for their time. For Medicare, the new proposed rules for 2023 would cut reimbursement by around 5%. When adjusting for inflation, Medicare reimbursement decreased by 20% in the last 20 years.

These costs add up, making it extremely difficult for physicians to thrive financially while running a private practice.

5 | Tuition Debt

Lastly, we can’t talk about a doctor’s finances without mentioning the exorbitant debt so many graduating physicians are left with. It won’t shock you to hear that med school is expensive. Extremely expensive. The average cost of tuition for a single year is nearly $60k, with significant variance from school to school, and that’s before accounting for living expenses.

In-state applicants pay less than out-of-state applicants, and students at private schools typically pay more than students at public medical schools. The astronomical costs mean the vast majority of students can’t pay for medical school out of their own pockets. And unless your family is part of the 1%, even with your parents footing the bill, it’s difficult to cover tuition, let alone rent, groceries, transportation, tech, social activities, exam fees, and application costs.

The average total student debt after college and med school is over $250k. But keep in mind that’s the average, which includes 27% of students who graduate with no debt at all. This means the vast majority of students leave medical school owing much more than $250k.

For some perspective, in 1978, the average debt for graduating MDs was $13,500, which, when adjusted for inflation, is a little over $60,000. There are multiple ways to eventually repay these loans, but time and discipline are essential to ensure this money is paid off as quickly as possible.

MORE: https://medicalexecutivepost.com/2024/12/03/12-investing-mistakes-of-physicians/

THE FINANCIAL FIX

According to financial advisor Dr. David Edward Marcinko MEd MBA CMP™; consider the following:

Place a portion of your salary (15-20% or more) into a savings account, and another portion (10-20% or more) into wise investments [stocks, bonds, mutual funds, and/or ETFs].

Pay off your bills each month, and then use leftover spending money to purchase fun things like vacations and fancy dinners, within your means. Shop sales, buy used clothes, and use credit card points for travel.

Hire an excellent tax professional and meet with an investment advisor once or twice a year about your investment status and strategy. http://www.MarcinkoAssociates.com

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PALACE FALLACY: Memory Loss

Posted on September 23, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

By Staff Reporters and A.I.

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The Memory Palace Fallacy – Learning Styles Don’t Actually Exist

Remember being told you’re a “visual learner” or an “auditory learner”? Well, turns out that whole learning styles theory is pretty much bunk.

Common Learning Myths have been thoroughly debunked by modern educational research, and this is a big one. Studies consistently show that matching teaching methods to supposed learning styles doesn’t improve outcomes at all.

What actually matters is matching the teaching method to the content itself – you learn geography better with maps because geography is visual, not because you’re a “visual person.” It’s like trying to learn piano by reading about it versus actually playing keys. The activity should match what you’re trying to learn, not some made-up category about how your brain supposedly works.

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SERIES #7 EXAM: General Securities Representative Qualification

Posted on September 22, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By A. I. and FINRA

SPONSOR: http://www.CertifiedMedicalPlanner.org

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The Series 7 exam — the General Securities Representative Qualification Examination (GS) — assesses the competency of an entry-level registered representative to perform their job as a general securities representative.

The exam measures the degree to which each candidate possesses the knowledge needed to perform the critical functions of a general securities representative, including sales of corporate securities, municipal securities, investment company securities, variable annuities, direct participation programs, options and government securities.

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PHYSICIAN NET WORTH: Versus Average Family

Candidates must pass the Securities Industry Essentials (SIE) exam and the Series 7 exam to obtain the General Securities Representative registration.

For more information about the SIE and Series 7 exams, refer to FINRA Rule 1210 and FINRA Rule 1220(b)(2).

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QUANTUM COMPUTERS: A Peek into the Future?

Posted on September 20, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

NIST, A.I. and Staff Reporters

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SPONSOR: http://www.CertifiedMedicalPlanner.org

A computer that could break the encryption that safeguards your private information on the internet. A machine that can design powerful new drugs by precisely simulating the behavior of individual molecules. A device that optimizes complex supply chains to help companies get the parts they need and assemble them in the most efficient way possible.

These are all examples of how an emerging technology — the quantum computer — could change our world.

PODCAST: On Replacing Doctors with Computers and Smart Phones

These computers work by harnessing quantum physics — the strange, often counterintuitive laws that govern the universe at its smallest scales and coldest temperatures. Today’s quantum computers are rudimentary and error-prone. But if more advanced and robust versions can be made, they have the potential to rapidly crunch through certain problems that would take current computers years. That’s why governments, companies and research labs around the world are working feverishly toward this goal.

Quantum computers will not replace our familiar “classical” computers. Rather, the two types of machines could work together to solve problems that stymie classical computers, potentially supercharging scientific research in fields such as materials and drug discovery, giving a boost to industry and upending cybersecurity as we know it.

So, let’s explore how quantum computers work.

MORE: https://www.nist.gov/quantum-information-science/quantum-computing-explained

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Filed under: CMP Program, Drugs and Pharma, Ethics, Experts Invited, Information Technology | Tagged: CMP, computers, Cyber Security, Drugs, internet, molecules, NIST, PC, PCs, personal computer, physics, quantum computers | Leave a comment »

INVESTING PARADOX: Flexibile and Dogmatic

Posted on September 17, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

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A paradox is a statement or situation that seems contradictory but actually makes sense when you think about it more deeply. It challenges logic and often reveals a hidden truth.

FLEXIBLY DOGMATIC PARADOX

The Flexibly Dogmatic Paradox suggests that no matter how sensible your financial planning, investing or wealth management process is there will be uncomfortably long periods when it looks broken. And process is the best way of ensuring you keep standing for something because if you don’t stand for something, you’ll fall for anything. This is why, when assessing an investment fund, focus 50% on the manager’s character and 50% on their process. Everything else is detail. There are few guarantees in investing, but the fact that markets will batter you emotionally is one of them.

