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Celebrating National Doctors’ Day 2018

History of National Doctors’ Day

By Dr. David E. Marcinko MBA CMP™

http://www.CertifiedMedicalPlanner.org

National Doctors’ Day is held every year on March 30th – April 1st –  in the United States. It is a day to celebrate the contribution of physicians who serve our country by caring for its’ citizens.

The first Doctor’s Day observance was March 30, 1933 in Winder, Georgia.  Eudora Brown Almond, wife of Dr. Charles B. Almond, decided to set aside a day to honor physicians. This first observance included the mailing greeting cards and placing flowers on graves of deceased doctors.

  • On March 30, 1958, a Resolution Commemorating Doctors’ Day was adopted by the United States House of Representatives.
  • In 1990, legislation was introduced in the House and Senate to establish a national Doctor’s Day.

Following overwhelming approval by the United States Senate and the House of Representatives, on October 30, 1990, President George Bush signed S.J. RES. #366 (which became Public Law 101-473) designating March 30th as “National Doctor’s Day.”

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Traditional Reasons for a Medical Practice Valuation

Some economic reasons for a medical practice valuation 

By Dr. David Edward Marcinko MBA CMP™

http://www.CertifiedMedicalPlanner.org

The decision to sell, buy or merge a medical practice, while often financially driven, and is inherently an emotional one for these impact investors who went into the profession largely because of a deep seated zeal to help others.

Still, beyond impact investing musings, there are other economic reasons for a practice valuation that include changes in ownership, determining insurance coverage for a practice buy-sell agreement or upon a physician-owner’s death, organic growth meter, establishing stock options, or bringing in a new partner; etc.

Practice appraisals are also used for legal reasons such as divorce, bankruptcy, breach of contract and minority shareholder complaints. In 2002, the Financial Accounting Standards Board (FASB) issued rules that required certain intangible assets to be valued, such as goodwill. This may be important for practices seeking start-up, service segmentation extensions, or operational funding. Some other reasons for a medical practice appraisal, and the considerations that go along with them, are discussed here.

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

Estate Planning

Medical practice valuation may be required for estate planning purposes. For a decedent physician with a gross estate of more than current in-place tax limits, his or her assets must be reported at fair market value on an estate tax return. If lifetime gifts of a medial practice business interest are made, it is generally wise to obtain an appraisal and attach it to the gift tax return.

Note that when a “closely-held” level of value (in contrast to “freely traded,” “marketable,” or “publicly traded” level) is sought, the valuation consultant may need to make adjustments to the results. There are inherent risks relative to the liquidity of investments in closely held, non-public companies (e.g., medical group practice) that are not relevant to the investment in companies whose shares are publicly traded (freely-traded). Investors in closely-held companies do not have the ability to dispose of an invested interest quickly if the situation is called for, and this relative lack of liquidity of ownership in a closely held company is accompanied by risks and costs associated with the selling of an interest said company (i.e., locating a buyer, negotiation of terms, advisor/broker fees, risk of exposure to the market, etc.). Conversely, investors in the stock market are most often able to sell their interest in a publicly traded company within hours and receive cash proceeds in a few days. Accordingly, a discount may be applicable to the value of a closely held company due to the inherent illiquidity of the investment. Such a discount is commonly referred to as a “discount for lack of marketability.”

Discount for lack of marketability is typically discussed in three categories: (1) transactions involving restricted stock of publicly traded companies; (2) private transactions of companies prior to their initial public offering (IPO); and, (3) an analysis and comparison of the price to earnings (P/E) ratios of acquisitions of public and private companies respectively published in the “Mergerstat Review Study.”\

With a non-controlling interest, in which the holder cannot solely authorize and cannot solely prevent corporate actions (in contrast to a controlling interest), a “discount for lack of control,” (DLOC), may be appropriate. In contrast, a control premium may be applicable to a controlling interest. A control premium is an increase to the pro rata share of the value of the business that reflects the impact on value inherent in the management and financial power that can be exercised by the holders of a control interest of the business (usually the majority holders). Conversely, a discount for lack of control or minority discount is the reduction from the pro rata share of the value of the business as a whole that reflects the impact on value of the absence or diminution of control that can be exercised by the holders of a subject interest.\

Several empirical studies have been done to attempt to quantify DLOC from its antithesis, control premiums. The studies include the Mergerstat Review, an annual series study of the premium paid by investors for controlling interest in publicly traded stock, and the Control Premium Study, a quarterly series study that compiles control premiums of publicly traded stocks by attempting to eliminate the possible distortion caused by speculation of a deal.

Human Skull

Buy-Sell Agreements

The ideal situation is for physician partners to put in place a buy-sell agreement when practice relationships are amicable. This establishes the terms for departure before they are required, and is akin to a prenuptial agreement in the marriage contract. Disagreements most often occur when a doctor leaves the group, often acrimoniously. Business operations of the practice decline, employee and partner morale suffers, feuding factions develop spilling over into the office, and the practice begins to implode creating a downward valuation spiral. And so, valuations should be done every 2-3 years, or as the economic circumstances of the practice change. Independence and credibility are provided, and emotional overtones are purged from the transaction.

Physician Partnership Disputes

Medical practice appraisals are often used in partnership disputes, such as breach-of-contract or departure issues. Obvious revenue declinations are not difficult to quantify. But, revenues may not immediately fall since certain Current Procedural Terminology [CPT®] code reimbursements may actually increase. Upon verification however, lost business may be camouflaged as the number of procedures performed, or number of patients decrease after partner departure.

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

Divorce

Physicians getting divorced should get a practice appraisal, and either side may hire the appraiser, although occasionally the court will order an expert to provide a neutral valuation. Such valuations should be done in light of both court discovery rules and IRS requirements for closely held businesses. Generally, this requires the consideration of eight elements:

• Practice specialty and operating history
• Economic and healthcare industry condition
• Estimates of practice risks and future returns
• Book value and financial condition of the practice
• Practice future earning capacity
• Physician bonuses, dividends and distributions
• Intangible assets
• Comparable practice sales

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

Assessment

Sometimes, the non-physician spouse may even desire a lifestyle analysis to evaluate the potential for under reported income, by a forensic accountant, or appraiser. A family law judge is often the final arbiter of different valuations, and because of varying state laws there may be 50 different nuances of what the practice is really worth.

MORE: Valuation

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CONSENSUAL AMOROUS RELATIONSHIPS IN MEDICINE?

NON-CONSENSUAL AMOROUS RELATIONSHIPS DEFINED

By Vicki L. Buba JD

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

By Dr. David Edward Marcinko MBA CMP™

http://www.CertifiedMedicalPlanner.org

An “Amorous Relationship” is defined as a consensual romantic, sexual or dating relationship. This definition excludes marital unions. The term also encompasses those relationships in which amorous or romantic feelings exist without physical intimacy and which, when acted upon by the faculty or staff member, exceed the reasonable boundaries of what a person of ordinary sensibilities would believe to be a collegial or professional relationship. The faculty/student and supervisor/employee relationship should not be jeopardized by question of favoritism or fairness in professional judgment.

Furthermore, whether the consent by a student or employee in such relationship is indeed voluntary is suspect due to the imbalance of power and authority between the parties. All members of the healthcare entity should be aware that initial consent to a romantic relationship does not preclude the potential for charges of conflict of interest, or for charges of sexual harassment arising from the conflict of interest, particularly when students and employees not involved in the relationship claim they have been disadvantaged by the relationship. A faculty, staff member or graduate assistant who enters into an “Amorous Relationship” with a student under his or her supervision, or a supervisor who enters into an “Amorous Relationship” with an employee under his or her supervision, must realize that if a charge of sexual harassment is subsequently lodged, it will be exceedingly difficult to prove blamelessness on grounds of mutual consent. This policy is superseded by the laws governing inability to consent based on age.

HANDLING ROMANTIC PATIENT ADVANCES

While physicians vary in their approaches to managing flirtatious patients, many agree that nipping the behavior in the bud is critical to maintaining professionalism and upholding ethical standards. “It’s flattering to have a flirtatious patient,” said Dr. William P. Scherer MS, Professor of Radiology at the Barry University School of Medicine, Boca Raton, Florida. “But, we have an obligation to protect the integrity of our medical profession, and to our marital contracts and spousal relationships and family, and to act professionally at all times” [personal communication].

Dr. Scherer finds it helpful to put some professional distance between himself and a flirtatious patient. “I have no problem saying to a patient: I appreciate what interests you may have, but I have to draw the line to take proper professional care of you, instead.”

