PODCAST: Hedge Fund Manager Michael Burry MD

Posted on February 22, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

In The Subprime of His Life – My Story

By Dr. David Edward Marcinko MBA, CMP™

[Editor-in-Chief]

I am a long time fan of financial industry journalist Michael Lewis [Liars’ Poker, Moneyball and others] who just released a new book. The Big Short is a chronicle of four players in the subprime mortgage market who had the foresight [and testosterone] to short the diciest mortgage deals: Steve Eisner of FrontPoint, Greg Lippmann at Deutsche Bank, the three partners at Cornwall Capital, and most indelibly, Wall Street outsider Michael Burry MD of Scion Capital.

They all walked away from the disaster with pockets full of money and reputations as geniuses.

About Mike

Now, I do not know the first three folks, but I do know a little something about my colleague Michael Burry MD; he is indeed a very smart guy. Mike is a nice guy too, who also has a natural writing style that I envy [just request and read his quarterly reports for a stylized sample]. He gave me encouragement and insight early in my career transformation – from doctor to “other”.

And, he confirmed my disdain for the traditional financial services [retail sales] industry, Wall Street and their registered representatives and ‘training’ system, and sad broker-dealer ethos [suitability versus fiduciary accountability] despite being a hedge fund manager himself.

I mentioned him in my book: “Insurance and Risk Management Strategies” [For Physicians and their Advisors].

http://www.amazon.com/Insurance-Management-Strategies-Physicians-Advisors/dp/0763733423/ref=sr_1_2?ie=UTF8&s=books&qid=1269254153&sr=1-2

He ultimately helped me eschew financial services organizations, “certifications”, “designations” and ”colleges”, and their related SEO rules, SEC regulations and policy wonks; and above all to go with my gut … and go it alone!

And so, I rejected my certified financial planner [marketing] designation status as useless for me, and launched the www.CertifiedMedicalPlanner.org on-line educational program for physician focused financial advisors and management consultants interested in the healthcare space … who wish to be fiduciaries.

And I thank Mike for the collegial good will. By the way, Mike is not a CPA, nor does he posses an MBA or related advanced degree or designation. He is not a middle-man FA. He is a physician. Unlike far too many other industry “financial advisors” he is not a lemming.

IOW: We are not salesman. We are out-of-the-box thinkers, innovators and contrarians by nature. www.MedicalBusinessAdvisors.com

From a Book Review

According to book reviewer Michael Osinski, writing in the March 22-29 issue of Businessweek.com, Lewis is at his best working with characters and Burry is rendered most vividly.

“A loner from a young age, in part because he has a glass eye that made it difficult to look people in the face, Burry excelled at topics that required intense and isolated concentration. Originally, investing was just a hobby while he pursued a career in medicine. As a resident neurosurgeon at Stanford Hospital in the late 1990s, Burry often stayed up half the night typing his ideas onto a message board. Unbeknownst to him, professional money managers began to read and profit from his freely dispensed insight, and a hedge fund eventually offered him $1 million for a quarter of his investment firm, which consisted of a few thousand dollars from his parents and siblings. Another fund later sent him $10 million”.

“Burry’s obsession with finding undervalued companies eventually led him to realize that his own home in San Jose, Calif., was grossly overpriced, along with houses all over the country. He wrote to a friend: “A large portion of the current [housing] demand at current prices would disappear if only people became convinced that prices weren’t rising. The collateral damage is likely to be orders of magnitude worse than anyone now considers.” This was in 2003.

“Through exhaustive research, Burry understood that subprime mortgages would be the fuse and that the bonds based on these mortgages would start to blow up within as little as two years, when the original “teaser” rates expired. But Burry did something that separated him from all the other housing bears—he found an efficient way to short the market by persuading Goldman Sachs (GS) to sell him a CDS against subprime deals he saw as doomed. A unique feature of these swaps was that he did not have to own the asset to insure it, and over time, the trade in these contracts overwhelmed the actual market in the underlying bonds”.

“By June 2005, Goldman was writing Burry CDS contracts in $100 million lots, “insane” amounts, according to Burry. In November, Lippmann contacted Burry and tried to buy back billions of dollars of swaps that his bank had sold. Lippmann had noticed a growing wave of subprime defaults showing up in monthly remittance reports and wanted to protect Deutsche Bank from potentially massive losses. All it would take to cause major pain, Lippmann and his analysts deduced, was a halt in price appreciation for homes. An actual fall in prices would bring a catastrophe. By that time, Burry was sure he held winning tickets; he politely declined Lippmann’s offer”

And the rest, as they say, is history.

Link: http://www.businessweek.com/magazine/content/10_12/b4171094664065.htm

My Story … Being a Bit like Mike

I first contacted Mike, by phone and email, more than a decade ago. His hedge fund, Scion Capital, had no employees at the time and he outsourced most of the front and back office activities to concentrate on position selection and management. Early investors were relatives and a few physicians and professors from his medical residency days. Asset gathering was a slosh, indeed. And, in a phone conversation, I remember him confirming my impressions that doctors were not particularly astute investors. For him, they generally had sparse funds to invest as SEC “accredited investors” and were better suited for emerging tax advantaged mutual funds. ETFs were not significantly on the radar screen, back then, and index funds were considered unglamorous. No, his target hedge-fund audience was Silicon Valley.

And, much like his value-hero Warren Buffett [also a Ben Graham and David Dodd devotee], his start while from the doctor space, did not derive its success because of them.

Moreover, like me, he lionized the terms “value investing”, “margin of safety” and “intrinsic value”.

Co-incidentally, as a champion of the visually impaired, I was referred to him by author, attorney and blogger Jay Adkisson www.jayadkisson.com Jay is an avid private pilot having earned his private pilot’s license after losing an eye to cancer.

Mike again re-entered my cognitive space while doing research for the first edition of our successful print book: “Financial Planning Handbook for Physicians and Advisors” and while searching for physicians who left medicine for alternate careers!

In fact, he wrote the chapter on hedge funds in our print journal and thru the third book edition before becoming too successful for such mundane stuff. We are now in our fourth edition, with a fifth in progress once the Obama administration stuff [healthcare and financial services industry “reform” and new tax laws] has been resolved

http://www.amazon.com/Financial-Planning-Handbook-Physicians-Advisors/dp/0763745790/ref=sr_1_1?ie=UTF8&s=books&qid=1269211056&sr=1-1

Assessment

News: Dr. Burry appeared on 60 Minutes Sunday March 14th, 2010. His activities with Scion Capital are portrayed in Michael Lewis’s newest book, The Big Short. An excerpt is available in the April 2010 issue of Vanity Fair magazine, and at VanityFair.com

Video of Dr. Burry: http://www.cbsnews.com/video/watch/?id=6298040n&tag=contentBody;housing

Video of Dr. Burry: http://www.cbsnews.com/video/watch/?id=6298038n&tag=contentBody;housing

PS: Michael Osinski retired from Wall Street and now runs Widow’s Hole Oyster Co. in Greenport, NY http://www.widowsholeoysters.com

And, our www.MedicalBusinessAdvisors.com related books can be reviewed here: http://www.amazon.com/s/ref=nb_sb_noss?url=search-alias%3Dstripbooks&field-keywords=david+marcinko

Assessment

Visit Scion Capital LLC and tell us what you think http://www.scioncapital.com.

And to Mike himself, I say “Mazel Tov” and congratulations? I am sure you will be a good and faithful steward. The greatest legacy one can have is in how they treated the “little people.” You are a champ. Call me – let’s do lunch. And, I am still writing: www.BusinessofMedicalPractice.com for the conjoined space we both LOVE.

Conclusion

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

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

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FINANCE:Financial Planning for Physicians and Advisors
INSURANCE:Risk Management and Insurance Strategies for Physicians and Advisors

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

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

***

Filed under: Book Reviews, Breaking News, CMP Program, iMBA, Inc., Interviews, Investing, Portfolio Management, Recommended Books, Videos | Tagged: 60 Minutes, Ben Graham, CFP, CMP, Cornwall Capital, David Dodd, david marcinko, Greg Lippmann, Jay Adkisson, Michael Lewis, Nicahel Burry, Scion Capital, SEC, Steve Eisner, subprime mortgage market, The Big Short, value investing, Wall Street, www.certifiedmedicalplanner.com, www.HealthDictionaySeries.com, www.medicalbusinessadvisors.com | 34 Comments »

SECOND OPINIONS: Physician Financial Planning, Investing, Medical Practice Management and Business Valuations; etc!

Posted on February 21, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

BY DR. DAVID EDWARD MARCINKO MBA CMP

***

Financial Planning for Medical Professionals

HERE: https://medicalexecutivepost.com/schedule-a-consultation/

CONTACT: Ann Miller RN MHA

770-448-0769

***

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Musings on a Famous Portfolio Asset Allocation Study

Posted on February 14, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

Some Critics Claim Brinson, Hood, and Beebower Conclusions Wrong

[By Dr. David Edward Marcinko MBA CMP™]

http://www.CertifiedMedicalPlanner.org

[Publisher-in-Chief]

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

Enter the Critics

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

The Jahnke Study

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

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

Assessment

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

Conclusion

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

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Filed under: CMP Program, Experts Invited, Investing, Op-Editorials, Portfolio Management, Touring with Marcinko | Tagged: asset allocation, Brinson, CMP, david marcinko, Hood Beebower, The Asset Allocation Hoax, William Jahnke, www.certifiedmedicalplanner.com | 1 Comment »

SECOND OPINIONS: Physician Financial Planning, Investing, Medical Practice Management and Business Valuations; etc!

Posted on February 12, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

BY DR. DAVID EDWARD MARCINKO MBA CMP

***

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CONTACT: Ann Miller RN MHA

770-448-0769

***

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What is the Current Rate of Return [CRR] for [Pandemic] Investments?

Posted on February 4, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

THE INVESTING “CURRENT RATE OF RETURN“

By Dr. David Edward Marcinko MBA CMP®

SPONSORED: http://www.CertifiedMedicalPlanner.org

Stock Market Pandemic History

Technology stocks have largely been in favor since the COVID-19 pandemic began, but re-openings in the U.S. and elsewhere as vaccines take hold have pushed investors toward value stocks, which are geared more toward the economy. But lately, stronger growth expectations are also sparking worries of higher inflation, and a potential tapping of the brakes by central banks.

Therefore, an important concept for physicians and all investors to understand is the Current Rate of Return (CCR).

So, What Exactly is CRR?

According to this principle, the current rate of a taxable return must be evaluated in reference to a similar non-taxable rate of return. This allows you to focus on your portfolio’s real (after-tax return), rather than its’ nominal, or stated return. Since most medical professionals own a combination of both vehicles, it is important to calculate the average rate of return (ARR), as demonstrated in the following matrix. Usually, this will result in the assumption of more risk, for the possibility of great return.

To compare after tax yields, with taxable yields, use the following formulas:

Tax equivalent yield = yield / (1 – MTB), while taxable yield X (1-tax rate) = tax exempt yield.

Example: if the yield on a tax exempt municipal bond was 6%, and you are in a 28% tax bracket; the equivalent taxable yield (ETY), is 8.3%, calculated in the following manner: 06 / 1.00 – .28 =.083, or, 8.3% ETY.

This means that you would need a taxable instrument paying almost 9 % to equal the 6 percent tax exempt bond.

ASSESSMENT: Your thoughts are appreciated.

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

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VIDEO TELECONFERENCE: How to Prepare?

Posted on January 12, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Coach: Dr. David Edward Marcinko MBA

***

***

PHYSICIANS AND ADVISORS

TIPS TO PREPARE FOR A VIDEO INTERVIEW

Practice with someone to become comfortable with the process.

Background/Staging:

• Pay attention to the background, what will be seen around and behind you. Get rid of
clutter – it affects “your presentation.” Make sure there is nothing in the background you
don’t want anyone to see including personal pictures, etc.

• Conduct the test in the same location you plan to conduct the video interview.
• Adjust lighting to highlight your face. Do not let light wash out your facial features.

• Have back-up equipment nearby (extra laptop, phones, cables).
Clothing

• Dress in professional, conservative, non-fussy clothing as though you were going to be
with the committee in person. Wear a jacket.

• Wear a solid/bold color. Stay away from dark colors.

• Stay away from prints (e.g. herringbone) which, depending upon the design, lighting and
camera pixels, can make your outfit “vibrate” on screen.

• Dress knowing that the committee will see you “closer up” than you will see them.
Eye Contact/Body Language/Clear Communications

• Be sure to look at the camera not at the image of the committee on the screen;
otherwise you do not appear to be “looking them in the eye” or will appear nervous.

• It is hard to read committee body language without typical in-person conversation cues,
so watch the time and limit each answer to 3-4 minutes. Be attuned to a timer.

• Be attentive to your body language — leaning back in your chair is a no-no; lean forward
to convey interest in the position and the committee. Don’t rock back and forth.

• Place support things out of camera range (glass of water, a timer, notes, notepad, pen,
list of committee members) so your eyes go to the side and not up/down to these items.

• Don’t be afraid to ask to have questions repeated, either because the question was long
and complex or because of audio problems. Jot notes on complex questions.

COACH: https://medicalexecutivepost.com/2023/01/08/personal-coaching-dr-marcinko-at-your-service/

Sound Amplification and Noise Control:

• Microphones magnify noises and can be distracting to the committee. Avoid ruffling
papers and jangling jewelry. In the same vein, speak up clearly and enunciate your
words.