FINANCIAL PARADOX: https://medicalexecutivepost.com/2025/07/27/paradox-of-financial-health/

Example: During volatile times, the temptation to abandon the process is strong. But that’s why it’s there. Process is what forces one fund manager to keep buying unbroken companies when everyone else thinks they’re bust, and another to keep faith with a top-quality company when the mob says it’s too expensive The best fund managers dogmatically stick to their process when it’s out of favor. Then, when it returns to favor, the elastic pings back: they recapture lost ground surprisingly fast. However, every rule has an exception. And spotting the exceptions to their process is something the true greats have a knack for buying and selling.

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Example: In 2007, US value manager Bill Miller had the makings of an investment legend, but the financial crisis wrecked all that. His process told him to double down into falling share prices, which had worked well for years. But it doesn’t work if the companies go bust, which many of his financial stocks did in 2008.

ADVISORS PARADOX: https://medicalexecutivepost.com/2025/06/20/paradoxical-contradictions-all-financial-advisors-must-know-to-win-clients/

Conclusion

The fact is that no matter how good it is, a process operated without human judgment is just an algorithm. The best fund managers and financial prospectors and sales men/women know this.

They stick dogmatically to their process but somehow remain flexible enough to spot the occasions when it’s about to drive them into a brick wall.

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Filed under: CMP Program, Ethics, Experts Invited, finance, Financial Planning, Glossary Terms, Marcinko Associates, mental health, Portfolio Management | Tagged: bill miller, brain, budgeting, CMP, dogmatic, dogmatic paradox, finance, financial planniing, flexibility paradox, flexible, Investing, investing paradox, marcinko david, mental health, money, paradox, personal-finance, US value, wealth management | Leave a comment »

CAPITATION REIMBURSEMENT: A Historical Economic Review

Posted on September 15, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

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By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

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DEFINITION

Capitation is a type of healthcare payment system in which a physician or hospital is paid a fixed amount of money per patient for a prescribed period by an insurer or physician association. The cost is based on the expected healthcare utilization costs for a group of patients for that year.

With capitation, the physician—otherwise known as the primary care physician— is paid a set amount for each enrolled patient whether a patient seeks care or not. The PCP is usually contracted with an HMO whose role it is to recruit patients.

ACOs: https://medicalexecutivepost.com/2024/12/01/record-breaking-savings-for-acos-in-2023/

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CAPITATION REIMBURSEMENT HISTORY

According to Richard Eskow, CEO of Health Knowledge Systems of Los Angeles, capitated medical reimbursement has been used in one form or another, in every attempt at healthcare reform since the Norman Conquest. Some even say an earlier variant existed in ancient China [personal communication].

Initially, when Henry I assumed the throne of the newly combined kingdoms of England and Normandy, he initiated a sweeping set of healthcare reforms. Historical documents, though muddled, indicate that soon thereafter at least one “physician,” John of Essex, received a flat payment honorarium of one penny per day for his efforts. Historian Edward J. Kealey opined that sum was roughly equal to that paid to a foot-soldier or a blind person. Clearer historical evidence suggests that American doctors in the mid-19th century were receiving capitation-like payments. No less an authoritative figure than Mark Twain, in fact, is on record as saying that during his boyhood in Hannibal, MO his parents paid the local doctor $25/year for taking care of the entire family regardless of their state of health.

Later, Sidney Garfield MD [1905-1984] is noted as one of the great under-appreciated geniuses of 20th century American medicine stood in the shadow cast by his more celebrated partner, Henry J. Kaiser. Garfield was not the first physician to embrace the notion of prepayment capitation, nor was he the first to understand that physicians working together in multi-specialty groups could, through collaboration and continuity of care, outperform their solo practice colleagues in almost every measure of quality and efficiency. The Mayo brothers, of course, had prior claim to that distinction. What Garfield did, was marry prepayment to group practice, providing aligned financial incentives across every physician and specialty in his medical group, as well as a culture of group accountability for the care of every member of the affiliated health plan. He called it “the new economics of medicine,” and at its heart was a fundamentally new paradigm of care that emphasized – prevention before treatment – and health before sickness. Under his model: the fewer the sick – the greater the remuneration. And: the less serious the illness, the better off the patient and the doctors.

VBC: https://medicalexecutivepost.com/2018/12/07/the-state-of-value-based-care-vbc/

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Such ideas were heresy to the reigning fee-for-service, solo practice, ideologues of the mainstream medical establishment of the 1940s and ‘50s, of course. Throughout the period, Garfield and his group physicians were routinely castigated by leaders of the AMA and county medical associations as socialistic and unethical. The local medical associations in Garfield’s expanding service areas – the San Francisco Bay Area, Los Angeles, and Portland, Oregon – blocked group practice physicians from association membership, effectively shutting them out of local hospitals, denying them patient referrals or specialty society accreditation. Twice in the 1940s, formal medical association charges were brought against Garfield personally, at one time temporarily succeeding in suspending his license to practice medicine.

Of course, capitation payments made a comeback in the first cost-cutting managed care era of the 1980-90s because fee-for-service medicine created perverse incentives for physicians by paying more for treating illnesses and injuries than it does for preventing them — or even for diagnosing them early and reducing the need for intensive treatment later. Nevertheless, the modern managed care industry’s experience with capitation wasn’t initially a good one. The 1980-90s saw a number of HMOs attempt to put independent physicians, especially primary care doctors, into a capitation reimbursement model. The result was often negative for patients, who found that their doctors were far less willing to see them — and saw them for briefer visits — when they were receiving no additional income for their effort. Attempts were also made to aggregate various types of health providers — including hospitals and physicians in multiple specialties — into “capitation groups” that were collectively responsible for delivering care to a defined patient group. These included healthcare facilities and medical providers of all types: physicians, osteopaths, podiatrists, dentists, optometrists, pharmacies, physical therapists, hospitals and skilled nursing homes, etc.