And a good way to derails flirtatious behavior from patients is by deflecting their unwelcome comments. “And, you can’t act sheepish about it.” When a patient’s remark crosses the line from complimentary to something uncomfortable, the doctor may either curtly laugh it off or ignore it. “I don’t acknowledge the statement and immediately move the conversation into something clinical in order to put the rest of the visit in a serious tone.”

On the other hand, Dr. Barbara S. Schlefman MS, a fitness trainer and retired podiatrist, instructed her nurses to have another staffer accompany them into an examination room when a patient is known for being flirtatious was waiting to be seen; and to leave the door open [personal communication].

Likewise, other physicians use a “more is merrier” approach for themselves and their staff as a defense against flirtatious behavior. This is a problem that can be avoided by having physicians never see patients alone. So, as Dr. Schlefman advised, be sure to always a nurse or medical assistant in the room with the physician, even if you have to see somebody in the office on call after hours. And, be sure to have a call schedule for the nursing and medical assistant staff that includes patients of both genders, regardless of physician gender, since flirtatious behavior can be same-sex flirtatious behavior. Fortunately, adjunct or visiting clinical professors, or doctors on a medical school clinical teaching staff, rarely have patient encounters without a medical student, intern, resident fellow or nurse in the room during examinations.

Recognize the Signs

While it’s important that physicians don’t act on a flirtatious patient’s advances, it’s equally critical to recognize subtle flirtatious signs from a patient; according to Donna Petrozzello MD, an otolaryngologist at the California Sinus Centers.

A patient that maintains unusually long eye contact with their doctor, or engages in talk not related to their visit, or makes a habit of touching the physicians when not medically necessary may be flirting. Additionally, doctors can protect themselves when performing some common procedures that put the physician in close proximity to a patient’s face, breasts, genitals, legs and even feet. That closeness could turn a clinical exam into a flirtatious event. Wearing a mask to perform each of these local or regional examinations is not only for the purposes of infection control but gives the added benefit of establishing some personal space and protection, to avoid any potential misunderstanding. For example, auscultating lungs through a shirt, not underneath, is a good idea with this type of exam on a young woman patient.

[Two icons of romantic relationships]

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Advisor V. Adviser [The Ultimate “Terminology” Fraudster?]

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Anonymous Doctor

[By Anonymous]

Are the US Securities Acts the Ultimate “Terminology” Fraudster?

As a doctor and investor, I have learned thru the internet that Larry Elford, an Investment Misconduct and Malpractice Consultant – and many others – believe that the ultimate terminology fraudster is the US Securities Acts (1935 & 1940) and the Investment Adviser Act. Why?

They have no such category as “advisor” in the Acts.

Industry lawyers know this well, as does FINRA, and may be using this “spelling ruse” to dupe and deceive millions of Americans into believing that their commission sales “broker” is some kind of fiduciary “adviser” professional.

Some even believe it to be an industry pandemic of “bait and switch” to deceive and then shortchange investors.

Source: http://www.investoradvocates.ca/viewtopic.php?f=1&t=193&sid=1cc2690bde2ebdfaa749be1d35395083#p3867

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VIDEO: Here is an under 2 minute glimpse into the Three Card Monte game being played, upon investors, when your Securities Commission proudly tells you to “check your “adviser’s” registration”.

Link: https://youtu.be/zIjt0qRsJKg

Assessment

Is this a mere lexicon conundrum; or truer pathology?

And, did you know that a Certified Medical Planner® is a client fiduciary at all times? Visit: http://www.CertifiedMedicalPlanner.org

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Enter the CMPs

Conclusion

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[PHYSICIAN FOCUSED FINANCIAL PLANNING AND RISK MANAGEMENT COMPANION TEXTBOOK SET]

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[Dr. Cappiello PhD MBA] *** [Foreword Dr. Krieger MD MBA]

Front Matter with Foreword by Jason Dyken MD MBA

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Disruptive Behavior and Bullies in Medicine

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“Micro-Aggressors” in Healthcare

[By staff reporters] http://www.CertifiedMedicalPlanner.org

Every workplace has “micro-aggressors” or/or bullies that exhibit disruptive behavior.

But, when the workplace is a hospital, it’s not just an employee problem.

Definition

Microaggression is a term coined by psychiatrist and Harvard University professor Chester M. Pierce in 1970 to describe insults and dismissals he said he had regularly witnessed non-black Americans inflict on African Americans.

In 1973, MIT economist Mary Rowe extended the term to include similar aggressions directed at women; eventually, the term came to encompass the casual degradation of any socially marginalized group, such as the poor and the disabled.

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Case Report

In one reported case, the worker, felt threatened: His superior came at him “with clenched fists, piercing eyes, beet-red face, popping veins, and screaming and swearing.” He thought he was about to be hit. Instead, his angry co-worker stormed out of the room.

But, it wasn’t just any room: It was in a hospital, adjacent to a surgical area. The screamer was a cardiac surgeon, and the threatened employee was a perfusionist, a person who operates a heart/lung machine during open heart surgery. In 2008, the Indiana Supreme Court ruling in Raess v. Doescherupheld a $325,000 settlement for the perfusionist, who said he was traumatized.

Conclusion

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A Brief History of Accountable Care Organizations

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ACOs to the Rescue – Not!

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By Dr. David E. Marcinko MBA CMP®

http://www.CertifiedMedicalPlanner.org

According to the Health Dictionary Series of administrative terms; valuation expert and colleague Robert James Cimasi MHA, ASA, AVA CMP of www.HealthCapital.com; an ACO is a healthcare organization in which a set of providers, usually large physician groups and hospitals, are held accountable for the cost and quality of care delivered to a specific local population. ACOs aim to affect provider’s patient expenditures and outcomes by integrating clinical and administrative departments to coordinate care and share financial risk [personal communication]

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Enter the PP-ACA

Since their four-page introduction in the PP-ACA of 2010, ACOs have been implemented in both the Federal and commercial healthcare markets, with 32 Pioneer ACOs selected (on December 19, 2011), 116 Federal applications accepted (on April 10, 2012 and July 9, 2012), and at least 160 or more Commercial ACOs in existence today.

Federal Contracts

More recently, Donna Marbury writing in Medical Economics, revealed that Federal ACO contracts are established between an ACO and CMS, and are regulated under the CMS Medicare Shared Savings Program (MSSP) Final Rule, published November 2, 2011.  ACOs participating in the MSSP are accountable for the health outcomes, represented by 33 quality metrics, and Medicare beneficiary expenditures of a prospectively assigned population of Medicare beneficiaries. If a Federal ACO achieves Medicare beneficiary expenditures below a CMS established benchmark (and meets quality targets), they are eligible to receive a portion of the achieved Medicare beneficiary expenditure savings, in the form of a shared savings payment.

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Commercial Contracts

Commercial ACO contracts are not limited by any specific legislation, only by the contract between the ACO and a commercial payer. In addition to shared savings models which may not be in effect for another 3-5 years, Commercial ACOs may incentivize lower costs and improved patient outcomes through reimbursement models that share risk between the payer and the providers, i.e., pay for performance compensation arrangements and/or partial to full capitation.

Although commercial ACOs experience a greater degree of flexibility in their structure and reimbursement, the principals for success for both Federal ACOs and Commercial ACOs are similar. And, nearly any healthcare enterprise can integrate and become an ACO, larger enterprises, may be best suited for ACO status.

Medicare Contracts

Assessment

Larger organizations are more able to accommodate the significant capital requirements of ACO development, implementation, and operation (e.g., healthcare information technology), and sustain the sufficient number of beneficiaries to have a significant impact on quality and cost metrics.

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Conclusion

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[HOSPITAL OPERATIONS, ORGANIZATIONAL BEHAVIOR AND FINANCIAL MANAGEMENT COMPANION TEXTBOOK SET]

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Why and How to Become a Certified Medical Planner™

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Think Different – Be Different  – Thrive

[By Ann Miller RN MHA]

Dear Physician Focused Financial Advisors;

Did you know that desperate doctors of all ages are turning to knowledgeable financial advisors and medical management consultants for help? Symbiotically too, generalist advisors are finding that the mutual need for knowledge and extreme niche synergy is obvious.

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But, there was no established curriculum or educational program; no corpus of knowledge or codifying terms-of-art; no academic gravitas or fiduciary accountability; and certainly no identifying professional designation that demonstrated integrated subject matter expertise for the increasingly unique healthcare focused financial advisory niche … Until Now! 

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“The informed voice of a new generation of fiduciary advisors for healthcare”

Think Different

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So, if you are looking to supplement your knowledge, income and designations; and find other qualified professionals you may want to consider the CMP® program.