• Place a “do not disturb/do not enter” sign on the door of your space. Turn off running
programs (like your email) to eliminate beeps when new emails arrive.

• Silence all other technology EXCEPT if there should be technical issues, turn your
phone back on to receive a call from your Greenwood/Asher consultant for
troubleshooting.

• Ask family and colleagues to be quiet during the interview. If a family member or
colleague is your resident IT expert, have that person close-at-hand but out-of-sight
during the call.

• Be prepared to switch to a landline or cell speaker phone for the audio portion since
audio with Skype/Zoom is not always great. If you do use this option, mute your
computer microphone to eliminate conflicting noise.

SECOND OPINIONS: https://medicalexecutivepost.com/2023/01/10/physician-coaching-second-opinions

PODCAST: https://www.youtube.com/watch?v=n7bYGhEVjd8

***

COMMENTS APPRECIATED

Thank You

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Filed under: "Ask-an-Advisor", "Doctors Only", Experts Invited, Touring with Marcinko, Videos | Tagged: advisors, david marcinko, doctors, Marcinko, Nicole Laskowsky, teleconference, TELECONFERENCE: How to Prepare? | Leave a comment »

Musings on a Famous Portfolio Asset Allocation Study

Posted on December 14, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

Some Critics Claim Brinson, Hood, and Beebower Conclusions Wrong

[By Dr. David Edward Marcinko MBA CMP™]

http://www.CertifiedMedicalPlanner.org

[Publisher-in-Chief]

Enter the Critics

The Jahnke Study

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

Assessment

Conclusion

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

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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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Understanding the Cost of Not-for-Profit Hospital Capital

Posted on October 13, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

A “Must-Know” Economic Concept for Not-for-Profit Hospital Executives

[By Calvin W. Wiese; MBA, CPA]

It is critical to understand and to measure the total cost of capital for any hospital or healthcare organization. Lack of understanding and appreciation of the total cost of capital is widespread, particularly among not-for-profit hospital executives.

The capital structure includes long-term debt and equity; total capital is the sum of these two. Each of these components has cost associated with it. For the long-term debt portion, this cost is explicit: it is the interest rate plus associated costs of placement and servicing.

Equity Cost

For the equity portion, the cost is not explicit and is widely misunderstood. In many cases, hospital capital structures include significant amounts of equity that has accumulated over many years of favorable operations. Too many physician executives wrongly attribute zero cost to the equity portion of their capital structure. Although it is correct that generally accepted accounting principles continue to assign a zero cost to equity, there is opportunity cost associated with equity that needs to be considered. This cost is the opportunity available to utilize that capital in alternative ways.

Equity Greater than Cost of Debt

In general, the cost attributed to equity is the return expected by the equity markets on hospital equity. This can be observed by evaluating the equity prices of hospital companies whose equity is traded on public stock exchanges. Usually the equity prices will imply cost of equity in the range of 10% to 14%; or lower recently. Almost always, the cost of equity implied by hospital equity prices traded on public stock exchanges will substantially exceed the cost of long-term debt.

Thus, while many hospital executives will view the cost of equity to be substantially less than the cost of debt (i.e., to be zero), in nearly all cases, the appropriate cost of equity will be substantially greater than the cost of debt.

The Weighted Average Cost of Capital

Hospitals need to measure their weighted average cost of capital (WACC). WACC is the cost of long-term debt multiplied by the ratio of long-term debt to total capital plus the cost of equity multiplied by the ratio of equity to total capital (where total capital is the sum of long-term debt and equity).

Assessment

WACC is then used as the basis for capital charges associated with all capital investments. Capital investments should be expected to generate positive returns after applying this capital charge based on the WACC. Capital investments that don’t generate returns exceeding the WACC consume enterprise value; those that generate returns exceeding WACC increase enterprise value. Hospital executives need to be rewarded for increasing enterprise value.

Conclusion

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Filed under: Career Development, CMP Program, Health Economics, Healthcare Finance, Investing | Tagged: Calvin Wiese, cost of hospital debt, david marcinko, equity costs, equity markets, equity public markets, not-for-profit hospitals, WACC, weighted average caost of capital, www.healthcarefinancials.com | 4 Comments »

VALUATION: Clinic and Medical Practice Worth

Posted on October 10, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

Plastic Surgery Proto-Type

***

Download our Complimentary “Free” Resources

[Medical Practice Worth, Valuation, Sales and Succession Planning]

Part (1) – Part (2) – Part (3)

By Dr. David Edward Marcinko MBA DPM MBBS CMP™

By Professor Hope Rachel Hetico RN MHA CPHQ CMP™

By Robert James Cimasi MHA AVA CBA ASA FCBI MCMA CMP™

YOUR THOUGHTS ARE APPRECIATED.

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DICTIONARY: Health Economics and Finance

Posted on October 7, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

BY DR. DAVID E. MARCINKO MBA

Designated a Doody’s Core Title!

“”Medical economics and finance is an integral component of the health care industrial complex. Its language is a diverse and broad-based concept covering many other industries: accounting, insurance, mathematics and statistics, public health, provider recruitment and retention, Medicare, health policy, forecasting, aging and long-term care, are all commingled arenas.

The Dictionary of Health Economics and Finance will be an essential tool for doctors, nurses and clinicians, benefits managers, executives and health care administrators, as well as graduate students and patients? With more than 5,000 definitions, 3,000 abbreviations and acronyms, and a 2,000 item oeuvre of resources, readings, and nomenclature derivatives? it covers the financial and economics language of every health care industry sector.””
– From the Preface by David Edward Marcinko “

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Dictionary of Health Information Technology and Security

Posted on October 2, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

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Whither the “Dictionary of Health Information Technology and Security?”

A simple query that demands a cogent answer!

There is a myth that all stakeholders in the healthcare space understand the meaning of basic information technology jargon. In truth, the vernacular of contemporary medical information systems is unique, and often misused or misunderstood. It is sometimes altogether confounding.

Terms such as, “RSS”, “eHRs”, “DRAM”, “ROM”, “USB”, “PDA”, “NPI”, “CCHIT”, and “DNS” are common acronyms, but is their meaning AND functionality truly understood?

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Sponsors Welcomed

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Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Glossary Terms, Information Technology, Sponsors | Tagged: david marcinko, dictionary, dictionary health information technology, DNS, EHRs, EMRs, glossary, health information technology, HIT, HIT glossary, information technology dictionary, IT, NPI, ROM, RSS, USB, www.healthdictionaryseries.com | 2 Comments »

Enter “Population Health” Management

Posted on July 12, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

Understanding the Costs and Risks

[By Dr. David Edward Marcinko MBA]

Gratefully, our book, Financial Management Strategies of Hospitals and Healthcare Organizations [Tools, Techniques, Case Studies and Checklists] has become an academic best seller.

HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731

It contains a chapter on Wellness and Population Health 2.0; included here for your review [By Jennifer Tomasik, Carey Huntington, and Fabian Poliak]. .

Population Health

I am especially proud of this work. This managerial book mimics the popular style of colleague Atul Gawande MD in his acclaimed work The Checklist Manifesto.

Why? All hospitals are still subject to the imperative: No Margin – No Mission.

***

Assessment

In an example of population health management and policy leadership, another colleague, David B. Nash MD MBA of the Wharton School, and Endowed Dean of Jefferson University Medical School [father of population health], even wrote the “Foreword”.

Click on this link to read it entirely.

Link: Foreword.Nash

More:

Conclusion

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PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

***

Invite Dr. Marcinko

***

Filed under: Book Reviews, iMBA, Inc., Research & Development | Tagged: atul gawande MD, david marcinko, Dr. David Marcinko, Financial Management Strategies of Hospitals and Healthcare Organizations, Population Health, public health; David Nash MD MBA | 4 Comments »

A Doctor – Economist’s Solution for Health Reform

Posted on July 1, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

My Laundry Wish List for all US Healthcare Stakeholders

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

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

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

Assessment

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

Conclusion

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

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

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

Our Other Print Books and Related Information Sources:

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

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

THANK YOU

Filed under: Career Development, Drugs and Pharma, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Information Technology, Interviews, Managed Care, Op-Editorials | Tagged: ADA, AMA, CCHIT, CPT codes, CRNAs, david marcinko, dentists, DNPs, DNV, ER, evidence based medicine, expert based medicine, Fox news, Health Insurance, healthcare reform, hospitalists, HR 3200, HR 3400, HSAs, JCAHO, malpractice reform, medicare, never-events, NPs, nurses, obama, osteopaths, P4P, podiatrists, politics, retail medical clinics, RNs, tort reform, townhall meetings | 6 Comments »

Thinking Beyond Portfolio Asset Allocation

Posted on June 14, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

Don’t Forget Your Spending Policy – Doctors

By Dr. David Edward Marcinko MBA CMP™

www.CertifiedMedicalPlanner.com

[Publisher-in-Chief]

If you are economically literate – or read the ME-P regularly – you may be tired of hearing the familiar saw, “the single most important determinant of investment results over time is asset allocation.”

But, as most of us realize, this glosses over critical obstacles to building personal wealth—taxes, inflation, and spending policy. A doctor’s spending policy itself is as critical as asset allocation in preserving wealth, as well as for all investors who understand the trade-offs: there are both allocation and spending strategies that stand to preserve wealth and insulate against excessive equity risk at the same time.

Income versus Security

In proving his point a decade ago, the author—Roger Hertog in “Income Versus Security”— traced the growth of a $1 million portfolio during the period of 1960–1994. He showed that while an all-stock portfolio would have experienced a compound growth rate of 10.1%, an all-bond portfolio of 7.4%, and an all T-bill portfolio of 6.1%, these growth rates dropped to 8%, 5%, and 3.7%, respectively, after taxes and conservative transaction costs. When further reduced by inflation, they dropped to 3.1%, 0.2%, and -1%, respectively. Stocks still nearly tripled in real value after taxes.

Next, Hertog factored in spending. He showed that the greater the equity exposure, the more likely investors will preserve or increase their levels of real spending and wealth. Also, he demonstrated how a spending policy of a fixed percentage of the portfolio; or of spending all the income is ill-suited to estate building. He arrived at an optimum allocation of 60% stocks and 40% bonds with a policy of spending all stock dividends but only spending interest to the extent it exceeds inflation. This latter spending policy adjusts for the fact that in – unlike today but perhaps again in the near future – an inflationary environment a portion of bond interest is a return of principal. This type of asset allocation and spending policy resulted in the greatest amount of growth over the years and gained on inflation. Hertog contends that the 60/40 allocation provides an appealing combination of growth and protection.

IOW: It gives investors a milder ride.

Assessment

Over the 35-year period studied, a 60/40 mix returned almost as much as the all-stock portfolio both before taxes and after taxes and achieved some 75% of its real after-tax growth. Also, the portfolio’s worst year was only half as bad as the all-stock portfolio. Hertog believed that balancing with bonds softened the downside. But – what about the “flash-crash” of 2008-09?

Note: “Income Versus Security: Do You Have To Choose?” Roger Hertog, Trust & Estates, March 1997, pp. 44–62, Intertec Publishing Corporation.

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Is the bull market in bonds over? Do you believe Hertog? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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

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Filed under: CMP Program, Investing, Portfolio Management | Tagged: asset allocation, david marcinko, Income versus Security, Portfolio Management, Roger Hertog | 7 Comments »

RECAST: An Interview with Fiduciary Bennett Aikin AIF®

Posted on May 21, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

On Financial Fiduciary Accountability

[By Dr. David E. Marcinko MBA CMP™]

[By Ann Miller; RN, MHA]

Currently, there is a growing dilemma in the financial sales and services industry. It goes something like this:

What is a financial fiduciary?
Who is a financial fiduciary?
How can I tell if my financial advisor is a fiduciary?

Now, in as much as this controversy affects laymen and physician-investors alike, we went right to the source for up-to-date information regarding this often contentious topic, for an email interview and Q-A session, with Ben Aikin.

About Bennett Aikin AIF® and fi360.com

Bennett [Ben] Aikin is the Communications Coordinator for fi360.com. He oversees all communications for fi360. His responsibilities include messaging, brand management, copyrights and trademarks, and publications. Mr. Aikin received his BA in English from Virginia Tech in 2003 and is currently an MS candidate in Journalism from Ohio University.

Q. Medical Executive Post

You have been very helpful and gracious to us. So, let’s get right to it, Ben. In the view of many; attorneys, doctors, CPAs and the clergy are fiduciaries; most all others who retain this title seem poseurs; sans documentation otherwise.

A. Mr. Aikin

You are correct. Attorneys, doctors and clergy are the prototype fiduciaries. They have a clear duty to put the best interests of their clients, patients, congregation, etc., above their own. [The duty of a CPA isn’t as clear to me, although I believe you are correct]. Furthermore, this is one of the first topics we address in our AIF training programs, and what we call the difference between a profession and an industry. The three professions you name have three common characteristics that elevate them from an industry to a profession:

Recognized body of knowledge
Society depends upon practitioners to provide trustworthy advice
Code of conduct that places the clients’ best interests first

Q. Medical Executive Post

It seems that Certified Financial Planner®, Chartered Financial Analysts, Registered Investment Advisors and their representatives, Registered Representative [stock-brokers] and AIF® holders, etc, are not really financial fiduciaries, either by legal statute or organizational charter. Are we correct, or not? Of course, we are not talking ethics or morality here. That’s for the theologians to discuss.