However, the healthcare industry isn’t collective by nature, and these efforts tended to be too complicated to succeed. One lesson that these experiments taught is that provider behavior is difficult to change unless the relationship between that behavior and its consequences is fairly direct and easy to understand.

MORE: https://medicalexecutivepost.com/wp-content/uploads/2008/11/capitation-actuarial-medical-econometrics.pdf

Today, the concept of prepayment and medical capitation is to uncouple compensation from the actual number of patients seen, or treatments and interventions performed. This is akin to a fixed price restaurant menu, as opposed to an àla carte eatery.

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Filed under: Ask a Doctor, Career Development, CMP Program, curated experts,, economics, Ethics, Experts Invited, finance, Glossary Terms, Health Economics, Health Law & Policy, Healthcare Finance, Marcinko Associates | Tagged: AMA, capitation, capitation economics, CMP, david marcinko, DDS, DMD, DO, doctor compensation, DPM, exchange-server, Health Economics, Health Insurance, HMO, Managed Care, MD, PCP, physician compensation, powershell, primary care provider, Richard Eskow, RN, Sidney Garfield, system-center | Leave a comment »

STOCK MARKET: Beware Manipulation Schemes

Posted on September 10, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd CMP™

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SPONSOR: http://www.MarcinkoAssociates.com

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What are types of market manipulation schemes?

Pump and Dump

When owners of a security spread false information to pump up the price of the security and subsequently sell off their shares, making a profit—the “dump.”
Would you like to learn more about pump and dump schemes? Check out some real-world examples.
PUMP DUMP: https://medicalexecutivepost.com/2022/12/16/pumpers-dumpers-social-media-influencers-charged-in-scheme/

Bear Raids

Refer to attempts by investors to move the price of a stock opportunistically by selling large numbers of shares short. The investors pocket the difference between the initial price and the new, lower price after this maneuver. This technique is illegal under SEC rules, which stipulate that every short sale must be on an uptick. For more information on this complex tactic, read on in this piece from the Wharton School of Business.

Wash Trading

Involves the simultaneous or near-simultaneous sale and repurchase of the same security for the purpose of generating activity and increasing the price.
CHURNING: https://medicalexecutivepost.com/2021/10/25/churning-front-running-and-pumping-dumping/

Matched Orders

When fraudsters manipulate the market through matched orders, they enter trades to buy or sell securities with the knowledge that a matching order on the opposite side has been or will be entered. During his tenure at the Commission, our partner Jordan Thomas was involved in a case where the SEC won summary judgement and obtained settlements with an astonishing 16 defendants who engaged in matched trades, among other illicit tactics.

Painting the Tape

Painting the tape refers to placing successive orders in small amounts at increasing or decreasing prices.

Spoofing & Layering

High frequency traders are known to use the tactics of Spoofing & Layering to manipulate share prices. Spoofing is the placing of a bid or offer with the intent to cancel before execution. Layering is a form of spoofing in which the trader places multiple orders on one side of the book, in order to create a false impression of heavy buying or selling.
PONZI: https://medicalexecutivepost.com/2021/09/22/what-exactly-is-a-ponzi-scheme/

DOCTORS: Early Investing Needed for Retirement

Posted on September 9, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

NEW FINANCIAL STRATEGIES?

By A.I. and Dr. David Edward Marcinko; MBA MEd CMP™

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SPONSOR: http://www.CertifiedMedicalPlanner.org

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Starting early is key to saving for retirement

Although 97% of people aren’t yet millionaires, many could eventually meet that target if they start investing sooner rather than later; especially doctors [MD, DO, DPM, DDS or DMD].

BROKE DOCTORS: https://medicalexecutivepost.com/2025/08/02/doctors-going-broke-and-living-paycheck-to-paycheck/

A 20-year-old, for instance, needs to invest just $330 a month into an asset class that delivers a 7% to 8% annual return to reach $1.26 million by the time s/he turns 65 years old. The luxury of time significantly boosts your chances of becoming a millionaire.

This doesn’t mean it’s too late for middle-aged savers to reach that millionaire milestone, but it will take a significantly greater investment. If a 50-year-old doctor hasn’t started saving for retirement, s/he would need to invest $3,958 a month at a steady 7% return to reach $1.26 million by retirement.

MONEY ADDICTION: https://medicalexecutivepost.com/2025/08/07/moiney-addicted-physicians-the-investing-and-trading-personality-of-doctors/

However, according to one Goldman Sachs report, investors could expect the S&P 500 to deliver just 3% annualized nominal returns over the next 10 years.

After an average 13% yearly return for the past decade, a new strategy outside of the stock market may be needed for that level of outsized gain, especially if you’re late to investing.

RETIREMENT VISION: https://medicalexecutivepost.com/2025/08/04/physicians-determine-your-retirement-vision/

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AI/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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MEDICAL EXPENSES: Out of Pocket and Out of Network Fees

Posted on September 9, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By A.I. and Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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OUT OF POCKET [OOP] EXPENSES

Classic: The portion of medical expenses a patient is responsible for paying.

Modern: Refers to the maximum you will pay during your policy period, which is typically a year, before your plan starts to pay 100% of your allowed amount. The costs of your deductible, co-pay, and co-insurance are included here, but not your premium.

CO-PAYS: https://medicalexecutivepost.com/2025/05/17/cleveland-clinic-controversial-new-health-insurance-co-payment-policy/

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OUT OF NETWORK [OON] EXPENSES

Classic: “Out-of-network” health care providers do not have an agreement with your insurance company to provide care. While insurance companies may have some out-of-network benefits, medical care from an out-of-network provider will usually cost more out-of-pocket than an in-network provider.