Enter the Certified Medical Planner™ charter professional designation. And, CMPs™ are FIDUCIARIES, 24/7.

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Conclusion

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***

Become a CMP

***

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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A Brief Historical Review of Behavioral Finance and Economics

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And Related Influential Thought-Leaders

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

***

doctor

***

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

TTM Stages of Change

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

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

Relapse

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

***

Psychology

***

Uniting Psychology and Financial Behavior

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

Enter Kahneman and Smith

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

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

in vitro and in-vivo Economics

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

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

University of Chicago

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

Laboratory

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

Assessment

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

READ: Behavioral Economics and Psychology DEM

e513455b-e924-451f-9132-d4bbbeb8e033-original

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Conclusion

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Understanding Stock Market Performance Benchmarks

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An important role in monitoring investment portfolio progress

By TIMOTHY J. McINTOSH; MBA, MPH, CFP®, CMP™ [Hon] 

tim

Performance measurement has an important role in monitoring progress toward any portfolio’s goals.  The portfolio’s objective may be to preserve the purchasing power of the assets by achieving returns above inflation or to have total returns adequate to satisfy an annual spending need without eroding original capital, etc.

Whatever the absolute goal, performance numbers need to be evaluated based on an understanding of the market environment over the period being measured.

So, here is a brief review for our ME-P readers, doctors and subscribers; after a good market day today.

17,666.40 +305.36 +1.76%

Time-weighted Returns

One way to put a portfolio’s a time-weighted return in the context of the overall market environment is to compare the performance to relevant alternative investment vehicles. This can be done through comparisons to either market indices, which are board baskets of investable securities, or peer groups, which are collections of returns from managers or funds investing in a similar universe of securities with similar objectives as the portfolio.  By evaluating the performance of alternatives that were available over the period, the investor and his/her advisor are able to gain insight to the general investment environment over the time period.

The Indices

Market indices are frequently used to gain perspective on the market environment and to evaluate how well the portfolio performed relative to that environment.  Market indices are typically segmented into different asset classes.

Common stock market indices include the following:

  • Dow Jones Industrial Average- a price-weighted index of 30 large U.S. corporations.
  • Standard & Poor’s (S&P) 500 Index – a capitalization-weighted index of 500 large U.S. corporations.
  • Value Line Index – an equally-weighted index of 1700 large U.S. corporations.
  • Russell 2000 – a capitalization-weighted index of smaller capitalization U.S. companies.
  • Wilshire 5000 – a cap weighted index of the 5000 largest US corporations.
  • Morgan Stanley Europe Australia, Far East (EAFE) Index – a capitalization-weighted index of the stocks traded in developed economies.

Common bond market indices include the following:

  • Barclays Aggregate Bond Index – a broad index of bonds.
  • Merrill Lynch High Yield Index – an index of below investment grade bonds.
  • JP Morgan Global Government Bond – an index of domestic and foreign government-issued fixed income securities.

The selection of an appropriate market index depends on the goals of the portfolio and the universe of securities from which the portfolio was selected. Just as a portfolio with a short-time horizon and a primary goal of capital preservation should not be expected to perform in line with the S&P 500, a portfolio with a long-term horizon and a primary goal of capital growth should not be evaluated versus Treasury Bills.

***

Healthcare job expense deductions

***

While the Dow Jones Industrial Average and S&P 500 are often quoted in the newspapers, there are clearly broader market indices available to describe the overall performance of the U.S. stock market. Likewise, indices like the S&P 500 and Wilshire 5000 are capitalization-weighted, so their returns are generally dominated by the largest 50 of their 500 – 5000 stocks. Although this capitalization-bias does not typically affect long-term performance comparisons, there may be periods of time in which large cap stocks out- or under-perform mid-to-small cap stocks, thus creating a bias when cap-weighted indices are used versus what is usually non-cap weighted strategies of managers or mutual funds. Finally, the fixed income indices tend to have a bias towards intermediate-term securities versus longer-term bonds.

Peer Groups

Thus, an investor with a long-term time horizon, and therefore potentially a higher allocation to long bonds, should keep this bias in mind when evaluating performance.Peer group comparisons tend to avoid the capitalization-bias of many market indices, although identifying an appropriate peer group is as difficult as identifying an appropriate market index.

Furthermore, peer group universes will tend to have an additional problem of survivorship bias, which is the loss of (generally weaker) performance track records from the database. This is the greatest concern with databases used for marketing purposes by managers, since investment products in these generally self-disclosure databases will be added when a track record looks good and dropped when the product’s returns falter. Whether mutual funds or managers, the potential for survivorship bias and inappropriate manager universes make it important to evaluate the details of how a database is constructed before using it for relative performance comparisons.

***

investing

***

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The Author

Timothy J. McIntosh is Chief Investment Officer and founder of SIPCO.  As chairman of the firm’s investment committee, he oversees all aspects of major client accounts and serves as lead portfolio manager for the firm’s equity and bond portfolios. Mr. McIntosh was a Professor of Finance at Eckerd College from 1998 to 2008. He is the author of The Bear Market Survival Guide and the The Sector Strategist.  He is featured in publications like the Wall Street Journal, New York Times, USA Today, Investment Advisor, Fortune, MD News, Tampa Doctor’s Life, and The St. Petersburg Times.  He has been recognized as a Five Star Wealth Manager in Texas Monthly magazine; and continuously named as Medical Economics’ “Best Financial Advisors for Physicians since 2004.  And, he is a contributor to SeekingAlpha.com., a premier website of investment opinion. Mr. McIntosh earned a Bachelor of Science Degree in Economics from Florida State University; Master of Business Administration (M.B.A) degree from the University of Sarasota; Master of Public Health Degree (M.P.H) from the University of South Florida and is a CERTIFIED FINANCIAL PLANNER® practitioner. His previous experience includes employment with Blue Cross/Blue Shield of Florida, Enterprise Leasing Company, and the United States Army Military Intelligence.

Conclusion

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Efficient Market Hypothesis – or Not?

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Contradicting the Hypothesis

[A SPECIAL ME-P REPORT]

[By Timothy J McIntosh MBA CFP® MPH CMP™ [Hon]

[By Dr. David Edward Marcinko MBA CMP™]

http://www.CertifiedMedicalPlanner.org

***

Not everyone believes in the efficient market.  Numerous researchers over the previous decades have found stock market anomalies that indicate a contradiction with the hypothesis.  The search for anomalies is effectively the hunt for market patterns that can be utilized to outperform passive strategies.

white swan

[White Swan of the EMH]

Such stock market anomalies that have been proven to go against the findings of the EMH theory include:

  1. Low Price to Book Effect
  2. January Effect
  3. The Size Effect
  4. Insider Transaction Effect
  5. The Value Line Effect

The Anomalies

All the above anomalies have been proven over time to outperform the market.  For example, the first anomaly listed above is the Low Price to Book Effect.  The first and most discussed study on the performance of low price to book value stocks was by Dr. Eugene Fama and Dr. Kenneth R. French.  The study covered the time period from 1963-1990 and included nearly all the stocks on the NYSE, AMEX and NASDAQ. The stocks were divided into ten subgroups by book/market and were re-ranked annually.

In the study, Fama and French found that the lowest book/market stocks outperformed the highest book/market stocks by a substantial margin (21.4 percent vs. 8 percent).  Remarkably, as they examined each upward decile, performance for that decile was below that of the higher book value decile.  Fama and French also ordered the deciles by beta (measure of systematic risk) and found that the stocks with the lowest book value also had the lowest risk.

What is Value?

Today, most researchers now deem that “value” represents a hazard feature that investors are compensated for over time.  The theory being that value stocks trading at very low price book ratios are inherently risky, thus investors are simply compensated with higher returns in exchange for taking the risk of investing in these value stocks.

The Fama and French research has been confirmed through several additional studies.  In a Forbes Magazine 5/6/96 column titled “Ben Graham was right–again,” author David Dreman published his data from the largest 1500 stocks on Compustat for the 25 years ending 1994. He found that the lowest 20 percent of price/book stocks appreciably outperformed the market.

***

Ex-Cathedra black swan

[Ex-Cathedra or Black Swan Event]

Assessment

One item a medical professional should be aware of is the strong paradox of the efficient market theory.   If each investor believes the stock market were efficient, then all investors would give up analyzing and forecasting.  All investors would then accept passive management and invest in index funds.