A. Mr. Aikin

One of the reasons for the “alphabet soup”, as you put it in one of your white papers [books, dictionaries and posts] on financial designations, is that while there is a large body of knowledge, there is no one recognized body of knowledge that one must acquire to enter the financial services industry. The different designations serve to provide a distinguisher for how much and what parts of that body of knowledge you do possess. However, being a fiduciary is exclusively a matter of function.

In other words, regardless of what designations are held, there are five things that will make one a fiduciary in a given relationship:

You are “named” in plan or trust documents; the appointment can be by “name” or by “title,” such as CFO or Head of Human Resources
You are serving as a trustee; often times this applies to directed trustees as well
Your function or role equates to a professional providing comprehensive and continuous investment advice
You have discretion to buy or sell investable assets
You are a corporate officer or director who has authority to appoint other fiduciaries

So, if you are a fiduciary according to one of these definitions, you can be held accountable for a breach in fiduciary duty, regardless of any expertise you do, or do not have. This underscores the critical nature of understanding the fiduciary standard and delegating certain duties to qualified “professionals” who can fulfill the parts of the process that a non-qualified fiduciary cannot.

Q. Medical Executive Post

How about some of the specific designations mentioned on our site, and elsewhere. I believe that you may be familiar with the well-known financial planner, Ed Morrow, who often opines that there are more than 98 of these “designations”? In fact, he is the founder of the Registered Financial Consultants [RFC] designation. And, he wrote a Foreword for one of our e-books; back-in-the-day. His son, an attorney, also wrote as a tax expert for us, as well. So, what gives?

A. Mr. Aikin

As for the specific designations you list above, and elsewhere, they each signify something different that may, or may not, lend itself to being a fiduciary: For example:

• CFP®: The act of financial planning does very much imply fiduciary responsibility. And, the recently updated CFP® rules of conduct does now include a fiduciary mandate:

• 1.4 A certificant shall at all times place the interest of the client ahead of his or her own. When the certificant provides financial planning or material elements of the financial planning process, the certificant owes to the client the duty of care of a fiduciary as defined by CFP Board. [from http://www.cfp.net/Downloads/2008Standards.pdf]

• CFA: Very dependent on what work the individual is doing. Their code of ethics does have a provision to place the interests of clients above their own and their Standards of Practice handbook makes clear that when they are working in a fiduciary capacity that they understand and abide by the legally mandated fiduciary standard.

• FA [Financial Advisor]: This is a generic term that you may find being used by a non-fiduciary, such as a broker, or a fiduciary, such as an RIA.

• RIA: Are fiduciaries. Registered Investment Advisors are registered with the SEC and have obligations under the Investment Advisers Act of 1940 to provide services that meet a fiduciary standard of care.

• RR: Registered Reps, or stock-brokers, are not fiduciaries if they are doing what they are supposed to be doing. If they give investment advice that crosses the line into “comprehensive and continuous investment advice” (see above), their function would make them a fiduciary and they would be subject to meeting a fiduciary standard in that advice (even though they may not be properly registered to give advice as an RIA).

• AIF designees: Have received training on a process that meets, and in some places exceeds, the fiduciary standard of care. We do not require an AIF® to always function as a fiduciary. For example, we allow registered reps to gain and use the AIF® designation. In many cases, AIF designees are acting as fiduciaries, and the designation is an indicator that they have the full understanding of what that really means in terms of the level of service they provide. We do expect our designees to clearly disclose whether they accept fiduciary responsibility for their services or not and advocate such disclosure for all financial service representatives.

Q. Medical Executive Post

Your website, http://www.fi360.com, seems to suggest, for example, that banks/bankers are fiduciaries. We have found this not to be the case, of course, as they work for the best interests of the bank and stockholders. What definitional understanding are we missing?

A. Mr. Aikin

Banks cannot generally be considered fiduciaries. Again, it is a matter of function. A bank may be a named trustee, in which case a fiduciary standard would generally apply. Banks that sell products are doing so according to their governing regulations and are “prudent experts” under ERISA, but not necessarily held to a fiduciary standard in any broader sense.

Q. Medical Executive Post

And so, how do we rectify the [seemingly intentional] industry obfuscation on this topic. We mean, our readers, subscribers, book and dictionary purchasers, clients and colleagues are all confused on this topic. The recent financial meltdown only stresses the importance of understanding same.

For example, everyone in the industry seems to say they are the “f” word. But, our outreach efforts to contact traditional “financial services” industry pundits, CFP® practitioners and other certification organizations are continually met with resounding silence; or worse yet; they offer an abundance of parsed words and obfuscation but no confirming paperwork, or deep subject-matter knowledge as you have kindly done. We get the impression that some FAs honesty do-not have a clue; while others are intentionally vague.

A. Mr. Aikin

All of the evidence you cite is correct. But that does not mean it is impossible to find an investment advisor who will manage to a fiduciary standard of care and acknowledge the same. The best way to rectify confusion as it pertains to choosing appropriate investment professionals is to get fiduciary status acknowledged in writing and go over with them all of the necessary steps in a fiduciary process to ensure they are being fulfilled. There also are great resources out there for understanding the fiduciary process and for choosing professionals, such as the Department of Labor, the SEC, FINRA, the AICPA’s Personal Financial Planning division, the Financial Planning Association, and, of course, Fiduciary360.

We realize the confusion this must cause to those coming from the health care arena, where MD/DO clearly defines the individual in question; as do other degrees [optometrist, clinical psychologist, podiatrist, etc] and medical designations [fellow, board certification, etc.]. But, unfortunately, it is the state of the financial services industry as it stands now.

Q. Medical Executive Post

It is as confusing for the medical community, as it is for the lay community. And, after some research, we believe retail financial services industry participants are also confused. So, what is the bottom line?

A. Mr. Aikin

The bottom line is that lay, physician and all clients have a right to expect and demand a fiduciary standard of care in the managing of investments. And, there are qualified professionals out there who are providing those services. Again, the best way to ensure you are getting it is to have fiduciary status acknowledged in writing, and go over the necessary steps in a fiduciary process with them to ensure it is being fulfilled.

Q. Medical Executive Post

The “parole-evidence” rule, of contract law, applies, right? In dealing with medical liability situations, the medics and malpractice attorneys have a rule: “if it wasn’t written down, it didn’t happen.”

A. Mr. Aikin

An engagement contract accepting fiduciary status should trump a subsequent attempt to claim the fiduciary standard didn’t apply. But, to reiterate an earlier point, if someone acts in one of the five functional fiduciary roles, they are a fiduciary whether they choose to acknowledge it or not. I have attached a sample acknowledgement of fiduciary status letter with copies of our handbook, which details the fiduciary process we instruct in our programs, and our SAFE, which is basically a checklist that a fiduciary should be able to answer “Yes” to every question to ensure the entire fiduciary process is being covered.

Q. Medical Executive Post

It is curious that you mention checklists. We have a post arguing that very theme for doctors and hospitals as they pursue their medial error reduction, and quality improvement, endeavors. And, we applaud your integrity, and wish only for clarification on this simple fiduciary query?

A. Mr. Aikin

Simple definition: A fiduciary is someone who is managing the assets of another person and stands in a special relationship of trust, confidence, and/or legal responsibility.

Q. Medical Executive Post

Who is a financial fiduciary and what, if any, financial designation indicates same?

A. Mr. Aikin

Functional definition: See above for the five items that make you a fiduciary.

Financial designations that unequivocally indicate fiduciary duty: Short answer is none, only function can determine who is a fiduciary.

Q. Medical Executive Post

Please repeat that?

A. Mr. Aikin

Financial designations that indicate fiduciary duty: none. It is the function that determines who is a fiduciary. Now, having said that, the CFP® certification comes close by demanding their certificants who are engaged in financial planning do so to a fiduciary standard. Similarly, other designations may certify the holder’s ability to perform a role that would be held to a fiduciary standard of care. The point is that you are owed a fiduciary standard of care when you engage a professional to fill that role or they functionally become one. And, if you engage a professional to fill a non-fiduciary role, they will not be held to a fiduciary standard simply because they have a particular designation. One of the purposes the designations serve is to inform you what roles the designation holder is capable of fulfilling.

It is also worth keeping in mind that just being a fiduciary doesn’t equate to a full knowledge of the fiduciary standard. The AIF® designation indicates having been fully trained on the standard.

Q. Medical Executive Post

Yes, your website mentions something about fiduciaries that are not aware of same! How can this be? Since our business model mimics a medical model, isn’t that like saying “the doctor doesn’t know he is doctor?” Very specious, with all due respect!

A. Mr. Aikin

I think it is first important to note that this statement is referring not just to investment professionals. Part of the audience fi360 serves is investment stewards, the non-professionals who, due to facts and circumstances, still owe a fiduciary duty to another. Examples of this include investment committee members, trustees to a foundation, small business owners who start 401k plans, etc. This is a group of non-sophisticated investors who may not be aware of the full array of responsibilities they have.

However, even on the professional side I believe the statement isn’t as absurd as it sounds. This is basically a protection from both ignorant and unscrupulous professionals. Imagine a registered representative who, either through ignorance or design, begins offering comprehensive and continuous investment advice. Though they may deny or be unaware of the fact, they have opened themselves up to fiduciary liability.

Q. Medical Executive Post

Please clarify the use of arbitration clauses in brokerage account contracts for us. Do these disclaim fiduciary responsibility? If so, does the client even know same?

A. Mr. Aikin

By definition, an engagement with a broker is a non-fiduciary relationship. So, unless other services beyond the scope of a typical brokerage account contract are specified, fiduciary responsibility is inherently not applicable. Unfortunately, I do imagine there are clients who don’t understand this. Furthermore, AIF® designees are not prohibited from signing such an agreement and there are some important points to understand the reasoning.

First, by definition, if you are entering into such an agreement, you are entering into a non-fiduciary relationship. So, any fiduciary requirement wouldn’t apply in this scenario.

Second, if this same question were applied into a scenario of a fiduciary relationship, such as with an RIA, this would be a method of dispute resolution, not a practice method. So, in the event of dispute, the advisor and investor would be free to agree to the method of resolution of their choosing. In this scenario, however, typically the method would not be discussed until the dispute itself arose.

Finally, it is important to know that AIF/AIFA designees are not required to be a fiduciary. It is symbolic of the individuals training, knowledge and ongoing development in fiduciary processes, but does not mean they will always be acting as a fiduciary.

Q. Medical Executive Post

Don’t the vast majority of arbitration hearings find in favor of the FA; as the arbitrators are insiders, often paid by the very same industry itself?

A. Mr. Aikin

Actual percentages are reported here: http://www.finra.org/ArbitrationMediation/AboutFINRADR/Statistics/index.htm However, brokerage arbitration agreements are a dispute resolution method for disputes that arise within the context of the securities brokerage industry and are not the only means of resolving differences for all types of financial advisors. Investment advisers, for example, are subject to respond to disputes in a variety of forums including state and federal courts. Clients should look at their brokerage or advisory agreement to see what they have agreed to. If you wanted to go into further depth on this question, we would recommend contacting Brian Hamburger, who is a lawyer with experience in this area and an AIFA designee. Bio page: http://www.hamburgerlaw.com/attorneys/BSH.htm.

Q. Medical Executive Post

What about our related Certified Medical Planner® designation, and online educational program for financial advisors and medical management consultants? Is it a good idea – reasonable – for the sponsor to demand fiduciary accountability of these charter-holders? Cleary, this would not only be a strategic competitive advantage, but advance the CMP™ mission to put medical colleagues first and champion their cause www.CertifiedMedicalPlanner.org above all else.

A. Mr. Aikin

I think it is a good idea for any plan sponsor to demand fiduciary status be acknowledged from anyone engaged to provide comprehensive and continuous investment advice. I also think it is a good idea to be proactive in verifying that the fiduciary process is being followed.

Q. Medical Executive Post

Is there anything else that we should know about this topic?

A. Mr. Aikin

Yes, a further note about fi360’s standards. I wrote generically about the fiduciary standard, because there is one that is defined by multiple sources of regulation, legislation and case law. The process defined in our handbooks, we call a Fiduciary Standard of Excellence, because it covers that minimum standard and also best practice standards that go above and beyond. All of our Practices, which comprise that standard, are legally substantiated in our Legal Memoranda handbook, which was written by Fred Reish’s law firm, who is considered a leading ERISA attorney.

Additional resources:

Q. Medical Executive Post

Thank you so much for your knowledge and willingness to frankly share it with the Medical-Executive-Post.

Assessment

All are invited to continue the conversation with Mr. Aikin, asynchronously online, or thru this contact information:

fi360.com
438 Division Street
Sewickley, PA 15143
412-741-8140 Phone
866-390-5080 Toll-free phone
412-741-8142 Fax

Conclusion

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PRACTICES: www.BusinessofMedicalPractice.com
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CLINICS: http://www.crcpress.com/product/isbn/9781439879900
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Filed under: "Advisors Only", "Doctors Only", Book Reviews, Career Development, Ethics, Financial Planning, Insurance Matters, Interviews, Investing, Media Mentions and PR, Monthly Reports, Op-Editorials, Portfolio Management, Professional Liability, Quality Initiatives, Research & Development, Sponsors | Tagged: AIF, ann miller, bennett aikin, Bob Veres, certified medical planner, CFA, CFP, CMP, CPA, david marcinko, Fi360, fiduciary, financial fiduciary, Fred Reish, hope hetico, iMBA, Inc., insurance agents, RR | 20 Comments »

List of Healthcare IT Trade Associations

Posted on May 6, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

Advancing Medical Practice Success with Strategic Relationships

By Staff Reporters

To be efficient in healthcare delivery today, doctors must partner and understand the resources and affiliations that are available to them. Here is a brief list of several healthcare trade associations and leading industry vendors submitted for your review.