Modern: The amount that a health care insurance plan will contribute toward out-of-network services will vary by your insurance company and is often based on a “reasonable and customary” amount that the service should cost

Example: If you go to an out-of-network dentist and are billed $300 for the service, your insurance company may contribute $200 toward paying this cost because $200 is the amount it has decided is “reasonable and customary” for this service. When out-of-network, any remaining cost above this amount ($100 in this case) may have to be fully covered by the person receiving care. When out-of-network, the usual coinsurance rates that apply in-network may not apply out-of-network. Additionally, out-of-network service costs may not count toward an annual deductible.

CHARGE-MASTER: https://medicalexecutivepost.com/2024/11/20/charge-master-medical-bills-paradox/

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PHYSICIAN BANKRUPTCY: Six Total Types to Know!

Posted on September 7, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By A.I. and Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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According to Medical Economics, there were 10 clinic and physician practices filing bankruptcy in 2024, making it the highest level of the last six years, according to a new analysis of cases with liabilities of at least $10 million.

Meanwhile, the Steward Health Care System bankruptcy, which was based in Massachusetts but making headlines across the nation, has become “the largest hospital sector bankruptcy by far in the last 30 years,” according to a new analysis by Gibbins Advisors, based in Nashville, Tennessee.

Health care bankruptcy filings totaled 57 last year, down from 79 in 2023, said “Healthcare Restructuring: Trends and Outlook.” The report analyzed Chapter 11 health care bankruptcy cases with liabilities of at least $10 million, since 2019.

Last year’s total was down 28% from 2023’s peak, but greater than the 2019 to 2022 average of 42 filings a year, the report said.

BROKE DOCTORS: https://medicalexecutivepost.com/2025/08/02/doctors-going-broke-and-living-paycheck-to-paycheck/

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Bankruptcy, often considered a last financial resort, is a legal process that can help alleviate outstanding debts for individuals and businesses. Reasons to file for bankruptcy can include divorce, job loss, exorbitant medical bills or credit card debt.

There are several types of bankruptcy — six, as a matter of fact. The two most common types of bankruptcy for individuals are Chapter 7 and Chapter 13.

But there are four other types as well: Chapter 9, Chapter 11, Chapter 12 and Chapter 15. And, the type of bankruptcy filed depends on the situation.

Regardless of which type, the process is typically the same: You’ll usually retain an attorney and make your case before a judge, who will then erase some debts or set up a repayment plan.

Also note that an eligibility requirement — for all bankruptcy chapters — is that you must undergo credit counseling within the 180 days before filing.

DOCTORS: https://medicalexecutivepost.com/2025/07/17/doctors-and-lawyers-often-arent-millionaires/

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PSYCHOLOGICAL BIAS: The Ikea Effect in Finance?

Posted on September 5, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko; MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

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IKEA EFFECT BIAS

Ikea Effect Bias describes the tendency of people to place a higher value on products they have partially created or assembled themselves. This phenomenon is named after the Swedish furniture retailer Ikea, known for selling furniture in flat-pack kits that customers must assemble at home.

he IKEA effect was identified and named by Michael Norton of Harvard Business School, Daniel Mochon of Yale University and colleague Dan Ariely PhD of Duke University, who published the results of three studies in 2011. They described the IKEA effect as “labor alone can be sufficient to induce greater liking for the fruits of one’s labor: even constructing a standardized bureau, an arduous, solitary task, can lead people to overvalue their (often poorly constructed) creations.”

Example: A prospect is more likely to pursue his/her own financial plan than that one from an informed financial planner, CPA or professional advisor.

2011 study found that subjects were willing to pay 63% more for furniture they had assembled themselves than for equivalent pre-assembled items.

IN FINANCE AND INVESTING

The IKEA effect can contribute to reducing panic selling. Investors typically reduce their stock market exposure after a financial crash which often results in “buy high, sell low” strategy that is detrimental to long-run wealth accumulation.

Ashtiani et al.’s study proposes a nudge utilizing the IKEA effect to counteract this phenomenon: “actively involving investors in the selection process of the risky investments, while restricting their selections in a way that preserves a large degree of diversification.”

DIVERSIFICATION: https://medicalexecutivepost.com/2025/06/17/correlation-diversification-in-finance-and-investments/

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PHYSICIANS: Alimony V. Palimony

Posted on September 2, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By A.I. and Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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What is Alimony

According to Hello Divorce, alimony, often referred to as spousal support, is a court-ordered payment from one spouse to the other following a divorce or legal separation. Its existence is tied to the legal status of marriage. The underlying principle is that both spouses contributed to the marital standard of living, and the dissolution of the marriage should not cause an inequitable economic outcome for the lower-earning spouse. This support is not intended as a punishment but as a means of mitigating the financial impact of divorce.

The purpose of alimony can vary. In some cases, it is rehabilitative, providing temporary support while one spouse obtains education or job training to become self-sufficient. For longer marriages, it might serve to help maintain the standard of living established during the partnership. Alimony is a legal tool derived from family law statutes to address the financial interdependence created by marriage.

DIVORCE: https://medicalexecutivepost.com/2025/08/14/physician-divorce-within-the-medical-profession/

Note: The federal tax treatment for alimony changed with the Tax Cuts and Jobs Act of 2017. For any divorce or separation agreement executed after December 31st, 2018, alimony payments are no longer tax-deductible for the person paying them. The recipient of the support does not report the payments as taxable income. This change is permanent and does not expire with other provisions of the act.

What is Palimony

According to Wikipedia, Palimony refers to financial support that may be awarded after an unmarried couple separates. Unlike alimony, palimony is not rooted in family law but is a concept derived from contract law. An award depends on the existence of an agreement between the partners. This agreement can be a formal written contract or an oral or implied agreement for support in exchange for services, such as managing the household.