But, if this were to happen, the market would no longer be efficient because no one would be scrutinizing the markets.  In actuality, the efficient market hypothesis actually depends on active investors attempting to outperform the market through diligent research

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The Author

Timothy J. McIntosh is Chief Investment Officer and founder of SIPCO.  As chairman of the firm’s investment committee, he oversees all aspects of major client accounts and serves as lead portfolio manager for the firm’s equity and bond portfolios. Mr. McIntosh was a Professor of Finance at Eckerd College from 1998 to 2008. He is the author of The Bear Market Survival Guide and the The Sector Strategist.  He is featured in publications like the Wall Street Journal, New York Times, USA Today, Investment Advisor, Fortune, MD News, Tampa Doctor’s Life, and The St. Petersburg Times.  He has been recognized as a Five Star Wealth Manager in Texas Monthly magazine; and continuously named as Medical Economics’ “Best Financial Advisors for Physicians since 2004.  And, he is a contributor to SeekingAlpha.com., a premier website of investment opinion. Mr. McIntosh earned a Bachelor of Science Degree in Economics from Florida State University; Master of Business Administration (M.B.A) degree from the University of Sarasota; Master of Public Health Degree (M.P.H) from the University of South Florida and is a CERTIFIED FINANCIAL PLANNER® practitioner. His previous experience includes employment with Blue Cross/Blue Shield of Florida, Enterprise Leasing Company, and the United States Army Military Intelligence.

Conclusion

So, what about the “January Effect for 2015“?

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On Internet and Investing Psychology

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And … Wi-Fi Doctor Investors

[By ME-P Staff Reporters]

***

wifi

Sourcehttp://www.xkcd.com

***

OVER HEARD IN THE DOCTOR’S LOUNGE

***

Of course you don’t need a human financial advisor … until you do.

Today, we’ve had unfettered internet access to a wide range of investments, opinions and models for at least two decades. So, why the bravado to go it alone; five straight positive years for equities, since 2009!

The financial advisor’s role is to remove the human element and emotion from investing decisions for something as personal as your wealth. Emotion drives the retail investor to sell low (fear) and buy high (greed). This is the reason why the average equity returns for retail investors is less than half of the S&Ps returns.

No, of course you don’t need a human financial advisor … until you do. And when you do, it may be too late.

***

Dan Ariely PhD

[The Irrational Economist]

WiFi

OUR NEW BOOK

[BY DOCTORS – FOR DOCTORS – PEER REVIEWED]

[Chapter One]

UNIFYING THE PHYSIOLOGIC AND PSYCHOLOGIC FINANCIAL PLANNING DIVIDE  [Holistic Life Planning, Behavioral Economics, Trading Addiction and the Art of Money]

  • Dr. Brad Klontz PhD CFP
  • Dr. Ted Klontz PsyD
  • Dr. Eugene Schmuckler PhD MBA MEd
  • Dr. Kenneth Shubin-Stein MD CFA
  • Dr. David Edward Marcinko MBA CMP MBBS [Hon]

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Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Financial Planning MDs 2015

Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants

***

The Financial Planner’s Responsibility?

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Are Consumers Losing Ethical Ground?

By Rick Kahler MS CFP http://www.KahlerFinancial.com

Rick Kahler MS CFPSuppose one of my clients has his heart set on using half of his retirement account to buy each of his grandchildren a new car.

Or, a physician-client in a panic over falling markets wants to sell all her stocks and buy gold. What is my responsibility as their financial planner? How far should planners go to try to keep clients from making serious financial mistakes?

Just as with the patient engagement, it’s important for planners to respect clients’ competence and ability to make their own life decisions. Client-centered planners also need to remember that the goal is to help clients get what they want, not what the planner might want or think the client should want.

On the other hand, should a planner stand idly by and watch someone walk off what the planner perceives as the edge of a financial cliff?

Potential Answers?

Part of the answer to this dilemma stems from a planner’s legal obligation. Most advisors who sell financial products have no fiduciary duty and are not legally required to put their customers’ interests first. Fiduciary advisors, which include those who are fee-only, do have a legal obligation to act in their clients’ best interests.

Fiduciary Responsibility

Doctors, clergymen and attorneys are fiduciaries. But, what is the legal responsibility of a fiduciary financial planner who believes clients are about to do themselves financial harm?

Example:

Let’s say I have a client who is about to do something that may be viewed by a court of law as “extreme” or “imprudent.” (An example would be putting all his money into one asset class like gold, cash, penny stocks, etc.) At the minimum, I would need to protect myself by carefully fulfilling my legal responsibilities. This would include making certain I emphasized to the client that, given the research and data available, his actions could hurt him financially. I also would want to be sure the client fully understood and took responsibility for his actions.

***

comedy

***

In terms of the broader aspect of what financial planners owe to their clients, meeting this legal obligation is not enough. In my view, fiduciary planners’ obligation to put clients’ interests first includes an ethical responsibility to do no harm. Sometimes this ethical and legal responsibility requires planners to give clients information they may not want to hear.

As we focus on the clients’ goals and help them carry out their wishes, part of our role is to make sure they have all the information they need. This gives us a responsibility to educate ourselves so the advice we offer is as sound as we can make it. We also need to do whatever we can to help clients hear and understand that advice.

Clients who are hovering on the edge of a financial cliff are typically about to act out of strong emotions such as fear. They often can’t take in financial advice until they are able to move through that fear. It only makes things worse if financial advisors shame clients, bully them, or abandon them to their fears. The challenge for planners is to help clients reach a more rational place so they can gather additional information and make decisions that will serve them well.

Industry Update is Not Good – Give Up the ‘Fiduciary’ Fight

According to industry pundit Bob Veres, so-called Financial Advisors need to face a hard truth – Independent Registered Investment Advisors [RIAs] have lost this round.

But, we already told you so on this ME-P.

Fortunately, there are other better ways to set yourself in the medical ecosystem.

The Certified Medical Planner™ Designation

A Certified Medical Planner is a fiduciary at all times.

More:

Assessment

With the right kind of support, clients are almost always able to get past the fear that is pushing them to make imprudent decisions. Providing such support by working with clients’ emotions and beliefs about money, perhaps with the help of a financial therapist or financial coach, is well within a financial planner’s ethical responsibility. Our role is not merely to do no harm. It is also to use all the tools we have to help clients act in their own best interests.

Product Details  Product Details

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Financial Planning MDs 2015

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

How Financial Advisors Build Trust with Physician Prospects and Clients

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Niche Career Development for Financial Advisors

VR MD

[By Vicki Rackner MD]

Attention Physician Focused Financial Advisors

If you are a financial advisor who would like to acquire more physician clients, consider these facts:

  • Fact: Half of physicians are behind where they would like to be in retirement planning.
  • Fact: About half of physicians work with professional financial advisors.
  • Fact: Physicians who work with financial advisors are better prepared for retirement.

The Survey

How can YOU build trust and be found by more physician prospects? Here are some steps. Trust is an abstract concept. It begs the question: Trust to do what? I asked my physician colleagues and friends, “When you say you trust your financial advisor, what do you mean?”

Here are some of the answers:

  • You may trust your hairdresser to give you a great look, but you would not trust her to take out your gallbladder.
  • Ask, “Trust to do what?”
  • A recent survey offers insights. Almost half of physicians said that they do not work with advisors because they cannot find someone they trust.
  • This leads to an obvious question: Why would physicians–smart professionals who spend their days identifying problems and fixing them–fail to take action and get on track for retirement?
  1. I trust that she cares about me.
  2. I trust he puts my best interests before his own.
  3. I trust he knows what he’s doing.
  4. I trust he understands the challenges I face.
  5. I trust that she’s honest and direct. A person of integrity.
  6. I trust that he’ll challenge me if I’m about to make a dumb financial move.
  7. I trust the person who gave me his name.
  8. I trust that I’ll keep more money than I spend in fees.

***

Product Details  Product DetailsProduct Details

***

Take steps to build rapport and trust – Be authentic

Tell the story of how and why you came to offer financial advice to physicians.

Here are a few examples from my own clients:

  • Show you care. A famous quote among physicians is, “For the secret in the care of the patient is caring for the patient.” Your first step in building trust with physician prospects and clients is demonstrating you care about them.
  • You can survey your clients and Identify how they how they see your trust-building strengths.
  • An advisor tells the story of his surgeon father who outlived his money. That inspired him to help other surgeons enjoy true financial security.
  • A cancer survivor tells physicians he’s giving back to the doctors who helped his kids grow up with a father.
  • An advisor tells the story of always wanting to be a cardiologist. Now he’s using his real gift–making money grow–to help cardiologists build wealth.

More Tips:

Keep your promises

As my grandmother said, “Keep every promise you make, and only make promises you can keep.”

Conduct yourself like a physician

What does your personal physician do to win your trust? Do the same!