AHIMA
The American Health Information Management Association (AHIMA) is the premier association of health information management professionals. AHIMA’s 51,000 members are dedicated to the effective management of personal health information needed to deliver quality healthcare to the public. Founded in 1928 to improve the quality of medical records, AHIMA is committed to advancing the health information management profession in an increasingly electronic and global environment through leadership in advocacy, education, certification, and lifelong learning.

EHRA
HIMSS EHRA is a trade association of Electronic Health Record (EHR) vendors that addresses national efforts to create interoperable EHRs in hospital and ambulatory care settings. HIMSS EHRA operates on the premise that the rapid, widespread adoption of EHRs will help improve the quality of patient care and the productivity of the healthcare system. The primary mission of the association is to provide a forum for the EHR vendor community relative to standards development, the EHR certification process, interoperability, performance and quality measures, and other EHR issues that may become the subject of increasing government, insurance and physician association initiatives and requests.

HIMSS
HIMSS (Healthcare Information and Management Systems Society) is the healthcare industry’s membership organization exclusively focused on providing leadership for the optimal use of healthcare information technology and management systems for the betterment of human health. Founded in 1961 with offices in Chicago, Washington D.C., and other locations across the country, HIMSS represents approximately 17,000 individual members and some 275 member corporations that employ more than 1 million people. HIMSS frames and leads healthcare public policy and industry practices through its advocacy, educational and professional development initiatives designed to promote information and management systems’ contributions to ensuring quality patient care.

HITSP
The Healthcare Information Technology Standards Panel serves as a cooperative partnership between the public and private sectors for achieving a widely accepted and useful set of standards specifically to enable and support widespread interoperability among healthcare software applications, as they will interact in a local, regional, and national health information network for the United States. Comprised of a wide range of stakeholders, the Panel will assist in the development of the U.S. Nationwide Health Information Network (NHIN) by addressing issues such as privacy and security within a shared healthcare information system. The Panel is sponsored by the American National Standards Institute (ANSI) in cooperation with strategic partners such as the Healthcare Information and Management Systems Society (HIMSS), the Advanced Technology Institute (ATI), and Booz Allen Hamilton. Funding for the Panel is being provided via the ONCHIT contract award from the U.S. Department of Health and Human Services.

HL7
Health Level Seven is an American National Standards Institute (ANSI)-accredited Standards Developing Organization (SDO) operating in the healthcare clinical and administrative data arena. It is a not-for-profit volunteer organization made up of providers, vendors, payers, consultants, government groups, and others who develop clinical and administrative data standards for healthcare. Health Level Seven develops specifications; the most widely used being a messaging standard that enables disparate healthcare applications to exchange keys sets of clinical and administrative data.

MSHUG
Microsoft Healthcare Users Group (MS-HUG) unified with the Healthcare Information and Management Systems Society (HIMSS) as part of the HIMSS Users Group Alliance Program in October 2003. The unification strengthens the commitment of HIMSS and MS-HUG to better serve their members and the industry through a shared strategic vision to provide leadership and healthcare information technology solutions that improve the delivery of patient care.

WEDI
The Workgroup for Electronic Data Interchange [WEDI’s] goal is to improve the quality of healthcare through effective and efficient information exchange and management. They aim to provide leadership and guidance to the healthcare industry on how to use and leverage the industry’s collective knowledge, expertise, and information resources to improve the quality, affordability, and availability of healthcare.

Assessment

As the health information technology industry evolves, we will continue to contribute our expertise to foster ideas that shape the future of healthcare by offering more examples similar to the above.

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Who did we miss? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Book Reviews, Glossary Terms, Information Technology | Tagged: Advanced Technology Institute, AHIMA, American Health Information Management Association, American National Standards Institute, ANSI, ARRA, ATI, Booz Allen Hamilton, CCHIT, david marcinko, DHHS, EHRA, EHRs, EMRs, health information technology, Health Level Seven, Healthcare Information and Management Systems Society, Healthcare Information Technology Standards Panel, HHS, HIMSS, HITECH, HITSP, HL7, IT, Microsoft Healthcare Users Group, MSHUG, Nationwide Health Information Network, NHIN, obama, ONCHIT, SDO, Standards Developing Organization, WEDI, Workgroup for Electronic Data Interchange, www.healthdictionaryseries.com | 4 Comments »

CELEBRATE: National Public Health Week 2022

Posted on April 8, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA

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National Public Health Week is observed during the first week of April every year. That’s seven days to champion the health of all Americans. It’s a week to recognize that everyone should lead healthier lives, irrespective of where they live, work, or come from. Since its founding in 1955, the initiative has become an important movement to highlight issues that can improve the health and happiness of a nation. You could choose to crush a workout or any workout challenge today. It’s a great week to start eating healthy and stick to it. Whatever you do, remember to involve your friends, family, and the larger community. It’s also a week when we campaign for health policies that are fair, inclusive, and accessible to all communities in the United States.

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

HISTORY

The first National Public Health Week took place in April 1955 and was organized by the American Public Health Association (A.P.H.A.). Since then, the initiative has received tremendous support from civil societies and administrations across the United States. The day recognizes the long history and achievements in public health. It also serves to highlight critical issues to help people lead healthier and happier lives.

In attempting to reach these goals, National Public Health Week seeks to address the root causes of poor health, disease, and lifestyles. It starts with recognizing that healthcare is still a privilege many cannot afford. Where people are born, their neighborhoods, places of work, different lives, and backgrounds determine the quality of healthcare access.

For example, a child who goes to school hungry will not be an engaged student. People working for minimum wages sacrifice health for the sake of an income. It’s thousands of families who have no access to nutritious food in their communities. Or those without the means to travel to access quality healthcare, often located far away.

National Public Health Week is committed to making health inclusive and equitable. It hopes to foster decision-making that considers the health of all communities — irrespective of income, race, or gender. Each year, the first full week in April celebrates the power of the community in realizing this vision. The A.P.H.A. usually announces different themes for each day of the week. From fitness challenges and discussions to sharing healthy recipes — it’s seven days of committing to health as a country.

So, no matter where you are, APHA invites you to join us as we celebrate National Public Health Week! This year’s theme, Public Health Is Where You Are, celebrates what we know is true: The places where we are, physically, mentally and societally, affect our health and our lives.

Celebrate and promote health in your community by hosting your own NPHW event!

***

…
Here are a few ideas:

Host virtual health panels and discussions. …
Team up to reach new audiences and build community. …
Take advantage of Student Day. …
Organize around the daily themes. …
Make advocacy easy. …
Find movement opportunities.

***

COMMENTS APPRECIATED

Thank You

Subscribe to the Medical Executive-Post

***

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Filed under: Ethics, Events-Planner, Glossary Terms, Health Insurance, Media Mentions and PR, Touring with Marcinko | Tagged: American Public Health Association, APHA, david marcinko, National Public Health Week, NPHW, public health, public health week | 1 Comment »

Why 75+ Years of American Finance Should Matter to Physician Investors

Posted on April 7, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

A Graphic Presentation [1861-1935] with Commentary from the Publisher

By Dr. David Edward Marcinko FACFAS MBA CPHQ CMP™

http://www.CertifiedMedicalPlanner.org

As our private iMBA Inc clients, ME-P subscribers, textbook and dictionary purchasers, seminar attendees and most ME-P readers know, Ken Arrow is my favorite economist. Why?

About Kenneth J. Arrow, PhD

Well, in 1972, Nobel Laureate Kenneth J. Arrow, PhD shocked Academe’ by identifying health economics as a separate and distinct field. Yet, the seemingly disparate insurance, asset allocation, econometric, statistical and portfolio management principles that he studied have been transparent to most financial professionals and wealth management advisors for years; at least until now.

Nevertheless, to informed cognoscenti, they served as predecessors to the modern healthcare advisory era. In 2004, Arrow was selected as one of eight recipients of the National Medal of Science for his innovative views. And, we envisioned the ME-P at that time to present these increasingly integrated topics to our audience.

Healthcare Economics Today

Today – as 2022 passes – savvy medical professionals, management consultants and financial advisors are realizing that the healthcare industrial complex is in flux; along with the Russian war, domestic inflation and this dynamic may be reflected in the overall flagging economy.

Like many laymen seeking employment, for example, physicians are frantically searching for new ways to improve office revenues and grow personal assets, because of the economic dislocation that is Managed Care, Medi Care and Obama Care [ACA], the depressed business cycle, etc.

Moreover, the largest transfer of wealth in US history is – or was – taking place as our lay elders and mature doctors sell their practices or inherit parents’ estates. Increasingly, the artificial academic boundary between the traditional domestic economy, financial planning and contemporaneous medical practice management is blurring.

I’m Not a Cassandra

Yet, I am no gloom and doom Cassandra like I have been accused, of late. I am not cut from the same cloth as a Jason Zweig, Jeremy Grantham or Nouriel Roubini PhD, for example.

However, I do subscribe to the philosophy of Hope for the Best – Plan for the Worst.

And so dear colleagues, I ask you, “Are the latest swings in the economic, healthcare and financial headlines making you wonder when it will ever stop?”

The short answer is: “It will never stop” because what’s been happening isn’t any “new normal”; it’s just the old normal playing out before a new audience; sans the war.

What audience?

The next-generation of investors, FAs, management consultants and the medical professionals of Health 2.0.

How do I know all this?

History tells me so! Just read this work, and opine otherwise, or reach a different conclusion.

Evidence from the American Financial Scene, circa 1861-1935

The work was created by L. Merle Hostetler in 1936, while he was at Cleveland College of Western Reserve University (now known as Case Western Reserve University). I learned of him while in B-School, back in the day.

At some point after it was printed, he added the years 1936-1938. Mr. Hostetler became a Financial Economist at the Federal Reserve Bank of Cleveland in 1943. In 1953 he was made Director of Research. He resigned from the Bank in 1962 to work for Union Commerce Bank in Cleveland. He died in 1990.

The volume appears to be self published and consists of a chart, approximately 85′ long, fan-folded into 40 pages with additional years attached to the last page. It also includes a “topical index” to the chart and some questions of technical interest which can be answered by the chart.

Link: http://fraser.stlouisfed.org/75years

Assessment

And so, as with Sir John Templeton’s [whose son is an MD] four most dangerous words in investing (It’s different this time), Hostetler effectively illustrates that it wasn’t so different in his era, and maybe—just maybe—it isn’t so different today for all these conjoined fields.

Conclusion

Your thoughts and comments on this ME-P are appreciated. While not exactly a “sacred cow,” there is a current theory that investors will experience higher volatility and lower global returns for the foreseeable future.

In fact, it has gained widespread acceptance, from the above noted Cassandra’s and others, as problems in Europe persist and threats of a double-dip recession loom. But, how true is this notion; really?

Is Hostetler correct, or not; and why?

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.

Our Other Print Books and Related Information Sources:

DOCTORS:

“Insurance & Risk Management Strategies for Doctors” https://tinyurl.com/ydx9kd93

“Fiduciary Financial Planning for Physicians” https://tinyurl.com/y7f5pnox

“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8

HOSPITALS:

“Financial Management Strategies for Hospitals” https://tinyurl.com/yagu567d

“Operational Strategies for Clinics and Hospitals” https://tinyurl.com/y9avbrq5

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

Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed. Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Health Economics, iMBA, Inc., Investing, Op-Editorials, Portfolio Management | Tagged: ACA, CMP, david marcinko, double-dip recession, Jason Zweig, Jeremy Grantham, Ken Arrow, L. Merle Hostetler, National Medal of Science, Nouriel Roubini PhD, physician investors, Sir John Templeton’s, Why 75 Years of American Finance Matters, www.BusinessofMedicalPractice.com, www.certifiedmedicalplanner.com, www.healthcarefinancials.com, www.medicalbusinessadvisors.com | 12 Comments »

What is an “Inverse” ETF?

Posted on March 26, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

WHAT IT IS – HOW IT WORKS

Traditional ETFs: https://medicalexecutivepost.com/2008/01/07/exchange-traded-funds-etfs/

Tax and ETFs: https://medicalexecutivepost.com/2008/01/11/etfs-and-tax-efficiency/

INVERSE DEFINITION:

An inverse exchange-traded fund is an exchange-traded fund, traded on a public stock market, which is designed to perform as the inverse of whatever index or benchmark it is designed to track. These funds work by using short selling, trading derivatives such as futures contracts, and other leveraged investment techniques.

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

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READ: https://smartasset.com/investing/inverse-etf

ASSESSMENT: Your comments and thoughts are appreciated.

THANK YOU

****

Filed under: "Ask-an-Advisor", Investing | Tagged: david marcinko, ETFs, inverse ETF, leveraged ETF | Leave a comment »

Understanding Municipal Bond Underwriting

Posted on March 24, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

A Primer for Physician Investors

By Dr. David Edward Marcinko MBA CMP™

[Publisher-in-Chief]

While the underwriting procedures for corporate bonds are almost identical to corporate stock, there are significant differences in the underwriting of municipal securities. Municipal securities – hospitals for example – are exempt from the registration filing requirements or the Securities Act of 1933. A state or local government, in the issuance of municipal securities, is not required to register the offering with the SEC, so there is no filing of a registration statement and there is no prospectus which would otherwise have to be given to investors.