The legal basis for palimony was established by the 1976 California Supreme Court case, Marvin v. Marvin. In that case, the court ruled that unmarried cohabitants could make enforceable contracts for support, as long as the agreement was not based on sexual services. Because it is a contract claim, a palimony case is pursued in civil court, not family court. Palimony is not available in all states and is only recognized in a minority of jurisdictions.

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

Note: The tax implications of palimony are less defined than alimony because the IRS does not have a specific rule for it. How palimony is treated depends on the nature of the underlying claim. If the payments are a settlement for services rendered, they may be considered taxable income to the recipient. If the payments are characterized as a gift, they are not considered taxable income for the recipient.

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PHYSICIANS: Why Salary is Down?

Posted on August 28, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL PROVIDER PAYMENTS LOWERED

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Statistic: $2.8+ billion dollars

That’s how much Blue Cross and Blue Shield plans agreed to pay to settle litigation over claims they conspired to lower payments to providers. (Healthcare Dive)

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PHYSICIANS BEWARE: The APR Car Lease “Money Factor”

Posted on August 25, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By A.I. and Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

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What is it?

The so-called money factor (abbreviated as MF on invoices) is a number in a decimal form that dealers use to calculate the APR of a car lease. It’s a major part of your monthly payment and dealers are known to jack up the money factor to pad their profits.

BROKE DOCTORS: https://medicalexecutivepost.com/2025/08/02/doctors-going-broke-and-living-paycheck-to-paycheck/

How it works

Most doctors don’t ask to see it because they’re not aware of it or don’t know how to calculate it. Ask to see the money factor, then multiply it by 2,400.

For example, if the money factor is .00150, you multiply it by 2,400 to get 3.6%. If that’s higher than the prevailing rate, you have room to talk them down.

How to reduce it

So how do you get a good interest rate when you lease a vehicle? The same way you do when borrowing for any other reason, whether it’s buying a home or applying for a personal loan: by having good credit. This may reduce your interest rate because you’ll represent a lower risk to a lender.

A high residual value on the car could also help you get a better interest rate. A higher residual value means you’d have lower monthly payments because there would be less depreciation on the vehicle. Since interest is applied to your monthly payment, a lower monthly payment would equate to reduced interest charges.

MONEY DOCTORS: https://medicalexecutivepost.com/2025/04/08/psychology-a-money-relationship-questionnaire-for-doctors/

Financial implications

The money factor is one of the many numbers you may want to learn about when leasing a car. It’s one of the transactional costs that come with leasing, and allows dealers and finance companies to make a profit on every lease they execute. As a consumer, it’s a smart idea to learn the financial implications of this number and how it’ll affect your overall costs over the course of a multi-year lease.

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If the interest rate is too high, you may need to shop around for a better rate, negotiate with the dealer or lender to lower the money factor, or consider leasing another vehicle that’s more in line with your budget. Either way, make sure you explore all your financial options before taking a car off the lot.

SALARY NEGOTIATIONS: https://medicalexecutivepost.com/2016/08/21/salary-negotiations-skills-for-doctors-hospitalists/

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PHYSICIAN DIVORCE: “Buyer’s Settlement Remorse”

Posted on August 24, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By A.I and Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Introduction

It is normal for physician litigants to develop a case of “buyer’s remorse” after any mediation or divorce settlement. They may feel disappointed after entering into a settlement agreement or feel that they received a bad deal.

PHYSICIAN DIVORCE: https://medicalexecutivepost.com/2025/08/14/physician-divorce-within-the-medical-profession/

Mediation: Some advantages of divorce mediation over divorce litigation include:

◊ Mediation is generally faster and less costly.

◊ Mediation is voluntary, private and confidential.

◊ Mediation facilitates creative and realistic solutions.

◊ Mediation allows parties to control their agreements.

◊ Mediation eliminates a win-lose atmosphere and result.

◊ Mediation provides a forum for addressing future disputes.

◊ Mediation fosters communication and helps mend relationships.

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Settlement

And so, in a vast majority of cases, mediation and settlement is probably a good deal. In fact, it is probably a great deal because you are receiving something without having to risk losing. Remember, trial can be a crap-shoot, and nothing is worse than losing it all at the time of trial.

Bench trial verdict by a trial judge.
Jury trial verdict by your “peers.”

Instead, you entered into a settlement agreement and now your divorce case is over.

But beware since trying to get out of a settlement agreement reached at mediation or settlement is virtually impossible.

Why? Well, there is a strong interest by the court to enforce mediation and settlement agreements. The court wants your divorce case to be over and off its docket. There are a few very narrow exceptions; for example, if one party was truly coerced because someone held a gun to their head. But that rarely happens, and it certainly doesn’t happen to most doctors or dentists.

MEDIATION: https://medicalexecutivepost.com/2024/09/15/financially-egalitarian-dating-marriages-and-divorce-mediation-for-doctors/

Re-litigate?

Of course, you can fight against your mediation or settlement agreement if you like, but you won’t get too far. There’s an old adage in the law that a bad settlement is better than a great trial. That’s because no one knows how a judge or jury will rule come time of trial.

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This buyers remorse phenomenon also isn’t uncommon among people who receive sudden wealth, whether through divorce settlements, inheritances, lottery winnings, or other windfalls.

Assessment

Financial advisors often see clients struggle with “sudden wealth syndrome”—the inability to properly manage a large sum of money they’re not accustomed to having.

Common mistakes include:

Lifestyle inflation without sustainable income to support it.
Poor investment decisions or lack of investment planning.
Emotional spending following traumatic life events like divorce.
Failure to set aside money for taxes on the settlement.
Not creating a long-term financial plan for the money.

So, do not let these mistakes happen to you!