Be consistent

Conservative physicians may need to be exposed to you and your message six to ten times before they take action. Do you have lists of prospects and clients? Have you built an automated way of delivering something of value to them on a regular basis?

Quote other physicians

The most influential person in a physician’s life is another physician. If a physician offers a great idea or a best practice, ask permission to share this pearl of wisdom with other physicians. You want to be known as the financial advisor who rubs shoulders with physician leaders.

Regularly ask

Ask MD prospects and clients, “How can I do better?”

Take steps to be found

Physicians find financial advisors in much the same way you find a personal physician. You begin with someone you trust. Like me, most physicians turn to their own colleagues for names of financial advisors.

Address painful problems that need to be fixed TODAY

Busy people tend to put off problems that are asymptomatic today, even when they know the neglected problems will lead to pain in the future. Retirement is years away for most physicians. However, they seek relief from the acute financial pain of ObamaCare today.

Partner with experts and offer solutions to the problems of falling reimbursements, rising practice costs and heavier tax burdens. When physicians have more money to invest, they build wealth more quickly.

Interview key physician opinion leaders

Ask top physicians how ObamaCare impacts their day-to-day practice and their plans for the future. Uncover specific active problems. These are all opportunities for you. A key physician could introduce you to many physicians.

Listen to physicians

Active listening builds trust. Further, when you express true curiosity in others, they will want to learn about you.

Go to places physicians gather

Offer to speak at medical meetings about topics that the key physician opinion leaders identify. Submit articles for association publications. Join conversations on social media if that’s where your physician prospects gather.

What this means for you

Here’s why you may want to build trust and be found among physicians: you can mine the treasures in the medical market.

  • Fact: Doctors make up 9 of the top 10 earners in the US.
  • Fact: 500,000 US practicing physicians and dentists are financial do-it-yourself’ers.
  • Fact: 40% of practicing physicians are age 55 or older.Physicians’ acute financial pain is your business opportunity. Someone will offer financial leadership to physicians. Why not you?
  • Assessment
  • Every physician is actively developing a personal ObamaCare plan; this is complex personal financial plan for which physicians solicit expert opinions.

Assessment

Enter the Certified Medical Planners

About the Author

Vicki Rackner MD, author, speaker and President of Targeting Doctors, helps financial advisors accelerate their practice growth by acquiring more physician clients. She calls on her experience as a practicing surgeon, clinical faculty at the University of Washington School of Medicine and nationally-noted expert in physician engagement to offer a bridge between the world of medicine and the world of business.

Conclusion

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

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

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

The “ObamaCare Opportunity” for Financial Advisors

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Why Physicians Need Financial Advisors Now!

[By Vicki Rackner MD]

http://www.CertifiedMedicalPlanner.org

VR MDI recently attended a surgical meeting. Most conversations with my physician colleagues turned to the same singular topic: physicians’ new financial reality.

And the message is, “It hurts!”

Physicians’ Financial Plans

Financially savvy physicians execute thoughtful retirement plans. Yet, today about half of surveyed physicians are behind where they would like to be in retirement preparedness. Further, today only about half of physicians work with professional financial planners.

As a physician myself, I understand why smart physicians fail to take smart financial action. We physicians dedicate ourselves to the alleviation of pain and suffering of others. Retirement is a distant personal concern that does not cause immediate financial pain today. We put it off.

Lesson from My Dentist

Years ago my dentist recommended that I undergo a procedure to replace a filling. He explained that the filling material put in my mouth about 40 years ago tends to pull from the tooth over time and allow new cavities to form.

As much as I like my dentist, I actively avoid spending time in his dental chair. I put off the recommended filling replacement year after year. That is, of course, until I experienced vague throbbing from that tooth. I rearranged my schedule so I could tend to this small problem before it became a much bigger problem. Who wants a root canal!

For physicians retirement planning is like that proactive filling replacement. We understand that without action there will be problems down the road. However, the threat of a problem in the distant future does not propel many like myself to action today.

***

Product Details  Product Details

***

The ObamaCare [PP-ACA] Opportunity for Financial Advisors

ObamaCare is the source of acute financial pain for physicians. It’s the financial toothache. Practicing physicians are looking at:

  • Higher taxes. Doctors represent 9 of the 10 highest earners in the US.
  • Rising costs of goods and services as businesses address their own higher tax bills.
  • The costs of building the infrastructure that will lead to greater healthcare efficiencies, like converting to electronic medical records, hiring new staff to address new administrative demands and aligning with new compliance requirements.
  • Lower professional fees. The 24% Medicare fee reduction that was averted this year will become reality soon. As Medicare goes, so, too, go the rest of the insurance fee schedules.
  • Decreasing patient referrals as primary care doctors sell their practices.
  • Physicians know they need to act now to avoid the financial root canal. Each physician is in the process of creating a personal ObamaCare plan.

Physicians’ Wants and Needs

As a financial advisor, you know that physicians NEED a retirement plan. Kids need to eat their broccoli, too. It’s good for them.

Physicians WANT a plan to help them achieve the personal, professional and financial goals that drew them to a career in medicine. Engaging physicians by address their ObamaCare plan is about as hard as getting kids to eat ice cream.

What This Means for You

Today physicians actively seek experts to help them create their ObamaCare plans.

Financial advisor are winning new physician clients. As Seattle Seahawks quarterback Russell Wilson asks, “Why not you?”

If you want to work with more physician clients, this is your moment! Seize it. You have a chance to join the high-performing financial advisors mining the treasures in the medical market.

Assessment

Should wish to learn more here’s a video that addresses 4 questions:

  • Why do physicians need you now?
  • What do you need to know about physicians now?
  • How do you engage physicians now?
  • How do you conduct yourself so physicians want to conduct business with you now?

About the Author

Vicki Rackner MD is an author, speaker and consultant who offers a bridge between the world of medicine and the world of business. She helps businesses acquire physician clients.

VIDEO: https://www.youtube.com/watch?v=CeCyidc4JP8&feature=player_embedded

Enter the Certified Medical Planners

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Financial Planning MDs 2015

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

I’m a 47 year old MD – Can you help me?

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cmp-program1

A Real-Life Case Model

By Ann Miller RN MHA

http://www.CertifiedMedicalPlanner.org

As a generic financial advisor, how would you answer this client prospect’s inquiry?

QUESTION: I’m a 47 year old MD – Can you help me?

TRADITIONAL ANSWER: I am a stock-broker [aka financial advisor] or insurance agent, and I sell financial products and insurance policies on a commission basis.

What do you want to buy?

CURRENT ANSWER: I am a financial planner, and I charge a percentage amount on the assets I “manage” for you. But, I have a minimum portfolio amount.

So how much money do you have to invest?

DEEP NICHE ANSWER: Yes! I am a fully CERTIFIED MEDICAL PLANNER™ practitioner.  I understand holistic financial planning for medical professionals and current health industry tumult. And, as an informed fiduciary – with transparent fees – I can help with your medical practice, business and/or personal financial planning matters.

When can we meet to discuss your needs?

***

Financial Planning MDs 2015

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

***

ENTER THE CMPs

Enter the CMPs

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

 Product Details  Product Details

Why Medical Professionals Need a Financial Plan?

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We don’t plan to fail – We fail to plan

[By Dr. David Edward Marcinko MBA CMP™]

http://www.CertifiedMedicalPlanner.org

Dr. DEM

Our newest textbook COMPREHENSIVE FINANCIAL PLANNING STRATEGIES FOR DOCTORS AND ADVISORS [Best Practices from Leading Consultants and Certified Medical Planners™] will shape the physician-focused financial planning landscape for the next-generation of Health 2.0 medical professionals and their financial advisors.

Why Now?

We created this innovative textbook because the healthcare industry is rapidly changing and the financial planning ecosystem has not kept pace. Traditional insurance-commission and sales-driven generic advice is yielding to a new breed of deeply informed fiduciary advisor, and educated consultant, or Certified Medical Planner (CMP™). Internet and social media of the last decade demonstrates that medical providers are becoming accustomed to the need for knowledgeable advice. And so, financial planning is set to be transformed by “market disruptors” that will soon make an impact on the $2.8 trillion healthcare marketplace for those financial advisers serving this sector.

We are at the leading edge of this positive disruption — also known as niche based Financial Planning 2.0 — that over time will see today’s command-controlled financial services industry becomes a wide open academic marketplace. And, a growing cadre of specialty entrants is poised to shake up the industry drawing billions of dollars in revenue from traditional broker-dealer organizations while building lucrative new markets.