Municipal Underwriting

There are two main methods of financing when it comes to municipal securities. One method is known as negotiated. In the case of a negotiated sale, the municipality looking to borrow money would approach an investment bank and negotiate the terms of the offering directly with the firm. This is really not very different from the equity process.

Competitive Bidding

The other type of municipal underwriting is known as competitive bidding. Under the terms of competitive bidding, an issuer announces that it wishes to borrow money and is looking for syndicates to submit competitive bids. The issue will then be sold to the syndicate which submits the best bid, resulting in the municipality having the lowest net interest cost (lowest expense to the issuer).

If the issue is to be done by a competitive bid, the municipality will use a Notice of Sale to announce that fact. The notice of sale will generally include most or all of the following information.

Date, time, and place. This does not mean when the bonds will be sold to the public, but when the issue will be awarded (sold) to the syndicate issuing the bid.
Description of the issue and the manner in which the bid is to be made (sealed bid or oral).
Type of bond (general obligation, revenue, etc.)
Semi-annual interest payment dates and the denominations in which the bonds will be printed.
Amount of good faith deposit required, if any.
Name of the law firm providing the legal opinion and where to acquire a bid form.
The basis upon which the bid will be awarded, generally the lowest net interest cost.

The Bond Attorney

Since municipal securities are not registered with the SEC, the municipality must hire a law firm in order to make sure that they are issuing the securities in compliance with all state, local and federal laws. This is known as the bond attorney, or independent bond counsel. Some functions are included below:

Establishes the exemption from federal income tax by verifying requirements for the exemption.
Determines proper authority for the bond issuance.
Identifies and monitors proper issuance procedures.
Examines the physical bond certificates to make sure that they are proper
Issues the debt and a legal opinion, since municipal bonds are the only securities that require an opinion.
Does not prepare the official statement.

When medical or other investors purchase new issue municipal securities from syndicate or selling group members, there is no prospectus to be delivered to investors, but there is a document which is provided to purchasers very similar in nature to a prospectus. It is known as an Official Statement. The Official Statement contains all of the information an investor needs to make a prudent decision regarding a proposed municipal bond purchase.

Underwriting Syndicate

The formation of a municipal underwriting syndicate is very similar to that for a corporate issue. When there is a negotiated underwriting, an Agreement Among Underwriters (AAU) is used. When the issue is competitive bid, the agreement is known as a Syndicate Letter. In the syndicate letter, the managing underwriter details all of the underwriting agreements among members of the syndicate. Eastern (undivided) and Western (divided) accounts are also used, but there are several different types of orders in a municipal underwriting.

Order Types

The traditional types of orders, in priority order, are:

Pre-Sale Order: Made before the syndicate actually offers the bonds. They have first priority over any other order turned in.
Syndicate (group net) Order: Made once the offering is under way at the public offering price. The purchase is credited to each syndicate member in proportion to its allotment. An institutional buyer will frequently purchase” group net”, since many of the firms in the syndicate may consider this buyer to be their client and he wishes to please all of them.
Designated Order: Sales to medical investors (usually healthcare institutions) at the public offering price where the investor designates which member or members of the syndicate are to be given credit.
Member Orders: Purchased by members of the syndicate at the take-down price (spread). The syndicate member keeps the full take-down if the bonds are sold to investors, or earns the take-down less the concession if the sale is made to a member of the selling group. Should the offering be over-subscribed, and the demand for the new bonds exceeds the supply, the first orders to be filled are the pre-sale orders. Those are followed by the syndicate (sometimes called group net) orders, the designated orders, and the last orders filled are the member’s.

Assessment

Finally, be aware that the term bond scale is a listing of coupon rates, maturity dates, and yield or price at which the syndicate is re-offering the bonds to the public. The scale is usually found in the center of a tombstone ad and on the front cover of the official statement. One of the reasons why the word “scale” is used – is that like the scale on a piano – it normally goes up. A regular or positive scale is one in which the yield to maturity is lowest on the near term maturities and highest on the long term maturities. This is also known as a positive yield curve, since the longer the maturity, the higher the yield. In times of very tight money, such as in 1980-81, one might find a bond offering with a negative scale. A negative (sometimes called inverted) scale is just the opposite of a positive one, with, yields on the short term maturities are higher than those on the long term maturities.

http://www.amazon.com/Financial-Planning-Handbook-Physicians-Advisors/dp/0763745790/ref=sr_1_1?ie=UTF8&s=books&qid=1276795609&sr=1-1

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

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Filed under: Investing | Tagged: Agreement Among Underwriters, bond attorney, competitive bond bidding, david marcinko, Municipal Bond Underwriting, municipal bonds, negotiated bond bidding, syndicate letter | 1 Comment »

Financial Management Strategies for Hospitals and Healthcare Organizations

Posted on January 11, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

Click to access foreword-nash1.pdf

SPONSOR: http://www.CertifiedMedicalPlanner.org

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

SECOND OPINIONS: https://medicalexecutivepost.com/schedule-a-consultation/

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

THANK YOU

***

Filed under: "Doctors Only", Accounting, Book Reviews, Career Development, CMP Program, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc., Managed Care, Practice Management, Recommended Books, Sponsors, Touring with Marcinko | Tagged: Certified Medical Planner™, CMP™ Course, david marcinko, Dr. David Edward Marcinko MBA CMP™, Financial Management Healthcare, Financial Management Hospitals | 1 Comment »

The “BUSINESS” of Transformational Medical Practice Skills

Posted on August 30, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

[3rd] THIRD EDITION

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

THANK YOU

Click to access foreword-hashem-md-phd.pdf

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Click to access foreword-silva.pdf

Filed under: "Advisors Only", "Doctors Only", Accounting, Book Reviews, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc., Information Technology, Managed Care, Marketing & Advertising, Practice Management, Practice Worth, Taxation, Touring with Marcinko | Tagged: Business of Medical Practice, david marcinko, Practice Management, Practice Worth | Leave a comment »

The BUSINESS of Medical Practice

Posted on August 24, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

BY DR. David Edward Marcinko MBA

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INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-

Second Opinions: https://medicalexecutivepost.com/schedule-a-consultation/

THANK YOU!

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Filed under: "Advisors Only", "Doctors Only", Book Reviews, Career Development, Funding Basics, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Insurance Matters, Practice Management, Practice Worth, Professional Liability, Touring with Marcinko | Tagged: Business of Medical Practice, david marcinko, healthcare business | Leave a comment »

Management Strategies, Operational Techniques, Tools, Templates and Case Studies

Posted on August 16, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

FOR HOSPITALS AND HEALTHCARE ORGANIZATIONS

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BY DR. DAVID E. MARCINKO MBA

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

THANK YOU

***

Filed under: Book Reviews, Health Economics, Health Insurance, Managed Care, Practice Management, Professional Liability, Quality Initiatives, Recommended Books, Risk Management | Tagged: david marcinko, hospitals, Hospitals and Healthcare Organizations | Leave a comment »

National “Financial Awareness Day” 2021

Posted on August 14, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

MAKE IT EVERYDAY FOR PHYSICIANS AND MEDICAL COLLEAGUES

By Dr. David Edward Marcinko MBA CMP®

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Use National Financial Awareness Day to your Advantage

Aug. 14th is National Financial Awareness Day. Financial awareness is about more than just understanding the basics on how money works. It’s also about evaluating your own budget, savings and investments to make sure your finances are working for your needs.

HERE: https://nationaltoday.com/national-financial-awareness-day/

So if it’s been a while since your last financial “check up,” National Financial Awareness Day can be the extra push you’ve needed to finally take a look under the hood.

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INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-

Second Opinions: https://medicalexecutivepost.com/schedule-a-consultation/

THANK YOU!

***

Filed under: "Doctors Only", Financial Planning, iMBA, Inc., Investing, Touring with Marcinko | Tagged: david marcinko, financial awareness, financial literacy, Financial Planning, financial planning for doctors, National Financial Awareness Day | Leave a comment »

DICTIONARY: Health Information Technology and Security

Posted on August 11, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

Review

This is a handy, word-packed reference book with health information technology terminology of the past, present, and future. The paperback book is small and compact in size but amazingly full of words, abbreviations, and even names of leaders in the health information technology industry. While any book like this will require updating on a periodic basis, many of the terms will remain relevant for a good period of time. I found the dictionary very useful and recommend it as a good addition to the reference shelf in the office or library.

—Doody’s Book Review

From the Back Cover

Over 10,000 Detailed Entries!

“”There is a myth that all stakeholders in the healthcare space understand the meaning of basic information technology jargon. In truth, the vernacular of contemporary medical information systems is unique, and often misused or misunderstood? Moreover, an emerging national Heath Information Technology (HIT) architecture; in the guise of terms, definitions, acronyms, abbreviations and standards; often puts the non-expert medical, nursing, public policy administrator or paraprofessional in a position of maximum uncertainty and minimum productivity ?The Dictionary of Health Information Technology and Security will therefore help define, clarify and explain…You will refer to it daily.””

–– Richard J. Mata, MD, MS, MS-CIS, Certified Medical Planner? (Hon), Chief Medical Information Officer [CMIO], Ricktelmed Information Systems, Assistant Professor Texas State University, San Marcos

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Filed under: Book Reviews, Glossary Terms, Information Technology, Touring with Marcinko | Tagged: david marcinko, Dictionary of Health Information Technology and Security, health information technolgy, HIT, IT | 1 Comment »

Financial Management Strategies for Hospitals and Healthcare Organizations

Posted on July 21, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

TEXTBOOK RELEASE AND REVIEW

Reviews

Navigating a course where sound organizational management is intertwined with financial acumen requires a strategy designed by subject-matter experts. Fortunately, Financial Management Strategies for Hospital and Healthcare Organizations: Tools, Techniques, Checklists and Case Studiesprovides that blueprint.
―David B. Nash, MD, MBA,Jefferson Medical College, Thomas Jefferson University

It is fitting that Dr. David Edward Marcinko, MBA, CMP™ and his fellow experts have laid out a plan of action in Financial Management Strategies for Hospital and Healthcare Organizationsthat physicians, nurse-executives, administrators, institutional CEOs, CFOs, MBAs, lawyers, and healthcare accountants can follow to help move healthcare financial fitness forward in these uncharted waters.
―Neil H. Baum, MD, Tulane Medical School

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SECOND OPINIONS: https://medicalexecutivepost.com/schedule-a-consultation/

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

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Filed under: Accounting, Book Reviews, Glossary Terms, Health Economics, Health Insurance, Healthcare Finance, Practice Management, Taxation, Touring with Marcinko | Tagged: david marcinko, Financial Management Strategies for Hospitals, hospital finance, hospital finance strategies, hospital financial management | Leave a comment »

AGI: What it is – How it Works?

Posted on July 21, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

ADJUSTED GROSS INCOME

https://medicalexecutivepost.com/wp-content/uploads/2018/06/david-edward-marcinko.png

BY Dr. DAVID EDWARD MARCINKO MBA CMP®

SPONSOR: http://www.CertifiedMedicalPlanner.org

The U.S. individual tax return is based around the concepts of Adjusted Gross Income (AGI) and Taxable Income (TI). AGI is the amount that shows up at the bottom of page one of Form 1040, individual income tax return. It is the sum of all of the taxpayer’s income less certain allowed adjustments (like alimony, one-half of self-employment taxes, a percentage of self-employed health insurance, retirement plan contributions and IRAs, moving expenses, early withdrawal penalties and interest on student loans). This amount is important because it is used to calculate various limitations within the area of itemized deductions (e.g., medical deductions: 10 percent of AGI; miscellaneous itemized deductions: 2 percent of AGI).

When a healthcare professional taxpayer hears the phrase “an above the line deduction”, the line being referenced is the AGI line on the tax return. Generally, it is better for a deduction to be an above the line deduction, because that number helps a taxpayer in two ways. First, it reduces AGI, and second, since it reduces AGI, it is also reducing the amounts of limitations placed on other deductions as noted above.

Obviously, if there is an above the line there is also a “below the line” deduction. These below the line deductions are itemized deductions (or the standard deduction if itemizing is not used) plus any personal exemptions allowed. AGI less these deductions provides the taxable income on which income tax is actually calculated. All of that being said, it is better for a deduction to be an above the line deduction. Although this is a bit dry, it helps to understand the concepts in order to know where items provide the most benefit to the medical professional taxpayer.

PERSONAL TAXATION CALCULATIONS

Gross Income (all income, from whatever source derived, including illegal activities, cash, indirect for the benefit of, debt forgiveness, barter, dividends, interest, rents, royalties, annuities, trusts, and alimony payments-no more)

Less non-taxable exclusions (municipal bonds, scholarships, inheritance, insurance

proceeds, social security and unemployment income [full or

partial exclusion], etc.).

Total Income

Less Deductions for AGI (alimony, IRA contributions, capital gains, 1/2 SE tax,

moving, personal, business and investment expenses, and

penalties, etc.).

Adjusted Gross Income (bottom Form 1040)

Less Itemized Deductions from AGI, (medical, charitable giving, casualty,

involuntary conversions, theft, job and miscellaneous expenses, etc.), or

Less Standard Deduction (based on filing status)

Less Personal Exemptions (per dependents, subject to phase outs)

Taxable Income

Calculate Regular Tax

Plus Additional Taxes (AMT, etc.)