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Filed under: "Doctors Only", CMP Program, Ethics, Financial Planning, Glossary Terms, Health Economics, Healthcare Finance, Investing, LifeStyle, Marcinko Associates | Tagged: bench trial divorce, buyers remorse, certified medical planner, CMP, david marcinko, divorce, divorce mediation, doctor divorce, jury divorce trial, law, mediation, news, physician divorce, politics, settlement divorce, sudden wealth syndrome | Leave a comment »

NET WORTH: Defined for Physicians

Posted on August 23, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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What does net worth really mean?

Net worth is everything you own of significance (Assets) minus what is owed in debts (Liabilities). Assets include cash and investments, real estate, cars and anything else of value.

BROKE DOCTORS: https://medicalexecutivepost.com/2025/08/02/doctors-going-broke-and-living-paycheck-to-paycheck/

How is net worth calculated? Assets – Debt = Net Worth. Net worth is calculated by adding all owned assets (anything of value) and then subtracting all of your liabilities.

Is net worth yearly? No, net worth is not yearly. Net worth isn’t inherently yearly but is often tracked on an annual basis to assess financial progress year over year.

What net worth is considered wealthy, rich and upper class?
In the U.S. salary average is around $59,000, and only 20% of Americans have a household income of $100,000 or more.

MONEY ADDICTION: https://medicalexecutivepost.com/2025/08/07/moiney-addicted-physicians-the-investing-and-trading-personality-of-doctors/

Is net worth the same as net income? No, net worth is not the same as net income. Net income is what you actually bring home after taxes and payroll deductions, like Social Security and 401(k) contributions.

Can one measure their net worth if they don’t have many assets or a high income? Yes. Knowing your net worth isn’t about the amount you have; it’s about understanding your financial position. It helps you track your progress, informs your financial decisions, and motivates you to improve your financial health, regardless of where you start.

HEDGE FUNDS: https://medicalexecutivepost.com/2025/06/08/hedge-funds-defined-for-doctors/

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Filed under: "Ask-an-Advisor", Accounting, finance, Glossary Terms, Investing | Tagged: Accounting, assets, broke doctors, CASH, CMP, debts, finance, liabilities, liquid assets, liquid net worth, net worth, rich, salary inflation | Leave a comment »

Stocks Up, Bond Yields Down as Commodities Rise and Fall

Posted on August 23, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By A.I and ME-P Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Stocks: The stock markets rose today after Jerome Powell opened the door to interest rate cuts. The Dow soared to a new all-time high, while small-cap stocks in the Russell 2000 had a banner day.
Bonds: Yields fell while the chances of a rate cut after the Fed’s next meeting in September rose to 83%.
Commodities: Gold rose on rate cut hopes while oil fell as peace talks between Ukraine and Russia stalled. But the biggest winner is coffee: prices have risen for six straight days to cap off its biggest weekly gain since 2021.

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Filed under: "Ask-an-Advisor", CMP Program, finance, Financial Planning, Funding Basics, Investing | Tagged: bond yields, bonds, CMP, coffee, commodities, DJIA, DOW, fed, Federal Reserve, gold, interest rates, oil, Powell, S&P 500, stocks | Leave a comment »

OB-GYN V. Obstetrician V. Gynecologist V. Mid-Wife V. Doula

Posted on August 15, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

DEFINITIONS

A.I. and Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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OB-GYN

An obstetrician-gynecologist, or OB-GYN, has expertise in female reproductive health, pregnancy, and childbirth. Some OB-GYNs offer a wide range of general health services similar to a primary care doctor. Others focus on the medical care of the female reproductive system. OB-GYNs also provide routine medical services and preventive screenings. This type of doctor has studied obstetrics and gynecology. The term “OB-GYN” can refer to the doctor, an obstetrician-gynecologist, or to the sciences that the doctor specializes in, which are obstetrics and gynecology.

Obstetrician

Obstetrics is the branch of medicine related to medical and surgical care before, during, and after a woman gives birth. Obstetrics focuses on caring for and maintaining a woman’s overall health during maternity. This includes:

pregnancy
labor
childbirth
the postpartum period

OB-GYNs can conduct office visits, perform surgery, and assist with labor and delivery. Some OB-GYNs provide services through a solo or private practice. Others do so as part of a larger medical group or hospital.

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Gynecologist

Gynecology is the branch of medicine that focuses on women’s bodies and their reproductive health. It includes the diagnosis, treatment, and care of women’s reproductive system. This includes the:

vagina
uterus
ovaries
fallopian tubes

This branch of medicine also includes screening for and treating issues associated with women’s breasts. Gynecology is the overarching field of women’s health from puberty through adulthood. It represents most of the reproductive care received during a lifetime. If pregnant, one goes to an obstetrician.

Mid-Wife

Midwives are registered nurses who specialize in midwifery. As such, they’re trained healthcare providers who can oversee low-risk pregnancies, labor, and birth. They can provide other obstetric and gynecological services too. They can do exams and help with basic gynecological concerns like sexually transmitted infections, urinary tract infections, or yeast infections. They help support during labor and in the postpartum period with breastfeeding and birth control.

Doula

Doulas aren’t clinical professionals and can’t give medical advice. They can’t prescribe medicines, and they can’t deliver a baby. But they can offer physical and emotional support during labor—and sometimes during and after pregnancy. Doulas can help with breathing techniques, positional changes, and relaxation strategies during labor. Studies show doulas are associated with fewer C-sections and more vaginal births.

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Filed under: Ask a Doctor, Career Development, CMP Program, Ethics, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance | Tagged: births, child birth, CMP, DO, doula, Gynecologist, gyno, health, MD, mid-wife, motherhood, ob-gyn, Obstetrician, physician, pregnancy, RN | Leave a comment »

PHARMACY BENEFITS MANAGER: The Business Model Explained?

Posted on August 12, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By A.I. and Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Business Model Defined

Doctors and dentists earn money by treating patients. CPAs and Attorneys have clients, and retail stores buy items low and sell them at higher prices. This is called a business model.