For example, an iMBA Inc survey points to the growing need for financial advisors to serve current and future medical professionals thanks to their eagerness to seek premium financial planning solutions from non-traditional sources and providers; like the online Certified Medical Planner™ charter designation program. The industry is ripe for a shakeup and physician focused financial planning will soon have its own new brands. We aim to be among the first-movers and top tier names in the industry.

Doctors and Computers

How We Are Different?

COMPREHENSIVE FINANCIAL PLANNING STRATEGIES FOR DOCTORS AND ADVISORS [Best Practices from Leading Consultants and Certified Medical Planners™] will change this niche industry sector by following eight important principles.

1. First, we have assembled a world-class editorial advisory board and independent team of contributors and reviewers and asked them to draw on their experiences in contemporaneous healthcare focused financial planning. Like many of their physician and nurse clients, each struggles mightily with the decreasing revenues, increasing costs, automation, SEC scrutiny and higher physician-client expectations in today’s competitive financial advisory and technological landscape. Yet, their practical experience and physician focused education, knowledge and vision is a source of objective information, informed opinion and crucial information to all consultants working with doctors and medical professionals in the financial services field.

2. Second, our writing style allows us to condense a great deal of information into one volume. We integrate bullet points and tables; pithy language, prose and specialty perspectives with real world examples and case models. The result is an oeuvre of integrated financial planning principles vital to all modern physicians and allied healthcare professionals.

3. Third, to the best of our knowledge, this is the first peer-reviewed book of its type, as we seek to follow traditional medical research and journal publishing guidelines for best practices. We present differing viewpoints, divergent and opposing stake-holder perspectives, and informed personal and professional opinions. Each chapter has been reviewed by one to three outside independent reviewers and critical thinkers. We include references and citations, and although we cannot rule out all biases, we do strive to make them transparent to the extent possible.

4. Fourth, our perspective is decidedly from the physician-client side of the equation. More specifically, as consultants to medical professionals, we champion the physician-investor over the financial advisor. And, to the extent that both sides ethically succeed; we hope all concerned “do well – by doing good”. This is unique in the fee and commission driven financial services industry. Much like the emerging patient-centered care initiative in medicine, we call it client-centered advice.

5. Fifth, it is important to note that deep specificity and niche knowledge is needed when advising physicians and healthcare providers. And so, we present information directly from that space, and not by indirect example from other industries, as is the unfortunate norm. Medical case models, healthcare industry examples, and anecdotal insights from the Over Heard in the Doctor’s Lounge, and Over Heard in the Advisor’s Lounge features, are also included. Finally, personalized financial planning for all medical professionals is our core, and only focus.

6. Sixth, this textbook represents an academic template for about 25 percent [125/500 credit hours] of the Certified Medical Planner™ chartered professional online certification program curriculum. It is useful for those studying, auditing, or considering matriculation for this prestigious designation mark.

7. Seventh, we include a glossary-of-terms specific to the text, a list of comprehensive advice sources, and three illustrative physician-specific financial plan examples additionally available by separate order.

8. Finally, as editor, we prefer engaged readers who demand compelling content.  According to conventional wisdom, printed texts like this one should be a relic of the past; from an era before instant messaging and high-speed connectivity.  Our experience shows just the opposite. Applied physician focused personal financial planning literature, from informed fiduciary sources, is woefully sparse; just as a plethora of generalized internet information makes that material less valuable to doctor clients.

***

plan

***

A Seminal Work

And so, rest assured that COMPREHENSIVE FINANCIAL PLANNING STRATEGIES FOR DOCTORS AND ADVISORS [Best Practices from Leading Consultants and Certified Medical Planners™] will become a seminal book for the advancement of personal financial planning and related personal micro-economic principles in this niche ecosystem.

In the years ahead, we trust these principles will enhance utility and add value to your book. Most importantly, we hope to increase your return on investment by some small increment.

If you have any comments or would like to contribute material or suggest topics for future editions please contact me.

More:

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Financial Planning MDs 2015

Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants

Stock Market at New Highs!

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Is this a Bubble?

[A SPECIAL R&D REPORT FOR THE ME-P]

By David K. Luke MIM, MS-PFP, CMP™ [Certified Medical Planner™] http://www.networthadvice.com

David K. LukeThe market news has been replete with the phrase “new market high“ in the business news every couple of weeks as of late. The corresponding message is often that the stock market is likewise in a bubble. The S&P 500 index and the Dow Jones Industrial Average index are at all-time highs. The indexes have surpassed the 2007 peak.

The reality is however that the S&P 500 is up less than 6% from the beginning of the year, and the Dow is up about 2%. Most investors, of course, do not invest just in these two indexes, as these two indexes represent very large capitalized companies.

I am reminded of the customer in 1995 when I worked at a national brokerage firm that called me to liquidate his entire stock portfolio. “The stock market was too high,” he said. He was 5 years too early.

Risk Mitigation

Most investors will have a diversified portfolio that includes mid-cap stocks, small-cap stocks, and international stocks as well as large cap stocks such as found in the S&P 500.

Of course, these equity investments are also typically subdivided into the broader categories of “Growth” and “Value.” Which means most investors that believe in diversification will own four different “types” of stock, each divided into two different categories for eight different baskets of stock if you will. The typical daily news will focus only perhaps on the S&P 500, which is a portfolio of large capitalized growth stocks. This is only one of the eight different types of stock that an investor would typically own.

  Product Details

In strong bull markets, typically all eight categories of stock go up together with some degree of correlation. This is also true in strong bear markets with all eight categories of stock going down in some degree of correlation. Portfolio managers typically try to offset high correlation of investments by owning investments in asset classes that typically do not all correlate together. This is a major technique used to reduce the volatility in an account.

However as you can see so far this year, most all of the eight stock indexes with the exception of small-cap growth are up slightly in line with the S&P index.

***

[As of June 13, 2014] 

Name Ticker % Total Return YTD % Total Return 12 Month
Large Cap iShares S&P 500 Growth IVW 5.59 22.55
iShares S&P 500 Value IVE 5.76 18.39
Mid Cap iShares S&P MidCap 400 Growth IJK 2.69 18.24
iShares S&P Mid-Cap 400 Value IJJ 7.66 23.19
Small Cap iShares S&P Small-Cap 600 Growth IJT -0.52 20.8
iShares S&P Small-Cap 600 Value IJS 2.3 21.37
Foreign Large Blend iShares Core MSCI EAFE IEFA 3.75 19.25
Barclays Aggregate Bond Index iShares Core US Aggregate Bond AGG 3.26 2.39

Source: Morningstar

***

Inflation

The buying power of the US Dollar has changed over the years. The Consumer Price Index (CPI), a common measure of inflation, has averaged around a 3% annual increase from 1913 – 2014 according to the U.S. Department of Labor Bureau of Labor Statistics.

In fact, an item purchased for $5.00 in 1913 would have a cost of $119.73 today, or a cumulative rate of inflation for the past 100 years of 2,294.7%. The cost of living rising each year is a safe bet. Inflation has increased every year in the past 50 years with one exception: 2009 when inflation fell -0.4%.

Product Details

Update: 06/17/2014 04:10 ET

[Market Update]
Symbol Last Change
DOW 16,808.49 +27.48
NASDAQ 4,337.23 +16.13
S&P 1,941.99 +4.21

Conclusions:

  1. The Market Indexes at new highs does not indicate a bubble. In fact, the market should, relatively speaking, regularly be hitting new highs because of the consistency of positive inflation. Prices of goods and services today are at all-time highs. Does that mean we are in an “inflation” bubble? No. This is normal.
  2. The S&P 500 is not an accurate measure of the US economy. While the S&P 500 is the common “market” indicator in the US, only about 55% of the earnings of the index come from the US. (Source: RBC Capital Markets Research, Capital IQ 2012). This is because mainly large multinational companies such as Google, IBM, and Apple that have a significant amount of overseas revenues weight the index.
  3. The S&P 500 or the Dow Jones Industrial Average (DJIA – 30 stocks) is most likely not an exact reflection of your personal stock portfolio, which would expectantly be more diversified. A typical well-diversified long-term investment portfolio would include not just large cap stocks (such as found in the S&P 500 or DJIA), but mid, small, and international stocks from the growth and value camp, as well as a diversified bond holding.
  4. Overpriced stocks, just like overpriced real estate, are more prudently ascertained by value measures, not simply by raw index numbers. A stock hitting new highs could still be quite undervalued. Meaningful variables such as earnings growth, price to earnings ratio, dividend yield, price-to-book, price-to-sales, and other metrics should be considered.