Minus Credits (child care, foreign tax credit, earned income housing, etc.)

Plus Other Taxes

Total Tax Due

YOUR THOUGHTS ARE APPRECIATED.

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

Thank You

***

Filed under: "Ask-an-Advisor", Accounting, CMP Program, Experts Invited, iMBA, Inc., Taxation, Touring with Marcinko | Tagged: adjusted gross income, AGI, Certified Medical Planner™, CMP, david marcinko | Leave a comment »

FINANCIAL PLANNING: Strategies for Physicians and their Advisors

Posted on July 18, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

A Textbook Review

SECOND OPINIONS: https://medicalexecutivepost.com/schedule-a-consultation/

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SPONSOR: http://www.CertifiedMedicalPlanner.org

THANK YOU

***

Filed under: Book Reviews, CMP Program, Financial Advisor Listings, Financial Planning, Insurance Matters, Investing, Managed Care, Portfolio Management, Recommended Books, Research & Development, Risk Management, Touring with Marcinko | Tagged: Certified Medical Planner™, CMP, david marcinko, Financial Planning, Investing, investing portfolio management, stocks and bonds | Leave a comment »

PODCAST: High Deductible Health Plans

Posted on July 16, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

HSA Update 2021

By Michael Thompson

High-deductible health plans have been popular, but it’s becoming clear they are not right for all employees, said Michael Thompson, president and chief executive officer of the National Alliance of Healthcare Purchaser Coalitions.

PODCAST: https://www.healthsharetv.com/content/michael-thompson-use-high-deductible-health-plans

Your thoughts are appreciated.

THANK YOU

INVITATIONS: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

CONTACT: Ann Miller RN MHA

MarcinkoAdvisors@msn.com

Ph: 770-448-0769

Second Opinions: https://medicalexecutivepost.com/schedule-a-consultation/

***

Filed under: Experts Invited, Financial Planning, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Touring with Marcinko, Videos | Tagged: By Michael Thompson, david marcinko, health savings account, high deductible health care plans, HSA, HSAs | 2 Comments »

Are Today’s Doctors Desperate?

Posted on July 14, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

Emotions Rise with Healthcare Reform

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

NOTE: I penned this essay more than a decade ago.

Managed care is a prospective payment method where medical care is delivered regardless of the quantity or frequency of service, for a fixed payment, in the aggregate. It is not traditional fee-for-service medicine or the individual personal care of the past, but is essentially utilitarian in nature and collective in intent. Will new-age healthcare reform be even more draconian?

Unhappy Physicians

There are many reasons why doctors are professionally and financially unhappy, some might even say desperate, because of managed care; not to mention the specter of healthcare reform from the Obama administration. For example:

A staggering medical student loan debt burden of $100,000-250,000 is not unusual for new practitioners. The federal Health Education Assistance Loan (HEAL) program reported that for the Year 2000, it squeezed significant repayment settlements from its Top 5 list of deadbeat doctor debtors. This included a $303,000 settlement from a New York dentist, $186,000 from a Florida osteopath, $158,000 from a New Jersey podiatrist, $128,000 from a Virginia podiatrist, and $120,000 from a Virginia dentist. The agency also excluded 303 practitioners from Medicare, Medicaid, and other federal healthcare programs and had their cases referred for nonpayment of debt.
Because of the flagging economy, medical school applications nationwide have risen. “Previously, there were a lot of different opportunities out there for young bright people”; according to Rachel Pentin-Maki; RN, MHA”; not so today. In fact, Physicians Practice Digest recently stated, “Medicine is fast becoming a job in which you work like a slave, eke out a middle class existence, and have patients, malpractice insurers, and payers questioning your motives.” Remarkably, the Cornell University School of Continuing Education has designed a program to give prospective medical school students a real-world peek, both good and bad.

The Ripple Effects of Managed Care and Reform

“Many people who are currently making a great effort and investment to become doctors may be heading for a role and a way of life that are fundamentally different from what they expect and desire,” according to Stephen Scheidt, MD, director of the $1,000 Cornell fee program; why?

Fewer fee-for-service patients and more discounted patients.
More paperwork and scrutiny of decisions with lost independence and morale.
Reputation equivalency (i.e., all doctors in the plan must be good), or commoditization (i.e., a doctor is a doctor is a doctor).
The provider is at risk for (a) utilization and acuity, (b) actuarial accuracy, (c) cost of delivering medical care, and (d) adverse patient selection.
Practice costs are increasing beyond the core rate of inflation.
Medicare reimbursements are continually cut.

Early Opinions

Richard Corlin MD, opined back in 2002 that “these are circumstances that cannot continue because we are going to see medical groups disappearing.” Furthermore, he stated, “This is an emergency that lawmakers have to address.” Such cuts also stand to hurt physicians with private payers since commercial insurers often tie their reimbursement schedules to Medicare’s resources. “That’s the ripple effect here,” says Anders Gilberg, the Washington lobbyist for the Medical Group Management Associations (MGMA).

Assessment

And so, some desperate doctors are pursing these sources of relief, among many others:

A growing number of doctors are abandoning traditional medicine to start “boutique” practices that are restricted to patients who pay an annual retainer of $1,500 and up for preferred services and special attention. Franchises for the model are also available.
Regardless of location, the profession of medicine is no longer ego-enhancing or satisfying; some MDs retire early or leave the profession all together. Few recommend it, as a career anymore.

Assessment

To compound the situation, it is well known that doctors are notoriously poor investors and do not attend to their own personal financial well being, as they expertly minister to their patients’ physical illnesses.

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Tell us what you think? Are you a desperate doctor? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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

References:

www.managedcaremagazine.com/archives/9809/9809/.qna_dickey.shtml
www.hrsa.dhhs.gov/news-pa/heal.htm
www.bhpr.hrsa.gov/dsa/sfag/health-professions/bk1prt4.htm
Pamela L. Moore, “Can We All Just Get Along: Bridging the Generation Gap, Physicians Practice Digest (May/June 2001).

Filed under: Career Development, CMP Program, Financial Planning, Health Insurance, iMBA, Inc., Managed Care, Op-Editorials, Practice Management | Tagged: Anders Gilberg, david marcinko, fee for service, Heal loans, healthcare reform, Managed Care, Medical Group Management Associations, medicare, MGMA, obama, Richard Corlin, Stephen Scheidt MD | 2 Comments »

CMS: Open Payment Data

Posted on July 4, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

OPEN PAYMENTS DATA – SEARCH TOOL

By Dr. David Edward Marcinko MBA

The Open Payments Search Tool is used to search payments made by drug and medical device companies to physicians and teaching hospitals.

CMS releases star ratings; nearly 10% of hospitals earn ...

WEBSITE: https://openpaymentsdata.cms.gov/

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-

Your thoughts are appreciated.

THANK YOU

***

Filed under: Funding Basics, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Touring with Marcinko | Tagged: CMS, CMS search tools, david marcinko, Open Payments DATA CMS, Touring with Marcinko | Leave a comment »

What is a MEME Stock?

Posted on July 2, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

MEME ME!

**BY PROFESSOR DR. DAVID EDWARD MARCINKO MBA Certified Medical Planner**®

SPONSOR: http://www.CertifiedMedicalPlanner.org

A “MEME” stock isn’t as easily defined as a growth or value stock, so to give it a definitive categorization would be inappropriate. Nor would actually categorizing it alongside growth and value stocks. They won’t be found in textbooks anytime soon, but to overlook their impact could potentially be an expensive oversight.

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

Stonks Meme, Explained: What Can It Teach You About Actual ...

READ: https://blog.mywallst.com/what-is-a-meme-stock/#:~:text=A%20meme%20stock%20isn%E2%80%99t%20as%20easily%20defined%20as,their%20impact%20could%20potentially%20be%20an%20expensive%20oversight.

DIY Textbooks: https://medicalexecutivepost.com/2021/04/29/why-are-certified-medical-planner-textbooks-so-darn-popular/

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-

CONTACT: Ann Miller RN MH

[Executive Director]

MarcinkoAdvisors@msn.com

***

Filed under: Career Development, CMP Program, Glossary Terms, Investing, Research & Development, Touring with Marcinko | Tagged: certified medical planner, CMP, david marcinko, MEME stocks | 2 Comments »

“HOSPITALS AND HEALTH CARE ORGANIZATIONS”

Posted on June 27, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

INSTITUTIONAL Foreword WITH Comprehensive Review AND FREE PREVIEW

Click to access foreword-nash1.pdf

Filed under: "Doctors Only", Career Development, Health Economics, Healthcare Finance, Managed Care, Practice Management, Professional Liability | Tagged: david marcinko, Hospitals and Healthcare Organizations | Leave a comment »

ME-P Speaking Invitations

Posted on June 17, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

Dr. David E. Marcinko is at your Service

Dr. David Edward Marcinko MBA CMP® enjoys personal coaching and public speaking and gives as many talks each year as possible, at a variety of medical society and financial services conferences around the country and world.

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

His talks tend to be engaging, iconoclastic, and humorous. His most popular presentations include a diverse variety of topics and typically include those in all iMBA, Inc’s textbooks, handbooks, white-papers and most topics covered on this blog.

CONTACT: Ann Miller RN MHA

MarcinkoAdvisors@msn.com

Ph: 770-448-0769

Abbreviated Topic List: https://medicalexecutivepost.com/wp-content/uploads/2009/02/imba-inc-firm-services.pdf

Second Opinions: https://medicalexecutivepost.com/schedule-a-consultation/

DIY Textbooks: https://medicalexecutivepost.com/2021/04/29/why-are-certified-medical-planner-textbooks-so-darn-popular/

THANK YOU

***

Filed under: Career Development, CMP Program, Estate Planning, Financial Planning, Health Economics, Health Insurance, iMBA, Inc., Insurance Matters, Investing, Managed Care, Portfolio Management, Practice Management, Practice Worth, Professional Liability, Retirement and Benefits, Risk Management, Touring with Marcinko | Tagged: david marcinko, Financial Planning, Investing, malpractice, medical prctice management, Physician retirement, practice value., Practice Worth | 1 Comment »

The “Zero-Based Budget” for Physicians?

Posted on May 24, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

Zero-Based Budget

SPONSOR: http://www.CertifiedMedicalPlanner.org

A zero-based budget means you start with the absolute essential expenses, and then add expenses from there until you run out of money. This is an extremely effective, yet rigorous exercise for most medical professionals and can be used personally or at the office.

Guess what your first personal financial item should be?

That’s right, retirement plan contributions. Then your mortgage and other debt payments, and other required fixed expenses. From the office perspective, the first budget item should be salary expenses, both your own and your staff.

Operating assets and other big ticket items come next, followed by the more significant items on your net income statement.

Some doctors even review their P&L statements quarterly, line by line, in an effort to reduce expenses. Then add discretionary personal or business expenses that you have some control over.

P&L: https://medicalexecutivepost.com/2008/03/18/net-income-pl-statement/

Do you run out of money before you reach the end of the month, quarter, or year?

Then you better cut back on entertainment at home or that fancy new, but unproven piece of office or medical equipment. This sounds Draconian until you remind yourself that your choice is either a) entertainment now but no money later, or b) living a simpler lifestyle now as you invest so you’re able to enjoy yourself at retirement.

Risks: https://medicalexecutivepost.com/2017/10/18/on-retirement-planning-risks/

Zero-Based Budgeting: The Ultimate Guide - MintLife Blog

Why?

When you were a young doctor, it may have been a difficult trade-off. But at mid-life, you’re staring ultimate retirement in the face.

ASSESSMENT: Your thoughts are appreciated.

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

THANK YOU

***

Filed under: Accounting, iMBA, Inc. | Tagged: david marcinko, zero based budget | Leave a comment »

What Exactly is a D.O.?

Posted on May 11, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

DOCTOR OF OSTEOPATHIC MEDICINE

By Dr. David Edward Marcinko MBA CMP®

[Editor-in-Chief]

OK; I admit it. I have a formal educational background in allopathic, podiatric and osteopathic medicine. I also have both earned and conferred medical degrees from the States as well as Europe. I even dropped out of dental and law school back in the day … Such the protean dilettante!

Now, today there are about 950,000 allopathic physicians, 20,000 podiatrists, 150,000 dentists and 50,000 osteopaths. And, from this cohort of medical professionals, the Doctor of Osteopathic Medicine [DO] seems to be the least well understood practitioner.

And so, I thought this essay from Very Well Health might be helpful to all our Medical Executive-Post readers and subscribers [Differences Between a DO Physician and an MD – Comparing Osteopathic and Allopathic Medical Training].

LINK: https://www.verywellhealth.com/do-doctors-vs-md-doctors-whats-the-difference-3157310

ASSESSMENT: Your thoughts are appreciated.

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

THANK YOU

***

Filed under: Career Development, Experts Invited, iMBA, Inc., Op-Editorials, Touring with Marcinko | Tagged: D.O., david marcinko, doctor of osteopathic medicine, doctor of osteopathy | 1 Comment »

On Bill Gates, Doctors and Divorce – Oh My!

Posted on May 8, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

OF COMMON CAUSE WITH TOO MANY PHYSICIANS?

Dr. David Edward Marcinko MBA CMP®

SPONSORED: http://www.CertifiedMedicalPlanner.org

Bill Gates has been a business hero for me for the past 35 years. I even met him, once briefly back in the day. So, the marital union of the Microsoft Founder and Melinda French seemed perfect, and their marriage stood the test of time as it neared the three-decade mark, a rare feat in the world of A-list couples.