More formally, a business model identifies the products or services the business plans to sell, the target market, and any anticipated expenses, in order to outline how to generate a profit. Business models are important for both new and established businesses. They help companies attract investment, recruit talent, and motivate management and staff.

Businesses should regularly update their business model, or they’ll fail to anticipate trends and challenges ahead. Business models also help investors to evaluate companies that interest them and employees to understand the future of a company they may aspire to join.

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The Business Model of Pharmacy Benefits Managers

In the United States, health insurance providers often hire a third party to handle price negotiations, insurance claims, and distribution of prescription drugs. Providers that use such pharmacy benefit managers include commercial health plans, self-insured employer plans, Medicare Part D [drug] plans, the Federal Employees Health Benefits Program, and state government employee plans. PBMs are designed to aggregate the collective buying power of en-rollees through their client health plans, enabling plan sponsors and individuals to obtain lower prices for their prescription drugs. PBMs negotiate price discounts from retail pharmacies, rebates from pharmaceutical manufacturers, and mail-service pharmacies which home-deliver prescriptions without consulting face-to-face with a pharmacist.

PBMs DEFINED: https://medicalexecutivepost.com/2019/01/18/on-pbms-pharmacy-benefits-management/

Pharmacy benefit management companies can make revenue in several ways.

First, they collect administrative and service fees from the original insurance plan.

Then, they can also collect rebates from the manufacturer.

Traditional PBMs do not disclose the negotiated net price of the prescription drugs, allowing them to resell drugs at a public list price (also known as a sticker price), which is higher than the net price they negotiate with the manufacturer. This practice is known as “spread pricing”. The industry argues that savings are trade secrets. Pharmacies and insurance companies are often prohibited by PBMs from discussing costs and reimbursements. This leads to lack of transparency.

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Therefore, states are often unaware of how much money they lose due to spread pricing, and the extent to which drug rebates are passed on to en-rollees of Medicare plans. In response, states like Ohio, West Virginia, and Louisiana have taken action to regulate PBMs within their Medicaid programs.

For instance, they have created new contracts that require all discounts and rebates to be reported to the states. In return, Medicaid pays PBMs a flat administrative fee.

PBM PODCAST: https://medicalexecutivepost.com/2023/08/26/podcast-cvs-replaces-its-pbm/

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Filed under: Accounting, Ask a Doctor, business, CMP Program, curated experts,, Drugs and Pharma, finance, Funding Basics, Health Economics, Healthcare Finance, Managed Care, Videos | Tagged: business modelk, CMP, CMP pricing, CMP Program, david marcinko, drug plans, drug rebates, Drugs, health, Health Insurance, healthcare, insurance, medicare, Medicare Part D, PBMs, pharmacy benefits manager, retail pharmacies, spread pricing | Leave a comment »

Ophthalmologist V. Optometrist V. Optician V. Ocularist

Posted on August 11, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

A.I. and Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Difference-between-Optometrist-and-Ophthalmologist

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An ophthalmologist is a physician [MD, DO] who undergoes sub-specialty training in medical and surgical eye care. Following a medical degree, a doctor specializing in ophthalmology must pursue additional postgraduate residency training specific to that field. In the United States, following graduation from medical school, one must complete a four-year residency in ophthalmology to become an ophthalmologist. Following residency, additional specialty training (or fellowship) may be sought in a particular aspect of eye pathology.

Ophthalmologists prescribe medications to treat ailments, such as eye diseases, implement laser therapy, and perform surgery when needed. Ophthalmologists provide both primary and specialty eye care—medical and surgical. Most ophthalmologists participate in academic research on eye diseases at some point in their training and many include research as part of their career. Ophthalmology has always been at the forefront of medical research with a long history of advancement and innovation in eye care.

Optometrist

Optometrists focus on regular vision care and primary health care for the eye. After college, they spend 4 years in a professional program and get a doctor of optometry degree. But they don’t go to medical school. Some optometrists get additional clinical training or complete a specialty fellowship after optometry school. They:

Perform eye exams and vision tests
Prescribe and fit eyeglasses and contact lenses
Monitor eye conditions related to diseases like diabetes
Manage and treat conditions like dry eye and glaucoma
Provide low-vision aids and vision therapy

There are specialties among optometrists. They include:

Pediatric optometry. These providers work with babies, toddlers, and children, using special techniques to test their vision.

Neuro-optometry. If you have vision problems that result from a brain injury, this is the type of optometrist you might visit.

Low-vision optometry. If you have low vision—that means you can’t see well enough to perform your daily activities and your sight can’t be corrected by glasses or contact lenses, medicine, or surgery—low-vision optometrists offer devices and strategies that can improve your quality of life.

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Optician

An optician is an eye care specialist who helps you choose the right eyeglasses, contact lenses or other vision correction devices. They can’t diagnose or treat conditions that affect your eyes or vision. They’ll work with you to get the right corrective lenses after your optometrist or ophthalmologist gives you a prescription.

Ocularist

An ocularist is an eye care specialist who provides care for people needing prosthetic eyes due to injury, infection or congenital disease (present at birth). Losing or damaging an eye can be a traumatic experience, and the need for a prosthetic can be overwhelming. Ocularists offer long-term care. They collaborate with your healthcare team to create or restore a more natural facial appearance with the goal of enhancing your health-related quality of life.

A former term for this medical branch is oculism.

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Filed under: Ask a Doctor, Career Development, CMP Program, Drugs and Pharma, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc. | Tagged: CMP, DO, eye, eye doctor, MD, oculism, oculist, ophthalmologist, optician, optometrist, WebMD | Leave a comment »

Commodities, Stock Markets and International Trade

Posted on August 1, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By A.I.

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Trade: President Trump signed an executive order late yesterday unleashing a wave of new tariffs on 69 US trading partners that will go into effect on August 7th. Here’s a handy list of tariffs and their economic effects for anyone else having trouble keeping track of all these new numbers.