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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Certified Medical Planner™ Program “In-the-News”

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Post-CFP® Subject Matter Expertise

By Ann Miller RN MHA [iMBA Inc., Executive Director]

Mike Kitces MSFS, MTAX, CFP®, CLU, ChFC, RHU, REBC an uber-financial services blogger over at www.Kitces.com had this to say about us in a recent essay: Finding Your Niche Or Specialization With Post-CFP Designations

The News Essay

CMP (Certified Medical Planner) – The CMP™ designation was created by Dr. David Edward Marcinko MBA CMP™ [reformed CFP®] and the team at the Institute of Medical Business Advisors, Inc., (who also produced the “Financial Planning Handbook for Physicians and Advisors“). It is intended for advisors who aim specifically to serve physicians and the medical community. Content focuses not only on the insurance and investment issues relevant to physicians, but also provides an understanding of the business of medical practices themselves so advisors can help work with their physician clients to have more successful businesses as well.

CMP™ Practitioner Testimonials

I am happy to give my unbiased, unpaid opinion on the CMP™ program to anyone considering the course.

David K. Luke MS-PFP, MIM, CMP™ [Net Worth Advisory Group]

9980 South 300 West, Suite 110 Sandy, Utah 84070

david.luke@networthadvice.com

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cmp-program1

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CMP™ Practitioner Testimonials

I am in favor and support the CMP™ program and curriculum … but just like any other academic curriculum, it is an “accretive academic” program rather than an instant “change of life” program.  I use the material that I learned on a regular basis, but I cannot say that I use it every day.  You will be more able to “talk-the- talk” of the physicians if you have completed the CMP™ curriculum. I would do it again!

Savant recently hired a physician, Dr. Brian Knabe MD as an advisor. He is leaving the medical field, transitioning out, and entering the field of financial services. He has enrolled in this curriculum. Let me know if you wish to discuss.

Thomas A. Muldowney MSFS CFP® ChFC CLU CRC CMP® AIF®

[Savant Capital Management, Inc®]

190 Buckley Drive – Rockford, IL 61107 Tel 815-227-0300 – Fax 815-226-2195

Tmuldowney@savantcapital.com

caution

Assessment:

Link: What Comes After CFP Certification? Finding Your Niche Or Specialization With Post-CFP Designations

Visit: www.CertifiedMedicalPlanner.org

Visit: Enter the CMPs

Conclusion

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

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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Attempting to Time the Stock Market?

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A Fruitful or Futile Endeavor?

[By Dr. David Edward Marcinko MBA CMP]

BC Dr. MarcinkoSome medical professionals, or their financial advisors, believe they are “smarter than the market” and can time when to jump in and buy stocks or sell everything and go to cash.

A Tale of Two Physician Investors

Wouldn’t it be nice to have the clairvoyance to be out of stocks on the market’s worst days and in on the best days? Consider these two doctors.

The Good Stats

Using the S&P 500 Index, our agile imaginary MD investor managed to steer clear of the worst 12.42% annualized return (including reinvestment of dividends and capital gains) during a recent 20+ years time frame, sufficient to compound a $10,000 investment into $107,100.

The Bad Stats

But, what about another unfortunate DO investor that had the wonderful mistiming to be out of the market on the best day of each year. This ill-fated investor’s portfolio returned only 4.31% annualized from Jan. 1992-March 2012, increasing the $10,000 portfolio value to just $23,500 during the 20 years.

Assessment

The design of timing markets may sound easy, but for most all investors it is a losing strategy: http://www.CertifiedMedicalPlanner.org

caution

Conclusion

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

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

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

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SPECIAL ISSUE VOTING

***

Poll: Do you support a one-year delay to ICD-10?

Take the Medical-Economics poll, and let them know what you think about the pending ICD-10 delay. » Click here to Vote

About the AIF® Designation

Certified Medical Planner

A Fiduciary Moniker?

[By Dr. David Edward Marcinko MBA CMP®]

DEM blue tieInvestment fiduciaries and professionals are constantly exposed to legal and practical scrutiny — it comes from multiple directions and for various reasons.

And, it is likely that complaints and/or lawsuits alleging investment mismanagement will continue to increase.

Although some of these allegations may be justified, many can be avoided by having clear knowledge of who constitutes a fiduciary and what is required of one.

AIF® Designation Training 

The AIF Designation Training and designation help mitigate this liability by instructing in practices that cover pertinent legislation and best practices. The Accredited Investment Fiduciary® (AIF®) designation represents a thorough knowledge of and ability to apply the fiduciary practices.

And, did you know that all Certified Medical Planners® are fiduciaries for their clients? http://www.CertifiedMedicalPlanner.org

Assessment

So all FAs, feel free to check em’ out at: http://www.fi360.com/

More:

Conclusion

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

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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New “Physician-Focused” Financial Planning Book Reviewers Needed

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Discerning the “Best Emerging Practices” in Financial Planning for Doctors and Health Professionals

http://www.CertifiedMedicalPlanner.org

By Ann Miller RN MHA AdviceforDoctors@Outlook.com

[ME-P Executive Director]

The Medical Executive-Post occasionally fact-checks and codifies the posts and comments of our readers, subscribers and other experts in order to present them in book form. This is a form of academic, or cognitive, crowd-sourcing. It might also be called a form of private Wikipedia styled information gathering. We may use it to create new books, up-date prior books, or fill in the gaps of books-in-progress.

Book Reviewers  

And so, we are requesting informed [MD-DO-DDSs] doctors and [FA, CFP, CPA, CMP, PhD, CFA or MBA] related folks, or other knowledgeable readers and subscribers to review the Table of Contents of our current project, now under review. We wish to ensure no important topics of interest are omitted for modernity. Editorial writing and assistance will be provided.

www.CertifiedMedicalPlanner.org

Our ME-P Book Review Format:

An easy to follow, and typical book review format, usually starts with the preliminaries such as stating the title of the book, its author, place of publication, publisher, date of publication, and the number of pages. This is completed by us.

What follows next is the making of an introduction to at least give the readers a preview of the review. It is sometimes followed by background information of the book in order to set out criteria in judging a book.

This includes the author’s basic information such as the era in which he wrote the book, or how it relates to his life experience.

Then it is followed by writing a short summary of the content or text of a novel, history book, or any other type of book.

Testimonials, Too!

Crafting a brief, 2-3 sentence, informal testimonial is also needed.

Books

Assessment

This is highly confidential peer-reviewed styled publishing; do not disclose material. MarcinkoAdvisors@msn.com

Conclusion

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

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

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Fiduciary Financial Advisor versus Non-Fiduciary FAs

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Understanding the Difference

Dr. DEMBy Dr. David Edward Marcinko MBA CMP™

GOAL: To understand the difference between fiduciaries and non-fiduciaries, examine the SEC conduct rules.

Stock-Brokers (non-fiduciaries) are subject to FINRA Conduct Rule 2310(a) which reads:

In recommending to a customer the purchase, sale or exchange of any security, a member shall have reasonable grounds for believing that the recommendation is suitable for such customer upon the basis of the facts, if any, disclosed by such customer as to his security holdings and as to his financial situation and needs.

A fiduciary follows a higher standard of conduct: 

A fiduciary duty is an obligation to act in the best interest of another party. A fiduciary obligation exists whenever the relationship with the client involves a special trust, confidence and reliance on the fiduciary to exercise his discretion or expertise in acting for a client. A person acting in a fiduciary capacity is held to a high standard of honesty and full disclosure in regard to the client and must not obtain a personal benefit at the expense of the client.

Five primary responsibilities as a fiduciary to clients are:

  • To always put clients’ interest first
  • To act with utmost good faith
  • To provide full and fair disclosure of all material facts
  • Not to mislead clients, and
  • To expose all conflicts of interest and all compensation to clients.

More:

Assessment

Conclusion

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

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

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How You Can Financially Profit from the PP-ACA?

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An Obamacare Sales Opportunity

By Dr. David Edward Marcinko MBA CMP™

[Editor-in-Chief] www.CertifiedMedicalPlanner.org

Dr. MarcinkoPresumably, as a result of my financial advisory activities, I received this email solicitation the other day,

So, I thought I’d pass it along [unchanged] to our ME-P readers, FAs, insurance agents and subscribers for comment.

USA BENEFITS GROUP EAGLE DIVISION  ………. PROVIDING CAREER SOLUTIONS FOR 36 YEARS 

[Better Contracts + Better Schedule + Better Career Opportunities] 

Dear Prospect [that would be ME],

I received your resume on Monster.  You already know that the real money in any organization is in sales. The salespeople of the world make things happen and are highly rewarded for that work.  But it’s hard work.