Sadly, when they announced their split on Twitter this week, many were shocked, even heartbroken. People reflected on their own marriages and wondered how they could make it work if the Gates’ could not.

And collectively, we found we cared about the split — a lot.

But, what about physician colleagues and divorce?

Do we doctors have some common cause with Bill and Melinda?

Divorce for Physicians What You Should Know - bidti.org

MEDIATION: https://medicalexecutivepost.com/2016/02/11/a-step-wise-approach-to-the-divorce-mediation-process-for-mds/

QDRO: https://medicalexecutivepost.com/2008/05/19/what-is-a-qdro/

SETTLEMENTS: https://medicalexecutivepost.com/2008/05/28/doctors-and-divorce-settlements/

PRACTICE VALUE: https://medicalexecutivepost.com/wp-content/uploads/2011/12/medical-practice-valuation-blunders1.pdf

BUY-SELL: https://medicalexecutivepost.com/2008/07/03/marital-dissolution-buy-sell-agreements-and-practice-value/

GREY DIVORCE: https://medicalexecutivepost.com/2019/10/21/older-divorcing-medical-professionals/

ASSESSMENT: Your thoughts are appreciated

***

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

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

THANK YOU

***

Filed under: Breaking News, Financial Planning, LifeStyle, Risk Management | Tagged: Bill Gates, david marcinko, divorce settlements, Gates Divorce, mediation, Melinda French, microsoft, physician divorce, QDRO | 3 Comments »

Five Ways to Protect Your Vehicle’s Exterior from Dings, Scrapes and Grime

Posted on September 2, 2019 by Dr. David Edward Marcinko MBA MEd CMP™

But, Don’t be Obsessive

By Dr. David Edward Marcinko MBA with Nalley Collision Center, GA.

Some automobile owners, like me and other medical professionals, take pride in their cars. Regardless of whether you bought a new car from the showroom or bought your car used, you want to keep your vehicle looking like new for a long time.

Unfortunately, modern life is the enemy of a great-looking car. Tar and stones from roadways can wreak havoc on beautiful finishes. Other drivers can carelessly dent your car in hospital or mall parking lots, and refuse to accept responsibility for the damage. Debris flying out of trucks, birds, and other problems add to the long list of threats to your car.

The Steps

Rather than accepting dings, scrapes and grime on your car as a fact of life, follow these five steps to keep the exterior of your car looking fabulous.

1. Get Covered

Rain, snow, and sunshine can all adversely affect the exterior of your car. You can do little about the weather while driving your car, but when you get home, you can cover your car to protect its beautiful finish. Although garages offer the best protection against outside forces for your car, you might find out that you can get similar results by using a car port or a portable garage. A portable garage is a flexible cover that you can put over your vehicle to protect its exterior while not in use.

2. Paint Protection Film

Special products exist that help protect the finish of your car at all times, even while you drive. Paint protection film creates a layer of protection between the exterior surfaces of your car and the environment, so your car can withstand an array of road hazards. This type of product eliminates expensive trips to your dealer’s body shop for touchup work and preserves the resale value of your car.

3. Wash Your Car

Although a carwash can put the exterior of your car in jeopardy, it can help prevent harmful grime build up. If you care a lot for your car, you will give it a loving hand-wash, detail and wax periodically to keep its finish looking great. While you wash, you can look for new scrapes and dents that either you or your dealer can quickly repair before they become ugly and embarrassing.

4. Cautious Parking

Parking lots pose some of the most severe threats to auto exteriors. It is my pet peeve. Regardless of how carefully you park, someone else will come along and park too close to your car, giving your car a free dent. Although often minor, parking-lot damage can cost a lot to repair. Motorists these days live with the fear that a claim will cause their insurance premiums to rise, so they might not take responsibility for denting or scraping your car.

It’s time to take parking into your own hands. You can try taking up two spots when you park, making it impossible for other car doors to reach your vehicle. Also, you can park far away from other cars where most people will never park. The long walk will give you valuable health benefits, and the remote parking spot can help prevent damage to your car.

5. Common Sense

Your best defense against scrapes, dents, and grime might reside under your own hat. Common sense should tell you to avoid roads while they undergo paving line-painting work. Avoid attempting to enter narrow alleys and resist the temptation to drive up to your mailbox when you get home at the end of the day. Never drive your car near trees and bushes. Always avoid dirt or gravel roads. Also, keep your garage and carport clear of tools and other objects that can easily fall and damage your car.

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Conclusion

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Filed under: Insurance Matters, LifeStyle, Risk Management | Tagged: david marcinko, Jaguar, jaguar XJ-V8-L | 3 Comments »

Dr. Marcinko Appointed to “Medblob” Advisory Board

Posted on May 22, 2019 by Dr. David Edward Marcinko MBA MEd CMP™

Professor Marcinko Appointed to Medblob Advisory Board

By Richard S. Tannenbaum; MS

[Co-Founder and Chief Financial Officer]

www.Medblob.com

At Medblob, we manage healthcare data for patients, providers, and research organizations. Our leadership team is from multi-disciplinary back grounds, including medicine, software and research. And, our advisors have broad experience and training in clinical medicine, insurance and healthcare information technology companies.

So, we are pleased to announce that Dr. David Edward Marcinko MBA CMP® has just been appointed to the Advisory Board of our company.

About Medblob™

The Challenge:

One of the biggest challenges for providers is having all of the patient’s medical information, at the point of care.

The Solution:

Medblob™ is an emerging and secure military encrypted and HIPAA compliant health information exchange and data warehouse, known as HealthFile™, that aims to have medical information available at the point-of-care so clinicians are able to make better decisions to improve their patients’ health.

The Outcome:

MedBlob™ solves a major cause of medical errors and preventable death: inaccurate or missing health information.

Assessment

Member of Medblob’s Advisory Board composed of medical, legal, and financial experts assisting the management team in the company’s mission of improving public health and outcomes for patients. Medblob Advisory Board was chartered to provide advice to the executive team regarding the company’s strategy, development, market positioning, and growth trajectory. LifeBook is Medblob’s military-grade secure patient electronic health record that acts as a single source of truth health record, medical data platform, and Network as a Service (NaaS).

Board of Advisors Link: http://www.medblob.com/board-of-advisors/

More: Please contact us to get involved in the future of healthcare information technology!

***

DAVID EDWARD MARCINKO

Filed under: Experts Invited, Information Technology | Tagged: david marcinko, HealthFile™, Medblob, Richard Tannenbaum | Leave a comment »

Two Different Personal IRA Investing Strategies?

Posted on March 11, 2019 by Dr. David Edward Marcinko MBA MEd CMP™

Based on Tax Considerations?

By Dr. David Edward Marcinko MBA

LINK: https://medicalexecutivepost.com/schedule-a-consultation/

One personal investing strategy is to place more conservative investments (those with lower expected returns) in a tax-deferred traditional IRA, 401-k, 403-b or similar, and more aggressive (higher-earning) assets in a taxable brokerage account or Roth IRA.

WHY? Each account is thus working hard but in very different ways.

HOW? The conservative funds in the traditional IRA or retirement accounts would fill any needs for safety as they grow more slowly – and the higher tax rate won’t take out as big of a bite.

Meanwhile, the more aggressive funds in a taxable brokerage accounts would grow more quickly, but be taxed at a lower rate.

Assessment: Any thoughts?

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

MORE FOR DOCTORS:

“Insurance & Risk Management Strategies for Doctors” https://tinyurl.com/ydx9kd93

“Fiduciary Financial Planning for Physicians” https://tinyurl.com/y7f5pnox

“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8

***

Filed under: Investing, Retirement and Benefits, Taxation | Tagged: david marcinko, IRA, retirement planning, Roth IRA | Leave a comment »

PODCAST: Off Road Christmas Touring with Dr. Marcinko

Posted on December 25, 2018 by Dr. David Edward Marcinko MBA MEd CMP™

City Lights in Baltimore, Maryland

By Dr. David Edward Marcinko; MBA, CMP™

[Editor-in-Chief]

I stopped off in Baltimore, Maryland during the recent holidays to visit current clients, prospect for new ones, do a little public speaking and promote our book [Business of Medical Practice, third edition].

Of course, we stopped by Johns Hopkins University where my sister worked, and promoted the Medical Executive-Post, as well.

Enter Christmas Street

And so, it was with great anticipation that we agreed with our host to visit Baltimore’s Christmas Street, in a section of the city known as Hampden. For 65 years, the residents of Baltimore’s 34th Street have drawn crowds from all over the world to view their display of Christmas lights.

Assessment

Crowd favorites are the motorized robot, the hubcap “Christmas tree”, and “snowmen” made from bicycle tires. The eaves of houses drip with strings of lights that illuminate Nativity scenes, while glowing candy canes light the sidewalks.

And, the hot chocolate and pizza, down the street at Angelo’s Restaurant, was especially delicious on any cold wintry night.

Video link: https://www.youtube.com/watch?v=hwk5N6qBx8Q

Channel Surfing

Have you visited our other topic channels? Established to facilitate idea exchange and link our community together, the value of these topics is dependent upon your input. Please take a minute to visit. And, to prevent that annoying spam, we ask that you register.

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

***

Filed under: LifeStyle, Touring with Marcinko, Videos | Tagged: Baltimore, Business of Medical Practice, Christmas Street, david marcinko, Hampden, Hampden Lights, Johns Hopkins University, PODCAST: Off Road Christmas Touring with Dr. Marcinko | 1 Comment »

Dr. Marcinko Interviewed on the Physician Credit Crunch

Posted on May 6, 2018 by Dr. David Edward Marcinko MBA MEd CMP™

Financial Experts Share Tips on Obtaining Loans to Start or Expand a Medical Practice

By Michael Gibbons

Editor: ADVANCE Newsmagazines

Maybe you’re a young dermatologist or plastic surgeon who dreams of starting your own practice. Or maybe you’re an established professional but want to expand your palette of anti-aging services. Either way, you’ve probably made an unpleasant discovery: Banks are leery about lending today. Global recessions with seemingly no end in sight tend to give loan officers sticky fingers.

Dermatologists and Plastic Surgeons

We have it on good authority that dermatologists and plastic surgeons as a group are less affected by this problem than physicians in some other branches of medicine. Still, there’s no better time than now to absorb some sound advice on how to approach banks for loans—whether you’re a fresh-faced newcomer to the fresh-face business or a wrinkled veteran at eliminating wrinkles.

Start Small

There’s no soft-soaping it: Starting a healthy aging practice is much harder than expanding an existing practice, even in the flushest of times.

“For young dermatologists starting out, I recommend you start small,” advises Jerome Potozkin, MD, who offers facial rejuvenation, liposuction, body contouring and dermatological care through his practice in Walnut Creek, CA. “You can always expand. Keep your overhead low. Know what your credit score is and do everything you can to improve it. Pay your bills on time.”

Lasers aren’t cheap. Besides the initial acquisition costs, a service contract can cost $7,000 to $12,000 a year, according to Dr. Potozkin. “Don’t feel you have to buy every new laser under the sun,” he says. “In fact, renting rather than purchasing is an option many companies offer. When your volume is low you can rent and schedule laser days—although the pitfall there is you don’t have lasers available whenever patients come in.”

Also, young dermatologists “will probably have an easier time getting a loan if they go to a relatively underserved area, as opposed to an area that has a large number of dermatologists per capita,” says Dr. Potozkin, who began practicing 10 years ago. “There are two schools of thought on this: Go where you want to live to start a practice or go to where there’s a need and be instantly successful. I chose the former. It took me longer to get started but I’m very happy where I am.”

Patience, Prudence and Passion

Be patient, prudent, passionate—and start with a spare office and as little debt as possible, advises Dr. David E. Marcinko MBA, a financial advisor and Certified Medical Planner™. Marcinko, a health economist, is CEO of the Institute of Medical Business Advisors Inc., a national physician and medical practice consulting firm based in Norcross, GA www.MedicalBusinessAdvisors.com

“Patients are looking for passion from you, not lavish trappings,” Dr. Marcinko says. “When a banker or a loan officer sees $175,000 or more of debt they are loath to give a loan—and it’s hard to blame them. Purchase a home after you become a private practitioner. You need to be as close to debt-free as you can be.

Exit Strategy

“Another thing bankers want to know is, ‘If we give you a loan and you start a practice and it fails, how will we be paid back?’ They want an exit strategy.”

The good news is dermatology “remains a very lucrative specialty, and in most parts of the country they are in a shortage position, particularly with the aging population,” says Sandra McGraw, JD, MBA, principal and CEO of the Health Care Group, a financial and legal consulting firm based in Plymouth Meeting, PA., that advises the American Academy of Dermatology, among other groups.

“I would start with a realistic business plan for why you think this practice can succeed, in the specific location,” McGraw says. “How many patients do you expect to see? How will they know you are there and available? Remember that banks lend to all kinds of people, so keep your numbers realistic. Overestimating expenses is as bad as underestimating them. Then determine how you want the money—usually a fixed loan for a period of time and then a line of credit as you get your practice going and sometimes need the cash flow.”

Expanding a Practice

Established dermatologists should have an easier time getting loans to expand their practices. They have, one hopes, a track record of success and assets to put up as collateral.

Mid-career physicians “have cash flow, physician assets and equity to some degree in a house and personal assets,” Dr. Marcinko observes. “Banks can attach loans to personal assets and savings accounts. Ninety-nine percent of times you must sign a personal asset guarantee. Mid-lifers have assets young ones don’t, so mid-lifers aren’t quite the risk. They have businesses that have value and cash flow. Banks like cash flow.”