Markets: Stocks opened lower and kept falling thanks to a double whammy of new tariff rates and a shocking slowdown in the labor market, while bond yields tumbled.

Commodities: Gold jumped as the likelihood of a rate cut rose due to the latest jobs report, while oil sank on reports that OPEC+ may announce a crude production boost as soon as this weekend.

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Filed under: Contest Entrance, economics, finance | Tagged: bonds, CMP, export, gold, import, oil, OPEC, stocks, tariffs, trade, Trump | Leave a comment »

PHYSICIAN INVESTING: Understanding Risk and Return

Posted on August 1, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko; MBA MEd CMP™

SPONSOR: http://www.MarcinkoAssociates.com

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Investment Risk and Return

One of the major concepts that most investors should be aware of is the relationship between the risk and the return of a financial asset. It is common knowledge that there is a positive relationship between the risk and the expected return of a financial asset. In other words, when the risk of an asset increases, so does its expected return. What this means is that if an investor is taking on more risk, he/she is expected to be compensated for doing so with a higher return. Similarly, if the investor wants to boost the expected return of the investment, he/she needs to be prepared to take on more risk.

PORTFOLIO ALPHA: https://medicalexecutivepost.com/2025/07/02/managing-for-endowment-portfolio-alpha/

Harry Max Markowitz (August 24, 1927 – June 22, 2023) was an American economist who was a professor of finance at the Rady School of Management at UCSD. He is best known for his pioneering work in modern portfolio theory, studying the effects of asset risk, return, correlation and diversification on probable investment portfolio returns.

One important thing to understand about Modern Portfolio Theory (MPT) is Markowitz’s calculations treat volatility and risk as the same thing. In layman’s terms, Dr. Markowitz uses risk as a measurement of the likelihood that an investment will go up and down in value – and how often and by how much. The theory assumes that investors prefer to minimize risk. The theory assumes that given the choice of two portfolios with equal returns, investors will choose the one with the least risk. If investors take on additional risk, they will expect to be compensated with additional return.

MARKOWITZ: https://medicalexecutivepost.com/2011/01/19/the-living-legacy-of-dr-harry-markowitz/

According to MPT, risk comes in two major categories:

Systematic risk – the possibility that the entire market and economy will show losses negatively affecting nearly every investment; also called market risk

Unsystematic risk – the possibility that an investment or a category of investments will decline in value without having a major impact upon the entire market.

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Diversification generally does not protect against systematic risk because a drop in the entire market and economy typically affects all investments. However, diversification is designed to decrease unsystematic risk. Since unsystematic risk is the possibility that one single thing will decline in value, having a portfolio invested in a variety of stocks, a variety of asset classes and a variety of sectors will lower the risk of losing much money when one investment type declines in value. Thus putting together assets with low correlations can reduce unsystematic risks.

DIVERSIFICATION: https://medicalexecutivepost.com/2024/08/13/the-negative-short-term-implications-of-diversification/

a. Understanding the Risk

Although broad risks can be quickly summarized as “the failure to achieve spending and inflation-adjusted growth goals,” individual assets may face any number of other subsidiary risks:

Call risk – The risk, faced by a holder of a callable bond that a bond issuer will take advantage of the callable bond feature and redeem the issue prior to maturity. This means the bondholder will receive payment on the value of the bond and, in most cases, will be reinvesting in a less favorable environment (one with a lower interest rate)
Capital risk – The risk an investor faces that he or she may lose all or part of the principal amount invested.
Commodity risk – The threat that a change in the price of a production input will adversely impact a producer who uses that input.
Company risk – The risk that certain factors affecting a specific company may cause its stock to change in price in a different way from stocks as a whole.
Concentration risk – Probability of loss arising from heavily lopsided exposure to a particular group of counterparties
Counterparty risk – The risk that the other party to an agreement will default.
Credit risk – The risk of loss of principal or loss of a financial reward stemming from a borrower’s failure to repay a loan or otherwise meet a contractual obligation.
Currency risk – A form of risk that arises from the change in price of one currency against another.
Deflation risk – A general decline in prices, often caused by a reduction in the supply of money or credit.
Economic risk – the likelihood that an investment will be affected by macroeconomic conditions such as government regulation, exchange rates, or political stability.
Hedging risk – Making an investment to reduce the risk of adverse price movements in an asset.
Inflation risk – The uncertainty over the future real value (after inflation) of your investment.
Interest rate risk – Risk to the earnings or market value of a portfolio due to uncertain future interest rates.
Legal risk – risk from uncertainty due to legal actions or uncertainty in the applicability or interpretation of contracts, laws or regulations.
Liquidity risk – The risks stemming from the lack of marketability of an investment that cannot be bought or sold quickly enough to prevent or minimize a loss.

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Filed under: "Ask-an-Advisor", CMP Program, finance, Glossary Terms, Marcinko Associates, Portfolio Management | Tagged: call risk, CMP, commodity risk, company risk, concentration risk, credit risk, currency risk, deflation risk, economic risk, finance, interest rate risk, Investing, investment, legal risk, liquiidity risk, Marcinko, MPT, personal-finance, return, systemic, unsystemic, volatility | Leave a comment »

Why [Too Many] Physician Colleagues Don’t Get Rich?

Posted on July 29, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

Filed under: "Ask-an-Advisor", Ask a Doctor, Career Development, Experts Invited, finance, Financial Planning, Health Economics, Health Insurance, Health Law & Policy, Touring with Marcinko | Tagged: ACA, CFP, CMP, CMS, DDS, doctors, DPM, dumb doctors, dumb physicians, Dunning, financial advisors, HHS, Marcinko, MD, Paul Larson, physicians, poor physicians, PP-ACA, rich physicians, Thomas Stanley | Comments Off on Why [Too Many] Physician Colleagues Don’t Get Rich?

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