The Product

What if you could find a product that everybody needs, that they have money budgeted to purchase, and are looking for someone to help them buy it?  Do you think you could help that person? That’s exactly  the situation in the health insurance industry today!

Our government is telling people they HAVE to have it.  Folks are either buying it now from somewhere or will soon be eligible for subsidies so they CAN buy it.  And EVERYONE is confused and looking for someone with answers on how to get this product!

You can be that Person

Over the next sixty months, billions of dollars are going to change hands as people readjust to a dynamic health care environment.  How can you get into the river and get your hands on some of that money?  By preparing to serve people!

USA Benefits Group 

The USA Benefits Group is a highly successful team of insurance brokers who are “reform ready” – staying up to date on this perhaps once-in-a-lifetime shift in this industry.  We are independent, non-captive agents who are setting up qualified, turn-key “private exchanges” to help people obtain health insurance in a webinar-based setting from our home offices.

I’m encouraging you to click here: www.usabg.net/dcollins to learn more. If you’re serious and ready to make a move, you can call me toll-free now at 866-328-6182. If you’re qualified, I also have Regional Management positions available.

Advantages of working with my Eagle Division 

  1. 1. 36 year old system for success
  2. 2. 100% control of your future
  3. 3. Equal opportunity
  4. 4. Recession proof
  5. 5. Top Companies to represent
  6. 6. Excellent co-op lead program
  7. 7. Weekly advance commissions ($2,000 To $4,000 Net Weekly)
  8. 8. Vested Lifetime Renewals ($10,000 To $20,000 Monthly In Under 3 Years)
  9. 9. Annual Incentive Trips
  10. 10. Annual Production Bonuses to $50,000+

I’m looking forward to talking to you.
David Collins
DIVISION MANAGER
866.328.6182
DC@usabg.net

Assessment

  • Is this a good product to sell? If so, why does it need an intermediary to push it?
  • Don’t subsidies, carve-outs, exemptions and sales commissions serve to jack-up price and lower quality? [think eMRs]? What about the overall cost of healthcare delivery; up or down?
  • What about the USA Benefits Group; credible or not? Are cold calls the way to go?
  • What is your impression of Division Manager Mr. David Collins and his Eagle Division? Feel free to contact him … and tell him what you think.

Conclusion

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Ground Breaking Book Explains Why Accountable Care Organizations May Be the Answer the Health Care Industry Has Been Seeking!

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Book Reviews, with Testimonial, by ME-P Founding Publisher Dr. David Edward Marcinko MBA CMP®

PRESS RELEASE!

August 23, 2013CRC Press / Productivity Press is pleased to announce the publication of  Accountable Care Organizations: Value Metrics and Capital Formation authored by nationally recognized healthcare expert, Robert James Cimasi. This dynamic book explores the historical background and evolution of the highly anticipated ACO model which is rapidly expanding since its adoption as part of the Affordable Care Act, commonly referred to as Obama Care. The book describes the basis for the development of value metrics and capital formation analyses that are foundational to assessing capacity for change in healthcare organizations considering the development of an ACO, as well as, the current efficacy of the model.

Book Reviews

“Bob Cimasi has done it again. As a thought leader in contemporary healthcare matters, his new book, Accountable Care Organizations: Value Metrics and Capital Formation, establishes and explains, in plain terms, the operational and financial DNA and genomic construct and understanding for any organization considering the development and operations of an ACO…a must read and resource for any healthcare industry executive.”

-Roger W. Logan, MS, CPA/ABV, ASA, Senior Vice President of Phoenix Children’s Hospital

“Accountable Care Organizations is the first comprehensive text on capital formation and value metrics for this new healthcare business model… I can think of no one more qualified to write it than Bob Cimasi at Health Capital Consultants … it is destined to become a classic work … read, review, refer, and profit by this valuable resource.”

-Dr. David Edward Marcinko MBA CMP® of the Institute of Medical Business Advisors, Inc Atlanta, GA

“As both a healthcare management educator and as a consultant who has worked on health and professional services transactional advisory work for many years, I applaud the ambitious undertaking of Bob Cimasi’s latest book, Accountable Care Organizations: Value Metrics and Capital Formation. Cimasi’s description of the complex history and evolution of the US health system provides a useful framework for students and professionals who may lack a detailed background in the field. This should help them better understand both how we have arrived at the ACO approach, and how it might work. This addressing capital and valuation information is also uncommon in the literature on ACOs. It should provide a valuable contribution to the field, especially given that a some surveys of healthcare leaders have pointed to access to capital and to a lesser but still important degree, agreement on valuation, as concerns as they consider acquisitions, mergers, and other affiliations towards forming/joining ACOs or similar organizations to help deal with the changing reimbursement and competitive environment.”

-R. Brooke Hollis, MBA/HHSA, Executive Director, Sloan Program in Health Administration, Cornell University and Managing Member, Hollis Associates Acquisition Advisors, LLC

The book examines the Four Pillars of Value in the Healthcare Industry: regulatory, reimbursement, competition and technology in addressing the value metrics of ACOs, including requirements for capital formation, financial feasibility, and economic returns. It focuses the discussion of non-monetary value on a review of aspects of population health within the context of such objectives as improved quality outcomes and access to care. It also examines the positive externalities of the ACO model, including results for third parties outside the basic construct of the ACO contracts shared savings payments. The potential role and opportunities for consultants in assisting their provider clients in the consideration, development, implementation, and operation of an ACO are also discussed.

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Accountable Care Organizations

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About the Author:

Robert James Cimasi, MHA, ASA, FRICS, MCBA, AVA, CM&AA, CMP® is CEO of Health Capital Consultants (HCC), a nationally recognized healthcare financial and economic consulting firm headquartered in St. Louis, Missouri, since 1993. Cimasi has more than 30 years of experience in serving clients in over 45 states, with a professional focus on the financial and economic aspects of healthcare service sector entities including feasibility analysis and forecasting; valuation consulting and capital formation services; healthcare industry transactions including joint ventures, mergers, acquisitions, and divestitures; certificate-of-need and other regulatory and policy planning consulting; and, litigation support and expert testimony.

Mr. Cimasi has served for many years as faculty in both an academic and professional basis for continuing education courses, and he has provided testimony before federal and state legislative committees and has served as an expert witness in numerous court cases. He is a nationally known speaker on healthcare industry topics, the author of several books, including A Guide to Consulting Services for Emerging Healthcare Organizations (John Wiley & Sons, 1999), The U.S. Healthcare Certificate of Need Sourcebook (Beard Books, 2005), The Adviser’s Guide to Healthcare (AICPA, 2010), and Healthcare Valuation: The Financial Appraisal of Enterprises, Assets, and Services (John Wiley & Sons, 2013), as well as numerous chapters, published articles, research papers and case studies, and is often quoted by healthcare industry press.

 

UPDATE:
Top Five Videos Trending in The Last Month On HealthShareTV
  1. Accountable Care Directory 2014
  2. Achieving Quality in Accountable Care Organizations
  3. High-Performing Care Coordination in a Patient/Family-Centered Medical Home
  4. ‘Aetna’s Medicare Advantage Collaborative Initiatives’
  5. Aligning High Performance in Medication Safety to Improve Patient Outcomes and Reduce Readmissions

Source: HealthShareTV

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On “Meaningful” Tchotchkes for Doctors

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Prospecting with Trinkets -OR- Items of Real Value for Physician Clients?

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According to Wikipedia, a tchotchke is a small bauble, doodad, doohickey, gewgaw, gismo knickknack, swag, thingamabob, thingamajig, toy, trinket, whatchamacallit, whosie-whatsit, widget, etc. Drug representative, various trade vendors and even prospecting financial advisors that give such cheap souvenirs to potential clients are even sometimes called “tchotchke dukes.” This industry practice is well known and wide spread.

Value-Less

Depending on context, the term has a connotation of worthlessness or disposability as well as tackiness, and has long been used in the regional speech of New York City and elsewhere.

The word may also refer to swag, in the sense of the logo pens, key rings and FOBs, t-shirts, golf balls, and other promotional freebies dispensed at trade shows, conventions, and similar large events. Most are largely value-less promotional pieces.

Valuable

Medical professionals of all types are fertile prospects for pharmaceutical representatives, insurance agents, financial advisors and like minded vendors. Most of these commissioned salesmen offer tchotchkes to their doctor clients and prospects as a reminder of their wares.

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http://www.HealthDictionarySeries.org

Assessment

And so, wouldn’t it be interesting for these vendors to offer their doctors something of real value?  How about one of our Dictionaries of Health … in our series of three non-clinical handbooks? Affordable, memorable and valuable!

CMP™ Course

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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