However, even veterans must do some homework before approaching a bank. “You still want to establish why you want the money and how the expansion will increase your income,” McGraw says.

Another tip: If the bank has loans out with reputable vendors, you might ask the loan officer to recommend them to you as potential contractors. “Sometimes keeping it local and supporting others with loans at the bank can be helpful,” she says.

Assessment

Dr. Marcinko adds, “Bankers today want you to come in with a well-reasoned, well-thought-out and well-written business plan. Give bankers a 30-second elevator speech on why you are different. It’s really important to ask yourself, ‘What can I offer the community as a doctor in my specialty that nobody else can?’ If you bill yourself as the first dermatologist to do laser surgery, that’s a perceived advantage. You purchased the equipment and learned to use it. But anyone can do that. If you can come up with something that nobody else has or can do, that’s how you’re successful in anything.”

Link: Dr. Marcinko Interview

Link: https://medicalexecutivepost.com/wp-content/uploads/2009/08/dr-marcinko-interview.pdf

Conclusion

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

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

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: "Doctors Only", Book Reviews, Career Development, CMP Program, Experts Invited, iMBA, Inc., Interviews, Managed Care, Practice Management, Practice Worth, Recommended Books, Research & Development | Tagged: ADVANCE Newsmagazines, bankers, business plan, certified medical planner, CMP, credit, credit crunch, david marcinko, dermatologists, Health Care Group, Jerome Potozkin, loans, MD, Michael Gibbons, plastic surgeons, Sandra McGraw, www.certifiedmedicalplanner.com, www.medicalbusinessadvisors.com | 2 Comments »

2018 – 2021 HSA Contribution Limits

Posted on April 6, 2018 by Dr. David Edward Marcinko MBA MEd CMP™

Inflation Adjustments for the Tax Cuts and Jobs Act

By Dr. David Edward Marcinko MBA

http://www.CertifiedMedicalPlanner.org

On March 5, 2018, the IRS released Revenue Procedure 2018-18 (as part of Bulletin 2018-10). Due to changes made in the Tax Cuts and Jobs Act, certain adjustments needed to be made to inflation amounts.

The includes a reduction in the maximum family HSA contribution for those with family coverage under an HDHP from $6,900 to a new limit of $6,850 for calendar year 2018. The single contribution limit remains unchanged at $3,450 per year.

This reduction affects employees participating in an HSA Plan who have elected to contribute more than $6,850 for family coverage in 2018.

***

Filed under: Accounting, Health Insurance, Taxation | Tagged: david marcinko, HSA, Tax Cuts and Jobs Act | 8 Comments »

Leave FACEBOOK and Join the MEDICAL EXECUTIVE POST.com

Posted on March 27, 2018 by Dr. David Edward Marcinko MBA MEd CMP™

AN “OPEN LETTER” FROM THE PUBLISHER-IN-CHIEF

Niche Specificity is the Key to Future Social Media Action

By Dr. David Edward Marcinko MBA [Publisher-in-Chief]

My solution to Facebook dilution.

It was a no good, very bad week for Facebook.

WHY: It came to light that up to 50 million users had their data improperly accessed by data firm Cambridge Analytica. Ever since, the company has been under incredible scrutiny as its’ stock price is in free fall. In fact, CEO Mark Z. lost about ten billion dollars; at least on paper…Ouch! But, he is still worth about 65 billion dollars, so don’t worry — be happy for him!

The Critics

Did you know that Elon Musk is joining a growing group of people in the tech industry who have taken aim at social media companies and Facebook in particular?
Aaron Levie, CEO of cloud computing company Box, recently tweeted: “The days of arguing that (and acting like) tech companies are merely platforms and pipes are behind us.”
Marc Benioff, CEO of business software company Salesforce, recently started equating social media to smoking cigarettes.

And now, this Medical Executive-Post is jumping on the alternate social media site bandwagon. Leave Facebook now!

***

Here’s How to manipulate Facebook instead of it Manipulating You

Social media platforms know a lot about us—but that doesn’t mean we can’t have our own ways of fighting back.

So, try these six tricks to take back control of your digital life. https://tinyurl.com/y888s8m5

Intellectual Riches … thru Niches

As Facebook became ever-more generalized, it also became less powerful, less informed, less important and therefore less credible; writ large. All opinions are not informed opinions

“When you try to be all things to every one – you became nothing to no one”

But smaller, niche alternatives like this Medical Executive-Post can provide new ways for us to interact with other smart, like-minded and informed people online.

Re-Enter the Medical Executive-Post of iMBA, Inc.

This Medical Executive-Post is sponsored by the Institute of Medical Business Advisors Inc., of Atlanta, Georgia; which was founded in 2006 as a leading national scope provider of healthcare administration education and medical practice management reports, books, dictionaries, journals, white-papers, fair-market valuations [FMV] and economic advisory opinions using multi-platform and traditional seminars and channels of knowledge distribution.

iMBA helps the nation’s medical, healthcare and education professionals make decisive improvements in their direction and performance by empowering them through unbiased information, consultants and proprietary tools, books, templates and B-school styled case models.

We serve universities, medical, business, graduate and nursing schools; physicians, dentists and legal societies; accountants, financial service providers, wealth and hedge fund managers; emerging entities, hospitals, clinics, outpatient centers, CXOs and their BODs – the press, media and related organizations.

My Idea

For the solution to Facebook dilution, my idea is not new or radical; but it is simple. Join the Medical Executive Post. It is time.

To achieve a better and more niche focused professional social site, we need to be much more concentrated and serious about all vital topics in the healthcare industrial complex – which is an ecosystem projected to become 20% of domestic GDP; very soon.

Thus, this academic niche is not so small; but we are indeed highly educated, powerful and can become very influential and very actionable; more so than the general Facebook populace hoi polloi.

Remember, Pareto’s 80/20 Law and the trivial many versus vital few. Show us your vitality.

More Reasons to Join Us – Today!

Conclusion

Contact: MarcinkoAdvisors@msn.com

***

Filed under: iMBA, Inc., Touring with Marcinko | Tagged: #DeleteFacebook, david marcinko, Leave Facebook | 31 Comments »

On “Financial Advisor” Salesmen and Saleswomen

Posted on August 27, 2017 by Dr. David Edward Marcinko MBA MEd CMP™

UGH! Financial Services still not a real Profession

By Dr. David Edward Marcinko MBA MEd Certified Medical Planner™

http://www.CertifiedMedicalPlanner.org

Introduction

A few weeks ago I received the following unsolicited email job exhortation:

Dear David,

Our xxx/ooo office is currently hiring “Financial Advisors” with Series 7 and 63 Certifications. The minimum requirements include: high school diploma or GED equivalent, 6+ months of experience in customer service and experience in a sales environment. We offer paid training and access to full benefits.

Learn more about this position and apply today: xxx/ooo

*** ***

Assessment

GED; a very high credentials bar, indeed!

NOTE: My friend and colleague, the late great Dick Wagner JD CFP™ who wrote extensively about financial planning as a “profession”, would be mortified.

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.

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

***

Filed under: Ethics | Tagged: certified medical planner, CMP Program, david marcinko, Dick Wagner JD CFP™, financial advisors | 1 Comment »

Join the Medical Executive-Post

Posted on April 28, 2017 by Dr. David Edward Marcinko MBA MEd CMP™

Publishing and Peer-Review Opportunities Always Available

By Ann Miller; RN, MHA

If you have academic credentials and experience like those of our contributing authors, subject matter experts and “thought-leaders – and would like to contribute to our blog or become a peer reviewer – please contact us today!

CV Required

We’d be happy to review your CV, submission and/or a copy of you previously published works. OR, just point us to your own blog, wiki, or website; etc. You may also use the contact form, below.

Phone: 770-448-0769

Email: MarcinkoAdvisors@msn.com

Channel Surfing

Have you visited our other topic channels? Established to facilitate idea exchange and link our community together, the value of these 50 topics is dependent upon your input. Please take a minute to visit. And, to prevent that annoying spam, we ask that you register.

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

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

CONTACT US!

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Filed under: "Advisors Only", "Doctors Only", Career Development, Experts Invited, Quality Initiatives | Tagged: CFA, CFP, CMP, david marcinko, financial advisors, Health Economics, health journalist, healthcare administration, Healthcare Finance, healthcare thought leaders, medical practice management, www.CertifiedMedicalPlanner | Leave a comment »

WEBINAR on Medical Office Sexual Harassment Issues

Posted on March 11, 2017 by Dr. David Edward Marcinko MBA MEd CMP™

About MentorHealth

MentorHealth, the sponsor of this webinar, is a comprehensive training source for healthcare professionals that is high on value, but not on cost. MentorHealth is the right training solution for physicians and healthcare professionals. With MentorHealth webinars, doctors can make the best use of time, talent and treasure to benefit their continuing professional education needs.

***

Romantic Patient Advances

***

Presented By

Professor David Edward Marcinko

March 13, 2017

Romantic Patient Advances

***

Overview: Within the medical practice, clinic, hospital or university setting, faculty and supervisors exercise significant power and authority over others. Therefore, primary responsibility for maintaining high standards of conduct resides especially with those in faculty and supervisor positions. Members of the medical faculty and staff, including graduate assistants, are prohibited from having “Amorous Relationships” with students over whom they have “Supervisory Responsibilities.” “Supervisory Responsibilities” are defined as teaching, evaluating, tutoring, advocating, counseling and/or advising duties performed currently and directly, whether within or outside the office, clinic or hospital setting by a faculty, staff member or graduate assistant, with respect to a medical, nursing or healthcare professional student. Such responsibilities include the administration, provision or supervision of all academic, co-curricular or extra- curricular services and activities, opportunities, awards or benefits offered by or through the health entity or its personnel in their official capacity.

Employees are prohibited from having “Amorous Relationships” with employees whom they supervise, evaluate or in any other way directly affect the terms and conditions of the others’ employment, even in cases where there is, or appears to be, mutual consent.

Date : Monday, March 13, 2017 10:00 AM PST | 01:00 PM EST

Duration : 60 Minutes

Price : $139.00

Romantic Patient Advances

Areas Covered in the Session:

Consensual Amorous Relationships Defined
Handling Patient Advances
Signs of Flirtatious Behavior and Discouragement
Sexual Harassment Defined
Preferential Treatment
Un Reasonable Interference with Performance
Two-Pronged Test Approach
Offensive Behavior
Gender Based Animosity
Same Sex Harassment
Employer Liability
Disciplinary Actions
Tangible Employment Actions
Punitive Damages
Financial and Economic Costs

Who Will Benefit:

Physicians
Dentists
Podiatrists
Osteopaths
Pharmacists
Nurse Practitioners
Physician Assistants
All Clinical and Allied Healthcare Providers
Attorneys
Risk and Medical Compliance Managers
Health Insurance Agents

SIGN-UP HERE

Romantic Patient Advances

REGISTRATION

***

WEBINAR NOTE: These are online interactive training courses using which, professionals from any part of the world have the opportunity to listen to and converse with some of the best-known experts in the HR Industry. These are offered in live & recorded format for single & multiple users (corporate plans ). Under recorded format each user gets unlimited access for six months. Corporate plans give you the best return on your investment as we do not have upper limit on the number of participants who can take part in webinar.

***

Filed under: iMBA, Inc., Risk Management, Touring with Marcinko, Videos | Tagged: Amorous Relationships Relationships, david marcinko, MentorHealth, Romantic Patient Advances, Sexual Harassment Issues | Leave a comment »

WEBINAR on Medical Workplace Violence Issues

Posted on February 20, 2017 by Dr. David Edward Marcinko MBA MEd CMP™

About MentorHealth

Medical Workplace Violence Issues

[Its Growing Recognition and Impact]

***

Presented By

Professor David Edward Marcinko

February 22, 2017

Medical Workplace Violence Issues

Violence Pillai Thesis MPH

***

Overview: Violence in hospitals usually results from patients, and occasionally family members, who feel frustrated, vulnerable, and out of control. Transporting patients, long waits for service, inadequate security, poor environmental design, and unrestricted movement of the public are associated with increased risk of assault in hospitals and may be significant factors in social services workplaces as well. A lack of staff training and the absence of violence prevention programming are also associated with the elevated risk of assault in hospitals. Although anyone working in a hospital may become a victim of violence, nurses and aides who have the most direct contact with patients are at higher risk.

Date : Wednesday, February 22, 2017 10:00 AM PST | 01:00 PM EST

Duration : 60 Minutes

Price : $139.00

Areas Covered in the Session:

Definition and Types of WPV
Contributing Factors and Risk Analysis
Effects and Outcomes
Financial and Economic Costs
Dealing with WPV
Prevention Plan Creation
The Haddon Matrix
Establishing WPV Prevention Guidelines

Who Will Benefit:

Physicians
Dentists
Podiatrists
Osteopaths
Pharmacists
Nurses
Nurses Aids
Nurse Practitioners
Physician Assistants
All Clinical Mental and Allied Healthcare Providers
Attorneys
Risk and Medical Compliance Managers
Health Insurance Agents

SIGN-UP HERE

Medical Workplace Violence Issues

REGISTRATION

***

Filed under: Risk Management, Touring with Marcinko, Videos | Tagged: david marcinko, Medical Workplace Violence Issues, MentorHealth | Leave a comment »

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